Exactly one year ago today, I posted this photo…

While I had already starting writing a bit about our infertility journey, this was my first foray into posting about the horrific, painful, and raw emotions that often accompany infertility.  I posted the picture because I just couldn’t get the words out.  Describing that kind of emotion isn’t easy.  Still, it was a definitely a turning point for my blog and for myself.  It was the point when I decided that I wasn’t going to keep quiet about what I was going through.  Sure, it might be ugly.  Sure, it would make some people uncomfortable.  But I needed to talk about it.  And so it began.

There was infertility testing, surgery, drugs and injections, four IUIs, and then two babies.  I wrote about it all, and I kept taking pictures.  I came to find that being open about my infertility was one of the best decisions I’ve ever made.

Now here we are, exactly one year later, dealing with a whole new set of often indescribable emotions.  Some of those painful infertility feelings still pop up from time to time.  I’m honestly not sure they will ever completely go away…and I’m not sure that I really want them to.  Still, anticipating the arrival of our two baby girls, the picture has changed quite a bit.

It seems I have some body image issues.  I’m not talking about the I’m too skinny/too fat/hate my nose/butt/legs kind of body image issues.  I’m talking about the kind of body image issues that arise when your body doesn’t do what it’s supposed to do.

It started, of course, with the infertility.  There I was, doing everything I could to make a baby, and my body just wouldn’t cooperate.  It seemed that my body was incapable of doing the very thing it was designed to do.  Meanwhile, people all around me were just magically pregnant.  It took us years of trying, surgery, pills, injections, and 4 IUIs to get pregnant with the girls.

Eventually, though, all our hard work paid off, and my body agreed to cooperate and carry two baby girls.  With each passing day, my anger at my body faded into the background.  Things were going great!  Every day I expected a problem, and every day passed without a sign of a problem.  My girls were growing and healthy, my cervix was long and closed.  I was taking care of myself and even starting to enjoy this pregnancy.

Then, along came gestational diabetes, and all of those rotten feelings about my body came back.  Once again, I find myself standing on the outside.  While all the other pregnant women I know get to eat what they want when they want…not so for me.  I have to eat certain things at certain times.  I can’t just eat whenever I’m hungry.  I have to wait two hours after each meal to check my glucose, and only then can I have a snack.  Could I have a bowl of ice cream?  Sure.  Half a cup.  And the choice to eat that ice cream is the choice to not eat something more filling and that has real nutritive value for my girls.  Once again, I feel like my body is failing to do the very thing it was designed to do.  I was a failure at getting pregnant, and now I feel like a failure at being pregnant.

And, of course, along with the gestational diabetes comes the advice.  Just like with infertility, everyone is quick to tell me just what it is they think I need to do.  I’ve had some very helpful conversations with people who have had gestational diabetes, but I also have an inbox full of advice from people who have never been pregnant, never had gestational diabetes, and certainly don’t understand the complexities of dealing with gestational diabetes while eating enough to keep me and my girls healthy.  It feels like infertility all over again.

On top of all that, it’s looking more and more like I’ll be the lucky recipient of a c-section for the birth of my girls.  Having multiples combined with the gestational diabetes just makes the likelihood of a c-section extremely high.  It’s something that I really don’t want.  I understand that women do it all the time.  In fact, something like 40% of births in the US are c-section.  Still, I’m not a fan of having major abdominal surgery, and I really, really want to give birth.  I would like to give my body the chance to do what it’s supposed to do.  I’m not giving up hope completely on the chance of a vaginal birth, but it’s looking less and less likely at this point.

I’m sad.

I’m tired and angry.

And I’m really frustrated with my body.

What I want right now is to drown my sorrows in a gigantic brownie sundae.

What I want right now is to snuggle my girls.

What I don’t need right now is anymore advice from people who don’t know anything about gestational diabetes.

What I don’t need is people e-mailing me telling me how much worse their problems are than mine.

What I don’t need is to be told to be grateful that I’m pregnant.  If you know me at all, you know how much this pregnancy means to me.

Instead, what I need is to find a way to deal with the shortcomings of my own body.

I need to stop putting so much pressure on myself to fix things I have no control over.

I need to find a way to be at peace with my body.

Your responses to my previous post gave me a lot to think about.  I so much appreciate how many of you who didn’t struggle with miscarriage or infertility reached out and confessed your fears and anxieties.  I think that so often, women are just expected to be bubbly and excited about their pregnancies.  If you visit pregnancy sites or chat rooms, the biggest concern seems to be what color to paint the nursery.  Some fears are addressed, but a lot aren’t even mentioned.  Pregnancy is a miraculous thing, and no matter how you came to be pregnant, every pregnancy comes with it’s own set of fears and anxieties.  As an infertile, are some of my fears different or more intense than someone who didn’t struggle?  Probably.  At the same time, do I have any idea about the kinds of anxiety that comes with an unexpected pregnancy?  Nope.  I feel so lucky though to know so many of you, both those who have struggled and who haven’t, to support me through this amazingly crazy time in my life.

