Secondary Infertility, Trying to Conceive, IUI, IVF, 30s

A woman shares her struggles trying to conceive her second child. She shares her worries, the pain of being open about her struggle with friends and family, and how to be your own cheerleader.

Kelly’s Story Part II

All was right in the world, I had a beautiful baby boy — alive and healthy despite a difficult birth — a wonderful husband and a new burgeoning business. It was pure unadulterated bliss, albeit sleepless. My husband wanted to start trying to have another baby right away. Maybe he wanted to start when our son was 3 months old when I first got my period? Perhaps I exaggerate. All I remember was thinking he was completely mad to want to try when he did. Our son wasn’t even sleeping through the night at that point and having sex wasn’t on my To-Do list. We argued about it and I won with my 40-week trump card. I didn’t understand his rush. I was still relatively young at 35 and we had had no trouble getting pregnant with our son post-miscarriage.

My logic was that at 35, I was young enough to at least wait until my son was 12 months old to start trying. I had wanted to breastfeed him for a year because I’d read that if you breastfeed for a total of 36 months in your lifetime that you reduce your risk of breast cancer by a 1/3rd. I calculated, 3 kids, 12 months each. Done and done. I wasn’t working full time so it was possible as it was almost like a second job to breastfeed. So when Teddy was 13 months, I stopped breastfeeding and we started trying, or rather as I would learn in the language of abbreviations on fertility boards online, I was “TTC” with “DH” — “Trying to conceive with dear husband”.

We kept TTC and TTC and then TTC some more. It turns out that I wasn’t as young as I thought. Unbeknownst to me 35 is the age one medically speaking is considered “geriatric” in terms of maternal health. Ugh. With my miscarriage, it had taken two months to get pregnant. With our son, it had taken 2 months. I was now 12 months plus in of TTC. I spent many a night with insomnia, bawling, praying for another child, making bargains with God if he was listening.

I went back to my old temperature tracking methods and ovulation kits. I even bought an expensive ovulation tracking machine. Nothing. Half of the moms in my mommy group were all about to pop out their second kid. Everyone was full of advice. “My sister-in-law would literally do a headstand after sex to make sure everything stayed in there and it worked!” “You just need to get shitfaced, relax and have sex.” “I had so much trouble trying to conceive with my first and then we went to [insert fantastic beach getaway] for the weekend and voila. I think I was just trying too hard.” And then my favorite, “I have a friend who tried and tried forever to have a second child and then finally she decided to get a dog and is so happy now.” I already had a dog. People mean well though.

All of the sudden, my perfect world and family didn’t seem so perfect. Every month, a visit to the bathroom on the day of my period would bring hope and then a wave of defeat. During this TTC time, I remember once at twilight giving my son a bath in our kitchen sink watching the sunset over the Hudson — it was a small NYC apartment but it had killer views. When I was drying him off in the sink, we stood there and I clung to him and he to me in this ethereal light. I knew how precious he was to me. But now that I was faced with the fact that another child might never appear, I realized the word precious didn’t adequately capture his importance.

At my annual exam, my OB-GYN, Dr. Noiret, was thoughtful and listened to my fears. He was hopeful but clearly had seen it all before. He referred me to the hospital’s fertility center and an acupuncturist. He used the acupuncturist himself and she sold this great green powder to drink. I was relieved to have some help because I was losing hope. And with that referral, I dove into the rabbit hole of the fertility world.

When I first visited the fertility center there was a woman crying. And not a polite, waiting room cry, it was bad enough that I was about to ask if she was okay when the doctor came out and started talking to her about her procedure. I’m not a doctor, nor do I play one on TV, but I’m pretty sure it can’t be legitimate to discuss medical stuff with your patient IN the waiting room where other patients are sitting. It was jarring.

After my initial exam, my first fertility doctor told me that my ovaries looked “old”, like “the ovaries of a 40-41 year old” — I was 36 — which translated into my language of inadequacy meant, “You’re an old hag”. He suggested we run some basic tests to make sure fallopian tubes and uterus were fine and if so, do up to three rounds of IUI — in utero insemination or what I previously had thought was called, artificial insemination. They would stimulate my ovaries to produce an egg, I’d come in for regular sonograms to look at my ovaries and determine when to do the IUI. This sounded easy enough.

