Did Houdini die in this tank?

Microblog_Mondays

I never meant to follow the science project so far down the rabbit hole. We were fortunate enough to have very generous insurance coverage for IVF, and we used that to set our limits: we would try as many times as insurance would fund, and we drew the line at adoption. At every step, we discussed and weighed and endeavored to make decisions systematically from a rational place, but there was nothing rational about the outcomes, which is where the whole thing went haywire. You’re young, the doctors exclaimed; your FSH is normal and your response to Clomid is encouraging, they beamed in the early days; there’s no reason you can’t get pregnant, they promised, but I kept landing on the wrong side of chance and there was no reason why. Really, I was ‘done’ after the 4th failed IVF, and everything that followed at CCRM was a really quest for answers so we could at least make an informed choice between gestational carrier and egg donor. We never expected to get embryos from CCS; we expected to get closure, but even that sense of clarity proved elusive. The boon of euploid blastocysts effectively plunged us headlong into Alice’s hall of doors, where we’re seemingly too short to reach the key we left on the table, and we’re peaking through the keyhole at the idyllic garden with no clue how to gain entrance. In the meantime, Alice is drowning in her sea of tears.

I sent this message to Cousin (the maternity nurse) yesterday.

Don't judge her on weigh vs. way: she's bright, just texting-with-children.

Forgive typos: she’s texting-with-children.

Truly, the irony is as thick as the murky slop in my head. In trying to have a baby, I have subjected myself to multiple risk factors. Namely:

  1. As a person with a prior history of depression/anxiety, I am at elevated risk of depression as a result of infertility.
  2. As a person with a prior history of depression/anxiety, I am at elevated risk of depression as a result of recurrent miscarriage.
  3. As a person with a prior history of depression/anxiety, I am at elevated risk of postpartum depression after my 23-week loss.

And we can stop calling it “elevated risk” at this point because I am raising the white flag, Hello, my name is A. and I am depressed. I’m being double-teamed by stillbirth and recurrent IVF failure, and I still have embryos that need to be dealt with, which means this isn’t even over yet (!!!) so, you know, since SSRIs have been shown to diminish IVF outcomes and pose multiple risk factors for pregnancy, I sort of feel like I’m drowning inside a locked box. I have done all the other things (therapy, meditation, exercise) and they were effective for enabling me to manage my emotions…until now. What’s a girl to do?

35 thoughts on “Did Houdini die in this tank?

  1. I am so sorry to read all this. While I don’t feel at all qualified to answer your questions, from what you say it seems to me that it is really important that you find a way to manage your depression, even if it means taking medication. You have been and are going through so much, I really feel for you & I hope the doctors listen to you. Take care x

    Liked by 1 person

  2. My friend, I am so sorry this is your current reality. I wish I had answers and meaningful suggestions. As Theresa suggested, s it possible to take a TTC break, focus on your mental health and return to TTC in a few month’s time? Sending love your way.

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    • Would be more like a year than a few months for time to build dosage, heal, and then wean. TTC breaks never feel like breaks to me either bc the rest of the world just goes on being all fertile in my face. And with this crazy verdict looming, only 2 left before we give up, I’d not stop obsessing and fearing, I think. already feel old, etc. Thank you for the love, tho ❤

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  3. There are never easy answers, are there? I’m sorry you’re feeling this way.

    Have you figured out what and when the next step is, ttc-wise? Could you try medication for a few months while you get a handle on it and then wean off before trying again?

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    • It takes a few weeks to slowly increase dosage for SSRIs to have an impact and then it takes weeks to wean off. It would mean an indefinite delay. I either have to do without while I close this misery up for good or resolve to be on meds and take the risk of it hurting the outcome. Decisions, decisions (as usual)

