Our Story: Part III

This is Part III our journey through infertility and IVF. Click here to see Part I and Part II

 “Things Have To Change”

Our personal hell continued through the summer of 2009 and into the holiday season. Christmas is so kid-centric, and for a couple suffering from infertility, it is equal parts frustration and disappointment. I don’t want it to sound like every waking moment for us was awful, it wasn’t. And we had a wonderful Christmas in 2009, but we were both so tired of being let down. Another Christmas passed without kids. As we looked for gifts, hung stockings, and received holiday cards adorned with smiling kids, we were routinely reminded that something was once-again missing from our life.

The head-in-the-sand approach we had taken had to come to an end. We couldn’t continue down this road without finding out what was happening physically, regardless of what we may learn. The hope-and-despair cycle we had been in for 18 months had taken a visible toll on us individually and as a couple. I was 38, Jess was 34 and neither one of us wanted to wait any longer. Furthermore, it was all paid for by our insurance company. It was time to take control of the situation. After New Years we called our insurance company and set up an appointment with a fertility specialist. It was so scary, but it finally felt like we were in charge of the next step. Maybe it would work, maybe it wouldn’t. But at least we knew we were going to put this in the hands of people trained to fix the problem.

I’ll never forget the first trip to the fertility specialist…it started with frustration.  Perhaps we were overly sensitive, but we found the waiting room to be a source of sadness. Before each meeting, we waited there with other folks experiencing their own fertility obstacles. Just by looking around the room, you could tell who was pregnant and who was not. The pregnant couples smiled and playfully chatted. They looked at ultrasound photos of the child inside the mother’s belly. Meanwhile, the infertile couples---like us---held hands quietly. Or they were independently despondent. Eyes wide and staring deep inside themselves, lips pursed, and exhaling heavily through the nose. Anger? Check. Jealousy? Check. Our people.

Almost every time we went, a couple was met by the fertility specialist at the edge of the waiting room, with a wide smile and a hearty “Congratulations!” It was like a dagger.  We hated that. Of course, the purpose of such a public display is to instill hope in those who don't have any. God, how we wished we were that couple. And each time we weren’t it got harder to witness.   I’m still torn about the public congratulations. I get why they do it, but for us it just reinforced what we assumed to be true: other people get pregnant, we get screwed by fate.  And when your fertility treatments don’t work, it’s even more unbearable to watch.

“First Brave Step”

Our fertility specialist is a great man. He was aggressive and had a full plan ready to go. But before we could start any kind of treatment, Jess and I had to undergo some tests to see if there was an identifiable reason that impeded our ability to conceive. They checked my sperm count which was OK. Not great, but certainly sufficient. I won’t go into the details of my particular test, but it wasn’t unpleasant or intrusive.

The same could not be said for what Jess had to go through. She had to undergo an exam to see if there was blockage of any sort in her fallopian tubes. This required inserting a tube, vaginally and squirting a liquid that the doctors would track via ultra sound. This process was incredibly uncomfortable for Jess and it killed me to see her so distressed. The procedure didn’t take particularly long, just a few minutes. But it seemed like an eternity as we waited to find out if the dyed liquid made it all the way.  Both of us were anxious, but it was Jess on the table, naked from the waist down as strangers hovered around. Finally, the doctor gave us a play-by-play and said, “It made it all the way! Perfect! No blockage! This is great!”

With those words, tears flowed from Jess’ eyes and I followed suit. For the first time in ages, there was  clinical proof that it was possible for us to have children. Maybe we weren’t doomed, after all.

“Unexplained Infertility and IUI”

After a year and a half of trying to conceive, we were finally on a defined road towards doing something about it. It felt empowering. This isn’t to say we weren’t struggling---we were. But at least we were moving forward, instead of laterally or backwards.  Yes, we were experiencing infertility, but we weren’t infertile. We had “unexplained infertility”, which is a double-edged sword: There was no reason we couldn’t conceive, but since it was “unexplained”,  there was nothing to fix or reverse. 

Our fertility specialist had his druthers, we would have started in vitro fertilization immediately. However, IVF is an expensive procedure (about $15,000-$20,000 per pop). Insurance companies in Massachusetts are required to cover fertilization treatments, but they have requirements they put upon their patients. You have to do three rounds of what is called intrauterine insemination (IUI) before you can move on to IVF. This procedure is costs about 1/10 of IVF, so if it works the insurance company saves a great deal of money. If not, it still only cost them a fraction of a single IVF treatment. Makes sense, but still frustrating.

Here’s what the IUI treatment consists of: a sperm sample is collected, “washed”, put into a tube, which is inserted into the vagina, and released. Or as our fertility specialist put it, “Think of it this way, we’re throwing the darts a lot closer to the board…and with only the best darts.” We really liked this guy!  The success rate for this procedure for women in their early 30s is around 20-25% per cycle. Not great odds, but we figured it was better than our current batting average.

