Foreward by ~ Kellie Asaro (site founder)
IVF twins are becoming commonplace among women undergoing infertility treatments these days. Mother's expecting twins (and even those who already have them) will often be asked by perfect strangers if their particular twin pregnancy was due to infertility treatments or IVF (In Vitro Fertilization)...as if it's anyone's business. And what does it really matter anyway? Needless to say, they will still be asked. How they answer however, will vary.
I think the unknown is always intriguing, hence the inevitable inquiries. What most people don't, and will likely never fully understand, is the amazing, stressful, chaotic, painful, surprising, depressing, confusing, inspirational, journey that women undergoing IVF treatments embark on....and I have only scratched the surface on the scope of emotions.
Luckily, there is a growing sisterhood of women willing to share their
own stories of IVF and twin pregnancy. I was happy to be able to
connect with one of them myself and get her take on the process.
She's a mother of twins, as well as an M.D., so her story includes much
of the "science" behind infertility treatments as well as her
refreshing, frank, sometimes humorous account. Please read her story
I'm not sure what I've got planned for thirty-two as yet.
I'm writing a little on the IVF process and my experiences, from astride the stirrups (so to speak), instead of the clever version that comes with the brochure in the average clinic showing Happy Couple + Infant on the cover. I don't have any objection to the clever version, other than that it all sounds so very neat and tidy and life is rarely so. Presumably for some people it IS. But for many it's not simply a few injections along the way, a nice sleep in an operating theater and BAMMO, babies (sometimes several at once, even).
No, IVF is not quite like that.
It's also not ten inch needles and rivers of blood.
The truth is, as is often the case, somewhere in between. It's not That Scary but it's also Not Especially Fun. Additionally, the main thing the brochures completely neglect to mention is that very few couples wake up one day with a spare ten thousand dollars burning a hole in their pocket and think 'I know! Let's do IVF, just for kicks.'
It's totally normal to be fairly wrung out by a couple of years of fertility treatment and persistent not getting OR not staying pregnant before IVF looms on the horizon. It's normal to feel like you've hit the end of the line. It's normal to be a bit scared about the whole thing, and rather more anxious than a long-tailed cat in a rocking chair factory.
Me? I was an utter irritating mess during my cycles. I distinctly
recall, with more than a little shame now that I have the clear vision
of hindsight that the retrospectoscope provides, lying on my couch all
weekend after my first transfer, obsessing that the ride home may have
dislodged a precious embryo, and mortally convinced my feverish feeling
meant I'd gone and caught raving endometritis from the transfer catheter
and the whole thing wouldn't work. Although it is always irritating to
hear ex-IVFers roll their eyes at this sort of worry when it's YOU in
the firing line, I'm going to go out on a limb and say that it IS
actually okay to carry on like normal after your transfer. Success rates
are not influenced by how horizontal you are in the two week wait.
But I'm getting ahead of things. Who am I, anyway?
I'll share my experience, since like most people I find it very easy to talk about myself. My story is not that uncommon, but note that the reasons you may reach IVF personally may be quite different from my own. The details of my cycles may be slightly different to yours, but the general process is much the same and I suspect my emotions were fairly typical.
I have a fairly common condition called polycystic ovarian syndrome
which means that not only do I not ovulate on my own, but I get some
pretty impressive acne. For most of my adult life, to be honest, the bad
skin was my major focus and I spent a veritible fortune on potions and
the contraceptive pill to banish them. But then my husband and I decided
to have a baby.
We didn't suceed for the first year because it's hard to get pregnant when you don't ovulate. The first infertility treatment I took was Clomiphene. Clomiphene isn't so bad, since there's nothing sharp involved and there's not that many side effects for most women. I had a few hot flushes, but that's about it. I responded to the medication.
Caution! Science content:
I'll be very honest, all of this attention on reproduction didn't do
much for our you-know-what life. 'Honey! I'm ovulating!' doesn't rank
all that highly in the wink-wink stakes. It's not an uncommon problem in
couples with infertility.
Although I was now ovulating, that was not enough on it's own. Further testing revealed that like about a third of couples with infertility, both of us had reasons to explain the lack of two pink lines. We had male factor infertility in the kind of range for which ICSI is utilised. ICSI requires IVF.
