As some of you may have heard or seen on my snapchat, I am terribly sad to report that we lost both of our sweet little growing babies, yet again. This time, I was seven and a half weeks along with fraternal twins. We are utterly devastated and heartbroken, and quite frankly, outright frustrated. This is our second miscarriage in a row. And while I know nothing I have done could have caused this, I just can't help but feel defeated and lost. Like my body is responsible by turning on me and the thing I want most... my family.
As you all know, when we found out we were pregnant (again) we were beyond overjoyed. We couldn't wait to share the good news with all of you, and we thought we had finally figured out how to stay pregnant. This time around, I had been taking new medications and extra precautions to prevent another miscarriage, and we really truly believed this time was it. When we went in for our first ultrasound, we were told the heartbeat on baby A was a bit low. But ever the optimist that I am, I thought, there's no way this little pumpkin isn't growing. She just got a late start. So when we went in for our second ultrasound, I was happy, albeit nervous, and smiling. However, when we saw no flickers on the screen and heard nothing but the deafening sound of no heartbeats, my own heart just dropped. I squeezed Ben's hand and was fighting back the sobs. How could this have happened again? Why did this happen? Why can't we just stay pregnant? I looked over at Ben and it just broke my heart to see his face as he fought back tears and tried to remain my ever-sturdy rock, reassuring me that it's ok, we'll be ok, and we will have our family someday.
Needless to say, I have had a really hard time this week. I haven't left the house for much other than food, and can't seem to find the motivation to move on. But life moves on. So I guess it's time I pick up the pieces and put one foot in front of the other. And step by step, we will prepare for the next IVF round.
The first step for us involves "clearing out" my uterus. Right now, it's still being occupied by our sweet little peas who didn't make it. As you may recall last time, we chose to have a complete miscarriage naturally. It was a painful and drawn out process where I had to carry our little (dead) ones around for over a month. It was agonizing and for those 32 days, I was both dreading the day when I'd start to finally bleed, yet I couldn't wait for when my uterus was clear for another baby to occupy. So this time around, I have chosen to undergo a D&C (dilation and curettage), a procedure where you go under anesthesia so the doctor can remove the fetuses and all pregnancy tissue from your uterus. This will speed up the process because honestly, I am ready to move on and try again. I am ready to make this thing happen, and our baby(ies) can't come soon enough.
After my body recognizes it is no longer pregnant and my beta levels (HcG) get back to zero (which may take a while), we can then do some more blood work to figure out why this happened, yet again. We are hoping to pinpoint a problem. I really truly hope they find something wrong with me. Because without a problem, there is nothing to fix. But all I can do right now is hope and pray.
Because we used the last of our frozen embryo's, this means that we are back at square one. Ugh, how disheartening, frustrating and disappointing. But, I guess it is what it is. So, today I thought I might share with you a little bit of what our next steps are and what the entire In Vitro Fertilization process looks like.
Before I dive in, I must start out by saying that just like your monthly cycle, no two women have the exact same IVF protocols. Thus, my experience may be different than yours, but the entire IVF process is typically several months long and involves medications designed to recruit and grow multiple eggs within your follicles, as well as prepare your uterus for the embryo(s) you create.
The whole thing is a bit of an overwhelming process, to say the least. One way to compartmentalize the process is to divide it into three phases: the preparation phase, the stimulation phase and the luteal support. And I am about to go into some major depth here so lend me your ears ladies and grab a comfy pillow because you might be sitting here for a while. So let's get started...
THE EGG RETREIVAL PREPARATION PHASE:
To give you a little bit of background, the preparation phase is designed to help suppress your hormones to ensure your body is ready for the stimulation medications. It's kind of just a way to calm everything down before you begin amping everything up.
If it's your first go-around, you'll likely first be scheduled for a HSG and/or SGH procedure where they inject dye into your uterus to show whether your fallopian tubes are open and simultaneously clear them out if they aren't. This can help increase your chances of pregnancy as well (woohoo)! It usually only takes about 5 minutes and only causes minor cramping - just be sure to wear a pad afterwards because nobody wants dye in their panties.
Once we're ready to begin the preparation phase, my doctor typically puts me on birth control (weird, I know) to help my ovaries prepare. This phase usually lasts about four weeks and starts once your period comes along. I don't really have any major qualms with the preparation phase other than a little nausea and other symptoms here and there, but you best get used to that eventually because it's pretty much to be expected throughout the entire process.
After about three weeks, we usually stop the birth control and I am started on Lupron, which kind of shuts down or controls my ovaries temporarily to prevent premature ovulation. It's one of my least favorite drugs because it gives me the worst freaking hot flashes and makes my bones ache, literally. It sort of feels like they're stretching or something and hurts to move my wrists and ankles, especially at night when laying in bed. But remember ladies, the end goal is so worth the journey to get there. Plus, my doses are usually cut in half after a week (from 20 units to 10 units), and that helps too.
After that, I typically come in for my baseline monitoring appointment, blood work and an ultrasound to determine if my body and uterus are ready for the next stage of medications. If all is good, I usually begin the "stimulation phase" of our IVF egg retrieval cycle.
