To My Readers Who Are Struggling with Infertility

I don’t just sympathize – I truly empathize with you. I feel your pain. I walked in your shoes. Whatever you are going through or feeling right now, I probably experienced it:

…..Miscarriages, adoption paperwork, IUI, IVF, Clomid, Follistim, Bravelle, Lupron, progesterone suppositories, 1.5” needles, glass vials, cysts, insensitive comments from strangers or non-strangers, meeting with social workers to prove that my house was suitable for children, getting fingerprinted at the police station like a criminal to prove that I was suitable for children…

…Spending $1500 out of pocket at the pharmacy for one month’s medications, enduring laparoscopic surgery for endometriosis, waking up in agony after egg retrieval surgeries during IVF cycles, wasting thousands of dollars when my period started and that cycle didn’t work, breaking down in tears at family parties, screaming in pain during not one but two HSG procedures (barbaric), blood tests every other day, vaginal ultrasounds sometimes EVERY day…

…Genetic testing for me and for my lost fetus, trying to change everything from the lotions I used (parabens!) to the temperature of the water I drank (the ayurvedic doctor said only hot water!), crying  in Wal-mart because I saw a poster of a baby, wanting to run over the “stork parking” signs in parking lots, hating my body because it couldn’t do something that teenagers/ out-of-wedlock couples/ drug addicts can do by accident… (And I’m worrying about the kind of Teflon on my pots?!)

Did I forget anything?

The whole thing was infuriating, and it made me feel powerless over my life and my body and my future. I wanted more than one child, and the clock was ticking.  I even listened to my doctor say, “Well, if it hasn’t happened in five years, it’s probably not going to.”

So, yeah, I get it.

But, I am here to tell you something. I not only survived infertility, I kicked its butt! I never want to dull the pain of what happened to me, because I want to support those who are coming down the infertility path behind me. I want to be a small source of hope for you. Everyone is probably telling you stories (like “My friend so-and-so…”), but I don’t want to be that person. I just want you to know that I felt how you felt at one point, and now it’s over. It’s over. And it will be over for you someday too. I know it.

I experienced all of those things, and more. After 13 rounds of fertility drugs, 2 rounds of IVF, miscarriage, and adoption, I now have three beautiful boys. Although we haven’t used birth control in nearly a decade, none of those children were conceived in my own body. One of them came to us through adoption, and two of them came to us (simultaneously) through IVF. All of them have souls that belong in this family.

While the acute pain of infertility has ended, I refuse to forget about it. I think I know what you are feeling. And that feeling won’t last forever.

"Not room enough to receive it."

“Not room enough to receive it.”

I reflect on my infertile time each day at naptime, when I settle my three big baby boys on my lap for their milk. Combined, they weigh almost as much as I do. They take up all the space on my big rocking armchair. My lap literally cannot hold them all. I get weepy and emotional each day during this rare few moments. It’s the only time of day I get to cuddle them all. I think of a scripture each day during this time: “I will…open you the windows of heaven, and pour you out a blessing, that there shall not be room enough to receive it.” (Malachi 3:10) That scripture runs through my mind as they try to sit there on my lap because there is literally “not room enough to receive” them all. My arms are full. My lap is full. The windows of heaven opened, and, I must say, we worked really really hard to open them.

We may have never had this lap full/chair full/ house full of children if we had not prayed, or had miscarriages, or done the adoption paperwork, or decided to do IVF twice. I don’t know. All I know is that, in my case, I had to wait. I had to wait and learn and be patient and work really hard. But, most of all, I had to break. I didn’t bend when I was supposed to bend. I was not a strong branch. Eventually, instead of bending, I broke. But after that, I accepted my life/journey/path/challenge (ugh, each of those word choices is equally as cheesy as the next). I reached a state of peacefulness and true patience somewhere around the eight-year mark – and that’s when my children started arriving.

There was not room enough to receive them.

***

[And, yes, I do know that the verse from Malachi is about tithing, not IVF.]

How to Avoid Being a Jerk to Your Infertile Friend

infertilityThis topic has probably been beaten to death, but I’m going to add my voice to the commotion anyway. We were married for eight years before we adopted our oldest son, so we’ve heard a few things along the way. We would like more children, but we’re not sure we can conceive again. I still align myself with the Infertile Myrtles, despite the fact that I have three children in diapers (none of whom were conceived in my own body).