Caution! Science content:
As we were preparing ourselves for the possibility of IVF, we got very
lucky and had a spontaneous pregnancy. Unfortunately, our baby had a
lethal birth defect and there was not going to be a happy ending. We had
to start again.
This meant that upon entering IVF, we had all the emotional baggage that
goes with infertility along with the misery that is unique to those who
have lost a pregnancy. There are many women who go through far worse
before IVF, but whatever your situation, pain is pain. I would never
advocate comparison or ranking struggles, although I will admit I often
used to peek around the waiting room of my clinic and wonder why the
very young-looking lady with the snazzy red shoes was there, or why
blue-shirt woman looked so sad that day. But I'm quite nosy. Most people
read the magazines, or at least pretend to read them.
The IVF process, to begin at the beginning, usually involves some combination of the following elements:
Caution! Science content:
So, how does all of that feel?
Personally, I would say that down-regulation feels like an early taste of menopause complete with hot flushes and horrid sinus headaches. The stimulation phase is better as hormone levels improve and humanity is restored. Every scan is a little scary because dosage is always a bit of a guess, especially in the first cycle where there is no previous response to compare with. Our first cycle went well. We had great fertilization rates, thanks to ICSI manually banging the sperm into their destination. We had lots of good embryos.
We didn't get pregnant.
I bled before the beta.
So we tried again, using some of our frozen embryos.
Caution! Science content:
Because of my natural disinclination to ovulate, we opted for an
artificial cycle. Unfortunately I am one of a small number of women for
whom that doesn't work, and I started bleeding within a few days of
transfer (well before the embryos could have begun to implant) and did
so despite increasing doses of progesterone until we abandoned the
Obviously, I didn't get pregnant that time either but it was by far the hardest emotionally.
It is one thing for IVF not to work, but go according to plan, that's expected. We all know that success rates are far from 100%, even in the best of circumstances. It is heartbreaking when the whole cycle goes comprehensively pear shaped.
Finally, after nearly three years of trying to achieve a viable pregnancy, I put on my best stirrup socks and we had one more go at a frozen cycle with a change of protocol to include me ovulating. Then I almost completely failed to do that critical part. I think I have the record at my clinic for the longest frozen cycle, given I was nearly cancelled three times and finally ovulated on cycle day thirty-something. I cannot describe the tension at this point. Nail-biting is too much of a cliche and not strong enough worded, unless you're referring to perhaps an elephant's nails.
I got my transfer of two okay'ish embryos and we added a bunch of progesterone supplementation. I then cynically forgot about the whole thing, went to the pub, ate sushi and drank red wine in fits of misery, convinced that none of it mattered, anyway. I got my first positive pee-stick at only a week post transfer.
My beta was very high.So was the second, and the third. By the fourth
beta I got enough of a hold on my fear to stop harassing the
phlebotomists to take my blood.
At the six week scan there were two heartbeats.
I spent the entire first trimester in terror that I would miscarry. I
yearned to have the reassurance of my head in the toilet, talking on the
porcelain phone but apparently I am immune to HCG. Despite conspicuous
absence of any symptom other than ravenous must-have-toast-in-bed-at-3am
hunger and truly painful fatigue, I stayed pregnant. The moral of the
story is that a lot of symptoms do not guarantee a healthy pregnancy and
an absence of them does not mean all is lost. If you're not vomiting,
At the twelve week scan there were two normal babies.
I started contracting at twenty weeks, but that (and the risks of multiple versus singleton pregnancy) truly is another story. I type this with twins complaining in the background that it's, most emphatically, no longer nap time.
Summary? If you're struggling with infertility or doing IVF, talk to somebody. You are comprehensively not alone. There's a fantastic online community out there who've all been where you are now.
On to the next step - See my article on Twin Pregnancy Complications
Feb 18, 19 01:52 PM
The placentation of twins refers to the the type or structure of the placenta during a twin pregnancy. Monochorionic, monoamniotic, dichroionic, diamniotic
Feb 16, 19 04:06 PM
Identical or fraternal? Twin zygosity is the medical term relating to each type of twins. See ultrasound photos and infographic to more easily understand
Feb 16, 19 01:15 PM
Understanding vanishing twin syndrome. See symptoms, causes, new data, statistics, photos and FAQs.