133 Weeks of Trying

One hundred thirty-three weeks I had been waiting, and this one after an IVF cycle was mainly kicking my butt.

If you haven’t heard the term before, a two-week wait is the period between ovulation and your period. It is both a dreaded and anticipatory time for women trying to conceive.

It is when time freezes, and you wish upon everything that the monthly flow won’t raise its ugly head. And if you have struggled with infertility, as I have, it becomes a ritualized experience preceding an obligatory four to five-day mourning period. Literally.

Blood flowing like tears.

The 2WW is filled with symptoms you analyze backward and forwards.

Is that fleeting sense of nausea and tender breasts a sign? Is the moodiness telling me something? What about cramps? Is that implantation?

When you are PUPO (pregnant until proven otherwise), if your symptoms indicate pregnancy and not just the side effects of taking hormones, there is no guarantee you will stay that way.

Approximately thirty percent of all IVF cycles will end in miscarriage, and a large majority will be chemical ones, i.e., end before you even get what you assume is your period. I had one of those during my first IVF cycle.

Let me back up to when I got on the 2WW hamster wheel.

It was in 2004, a while after I had an ectopic pregnancy that resulted in a Fallopian burst tube that had to be removed in emergency surgery. A loss like that is intense enough to catapult you into the 2WW vortex, but this occurred less than a year after my daughter’s death from SIDS in 2003.

I had never considered that period between ovulation and my period before these losses. It took only a few months off of the birth control pill for me to conceive my daughter, and after her death, I went back on birth control. Again, it took only a few months off the pill before I had the ectopic pregnancy. We never “tried” to conceive those two times. It just happened.

And so, the first year we decided to commit to TTC (trying to conceive), I started to notice the 2WW. At first, it was only a slight irritation. It wouldn’t be too long. Right?

The doctor who performed the surgery to remove the ectopic pregnancy said I would have no trouble conceiving after losing my right tube. He even put me back on birth control for a few months so my body could heal before I got pregnant again. I figured that in a few months; I would be preggo again.

But with each successive 2WW that passed, the negative HPTs (home pregnancy tests) stared blankly at me. I was now past 30, and it looked like I needed to see another doctor and figure out what the delay was. I had this nagging worry that the surgeon was unrealistically optimistic.

Dr. Google found that ectopic pregnancies rarely happen for no reason. My sneaking suspicion was that the emergency C-section, done because my daughter was breech and my water had broke, might have damaged the tube itself. Although the surgeon said the other tube looked fine, the proof seemed to be in the pudding. I wasn’t getting pregnant.

I went to a new OB/GYN, and she put me on Clomid and then scheduled an HSG (hysterosalpingogram). This is a procedure in which they shoot dye up inside your uterus, through your cervix, and then into your tubes. If they are clear, the dye spills out like a beautiful pool on the screen.

The first attempt at shooting the dye into me, the pain was so intense that I had a seizure. I am not epileptic, so this reaction was quite startling and unexpected. After taking a beat and letting me get oriented, the technician shot the dye inside my remaining tube again. This time it spilled out, showing the tube was clear.

The test results proved to the new doctor that a damaged tube was not why I wasn’t conceiving. In hindsight, I realize that the difficulty of pushing the dye through in the first place might have suggested some anatomical anomaly that did play a factor, even if it was just subtle.

Leaving the office with a prescription for Clomid, a drug designed to jumpstart or amplify ovulation, I had newfound confidence that my 2WW future would be limited.

After a horrible reaction to the drug, which I would find out can cause emotional mood swings and other more disastrous physical symptoms, I decided to go back to trying to conceive without medical intervention. After all, the doctor said the tube wasn’t the culprit, and blood tests showed I was ovulating perfectly fine.

I embarked on another journey of taking my temperature, monitoring my cervical mucous, and using ovulation prediction tests to aid my efforts to conceive.

It was just a matter of time — I believed.

And five years passed. I was nearing the invisible line between 34 and 35 when the statistics showed that fertility rates started dropping considerably.

Let me stop right there.

I endured another five years of 2WWs, and it didn’t occur to me to get another medical opinion on why I wasn’t conceiving. The standard wisdom is that you seek medical treatment after one year of trying (six months if you are over 35) with no success. But, other than Clomid and perhaps IUIs, I wasn’t aware of any treatment options other than IVF that would address my problem.

Not a single doctor I saw during that time urged me to see a specialist. Not a single one uttered the word infertility. They just thought it was a matter of time. And I believed them through 5 years of neverending 2WWs.

