I’ve been sharing lately about parachuting into unknown territory with The Electrician as we edge closer our dream of biological children. Our route through the barely-charted waters of gestational surrogacy has been choppy at best, and many days the waves make me queasy.
Today I’m going to write about the freaking needles.
But first, let’s start with the repeated invasive ultrasounds, shall we?
Most women start an In Vitro Fertilization (IVF) treatment carefully timed with their cycles. Since I haven’t had a period since 2007, we couldn’t track my body in the typical way. Dr. Miracle’s solution was weekly blood tests and internal ultrasounds for a literal month of Tuesdays. The process would also show if my ovaries were good to go, or if my hysterectomy years ago created too much pelvic damage to proceed with IVF.
For those lucky enough among you to have never attended an ultrasound appointment at a fertility clinic, here’s how it goes:
The already nervous woman (me) and possibly her partner (The Electrician, if he can get away from work) wake up very early to ensure they arrive at the clinic as close to the doors opening as possible. Fertility ultrasound appointments aren’t actually appointments: you are scheduled for a day but not a time, and something akin to a femininely hormonal running of the bulls happens when the elevator to the clinic opens at 7:15 AM and the women jostle inside. The object is to reach the little basket holding the laminated number cards, and pray for a numeral as low as possible.
If you luck out and get number, say, three, which I did twice during my four week ultrasound marathon, you may be at the clinic for an hour. If you sleep in and end up higher in the numerals, like the terribly unlucky twenty-two I pulled once, you are looking at three hours, minimum. Not knowing when you will make it to work adds heaps of stress to an already uncomfortable morning.
I would love to tell you I am fearless and laugh in the face of danger. I do, after all, teach junior high. Truthfully, I am terrified of needles. Like, cold sweat, turn the colour of havarti, need to lie down to have a blood draw scared. Needles are creepy and wrong, okay? My blood is my blood and it belongs on my insides. The thought of having bloodwork weekly for a whole month really stirred my guts, but I was willing to fight through for the cause.
I deliberately kept myself in denial about injecting myself during the upcoming IVF cycle.
When your number finally comes up, a nice lady with a not-nice basket of sharp things takes you back for the blood-letting. The first time she tried to sit me in a lightly-padded chair with a lightly-padded armrest, I said, “I–” cue sweat behind my knee caps, “Fainter. Need to lie down. Please.” And lie down I did. Faint I did not. It sucked but I was all good, four weeks in a row. I bruised spectacularly that month.
Next, you are sent to the tiniest change room in the world, where you wrap your lower body awkwardly in a sheet, check to make sure your socks are cute, or match, at the very least, and wait for your name to be called yet again.
I’m not going to get into the gory details of the ultrasound, but since the goal is to get a clear view of your ovaries and other such bits, you can imagine how they get there. Depending on the doctor running the device, the experience could be either mildly unpleasant or remarkably painful. One doctor I saw, not Dr. Miracle, was so rough I thought she was trying to accomplish a pituitary scan via my undercarriage. I managed to avoid kicking her, but I did not avoid thinking about how satisfying it would be to do so. (Very. The answer is very.)
Folks undergoing fertility treatment celebrate odd stuff. The Electrician and I celebrated the fact that my ovaries were functioning properly aside from my Polycystic Ovarian Syndrome. My hormone levels were excellent, as was my antral follicle count, which in my limited understanding estimates the potential number of eggs a woman has available.
In short, my ovaries and I deserved a celebratory cupcake.
From there, Dr. Miracle decided to manipulate my cycle by placing me on regular old birth control pills for a month. Those suckers mess with my moods and make me a little bit melodramatic, but again, all for a good cause.
Our IVF cycle injections were due to begin in March 2016.
Always, looming in the back of my mind and being actively ignored, was the upcoming hormone injections. The cupcakes helped.
I will be writing about the astonishing costs of IVF in another post, but I was pretty green the first time a filled a prescription for my injectable drugs. We could have gone on a lovely vacation for what we spent on the first four days of shots alone. Yes, really.
