Category Archives: IVF

The bearable heaviness of being

Yesterday a year ago was the day our little miracle was conceived in a dish in a laboratory in Amsterdam. Now he is sleeping in his pram in the other room. 3 month old and more beautiful and amazing than I ever imagined. The gratitude I feel is indescribable!

Since M was born on the 17th of August in London, life has been a roller coaster. I have been meaning to write a million times, but just never had the time or energy to do it. I kept postponing, but the longer I waited the more there was to write about. Thus making it even more difficult to get down to business and actually do it.

First there was the birth. I needed some distance from it before I could write about it. Now I’m not sure that I can adequately reflect my experience because time is a healer and as the days goes by it reconfigures how we make sense of experience. So I will try to describe it as objectively as I can.

I was induced with prostaglandin gel at 10pm the 16th of August. It was an in-patient induction, so I stayed in hospital while my husband had to go home. No one expected anything to happen anytime soon, because my cervix was still firmly closed. Nevertheless, within a couple of hours my contractions started and got quite frequent and strong. I dealt with them alone, without pain relief and behind only a curtain in a hospital ward full of other women.

Close to 6am in the morning my waters broke and my husband was allowed to join me again. However it wasn’t until around 10am they finally moved me to the labour ward where I got my own room with space to move around and my own toilet and shower. I remained fully closed despite having strong contractions every three minutes. Both midwife and consultant was ready to start the syntocinon drip since I wasn’t progressing, but we managed to talk them out of that intervention for the time being. I knew that my contractions were plenty strong enough and had they hooked me up on the drip at that stage I would have most likely ended up becoming extremely overstimulated with the risk of causing distress to the baby.

Instead I was thankfully allowed to continue naturally, dancing around to reggae music which proved to be a fantastic way for me to deal with labour and the pain. I managed with just the music, deep breathing and my husband massaging my back etc. After some hours I suddenly started progressing very quickly and went from fully closed to fully open in just under three hours. The staff had not seen anything like it 15 years apparently, so I started attracting lots of attention amongst midwives and consultants. By this time it was 5pm and everybody now expected that I would be dropping that baby on the floor in no time. I felt happy and empowered both by my ability to manage the pain successfully and the minimal intervention. Apart from the one dose of gel that had kickstarted it all, natural child birth seemed to be within my reach.

But it wasn’t meant to be. My contractions slowed and nearly disappeared and I never got the urge to push. The midwife and consultant held off and waited as long as they could to give me a chance once again, but after a couple of hours with nothing happening, they had to put me on the drip. The baby had to come out. This time we didn’t object. I knew I didn’t have strong enough contractions. My body had done so well up until this point, but couldn’t manage the rest. The syntocinon went in my veins and the contractions picked up a bit, but they never became very strong again. Not even when they kept increasing the dose. I had to push with all my strength and will instead and finally, with the help of ventouse (suction), my son was born at 8pm on the 17th of August. In the process they cut me, i.e. did an episiotomy. I had indicated in my birth plan that I did not want one, but in the heat of the moment I did not have much choice but to agree. I have been paying the price ever since in the form of infection, break-up of the stitches and permanent damage to muscle tissue.

In the moment I didn’t care of course. My son was born. He was alive, well and healthy. It was, and still is, all that matters! His birth involved more intervention than I would have wanted, but more importantly less then what I had feared. And I still feel empowered by having avoided pain relief and being able to give birth to my son – albeit with a little help. The only thing that makes me sad is that because of the ventouse delivery he didn’t get to stay on my chest for much skin-to-skin. He was only on my chest for barely a second before he was whisked off to be checked over. My husband had the first real skin-to-skin with him while I was being stitched up.

Then came the postnatal complications on day 9 after the birth in the form of three infections at the same time. Mastitis, wound infection in the stitches after the episiotomy and urinary tract infection. I fainted, ran a fever of 40 C (104 F) and ended up in the hospital on a drip with intravenous antibiotics etc. I was ill for quite some time and trying to cope with taking care of a newborn. At the same time I was also expressing my milk every three hours, 24 hours a day because our little boy was tongue-tied and could not breastfeed. Blogging was the last thing on my mind!