I didn’t fully comprehend that I couldn’t actually make any future plans because my body was now at the mercy of my ovaries and the doctor’s decision about the optimal time to do the IUI. Nor did I realize this would be my life on and off for the next 5 years. It was like having an unreasonable boss who repeatedly made me cancel my plans last minute.

At this point, I decided to continue to be open with good friends and with my supportive mom group friends about what I was going through. Infertility seemed such a hush-hush, shame-filled subject and needn’t be. I would be “brave” and put it all out there with people I trusted and who I’d found to be kind people. I did this right up until I was discussing the possibility of having to do IVF with a group of moms and one of them straight up said to me, “But are those like real babies?” After that, I decided I didn’t want to be brave and “change” the world. I just wanted another baby. I twisted myself into a pretzel figuring out how to continue to live my life without having to share with every — however well-intentioned — Tom, Dick & Harry in my life that I was undergoing fertility treatments. I told a lot of white lies.

The staff was all business and unfriendly, whether taking my blood to measure hormone levels, making appointments, or waiting with my feet up in stirrups while they monitored my ovaries with some sort of sonogram dildo. When I worked at a coldhearted hedge fund, people were cheerier and kinder. On each visit, I’d go in armed to figure out how to make one of the nurses or receptionist smile. I couldn’t shake the notion that perhaps it ought to be in reverse.

Once I couldn’t find a sitter for Teddy. and had to bring him to one of my myriad early morning appointments. I remember the stares from other hopeful mom-to-bes. Not one smile from anyone as this cherubic baby played on my lap. I had crossed some invisible red line bringing him. When you’ve got secondary infertility, there’s not quite the level of sympathy one might get when trying to have your first.

We did IUI three times. No luck. So, 16 months into TTC, Jay accompanied me to their dreary offices, we met with the doctor again and he recommended IVF —in vitro fertilization or as I think of it now IUI on steroids. He said that if IUI didn’t work on the 3rd try then it wasn’t likely to work on the 4th try either. I asked how much that would cost — about $20,000, gulp — and if there were any tests we might run before embarking on this rather costly endeavor. He said not really. But, I had done some research and discovered that autoimmune issues can cause fertility problems and asked if we might do some of those. He agreed it was possible and would order an autoimmune panel.

The clinic called to tell me the autoimmune panel was all clear. But, I decided before embarking on IVF that I’d seek a second opinion. Luckily, I had a friend from a networking group who had been TTC for quite a while. She finally got pregnant with the help of Dr. Gordon, at a different clinic in Manhattan, after using at least 3 other clinics. I asked for my medical records from the first clinic. When they arrived in the mail, I read through my file, which was mostly the auto-immune panel results, I noted that I had some genetic disorder for a tendency to clot blood that eventually can lead to blocked arteries — hidden heart disease in my family explained? I was disconcerted that my doctor hadn’t informed me of this condition.

I called this new clinic, made an appointment with Doctor Gordon, sent over my paperwork, and hoped for the best. My favorite part of my consultation with Dr. Gordon. was that he noted that I had this genetic clotting disorder and should consider taking a daily baby aspirin. Not just for pregnancy but for my long-term health. That’s what sold me on Dr. Gordon: Attention to detail, concern for my longevity, and friendly staff with a great inspirational poster quote from Nelson Mandela. “It always seems impossible until it’s done.”

Also, I’d seen a piece on the Today show about a woman who used this clinic to get pregnant after a horrendous experience somewhere else. I thought of it as a sign. At this point, I clung to anything as a sign from the universe/God. I picked up every lucky penny that was heads-up even if I was on 42nd street with cars were barreling toward me. Tails-up — which my paternal grandmother told me was bad luck — and I’d turned them over for the next desperate person looking for a spot of luck. I liked to think my grandma was up there throwing pennies my way even if that theory didn’t explain tails-up ones. Let’s just say a lot of rational thought flies out the window when standing on an infertility precipice. I didn’t tell my germaphobe husband about my dirty, penny collecting habit.

This clinic also had free cookies — those Danish ones in the round blue tin — and spring water. I mean, if you’re going to spend tens of thousands of dollars of your savings not to mention additional money on weekly fertility yoga and fertility acupuncture, that’s a nice bonus. I would sit staring at the Mandela poster munching a cookie or two then head in for blood draws.

