Sometimes Babies Come From Petri Dishes

My Seven Part Story of How I Became a Mom

When I first started writing my blog, I used seven entries to write about my journey to become pregnant and the multiple rounds of IVF I went through.  These are the seven posts I wrote to tell my story.

The Birds and The Bees-and The Petri Dishes....

Through the wonders of facebook, it has come to my attention that an astounding number of women I know are struggling, or did struggle, to become pregnant. I would not find this surprising if I was older, but since I am still in my mid-twenties (ok late-mid-twenties) (ok, ok, late twenties), this is really surprising to me. I had a hard time getting pregnant. A really hard time. And one of the things I found most helpful, and often times most inspiring, was reading or hearing about other people's journeys. My journey was long, and will likely take me a while to tell, if I even decide to tell it all, but in hopes that someone might find it helpful, I thought I would start writing it down, piece by piece. I am also hoping that writing will help me find a little peace, and maybe a little inspiration. I guess we'll see...

I've always known I wanted to be a mom. No one ever anticipates having problems getting pregnant, and when you're only 22, it barely crosses your mind. It was on my mind though, thanks to my darling husband's vasectomy. He had agreed to have it reversed after our wedding, and he was good to his word. The doctor filled our head with all sorts of positive statistics and told us soon enough we would be sending him a thank you note with a picture of our beautiful new baby. Lesson One: Doctor's are full of crap. A few months after the surgery we were told things looked good, sperm had returned and it would be a waiting game while the number of sperm and the quality of sperm improved. So we waited. And waited. And waited.

During this time I educated myself on the art of getting pregnant. Basal Body Temperature charts-I was a pro. Ovulation Predictors-a champ. Getting pregnant-not happening. My doctor was not concerned about my health at all, but suggested we go see the new fertility doctor in Portland after a year of trying had not given us results.

Going to see the fertility doctor is not cheap, and it is not covered by insurance. (Which is a whole other rant for another day!) Needless to say we spent a chunk of savings on our visit (that we waited over 2 months for) and ended up meeting with the doctor for a 10 minute discussion about IVF and why we needed to move to Massachusetts. (See Lesson One) We were not pleased. She felt that we would likely need IVF to become pregnant, and since we couldn't afford IVF, our best option was to move to Massachusetts where fertility benefits are a part of health insurance. She did order a semen analysis for us, and we discovered just what we were working with. While the reversal surgery was successful to a point, we did not have a high enough sperm count or good motility numbers to try anything other than IVF. Conceiving on our own was not going to happen, as made clear by the nurse who gave me the test results.

IVF, for anyone not familiar, is the process of stimulating the ovaries to produce multiple eggs, removing the eggs from the ovaries, fertilizing the eggs in a petri dish, and returning them to the uterus after several days of growing in said petri dish. It is a hormone-filled, emotional roller coaster that costs anywhere from $12,000-$30,000+ depending on the number and type of cycles you sign up for. This, we were told, was our only option. And since we were just making ends meet financially, a completely impossible option for us. Or so we thought....

Part II-Popsicle Baby

So, continuing from where I left off in my story...

We were pretty much at a standstill due to the super high cost of IVF. I had another visit with my doctor who suggested we look around for a clinical study. Most studies just test the usefulness of different types of the same medicines or different amounts of medications. My husband contacted Boston IVF and, miraculously, they had a study we qualified for.

This study was to examine the effectiveness of freezing eggs, thawing and fertilizing them and then returning them to the uterus. The usual IVF process fertilizes the eggs immediately after retrieval and freezes any remaining embryos. I don't know all the science behind this, but basically human eggs are made up of a large portion of water, when the eggs are frozen and thawed, the water expands and contracts, damaging the egg. Embryos are not made up of so much water, and do not suffer this type of damage. The study was to try out a procedure for freezing and thawing the eggs that kept the eggs from becoming damaged. The purpose was two fold. This procedure would help women save their eggs to use later on if they were undergoing chemotherapy or if they had to have their ovaries removed for any reason. These women would not lose the option of having their own "biological" children. However, there is a lot of money to be made marketing this to "thirty-something" year old women who want to put off motherhood a bit longer. I'm still not sure how I feel about this whole thing, but when life hands you free IVF, you make a baby.

