Infertility, IVF, and Endurance

My guest today is Bryan. He's an endurance runner and real estate enthusiast with type 1 diabetes who talks with me about his (and his wife's) infertility journey. We learn about IUI, IVF, sperm count, motility, and shots. Lots of shots. I split our conversation into three acts, so this is a bit longer, but it's worth it. I promise. If you're struggling with infertility or going through IVF, you'll appreciate this episode. If that's not part of your journey, I still think you'll like this one.

Transcript

BART [intro]:
Hello, and welcome to episode two. We are, and by that I mean I am, so glad you made it. Last episode we talked about the process of conception, and we briefly mentioned infertility. Today we're going to do a deeper dive into that, and maybe this isn't on your radar. Maybe y'all are already pregnant. Maybe you're not worried about it, whatever. But according to the Mayo Clinic, one in seven couples experience infertility.

BART [Cont.]
So you might struggle with this, but if you don't, you definitely know someone who does even if you don't know that you know them, you know? You know. It's not exactly something people are talking about outside of very small circles, but one in seven... that's almost 15% It's like 14 point something percent of couples. It's a lot of people.

BART [Cont.]
You already know this but it's another reason not to nag your buddies about when they're going to have kids or why they don't have kids. Or maybe you're an older dude who likes to make new couples feel uncomfortable by asking those questions. And this is why maybe don't do that. Maybe they've been trying for a year or two years or more and maybe they've been spending a ton of money and maybe it's been really stressing their relationship. All that to say this is a big deal. We don't talk about it for a few reasons.

BART [Cont.]
One is that men aren't known for their vulnerability. Yeah, we're all starting to go to therapy. Or maybe we're not and we should be, and we've all read Brene Brown, or maybe we haven't, and we should also think about doing that. Anyways, it's very cool in theory to be vulnerable and open. And I think men are truly heading in that direction, at least in the US, but in practice, men aren't going around broadcasting things that they feel weird about, and infertility is one of those things. Infertility is one of these vicious cycles of shame.

BART [Cont.]
If you're struggling with infertility, you don't want to talk about it because you may feel shame for dealing with it. You might feel shame because no one else talks about being infertile so you feel alone. See? That's it. That's the cycle. There's a ton of these shame cycles around human reproduction. We don't talk about sex because it's taboo. We don't talk about trying to have a kid because what if it takes a long time or it doesn't happen? We don't talk about how we're pregnant until the sacred 10 weeks has passed in case there's a miscarriage. Or pregnancy loss. We don't talk about pregnancy loss and miscarriage because we've I don't know we just rather not.

BART [Cont.]
My buddy Andrew was telling me about people who die from choking on food, they choke, they excuse themselves to go to the bathroom and they die. They're alone because they didn't want to ask for help or inconvenience anyone. And because they were embarrassed to be choking. I'll be right back. I'm just gonna go die in the bathroom real quick. It was very funny when he said it. My point is if you want to suffer alone, you can. But there are people and groups who are dealing with this and they're all over the internet, which is awesome.

BART [Cont.]
I have a conversation with one of my good friends Bryan about this. He and his wife went on this journey / through this journey. Bryan is an ultra runner, former high school basketball star real estate guru. He's actually getting this housework done. While we speak so you're gonna hear some construction noises in the background. Anyhow, I love this man and you're gonna love him too. All right, here we go back to one. The first like take me from the start you guys got married in 2018?

BRYAN 
Yes. Sounds right. Okay, basically from the very beginning---and I laugh at this looking back now---but when we first got married, we talked about it leading up to it. Well, when do we want to try? You know, this and that, and Jodi's kind of like, we should start right away. And I'm like, No way. You know, that's crazy. Like we're just getting married. So we agreed that we would wait a year. We'd get married. And we'd wait a year before starting to try and I remember, on our one year anniversary weekend, we went and did an Airbnb up in Traverse City. And we're on that trip on that weekend and Jodi, she she's like, Alright, let's go.

BRYAN [Cont.]
And I was freaking out. I was like, It's too soon. Like, we've been married a year. I literally was thinking I was like a year and nine months like it's, I'm gonna get pregnant today or tomorrow. And then we're gonna have a baby in nine months. And I was like, I can't. So of course. We start trying then we pull the goalie and then lo and behold, you know the journey is way more drawn out way more comp, and now you look back and you're like, Oh man, if I had known then what I know now like, we probably never would have even put a goalie in place from the start. So

BART 
Can I ask you what kind of goal you guys were using?

