Fitness and Infertility

trail walkStaying mentally and physically healthy through infertility, IVF, embryo transfers, short periods of pregnancy and miscarriages has been incredibly challenging and often feels impossible. Since my journey through this process has spanned over the past couple of years, my fight to stay physically strong coupled with a desire to not give up on happiness and mental stability has often left me exhausted, drained and empty. And I’m just talking about ME. I’m not even getting into the impact this has on my marriage. This has left me struggling with what feels like a never-ending and futile attempt to lose weight (or to at least stabilize my weight) combined with cycles of deep sadness and sometimes depression through the disappointments and losses I have experienced on this journey. It is a constant start and stop process with exercise whether I’m in between cycles (amp up the exercise routine) or low impact walking post embryo transfer. As soon as I start to feel progress with physical fitness or any hope of losing a couple of pounds, here I am again making adjustments to put the possibility of pregnancy as the top priority following an embryo transfer. With the two pregnancy losses we have experienced, the only other possible thing my doctor recommended to increase my chances of future success is weight loss. My doctor recommended a certain BMI to enable optimal pregnancy health. I did the calculations. To reach this BMI, I would need to lose 35 pounds. That would take me months to achieve with 100% focus on nothing but exercise and nutrition. (and my body is STUBBORN!!) But sadly, I’m time-bound by the financial piece of this process. We are invested in a “refund plan” that allows us to have as many embryo transfers as needed to become pregnant within one year of starting this contract using embryos from our egg donor. (we have about 6 months left) This does not allow me the extra time off to reach this health/fitness and weight loss goal. By the time I have my next embryo transfer I will have had a little over 2 months to recover from the D&C procedure which was then followed by depression, a terrible flu and then a bad cold just two weeks later. This made it nearly impossible to try to lose weight in this period of time. As soon as I recovered, I started walking and swimming again and went back to the gym with my personal trainer. But do you know how hard it is to lose weight with the hormone fluctuations of pregnancy, followed by pregnancy loss, then throw in some depression, the holidays and some illnesses? It feels completely hopeless. My body fluctuated up and down in a 10 pound range following the pregnancy loss for at least a month. I’ve done a cleanse, given up sugar and alcohol and I exercise regularly and there is no weight loss happening here.

My health and exercise has always been a top priority for me. I’ve always been active and involved in sports or fitness activities, however I have struggled with my weight since I was a child. I have tried so very hard to stay in shape through this process of trying to make a baby. Prior to my first round of IVF, I spent one year training at a CrossFit gym trying to get as strong as possible before pregnancy. I’ve never given up on exercising and I work hard to eat as healthy as I can. But it is a daily struggle and very frustrating when doing my best may not be good enough. I definitely want to avoid blaming myself for a failed pregnancy because I wasn’t “fit” enough or because my BMI was too high. So, for now I just have to settle for what is realistic for me. The best I can do involves getting outdoors and enjoying walks with my dog and swimming and weight training (at least until Sunday). Then the exercise plan shifts again… I hope this time I will have a new 9 month fitness plan.

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Photos by CJE

Oops

Bill L imageSix cycles and too many injections to count. Calendars to follow and tracking injections on the right day at the right time on and off for the past two years. And we’ve done it perfectly every time. Until now. Last night was my first screw up. For this embryo transfer cycle (controlled cycle) I have to have an intramuscular injection of Delestrogen (which by the way is not an easy drug to get your hands on) on Tuesdays and Saturdays. I was supposed to start the Progesterone injections tonight. But, my brain somehow mushed the Tuesday and Wednesday calendar notes together and I did both last night. By the way, the calendar is color coded so the two drugs are highlighted in different colors. And, I wrote in large letters on the Wednesday date (START HERE), so I wouldn’t screw up the Progesterone start. My clinic had deliberately scheduled me to start Progesterone on Wednesday to enable a Monday transfer with MY doctor so that it would align with his schedule. After panicking last night and waiting for a call back from the nurse all morning, I found out that I did indeed mess up the transfer date since Progesterone is a trigger. It’s now on Sunday. Which should be no big deal (yay, one day earlier), but I know they do their scheduling to avoid transfers on the weekends. So, now I’ve made their weekend schedule more challenging for the lab and the doctors. And I don’t know which doctor will do the transfer. I was really relieved that I knew I would have MY doctor on Monday. Ugh. I’m trying to find a way to shake off my mistake Taylor Swift style, so I called up a good friend who has been through this same process. And she made me laugh. She re-enacted what the nurse was saying on the line while I was on hold…”dumbass on line 1, dumbass on line 1”. And in my head, I’m hearing that horrible boss from Office Space, saying to the doctors…”Yeah, I’m gonna need you to come in on Sunday. We’ve got a special embryo that needs to be transferred, ‘cause someone didn’t read her calendar.”

