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Communication is Key

Sarah Preston Gorenstein

As soon as I stopped all the meds in mid-September, after my embryo transfer was canceled during my IVF cycle, my period came almost immediately (literally days later). But since this time I wasn’t expecting to be pregnant I didn’t see it as a sign of defeat—I saw it as a sign that I could start preparing my body for a frozen embryo transfer. When time’s not on your side, you tend not to want to waste any of it.

That’s the thing about these fertility treatments: Like I said before, once you get on the roller coaster, it often feels like there’s no way of getting off. There’s even some research that indicates it’s actually better not to take time off in between cycles, especially when age is a consideration. That stupid age thing again.

I started feeling better almost as soon as I stopped the meds, so I felt ready to get back on this infertility train. The process for a frozen embryo transfer is a lot easier than an IVF cycle: Because I decided to freeze all my embryos, I didn’t have to go through that awful egg retrieval process again thankfully.

By the way, keeping your embryos on ice isn’t cheap: There’s an $800 storage fee, every year you want to freeze them. I really feel for people whose insurance plans don’t cover any of these fertility costs because even with insurance I had a 30 percent co-pay (which, by the way, didn't cover the $800 storage fee). In preparing for IVF I had a giant box of medications delivered to my house, full of pills and injectables, to the tune of $1500 that came out of my pocket—30 percent of the actual cost of the meds. And that was just for one cycle.

So, I was on what they call an HRT protocol, or hormone replacement therapy. It starts with birth control pills, then after about 2-3 weeks I had to start taking Lupron, another shot injected subcutaneously (in my stomach…my poor stomach!). What this does is suppress your hormones, or in more clinical terms LH and FSH—it literally tricks your body to control it from releasing eggs on its own. The known side effects of Lupron, per Conceive: “Hot flashes, sweating, nausea, vomiting, diarrhea, constipation, an increased need to urinate, breast tenderness, and vaginal dryness.” I had 6 out of 9 of these symptoms to their fullest degree of awfulness.

Lupron is an evil, evil drug. The shots themselves? No big deal. The side effects of those shots? A very big deal, especially the accompanying hot flashes. It puts your body into a pre-menopausal state. I was putting on my socks one morning and my husband, looking at me, said: “Babe, is that a sweat mustache?” 

I was in a constant state of sweating, which made for very awkward conversations at kids’ birthday parties, or anytime I was toting Preston around. I slept with the window wide open, always, regardless of the temperatures outside. It was worse than when I was actually pregnant—which was pretty bad then, too. I had to think about what I was wearing to work each day, because I sat in so many meetings I had to make sure I wore black so sweat marks didn’t show through my pants.

A more painful side effect of Lupron for me was the hormone-induced migraines that rendered me useless for days. I also feel for people who have chronic migraines after what I experienced—having migraines with a toddler in the house who has no volume control on his voice? I’d be lying in my bed with the lights and TV off, suffering from another horrible migraine, and Preston would come charging in, screaming nonsense in my face out of excitement about nothing particularly exciting: “MOMMM-EEEE, BARKLEY MADE POO-POO OUTSIDE! DADDY, MOMMY, BARKLEY, POO-POO, PEE-PEE, CHICKEN NUGGETS, FISH STICKS, YAYYYY!”

It’s hard to tell a toddler who gets excited about EVERYTHING that Mommy isn’t feeling well and needs the lights off, the door closed, the noise level down, and a rock to crawl under for a few dozen hours.

After the Lupron, which suppressed the hormones, you then put the hormones back into your body by taking Estrogen pills and progesterone suppositories (inserted vaginally, don’t even get me started on how horrible that was). Once you start replacing the hormones, the headaches gradually start to fade away and life becomes livable again.

You’re on so many drugs throughout this process—between the birth control pills, nightly Lupron injections, Estrogen doses that increase over time, and three-times-a-day progesterone suppositories (yes, three times a day, while I was at work!), plus baby Aspirin and more progesterone in the form of pills taken orally at night, then they put me on Azithromycin the week leading up to the transfer (the specific protocols really depend on your doctor so it always varies slightly)—it’s very hard to keep it all straight.

That’s why communication is such a key component to all of this: You need to have clear communication with your doctor, or more likely your doctor’s nurse. And you need to trust that they’re giving you all the correct information. Trust is the foundation. 

I learned early on that bringing a notepad with me to each appointment helps. Ask every question you can think of—and pay attention to the answers. I always insisted on a timeline—because of work obligations and some travel plans we had, it was imperative I knew the exact schedule of what I'd be on and when, and what the possible side effects were, so I could be prepared. I actually had to go to the Playboy Mansion during my IVF cycle, and I couldn't bring my husband with me since this was for work (no one to give me the injections), so I had to work the whole cycle around that—looking back at the pics from the weekend now I can see how bloated I was, not that anyone was looking at moi, trust me.

You need to sit down with your nurse to lay out your medication plan. What a lot of people don’t realize, or what I didn’t realize, is you actually have very little interaction with your doctor after the initial consult. It’s the nurse you’re dealing with most of the time, so she needs to understand the protocol every bit as much as your doctor does. She needs to be the one you trust.

In your experience, did you develop closer relationships with the nurses than your doctor? Were you happy with your experience at your fertility clinic, or did it feel more like a baby factory? Would you have wanted Hef to administer your shots? Kidding!

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