Merry Christmas

Wishing all of my internet friends a wonderful day. Hoping For peace and love for you. :)

Living like it's going to work out

I've been wondering lately I could start believing again that this is all going to work out.  I used to think that way, that it was just a matter of time.  But something in me shifted.  I don't know when it happened, but if I had to peg it down, I would say it was sometime after our second miscarriage last April.

I started becoming acutely aware that not everyone resolves their infertility. And even more frightening, that we could be one of them.  Crap, right now we are one of them.

I'm feeling sad and frustrated today.  I found out that another one of my real life IF friends is pregnant.  And, not the one that I wrote about yesterday.  She's 12 weeks.  She's a great woman who I'm sure will make a wonderful Mommy.

I've been trying to build up my IF armour over the last couple of weeks to head into Christmas but I don't think it's working.  I've been too busy deflecting little IF bullets.

I've read a little mantra somewhere from fellow IFer.  "It's not their baby I want, it's our baby that I want".   The truth is, I don't know if that's going to cut it. If any of the preggos I know offered me their baby I'd take it.  I need a new little mantra to get me through the holidays.

In the mean time I will go about my little life.  Preparing to leave town for a few days to visit with family.  I'll return a few days before New Years when we are having a party for our friends who have sitters.  We used to have a big party at home and invite all of our friends.  That was before the baby boom years.  I miss those days.

A bummer of a post.  I hate feeling like I'm bringing people down.  If you are reading this, I'm sorry about that.

Waiting for the phone call

They were introduced to us by the social worker who completed our home study.  She asked for permission to pass along our names to another couple navigating the waters of embryo adoption.   We had been her first couple dealing with embryo adoption, and they were her second.  We happily obliged.  

The couple contacted us, and we shared a meal at a restaurant.  They are the kind of people that you meet and instantly like right away.  Down to earth, kind, and funny.  She's a mix of country and the big city.  He's all country.  They are kind of couple that you know would make fantastic parents.  

We shared with them our journey that led to working with the Snowflakes program through the Nightlight Christian Adoption Agency.  They too had selected the same agency.  It was nice to be face to face with another couple navigating the same process.  I day dreamed about us both having children who played together. 

We've been keeping in touch for the last couple years mostly over the phone and by email.  However, last year around Christmas, we lost touch.  They had announced they were pregnant via their first embryo adoption procedure only a few months before.  We were in the midst of the early stages of our first pregnancy, and then quickly experienced the loss of our twins.  

In truth, I just didn't feel that I had anything to really say to them.  I felt like they would be able to see through my facade and I didn't want to be a downer on their happiness.  Besides she had gotten pregnant on their first try with donor embryos.  I wondered if she would even be able to relate.  

Early in the new year, they reached out to us with an email announcing the birth of their daughter.  The email included pictures of a beautiful teensy tiny baby girl, and a brief story about her caesarian birth at 21 weeks, and her passing 10 days later.  We were absolutely heart broken for them.  I remember getting the news and sitting on the couch crying with D. 

We reached out to them, sending our condolences and a gift in memory of their daughter.  

A couple of months later, they visited us and we tried to comfort them as they shed tears about the death of their daughter, and a due date passing.  If I could have done anything to help ease their pain I would have.  It was just so palpable. 

A couple of months ago they were matched with another family, and had their third FET procedure.  The day of their daughter's birth came and went.  I sent an email to her to tell her that I was thinking of them.  

She reached back just the other day.  She said they are moving and she would love to talk with me soon.  Her emails had a hint of joy.  She suggested we talk within the next few days.  

I thought this was a little strange, because if I was moving the last thing I would be doing is having long conversations with friends.  And that's the kind we usually have, somehow they always end up being 1-2 hours on the phone.  We spent all afternoon in a restaurant once.  It always seems that we have so much in common and so much to say. 

I have this feeling though that she's going to tell me she's expecting.  My five years of IF have helped me to develop a keen sense of 'preg-dar', radar for preggos.   

I've been practicing my "happy reaction" to their news in my head.  

