Erika's Story Part One: A First IVF Cycle and a Tenacious Ectopic Pregnancy

Four days ago was the sixth anniversary of the final termination of my ectopic pregnancy. The psychological pain from the whole ordeal has slowly been fading from my immediate memories; this anniversary didn't even hit me until earlier today, when I extended my sympathies to a Twitter acquaintance's tweet about her recent ectopic. She asked me if I would share my experience, and of course I said yes. Immediately, then, the memories came flooding back, crashing down onto my shoulders and washing over me with a cold presence. The ectopic wasn't in my immediate memory, but it certainly didn't recede very far, either. The floodgates opened with lightening speed, and I think it took about 15 seconds to feel like it had just happened yesterday.

I've written and deleted entire drafts of this story more than once, but I've never been able to re-live it long enough to save and publish it. Parts of the story are buried in various articles and threads here on IVFConnections; it's easier to talk about it in parts. But now is a good time to write it down. Someone else wants to hear it, and that means there is a chance I can help her with the pain I know she's in. When I was in the midst of my own ectopic nightmare six years ago, the only thing that helped me keep my sanity was searching and searching and finding someone else's story. Knowing that someone else had gone through something similarly awful - and survived - kept me from going completely down the drain.

That's why I started an infertility support website three years ago, really. And why I ended up buying IVFConnections.com and merging the two together. If it weren't for the amazing forum full of women who basically held my hand throughout my infertility journey, I'm really not sure where I'd be today. Growing IVFConnections and reaching out to more and more people is how I give back to the community that helped me when I needed it most.

So here's my ectopic story, @EndoJourney. I hope it helps you in some small way.

((A brief history: at age 32 (42 for DH) we had no luck trying to conceive. One of the first problems we faced was an irreparable, fluid-filled fallopian tube. One laparoscopic surgery later I had one less tube and the left half of my pelvic cavity free of scar tissue. We tried several IUIs with the usual failures and losses before moving on to IVF.))

The ectopic happened with our first fresh IVF cycle.

I was a good responder and produced a rocking thirty-three follicles, ending up (of course) with a mild case of OHSS. The retrieval was December 11th (our wedding anniversary), 10 embryos made it to day 5 and two were transferred. The IUIs had not done the devastating job of humbling me like they should have; at the time of retrieval I was still naive enough to think that we were going to slide into success with our first IVF cycle.

That year happened to be the year we were supposed to drive from Austin to Iowa to spend Christmas with my in-laws. I didn't want to leave home, and I didn't want to go to Iowa, so I started the trip with a bad attitude. (Unfortunately, I have had to learn the hard way more than once that adjusting my attitude about something like a trip to see the in-laws is necessary for mental health. But that's another story.) We got in the car and headed north on I-35, on Day One of our two-day drive to Iowa.

Before we had even gotten out of Texas, I started to bleed. It was more than just spotting, but it wasn't a full bleed. "Freaking the hell out" doesn't begin to describe my state of mind. I called the RE's office, expecting some sort of miracle (or a doctor's order to drive back to Austin) - and got the same response that every Freaked Out 2ww Bleeder gets: "There's nothing we can do about it, bleeding doesn't necessarily mean a loss, wait and see; try not to worry." We were stuck in traffic and it took longer than it should have to get to Oklahoma City (our stopping point for the day).

When we got to OKC we went to a drugstore and picked up a pack of home pregnancy tests (HPTs). It was too early to matter, but I did two consecutive HPTs and both were negative (of course). The next day we made it to Iowa and checked in at an average motel (small town, no real choice … my bad attitude about Iowa extended to the motel situation and I was really angry that we had to stay in a "dump". My hormones were going haywire at the time but I had no basis for comparison and I just let all of my anger and frustration out on the motel. I could tell you every little awful detail about the place; it was like I had to focus on something, so I chose the shitty motel room to focus on. The window wouldn't open, the iron scorched my shirt, the carpet was sticky, the bedspread looked like one of Bill Cosby's sweaters from the '80s …).

On Christmas Eve I POAS (peed on a stick) again and saw the faintest, lightest line. My husband couldn't even see it. I had to hold the stick up to the light, angle it a certain way and then point in order for him to even think he might be seeing a line. I had a glimmer of hope.

The next morning I POASed again. Same line, no darker, but my husband agreed that he probably saw it, too. The tiny bit of hope continued.

When we got back home on the 26th I called my RE, who told me to have my beta drawn the next morning. I went to bed, determined to get to the lab the moment they opened the next morning: 7am. I woke up to the news that we had had an ice storm overnight. The main roads were said to be passable, but everything was closed because the side roads were dangerous. At 7am I called and the lab was open, so I made my husband drive me through the ice storm to get there.

My first beta was 51. I held onto that 51 with all of my heart, and even when my wonderful nurse told me that the doctor would "rather see it be at least 100 points higher", I hoped and worried, and worried and hoped. My next beta barely doubled. The one after that did not, and the fourth beta creeped up high enough to keep a wisp of hope in my heart, but not high enough to keep me sane.

When my beta hit the mid-900s, my doctor had me come in for an ultrasound. He could find nothing in my uterus (or anywhere else) and told me that it was ectopic. He was worried because the pregnancy had progressed far enough that the tube was at risk of rupture, and he prescribed a round of methotrexate (MTX) to end the pregnancy.

At the time I was working as an oncology nurse, finishing up my Master's degree in nursing. I was working as a hospital nurse and had spent about three weeks taking care of a man who was to become one of my favorite patients. His diagnosis was Burkitt's Lymphoma - a disease with pretty good survival rates but with a cruel chemo regimen. It was a long treatment cycle, it required inpatient care, it caused wicked, wicked nausea and vomiting and included methotrexate as one of the drugs.

So when my RE ordered methotrexate, I burst into tears. I was pregnant, but it was in the wrong place. I had to end a pregnancy - and desperately didn't want to. And I had to do it with methotrexate, a drug I was watching make someone's lifesaving treatment nearly unbearable. My RE slowly got all of the story out of me and then laughed. It was a low, quiet chuckle that had such a sympathetic tone. "Oh, Erika. The methotrexate dose you're getting is the equivalent of lemonade in comparison with what you're giving at the hospital. It's very mild, and I'm very sorry that you have to go through this."

It was 4pm, and the doctor called the nearby speciality pharmacy to check for availability of the drug. They told him they had it, so he dashed off a prescription for methotrexate and sent me flying out of the office to get it before they closed. When I got there I learned they didn't have it, but that someone at another location was going to deliver it. I waited for it to be delivered, sitting in the only chair in the place: a small, hard wooden chair. I spent over two hours in that godawful chair before the drug was delivered. Where else was I supposed to go? How did I know it was going to take so long?

With the drug finally in my hands I headed back to my RE's office.

"This is expired," my RE said, looking at the label. "I can't give this to you."

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Ready for part two?

Erika's Story Part Two: If the Ectopic Isn't Fatal, It Will Kill You Some Other Way