Unknown Speaker 
We just condoms. Yeah, we never. I think Jody, she you know, more natural, holistic side of things. So that was what she wanted to use. And I was like, whatever. So yeah, after a year of marriage, we pulled the goalie we tried for six, seven months or so and ended up getting pregnant naturally, in December, but within just a few days of getting the positive test, she started bleeding so we had the chemical pregnancy the early miscarriage and that was like right before Christmas and that was that was very difficult not not just like learning that news. But for two or three months after that the hormonal and emotional like roller coaster especially for my wife was It was awful. It was like when I look back at the entire infertility journey. Those were some of the most difficult challenging months for us. And we couldn't really put a finger on it. It was just emotionally and hormonally all over the place.

Bart 
How did that manifest itself? Like what would it looked like?

BRYAN
We--just condoms. Yeah, we never... I think Jody, she you know, more natural, holistic side of things. So that was what she wanted to use. And I was like, whatever. So yeah, after a year of marriage, we pulled the goalie we tried for six, seven months or so and ended up getting pregnant naturally, in December, but within just a few days of getting the positive test, she started bleeding so we had the chemical pregnancy the early miscarriage and that was like right before Christmas and that was that was very difficult not not just like learning that news. But for two or three months after that the hormonal and emotional like roller coaster especially for my wife was It was awful. It was like when I look back at the entire infertility journey. Those were some of the most difficult challenging months for us. And we couldn't really put a finger on it. It was just emotionally and hormonally all over the place.

BART
How did that manifest itself? Like what would it looked like?

BRYAN 
It threw her body for a loop. And like we were just we were fighting about stuff that we never would fight about and like we would have these like irrational conversations and and it like went on for weeks and different things and then all of a sudden one day we were talking about it, we're like, oh my gosh, like there's a reason for all this and it's like, you know, the hormonal, the grief, the emotion and and honestly, once we kind of had that light bulb go off, then we both kind of like, opened our hands and we're like, okay, we need to walk through this differently and give ourselves space to like, grieve and heal and and be a little bit crazy for a little while. Yeah, and from that moment on like it's not like it magically resolved and went away but it just more of the healing took place. I think

BART [Narration]
I can seem like a cop out to say that someone's acting crazy because of hormones. And I think it's hard for men to really understand what it feels like. But here's a couple of facts from Johns Hopkins: hormones are working overtime during pregnancy hCG. HPL, estrogen and progesterone. So HCG is human chorionic gonadotropin, and pay attention because there's going to be a quiz later. This is only made during pregnancy. It's how pregnancy tests work. The HCG levels in the blood and urine rise a ton during the first semester. Then there's HPL, human placental lactogen. This is also known as human chorionic gonadotropin. ...Did I say that right? It's also made by the placenta and gives nutrition to the fetus and it stimulates milk glands in the breasts. Estrogen helps develop the female sexual traits, and progesterone stimulates the thickening of the uterine lining for implementation of a fertilized egg. So there's a lot going on in her body. You can cut her some slack.

BART [in conversation]
I think that what I can empathize with now that I couldn't have before is like this kind of like this timeline that you start in your brain where you're like, these are the expectations that I now have. Like, for this kid and for myself. It's like, oh, this is this is crazy. The further along in pregnancy you get the more you kind of, you just can't help yourself, and I think that this is like part of our biology to to bond with these kids before they are out of the womb...is like you have plans.

BRYAN
Oh, yeah.

BART
Is that part of what made it so difficult when the chemical pregnancy happened?

BRYAN
Definitely.

BART [Narration]
I should say a chemical Pregnancy is a very early miscarriage like after five weeks of pregnancy. You take a pregnancy test, it comes back positive, then you get a heavy period.

BRYAN
I probably shouldn't do this, but I relate a lot of things in life to real estate and everybody always gives you the advice when you're shopping for a house. You know, you go you walk through it. You look at the pictures you do this, you do that. You put in an offer. What does everybody say? Don't get attached, don't get emotionally invested in this house because it probably won't work out. But it's just part of the process that's going to happen you go there, and I think the same the exact same thing happens when you're trying to conceive or when you finally get that positive test. Like all along Jodi and I, we wouldn't let ourselves go there, and then you get that positive test. And you go there. And we, for, literally it was like two or three days that we were like pregnant and we had...we had so much fun for two or three days. Like we got to talk about and like celebrate these things that we had kind of been trying not to talk about and not to go there for a long time. And so yeah, you you let yourself do it. And then it gets, you know, the rug gets pulled out.

