IVF #13

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It’s almost the end of February, 2013, and I recently had my 13th egg retrieval.  I had gone in on day 3 of my period thinking that we would proceed and ready my body for the transfer of my two frozen embryos, who are still waiting for us patiently, on ice, in a state-of-the-art refrigerator in Tarzana – wrapped warm, I like to think, in the blanket of our love for them, but when the doctor saw that I had 6 follicles on day 3, we decided that we should stimulate my ovaries instead of transferring the embryos we already have.

The progress was fine along the way; there were the moments of concern that my estrogen was too low at first, and then it rose appropriately.  If the growth of the follicles wasn’t impressive, the estrogen comforted my doctor with the knowledge that yes, my follicles were growing appropriately. There were cysts, as there always were, but they weren’t growing that much, and so would not interfere by polluting my estrogen count with false hope.

- my belly after several days of medication

– my belly after several days of medication

I ended up on the medication for 11 days.  I think that is my new personal best.  By the end of the cycle, my belly was bloated to the max; it was bruised, terribly and grotesquely bruised from the daily shots of two to three medications.  My senses were heightened in the most uncomfortable way; the side effects always made me irritable or sweaty or increase my insomnia, but after 11 days, the anxiety I was feeling was irritating, and painful.  But I have gone through enough that I am able to separate normal anxiety from that which the medication causes.  I can feel the pain and anxiety, and close my eyes and remind myself how powerful the medication is, that this feeling will not last forever.

There was one round of a screaming match between Craig and me during the cycle.  This was not unusual; in fact, it was downright predictable.  My senses were heightened and I was feeling the pressure and he said the wrong thing, at the wrong time, and since I was feeling overwhelmed by the 3-times a week doctor visits to the valley in the middle of an insanely high pressured post-production and the invasion of my vagina and the drawing of the blood and the scrutiny that I fell under as a woman as I was measured and judged in terms of follicle size and estrogen amount, coupled of course with the deep and soulful longing to hold my child, I had a breakdown.

This time we fought about my weight, and the fact that the only thing, very truly, the only thing I haven’t done “perfectly” in regards to my efforts, was lose it.  Of course I have multiple excuses why I should not have to diet:

I have asked multiple specialists if being overweight could interfere at all with my fertility efforts. The answer was no.

I am sober for coming up on 7-years.  My remaining vice is food.

I have more pressure on me than any one person should have, between professional stresses and being responsible to help achieve my husband’s and my personal dreams.  Adding restrictions on food requires great intent, and that to me feels like another full time job.

Oh, and overweight women get pregnant all.the.time.

Still, he is right; that is the one health area that I have not perfected, and of course an area I am highly sensitive about, so I broke into tears and we screamed at each other for a bit.

And then the next day I had my egg retrieval, and they got out 3 eggs.  I was thrilled.  And then the next day only 1 of them had fertilized.  I was disappointed that more hadn’t fertilized, but happy nonetheless. And then the next day I learned that instead of being at 4 cells, my embryo was only 1 cell.  I was concerned; that was not good news.  On Thursday it was still at 1 cell, and so we knew that we would have nothing new to transfer.

11 days of medication.  About $10,000 in medical costs on this round alone.  And no egg to add to my basket, my lovely, frozen embryos basket of two.

Devastated, but not defeated, I made an appointment to chat with the doctor.  We spoke, and he was very clear that just because I had a bad cycle, didn’t mean that this was the sign of bad things to come; it was not as if I was going into pre menopause; I just had a bad cycle. Hell, only 2 months before I had produced eggs that upon meeting Craig’s sperm became strong enough to create 1 Blastocyst and 1 Morula that made it to the freezer.  (Blastocyst is an embryo at 5 days of development; a Morula is where the embryo should be at 4 days, which means that this one was either just a little behind, or would not make it once thawed.)

Dr. V, my Israeli fertility specialist, among the top 3 in Los Angeles – high praise indeed, whose expertise and knowledge I trust academically, and who is very committed to Craig and I emotionally, and I came up with the plan: wait for my period and prepare my body for the frozen embryo transfer (FET). We went over all of the details of how this time is different: I’ve never transferred embryos that have been frozen. I have always done transfers right after the magic poison courses through my body, which some scientists theorize is a reason that frozen embryo transfers are often more successful.  We did poor man’s genetic testing, in the sense that we let the embryos grow to day 5, as if they hadn’t made it, we would not have frozen them.  (Many doctors believe that if an embryo doesn’t last until 5 days in the laboratory, it won’t last in the woman’s uterus.)

