I Am Woman

So the frozen embryo transfer (FET) happened today. I'm not quite sure how to process this yet; there are so many feelings welling up inside of me that I don't know if I should be ecstatic and hopeful or hide under the covers until it's all over. I think I'm somewhere in between those two extremes right now to be honest. A friend of mine who's been in my shoes more than once told me that for her the hardest part was waiting those 2 weeks to find out whether or not implantation was successful. My doctor told me to think of this window of uncertainty as a little vacation but how can I relax with all these fears and doubts in my head? I thought that maybe writing it all down would help so that some day, even if things don't go as planned, I can look back on this time with a better sense of appreciation for what I endured.

Our fertility journey actually started in 2018; after months of trying to conceive on our own I couldn't get pregnant. I wasn't too surprised since I was already 40-years-old then and had been on the pill for years. I wasn't ready to start a family in my early 30's since my husband and I had just finished our medical residencies and we were committed to putting our careers first. Not to mention we weren't financially secure right off the bat since we had acquired so much debt due to pursuing higher education. Finally, after waiting for the dust to settle and adopting our fair share of fur babies in the meantime, we decided it was time to start the next chapter of our lives. We'd be older parents but at least we were blessed with looking young for our respective ages.

I finally sought out a reproductive endocrinologist and underwent extensive testing (ultrasounds, MRIs, a hysterosalpingogram- my least favorite study) that took months to complete thanks to insurance setbacks. I at last discovered the root cause of my infertility struggles: I had a septate uterus which is a congenital deformity that divides the uterus down the middle. This makes it difficult to carry a baby to term since there is limited space for it grow in the womb; hence, the miscarriage rate is fairly high. My septum, unfortunately, was complete, meaning it went all the way from top to bottom, and the thick band of tissue was going to be difficult to remove.

Since I wasn't getting any younger, and it would take a while for the office to schedule the surgery, we decided that IVF would give us the best odds of having children. I was aware of the risks involved but my biggest fear was what the hormones would do to my figure. I had seen patients in my practice who complained about gaining 30+ lbs upon completing round after round of IVF and as someone who has struggled with their weight and body image their entire life, I really debated whether or not I was willing to put myself through that. In the end I knew that if I didn't do it I would regret not giving it my all, no matter what it cost me physically or emotionally. I was lucky to have a supportive husband at my side, who maybe took a little too much pleasure in injecting me every night, and was able to put up with my mood swings along with the extra pounds (nearly 13 to be exact but on my petite frame it looked more like 20).

I struggled with how I felt about my appearance after that first cycle of IVF, which ultimately only yielded one normal embryo (my eggs were not the best sadly). I didn't fit into the nice clothes I once did and the face staring back at me in the mirror was rounder with an extra chin. My blood pressure also crept up to the 140-150s/90-100s and I wasn't sure if it was due to the weight gain or the stress, though I knew my genetic makeup might have had something to do with it as well. I watched what I ate, I exercised regularly but the weight didn't want to come off. It was extremely frustrating and I felt like IVF was maybe an expensive mistake.

Nonetheless, my doctor, my husband and my friends encouraged me to try it one more time to see if we could create a back up embryo(s) in case the first one didn't take. I reluctantly agreed but for whatever reason the second cycle yielded zip. I blamed myself and thought maybe if I hadn't been overweight it would have been successful. We took a gamble hoping for the best, investing our hard earned money into this dream of having a child together, and I felt like I let my husband down. It was really hard to swallow that loss, not just the financial one, but also the time we spent on getting to that end.

I wish I could say that my heartache stopped there but it didn't. We scheduled the surgery soon after the first IVF cycle and I was optimistic that it would go well and that in a couple of months we could proceed with the FET. However, for reasons I can't explain, my vital signs weren't optimal as my doctor was operating on me so she had to pull out before she could remove the entire septum. It was devastating because it meant not only that I would have to go through another surgery but more importantly, it would delay our plans to conceive.

It eventually took about 5 months to coordinate the second uterine septoplasty and I took this time to get my body primed for the procedure. I knew I had to take a much needed vacation because the long hours in the office kept me from exercising as much as I wanted to when I got home. After doing some research I settled on a 2 week boot camp program out in Long Beach; you stay on site and basically work out from early morning until dinner six days a week and they have meals and snacks prepared for you as well. I took this opportunity for self care very seriously and I was proud of what I achieved in my time there. I came back slimmer and more motivated to make fitness and wellness a priority in my life. I think having that positive outlook impacted me on so many levels and got me out of the funk I was in. I came out of that second surgery as if it had never happened at all; I was pain free and I felt great. I was ready to take on the next challenge or so I thought.

As a doctor I think I'm naturally inclined to be more analytical so I read up on what to eat to favor implantation and prepare my body. I eliminated a lot of processed foods, refined carbohydrates and sugar. I also curbed my alcohol consumption a great deal. I went to my cross fit class almost everyday and the weight stayed off...that is, until I began the high doses of estrogen and progesterone. I had to take them for a month prior to my ERA and then after a short break restarted them so that my endometrial lining would be thick enough for the big day...today!

Even though I was psyching myself up for this moment all these months I still tried to distance myself from the event as I was guzzling down water to fill my bladder before the procedure. I know all to well that the odds of having a baby at my age are pretty slim so I didn't want to form any type of attachment in case this new life inside me never actually takes shape. I probably freaked out the embryologist when she came in to the room to confirm my name and date of birth and all I could do was burst into tears. I couldn't even bring myself to look at the ultrasound as the embryo was inserted but she said everything looked good. Now it's just a matter of waiting it out and going back for a blood test in 10 days. I am finding it hard to be on bed rest but hopefully next week I can resume some light activity. No matter what happens I'm just grateful that I had the chance to at least try and share my story.