My fertility journey

My fertility journey hover background

Jan 22
2019

I never imagined it would be as hard as it was to get pregnant.  

I knew I was older — 38 when we started trying. And I knew I had endometriosis. I also knew that infertility was real because I’d been supporting women struggling to conceive as an acupuncturist for many years…  

But I did not think it would happen to me.

My fertility journey was the biggest roller coaster ride of my life — moments of optimism and excitement would nosedive into frustration, anger, and hopelessness, sometimes within seconds. Then a new day or new opportunity would come along and we’d be on the upswing, only to have everything go wrong again. It felt like everything was working against us at every turn, sometime including the very people and systems that were supposed to be helping us.

We all walk a slightly different path towards parenthood. Some are smooth and direct, green lights all the way. Some, like mine, are a summer morning commute in bumper-to-bumper rush hour traffic with no AC. They test your faith as well as your patience, leave you consumed with worry, in pain, and convinced that you are never, ever going to get there.

And you desperately want to get there.

I offer my experience in solidarity with other women fighting their way through infertility so that it may inspire hope, but also to encourage fierce self-advocacy and finding support, whether from a community or a professional. There’s so much on this ride we can’t control, so we need to take control of the things we can.

This is my story.

Because we couldn’t try at home naturally, our journey began with the search donor sperm. We were excited when we chose our donor and felt so optimistic as we headed in for the first IUI. It wasn’t romantic and it certainly wasn’t how I wanted to make a baby — under fluorescent lights with a speculum and a nurse who I’d never met before making idle chit chat about the weather — but it’s how my wife, Ellen, and I would be able to have a baby and for that we were grateful. We were thrilled to have the chance at getting pregnant.  

One IUI led to another and then another. I knew it might take some time so we weren’t particularly worried yet. But the logistics were taking a toll. At the time we were living and Maine and commuting to our shared office in Cambridge. Each ultrasound, blood test and procedure required driving from Maine to Boston during morning rush hour. Scheduling our life got so difficult. Vacations and holidays were disrupted and in some cases cancelled. And, we hadn’t told our families we were trying, so we had tell little white lies as to why we wouldn’t be attending such and such party or holiday event. I hated lying and I hated hiding such a big part of my life from my family, friends and even my patients.

After a string of unsuccessful IUI’s we decided to get a second opinion, and our new doctor did a much more thorough workup than anything I had had to date.

I can’t remember why I would have considered going to the follow-up appointment without Ellen — I guess it just really didn’t even occur to me that something could be so wrong. But that morning, I sat alone across from the doctor as he read aloud the results of the blood test.

Because of the work I do, I know these numbers. I talk about them everyday with my patients. That result was indicative of not just low ovarian reserve, but very low ovarian reserve. I was stunned. It felt like the wind had been knocked out of me. I remember sitting across from the doctor after he shared my test results. My head spinning, unable to focus my gaze and struggling to listen.

I could handle a fertility journey that was a little bumpy, but not being able to have children? I wasn’t prepared for that.

I was so mad at my previous Reproductive Endocrinologist for not doing a thorough enough evaluation. For letting us go through six IUI’s with little to no chance of getting pregnant. For letting us spend all that money, for wasting all that time. I was just getting closer and closer to 40 and with ovarian reserve that low, every second felt like it mattered. It felt as though the process – testing, waiting, insurance requirements, more waiting, busy doctor schedules – had stolen precious time.  

My troublesome ovarian reserve wasn’t the only disheartening revelation from that round of testing. We discovered I’m a carrier for Hypochondrial Dysplasia (HD), a rare bone disorder, so had to pay an additional $1,000 to have our donor tested (he turned out to be negative). On top of that, the doctor recommended laparoscopic surgery to address my endometriosis, which would delay IVF by several months. I didn’t want to waste time with surgery, so we decided to move forward with IVF and re-evaluate after the first cycle if it didn’t work.