What Not to Say:

“Just relax.” Ummm, Do you think that a physical problem can be remedied with a long bath and a vacation? If it could, don’t you think I would have figured that out by now? I saw a t-shirt that said, “Guess what? Relaxing does not make a baby!” Also, permit me to say that relaxing while enduring daily doctor appointments, shots, and weird comments is impossible.

“Maybe you should ‘just’ adopt.” This one was my own personal most-hated phrase. First of all, adoption is a very personal decision that can only be made between the couple involved. There are many reasons that adoption may or may not be appropriate for a family. Second of all, there is no “just” involved in adoption. Adoption is called a “paper pregnancy” because the paperwork alone can take as long or longer than gestation. And you are “just” bringing a human being into your lives permanently for your next 60 to 80 years. Adoption is hard work and not for the weak.

“My friend so-and-so …”  Do not begin any sentence with this statement. Just don’t. (Anyone who has had cancer can maybe relate.)

“It was God’s will.” Okay, I am as religious as anybody. Maybe I even believe it was God’s will that any of this stuff has happened to me. (I do believe that we endured miscarriages so that our son R could come to our family through adoption. How else would he have made it our family?) But that does not give you the right to say it.

“Surprise, we’re pregnant!” It’s the “surprise” part of this sentence that is a big no-no.  If you are about to announce a pregnancy, please take pity on your infertile friends or family members by telling them personally, ahead of time, so they are not blindsided at the family Christmas party. Let them deal with their pain and sorrow in private, so they can then put on their Big Boy Panties and deal with it before the party. Sometimes, even a kindly worded email can be enough if you want to spare the person the experience of trying not to sob on the phone.

“You can always do IVF.” Um, no, you can’t always do IVF. It’s crazy expensive, especially in states where it is not covered by insurance. It is crazy hard, too. Daily injections and daily vaginal ultrasounds and daily hormone-induced breakdowns are just not for everyone. It’s also not appropriate for all medical conditions. And, how do you know that she didn’t already try it? It only works about 30% of the time… so maybe she was one of the 70% who spend ten grand for nothing and didn’t want to tell you about it.

“You should be glad you don’t have a baby. It’s so much work!” Just don’t ever say that. It does not help. I wanted to be immersed in the poop and the crying and the sleepless nights. Besides, I was not trying to have a baby; I was trying to begin a human being. I am trying to bring a soul to this family and to this world. Who cares about how much work that is? That statement is some kind of middle-school version of psychology.

“Why the rush? You have plenty of time!” The decision of when to have children is a personal one between a husband and wife, and maybe God. For me, it was a spiritual feeling that their souls were missing from our home and were trying to get here. Are you gonna argue that with me? Plus, I didn’t want just one baby. If I did, maybe I could afford to wait until I was 45 (just kidding). However, making multiple babies multiple times might mean starting a little earlier than that.

“Is it your husband’s fault?” Short answer: none of your business. Long answer: most husbands are feeling already emasculated about this whole situation, and most wives are rightfully reticent to throw their husband under the bus about infertility. I don’t think any husbands welcome anyone talking about their sperm. It’s hard enough to listen to the doctor do that. Plus, I think a good marital team adopts a no-fault system, like California divorces. Your problem is my problem and that’s all there is to it.

Okay, so now your lips are zipped and you’re too scared to make a peep. Now what? Here are some things that others said or did that actually helped me.

What You SHOULD Say/Do:

