Proven Otherwise.....

IVF is a club that no-one really wants to be in. I am a part of a fantastic support group online, and I treasure these ladies - we welcome new members by wishing them a short stay, and send off successful friends with statements like "I hope I never see you again". 

I have a beautiful friend in my offline life currently going through IVF too. She is years further in this journey, and I have to say, that despite my best intentions to support her prior to us commencing IVF, I really had no understanding of what she was going through, month after month. 

So I am writing a post that I wish had been there for me to read - to better understand her journey, and the pain years ago. And so I preface this post with an apology for my inadequacies, to you my friend - my bumbling attempts to comfort when I didn't truly understand the pain - and an enormous thank you for being there for me every injection, every blood test, every freak out, and every heartbreak, geographical distance notwithstanding. 

PUPO

The assisted reproductive world is filled with acronyms, some official, some created by those undergoing treatment. One of the common ones amongst my internet friends in treatment is PUPO - it stands for Pregnant Until Proven Otherwise.

It's a beautiful, optimistic stance to have - and it's not something people who haven't experienced this can really understand. 

One would think that self-classification of pregnancy would only happen after the third, correctly doubling blood test results had been received - that experience and disappointment would create a hardened shell that hope had no chance of breaking through again. 

But hope does break through, and regardless of whether they are bold enough to put it in their forum signature, all of my friends feel the same way during the dreaded two week wait (TWW) after transfer. That this cycle is THE ONE. Pregnant Until Proven Otherwise.

The disappointment of a failed IVF cycle can't just be summed up in loss of money, or loss of time (or sex life, waist line, wine that could have been drunk, sushi that could have been eaten, looong hot baths that could have been savoured). But Pregnant Until Proven Otherwise explains it a little. 

You see:

For a Normal /  Natural pregnancy to occur: 

• A dominant follicle needs to grow and mature in the ovaries. 
• The body needs to trigger it's release. 
• The ovum needs to make its way down the fallopian tubes towards the uterus
• A sperm needs to swim up to meet it. 
• The egg needs to allow the sperm inside (bizarrely, they are quite resistant)
• Then the fertilised embryo makes its way to the uterus, cells dividing along the way. 
• After 6 days, it implants in the wall, the follicle from which it was released (corpus luteum) secretes progesterone, to stave off menstruation and support the pregnancy before placenta development. 

During IVF, all of the steps in blue - all of those points where things could possibly go wrong are achieved prior to embryo transfer. During transfer, extreme care, and ultrasound guidance are used to ensure the embryo placed in the right spot. The embryo has ONE JOB - and that's to stick to the goddamn wall. That's it. Simple right?

Okay - I'm getting distracted with "one job" meme's, I promise I will stop and get back to the post. 


Sometimes, the embyro's do stick around for a few days - enough to give nausea, sore boobs and multiple positive home pregnancy tests. These implantation failures "chemical pregnancies" are a special kind of devastation of their own.

The overall point I want to make here is that there is no tangible difference in the pain felt between a failed IVF cycle, and an early pregnancy loss. As someone with the dubious honour of having 5 miscarriages under her belt pre-IVF, and as of today, 5 failed IVF cycles, I am speaking from a place of experience. 

In both situations, you have spent a couple of weeks thinking about a baby, of feeling pregnant (progesterone, the culprit for most early pregnancy symptoms is administered continually post transfer in an IVF cycle), of feeling excitement and hope - accessing online due date calculators and wondering how on earth you can have a Christmas Eve baby and travel across three states to see family!

And you have the crushing guilt that compounds the disappointment - the sense that you are broken, so broken all the science in the world can't fix you. That you did something wrong. That you didn't want it enough. That you didn't do 58 sessions of acupuncture to increase the chances. That you shouldn't have had that sip of wine at Easter, or missed your megafol and asprin one day.


So if you have someone in your life going through IVF, and a cycle hasn't worked - treat them with the same love and care as you would if they had miscarried at 7 weeks.

Don't say things like: "oh well, there's always next time", or "there must have been something wrong, it's God's/Natures way" (because these embyro's are screened and graded - and there is nothing quite like knowing you had a perfect one and it still didn't last for more than a week) "have you thought about adoption", or "a friend of a friend of mine went through IVF and stopped and got pregnant naturally, stop trying so hard and it will happen".

Do give lots of hugs - have a catch up with all the "naughty" things pregnant women aren't allowed - crack out the soft cheeses and booze.  Be an ear, that can hear a rant about the unfairness of it all (c'mon, junkies can have babies and I can't?)

Be prepared for extreme emotional swings - from optimism to believing it will never ever work. I think I'm averaging about 6 emotional states an hour right now.

Don't hide pregnancy announcements or news, just give the recipient the space to process it. 



On a personal note, today marks my 5th failed IVF cycle, and second chemical pregnancy in a row. Last month, when my first beta hcg was fine at 30, and then crap (1.7) three days later, I took it in my stride - I saw it as a positive step, that it had actually stuck, just for long enough. It filled me with hope to keep going. 

Today is like the grief I avoided with positivity last month has caught up with me. I'll be honest - I'm not great, but that's actually okay. I never expected myself to be anything other than heartbroken with the pregnancies we lost, and I'm not going to force myself to play happy just yet. I can let the sadness have a place - but the nature of the beast is that sadness will be overrun with anticipation in a few days when I start "shooting up again" (the fridge is full of drugs) and then anticipation will once more give way to hope. 

Until then, I have some wonderful Clare Valley wine by my keyboard, and I will soon snuggle in bed with my wonderful husband, an episode of Stargate on my iPad and our three "fur babies"- Molly, Jasper and the still sore and sorry for herself (but ultra snuggly) Ruby.