BART 
I made the mistake of like, I was like, I'm gonna document this whole thing. So Taylor had this pregnancy test. She went in the bathroom, peed on it came out and I'm there filming and then  she's like, um, it says that we're not pregnant. And I was like, Okay, I'm gonna put this camera away. I'll stop the video. And I was like that was that felt bad enough that maybe I'm not gonna do that again. Um, but the test like, what a roller coaster.

BRYAN 
Did you keep did you keep that clip? And have you guys watched it since?

BART
I think I did keep it and I haven't. I haven't looked at it. I haven't looked at it since it's a good call. I should bring it up.

BRYAN 
We had something similar. When we did get pregnant, Jodi took a test at work and wanted to wait and tell me in person. It was on a Friday. So I had no idea that it was coming and that it had happened. So we were in our apartment. She had the test. She set up her phone and like put it on the table and wanted to like take a picture and I was like, Oh, this is kind of weird. Little did I know she had started recording a video. And then we sat down to like take the picture and she like, busts out this pregnancy test and I flip it over and it says positive and we are like both getting emotional. We're hugging. And then she goes to like, you know, grab her phone and check the video. And she didn't realize that she had the camera flipped around. So she has this video recording that's facing the wrong way and you can only hear the audio of me finding out. And same thing as you we still have it but we have not listened to that video recording yet.

BART [Narration]
This is Bart from the future and Brian sent us that tape. So here it is.

JODI
Saaaay, we're gonna have a baby!

BRYAN
What?

JODI
We're gonna have a baby!

BRYAN
WHAT?

JODI 
Yeah!

BART [Narration] 
Listen, it's okay to cry. Let it go. Let it go. All right, back to the show.

BART
So, tell me what happened next. After you got the positive test. Did you call anyone or were you like, let's keep it under wraps for just a little bit?

BRYAN 
We definitely weren't telling a ton of people because we'd been trying now for six, seven months or however long by the time Christmas came around. We were telling people that we had been pregnant and that we had a miscarriage. So Christmas and the holidays that year had had a bit of that dark cloud over them.

BART
Do you have any examples of like what to do or what not to do? Did you have any people who  you were like, I really appreciated the way that this friend handled this or this parent handled this or, I really wish that this person had not said this or that? Do you have any of those?

BRYAN
The danger I think with being someone else who's hearing about somebody else's thing is to respond by sharing your own story or your own thing. And being like, oh, yeah, it took us three months to get pregnant and it was awful. And you're like, you just want to flip them the double bird and you're like, I'm going through this right now. And everybody's journey is different. I don't need to hear about your three month try. You know.

BART
I mean, that could be me. So Taylor and I took it took four months for us. I had been doing all this research for for class on endocrine disrupters and male infertility. And so I think that just my personality, I started to be like this could happen to me very easily, like I did. get kicked in the balls a lot as a kid like that one time I went down a zip line too fast and like got caught up in a tent wire. It's like, oh, no, my balls, you know.

BRYAN 
That one time I sat in 104 degree hot tub for six hours straight and didn't have a drop of water.

BART
Exactly, exactly! But then I was like, Well, it took us four months, which for me, you know, one of my buddies was like, it happened on the first try. And I was like, Oh, wow. But I hear you. I think that there's like, there's a lot of that's like a natural human thing. And we're like, this is your story. Here's my story, in how that's similar to yours, even when it's like total opposite ends of the spectrum, you know?

BRYAN
Yeah, it's really not it's really not to be dismissive of anyone else's because honestly, any amount of months that you're trying is a roller coaster, right like you go through that roller coaster each and every month. So whether it takes two months, four months, or 28 months, like you're all on that roller coaster, it's just kind of for how long so it's not to be dismissive of how long it takes. I think it's just, I think when you're when you're in it and that moment is so fresh, like as a support system. To me, it's like, I have to remind myself like okay, this one's not about me or my journey right now. It's, it's really about showing up for the person that's freshly going through it so affirm it, acknowledge it, tell them it sucks, you know, and that might be it.

BART
Yeah, I need to work on that. That's great advice.

BART [Narration]
Before we jump into act two, let's do some defining. I mentioned endocrine disruptors earlier. These are chemicals and everyday products like food cans, shampoos, toys, even ATM receipts, and a bunch of other everyday products. And these chemicals disrupt your endocrine system which is needed to produce hormones so your hormones get disrupted, which is not good. Okay, act two, Heartbreak Hill. Here we go.