  • Yes, do invite your infertile friend to that baby shower. No, don’t expect her to come to it, but don’t leave her out either. Let her make the decision. I never ever went to baby showers, but I appreciated being included. Some of my stronger infertile friends continue to go to showers.
  • Yes, do tell your infertile friend that you are pregnant. As I mentioned above, telling her in private before everyone else finds out is the best and kindest thing. You can even tell her by email or phone. Just don’t let her be ambushed, where she would have no choice but to hide in the bathroom to avoid a public meltdown at the big family function.
  • Ask her how she is doing, and just listen. A well-timed, “Man, that really sucks” is all you need to say. Really. We don’t need advice- we need friends!
  • Check up on her often. Infertility is so lonely. Messages, cards, emails, phone calls, texts all count. It doesn’t matter how you do it, but it matters that she doesn’t feel forgotten. Just say “I was thinking about you today.” Or just say “hi”!
  • Don’t talk about babies. If you have kids already, tone it down and wait for her to ask about them. Visiting with her is not a playdate.
  • Face that elephant in the room: Although I suggest avoiding talking about your babies, this is not a license to avoid talking about her situation. You can even say, “I don’t know what to say, but I want you to know that I am your friend.” She may or may not want to talk about the whole thing, but give her the opportunity, and then follow her lead. Personally, I was an open book about it all, because that was my therapy. I had a good friend who never talked about it, and that was what was best for her.
  • If you have kids, maybe don’t bring them around. However, some women prefer some good ole’ fashioned “baby therapy” and might appreciate holding your little one. You will have to be  a good and attentive friend to figure this one out!

With possibly one in six couples facing infertility at some point in their lives- even possibly after having a child- the chances are great that you already know someone who needs your support. Good luck!

When Twins Are Both the Problem and the Solution

Some things are actually easier with twins.

IMG_6674(Well, making dinner isn’t. Mercy. And don’t look at my counters.)

When I found out I was carrying twins, mostly I only felt grief and fear. I grieved for some lost things. It might sound crazy to grieve about twin pregnancy after doing fertility treatments for six years, but I wasn’t alone. I found entire chapters devoted to grief in my twin pregnancy books. Parents of multiples actually go through the stages of grief, often in order. We have to deal with letting go of all of the preconceived notions we had. In my case, I grieved about:

1) Future adopted children that I can’t have: We would never be able to adopt again through our church agency because LDS Family Services only approves couples who have no more than two children.

2) My oldest son: While I can’t predict how he will feel, I never intended for him to be the only adopted child in our family. I didn’t want him to be the only one who didn’t biologically resemble us.

3) The ideal pregnancy I wouldn’t have: Having two babies in there at once is almost less…. intimate. At first, I couldn’t tell who was who; I couldn’t bond one-on-one. I couldn’t really even explain it to myself, but I felt kind of outnumbered. It made it harder to bond, feel cozy together, and to imagine the future. In addition, my pregnancy was a living hell that I would not wish on anyone. I won’t go into too many details here, but I can throw out a few hellish keywords: morning sickness until 17 weeks; contractions starting at 18 weeks; choking and almost fainting while lying down by 20 weeks; being unable to walk up stairs without crying by 24 weeks; outgrowing maternity clothes and going on bedrest by six months; heart enlargement, anemia, narcotics, and an inability to sleep, shower, or care for my bodily needs in the last month. Maybe I should write a blog post about that. Let me get on that.

4) The ideal birth that I wouldn’t have: I had to give up my ideas about birth, because I knew it just wouldn’t go the way I wanted or expected. I couldn’t choose which hospital, or which birthplan, or any of that stuff. But maybe that’s a relief. I saved a lot of time not doing any research!

Ten years ago, I was so much more of a know-it-all, or a “breastfeeding Nazi”, or a no-gray-area kind of person. I think having an adopted child really loosened me up. I couldn’t breastfeed, so obviously I had to let that go. (See Tina Fey’s thoughts on silencing the “Teat Nazis” with “Adoptive Mommies” *) We didn’t have time to choose the most perfectly-rated carseat or decorate a cute nursery. We just picked the lightest-weight carseat and threw our kid in the guest room.

And, then, with the twins, I felt a similar feeling. We may have had the luxury of time this time around, but it was not a normal pregnancy. The normal rules didn’t apply. I couldn’t exercise, I had to gain more weight, my body contracted and acted like it was two months ahead of where it was, and I had to give up any ideas about choice that other moms have about their pregnancy or birth. In a way, it was kind of relaxing. It actually didn’t make me sad or upset- it made me let go and quit worrying. Too many choices make us crazy. That’s why people like Costco. (When I ask my husband to bring home laundry detergent, there are a couple to choose from, so he always gets it right. I call this my Costco Theory. )

Besides the grief upon finding out I was carrying twins, I had so many fears. I guess I had “Infertility Aftermath”. People who have been through miscarriage or IVF go through a kind of PTSD, even if they do get pregnant. We worry more and can’t enjoy the pregnancy like other people. I had so much anxiety and fear from my last miscarriage that I felt cheated out of enjoying my pregnancy.

