When we finally started trying, I knew enough to know that people rarely get pregnant immediately. I had a few indicators that this might be the case regardless, so when it didn’t happen immediately, or even in the first few months, I wasn’t worried. But I did think that as I worked to resolve those issues that with time and a little luck (because really, when you consider how exquisitely sensitive the timing involved is, it’s kind of a miracle anyone gets pregnant) it would happen. I took my Chinese herbs diligently, tried to fit in acupuncture, waited with bated breath each month to see if this was the lucky month.
But it never was.
As the months passed, three, six, seven, eight – hope and anticipation turned into an absence of expectation, which eventually turned into resignation that our path to parenthood might not be easy.
But this is America and insurance companies are evil, so we had to wait for a year before anything could really happen. So I waited, and January of 2020 marked a year and a formal diagnosis of infertility. Seeing the words was both a relief and a punch in the gut. You’re relatively healthy in all others ways, yet your body can’t do this one thing without help, but the diagnosis also means you can get help. So, diagnosis in hand, we met with a reproductive endocrinologist at the end of January.
The first steps were bloodwork, an ultrasound, and a dye scan, all scheduled for February vacation. Unfortunately, because it was vacation, I couldn’t get the scan done because everyone was out of town. I vividly remember how frustrated and almost in tears I felt, standing in the middle of Old Navy and realizing this would delay everything another month.
Little did I know.
It took my doctor another week to get in touch about the ultrasound – he was glad I hadn’t had the scan, because the ultrasound seemed to indicate that there was an issue with my left fallopian tube, likely fluid, and the dye scan could have triggered an infection. He called while I was out with coworkers at a Mexican restaurant in downtown Boston, and I remember standing in the corner trying desperately to process what he was saying. The end result: a referral for a 3D ultrasound.
After much back and forth, I got a date for the ultrasound on March 9th. It was a beautiful, sunny spring day. I left work early and drove to Brookline for the appointment. There were already warning signs about COVID if you’d traveled to China – I remember the woman next to me at the receptionist’s desk was apologizing profusely for her cold – she was also a teacher, and said that she picked up everything that went through her building. I nodded sympathetically, then sat down to wait, acutely conscious of my very not-pregnant status amidst a room of very visibly pregnant women.
The appointment itself was terrible. The tech did a phenomenal job, but when the radiologist came in, she made a series of cryptic remarks as she looked at the screen, then bluntly told me “oh yeah, no wonder you can’t get pregnant.” It was dehumanizing and hurtful, and as she left, I took a few moments to get over my panic and tears before leaving.
There were times after work where I would go to the McDonald’s in Bedford on my way home to get work done – I can’t focus in Starbucks, but McDonald’s served as my “place.” I was in a panic trying to prepare for Genius Hour when my doctor called again. He shared that the 3D ultrasound had confirmed an issue on my left side, probably fluid inside the tube, and that I would need surgery before we could continue. The surgery was necessary because the fluid can pose a risk to a pregnancy. The most likely cause of the fluid based on my history was endometriosis, something no doctor had ever mentioned to me before.
March 12th was the last normal day of school. Teachers came in on March 13th to plan, and over the next few days, the whole state shut down t try and control our spiraling COVID crisis. The shutdown meant that surgery couldn’t happen, which meant interventions couldn’t happen either. Neither could new cycles, but it still sucked.
And so we waited.
And then, out of the blue, just before Memorial Day weekend, it looked lke I might have a surgery date. It didn’t make sense, because elective procedures were still off-limits, but I went with it. Suddenly everything seemed really imminent and scary. I went through a rollercoaster of emotions only to find out that it wasn’t actually going to happen.
But then, as Massachusetts transitioned to stage 1, I got an email offering me the choice of 6/15 or 6/19 as a surgery date. I picked 6/15, sent the email, and then didn’t check my email for the rest of the day.
I woke up the next morning to several frantic voicemails telling me that I needed to come to the hospital ASAP for my pre-op appointment otherwise surgery would have to be pushed back. I freaked out, called back immediately, and headed in a few hours later.
It was terrifying. We had barely begun doing the occasional distanced visit, but other than that, I hadn’t been in contact with anyone. I only went to school, the grocery store, and the odd trip to CVS. My heart rate was through the roof – well over 100 when they took my BP. The nurse asked if I was ok and I said yes, but this is a lot to take in. Three hours ago, I didn’t even know I had an appointment. We agreed to take my blood pressure again at the end of the appointment. I met the surgeon who was lovely even though the list of “maybes” on the surgery consent form was a little scary to contemplate.
