Episode 80SN: An IVF Journey that includes repeated miscarriage…and pregnancy: Amy’s Story, Part II

This is a show that shares true experiences of pregnancy to help shift the common cultural narrative away from the glossy depictions of this enormous transition to a more realistic one.  It also celebrates the incredible resilience and strength it takes to create another person and deliver them into the world. I’m your host, Paulette Kamenecka. I’m a writer and an economist and the mother of two girls. In this episode you’ll hear more advice about things to think about on your fertility/ivf/pregnancy journey–knowledge that just might make the often challenging process of fertility a little easier to bear (and maybe also things to help you to keep hold of a bit of your sanity, as her book title suggests) from the former writer who covered the “fertility beat”, before such a thing existed, for the New York Times. What follows is the second part of our conversation.

Fertility Statistics

https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2014/03/female-age-related-fertility-decline

https://www.acog.org/womens-health/faqs/having-a-baby-after-age-35-how-aging-affects-fertility-and-pregnancy

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8237340/

Tongue-Tie

https://www.mayoclinic.org/diseases-conditions/tongue-tie/symptoms-causes/syc-20378452

https://kidshealth.org/en/parents/tongue-tie.html

Audio Transcript:

Paulette: Hi, Welcome to war stories. This is a show that shares true experiences of pregnancy to help shift the common cultural narrative, away from the glossy depictions of this enormous transition to more realistic one. It also celebrates the incredible resilience and strength it takes to create another person and deliver them into the world. I’m your host, Paulette Kamenecka. I’m a writer and an economist and a mother of two girls. In this episode, you’ll hear more advice about things to think about on your fertility/IVF/pregnancy journey that just might make the often challenging process of fertility a little easier to bear, and might help you keep hold of your sanity in this process. This story comes to you from the former writer who covered the fertility of you before such a thing existed for The New York Times what follows is the second part of our conversation. 

Why is it so constricting of your time other than like the windows were like, Oh, we, I guess I don’t even know what the windows look like what?

 

Amy: So let’s say you have to go in on the first day and if you don’t know when you don’t know when you don’t know when you first see is you don’t know when you hit. You’re not supposed to be drinking. Usually I’m not a doctor and so I’m not giving any medical information but a lot of people don’t drink and let’s say don’t even do drive through or whatever they want to ruin their psychology. You know, marijuana can cause firm documents. So do not get in. Let’s say you go in the first day of your period and if you go the third day and the fourth day seven planets around your work, then you have to see how your body then you’re taking medicine to increase the egg while you’re doing an IUI or an IVF. Medicine so you don’t know how the medicine might keep you up at night. You might be sleeping, it might be bloated. Then you have to do a retrieval which is like a half a day off but you don’t know if you could go away you don’t know is there going to be on day 14 or 16 if I got am i doing a transfer my cancer the embryo back to me and am I gonna guess take it easy those days that I have to wait two weeks or a week and a half to find that out or not? And then I might be a little bit pregnant, and then I might be not pregnant. So I mean, I don’t even taking over your entire life.

 

P  2:32  

Yeah, yeah, that is dramatic. When I remember about my experiences that I felt judged not by my doctor, but by the process. The idea that as a woman you could or should be having babies and so it’s culturally reflected back to us in 100 different ways. And when your personal machinery to make that happen, they’d be feeling you. It’s hard to feel as though you’re doing something right. It almost felt like like a moral condemnation. Oh, you know what am I going to save my ovaries not working. You’re not fit to reproduce, or it just it felt very personal in a way that some issue with my with my appendix with them.

 

A  3:10  

I mean, I hope that the doctors are better now than they were then. You know, you’ve dealt with women at the clinic. But then you’re like on Facebook at a meeting about someone else. Oh, I only got 20 eggs and you’re like what I got three eggs. And then there’s that competition is rife with so much disappointment. Like once you’re the thing Oh, I only got 20 eggs and only kind of fertilized and only five minutes day three and the only one ready for transfer. So there’s just you know, this law of diminishing returns on your disappointment. But there is for anyone who can’t get pregnant right away. Just this notion that we all thought it would be easy, and it would be quick and it would be simple. There’s that whole disappointment of like my body’s failing me I’m not doing what I thought would be easy to do.