Gosh. I wouldn't wish this journey on anyone, and especially not them.  Yet, I can't help to feel a little bit sad.  Another one of my few real life IF friends is no longer going to be in the battle.  It's a reminder that makes me feel like we've been left in the dust again.   

Bridesmaid

I was asked to be a bridesmaid in a wedding this July.  The offer completely caught me off guard to say the least.  I had met her all of three times before she asked me.   I'm not a good surprise-reactor under the best of situations, let alone this one where I hadn't even had time to process what I thought about it all.  D was also asked to be in the wedding party.

So, I hugged her and said a mostly enthusiastic, "sure!"

A month or so later it came out, that I was actually being asked to stand up for her fiancé, which made a little more sense.  He is D's long time friend, and he has hung out at our house a lot.  We've helped him get through some tough times in his past.

It's interesting. But, oh well I thought.  It will save me sitting at a table full of significant others who I don't know.  And maybe D & I will get a nice picture all dolled up together.  :)

The bride has been changing her mind (a few times) on the styles of bridesmaid dresses that she would like.   While other bridesmaids were growing slightly annoyed by the decision making process, I couldn't care less.  For one, I don't care what I'm wearing, it's her day, and I'm happy to wear a paper bag if that is what she wants.  It would be a plus if I liked the dress,  but it doesn't really matter.   The bride had many other people chiming in to give her advice, so I just sat back and relaxed.

After much deliberation over the course of a few months, the bride selected the bridesmaid dresses. She also let us know that they are on sale right now.  So, the good bridesmaid that I am, I called the store and ordered my dress.

There is only one problem though.  What size to order?   At first I thought I would just order my size and an extra bit of material.  You know, in case I was actually pregnant next July.

But I wasn't sure if this was the best option.  Maybe I should just order a larger dress?  That might be a weird conversation.  Umm, I'm planning on getting fatter, what size should I order?  So, I confided in the clerk my hopes of becoming pregnant, and asked her what I should do about sizing.  Deep down, I silly even saying it his to her.  Of course she doesn't know my history, but I've been through this before.  Thoughts of maybe by next Christmas or at my next birthday?  Should I buy that new winter coat? This sweater is great, because I could also wear it as a maternity sweater, I've told myself more than a few times.

It's such a hard thing to figure out.
a) If I'll be pregnant (please, please, please universe!), and
b) what size of a preggo I would be? (I think I'll be a nice plump one if I ever get the chance) , or
c) Will it be a pregnancy from our first CCRM IVF resulting in third trimester baby bump?
d) Will we (still holding my breath for a miracle) have more embies to transfer in a frozen cycle if the first transfer doesn't work?  Might I be pregnant, but only in the first or second trimester?
e) Will we have finally closed the door on OE, and moved on to DE and be in the early stages of a DE pregnancy? or
f) be where we are now, childless and not pregnant with one super-sized teal coloured bridesmaid dress?  Correct that, I mean as the bride would say, "malibu" coloured dress.

I decided to error on the side of optimism.  I ordered the dress two sizes larger than I am now.   They told me they could take it in if they needed to, and that it shouldn't be too hard with the style of dress.   But if things don't work out, I'm going to have a yucky little reminder in the early summer when I go in have my alterations done.

Here's to hoping I won't need those alterations.

Regroup

Hmm.  The nurse called just a few hours after our last conversation.  The doctor has reviewed our results.  She said that they usually get instructions for a protocol at this point, but for "whatever reason" he is requesting a regroup.

I don't like the sounds of that.  That means something has changed.  And I don't think it's to call us and tell us that our chances are better than he expected.

The good news is that we won't have to wait long for the appointment because I already had one booked on the 26th to discuss the laparoscopy further.  I was going to cancel it shortly because it seemed unnecessary after conversations with the nurse.

Shit.

Day 3... Results are in!

My results are in,  (drum roll please! haha)...

Estrogen:  35.  They would like it to be below 50.

FSH:  11.9. This is just a bit elevated over the 10 they would like to see - YIPEE!!

