“I have been bent and broken, but – I hope – into a better shape” – Charles Dickens
I will never forget the day I received my FSH results from the Quest portal. I didn’t know what any of the numbers meant but I turned to Dr. Google. I was 33 and had a FSH of 15.5 and all I kept seeing was “donor eggs” and “severe diminished ovarian reserve”. I fell into a deep panic and spent the morning crying in bed. I had an appointment later that day for a saline sonogram and my husband begged me to get off the internet and wait to see what the doctor said.
During the procedure I cried and clutched the folded paper in my hand. I handed her the paper when she was finished and I watched her face drop. I could see the pity in her face but she told me to wait and see what the other tests showed. A few days later we received the rest of my blood work, my AMH was undetectable and my ovaries were behaving like those of a 50 year old. I thought it was over before we had even begun. I felt so much guilt and embarrassment of my deteriorating reproductive system.
We started with clomid (the fertility gateway drug) and IUIs. They were easy enough and I kept my expectations low. Hope has its way of slipping in but hope can be a dangerous thing. With the return of CD1 each month it became increasingly obvious we were heading to IVF. Once that decision was made I decided that we needed a second opinion.
It was my new RE who diagnosed me with endometriosis, a condition I had secretly worried about for several months. He didn’t believe that DOR was necessarily the reason why we weren’t getting pregnant; women with low AMH become pregnant all the time without ever knowing they had low AMH. My period pain was moderate, I was able to function and go about my business but ovulation was always uncomfortable and I experienced some localized pelvic pain. We agreed that we would start embryo banking and deal with the endo later down the road.
I was excited to start IVF, I felt like we were finally doing something. I started stims in May but after six days we were canceled. I was so angry at my ovaries for not responding to the meds and I felt stupid to ever think it could work. I quickly learned that IVF would not be our cure all.
We started our June cycle with the same number of follicles as our May round but we decided to move forward and see what happened. It was a stream of ups and downs between each monitoring appointment. I felt like I was constantly holding my breath. We wound up getting 6 eggs, 4 mature, 3 fertilize, and 3 blasts. We were ecstatic and for the first time in a long time we regained some hope. Another round in July yielded 3 eggs, 2 fertilized, and 1 blast. Not as promising as our first cycle but we were grateful for the one blast we had. With four blasts now frozen we had our little embryo safety net and felt a great deal of pressure removed from our shoulders.
It was time to address the endo. After researching my options I did not feel comfortable with using depot Lupron to reset my uterine lining. Depot Lupron essentially puts your body into menopause and I was afraid that my ovaries would never recover. I feel like I’m a sneeze away from menopause at any time to begin with! I found a surgeon who would excise my endo (if I had any). I was technically considered “silent” endo since my period pain was manageable and I didn’t have some of the other classic endo symptoms. Turns out that I had stage 3/4 endometriosis but I was lucky that it did not affect my tubes or have endometrioma cysts. We were given the green light to try again in September (of course I was away for our ovulation window) and were back in active treatment in October.
We were all set to start our last IVF cycle. My body had other plans. My AFC was super low so we decided to save our meds and convert to an IUI with clomid from the start. To our surprise it worked. We were beyond ecstatic but I was cautious from the start. I reminded my husband that 1 in 4 pregnancies end in miscarriage. With each ultrasound we became a little more hopeful. He was eager to tell his parents, I wanted to wait until we heard the heartbeat. When we heard the heartbeat I still wasn’t ready to start celebrating. I wanted to push it until Christmas Eve when we would be 11 weeks.
The week after Thanksgiving we went to what was supposed to be our final RE appointment. The moment we found out our pregnancy wasn’t viable is seared into my memory. The doctor took a little too long to speak, there was quiet tension in the room as she looked at the screen. My husbands hopeful voice broke the silence, “there it is” he said. What followed was the worst words I have ever heard “I’m sorry, I’m not detecting a heartbeat”. It was as if the air had been sucked out of the room. I grasped for my breath and when I opened my mouth a deep sob came out, along with some other choice words. My husband just looked at the screen, my heart was breaking for him, for us. It was the worst day of our lives. Two days later I had a D&C. Right before the anesthesia kicked in I put my hands over my belly and said goodbye to our baby.
What no one tells you about a miscarriage is the wait. The wait for your HCG to return to zero, the wait for your body to realize it’s no longer pregnant, the wait for your period to come back, the wait for life to return to some sort of normalcy. It took seven weeks for my HCG to hit zero, I had never been so happy to see a negative pregnancy test.
We were ready to start treatment again in February only to have another canceled cycle. It was beginning to feel cruel at this point. We converted to an IUI with the hope that lightning would strike twice. It didn’t. Our next cycle in March showed two 9mm follicles at baseline and nothing else. I was tired of being canceled so we went for it. We wound up transferring two beautiful day three embryos but they didn’t stick. I was surprised how well we had both handled it. I already had plans B, C, and D in my head and was ready to move onto the next cycle.
That’s where we are today. When I look back at what we have been through the past sixteen months I’m shocked we’re still standing. It has become our new normal. I’ve learned a lot about us as a couple, how we deal with anxiety and grief-that it might not always look the same but we’re each feeling it and how to communicate our needs to one another. I’ve realized that I’m stronger than I ever thought possible. I had hoped to be pregnant by our baby’s due date, July 4th, but that is feeling less likely and I think I’m okay with that. I think of IVF as a numbers game, eventually it will work. It’s not a question of “if” but “when”.
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