Looking back, being infertile helped me live a healthier life— albeit in an incredibly expensive, saving’s sucker kind of way. I read every article about IVF that I could find and only watched uplifting movies — following the Law of Attraction I’d once learned about from the seriously researched medical opus “The Secret”. But, I would leave no stone unturned, no advice unheeded no matter how wacky.

I ran. I lifted. weights. I flossed. I ate 5-7 servings of raw vegetables a day — roughly 5x what I normally ate. I saw the clinic’s in-house acupuncture guy in addition to my other acupuncturist. I cut out seltzer water, had mental heart palpitations even having a sip of wine at a social function, drank 60 oz. of water/day, and maybe a half cup of coffee a day. I took special fish oil that one of my acupuncturists recommended and some green powder she made, which on paranoid days I’d wonder if there were things in there that keeping me from getting pregnant. I did fertility yoga once a week, which was therapeutic with all of the breathing and meditating. I contemplated adding in an energy healer where you lay on a crystal bed but I ran out of hours in a day. If you told me to walk on hot coals to get pregnant I would’ve. It was exhausting.

I tried to keep my morale up because this experience felt like a mental game even if it was physical. When I ran on the treadmill, I’d listen to Bill Conti’s final score for Rocky. As a kid, that movie always spoke to me about persevering against all of the odds. I cry every time he’s yelling “Adrienne!” I told myself that I’d play that song on my iPhone when I got to the hospital to deliver this future baby. Until then, I ended every run with that song pushing myself to the brink and finishing in a pool of sweat and tears. Thankfully the gym was often empty.

Dr. Gordon talked in probabilities and logic with gentle words of encouragement. Probabilities sound cold but I always found comfort in the logic of statistics. The probability that I’d get pregnant with IVF at the age of 37 given I’d passed initial IVF tests with flying colors? A little over 30%. This seemed depressingly low until I realized that if I had to do 3 IVF cycles, I’d have a 90% chance of getting pregnant. I perked up until he walked me through the hurdles I needed to vault over to get pregnant: Follicles that respond to hormone regimen, successful egg retrieval, mature eggs, fertilized eggs, viable embryos by day 3, viable embryos by day 5, pregnancy hormone in my bloodstream at x level by day 10, doubling of said pregnancy hormone by day 12, proper fetal development by day 21 during a vaginal ultrasound, heartbeat by week 6, continued proper fetal development by week 10 to graduate to regular OB-GYN to hopefully make it to a live birth. I didn’t know how to mentally make it through this daunting list. I was swirling into an emotional tailspin. So I did what I’ve always done when I can’t handle the stress of something, I put this daunting schedule in terms of sports.

Sports brings out my logical side, shuts down my self-pity streak, and makes me feel like I can do anything. I likened the IVF process to playing baseball. I’m ironically a terrible athlete with no eye-hand coordination and baseball is my worst sport, but I probably thought about it this way because I had memorized that Meatloaf song “Paradise By the Dashboard Light” growing up not realizing that it wasn’t about baseball. I tackled the IVF list by likening getting pregnant to getting on first base. Nobody scores without getting on first. So that litany of IVF stuff before the pregnancy was like being up at bat. I just needed to get my bat on 6 pitches to stay in this game and then get a hit to first. I further reasoned that I’d made it to first base twice before with my initial miscarriage and then my son. So, I could get to first base again.

At some point almost at the end of this IVF process, I was in a cab en route to this new clinic, my sister called to tell me she was pregnant, early days, maybe 6 weeks. I told her how happy I was for her, and I was. She had had a bumpy road trying to conceive her third child, didn’t have a ton of savings nor insurance that covers IVF. She tried IUI and it worked. I hung up the phone and cried. It’s not a game of musical chairs but it cut the same way it did when I was little and left standing without a chair. I went to my appointment, plopped myself in a waiting room chair, stared at that Nelson Mandela poster, and ate my Danish cookies.

During this time, I injected myself with needles daily. I’d done this for IUI but IVF was way more intricate as if I’d been playing in the minors and was called up to the big league. Dr. Gordon. vehemently disagreed with my IUI doctor’s hormone protocol. Dr. Noiret likened IVF doctors to French chefs and he was mostly right. To me, this new clinic was a fancy French restaurant but the place I had been for IUI was some greasy spoon. Dr. Gordon used fancier ingredients more precisely. Hormones to shut things down for a bit (Lupron) and then others to rev things up, short needles, long needles, patches, a dial-needle pen. If someone could’ve told me that I was guaranteed to have a baby and not get cancer from it all one day, I’d have enjoyed being part of what seemed awfully close to a science experiment.

