Perfect Timing

This isn't your typical quarantine pregnancy announcement...

    If you keep reading, you won't find any of that “Oh, we’ve been stuck at home with nothing else to do” business. In fact, Andrew and I have been essential workers throughout the pandemic, and I even transferred Target stores in the midst of all this... so there definitely has been no down time for us. But for as much as we didn’t plan for this news to be announced in the midst of a pandemic, it’s been the biggest test in patience, faith, and emotional endurance either of us have faced in our lives. And although our story is nowhere near complete, it is a story that has shaped us in numerous ways and prepared us for what is to come, and it's time that this story was shared with you.

Murphy the Dog (and future big sister)

    Because I’m a goal setter and one to look ahead to what’s next in life, I have always had my heart and mind set on the large milestones. In my teenage years and young adulthood, it seemed there was always something big to look forward to, whether that was a graduation, wedding, promotion, or something else. In fact, something that Andrew and I talked about often early on in our relationship and marriage was how few hardships we had to endure in our lives and how often things seemingly “worked out” according to our plans. Sure, we worked hard to get where we were, but it always seemed that whatever plans we put in place would land us where we wanted once things were set into motion. In both of our higher education plans and careers, this was certainly the case as we didn’t face many closed doors en route to successful jobs. We realize that is not necessarily normal, and something that when we reflect, makes us truly grateful, especially being in much more uncertain times today. But of course, when you are used to making a plan, setting a timeline, and working hard towards that goal, it’s hard to anticipate how you may react to a road block... and when we finally decided we were ready to start a family, we never expected the major turmoil we were about to face. 

    It was the spring of 2017, and I had just turned 27 years old when my maternal clock finally started ticking. I saw numerous posts on social media from others my age and younger expanding their families, and I knew then that I was ready to take that step. Plus, Andrew and I had been married for five years, and we had just made it through his first year of residency and my first year as a Store Director for Target. The timing seemed perfect. I knew starting a family would involve a lot of sacrifice, not to mention time and effort, but as I mentioned, I am not a stranger to hard work. But, I figured, how hard can it really be? People have babies all the time. I stopped birth control, downloaded an app to track my cycle, and bought ovulation predictor tests thinking it would take a couple months at most and we’d be on our way to checking off one of my three main goals of adulthood: house, dog, and baby.

    It was an exciting time for the first few months. But then three months turned to six, and six turned to a year. We fielded questions at every family and friend function about when we were having kids, and since we had kept the news to ourselves that we were trying, we would just smile, nod, and say “Someday soon!” or "When the timing is right!”, hoping that maybe the next month we would have something of substance to share. As we approached the sixteenth month of trying with no success, we finally decided we needed to seek professional help. It was then that we shared the news with our families. There’s no other reason of why we waited so long to let our loved ones in on this journey except that we had shame and fear. Shame that something that came so naturally for most people was proving to be difficult for us. Shame that we couldn’t provide a much anticipated bundle of joy for our families. Shame that we were finally experiencing a life roadblock that we couldn’t overcome with planning and hard work. And fear that the one thing that we now were longing for more than anything may not be biologically possible for us, which was something neither Andrew or I ever anticipated would happen. 

    I remember distinctly the mixed feelings I had when we visited the infertility clinic the first few times. For starters, the doctors and nurses could not have been more welcoming. Our initial consultation felt eerily personal, and as we opened up about our struggles and our medical history, it felt like a major weight was lifted off my back. To be able to tell someone “I’m struggling” and for them to say “I can help you”... it was a much more emotional experience than I bargained for. Between our first and second visit we had a barrage of tests, none of which were too pleasant but that we understood were necessary in formulating a plan for success. When the results of our tests came back and we sat down with the doctor for a regroup, there was a sense of relief to finally have answers as to why we had such a hard time. But even those answers didn’t provide clarity on the biggest (and admittedly most selfish) thought that lingered with me: WHY US?

    Based on the results of our unexplained infertility, our doctor recommended that we would have the best chances of success if we started IVF. I knew very little about the process going in, except that it could be considered controversial in terms of messing with fate and “playing God”, often resulted in multiple births (think sextuplets), and was extremely expensive. But we felt strongly enough in exploring every avenue of having our own biological children that we chose to walk that path together. I know the doctors and nurses tried, but I don’t think anyone could have prepared us for how emotional of a journey we were about to embark upon. 

