Saturday, December 31, 2011

Adventures in Fertility, Part II

    
     Once we had our diagnosis of 'unexplained infertility' it was time to begin treatment.  The first course of action is usually IUI or intrauterine insemination.  This involves taking the medicine Clomid which stimulates the ovaries to release more follicles, which contain an egg each.  Otherwise, the ovaries only release one follicle, from which one egg emerges each month. 

     After taking the medication, the doctor performed an ultrasound to determine how many follicles there were.  We stared at him incredulously as he informed us that there were, not one, not two, but EIGHT! We were surely going to have multiples.  The nursery was being decorated in our minds as the overwhelming thought of all those babies danced in our heads.  The doctor informed us that, it was likely that no more than one or two would fertilize.

       The hospital had gotten rid of the private room for men to produce a sample of sperm due to budget cuts.  So, men were told to go to the hospital public restroom which contained only one stall.  All the men nervously waited outside of the bathroom as another man produced his sample.  When the man inside emerged holding a bag, the man next in line would avoid eye contact and scurry into the restroom.  Due to the usual purpose of the stall in the mens' room, it often had the fragrant aroma of excrement.  It was a superhuman feat to emerge with the little swimmers primed for their mission.



     My husband Greg was a trooper and went to the nurses, bag in hand.  The nurses chatted for a while, failing to notice him while he stood there feeling mortified.  "What do you have?," they asked.  "It's my sample," he said softly.  "What?," one of them asked.  So, to his embarrassment, he repeated what it was more audibly.  One of the nurses then announced it back to him loud enough for people behind him in line to hear.

     Then, the IUI was performed using Greg's swimmers.  We waited a couple of weeks anxiously for news of a positive pregnancy.  After all, there were EIGHT follicles.  Surely I would be very pregnant.  When the news arrived that I was not pregnant at all, we could not believe it.  All the ingredients were there, meticulously joined.  The math was just not adding up.

     This scenario repeated itself six times with the occasional cyst in between which meant we had to wait out a cycle.  We relived this disappointment for over a year until the doctor finally conceded that we were not likely to succeed with this method.  He referred us to a doctor for invitro fertilization, a.k.a., IVF. 

Friday, December 30, 2011

Adventures in Fertility, Part III


After our referral for IVF, we had to wait about six months for my body to recover from all the medications from the previous IUI cycles.  We were referred to a wonderful doctor who was empathic and committed to helping us begin our family.  We did our first in vitro cycle and my body responded well to the medications, which resulted in many high quality embryos.  On our first transfer, three beautiful embryos (of which we were given a picture)  came to rest in my uterus.  I practiced positive thinking and followed all the doctor's instructions to the letter.  I convinced myself that I was pregnant.  So, when the nurse called with the 'good news,' I was excited.  She informed me in a sympathetic tone that I was, once again, not pregnant.  Since I had not mentally prepared for this scenario, I could not control the sobbing as I thanked her for the news.  Normally, I would have been more composed, not wanting her to feel bad for being the bearer of bad news. 

     I began to follow message boards about IVF and learned such acronyms as POAS (pee on a stick) and TTC (trying to conceive).  I began accupuncture after reading that it increased the chances of IVF success.  On the second cycle, I convinced myself that I was probably not pregnant, but could not stop the flame of hope that burned of its own accord.  When I received the news that I was pregnant, for the first time in my life, we were overjoyed.  It was around Thanksgiving time and I had planned to prepare the big meal for a large gathering of relatives.  No one wanted me to be on my feet or to have any strain, so everyone pitched in to put the meal together.  A few days later, I had a follow up test which showed that my HCG levels, used to measure pregnancy, were dropping indicating that it was likely I was no longer pregnant.  I needed a follow-up test to confirm the end of the pregnancy, and it confirmed it.   We felt devastated, again.  It was getting to a point where we were in disbelief about our own capacities for pain.  Surely, we would get numb eventually? We never did.

     The next loss was even harder.  I was pregnant through in vitro and saw my baby's heartbeat on the monitor.  There is nothing more real than seeing your baby's heart beat.  It was beyond sad when the doctor informed us at a subsequent visit that our baby's heart had stopped beating.  After several losses, I underwent more tests to figure out what was wrong.  The embryos were such high quality that the embryologist beamed each time he showed us the latest pictures.  They resulted in pregnancies. Then, with no explanation, the pregnancies terminated. 