We had a plan.

But still, the nagging thought came into my mind what Craig said: What if losing some weight could change things? What if my love for Lindt chocolate is interfering with the embryos attaching?  What if?

I contacted a peer who I knew had experience with cleanses, and was put in touch with a woman who would help me.

The task:  reduce the inflammation.  I couldn’t lose significant weight in two weeks, but at the very least, I could reduce the inflammation, which is the number one side effect of Follistim, that magical poison that has been stimulating my ovaries every other month for about 3-years.

The solution: have a woman prepare all of my meals for 4 days, done 2 days at a time so the organic ingredients remain fresh.

The cost: $360

My period came like clockwork, something I do not take for granted, and so I made my appointment to see the doctor on a Saturday morning.  I hiked first, which required me to wake up at 7ish on a Saturday to head to Malibu from Venice, before I drove from Malibu over Topanga Canyon to Tarzana for my 9:30 appointment.  The lovely female specialist at my doctor’s practice confirmed my uterine lining was exactly where it should be.  I let her know that it had to be perfect, absolutely, in order for us to proceed, and put me on estradiol, which I was prescribed to make sure that my estrogen would be regulated for the next several days; to encourage my uterine lining to develop.

I had never had issues with uterine lining development in the past, but needed the assurance that we were operating under optimal physical conditions to proceed. I’ve gone through too much, lost too much, to keep on taking such enormous risks, and I’m not even referring to the measurable risks.

My own hope has become a risk.

Once assured that everything was exactly as it should be, I proceeded to start the estradiol, twice a day.  Already an emotional woman, I was now taking tiny blue pills that made me even more emotional.

I did a 4-day food cleanse. The thing about me is that once I commit to something, I really commit, and so even while working in post production, with people seemingly dedicated to bringing me lattes or juices or sushi or cookies or anything I could dream of at multiple junctures of the day, while I am glued to my computer or to conference calls or to watching special effects done on the best television monitors imaginable (which often feels like watching paint dry), I stuck to the menu provided.  There were delicious smoothies, and there were juices that made me gag because there was too much of some healthy, weird ingredient that was unfamiliar to me and unfriendly to my taste buds.

On the 4th day of my cleanse, I returned to the doctor’s office, to see my specialist who I sometimes refer to as the wizard, to confirm that everything was developing exactly as it should. We talked about the perfect day to do the transfer, and I let him know that if at all possible – without risking an ounce of the probability of this working, I would prefer to do this on a weekend.  He thought about it for a moment, and then said yes, we could do it in a week, on Saturday, March 2nd.  “Seriously, if by doing it Saturday this decreases my chances like point 1 percent, we can’t do it.  I just don’t want to be stressed with work and want to create the best environment for myself.”  “The only issue is that now I have to work on Saturday,” my doctor responded.  “Do you mind, Dr. V?” I asked; “If we do it Friday and I have to take work emails and this doesn’t work I will wonder if that’s why….”  He interrupted, “I would not do it for anyone else, but I will do it for you.”

There are not a lot of benefits to being a repeat customer in the fertility realm, but him knowing me and being willing to change his personal schedule to accommodate me is definitely one of them.

I drove to the specialty pharmacy in Westwood to pick up about $350 in additional medication, progesterone oil, which helps keep pregnancies safe.

I kept thinking of the percentage of chance Dr. V had uttered to me in a previous conversation: A Grade A embryo like mine allowed a 35 – 40% chance of resulting in pregnancy.  But women get pregnant all of the time with less than Grade A, too.  I would just have to stay calm and outstretch my arms and pray.

I decided not to continue the cleanse officially, but to take that learning from those 4 days and apply it best I can, so I went to the market and bought some of the teas and a few other fresh ingredients, and have committed this week to keeping the chocolate down to 1 square a day, at the most, not eating pasta even if my husband is eating chicken parmesan right next to me; to just do the best I can to decrease the inflammation.  Shortly I’ll be having some sashimi and seaweed salad and having a green juice as my snack later, with salmon in the fridge for dinner, so I think I’m doing pretty well!

And more than all of the ‘actionable’ things that I am doing, I close my eyes, and invite those beautiful little spirits who I KNOW are out there waiting to be my child or children, yes, children, and take the biggest risk of all:  I hope.

