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by Anne Judge, RN
Seattle Reproductive Medicine

For me, things started so simply about seven years ago: a decision to stop birth control followed by months of frustration that I was not having regular cycles. A trip to my OB led to one cycle of Clomid, interrupted in the middle with the news that my husband’s semen analysis had come back showing too few sperm to count. All of a sudden things were much more serious than just taking a pill to ovulate, and we were referred to Seattle Reproductive Medicine to talk about IVF.

I remember reading about IVF online and just thinking “but I don’t want to do that.” It seemed so technical, so intimidating, so far removed from the natural world of childbirth that I loved so much in L&D nursing. But if this is what it took to have a baby, I was all in. We were doing injections within a month of our first visit to the fertility clinic. I was on a bit of a high the whole cycle. With my polycystic ovaries, they were counting fifty or more follicles at each ultrasound, and I remember thinking, “I’ll have embryos forever! One cycle should be all I need for our whole family.” But as the REI nurse I am now could have predicted, I hyperstimulated and we had severe male factor, so by the end of the cycle we had one great blastocyst to transfer, and three in the freezer. Not bad, but not at all what I as the patient expected. So one of my crucial jobs now is helping bridge the gap between what seems to make sense from a patient perspective (more eggs is always better) and the medical reality of quality over quantity.

Everything had gone well, but I started bleeding the day before my pregnancy test was due and then sat on the couch for the longest afternoon ever until the “your pregnancy test is negative” call finally came. That was the real moment I was hit with my infertility. Until that point, I saw everything as a problem to be solved. Since I’m not ovulating and there isn’t sperm, IVF is the solution. Yes, it’s expensive, technical, and invasive, but what great odds of success! Now we had done everything anyone asked of us, and it didn’t work. The rest of the year was spent doing unsuccessful frozen cycles before we made the decision to take a break.

I joined a RESOLVE support group that helped me realized that while I couldn’t change my infertility, I could change the things related to it that were causing me stress, including my job. As much as I had loved L&D, I needed to not be around other peoples’ babies all day. I (and the REI clinic) were a little nervous about having a former patient work as a nurse. Would it be too personal? But it was so freeing to realize how many other people were going through similar circumstances, and it was gratifying to be in a position to help them. It also helped me to learn about all the different sides of REI, from our non-fertility endocrine patients to those experiencing recurrent pregnancy loss. I enjoyed seeing my new job as a reminder of what was possible rather than what I wanted and did not have. Learning the other side of the infertility role gave me the courage to believe in the process and try again, and for us the fourth IVF cycle was the charm. My daughter is now three and a half and (because I just have to hit every infertility stereotype) even with our dismal sperm counts and my lack of regular ovulation, I also have a one year old son who was a ‘surprise,’ truly proving that anything is possible.

Now every day I try to help my patients understand the variety of options available to them. If you want to be a parent, truly want it, then it will happen. It just may not be the path you saw in your daydreams. You may have to do IVF, and you may have to do it more than once. You may have to use donor egg, donor sperm, or even a gestational carrier. Or maybe you will be like my other friends from my RESOLVE support group, who had their own ups and downs with adoption before finally getting their precious child.

I never would have thought seven years ago that I could be so happy in my life, especially working in a job I never knew existed. One way that REI is a lot like L&D is that the outside world only imagines the positive. When I tell people what I do instead of hearing “how fun to deliver babies every day!” I now get “how great to tell people they are pregnant!” But the reality is you are there for either the happiest or saddest experiences of people’s lives. As an REI nurse, now I hopefully get to be there for both the ups and the downs. I know that each day I make a difference, teach someone something new, or just provide the support to not give up. At the end of our RESOLVE support group, our leader gave us each a framed sign that said, “Courage doesn’t always roar, sometimes Courage is the quiet voice that says, ‘I will try again.’” That sign now sits on my desk and reminds me every day why I do what I do.