Baby in arms. That’s what our fertility doctor would say to remind us of our goal as we met with their amazing team over the last four years (after a year of trying on our own to get pregnant). While more people are sharing their fertility journey now, in the past it’s been a very taboo topic. My mother often told me growing up (and I swear it wasn’t a scare tactic), “we’re very fertile, Amanda!” So, honestly it never once crossed my mind that my fertility journey would be anything but easy. Until it wasn’t.
Fertility, or infertility, is hard. Going through IVF, even with an incredibly supportive partner, is draining and tough on your body. And, there are so many reasons that couples choose to go through IVF beyond those who are struggling to conceive. Finding the fertility clinic that’s right for you, deciding whether to do IUI or IVF, figuring out how you’ll pay for IVF – it’s all so overwhelming. For us, ultimately the hardest part was making the decision to use donor eggs to make our dreams of having a family come true. I may not get to all of that in today’s post. But, I’ll start with where my fertility journey began and some of the choices we made that led us to this point. In full disclosure, it’s a series of ups and downs with what at times felt like more downs than ups! That said, we kept the faith that we’d find a way to start our family. And, we did!
My Fertility Journey – Coming To Terms with Infertility
I remember when we got married thinking that we could perfectly time when we got pregnant. Now, looking back it feels so naive. I hadn’t started tracking my period or my ovulation (later I used the Ava bracelet). There was no sense of urgency, at least on my part, even though we got married in our mid-thirties. Being the optimist that I am, I assumed my fertility journey would just be easy.
Then came the months of negative pregnancy tests that never got easier. Even when we started talking about seeing a fertility doctor, I truly hadn’t come to terms with infertility because I just thought it was something we could easily “fix”. I’m sharing all of the steps we took along the way below. But, remember that everyone’s fertility journey is different. The best thing you can do is educate yourself (just enough to not drive yourself crazy!) on your options so you know the questions to ask at each phase.
All the Steps with Infertility and IVF
First things first. I went on birth control at age sixteen and came off at 34. So, it was an incredibly long time to be suppressing and controlling my cycle. After 10 months or so of trying to conceive (TTC) I was conveniently ovulating when I had my scheduled, annual OBGYN exam. Funny – I actually thought I could start tests with my longtime doctor. After he informed me I’d need to see a specialist, I did what I do best. I made up my mind. We needed to get an appointment immediately. I went into the car and started looking for the best doctor who could see me that day. I wasn’t nervous or upset. What I wanted was action.
My First Appointment with Our Fertility Specialist
Luckily for us, we found Palm Beach Fertility Center, one of the top 25 fertility clinics in the nation led by Dr. Mark Denker. They got me in the same day I called (side note: post-COVID they are far busier and you may not have this same experience). We were able to do some baseline tests, including an ultrasound to determine my follicle count, as well as take some standard blood tests to check various hormone levels, including my AMH levels (which tells you how well your ovaries are producing eggs).
Now, this is the part where it can get frustrating for a lot of us (myself included). My follicle count was great. Blood tests all came back normal. My AMH level made me look like I could be an egg donor even though I was 36 years old. We scheduled an appointment for Matt to go through a series of tests and all of those came back positive as well. We now fell into the group of 15 to 30% of couples who have unexplained infertility.
Getting an HSG Exam
So, what next? Dr. Denker and team recommended I get an HSG exam. A hysterosalpingography, or HSG, determines if your fallopian tubes are blocked by using an X-ray test. A thin tube called a cannula goes into your vagina and cervix to your uterus where dye (iodine) is deposited. They follow the dye to help determine if the shape of your uterus is irregular or if your tubes show any blockage.
The test can be… uncomfortable. So, you’ll normally be given instructions on if you should take any pain meds before the procedure. Since it was several years ago, I don’t remember what I took. But, I know I had a pain med and it helped tremendously. Thankfully, I had very little cramping after the procedure. The results came back a few days later and they were normal. Good news, for sure.
Do I have endometriosis?
After more talks with our fertility doctor and team, we determined I had all the classic symptoms of endometriosis (this is when tissue that is similar to what is normally in your uterus grows outside of your uterus). For example, once I went off of birth control my periods got progressively worse every month. There were several incidents where I fell to my knees in pain and started sweating with intense cramping and the shakes. I’d have to lie down and wait until it passed.