    Eventually, it was discovered that I had a blood clotting mutation which meant that the blood supply was being cut off to the babies, preventing their survival.  So, we tried using blood thinners along with IVF and, while I could get pregnant, we continued to sustain losses.  Our doctor informed us that we had a good chance of succeeding using surrogacy, because the embryos were high quality and the surrogate would not have the issue with blood clotting.  I mourned the loss of not being able to carry my own child, and to bond with my baby in utero.  However, I accepted defeat and we were grateful to have another avenue to starting our family.

Monday, December 26, 2011

Adventures in Fertility, Part IV

      

     We needed a new oven for our frozen buns.  The search was on.  We explored many options for surrogacy and decided to go through an agency because it felt more secure.  In the online profiles galore,  one person stood out.  There was something about her smile and the warmth in her eyes.  The caption under her picture read, "on hold."  We were unsure as to what that meant, guessing that maybe her application was on hold.  It turned out that she was on hold for another couple.  We were told that we would have a chance to meet her if the arrangement with the other couple fell through.  What were the chances of that?  "Slim," we thought. 
      But, much to our surprise, their doctor had rejected her.  Sometimes, facilities want to have great stats so that they look good to potential patients.  She had had slight gestational diabetes in her last pregnancy and that was enough for their doctor to put a halt to the arrangement.  We were very excited at this stroke of luck and anxious to meet her. 

     The meeting was set up at the agency office, a neutral location for both our potential surrogate and for us. When we saw her in the waiting room, looking just like her picture, we felt instantly comfortable. The warmth from the photograph was real.  In our meeting, we hit if off right away.  We wanted someone who was comfortable carrying twins or triplets.  Since this was our last shot at having a family, as we could not afford to do surrogacy twice, we wanted a surrogate who was open to the possiblity of multiples.  She agreed that she was comfortable carrying up to three babies, though we all knew the chances of that were slim.  She had three kids of her own and had done two previous surrogacies.  In those surrogacies, three embryos were transferred, and only one implanted resulting in two single baby pregnancies. Typically, more than one embryo is transferred in the hope that one will take. 

     The next step was all of the paperwork and arrangements with the agency.  We were then set up to have a transfer of embryos in the New Year.  We were anxious and excited to begin the process.

Sunday, December 25, 2011

Adventures in Fertility, Part V

   
      I began to take low dose aspirin for my own health due to the blood clotting issue.  As we waited for the embryo transfer, Aunt Flow made a very brief visit.  Her stay was so short that I had to wonder why she changed her routine.  The day before her visit, I had the mother of all migraines.  That hadn't happened since I had taken the pill as part of the 'resting' period between fertility cycles.  I felt a little warmer than usual.  I took my temperature which was one degree above my normal.  So, just to prove to myself that I was not pregnant, as I had done many times before, I pulled out the last of my digital pregnancy tests.  I dipped the stick and then walked away and returned to hear, "Pregnant," screaming out of the digital window.  No way.  I could not believe it. 

     I had to leave for work in a few minutes, but I threw on some clothes and headed to the drug store where I bought three more digital tests, figuring that there must have been a malfunction in the first one.  Luckily, I had used the cup method and could, therefore, dip additional sticks into it.  I dipped another stick, "Pregnant," it screamed.  The same message appeared with the third.  I was in awe, but I believed it. We were pregnant without any intervention from doctors, no IUI, no invitro, just pregnant naturally.   I saved the third stick to see if we were still pregnant in a few days.   I told no one.  I went to work as if nothing in my life had changed.  I pondered how to tell my husband.



     After we ate dinner that night, I told my husband I had something for him.  I presented one of the positive pregnancy tests inside a covered silver butter dish, because I thought this news needed to be delivered on a silver platter.  He opened the dish and disbelief registered on his face followed by the realization that we were pregnant.  It's funny, I used to think it was silly to say that 'we' were pregnant when only the woman went through all of those changes.  But, after all that we went through to get to this point, it was we, not I that were  pregnant. We were joyful, but scared after so many losses.

