“Woahhhhh, we’re halfway there. Woahhhhh, livin’ on a prayer!”
Officially 20 weeks pregnant. Halfway to our due date. Which also means: A pinterest board overflowing with ideas. Apps on my phone telling me the baby’s comparison to a fruit size along with other helpful hints and information. Pictures of the ultrasound framed along with our first picture when the baby was just an embryo…a prayer.
Our journey started with a wish, followed by a prayer, an abundance of positive thoughts, and my own personal team of Avengers.
In my past blog post “Everything worthwhile is Uphill” I ended by sharing how I was assembling what I like to think of as my team of Avengers, my own team of heroes. My Avengers didn’t include Thor, Hulk, or Iron Man though. Instead, I had assembled my Rheumatologist, RMANJ fertility doctor, high risk doctor, and my fertility nurse. Then, to head my support system of Avengers I did have the same leader, my very own Captain America, my husband (my teammate). Which is now pretty fitting with the Avengers: Endgame movie currently climbing the box office records charts. (No worries. No Spoilers here!)
With my Avengers in place we were ready to start infertility treatments. At Reproductive Medicine Associates of New Jersey (RMANJ) they take an individualized approach to their fertility treatments. They view infertility as not a one size fits all treatment clinic which I found to be reassuring and helped with knowing that our plan is what will set us on the road towards parenthood.
We did several fertility tests to get the full scope of which treatment plan was right for us. Our plan was to begin the Intrauterine insemination (IUI) process. There are several different types of IUI in order of least to most aggressive; IUI with no medication, Timed intercourse with medication, IUI with ovulation induction and IUI with Superovulation. The decision was made that we would go aggressive to start with a Superovulation IUI cycle and do a double insemination.
You might be thinking, “What the heck does that mean!?” And I do not blame you. We were thinking the same thing. In layman’s terms it means that I would be taking injectable medications to help stimulate the growth of more than one egg to increase the chances. Nightly injections were followed by morning visits for blood work to monitor my hormone levels and ultrasounds to check the growth and stimulation of my eggs. Every morning visit was followed later in the day with my nurse calling to give that night’s instructions on how much medicine to inject and how far along we were looking. After the 10th day my eggs were at the ideal size with stimulation and I was instructed to give myself the “trigger shot” which ultimately tells my body to start ovulating and release those eggs!
We went into the office back to back mornings for insemination to increase our chances. During both those visits sperm cells were put directly into my uterus using a catheter, so that the sperm starts its swimming closer to the egg. If you ever saw the movie “Look Who’s Talking” with the beginning scene of the sperms racing towards the egg, then this is exactly what I was thinking was immediately happening afterwards. If you never saw the movie or need a mind refresher…watch that video! Chris thought I deserved a reward so he made a balloon out of the latex gloves, hence that is what I am holding in the picture. Once you leave the office then the wait begins…
Two weeks later and the results were in. There I was, sweating it out, nervous, like a kid waiting to go into the principals office. Were we pregnant? Did IUI work? or Would I be heading into another cycle? Another month of RA pain and another month of trying to get pregnant. The call came in, and the words “I’m sorry” came across the phone and punched me straight in the gut. It was upsetting news for sure. I came home from work to post-it notes hidden throughout the house from Chris and a little sunshine of flowers to help boost my positive spirits again. It was back to the drawing board with my Avengers to see where our next path will lead us in our journey to become parents.
Shortly following the news of the failed IUI cycle, I had a flare up with my rheumatoid arthritis in my hands and wrists. I was back on a taper of prednisone to help with relief of inflamed joints and inflammation. We were planning on entering into a second cycle of IUI, but with another flare up and possibility of having to do a second laparoscopic surgery for the endometrioma cyst that came back from my first surgery the plan was altered. We were going to head right into an In Vitro Fertilization (IVF) cycle. However, first it had to be cleared by insurance. While we waited for the clearance from insurance, I was put on birth control in order to halt my menstrual cycle so we would not miss this month’s possible cycle. It did feel a little backwards, going on birth control, when you are trying to get pregnant. But, doctor’s orders and he is the boss! Insurance dictates how many cycles of IUI you have to do first before you are allowed or considered to do IVF. With our insurance we are supposed to do 2 rounds of IUI first. After reviewing my medical background and history, insurance was able to waive the second IUI and we were ready to go with the green light for an IVF cycle.
