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PAILS of Hope

Paths to Parenthood
by Jennifer Mason
Our path to parenthood was not the normal easy path that many people take. Our path was long, painful, stressful, convoluted, and finally successful. For us, it was a four-year journey through the maze of medical procedures that are infertility/fertility treatments. Our journey ended with one attempt at in vitro fertilization.

At the beginning of this journey I defiantly stated that I would "never" go through treatments that involved hormone shots. I could handle the thought of pills and the minimal interruption in life that they caused, but the thought of something so intrusive as shots was beyond my commitment level at the time. I believe that is why this type of treatment is a process that breaks down the barriers for the next, more intrusive or invasive procedure. For us, we went through all the tests and procedures until everything except in vitro was exhausted.

The good news for us was that we did have a diagnosis so we knew what we were battling and how to best win the battle. After 3 1/2 years with my gynecologist providing the treatment, he confidently referred us to a fertility specialist who agreed that we were good candidates for in vitro fertilization. He felt very strongly that this procedure would work for us. We were lucky that there was a successful fertility clinic in our town only 15 minutes from our home. This allowed us to begin the process of treatment with minimal amount of intrusion into our normal lives.

I think that for me maintaining a normal life was hard, but essential to my sanity. We chose to involve our family and those who work with us in our process and we were quite open about the entire process. Luckily for both of us, we received nothing but support from our families and our coworkers.

We first met with the fertility specialist in April and had blood work and any tests older than one year repeated to prepare for in vitro. We were told that their next in vitro cycle would not start until September. While this seemed like a long time to wait at the time, it actually gave us some time to prepare financially and emotionally for the journey that is in vitro. It also allowed me some more time to research exactly what was going to happen to my body and speak to people who had been through the procedure. As I said before, we were also very open with our friends and family about what we were doing and this allowed everyone time to prepare. The months from April to September flew by as we were both attendants in my husband's brother's wedding in June and had a 10-year high school reunion in August that was our last blow out before the in vitro. We were also lucky enough to be invited to spend the weekend before the in vitro started at the beach with two good friends and their two children. This allowed us time on a private beach to talk about what was coming for us and prepare ourselves.

On the Monday when we returned from the beach, I started the Lupron shots to suppress my ovaries. This is the initial step in the in vitro process for our clinic. After my blood levels and sonograms showed that my ovaries were suppressed, the hyperstimulation drugs for my ovaries were started. Initially, I took one shot in the morning and one in the evening. These were shots that I could give myself. Our clinic used drugs in a single form, LH and FSH separately, instead of combination drugs like Pergonal. This single form allowed them to control the dosage and the number of follicles more carefully than the combination drugs. After six days of this, I returned to the clinic for blood work and a sonogram every day until the follicles reached a certain size. The blood work and sonograms determined the dosage of LH and FSH for the night injection and the injection the following morning.

During these injections, I did experience side effects. I was moody and sometimes I was nauseous and I was very stressed. I realized that I was only going to do this once and I desperately wanted this attempt to succeed.

After several days, the sonogram showed that the follicles were ready to be retrieved. That evening my husband gave me the HcG shot. This shot is given precisely 35 hours before the retrieval is scheduled. If the retrieval is done late, the patient may ovulate and if the retrieval is done early, the follicles may not be ready for fertilization.

For me the retrieval was very stressful. I was worried that someone would be late or they wouldn't get enough eggs or any other number of things that I could think of to worry about. For my husband, it wasn't stressful until we arrived at the clinic and I was sedated and went to sleep and he was left to worry. He could watch the retrieval on a monitor in a separate area, but he was totally alone and I was asleep. For us they retrieved nine eggs. This was on a Friday morning and after the procedure I was very sore. I was sent home to rest for the weekend. I spent the weekend praying that we would have two "good" embryos to transfer back when we returned to the clinic. On the night of the retrieval we started progesterone shots to prepare the lining of the uterus for implantation of the embryos.

On Monday we returned to the clinic for transfer. I think we were both nervous at this appointment. When we arrived at the clinic one of the doctors spoke to us regarding the "grade" of the embryos. We had planned on only transferring two embryos because we decided that two babies were the most that we wanted to have at one time. Well, two of the embryos were the highest grade and a third embryo was okay, but not good enough to survive freezing for a future attempt. Since we didn't want the embryo destroyed we decided to transfer all three embryos and take our chances. This is a difficult time because this decision is made in a matter of minutes. Luckily, we had a pretty strong opinion regarding the number of embryos we wanted to transfer. Our clinic also has strict limits on the maximum number of embryos it will transfer based on the mother's age.