We scheduled the procedure which involves a laparoscopy to remove any issue growing outside the uterus or polyps attached to the uterus. I was so hopeful this would do the trick. But, when the procedure was complete and I was slowly coming out of the anesthesia I remember asking Matt how it went. He said something to the effect of, “you were textbook perfect inside. You did not have endometriosis.” As an optimist, this was a harder moment for me in all of my fertility journey. On one hand, it was good news. But, I couldn’t help but cry.
Trying Two Rounds of IUI
Despite the diagnosis of unexplained infertility, we continued into the IUI and IVF process knowing the success rates were in our favor. Well, IUI maybe not so much (it ranges from 9 – 13% depending on age). At around $1K each time, we opted to do two rounds of IUI (intrauterine insemination). Basically, they deposit concentrated sperm into your uterus when you’re ovulating to help things along. The first round I had some bad cramping as a side effect. But, the second was very easy. Unfortunately, we weren’t any closer to “baby in arms.” We were on to IVF.
IVF – Cycle 1
With some travel over the holidays and a business trip to kick off the New Year, we took a few months off and set the date to start our first round of IVF in January 2019. Based on my initial test results, my medication plan included lower dosages of our fertility drugs. We started our regimen of daily shots, but the team quickly realized something was wrong. My follicles weren’t maturing. So, we increased the dosage. But, it almost seemed too late. My left ovary wasn’t responding.
At our egg retrieval, we managed to get 7 eggs. We weren’t sure we’d get any just a few days before. So, it was better than we thought it might turn out. But, it was still disappointing. By day 5, we had three embryos and the plan was to transfer 1-2 and freeze one. But, when we went in for our fresh embryo transfer, only one had survived.
Unfortunately, that cycle was unsuccessful. But, I learned a lot! I needed to educate myself more. Until this point, I read very little about others IVF experiences. While I don’t think it’s helpful to compare yourself to others (there are too many factors to consider!), I do think seeing the variance in numbers helps normalize the results. Also, although it wasn’t diagnosed, I believe I had ovarian hyperstimulation syndrome (OHSS). My ovaries were working over time and felt so swollen it was tough to stand up or sit down. I remember saying, “I feel pregnant even though I don’t look like it!” It was likely mild, but the bloating was intense and took weeks to recede.
IVF – Cycle 2
Most doctors will recommend at least two menstrual cycles between your rounds of IVF. Due to the timing of a few things, we went three months and then started our second cycle in May 2019. Our team changed the plan of attack and this cycle was much smoother. Heading into our egg retrieval we had 6 follicles on the left and 5 on the right. I was hopeful we’d get 9-10 eggs. But, the result was the same as the last cycle: 7 eggs. A few days later, we were in the same position – there was only one embryo to transfer.
Then, we went into the dreaded two-week wait (2WW). During the first cycle, I didn’t take a pregnancy test while we waited for the blood results from the doctor. I didn’t want to do that again. So, this time I took a test and knew going into the appointment that we weren’t pregnant. It was devastating, of course. IVF treatments are an investment if you don’t have any insurance to cover the costs (which we didn’t). Like many others, we took out a loan and were slowly paying it off. So, what next? I never anticipated the words I’d hear from Dr. Denker.
Evaluating our IVF Results – Poor Embryo Quality
We scheduled an appointment to review the results of our IVF cycles. Dr. Denker explained that what we saw in the first cycle is that for some unknown reason, we had poor embryo quality. They were fragmented and not coming back together as expected after dividing. To see that in one cycle isn’t overly concerning. But, then the same thing happened in our second cycle. It didn’t necessarily mean it would happen over and over again. But, our goal was “baby in arms”. How much more money could we invest in starting our family?
It was then that Dr. Denker said, “I recommend you look at using donor eggs.” I’ll put together a separate post on how I came to terms with this new reality, but I just recall being shocked. I know I asked a series of questions about what that meant. But, honestly – looking back, it’s all a fog.
How to find an Egg Donor
For some couples, sperm quality is an issue. But, for us it was my eggs. We tried to better understand what was happening. Did I have a chromosomal abnormality? Nope. Was anything else off in terms of my hormones or bloodwork? Nope. So, we started slowly looking for egg donors. Our fertility clinic offered an egg donor program and that was our first choice as it was the least expensive route. But, they also recommended Egg Donor Solutions and Eggceptional Donor Group.
