This is more of a thesis, not a blog post. I have had so many people – even people I have never met – seek me out for help on this topic. I am an open book about my experiences with infertility, precisely so it can help others. However, I was hesistant to share THIS much. It’s a doozy. Caution: medical grossness ahead.

So What is IVF Really Like?

It sucks. It’s weird. It’s expensive. It’s embarrassing. It hurts. And it sucks.

IVF stands for In Vitro Fertilization, which means “fertilization in glass”. The eggs are actually removed from my body (while I am under anesthesia, thank goodness) during a surgery called “egg retrieval”, then put in a Petri dish with the sperm. After they grow for 3-5 days, they are put back into my body in another procedure, called embryo transfer (while I am only under Valium, unfortunately).

The weirdest part is leaving my little fertilized eggs in Maryland while we just…drive home. Bye, little eggs! We will back for you in 3-5 days! No problem. This is not weird, right?
Anyway, since we did 13 drug cycles before beginning IVF, we had already dealt with the emotions that come with infertility. The rage, the unfairness, the questioning – it’s all old news. I was comforting another woman going through infertility the other day, and I realized that I had actually made progress. I was giving her advice! I truly empathized with everything she was feeling, but some of it was actually over for me. I hadn’t realized that I had progressed.

In our previous 13 drug cycles, I either took pills (Clomid) or did injections (Follistim), combined with IUI (Intra-uterine Insemination, or, basically, a turkey-baster method). We never got to the point of actually taking the eggs out of my body (IVF). We experienced one confirmed pregnancy, which we lost at ten weeks after having seen a heartbeat and everything. I had to have a D&C for that, which was as traumatic as losing the baby in the first place. They did genetic karotyping afterward on the fetus to determine why we lost it, and it was determined to be a common chromosomal abnormality. Just “bad luck”, according to my dear doctor. They also determined that “it” was a girl.

We had several other suspected pregnancies, which ended in monstrously painful periods that left me locked in a crouched position and sobbing (when it was possible to sob between contractions, I guess). We also basically told my doctor that I had endometriosis, and he did laparoscopic surgery to see if I was right. Indeed, I had Stage 2 endometriosis, which they burned away with lasers. Yes, lasers! Congrats, you were right, and you get lasers as a prize. The doctor told me to expect to be back to my old self in 3 days. Ummm, it took 4 days before I could even sit up, and 10 days until I could drive my stiff clutch again. Never never believe them about how many days you need to recover.

During these past 6 years of “trying” (ugh, how we Infertile Myrtles detest that word!), and our many many attempts at intervening-with-modern-medicine, we verrrrry slowly stopped wondering “why us?” We started just dealing with the “new normal” by always planning and plotting what we would do next. Infertility is a loss of control, and the only way to mentally deal with it is to regain control… either by jabbing yourself with needles, deciding to watch reality TV on E! until your eyes bleed, or by filling out adoption paperwork. When I finally gained a testimony of adoption, it was because I wanted to be a mother more than I wanted to be pregnant. Some women take a long time to tip that scale. I sure did. But once I was tipped, I wasn’t looking back. I am such an advocate of adoption that I now serve in a public capacity to promote adoption.

Our adoption story is too big and too wonderful to be included here in my epic epistle of infertility. We can call this bracket and ellipses my adoption story of our son R: […..]

Once our son turned a year old, it was time to start thinking about how to get Baby #2 to our family. We had many “woe is me” moments about how unfair it was that we have to pay big bucks to get a baby into our family. But you know what? My husband worked his butt off for, and has been blessed with, an excellent and stable career that allows us to even have conversations about adoption and IVF. We are very fortunate. I once heard someone say that if we all took our problems and put them into a pile, and then were allowed to choose a new problem, we would all just take our own problems back.

