fertility · ivf · parenthood

“So, How Was It?” IVF Edition

Any regular readers of my blog — assuming I was writing regularly, Oops — will have noticed that I hadn’t posted anything between the blog last December about our first IVF transfer and the one this October about newborn-babying being a blur. Clearly, there were some interstitial events! So, what happened? My intention, as it stands at 6am next to a sleeping bebe, is to write a few blogs that account for IVF, Pregnancy, Labor & Birth, and, now, more on Life as a Family of Three (plus a cat, Stella would have me add). We’ll see how it goes. 😉

J and I were lucky (very lucky) to have been able to create and save 5 embryos from my IVF last summer/fall. We were very lucky with all the numbers, in fact, especially for a then 38-year-old cancer survivor and a 46-year-old dude man. The number of eggs I “matured” each month was high, the number of eggs collected to be inseminated was high, the number of embryos sent to the lab for genetic testing was high, and, finally, the number of embryos that came back chromosomally normal was high.

The whole thing is/was a bit boggling, honestly. Science was enabling us to bypass continued months of trying, and failing, to produce a healthy embryo, pretty much without our having to do… well, anything. Aside from, you know, months of shots (belly and bum, morning and night), pills, creams, blood draws, ice packs, heat packs, internal exams, external exams, “couch” rest, abstention, and more trips across the Bay Bridge in a few months than I’d made in several years — but, you know, aside from that!!!

Aside from that, J and I were able to check our email and have a video visit with a genetic counselor and our doctor and learn that there were 5 genetically normal embryos. 5 potential life forms. 5 potential chances for us to have a family (a larger one, that is, than us two). And 5 potential chances for us to fail. (And, please, I use the word “fail” extremely lightly.)

As you may have read in the blog post last December, our first embryo transfer did not “take.” And as soon as it was healthy to do so, we all tried again with the next embryo on the list. Though, it must be said, I still even now think about that one embryo, the one labeled and now so-named in my head and heart “Number 10.” Number 10 on our chart listing our “products of conception,” as the medical team calls them. It’s as hard as any miscarriage we’d had before, except that this time we knew the gender (or sex) of the embryo. We knew how it would present in the world were it carried to term as a healthy being. We (I) could envision it… could envision Her. And so, Number 10 remains in my psyche. But … she’s gone. And when I talk about her, I use euphemisms like the one I wrote above: “It didn’t ‘take.'”

So much is encapsulated in those three words. And because of that experience, and all the ones prior (See: Pee Stick Dance), I spent much of my winter holiday with J mildly(?) terrified. We went up to Lake Tahoe for the week between Christmas and New Years ’20-’21, ostensibly to ski. But, having just had a new embryo transfer and then several positive pregnancy tests, as J and I descended the ski slopes, every single jolt over the snow set off a shock wave of anxiety. Did I knock the embryo out? Did that wobble over the hill dislodge her from my uterine wall? Am I about to right now have a(nother) miscarriage?

I just couldn’t do it.

I told J that he could ski but I was going to stay in the rental apartment and watch bad tv and drink tea. With the snow falling outside the floor-to-ceiling picture windows, this was not an altogether unpleasant sequestering! Lucky, too, was I that I’d reached out to and begun to see regularly (via Zoom) a therapist who specialized in people facing fertility challenges. And grateful was I that I got to have a session (maybe even 2?) while we were up on vacation. I got to tell her how scared I was, how reluctant to even acknowledge that there was at that moment a bundle of cells oh-so-rapidly dividing and multiplying. How could I hold on to hope, to belief, when so much had happened to make such hopes feel … fruitless? So, yes, luckily I had a person to talk with about and through my fears. And, yes, luckily, I was able to get though to my doctor to talk about and through my questions. And, yes, luckily: She stayed. She took, as it were.