BART
So tell me what happened. You guys were trying for a while you had this early miscarriage and then...

BRYAN
We had been told, you know, don't bother seeking help until you've been trying for six months. If you seek help, before that, they'll just tell you guess what? This is very common. Let's wait a bit. So we had started seeking help around somewhere around the six month mark, I think right before we got pregnant. So then after the couple three months after the early miscarriage, we kind of picked that back up and resumed. And that's when we really went into I guess what I would call like the testing phase, of like, you find out how intricate and how many effing variables there are, or could be. You both get so many tests done, and you start like uncovering and mixing your own, like, infertility cocktail of things that might be contributing to why. So Jody and I both went through rounds of bloodwork, different checkups, seeing different specialists. We both had things that they were like, Oh, this level is out of whack. That level is out of whack. Let's, we'll get you on this. We'll get you on that. I had low I had low sperm count and low motility.

BART [Narration] 
Motility is referring to movement. So how much movement is there in your sperm? Low motility means there's low movement, if over 40% of your sperm are moving you probably don't have a problem with motility.

BRYAN
So I, I basically just chalked it up and ended up self diagnosing myself with Bum Nads. [Laughter] I think I called it Bum Nads Syndrome, because I was like, Man, these things might as well be a punching bag because they're not doing anything.

BART
What does motility mean?

Unknown Speaker 
The way I understand it is, motility is like swim-ability. How strong of swimmers do you have? Do you have the Michael Phelps? Or do you have you know me in the shallow end with floaties on. Because there's kind of, there's the way I understand it, there's count (how many) volume and then motility (strength of swimmers) and I had low of both. My sperm count was very low and I had I got so many semen analyses done so I have so many data points and it always ranges. But my sperm count was like Well, I think normal normal sperm count they say or Lord Google will tell you anything under like 12 million 15 million somewhere in there would be considered low sperm count. So that's like dang, that's a lot. My sperm count got as low as 300,000. And that was an interesting month because I had just been sick so that was another thing we learned in the process was like if you're sick one month, the next month, your sperm count might be way down because your body is recovering from something and that's what had happened to me.

BART
It's not necessarily putting the energy into producing sperm it's, it's fighting off...

BRYAN 
And fevers will do that. Like you know, they say don't go in the hot tub of B spike a fever to sort of similar effect. I guess I'm on sperm count. Right. So yeah, I was anywhere from 300,000 to like two and a half million and all over the place in between. So which is pretty low.

BART
Yeah.

BART [Narration]
Our friends at the Mayo Clinic say that normal sperm densities range from 15 million to greater than 200 million sperm per milliliter of semen. So you're considered to have a low sperm count if you have fewer than 15 million sperm per milliliter.

BRYAN 
One interesting aside, I guess, on that, one place that I found a great deal of like empathy and support was Reddit, which I was not. I don't know that I've ever actually frequented Reddit before that but when I was kind of going through that in the middle of that and some things were popping up, I was like, I'm turning to the interwebs and I'm looking for you know, other people and you don't really want to read stuff that shows up on the first page of, you know, Google results. That's just this clinic that this clinic that so I popped on Reddit and started looking for some of these things. And there's so many people going through it and who were just ranting and venting about it and it was like, that was cathartic for me. I didn't type anything. I just read through things and it's like okay, I'm not the only one who's got this set of circumstances.

BART
Right? This maybe this is an odd question, but like somebody's listening to this and they're going through it now. What do you what do they find? What do they search for on Reddit in order to find this.

BRYAN 
So what I was looking for specifically, was varicocele, which is basically an enlarged varicose vein in your scrotum.

BART
Is that what you were diagnosed with?

