What to Expect When You’re Not Expecting

I lost another embryo. This one was a girl. The only girl. Now there is only one embryo left. We learned about the loss on February 28, so it has been about six weeks. Once again there was crushing grief, but this time it came with a couple of new elements. The first is that the possibility of having a daughter is likely gone. The second is that now, even if our last embryo makes it, he will be alone. An only child is never what we pictured. The grief is compounding, and my faith that I will have any children at all is dwindling.

When we lost our last embryo, the first boy, I don’t think we took enough time to cycle through all the phases of grief. After the first loss we learned that about 30% of women have a different implantation window than the majority of women. We underwent a test cycle to find out if I was one of those women. The test cycle involves taking all the same drugs: daily Lupron injections (small needle) for several weeks followed by daily progesterone injections (giant needles to the upper hip that my husband I have affectionately dubbed “murder needles”) for a week. After the hormonal prep, instead of doing an embryo transfer they do a biopsy of the uterine lining. My results were that I am (of course) one of the 30% if women with a different implantation window. Also, I had a bacterial imbalance and some new polyps. Awesome. I had to take antibiotics for a couple of weeks and then had an in-office procedure to remove the polyps (I was on valium, but awake. I do not recommend).

Once that was all done, it was time to try transfer number two, our girl. The transfer went smoothly. I didn’t think much during the two-week wait. My perspective was that worrying about it or thinking about it wouldn’t change the outcome. When I learned that I wasn’t pregnant, I did go to blaming my stress levels and my weight. My job can be super stressful and was particularly so during January and February this year. Also, I am overweight, and being on hormones for most of two years certainly hasn’t helped. I look pregnant even though I’m not.

When I had my post-failure consult with my doctor, she assured me that stress doesn’t have as big of an impact on pregnancy success as people think it does, and that if it did nobody would every have babies because all modern women are stressed out. That was reassuring. She also said that, contrary to popular belief, caffeine doesn’t make much difference, either (I had given it up anyway, other than the odd square of dark chocolate). She said that she wouldn’t consider my weight to be a big factor, but it is the only medically significant issue that I have some control over. If I want to try losing some weight, it might help, but the bottom line is that I am very healthy by all markers, including the ones that may typically make weight an issue (blood pressure, cholesterol, diabetes). In other words, there are no known health indicators for why my embryos haven’t implanted.

When we lost our first embryo, we went right into a test cycle, and I think that kept us busy enough to defer some of our grief. With the second embryo, we are taking a break from everything. No drugs of any kind, including birth control. I want to give my body a chance to stabilize, and give my heart a break, too. One of the results of taking some time is that I have made it to the anger stage of grief. I think I am beginning to see what’s on the other side of it, which might be hope. But for now, I am still pretty pissed off by how unfair this all is; that I can’t have the most natural thing in the world. That I have been through so much emotional and physical and financial turmoil for nothing. That I have to grin and bear it while people say well-meaning stupid shit to me about what I’ve been through. That others can’t bear to face it and prefer not to acknowledge what’s been happening. That I still have to go to work and pretend I’m fine. That somehow, I still have to actually be fine because there’s no shared language, no social conventions, for infertility or pregnancy loss. There is no other choice but to be O.K.

We’re going to take a break at least until the end of summer. I will try to lose some weight…maybe it will be easier once all the drugs are out of my body. It takes awhile to get them out – I can still feel some bumpiness and tenderness from the progesterone in oil. I will try to remember who I am. I will go to a lot of concerts and spend a lot of time outdoors and with friends. I will take walks. I will read books. I will listen to music and try to patch my heart back together. I will try to take care of myself, and in the fall, I will try one last time to physically be a mother.

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