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  4. I’m so sorry you are drowning…as you know, I’ve been there, and I feel for you deeply (but stillbirth is another level entirely). I have pretty strong opinions about this subject so I try to temper my voice because I know what a complex decision this is, and I know I’m probably in the minority in my opinions. Depression and anxiety carve deep paths in your brain—in some research its called the Super-highway in your brain, a highway that thoughts can speed through with ease because the neurons/dendrites have been reinforced, thickened, by repeated trauma. It is, in my opinion, extremely difficult to overcome with exercise and diet alone. Giving your brain a serotonin bath really does allow you to help yourself heal your brain. It gives you a platform from which diet and exercise really can help. It raises your baseline functioning, sending all sorts of physiological signals to the mind/body that you are safe. I went on a low dose, and it was the only time I successfully went through a treatment to live birth. Zoloft was a key factor in the live birth and although it is impossible to say for sure, my experience tells me it was indispensable. Being thrashed about by repeated trauma is so dangerous (and the injustice is a horror), dangerous to you in the aftermath, and with embryos left and such hard decisions to make, your system needs help, needs calmed. My REs were all for it, as was my OB. I weaned off it at 8 weeks pregnant, but I would have felt ok staying on a low dose if I felt that buzzy anxiety or that suffocating depression. You come first right now, and then your healing leads to a better place. I’m thinking of you.

    Liked by 4 people

    • I thought of things you said to me by email when I was writing this and actually looked up some of your old posts about making the decision to start Zoloft. I’m negotiating between what has become an almost superstitious fear that everything from a sneeze to a spicy pepper could cause my cycle to fail (since nothing makes any sense) to feeling that level of desperate sadness that I know means I need help. But I 100% hear what you’re saying about neural pathways and the power of meds to help hit the reset button so you’re starting at least from a fair place. I have to let the question simmer. I may reach out privately.

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      • I hate what you are going through and I think of you often, mentally willing your way OUT to come to you as soon as possible. You are strong and have a rich life and always manage to keep on keeping on but I still worry….recalling the episodes of suicidal ideation I experienced, and just the daily suffocation that is so hard to breathe through. I changed dramatically on Zoloft and had that thought: why didn’t I do this earlier? Of course, for the same reasons most don’t: concerns about the risks. (I went on a low dose quite early on, between losses, but I realize now that I didn’t stay on it long enough for it to have the full effect.) It felt like all of the hard work I was doing to stay afloat and become a mama had no stable place to build from, and once I’d created that stability, a lot of things fell into place, and I felt saner and more ready than I had in ages. I didn’t realize how much I was struggling and straining every single day until the medication kicked in and I noticed the difference between before and after. The stress my system had been under calmed. The volume on my triggers went down. I have a history of depression and anxiety, and many family members on antidepressants, and there is also bipolar in my family, so I’m quite sure I am genetically primed for anxiety/depression. There’s no doubt for me, now, that my brain needs a serotonin bath when times are hard. In my case, none of the professionals involved were even slightly concerned about the risks and in fact encouraged the low dose. Now that S has microtia of one ear, they say adamantly it has nothing to do with the drug, which I weaned off of at 8 wks (the best guess is an amniotic band, and we pretty much know for sure, now, that it is purely cosmetic). Anyway, I’m here, shoot me an email..

        Liked by 1 person

        • Also, just wanted to mention that in my case, the professionals (REs, OBs, etc.) were not concerned with the low-dose not only while undergoing treatment but also while pregnant—because if there were problems, we all agreed it was best if I had the SSRI in my system to help me cope. Some women stay on low-dose Zoloft their entire pregnancies, and my OB repeatedly reminded me that she recommended my going on it at any point in the pregnancy, as the risks were so small compared to the benefits. I was on it for approximately 3 months, I think, before BFP, and I started feeling the effects after 1 month. So just saying that you don’t have to choose, don’t have to delay TTC, don’t have to let it build for a year and wean off before TTC.

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  5. I would take the effing drugs. By way of background… I took Rx drugs to sleep and function when it all became too much even though we were still planning our next cycle. It was a matter of stay alive on drugs or the unthinkable alternative or orphaning my miracle toddler. I’m sorry you are in this dark lousy place.

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  6. Talk to your doctor (not a nurse), I hit my lowest point and my psychologist and doctor agreed that the benefits of anti-depressants outweigh any potential cons. My fertility clinic doc doesn’t believe it will hinder IVF.

    Sending you strength! These are hard times!