LH: 9.1.  She said this should be about 1/2 of the FSH level. (Which obviously it's not). The nurse said that this gives the doctor an idea of what type of protocol to put together.  I'll need to find out more about this later.

I love how without asking the nurse just gives the reference range for a result.  It's awesome.

From here, she will ask the doctor to put a protocol together.  They will determine if they will use this cycle or the next.   Oh my gosh! I didn't even think this cycle would be an option.  Happy dance!!!

She discussed Dr. Dandruffbeard's desire to have a sono-HSG before doing the laproscopy.  The nurse said, "let me just think of the polite way to say this".  I told her "there's no need, you can just tell me what he said".  She told me that Dr. Schoolie thought it was an "idiotic" thing.  She explained further to me, that it would be like having an MRI and seeing you have a tumour, but then saying that you need to look at someone's eyes before doing surgery.  Or, that if you had a mammogram and found a mass, but then wanted to do a breast exam.    She said he thought it would be a waste of time, using a less sophisticated technology and and that it would give us no more information then we had now.

She said if I needed to do the sono-HSG to follow the rules of the Canadian health care system, then to do it.

I asked her if I should be worried about being under his care?  Should I have someone else do the surgery?  Now I'm not so sure.  Ironically, I'm no longer trusting Dr. Dandruff's opinion.  Oh.  And did I mention that Dr. Dandruff is the head of his department at one of the larger hospitals in my area?  Now I can't get the thought of 20 year old equipment and dirty operating rooms out of my head. Yikes.

I might reconsider paying the $3,500 it costs to have the laproscopy procedure done at CCRM.  Maybe they could do it after my egg retrieval if we get that far?.

Dr.  Dandruff had also told me that if there was no hydrosalpinx shown that there would be no way for fluid to be moving in the direction of uterus.  That fluid is pushed out of the tube towards the ovary.  I asked the nurse for Dr. Schoolie's opinion on this.  She said that it is nonsense.  I asked why, she said that some doctors just believe different things.

Gearing up

Gah, I want to post something just so I don't have to look at the last pic anymore.  Bad call on the beard pic, and it doesn't even have any dandruff in it.  I don't hate beards, but ew!

The exercise class has been going well.  As I write this my face is attempting to return to it's normal colour, down from the beet reddish-purple that it is right now.  I've never been a person who sweats much, and I think my body tries to compensate by turning colour.  I can remember in elementary school when I was running cross country, people used to ask me if I was ok because of it.

I'm emotionally putting on my armour, and gearing myself up for Christmas. This will be my last family Christmas (on my side) that will be child free.  This baby will be my parents first grandchild. The truth is that I've enjoyed the fact that I could escape our IF when I was with my family.  I have 2 younger brothers and 2 younger sisters, and baby making and child rearing have never been a part of our conversations.   That's about to change, with my brother's girlfriend expecting this January.

Of course I am jealous.  However, I am cutting myself some slack because I think it's not surprising that I'm feeling this way.  Who wouldn't if they were in our shoes?  5 years of IF hell and your brother's girlfriend gets pregnant by accident while on the pill?  Uh.   The IFers know the drill all too well.   It just hadn't infiltrated my family yet.  It was one of my remaining safe places from IF.

The only good thing about her pregnancy is that she isn't super pumped about it.  I know that sounds terrible and that this fact would make a lot of people upset, given how much they want a baby.  But I'm ok with it.  I get it.  She wasn't ready.  If I wasn't ready (say 10 years ago), I would probably feel the same way too.  I'm trying to see it as a small blessing.  She's not flaunting her pregnancy around me, letting me know when the baby has gone from the size of a plum to a medium apple to a turnip.

I'm hoping for my day 3 FSH today.  This is the last piece of the pre- IVF work that needs to be complete.   I'm hoping for sky-high or low.  No middle iffy number.    I want to make a final decision about this IVF, DE or OE and move forward.

Trust

During our preoperative consult, Dr. Dandruffbeard explicitly asked me if I trusted him.   He said that it seemed that I preferred the care of the other doctors in America, because I had chosen them for my care.  He said that there were many surgeons that could do the ligation for me in Canada besides him, if it was a trust issue.  He said I should have a surgeon that I trust.   He said this all in a very nice and respectful way.  However, it caught me a bit by surprise! In all of the specialists I've seen over the last five years, this has never come up before.