Fortunately for us this was a free study. We paid for an initial consultation with the doctors, and paid to have tests done that gave me a clean bill of health. There was one catch, in order to have all the cycle monitoring done for free, I had to drive to Waltham during the stimulation phase for ultrasounds...every two to three January.

We managed to do it though, the drugs, the shots in the belly and thighs, the hormonal highs and lows and many, many trips to Waltham. The most intimidating part was the retrieval. I was brought into a sterile operating room, alone, had my feet put in the stirrups and knocked out completely. There is nothing quite like being put under anesthesia with your knees next to your ears... They retrieved about 18 eggs and froze them all. We left and were told to return in a few months for the second part of the procedure.

When we did begin our transfer cycle a few months later I was introduced to Progesterone in Oil. Perhaps the WORST of the fertility drugs. It is an instramuscular injection in the upper butt with a BIG needle. That sounds bad enough, but the worst part was actually the after effects, the oil would form a little ball in the muscle it was injected into and sit there, in the muscle, irritating it everytime I moved. It was horrible. I spent all day sitting on a heating pad. It was pretty miserable.

Then there was the day of the transfer. We had been told that 6 of the eggs fertilized. We were thrilled, that meant we would transfer two and freeze the remaining embryos. We went down to Waltham the night before, with my stepsons in tow, and showed up ready and excited first thing in the morning. The excitement was short lived. We only had two embryos, the other 4 had stopped developing. And the two we would be getting were both underdeveloped and of poor quality. This news was delivered nonchalantly by a nurse and we were herded back into the sterile operating room. Near tears at this unexpected and devasting news, they embryos were transfered within minutes and we were shooed back out the door to head home. It was devastating news. I cried for the 2 hour drive home from Waltham.

Needless to say, this IVF round did not work. We had no frozen embryos to fall back on, and we ended our relationship with Boston IVF. Free IVF did not work for us....and we didn't know what would be next.

The Intermission Between IVFs

So, to continue on my TTC journey...

We weren't exactly surprised the IVF trial didn't work. We knew it was experimental, we knew they couldn't guarantee anything, but that still doesn't mean it didn't hurt to hear the news. Our follow up appointment with the Boston IVF doctor was positive since he said he really believed the problem was just the freezing of the eggs, and not something wrong with our ability to conceive through IVF. He did offer us the opportunity to try another study, but we had mixed feelings about that and decided to stay away from "studies" for a bit. We decided to take a bit of a break and recharge and reassess the situation.

After a few months I met again with my doctor to discuss the possibility of doing an IUI (intrauterine insemination aka the "turkey baster" approach). This would be a much more effective approach if we had higher sperm counts, but it wasn't too expensive, and it at least made us feel like we were trying. Since I had no ovulation problems we did not use any medications for these IUIs. The first went well, low sperm counts, but not horribly low. No success. Number two was a bit more complicated as the doctor performing the procedure had a hard time and ended up using a clamp on my cervix (ouch!). Sperm count was lower this time so we weren't very optimistic. No success. The third attempt was disastrous. When we showed up for the appointment they said "Office visit?" and I said, "No...IUI" and they just said, "Oh, it says office visit. Go have a seat." A bad sign. When we went into the room I was told not to bother with a gown just yet. Another bad sign. And sure enough the doctor came in to tell us that they were only able to find one sperm in the sample. One. She didn't think it was worth spending the money on an IUI with one sperm so was giving us the option to cancel. We canceled.

As devastating a blow as that was to me, I know it was so much harder for my husband. I never blamed him for our problem conceiving, I knew what I had signed up for from the very beginning of our relationship, he, however, blamed himself completely. It was a quiet ride home that day.

