April, May and June were very tough months. During the course of fertility treatments, I had developed hyperthyroidism, which prevents ovulation and is linked to miscarriage. I wasn’t getting my period. I felt further from conception than ever and I was sinking emotionally. I was having dark thoughts and considered starting anti-depressents. One of the only bright spots was a workshop I went to in mid-June led by Julia Indichova. It was a day-long event filled with lots of bonding and powerful insights. In the circle of other people going through the same pain, I felt supported, like I could finally let my guard down. At the end of the day, I ducked into the bathroom and discovered I was getting my period. Could it be that my body was regaining its equilibrium?
I spent the next month, doing the imagery and body work Julia recommended, including listening to her cd recommendations. One of the exercises was to imagine myself with my baby. That was hard. I was afraid if I let my mind go there, my heart might break. But amazingly, it didn’t. And I felt strangely happy holding my imaginary baby. And something weird started happening: I started to feel as though I was getting more fertile. Granted, I had no evidence to back this up. I just started to think that all my lifestyle and dietary changes
were working. My mindset was shifting.
My husband and I decided we would do one last cycle. We would soon be moving and we knew we wouldn’t try IVF again in a new city. I had read about a drug called Letrozole, which had reportedly shown promise with “poor responders” and asked my RE if I should try it. He said as far as he knew it had never been used in the US before but he would be willing to write it in a protocol for me. He presented me with a new protocol that included a two-week stint of birth control pills followed by Lupron, Gonal-F, Repronex and Letrozole. But I didn’t like it. I told him I didn’t want to take the birth-control pills anymore. It had never felt right to do so and I had just found this article (poor responder Zouves article) online that backed up my suspicion. And the more I read about Letrozole, (one article said it acted like Clomid, which for me had caused a breast cyst), I decided against using it too. It started to seem obvious that since my body didn’t respond well to the drugs, fewer would be better. My long-suffering RE had to go back to his 12-person team to tell them to rip up the protocol that they’d just crafted -- his stubborn patient didn’t want the Lupron or the birth-control pills or the Letrozole. They agreed to do it my way.
By the time I started the injectibles, I had transformed my life in every way imaginable to make it more hospitable for a baby:
-- I ate mostly vegetables
-- I ate only organic meats
-- I ate earlier at night to give my body a few hours to digest before bedtime.
-- I avoided protein at night (harder to digest)
-- I started eating more slowly and chewing my food more thoroughly (my body needed as much energy as possible for egg-producing, not digestion)
-- I avoided tofu but did eat miso and tempeh
-- I cut out even decaf coffee and tea (it still contains a little caffeine)
-- I ate fruit in the morning
-- I drank red clover, raspberry leaf and nettle tea
-- I took daily doses of folic acid, B6, B12 and fish oil
-- I cut out dairy
-- I consistently did acupuncture twice a week
-- I drank wheat grass as often as possible
-- I practiced Julia Indichova’sbody work
-- I did yoga positions designed to bring blood flow to the uterus
-- and for the first time I got to the root of my deep-seated fear of not being able to have children. I explored my old childhood messages about the value of motherhood and what that meant to me.
On August 12th, I went in for retrieval and got 7 eggs – the most I’d ever had. The next day we found out 5 had fertilized – our best ratio. On August 15th, we went in for transfer and learned we had four good embryos – 3 of them 8 cell. The doctor looked at my chart with its history of chemical pregnancies and said words that I would cling to during the 2ww,
“Well, we know your eggs can do it. “ She transferred all four embryos. At 38 years old, three years after starting the process, this was my best cycle.
I was on progesterone suppositories 3x a day, which is no treat, by the way, to insert one at 2:30pm in the middle of the work day. But it’s better, in my book, than the injections. I was also on 100 mg of Doxycycline, for assisted hatching patients, for four daysand Medrol, 16 mg, for four days following retrieval. (I was wary of assisted hatching and wrote a note on my permission form prior to retrieval not to do it unless the embryologists felt it was absolutely necessary).
My doctor also suggested that I take Estrace, starting two days after transfer but I was petrified to do so. I didn’t want to screw with what I believed to be the delicate hormonal balance that had allowed me to get pregnant the first two times. I pestered my RE for his reasoning behind prescribing the Estrace and here was his response, “It can’t hurt.” But I wasn’t convinced of that. So I went online for answers. I found an article from January of 2000 about the effect of estradiol on IVF cycles and, of course, the findings were maddeningly mixed: it showed success for women under 38 but not for women over 38 years old. I was 38. So at the 11th hour, I found an email address for the study’s author, Dr. Norbert Gleicher, and wrote him a letter asking if he could shed any light on whether the Estrace might work for me. I sent it at 7:53am. If I was going to take the Estrace it had to happen by midnight. I hadn’t heard back from the doctor by midnight. So with great trepidation, I took the estradiol. Dr. Gleicher wrote back to me five days later. Here was his response:
Now I felt even more anxiety. I wrote an email to my own RE asking him to allay my fears.
Here’s his response:
On August 30th I went in early for the pregnancy test. As usual, I felt nothing: no breast tenderness, no cramping, no nausea. Nada.
IVF creates such a strange situation: sitting and waiting for the phone to ring with monumental news that will set your life on one course or another. I kept staring at my phone all morning. Finally, I had to run an errand, so I put my cellphone on the car seat where I could see and hear a call come in. But wouldn’t you know, the call came during the one-block dead zone on my drive home. My phone registered “missed call” forcing me to pull over to listen to the message. My stomach was in knots knowing the heartbreak that could be waiting on the other end. But I forced myself to hear it. And there was Nurse B’s reassuring voice, “I have good news. The test is positive. You’re pregnant.” My heart jumped. Then she paused, “But I know we’ve been here before, so we’ll just take it one day at a time.”
And that’s what we did. We approached the news as cautiously as possible and refused to even consider the pregnancy real until the ultrasound seven days later when, for the first time, we actually saw a heartbeat. And then two weeks after that we shockingly saw two heartbeats.
I never had any symptoms and never felt pregnant. It often didn’t feel real. I was petrified much of the time, fearing the pregnancy would vanish much like the others. But it didn’t. And, though my twin girls were born early (at 31 weeks), they were healthy. Part of me still can’t believe they exist. I’ve heard experts say that once women have babies, they put away their infertility experience, rarely talking about it again. That didn’t happen for me. The infertility odyssey stuck with me. In many ways, and I never thought I’d says this, I’m grateful for the experience because I’ve never taken one day of parenthood for granted.