BRYAN 
Yeah, I ended up...kind of my two big things that came up from testing that would be contributing to low sperm count and low motility were: I had I had high prolactin levels, which was caused by a very, very, very, very tiny, benign growth right outside of my brain. Which felt super scary, you know, but it has to do with male hormones and like testosterone, prolactin, so I went through testing for that, MRI, I think for that, and then ended up taking a very, very low dose of dopamine and got my levels back in place and it's shouldn't be anything to worry about. So that was one, and then two was, I saw a neurologist because when I was in high school, we found that I had a varicose seal on I don't even remember if it was the left side or right side of my scrotum. So I had the varicose seal procedure in high school to take care of that. Because it was it was tender and swollen and that kind of thing. It had been fine ever since. So they wanted me to go to the neurologist to get it checked out. He looked at it said hey, everything's appears normal should be fine. There is a very, very small chance that it can come back so I think it'd be wise for you to go get a testicular ultrasound. So he ordered that up. And so this was totally just like a double check. You know, for the off, off chance and he was right that it hadn't come back on that side. But what it revealed, to my chagrin was I had varicose seal on the other side. So, which I don't know how common that is. I don't think it's horribly uncommon but not super common to have it on both. So I ended up having a second varicose seal surgery to take care of that one. And then you wait two or three months recovery before you're supposed to be able to try again and see the effect it has on sperm count and all that

BART 
What are the what does that surgery look like? Or feel like?

BRYAN 
That's--it, it varies. And that's like what I was that's what comforted me on the Reddit because I was told, you know, hey, this is it's a fairly quick thing depends on severity, you know, these factors. The neurologist he said to me, he was like, because I'm I like to run I was like, you know when can when will I be back walking? When can I be back to running and he was like you pretty fit pretty healthy. He's like you'll be back to running in two or three weeks. I'm like, okay, that's not bad. So they put you under for the surgery. You get a little incision, nothing crazy. And two weeks later, and I like could barely stand up. Wow, really? I was on the couch. I was just working on my laptop horizontally for two weeks. I iced it like crazy. It was like the incision was kind of swollen things were tender. I could not like I couldn't stand up straight for like three weeks. And this is why it varies because I think I mean when I had in high school I think I bounced right back and I think plenty of people bounce right back from it. And then there's others that it takes weeks or months and honestly even months later I could I still had some tenderness and it's just very slowly healing and improving. So and then the whole thing is like, Hey, we're doing this because we're trying to increase sperm count and motility and get you pregnant. So after two or three months of recovery, then I go for a semen analysis and we started doing IUI again, and I think my cow had come up a bit but I mean, still far, far, far below what would be considered normal. So then it's like, Oh, dang it. This didn't work.

BART
Okay, here's the Mayo Clinic definition for IUI: intrauterine insemination. It is a procedure for treating infertility. Sperm that have been washed and concentrated are placed directly in the uterus around the time that the ovary releases one or more eggs to be fertilized.

BRYAN
Basically, the turkey baster method. Basically, you give a spur, sperm or semen donation, they wash the semen separate you know, the good boys from the weak boys, you learn your count, you do this, so that happens like in the morning and then your partner or Jodi would go in and they would literally do like have the good ones separated. And Turkey baster or put them in and try to get it, you know, far enough in to give it a good chance of meeting and fertilizing. So, logically speaking, it's like it's a great idea. It solves for some of the like motility issues and things like that. And yeah, I think in total, I honestly don't know we either did six or seven rounds of IUI before and after my surgery.

BART
Wow. And those, she has to -- you have to wait for Jodi to be in like the fertility range, right? Like her cycle has to be matched up?

BRYAN 
Yeah, yeah. Yeah, everything revolves around ovulation. Early on we started the pee diary so she's you know, peeing on strips and taping them in the, you know, in her pee journal, and we're she's got the app and we're doing you know, basal temperature and to an all day because you really do learn like you have this nice window of opportunity. So yeah, with IUI you are doing it around around ovulation and there's also like things that they can do to trigger ovulation. So we got to that point to where she would basically take a trigger shot to lead up to it so that it was like hey, let's let's kind of force the stars. To align here.

BART 
So where are you mentally during this? Like you, you've always been very like good natured about even even earlier, when you were describing your balls. You're like...what did you call them Bum Nad...

BRYAN
Bum Nad Syndrome

BART
So like, I know you're able to, to laugh at it and stuff. But I'm sure when you're going through it, you're like, were you just like really angry or like how did that manifest itself?

BRYAN
The way it played out, for me was, anytime we would shift gears and do anything, for the first time, I would get my hopes up. I remember like the first IUI that we did, and then the first IUI after my varicose seal procedure. And then anytime they introduce these new variables, like a trigger shot or something. Just that little bit of like, hope and change, I would be like this is it, you know, so I get my hopes up, and then it wouldn't happen and you'd be you'd be devastated for that month. Also, not to mention the two week waiting period, no matter what -- if you're just trying naturally or going through IUI or these other things -- like after ovulation and before, you know, cycle day one, like that two week takes an eternity. So, so that's how it manifested itself. I'd get very excited, very worked up and then once that one wouldn't work, then I'd go back to being like, okay, my expectations have been leveled. I'm not expecting this to work. So times two through N, however many N was. I'd be kind of like, Alright, we'll see how this goes.