We had discussed numerous times the possibility of using donor sperm. For me it didn't matter as much, I just wanted to carry a child. My husband would be there to raise the child, and to me that was so much more important than having his DNA. I don't think it was quite the same for him. While he's not opposed to people using donor sperm, he didn't want that for us. I think he really wanted his sons to be able to share a connection with our child, and I don't think he felt this would be as intimate if our child wasn't somehow related to them. I could be wrong, but at the end of the day he was still holding out against donor sperm. Which meant our only option was IVF. Which meant we had to find a cheaper IVF option. And so I began to google...

Eggs for Baby

It always seemed as though every time we suffered a set back in our journey, someone we knew would end up pregnant, or give birth. The summer we were trying our IUIs was no different. A co-worker and his wife were happy to announce that they were expecting a baby at the end of February. They of course had to fill us in about their "harrowing" experience trying to get pregnant. (Six months of trying only to discover they were pregnant the day before their appointment with a fertility doctor. I didn't have much sympathy.) This of course spurred us on to find an IVF solution sooner rather than later. Boston IVF had no open studies, so we were out of luck there, so I began researching other options. We could fly to India, where IVF was very cheap...but that didn't seem reasonable, or safe. Neither did flying to Russia, France or other countries where IVF is much more affordable.

I looked into low stimulation IVF, where you are given fewer hormones, causing you to produce fewer eggs, which means less monitoring and less pain during retrieval, meaning you wouldn't need anesthesia. This was cheaper, but the success rates were lower per try and it meant no anesthesia, which I couldn't imagine would be a pleasant experience.
I finally found a clinic in New Jersey that offered a shared IVF program. As far as I could tell, it was the only clinic in the country with the program, and I was very leery. I was also very desperate. So I called.
The program was essentially this: I would become an egg donor, and my payment for donating my eggs would be IVF. As the donor, I would pay for my testing and cycle monitoring and the recipient would pay for the medications, retrieval and a transfer for me. I would keep half my eggs and she would get the other half. In a traditional donor egg IVF cycle, the recipient would pay for monitoring, testing, medications, retrival and their own transfer, PLUS compensation to the donor. In the share cycle, the recipient would save money by not paying for monitoring or testing, but instead pay for two transfers, one for me and one for her, but no compensation. It was essentially affordable IVF for everyone involved.
It was not an easy decision to make. Giving away my eggs was a very conflicting idea for me. But, when we added up the cost, including a weeks stay in New Jersey, the savings compared to standard IVF was substantial. And if it didn't work, and we did have extra embryos, a frozen transfer was cheaper than a transfer at any other clinics in the area. After 3 years of trying to get pregnant, this became essentially the only option we had. The question became Do I want to keep all my eggs and possibly never have a child, or give my eggs to someone in need and have my own child? And so we began preparing for New Jersey...

A Strange Place for an Ultrasound Machine

When I reached the point in the stimulation phase that I had a sufficient number of healthy follicles, I was told it was time to head to New Jersey for one final ultrasound and the retrieval. My appointment was to be at noon on Saturday. A convenient time for someone traveling from Maine. We left very early in the morning and managed to arrive on time. The only IVF clinic I had been to prior to this was Boston IVF, a vision of stainless steel, elegant woods and beautiful colors. The New Jersey clinic was dirty and outdated. The ultrasound was located in a room that doubled as a filing room. I was shocked, discouraged, overwhelmed and hormonal. I made it through the appointment and the retrieval was set for Monday. We left the clinic and I cried. It was NOTHING like I had expected. I was tempted to turn around and head for home. But we talked it out and agreed to stay, we had made it this far, a filing/ultrasound room wasn't about to scare us off!