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  7. The sheer number of things that “might” have an impact on the outcome of IVF or getting pregnant is just enormous. Talk to your most trusted medical practitioner and go from there. I’m sorry that you’re in this tank at all! (((HUGS)))

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  8. I am so sorry that you are in this twisted conundrum, and I echo the sentiments that a low dose of meds might outweigh any risks when there are so many touted factors to go into why a cycle may or may not stick. Having yet another one to contend with could leave you feeling somehow like it was a preventable risk later (if your mind goes in endless circles like mine does), but living in this tank seems untenable. I hope you can find your way through these decisions with the help of those who medicated TTC before you, and in a conversation with your RE with all risks out on the table. I am thinking of you and hoping for a solid way out of that tank.

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    • Yes, it is that seed of doubt that is the problem. Thank you, and happy anniversary! I tried commenting on your post, but Blogger has been eating my comments lately.

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  9. I know you’ve already thought of this, but here’s what I think: there are no breaks in TTC. “Taking a break” suggest we have control, and we don’t. It sucks, it’s hell, it’s unfair, but we don’t. I tried taking breaks, hoping that a TTC-break would prevent heartbreak. One short break, 5 (yes five!) of my colleagues got prego and shoved their bellies in my face, along with giggles about “something in the office water”. One break, I lost one of my closest friends because I couldn’t forgive her for saying to a mutual friend that it seemed I didn’t want children very much as I “wasn’t even trying”. Another break, I found new opportunities to move forward to donor eggs and what was supposed to be time off of TTC-worries turned into the most difficult decision making so far. Looking at 2 years of stats on attempts I realized that periods flagged “doing everything I can” and “on a break” were identical in terms of what actually went on, the only difference was in my mind where I wondered why my “break” gave no ease of tension and anxiety.

    If you go on meds, you might lower your chances because of the meds but increase chances to get through this hell at all and have reasonable stress levels for conception and healthy pregnancy. If you don’t go on meds, your stress levels might lower your chances but trying sooner means you might be out of this hell sooner. Either way, things will happen that will scar or save you. Things that are beyond the issue of meds or no meds. Really, there is no better choice. This is not to make you feel worse. It’s to acknowledge the impossible situation you are in and to say that you can’t go wrong whatever you chose.

    Hoping for a break in the tank soon, so that you can come out on the other side and begin to heal.

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    • That much more difficult when there are no easy choices ❤ Sorry that your friend said that 😦 Just goes to show that we really have no idea what people are going through no matter how things look on the outside!

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  10. I’m no expert on the effects of anti-depressant/anti-anxiety meds on conception, but perhaps in this case it is worth the (probably tiny) risk.
    I think Tertia (of ‘So Close’ fame) took them after her 2nd trimester loss when she was drowning. Perhaps send her a mail.
    So many people who start taking the meds describe life going from grey to colour.. and goodness knows you need all the dazzling colour you can get as you continue onward.
    You’ll get out of the tank because you are you – but you may need a lifeline.
    xxx

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  11. I’m so sorry for all your struggles. In my experience trials are magnified in the face of clinical depression and it is so hard to find any comfort behind that fog. I was recovering from a depressive episode when we first discussed starting TTC and went back and forth with my psychiatrist and OB/GYN whether it would be best for me to wean off my very low dose of prozac before we started trying (my preference) or stay on it and see how I felt if I got pregnant. Moot point, as it happens, as we’re well into the IVF journey now and I weaned myself off them after about 6 months of TTC when I genuinely felt much better before ART had even crossed my mind. But, my OB/GYN and psychiatrist were both supportive of staying on them while TTC and potentially thoughout the entire pregnancy and stressed that there are also bad outcomes for babies of mothers with untreated depression so the decision you’re weighing isn’t necessarily between suffering with guaranteed good outcomes for the baby and getting treatment with accompanying risk. Unfortunately, for those of us who suffer from depression the decision is really between which risks are greater: those from untreated or treated depression. Just wanted to point this perspective out since I didn’t see it in your other comments. I recently found your blog and so appreciate you sharing your story. This is so hard and I hope you can find some trusted professionals to help you make the decision. Personally, if I were in your shoes and my doctors had the same stance as they previously held I’d take the medication. Life is too short to feel so miserable, but as you articulated so well, all of us who get to the “beyond science” part of ART are merely making decisions between bad choices. There aren’t any clearly better options lots of the time.

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  14. It’s just an antidote, but Kimberly at No Good Eggs had hives with her first two transfers with donor eggs. Top allergists couldn’t figure the cause, and suggested possible stress. She started Zoloft and her final transfer yielded twins

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