MY FIRST PREGNANCY - A LESSON IN MANAGING EXPECTATIONS

I had gotten married "late" at age 31 and assumed since it took a while to find my bashert that having children would come when we wanted it. When it didn't come easily I immediately went for help.

After three failed "natural cycle IUIs" and two failed "hormone assisted" ones, I finally got a positive "Beta*" back. I was thrilled - YAY! Pregnant! They told me to come back in 2 days for a repeat. I came back and sat triumphantly in the phlebotomist's chair while they took my blood. My nurse called hours later and took my high down a notch. 

"The numbers are supposed to double, yours still rose, but not double. Come back tomorrow, sometimes it takes a little more than 48 hours."

Still with hope, but more guarded, I pulled up my sleeve to reveal the "good vein" for blood draw. I gave my sample and I waited. The call came hours later, and the number rose by 3, the pregnancy was ending. 

I had to come back the following week to make sure the number was headed to zero. So I did, and the number had risen a little. I asked "Does that mean the baby is fine since the number is now rising again?" No, it meant a special call from the doctor.

The doctor told me he was advising I come to get a shot of methotrexate. I had never heard of this before, but it alarmed my father. "Isn't that a drug they use for CHEMOTHERAPY?" So I called the doctor back, he said that cancer grows like cells do in making babies in that it is the splitting of cells. This is a LOW DOSE and would wipe out the pregnancy, or what was left of it. My special instructions were to refrain from sex (or use a condom) for two months until the drug got out of my system. A pregnancy with this drug present in the body could be dangerous for a baby.

It was my third hormone assisted IUI which failed, so I asked if we were moving on to IVF. The doctor said "No, it worked, you got pregnant, but it didn't stay. So we know you CAN get pregnant through IUI, so we wont jump to IVF yet."

Dejected, my husband tried to get my mind out of failure. He suggested we take a trip since we wouldn't have to plan our lives around early morning monitoring or shots. I needed a spiritual uplifting, so we decided on Israel. Eilat for our physical vacation, and visiting holy sites to help heal our spirits. 

No one knew about this loss since it was so early on, but it had a huge impact on me. It taught me a valuable lesson in my managing expectations in ARTs. A positive "Beta" meant nothing. In order not to get emotionally hurt again, we would not get excited until our numbers would double, then we would be able to breathe. 

Little did I know that level of expectation would change again as we continued down the road towards parenthood.








*"Beta" is the term used for blood test that measures your BetaHCG levels. Also known as Blood Pregnancy Test.

SURVIVOR'S GUILT

Last year, I was sitting in the Maternal Fetal Medicine department of my local hospital waiting for my 20 week ultrasound. I was very stressed. Many of my pregnancies didn't go well, and this was an important hurdle to tackle.

I was filling out the questionnaire when something hit me...

How many pregnancies have you had? __6_

How many live births have you had? _2__

How many women see these questions and answer them with ease, whereas I am counting on my fingers: my IUI miscarriage that had to be resolved with methotrexate - a strong drug that made me wait 2 months before trying again , my IVF with the chemical pregnancy, my miscarriage of the twins, you get the idea...

I wanted to do something for others who were in this lonely boat to let them know they are not alone. I was thinking about what point in the cycle made me feel most alone, and it hit me -

THE MIKVEH

The mikveh was the time when it was obvious to me that my body had failed me. I heard a Rebbetzin mention that the Gemarah in Ketuboth describes the "impurity of niddah" as a "whisper of death."

EXACTLY! A new life was in arms length for us, but a miscarriage so early on, or a failed ART cycle was just a whisper. No one knew how close I was, and its hard for others to understand the grief of something that was barely alive. The mikveh would be the place to publicize a support group for women.

I jumped through bureaucratic hoops in my little town to get "small pretty signs" up in the mikveh. And then I waited...

Would anyone email?

Would anyone call?

I imagined in my mind that my couches would be taken up by 10 women from my town who I may not know who just wanted to vent. Could it be that I was the only one?

Then I got a phone call "I saw your sign in the mikveh, but I don't want to meet in a group setting. Would it be ok if we just spoke on the phone?"

Sure! Anything to help someone out. We spoke on the phone for two hours. When we hung up I realized that it was a bracha she only wanted to speak on the phone. You see, there was one thing I failed to mention and left out of my story on purpose - that I already had two children through successful ART.

YES, I want to help, but I don't want someone to feel badly that here I was, mother of two, and in my 20th week of pregnancy with twins, meeting or speaking to someone about trying time and time again to have a child.

