Our IVF Journey

October 2013

We set an appointment for the IVF process in late October. Prior to our first appointment, we had routine lab tests for infection disease testing. Everything came back clear except that I did not have enough resistance to Rubella and would need an MMR booster shot. Rubella is virtually eradicated in the US, but the risks to a developing fetus are great if exposed to the virus. With the associated concerns, we decided it would be best for me to get the booster shot, which unfortunately…delayed when we could actually start the IVF process.

At our 1st appointment, during the first half of our appointment, we signed a lot of paperwork – similar to the amount you sign when you buy a house. We went over financial and legal details. Even though we expected insurance would cover a significant portion of the program, we had to make full payment at this time – yikes! During the 2nd half of our appointment the doctor preformed a sonohysterogram on me (an internal ultrasound). After the doctor finished the procedure he explained that they found something – that everything was fine and not to worry they would go over everything with me in the consultation room. Really?! They found something – but don’t worry…easy for them to say. In my head, all I could say to myself was “oh great, now what!?”

In the consultation room the doctor explained that what he saw was either a uterine polyp or fibroid. He suggested that it be removed in order for best results. Our other option was to leave it alone – but there would be a possibility that it could prevent the embryos from attaching to the uterine wall or it would be possible that I could get pregnant but the odds of miscarriage would be high. After discussing how the surgery is performed and the recovery time – we decided that I would have surgery. Next, we went on to discuss the scenario with our IVF procedure and the number of embryos that would be transferred.

After leaving the clinic I immediately called my OBGYN to schedule my surgery. I needed to meet with my doctor first to go over the procedure and do a pre-op consultation. After it was scheduled I broke down and cried. It was another setback and I was getting so frustrated. Every time we tried to move forward we took another step backwards. Then my thoughts transitioned to – something is wrong with me…again. Even though the fertility doctor tried to assure me that the polyp/fibroid wasn’t cancer…I thought, what if it was. Then what?! I had to stop myself from going there and just keep moving forward.

November 2013

I was extremely nervous leading up to my polypectomy, as this was the first time I would be having surgery. I was most worried about going under general anesthesia and the potential complications. Because of this, I opted for a spinal anesthesia and a sedating drug. When it was time to prep for surgery, they had some trouble with my IV and it took two attempts from one nurse before calling in another nurse to tap the vein on the third try. Off to a great start! Being as nervous and scared as I was, my emotions overcame me and I started to cry. My mom was there to help calm me and was great support through it all. Surgery took a bit longer than expected, and a while after the procedure started, I started feeling the pain. The doctor had to request more drugs to keep me sedated. After it was finished, I was told they removed a large polyp. This was good news because a fibroid could have been more extensive with a higher risk of collateral damage. They would have had to cut into the uterine wall, which could have caused complications or been impossible to completely remove. The initial recovery was fairly quick and I was back at work in a few days. About a week after the surgery, the lab results on the polyp came back as benign and we were able to breathe another sigh of relief.

Julie with her fertility medications
Julie after unpacking her fertility medications

A few weeks later, I started the IVF meds. My insurance plan required all medication to be mail ordered. It all arrived in a large cardboard box, stuffed full. Even though they told me not to be overwhelmed because I would not take all the medications at once, I was overwhelmed because it was a LOT of medications! It was 12 days of both shots in the tummy (two daily) and oral antibiotics to prevent infection prior to the egg retrieval. I was monitored every three days with bloodwork and ultrasound to be sure my hormone levels were progressing as planned and my ovaries were not being hyper-stimulated.

Based on my test results, more injectables needed to be ordered. They were mail ordered with overnight delivery to arrive on a Saturday. At the time, there were a lot of winter storms going through the country, especially along the east coast where my mail order pharmacy happened to be. Well, wouldn’t you know my luck, the medications were stuck in an airport due to weather. As we tracked the shipment, we could see there was no hope of delivery on time. We started to panic a bit. Just as a review, this is medication that is very rare, very expensive, and very time sensitive. You can’t just walk into your corner drug store and pick it up.