We started our first IUI cycle in mid-February of 2010 and spirits were high. Despite knowing the relatively low odds, we allowed ourselves to do something we hadn’t done in a long time: we believed. As the ice of pessimism began to melt just a little, openly talked about kids names, and birthday parties and walks in the park. We allowed ourselves to embrace positivity and feel good. A little more than four weeks later, we were on pins and needles. Jess’ period was a couple days late and she said she just felt different. This was it! We just knew it had worked.  But…..

Jess got her period. The emotional weight we chucked away in the previous month was now back on….and heavier than ever.  Yes, we would continue because it’s what we had to do. Yes, we would hope because we were in one of the best fertility clinics in the nation. But no, weren’t going to talk about what could be until it actually was. We would do everything within our power to make this work, and trust that these folks knew what they were doing. But we weren’t going to get roped into talking about things that weren’t actually happening. Entertaining fantasies is for fools.

To make matters even worse, for Jess were the side effects of the fertility drug, chlomid. She was left with splitting headaches that practically debilitated her some days. There were days she was so spent, all she could stand to do was lay motionless in a dark room. So to go along with the disappointment and sadness, she felt like her head was going to split open.

Up next was the second round. What can I tell you about it? Same old story. No pregnancy, tears, frustration, less optimism, deep breath, let’s do it again. We had one more round of IUI, before moving on to IVF. We weren’t sure how much more we could take. We were about to find out.

“Of All the Days”

As we entered our final round of IUI, our fertility specialist met with us to design a plan for the next step, should the cycle not result in pregnancy. If this attempt wasn’t successful, he suggested we move on to IVF as soon as possible. IVF, in its simplest terms, consists of mixing a sperm sample with eggs extracted from the woman’s uterus. The two are fertilized in a lab and reinserted into the woman a few days later. Our biggest question was, whether or not we’d be automatically approved for IVF after the third round. I called our insurance company and was told over the phone that situations vary, but in most cases the doctor’s recommendation held a lot of weight.  

It was great to have a plan laid out just in case, but we still had our final IUI round to get through. Maybe it would work. Maybe.  Let’s go! To say were impatient was an understatement, and that impatience was equaled only by our frustration. The four weeks passed and, like the first round Jess was a couple days late. Please, please, please let this be it! IVF is so much more difficult and we were tired of waiting even one more day. Like the first time, she said she felt different. Despite a negative pregnancy test, we were still hopeful, as more days elapsed without a period. We didn’t have a lot of hope, but weren’t giving up. This had to be it!  

In what can only be described as the most horrible day of our infertility, Jess got her period on a Sunday morning. But not just any Sunday.  Mother’s Day. God damn, Mother’s Day.   Does it get any crueler than that? Jess was as lost and sad as I’d ever seen here. There was nothing I could do or say to ease the pain. Even more challenging, we had to drive an hour and put on happy faces for a Mother’s Day lunch at her mom’s house. How she sat there listening to Mother’s Day cards being read aloud and Mother’s Day presents being opened is beyond me.  Inside she was ripped to shreds. Of all the days, it had to be this one?  What kind of perverse thrill was fate getting out of our misery? Fuck all of this. Every little bit.

“You Gotta Be Kidding”

Mother’s Day took some getting over and the mood around our household was grim. The prospect of starting IVF was the lone bright spot going into the work week. However, that too, wouldn’t be easy. Not that we hadn’t suffered enough, another haymaker was about to land on our jaw.  Jess called me at work early that week crying, “We didn’t get approved for IVF.”

This had to be a mistake. Had to be. There’s no way this is happening. No!! What about the conversation I had with the person who worked for that very same insurance company who said all we needed was the doctor’s approval? You people are screwing with our lives! What part of “we can’t have kids” don’t y’all understand?  To this day, I still don’t understand what happened. The insurance company wanted us to try two rounds of injectable IUI before moving on to IVF.  

The setbacks were taking a toll. The prospect of having children seemed dim because of physical and bureaucratic obstacles that we had zero control over. By this time, I had wrapped my mind around the fact that we may never have children and was trying to be OK with that. I was with the woman I wanted to be with for the rest of my life and if it was going to be just us, then so be it. This news only pushed me further in that direction. In my mind, I was just being realistic…or that’s what I convinced myself of. In reality, it was just easier to give up, and go through the motions. Then if we did get pregnant, it would be a pleasant surprise. However, Jess never reached that point. As heart-wrenching as this experience had been, she wasn’t ready to emotionally submit to the possibility of a childless future. Can’t say that either one of us were feeling optimistic, but our levels of hope against all odds were not equal.

“Unexpected Good News”

When you get used to bad news---and we got plenty of it---you come to expect it. But soon after the insurance company gave us our next round of challenges, our fertility specialist intervened on our behalf. We don’t know what took place, but later that week we found out that the original denial was going to be reversed!! We would start IVF soon! Much like the moment when we learned Jess was fine inside, we started to see a crack in our wall of defense, protecting us from optimism. Forget the fact that we shouldn’t have been denied in the first place…it was something that was actually going OUR way! You take your victories when you get them, I suppose.