On top of it all, we were still living with my mother-in-law and dealing with the insecurity and worry associated with my husband struggling to find a job. Being in a creative industry where jobs, let along good jobs, are rare and the competition relentless.

Then another miracle came our way. When M was 4 weeks old, my husband got that phone call we had dreamt of, but hardly dared to hope for. An offer of a fantastic job in higher education which would provide all the things most other jobs in his industry never will, i.e. decent pay, job security and pension. The only catch was that it is not in London, but in a smaller university city approx. 2 hours from London and they wanted him to start two weeks later. Commuting would be unfeasible so we had to move there. So in a matter of about 10 days we managed to find a place to live in our new city and relocated in time for my husbands job start on the 1st of Oct. This would be stressful under any circumstance. With a baby of barely 6 weeks and with me still struggling to recover from the various postnatal complications it was a whole other ball game. By this time I had only just managed to recover from a second round of mastitis which had once again left me extremely ill with high fever.

I finally had to accept that I had to give up on trying to breastfeed. M had had his tongue-tie division done the very day my husband got the call, but after being so used to bottles he still didn’t manage to latch on and I was still having to carry on with my gruelling expressing schedule day and night in order to ensure that he got as much of my milk as possible. However, it was time to call it a day. As the doctor pointed out, I am apparently extremely prone to mastitis making it too risky to continue.

It was extremely difficult to let go of the idea of breastfeeding. I wanted to breastfeed with all my heart. I know it is best for baby and I had never even imagined not doing it or that there could be so many obstacles making it unfeasible. Once again I was faced with the experience of not being able to do what is natural, taken for granted and commonly believed to be simple and easy. Once again I had to let go and accept things as they are. And realise that it does not matter.

Having lived with infertility for so long has taught me to do precisely that. Now as I mix M’s formula and feed him with a bottle, I no longer think about it. I no longer feel sad that I never got to have the experience of breastfeeding my baby. Just as I no longer feel sad that we could not conceive him naturally in the first place. There is no more sadness, because he is here! When I look at him I know that it does not matter how he was conceived. It does not matter how he was born. It does not matter how he is feed. All that matters is that he is here and he is growing, thriving, smiling, laughing, chatting, trying to ‘sing’ along to the reggae music he loves and of course also crying a lot when he is hungry, tired, needs changing or for some other unknown reasons. I appreciate it all.

This is not to say that I don’t feel tired or overwhelmed sometimes. I do, and I have many times throughout the last three month, because it has been heavy to say the least. Taking care of a baby is in itself pretty heavy at times. But it’s also bearable. None of it has really seriously rocked my boat so to speak. Because it matters. Because it is labour of love. Because it is the stuff of life.

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12 hours to go…

… says my pregnancy countdown as I’m writing this. My due date is tomorrow and we have decided to go with medical advice and accept induction at 40 weeks. Two days ago I went in for a second membrane sweep, but although it had been 12 days since the last attempt, there was no progress at all. It was impossible to do a sweep on me. My cervix is still tightly closed and the baby is not engaging at all. The doctor said they would have expected to see at least some development at this point, but since there is none it’s very unlikely to make any difference to postpone induction a few days or even their usual policy of 10 days past the due date for low risk (and non-IVF) pregnancies.

Basically there are strong indicators that I will need induction no matter what. So if there is only a very slim chance of any benefits to waiting, why take the risk and the worry. Especially since they do not actually investigate how well the placenta is working at this point. With this we feel at peace with the decision and in acceptance of intervention once again. Whatever it takes, whatever happens – it will all be worth it!!

In thinking about this over the last two weeks, I have come to realise that I’m not attached to any particular idea of a natural and idealised birth experience. I only care about the end result of holding a healthy baby in my arms, while of course hoping that the process to get to that point will go as smoothly as possible and involve as little distress as possible for both me and baby. But I would never even consider giving birth anywhere else than in a hospital and I trust the professionals there to deliver my baby safely by whatever means necessary. ‘Mother nature’ is also cruel and cannot necessarily be trusted. The millions of women and babies who have died and still die in childbirth in places and times with no access to medical help, is testament to that.

