I went into stims with enthusiasm and I brought that same vibe to my second egg retrieval. I basically hopped and skipped into that procedure, knowing what to expect now. I had the same number of follicles as last time, similar sizes and I was on a so-called miracle drug called saizen/omnitrope which I was sure would bode well for us given our previous outcome). We just needed a bit better quality and we’d be golden.

As before, my husband dropped me off, waiting with me until it was my turn to go into the procedure area. He stuck around for his part, did the job and left. I took my ativan since I’d be having another IV placed. I was in a nice daze as I awaited the okay to head into the operating room. Things were light and easy this time. My nerves were low, and we chatted about the hoopla of the Taylor Swift Eras tour, even getting the doctor in on the chatter. It was another doctor I hadn’t met before. But all was well. I was ready to do the damn thing.

I faded out a bit – didn’t quite fall asleep, but remember time warping slightly and we were done (thanks meds!). They walked me out and the embryologist came shortly after to give me my news.

We had 13 eggs retrieved (same as last time!), 12 were mature and would be fertilized using ICSI. I was over the moon.

I received a call the next day at 8am sharp. Out of the 12 mature eggs, 10 fertilized normally.

Looking back, I felt a little sad about this. Our first cycle just 9 months earlier was:

13 retrieved, 13 mature, 13 fertilized, 7 made it to blast on day 5/6. I was still super hopeful. Quality over quantity I kept saying! Our first cycle yielded just the two normal embryos after testing, so I wanted this cycle to be better quality even if it meant fewer embryos.

The wait until day 4 after transfer was painful, but we had friends visiting and I took every opportunity to enjoy myself. We went to a music festival two days after my retrieval. We celebrated my best friends birthday. We came home and I caught up on work. Doing a retrieval mid wedding season is no joke!

Day 4 I got a call. We had embryos!!! I’d be heading back for a fresh transfer that next day. I booked the ferry, we left at 6am and we’re ready to meet our embryos! This time we had planned to transfer two, in lieu of testing. Due to the added cost, we didn’t want to bother and discard anything. We decided each untested transfer would be a double transfer.

I arrived at the clinic with so much excitement. I was so damn ready. So damn positive. My husband donned his hazmat suit and I changed into my hospital attire. We were sent to the little waiting room we’d been in countless times before and we sat for a bit and waited for the embryologist to come give us a report before we did the transfer.

After about ten minutes she entered. She was so hard to understand, with a very thick Eastern European accent. I had to clarify a few things because it was hard to hear every word. She told us we were ready to go, and we’d be transferring 2 embryos – a 3BA and a 2AB….

Say what? I was confused. Last time we had a myriad of 4-5s (further along basically I’m growth with more cells), and some AAs. These were the two they wanted to transfer? She said yes, and proceeded to tell us how the others were doing. I barely understood her, but from what I gathered, a few were growing normally, just behind, and the others were trying to catch up.

Okay… so we had two, and that’s all we knew so far. Last time we had 6 full on blastocysts by this stage on day 5. I was worried.

While my legs were splayed and my drapery open, I asked the doctor if we should transfer two after all given this news. What if they were our only shot? She assured me that embryos do much better in our bodies than in the lab, so yes we should! (I found out later that the 2BA was something they wouldn’t even normally freeze, so this is likely why she urged us to transfer).

We went ahead with the transfer but the mood had changed. I was scared. Another 20 thousand dollars was on the line. I was told to stay hopeful, to keep positive. We had two embryos on board and that’s all that mattered. We travelled home immediately after the transfer – went to the ferry early and waited. I had a slice of pizza and an egg salad sandwich for dinner.

The next morning at around 9am I got the final call. Day 6 report. None of our embryos had made it. None. Not one. It was the same embryologist who delivered the news the day before. Her bedside manner was lacking, the way the news that we lost everything except the two embryos in me came across was appalling to be honest. She said “they are all discarded, ok? Anything else?” when I asked for clarification. I held back tears.