BART
Sounds like you. You kind of learn to temper how you were feeling about things did you start to feel like, I don't know if depressed is too strong or like did you start to... I don't know did it hit your identity at all?

BRYAN
It did, because it is... It is defining so much of your emotional and mental bandwidth. And I'll say this too, like the females have it way harder and like I -- watching Jodi go through that ... was honestly like that was the most heart wrenching part of the whole thing. Because I'm kind of in this, you know, support role and I'm experiencing it also. But it's like, there's something about like it just being like taking place or not taking place in her body and she's the one that's got to like pee on the strips, take her temperature every morning, and you can't move and can't do anything till you get this, and she had, you know, all these tests and don't get me started on all the shots for IVF and all this... it's just like it is they go through so much. And that for me, that was the worst part of the whole thing. So when it came to like infertility, you're both gonna find things that could be contributing but I was I told her this I was almost glad that it felt like my Bum Nads were the reason and I could blame it. Because I was like, I just want to take something off of your shoulders. I don't want you know, let me let me bear that let me be at fault here. So yeah, it's it's, it weighs on you big time. And for us while we were going through kind of the thick of it and the long months of this like good or bad... Like there were times that we just like kind of wouldn't talk about it. And we try to focus on other things. We are shopping for a house we were you know going through job changes and you know, big things happen in that work and we just would try to focus on that stuff. We we like tried to get really big into like date nights we had Tuesday night date nights, and we try to go do something fun. And like make ourselves laugh and smile and just kind of distraction mechanisms, anything you can do to like, dig into something else so that you're not just sitting there mellowing in the waiting game.

BART
Yeah. I think that's, I mean, I think that's great advice. Did you learn that somewhere? Or were you like, were you like, we need to just do this. This is something that we need to do for our marriage?

BRYAN
I think it's, I mean, it's, it's a bit of an evolution and it's the same thing, you know, the whole real estate thing like don't get attached to it. Well, the only way you're really not gonna get attached to it is if you let yourself get attached to it and then get burned by it. So I think for us, it was like we we went through it for long enough to have enough months that like, we experienced the, you know, the depressing times, and then we're like, okay, you know what we've done that we know what this could look like, for however long this is going to last. We can either continue to do that. Or we can do something else about it. And it was certainly wasn't an overnight thing like this is an evolution. It's a progression. And I think we kind of just found our selves, pushing more for trying to be happy and content. And yeah, not to get preachy or faithful, but like, my, my life passage has always been Philippians 4:13. And as I've gotten older, I've just expanded and incorporated more of that chapter of the Bible. And so now it's really just all of Philippians four, but I can't tell you how many times like I would say out loud, or we would say out loud Philippians 4:10. That, you know, "I've learned to be content, whatever the circumstance, you know, whether well fed or hungry" and we just had to be like, you know what, there are so much that we yearn for in life right now. We want---we so badly want to start a family. But you know what, we have a beautiful marriage in a relationship with each other that we we enjoy and all these other things to celebrate and so we just tried to focus on that.

BART
That's awesome. What is Philippians 413

BRYAN 
Philippians 4:13 is I can do all things through Him who gives me strength which is ---

BART
---oops go ahead,

BRYAN 
I'll try to get through this without crying, but that has been my life verse. First introduced to me at age 11 when I was diagnosed with type one diabetes, by my grandfather, and the way he explained it to me was it's not about like strength as in like, a feat of strength or of might it's about it's about endurance, and, you know, having the support of Christ who's walked ahead of us, behind us and with us, and so I've clung on to it since I was 11. And then when my dad passed away in high school, that was what I clung to it, it was it was like how I got through days, weeks and months and so infertility it was like, any time I'm going through something troubling or traumatic now and it's it's, it's what I cling to, so but it's just yeah, the verses have expanded.

BART
Man. You know, I think that you might be one of the most mentally strong people I know. And so much of this experience seems to be I think about you running like ultras. And so much of this experience seems like that where you're like, Man, when is this going to end?  I imagine that you get in the middle of one of these long races that you run, and you're like, oh my gosh, like, I imagine that you're kind of you have to stay level. Otherwise you're kind of going in peaks and valleys and then you can't finish the race. So I don't know your, kind of life verse, is just, it's just -- it's perfect for you. And as kind of an observer, you embody it. So that's awesome.

