Battling Resentment While Trying to Conceive

While riding my bike to the clinic on my seventh day of stims I was overcome gratitude. “Wow,” I thought, “I don’t feel the anger that I used to… I am so lucky to be here and to have this opportunity… we are so lucky…  we have flipped this IVF process on its head and are living this amazing adventure.” It was a beautiful and sunny day in Valencia- a quintessential spring day- with birds chirping and fragrant flowers adorning each tree. I gave myself a pep talk and recognized how far I have come from my darkest moments. I realized only then how I had let so much of my deeply held anger and resentment go. On this trip to the clinic my heart was filled with excitement and my mind was content. I had stopped comparing myself to others, stopped worrying about what the future holds.

Instagram’s Punch in the Gut

That night I went on Instagram and I saw a “big announcement” post from someone I follow. Several weeks ago she had announced they were going to start trying “to see what happens” and that they were OK with whatever the outcome was.  On this night they announced that they are expecting, and they broke the big news with hash tag #gotitonthefirsttry.

My immediate response was “Fuck you.”

So, I guess I haven’t come as far as I thought.

The Self-Inflicted Pain Caused By Comparison

Trying (unsuccessfully) to get pregnant is hard. There is always someone who has it worse than you, and I don’t mean just from an infertility standpoint. When I look at my other TTC sisters, I see women who have been trying longer, who feel more hopeless, and who have a smaller chance than me to conceive- even with all of the best medical technology in the world. And I want to acknowledge that struggle, and feel thankful for the access to options that MH and I have that others don’t.

However, in some moments I still have that visceral self-pitying response of “Why can’t that be me?” Why do I have to spend $13,000, administer injections and go through a three month (at least!) process after trying for almost two years? Why can’t I have fun and spontaneous sex and then 3 weeks later realize my period is late, and voila, see two pink lines staring me in the face?

Permission to Feel How You Feel

When I was having a particularly tough time, one of my best friends told me that it is OK for me to feel this way. Those words- that permission- took a huge weight of my shoulders. I had felt shame for having negative feelings like jealousy and resentment. And I think that shame made me feel worse about myself than having the actual feelings. Yes, of course it isn’t healthy to bask in a cauldron of negativity. But it is also not healthy to deny how you feel; these emotions tend to fester more when you disclaim them. They also can inflict real damage in a very subversive way.

By acknowledging how I feel, and allowing myself to feel those emotions, it was easier to loosen their grip and make space for how I want to feel: grateful.

Current Update – My IVF Consultation and Protocol in Valencia

ivi clinic valencia

I cannot believe how quickly time has flown since we have arrived in Valencia! We arrived on Tuesday, April 17th, and on Friday, April 20th we had our first consultation with Dr. C* at the IVI clinic.

Our initial consultation

Our hotel was a short walk to the clinic, and when we arrived at the modern and bright facility we were directed to go to the international patients’ check-in desk. Here we were greeted by an English speaking coordinator, who took our photographs, documented our passport information, and then explained that we would be assigned a “tutor.” Tutors at the clinic are medical professionals who guide international patients through the initial consultation and the IVF process.

We waited in the waiting room for only several minutes before our tutor introduced herself, and then she ushered us from one room to another to complete the intake process. During this process we submitted all of our recent bloodwork, semen analysis results, and other diagnostic test and health history information. We reviewed and signed the treatment paperwork, and then were directed back to the waiting room to wait for our appointment with Dr. C.

Meeting Dr. C

Just before our scheduled time to meet with Dr. C, our friend Phillip (who is a friend of Dr. C and arranged for us to be seen at the clinic) met us to say hello and to make sure we were having a pleasant experience so far. He then walked us into Dr. C’s office to personally introduce us.

During our meeting with the doctor MH and I reviewed our health histories, the doctor performed a transvaginal ultrasound and a trial transfer (note, this was quick and painless, and I did not take Advil prior to my appointment), and then we discussed next steps. I had several more tests to take, which I would need to do the following Monday since I needed to fast beforehand. MH would need to have another semen analysis and we would also do a freeze.  Thankfully, all tests are performed at and processed by the clinic, so waiting time for the results were just a matter of hours (as opposed to days or a week when compared with my experience in the USA).

