ROI

My second appointment at the fertility specialist was an intake with a nurse who was to run through the intricacies of IVF with me. She was young and crisp, tasked with providing the facts and the timeline. She started with describing the pharmaceutical order, which would be delivered to my house in two Styrofoam coolers. Inside, nestled in ice packs, would be nine different drugs, including:

·        Ganirelix AC injectibles

·        Docycycline capsules

·        Estradiol tablets

·        Methylprednisolone tablets

·        Ovidrel injectibles

·        Crinone gel

·        Gonal-F injectible

·        Menopur

·        Progesterone oil

They would also include two different sizes of syringes (3ml LL syringes 22 gauge and 18 gauge) and a Sharps container for the endless used needles I would produce.

I would be ingesting or injecting all of these drugs throughout the months-long process. I would be coming into the office at least once a week for blood draws, sometimes as many as three times a week, depending on the phase. I would have an egg retrieval for which I would be fully anesthetized, in which a massive needle would puncture my vulva, my uterus, and suck eggs from my ovaries. I would later go through an embryo replacement where the healthiest looking embryo would be placed into my uterus with the hopes that it would survive, implant, and grow.

This sharp young nurse, who looked far too young to have children of her own, kept checking off the boxes on her procedural list, listing out my fate, reading out my doom.

I began to feel hot. Really hot. I started to take off my sweater. The nurse asked me if I was ok, and I told her I was just getting really hot. I started to feel dizzy. I stared at the bland industrial carpet beneath my chair. The room started to unravel and her words started to echo. Then- darkness.

I fainted, fell out of the chair and hit the floor. I dreamed a ten second dream of the most vivid wild universe, where I saw a brilliant rainbow prism. Then the darkness started to recede, and there were all of these people around me- the nurse, the doctor, other staff members. I was utterly confused as to where I was and who these people were. They were asking me questions but I couldn’t answer. They looked worried. They brought me water and propped me up against the wall. Slowly, the room stitched back together again- I was in the same office, sitting on the tan carpet, and I was vibrating with fear.

I couldn’t speak for what felt like a long time, but eventually was able to respond to their questions (what month is it? Who’s the president?), enough to satisfy them that I didn’t have a concussion. I was struggling to breathe right, to regulate one breath in, one breath out. The doctor asked me if I had someone who could drive me home. My husband worked about an hour and fifteen minutes from the hospital, and as a school teacher, it wasn’t ideal to ask him to leave his students to come rescue me. My co-worker and good friend, however, worked very close by. I called her and explained that surprise! I’d been going to a fertility clinic and I’d fainted and could she please come pick me up?

I sat on a bench outside the clinic. The sun was shining, and early spring flowers were sprouting from the mulched beds- pansies and petunias, in shades ranging from purple to pink. My friend pulled up in her white minivan and asked me on the drive home, “So you’re trying to get pregnant? That’s exciting!” I wanted to match her enthusiasm, and agreed that it was exciting, but my words trailed off. I was still having some difficulty verbalizing anything, and it felt like my head was stuffed with cotton. I didn’t know why I had fainted, and it was upsetting.

She drove me home and helped to situate me on my soft, grey couch in the living room. She looked at me kindly as I reassured her that I would be fine, then she left. My dogs sat on the couch with me, Olive trying to kiss my face over and over again. She was always so sensitive to my emotions. I wrapped my arms around my knees to try to hug myself, and closed my eyes, waiting for my husband to come home.

When he came home, my husband was intensely focused on me. He also didn’t understand why I’d fainted, and he was worried about me. We wanted to make sense of it, but it wasn’t clear if it was a physical or mental issue. I called my primary care doctor and made an appointment. A couple of days later at the doctor’s office, they ran some tests including an EKG to determine if there was a medical cause for my fainting, but nothing turned up. The doctor suggested something called Vasovagal syncope, a fairly common condition that leads to fainting. He told me that sometimes your nerves give the wrong signal to your blood vessels causing them to open up, and that your heartbeat simultaneously slows down, which causes your blood pressure to drop. And then you lose consciousness and fall out of your chair at the doctor’s office.

The thing was that the fainting didn’t go away. Over the next few weeks, I was subjected to rounds of injections of hormones, delivered at home by my husband. The first time he had to inject me in the thigh, I passed out at the sight of the needle. I had never before been afraid of needles, but I was suddenly so terrified that my brain shut down my entire system. I had to lay down for every injection to prevent fainting. It happened at the fertility clinic too. I went through weeks of blood draws to test my hormone levels and fainted the very first time. The nurses learned quickly that I had to lay down for every blood draw. I tried to joke with them about it, saying, “Can I lay down? I’m a fainter”. But it didn’t feel funny. I just needed to feign humor to get through the stress of each needle. What was actually happening to me was disassociation- the protective trauma-induced response to shut off parts of your brain to keep you from fully experiencing that which is terrorizing you. Disassociation can be a symptom of active trauma, PTSD, anxiety, or other mental health abberations. It can be frightening when it happens, but it’s your system’s best defense in the face of that which it thinks you absolutely cannot handle.

What did it mean that I was voluntarily participating in a medical process that was so terrifying to my system that I kept disassociating again and again?  Why did I continue to push through it, overriding the very loud and incredibly persistent signals that I was way beyond my boundaries of comfort? The truth is that I wasn’t aware that I was being traumatized appointment after appointment. I was succumbing to the trauma in service of producing a child as quickly as possible because my time was running up. I felt like my future hung on this very thin nail, wobbly in the wall and almost ready to fall to the ground. I’ve always been good at intellectualizing rather than listening to my body, whether that meant landscaping for my dad for ten hour days in 90 degree heat without a proper break or trying to not break my stride at work when dealing with an active migraine. I was excellent at rationalizing that the work itself was more important then my well-being or comfort. So IVF wasn’t any different. There was a problem that we were trying to solve, and that problem was my infertility. Therefore it was my responsibility to solve that problem and get pregnant, no matter the cost.

If I were given the choice to go through it again, I’m honestly not sure what I would choose. IVF was horrible for me- gut-wrenching emotional and physical pain, riddled with trauma and fear. One more than one occasion I cried at my husband to get away from me with the needles. I felt unsafe and threatened by the entire process, at an atomic level. And yet, it succeeded. We reached our objective. I did produce a beautiful, wonderous, curious and bright child. He is a healthy, brilliant addition to the world. But was the sacrifice worth it? Did I need to incur the mounting costs of trauma that would take years of therapy and medication to unravel so that I could morph back into an emotionally integrated human? Was the cost of disregarding my system’s primal screams for safety- of not listening to my truest needs and fears- worth subverting for any objective? I wrestle with these complex questions as I continue to hack my way through the path of healing.