BRYAN
Well, thank you. Yeah, it's I think it's, it's, you know, it's this enabling and supporting, supportive reminder. But it also in some ways, it's liberating because it's like, you learn to be okay with where you are. And like, if if you're if you're bummed out about something or yearning for something like it's kind of this like affirmation that like it's okay to be there for a while and like, affirm it, and, and sit with it. So, there's probably some great quote about something like that, but like, strength does not mean like having your shit together all the time. Like, it's okay to weep. It's okay to cry. It's okay to admit that you're you're troubled and frustrated by something.

BART
Right.

BART [Narration]
Okay, act three. You're gonna love this. Trust me. Thanks for sticking with us. Act three finish line.

BART
Tell me about the next step.

BRYAN 
Let's see. So, quick recap. Tried for a while, early miscarriage, bunch of testing, couple/three rounds of IUI. Varicose seal procedure, some recovery. Couple / three rounds of IUI. I honestly cannot remember how many total rounds of IUI we did. I think it's either six or seven then we got to the point where where we're looking at IVF

BART 
In vitro fertilization, IVF. It's a complex series of procedures used to help with fertility or prevention attic problems and assist with the conception of a child. So during IVF mature eggs are collected or retrieved from ovaries and fertilized by sperm in a lab. Then the fertilized egg, the embryo or eggs, embryos, are transferred to a uterus.

BRYAN
It was you know, something that had been on the table for a while, but it's obviously more involved. It's very expensive. So I couldn't help but kind of be doing the, you know, slight financial, you know, analysis the whole time. It's like, okay, every time we do IUI, it's costing this IVF is going to cost that but after you've done six or seven rounds of it, you're like, honestly like, let's just go for it. It's certainly not a financial decision. That's just one component of it. It's if IUI can work like by all means it's worth trying and do it. And it got to the point where, you know, our infertility doc was like, at this point, I think you guys's resources, time, money, emotions will be better spent going through IVF prep, and then IVF. Mentally we had thought about doing a few months before and we just weren't there yet. And so we want to keep going with IUI. Then at that point we visited it and it was like yeah, like it's time. Jodie. You know, we'd obviously heard a lot about it. Jodi was she was reluctant about all the shots. Just, you know you if you've been introduced to the idea or you know someone who's gone through it, you hear about how many frickin shots it is. And I can say, as a type one diabetic for over 20 years, I've been jabbing myself with needles for decades. Honestly. The shots with IVF are no joke. The gauge on the needles, they're good sized needles. The progesterone is this oily substance and it's something about the process like there's a little bit of a burn effect to it. And Jody, she was reluctant to, you know, sign up for that, rightfully so. And even after going through it like it's not crazy. It's it's it's doable, but it's not pleasant.

BART
Where, where do they give the shots? Are the shots are just progesterone, or what else is in them? And how many? Sorry, lots of questions.

BRYAN
So we did some other -- because there's like these like trigger shots that you can do for ovulation -- so I'm I'm trying not to mix and match all those ... but there were some shots .... So with IVF you kind of go through like suppression where they're basically just trying to get ready for it. I kept calling it like they're getting ready for Easter. Like they're they want the big Easter egg hunt, the big egg retrieval so you kind of go through this like suppression of the cycle so that you don't drop any eggs. Then you go through like stimulation, I guess to basically grow as many eggs as possible. And then they do this big egg retrieval and then combine that with with semen and fertilize as many as they can see how many healthy last and then those are, you know, you have, you have science babies. So that's my limited understanding of how the process works. But with the shots, there were some stomach shots in the -- I believe earlier on in the stimulation and or suppression parts--  but then you get to the routine one, is the progesterone. And that one you do, we did in her butt. So you kind of do like upper - outer butt. They literally draw like circles of kind of the quadrant of on your butt where it should go. And yeah, it's just we had a lot of oozers. We had a lot of bruising. We had a lot of times where like, I would like put it in and it would it would be it would be burning her like as it's going in and getting towards the end and then I take the needle out and we had some some bleeders and then you'd have some were like I don't know if there's kind of the scar tissue that gets built up or because of this oily substance that doesn't like set well...that like the progesterone would like start seeping out so I'd always come ready with the syringe and a mandaid. So I had duct tape and toilet paper ready to go. Take the needle out, wipe up anything and then I put a mandaid on it. And she'd wear that for a little while until blood or progesterone would stop seeping out.

