IVF #7

I have landed in physical therapy many times, from various injuries.   Most have been textbook type of things that anybody would guess an overweight woman might suffer, like back injuries, or knee issues or whatever.  But I have had a few that were odd.  Once I pulled my quadratus muscle, which is an obscure rib-bone-connected-to-the-hip-bone kind of thing (sorry if I’m getting too technical here).  The physical therapist didn’t figure out  that’s what it was until he employed the usual PT detective work which is <poke> “does that hurt? <poke> how about that?” until I scream.  Come to think of it, the dentist does that too with the cold-air thing, trying to find the tooth that makes me cry every time I eat ice cream (and do I stop? nooooo)

Lately I have been poking myself.  Trying to see what condition my condition is in.  People pregnant here and there, and all that.  Even though I’m probably expected to slide back into the emotional inflammation so typical after an infertility loss – the punch in the gut when I hear so-and-so is pregnant – I haven’t.


I certainly don’t begrudge anyone that particular thing.  It’s just part of the deal, worse for some than others.  Some women puke when they’re pregnant; some get cankles.  What are you gonna do.  Some of us felt worthless and picked on by God, some of us had evil fertile cousins, some of us had wonderful attitudes all the way through.

I have written before about how some of my crappiest life experiences have woven themselves into the fabric of who I am.  I am not a person to whom this or that heartbreak happened; I am a person, and that heartbreak is a part of me, just like some other undeserved gift also is a part of me.  Obviously having a child, and the child that we got, really turns down the volume on the heartbreaks that came before.

And I am thankful/sorry/grateful/sad that even as I have the occasional friend pregnancy to remind me of what we lost, I also have baby loss, and miscarriage, among my friends and relations.  To remind me of what we have.

So I’ve been poking, at my heart.   Friends having babies.  The Time article on only children, which has been suggested and recommended to me more than once.  <does that hurt?>  The bags of baby stuff, and the hesitant way my husband and I try to discuss a future that may or may not have another baby in it.   That was a baby we used to feel sure of, and now we don’t.  <poke>

I seem to be fine.  Still recovering from losing the embryos; still peeling back the layers of anger and numbness and sadness and fear.  But I’m pretty sure that the jealous, bitter, cheated part of me dissolved somewhere along the way.  I continue to believe that letting that little tumor be what it is, until its work is done, is a healthy thing for me.  Trying to pretty up infertility and not feel the blackest parts usually just made it even worse, so I was messy and jealous and … you know.  Let’s just say I rode all the rides.

I wish I could show my face (in the way that I never wanted to before) when good news strikes, and let the friends who get it know: it doesn’t hurt anymore.   Really.  Poke away.


I don’t do “empty.”  Never could.   I like a full schedule.  God knows I like a full belly.  Full womb was incredible (along with incredibly uncomfortable).

Empty is hard because it scares me a lot.  I spent a lot of my life figuring out all the things I could stuff into the empty.  It all works… for a minute.  Empty feels full, full resembles happy, or not scared, or loved / included / needed.  Pretty soon (if not really soon) the heavy social calendar, the overeating, the striving and pushing and banging too hard on the wrong door for too long… is just exhausting, and there’s that empty again.  Emptier than ever.  Even in good times, I feared the empty.

Sometimes “empty” meant “unloved.”  I thought that activities and gigs and commitments proved that I was liked and needed.  And in the commitments that I cultivated, I tried to prove that I had value.  I was like those people who think it’s rude to show up at a party without a gift or a bottle of wine.  Like just their company isn’t enough.

Since I got to be really good at filling up the empty, I rarely had to face it.  Today, empty is a deep black hole and it has swallowed me.

It doesn’t take decades of therapy to know that “empty” means “available to feel unpleasant emotions” or, more succinctly, “drowned.”  I knew it the minute we got off the plane from Chicago.  The first thing I did (after buying a chocolate milk shake) was start looking for clinics and thinking about what we’d do differently for IVF#8.  But after a few days, I knew that IVF #8 wasn’t going to fill the empty left by IVF #7, and then thinking and planning didn’t comfort me any more.  Didn’t fill me.