I hung up the phone and texted my husband from bed. I couldn’t handle speaking the words out loud. He came rushing into the bedroom and found me sobbing in a puddle of tears. I was hysterical. I couldn’t stop crying. My world stopped in that moment. Hearing every single embryo had either arrested or was such poor quality that they couldn’t be frozen was one of the most upsetting moments in my life to date. This moment was harder than the miscarriage news. It was almost as hard as hearing my little sister died in a car crash, over the phone nearly ten years prior (that one takes the cake). It broke me in some deep way. All the hope. All the positivity. All the parts of my that had convinced myself that I deserved a family of my own were fractured into a million shards. I began to spiral, and I wondered why me. Why the hell couldn’t I just have anything without fighting so damn hard for it and suffering so much over it.

I’d love to say this had some silver lining, but for once it just didn’t. Maybe that’s why it hurt so unimaginably.

People kept saying “but you still have two!”, “be positive for those embryos inside you!”. I couldn’t. I was convinced it was over.

We waited 8 more days until our beta test. To be honest though, I tested every damn day from my transfer onward. I did a HCG trigger again, like the first retrieval. So my tests were positive for many days. I wanted to test that trigger out. The tests got lighter almost every day, until they didn’t. They kind of went stagnant, with a faint little pink line for about 4 days straight. It was beta time and I actually thought, despite my pessimism that I might be pregnant. That they were slow to grow and probably slow to implant. I went for my beta and I got my results.

<1. I was not pregnant.

20k. 8 weeks of my life. Pain. Bloating. Excruciating waiting. For nothing. Absolutely nothing.

It was September 2. We had been trying for 1 year and 9 months with nothing but heartache and loss.

I called my clinic to make a follow up appointment with my doctor to find out how, why… they couldn’t get me in for a phone call for 6 weeks. 6 WEEKS. 6 weeks to ponder my failure, 6 weeks in the dark. 6 weeks of doing nothing to move forward. They didn’t seem to see the problem with this. They had made their money and that’s all that mattered to them.

I made a very crucial decision that day. I decided to leave my clinic. The clinic where I only ever spoke to my doctor 4 times in over a year. The clinic that screwed up and gave me someone else’s PGTA results and all their personal information. The clinic who I had to babysit at every damn turn. We only have two clinics regionally where we live, and I decided I was burning the bridge and jumping ship. Nothing can change if you do the same old things over and over. I wasn’t about to risk more money down the drain, it was mother effing go time. I wasn’t getting any younger.

Exactly 3 months before my 39th birthday I got my period and I got myself a new doctor.

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We tried ‘naturally’ for 11 months with one chemical pregnancy. When it came time for us to start IVF the feelings were bittersweet. On one hand we both felt so defeated and mad that we had waited so long to make the decision we had to try at all, and then angry that what other people get for free was going to cost us 20k+. On the other hand it felt very much like go time. We felt a bit more productive, but we still really had no clue what IVF entailed and what to expect.

I started out with a clinic that had a local office where I live. I didn’t know much about anything to be honest, and I trusted that my doctors and my nurses would guide me through the process.

I learned really fast that there would be no hand holding.

I got a phone consult with my doctor, and super quick monitoring appointments in the clinic. A crash course on meds and injections via zoom, and was left to my own devices.

I didn’t know what I didn’t know.

There were some things I wish had been explained to me in more detail. A few questions that arose were:

• What do each of the meds actually do?
• What are the stages of an IVF cycle?
• How long does a cycle actually take?
• Why did my doctor choose the protocol they did for me specifically?
• Should I be doing anything else to improve my chances?
• What are the risks?

None of this was provided by my clinic, so I started to seek out online forums on social platforms to ask these questions and get the lay of the land. I used Reddit, Facebook, Instagram and a few popular baby making apps. Soon, I realized there was a lot more to IVF that I wasn’t aware of. What I thought was an exact science was far from it. I’ll do my best as I write here to explain this stuff in case anyone new to IVF needs some insight.

There are a few stages of an IVF cycle.