So often, baby talk in our society revolves around cute baby outfits and baby names.  We don’t talk about the down and dirty of it all, and I think that we should.  How else as women are we supposed to know what’s “normal” and what’s not?  How else are we supposed to adjust to what is probably the most life-changing thing to happen to us?  It’s not that I don’t think that picking out baby names or nursery colors is fun, but there is so much more to being pregnant that than.  I would imagine that to be especially true with a first pregnancy.

We can talk about sex, war, famine, and environmental disaster, but we can’t seem to muster up the courage to talk about the horror of infertility and miscarriage.  It’s just not deemed polite conversation despite the fact that millions of women are dealing with this every day.  We also can’t seem to find a way to talk about the completely normal anxiety that comes with bringing a child into the world.  No one who asks about your pregnancy wants to hear that you were up at 3 a.m. freaking out about getting things done, or that you’ve had nightmares c-sections.  They just want to know how far along you are, what you’re having, and if you have names picked out…and to give you well-meant, but often nonsensical advice.

As a community, I think that bloggers do a far better job about talking about these things than others do.  I certainly don’t shy away from sharing my scary thoughts with you.  Now, we just need to work on spreading that conversation around.  Becoming a parent, however it happens, is something that affects most people who want it (and plenty who don’t) at some point in their lives.  We should be able to talk about it.

You know how sometimes you’re feeling all kinds of things, but you just can’t get the words out to talk about it?  Well, this is that kind of post.

Sometimes I can’t remember who I was before infertility.  Does it matter?  I suppose not.  What matters is who I am now.

People often ask me if I’m relieved now that I’m done with infertility.  Am I done?  There isn’t a day that goes by that I don’t deal with some aspect of that struggle.  A big part of what I deal with is figuring out who I am now that I’m on the other side of it.

I still get annoyed when people make stupid comments about getting pregnant.  The whole “just relax” thing still makes me irrationally angry, even when it’s not said to me or about me.  Yes, stress can affect your fertility, but it doesn’t cause infertility!

I’m irritated when people make innocent comments assuming that it was easy for me to get pregnant.  I generally politely correct them, but the assumption bothers me.  It’s silly because I certainly can’t expect the world to know that we struggled.

Pregnancy announcements still make me catch my breath.  They don’t knock the wind out of me, but I still get uncomfortable from time to time…and then I feel bad for having that kind of initial reaction.

I still have so many friends who are struggling, and supporting them is so important to me.  Is being a part of that community preventing me from moving on?  Is it helping me to remember where I’ve been?  Is it giving me an opportunity to learn about the pregnant side of infertility?  Do I even belong there?

I feel guilty for being pregnant when others are not.  I feel like I shouldn’t be grappling with all these crazy emotions when my journey was so much shorter than others.

So much of me is still in the infertility game.  I feel more comfortable there than I do at the OB, and I’m finding it hard to let go.  Maybe I don’t need to let it go though.  Maybe I just need to figure out how to incorporate it into my new life.

I need to be prepping myself to be a mother, but being pregnant is still so surreal to me.  I still check for blood every time I go to the bathroom.  I’m counting down the days until viability.  Is that morbid?

I’m supposed to be all giddy and excited about my babies, and of course I’m thrilled about them, but I have such a hard time believing that this is actually happening for us.

It’s like I’m stuck here in some sort of limbo.

I’m pregnant, so clearly something is working.  My babies are growing and healthy, so I must be doing something right.  Yet I still struggle with feelings of inadequacy when it comes to my body.

I know that my infertility isn’t my fault.  I know that we couldn’t get pregnant on our own because of my endometriosis.  Rationally, I get that, but my head still wonders why my uterus decided to fill itself up with so much gunk as to make growing a baby impossible.

I just wonder what it’s like to have a normal pregnancy.  I’m sure some of these feelings are typical for many pregnant women, but I’ll never really know.  Does it matter?  Not really, but I’m curious as to who I would be as a mom if we hadn’t struggled.  I’m curious as to who I will be as a mom since we did struggle to get here.

I don’t know if any of this makes sense, but that’s okay.  It feels good to get it off my chest and out of my muddled brain.

During my struggles to get pregnant, I got used to feeling left behind.  I was always thrilled for my friends who were getting pregnant, but I still felt left behind.

I just always figured that I would be the one who was left behind…

Amazingly, miraculously, I wasn’t.