We had reached the end of the road with all other intervening-with-modern-medicine options, and we had three different doctors tells us that sooner was better than later for IVF. (By the way, it feels like a kick in the gut to hear a doctor nonchalantly say, “Five years, huh? Well, it would have happened by now if it were gonna happen.”) My endometriosis, combined with my advanced egg age of 31, was not appealing to potential embryos. We had saved and saved and saved for IVF, all the while managing to pay for the adoption and a (small) down payment on a new house. I had quit teaching years before, but I had dog-walked my way to the adoption. The adoption tax credit that our government gave back to us, combined with our savings, allowed us a 3-try IVF plan. (By the way, again, can I just shout from the rooftops about that adoption tax credit?! If more people knew about it, more people might adopt!) Once we had decided to go for it, and had the money in place, we still had to get our paperwork together. Since we had moved, we were starting over with a new doctor, or, to be more precise, with the first and largest fertility clinic in the country. Their motto is “Where We Have the Best Pregnancy Rates But You Are Just a Number”. Anyway, let’s just say that these brackets and ellipses serve as the paperwork hell that included doctor wrestling, injection classes, repeats of many painful tests, lots of babysitters for R, and ridiculous amounts of faxing: […..]

So, it was time to do IVF Round 1. I saw some sort of chart that depicts a woman’s state of mind during IVF, and it was a little scary. The line goes up as she gets started (ah, the control you feel when you wield that needle! I will “shots” myself to a baby! I am in control!), then goes down as the side effects take over (Crazy Woman!), then go up as your surgery happens (Finally, Some Progress!), then goes down when you see how few eggs fertilize (Dismay!), then goes up as they implant some back in (Hope!), then goes down when you get your pregnancy test back (Negative. World Goes Black. You Just Wasted Ten Thousand Dollars.).

So, we were prepared. We had been through so many procedures together, and we had become old pros at injections and getting bad news, and I had seen the dang graph about my emotions. I was prepared. We had been waiting years for the Big Daddy IVF. Bring it on!

They start you easy enough: just birth control pills for 3 weeks. Isn’t that ironic?! Irony is something with which we Infertile Myrtles are familiar. The doctor wants to completely control your cycle, so after being infertile for 6 years, we were once again popping those dang pills. I felt so detached from my body while I was on birth control pills. I missed the familiar ups and downs of a normal hormonal body. I felt like a robot – with no crying at commercials anymore, but also no interest in my husband anymore.

During this time, it’s time to go to the pharmacy to see what injectable meds they have in stock, don’t have in stock, or will never have in stock. Then it’s time to work with specialty fertility pharmacies that will get you the latter. After countless phone calls/trips/emails/price checking among my local pharmacy, two specialty pharmacies, and my assigned nurse, I finally had what I needed….at the lovely discount price of never-you-mind. It was so much medication that they gave it to me in two shopping bags- with handles! Picture yourself walking out of the pharmacy with that! Also, could you ever picture yourself smiling with relief when the cashier tells you that one week of one kind of medication would be $1000? Well, I did. I was so happy because they had previously quoted me $2000 for a different brand of that same medication. The $1000 version involved two injections per day, but the $2000 version involved one injection per day. We decided the extra injection each day was worth saving the daily $100.

After three weeks of pills, it is time to stop the pills. For some women, this may not be a big deal. For me, estrogen withdrawal (also known as a period) causes a 4-day migraine. In case you’re not familiar, this is the kind of headache that makes me not want to have children and pass down my bad genes. I vomit, I feel seasick, I sometimes can’t see out of my right eye, I can’t eat, I can’t move my head, and lights feel like ice picks in my eyes. Sometimes it’s so bad that I could picture actually stabbing my head with said ice pick to get some relief. I don’t actually sleep for real, because the pain is cutting through my sleep. I look gray and talking is difficult. I grind my teeth and can’t move my neck from bracing myself against the pain. Now, please remember that I do have a two-year-old to take care of all day while my husband earns the money for these pills and shots that make me feel this sick. I am technically allowed to take my migraine medicine at this point in my cycle, but the headache is so bad that it barely takes the edge off – but at least enough to make me eat.