Consultation surprises

There were a couple of surprises during this consultation. One, we learned that I would need to complete an ERA test. This is a test that evaluates the ideal time for implantation, and based on these results, will determine the optimal day for the FET. Unfortunately, this test means we have to do a “mock cycle” in between the retrieval cycle and the transfer cycle. Therefore, it will extend the amount of time before we could actually become pregnant. We were planning on taking a month off in between regardless, but since we have to a mock cycle with a biopsy for the test, I will need to be on medication and have to stay close to Valencia for several doctor’s visits during this time. We considered traveling back to the USA to perform the test there, but the cost of the test would be at least double than what we would pay here in Valencia.

The second surprise was according to testing I had completed in the USA, my AMH levels had dropped significantly from June 2017 to April 2018. Dr. C was not happy with the latest number, but his concerns dissipated when he conducted the ultrasound and counted about 17 follicles. He said that AMH was just one of the parameters he looked at when evaluating ovarian reserve, and the drop in levels could have been due to a faulty test. To be sure, he wanted me to get my levels retested prior to my next appointment.

We also learned that Dr. C was going to put me on a “short protocol“. At first I was disappointed to learn that we couldn’t start treatment in my current cycle. I had assumed that I would be on a protocol that was similar to what my previous doctor had recommended, which was referred to as a “long protocol.” A long protocol requires about two extra weeks of medication and it starts during the menstrual cycle preceding the ovarian stimulation phase. However, Dr. C explained that the clinic’s approach is to use the most gentle protocol as possible, so there was no need for me to be on medication prior to my next period. With a short protocol, I would start my stimulation medications on day 2 or 3 of my next cycle, and if all goes well, have the retrieval 10-12 days later. Since I was dreading the shots and how the medication would make me feel, that sounded good to me!

Follow up visit

The following Monday we went back to the clinic for blood work and our follow up visit to discuss next steps. Dr. C confirmed that my AMH levels looked great, and we would start treatment on either Day 2 or Day 3 of my next cycle.

Dr. C did have concerns about MH’s semen test results from Friday. Due to the low count, low motility, poor direction, and poor morphology, Dr. C recommended that we PGS test the embryos. He explained that there is a correlation between poor parameters and genetic issues (which we were aware of because we were recommended to have the DNA fragmentation test performed in the States). Since we are at a higher risk of having genetically abnormal embryos, he wanted to mitigate the risk of transferring an abnormal embryo as much as possible by screening them out.

A different kind of TWW

After our last appointment we excitedly awaited my period… for over two weeks! We visited the clinic several times to pay for services, pick up my prescriptions, receive my first tutorial for administering the medication, and have my questions answered about timing of the ERA test and the FET. On the first day of my cycle I walked to the clinic to inform them I was ready to start; luckily, I already had an appointment on the books for the following day, so I returned to meet with Dr. C and officially started my protocol.

Overall experience

We have been beyond pleased with the clinic and the service so far, with the exception of being able to easily contact an English speaking operator during peak hours. Luckily we are only a 25 minute walk or bike ride away, so we have been able to simply “show up” and speak with someone who can answer our questions.

Everyone at the clinic- including Dr. C- is so friendly, helpful, and efficient. Despite coming from thousands of miles away, we feel completely at ease. I learned that approximately 50% of the patients are international patients, many of whom come to Valencia specifically to be seen by Dr. C. Based on the “concierge” level of service we have received, the clinic is clearly set up to treat a global patient population .

*We have changed the names to protect the privacy of these individuals.

The Two Year Wait – The Second Year

The first weeks

The weeks after our wedding were blissful. We traveled from Dominican Republic to Miami where we had a mini honeymoon. We also officially tied the knot in the Miami Beach Art Deco styled court house. MH and I people watched, jogged through the boardwalks and parks, and ate amazing Peruvian ceviche. During this time, however, I had a nagging shoulder pain. It had started the year before during an improperly taught barre class.  It seemed like the physical therapy sessions I had in the month prior to getting married didn’t fix the problem.

Shoulder surgeries

As an avid (AKA obsessed) surfer, I found this pain and weakness in my shoulder to be life altering. Surfing was my outlet, my escape, my reset button, and my spiritual source. Without the daily routine of waking at dawn and surfing before work I felt lost, and really cranky. The constant and increasing pain wasn’t helping my mood, either.