P.S.  While I was hard on myself, the nurse that I talked to was very helpful, understanding and sweet.  She made me feel better and they know that sometimes these things will happen.

Ummmm….No.

NoWhen I’m going through an embryo transfer cycle, I feel like I turn into the Queen of No…might as well call me Grumpy Cat. I feel like I have to defend my energy level, attitude and well-being, which means I have to say no to stuff. I have to stay focused on getting enough rest, exercising and eating right. And then I have to say no some more. And this applies to everyone (well, except the dog). But everyone else…husband, family, friends, work. My husband gets the worst of it.

Husband: We should adopt another dog! Let’s go look at rescue dogs next weekend!

Me: No.

Work: Do you think you can complete this project or take on this new assignment or travel to…

Me: No.

Dog: I love you! I love you! Play with me! Feed me! Cuddle with me!

Me: Well, ok…how can I say no to you.

Friends: We should go out to…

Me: No.

Husband: When do you think we can take a trip to…

Me: No.

Husband: Hey, let’s go…

Me: No.

Husband: Do you think you could…

Me: No.

Husband: Will you…

Me: No.

Chance #3/31: Day 2 (1/16/15) Stepping Forward

footprint imageI was feeling stable and strong showing up to my Dr. appointment on Friday for the baseline ultrasound to start our next embryo transfer cycle. I was looking forward to seeing my doctor and the familiar faces around the clinic. I was happy to get this baby-making project started again. I thought I had sufficiently put my recent pregnancy loss behind me (at least for the sake of getting through this appointment) and was focused on the forward march ahead. But then I saw a glimpse of the nurse down the hall who was with us in the room the day we saw our twins at the end of their short little life…and it all came rushing back. And then I was escorted to the exam room, where the site of the ultrasound television screen nearly brought me to tears. The last image I saw there was of complete stillness and shook me to the core and left me devastated. But I put a smile on my face and held it together as I shook my Dr’s hand and responded with “yes” and a smile to his question, “have you had enough time to refill your emotional tank?” The ultrasound showed that everything was fine. I had my blood drawn by a very sweet and friendly nurse where we had a chance to giggle. I asked her how best to break down scar tissue and referred to this as my “butt injury” as my glute muscles have still not recovered from all the intramuscular injections from the previous cycle and pregnancy. I had my new injection schedule in hand, and I walked away from the building focused on the next step with some hope in my heart.

Here we go…

Chance #3/31: Day 1

beach sunsetAnd so it begins…After waiting and waiting following my D&C (almost 2 months ago), I finally started a new cycle.  Tomorrow I have a baseline appointment at our fertility clinic to start another frozen embryo transfer cycle.  Medications, needles, syringes, gauze pads, alcohol swabs, sharps container and a dash of hope are ready to go.

Photo by CJE

Chance #1/31 (May-July 2014)

