An Acceptable Side Effect

By Amy Szpara

Premature Ovarian Failure. The first time I heard those words was via voicemail from a family practitioner, who stumbled through my last name. I knew what each individual word meant, of course, but I had never heard them strung together before. Ovaries that quit working early. That’s what she thought the problem might be.

Months later it was confirmed. Blood test after blood test, a few doctors down the road, and then a gynecologist was repeating those words to me. This time it wasn’t through recorded message. I was somewhere on the outskirts of Dallas, following the directions of an Australian accent coming from my GPS, telling me how to get to my aunt’s house in McKinney, Texas. My cell rang. It was him, saying that I did, indeed, have a pair of ovaries that no longer functioned.

This meant a greater chance of osteoporosis, higher risk of heart disease, and other “post-menopausal” issues. I was just 31 years old. It also meant no chance of conceiving children.

This didn’t mean I couldn’t carry a baby, he offered. My uterus appeared to be fine. I just wouldn’t be able to be part of the conception process. I should be good to go on the growing part of things, though. “You’ll need donor eggs,” he added.

Donor eggs? I drove aimlessly through a chunk of farm country that I had never imagined existed between a major metro area and a booming suburb. The water filled my eyes and blurred my view of the road, as I clicked the phone off and tossed it to the passenger seat.

With no idea where I had gotten off to, I pulled the car over and cried hard. Empty crop fields surrounded me. Appropriate. I called my aunt, told her I was lost, and she gave me turn by turn instructions until I pulled into her driveway.  Then, more crying.

Just the week before, I’d been in California, kissing my husband, Ray, goodbye. A U.S. Marine, he was headed to Iraq for an 8-month deployment, and I was moving back home to Louisiana to be with family.  My sister, Kim, had flown out to ride back with me. After his send-off, we were setting out on a road trip to take my mind off of things. Before we got going, I had one last appointment at the base hospital to check my Follicle Stimulating Hormone (FSH) level. FSH is released by the pituitary gland and helps control the menstrual cycle and the production of eggs by the ovaries, I had learned. After that one hospital stop, we were on our way.

Over the next few days, Kim and I visited a ghost town somewhere in California, hit Las Vegas for a night, stopped at the Grand Canyon for exploring and camping, enjoyed the quirkiness of Albuquerque, and spray painted our names on cars at Cadillac Ranch in Amarillo. Then we eased into Dallas with a collection of great memories and completely exhausted.

The next afternoon when my sister was headed to work, I was off to spend a few days with my aunt before the next leg of my trip to Louisiana. And then the news. The blood test had come back and the FSH level was sky high.

Some things began to make sense. At 25, I had gone through a really strange period of fatigue, achiness, and brain fog. It was the summer after I finished grad school. My fresh diploma sat on a desk waiting to be framed, while I’d gone with family on a cruise to celebrate graduation. When I returned, I began to notice the odd symptoms. I was really tired – not just my body, but my brain. I had a full body, dull achiness. My joints and muscles were sore. I had trouble concentrating.

Convinced I’d caught an obscure disease while in Belize or Honduras during the vacation, I went to an infectious disease doctor. Nothing. So, I followed up with a neurologist, my family practitioner, my gynecologist, and a rheumatologist. Nothing. After a long list of blood tests and exams, I was told it was Fibromyalgia, a diagnosis of exclusion.

But no one had ever thought to look at hormones. No one thought that a 25-year-old woman’s body was going through menopause and trying to adjust to those changes. I certainly never considered that. So, I took the diagnosis, and I slowly adjusted. The symptoms never completely went away, but with exercise and a low dose of an SSRI – Effexor – (for mood swings and depression), I was okay to get on with life.

Five years later, by my thirtieth birthday, I’d all but forgotten about that bout with bizarre symptoms. I had also been off the pill for two years, without getting pregnant. And I hadn’t had a period in six months. Never had it dawned on me that any of the issues from before could be linked to hormonal deficiencies or have anything at all to do with fertility. It wasn’t until I stopped getting a period altogether and learned that my FSH level was that of a woman who had gone through menopause that I made that connection.

While in California, Ray and I had been the ultimate tourists – visiting wine country, going to Hollywood, taking trips to San Francisco, driving down to Mexico, camping in Big Sur, spending our weekends at the beautiful beaches, and taking off for Vegas here and there. The end of that tour found Ray going to Iraq and me back in Louisiana, where I shelved the ovarian failure for later.

I enjoyed the time with family, and when Ray returned, we followed orders to South Carolina, where we bought our first house and settled into a slower pace of life.