In the meantime, it’s time to go to the doctor for a “Lupron Evaluation”, which is just bloodwork and a vaginal ultrasound to test my readiness for the next step. So, before the migraine even subsides, the doctor puts me on Lupron injections once or twice a day. Thankfully, I get to use the small subcutaneous insulin needles, so it doesn’t hurt much. Lupron is a liquid medication that shuts ovaries down. The doctor wants them totally at rest so she can build them back up again her way. In IVF, a woman needs to make as many eggs as is safely possible, but they all need to be the same size. Guess what a side effect of Lupron is? More migraines.

For the first few days, I think, “Oh, this is easy. No problem. I feel fine and normal.” And then, BAM! Here is a little list of the Lupron side effects for me:
• Menopause: Hot flashes; night sweats that make it seem like I’ve peed the bed
• Insomnia : So I can stay up and make lists
• Anger/rage: Even though I am a person who never really gets mad
• “Nerve aggravation”: This is a weird one. My husband thought I was just having the heebie-jeebies from all the shots, but I kept telling him that my skin was crawling all the time. I finally noticed this excellent phrase listed in the fine print.
• Feeling stupid: My ability to concentrate decreases as each day passes. By the end, I can’t even understand basic sitcoms that I watch every week.

After a few days of that, it’s time to start the Big Daddy Drugs. Starting them is actually a relief because it makes my estrogen climb again, which relieves the migraines. Plus, starting more injections means More Control! My Big Daddy Drugs protocol includes Bravelle and Menopur injections. These are powdered medications that come in old-fashioned glass vials. We mix several vials of each with a vial of sterile water and meticulously get every drop of them into a needle. This needle is much bigger than the insulin needles, but it is still a subcutaneous injection, which means just under the skin, and not all the way into the muscle (i.e., less painful). However, unlike the Lupron, this is a large amount of fluid being injected, and it BURNS under the skin. It continues to burn for almost an hour. Sometimes my thigh gets lumpy, and sometimes I limp. As a side note, women are encouraged to inject in the abdomen, but I find this ridiculously uncomfortable. I think my BMI is too low for that, so we inject in my fattiest part. Yep, my thigh. The purpose of these medications is to stimulate the ovaries to release more than one egg at a time, and also to mature more than one egg at a time. We got so good at it, that Mr. Okayest didn’t even have to wake me up for the morning injections. He just mixed the vials, threw my covers back, jabbed me, kissed me, and left for work. What a man.

Soon enough, the side effects waltz on in. For me, they include:
• Swollen ovaries
• Swollen abdomen: pants not fitting, pants hurting, belly distended more each day
• Wearing jammies all day
• General stiffness and soreness: Perhaps as a result of not being able to exercise
• Decreased urination: The ovaries and follicles are filling with fluid. The doctor told me to double my water intake, but, no matter how much I drink, I am still peeing less than normal.
• Moodiness: “We” had to instill a no-chewing-ice-policy while-on-the-couch. That about sums that up.
• Waddling: By the end, I have to hold my belly up whenever I laugh, go up stairs, or get up from the couch. I know I walk funny too.
• Not being able to lift my 30-pound toddler: At the doctor’s request, there is no more lifting after a certain point because it can cause “ovarian torsion”, which can cause the loss of an ovary. The doctor did not specify how exactly I was to get R into the crib, highchair, or carseat without losing an ovary.
• Dumber by the minute, can’t focus eyes toward the end

These medications are dangerous. The doctor needs to see me every other day, and then, every day, for bloodwork and vaginal ultrasounds. The doctor did not specify how exactly I was to get to the office every morning without R in tow. Did I mention that the clinic has a no-children-in-the-office policy? I can certainly understand why – I am not that far removed from crying when I saw pregnant women, or posters of babies in Wal-mart. However, I feel like R is a shining example of how adoption can bless the lives of women. I want to parade him around and say, “Get out of this fertility clinic and run straight to the nearest adoption agency!”