 

The story of my shoulder surgeries, the pain and misdiagnosis leading up to them, and the life altering results are a novel of their own. All I can say is that I was in intense physical pain for a long time.  Three years later I am still adjusting to my “new normal”. My first shoulder surgery was on my right shoulder in May of 2015. When I had I stopped physical therapy prior to my first surgery, my left shoulder destabilized, so six months later I had surgery on my left shoulder. I had stretched out both my capsules from the repeated overhead motion of surfing, improper muscle use, and just poor genetic luck.

 

Surgery fixed the problem (it was treated as a labral or SLAP tear for those who are wondering), but the nerve pain, which was exacerbated by any type of computer work, was physically and emotionally exhausting. For an entire year I was in a constant state of irritation and borderline depression. The last thing I could think about was having children; I literally did not have the ability to lift or hold them.

The unexpected

To make matters worse, our small condo received thousands of dollars of water damage just prior to my first surgery. A neighbor who was renovating his condo above was testing a pipe that was apparently unconnected, and the result was our kitchen and bathroom being flooded. We unexpectedly had to move out for several days.  The contractor hired by the insurance company was terrible.  It took 5 months for the work to be completed. What this meant, though, was that when MH’s parents came to visit us from the Dominican Republic they couldn’t stay with us. Their several week stay turned into two months in a nearby hotel, during which MH’s father went to the emergency room due to an Rheumatoid Arthritis crisis. He hadn’t taken enough medicine with him before he left, and his body was on the verge of shutting down.

An unfortunate event

Shortly after my in-laws returned back to the Dominican Republic, I got news that my cousin had tragically passed away. Going home to attend the service and spend time with my cousins and family was a healing experience.  However, for many months I was hurt, shaken, and angered by his death. The voids that had been created by what “could” and “should” be from every other challenge that I had experienced so far that year paled in comparison to the vacuum created by actually losing someone you love.

 

By the end of 2015 my baby fund was drained and I felt like I was at my breaking point. MH’s and my union was tested in ways I could not have imagined during our first year of marriage, and I could not have anticipated that the hurdles would keep coming in the months ahead.  Starting a family seemed so far away.

The Two Year Wait – The First Year

When MH and I started dating things moved pretty quickly. We met in March, by July we were living together part-time, and in September we took the leap and rented a place of our own. While I thoroughly enjoyed being courted by such a romantic (and cherished my independence), I wanted to gauge whether or not our relationship had marriage potential. After all, I was 30 and I knew I wanted to have children, so I felt like I didn’t have time to waste. We rented a charming cottage with a patio and a garden (that I would subsequently kill) in the eclectic and eccentric beach community of Ocean Beach. By January we decided we liked each other enough to buy a condo together, and begun the conversation about starting a family. Of course, once we started paying our monthly mortgage payments our financial obligations became tangible, and the concept of reducing our income by half for any amount of time was no longer in the abstract. The weight of these new commitments was acutely felt by MH, so we agreed to wait.

 

Originally we had agreed to wait two years. Two years, I had thought, would give me enough time to shore up some savings AND enough time to “massage” the idea for MH a little more. I had hoped that given some time to acclimate to our new life together his desire to start a family sooner rather than later would return.

 

The first year living together was a blur of travel to Hawaii, Seattle, Vancouver, Whistler, Channel Islands, Coachella, New Jersey, New York, and Las Vegas. We also managed to accomplish some serious remodeling in our condo in between being on the road and our demanding work schedules. At times it was overwhelming, but we had a blast.

During July of 2014, however, our pace came to a screeching halt. While I was in New Jersey visiting my family I received a flurry of texts from MH’s sister and her husband, who were unsuccessfully trying to contact MH.

 

His father was going into emergency surgery, I was told, and he may not make it. He needed to fly home to the Dominican Republic as soon as he could. I flew back to San Diego a couple hours later, and the next morning we flew to the Dominican Republic to be with his family. Upon our arrival learned that his father had a massive heart attack, and although he was expected to recover, he came very close to passing away. We had been waiting until we were actively traying to start a family to get married, but this experience had a sobering effect. We couldn’t take for granted that our parents would be at our wedding, let alone be grandparents to our children one day, so on at a beach bar in Cabarete we decided to move up our timeline.

 

The day after Christmas we had the loveliest, most intimate and beautiful wedding I could have ever imagined at sunset on the beach of Playa Coson, in Las Terrenas. My parents, sister, and brother attended, along with MH’s immediate family. As someone who did not grow up dreaming about my wedding day, it unexpectedly had felt like the happiest and most important day of my life. And on that day looking ahead, I was anticipating growing our family in the upcoming months.