“IVF Ain’t No Joke!”

As we prepared for this next phase, we learned more about the process. Like most fertility treatments, women get the absolute worst part in the play. Before the actual procedure can take place, she must undergo a series of daily injections of drugs that stimulate egg production. In essence, the drugs completely take over the menstrual cycle in an effort to produce as many eggs as possible in one month. Afterwards, the doctors will see how many are viable. It’s quite an interesting numbers game.

Each morning at 6:15 I went to the kitchen and prepared a syringe for Jess, while she prepped her stomach with rubbing alcohol. Neither one of us are wild about needles, but she couldn’t see giving herself the shot. So I did it. Some mornings I made a clean stab, other mornings I didn’t. On those mornings I was not the most popular human being on the planet. Then after a few weeks, there was another shot added to the morning mix. It was bigger and also went in the belly. After a while, the challenge became finding new places to insert the needle, as her stomach was getting hole marks. Poor thing was like a voodoo doll.

By the end, we were up to three shots a day, culminating in the final shot. This was the big mamma jamma. It was very, very long and had to be done at an exact time, based on when you were going in for egg retrieval the following day. For us, the shot would be administered at 11:45 PM. We were absolutely exhausted, but stayed up late to do it. The shot had to be in an area between the hip and the butt. I was so nervous for my wife. This was not going to feel good, and expert as I had become in giving shots, this thing was huge. Jess was visibly nervous, so I couldn’t show any signs of doubt. If I appeared calm on the outside, I was freaking on the inside. I steadied my hand drew it back and plunged it into her backside as quickly as I could. I released the medicine and pulled it out. Whew. Done.

When all was said and done, Jess endured 54 shots over the course of four weeks. In addition, she made dozens of trips to the doctor’s office; IVF requires constant monitoring. It also requires numerous blood samples. By the end of the treatment phase, nurses had a very difficult time finding a place on her arms---yes both---to successfully draw blood. Both arms ached. The emotional toll of all this prodding is one thing, the physical toll is yet another. This damn-well better work.

“Here We Go…”

On Friday June 25, 2010 Jess and I went to the hospital for egg retrieval. Unlike other procedures she underwent up to this point, retrieval would require anesthesia. Having never gone under before, Jess was understandably nervous. The doctors explained that it would be painless and that it would only take around 15 minutes or so. Meanwhile, I went off to the so-called “men’s lounge” and produced the sample needed to fertilize the eggs that would be retrieved. It really cannot be stressed how inequitable the gender-based tasks in this fertility treatment are.  She required anesthesia, I required “Girls of the Big 10”.  

Jess came out of the procedure like a champ. After about 90 minutes or so, we were released and we went home. The doctors would now see how many eggs they could fertilize. On Monday we would go back in to have, what we hoped to be, fertilized eggs put back into Jess’ body.

Under normal circumstances, we probably would have spent the weekend hoping, praying, thinking, and worrying about Monday. But we didn’t have time for that. The day after retrieval, our nine-year old niece arrived from Idaho for a 16-day visit. No, we don’t like to do things easy. The scheduling of our two big events of the summer could not have synched up more poorly. But we learned early on in this process, few things in our life go as planned. So Jess recovered as best she could, and went with me to the airport to pick Hailey up less than 24 hours later. What a trooper.

“The Final Step”

On Monday, June 28, 2010, we went back to the hospital for implantation. After fertilization, we had only two eggs that were strong enough to be implanted. Both would go in on this day. If there are several, those eggs can be frozen for future implantation. That wasn’t the case for us; it was all or nothing. If it didn’t work we’d start the whole process---shots and all---over in a couple of months. With no guarantee of success.

We arranged for Jess’ mom to watch Hailey while we returned to the hospital for implantation. Obviously, this was a concept too confusing for a kid her age  to consume, so we made up a story of some sort explaining our absence. She seemed a little confused, but OK with it. Years later, I think Hailey will be pretty excited to know that she was with us when her two cousins were created.

The implantation process didn’t take very long, but like everything else in this ordeal, it required Jess to be physically exposed. I was there, by her side as our children were put into their mommy. It was a bizarre scene, and certainly not the one I envisioned years ago, but it was amazing. If there was a moment of levity, it came after the procedure. She was asked to have a full bladder. She took this order to heart and guzzled water like she owned stock in Evian.. By the time the procedure was over, she was about to burst. However she didn’t want to go to the bathroom right away, for fear she would somehow pee the embryos out. What? I’m gonna argue with her?

At this point, there was nothing we could do but wait for the results. In 15 days we’d get the news. That’s a long-damn time.

The fourth, and final, installment of “Our Story” is coming soon…