One of the things that does “fill me” is music and theatre.  I performed professionally most of the time we lived in Chicago; along with teaching and writing it is my official occupation.  The vague plan was that here in this smaller market I would be able to start all over again, find a gig or two, start a band, write some things, whatever.  I was going to do that after the baby came… after the depression… after I lost the 40 pounds I gained in the 4th trimester… but once I got home from Chicago, filling the empty became an emergency.

I saw an opportunity and went to the audition.  I knew that just reading at the audition would be a mini-performance in itself, and thus would be fun, a whiff of the airplane glue high that I get from performing.  It wouldn’t amount to anything, and I would shrug it off, and maybe meet some new people.  But by the time I got home, knowing that I had done well,  the play was no longer an irrelevant piece of candy but had turned into something big and essential.

To fill the empty.

Obviously, in the way that these things go, I didn’t get the part.  The cameraderie, the juice of being chosen, the time so deliciously full, the important way I would say “I have to go to rehearsal...”  dried up and blew away, and into the whistling darkness of the empty poured all that delayed, denied grief and sadness and fear and anger from our loss.

The empty stretches before me for the rest of my life, because even as I drown in it, I know that I’ll never get away from it.  Some of what defines the empty for me is my slippery hold on my purpose.  What is my purpose, beyond overcoming it all, finding marriage, becoming a mother, becoming a mother again?  What am I for, when that’s all over?  Suddenly nobody’s pulling on the other end of the rope and I fall into the empty.

I’m a religious person, and apparently not a very good one, because God 101 is that He fills me.  This is the “God shaped hole” writ large, and I should fall into the empty and wait for Him there.  I know this.  I also should know that when the empty fills with grief and sorrow, I won’t drown.  But I don’t feel like I know these things today.  The knowing of them in a solid way is stuck on a shelf somewhere and not comforting me.

I felt relief when we found out all five died… it was the worst thing I could think of, and I didn’t have to dread it anymore.  I felt relief when I found out that I am not cast in this stupid play.  I hate the empty and I probably always will, but that panicky moment of standing on the edge and wheeling my arms, grabbing for something, trying not to fall…  is worse.

I haven’t lost much in my life, I guess.  I always seem to forgot how to grieve.  I have my own stages, like “Thinking I’ll Somehow Skip the Being-Sad Part.”  Or “No One Will Put Up With Me if I Don’t Skip the Being-Sad Part.”  Or “If I Somehow Replace the Lost Thing, Really Fast, Everything Will Be Fine.”

I got into an argument with my husband about cleaning the carpets which was really about money which was really about how scared I was that he would say hell no, we can’t spend another $10k trying for another baby.  Since parting with $300 to clean the carpets was just about to kill him, it was a valid fear.  But he is willing to try again, and maybe that’s why he doesn’t want to spend a bunch of random $300 here and there.

So, I’m off to the races.  Where will I find the right clinic?  Should we try the clinic that’s 90 miles away?  I can’t go back to the Bad Clinic that is the only one here in my PPO, what with the registered letters and lawsuit threats flying around.  (more on that another day).  Should I travel to one of the clinics that is supposed to be amazing, that people travel to, like Cornell or Oregon?  And there are a million other arrangements.

But of course, none of that is going to make up for the five embryos we lost, and the hopes we had for at least one of them, and the shock of preparing six weeks for … nothing.   And none of that is going to prevent the sudden, weak-kneed crumpled-face helpless sobbing that grabs me when I see the face of someone who gets it, or random moments when I think about another little boy like Daniel.  Or when I stand on stage, as I did Sunday, and sing “Lord I’m amazed by you… and how you love me.”  And I want to just stop and cry about how hard it is, because I’m in all the way with God and I do think He loves me,  and this is just how it is sometimes.  But I couldn’t cry (very much) then so I just kept on singing.

I thought I’d be “fine,” as in not too sad.  But I’m actually fine, because crying one day and being snappish and angry (my specialty) another day and being optimistic on the day after that, is how it is.  It’s like when  you take a bad fall, and people are standing over you asking are you okay, are you okay, and I always get up because I’m embarrassed, and nothing seems broken and everything is working and I say that I’m fine so everyone will stop looking at me.  Only after a little while do I realize that I’ve got a huge scrape, and my glasses are all bent, and I feel some bad bruises coming.