 

P  3:59  

As me suggests it would be super easy to get pregnant. idea that felt like a threat before I was ready to have kids and a taunt once I was ready and couldn’t get pregnant. But I don’t think that I did matches up with the numbers. So here’s some of the numbers. According to the American College of Obstetricians and Gynaecologists, also known as ACOG. You had your maximum number of oocytes or immature eggs when you were a 20 week old fetus, which was six to 7 million by your birth to down to one to 2 million. By puberty, you have 300,000 to 500,000 by age 37 with 25,000 and only 1000 By age 51. This is a sight on here but I thought this was pretty funny. I was telling my daughter about these numbers and she said that’s fine. It’s not like a little What 25,000 Is what I’m 37 So the issue with that is that not always xx will be chromosomally normal, otherwise known as euploid. Sperm mature over a period of about two months. Eggs mature over a period of decades. It sounds like there’s a lot of stops and starts they mature to a point and then they wait and then the next trigger happens and then they continue to ensure it’s not like these miniature eggs are active for the whole period. And it’s important this very long maturation process that scientists think contributes to the much higher rate of chromosomally abnormal eggs that’s firm. By the way, male fertility also declines with age but less predictably. The American Society of Reproductive Medicine reports that while women under 30 have about a 25% chance of getting pregnant naturally each cycle, that chance it drops to 20% for women over 30 Forget estimates by the American Society of Reproductive Medicine by 40 the chance of getting pregnant naturally each month. It’s just 5%

 

A  5:45  

you know, just like you need medical medical, you didn’t think you would, you know you just thought you’d get up at the doctor for when you’re pregnant. But you didn’t think like this basic bodily function is not you know, I think like a third of IVF patients are under 35. So it’s not a matter of needs a lot of young women going through this Ludhiana Linda. So it’s not like oh, I’m too old and I waited too long, but also like oh my god, I’m so young and all my friends are getting pregnant and I can’t that’s such a hard feeling.

 

P  6:16  

Yeah, that was definitely a hard feeling. It was definitely a hard feeling. But I agree with you that it this is like a cultural perception of what men expect your body to do and what it means if your body can’t do that. And it’s not necessarily accurate, right, your body can still do a million other things.

 

A  6:33  

I’m sure though people who have diseases might be mad at their body to you know, yes or no.

 

P  6:44  

So I’ve always been issues in cancer and I can, I can attest that at least in my experience, there is this sense of failure of like, how did I you know what did I do wrong to get to this spot, although that also and pregnancy are less than this. You don’t have that much control over your right. We imagine that we deal with but we don’t really

 

A  7:06  

  1. You know, right? You don’t know how your body’s going to deal with anything. In life. That’s the truth.

 

P  7:14  

So you did all that and had miscarriages and then he did, did you say nine cycles of IVF? Yeah. How many years does that take

 

A  7:29  

it was three years until I was pregnant with my daughter. So it was four years until I had my daughter because it wasn’t like once I had my daughter, I knew she was going to be my daughter for i for all intents and purposes, I was never sure she was going to be born either. You know, so that fourth year was brought during her pregnancy. Well, because pregnancy after it’s good after IVF but also after a miscarriage is very fraught like my doctor said to me, you’re not going to be happy until the baby is in your hands. Because I was like, why am I not happy? He’s like, because of what you’ve been through. Yeah, that’s,

 

P  8:07  

that’s a hard road. So did you enjoy the pregnancy at all? Were you able to?

 