When the day arrived to start the IVF cycle proper, we were back to the clinic for another round of blood and probe. Frankly, I was so busy thinking about the needles I didn’t care. I was sent to the other side of the city to a pharmacy that specializes in fertility drugs to fill my prescription. I was so nervous I probably shouldn’t have been driving. Thankfully, the ladies there were incredible and answered all my questions. They even trained me on injectors and syringes, and ways to make it all hurt less.
My nerves were so bad, partly because needles are wrong and creepy and partly because a single injection of the medication that had to be administered first cost over $350, that I decided to get creative. Menopur, one of my drugs, is sold in powder form and needs to be mixed with sterile saline just before injecting. I decided to get the worst over with by injecting a “dose” of just the sterile saline a couple days before it was actually go time.
I propped myself up in our bed using every pillow I could find, already feeling light headed. My goal was to manage a single subcutaneous injection while remaining conscious. I numbed the target area on my belly with an ice pack for a half minute, swabbed like crazy with the alcohol wipe, and tried to stab myself.
I couldn’t do it.
A strange moment passed where I thought through what I was doing, really thought about it, and I steeled my spaghetti nerves. The first step to getting our baby was to inject myself with salt water at ten past nine on a Monday night: not that big a deal.
Still couldn’t poke my tummy with that needle.
I prayed to the patron saint of huge chickens, Saint Drumstick, that I could be brave enough to do the stupid injection and to carry on with the real IVF. I promised myself chocolate and an early bedtime if I could just do it, already. Between my toes was sweaty. Behind my ears was sweaty. My left eyeball twitched.
The first time I actually got that needle into my stomach, I couldn’t make myself push down the plunger. Truthfully, it took me eight pokes and three alcohol wipes to actually administer my saline. I lost consciousness for a couple seconds and very nearly puked on the new duvet, but I finally succeeded.
Strange as it sounds, that horrid practice run helped me to feel less nervy about the rest of the process, which looked like this:
One IVF cycle for me meant over thirty injections of crazy hormones in just over a week. I injected every one of them myself, which was a visceral conquering of one of my deepest fears. Every needle on that tray, even the ones at the top of the photo that are sealed inside those little plastic caps after they’re used, was jabbed into my tummy, and every one of them arrived with a cuss word and left with a bruise.
Most of my injections really didn’t hurt that much. The Puregon, which is the super expensive one, arrives in a chirpy little pen that’s almost cute and makes injecting pretty smooth. The Menopur–that one that needs mixing every time–stings but that dissipates quickly.
I ran into trouble with the Orgalutran, which prevents the rapidly ripening follicles from being ovulated prematurely. Beastly stuff. It comes pre-loaded in glass syringes; you would expect this to make the process easier. For some reason, the needles for every dose of that stuff were dull. Every injection took two or three hard stabs to break the skin, finally forcing me to resort to pinging it on through like a dart. The Decapeptyl, the final two doses of medication that prep the eggs for retrieval, is made by the same manufacturer, and mine came in similarly dull stupid needles. Those doses took everything I had to get through.
God, IVF sucked. I was a hot-flashy, sweaty, emotional wreck, counting down to the next injection and worrying about our bank balance.
On the whole, though, I was victorious. I self-administered as many as five needles each day, and I didn’t cry (much), barf (at all), or fear-pee on the couch (not even a little bit). The Electrician supported me tirelessly through all of it, and didn’t say a word about my irrational hormonal self. I am lucky he’s mine.
We were so very fortunate that our IVF medications worked well on the first cycle. My rockstar ovaries (thanks, girls) ripened twenty-two healthy eggs. I’ll be writing more about the heinous process of retrieving all those eggs in another post, but I was thrilled that all my blood, sweat, and tears resulted in something positive and tangible on our path toward a family.
Stay tuned for more from the fertility trenches, friends. Thanks for the love you’ve sent our way. We’re inching our way forward; even glaciers get somewhere eventually.