I told him that no, it wasn't a trust issue.  It is an opinion issue and a timely-care issue, but I didn't go into that.  I told him that geographically it made sense for us to proceed with the other doctor (which he understood).  Also, I reminded him that at the time the only option he gave to us was donor egg, from a known donor.   And since that for us was pretty much out of the question for us, we moved on.

It was his opinion, combined with Dr. Snowflake's that led us to choose embryo adoption.  He told me he was not interested in trying to get eggs from me because of the low probability of success (less than 5% chance).  He told me that twice. Almost 5 years ago, and more recently 3 years ago.

It's painful to think about all of that.  I wonder if he is going to be proven right after all of these years?  If we just stuck with his opinion, and chose other family building options would we have a family now and have avoided a lot of heartache?  Our savings would have certainly taken less of a beating.

I suppose, we've already proven him a little bit wrong.  We did do an IVF and made 11 eggs and 6 embryos, resulting in one pregnancy.  I'm hoping to completely prove him wrong with this IVF in Colorado.  

Later on, I visited his website.  At the bottom of his page was a quote "I thank my patients for their trust.  They know they can count on me 100%.  Interesting.

I'm hoping that maybe we can do the ligation after the IVF cycle.  I've left a message for the nurses to see what the doctor thinks of this idea.  This would allow me to be on a waiting list in Canada for the procedure, without wasting precious time.  Plus, I'm on all of these supplements and restrictions and I want to be finished with them sooner rather than later.   We will know for sure after my day 3 blood work is processed.  We need this before Dr. Schoolie will give his final blessing on any OE IVF cycle.

Update: Yeah - Because we are planning to do a frozen cycle with CCS, we are able to do the laproscopy later.  I'm excited about that news.  Now just awaiting the day 3 blood work.  Please, let it be ok.

Tubal Ligation Preoperative Consult

Well, it seems things are going to get a teeny bit more confusing before they get simplified.

I'm hoping it's like when you spring clean and need to spread things everywhere and make a big mess before putting it away neat and tidy.

I had my preoperative consult with Dr. Dandruffbeard.  Although strangely, today he didn't have any dandruff.  I wanted it to be simple, for him to concur with Dr. Schoolie's opinion, and book the surgery in early January.  The surgery was for what I described here, a laproscopy and possible tubal ligation.

Blah.  But not so fast.  I forgot that this surgery is "optional", and not 100% indicated by my previous tests.  It's just to basically rule a possible problem out, for the best chances of implantation.

Dr. Beard said that in Canada they do a sonohysterogram to determine if there is a hydrosalpinx that requires ligation.  He said they don't go by the x-ray (the HSG) because it is an imperfect test.  The rule in Canada is that if there is no accumulation of fluid shown in a sonosysterogram, they don't do a tubal ligation.

I didn't have a sonohystergram.  But I made a big oopsie and told him I had during my ODWU.  Now things are confusing because my whole consult was based on Dr. Beard reviewing the sono, then talking with Dr. Schoolie briefly, then doing the surgery.

I've messed things up.  :( So now I'm back tracking.

One unexpected perk was that the appointment served as a second opinion on the procedure.  Dr. Beard said that basically if there is no balloon of fluid in the tube aka. hydrosalpinx, that there is no way for fluid to leak back down into my uterus.  And that he doesn't think I have this problem anyways because I've had implantation at "a reasonable rate".  He said the fluid leaking out of the tubes causes an implantation problem, not a miscarriage problem.   He offered though to do what he could to help me.  Hmm, interesting.

Then we had a semi-awkward conversation about trust, that I'll have to write about another time.  I'm off to my exercise class.

Surgery it is

 *image from goivf.com

It took a few phone calls and a couple of days, but I've made a decision to have the surgery.  Checking another thing off the list.

After pressing for more information, Dr. Schoolie says that it is only a three day recovery and that without it he would reduce our chance of a normal embryo implanting by 50%, to only 25%.