A  8:12  

I think I had a moment in my second trimester. You know, there was a moment in my second trimester where I was like, we went on a baby man and everything but I think that I was very, a little bit dissociated from it. In the whole time like my heart we had a rule because we have a whole heartbeat monitor because like I would go to the doctor I would get everything would be great. And then by the next day, I was like, I don’t know if I you know, cancel a baby. So my husband we put a cap on it that I was allowed to check the heartbeat once a day on the home heartbeat monitor, and even that and my husband used to do the state, like you need cream to put it on the ultrasound jelly. And he was let me try it without jelly. And like I would still you know, I would still lose my mind in that moment before I felt the heartbeat. So when I was like nine months pregnant, and I was dealing with you know, at the end of June and July and everything I felt pregnant, but I never like allowed myself to leave in full for like I talked about this in the last chapter in my book about you know, pregnancy after miscarriage pregnancy together. IVF and there’s a school and this is you know, for everything. Electrification like Oh, I’m happy, you should be happy. And like, I hate the word. Like you shouldn’t be happy, okay, you know, my body. Don’t tell me how to be like, I’m nervous and I’m understandably nervous and I can’t be happy. You know? I’m sad that IVF and more repeat miscarriage do not ruins but robbed me of that experience of being you know, the happy go lucky. But that’s just what a lot of people have to go through.

 

P  10:05  

Yes, yeah. Amy talks about the complicated feelings that accompany pregnancy after repeated miscarriage. She writes that if you’re like me, and so many other women who grow to motherhood was as wealthy as a bouncy castle, you might not exactly have the pre pregnancy always dreamed up. You may no longer have the desire to post Tietze but in the oven gift on social media, have a gender reveal party with a pink or blue cake or endlessly debate baby needs. First of all, you might not want to do all of that sensitivity to all your friends who are still adding second, you might be too nervous. I myself have been pregnant so many times that at first I couldn’t believe this fifth pregnancy was the one that was going to stick. And then she writes with a heartbeat came relief but only momentarily. A few days later, I’m back to worrying again. After all I’ve heard a heartbeat once before and after this he ended it because I hadn’t been paying enough attention now I was paying attention to every swallow twinge flutter. always nervous while I wasn’t feeling anything in particular pregnancy was so so tense. Even when I pass the in utero blood test for major diseases and move into my second trimester. I still couldn’t relax. I couldn’t be happy not for longer than two minutes. I was having what I later realized was infertility PTSD. I can’t imagine you’d be any other way after your experience. Right? I mean, then

 

A  11:26  

people you never know. You know? Some people on IVF people are not. Well, some people like a pregnancy anyway. They hate every minute of it. They also have to deal with oh, why are you healthier? You should be happier. You don’t have happy hormones. It’s gonna ruin the baby. You know, almost expectation. It goes I mean for fertility people it goes farther back with like, oh, you should be happy for her. Why can’t you be happy for her? You know, your best friend’s pregnant your sister’s pregnant? Your brother in law’s pregnant and you should be happy for them. You know, it’s funny like in the last 10 years, so much has changed, like fertility has got better and more people have done it but sitting on all these Facebook groups, which didn’t exist when I was going through it, but like, it’s still the same emotional journey. You know, like people just complaining that their mother is yelling at them. They’re not acting happy for their sister. Or you know, things like that. It’s just an expectation about how we should feel is ridiculous. And I don’t know if you can explain it. You know, I always tell I always say that. I went through so much with infertility and still when I was pregnant and I had some that I kind of understood finally why other people want you like to share that joy. So I do it from both sides of the aisle. But we can’t expect anyone to like have feelings for us. They have their journey and we have Arthur.

 

P  12:50  

It is it is hugely complicated. And I remember going to the gynecology office when I wasn’t yet pregnant, surrounded by pregnant women, you know, waiting my turn to do the IUI or whatever, you know, just overwhelmed by the sense of like they’re making it look easy. A lot of pregnant people out there is this is true. You seems hard to me somehow.

 

A  13:11  

I mean, the nicest thing I always say this, my oldest friend was growing up. The nicest thing she said to me was she had four kids and her oldest was eight. So I had assumed she was like totally done. And I was trying to hear about something. And she said, Amy, I have to tell you something. I’m like I don’t know. And she said to me, I just need to tell you that I’m pregnant. And but you don’t have to be happy for me. I just want you to know that. This still makes me cry because I’m always like, that is the nicest thing anyone ever said. Like just letting you know, you don’t have to monitor your reactions for me like you could just be who you are.