Approaching 35, I decided it was time for us to seek advice from an infertility specialist. When we went to the consultation, the doctor seemed slightly alarmed that we had tried for so long, and she seemed to understand why I was loathed to try any more medical intervention after a bad reaction to Clomid. She said the drugs used for IVF tended to bypass the brain and have far fewer emotional side effects.

However, we weren’t prepared to proceed with IVF, which she said was our best chance. Money wasn’t the issue — my husband worked in a state with an insurance mandate, so four cycles were covered. However, my husband had ethical reservations because he grew up Catholic. We decided to go to a doctor who was also Catholic to see if we had any other options.

After talking to this new doctor, based on some of the symptoms I described — heavy and painful periods — he believed I had endometriosis. This is when the uterine lining begins to grow — and then bleed during your period — outside your uterus and other organs. He thought this was causing my infertility.

I then had surgery to determine if this diagnosis was correct and see about removing the endometrial growths.

After the surgery, he told us that he cleaned out almost all of the lesions — I had severe endometriosis. But it also turned out my pelvic cavity inside looked like a grenade had gone off.

I had extensive scarring; my uterus stuck to my bladder, my right tube was attached to my right ovary, and that ovary was almost entirely encased by scar tissue.

Adhesions were the ties that bind.

He was confident he had removed the scarring and cleaned up everything enough, so I wouldn’t have trouble getting pregnant. But to make sure, he suggested I take a low dose of Clomid to increase the odds — he assured me the emotional side effects would be minimized. We decided to try this, which turned out to be accurate, with no mood swings – eight months of Clomid with a cleared-out pelvic cavity, and still no pregnancy.

By this time, I was 38, speeding towards the point of statistical no return: 40. So, we decided to return to the IVF specialist. My husband’s ethical concerns had softened. It appeared we had done everything outside of this procedure we could think of that had a reasonable chance of working.

What pushed us over the assisted reproduction edge was when a doctor told us that my adhesions had returned. My ovary on the side of the remaining tube was again almost encased in scar tissue; my spare tube was starting to stick to my uterus; I had less than a one percent chance of getting pregnant each month — if that — even if I continued to take Clomid. And most doctors would not suggest taking that drug many more cycles because of the increased risk of ovarian cancer.

Approaching 39, we scheduled my first IVF cycle. It got delayed because tests showed my hypothyroidism was not under control; my medication needed to be adjusted, and we had to wait for my thyroid levels to normalize before proceeding. So, finally, in December 2014, I had my first IVF cycle.

This was the most intense 2WW I had up until then. A day before I was supposed to get my period, I took a home pregnancy test, which was positive. We were elated. It was the most beautiful happy ending of a 2WW I had experienced in the last ten years.

I started bleeding the next day.

Blood tests confirmed the pregnancy, but the bleeding — and then the cramping — would not go away. My HCG levels were lower than desired, and then they dropped. I was miscarrying.

The next few 2WWs went by without my noticing, a strange feeling because of how ever-present they had been for so many years.

I was ready to transfer frozen embryos using some of the five embryos we had on ice from the first IVF cycle. But, again, my thyroid was out of whack. It took until April for it to normalize again.

A frozen embryo transfer (or FET) is a piece of cake compared to IVF. Rather than expensive and cumbersome multiple shots of potent drugs for a month, you take pills every day for two weeks and then add one shot for a day the rest of the time.

I was, smack in the middle of the 2WW, with two embryos transferred into my womb. I was to get my blood test done the following week.

I was conflicted. It was like time being suspended, being PUPO forever. Ironically, I got to be this pregnant during Mother’s Day, which made the holiday day a bit easier for me than it usually was.

But, as I said, this 2WW was kicking my butt.

I waited and waited like millions of women do every month—women who dread the possible menstrual flow that will happen for most of us. Women eagerly await rushing to the drugstore and loading their shopping carts with pregnancy tests—women who keep checking their phones to see if the doctor has called with the blood test results.

The 2WW. A rite of passage for infertile women everywhere.

I finally gave in six days after my transfer. A light positive hpt. I took another test the next day – a darker positive. I posted a photo of the test on the online support groups I rely on, and the consensus was, yes, I was pregnant.

And so I would wait some more. The end of the 2WW blood test. If it confirmed a pregnancy, I would wait until the next blood test, the first ultrasound, the end of the first trimester, and the baby’s first cry, all while holding my breath myself.

So, I gently — temporarily — exhaled and put aside my hopes.

And we waited.