Sometimes I feel embarrassed because we “only” lost embryos.  In order to convey the loss I sometimes have to describe it to people who are kind of glassy eyed because they don’t know what that means, or maybe they have some kind of hangup about assisted reproduction, and I just can’t take it, so I don’t end up telling people about it at all.  And sometimes there are people who do get it, or are kind enough to walk in my shoes a little bit so they can get it, and I have a day when I feel okay, and then I feel like a fake because they were so kind and now I seem fine.

There’s nothing like feeling dumb on top of everything.  But I do!  People have lost husbands, and living babies, and babies at 20 weeks, and babies that were 17 years old, or never had a baby at all after so, so many tries.  That’s something to grieve about.

And… so is the five embryos and that whole part of our lives.  Gone.

Now that I’m reminded of what grief is like, this little-ish grief that I have to own, I remember how to do it.  How to drink more water, get enough sleep, go slow, and take care of the big scrape, and the bent glasses; and get ready for the big bruises that will be coming for a while.

It would be rude if you said I should enjoy the baby that we have, and how healing that can be.  But it’s true, and I do and cry five minutes after that and this is just how it is sometimes.

The first thing is I can’t believe how much better I feel.

This makes sense, because cycling again, and being away from home, was stressful.  I was full of angst and fear and worry about what we could lose, and after last week’s bout of puking stomach bug, I felt a little traumatized by my body’s sudden betrayal.  We stupidly scheduled a long weekend trip that featured a nine-hour drive, with only one day at home before making the Chicago trip.  We’re not easy travelers, and back-to-backing it would have been hard even without the puking bug, which had to hit us on the same day as the nine-hour drive home.

In the very limited sphere of our IVF plans, we lost a lot.  Losing a full sibling for Daniel is a little bit hard, and of course we were hoping for another just like him, even if  that isn’t … wasn’t very possible.  Once we got the first phone call that two embryos had died, I feared / knew that we were a lot closer to losing everything we had.  Or at least everything we had in that freezer.

It didn’t help that Daniel kept us awake most of the night before with a very rare restless night.  He probably picked up on our tension.  Having to get packed and out and to the hospital early was stressful, and once we got the bad news, the exhaustion just magnified everything.

In terms of going forward, and what next, and all that, I feel only a few things.  When we got the news – and can I just say that getting bad news in a hospital gown with half your ass hanging out is extra sucky?  At that point I was exhausted and hormonal and the idea of cranking it up again, finding a new clinic, yadda yadda, seemed impossible and ridiculous.  But when my husband expressed despair about not being able to try again,  I had a big, loud, angry NO in my spirit at the idea of “stopping.”  Of just saying, that’s it, I don’t have any more cycles in me, it would be easier to get used to having an only child than it would be to go back to the drawing board.

Throughout our time of doing IVFs and struggling and all that, I have logged endless hours thinking and discussing what God thinks about infertility, and IVF, and all that.  When a natural process like conceiving a child goes off the rails, many religious people get uncomfortable.  We like to believe that when having a child works as planned, all we do is roll the dice by having sex; God decides when the seed yields a baby, and when it doesn’t.  Fabulous.  That is a lottery most of us will hit.

But if the baby never happens in the usual way, then the paradigm doesn’t work anymore.   Did God just decide “no” for us, “no” every month, every egg, every time?  That’s a lot of “no.”

And then we look around, and see that the paradigm doesn’t work all over the place.  When a woman has a lump in her breast, is God saying “no” to her hope that she will live a long life?  Not necessarily.  Did God say “no” to most of the people who got smallpox, diphtheria, typhoid – until there was a vaccine, and then God started saying… what?  “Never mind?”  “Drat, foiled again!”  Who can fathom it?

I had to adjust my own paradigm, and that means that it got bigger.  God says “yes” to the seed planted in the usual way – for some.  God has said “yes” to the embryo that grew in a laboratory for us, and God apparently said “no” various times as well.   But now I think that we see “yes” and “no” where we want to.  Need to.  Some of us religious folk see “no” even where it breaks our hearts, because a God who takes away but stays within the paradigm is better than a God who seems terrifyingly random.

