August – September 2008
Suddenly, in August, something shifted for me. Months before, when we first started talking about fertility treatment, Sandy had wanted to make a schedule: this many months of IUI, this many tries at IVF before deciding to give up and adopt. I refused. I knew that my feelings would evolve slowly over time and that I would feel anxious if I was tied down to decisions made months before. I felt like I would just know when I was ready to move on to IVF, or stop trying, or start researching adoption. As it turned out, I was right.
The possibility of IVF had been creeping up on me. The doctor had mentioned it when we’d gone to see her about my overreaction to Clomid. IVF is great if you make too many eggs, because what they do in IVF is take all your eggs out of your body, fertilize them in the lab, and then just implant as many embryos as you ask for. It’s also great for women with totally unexplained infertility, because it bypasses just about every potential roadblock between the sperm and the egg.
The success rates when there’s nothing else wrong with you are really high, like 60% per cycle, compared with 20% for the IUI.
But, oh my god, it sounded horrible. They take your eggs out! With some kind of needle/catheter through your vaginal wall! It’s so painful you have to be sedated. And the medication, it’s all injected.
On a more emotional level, it was another giant step away from my hope that getting pregnant would be natural and easy. With IUI, we’d already gotten used to the idea that we might get pregnant without actually having sex, but at least all the other steps were still happening in my body. IVF removed the last pretense that I could get pregnant more or less on my own, and it was a hard thing to accept.
Suddenly, though, I was ready. Just like that. I got the negative pregnancy test, and the first thing I said was, “OK, that’s it. Let’s do IVF.”
Making that big decision made me impatient. I was ready, and I didn’t want to wait any longer. But, as it turns out, IVF cycles are long. There’s an entire month where they do nothing but depress your reproductive system in order to reset it and ready it for all the hormones to come, first with birth control pills (of all things) and then with a drug called called Lupron (labeled use: advanced prostate cancer).
While I tried desperately to be patient, and went back on the pill, we started filling out the pages and pages of consent forms. Yes, you can make me produce a zillion eggs. Sure, go ahead and fertilize them all. Sure, you can freeze the ones you don’t implant. Suddenly Sandy and I were so excited. We’re going to get to donate embryos to stem cell research! Take that, religious right! We searched in vain for the consent forms to send all our embryos to the scientists to find the cure for Alzheimer’s. The nurse slowed me down, and reminded me that maybe we’d want some of those embryos. Remember? Trying to get pregnant? The frozen embryos could be kept for five years in case our first try didn’t work, or we wanted to get pregnant again and use my 33-year-old eggs instead of my rapidly aging ones. The labs will still need embryos in five years. Take a deep breath.
Take a deep breath and inject yourself with a shot of Lupron in the stomach every night. While I had done a few shots in the previous months, those were pre-filled syringes. I was now loading up my own needles and tapping them with my fingernail to get the bubbles out like a pro.
After eleven days of shooting myself full of Lupron, I headed in for a checkup, terrified that they’d cancel me for one reason or another. But everything looked good, and they told me I could start my massive dose of Follistim, which would cause my ovaries to produce lots and lots of eggs.
The nurse showed me how the special Follistim injection pen worked, and sent me on my way. Luckily I was working at home that day, and luckily I was so distracted and obsessed with my IVF regimen that I decided to rummage through my big box o’ syringes and read all about the Follistim. Lucky because I didn’t have a special Follistim injection pen.
I called the pharmacy who blamed the clinic for not including the pen on their order. The crazy lady taking hormone shots in the stomach whimpered, “I’m not saying it’s your fault….but what am I supposed to do? I HAVE to start tonight! Help me please!” Nothing. No same-day delivery. Maybe call the clinic?
Oh right. The clinic. Where the nurse showed me how to use the special injection pen with — right — a special injection pen. I called, and they have TONS of extras lying around. Just come on back! For the second time that day, I headed out to the clinic that, of course, was not anywhere near our house.
That night, with my new special injection pen I started my new drug regimen. Four days later I had my first ultrasound. I was again terrified that something would go wrong. Again everything looked good. Two days later, it was still looking good. The next day, of course, still good. One ultrasound tech looked at my uterus and said, “that’s the best-looking uterine cavity I’ve seen all day.”
The day after that, the nurse announced that we were ready. I would take a trigger shot that night, consisting of a hormone that would tell my ovaries to release the eggs in about 36 hours, and then, in about 36 hours, I’d come in, get sedated, and they’d suck the eggs out. I was ready and grateful, because my ovaries were starting to feel palpably huge. In a normal cycle, before you ovulate, you have one large egg follicle on your ovary. I had at least 22. My abdomen was a little stuffed and my patience was wearing thin.
[Next: Part VII]