    With IVF, everything is about perfection, whether that is creating the perfect conditions or acting on the perfect timing. There were many times during the preparation for my first egg retrieval that I thought to myself what a miracle it is that any of us were even born in the first place. For all of the things that have to go just right, how is it that there are so many unwanted/unplanned pregnancies or orphaned children in the world? Going through the process made me hyper-aware of the topic of abortion and adoption, and while I knew that there are reasons why those decisions are being made every day, it didn’t make it any less unsettling to grapple with the fact that creating life seemed so easy for those who didn’t expect it yet so hard for those who may want it more than anything. 

    If IVF’s theme is perfection, the logistics of that theme comes down to the medication. Pills, both oral and suppository, and injections, both abdominal and intramuscular, were part of my new normal. Even though I was a late bloomer, I am thankful that I finally learned to swallow pills at age 22 (I know, it’s embarrassing to even admit it took that long). I am also eternally grateful for my physician husband who saved me from having to self inject, something I only had to do once when Andrew was unavailable. To this day I still am not sure how I worked up the courage to stab myself in the belly on the evening of Easter Sunday 2019 and if I could manage to do it again. At one point in the midst of my cycles, I was doing the math on how many shots I had received since we started the journey - I stopped counting when I reached one hundred, the red Sharps containers under my sink spilling out of its clear cap. With each injection into my bloated, itchy, and tender midsection, I felt acutely aware of how fortunate I was to not be dependent on this method of taking medication for the rest of my life; what I was going through was just temporary and had an end goal that was much greater than any bruises or pain I would endure in the short term. 

         
     

    Each cycle of IVF medications follows a rigid schedule that helps to regulate the conditions in the body and make them perfect for whatever procedure is the end result. And each schedule is a minimum of a two month process from start to finish, so it’s definitely an investment logistically -- many meds are dependent on taking them at specific hours of the day --, financially -- insurance barely covered the cost of one medication --, and emotionally -- there's no guarantee that all your efforts will succeed. The initial procedure, the egg retrieval, involves stimulating the ovaries to release 10-20 times more eggs than a woman should at one time. The hope is that when the eggs are retrieved, the doctor yields enough of high quality and maturity that they do their job in vitro and develop into embryos. The second procedure is an embryo transfer where you just hope that the implanted embryo sticks. Sounds simple, but a lot has to go right to get to those points. I had almost completed an entire stim cycle for my first egg retrieval when we had to cancel and start over due to my period not falling as it should have and my levels not rising fast enough. And days before my first scheduled embryo transfer, we had to cancel because I had contracted CMV, a flu-like virus that is potentially harmful to a fetus. We had to begin again Because the conditions weren’t perfect. And of course with IVF we expect perfection. 

       

    I ended up having two egg retrievals in 2019, one in late April and the other in late July, before we got the desired result, and Andrew had to undergo his own procedure before the second one to give us a better chance at success. The days after the egg retrieval were some of the most emotionally trying days of this entire process. After I woke up from the anesthesia post-procedure with a warm gel pack on my belly, the nurse came to tell me how many eggs were retrieved, and of course I had looked up the numbers on what would be considered a strong yield. On our first try they got 18 of good maturity, and Andrew and I high fived thinking we knocked it out of the park. But as the embryologists began the true in vitro process and attempted to create life, the doctors were clear that the 18 opportunities we felt so good about would dwindle with each passing day, and that it was perfectly normal. I got phone calls from the lab to update me on how the embryos were developing on day two, four, and five, and if they looked strong, healthy, and compatible with life. After undergoing so much to get to that point (while also recognizing there would still be so much to go), we were hopeful that things would work out as planned. And that was why the phone call I received on the afternoon of Friday May 3 telling me that none of our embryos had survived struck a nerve so deep it’s painful to even recount in writing. Our cycle failed. We failed. We would have to start over again. 

                                      

    Thankfully, our doctors never lost hope and made adjustments to our plan that led to a better result in July of 2019. After an even stronger yield in the second egg retrieval and five days of assisted hatching, we learned we had six viable embryos. I hesitated to call them anything but their medical term since there was still so much that had to go right before they could truly become living beings... babies. Because we had already endured enough heartbreak to that point, detaching myself from the “human” elements of this process along the way became the norm, as did the waiting game. Before being sent to cryopreservation, a microscopic amount of cells was extracted from each embryo to be sent out for genetic testing to ensure we could select against harmful diseases and conditions. The four weeks of waiting felt like an eternity. When the results finally came back from the genetic screening, we learned that three of our six embryos were eligible for transfer. That was the moment when things began to feel a bit more real. As much as I tried to get the thought out of my head for self-preservation, I couldn’t help but entertain a fuzzy vision of a future with Andrew and I and our three perfect kids whose journey of life had oddly all just begun at the same time. 