never give up_blogOur first embryo transfer with our donor embryos was a rather long but interesting process. Our clinic worked with both of us to coordinate our cycles through medications up until the embryo transfer. During month one, the medications set us up to synchronize our menstrual cycles. This allowed us to be working in parallel in month two so that she could go through the IVF and egg retrieval process, while my body was being prepared for the embryo transfer as soon as the embryos were ready.   While this feels like a complicated process for the patient, our clinic has the scheduling and coordination down to a science. Although it is a bit nerve-wracking to think that not only do I need to be on top of all the correct medications every day and coming in for doctor appointments on specific days, but my donor has to do that too. On top of which I knew she had flights to coordinate for the trips to our clinic for various steps of the process. I kept thinking to myself, “Please don’t let her have flight delays or canceled flights! Get her to the clinic safely! She’s carrying all my eggs! Her ovaries are saturated with my dreams!” One of my biggest fears was that something would not go right with one of our bodies and we’d have to abort the process and start all over. But it all went like clockwork and my donor was amazing! Her body made 42 eggs, 38 fertilized and 31 became high quality embryos that we would now own. My husband and I felt like we won the egg donor lottery! And all went as planned. My body was ready to receive an embryo on day 5 of their development and that was it. And then we waited…those 9 excruciating days to see if all that work (and money) created a pregnancy. During those 9 days our brains do amazing things to make us think we are pregnant or make us think we aren’t pregnant so that we will be prepared somehow for the outcome. Every time, I tell myself not to look on the internet for ANYTHING. But somehow I end up looking up every site that I can find that talks about early pregnancy symptoms and embryo development during those 9 days post transfer. The symptoms are evil tricksters because the medications to help foster the pregnancy (progesterone and estrogen) will also give you pregnancy symptoms. In this case, I thought for sure I was pregnant. And then for the fourth time reading the lab results (where our last two tries were negative) looking for an HCG level over 50, we saw zero…AGAIN. Three times in a row, not pregnant. It’s like running full force into a brick wall. That moment is one of the most painful, excruciating moments in the process. I try not to get my hopes up, but of course I do, because the dream of having a baby is just darn overwhelming and exciting and joyful. But every time I’ve seen the lab test come back as “not detectable,” it becomes the darkest, deepest, most intense moment of sadness and heartbreak. And for me, my brain tortures me with re-living the loss of my first pregnancy where I not only see visions of the horrific loss of our baby, but also start remembering the wonderful details of what it felt like to be pregnant. And all of it hurts. And it feels so far away and maybe even impossible to see a positive pregnancy test and fill the desperate need and desire to be pregnant again.  So, here I am sitting in my car with this piece of paper in my hand that just shattered my world and now what? How do I get strong enough to put myself through this again? Do I want to? But then all I can do for that moment is just cry while everything else in the world disappears except for that one thought…that I just lost this dream again. And then I pull myself together for enough seconds to realize that I better call in sick to work because I know the tears will not stop today. And I can’t bear to look at my husband through my tears because I know I’ll just see a face of helplessness, because he can’t fix it either and he just lost his dream too.

Then time passes…and somehow we do find the strength to try again.

The DNA Decision

child book ED storyWhen we dream of having our own children, we wonder how our looks and personality will pass down to our baby. Will they have our nose, our eye color or hair color? Will they laugh like us, look like us, smile like us? Maybe she will be my strawberry-blond mini-me bringing on comments from friends saying, “she’s so cute, she looks just like you!” But how does this all change and how do we accept that this type of dream is gone, when the genetics are not ours? How do we decide to move forward with the journey to baby when we can’t have “our” baby? Surprisingly, the decision turned out to be quite simple. Not that there weren’t fears that came along with it, but as options dwindle, the path becomes clear and now here we are with our donor embryos. When successful IVF with my own eggs became such a remote possibility, our next logical step seemed to be adoption. But then we found out about egg donation. Knowing my first choice is to carry the pregnancy on my own and be in control of the health of the baby from day one, this became our next best option. The process with our agency was so respectful and comforting that it became such an exciting new path for us. We chose a donor that resembled me as closely as possible to my eye, hair and skin color. We were able to review medical history and a thorough profile including photos from various years of her life. And then we had the option to meet her. While all personal information including names are kept confidential, we were able to sit with her for an hour with our conversation guided by a psychologist. I left the meeting feeling so thrilled to now have insight into her personality, her childhood, her family, her hobbies, music interests, travel desires and mannerisms. I left there hoping I would be able to share this with my child someday.

Here are a few things that I wrote about her shortly after meeting her:

…She has a cute smile. I hope we will get to see that smile again. She’s confident, witty, smart, a hard worker and likes reggae, rap, hip-hop and Jimmy Buffet. She has green eyes that sparkle with a daring and adventurous spirit. Blond hair that was dyed a bright orange-red with a short, spunky haircut. When we walked in the office to meet her I went to shake her hand and was surprised and happy to be met by a hug.

…She warned us that she is adventurous and daring, apologizing ahead of time that we could have a child climbing the walls.

After going through two partial pregnancies and experiencing the love for the life growing within me; there was no longer a fear or thought that “this baby isn’t mine.” They all felt like mine from the moment I heard a heart beat. The genetics did not mean a thing when I saw them on the ultrasound. All I saw were my babies and all I felt was love. And isn’t it exciting to think of creating a child where there are no preconceived ideas of what they should be like because you expect them to be like you? How wonderful to let go of that and just let them grow and blossom into who they are meant to be! So, if our miracle comes and someone says, “she’s so cute, she looks just like you!” I will smile and know that it’s because our love and our connected souls are shining through her eyes (or his, I’m not picky). We will belong to each other.