So three embryos were transferred and the head of the bed was lowered and I stayed as still as I possibly could for the next hour. I then gingerly changed into my clothes and shuffled to the car. I know that they told me I could walk normally, but I didn't want to do anything to shake those embryos loose. Our protocol called for five days of "light activity" which I took to the extreme. I didn't want to do anything that I could look back on and say, "If I hadn't done that" then may be the in vitro would have worked so I did almost nothing for three days. This wasn't hard since I was still pretty sore from all that my body had been through in the weeks before. On the fifth day I started to have sharp pains in the area of my ovaries, so my rest was extended for two more days through the next weekend.

I should say that I took advantage of the Family Medical Leave Act in order to reduce my schedule at work, keep my benefits, and focus 100% on the in vitro. This allowed me to preserve my sick and vacation time for later use. I reduced my schedule until the HcG shot and then I took time off until after the pregnancy test.

Two weeks after the transfer we were scheduled for the pregnancy test. This was on a Monday. The week before the test, the clinic called and asked if we could move the appointment to Friday because our doctor would be available on Friday. We had already told our family and friends that we were having the pregnancy test on Tuesday (just in case we needed time to recover before we had to speak to anyone). I chose not to change this when the clinic changed the appointment. I went into the clinic at 9:30 that morning and had the blood drawn for the pregnancy test. Our appointment was at 11:30 a.m. so I went and had breakfast and tried to keep busy until it was time to meet my husband at the clinic.

When I heard the doctor remove the chart from the door, my stomach turned over. This doctor held the most important information I had ever received in my life in his hands. The doctor came in and asked how I was feeling. I had decided that if he told me the test was negative, I was going to ask him to do some tests because I was so exhausted and had unexplained nausea off and on. I told the doctor that I wasn't feeling so great and he said that was because I was "officially pregnant." I don't think I had ever heard such sweet words in my life. He told us that the HcG level was very high and he wanted to repeat the test in 48 hours to see how much the level went up. The hope is that it would double to confirm a pregnancy. Forty-eight hours later our level was almost triple the initial number.

My husband and I couldn't wait to get home and start calling people. I realize that conventional wisdom is to wait until you are three months along to tell people, but when people know that you are going through this process, they also know that you are going to find out around a certain time frame whether it worked or not. For us, telling family required phone calls because all of our family lives out of town. My mother-in-law was in tears, my dad was reserved but excited, and my grandmother said, "You won't know that until Tuesday!" We had to convince her that the doctor had changed the appointment. The other advantage to the doctor moving our appointment to Friday was that my mom was in town by coincidence with a group of friends. She had checked out of her hotel on Friday morning and was at the airport waiting for her plane with her group of friends when my husband and I walked up. We said that my husband hadn't gotten to see her during her stay in town so we came to see her at the airport. We then gave her a picture frame that said "I Love Grandma." It took her a second to realize what it said and then she erupted along with all of her friends. It was wonderful to finally get to say those words, "I'm pregnant!" to someone in person or even to say them at all.

We never will know what the purpose of us having to wait four years to become pregnant was, but I believe I was meant to educate others about what they are getting into with in vitro or other infertility procedures. I also believe that my story educated family members and coworkers so they are a little more sensitive about what a person is going through during this process. I know that my family and my coworkers simply thought that in vitro meant taking the eggs out, fertilizing them, and then putting them back. They had no idea of the physical or emotional strains involved in this process. I know that if they are ever approached with this situation again, that my openness will allow them to be more supportive than they would have been previously.

Keep trying is the point of our journey. Personally, I needed to hear a doctor tell me that I was never going to give birth to a child before I could move on to the option of adoption. I don't believe that was true for my husband, but he was wonderfully supportive of my need to bear our child. I continued to hear that this procedure failed or that test was abnormal, but I never heard there was no hope for me to have a child and that is what kept me going.

On May 14, 1999 I gave birth to our twins at 36 weeks and 6 days. Our daughter weighed 6 pounds 14 ounces and our son weighed 7 pounds 6 ounces. What a blessing!

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