"Hi," said the young doctor, waiting at the end of the bed, now without his skull cap. I could tell from his awkward expression that something was wrong and was disappointed that instead of being here himself, our doctor had sent him. "As you know today, we did the oocyte retrieval... and I'm sorry to inform you, but there was only one egg." And with that, all the air seemed to be sucked out of the cold room.
-------------
I always think things are better the next day, but today I woke up with a dull ache in both the right and left side of where I gather my ovaries are, and my heart hurt. I felt dull too, and dehydrated, probably from the GA and from crying my eyes out the day before. I had cried in the hospital, cried all the way back home, cried at night and until I'd fallen asleep. In all the number of months that this has dragged on, I've shed quite a lot of tears, certainly more than with any other traumatic experience in my past (and there have been a couple of those, believe me), but I don't remember ever crying for this long or this hard. The nurses kindly gave us some space and time to check out of the room, though they could scarcely have not heard or noticed my puffy eyes.
I felt angry, angry at this whole situation (hardly a new feeling), angry at my doctor for having let this happen, for his process of medicines and combination of drugs that were supposed to do better, angry at myself, angry at these stupid ovaries and misleading follicles that had built up our hope over the past weeks, angry even at my previous doctor for talking me into four rounds of IUI stimulation when they may all have been equally empty of eggs.
I didn't want to get out of bed. Indeed, I didn't need to get out of bed to feel the raw edge of my impatience and my simmering, undirected anger. That there didn't feel anything wrong, or definitively wrong with me physically, seemed to amplify what was silently wrong. It seemed almost too awful, too shameful, too hurtful, to write out loud. Above all the latent angers was the one dominant outrage that this, the result of one egg produced, would have been the exact same outcome, had I never ever taken any of the injectibles. I had actively done nothing but administered harm to myself, confirmed my worst fears and crippled our hopes that we would soon, or ever, be biological parents. I don't know how many of you would truly understand the depth of that emptiness, that feeling of falling with no bottom, but I don't wish it on anyone, nor is it, I think, a natural feeling.
And although I started this blog with the intent to write it all out and get it out of my system, it has been days and I can't bring myself to write it out. I don't want to relive it again or make it real. I am still in denial, still moping, still gutted, still staring into nothing, and feeling hollow. That's the dominant feeling, hollow. Also lost, and sick. Still somehow wanting to live like it's not real, like it didn't really happen. And the best I could do was to write scraps of it on emails sent to myself and hope that one day it would mean little enough for me to piece it back together.
I waited, waited for something, anything really, to make me feel excited, or like actively living or writing again.
If you think the IVF process is weird, the recovery from one can be even more surreal. At a snail's pace, it seemed like I picked myself back up again. There was, of course, the one remaining egg, but for me, on that young doctor's announcement, everything had gone black. I am neither an optimist nor pessimist by nature, but I knew that the chances were very slim and to me, having already had such a poor egg production, meant that, logically, I wrote it all off immediately. I would have rather been surprised at a successful outcome and, as it turned out, the lab called the next day to say that there had been no fertilization. Not no germination, mind you, it had not even fertilized. The very one egg, on which we had hoped against hope, had been a dud, maybe be even from the moment it'd been produced.
At the beginning, it really seemed like I was just forcing myself through the motions of each day. The day after, my dear friend came over and brought our goddaughter back from their holiday in Japan, and we made breakfast and made berry crumble. I don't know if she could tell that I felt like a marble statue inside, but the good thing is, to most young children, it really doesn't matter.
For a few days, I fell ill (I now know that it was a temporary effect of the breathing tube they push down your throat) and I cursed the antibiotics. I moped more, refused to go in to work (although I didn't truly need my medical certificate), grumbled about the (marginal) sharp ache on each side where my ovaries were. To pass the interminable hours, I trawled online for a baker to make a croquembouche for my college roommate's wedding. I went back to work after three days, not because I felt a lot better emotionally, but because I didn't feel worse physically and being around people helped me to feel more normal.
