Thursday, December 1, 2011

Pregnancy after Infertility

Pregnancy after Infertility was a very surreal experience for me. I had had one loss early on, and had met many other women who had miscarried or had stillbirths as I sought out support for our journey, and the thought that nothing was guaranteed for 9+ months scared. me. to. death. I can honestly say I savored every moment, because every moment I also had the lingering thought that it could be the last one.

I was spared a lot of worry because my clinic was not extremely intervention happy if there was no indication for testing. I had a light but positive home pregnancy test 6 days after a 5 day transfer (if I remember correctly), and an HcG (blood test) that registered in the 70's 9 days after transfer. The level was 78? Maybe? Most clinics will do a second blood test 48 hours later, and sometimes even a third 48 hours after that, but mine didn't as long as the number was "high enough," and mine was high enough for them.

At 7 weeks, I had an ultrasound, which happened to coincide with an episode of bleeding, so seeing the heartbeat on that screen was the best feeling in the world after the worst morning I could have imagined. Hannah was measuring about a week behind at that point, so I went in again at 8 weeks and she was growing just fine. I think I cried on the table. I could have had an ultrasound every week if I had wanted, but my clinic was fine with me not doing so too, so I didn't make the hour and a quarter drive after that.

I continued taking progesterone shots/ suppositories (we used the progesterone in oil up so as to maximize our investment- that stuff's expensive!) until 11 weeks, and then I was released from the Reproductive Endocrinologist's care. I was just... pregnant! And low risk at that. I called a midwife, and started normal care.

But I didn't feel normal. The infertility feelings didn't go away. We took a picture every week, and every week I wondered if that would be the last one. I blushed and changed the subject when people would comment on my pregnancy. I felt that I was not allowed to experience negative emotions regarding or complain about the discomforts of morning sickness or exhaustion. I didn't prep a nursery. I wanted to run away when the time came to register for baby items, and I was intensely uncomfortable at my own baby shower.

Don't misunderstand, I was certainly overwhelmingly grateful, but I was not overwhelmingly happy. I wouldn't say I was fearful, but my emotions were definitely reserved. I remembered what it was like to be naively excited and optimistic before I experienced the loss of a baby, and those feelings did not resurrect themselves after 3 years of grief in not getting pregnant again.

Every woman experiences this differently. A lot of my situation, I believe, stems from my naturally introverted personality. Some women are nothing but excited after years of trying, but I have also met several others, like me, for whom pregnancy after infertility is a very private and protective experience. I have since learned that infertility can predispose a woman to pregnancy and post-partum depression, neither of which I experienced, but I can definitely see why this would be true.

Once I was in the third trimester, I began to get a little bit of that excitement that seems to be expected. A friend of ours, who was a budding photographer, gave us a photo shoot, and those are some of the best memories I have of that sweet and special time. She perfectly captured the intimacy and preciousness of how I felt savoring the life inside me. I'll end by sharing a few of my favorites.

Tuesday, March 29, 2011

Transfer of Property, or, Adoption of the Heart

The process of contract to transferring an embryo is very medical and seems very sterile on paper. While I have never been Catholic, their criticism of assistive reproductive therapy as "clinical" and "unloving (their term, not mine)" has its place in the experience, for sure. What they seem to miss is the emotional aspect that nobody wants to go to the doctor to get pregnant. And for us, getting pregnant clinically was the *only* way we would ever have the chance to meet these babies and welcome them into our lives. As I stared at the paper outlining the medication and procedure calendar, I realized I was understanding how parents become willing to do anything for their children, without reservation, without second thought, no matter how far removed a decision had seemed from them previously.

To start with, I had to start taking hormonal birth control in mid-February 2011, something I had never done before in my life (I realize that some women have been able to do natural cycles without medication and hormones, but this wasn't possible for my body). Then I had to start giving myself shots of Lupron (a hormone suppressant) in the stomach starting early March. To that, we added a "baby" Aspirin per day, and then started mimicking a the early phase of a natural cycle by taking estrogen in increasing doses after about a week on the Lupron. Half-way through March, I had an ultrasound to check my lining and make sure I wasn't trying to ovulate through all those meds trying to stop me from doing so.

A week later I had another ultrasound, and when it was determined that I had built a sufficiently thick lining with the Estrogen pills, I started taking intramuscular shots of Progesterone. Lucky Mr. Myth got to give them to me, and yes, I can assure you, if this had been a dream, those shots would have woken me up. It wasn't a dream though, and I also started taking an antibiotic and an oral steroid to make sure no infection or immune system flare could hinder implantation. Prednisone, I discovered, tastes like gasoline, no matter how you attempt to take it, but even that failed to jolt me out of any sort of delusion. This was real.

The morning of March 29th, 2011, we drove the 4 hours to our clinic (have I mentioned we live in the middle of nowhere?) and signed into our clinic for our transfer. The only choice we had made prior to the transfer was to only thaw and place 1 embryo, since the babies were all frozen individually. I have no idea what "grade" had been assigned, and the staff didn't volunteer the information. All I know is that when we were pulled back to the room, we were told that 1 thaw had been attempted, and the embryo had survived. I wanted to express some emotion- laugh, cry, but the truth is that I had a very full bladder for the procedure to come, and couldn't really breath deeply for fear of losing it and having to wait while it refilled. I just remember smiling, nervous as all get-out, feeling relieved, and sitting very, very still.

Unsurprisingly, my bladder was actually too full, and they sent me to relieve *some* of the pressure, which was its own special form of torture, but made me much more comfortable and able to focus on what was going on. Placing the embryo was very quick- maybe 10 minutes? Maybe less? The doctor came in and reviewed my chart. They asked me my name and date of birth for the umpteenth time, just to make sure, and then brought in a very normal looking catheter. Sam and I could watch the ultrasound on a very big screen right above the obstetric table. They put a very small bubble of air in the catheter where the embryo was, so that the first time we saw our daughter (not that we knew she was a girl then), we saw this:

It's rather surreal, when it's all over in just a couple of minutes, and you're lying there, holding your husband's hand, thinking, "That's it?  Now I'm pregnant?" The doctor wished us luck and left the room. Them embryologist came in next, and handed us a picture of the embryo right after the thaw. I remember looking at it and saying "Hi baby!" She was 120-something cells, just expanding after being rehydrated and warmed, (and yes, there is a thin spot where assisted hatching had been performed, for those who are interested), and looked like this:

In our contract, to protect the embryos from abandonment by the adoptive parents, the adoption isn't actually finalized until the baby is thawed and transferred. The law calls agreements regarding unborn lives a "transfer of property." It is abundantly clear, however, that we had not just become the *owners* of this little life, we had become parents for however long its life continued. We just stared at the picture, marveling at the details of the tiny speck of white in the ultrasound, and prayed that God would be the sustainer of life, acknowledging that any and all ownership rights belonged to Him alone.

And we were very, very happy.