Family Secrets

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I’ve been contemplating how much to write about what happened next, when I returned to LA from NY at the end of my 1st trimester.

I think of times I’ve said something disparaging about a family member to a close friend, perhaps revealed a family secret, and how when that friend repeats back to me something in that exact same context, how infuriated it has made me, as I am loyal to and protective of my family.

And then I think about all of the reasons I am writing this blog, including trying to help someone else.  I think of how alone I felt after Finley died; how alone I continue to feel on random days when the roller coaster of grief hits me; on holidays which highlight the hyper reality of the fact that my husband and I are parents, without a child to love on a daily basis; how painfully exhausting it is to still be going through fertility efforts.  I think about how as I have searched for answers as to why things happen and how to get through this, I have continuously felt alone, and how every now and then I’ve come across a phrase in a book or a person who maybe has said the right things to me on any particular occasion, whether it was after Finley died, or if it was sending me a text on Mother’s Day just last year to say I’m being thought of; I think of a woman I didn’t know very well being brave and generous enough to tell me how her family had failed her after she had to have a 2nd term abortion.

And for those reasons I will now share the truth about how my parents reacted when I told them I was pregnant, summer of ’09.

It was great to be reunited with Craig that late August after being in NY for one month for work.  Our relationship was far from perfect, but he and I had such a strong connection and such deep love, that returning to a hug from him grounded me in a place of peace and love.  Even as I re-read this, I can close my eyes and take a breath and know that foundation is built to last.  I was home.

And on top of that, I could now go check on our little growing baby by going to see the doctor!  I had my end of first trimester screening with my Israeli OBGYN, who took blood to make sure my levels were good and showed me how much our little baby had grown.  I cherished that picture even more than the earlier ones, and stopped the irrational though perhaps common fear that the baby was no longer inside me.  I had proof!

I talked to my Dad and told him I had some news to tell him and my Mother; that I wanted to do so in person, and gave him a couple of dates that could work. In a normal family, I’ll theorize that when a daughter who has wanted to get pregnant for so long, who is healthy, committed for 10-years with a great man, and employed, that her parents are happy.  That they jump at the good fortune.  But I don’t come from what I perceive as a normal family (uncommon as normal likely is), so for me, the drive to my parents’ home that Sunday morning to tell them I was over 12-weeks pregnant was one full of dread.  I don’t think I had any actual shame that I was pregnant (I have definitely spent time contemplating this in retrospect), but I felt emotionally pulled into the dysfunction of my family by anticipating what they would say.  Knowing from my eldest sister that my mother had guessed the news, and having not received a congratulatory call was only one indication that this was not going to go to well.  Another clue was the fact that my eldest sister had offered to go with me, to sort of buffer the situation.

And still other clues existed in my history of memories throughout my life with how my Mother, specifically, responded to situations.

I am sharing what happened next with great trepidation.  I have a relationship with my mother now, a woman I have come to accept entirely; who I love very much.  I don’t want to be disrespectful and air the family secrets, and I will censor this a bit so as to respect them, but at the same time, I am writing this honest memoir of my experience with my struggle to get pregnant, my pregnancy, my loss, and my current fertility struggles to help another; to form a sense of camaraderie in a community of women / parents / people who have had similar struggles.  I hope the risks I am taking, the vulnerability I am showing, will help someone else out there, and so I have made a choice to tell this part of my truth.

Just to give you a sense of my Mother:  When I was around 8 she yanked me out of a school mid-year because she didn’t like my teacher.  This was done to protect me, but when properly analyzed, I realize that she didn’t think of the disruption that caused me at the time.  When I was 14, she told me that she was planning a trip to Tunisia or Egypt or some other far away place, before she communicated this news to my father, with a copy of her itinerary on his breakfast placemat, the very morning she was leaving.  She once wore a very bright colorful outfit to my close friend’s funeral, while the other mothers wore navy or black suits (which horrified me at the time, and later that I think my friend Nicole would have loved).  And that’s just a paragraph’s worth of memories; the rest may eventually fill a different book.

So I walked in to their home, where I’d grown up, having not seen them in many weeks, ready to show them the latest commercial I produced, an incredibly powerful Public Service Announcement touting the importance of breaking the stigmatism attached to mentally ill people, and ready to tell them news that made my heart soar with happiness.  And I was leading up to my big news (again, I don’t think there was shame at being pregnant, but I was in a lot of fear obviously, in that I didn’t lead with the great news).