Anyhow, we got extremely creative with childcare for R during the two weeks or so that I had to go to the doctor every day. Mr. Okayest went in late to work, various relatives watched him, various church members watched him. Sometimes I even snuck him in with me…. He was silent as a mouse in there. Sometimes he saw my nether-regions, which might be why he was silent.

Every day, when you go in for your “monitoring” (i.e., bloodwork and vaginal ultrasound), you hope and pray that the doctor will tell you to stop the shots and start prepping for surgery. However, my body was slow as a tortoise. Not to veer from its usual path, it took forever. Much like late puberty (14) and slow fertility (6 years), my body took great pride in stretching two weeks of shots into three. “Sorry, dear, a couple more days.” This comes with a horrendous side effect: having to go back to the pharmacy- or worse, overnight special-order the drugs. Often, my slow egg-building would result in several hundred more dollars per day.

Finally, FINALLY, the day comes when the doctor says, “Ok, you’re ready!” She has decided that your eggs are exactly big enough- and not too big- to be released. This is when the shots cease – all but one- and you schedule your egg-retrieval surgery. This is the day you skip out of the office with a thick packet of instructions of how to inject THE SHOT. THE SHOT, a.k.a the “trigger shot” is the HCG injection, an intra-muscular injection (i.e., the most painful) that triggers your body to release all those eggs at the same time. They give you an EXACT time to inject it based on when your surgery will be. If the hospital schedules your surgery for 3 PM on a Friday, then you must wake up at 3AM, 36 hours before, to inject that sucker. They only allow a deviation of 5 minutes. If you miss it, you miss your surgery, your eggs die, and then you have to start all over.

Our surgery was scheduled for a Friday night at 6:45 PM. This meant that I had to trigger at 6:45 AM on Thursday morning. These injections are not designed to be self-inflicted. In fact, you are required to have someone else do it. The injection site is a precise spot on your butt/hip- don’t worry, because there’s a diagram for that in your giant packet. A diagram of someone’s butt, with lines drawn all over it, dividing it into quadrants based on your butt crack placement and other hilarious things. Again, we are old pros at this injection, too, but it’s never easy. I numb the spot with ice and lay flat (weight on that leg will make you hurt for days- don’t tense that muscle!), and then Mr. Okayest makes a few well-timed jokes about me being Mr. Burns from the Simpsons (you know, the episode where he gets a shot and it goes all the way through his arm and out the other side…). The needle is 1.5 inches long, and it’s supposed to go in to the hilt. “Hold it like a dart!” (Thankfully, because my BMI is low, I got special permission this time to use a smaller 1” needle.) Since my husband usually leaves the house very early, he has to go in late to work just to inject me first.

Once the trigger shot is done, you bite your nails and wait. Friday came and I wasn’t allowed to eat, since it will be a surgery under anesthesia. My mom came over to help with R since I was pretty woozy. She also planned to stay here with him while we went to the hospital.

Going to the hospital was a relief – we are seeing the finish line! The date is January 27, 2012. The hospital is in another state, which is quite a long hike, especially on a Friday evening. They have me get undressed, into the paper gown, and lay in a waiting cubicle. There are 3 cubicles in a row, and each is only curtained off. I can see them wheel Cubicle Lady #1 into the operating room. Half an hour later, they wheel her back out, moaning and crying and groaning. Repeat process with Cubicle Lady #2. I am starting to sweat. It’s a nightmare to listen to women groaning and crying as they come out of the same anesthesia and surgery that you are about to endure.

Then they lead Mr. Okayest away for his “sample”. The poor husbands do not get any attention or love during this process. It’s very clinical and weird, but his portion is just as important as mine! I cry to see him leave me. They have had me hooked to IVs this whole time, which makes the waiting more gross, and so they walk me and my IV into the operating room. They have me sit on the edge of the table and repeat my name and birthdate again. I see my stats written on a white board – my number of eggs, my diagnoses, etc. The room is freezing. No one will make eye contact with me. The IV goes cold and they lay me back and that’s all I remember.