When we started third phase of IVFing, which means we got the batch of embryos from IVF #4 that seemed promising, transferred two, and froze nine, the paradigm snapped into place easily.  We had nine frozen, and I figured that if God said no to every single one of those cycles until all of those embryos were gone, then maybe God really didn’t want me to have kids, and we would have had to waste a lot of time and money and tears to find that out.

That was actually one of my biggest fears.  And how mean is a God who would do that?

Obviously I am grateful beyond measure that we didn’t end up that way; I had the amazing experience of pregnancy and we have a gorgeous and healthy child who brought, and brings, indescribable joy.

And now that the finale of that batch seems to slam the door on our hopes for a sibling, I’m realizing that the paradigm works when we want it to, and doesn’t work when we don’t.  Because when I think about letting this be “it,” I feel the big “no,” and I remember that we always followed our hearts.  There were opportunities to stop.  There were people who said “Your poor body has been through so much,” which always feels like a veiled criticism to me.  There were setbacks and obvious opportunities to see a big “no” from God.

But I never wanted to stop.  The only “no” I could hear was my own: NO I don’t want to stop. I never got beaten down by it all, not enough to just walk away.  And I still don’t.   This is a lot to consider, and I am looking at it carefully.  Having an only child doesn’t fit my family paradigm, but that doesn’t mean I can’t decide to embrace it.  Being a mother, or being someone who “conquered” infertility, being the little engine that freaking finally could, is some kind of identity that I like for myself.  Who will I be if I’m not trying to overcome?

These are valid questions and I’m not minimizing them.  But I do have clarity on the God / yes / no thing.  If a single person has a crappy date, or is dumped by her boyfriend, is God saying “no” to marriage or companionship for her?  I sure hope not.  Even if a woman is dumped by ten boyfriends in a row, no one would say that she should give up and embrace singleness.   If an unemployed person applies for a hundred jobs and never gets so much as a rejection letter, because that’s how bad things are these days, would we say that God is saying “no” to that person’s hope and need to have a job?  Would we say ‘Isn’t it time to stop?” in that annoying, pitying tone?  I don’t think so.

I am trying very hard not to figure out where to cycle, and what it would cost.  (We still have insurance coverage, can you believe it?)  I am leaving a space in my ideas about now and the future, so that a one-child family can take root as an acceptable plan, if it should, or can.  I have faith that God will let me know if there is something new, different, better, that I should be doing instead of trying for a sibling.

But to those who will say “Do you think it’s time to stop?”  or “I guess you’re supposed to have just one child,” – and what is up with thinking that’s an okay thing to say?  Seriously?  In many minds there is still a kind of prejudice that says an infertile woman should accept her fate, and there is something wrong with “needing to be a mother” so much… and of course there is equal censure for the woman who is childless by choice, isn’t there?

Anyway, I hear the phrase “… time to stop…” and I understand the benefits of it and I’m not ruling it out.

But on that question I also, still, have a great big “NO.”

We lost them all.


The complexities and cost of having to cycle again, and the fact that we’ve always transferred two, but only one at a time has ever kindled.

Won’t it be embarrassing if it’s a big fat negative? It’ll be like the times I met a guy and agonized about the pros and cons of having him for a boyfriend only to find that he had already asked my friend out and only talked to me for so long because he wanted to meet HER.

Me? Bitter?

Anyway I forgot how much there is to worry about. This particular hormonal status… Well, it just is so easy to marinate in the sadness and frustration of zero babies, the fear of having/losing one, and the abject terror of carrying / having / losing / raising two.

I guess that about covers it. Transfer 8:30 am tomorrow.

We are staying with a friend of my husband’s who lives in a fancy suburb on the north shore of Chicago.  The house is … kind of a mansion.  (A little one).  It’s beautiful but formal; there is so much marble and wrought iron it’s kind of like staying at the Art Institute.  I was intimidated at first but finally got used to it.  The man of the house isn’t home much so I don’t have to worry that we’re imposing.