I told them about shooting with an Academy Award winning director and an Academy Award nominated actress at Grand Central. We sat in their living room, the place where lavish gifts were stored at Christmas time for my mother to give out to her daughters, her 2 grandchildren, and any stranger that was in her life at the moment; my mother was notorious for buying people gifts, as that was the way she best knew how to communicate love.

My parents were sitting opposite each other, and so I had to volley back and forth to make the small talk.  I noticed my mother had a crazy look I’d seen on her face before: the one when I can see her tongue clicking at her dental bridge, nervous, upset, distracted.  And she asked if I was pregnant.  And I smiled, and answered, “Yes,” and her eyes seemed to squint, while I volleyed over to my father’s first response, “Are you clean?”  It’s certainly not the response I would have dreamed of, and anyone who knew me, actually knew anything about me, knew that I was off cocaine, alcohol, cigarettes, sodas, and even coffee, lox, and sushi nowadays.  But, it was a reasonable question from my father who had once driven me to drug rehab so I could get help, over 3 years before, so I didn’t get upset, and I assured him that yes, I was sober.

My mother said, “Don’t expect any money from us,” a truly outrageous sentence to utter, as I made good money, and hadn’t asked them for any money in years.  But that was her way of controlling things, and also her way of removing her love; she had grown up poor, and daily spent my father’s means; she had married a father figure 12-years her senior; she herself grew up without a father.  I didn’t think of all of this then; I felt really stunned, but for obvious reasons yearned so desperately for their approval and proceeded to tell them about the pregnancy.

In retrospect, of course I should have gotten up, walked out, and returned home to the family I was creating, the one centered in love.  But having been raised under such dysfunction, like a dog doing tricks for some sort of approval, I continued to tell them details, like that I had initially been pregnant with twins but that I’d miscarried one early on, and that the baby inside of me was growing along well….

“You’ll probably lose this one, too,” I heard from my mother.

My head turned and my mouth dropped and I’m sure I had tears in my eyes but they were angry tears; tears of dismay that any human being, specifically my own Mother, would utter that thought.  At one point in her campaign to stop me from having a baby, she had said that she prayed I wouldn’t get pregnant.  I should have stopped speaking to her then and there, but I didn’t have enough strength and knowledge to break away at the time.

But when she said those words, “You’ll probably lose this one, too,” I first threw my plastic bottle of water at her, and then my father, typically timid to her tyranny, stood up and called her names and told her to leave the room…. And there was much more nastiness and far more emotion and I’d be lying if I didn’t admit how appalled and hurt I was by that 6 word sentence.

Today, years later, and on good terms with her, I think of that sentence and the power it had over me.

I know whether or not she prayed for me to get pregnant was irrelevant. But was it? Abraham Lincoln once wrote:  “I remember my mother’s prayers and they have always followed me.  They have clung to me all my life.”  Did her prayers have any influence?

I know that her saying that sentence is not how or why my son eventually did die.  She was not G-d, but as William Makepeace Thackeray wrote: “Mother is the name for God in the lips and hearts of little children.”

On a side note, there are many things I take issue with in how poorly equipped we Americans are when it comes to grief, and the common phrase of a person has ‘lost’ someone she loves is one that is outrageous to me. I sometimes lose my keys.  I often lose my remote control.  But I most certainly did not lose my son; I denote loss with a sense of carelessness, and if you know me at all personally, or have been reading along, it is obvious that I am not a careless person.  I didn’t lose my son, he was stolen from me by an act beyond my control; perhaps his fate; perhaps a pure product of  him not being strong enough since he was so very little when he was born; whatever the case:

I had never heard a meaner sentence uttered.

My Dad tried to assuage the situation, and brought out a photo album of his side of the family. He is a nostalgic man, my father, and his nostalgia often feels like a history lesson. I was in shock but appreciated that he was trying to distract me emotionally from the vicious, insensitive, and insane reaction of my mother.

As the days wore on, through conversations with my Craig and close friends and my sisters, I made a decision not to accept her behavior and violently rejected her premonition.  This incident began to allow me to change personal boundaries, something I remain confident will only help me be a better mother.

There is more to it, but this is not a story about the family from which I come, it is a story about the family that Craig and I were building, as our own family was well under-way, me being at this time now over 12-weeks pregnant and out of the woods from all of the fears associated with the 1st trimester.

Again: or so I thought.