I busied myself with work, fixing up the house, and meeting new friends. But everywhere I went I was reminded that I would not have babies. Someone was always pregnant, throwing a baby shower, or asking when I’d ever have any babies.

I finally started telling people I couldn’t have kids. It wasn’t going to happen. There were looks of pity, suggestions of adoption (I really was thinking hard about that), and occasional comments that we just weren’t “trying hard enough.” I didn’t bother explaining that all the sex in the world wasn’t going to knock me up. It wasn’t going to happen.

I was 33, when I decided to make something happen.

“If you needed a kidney, I’d give you that,” Kim said. An RN, she had been doing some traveling nursing and was ready to settle somewhere for a while. So she got a job at the hospital down the road from my house, and we began the process.

We had to thicken my endometrial wall, and then see how estrogen patches and pain-in-the-butt (literally) shots worked on me. Kim had to go through hyper-ovulation, taking shots to the stomach to make her release multiple eggs at once. We all had genetic testing and then visited a psychologist to discuss our feelings about Kim being the biological contributor. My endometrial tissue biopsy proved the doctor correct in warning “it was going to hurt like hell.”

Once all those boxes were checked, Kim went under general anesthesia to have the eggs removed. Ray discreetly made a contribution into a cup in a back room. The doctor did his magic: Injected sperm into eggs. And we had embryos! (But just four.)

The doctor matter-of-factly told me we’d implant two of those embryos, freeze the other two. If it didn’t work the first time, we could give it another go. At least I could say we tried, I thought, discouraged and convinced there would be no pregnancy.

I wasn’t getting my hopes up. I wasn’t going to trust that it would work. I had heard stories of people trying in vitro fertilization many, many times, without it taking. We only had two shots.

Still, I followed my instructions like my life depended on it when my turn came around. Kim had done her part. Ray had done his. Now it was all up to me. I had to start by making sure I had a full bladder for the procedure. This, somehow, would make it easier for the doctor to see where to insert the syringe to transfer the embryos to my uterus. It meant no going to the bathroom when I woke up that morning. I downed water the whole hour-long drive to the doctor’s office, as Kim and Ray both warned me that I should maybe slow down.

Upon arrival, I was in pure bladder pain. I could barely walk from car to office. Once I was on the table and the ultrasound wand was inserted, my insides popped up on the screen, and the doctor told me to go to the bathroom and pee a little. My bladder was too full. I ran to the toilet, peed for five seconds, and came back. He took another look. Still too full. Another five second pee, and he looked again. Once more to the bathroom. Finally, after the third trip, my bladder was in good shape to begin.

Five minutes later, I was in another room, on another table, legs up in the air for 45 minutes to let things take. I peed like a racehorse after, and we left.

If all worked out, I’d get three more months of thick, progesterone butt injections and sticky estrogen patches on the stomach. But, I wouldn’t need to worry about that, since it wasn’t going to work out.

I had to wait nine days to find out if one of the embryos had implanted, and as Kim and I were walking in for the blood test, I stopped. “Hey. No matter what happens, thank you for doing all this for me. It was such a gift.” She shrugged it off, like it was no big deal. But it was. She had never once hesitated about any step of the process. She had moved to my little coastal town to be there and go through all of it with me.

The nurse called later that afternoon. Positive. I was pregnant. Ray wasn’t surprised. He believed it would happen. But Kim and I both were. We wanted it to work, but we had mentally prepared ourselves for bad news. But there was none. Only good.

I had to wait until Week 6 to have an ultrasound to detect a heartbeat, and when that day arrived, the nurse inserted the wand for the umpteenth time in the past several months.

The doctor watched the screen and, nonchalantly, said, “Let’s look at that one first.” He pointed to something. Ray and I looked at each other, confused.

“Okay, now let’s look at the other one.”

Ray looked to the screen, then to me, and back to the screen. The nurse moved the wand as needed.

I looked to the doctor, incredulously. “The other one?”

“Yep,” he said. “Both implanted.”

Ray and I looked at each other again, stunned.

“Twins?” I asked, just to confirm what we were talking about.

“Yep. An acceptable side effect of fertility treatment.”

 

It’s now been five-and-a-half years since the day I listened to my mother laugh giddily on the phone at the news of twins, and went home to start planning for two of everything. My girls, Rayne and Jayden, are five and in Kindergarten. They are best friends, or worst enemies, dependent on the moment.

Premature Ovarian Failure. I don’t think much about those words these days. I take a low dose of birth control pills for the estrogen, get lots of calcium, and workout. So I went through menopause about 20 years early. If not for that, I wouldn’t have those girls. Those three little strung-together, devastating words led me to an amazing journey with my husband and sister, which brought me the two greatest gifts I’ll know in this life.

 

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