I got a call from someone else who wanted to meet in person. I got really nervous. I didn't want it to be one-on-one, so I called two of my friends whom I knew were seeing the same doctor I was. We planned to meet at my house. I picked out my BAGGIEST SHIRT, my friend who was also pregnant with twins came early to hide under a blanket. My other friend also failed to mention that she already had one child. We all felt we wanted to be there for others, but wanted to hide that we weren't presently in the same boat. Why did we feel guilty?

I had put my name out there as "THE FACE OF INFERTILITY" in my community, but I wanted to hide my expanding belly. Being in this sisterhood of infertility, I developed a GUILT that I had overcome infertility, not once, but twice, and was about to do it again.

Recently, at a YESH TIKVA (www.yeshtikva.org) event I was attending, I was able to get some peace of mind. The event had three professionals speaking about "Caring for Your Mind and Body Through Infertility." It was extremely informative, but the best part of the event was the mingling before and after.

I was speaking with someone who was going through the journey and when they asked "Where are you in the process?" (a typical question in such circles) I paused. I said "I have done IUIs, IVF, IVF with PGD and FETs." I was being vague because I felt guilty. Then they pressed me "Did any work?" With my head down, I replied, "I have 4 children, my first through IUI, my second through FRESH IVF with PGD and my twins through FET with PGD." They said "That's great, we are about to do IVF for the first time, what is PGD? What can you tell us, any advice?" I told them I felt guilty mentioning my success in this forum. They said, "You shouldn't feel guilty, you are giving us hope!"

HOPE... that's all I ever wanted to give. Hope and support.

I know that some people feel that once you have one kid you are no longer part of the sisterhood, but I am glad to know that there are some people out there who want to hear from people like me, so I am in the process of overcoming my survivors guilt. Thank you fellow fertility travelers from the YT event, you have no idea how you’ve helped me.

Support Systems - A True Lifeline

In 2012, I was pregnant with my second child. Some of my friends knew the scary drama that came with this pregnancy because I was open about it, I needed the support and their tefilot helped give me strength. 

One friend called me up and asked if I could give her friend, Emma*, strength. I said she should definitely give Emma my number. Emma never called.

A month later, I was standing in shul and I thought I saw her. I wasn't sure, since we weren't friends, but decided to be bold and walk over and introduce myself.

"Hi, you're Emma, right? You were supposed to call me about fertility stuff?"

"Yes, I know, but I figured that you are already pregnant, so how would you be able to help me?"

"Well, getting pregnant wasn't easy for me, it was really hard with different treatments, many failures..."

interrupts me

"Well, I have no problems GETTING pregnant, its just keeping the pregnancies. I have gotten pregnant 5 times already, and I bleed out by week 9 or 10."

In hindsight, I now know why Hashem had her WAIT to reach out to me. 

You see, for the two years prior to that moment I was a dedicated member to an online fertility support community called fertilitycommunity.com (I think they changed their name at this point). The Thursday before this chance meeting in shul, I was reading a thread by a virtual friend about how she had a blood clotting disorder, and that once she gets pregnant she has to take blood thinners in order not to clot and bleed out the pregnancy.

I told Emma to ask her doctors about this at her next visit. She said she was meeting with Maternal Fetal Medicine on Monday. I was surprised, since I thought they only dealt with women once pregnant, but didn't want to overstep. She said she would call me on Monday after her appointment.

On Monday she called to say MFM told her they couldn't help her, but she should see an RE. (What I expected) But she wanted to stay in touch with me.

The following year she called me again, she had mentioned to her new RE about the blood thinners and the next time she would get pregnant they would start the blood thinners, like we were hoping. Good, a new protocol, new hope.

I told her I was supposed to have a frozen transfer on Monday. She said she was scheduled for Friday. Did I need a ride to my transfer. YES! (You see, I didn't like having anyone in the room with me so I could focus on staying relaxed, so my husband wasn't going to drive me.) Emma volunteered to drive me and my 7 month old baby, drop me off and babysit while I had the transfer and then drive me home. It was perfect.

I was so grateful that on the way home I gave her a bracha "In the merit of you driving me to my transfer, may your transfer be successful." AMEN!

I went in for my beta, it was positive, so was hers.
My numbers doubled, so did hers.
I had two sacks, so did she.
I had two heartbeats, so did she.

Every Tuesday she would call me since Tuesdays were her appointment days. I would talk her through things and give her a sense of calm. She said she wouldn't get excited until she made it passed her first trimester without bleeding out. That day came and went and we were both so relieved. 