From there, however, life did not go as planned. At all.

Deciding When

Decided when to start a family became such an exciting prospect. It was something that was debated, carefully considered, and rationally decided. Of course, those conversations came after our blissful honey moon phase of “Yeah, we have only known each other for a couple of months, but let’s see what happens!”

Having children was a part of our conversation since our very first date. We later concurred that getting pregnant within the first six months of knowing each other was unwise, even though we frequently tempted fate by being less than careful. It was as if our hearts and minds were dueling the way a rebellious teenager and strict parent would.  Occasionally we would let our hearts get revenge for minds for unilaterally deciding what was in our best interest.

Having it happen within the next six months wasn’t ideal, either. Ten months into our relationship we decided to purchase a home together. Right before we signed the papers I thought I was pregnant, and I was beside myself. How would my husband really feel? Would he still want to buy a home if a baby was on the way? Housing in California is so expensive… are we ready to live off of a single income? Will he be ready? I thought the timing was terrible, and was dreading telling him. However, when I did, he was excited. “Why would that change anything?” he asked. Several days later we were disappointed (but a little relieved) when my menstrual cycle began.

At the 15 month mark we were living in our new home, and I announced that I didn’t want to wait any longer. I was 31, and armed with statistics, I made the case for why we should start trying now if we want to have more than one child. MH*, however, had a different take. Sometime within the last several months he had transformed from dreamer into provider. “We have a mortgage.” “We are not ready to lose an income given that we have no family within 2300 miles to help.” “We haven’t started a college fund yet.” All logical and understandable objections (minus the college fund, IMO), however it didn’t sway how I felt. I wanted to become a mother. He suggested that we start trying in two years, and I acquiesced- and the countdown started.

*MH (My Husband) asked that his name not be used publicly… he is a private creature 😉

To Have or Not to Have: Switching from Ambivalence to Certainty

I never thought much about having children when I was young. I am an animal lover, so in middle school my idea of a “perfect” family was a husband and a home full of creatures. In my high school and college years I had serious boyfriends, and overtime the concept of having children became more amenable and acceptable- partly due to my innate maternal desire, and partly due to the subconscious pressure to conform to social norms.

I mostly dated men who wanted to have children. My high school boyfriend wanted to become a father someday, and we picked out nicknames for future children. Even as college approached, the reality of us actually getting married and settling down was abstract and so far off; I never had to reconcile my true ambivalence towards the path we were on. We broke up before there was any proposal.

My college boyfriend adored babies, and his paternal drive was so strong it created insecurity as I questioned the veracity of my own ember of desire to be a mother. We, too, broke up before there was any proposal.

Like many of my peers, I spent my early to mid-twenties preoccupied with launching a career and finding a life partner. In my mid-twenties I appreciated being with someone who shared my point of view on most things in life. He, however, was adamantly against becoming a father. I loved the freedom that I had, and was really turned off by how small some parents’ worlds had become once they crossed that chasm.  From outside appearances, it looked like they were living a rat race- unsatisfied, exhausted, and just wanting for the kids to grow up and move out. I was genuinely happy for the people I knew who were having babies- It just didn’t feel like it was for me. Still,

Looking back, I can now see that the subtle pangs of wanting to experience motherhood were there. It was the lifestyle that wasn’t for me. Giving up my identity to become “Mom” seemed like the inevitable outcome of becoming pregnant; of course now, I have so many women in my life who model how to integrate children into their lives without giving up who they are. I have even seen motherhood complete them in a way they couldn’t have imagined.

By the time I reached my late twenties my heart was saying “bring it on”, but my mind hadn’t quiet caught up. I remember dating someone who was a couple of years younger than I was, and when we spoke about the desire to have children his outlook surprised me. This free-spirited man proclaimed that “having children is a part of the human experience”. When he looked at his brother, who had a child out of wedlock (to which his family was not very pleased), he didn’t see a man making poor choices. He looked at it as a miracle of life. After hearing his take, I knew where I landed in the decision of to have or not to have.

When I was 29 I realized that I was not going to meet the person I was meant to marry living where I was. If I felt that my home state didn’t offer the life that I wanted, I couldn’t expect to meet my life partner there either. The following January I moved across the country to San Diego, and two months later I met my husband. And I knew within months that I wanted a life- and a family- with him. So then, it became a question of when.