BART
And you found that that worked better than like a regular bandaid?

BRYAN  
That's -- just -- no I'm sure not. That's just me being frugal and us going through a house renovation at the same time. Like I got duct tape everywhere. So I was like huh anytime like this my hand doing, you know, working on the house like make a mandate so that was the I guess just the easiest thing for me to come up with. And you know, I you know, I'm frugal so I use the smallest piece of toilet paper like I'm ripping squares into it literally like into like fourths. And then I roll it up. I get the smallest little strip of duct tape I can possibly get. And I put this thing on and it's it's--

BART
I love thinking about this because it's like you have you have all this like science and technology in your you are playing surgeon giving your wife these these serious shots and then you quick grab a piece of duct tape. Toilet paper slap it on there. Also, I just I suppose I don't know. I don't know. I don't know Jodi super well. But it just -- knowing her -- It seems funny -- I just imagined her being like, give me a frickin bandaid, man!

BRYAN  
Yeah, she she does not. She does not share my like passion and predisposition towards like being cheap and frugal. So she's, she likes to do things right and do them well. So yeah, fortunately, she couldn't see the mandaid until after so I think she learned to live with it.

BART  
Yeah. So you -- so you gave her these shots. And then what happened next?

BRYAN
So we go through that. Then basically they do... She's going in for checkups and things then she ends up going in for egg retrieval. So they go in and pull all the eggs out.

BART
How do they do that?

BRYAN  
Basically they stick a needle in, they go up inside and into I think both ovaries and basically put the needle in and they suck out reverse syringe each one of these things out and then I'm assuming it was the same day we did egg retrieval I had gone in with a sperm sample and then they -- like IUI I think they do the wash -- then they fertilize and see how many take. Jodi, being the boss that she is, handled everything so well. She was like -- when you're going through IVF your ovaries get like loaded with eggs -- so you're like you're feeling it and 

BART
Like it's painful? 

BRYAN
Yeah, it's painful because I mean, I don't know what the normal amount of eggs and things are. But you're you're you're growing a bunch and harvesting a bunch suppressing. So you're you're over capacity for for normal. I honestly can't remember how many eggs she got out but it was more than I think they typically get. But then after fertilization, I remember I think we had basically 16 viable embryos, and then they can like they basically can grade them and I think there's all this way more stuff that I still don't understand that that they're able to tell about you know, viability and but they can create these things and then yeah, then then you get into, in my mind, like after deciding to do IVF like probably the biggest decision if things go well and you have five embryos, is how many do you transfer? And when? And again, I'm sure there's other other options within this but basically we could do...I mean, I guess you could still end up with twins, but you're you're putting in one embryo when you put in two, you're hoping that one or potentially both take and so we talked with our doc and she basically said you know based on your situation, like I think you should do, two Day Three embryos and we were like, you know, well, if we're if we're fortunate enough, we'd love to have multiple children. So let's do it. But again, at this point, the fertility journey has been so long and you know you're not really it's your first time doing IVF you don't know what the chances the likelihood is. So honestly, even when we put two embryos in, I was not -- I didn't know what to expect. I was I was basically like, is it going to be yes? Or is it going to be a no? And lo and behold, fast forward. They both took and we are pregnant with twins.

Bart  
Yeah! Crowd goes wild.

[Upbeat music]

BART
Congratulations, man.

BRYAN 
Thank you. Thank you.

BART
What a journey. What a journey. 

BART [Narrating]
Since recording this episode, Brian and Jodi have become the proud parents of two healthy baby girls.

Thank you to my good friend Brian Van Horn for the hard, good conversation about difficult and awesome stuff. And thank you to his wife Jodi for giving their story the green light and for sitting down for an interview with me. If you liked this episode, great! Tell a friend. You know the deal. Ctrl C, Ctrl V, send. Alright, I love you too. Bye bye



Music Credits: 

Agnus Dei X - Bitter Suite by Kevin MacLeod is licensed under a Creative Commons Attribution 4.0 license. https://creativecommons.org/licenses/by/4.0/

Source: http://www.amazon.com/Agnus-Dei-X/dp/B00QGC7W3Y

Artist: http://incompetech.com/

Good Times by Patrick Patrikios

Little Drunk, Quiet Floats by Puddle of Infinity

Quiet Nights by Nate Blaze

Hippo by Dyalla