Basically, I was scared to lose them and scared to keep them.

Other fears that kept me awake at night included:

1) Taking care of the twins + a toddler alone at night and during the day after Mr. Okayest would go back to work
2) Having to birth one twin vaginally and one through c-section (yes, it happens!)
3) Failing at breastfeeding
4) Succeeding at breastfeeding
5) Not using migraine medication during breastfeeding too
6) Having 3 kids under 3 (shudder)
7) Having 3 kids in diapers – who does that? Honestly? People have a kid, he grows, they potty train him, then they have another. It’s the natural order of things. What the heck did we do?
8) Never being able to go to the store again. At least until R is old enough to walk beside the cart.
9) Buckling 3 kids into carseats
10) That Mr. Okayest and I might be mean to (or at least snippy with) each other for the next two years
11) My body! What lovely things were awaiting me? Saggy boobs, stretch marks, exhaustion, no libido, jelly belly, blah blah blah… ? And the guilt I felt about worrying about those things when Heavenly Father has affirmatively answered my prayers- oh my!
12) You know that moment when your kid is in bed and the toys are picked up and the dishes are done and the husband’s lunch is made, and you can flop down on the couch and watch whatever mind-numbing drivel you want to? Or even read a book? Would that ever happen again? It was my favorite part of the day, no matter how much I love my kids or how long I waited for them.
13) Having the house to myself while my toddler “naps”. I doubted I would ever get three kids to nap at the same time and ever get the house to myself again.
14) Dealing with migraines with three kids under three
15) Hmmm, what euphemism to use for “marital intimacy”….?
16) Bedrest! What if I needed bedrest? It was quite possible with twins! Who would take care of my toddler?
17) Mr. Okayest’s grad school. He planned to keep going, no breaks, even when they were born. How would I handle that? I worried not only about the looooong days when he would be gone from 5AM- 9PM, but also about all the homework and papers that would require me to care for the kids on my own.
18) Cleaning. How would I keep up with keeping the house? I was already struggling at keeping up with 4000 square feet and a toddler. How would I ever find time or energy with 3 kids? (Well, it’s pretty dirty now- who am I kidding?)

Those fears came true. Well, not #2. But most of the others came true. But you know what? Now that the babies are almost one year old, I am realizing that a lot of those fears came true, but only for a short time. It was temporary, and we survived. Actually, I would say we thrived. Yes, I didn’t sleep for months on end, and I wanted to die, but the babies learned to sleep through the night by six months. Yes, I had not a single moment to myself for months, but I eventually trained all three to nap at the same time in the afternoon by seven months. Yes, Mr. Okayest still goes to grad school, and it sucks, but we also have help from my mother-in-law and from a mother’s helper. Yes, I can’t grocery shop with three little ones who need to sit in the cart, but Mr. Okayest has learned how to grocery shop (and even use coupons!). Yes, Mr. Okayest and I snapped at each other more than we ever had, but we knew it was temporary and were welded together by what had happened to us. Yes, my house is filthy, but I clean it a little bit, once in a while.

Now that they are almost one year old, I am pondering all the positive blessings that twins bring. These bonus things were not on my mind during the terrifying months of bedrest and recovery and sleepless nights. But I see them now. Some of them are trivial and some of them are amazing.

1) I never had to refer to my in-utero offspring as “it” before I knew the sex. The pronoun “they” is so much better.
2) We picked one name before the birth (to appease curious family and friends) and announced the other name at the birth (to surprise family and friends).
3) They keep each other company. They are never alone; they are never friendless or bored.
4) They don’t cry at naptime or bedtime, unless one twin is late getting into his crib. They look for each other, sigh, and just go to sleep.
5) They can entertain each other for an hour in their cribs in the morning before I have to get them up. They wake each other up with a Pterodactyl Scream of Joy.
6) They teach each other things. Watching a mirror image of himself learning to eat, sit up, crawl, and stand must really change a baby’s brain chemistry. (The downside of that is the mischief that comes on quicker!) I really hope this will be helpful during potty training.
7) They don’t mind riding in the car. Our oldest son was miserable in the car, but maybe he would have been happier if he always had brothers to look at next to him in the backseat.
8) I never waste baby food, formula, or an avocado. As soon as I open something up or serve it, I am sure it will somehow get finished by someone. (Today, my three babies ate six eggs in one sitting.)
9) I can always buy diapers and wipes in bulk to “save” money.
10) People take pity on us and donate far more clothing, toys, and gear because we have so many little ones (I think).