My ears always wake up before my eyes. I can hear the nurse saying my name. I can hear my husband’s sweet voice. I can feel him stroking my head. Then the peace disappears and my bottom feels like it’s on fire. My belly hurts so badly and the pressure on my bottom is horrendous. I am groaning and I can’t tell them. They want me to open my eyes but I just can’t. I try to roll onto my side and he understands what I need but the nurses don’t. We wait it off. I think they give me lots more pain meds. (As a side note, he later tells me that the anesthesia gives me the absolute weirdest bad breath. Great, I didn’t think it was possible to make this baby-making even more un-sexy.)

Much much later, my personal doctor explains that the endometriosis makes this process far more painful. The surgery is more intense. Plus, they had to work around my cysts and the surgeon was far more aggressive than usual, trying to get the eggs that were behind the cysts. She also says that skinny women feel the surgery worse because they get beat up a little more.

The report is that they got 11 eggs. Eleven beautiful mature eggs. They are fertilizing them, and we just have to limp home and wait. Fertilizing them, is of course, more expensive and difficult for us than for other people. Because of certain issues, we have to use ICSI, which is a $2000 flat-fee procedure where they choose 1 good sperm to inject into each egg by hand (instead of just putting the swimmers in a Petri dish with the egg like usual). Well, maybe not by “hand”. Probably with the smallest glass needle ever invented.

I get a Wendy’s Frosty on the way home as a reward.

At home, it’s Vicodin around the clock and waiting for our “fertilization report” that will come the next day. EIGHT! Eight eggs have fertilized. This is amazing news, because last time only 1 fertilized. We can’t believe it. Our emotions soar. I don’t feel so beat up anymore.

Every day we get a fertilization report from the doctor. It’s heart-attack-inducing every time the phone rings. May I just say how hard it is to wrap my head around the idea of these embryos? I mean, they are alive, but they are not babies. They are mine, but they are not in my body. I made them, but they are in a different state. My DNA has finally combined with my true love’s DNA. I begin to repeat a mantra every time I worry about them dying: “They are embryos. They are not babies.” But, every day they look very good and the doctor gives us great hope. They make it to Day 3, which is excellent. Since we have so many, and so many “Grade A” embryos (no longer just eggs- they are embryos now!), the doctor recommends that we push onward to Day 5. This is the Holy Grail of IVF. If your embryos reach Day 5, they have moved on to “blastocyst stage” of development, which is perfect and wonderful and amazing, but I don’t know why. Also, if you have any leftovers on Day 5, you can freeze them for later! This is also part of the Holy Grail of IVF. If you freeze embryos, then the next time you do IVF, you don’t need to go through the agony of injections and surgery before implanting them!

Day 5 arrives. February 1, 2012. First, we went for an acupuncture session at the urging of my mother-in-law. We had also had one before the retrieval. It has been shown to help with IVF statistics, but I hate it! We left R with my mother-in-law for this session, and also for the remainder of our day. I’m allowed to eat, since the egg transfer is done without anesthesia (grrrrr), so Mr. Okayest and I stop by Roy Rogers for lunch. (Yes, probably the last remaining Roy Rogers in America.) As soon as our meal is over, we receive THE CALL from our doctor. This is THE CALL – the last one- where she tells you exactly how your eggs look 1 hour before your transfer, and how many you should transfer back in. So it is here, standing outside the Roy Rogers, during THE CALL, where my doctor tells me that our embryos “look slow.” (Are you calling my kids handicapped!?) Pay attention, because this is a life-changing conversation.