 

P  13:48  

Yeah, I agree. I agree that I would imagine you feel seen when someone says yeah, because it is like a recognition of all the things that you’ve been hurt. Yeah, for sure. Amy has a chapter in her book about managing your feelings about other people’s pregnancy in the face of your infertility. I’m going to share another excerpt here. She writes, how culture can often perpetuate the myth that female friendships are Ride or Die through thick and thin Sex and the City girls etc. Reality lose friendships are rough, especially during life changes and extra especially when one of us is pregnant and one of us is not but desperately wants to give it to someone else to make room for their infertility feelings, or your pain or your fears for the future. And that’s a relationship where it’s safe. Because through the delivery of your daughter, I don’t know though. were you imagining you know, a water birth or you know, home birth or something like that,

 

A  14:44  

or what did that look like? You know, just it’s funny so I had all dated during my journey I went and all these alternative journeys as well. Like I went to baby healer who told me I had locked maternal energy. I went to the

 

P  14:59  

stop right there. So I’ve been to a Reiki healer as well. What do you think? Were in the moment where you’re like, Oh, this feels better?

 

A  15:07  

What was your reaction? I think I went twice so it must. I can’t What did I think I thought okay, I’ll try it like to think that I have very bad association with motherhood given my own family history, and I don’t have a good energy for motherhood and I have to connect to like the positive energy for motherhood.

 

P  15:33  

super interesting.

 

A  15:35  

Probably not really relevant to my journey. You know what I mean? Like it’s it didn’t solve any of my issue.

 

P  15:43  

Okay, totally interesting. So let’s go through that. I’m totally interested in the that once the conventional things don’t work, all you have left is to try all the alternative.

 

A  15:51  

Exactly. So I went to I went to the Jewish ritual bath, which many religious women go to every month after their

 

P  15:58  

bed. And what’s the what’s the theory behind that?

 

A  16:01  

Why is that supposed to help? Well, religious women go through actually something that’s very good for fertility basically, I don’t know if people know this. But they are not allowed to have the week of their paid and a few days after. So they’re basically abstaining from sex for the first 12 They’re basically having sex in the most fertile window. Their cycle if their cycle is normal and not normal, then they have a lot of trouble. So they could have the ritual bout themselves. There wasn’t something I was ever planning on doing. So some people go there and they say, they blessings and everything like that. And I just, you know, it’s one of the things I was doing making that kind of thing I was there. But one of the things I did after the Reiki healer, which was you know, not only it was also try to picture the picture, you know, lying on the table Q hospital scene of the woman screaming in pain, I mean, I always knew I was gonna have drive like after my journey, I’m like I but I always try to picture labor and kind of picture picture picture. I was like my, you know, law of attraction moment like picture giving birth. And it didn’t happen that way. Because the closer we got to Brenda, I was 40 What I really wanted and I was trying to avoid a C section at 40 weeks. My repeat miscarriage specialist by Amy I really liked you to know you’ve been through. I’d really like you to give birth. I was like just getting you to 41 He wasn’t even my, my maternal fetal medicine doctor. He’s like, he’s like, you can’t have 41 Like you work too hard to get here. So I just was like, No, my dad is going to come out. She’s going to come out now that I know her. And I know that she’d leave like her father all the time. And I think I sat in there for 14 So 14 and a half years. And at that point, I realized that you know, despite all my imagery of radicals, neighbors, friends, I was kind of like on the fence. I was like, I just like I don’t care their way of doing. I know what happened. When we started. We did the epidural, and they said that the baby was not taller. It wasn’t like an emergency C section. They just said she wasn’t tolerating it very well. So we’re gonna move into a C section. And I crazy. In the last month of my pregnancy, I had this crazy itchiness and it wasn’t due to any. Sometimes it has to do with like a liver problem, but I was just like praying for the baby. That’s when they gave me an epidural. I was like dying from fussiness and they gave me this massive dose of Benadryl. That’s kind of out of it. For the C section. There’s a little bit out of it, and I haven’t C section and my plan was not followed at all. I was still mad and my husband didn’t. I want I didn’t want her to be. I wanted her to have her right away. I’m still kind of upset about that. But I was on the fence at that point. I wasn’t going to ask for like a scheduled C section but I was like to do it.

 

P  19:17  

And so they did the C section and then they you get the time with the baby on your chest and how did you feel when you actually had her in your arms?