Forgive me for so much list-making, but I am usually typing while someone cries. I can’t always organize my thoughts.

Anyway, Okayest Mom has learned a thing or two since the terrifying moment when the doctor said, “What would you say if I told you it was twins?” I was sad; I was scared. The books told me to do it one way, but I forged my own path and became an atypical twin mom. I try to focus on the joyful moments, even if I don’t feel giddy all day long. And I am realizing that having a toddler and babies at the same time might be divinely inspired: a toddler wants nothing more than someone to watch him do weird repetitive things all day long, while babies want nothing more than for someone to do weird repetitive things in front of them all day long. I win.

***

*“Teat Nazis” , from Tina Fey’s Bossypants

These are the women who not only brag endlessly about how much their five year old still loves breast milk, but they also grill you about your choices. You can recognize the TNs by their hand-carved daggers:

“Are you breast-feeding? Isn’t it amazing? I really think it’s how I lost the weight so easily. Did you have a vaginal birth? I went natural and I didn’t even tear. Are you back at work already? Do you feel weird about going back to work? I just love my baby so much I can’t imagine going back to work yet. You’re not nursing? She’s only fifteen months; you should try again!”

Now, let me be clear; millions of women around the world nurse their children beautifully for years without giving anybody else a hard time about it. Teat Nazis are a solely western upper-middle-class phenomenon occurring when highly ambitious women experience deprivation from outside modes of achievement. Their highest infestation pockets are in Brooklyn and Hollywood.

If you are confronted by a TN, you have two options. One, when they ask if you’re breast-feeding, you can smile and say, “Yes. It’s amazing.” (You owe it to your baby to lie.) Or you can go for the kill. The only people who can shame the Teat Nazis are the Adoptive Mommies. If you have a friend who has an adopted child, especially one from another country, bring him or her around, because they make the Teat Nazis’ brains short-circuit: “How can I… feel superior… you… bigger sacrifice… can’t judge…” and…they crumple to the ground and disappear.

My Birth Story: How I Almost Lost My Uterus, My Life, and a Twin

I originally began writing this in December 2012, when the twins were two months old. I didn’t finish it until August 2013, when they were ten months old. It took me that long to address some of the hard memories.

*CAUTION: Medical grossness ahead. This post includes the phrase “torrent of blood” somewhere, as well as the word “uterus” eight times. *

preg belly and r photoshopped

(I had many months to go here!)

My Birth Story: How I Almost Lost My Uterus, My Life, and a Twin

It was scary. It’s true that I almost died, and most certainly came close to having a hysterectomy. More than a couple doctors and nurses  said that if I had been at any other hospital, my outcome would not have been good. I had postpartum hemorrhage and uterine atony (i.e., when the uterus can’t contract again after losing so many placentas, babies, and blood). I lost 5 LITERS of blood – enough to kill me. They worked quickly and ended up doing three other procedures after my c-section, that same day, to save me. I only remember one of them- the most pain I’ve ever experienced (and I would like to think I’ve had my fair share of pain)- and then 2 other procedures while sedated (thank goodness). I woke up with my hands tied down and a breathing tube in my throat and I didn’t know if I still had my uterus or if G had even made it. I never met him until his third day of life.

I had been on modified bedrest for the last trimester of a high-risk twin pregnancy, with a demanding and often quite sad 2-year-old. The women from my LDS church set up a rotating schedule for R during my last month, where a different sister picked him up each morning, and returned him each afternoon. They took him to their houses, or to the playground. For a major introvert like R, this was pure hell. Besides being pure hell, it was also a major contributing factor to the success of my pregnancy, according to my doctors. It was all I could do each morning to get him dressed and fed. I would hide my tears of pain from him as I got up off the floor. I had been having contractions since 18 weeks along. I had very carefully gained my recommended 75 pounds, and then 5 to 10 more of water weight – or tator tots. (I had been in the “underweight” BMI category.) By some miracle, I made it to 38 weeks, which is the very earliest the hospital would schedule a c-section. My pain was so great by the end that I was on narcotics for the last month. Don’t judge. Every ultrasound tech sucked in their breath and clucked with sympathy when they saw my babies’ head positions – dropped and locked. Together.