Personally all those years of infertility has taught me not to celebrate or have blind faith in ‘the natural way’ or be attached to any idea of ‘mother nature’ as a superior force. Of course I wish I could have gotten pregnant easily and naturally by making love to my husband rather than by way of doctors and IVF procedures in a hospital, but the reality turned out to be what it was. I no longer mourn that fact. It is what it is and my gratitude to modern medical science, and the intervention that got me pregnant, is limitless. The miracle of life is as amazing under these circumstances as in any other. Maybe even more so.

Tonight at 9pm I will be admitted to hospital to begin the induction process and I will stay there until the baby is out one way or another. It will be prostaglandin gel to start off with and probably a second dose later if nothing happens. Later again they might break the waters and eventually if labour is still not progressing they might put me on a syntocinon drip. They told me there is a risk that induction will fail and in that case a c-section will be considered. Thus prepared, we hope for the best while accepting to take each step as it comes and deal with whatever happens. In the end of the day no labour and birth is guaranteed to go smoothly. Anything can happen to any of us in that situation. Natural low risk labour can end up involving serious complications and drug-induced high risk labour can work out just fine. As with life in general you just never know what you’re gonna get!

Looking back on a long journey

There is something special about February. It’s the month of love. It’s the month we first met on a dance floor in London 9 years ago in 2003. It’s the month we decided we wanted to start a family 3 years later in 2006. It was so special and romantic for us to make that decision then. Little did we know what kind of journey lay ahead and that wanting to have children is something completely different from actually being able to make it happen. Now, 6 years later, it’s February again and I have entered the realm of the 2nd trimester of my first pregnancy.

February now feels more magical than ever before. But it also makes me think back on all those years of living with unexplained infertility and going through fertility treatment. These 6 years have changed me and us forever. I can’t imagine myself and our life any other way. We have learned that life is unpredictable and beyond our control. We have learned that nothing can or should be taken for granted. We have learned that it is possible to be happy even when life is turning out so differently from what we had imagined. We have learned that resisting what is only creates more suffering. At the same time, we have also learned that there are subtle, but very important, differences between denial and acceptance. We have learned that there is a time to let go and rest, but that there is also a time to start fighting again. We have learned that living outside the social norm is difficult, especially when you have had no choice in the matter, but also liberating. It teaches you to find your own way and to make conscious choices about who you are and how you want to live within the limits of whatever life is handing you. It has make us stronger and closer as a couple.

To put it differently, we have learned that being involuntarily ‘stuck’ in a liminal life state like infertility for years is painful on many levels, but also transformational. Looking back on my posts prior to IVF and pregnancy, I did know this when we were still in the trenches (see for instance this post), but only tentatively. It is much easier to reflect on it now when I’m no longer in the same state. As I do so, I realize to my surprise that I don’t actually wish that these years had been any different or that we had been spared the long journey to get to this point. I also realize that the only reason I can feel and say this is because the liminal state of infertility has effectively ended for us. For now at least. Over the course of the first three month of pregnancy I have transitioned into a new state – that of pregnancy. We have not become parents yet, but for the first time ever we are actually on our way there. We can see the light at the end of tunnel. This last stage of the journey is significantly different from any of the stages that have come before because the creation of a new life is no longer theoretical and impossible. It is happening. A new life is coming into being slowly and steadily with every day that passes.

We resisted IVF for a long time, but in the end it was IVF that made the miracle possible. Yesterday we went for the NT scan* and got to see our little miracle dancing again. He/she was making it very difficult to get the measurements done because of all the moving around. As the technician was waiting patiently for the right position we had lots of time to enjoy the show and revel in the representation of our miracle on the screen. I’m still in awe. I still can’t quite grasp that it’s really happening, because it has seemed like a complete impossibility for so long. But I’m getting there slowly. More so now when the morning sickness has lessened because I’m functioning more normally again. We have not looked at baby stuff or anything like that yet, but a few days ago I started looking at websites of hospitals in London to try to get an idea of where to give birth since we are moving there. As I was watching a little video that took you on a tour of a birth center, tears started streaming down my face. It was hitting me. It’s happening, it’s real. I’m pregnant. We are going to have a baby.

*Update 16/2-2012: We received a letter two days after the scan with the assessment of the risk for Down’s Syndrome etc. based on the combination of blood results, NT measurement (1.1) and my age (37). The risk was assessed to be 1 in 11000, which is reassuringly low for my age. 