While I'm not looking forward to having the surgery (who would?), I feel good that I got the information I needed to make the decision with confidence.

Dr. Schoolie says that it is a pretty basic surgery and he would be comfortable with me having another surgeon do it.  So, I am going to try to have the surgery in Canada to avoid the cost by traveling to Colorado and to avoid paying for this procedure (I suppose I guess I do pay via my tax dollars, but I digress).  I would also like to recover in the comfort of my own home.  I'll be traveling only 2 hours away and under the care of Dr. Dandruffbeard.

By some fluke of the Canadian medical system, on Friday afternoon I was able to get a Monday morning appointment for the surgery consult!   I appreciate socialized medicine for many things, but wait times for specialists is not one of them.  I'm considering this a mini-miracle.   The receptionist said that if the doctor agrees to preform the surgery that I could be looking at a January surgery date.  Perfect!

Dr. Dandruffbeard did request a letter from Dr. Schoolie, and the CCRM nurses amazingly emailed me one within an hour of my phone request.  The letter said:

"...During her testing she had an HSG that revealed delayed spillage and questionable hydrosalpinx in her left tube.  It is our recommendation that she needs to have a laparoscopy to evaluate her tube and if there is a hydrosalpinx noted, she needs to have her left tube ligated."

The letter makes things sound simple.  Getting to this point of understanding about this procedure has not been that simple.  I'm realizing that CCRM isn't perfect either.  I am however still very appreciative of their care.

I'm trying not to think (several times a day) about the possibility of this not working.  My mind just goes there, so it's difficult.  I'm also second guessing our decision to do OE IVF vs. donor, but not enough to change my mind I think.

JS

PS)  The exercising has been gratifying but... ouch! Muscles that were happily withering away are now mad at me in droves.   And I'm happy that today I discovered a warm, sweet drink that I can have sans-caffeine.  It's warmed milk with a little (or a lot) of my favourite french vanilla creamer.   I'm semi-lactose intolerant, so I'll have to do this in small doses.

Connecticut

I'm horrified beyond words after hearing about the massacre in Connecticut.

My prayers go out to everyone who lost someone today.  God, help us.

A friend

I have a long time friend, from my university days.  We lived together for over three years and have kept in touch for the ten years since our graduation.  We usually hang out in in a group with other friends who were also our roomies.  In the last year or so, I have been increasingly agitated when hanging out or talking with her.

In November, we spent a weekend together with our other roomies.  Several things happened that were bothersome to me, even bordering on offensive.  I decided to give things a month or two to let the rawness surrounding my feelings fade.   I decided to not to call her, to let her call me.  We usually only talk every month.  I thought this would be a good solution, giving us both time and space.

So today, she called me to chat.

She told me details about her recent work trip across the country, and about her sister's separation from her husband.  I enjoyed hearing about what was going on in her life.  Then she got another call and put me on hold.  We chatted again briefly and then she got another call from her boss.  She told me she would call me back.  She did 20 minutes later and we talked about her job.   That was fine.

Then she asked me what I have been up to.  This is a friend who knows about our IF struggles and most of what we've been involved with.  So, I told her that we went to Colorado for our ODWU.   I told her that this is likely it, and that we're only trying this a few more times.  (Side note - I'm feeling the urge lately to tell this information to give them a heads up.  Sort of like a "I might be an emotional wreck in the late winter" kind of heads up.  I'm not good at asking for support and I generally down-play how tough IF is around all of my friends is, so this is a start for me.)   We didn't talk about Colorado for more than a minute when she asked what our next steps might be, adoption?  I told her that adoption would be great, but that it's not a simple process either, despite what a lot of people think.  I remind her that we're ready to go that route though because we already have our home study done and our profile mostly complete from when we completed our embryo adoptions.

She then cut me off and in an attempt (I think) to be empathetic, and told me about how some things are so complicated, why can't they be easy? She talked about her Dad's funeral and estate arrangements. Another phone rings.  "Can you hold on?".  "Ok" I say.  I overhear what sounds like a totally non-urgent pointless call,  and she hangs up with the other person.