And now, she, Hannah Berlin, has thoroughly taken us. Over the moon. Into vast heartlands. To the edge of sanity, true. But:

She stayed.

curiosity · fertility · infertility

Schrødinger’s Baby

'The Annunciation'. 1501 - 1535. Oil on panel. ARCHANGEL GABRIEL. VIRGIN  MARY. Painting by Leon Picardo

Although perhaps not exactly as in the Bible, today I’m feeling a little like The Virgin Mary: Today my own Angel Gabriel will be a UCSF physician. As of about 3pm this afternoon, J. and I will leave the clinic, immaculate, and I will or will not be pregnant.

It’s the scariest, most life-altering thing to ever hope for, I think. To know that you are intentionally, and by appointment, asking to change your life and identity in an irrevocable way. And while, of course, it’s something you (I) say you want… I truly believe that you have no idea what you’re in for when you set these dominoes in motion. I don’t have any clue how I will change as I molecularly evolve from a woman to a parent. I don’t have any clue how I will approach the mess or the cries or the eye rolls or the unbounded love, despite the number of books I read to guide me.

I doubt there are many experiences like this seismic shift, though I recently equated it to an actor desiring to be famous and then having to deal with that fame when it comes! I guess I feel that parenthood is a “Be careful what you wish for” endeavor, but one that you… want(?) to not know how it’ll go! Talk about looking into the Abyss!

Another aspect that has been rolling around in my thoughts is the question of what, or when, is life? As an avowed Right to Choose-r, I have long thought, donated, and voted to support the right of women to make choices that support their needs. I have seen billboards with tiny babies and block letters claiming that a heartbeat starts 9 days from conception and bristled at their rigid, often erroneous, Right to Life dogma.

So it has been a jarring, unmooring experience to be regularly and consistently monitoring the health of my now-frozen fertilized eggs as though they are alive, as though they are beings. To receive a sheet that states how many eggs were retrieved, how many were inseminated, how many survived a few days’ gestation, and how many were reported to be genetically normal so they will be considered for implantation… well, you can see how my consideration of the health and development of these dozen-celled pods might call my long-held understanding of human life into question.

And that, I here report, is dysregulating. While I continue to hold mightily to my stance on a woman’s right to choose, I have to acknowledge that my conception (forgive the term) of What Is Life/A Life has become much more grey and nuanced these last few months. And, for that, I must here admit that I am also grateful. I do think that wherever I may have my own dogmatic clinging, any experience that can help me to open my mind to alternative viewpoints, even if I ultimately disagree with them, is a positive and widening human experience.

But… it’s “weird,” you guys! To know that I’ve thought and crossed fingers over eggs that have become embryos that have become tested frozen embryos … that now have become gendered? Yeah, I know the gender (or sex, rather) of our embryos. I know what they would and could and might and might never become. And that’s startling. It’s startling to celebrate the potential arrival of something that, under “natural” circumstances, I wouldn’t know for at least 5 months. And this specified knowledge begins to create a reality of a human, a picture of a human.

(For anyone curious about statistics, using genetically tested embryos, accounting for my age/health/etc., there is nearly a 2/3 chance that there will be a baby at the end of this. Which, conversely, means that there is a 1/3 chance that there will not be a baby, a possibility for which, while I am not precisely prepared, I am at least aware and not new to.)

And so, here we are, about to be maybe pregnant and maybe not.

To the ever surprising, edifying, and evolving nature of existence — and, for what it’s worth, considering it’s frankly a damn miracle that any of us were even born at all, maybe today do something cool, just because you’re alive to do it.

Love, M.

fertility · infertility · resilience

Don’t Fear the Reaper: A Different Kind of Harvest

Swollen, painful belly. Trouble bending over to tie my shoes. Tired and nauseous. Pregnant? Well, that sort of depends on your definition.

If you’re asking whether somewhere in the world, there are tiny combo cells of my and J’s genetics, multiplying and developing as Nature intended, then yes, I suppose we are making what could be children.

If you’re asking whether those cells are developing within my own body, then no.

Last Saturday, J drove me to UCSF to have my IVF egg retrieval–or, amusingly dark, my egg “harvest”–and though the procedure went quite smoothly and as pleasantly as possible, I now get the equal & opposite reaction of having amped up my hormones and egg-producing parts in the form of the aforementioned common, but highly uncomfortable aftereffects.