The day of the birth came. It was October 2012. I was so relieved.

DCIM100GOPRO

I hadn’t slept or sat or eaten properly for weeks. Twin pregnancy is a living hell that I wouldn’t wish on anyone. (Anyone who says otherwise is probably the kind of person who says they can climax during labor.) Thirty-eight weeks is considered full-term for twins. I was doing good, technically. The last ultrasound showed that the babies were only 5 ½ pounds each, which is respectable enough for twins. I had been 2 centimeters dilated for a few weeks, and having irregular, disorganized contractions. Everything looked good on paper. I was technically fine.But I knew something was wrong – or I just knew something was going to be wrong. I am not a pessimist. I just had this foreshadowing kind of a feeling.

The c-section started out normal enough. As they pulled E out, I literally (obviously) felt a huge weight lift – I cannot express the relief of taking a full breath. I saw him, and I could hear my husband exclaim, “He looks like my Dad!” I remember thinking, why is that baby so pink? I had almost imagined him as an African-American, like our first son. And then I couldn’t keep my eyes open. I was going dark. I was in and out of consciousness as they pulled G out. I never saw him. He wasn’t breathing. I wasn’t breathing. Things were going wrong, but no one seemed super concerned. I could hear the various professionals around me commenting on upping my this and my that, but they weren’t rushing and they weren’t nervous. I wondered why no one thought things were that bad. At some point, my husband tried to take a family photo of us with E, just as I had asked him to do. I don’t remember him taking the photo and didn’t see it until much later. My eyes are closed- BECAUSE I AM UNCONSCIOUS! –  and I look gray. It is not the kind of photo you put in your album.

My husband told me later that G first responded to his voice. The doctors and nurses were working on him, somewhere behind me, and it wasn’t until his Daddy whispered to him that he took his first breath.  Many, many months went by before I read all the detailed paperwork and realized G did not take a breath until he was 4 ½ minutes old. He was intubated and whisked off to the NICU.

The babies were huge for twins – or huge for a momma with an underweight BMI. They were 7 ½ pounds each. Well, maybe- they had weighed G with his intubation tube in, so they told me we don’t have an actual weight for him. My husband said to the doctor, “Why can’t you just subtract the weight of the tube from the birthweight?” She replied, “It doesn’t work like that.” He said, “Um, yes, it does.” In any case, the babies were far from the predicted size of 5 ½ pounds each.

As I lolled around, only halfway understanding anything, they wheeled us into the recovery room. I remember thinking, this is weird. I am not okay. Why are we moving ahead here? They gave E to me and my husband put him to my breast. We had a perfectly normal, yet out-of-this-world five minutes together as a family. E began to suckle. I couldn’t sit up and I couldn’t hold him, but E edged his way to his first meal. As a mom who previously did not give birth or breastfeed my “firstborn”, this was a heavy moment.

DCIM100GOPRO

(our five minues of heaven with E)

My heart was elsewhere, though, as I fretted for my unknown baby in the NICU. And then said heart started to feel very weak. I sensed the nurses beginning to rush. I wouldn’t say I heard or saw them, because I was getting fuzzy again, but I sensed things changing. It might sound weird, but my true thoughts were, “Finally. Someone knows that this isn’t right. Someone finally knows something is wrong with me.”

My husband took the baby and stood in the corner of this small cubicle as the nurses shoved him aside. They began to poke and prod me. I could understand that I should have been bleeding, and I wasn’t. I was only leaking water. While this sounds like the opposite of hemorrhaging, it is indeed hemorrhaging. I was bleeding on the inside. Two huge placentas and two huge babies detaching from my uterus so quickly can make hemorrhage and atony more likely. My uterus couldn’t adapt. Or maybe I have some sort of bleeding problem. We will never know. The blood is supposed to come out, and it didn’t. The uterus is supposed to contract, and it wouldn’t.