The cycle seems to be back on track.  At my last check, another long trip down from Rockford on Friday, my uterine lining was looking better (9.something) and my levels were up too.  So my doctor and coordinator are relaxed, I don’t have to get monitored again, and we’re set for doing the transfer Wednesday.  This is just one day later than originally planned.  It’s the day we leave, our flight is at 1:25, so that promises to be a mad rush.

I had a talk with a wise and dear friend last night, and we agreed that just transferring one has its benefits, since coming here – “having to” come here – and visit lots of friends and hang out in hip city places – isn’t that bad.  The next round of IVF for my clinic is in September since they’re on the batch system.  Another advantage of coming back to do another cycle is that my hsuband is back on his commuting schedule come September, so anytime I come to do a cycle is one week we don’t have to be apart.  The plane fares have weirdly fallen to very cheap levels, so I can fly easily & cheaply in the fall.

The other problems of transferring one (and not getting a positive on this cycle) are still there.  Our insurance coverage will probably max out on this cycle, so that’s money.  And I don’t have any place in my PPO to get monitored now that the Bad Clinic has probably put out a contract on me by now, and we may sue them.

The Bad Clinic,  by the way, has dodged calls from Blue Cross for two full weeks now and the whole situation has been escalated to “Provider Relations.”  I’m trying to figure out who to complain to, aside from Blue Cross, since they garbled every piece of data and never sent results on the same day, and actually held some results back completely.  Maybe ASRM?  I would hope the accrediting body would want to know of fraudulent billing and mild malpractice.

It occurs to me that if my Blue Cross maxes on this cycle, it won’t matter if I go to an in-network clinic for the next cycle; I’ll be self-pay anyway.  That’s a good point.

There is one piece of data that I need, and if you have any information about this please pass it along.  The question is: after having one baby, are you more likely to conceive the next time?  I always assumed yes.  But is that really true?  We all know women who had multiple miscarriages and then had a bunch of kids, the miscarriage issue seemingly resolved.  We are always told of infertile women who finally had a spontaneous pregnancy and then more babies after that.  The impression is that there was one pregnancy that “broke the seal” or something, and that woman’s problem was resolved.  I’ve always heard that a first pregnancy over 40 was highly unlikely, but less unlikely for a woman who’s already had a few kids.

Now i’m not so sure.  If a woman has some kind of infertility and it resolves enough for her to have one kid, then why would she not be able to have more?  Her fertility doesn’t increase with each kid, necessarily; she is fertile enough to have one, and therefore fertile enough to have 3 or 7 or whatever.  It sometimes seems like those unfortunate women who get pregnant six weeks after delivering a baby are “extra fertile,” but maybe they were just misled by not having had a post-delivery period, or thinking that breastfeeding is a perfect birth control.

Medical info and statistics muddies this question by the fact that after each pregnancy the woman is older, and therefore faces declining fertility.  Secondary infertility can often be attributed to this.

And, as every infertile knows, well-meaning friends always want to tell us about the over-40 pregnancies and post-miscarriage success stories.  But nobody wants to mention the many more who suffer, miscarry, and/or never conceive in silence.

If there is some medical reason why I’m more likely to conceive with the same batch of embryos than I was before, then absolutely, we only transfer one.  But if that’s just a myth, then transferring two is still on the table.  We’ve always transferred two, and never had more than  one take.  Even when we had losses due to ectopic and miscarriage, it was only one that implanted; the second one just quietly never took.

But…  even if it takes me two or three more single embryo transfers to hit the jackpot, and we have to buy more plane tickets and pay out-of-pocket for everything because Blue Cross is maxed, that probably doesn’t begin to compare to what we’d have to spend with twins.  Extra babysitting, and lots of it.  NICU, maybe.  And the incalculable cost of having a special-needs child, made more possible by the prematurity that almost always comes with twins.  The also-incalculable cost of damage to me, even if it’s just more knee and foot injuries incurred by me becoming Jabba the Hutt due to twins pregnancy on top of being 50 lbs. overweight.

Are you sick of my flippy floppy agonizing?  I am.  I usually dissect my choices into neat slices of data, risk, and intuition, and pull the trigger either way without dragging things out.  This one is tough.