The phone calls started to every pharmacy we knew of that might carry the medication (there are only three within driving distance of our house). Two of them were closed and the one that was open did not take our insurance. At the time, Ryan reassured me that everything would be fine and we would find a way. It was only later that he confided that he was really unsure and worried himself. Fortunately, by working with the mail order pharmacy and explaining our situation, they were able to give their credit card information to the one pharmacy in town that was open 24 hours on a Saturday and carried the medication. We made the 30 minute drive to pick it up. When we got the medication, we noticed it was the wrong dosage and started to worry. What if they did not have what we needed? What if we could not contact the doctor to clarify the prescription? Fortunately, they were able to straighten everything out. After our 5 hour ordeal, I clutched the bag of precious medicine the whole way home.

The Monday after this all happened, we went back to the clinic for another ultrasound and blood test. After the ultrasound, we were told I would need an additional two days of medication…and I only had one dose left. This meant that even with next day early delivery using mail order, I would not be able to get medications on time. We asked the nurse what we could do and she gave me some meds I could use and then replace when I was able to get medications by mail order. Because of the short time, we called the prescription insurance company to get approval to get the medication from a local pharmacy instead of by mail. We were glad that they allowed us to do this so we could continue the medication uninterrupted.

A day later was my final shot. The hCG shot, which prepares the egg for maturity and release from the follicle. I was told the timing of this was critical, to be done at 11PM. Not 10:55 or 11:05, but 11PM. To be sure everything would go smoothly, I prepared ahead of time. As I started to pull the medication out to mix it, I realized there was a problem. I had been using a  “Q-cap” for the injectables, which makes it easier to mix medications without the need for a mixing needle. The Q-Cap worked fine for all medication up to this point, but the hCG vial had a different size top and was not compatible. It was 10 minutes to 11PM! I didn’t know what to do. Do I go to the nearest pharmacy and hope they will just hand me a mixing needle? Do I try to use an injection needle to do the mixing and risk it breaking?

At the last moment I decided to search through items from my IUI round with injectables. There in the mix was a single, sealed and unused mixing needle – perfectly compatible with the vial of HCG. I was so thankful that the doctor who did IUI with us had thrown in an extra needle just in case. After quickly mixing, I took the injection at exactly 11PM. The next time I saw our IUI doctor, I was certain to thank him for saving the day!

After all of the medications came the egg retrieval. It was a procedure that required general anesthesia. Ryan will have to describe this part…

Julie before transfer procedure
Julie before transfer procedure, all set to go

At that point, the IVF doctor pulled out a gigantic needle. When I say gigantic, I mean it puts some FM radio station antennae to shame. At that point, the doctor proclaimed, “this is why we make sure they are under – so they don’t see the needle.” Indeed.

And so the doctor proceeded inserting the needle to suction out the eggs, using only the ultrasound and general sense of direction in a woman’s anatomy to seek out those precious eggs. The assisting nurse would call out the status of the fluid as it was suctioned out.

“Flowing! Drip….drip…..drip, drip, drip….drip….clear…..”

Her voice was a bit elvish, so it was hard for me to not laugh at the consecutive “drip, drip, drip” as I thought of a scene from Bambi.

I was told before this all started that they would hand each vial through the window to the embryologist, who would call out the number of eggs found. I didn’t know if they would call them out as “FOUND TWO” or what, but I eventually learned it was a cumulative count. As the doctor worked through each ovary, they said 4 in one, then 5 in another, and then the final count was 10. The doctor questioned this, and they said there was one more that was found in the first ovary so there were 10 total eggs found.

After the retrieval, Julie was wheeled back to the same room for recovery. I was told to try to talk to her and get her to wake up. It was a bit awkward for a while, talking to someone who was unresponsive. What do you say? So I went through describing what happened and she did a great job. It seemed like it was taking a long time for her to come to. I think her first response was to the nurse as she came into the room to ask how she was doing. Her response was simply, “so sleepy!”

Once she finally started waking up and becoming alert, I told her how well she did. “A perfect 10,” was how I described it. Although she was still very sleepy, the smile on her face indicated how proud she was.

Our first baby pics – aren’t they cute?