    As we neared our first scheduled embryo transfer date last October, preceded once again by a strict schedule of medications to perfect all conditions, we were again reminded about the valuable lesson of patience and proper timing. My diagnosis with CMV came just five days before the planned transfer as I was undergoing standard pre-op testing. Because of how long CMV could linger in my system, I was told to wait until after the new year. 2020 came, and we attempted again, but my cycle didn’t cooperate and we had to start over. We had a planned vacation out of the country in February that pushed things back yet another month, and then when we got back home, COVID had hit and our infertility clinic had to close its doors for an indefinite amount of time. At that point, we were upset and frustrated by things outside of our control, but we held faith that when the timing was right, the doors would be open for us. Still, it was hard to share the news with our families that things were on hold until a time when the world was less uncertain.

    On April 14, I was at work when I got a call from the clinic that could only be categorized as a sign from God. The clinic was opening up at a limited capacity to a few select patients, and because they knew we had been waiting, they wanted to get me in as soon as possible. I knew that the first step for an embryo transfer was a blood draw on the 21st day of my cycle; while I was on the phone I checked my tracking app, and it was day 21 exactly. I asked how soon I could get in, and they happened to have an opening in an hour. Although I was still somewhat skeptical due to what we had been through with our previous cycles, I felt strongly that the perfect alignment of all the events was no accident. I rushed out of work and raced to the clinic; I prayed the whole way there. 

    Transfer day was May 13, 2020. Similar to the setting of natural conception, I was laying on a bed and my husband was in the room, but it was anything but an intimate moment. Along with us was the ultrasound nurse, who squeezed gel on my belly to project an image of the catheter that the doctor would use to guide the embryo to the perfect spot; the doctor who had been with us from our initial consultation in September of 2018; and an embryologist from the lab, who wheeled in a large incubator that held our first chance at being parents. When asked if we wanted to take a picture, we awkwardly snapped an image with our iPhone, the first of many of our (future) child, we hoped. The whole procedure was short, painless, and honestly a bit anticlimactic, though the staff tried to make it as big a deal as they could, which was appreciated. We walked out of the clinic and nonchalantly went out to lunch as if everything was normal, but of course it was very possible our lives had just changed dramatically. But to keep with the theme, we had to play the waiting game once more...

                                                

    I had been told to lay low for the next week and come back to the clinic nine days after my transfer in the morning for a blood draw to test my HCG levels, and later that day I could expect a call from a nurse to give me the results. As much as I appreciated that level of planning, it didn’t feel right that the way I’d find out I was pregnant for the first time was through a phone call from an unknown nurse while I sat alone at home. It again felt anticlimactic and impersonal. I knew so many “normal” parts of our journey to become parents had been taken from us, so the night before my appointment, Andrew and I decided that I should take a home pregnancy test. As we anxiously waited through the five minute window for the test to develop, we huddled together and prayed for the news we had been hoping for since we had started tying to conceive three years prior. There was no doubt about the result - a very clear blue plus sign that signified the start of a dream come true. We hugged, we cried, and we celebrated the joy in a moment that we felt at one time would not be a possibility for us.

    In hindsight, as much as we were discouraged about the waiting, we have discovered that God’s timing is always perfect. When we first decided to start a family, we certainly were not in a financial position to afford IVF. Knowing that was ultimately the process we had to use, that year and a half of trying allowed us to focus on our career development and save up in order to make that investment in the treatment. Had each procedure worked out on the first try, we would have still been living in our humble condo, which would not have been as ideal as being able to grow our family in our new spacious home and practice our future parenting skills on our pup, Murphy. And had COVID not delayed our timing of an embryo transfer, we would not have been able to surprise our family with the news that we were expecting like couples who conceive naturally are able to. Since we involved our family in our journey, they had been with us for all the ups and downs, and although we know they would have been overjoyed to have known about the clinic reopening and our embryo transfer, there was something so “normal” about being able to share the good news with them as most other couples have the option to do with their families. And after all the blood draws, shots, hormones, heartaches, and anticipation, we are thrilled to finally announce publicly that our next dream is finally a reality: our perfectly created, miracle baby is due to arrive January 29, 2021!

                                  

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Afterword:

    One thing that I’ve learned through our journey with infertility over the past three years is that it became easier to handle the more I talked about it. Building a community of family and friends around us was essential to us feeling held and supported through the many ups and downs. But despite recognizing more and more women and couples who have struggled themselves in similar ways to Andrew and I, it is clear that the topic of infertility is still considered taboo by our society as a whole. Having gone through the range of emotions and experiences myself, I am keen to help any others who may be going through their own journey like this. I’m an open book when it comes to sharing my journey, so please reach out if you or someone you know could use support in any way!