reflections on the ups and downs of infertility, and why I need to balance optimism and realism
When I was younger I loved roller coasters. Loved them. The thrills, the speed, the surprises. Then one summer in college I suddenly became afflicted with motion sickness. Even half hour car rides can make me feel ill, so I keep dramamine handy to avoid feeling sick in the car if I’m not driving. However, I have learned the hard way that dramamine doesn’t quite do the trick for roller coasters. I can only manage to participate in the simplest rides at places like Disneyland. Peter Pan, Snow White, Winnie the Pooh — those are the kinds of rides for me, and that’s still with dramamine. It’s disappointing to sit and watch Matt go on the rides that my former self would have loved, but it’s not worth the sickness. So I hold on to my happy memories of getting off rides like Space Mountain, feeling the rush and excitement…
Unfortunately, the roller coaster I HAVE been riding for the past two years has been the worst ride of my life. And unlike the real life, fun, roller coasters, there are no cheerful workers who ask us kindly to buckle up and keep our hands and arms inside the car at all times. There are no warnings about the whiplash that’s possible on this ride. There is no screening process or recommendations in the beginning making sure we’re capable of tolerating the ride. Nope. This is the roller coaster of infertility. Pure chance signed us up for this twisted ride of ups and downs, and emotional whiplash, and we’ve been struggling to stay seated in our coaster car as we’ve been jerked around month after month.
The ups are when things seem to be going right. When I have a good follicle count. When Matt’s sperm counts are good. When we try a new medication. When we go in for an IUI. When the results of a diagnostic test or procedure come back normal. Anytime I have built up hope that *this is going to be the month*. Last month, for example, Matt and I were *so sure* I was going to be pregnant. We were so optimistic and full of hope.
The downs are when things don’t go right. When I found out I wasn’t ovulating. When I was diagnosed with endometriosis. When there was only one follicle ready. When Matt’s sperm counts are not good. When I test negative for pregnancy and my period starts. When I am pregnant and it ends up being ectopic.
The twists and turns are when something unexpected happens. These unexpected events have done everything from throw us off balance to nearly throwing us completely out of the coaster car. Sometimes the fact that we’ve managed to continue hanging on surprises me. Things like learning that sperm counts can change daily threw us for a loop. Matt’s first low count surprised us — we were not expecting that news because his analysis had originally been great. When I was pregnant we had an abrupt turn when we learned that my progesterone levels were low. Enter: progesterone injections. This was a twist we did not expect at all, but we re-adjusted and got used to doing the daily injections at home. The worst turn of all was the oh, so very sharp turn, down and to the right, corkscrewing round and round and out of control when the evidence of an ectopic pregnancy in my right fallopian tube became clear. They had been monitoring me for several days before the diagnosis, but even the knowledge that something might be off didn’t help to brace us for the impact. We reached the bottom of that corkscrew completely dazed and in the dark.
In any given month of trying to conceive and any given treatment cycle there are so many opportunities for ups and downs, twists and turns. Before we were using assisted reproductive technologies (ART), we’d build up hope, I’d do everything I could to prepare my body for pregnancy, we’d play “the baby name game” as I call it… then my period would arrive and I’d be disappointed and sad. The more we have progressed into ART, the more monitoring and data there is — meaning that there are even more opportunities for directional changes. We know the number of follicles, the thickness of my endometrium, and the number of sperm. People who have been through IVF know their follicle count, how many eggs were retrieved, the number of fertilized eggs, and the number of healthy embryos. There are so many ways for things to go well or poorly, ways to be delighted or disappointed.
Please note that I am not suggesting that knowing the data is a bad thing — I want to know everything that’s happening. It may not be right for someone else, but it’s right for me. Matt and I have so little control in this whole process and knowing as much as possible is something we like. It helps me to feel more in control… it’s not much, I’ll admit that, but knowledge is power and knowing what’s happening helps me. So we ask for numbers and details. And if they are good, then we are happy! But if they are bad, then we’re undoubtedly disappointed.
Even though there are opportunities for ups, during infertility the downs are more common. And they seem to last longer for me. They stick with me and they’re so painful. They make me afraid to let the car ride up to the top again. Reaching the optimistic point at the top where I’m full of hope and expectation means that the fall is greater when it doesn’t work out. And this kind of fall is not the fun kind where I’m screaming with excitement. It’s the kind where I want to scream out with fear and pain and despair because all I can see is darkness and the coaster car is plummeting as fast as it can, but I can’t even manage to scream. And then I’m down at the bottom feeling hopeless, confused, and foolish for getting my hopes up so high again. The emotional whiplash of these transitions and falls seem unbearable at times.
Here is where I wish I could share some kind of wonderful miracle cure for the emotional whiplash of infertility. Unfortunately I haven’t found one yet. The only thing I can say is that I have learned that the best way for us to handle this is to try to balance our optimism with our realism — to be cautiously optimistic. This is not always easy… and not everyone understands why it’s important to me to be cautious. But I need to stay balanced. Full on optimism (like last month) will likely lead to a great big fall — so far for us, it has every single time. I certainly hope this is not the case for us forever, but I have to be realistic with myself. There are no guarantees with treatments. And as we’ve learned, there is no guarantee of a live birth even if I get pregnant.
Just like I can no longer tolerate real life roller coasters, I do not tolerate being thrown around by infertility very well either. Proceeding with half hope feels right. It feels safe. We need enough hope to keep trying at this point, but I stay cautious in an attempt to guard my heart. The ups and downs, twists and turns are still going to happen. There’s nothing we can do about that, but we can attempt to moderate our expectations. For now we hold on to the hope we have and our cautious optimism, and buckle our seat belts tight.