As a back-story, Mr. Okayest and I had always agreed to follow the advice of the doctor regarding how many eggs to transfer. In 2012, the general consensus among doctors is that you should transfer one embryo if you are under 35, and 2 embryos if you are over 35. Our doctor had always wanted us to transfer one embryo because of our age, and also because our embryos were “Grade A”. Contrary to popular opinion, a fertility doctor’s goal is to impregnate you with ONE baby. Multiples are considered a big no-no in 2012.

So, to get back to THE CALL, our eight embryos had suddenly slowed their growth significantly on the Holy Grail of Day 5. Our doctor said there were two clear “front-runners” of equal growth, but they were looking slower than she would like. Furthermore, the other six didn’t look good. She believed that we would be highly unlikely to get any to freeze. This fact was a great sorrow to us both. More on that later… Most important is this: She said, “Based on today’s fertilization report, I recommend that you transfer two embryos. As long as you are aware of the 40% chance of twins and are comfortable with that.” We looked at each other and shrugged. Okay.

When we got to the hospital for our egg transfer, I was allowed to take my one piddly Valium, apparently because I am a wimp. The truth is, anytime they mess with my cervix, it’s excruciating, and I am still very bruised and banged up from the surgery five days earlier. The procedure takes place in a small room with low lights. There is a large screen showing MY OWN EMBRYOS in the lab next door. They open the door to the lab and I get a glimpse into the clean room where my babies were conceived. Not a bed, not a bedroom, not in my husband’s arms…. But in a clean room. Oh how I have a love-hate relationship with modern medicine at this moment. My legs are in stirrups, my bladder is ridiculously full to the right level, my hand is in his, and I am asked to sign a waiver about the number of embryos they are putting in. I look at Mr. Okayest one more time, and sign for my two babies. We never thought it could work, so why not put in the two? Then my eyes are glued to the screen. The lab door opens again and they bring in a catheter loaded with my two babies. They are so careful, it’s as if they are handling a live bomb. It’s over in a couple quick and painful minutes. We actually watch on the screen, live, as the catheter goes through the cervix and the two tiny dots go into my uterus. They just float on in. Then the doctor tells me to lie there on my back for five more minutes before I can relieve my bladder, tells me good luck, and leaves. We just stare at each other. The babies are back in my body where they belong. I am not pregnant because they haven’t implanted, but I am not not pregnant either.

We walk slowly and gently out of the building, with our odd instruction sheet. They say that you can’t sneeze, cough, or pee the embryos out, but no one says exactly WHY not. I mean, I saw them just floating there. They are microscopically tiny. And they are just lying there against the side of my uterine walls. What if he drives too vigorously on the way home?!

Now, after months of hormones, and daily doctor appointments, they just leave you alone. Yes, I have detailed instructions about the hormones I have to take 5 times a day, but that’s it. It’s just two weeks of waiting. I go home to my 24 hours of bedrest. Bedrest, by the way, is totally awesome for the first 3 hours, and then you just get a headache and get the fidgets.

The next day, we get our last fertilization report. The remaining six embryos have not made it to blastocyst stage, so they are gone. Just like that. Despite how many times I’ve repeated my mantra, how can I possibly not be sad? They were alive, and now they’re not. I can’t wrap my head around it. Even in our conservative church, we don’t necessarily believe that the soul enters at the time of conception. The prophets have hinted that the soul has not entered that early. So, with no soul, and no implantation, it’s not a baby. I know this. But they were alive, and now they’re not. The only thing that makes it better is when Mr. Okayest says that we just have to think of them as a vessel. They were a vessel, and it didn’t work. It’s time to focus on the two in my body now.

