A while ago, I made a comment about dealing with infertility testing and treatments, and how hard the process is while working in healthcare.

@arghavan_salles encouraged it, and it appears to have touched some folks.

So, here is a non- #COVID19 related thread.

Thread
1/

. @carpediemjh1977 and I waited a bit longer than we should have because I wanted to be done with fellowship, and my masters.

Maybe not the best decision we ever made, but in the end, the decision was made.

So once we started to try, things did not go as well as planned.

2/

We sought help, and it turns out we were right on the edge of being able to have kids.

Our tests suggested that we could get pregnant through IVF, very unlikely through IUI. But our chances were around 40%.

3/

We decided to try. This was complicated by the fact that my wife has had a history of a DVT/PE in her 20s and Factor V Leidein. So she needed to be on enoxaparin prophy.

So we went for a round of IVF. 4 shots a day, followed by a trigger shot, and IM progesterone.

4/

The first try failed. I found out during my clinic. While I had 18 patients on the schedule, 3 of which were new. And all were complicated fungus infections. I swallowed the emotions, and did not get to grieve until the drive home.

I felt more numb than sad.

5/

By not being able to grieve at the time, I swallowed my feelings, and just let it rot in my heart.

We were both emotionally drained, and Jess really suffered through the side effects.

So we decided to try IUI (against medical advice) because we could not handle the shots.

6/

Two rounds of IUI failed. We were heartbroken, but we had low chances anyway. The two IUI failures did not hit me very hard. I never expected them to work.

But they really affected Jess. One of our friends succeeded with "1% chance" on IUI and she was hoping we would too.

7/

We went back to the IVF. Second round of IVF, the side effects were different. But still awful.

On collection day, I had a meeting in Dallas, and Jess pushed me to go. My wife is an incredibly strong woman.

Our close friend @AjWiningham was with her.

8/

We only got 2 eggs. All that suffering, only for two eggs, making our chances of success with that round less than 5%. Jess was inconsolable.

Getting this information through texts, my wife sobbing, during a meeting I could not leave, was the worst part of my life.

9/

AJ was an amazing friend, and helped Jess. After a lunch, and some time Jess felt better.

I still regret not being there. It still hurts to think about it.

And obviously, that round failed. I swallowed those emotions, and they rotted in my heart.

10/

So, we went for IVF #3. 14 eggs. Side effects were pretty good.

After implantation, Jess started to have symptoms of implantation syndrome, and our doc and us both were convinced we were pregnant.

We were so happy!

11/

One day, while walking upstairs, Jess felt short of breath, and had calf pain.

She was sitting weirdly in a chair that day, so I (the brilliant internist that I am) said it was probably nothing.

She called her IVF doc the next day. And she ordered a doppler.

12/

While driving home from work, her doctor called me. Jess had a DVT, and given the symptoms, a PE. But she couldn't reach Jess.

I whip my car around, while driving back, I call her to make sure she did not have a cardiac arrest. She is waiting for her car at the hospital.

13/

She knows me, and she figures it out. She feels palpitations.

Is it anxiety, or is it tachycardia?

I pick her up, and take her to my research unit. I am so frazzled, I cannot take vitals.

One of our nurses, Teresa, comes and helps. The angel that she is.

14/

She is tachy, but the blood pressure is stable, and oxygenation is OK. She is crying, I am trying not to.

I swallow my emotions, because she is going through more than I am, and there I let them rot.

The rotten emotions are starting to make a bigger hole in my heart.

15/

In discussion with her doc, we decide no scanning in case she is pregnant, and go to therapeutic enoxaparin.

All the symptoms of pregnancy end in 48 hrs and the preg test is negative.

She was pregnant and likely lost the baby from the strain.

Sadness turns to rot.

16/

Next up, a 6 month break while the clot breaks up. We take the time to heal. But the healing is slow. And lots of rot has been created. A few other things happen in life that also brutally hurt us, but it passes.

17/

After 6 months, we go back to IVF #4.

#4 fails

#5 only 3 eggs

#6 fails

We are at this point largely broken people. We have each gained 40 pounds through hormones (her) and anxiety eating (both).

We start to get genetic testing.

18/

The genetic testing shows some mutations, none that are likely to cause problems.

Which is the worst result for us. WHY IS IT NOT WORKING?

She is going through so much, and so am I. But I don't talk about my emotions, because I should be strong for her. Rot grows.

19/

Our life feels like a giant centipede that keeps dropping shoes. Bad news almost every week.

While we are pushing through, we keep saying, "It just has to work once."

We do #7. It fails. Rot.

We have a conversation. "How long can we keep doing this?"

20/

The amount of money spent is immense. The cost on our emotions has been huge.

At some point, it just will not work, and it is time to move on with out lives.

We will go for IVF #8. Jess and I do not think it will work, but we need one more ray of hope before moving on.

21/

#8 will be the last one. We go through the shots, and collect eggs.

64 eggs between the 8 rounds.

The shots take their toll, and we firm up our decision. We are done after this one. Rot. I start talking to friends, because I can only hold so much.

22/

So we go through the implant.

And then, what happens on #8?

Well, lets just say, my dad just painted this in one of our rooms!

23/

In the end, if all goes well, we get to welcome Ana Avondale Spec on Sept 2nd, 2020.

24/

And yes, the happy ending makes it easier to write. And not everybody gets one, but I am so grateful that we do.

The rot is still there. But like the physical rot, it eventually goes away. Maybe my fungus friends can help me decompose it with time.

25/25

Ultimately, if anybody else is going through this, and they want to reach out, my DMs are open. It is not easy. I am still healing.

But the one thing I have learned, don't do it alone.