We spent the next day in Atlantic City and were at the clinic Monday morning bright and early. At this point I had nearly 30 follicles and very high estrogen levels. I was told that they may not do the transfer later in the week due to the risk of over stimulation. I was crushed and hoped they would change their minds. The only other thing I can remember from that morning was the anesthesiologist in the room with me. He introduced himself, and, as I was laying next to him with my feet in stirrups, he asked me if I had been imagining him in the room when conceiving my child. I laughed, he definitely was never a part of the plan.
Things went well and they retrieved 24 eggs. 12 for me and 12 for my recipient. They fertilized 10 and I found out the next day that 8 continued to grow. It was going to be almost a week before the transfer and since my husband had to return to work, my mom came down to keep me company and take me back to the clinic. We spent a week in a pretty trashy HoJos in a pretty trashy part of New Jersey, but by the end of the week I was told to come back for 2 perfectly healthy embryos!
I was elated! I was receiving one 9 and one 10 cell embryo, both of excellent quality. 4 others were going to be frozen for later use, if I wanted them. The transfer went well and I was sent home a few days later with some more hormones and orders to take it easy.
After two weeks of impatiently waiting, the day of the test arrived. We opted not to test at home, just wait for the blood test results. In hindsight, a bad decision. The call came and sadly, we were not pregnant. Devastated does not even begin to describe it. I spent a long time in the conference room crying and then lost it again when a coworker asked if we had our happy news yet. I went home early that day and went to bed.
Things were not good for a few months. This failure just hurt. It hurt badly. I disappeared for a while into books. The escape from my world was such a relief. The only little light at the end of the tunnel were the 4 embryos I had frozen in New Jersey. But at the moment, I didn't have the money to get them out.
And then my dad sold his motorcycle....

Finally, My Miracle

After the devastating failure of the New Jersey IVF, we knew we still had the option to go back for our remaining four embryos. While this wasn't a terribly expensive procedure (think several thousand versus tens of thousands) we just didn't have enough money to go back. Fortunately I have a loving and supportive family and both my parents offered us money to get us back to New Jersey sooner rather than later. They were a bit eager for grandchildren.
With the gifts from my parents and some scrounging in savings and (unfortunately) our credit card, we were able to go back to New Jersey for a Frozen Embryo Transfer. In this procedure I would be given extra hormones to help make my uterus a hospitable place for an embryo to grow. The embryos would be thawed and monitored and two would be put in my uterus. It would be a quick trip down and back, so we booked a much nicer hotel this time.
Unfortunately my old Nemesis progesterone in oil was back in the mix. These are the MASSIVE injections in the butt that make you hobble around in pain. It was a long and uncomfortable trip to New Jersey. When we went in for the transfer I was very disappointed to learn that our embryos were a bit tinier than I had expected. The nine and ten cells I received the prior trip were replaced by 7 and 8 cell embryos. Better perhaps than the Boston IVF embryos, but not what I had hoped for. I was discouraged, but there was nothing I could do. The embryos were transferred and we drove home the next day.
It was another anxious two week wait for our test results. This time we told no one when the test was and we decided to test at home before we went in for the blood test. It was a Saturday morning so we didn't have to worry about giving anyone bad news. So I peed on the stick.
And we both agreed, there was only one line. Then a few seconds passed....was that a shadow? Another line? We busted out the expensive digital test I had kicking around. A few minutes later there it was:

3 1/2 years of trying and we were finally going to have a baby! It was an amazing feeling. The positive result was confirmed by the blood test, and things looked great. We had a scare at our first ultrasound when all they could find was an empty gestational sac (they do very early ultrasounds on IVF patients because of an increased risk of tubal pregnancies, and because they transfer more than one embryo) but at our second appointment our little baby was there, with a beautifully strong heartbeat.
I remained on the HORRIBLE progesterone in oil for the entire first trimester and was finally tapered off it and the other hormones by my 5th month. That's a lot of stabs in the butt. I am happy to say I had a very smooth and uneventful pregnancy until my baby shower, six weeks before my due date, when my water broke. Oooops.

Benjamin was born 1/31/10 weighing 5 lbs 1 oz. He spent two weeks in the NICU growing and then came home, happy and healthy, and has been making me a very proud mommy ever since.

The moral of the story: Good Things Do Happen.

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