THE EGG RETREIVAL STIMULATION PHASE:
The stimulation phase is my least favorite. It kind of makes me cringe. It usually lasts a few weeks and involves stopping the Lupron but beginning more pills, creams and injections in order to grow the heck out my follicles. Think of having golfballs and baseballs chilling in your ovaries. Yeah, it hurts to move.
We usually start out with Follistim or Gonal-F, depending on what the local fertility specialty pharmacies are carrying, and Menopur injections (ouch) to help my ovaries produce lots of eggs. Basically they will make your follicles grow and grow and you'll feel super bloated and will look like you're already super pregnant, but that's a good thing and is to be expected. Last time we did this, I literally looked like I was already five months pregnant and I gained a bit of weight, but it eventually goes away. True story, I was flown to Hawaii for a business opportunity while on these meds to shoot photos and video assets for a hotel - think me in a bikini on film while looking like a beached whale. But hey, we do what we gotta do and sometimes you just have to say screw it, whatever, it is what it is, am I right?!
Ben is usually then put on Levaquin pills (fights bacteria) for a few days (oh poor him, right?) while I go in for nearly daily appointments for blood work and ultrasounds to monitor both my hormones and the size and amount of my follicles. You can expect to come into the office about 8-10 times - so no leaving town. The no travel portion is a bit more difficult for me because I have to say 'no' to a lot of amazing travel opportunities with my blog, but at the end of the day, it's worth it to start our family. You just have to set your priorities from the get-go.
Ok so moving on... when your body is ready to move onto the final phase and your follicles are nice and big and mature (aka you're nice a bloated and uncomfortable when you sit), you'll administer the HcG trigger injection at a specific time to "trigger" ovulation. They usually throw me on a Z-PAK as well to prevent an infection before doing our egg retrieval, which is scheduled 36 hours after your trigger injection.
THE EGG RETRIEVAL:
So the egg retrieval... not very fun. You're sedated by an anesthesiologist, kind of like a twilight sleep, and they literally steal your eggs using an ultrasound guided needle. They poke each follicle and suck out all of the fluid to capture the little egg in each. It's kind of crazy, that's how tiny they are. They then put your eggs with your hubby's semen and boom - you've got some tiny little embryo's made in a petri dish.
Last time, they captured eleven eggs from me. Of those eleven eggs, nine were of "good" quality. Of those nine, only six survived the freezing process. Of those six embryo's, only two were graded at a "B" level, with the remaining four graded at "F's." It was a little discouraging and not the numbers we were hoping for. This time, I am hoping we are able to capture many more and of better quality, to allow for more transfer procedures so we don't have to go through all of the above again.
Anyway, after our first egg capture I had a hard time being able to stand up all the way because I was super sore and just needed rest. I am not really looking forward to the recovery part again. My neighbor kept ringing our doorbell last time and I'd answer it looking like the hunchback of Notre Dame. Again, it is what it is. I was told to drink gatorade and just relax on "princess status." I am ok with that. I just worked, watched a lot of movies and netflix was my best friend. Hello Jane the Virgin.
Because we are doing a frozen embryo transfer (FET), we then give my body another month to calm down and recover. I then have to start a whole new "preparation phase" and "stimulation" phase in order to prepare for our transfer. Yikes. See, I told you it was a process.
THE FET PREPARATION PHASE:
After I start my next period, I will then start up the birth control once again to allow my ovaries to "cool off." I am usually on this for three weeks and stop before the placebo sugar pills. Before the last week of birth control, I start with the Lupron injections once more, remember those shots that I said make your bones hurt? Yeah, that. (20 units daily).
THE FET STIMULATION PHASE:
Once I get my second period, I then usually get to cut the Lupron injections amount in half (to 10 units) for a week, while also injecting myself with G-CSF every other day (which helps to expand your endometrium). Both injections just go in your stomach and don't hurt too bad, thankfully. I am also usually started on estrace pills twice a day, which contain a form of estrogen, as well as estrogen cream. This mostly just makes me retain water, gain a little weight (ugh) and feel bloated. Again, it's all for a good cause though. Just remember that.
Five days before our frozen embryo transfer date, I am also usually started on progesterone cream twice a day as well as the progesterone injection. I'd say the progesterone injection is the worst based on the size of the needle (nearly two inches long and has to go into your bum... past the tissue, past the fat, and into the muscle). Yup, ouch (and we have to do this every single night up until our tenth week of pregnancy).
THE FROZEN EMBRYO TRANSFER DATE:
Ahhhhh! This will be the day we have been looking forward to for nearly six months! It is the beginning of it all and finally marks the day where our next little embabies will begin to grow and thrive and I am finally pregnant again. I literally can't wait for this day already - and it's so far away (likely this coming November). This day is what we have been doing all of the painful above for! And it is oh-so-worth it just to get our precious little sea monkeys inside me. Weird to say? Whatever! This day can't come soon enough.
So, now you know the next steps in our IVF process. And yes, it is a process. Sadly, our latest miscarriage will set us back another six months or so in our efforts to start our family. It's very disappointing, especially with all I know that's ahead before we can technically try again.
But, we mustn't let that discourage us. Because, in the end, it will all be worth it. So, I will just have to keep my eye on the prize so-to-speak and the light at the end of this very dark tunnel. But as one of my very sweet readers recently reminded me, it has to get dark before we can see the stars.