Suddenly, I was the one who was pregnant.  Suddenly, I was the one with the happy news.  Suddenly, I was the one doing the leaving behind.

It wasn’t long after I found out that I was pregnant that the guilt set in.  I feel it every day.  I feel it with every sad blog post or tweet I read.  I feel it every time I write about my pregnancy.  I feel it every time I go to the doctor and hear that my pregnancy is going smoothly.  Please don’t get me wrong…no one is making me feel this way but me.  I just can’t seem to help it.

I found so much support and love in the infertility community, and in a lot of ways, I feel like my pregnancy almost hinders me from continuing to give my support and love to those who are still struggling.  When I’m too tired to keep with with all the posts, I feel horrible and unsupportive.  When I do leave a comment, I worry that I come off as the smug pregnant woman.  The truth is, I still keep up with your struggles.  I have literally burst into tears at some of your major sorrows.  The wounds of infertility are still very fresh for me.  I remember that pain clearly, and I often forget that I’m not still struggling with you.

Infertility has truly changed my life, and it’s something that I continue to deal with each and every day.

To those of you who have never struggled with infertility — Please reach out to your friends who are.  They need your support sometimes more than you know.

To those of you who are struggling with infertility — I’m still here.  I’m still cheering you on…but I totally understand if you need a break from my awkwardly pregnant world.

To those of you who have joined me in land of the pregnant infertiles — Please tell me I’m not the only one who feels this way!

This week, I figured I would answer a few questions that relate to my recent big news.

Erin wanted to know — Are you worried that the hormone treatments might mean that when you do get pregnant it will be multiples?

During my first IUI cycle, I literally didn’t sleep at all because I was terrified I was going to end up with quads.  I got over that pretty quickly when things just weren’t working.  We were certainly aware of the risk for multiples, and willing to take that risk.  We took a very medically responsible approach to our treatments, so I felt that we would be ok.  As much as TV makes it seem that higher order multiples are a regular thing, they really aren’t.  Truthfully, I did have hopes for twins just so we would never have to even talk about fertility treatments ever again.  I am thrilled that we are expecting twins.

Ashley wondered — You said before on twitter that you wanted books for pregnant infertiles. Isn’t that an oxymoron? Are you still considered infertile? Will your pregnancy be any different than a “fertile” person?

First things first.  My endometrioses, while in a sort of “remission” during pregnancy, hasn’t disappeared.  Women who have PCOS still have PCOS when they get pregnant.  Low sperm count still exists after a pregnancy.  So, yes, I would say that we are still infertile.  In addition to the physicality of it, there is a mentality that goes with it as well.  I will always be part of the infertile club, and proud to be.  Just because I’m pregnant doesn’t mean I’m going to forget what a struggle it was to get here.

As far as my pregnancy, I do think that it will be different in some ways from that of a fertile person.  For example, I’m currently taking progesterone supplements, which is something that most fertiles never have to deal with.  I have also had 6 doctor’s appointments during my pregnancy, and I’m not even 6 weeks pregnant.  Most women at this point in their pregnancies haven’t even had one appointment.  Finally, I think that emotionally my pregnancy is very different from that of a naturally fertile person.  Sure, some of the emotions and fears are the same, but I’ve got years of baggage and fear that came before this pregnancy.  That didn’t all magically disappear when a second line appeared on a pee stick.  It’s a big emotional adjustment to go from wondering if you will ever get pregnant to carrying twins.  When you pick up a regular pregnancy book it’s all about how excited you must feel, and most books only have a page or two about infertility.  I really feel that there should be a What to Expect Now That You’re FINALLY Expecting for those of us who have struggled to get here.

That’s all for this week!  Do you have a question (infertility or pregnancy related) for Fertility Fridays?  If you would like to submit a question, simply fill out this form.

Generally, when people learn that I’m pregnant, the response is something like this:

OMG!  I’M SO EXCITED!  WOO HOO!  FREAK OUT!  FREAK OUT!  CAPS LOCK CAPS LOCK CAPS LOCK!!!!

Generally, when I think about the fact that I’m pregnant, my response is something like this:

Pregnant?  Huh.  Really?  Huh.  Really?

Everyone is expecting me to be so excited/over the moon/on cloud nine/beaming/thrilled/etc.  I do feel those things from time to time, but it’s not an accurate assessment of my overall emotional state.  Truthfully I still feel shocked, confused, overwhelmed, anxious, and a little bit terrified.  I’m not comfortable in my own skin.  With each day, the pregnancy does become more real for me, but I still haven’t really accepted it yet.

It really is such a strange place to be right now.  I feel very much in limbo.  I’m so used to being an infertile that that’s the group I identify the most with…but I feel a little awkward in that community because I don’t want to hurt anyone’s feeling.  Still, I definitely don’t feel like I belong with all those other moms-to-be out there, because so many of them really don’t understand what it’s like for me.