The surgeon rushed in. She began “uterine massage.” This phrase is perhaps the most poorly named phrase in the history of the world. She worked quickly and she worked HARD. She pressed from the top and from the inside at the same time to stop the bleeding. I don’t want to make anyone faint or anything, but I will just say that this is the most painful thing I have ever experienced in my life- AND I WAS STILL A LITTLE NUMB FROM THE SPINAL BLOCK!  Please remember that she was pressing down on an area that had just been cut open and sewn back up.  This procedure left me bruised for weeks, so much so that I couldn’t burp my babies for three weeks because I couldn’t bear the pressure of their tiny feet on my belly.

I was levitating off the table. I was screaming. All I could think of, when I was screaming with blinding pain, was poor little E, there in my husband’s arms, three feet away. I prayed that my husband could read my mind, and he did. He covered E’s ears. What does that do to a child – to hear nothing but misery as he arrives? My husband later said that what he saw was a torrent of blood. His eyes and brain were scarred and I don’t think he has ever  told me the extent of the gore that he saw. He felt completely torn in half. He wanted to hold me, and he wanted to get E the heck out of there.

It didn’t work. I endured that pain for nothing. They whisked me away. I watched my husband and baby get smaller and smaller. I didn’t know what they were going to do to me. I didn’t know if I would hold E. I didn’t know if I would lose my uterus. And, worst of all, I had never even seen G with my own eyes and didn’t know if he was okay.

They mercifully put me to sleep. I don’t remember anything for a while. I woke up two days later, in the ICU, with a tube down my throat. It was dark. I was in terrible pain. I didn’t know where my husband was. I didn’t know if I had had a hysterectomy. I didn’t know if G had survived. It was the lowest point of my life.

Everything was okay. I had not had a hysterectomy, although I had come close, and the doctors told me that I most certainly would have if I had been at a smaller hospital. G was doing very well in the NICU, and was breathing on his own. My tube would come out.

My husband tried to piece things together for me. I was under a lot of narcotics, and this time is very hazy to me. He said that I had actually been conversing with them a little bit during my ICU stay. I didn’t believe him, so he showed me the papers where I had tried to scribble my questions when I couldn’t talk while intubated. He told me that my mother and father had been there too and he had pictures to prove it. I couldn’t remember any of it. Anyone who has ever been in the hospital for an extended stay would understand. I had been sedated into some sort of twilight phase. Sometimes, he would tell me something and these weird, underwater memories would seep back to me. I would cry from pain and confusion.

He told me, several times until I could remember, what had happened to me. When they put me to sleep, they immediately did a D&C to stop the bleeding. It did not work. Then they tried one last procedure, where they inserted a “balloon” into my uterus  to stop the bleeding. They left it in for a couple of days, and slowly decreased the size of it to help my uterus contract. It had a tube to let all the blood out. The balloon works by applying pressure to the uterus from the inside. Like an internal tourniquet. It was this balloon procedure that had saved me.

On the third day, I was wheeled into the maternity ward to learn some things, like how to pee and how to walk. It was an extremely painful week. I remember sleepless nights, although they were sadly from my pain and not from my babies. I remember having the catheter for far too long for anyone’s comfort. I remember tremendous amounts of narcotics – so much that I would get the shakes and the chills and flu feelings an hour before my next dose. My husband was by my side for the whole thing. He brushed my hair and my teeth. He brought back pictures and reports from the NICU, where G was, and the nursery, where E was.

They finally wheeled me down to meet G in the NICU as soon as I could possibly sit in a wheelchair. It was a momentous occasion, but meeting him was almost more than I could bear, physically. Sitting up made me sick and weak. I couldn’t hold my neck up and I didn’t know why. I later learned it was because I had had six ports SEWN into my neck for two blood transfusions. My neck was now bandaged into an unmovable position. I tried to hold G and feed him, but I started to cry and had to be taken back. Just getting back into the bed was more than I could bear. I was hooked up to all sorts of machines and had bandages all over my body for reasons I didn’t know.

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(the first time I met G, in the NICU, 3 days old)

There were some nights when I thought I would never get out of there. There were some moments when I thought I did not have the strength to ever walk to the bathroom again. (Even my throat and neck were searing from the pain of the intubation tube. I was hoarse for weeks. ) What I did felt like it took superhuman strength and willpower. I am not the first person to be hospitalized. I am not the first person to almost die after birth. I am not the first person to recover. I know that. But when it is happening to YOU, suddenly the world is a very cruel place. I can’t even look at hospital beds on TV shows without feeling sick these days.