 

A  19:27  

I was super out of it because it was Benadryl. I was happy. It was beautiful. It was like it at NYU downtown overlooking the water. Like we had that picture. It wasn’t like oh my god, I finally have the baby. My whole infertility journey was over. I can just relax now it took a while. You know, and I don’t know I don’t know how like a woman who wants to be home. I feel like I don’t know. I don’t have anything to compare to but there’s definitely like, I was definitely more nervous and I think if I would have just had a baby, like just straight. You know, I was like, nervous. I was always checking if she was awake. I was checking her heartbeat monitor and I know that a lot of newcomers. But I was that’s not my personality. It definitely is fertility made me a lot more overbearing and nervous than I would have been. And I think that there was like, you know, and then, of course you know, it’s so funny like when you’re not fighting but like when you ran a marathon. Then after the race you like, you want to have your medal, you know, and then you can relax. But after we have the baby, you’re like your baby breastfeeding and everything else that comes with it. So it wasn’t like you have time to go and do things like the first six months. I think it wasn’t like I didn’t have trouble bonding with her. But I don’t think I felt like I can release that breath. It took me a while to be separate even while figuring out breastfeeding, which is like the second part of the world after infertility.

 

P  20:57  

Well, you took four years to wind you up. So I can’t imagine you round down you know, immediately so that totally makes sense to me. And the extra attentiveness once the baby’s born also makes sense given that IVF kind of opens this, like pull the curtain back to show you what it looks like when things don’t go well. Medically. Right. Which is

 

A  21:20  

right, correct for a lot

 

P  21:21  

of us because we’re relatively young and we have kids. You haven’t seen that before. And it is a little bit shocking, right?

 

A  21:28  

I mean, I think I read a statistic that many women never send in the hospitals giving birth. Yeah. And I think I was also one of those people who just believe everything’s going to work out. I mean, I moved to New York City at 39. I moved to the Upper West Side and I met my husband. So that’s takes a kind of optimism that make the fire.

 

P  21:50  

That’s awesome. And so it sounds like the fourth trimester for you was challenging like it is for a lot of people. Yes. Did you get the hang of breastfeeding or how did all that

 

A  22:00  

go? No, I had to have my daughter’s tongue tied. Because she was I was pumping. I was explicitly pumping and she was not getting anything out. And then finally lactation consultants told me to, you know, get her time steps.

 

P  22:20  

According to the Mayo Clinic, tongue tie is a condition in which an unusually short thick or tight band of tissue connects the bottom of the tip of the tongue to the floor of the mouth, which restricts the 10s range of motion. Although doctors don’t know why it happens, they know what happens during fetal development. If a newborn has tongue tie, it can make it difficult to stick out their tongue and it may or if you’re breastfeeding, sometimes tongue tie might not be a problem. And sometimes it requires a simple surgical procedure, like the one we described, where the doctor clips the tissue to free the top. That tissue doesn’t have many nerve endings or blood vessels. So often this procedure is carried out in the doctor’s office without anesthesia and babies younger than three months old. And so and you said now she’s seven and a half. Oh, wow. What she is who? She does her singing

 

A  23:11  

damn fan talking and arthropathy Yeah, so she’s nonstop talker.

 

P  23:19  

That’s cute. Is that is that a run in your family? I guess. Like sometimes

 

A  23:27  

I was on. I don’t I don’t know if I mentioned this, but on my have the BBI with integrating High Courts of immune suppressive drugs. I don’t know if you are. But I can move on. Very high dose of prednisone steroid that is controversial, but you know and it makes you crazy. So I always joke I was like I was the steroids but she’s so like, everything is amazing. Everything with our daughter like a 10 She’s on either amazing or horrible traffic.

 

P  23:58  

That is super cute. So I’m actually a weird outlier. I love Britain. So I’ve been on a bunch of times. And it is the kind of thing where like, you never get tired,

 

A  24:07  

never feel tired. It’s like, sometimes you wish I was like, oh I can be but right now.

 

P  24:15  

Totally. But that’s amazing. She sounds horrible.

 

A  24:17  

Yeah, she’s great. And she just we just got it together.

 

P  24:24  

Wow, that’s fun. So I bet you have a lot of advice for younger you. But if you could give your younger self advice what what do you think you would focus on?