The two week wait is known as “2WW” in the infertility world. It’s the worst of any fertility cycle, because there is not much to do at this phase. The feeling of control is at an all-time low. I am taking estrogen pills twice a days and progesterone inserts (yes, inserts!) three times a day. I am not pregnant, because they haven’t yet implanted, but I am not not pregnant either. I have to remind myself of this every day. The hormones are called “implantation support” because they try to trick your body into implanting. During an IVF cycle, your brain does not make the right hormones, because you have tricked it into being pregnant. Therefore, you need to take them throughout the day and night to keep your hormone levels high. Inserts are totally messy and disgusting, by the way, and I don’t want to write about that or think about that ever again! Anyway, as Tom Petty says, “The waiting is the hardest part.” I tried hard to take things day-by-day and just not need headache medicine. We were expected to wait until Valentine’s Day for our in-office blood draw to determine if we were pregnant- that is, if the embryos had implanted. It would either be the best or the worst Valentine’s Day ever.

The HCG injection stays in your body for a certain amount of time. The half-life of it is based on your dosage and your size, but it takes about ten days for it to disappear from your system. Therefore, if you were to take a home pregnancy test during this time, you would get a false positive, which is way worse than a real negative. I’m an old pro, of course, at calculating when it is out of my body. During our first IVF, we were very obedient and did not take a home pregnancy test before our official blood test at the doctor’s office. That ended badly, because we got the call about our negative result in Target! Yes, Target! “Sorry to inform you that you have just wasted ten grand and your not-baby has died.” This time we wanted more control and more privacy, so together we decided to take the home pregnancy test at the right time- that is, after the HCG was out of my body and before the blood test at the doctor’s office. This day came on February 11th.

Before I go any further, let me explain that one more way infertility procedures are cruel: The hormones give you pregnancy symptoms. Therefore, nothing that you feel or sense means anything. For a woman who is pretty in-tune with her body, this is absolutely maddening. Yes, I feel pregnant. No, that doesn’t mean squat. What matters more in this situation is my spiritual life. I had made a pact with myself to read my scriptures every day during my cycle, and I kept that promise. If I were honest with myself, I knew in my soul, my heart of hearts, that the first IVF wasn’t going to work. This time, however, when I was sometimes able to part the clouds of anxiety and fear, I could feel the sunshine and calm assurance that this time it could work. Those moments were brief, and it took superhuman strength to break through the fear and PTSD of the last six years, but they were there for the taking.

So, on February 11th, 2012, in the privacy of our own bathroom, we got to experience something intimate together: taking the pregnancy test. We left the pee stick on the half-wall by the toilet, and then went back in together. TWO LINES! We were pregnant. I started shaking uncontrollably. The first thing I said, as we hugged, was “Will I still be pregnant tomorrow?!” Our joy was so tempered by the bad experiences we had had over the last 6 years. It was not the jumping up-and-down, screaming with excitement of the other pregnancy. We were too battle-weary and too knowledgeable about what could happen.

I learned a valuable lesson that day: The positive pregnancy test is only the start of the worry.

On Valentine’s Day, 2012, I took the blood test at the doctor’s office and they called me a few hours later to congratulate me on the positive news. My HCG levels were sky-high. I knew from research and from previous experience that they were extremely high for my particular day of pregnancy…. And I also knew what that meant: possibility of multiples. I didn’t know if I was happy or sad. Really, I didn’t know anything at that point, other than fear.

At this point, we were subjected to a second “two week wait”, as they don’t perform your first ultrasound at the fertility clinic until you are six weeks along. (A positive pregnancy test happens at 4 weeks, even though that is only 2 weeks after conception.) This 2ww just might have been more challenging than the first. I knew that a “clinical pregnancy” is possible, as are a hundred other things that would result in no baby. During this 2ww, we did blood tests every few days to determine if my HCG levels were rising/ doubling at the appropriate rate. This testing helps determine if it will be a viable pregnancy. My numbers were rising ridiculously quickly, which again indicated a possibility of multiples. The doctor did not hint at this, but I knew.

At the first ultrasound, Mr. Okayest was there with me. We knew we wanted to be together whether it was good news or bad. We would need each other. R sat silently on his lap. I searched the doctor’s face as she manipulated the ultrasound, and then she looked up and said, “What would you say if I told you it was twins?”