The worst  pain is that, when I look back on my one piddly little week in the hospital, I don’t remember much about the babies. I didn’t hold them. I didn’t nurse them, although we put them to the breast for comfort. I didn’t burp them. I certainly didn’t change them. I missed their first bath in the nursery. I missed G graduating from the NICU to the nursery. I missed out on a lot, which made me so angry after having missed out on the very beginning of R’s life as well (from the adoption). It wasn’t fair to any of them.

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My husband’s parents kept R for that entire week. They brought him to see me every day at the same time. It was the best and worst part of each day. He was so scared of me. He was so sad. He was so confused. He wouldn’t sit on the bed with me or hug me. He was not exactly an adaptable or happy kid anyway, so this major life event had thrown him. I tried so hard not to cry or show my pain when he was in the room. My husband would always take him down to the cafeteria and try to not let him overwhelm me. My mommy guilt was sky-high. I found out months later that he had thrown up in my in-laws’ Cadillac on the way to the hospital because he was so scared.

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(the first time R would go near me… please know that my kind husband heavily photoshopped this photo to make me look healthier or something)

That first day had been hard on everyone. We had four grandparents, two aunts, two cousins, and our firstborn son waiting in the waiting room for that joyous moment when my husband would come down and shout, “They’re here! Our two boys are here!” That moment never came. Little by little, they began to realize that things were going wrong and they would have to go home. Over time, I heard from each of them about what that day had been like for them, from their perspective, and it breaks my heart. One aunt described it the best. She began to sob as she said, “The whole day can be summed up in one moment: watching your mother-in-law walk out of the hospital with the balloons and flowers she had brought for you.” The joy left the hospital that day.

It was all so scary for me, but I feel the worst for my husband. He saw some major gore, had to deal with all our family’s questions, and had to go home alone that first night. He said that was the worst part: not knowing if I would make it, and having to go home anyway (there is nowhere to stay when someone is in the ICU), and realizing that all 5 of us were in different places. I was in the ICU, G was in the NICU, E  was  in the nursery, R was with grandparents, and even the dog was at the kennel! He wrote me a love letter that first night and sent it to my email…. and I got it a week later when I finally checked my email. Bless him. That was probably the most romantic, yet sad, gesture I can remember. It is too sacred to me to ever share.

I have recovered. I am probably 90% back. It was so slow- I had to learn to walk again. I came home  with a physical therapist and a walker. The whole thing was brutal. As the weight started to come off and the swelling went down, my ankles looked like cartoonishly skinny. My calves looked like a coma patient’s calves. Also, because of the blood transfusions, I almost didn’t make any milk. The doctors told me that transfusions messed with my pituitary gland, and that I might never make any milk. I surprised even the lactation consultants, when it came in later than they had ever seen – somewhere around the eleventh day. I am grateful that I can give my babies a little immunity even if I can’t make them full.

Nobody really likes us to talk about what happened. Only he and I knew how bad it really got. The days and weeks after were filled with sleeplessness, painkillers, a rotation of grandmas/aunts/cousins who never left us alone at night, meals provided by the church sisters,  two tiny babies who needed constant love, and a disgruntled 2-year-old who also needed constant love. He seemed to be dealing with his own PTSD symptoms after having his mother go into the hospital and stay there. Despite all that, my husband and I would catch a quiet moment together now and then, and he would tell me another little piece of my story from that week. He would show me the scribbled notes I had tried to write him when I couldn’t speak- and his translations beside them. He would show me another picture from the ICU. I don’t think I found the pictures of G in the NICU and his oxygen tent until months later, and I burst into tears because I still had no idea what had happened to him during those days when I was sedated. The mommy guilt was crushing. We also had practical concerns to address –  like what would happen if I were to leave him with three little ones!  We leaned on each other and cried, both from relief, and from fear. We had a lot to process together.

I sit here with G strapped to my chest in a carrier, R “fixing” his cars with his tools at my feet, while my husband does the dishes with E in a front pack. Life is good. I’m glad to be here.

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So, What Is IVF Really Like? (A Thesis)

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.

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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?”