     Then, there was the other issue.  We were about to have an embryo transfer.  If we did not tell our surrogate this news, it would be dishonest.  So, we decided to have the doctor confirm the pregnancy first.  The blood test confirmed it.  Then, I called our surrogate and told her the news.  She was surprised and excited.   I asked if she was still comfortable being our surrogate under the circumstances, reminding her that all previous pregnancies had ended in losses, but there was no way to know what would happen.  She said that she was happy to be our surrogate and was so happy for us that we were pregnant. 

Saturday, December 24, 2011

Adventures in Fertilitiy, Part VI

     The day of our transfer arrived.  Our embryos had been thawed the night before and nurtured by the embryologist until the big moment.  Our surrogate allowed for me to be in the room during the transfer and my husband waited outside.  We watched on the screen as our embryos nestled into her uterus.  This could be seen by the fluid around the embryos rather than the embryos themselves which were microscopic. 

     We were full of hope as all of her previous transfers had been successful on the first try.  Our doctor was hopeful for us too, having been there for so many of our losses.  Then, the day of the blood test arrived.  She called us with joy in her voice and announced that she was pregnant.  The HCG number was high which implied that it was possibly twins or triplets. Many online message boards warned that one should not read too much into HCG numbers as many Moms of twins had low numbers and singleton Moms had high numbers.  So, we tried not to read too much into it, but it was hard to stop our minds from imagining.  In the blood tests to follow, her numbers continued to rise as they should and were still high.

     The big day arrived, the day of the ultrasound.  This was the only way to know how many babies were there.  We had a different doctor that day, one closer to our surrogate's home.  He had not read the chart before performing her exam.  Again, I was in there for the exam and my husband waited outside.  One baby appeared on the screen.  He moved his instrument around and there was another baby.  He stopped and informed us that it was twins.




      I questioned, "are you sure?"  I asked him to look around one more time.  We informed him that there was another embryo and we wanted to see if it could be triplets.  He raised his eyebrows in surprise and took a closer look, and sure enough, hiding up top, was our third baby.  We were having triplets!  Our surrogate and I looked at each other and smiled.  Then we went outside and told our husbands who were both excited by the news.

Thursday, December 22, 2011

Adventures in Fertility, Part VII


  We had two pregnancies happening simultaneously.  I went to many of our surrogate's obgyn appointments, plus my appointments and worked.  Her appointments were initially thirty-five miles away for the first trimester at out fertility doctor's office and then eighty-four miles away for the remainder of the pregnancy.  Mine were pretty close by, but I had appointments weekly as I was considered high risk.  I saw a hematologist due to the blood clotting issues.  I injected my stomach daily with blood thinners throughout the pregnancy and took low-dose aspirin, often called 'baby aspirin.'  Due to our history, I think the name 'baby aspirin' is quite fitting.  I felt lucky to have had so many early ultrasounds because I was high risk and our surrogate was too.  We are fortunate to have so many early pictures.

     One of our triplets had a rough first trimester.  On several occasions, the doctor warned us that there might not be a heartbeat on the next ultrasound.  The thought of losing one of our babies was terrifying and stressful.  The triplets were called Baby A, B and C depending on their proximity to the cervix.  Baby C was furthest from the cervix.  Baby C did not seem to be growing at the same rate as the other babies.  Our doctor was doubtful that he would make it. Baby C made it to the end of the first trimester, but things were so shaky that we were vague about how many babies our surrogate was carrying due to our history of loss.

                                    




   
         We decided to have CVS to find out if there were any genetic issues in either pregnancy and, as a bonus, we would find out the gender of each baby.  We discovered that I was carrying a healthy baby girl and that our surrogate was carrying three healthy baby boys.  The perinatologist informed us that, whatever issues Baby C may have had previously, they had resolved.  He was thriving and we were joyful. 

Wednesday, December 21, 2011

Adventures in Fertility, Part VIII

     We enjoyed the amazing experience of having four babies growing at the same time.  We developed a friendship with our surrogate and her family.  Her husband was incredibly supportive throughout the pregnancy, taking care of their children, cooking and cleaning so that she did not experience strain.  All the while, he was enthusiastic and kept our babies in his prayers. 