The doctor made it clear that he believed IVF wouldn’t be increasing our chances any more than trying naturally on our own, but because we were a gay couple, he’s support us trying IVF. I would see heterosexual couples in my office all the time who felt like the months of “trying on their own” in between IVF cycles were a waste of time. To us, it just felt like another missed opportunity.

I was put on the high doses of Menopure and Gonal F. In that first round of IVF doctors retrieved five follicles, we got a beautiful little embryo and had an easy transfer. We were over the moon — after a year of trying, things were finally working.

When the positive pregnancy test results came in my HCG was low. The nurse said we would have to wait it out. I didn’t know how to feel, it was like living in limbo, waiting to hear the most important news of our lives. We tested again and then again, only to discover we lost the pregnancy. The next two months were particularly trying — more blood tests, more vaginal ultrasounds, HCG levels that went down and then back up. The doctors were worried that it was an ectopic pregnancy and emphasized that I could bleed to death, so if I had any pain with bleeding I should go to the ER.

But, I had endometriosis — I always had pain with bleeding. And the last place you want to be in that kind of pain is in a hallway on a hospital gurney for eight hours with no food and a dead cellphone.  

Eventually my HCG got back down to zero and we were able to discuss another IVF cycle. This time we were going to try the Lupron Flare protocol to see if we could get more follicles to develop. I wasn’t comfortable with the idea of taking Lupron and my gut was warning me against it, but how could I question the doctor? Plus, doing nothing felt awful — I just wanted another chance.

I was doing all the things I recommend for my patients —eating right, taking supplements. But, I was super stressed out. I wasn’t reaching out for help. I wasn’t telling anyone what we were doing except for a few close friends. Even still, no one really knew what I was going through. Not even Ellen. I felt alone. Really alone.  

As a practitioner who supports other women going through this exact thing, I thought I should know how to deal with the emotional side of the fertility journey. I thought, of all people, I shouldn’t need help because I understand the process. But I was sliding deeper and deeper into depression. I felt misunderstood and not listened to, like I was the only one who knew the truth of what was happening… that I would never get pregnant, never have my own baby. At least that’s what a voice in my head kept telling me.

We started our second round of IVF and everything looked like it was going great. When we got to retrieval day, we had 12 follicles, which was unheard of for a now 39 year old with my stats. We felt so optimistic again, but when I woke from the anaesthesia the surgeon told us she only retrieved five eggs and they didn’t look great. The other follicles were empty and/or filled with blood from the endometriosis.

Twenty four hours later we got a call from the doctor that none of our follicles had fertilized. I felt like I couldn’t breathe. I felt hopeless and defeated. I didn’t know how to talk about it and more than that I couldn’t understand how talking about it would help.

At this point I was just months away from my 40th birthday, which meant my insurance would require a follow-up Clomid Challenge. Given my age and AMH, the doctors were not optimistic that I would pass the Clomid Challenge, and if I didn’t pass I would no longer have insurance coverage. Or, as my doctor put it, “We’d be dead in the water.” I hated his nonchalance. We’d be looking at $20,000 to $30,000 out-of-pocket for a round of IVF which would present us with very low odds.

I just wanted another chance.

We scheduled another IVF cycle but at my baseline ultrasound they found an endometrial cyst large enough that they didn’t want to risk putting me on stimulatory medications. The recommendation was to go on birth control pills for a month and see if it went away on its own. Time was evaporating — I didn’t have the time to take birth control and wait. My panic grew.  

The month passed and the day before we left for vacation in Aruba I got an ultrasound to check the progress of the cyst.  We got the call from the doctor sitting on the beach — it hadn’t changed, they were cancelling the cycle.

I felt numb. I shrunk up, sank into myself. Shut down. We didn’t have time for this. Six months had passed since my last IVF cycle. I walked through the vacation like a zombie.

When we got back from vacation we met with the doctor who recommended endometriosis surgery. It would mean another two months of waiting — another delay. But it felt like we didn’t have a choice. We scheduled the surgery.  