I just keep thinking that if I actually had some major symptoms, I might feel more comfortable.  Right now, I have some minor breast tenderness, some minor cramps, and I’m a little moody.  Other than that?  Nothing.  I want to be puking my guts out.  I want to be so exhausted I can’t get off the couch.  Instead, I just feel like I’m waiting for the other shoe to drop.  I expect my period every time I go to the bathroom.  I panic after every blood test.  I know it’s early, but I just want to feel pregnant.

I have been trying to write this post for days, and I’m still not sure that it makes any sense, but it is what it is.  Sometimes you just have to post the word vomit.

So, even though I seem to be on a whole new journey now, I still want to answer your questions about my infertility journey.  Some of the questions might be strange to answer now that I’m on the “other side”, but I promise that I haven’t forgotten just what it felt like.

Stephany wondered — How is IUI different from IVF?

And Megan wanted to know — What is the entire process you have to go through for an IUI?

Well, IUI and IVF have some similarities and some differences.  This post will focus on IUI, and we can talk about IVF in the future.

There are a few main components to IUI (intrauterine insemination, formerly known as artificial insemination):  ovulation induction, monitoring, trigger shot, semen preparation, and the actual IUI.

• Ovulation Induction — This is the practice of using medication to cause the body to produce follicles, or eggs, for ovulation.  Clomid is the most popular drug for this purpose, but Femara is also used.  Clomid and Femara are typically taken on days 3-7 or days 5-9 of your cycle.  There are many injectable drugs that are also used to develop follicles.  Injectables are taken starting on day 3 of your cycle and generally stop right before your IUI.  The type and amount of drugs you take will depend on your diagnosis and your doctor’s preferred methods.
• Monitoring — Monitoring involves blood work to check your hormone levels, and ultrasounds to follow follicle development.  How often you are monitored depends on the type of drug you are on, your response to the drugs, and your doctor’s preferred methods.  For example, some clinics monitor on Day 3 and Day 12 of your cycle, but I generally had at least 4 monitoring visits per cycle at my clinic.  After the IUI, you will also have blood work to monitor your progesterone levels, and eventually to check for pregnancy.
• Trigger Shot — A trigger shot is an injection that will cause your ovaries to release mature follicles after 36 hours.  Generally, you take your shot once you have one or more mature follicles.  Some clinics do not have you use a trigger shot when on Clomid, and instead have you rely on Ovulation Predictor Kits to know when you will ovulate.
• Semen Preparation — About an hour before your IUI, your husband will drop off (or collect at the clinic) his semen sample for preparation.  The semen count is checked, and any dead or abnormal sperm are cleaned out.  I have no idea how this is done.  Let’s call it magic.
• IUI — About 36 hours after your trigger shot, you will go in for your IUI.  The IUI is performed by using a speculum to visualize the cervix.  A catheter is inserted through the cervix into the uterus, and then a syringe of semen is inserted directly into the uterus.  The process generally takes only a few minutes, and then you get to lay around for about 20 minutes.  There is no science that says laying on your back will increase your chances, but it can’t hurt!

I’m going to walk you through an IUI cycle with Clomid just to give you an idea of what the process looks like…

Cycle Day 1 — First day of your period.

Cycle Day 3 — Monitoring visit to check hormone levels and look for cysts.

Cycle Days 3-7 — Take Clomid

Cycle Day 10 — Monitoring visit.

Cycle Day 12 — Monitoring visit.

Cycle Day 14 — Monitoring visit.  If follicles are ready, take trigger shot.

Cycle Day 16 — Semen preparation and IUI about 36 hours after trigger shot.

Cycle Day 21 — Blood work to check progesterone levels.  Progesterone is needed to sustain a health pregnancy.

Cycle Day 28 — Blood work to check for pregnancy.  Not all clinics do this.  Some have you test on your own.

So, there you have it.  One nice and tidy IUI cycle.

Do you have a question (infertility or pregnancy related) for Fertility Fridays?  If you would like to submit a question, simply fill out this form.

I made this video blog on Thursday night, shortly after taking my first positive pregnancy test.  Even though it’s a little out of date now, I thought I would share.

Freaking Out! from Erin on Vimeo.

On Thursday night, I took I pregnancy test…and it wasn’t negative.

I took another test Friday morning…and it wasn’t negative.

I went for blood work on Friday morning…and it wasn’t negative.

My HCG came back at 83.

I’m pregnant.

Right now I’m feeling shocked, surprised, confused, and exhausted.

I know you are all eager to know more, but there isn’t really much more to tell at this point.

Thank you all for your kind tweets and e-mails, and for all of your support on this journey.