          This photo was taken in September, two months prior to the birth of our babies.


     As I approached my due date, our surrogate was hospitalized to ensure that she did not go into labor without perinatologists in place to assist with the delivery.  The doctors said that she would be there about two to three weeks.  I decided with my doctor to be induced one week prior to my due date so that I could be there for the birth of the boys.  Our surrogate had generously allowed me to be present for her C-Section, even though she had never had surgery before and this meant her husband could not be present. 

     I was induced in the morning in early November.  My water broke naturally and, after several hours of labor, Capri was born.  I had watched Baby Stories ad nauseam on TLC, and had had seen so many Moms handed their babies immediately after birth to bond.  When Capri emerged, four people appeared out of nowhere and whisked her off because, unbeknownst to me, she was born with the cord wrapped around her neck.  Fortunately, they were able to restore her to health and she was given to me to hold several long minutes later.  It was wonderful to bond with Capri.   My husband, Greg, and my mother enjoyed watching her come into the world and soon afterwards, his parents and my Dad met her for the first time. 

Tuesday, December 20, 2011

Adventures in Fertility, Part IX

   
      As I lay in my room recovering from giving birth to Capri, our surrogate called to inform us that the medical team had decided to move the birth of the boys one week sooner.  It was to happen in five days!  Our pediatrician checked on Capri at the hospital and then again after we were discharged.  She told us that she looked slightly jaundiced and took a blood test.  The day before the boys' birth, our doctor called and told us that Capri's bilirubin levels were dangerously high and that she needed to be hospitalized right away.  She recognized our unique situation and went the extra mile to have Capri admitted to the Neonatal Intensive Care Unit (NICU) at the hospital where the boys were to be born.  She told us to pack our bags while she made arrangements with the doctor.  We needed to meet my parents at the hospital because she said that it was an emergency and that her levels would continue to rise on the drive down and she did not want us to get stuck in rush hour traffic.

      We expected that the boys might be admitted to the NICU because they were triplets, but never did we imagine we would also be admitting our daughter.  We anxiously packed our bags and made it to the hospital in good time.  The doctors were very nice and Capri was admitted to a separate room of the NICU because she was born in a different hospital.  She was considered to be 'foreign' with potential germs that could threaten the other NICU patients.  Tears ran down my face as I watched her inside her little enclosure, called an isolette.  She had a mask over her eyes and looked so helpless.  We stayed until the end of visiting hours.  Walking back to the car with an empty car seat felt incredibly lonely. 



     We stayed in a nearby hotel which housed many parents with babies in the NICU.  During the night, when a baby cried, I sat bolt upright in bed.  I was now a mother, with a new sensitivity to the sound of an infant's cries.  I was sad when I remembered that Capri was in the hospital, and the cries belonged to someone else's baby.

Monday, December 19, 2011

Adventures in Fertility, Part X


  The alarm clock sounded early in the morning. My parents stayed in the same hotel and we all got ready and headed to the hospital to meet our baby boys.  I was not able to see Capri because it was before visiting hours in the NICU.  I washed up and put on my scrubs and waited. 

     When I was allowed in the operating room, I noticed the sheer number of medical professionals in the room.  Each of our triplets had his own doctor and our surrogate had her own doctor and there were at least two nurses for each doctor and an anesthesiologist for our surrogate.  It is amazing how many people were there to help our babies enter the world.  I held our surrogate's  hand while the anesthesia was given.  She was anxious but excited.

      The anesthesiologist gave me a tutorial on how to film the birth.  I had no idea that I would be allowed to film it and had brought the camera for after the birth.  The video has some bouncing around due to my lack of videography skills, but, I was able to capture the birth of the boys and their first several minutes of life.  In this way, the whole family could see the birth because I could angle the camera over the sheet allowing us to bear witness to this magical event.

     Here is part of the video of the boys' birth.  It shows each baby as he emerges and gives a glimpse of the wonderful doctors and nurses. 


video

    
     After the birth, the boys were whisked off to the Neonatal Intensive Care Unit (NICU) where they would remain for the next few weeks.  Capri was discharged after a few days and nights under the 'bili lights.'  

 
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