Having a fertility buddy is such a help and comfort to both, to compare notes and know you are not going crazy. We were both on bed rest, both cervix shrinking, and the babies were born one week apart. Each of us has a set of twins: a boy and girl. These 4 kids have no idea that they were connected way before they came out of the womb, and their mother and I are forever connected. FFF - Fertility Friends Forever.

* Name was changed to protect the innocent.

Unexplained Infertility - Pros and Cons

I remember going to my first appointment with my R.E. (Reproductive Endocrinologist) It was a cold winter day in September of 2008. I was 32 years old, married for a year and felt it was time to JUST CHECK if everything was ok. 

Here is what I did know:

• My cycles came like clockwork
• I ovulated on the halachically appropriate day (and if I did ovulate a day or two earlier, I had a psak from a Rabbi on how to handle the clean days vs. bleeding days)
• My mom had no trouble conceiving (granted she was about 23 when she got married and was done having kids by 28.)

My husband took the morning off of work since we BOTH needed to be present. Our appointment was around 11am. We took a cab from our apartment on the Upper West Side cross town to Cornell Reproductive to see a doctor who was very successful with helping people I knew. I was nervous, I looked over at my husband who didn't say anything and was stoic. 

I realized something. I knew we both wanted to have a family, but I didn't really ASK him if he was ok that WE, yes, BOTH of us were going to get checked out. You see, I am a "take the bull by the horns" type of person. If I have a thought in my head, I move heaven and earth until that thought is settled in my mind. I knew I wanted us to get checked out, so I called, made an appointment and THEN told him he was coming with me so we could find answers. I think my "take control" attitude was one of the things he loved about me, so his silence meant he was "in for the ride ahead."

We sat in the long waiting room and saw tons of chasidish looking couples and a sprinkling of secular and non-Jews coming out of doors and leaving. Lots of people coming in and out. I kept looking at the doors, when will they call MY name?

Finally, I was greeted by the administrative assistant who handed me a THICK booklet of questions to fill out, and I filled them out while my husband read a sports magazine. We were here at my insistence, so why make him fill things out?

Once the paperwork was done, we went to meet the doc. He took a medical history of me, and then took one of my husband. He explained we would then take blood from me, do an ultrasound of my ovaries and also require a "sample" from my husband. I assumed since I was the older one in our relationship that there would be nothing wrong with him. 

They took our blood and my husband's sample and took me to a room for my ultrasound. I was in shock that they asked me to remove everything from the waist down. Weren't ultrasounds done through the abdomen? When there is no baby inside they want to check your uterine lining and ovaries and do so with  a "trans-vaginal ultrasound wand." Basically, a phallic looking wand that they insert into your vaginal cavity. 

I was tense from the meeting and now even more tense from this "wand." When they looked on the screen, and i looked as well, I had no clue what I was looking at. (Remember that Friends episode where Rachel and Ross get to see their baby and she says "I don't see it!" It was like that.)

 So, I asked "what are we looking at, and what are we looking for?" They were looking to see if I had any ovarian cysts and if my endometrial lining was at the right thickness for that time in my cycle. He reassured me it looked great.

We came back a week later when the blood work and semen analysis results were ready. Bloodwork was perfect on both of us, my reproductive organs were great, my levels showed I would make an abundance of eggs, all seemed GREAT. There was one small issue, but the doctor didn't seem nervous. My husband had a few abnormal heads and tails in his "sample" but the volume he produced was so large that those wouldn't cause a problem with us.

Our diagnosis? They can't put their finger on anything wrong so it Unexplained Infertility. 

Great, there is nothing wrong with me. 

What the future would teach me is that sometimes I would hope for a specific problem because with unexplained, they try different protocols out on you and see what works. If you have  a specific issue they know how to resolve, the road is much smoother. But I would only learn that later on after 2 miscarriages under my belt.

"Well, That's Suspicious..."

I know I have been away for a couple of years, but thanks to an influx of wonderful people in my life looking for strength in anonymous corners of Modern Orthodoxy I am beginning to realize how important it is to be out and proud of being a traveler on the road of infertility.

So I am back, hopefully with more posts to come, but this one is a long time coming.


A couple of years ago my mother was sitting in shul on a regular shabbos. The Rabbi got up to announce the mazal tovs when something happened.

"Mazal tov to the Stern family on the birth of twin grandchildren, a boy and a girl, to their children who live in California."

