running

I guess my next logical post is to explain how I got myself into this situation, especially since it was not the norm. As you can tell from the title of this post, we conceived via IVF and were fortunate (very fortunate) to be successful on the first cycle. To put it in perspective, women age 35 to 37 have a 30% chance of a live birth per cycle. For women under 35, it’s 40%. Like my sister-in-law told me, someone has to be that 30%. We are lucky to be included in that percentage.

I don’t want the focus of this post to be infertility. Yes, we had fertility issues but I was able to get pregnant in less than a year. I don’t consider it a struggle, compared to others. This will be the only time I mention it on the blog because, in my mind, how I got pregnant is irrelevant at this point. What is important is that I am pregnant.

So why am I writing this post? Running, of course. When I knew we had to go through IVF and I was told I couldn’t run, the stubbornness in me Googled “IVF and running”. I didn’t find much information, considering exercise is contraindicated while going through IVF. But the thought of not running for a month plus, during an incredibly stressful time, was unfathomable. I am writing this post to document what I did during each stage, in hopes that it will provide information to others – with one caveat. This is what I did and sometimes it was against the advice of my doctor. If you are going through IVF, please consult your doctor, listen to your body, and use common sense before you consider lacing up your shoes for a run.

A brief background first. After trying for 6 months unsuccessfully, we were referred to a fertility clinic. Numerous tests later, we found out that our only way to conceive was IVF. Skip Clomid, IUI, and proceed directly to the end of the line. It was devastating news but luckily I have a husband who sees the glass as half full.

Knowing that I was about to go through something completely out of my control, I felt the need to control something. Enter my self-proclaimed quasi-training during the months of January to March. I was coming off the Rehoboth Beach Marathon and pretty much kept going, running 40-50 miles per week. Many of you asked me which marathon I was training for – or secretly training for – but the truth is I was training for IVF. I figured quasi-training would serve me well. Either I would enter pregnancy in the best shape of my life or, if the first cycle failed, I could easily start back up again and train for a Fall marathon (which would have been Steamtown – I’m actually registered for it!).

Finally – to the point of this post! I’ll break down each stage of IVF (as I see it), describe it briefly, and describe how my running was affected.

3 weeks of BCPs
Looking back this was the “honeymoon” phase of IVF. 3 weeks of birth control pills – piece of cake. I could run as much as I wanted so I kept my mileage between 40-50 and squeezed in a few solid long runs of 18 and 20 miles. I do know that some IVF protocols start Lupron injections towards the end of BCPs but my protocol did not.

Stimulation phase
Let the injections begin! I began injections with Follistim and Menopur on March 28^th. The point of this stage is to stimulate your ovaries to produce multiple eggs. I was on stimulation meds for 12 days (adding Ganirelix to the mix towards the end to prevent ovulation). The ballpark range for stimulation is 7 to 14 days but that all depends on how you progress. My progression was very gradual – meaning my ovaries didn’t grow to the size of grapefruits overnight! When your follicles are roughly 16-20mm in size (measured via numerous vaginal ultrasounds), ovulation is triggered with a big dose of hCG.

Running (or any exercise other than walking) is contraindicated during this phase for good reason. Ovarian torsion is a very real threat once your ovaries start to swell with follicles. The size and weight of your swollen ovaries can cause them to flip and cut off their own blood supply. You can imagine how any high impact exercise or any exercise with excessive bending and twisting (yoga) could increase your chances of ovarian torsion.

So instead of running, I walked…30 miles a week! The fertility clinic’s version of walking was a “nice post-dinner stroll with your husband”. My version of walking was a balls-to-the-wall sub-15:00 pace…multiplied by 30 miles. One day a nurse told me I was doing too much – I knew I wasn’t – I politely said “OK”. I never felt any cramping (a sign that you are doing too much) and, even though it sucked to not be running, it was better than nothing. I even did long weekend walks – 4 miles in the AM and 5 miles in the PM. Like I said, I’m stubborn as hell. I could not sit around and wait…or curl up with a book or movie (which was suggested to me numerous times).

Egg retrieval
This was hands down the worst part of IVF. 36 hours after you receive your injection of hCG, your eggs are retrieved by passing a needle through your vaginal wall. If it sounds painful, it was. You are under anesthesia and the procedure is quick. It’s the aftermath that is the worst. I felt like someone took a shovel to my torso and beat me up and down. And the bloating. Oh the bloating. I wish someone would have told me I would have looked 5 months pregnant. After your eggs are retrieved (and they retrieved 25 eggs from me – a huge amount), your follicles fill back up with fluid, causing excessive bloating. The only way to get rid of the bloating is to drink and eat excessive amounts of salt. I was eating table salt and washing it down with Gatorade. It was unreal. The soreness and bloating subsided after a few days.

I did run the 3 days after my egg retrieval (4 to 6 miles). And, if I had to do it all over again, I would not run. My ovaries were still very swollen and I could have risked ovarian torsion. It was completely stupid (and, again, stubborn) on my part. I should have stuck with walking.

Embryo transfer
This was definitely the most exciting day! After retrieval, your eggs are fertilized – love in a petri dish! Depending on how the embryo(s) are progressing, they are transferred back on Day 3 or Day 5. I had a Day 3 transfer. The transfer process is quick, painless, and does not require any anesthesia. With the help of an ultrasound the embryos are guided and placed into your uterus, with the hopes that one embryo (or more) will implant and result in pregnancy. After the transfer procedure was complete, I was on bed rest for 24 hours.

I ran the morning before my embryo transfer, just to ease my nerves and relax. The day after the transfer (after 24 hours bed rest) I walked 7 miles. I know this sounds insane to some people. Why couldn’t I just relax? Was I worried about interfering with the (possible) implantation process? I wasn’t. I know many of you can agree with me that, as runners, we are hyperaware and in tune with our bodies. I know when to push, when to pull back, and when to call it a day. I know immediately if something is off. I felt fantastic and didn’t feel like I was overtaxing myself. I just went with my gut.

The 2-week wait
The most stressful part…waiting to see if you are pregnant. After your transfer, you wait 2 weeks and return to the clinic for a blood draw to see if you are pregnant. The first week went by pretty fast and without much stress but the second week was awful. My blood test was scheduled for a Friday but Matt and I caved on Wednesday and took a home pregnancy test. Technically you’re not supposed to take a home pregnancy test due to the high rate of false positives (the hCG trigger shot you administered before retrieval can trigger a false reading). BUT, I knew the hCG was out of my system and this was the real deal. Three tests (1 good one and 2 cheapies) – all very positive!!! The relief, excitement, and sheer joy that we felt was (and still is) unexplainable.

I was told not to run during the 2-week wait. I followed that rule for about a week (continued my balls-to-the-wall walking) and then I began running again. I actually got the call from the nurse that I was pregnant while I was out running Was I putting myself at harm or putting the baby at harm by running so soon (and against medical advice)? No, not in my mind. Again, I felt incredible and running made me feel even better. Obviously, I would have stopped at the first sign that something was wrong.

And…I’ve been running every since. And I plan to continue to run for as long as I’m able.

If you’re wondering, I’m not having twins! At 6 weeks, they confirmed the presence of 1 baby, not 2!

If you have any questions, I’m more than happy to answer them through email. Again, this is what I did. You may feel differently. Always consult with your doctor and do what makes sense.

Unrelated bump shot – 11 weeks vs. 13 weeks.