I had my WTF meeting with our doctor, although this only happened two weeks after the failure (and a good thing too because I could barely hold back my tears with his nurse and the husband and I had a big fight of frustration on the morning of the doctor's visit), so I can quite understand that if I were an IVF doctor, I would not want to be confronted right away with rabid emotional women. He told us that my result was unusual and exceptionally poor, but without any real explanation, other than that, with high FSH, it is common to get a poor result with regard to the eggs retrieved and egg quality. Even so, the success rate across retrieval is typically 70%, not the miserable 1 out of 10 that we had experienced. It was difficult to tell what the quality of the egg was, nor the reasons for the lack of fertilization, given that there was nothing to compare against, having only produced and processed one.
He did not feel that we should stop, as we were young and had merely experienced the worst of the statistic, without also experiencing the best. He gave us some examples of women who had very different reactions to the same protocol each time, but he said he would not change the protocol because I had responded fairly well in terms of follicle production. In fact, I felt a suspicion that he did not think what we had been through was much; after all, it was merely 14 days of injections, and we were spared the ignominy and disappointment of failing after the transplant had already been done.
He also scheduled us right away, after a two-month wait, for a repeat procedure, explaining that we should not allow too much time to lapse, as I would benefit from already having been on medication, and that although my FSH would not necessarily be better, it would never be That much better. He brought up DHEA, which is a growth hormone, available over the counter in the US (and now, I'm told, in Singapore, where it has been legalized) and expressed his ambivalence. He didn't seem to think that we needed it, although he conceded it might help with the high FSH. We agreed not to go down that route, for now (although I would later feel insecure about this, trawling through web research regarding the low success rates in IVF women with FSH levels above 12). I felt much better at his words, or perhaps his conviction, and felt a little more like I could do this again.
The interesting thing is, through this entire process, I don't think I shifted from my fairly rational stance that having a child isn't a piece of cake. I understand well enough the tedium and sacrifices that are required from your own life and it's not that I'm chasing an idealistic and romantic notion. I don't think I have a rose-tinted version of parenthood and yet this whole process, is was wearing me down, and we were so far from anything tangible, struggling with our own internal incapability at ground zero, that it scarcely felt like the beginning and ending of the same subject.
Two weeks later, we left a hazy Singapore for Australia, then a wedding in Batam, then jumped on a plane to SF for my college roommate's wedding, the one that I was worried, almost six months ago, that I might not be able to attend. I wanted to leave it all behind, furiously and gloriously. I had a great time being away, I stopped thinking about it and being sad, as we sat on the plane that took us further and further away from home, away from our preoccupations and misery with what had become an awful, time-consuming, disillusioning and sometimes what felt like a delusional process.
For a brilliant two to three weeks, I stopped thinking about any of it at all, mainly because no one asked, because our surroundings were new and unfamiliar and being surrounded by friends and so much love, independence and happiness that it made us feel whole again. In the US, my friends come from such varied backgrounds and do such different things that there seems to be much less a season to nest or give birth. I do have friends who are new mothers (much fewer) and pregnant mothers (much fewer also), but in general, most of them are working on their careers, some are also trying to conceive, just as many are dating, enjoying their marriages, travelling or considering gay marriage. Children are just one of the many things you do, unlike how wrapped up Asian parents and mothers are in their role of parents. It felt normal and, by extension, I felt normal too.
Walking around my college campus and revisiting places I had been when I was last 18, or 20, or 22, was bittersweet. Saying those old, familiar names of streets and dorms and food again was itself like an ex-lover; it did make me think of the time that had passed, but it made me, thankfully, equally happy and sad. It made me feel young, rather than just remember what being young felt like. Lulled by the smell of eucalyptus and the cold Californian nights air, I slept like a baby while staying with friends who are resident deans living on campus. During a solo 10-hour drive from SF to Portland, I stared at the empty straight road and listened to new and old music as I drove. I felt the cool wind on my face and looked out at the dry yellow hills and bright blue sky giving way to broad green rivers and the musty cold of dark swarths of evergreens. I stayed at cheap little roadside motels, filled up on gas station donuts, danced on the sidewalks and spied families of deer near the streams.