Two days later, we got the call that we would be doing a day three transfer. So the morning we went in for the transfer, they told us the first 3 embryos fizzled out, that they were watching the remaining 4 and hopefully we would be able to freeze them and use at a later date. They transferred 3 embryos, which we got a picture of, and then I was on strict bed rest for 2 days. A few days later we found out our remaining 4 embryos didn’t make it, they didn’t continue to divide. It was so devastating – we lost a total of 7 embryos – babies we never had a chance to meet. All we could rely on were the 3 embryos they transferred – all our hope focused on them.

Julie and Ryan
Julie and Ryan the morning of the last pregnancy test.

It was almost 2 weeks that we had to wait to know if I was pregnant. I started spotting a couple days before the pregnancy tests and I thought it was over – I felt like it’s always what would happen and then I’d get my period. The next morning I was still spotting and I had some cramping too. We tried to be hopeful. A day after that, I went in for the first blood test for pregnancy. The following day I went in for my 2nd blood test, and while we waited for our results we kept ourselves busy by going out to breakfast and doing some shopping.

The Call

We were in the middle of Target when we got the call…and the nurse said, “I’m calling with GREAT news!” I couldn’t believe it! I asked her, “Really?!” and was on the verge of hyperventilating. I felt like I might collapse at any moment. She proceeded to tell us that the pregnancy test came back positive. Even after this, I still questioned her in disbelief. The two comparative blood tests should show a significant rise in hCG levels to indicate pregnancy. The nurse told us that the doctor’s notes said it was a “GREAT RISE!!!” with THREE exclamation points. (we thought nothing of the three exclamation points at the time other than that it was really positive, but it would later prove to be a bit prophetic). Because I was now clinically pregnant, I would need to take Endometrin (progesterone) for a few more weeks to help sustain the pregnancy.

Ryan and I were balling in the middle of Target. We were SO incredibly happy!!! As we tried to finish our shopping list, we probably looked like a couple of lunatics because we were laughing and crying tears of joy at the same time. It seemed that everywhere we turned there was a cart full of young kids.

January 2014

Ultrasound from fertility clinic - 3 sacs, two heartbeats
Three sacs, but only two heartbeats found.

Two weeks later I went in for an ultrasound. It would be at this appointment that they would confirm how many embryos took. We saw 3 sacs, but only 2 babies & 2 heartbeats. The doctor told us the third sac had nothing in it and would just fade away. I felt a bit sad that the third one did not take, but having the two (twins!) made us ecstatic. We went about telling our immediate family we had twins, using twin packs of Twinkies and packs of Doublemint gum as props.

We had a follow-up ultrasound two weeks later. The clinic had a new ultrasound machine and the machine rep was there to assist with the training. As the nurse searched around, the rep would point at the screen and nod. Maybe they were looking at the uterus or the bladder. There was no verbal indication as to what was going on, and their faces gave nothing away either. After a few times of poking and nodding, the nurse turned to look at my chart before turning back to us. Up to this point, I was a bit fearful because the doctor had warned us of the risks of losing one of the babies. I thought that it was likely that one would have faded away just  like the third sac.

“Today, we are seeing three heartbeats,” the nurse said. Both Ryan and I started to laugh. Then I cried a bit. Ryan was a bit frozen. I think he may have been in a little shock. Twins is one thing, but having triplets really changes everything. In 2010, only 0.14% of births were triplets. Besides being rare, triplets start to present unique challenges (think number of nursing stations, number of arms on a person, etc.) and also have higher associated risks with the pregnancy.

ultrasound - 3 sacs and 3 babies
This ultrasound shows three sacs and three babies.

After the immediate shock, the excitement and joy kicked in. THREE babies! What a blessing, as we had talked about wanting to have more than two kids before. After nearly 5 years of battling infertility, we would suddenly make up time quickly and fill up our household in a matter of months. They found 3 babies and 3 heartbeats!!! Apparently one baby was hiding. So crazy amazing!!!

Through it all, we never gave up hope. The infertility and IVF journey was one of the hardest things we’ve had to go through as a couple so far. We kept our faith in God to guide us through it, stayed strong as a team and had support of our friends and family to keep us going.

Julie is glowing
Julie is glowing

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