After diligently studying the clinic’s tutorials, I set sail. One inch to the left or right of my belly button with one hormone in the morning, which meant bruising all over my abdomen, then at night a hormone to stimulate things. Then there was the progesterone in the butt in a spot that was almost impossible to do on your own. I started off having Jay do it. But he was squeamish about stabbing me with a needle. I found it easier just to contort my body and do it myself versus standing there yelling at each other. Eventually, the shots became rote, like brushing my teeth. After every appointment, they’d either dial things up or down depending on how my follicles in my ovaries were growing. Life was giving shots, getting blood drawn, getting ovaries checked, and finding reassuring sports metaphors.

 I would frequently calculate when I might do egg retrieval because Jay and I had idiotically in hindsight booked a summer vacation before we knew we would have to do IVF to have a second child. As I barreled toward egg retrieval day, I started to worry it might crash into our carefully planned getaway. Now, I’ll be the first to admit that there is nothing tragic about missing a vacation other than the pain of losing a large deposit when you’re already freaking out about the large sums of savings you’re spending to have a second child. The fact that we had any of that extra money was a godsend. I just felt guilty and responsible for possibly ruining this for Jay & Teddy and both sets of our parents.

What is more, I hadn’t told the world what I was going through so a missed vacation would mean either I continued white lying or came clean about what felt to me like having to admit yet another failure in my life.  I hadn’t told my in-laws about what we were going through simply because they’re the type of well-meaning folks who give unsolicited advice ad nauseam and would have been more than I could handle. I’d have to admit to them that I kept them in the dark, which seemed mean even if it was done to protect our relationship. We told my parents about the possibility and just prayed it would all work out.

A couple of nights before retrieval, the clinic sent me home with a trigger shot to tell my ovaries it’s time to release the eggs. This shot goes in your upper arm, where they give flu shots, at a precise hour calculated back from when they schedule your retrieval. This seemed impossible for me to do so I had Jay do it. If we screwed up this shot, we ruined the entire cycle and thousands of dollars we spent would be for naught. I must’ve read the instructions 30 times but have no memory of the actual shot. I’m sure we argued because that’s what we do when we’re both stressed out of our minds. Bless my merciful brain for erasing that memory.

Egg retrieval was surprisingly a nice experience as far as having to have surgery in order to try to conceive a child goes. I followed my fertility yoga teacher’s advice & tried my special yoga breathing as I put my legs in stirrups and I lay on a gurney in an operating room within the clinic. This clinic used a mild sedative. Propofol, I think the stuff Michael Jackson used to use improperly to go to sleep at night. Oh man, I can see why. For what was probably a grand total of 5 minutes, I didn’t worry. I was weightless. Bliss. Well, that is until I woke up and was right back to my world and in a bit of swollen, bruised abdominal discomfort.

Jay had it worse. He had to perform his role in what I imagined to be a basic closet-sized room with some type of adult literature or videos that you know some other poor guy was just watching and doing the same thing. No Propofol to erase it from his memory bank. I honestly couldn’t have done it. It’s probably one of the few times in this experience I was glad I was a woman. I’m impressed that he rose to the occasion so that we could conceive another child. Pun intended.

I can’t remember exactly how many eggs they retrieved but it was a decent number in terms of probability, maybe over 10 but under 17 eggs.  Then they told me how many fertilized and we were down to under 10. These seemed good odds to get one good egg. Then on Day 3 there were only 6 in the running. At the time, they graded them A, B, etc., and some other measurement of quality I now forget. I had two As and two B which felt like an okay report card. I’d gone from 16 eggs to 4 in lightning speed. Finally on Day 5, somehow the two A’s growth slowed and the two B’s superseded them. But the transfer was a go. I didn’t even realize my good fortune at the time. Anyone who is a veteran of this process knows that an embryo transfer after egg retrieval is never guaranteed.

