The outcome of IVF attempt #5 is…

Normally I would try to use my sarcastic sense of humor and sardonic wit to shield the reader from the more emotional parts of this “journey”. Normally, I would try to find the positives in the negative or end on an uplifting note. But some days are much harder than others, and yesterday was one of them.

My blood test came back negative.

Not pregnant.

Again.

This was our 5th embryo transfer attempt, our 4th actual transfer (no embryos survived to transfer in IVF#3), and our 2nd transfer using donor eggs.

I would like to say that I was a paragon of strength while waiting to receive the news, but I was already teary-eyed even before having my blood drawn — knowing it was probably over. I was supposed to go into work while the lab processed my blood, but instead I cleared my schedule, went home, and crawled into bed to wait for the call.

Does it get any easier?

Just as I wasn’t the model of bravery while waiting to receive the news, I haven’t exactly been a shining example of mental fortitude afterward, either. I had hoped to treat myself to a cozy Netflix binge session yesterday afternoon, but even watching TV required more focus than I could muster. Even today, when my husband texted me to ask how I was doing, I replied with a picture of a large pile of used tissues.*

You’d think that with so many failed attempts, we’d be used to it by now. And I am, unfortunate as that may be. But for some reason, this one was still a particularly tough pill to swallow. I think I had prepared myself for the fact that donor eggs may not work the first time around, but I was still hoping that we’d get lucky the second time. With each new failure, I feel us inching further out in the distribution toward the “unlucky” IVFers, and it’s not a fun club to be part of.

What now?

We’re not anywhere close to giving up, in case you were worried about that. I still maintain that every failure makes us stronger, and we also still have four donor-egg embryos in the freezer. If the Universe wants to keep testing my patience, I aim to prove that I am as zen as a freaking Buddhist monk.

With that willpower, and because I am apparently something of a masochist, we are diving directly into another attempt this next cycle. That gives me only a small (~few day) respite from the hormone therapy, but it means we can squeeze in one more attempt before my month-long international work trip in December. I will therefore start the estrogen again as soon as my period shows up (which, given the crazy-thick uterine lining I managed to grow this time, I expect to resemble the Red Wedding.**)

In the meantime, I will take these few days before the next cycle to grieve this latest loss, which — there’s no way around it — totally and completely sucks. I think my sweet, wholesome mother summed it up best when I texted her the outcome, and she texted back “Fuck!”

xx

*Even in my grief-laden state, I still found this quite amusing.

**The Red Wedding is a Game of Thrones episode where (spoiler alert) almost everyone at the wedding is slaughtered. Basically, a bloodbath.

Frozen embryo update!

In the words of children’s author Judith Viorst, this past Wednesday (the day of our embryo transfer) was a terrible, horrible, no good, very bad day. After things seemed to be going so ridiculously well in this IVF cycle — our egg donor Marie produced 15 mature eggs, 100% of which then fertilized and were looking strong in the days that followed — we learned on Wednesday that only a single embryo had developed into a viable day-5 blastocyte. Two others had also become blastocytes, but they were too poor-quality to be frozen. When I tried to ask if there were any other embryos still in-the-running, the doctor was — excuse my language — a ginormous dick. He sounded so pessimistic — admitting it was a below-average response, and even hiding his chart so I’d stop asking questions(!) — and I left feeling completely despondent.

I sobbed the entire 2+ hour drive home from Belgium. Once back at our house, I transitioned onto the couch for further sobbing. I had made a deal with my husband earlier in the day that he had to do whatever I said all day so that I’d feel happy and relaxed after the embryo transfer. Before the bad news, this had come in the form of sassy decries (e.g., “I decry that you escort me around on your arm all day”; “I decry that you stop sending me stupid Reddit videos”). After the news, and back at home, I decried that he leave me be so I could mourn the unfairness of the Universe in solitude.

A sudden turn of events

After such a miserable day, you can image my surprise when I received an email the next morning saying that 5 embryos had been successfully frozen. FIVE! Not trusting my Dutch reading skills, I copy-and-pasted the email into google translate just to be sure. It still said the same thing…FIVE EMBRYOS COULD BE FROZEN!!!

IVF is such an insane emotional roller coaster.

So why the sudden turn of events? Well, my husband and I are still complete newbies when it comes to blastocyte development, since we never made it this far with my own eggs (or lack thereof). Apparently, in addition to freezing any good-quality blastocytes on day 5, they let the remaining embryos continue to develop overnight, allowing the stragglers to catch up. These slower-growing day-6 embryos may still turn into blastocytes which can result in a healthy pregnancy, and they will freeze any good-quality ones as well. I had no idea that there could be such a big change from day 5 to day 6, and it would have been nice if the dick — Sorry, I meant doctor — told us that there was still some hope.

What does this news mean?