A woman sitting down the row from my mother whispered to her neighbor "Well, that's suspicious!" My mother, involved in every step of my fertility journey, and not shy to involve herself in situations she thinks are wrong, leaned over to this woman and said "I'm not sure what you mean?" The woman replied "Well, it is their second set of twins, maybe they had... HELP." My mother said "and... G-d gave doctors the knowledge to circumvent the issue of infertility with many types of Assisted Reproductive Technologies. When we were having kids, if you couldn't have them naturally you were forced to adopt or give up on motherhood. What a bracha that families are growing by such methods. It is not suspicious, it is a miracle."

That's my mom!

Lately people have been telling me about how insensitive people are to their suffering of infertility. It is true that no one has any idea what each individual goes through, most of the time the reason for the insensitivity is ignorance.

• People may not know that you are suffering when they say hello to you and immediately look to see if you have a growing belly underneath your shirt.
• People may not realize that there is more to it that "just relax and it will happen."
• People may not know that today is the due date of the baby you miscarried.
• People may not know how long you cried in the prep room at the mikveh last night.

There are organizations that are starting to be created to help people, Rabbis, Rebetzins know how to TALK to people going through infertility. But unless you have been in the throws of it, you can't blame people for their ignorance, you need to educate them. Think about how in the dark you were when you began this process. If you are sensitive to people just not realizing, they will learn in a nice way how not to alienate you in the future and perhaps become your greatest champions.

This is a great list of things for others to know about in talking with people going through infertility:

http://www.resolve.org/national-infertility-awareness-week/25-things-to-say-and-not-to-say.html

Simple Rules For Navigating Through Your Journey

I received a phone call last night from a woman I don't know. 

She got my name from the woman who taught me laws of Taharat Hamishpacha (laws of family purity) before I got married. I had called my "kallah teacher" many times when I needed to know when to go to mikveh in this process, and since this was all new to her, we were learning together. 

I was very open with my teacher about my struggles, so when other women came to her with scientific questions, not halachic, she would call me. I would ask her initial questions about the woman, many questions she would not know the answers to, so we decided to just pass my number along to any woman going through this.

After chatting with this woman last night, I realized there are a few simple rules I want people to know in order to make their time count. Time is such a precious commodity in the land of infertility since we are dealing with our biological clocks, and losing patience of having to wait... and wait... and wait...

So, here goes:

Rules of Navigating YOUR Journey:

1. YOU are your best advocate
• No one wants whats best for you more than you do - so YOU must fight for YOU.
• If you want to be more aggressive in your treatment, ASK FOR IT
• Whats the worst they can say? No? And if that's the answer, your response is "WHY?"
• It's your money - you are the customer, and the customer is ALWAYS right
2. Trust your gut:
• If you find a doctor who doesn't give you an answer you like, go for a second opinion. You have to be happy with your doctor and trust in them, so find one you like.
• If you don't like the nurse assigned to your case, ask for a change - she will be the person you speak to most often and you need her to be your partner in this process.
3. TALK TO PEOPLE (most daunting but most important) 
• It doesn't have to be face to face, but there are support groups, online forums, blogs and even people like me who are open to hearing your story. Many have gone through similar situations of trial and error and can arm you with great questions and protocols to ask about so that you don't have to waste time, and your doctor will know you are educated. 
• Everyone's experience is different, but people may have similarities and can help you with suggestions or just give you hope.
• A support system is most important - besides your husband/partner, sometimes having someone outside of you two is a wonderful outlet to have as a sounding board and can be very therapeutic.

Be strong, don't lose faith... persevere. 

Frum and Infertility

An introduction:

I decided to write a blog about being frum and dealing with infertility because too many women who are praying for children go through this road alone, ashamed and silent. This sisterhood of women has been silent for too long. I personally have been very open with my own journey, but I remember the shame and embarrassment I kept inside when I began this journey 5 years ago.

Besides struggling with infertility, there is an added pressure or sense of failure when you are going through this in the realm of being an orthodox couple dreaming of the longed for "Jewish family." Every shabbos meal you go to, every pregnant person you see, you wonder - when will it be my turn? The peering eyes, and whispers behind your back "They have been married for how long and have no kids? I wonder why?"

I totally understand where you are coming from, and I hope that this blog will bring my readers some hope, chizzuk and (if needed) an education on fertility issues. This is my personal story and my travels through success and (many) failures. 

I am not a doctor, just a woman who dreamed to be called "mommy" and I'm here as your sister and sounding board so that you don't have to travel this road alone...