Finally we got the go ahead from the team (Insurance, RMANJ, Rheumatologist). This also meant a whole slew of new information which included: financial paperwork, consent forms, more medications for treatment, course enrollments for online learning, timelines, risks, procedure process and many emotions and feelings to top it off. This could easily be overwhelming. Chris and I decided to take each step in stride and create fun letter boards throughout the process to make a scrapbook in the end to show our future son or daughter. We were staying positive. That was our #1 way of thinking moving forward.
Day 1. The start to prepare for retrieval day! Injections and medicine have all been delivered. Our fridge was stocked. I had morning monitoring for blood work and an ultrasound. As I was giving blood, the song “In My Blood” by Shawn Mendes was playing. I couldn’t help but chuckle and share with Bill, my favorite phlebotomist there, because by now we have become buddies. Not only was it quite humorous. The lyrics could not have been more accurate. Giving up is not in my blood and just like that I thought, IVF let’s do this. That afternoon we got the call from our nurse and our instructions for injections for the next four nights.
Day 5. Routine continued. Morning monitoring followed by instructions for medicine. In the midst of these days I had another flare up. I was scared to go on prednisone. I did not want anything to interfere or be a possible reason for why the cycle was unsuccessful. But, I had no choice. My flare up began to get worse and my doctors aka Avengers agreed that it was best for me to go back on a taper of prednisone. I also began seeing an acupuncturist regularly. Research and studies showed the effectiveness with acupuncture alleviating stress, enhancing overall health and improving outcomes with infertility along with helping chronic pain management. So I was fully on board and embraced my visits and thus added a new member to my Avengers.
A year since we made our first wish to become parents arrived. We could not be more thankful and blessed to have shared our Thanksgiving in our home with our family. We ended the evening with our nightly shots and continuing on our path to make our wish, our prayer come true.
The following mornings were closely monitored to see my egg progression. I was doing well with giving myself the injections nightly since I was used to giving myself injections from my Rheumatoid Arthritis medicine I was on for the past 16 years prior to going off of it to become pregnant. That was definitely one silver lining. However, my arms definitely saw the brunt of giving blood every morning.
Day 12. After a total of 36 shots and 7 morning monitorings, the decision to “pull the trigger” was made. This shot is a single hormonal injection that helps in the eggs final development. During the preparation for retrieval your body definitely changes. Hormones are all over the place with the medication and your ovaries are being stimulated trying to produce as many eggs as possible. More eggs means more possibilities.
Day 14. RETRIEVAL DAY! Prior to going in we made our guesses to how many eggs we thought the doctor was going to retrieve. Come on now, there had to be some competition thrown in here given mine and Chris’s competitive nature. My guess was 11 and Chris guessed 27. The way retrieval works is that I am placed under “twilight anesthesia” (a medicated induced sleep). From there the doctor, using an ultrasound to guide him, inserts a thin needle attached to a catheter through the vaginal wall to draw out the eggs, one by one, from the follicles using light suction. (Insert the ant song but change the lyrics to “the eggs go marching one by one hoorah! hoorah!”) When the procedure is over, I head back to my recovery area where Chris was waiting for me. We then learned that lucky number 13 was the amount of eggs that were retrieved. (That is right I won the guessing competition!)
The next day when our nurse called to check on me and give me my next instructions, she gave us an update on our eggs. We retrieved 13 eggs, but 12 of them were only mature enough to inject with sperm. Out of the 12 that were injected, 11 of them became fertilized. The next part was that we had to wait a week to see how many made it to the next phase called blastocyst. When the results came in we were told that 4 have survived. Each blastocyst is then graded by an embryologist based on cell development with a number and 2 letter grades. It is the RMA policy to transfer the best quality embryo.
We then decided to have our embryos go through a comprehensive chromosomal screening (CCS). This comes with an additional cost, but looking back it was worth every penny. CCS is a technique that allows scientists to evaluate and detect chromosomal errors. This advanced embryo selection technique will not only prevent specific conditions such as Down Syndrome, but also dramatically reduce miscarriage rates and reduce the need to implant multiple embryos to achieve conception. Two weeks later our CCS results discovered that 2 out of our 4 embryos came back normal. It turned out that our 2 “highest graded” embryos were abnormal which meant that if we did not elect to do the testing those embryos would have been the first 2 embryos that would have been chosen for our transfer. Which ultimately would have ended with 2 failed transfers or miscarriages and definitely having to go through the cycle more than 2 times. Through doing the testing we improved our chances knowing that we now have 2 healthy embryos. 2 embryos that made our living on a prayer continue.