Obviously we hope that the embryo I currently have on-board will decide to stay put. However, based on its quality, it only has a 17% chance of resulting in a live birth (though a ~30% chance of pregnancy…fun implications there). If it decides not to stick around, then we can try what’s called a ‘frozen embryo transfer’ (FET) without having to go through the whole egg retrieval process again. Most of the embryos should theoretically survive the thaw, so that would hopefully give us another few chances.

In the meantime, I’m oscillating between cautious optimism and (more statistically realistic) extreme pessimism with the current embryo on board. It’s far more likely that it won’t stick….but there’s still a non-zero chance that it will. I seem to be growing (unwisely) more optimistic each day, which is probably the emotional equivalent of that slow upward climb on a roller coaster before the huge stomach-lurching drop. In that sense, the (potentially poorly translated?) advice that our favorite Belgian egg donation nurse gave me might actually make more sense: “Keep your head on.”

The emotional impact of premature ovarian failure

It’s almost time to break out the celebratory raw herring! Why? Because we are officially less than one week away from the arrival of our egg donor, Marie, in Holland. After so much intense preparation, I still can’t believe it’s finally actually happening. And while the odds are that it won’t work, I’m going to try to do my best to stay cautiously optimistic during this next IVF cycle.

With that said, the cycle hasn’t quite started yet, and I’m currently in a plane somewhere over Greenland, which always makes me emotional (the being-in-a-plane part, not Greenland…that would be weird). I understand this is actually a common phenomenon — perhaps because our tiny monkey brains still can’t process the modern miracle that is air travel. I already (somewhat embarrassingly) found myself nearly in tears while watching Blockers, a movie which is decidedly NOT a tear-jerker. So perhaps it’s a good time to talk about something that’s been on my mind a lot lately: What is the emotional impact of a premature ovarian failure diagnosis?

Maybe it’s hard to understand if it hasn’t happened to you, or if you don’t want kids, but finding out suddenly that you will likely never have biological children is pretty rough. However, I hadn’t considered that it might be even more serious than that until I was researching premature ovarian failure (POF) for a recent post exploring what causes it. One of the first places I looked, Wikipedia, had this to say about emotional health in those who had been diagnosed:

The most common words women use to describe how they felt in the 2 hours after being given the diagnosis of primary ovarian insufficiency are “devastated, “shocked,” and “confused.”[8] These are words that describe emotional trauma. The diagnosis is more than infertility and affects a woman’s physical and emotional well-being.[1] Patients face the acute shock of the diagnosis, associated stigma of infertility, grief from the death of dreams, anxiety and depression from the disruption of life plans, confusion around the cause, symptoms of estrogen deficiency, worry over the associated potential medical sequelae such as reduced bone density and cardiovascular risk, and the uncertain future that all of these factors create.

I knew most of this already from personal experience, of course, but I was struck by the phrase `emotional trauma’. As in, damage to the psyche that occurs as a result of a severely distressing event, and which can even lead to post traumatic stress disorder. I was further struck by the mention of the words “shocked” and “devastated”. Those words sounded familiar… I went back to the first post I had written, where I described receiving my diagnosis, and I used both of those words to describe it. It made sense actually — it was a trauma. Come to think of it, it was definitely in my top-five, and probably even top-three. For some reason, just knowing this has helped me to feel less like a victim, and more like a survivor.

How to get through it

I could talk more about the other physical and emotional consequences of the diagnosis listed in the Wikipedia article — and I’m sure I will at some point — but in the meantime, what else has helped me, personally, to get through it?

One thing that has helped me tremendously, of course, has been Marie’s offer to donate. Going through something like this can be an extremely isolating experience, especially with the constant bombardment of pregnancy announcements and baby picts that compose 90% of my social media. Knowing that someone is willing to go through all this for us is huge, and I’ll be forever grateful even if it doesn’t work.

I realize, of course, that not everyone has a big-hearted (& big-footed) Marie in their lives, so I also wanted to emphasize a few things that my fellow POF-sufferers can do for themselves:

  1. “Come out”. Sharing what you’re going through with friends — and maybe even more generally — can provide you with a crucial support system. If nothing else, it will stop relatives from asking you when you’re having children.
  2. Take care of yourself. The term `self-care’ is usually a bit touchy-feely for me, but it’s actually important in this case. Personally, I recently turned down a request to give 10 hours of lectures at a summer school (which I would also need to prepare from scratch). Another colleague made me feel guilty about this at first, which was particularly confusing because they know what I’m going through. But you know what? They can ask someone who ISN’T coping with an emotional trauma while also undergoing their 4th IVF cycle.
  3. Give yourself credit. Acknowledge that what you’re going through is hard, and make sure to give yourself proper credit. Couples split up and people quit their jobs over this stuff. If you’re at least making it through the day, you’re freaking killing it.