I was happy to have the cyst and endometriosis removed, but emotionally I was a mess. I had to get some support. I started telling more people what was going on. I saw the amazing therapist at the hospital, and I started seeing a therapist of my own. I reached out to the Resolve Community. I even went to Advocacy Day in Washington DC and told my stories to our Senators. It helped. It helped more that I expected it to help. Way more. I started really taking care of myself, not just going through the motions but actually caring for myself.

The surgery did go smoothly, but the menstrual cycle after the surgery was the most painful of my entire life. I called the doctor’s office but the nurses were dismissive, telling me that it would take time. We waited another cycle but the pain was not getting any better.  

At my six week post-op appointment I asked the doctor repeatedly if this type of pain six weeks out from surgery was typical. Was it something he expected? Did he see this in other patients? He flat out refused to address my questions, instead telling me to take Advil. I didn’t need someone to tell me how to manage the pain, I’d been doing that all my life. I needed to know if this was normal or if something was wrong. Why wasn’t I feeling better from the surgery? He never answered. He had removed the endometrial tissue he found and to him that was all that mattered. He cleared us for another round of IVF, just two months before my 40th birthday.

The insurance company was dragging its feet on our approval and the doctor’s office was in no rush, but I was. If I didn’t start this cycle I would likely need to repeat the Clomid Challenge. I was the one paying attention to all the details. So I pushed. I kept everyone on task. I made it happen but the stress of keeping it all together made what I was going through even that much harder.

With just days to spare, we started our third round of IVF.

But again, everything seemed to be working against us: The donor we had used in previous cycles, who we had grown so attached to, who we had gotten tested for HD, was suddenly and unexpectedly out of vials. We needed to have the sperm to the hospital in seven days, and if we couldn’t find a donor in time we’d have to cancel the cycle, wait another month, and re-do the Clomid Challenge. We found a donor in time, but had to take the risk and move ahead without testing him for HD. The retrieval went well and we got 6 eggs. Then we learned that the donor sperm did not meet the criteria for natural fertilization, so we would have to pay $2,000 out of pocket for a ICSI where the sperm would be manually inserted into the egg. All of our eggs fertilized, and we transferred one embryo three days later. I’ll never forget the embryologist saying “it was an embryo to swoon over.”

The day before my blood test, I broke all the rules – even what I recommend to my patients and secretly took a home pregnancy test. Right away I saw two lines.

I was pregnant.

There was a long way yet to go, but I had gotten past the first hurdle. I was happy but also terrified. I didn’t let myself believe it. For weeks I walked around asking Ellen, “Do you really think we’re going to have a baby?”

At eight weeks we had our first ultrasound. In the car heading to the hospital I felt oddly calm, though looking back I think I was really just numb and shut down from the pain of the previous two years. We waited a long time in the waiting room before being called back — a room full of other women and couples waiting for fertility related ultrasounds, a room full of trauma and heartache. The technician told us the heartbeat was perfect and turned the screen toward us so we could see our tiny baby and her fluttering little heart. I burst into tears and sobbed and sobbed. So much emotion had built up waiting for that moment and it all came spilling out right there on the ultrasound table.

We were discharged from the fertility department and into the care of an OB. As each week passed I let myself believe just a little more that maybe, just maybe, I could carry this little baby to term and have the family I wanted so badly.

Each pregnancy milestone was a victory — when we got the results of the first round of genetic testing, when I passed the twelve week mark, when we survived the 20 week anatomy scan (where they confirmed HD was not present), when my placenta previa moved away my cervix, when we found out we were having a girl, when we switched from hospital care to and hired our homebirth midwife  — but there was a shadow of doubt always hanging over me. I absolutely loved being pregnant and felt strong and healthy, but the fear of losing the pregnancy never quite left. I carried that with me to some extent the entire time.

Lennon arrived safely, strong and beautiful and 10 days early. I had a wonderful homebirth with a team of midwives and Ellen quietly, calmly supporting me through each contraction. I look at my baby now and still can hardly believe she’s real. And that she’s ours.

Part of me thought the pain of our journey would disappear when out little Lennon was born and some of it has. Even though I would do it all again, I know that the pain we went through will always be with me. But, it’s okay.  It’s our story.