This is Chapter 11 in the Infertility Memoir. Read previous chapters here.
With our embryos now in Pennsylvania, and a plan in place, it was time to start all of the appointments as we prepared for our second transfer. Back in March, my doctor started me on birth control so that once my embryos arrived my body would be ready to start the other medications. Originally I was only supposed to be taking them for a few months, but I had been taking them for six months. By the time September 2023 came, that created an added hurdle to proceed with a natural transfer cycle.
I was already a little skeptical about doing a natural cycle protocol when using a different protocol than what worked with my previous transfer. After all, that is what gave us our daughter. But I wanted to trust my medical team. The natural cycle was going to mean fewer appointments, which was good since the clinic had a no-child policy and finding childcare was challenging. It also meant I wouldn’t need to drive an hour each way to the clinic as often. However, my body wasn’t responding the way they had hoped after discontinuing the birth control pills, meaning that to save the cycle we had to switch to a different protocol.
This also meant we had to order different medications, even though we had just spent thousands of dollars on medications that were now going to go unused. We had to rush to get new medications ordered and delivered in order to start taking them. A lot of the medications used for fertility treatments aren’t available through a local pharmacy, meaning you have to use a special pharmacy. Normally, I had time to price out medications, apply for discount programs, and find the best self-pay price, but we didn’t have the time for that.
The shift in protocols also meant that I would need to go in for more monitoring appointments – we’re talking every one to two days. Our clinic’s no-child policy, while I understood it, was becoming a barrier. My previous clinics didn’t have that kind of policy, and seeing others in the waiting room with children gave me more hope than it hurt me. Seeing that fertility treatments worked, gave me hope in the waiting room. But how was I supposed to juggle caring for my daughter, spending endless hours in the car driving, long waits at the clinic, and all of my other obligations? I’m also not a morning person, so taking the earliest appointment was a huge challenge.
Thankfully, my husband was in a position where he could take my daughter with him to work, or work from home. There were days when I left the house at 7:00 am and didn’t make it back from my appointment until noon. Last October there was a three-week period where I spent around 20-30 hours each week just driving to and from my fertility clinic. That doesn’t include the hours I spent waiting in the waiting room or exam rooms. I felt frantic, stressed, and worried about the impacts it could have on my husband’s career. I drove faster than I should have on more than one occasion because I needed to pick up my daughter before my husband had an important meeting. By the end, I was emotionally and physically exhausted. I didn’t understand why exceptions couldn’t be made, why my clinic couldn’t work with me. After all, we were paying them thousands of dollars, yet I felt like we were just a number, not human beings.
Just days before our transfer, I received my next shipment of medications and I couldn’t believe my eyes when I opened up the injector kit – the autoinjector pen and medication were missing. The only thing I had was needles and an empty case. I was panicking. We called the after-hours line and hoped that something could be done. We were also furious that the pharmacy had sent us an empty medication box. How was there not some kind of verification of either their inventory or the packing system? Thankfully, there was a small amount of medication left in previous autoinjector pens and we were instructed to use them, and then call the pharmacy to get a replacement for the following night.
Let’s just say it’s really hard to work with a pharmacy that isn’t local. So, I resorted to posting on Facebook for help. I knew some people in the area that I went to high school with were fertility patients, maybe someone had leftover medication. I was desperate, and it is not something I would recommend, or even encourage people to do because you never know if the medication was stored properly, expired, etc. However, when a high school friend messaged me saying she had some and could meet me I jumped at the chance. She was a nurse, and someone I knew I could trust, otherwise I would have never done it. But if it wasn’t for Beth, we might have lost the cycle.
We finally reached transfer day, and we thankfully had help from family so that we could both be present for the transfer, something my husband missed out on the first time because of COVID. However, what happened next was one of the most frustrating moments in this whole process, and if you’ve been reading along you know there have been lots of those moments. We were going over the paperwork before the transfer, including reviewing my medications. While looking it over I noticed several medications listed that I was supposed to already be taking, except I wasn’t. Panic set in. Were we going to have to cancel this transfer?
I took a deep breath and looked up to whom I assumed was a nurse and said something like, “I’m not taking those medications, and nor do I have the ones it says I am currently taking.” I also explained that I didn’t have the medications listed for me to start that day. My husband also chimed in with how poor the communication or lack of communication had been since we started at the clinic. That day we were at a central office that handles the transfers, our local office does monitoring, labs, and IUI. We had never seen this woman before. And boy did we unload some not-so-good stuff on her about our experience. It turns out she was the clinic manager or something to that effect. She went to make a few calls and check a few things to make sure we could proceed with the transfer despite the differences in my chart and the procedure paperwork.
Once she came back into the room, she let us know that we were able to move forward with the transfer and that someone from my medical team would be in contact later that day to ensure I had all the proper medications. She also assured us that this was an unusual breakdown in communication and that she would be following up with my doctor and her team personally. I really tried to be hopeful, but there was this lingering feeling that maybe this just wasn’t our cycle. I also longed for the patient care that we received in Illinois because I never once questioned or doubted the team we had.
Once we got started everything was going great, but after the transfer, while we were waiting for the all-clear the team called out from the lab that the embryo was stuck in the catheter used for the procedure. I remember thinking, “What else could go wrong?” The doctor explained that it happens sometimes and that they would load the catheter back up and we would try again. Thankfully, the second attempt worked and our embryo was right where it belonged. The team told us that a “sticky” embryo, like ours, was a sign of good luck, and after this entire process, we needed all the luck we could get.
I was already frustrated at how challenging getting to this point was, and after our transfer, instead of feeling hopeful and excited that we were finally able to expand our family, I felt like there was this dark cloud over us. In a way, I felt traumatized by this experience, but I also knew we likely weren’t the only ones to walk away with experiences like this. To be clear, this isn’t the normal standard of care, and I truly hope there aren’t a lot of stories like mine. I vowed to make sure this never happened again, and I had every intention of starting that work. At some point in the future, I will circle back to this experience to ensure it doesn’t happen again.
After my two week wait, I again couldn’t wait for my appointment to get the news and tested early at home. I was honestly shocked that I was pregnant. I didn’t think after all the miscommunications, missed medications, and a shortage of progesterone that our transfer would be successful. All of our previous losses also prevented me from getting too excited or hopeful. Despite all of it, we had this beautiful gift of the pregnancy and baby that we had been waiting so long for, and with each appointment, we grew more confident that we would get to have the second child we always wanted.
I was so relieved when we “graduated” from our clinic. This pregnancy was healthy, and my OB’s office was slightly closer to where we lived. Again, we were stationed in Pennsylvania, but in a small, mountain town without a lot of things like stores and doctors close by. My OB’s office was only 45 minutes away compared to the hour it took to get to the fertility clinic. Graduation from the clinic also meant fewer appointments, less driving, and less stress over childcare. As I braced for the inevitable morning sickness to return and the upcoming holiday season I was finally starting to feel the excitement and wonder that comes with pregnancy. I knew that I would be able to use our experience to improve advocacy efforts as we were approaching the start of RESOLVE’s Advocacy Day planning season and my nonprofit was starting to take off. I thought that the dark cloud was finally lifting.