I read up about transfer day while digging deep into the medical tomes churned up by my random, late-night Google searches. The one thing that stuck with me was a study of women on transfer day. A clown visited half of them after transfer to make them laugh and the other half just went about their business as usual. The former had a higher rate of pregnancy than the latter. SO from that one study, I decided transfer day was going to be light, un-stressful, and full of laughter. I got a sitter, told my husband he was allowed nowhere near me during transfer and made a list of funny movies to watch on TV.

Transfer day came. Jay didn’t respect my ban but promised not to talk about anything stressful. They got me ready in stirrups, inserted a catheter-like tube up my yoohoo, and then they slid open a little metal door on the wall, like the kind you’d expect a dumbwaiter to be behind only behind this was a laboratory that in my hazy memory looked like what I imagined Q’s laboratory looked like in a James Bond novel and where quite a few babies were likely incubating in some sort of a fertility petri dish. The hand-off came with lots of official talk confirming the embryo, the patient, and what was happening at each step. It wasn’t quite the professional formality of a NASA rocket launch but a close second.

Afterward, my brilliant, baby, rocket scientists left me alone to chill out on the table for twenty minutes. Jay immediately forgot his promise and was chattering on about something stressful. I tried my best to tune him out. I got dressed. Switched to a basic exam room, the in-house acupuncturist arrived and I chilled out some more with yoga breathing. And then it was time to go home. We had discussed ahead of time that we should implant two embryos to increase our chances of getting pregnant and so we did. As I left, a nurse gave post-procedure instructions — no lifting over 10 pounds — and handed me an image of them. I remember thinking how incredible it was that I was potentially staring at the cellular level of my potential child … or just some embryos that never make it.  

While I wasn’t going to hire an actual clown to cheer me up — because that would be weird — I did the next best thing and searched for funny movies without anything stressful in them, which was harder than it sounds pre-streaming Netflix. The end result? Diary of a Wimpy Kid. I only had an almost-three-year-old at the time so had never heard of this movie or book. It was hilarious. I laughed so hard that at times, I worried if perhaps it would impede implantation. The cheese touch. Ha.

But, yet I digress. Fun fact: tense vacation is not an oxymoron. The other key thing that happened in July 2011 was that our family vacation wasn’t ruined by my failure to have a second child naturally. The day after retrieval, we got in a car to drive toward South Carolina, which with traffic ended up being a 15-hour journey. Miraculously, we kept it together and only lost our temper once that day. Okay, maybe once each. Mine? When Jay told me he and his high school buddies were joking about how they felt like they knew our sex life intimately because of the IVF process he shared. His? When we got to a hotel and I was asking him to do something for me after he’d driven 15 hours straight. Pretty good all things considered. I was useless on the trip. I couldn’t lift ten pounds so Jay was left carrying the bags in every sense of that phrase. We ordered pizza, got Teddy ready for bed, and kept hoping.

I forget how many days one goes in for a blood test to see if I was pregnant. Usually one does the blood draw at your IVF clinic but it’s not de rigueur. SO after a few days on the beach pretending to chill out and giving myself daily progesterone shots, we put Teddy in my parents’ hands and went to the nearby Quest Laboratory. I remember driving when we got the news from the Clinic. Our numbers were high enough to be considered pregnant. Super high. Twin level high. I burst into tears of joy. We were almost at first base.

I told family and friends with us on vacation — those who knew what we were going through — and they were elated. I was nervous. I knew it wasn’t a done deal. I had to go back in two days for another blood draw to see if the numbers had doubled. THEN I would know I was pregnant. My numbers almost doubled. I was on first base. Full stop. Yet despite reassurances, I couldn’t shake why my numbers hadn’t doubled. Did I have twins and one died off? What if the other one just died off too in a few days? I tried to let it go but it felt herculean to do so. Even if I was pregnant, I knew I had miles and miles to go. But I was on first base and as Dr. Noiret said to me after my first miscarriage, getting pregnant is half the battle.

Throughout this pregnancy, people who knew how hard I had been trying and for how long would ask if I was over the moon. Naturally, I was happy. I had made it to second base (the heartbeat) and was rounding third (making it to viability). I certainly recognized the joy that I was not waking up anymore with insomnia and crying for hours, longing for another child. My standard reply was, “I will let myself be excited when I’m holding my healthy, alive baby.” I’m not the sort of person who celebrates a run in a baseball until the runner touches home plate or if we’re going to cross sports metaphor until the football player breaks the plane and a referee signals it’s a touchdown.