• Birth control pills, estrogen or other hormones. Before you start IVF treatment, your doctor prescribes meds for ‘priming’. This can be anywhere from a couple of weeks to over a month or more.
• Ovarian stimulation, which this includes the dreaded injections (this lasts 8-15 days on average). During this stage your ovaries over produce eggs with the help of very strong hormones.
• Egg retrieval. This is where they extract the eggs you’ve grown, using a transvaginal ultrasound with a long needle attached. You’ll usually be sedated for this, but the type of sedation varies depending on where your clinic is located. You’ll find out the number of eggs retrieved that day.
• Fertilization is when they take your sperm sample and create the embryos. This can happen via standard IVF where they put a bunch of sperm into a petri dish with sperm and let them have at it. ICSI is another common form of fertilization where they inject the eggs with one individual sperm. You’ll usually be told the day after your retrieval how many fertilized. It’s common for not all eggs to fertilize.
• Embryo development happens over the course of 5-7 days after fertilization. It occurs in the lab, and usually no updates are given until day 5-6. The wait is painful.
• Embryo transfer occurs either on day 5 after retrieval if you have embryos that have met the blastocyst stage (a certain number of cells, shape, etc., or for others, all the embryos are frozen during a process called vitrification. Some may be biopsied before freezing for genetic testing for abnormalities. The transfer would then occur at a later date after thawing the embryos in the lab.
• Pregnancy…. that’s the goal anyway.
• Pregnancy Support is often needed with IVF, which includes taking progesterone and sometimes estrogen up to 10-12 weeks of pregnancy.

You’d think the clinic would tell us this, but they did not. We took it day by day learning as we went.

We started with a Saline Sonogram – a process where they insert a catheter through your cervix into your uterus, then pump saline solution into the uterine cavity to investigate it’s structure and rule out abnormalities. We then began our medications in November – beginning with birth control priming (more so to time the cycle to the clinic’s schedule). I started my stimulation meds (from here on referred to as Stims) on November 22.

I forgot to add that I am terrified of needles. Bloodwork makes me cringe, I fainted during an IV placement years ago, and am forever paranoid it will happen again.

Some couples have the partner do the injections, because it includes them in the process and they can look away. I am too much of a control freak to allow someone else to poke me if I can help it, so I did the injections myself. You do these injections generally in your belly, in a ring around your belly button while pinching the skin/fat.

I started on what is referred to as an Antagonist Protocol (never did learn why!), and was put on a dose of Gonal-F 300 IU, Menopur 150 IU, and Orgalutran .25mg. This is considered a fairly high dose due to my age. A few things I learned after starting stims:

• Stims are effing expensive (with no insurance coverage my Stims meds cost approx $10k CAD on top of my cycle cost for 11 days).
• Ice packs are your friend. 10 mins before and 5 mins after.
• Giving injections to yourself is scarier looking than it is in practice. I was TERRIFIED. After 3 days I was fine and could do it like a pro.
• When you start stims, giving an extra 30 minutes to prepare everything helps. Watching an injection video while doing the injections initially also helps (youtube is fine). It helps you follow along with the steps, including jabbing yourself.
• Some meds go in the fridge and some don’t. Making a list of steps helps you make sure you don’t mess up dosing or accidentally refrigerating something that isn’t meant to be cold.
• The timing is really specific. If you’re considering doing IVF and have a busy life with many obligations, it can be a big adjustment. Some meds happen in the AM while others happen mid day or at night. I did all of my first cycle of meds around 5:30pm because it worked for me at the time.

At the end of stims they make you take what is called a “Trigger Shot”. It’s one final shot which is timed exactly (!!!) 36 hours before your retrieval appointment.

With an antagonist protocol, here’s what the meds actually do:

Gonal-F (Rekovelle works the same), Menopur: Stimulate the ovaries and follicles to produce more than one egg at a time.
Orgalutran/ganirelix: Prevents ovulation of those eggs. If they ovulate, your cycle can be cancelled.
Trigger: Causes the eggs to “mature” in preparation to be retrieved. Mature eggs are the only eggs used for fertilization.

One thing they didn’t tell us is that if you have a hCG trigger, you can do a pregnancy test to confirm the trigger took. The trigger will show up the same as the pregnancy hormone will on the tests, so this provided a little bit of added peace of mind. This will only work with this type of trigger though, so caution against doing it with other types.

So we did our trigger at 8:00pm on December 3, one day after my 38th birthday and awaited the egg retrieval to follow on December 5 at 8am. I triggered and had one day reprieve from my injections in between as I prepared myself for the egg retrieval.

Our retrieval was to take place in a different city, since our clinic was a small satellite clinic of the main location, so we hopped on a ferry that next day, checked into our hotel and binged bad cable TV. I was bloated, uncomfortable, but so ready to get this part over with.

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