A little bit pregnant… maybe…

So this was the big day. My official test day where I was instructed to come in for a blood test. 14 days after egg retrieval or, in other words, 11 days after the 3rd day transfer. The day we would finally get to know.

I did as instructed this morning and then we waited for the call. I had been going over the two possible answers again and again in my head. Hopeful of one and fearful of the other. What I did not expect was a third possibility. The nurse did not say the words I have dreamt of for so long: “Congratulations, you are pregnant”. Neither did she utter the words I feared: “I’m sorry, you are not pregnant”. Instead it was some kind of explanation about a low hCG level and that they would like me to come back for another blood test in a week.

I can hardly remember what she said precisely, because my mind just stopped. It took a while for me to realize that what she was actually saying was that we have a ‘weak’ positive on our hands. The hCG level was 42 mIU/ml and to be a clear positive they would like to see 150 mIU/ml. I also remember that she instructed me to keep taking my progesterone and said that it could be that it is just a bit slow. But it could also be that something is wrong.

After a bit of google searching, we have concluded that this result probably indicates that I am a little bit pregnant, so to speak. It would seem that hCG levels vary a lot from woman to woman in early pregnancy and that 42 mIU/ml on day 14 after retrieval could potentially be fine. So we are allowing ourselves to become happy – slowly. But we are also weary. Do we dare to embrace it?

This is yet another surprise twist to our seemingly endness journey which we could certainly have done without. But at the same time I’m thankful. I would take a weak positive over a negative any day!!

Addicted to knowing

It’s the two week wait. Every tiny little physical sensation is noticed and pondered upon and typed into google. You read about what should be happening each day after transfer. You try to imagine and visualize it all. Maybe you pee on sticks way too early. Anything to get just the smallest hint of what is going on inside your body and how the little embryo(s) are doing. You are counting the days till the blood test when you will finally KNOW.

It’s like a desperate need to see, to know, to get some evidence. All of us who go through fertility treatment experience it. It’s as if we have become addicted to a level of knowing about our internal reproductive happenings which goes far beyond a woman’s normal experience of her body. A level of knowing which is completely externalized and dependent on visualizing technologies operated by professionals.

All the ultra sounds and blood tests have changed my bodily perceptions for good. It has become normal to SEE things which are normally invisible. Or at least a representation of it. There on the screen I have seen my follicles and followed them at their different stages of development. I have seen each one get punctured with a needle as they were retrieved. I have seen a picture of our 8-cell embryo and I have seen the air bobbles inside me when it was transferred.

Fertility treatment makes the invisible visible and the unknowable knowable. It’s addictive. As you enter the two week wait this visualized experience of knowing is brutally taken away from you. Instead you are left completely in the dark.

Where in the first part of the cycle you got to see and know much more than you would have normally been able to, in this part of the cycle you are robbed of all sources of sensing what is happening inside your own body. Symptoms and signs mean nothing because they are probably just caused by all the progesterone you are taking. Trying to get a fix by typing ‘early pregnancy symptoms’ into google will give you no answers that can be trusted. If you are spotting it can be both a good sign and a bad sign.

But what about intuition? Does a woman’s intuition still work during IVF? After six failed IUIs and lots of reading about other people’s IVF experiences, I have learned not to trust anything I feel or sense during the two week wait. And I never test. I just don’t trust anything, including test sticks. I don’t want to jump to any conclusions based on anything. Instead I try to embrace ignorance.

But it seems that the learning has only reached the rational part of my brain… The withdrawal symptoms are not easy to control. Other parts of me are still busy sensing. The other day I told my husband I felt pregnant. He looked at me in shock – ‘do you have anything to base it on?’ No I don’t. Nothing. Nada. There is no evidence. I can’t explain it and I don’t trust it. But it’s there.

Is it an intuitive feeling? Or is it rather that the visual image of our little beautiful embryo is stuck in my head. I KNOW it’s inside me because I SAW it being placed there. Maybe it’s just not possible to believe anything else then that it is still there, growing away happily, until proven otherwise.

On Friday the 9th of December I will get a fix again. Thanks to a blood test I will finally get to know.

