Miscarriage #4: IVF, tons of tests, no answers yet

It is impossible to believe that we are back here again…dealing with ANOTHER loss.

To recap, on November 8th, I went to my 12 week appointment and experienced the horrible silence of my doctor trying and failing to find the heartbeat of the baby. When I first looked up on the screen and saw that the baby was measuring 12 weeks, 3 days, I wasn’t expecting to have any issues because the baby was measuring right on track. But after what felt like an eternity and was probably only 15 seconds, I asked, “Are you finding the heartbeat?” My doctor responded, “No, but I am going to do a vaginal ultrasound to get a better look.”

I knew, in that moment, he was gone. Our perfect PGT highest grade embryo was gone. Our only boy embryo. In all of these scenarios, I have responded differently. The first time, when we miscarried the twins, I was holding the phone with Henry on FaceTime because of Covid, and I just screamed, “No!” The second time, with Brighton at 14 weeks, I ran to the bathroom and threw up. The third time, with our baby who had Triploidy, I think I laughed. This time, I just kept saying over and over again, “This CANNOT be happening again. No, I don’t believe it. This CANNOT be happening again. I can’t do this again.”

Soon after this ultrasound, we would be led out the back door of the office (they always lead you out the back or side door so you don’t have to see anyone). In my opinion, they don’t want a hysterical patient going out the front door because if they really cared about their patients not seeing another pregnant women, they wouldn’t make you wait in the waiting room for subsequent appointments with a bunch of other pregnant woman. Because miscarriages are still hard weeks later. I repeat MISCARRIAGES ARE STILL HARD TO DEAL WITH WEEKS, MONTHS, AND YEARS LATER. But I digress..

We went up to get a perinatal ultrasound, which confirmed our biggest fears. Because this happened on a Friday, I would have to wait until Tuesday to get a D&E - this would be my fourth procedure to remove a pregnancy I desperately wanted. Because I was 12 weeks, 2 days, I asked if I would need to get dilators inserted like I did when we lost Brighton at 14 weeks (the baby is bigger; therefore they need bigger equipment to get them out). My doctor didn’t think it was necessary because I was only 12+ weeks as compared to 14 weeks, but they did tell me to take Unfortunately, I was right in asking because when I woke up from anesthesia on Tuesday night (my surgery was 5 hours behind schedule), I was told they couldn’t go through with the procedure because they needed to put dilators in. They put three dilators in (they only put one in with Brighton) so you can imagine the level of pain I was in. They wanted to keep me overnight but Henry was able to convince them that I could go home and come back in the morning. By the time I got home it was past 10pm and I needed to be back at the hospital at 7am but being able to cuddle C.C. (who was so worried about me at this point) made that short trip home worth it.

I went back on Wednesday morning and was able to have a successful procedure. Because they gave me general anesthesia the day before - as opposed to the twilight anesthesia I am used to - my throat was killing me and I could barely speak when I woke up again. That would last for a few days but, at this point, I was just relieved that part of the loss journey was over. I knew what was next though. The part where reality kicks in, and I am not sure anyone fully recovers from this sort of loss, let alone four times.

The baby was sent off for testing, and this time my doctor requested more extensive tests. I also did all of the recurrent pregnancy loss testing again, which came back negative. Since then, I have done genetic carrier screening testing, as well as reproductive immunology testing. In total, it’s been probably about 100 vials of blood in two months. Henry has also needed to get blood tested - a nice change from the testing we’ve done before.

At my post-op appointment a week later, my doctor was concerned that I had a uterine AVM and sent me to an emergency radiology ultrasound. Thankfully, those findings were not concrete that I had a uterine AVM but rather they suspected an EVM. A few weeks later, I would have a pelvic MRI to see if any structural issues could be detected, which we almost hoped for to have some kind of answer as to why this keeps happening. No detections were found, but they did suspect retained tissue from the procedure (ie: they didn’t get everything out); however, that was also ruled out from a second opinion. Additionally, I have a follow-up radiology ultrasound on Monday to see if the suspected EVM is not an AVM, and is clear - in which case I would be cleared to start trying again - a terrifying thought.

At this point, I am not really sure what the next steps are. I can only see what’s right in front of me, which is all of this bloodwork hopefully coming back with some answers for a different protocol for a future transfer. Do I do another egg retrieval before I turn 38? Do I jump right back into another transfer? Do we pursue surrogacy? Over break I looked into surrogacy and noticed there are wait lists everywhere and the starting price tag is 100K (not including all of the legal fees, etc.). I’m not really sure what the next step is but I am holding on to faith that it becomes clear soon.

The holidays were better than I had expected. I made a choice to be present with C.C. and make sure she had a wonderful holiday. New Years Day, on the other hand, was brutal. Having to wake up to ANOTHER YEAR of this heartache was brutal. I was not prepared for the sadness I would feel on that day. I cried all day and could barely get out of bed, but the next day I got back up and tried again.

That’s going to be the theme of 2025 - trying again, no matter what it looks like. We are not done building our family and I will keep trying until we can’t try anymore. I also need to find better ways to care of my mental and physical health during this time. I am in therapy, which is great but I know there is more I can be doing. Quite frankly, I just haven’t wanted to. I remember after my mom died, there was a long stretch of time I could not accept my reality. I could not move forward without her. There are times I still feel that way. And now with the added layer of the five babies we lost, it sometimes feels impossible to move forward in a life that has been weighed done by so much loss.

But there’s really no other choice is there? I can continue to do the bare minimum, or I can live again, really live again, despite how broken and horrible some days can be. I guess that’s my hope for 2025 - to feel alive again, to not feel broken by infertility and loss, to not feel so much anxiety about how my life is unfolding, to do things even if I can’t feel joy right now with the hope that it will find me again. To read, to write, to walk, to run, to travel, to eat yummy foods without worrying how it’s affecting my body, and to drink the things I love even if it’s not fertility-approved.

To live again. I used to be so full of life before my mom died, before infertility, before postpartum depression and anxiety, before IVF, before losing our five precious babies,