I received a package today. Normally, mail time is a highlight of my day (#realtalk #oldandsad). Aside from all the bills (SO MANY BILLS), it usually brings with it all kinds of fun stuff. Paychecks! Birthday cards! That thing I ordered from Amazon! Today was no exception. FedEx appeared, dropped off the goods, and I tore it open. I was excited. I knew exactly what it was and I was ready for it. But when I opened it, all that excitement quickly turned into something else.
And the worst: something totally out of my control.
This package contained the torch of the IVF Olympics, the first symbol of The Great Fertility Hand-Off: my first cycle of IVF medications.
And just like that, all the pressure of this whole making-a-baby escapade transferred from Bobby (where I liked it just fine, thankyouverymuch) to me.
You see, in theory, all of this medical intervention we're using to get pregnant is an effort to bypass Bobby's fertility issue: his low morphology.
[Before we move on, I need to take a moment to say congratulations to Bobby's little swimmers. His most recent semen analysis showed that he has 2% - not 0% - morphology. Go, Bobby tadpoles, go!]
As I was saying, until now, the reason we weren't having any success was because of an issue with Bobby. I felt safe in my cocoon of fertility, a cozy spot from which I played the role of supportive wife as Bobby grappled with what I know was an incredibly emotional process for both of us, but especially him. And Bobby handled the stress like a pro, probably way better than I would have. Ok, definitely way better than I would have. There was a brief moment early on in this process where I was mistakenly told I might have premature ovarian failure and I didn't handle it with nearly as much maturity as Bobby handled his diagnosis (think tears and all the emotions and lots of self-pity). Yes, this has been so hard on Bobby, but for the most part, he handled the immense weight of his infertility diagnosis with grace, sensitivity, and humor, and I've watched in awe with an ever-deepening love and overwhelming appreciation for this man every step of the way.
But now, with IVF and ICSI (pronounced ick-see), we're sidestepping the problem that has been holding us back. From here on out, if we don't conceive, IT'S ALL MY FAULT. Yes, yes, I know that's totally irrational, but irrational fears are still fears nonetheless. And this fear is real.
WARNING: I'm about to say all kinds of words about the female anatomy and menstrual cycles. If you find that kind of stuff offensive, this probably isn't the blog for you (also, grow up).
For all you natural conceivers out there who are fortunate enough to not have to know a thing about this, there are many steps in the IVF treatment cycle, and thus many places where my body can fail me (and us) in making a baby. Here's a brief rundown:
PHASE 1: STIMULATION
It all starts with day 2 of my cycle. That's when I officially begin treatment - and by treatment I mean up to 3 self-administered injections daily, oral medications, and a few 1.5" needles straight into the coolie (in addition to about 10 check-ups over the course of 2 weeks to do blood work and barrel-of-laughs transvaginal ultrasounds. Did I mention how fun this is going to be?). The aim here is to stimulate my ovaries just enough to make a whole bunch of eggs (the body normally makes about 1 on its own each month) so they can be harvested later.
How I can fail: Mix the medications incorrectly; inject myself incorrectly; accidentally hit a major artery and bleed out (kidding); OHSS, or ovarian hyperstimulation syndrome, in which my ovaries go bonkers from all the hormones and I end up in the hospital or, you know, dead (not kidding, but this is very, very rare).
PHASE 2: RETRIEVAL
After about two weeks of medications - and assuming I don't screw them up - it's time for the docs to put me under anesthesia, poke holes in my uterus, and retrieve the follicles growing on my ovaries (which hopefully contain some eggs) with a little sucky tubey thing. Meanwhile, Bobby is in another room providing a sample so his sperm can be whisked away, injected into my eggs (that's the ICSI part), and then cultured in a petrie dish for a few days. Isn't it romantic? Upside: I get drugged up. Downside: Did you read the poking holes in my uterus part?
How I can fail: Not produce enough eggs; not produce healthy eggs; not produce any eggs at all. No pressure.
At this point, many people would begin gearing up for transfer day (more on that below). However, Bobby and I have opted to put all of our eggs in one basket (see what I did there?) and get genetic testing done on our embryos (assuming we come away with any). Because we're footing this procedure 100% out of pocket, we want to do everything and anything that will give us the best chances for a healthy pregnancy in one cycle (again, no pressure!). Genetic testing will help us eliminate any embryos that likely wouldn't have made it very far once transferred back into my uterus anyway. This takes about two weeks, so the embryos are frozen and then transferred during my next cycle about one month later.
How I can fail: Oh, there are many ways, but for this month, none have to do with fertility.
PHASE 3: LUTEAL PHASE
A mostly meds-free month will have elapsed by this point, and then, right about halfway through my cycle, Bobby will give me progesterone shots (those 1.5" needles in the booty again, oof) for 5 consecutive nights leading up to transfer day. This is to hopefully thicken my endometrial lining and create a cozy, welcoming environment for our embryo.
How I can fail: Not produce an endometrial lining that's thick enough; produce an endometrial lining that is too thick. Essentially, tell my poor little embryo that there's no room at the inn.
PHASE 4: TRANSFER & THE TWW
This is the biggie, guys. On day 5 of my luteal phase, I'll head back to the clinic to have our 5-day-old embryo transferred into my uterus with what is, as I understand, the spitball method. No anesthesia here, unfortunately. Just a quick wham, bam, hope you implant, mam. We go home and then begin what all of us on the TTC (trying to conceive) journey refer to as the dreaded TWW - the two week wait. And there's not much more to it than that: for two weeks, we wait, and hope, and pray (even though we're not the praying type) that our embryo implants and I'm officially pregnant.
How I can fail: Oh, just like, not implanting or getting pregnant, essentially flushing about $20,000 (give or take) right down the drain along with our hopes and dreams of becoming parents and being left with nothing but the painful choice of giving up or starting the whole process again.
So here we go. If all goes according to plan, this time next week I'll be injecting myself for the very first time and the weight of it all will officially be on my shoulders.
Body, don't fail me now.