 

A  24:36  

Well, if I would give any young women not only young women, young self, but just any young woman is I you know, we all know so much about our politics and our finances and I just wish that we knew more about our body. And you know, people would say Oh, do you think every woman should freeze their eggs? I’m like, I don’t care if people and I don’t care if they even have children. Norma, I just like in their late 20s. I want them to know about their body and they want them to know if they have people that might be if they have no period they want them to know that might be PCOS. They want you know, I speak to so many women in their late 30s When a lot of these things interfere. I just want everyone to be educated. And I think what happens is there’s so much going on in the world and there’s so much to be worried about. I think, you know, young women who don’t have a partner or don’t know if they want to don’t even think about it they don’t even look and they’re like I’ll deal with that only up I just want every author and every woman even men know your family history. Like I didn’t find out until who knows when that my brother had blood circulation issues. Hello blood circulation issues are gonna affect me as well. You know, I just want people to know whether I just want everyone to make an informed decision and have all the information just the way you would about like buying the house or just not that information like demands that were female empowerment.

 

P  26:03  

Yeah, it is. It is amazing. And I think a lot of us, myself included, learn a lot on a pregnancy journey. Well, when things don’t go well and when things do Right, exactly. We have not prepared to do it earlier. If I would give advice

 

A  26:16  

for anyone who’s having fertility issues and also just this is a finite moments in your life. It feels like it’s gonna last forever, but it’s not going to last forever. So like, you know, you know, even though I had that picture in my mind of having the baby on the table, and I didn’t have it the way I wanted, and you might not have the kid the way you know, but you might not have it the way you think you’re gonna have. You’re gonna get that in school, but you know, some one way or another.

 

P  26:43  

Yeah, I think that’s good advice. It is a useful perspective because for sure when you’re in it, there’s nothing else. Right, it’s very hard to look up. Well, thanks so much for coming on and sharing your story and your book called The trying game is available all over obviously. All over Amazon but

 

A  27:00  

any bookstore. Yeah. Actually, if you like the sound of my voice, I’m actually narrating the audible version.

 

P  27:09  

Oh, that’s that’s awesome. And you have a website people can go to to find your other writing. Yeah, you can go to

 

A  27:21  

trial, but that calm and I have lots of articles on fertility, health, parenting,

 

P  27:30  

things like that. Okay, that sounds great. Thanks so much. Thank you. I look forward to it. Thanks again to Amy for sharing more about and really appreciate conversations with women in which they share their actual experience. Our goods in general Warren, Washington.

 

You IBM, we’re also hashtag grateful for everything we fought for. You do not discuss our mixed feelings. I’m not talking about the feeling of being scared shitless the excitement and terror that comes from knowing I’m talking about the leftover infertility of the past, mixed in with the cost of child labor. She writes. I think it took me a few weeks to feel that unfair joy. Sure. I was recovering from major surgery and trying to exclusively breastfeed the second world after 70 to subsist on negative sleep to entertain every form family member by myself. I couldn’t relax. I understand she was here to stay that she was mine. Mama, exactly. Receptionist would say a few times before I understood that she was talking to me. I am the mama. Yes, I ran into check on the every five video monitor. Meanwhile, I was outside. The only ones because I was also still running for my feelings like I had during fertility. I was still unable to relax the Brotherhood. Did I fear of the baby not waking up one morning I was overwhelmed but my fears this year to see what another day with her would bring. An early read was crowded out. And finally going through infertility as they be more sensitive to others. Because I remember what it was. I don’t remember every HCG data. Every embryo counts every medical protocol. But I do remember the the desolation of not having a child having a child this child this wonderful, beautiful, adorable person. There were so many dark days. I never thought I would get here. I didn’t know whether I would recover from a pregnancy loss. I didn’t know that I could start fertility takes away from uproot my life move across the world with just the world getting pregnant and moving on without being who was denied the one thing I wanted. I did not know what the settlement was together. Yet. Here we are with our curly girl in a mermaid bathing suit flopping around with a fish. Most days the gratitude has to go against me to college and I have to just pretend to be a regular thanks so much for listening. Hope you enjoyed this episode. Feel free to like and subscribe. I will be back next week with another inspiring story.