We were now ready to move ahead with preparing for the transfer. Which meant new types of shots! These were progesterone in oil shots and were given intramuscularly into the butt. Warming up the oil beforehand definitely was key! This continued up to the day of our transfer, the day that felt like Christmas morning when you were a little kid. A day we have been anxiously awaiting.
January 9th, 2019. Transfer Day. Channeling every possible positive vibe that we could and strength from my Wonder Woman superhero powers. Check out the video to see a glimpse into our car ride there!
The whole actual transfer procedure only takes about 15 minutes, but science just blew me away with how in that time period it was making our prayers come true. Yes, only positive thinking was allowed. We were becoming pregnant until proven otherwise. Before the transfer we opted to do laser acupuncture that would be done pre and post transfer. Again, an additional cost, but studies showed that the acupuncture increased your chances by 4-6% so YES SIGN US UP! Plus we got to wear cool Men in Black sunglasses.
We were placed in a private room that played relaxing music to create a stress free environment. Shortly after acupuncture the embryologist and doctor came in with our embryo, our prayer. The doctor then placed a catheter into my uterus and we watched on the monitor as he transferred the embryo right into the perfect spot for implantation. The process had us both smiling from ear to ear. Our embryo, our prayer, our baby has now found a new home.
We were pregnant until proven otherwise. The wait was 9 days until I would get blood work and we would find out for sure, but until then I had to continue with the progesterone shots in the butt and I did every old wives tale possible that helped with implantation and the embryo “sticking”. As soon as we left the facility we stopped and had McDonalds French Fries and then for dinner more greasy food! Stick baby stick! Brazilian Nuts. Pineapple Core. Pomegranate Juice. All were facts? myths? who knows. But I read they worked so I was doing them. We even came home and watched Wonder Woman to give our embryo that extra strength! As the days went by I didn’t have any “symptoms” that made me feel pregnant. We just kept saying we were having a baby to one another and then the 9th day came…
I went for blood work in the morning and I let my nurse know not to call me until 3 pm when I would be home with Chris. We wanted to share the phone call together. 3 pm came and my phone started to ring. My heart was beating a mile a minute. We answered the phone and…
All the positive thinking, old wives tales, strength worked! We were officially pregnant. For the next 4 weeks after, I continued injecting the progesterone butt shots to make sure to create a balanced environment for the now growing baby. I went back for blood work several times to check my beta levels, each time making sure they continuing to rise. Rising numbers meant positive news. February 15th. We officially graduated from the Fertility clinic! We were now placed fully in the hands of our high risk doctor and ob-gynecologist. It was an amazing feeling.
“More than 1 in 8 couples – over seven million Americans – will have trouble getting pregnant,” according to MERCK Pharmaceutical Company. Although infertility is a common medical condition, it is an extremely emotional and difficult experience for couples, often leaving them feeling confused, isolated and alone. I remember walking in or leaving morning monitoring passing other females. Each one with their own personal journey and story. I always thought to myself how our stories might be all different, but we all had one common prayer, to become pregnant. I always made sure to smile at everyone. For you didn’t know if it was their first time ever coming to morning monitoring or they have seen several failed attempts and have been coming for months or years.
For anyone reading this and going through infertility, you are not alone. Reach out. Lean on others. I highly recommend the book “Hilariously Infertile” by Karen Jeffries. The book puts a comical spin on infertility to help make you laugh. Support is so important. I could not imagine being on this path without my Captain America, my Avengers, family and friends who have all been that support system that made me have the continued strength to stay positive.
For anyone that knows of someone who is going through the process. Be their support. Check in with them. Distract them. Be their positive light, their extra smile.
This blog might not relate to you at all. But I do thank you for taking your time to read our journey. Although you might not be trying to have a baby or know someone who is, I hope you can cling on to the thought of how positive thinking can go a long way. There are so many different situations where it is much easier to be pessimistic and think negatively. Thinking this way is not moving in the right direction to improve, succeed, reach a goal, be happy, overcome adversity, an obstacle or unexpected bad news. Change your mindset by trying my Unfortunately, Fortunately trick, take one step at a time, and also know who your own set of Avengers are to help you along the way.
I share our journey in hope that it helps others to be positive. The countless amount of days battling through rheumatoid arthritis flare ups with being off medicine, laparoscopic surgery to remove endometrioma cysts, leaning on RMANJ to guide us with the fertility path for us. All have been a fight worth fighting which has brought us to the point where we are now. Halfway there. Living on a prayer. All while continuing to SLAY RA!