72 hours before surgery, we drove to the hospital for my required COVID test. I promptly made a fool of myself as the nurse stuck the swab up my nose – a glamorous combination of coughing, crying and swatting with my hands as my head attempted to move out of the way. But I still didn’t trust surgery was happening until Sunday night arrived with no call telling me otherwise.
On Monday morning, Adam dropped me off at an absurdly early hour – COVID restrictions meant he couldn’t accompany me – but the team who cared for me was wonderful – caring and respectful and making me feel empowered at every step of the way. The last thing I remembered before the anesthesia kicked in was being wheeled into surgery – bright lights, people getting instruments laid out, and cold air conditioning.
When I drifted back into consciousness in the PACU, my first thought was “my throat hurts.” I faded out again fairly quickly, but the next time I woke up, I was slightly more alert. I dimly remember a nurse saying my throat would hurt because I’d been intubated. At some point, the surgeon and the doctor assisting her came to visit and gave me a rundown of what had happened: my tube had been left intact because it wasn’t blocked, but they had discovered endometriosis scarring, which they had broken up. I wasn’t quite sure what to make of my surgeon scrunching up her face and saying everything was “kind of stuck together,” but I didn’t have it in me to ask for details. Over the next few hours, I moved around, ate delicious Saltines, and finally, it was time to go home. I was in pain, but it felt more like someone had whammied me in the abdomen than intense pain. I got home, hobbled up the stairs, and got into bed, grateful for the miracles of pain medication.
It’s a humbling experience, recovering from surgery. Suddenly, even routine tasks like picking up your phone charger become impossible to do. You’re reliant on someone for every small detail of your daily existence, and it is hard. It’s even harder in a pandemic when nobody can come over to watch you and help out if your partner needs to leave the house, which Adam needed to do for graduation at his school. It was a nerve-wracking several hours, but I survived, and luckily, recovery was pretty fast. By the end of the two weeks, I was back to normal (minus some fatigue).
Getting the surgery report was…surreal. Reading about things that had been done to me while I was unconscious felt like a very dissociative experience. The surgeon hadn’t been exaggerating when she said everything had been stuck together. The scarring was extensive and severe – the entire left ovary and fallopian tube had been covered in scar tissue and also adhered to a ligament. The right ovary was also stuck to places it shouldn’t have been stuck to, one ureter was “tented,” and part of my colon was adhered to the back of my uterus. In addition to confirming endometriosis, the report also noted that, based on the external appearance of the uterus, that I likely also had adenomyosis, where the endometrium invades the uterine wall. But because women’s health gets short shrift, despite a lifetime of heavy periods and intense clotting, nobody had ever raised the prospect that this was anything but normal. It’s a little scary to think what other damage the scar tissue could have done if left unchecked.
Crucially though, the report did not detail what level of endometriosis I had (from 1-4), and this impacted our treatment plan when we finally had a follow-up with the RE. So we made plans to schedule a second meeting with him on 7/3 after I met with the surgeon so that we knew what our treatment plan would be. If the endometriosis was severe enough (stage 4), then we would be able to bypass the requisite three cycles of IUI, but could proceed straight to IVF. Not only did the surgeon confirm stage 4 endometriosis, she also showed me pictures of the scarring, which was simultaneously fascinating and terrifying. The entire left ovary/fallopian tube was completely encased.
So on July 3rd, we established a plan with the RE to begin IVF pending approval from insurance, lots of consent forms, and $4000 to cover the cost of genetic testing and freezing embryos. Insurance approved the plan, and as my next cycle approached, I contacted the nursing staff to let them know that I was getting close. The nurse wrote back saying she had requested my medication, but then a day later I got a phone call from the pharmacy saying that the medications needed prior authorization from insurance (again, insurance is evil) and I didn’t have that. This was a Thursday afternoon, so by the time the preauthorization got submitted (a process that takes 5 days to approve), it was Friday. My period arrived on Sunday, marking yet another missed cycle.
So here we are. I began shots two nights ago, and begin more intensive monitoring on Monday. After that, we do the egg retrieval and fertilization, then wait some more for the genetic testing results to come back. Hopefully, finally, at last, the first time will be the charm.