I felt lucky, and grateful. I felt like myself again.In the last week away, while I was passing through Korea for a business trip, I found my cycle dragging on to 30 days, with little sign of bloating, then 31, 32 and 33. I know what you're thinking and isn't it funny, despite knowing better, I also begun to hope and pray that miraculously, our wait might be over. I revelled in the many symptoms — those many symptoms you always feel when you are waiting on something. Everything becomes a symptom, how I was more tired, more hungry, how the PMS feelings had passed, that I needed the bathroom after every meeting. How marvellous it would be, how comforting, how purely relieved I would feel. I tried to hold myself back from even these thoughts, to quash them because thinking it aloud would make it not come true! I knew how many times in the past I had allowed myself to imagine what it must be like to finally say it out loud, how I would tell my bosses, the decisions we would make, how pleased our parents would be, the feeling of walking into the quiet, dark nursery and pulling out baby blankets I had forgotten that I'd bought years ago. I tried not to think any of these thoughts because I had thought them all in the past, only to have my hopes dashed by a negative pregnancy test and to feel like a fool.
On the 33rd day, I could no longer wait to find out and I took the test; as all the eight tests had been before it, it was a resounding negative. I cracked a wry smile, thinking that over the course of your life, you probably have trepidation in all these pregnancy sticks, first hoping that they would not be positive and then hoping madly that they would, against logic or reason or pain, be positive. But it was merely another sign of my body recovering from the IVF medication. It was true that the PMS pains had passed; in fact, the luteal period was so long that I had sustained basal body temperatures for a week longer than normal and the bloatedness and tenderness had long passed.
(I wanted to inject something here, and that is that, as much as I have thought about, and other people have suggested, taking some time off work, in truth, my work isn't stressful from a work hours point of view. There have been many days when I'm cheered, or intrigued, or happy about something that has happened at or through work. There have also been many times when I have been deeply grateful for the distraction and consuming quality of having something else to do. For example, in the last few days of my endless cycle, the question would float up in my mind, every hour. Every hour. I timed it at one point. Once an hour, at least, even with all my mind turned against telling myself, it is what it is. It is matter over mind, always, in these circumstances.
Only in the hours where I was preoccupied in a meeting did this question, and more importantly this longing and aching, go away. When I was in a translated meeting, however, where I didn't need to pay as close attention, the thoughts and questions immediately floated back up in my mind. Only when I was consumed with something else, like screwing my attention to managing a portfolio of companies, or making rational deductions in trying to write a paper, or washing my eyelashes with facial soap, did I truly achieve a measure of quiet, if busy, peace. Would staying at home, or being so free with every single day, really make me more relaxed and preoccupied? I don't know, but I somehow highly doubt so.)
It took a couple of days this time for me to have that long, desperate cry, and it came one morning, sat in the car, after a few days of testiness and tearing randomly at my desk. We had also tried naturally this month, over a longer period (just in case the luteal period was extended, which it was), but now I was tortured by the thought that I might be just producing aimlessly empty eggs or poor quality eggs each time. Even if they were of decent and not horrible quality, how long, I asked myself, was I going to keep doing this (meaning, trying with IVF) and did I really have the resilience to keep voluntarily medicating myself?
Although it now left me to be able to travel or act freely, in reality, I felt even more entrapped in my own condition. Partly from being back in Singapore and partly from having to revisit the hospital for the next round of pre-IVF check-ups, slowly but surely, I feel myself slipping back into the emotional tiredness of having to confront this nightmarish saga again, and day after day. It does not get any better. It gets worse. And the worst part of it is, even though we are on the verge of a second cycle, I still don't know what to do.