I continued my alternative fertility treatments throughout the pregnancy. I didn’t want to mess with anything that had gotten me this close to another child. As time grew closer, I made plans for a C-section. My first birth had been an emergency C-section, this baby was breech, and I wanted to get on Dr. Noiret’s schedule. But I didn’t want a C-Section. If I could get this far despite obstacles, I reasoned I could have a normal birthing experience. I did every treatment known to man to get my body to go into labor naturally. A week before my scheduled surgery, I wasn’t dilated or effaced so my OB-GYN manually tried to dilate my cervix. He got me to a centimeter.

The surgery day came. I got my hair blown out. Did my make-up. Arrived at the hospital and then waited all day long, so long that a local TV reporter from NY1 had time to interview me. The doctor on duty checked my cervix to see if I was dilated and might be able to do this naturally. I wasn’t even remotely dilated. I’d in fact regressed back to zero from a week prior when Dr. Noiret manually dilated me to 1 cm. My womb seemed to have trouble recognizing when it was time to vacate a child. It had been the same with my miscarriage and then my first child. Although I’d thought perhaps I miscalculated my due date with him. With IVF, I knew the exact time almost down to the minute that my pregnancy started.  I accepted my fate. I just wanted a baby.

Right before they wheeled me to surgery, I put my headphones on to listen to the Rocky theme song as tears came streaming out and I finally let excitement creep into my bones. My husband was there but I didn’t want him to be. This was what I had trained for over a year and a half for by myself. And yes, I realize this is the opposite of Rocky screaming for Adrienne to join him in a triumph that was theirs. But, I hadn’t felt part of a team. Jay is many, many wonderful things save a cheerleader. The moment Dr. Noiret took our baby out, I saw his face and before the doctor announced it was a boy, I immediately knew it was a boy named Charlie as we’d decided it would be. I’ll never forget that joy. It’s probably why I now get excited for any medical procedures or surgery.  It’s such a letdown afterward though. “Congratulations on your new ACL!” just isn’t the same.

Advice

When you’re trying to conceive over a long period of time, longing for a family, hearing about everyone getting pregnant but you, it feels like a game of musical chairs. Remember, it’s not. There are plenty of chairs out there. You will have a baby.

If you’re like me and feel like a failure sometimes, force yourself to list out your accomplishments in life. Be your own cheerleader. I was horrendous at this during my journey. For me, not being able to have a baby the “old-fashioned way” connected with every feeling of inadequacy I’d ever had. I’d go over trivial life stumbles in my head as if this was the origin story of a loserish, superhero — From my 6th-grade “boyfriend” and his best buddy dumping me and my best friend, Katie in a joint Dear Jane letter that they typed ensemble in typing class, to not getting into my first choice college (twice since I didn’t get in early decision or regular decision. Thanks a lot, UVA), not getting a job in investment banking, to inexplicably being fired from a hedge fund after being up 18% for the year, and then having my first pregnancy be a miscarriage. I could go on but then my mom would point out how I cleverly avoided weaving any of my life’s triumphs into that self-pitying tale of privileged woe … and she’d be right.

Get a second, third or fourth opinion. When I switched fertility clinics, my OB-GYN said that it was never a bad idea to try out a different one. To him fertility doctors were like chefs, they all have their own recipes and some of them dismiss competitors’ recipes as nonsense. You need to find the one that works for you. Right again, Dr. Noiret.

It’s okay to worry. Growing up, people always told me not to worry so much. I can worry about almost anything. It’s whatever the opposite of a gift is, oh yeah, a curse. When I couldn’t get pregnant, I worried about what it would be like having one child even though I’d always dreamed of having three kids. This was easily assuaged by the fact that the people I know who are only children are probably some of the best human beings on this planet. Likewise, my friends who have one child are some of the best parents with tight-knit families. But, then I’d worry if I could handle having all of my eggs in one basket so to speak. Would I smother my son with too much love and attention if he was an only child? If I had to use a surrogate would I breastfeed? If had to use an egg donor, when would I tell my child they were not biologically mine? Would I tell other people? These worries might sound endless. They were not. They got me to a place where I was comfortable with any path and I stopped worrying … so much.

Read Kelly’s Story Part III