Meet RoseSelavy – my zen master aka the rest police…

RoseSelavy“We have forgotten what rocks, plants and animals still know. We have forgotten how to be – to be still, to be ourselves, to be where life is: Here and Now.”  Eckhart Tolle.

RoseSelavy came into our lives in late 2006 when she was a tiny wild kitten we rescued from the bottom of the paper recycling container in the communal yard of our apartment building in Copenhagen. By coincidence my husband was looking out the window just as she fell. We got her out of there and took her in, together with her brother. She was ill, scared out of her mind and undernourished. Administering eyedrops twice a day to a wild kitten is no easy task, but miraculously she allowed us to hold her just to do that. As if she knew it needed to be done. She let us take care of her. Now the tables are turned it seems.

Lately she has been ‘bullying’ me relentlessly to stop doing things and just rest. She has never been a very vocal cat, but it seems she has found her voice and she is using it to let me know in no uncertain terms that she is not happy unless I’m laying or sitting in bed. The sofa will do as well, but she clearly prefers the bed. If I’m not resting she is not resting. She fuses around my legs, meowing, scratching the furniture and she won’t give it up until I settle down on the bed. Then she joins me immediately. At first I thought she just wanted cuddles, but she usually places herself too far away for me to reach her. She just lays there, looking at me with half open eyes, purring. The purring goes on for about half an hour until she falls asleep (after which she starts snoring…).

The last few days I have realized that her new ritual is teaching me to rest, to be still and be in the now. It is meditative to listen to her purring and watch her in her pure being and peacefulness. All thoughts disappear for a bit, along with the two week wait and its battle between hope and fear. Thank you my little white furry zen master!

Positive thinking and Realism

Yesterday, on day three after retrieval, one beautiful 8-cell embryo was transferred to its natural element :-).

8 cells is as it should be on day 3 they told us and they estimated that this one has 30% chance of making it and implanting. It was a clear winner amongst the 6 eggs that got fertilized out of the 8 retrieved. We had decided on a single-embryo transfer even before we began the IVF process and the IVF clinic also favors it generally in initial attempts.  The remaining 5 embryos will be assessed today to see if they are good enough for the big freeze.

It was quite amazing to see the microscope picture of our little embryo that can’t even be seen with the naked eye. Magical.  The doctor who did the transfer was just so sweet and calm. She is like an angel really. I expressed my appreciation and she got all touched. The whole experience was quite beautiful despite the stirrups and the bleak hospital room next to a lab…

Now I have officially entered the realm of the two week wait and the battle between hope and fear is commencing. At the moment I still feel quite positive and at peace. I’m trying to hold on to that, while also trying to accept and surrender to the fact that what is going on inside me is entirely out of my control. Nature is at work for better or for worse and all I can do is avoid interfering. I’m a realist. Statistically there is about 30% chance of success and this means a bloody big chance of failure.

As I’m pondering on these not so promising success rates, I hear that voice in my head. The voice of current dominant ideology, i.e. “positive thinking”. Believe it and it will happen. This dogma of thinking positive isn’t just a helpful suggestion to make you feel better, but seems more like a moral obligation. You have to think positively! Negative thinking will create negative outcomes. What you fear you will draw to you etc. etc.

This is one obligation I can certainly do without at the moment.I need to remind myself that I truly do not believe that neither positive nor negative thinking will make any difference with regards to the outcome. To that end, I love watching the animated version of Barbara Ehrenreich’s dig at the positive thinking dogma in “Smile or die”. Click here to watch on YouTube. It’s fantastic.

As she argues, it is cruel to suggest that people going through difficulty in life have themselves created it with their minds. Or that for instance cancer or infertility can be cured by way of positive thinking. Indeed it would be cruel to myself to think that my chances of becoming pregnant within the next two weeks should in any way be influenced by my ability to think positive or not. Realism gives me the freedom to feel however I feel at any particular moment knowing that the outcome is entirely beyond my control.

In this way I embark on my two week wait armed with a healthy dose of realism, mixed with some non-obligatory positive thinking for general well-being. It might make the wait more bearable and less characterized by premature suffering. I will suffer soon enough if the blood test is negative on the 9th of December. Until then I can allow myself some happy spells by thinking of the tiny little seed of life inside me :-).