On the plus(?) side, I’m getting to see how bloody inconvenient it is to be unable to bend to tie your shoes or sit without hinging at the waist. But. I’m not complaining… too badly. I’m grateful that it’s “Zoom school” for another few weeks for me, during which prep periods I can lay down and take steadying breaths to quell the nausea.

So, how did we get here? How come our genetic combos didn’t listen to all the very well-meaning, if increasingly painful platitudes and advice such as:

  • “It will happen”
  • “These things take time”
  • “There’s always next month”
  • “Have you cut out __ from your diet”
  • “Have you tried __(insert alternative medicine here)__”
  • “Are you taking prenatals”
  • “I have a sister/cousin/aunt/instagram follower who __ but now __” and
  • “At least you know you can get pregnant”??

(Don’t say these things, folks. We all know you mean well, and I’m sure I’ve even said them in the past, but unless they specifically ask for advice, just say something like, “That sounds so hard, I’m so sorry you’re going through this” and give them a squeeze on the arm.)

How come, despite all that and several mild interventions to boot, my body still refused to hang on to a pregnancy? Well, it should be noted that 1 in 4 pregnancies end in a miscarriage and 1 in 8 people experience fertility challenges, so it’s not altogether surprising. But as far as any medical reason? Perhaps my age (therefore my eggs’ age), perhaps the chemo, perhaps just the bad luck of the draw.

I’d said to J before we began “trying” that if and when we needed to talk about other options, we’d know. I said it after I had a chemical miscarriage last October; I said it after I had a true miscarriage this April; I said it after I had another chemical miscarriage in June: When the time comes to talk about other options, we’ll know.

And so it was, in mid-June on the final Zoom faculty meeting of the year that a coworker made an announcement. Coy and stilted, she announced that she, like the school, would be making some changes come the fall. A half-second’s thought of, “She’s not leaving, is she?” followed immediately by her display of a black-and-white photo we’ve all come to know from our social media feeds is a sonogram.

. . .

I smiled tightly for a moment. And then I turned off my Zoom camera and wept. Her little one was due the same month I’d been due when I was BFP (big-fat positive). The same month my pregnancy app community posts were gleeful with messages about Fall babies and pumpkin-toned newborn photos.

Camera off, I doubled over. In my desk chair in my living room, I wailed — with grief, with confusion, with exhaustion, with … well, despair.

When J came home that afternoon, I told him, “It’s time.”

The Universe, and my own soul, were achingly obvious in this message: You said you’d know when? Well, “despair” is when.

It wasn’t a hard decision to go for medical help, since I’d already made it, knowing that I would do what I could to aid a little one into the world. And I’m glad that it felt obvious and neutral. (There’s a book of index cards in the clinic’s waiting room filled with notes from other patients, some encouraging, angry, grief-stricken, even funny, and some telling of how IVF was something they’d never, ever considered and hope they’d still never have to.) But, though J and I tacitly agreed long ago that we’d accept and seek out medical intervention if necessary, we’ve also spoken that there are limits to what we feel, for us, is palatable intervention–or encouragement–of the “natural” parenthood option.

I had initial meetings with one public and one private fertility center. I moved my rainy-day fund from savings into checking. And a few appointments and Zoom calls later, my dining table was littered with syringes, vials, and swabs.

It’s all been a bit surreal, a bit wide-eyed as J and I filled out legal forms: What do you want to do with any frozen embryos if: you die, he dies, you divorce, you both die but within 30 days of each other?! But, it’s been 1000 times better than sobbing.

We’re in a waiting time right now; and any person trying to be a parent–“natural,” “assisted,” foster or adoptive–will tell you how very much of that there is. But, today I’m comforted in knowing that we’re taking the steps one at a time, little petri dishes of hope settled in a corner of an SF lab; comforted in knowing, too, that I’ll know when it’s time to have a new conversation.