Choosing an Egg Donor
Our list of “must haves” was pretty extensive. I wanted someone Hispanic who looked like me (easy, right!?). They had to have dark hair and brown eyes, have tall siblings and parents and a great family history. Finally, after a year and a half we saw a donor through the program at our clinic that we wanted to pursue. But, timing was not on our side. Look – I think it takes an angel of a person to even consider donating their eggs. Sadly, the donor we selected became unresponsive.
Then, in February of 2021 a donor popped up on the Egg Donor Solutions site that both of us felt good about. We kept going back to their site because the prices were more reasonable than other donor organizations, they had a pretty big group of donors to pick from and were regularly adding new donors. We had so many questions and went back and forth with the team there for a week or two. Then, the unthinkable happened. Another couple selected her. This was the moment I lost it. It was when I questioned whether we were supposed to have a family and everything in our fertility journey just seemed unfair.
A couple of months passed. Then, we caught a break. The donor magically popped back up as available and Matt happened to see it. She’d gone through some of the first required tests (mental health, bloodwork, and genetics) only to match with the other couple on a genetic disorder. Luckily for us, it wasn’t a match to our genetics for anything. We quickly put down our deposit. We had a donor and we were moving forward!
IVF with Egg Donor
The egg donation process is anonymous (most of the time). So, outside of what was on her profile, we don’t know much more about her. But, I’m 100% sure she was who we were waiting for. The paperwork was smooth and the tests were easy. Our donor showed up to every appointment and didn’t seem to miss a beat. When her retrieval came around, she gave us 30 beautiful eggs. Of those, 22 were mature and 18 fertilized. But, then only 5 embryos made it to day 6 and only 2 were genetically normal. So, that was that. We had 2 chances to get pregnant. We froze the embryos and prepared for my frozen embryo transfer.
Preparing for our Frozen Embryo Transfer
First, we did a mock cycle to be sure we had the plan right for the upcoming transfer. I’m so glad we did this because we realized that the progesterone inserts weren’t getting my levels to where they needed to be. Instead, I’d need to do the dreaded progesterone shot, plus the inserts.
After the holidays and the New Year, there was a lot going on personally. We both got COVID and then Matt’s father passed away. But, I tested negative the day before we planned to start our prep for the frozen embryo transfer (FET). Matt was still up north with his family. So, my mom actually helped me with the shots until he could get home. Then came transfer day and it went perfectly. I can’t put it into words, but I felt an incredible sense of calm during our 2WW. Then, it was the day to do our blood test.
We are pregnant!
The morning of our appointment, I took a pregnancy test. For the first time in five years that blue line lit up with a positive result. It was almost immediate. Tears started streaming down my face with the biggest smile I think I’ve ever had. Matt was still sleeping so I set up my phone to capture his reaction as I told him the news. I cry every time I watch it because it’s the definition of pure joy. We are pregnant.
Everything Else I Wish I Knew Before My Journey Began
Before my fertility journey began, I knew very little about IVF and even less about the egg donation process. We hadn’t researched the success rates of the various procedures like IUI and IVF. There are so many things I wish I knew. But, at the top of the list is that everyone’s journey is unique. Your numbers will be yours. This includes test results, follicles, eggs, embryos – all of it.
And, I also wish I just knew it could be hard to get pregnant. As a planner, I might have frozen my eggs years ago. Then, I wish I’d gone off birth control sooner. Sure – plenty of people stop taking birth control pills and get pregnancy right away. But, I was on the pill for nearly 20 years. My inkling is that it played a role in my fertility.
Lastly, I wish I’d shared our journey sooner. The power of community and support is so critical during what can be a very challenging time in life. I’m blessed to have Matt and our families and close friends by our side. But, leaning into others going through the same thing could have helped tremendously.
As I write this now I am 37 weeks pregnant and about to have our baby boy. There are so many beautiful, but hard, layers to this story that I’ll continue to share in other posts. This is not how I expected to start our family. But, it’s our path and we are finally getting our chance at baby in arms. I don’t care how we got here. We’re here.