Then, there is a ruckus on the phone because husband and her two kids are now home daycare.  I then get to hear her say hello to her kids and give them a smooch.   She chats for another minute and then lets me go because her kids need her attention.

I don't want to come across like I don't want to hear about my friend's life and challenges.  I know that sometimes things come up, and that sometimes conversations are unequal.  I do.  But sometimes, it becomes clear to me that some of my friends really just don't get it.

They have no idea what it's like to deal with IF, day in and day out.  That it is my "job". That it complicated and talking about it can be a good thing.  Or even just having someone listen.  That it can be painful for me to hear you welcome your children home.

I don't know how to deal with this "friendship" anymore.

Thanks for listening, internet.  You do a much better job.

Ready, set...

It seems things are mostly in order for January to start treatment.

• All of our medical records have been received including copies of physical and mammogram - check
• One day work up (ODWU) at CCRM complete - check
• Day 3 blood work shipped - check
• Extra blood work completed for the coagulation panel - check
• Decision made to try OE IVF - check
• Consents signed - check
• Decision on which local satellite clinic to use - check
• Naturopath visit completed, and supplements purchased and organized - check.
• Arrangements for the sperm samples being shipped to CCRM as a back up plan - check. 
• Chromatin assay test results from ODWU - still waiting. 
• Decision on tubal ligation and laproscopy.  Still awaiting more information from the doctor before making a decision. - Follow up in progress.  

I'm glad that everything that is waiting on me is mostly done.  And that it is done before the holidays.  Phew!

Right now I'm just working on walking that fine line between being an annoying patient and a proactive, organized patient to get the remaining information.  My unfiltered-self would like call the clinic frequently saying: "Hi, it's me again. Do you have those results yet? No? Ok. Can you call me later today with an update. Thank you".  Rinse and repeat. 

It's funny it seems almost foreign to me now that some people just go out for a nice dinner, have a glass of wine and roll in the hay and wake up two weeks later to a positive HPT.   Or hump a their pimp drug dealer and make a baby or ten.  But that's another post for another time.  

Visit with the Naturopathic Doctor

This afternoon I had my first acupuncture session with the naturopathic doctor. It was good.  And uneventful which is what I like.  :) I appreciate the doctor because she is very relaxed and a good listener.  I feel like she asks really good questions.  And she doesn't push the sales of any of her supplements or other procedures.

She did a lot of research on some of the supplements I was taking and also some new ones since our last visit.

Some of the things she shared with me:

• The active form of CoQ10 (which she pronounces as co-Q-ten) is called Ubiquinol.  She recommended this over the regular CoQ10 supplements.  She said that research actually shows CoQ10 it can positively affect the fertility of men as well.   It is expensive and about double the cost of regular CoQ10, and I just paid about $51 for a bottle of 60 x 100mg pills.  
• Regarding my vitamin D3 deficiency, she suggested to increase my dosage to 2000 IU per day because 2000 IU is what is recommended for pregnant women anyways.   
• She reminded me that gel capsules are easier for the body to absorb than hard pill form.   She said that if the hard pills are small enough (as they are with the D3), then the body can probably absorb them alright.   She also said if I am taking a supplement three times a day, I may not need to worry about getting time released supplements. 
• The recommendation for DHA for pregnant women is 200 mg.  She suggested that getting this in the form of a fish oil (with EPA as well), is a better way to supplement.  She said that the DHA is for baby's brain development and EPA is for my health.  She said if there is one general supplement she would recommend to everyone it would be fish oil.  
• She told me the prenatal vitamins I had chosen were ok, but did not have any iron in them.  She thought this was fine, as long as I switched to one with iron if I were to become pregnant.  She said that iron can be hard to digest and cause constipation.   My family doctor told me that I was slightly iron deficient in the spring.  She said that iron deficiency takes a long time to correct, and that iron is hard to get out of diet alone.   Because of this, I think I'm still deficient.  I decided to take her brand of prenatal multivitamin because it has iron in it, and is not in hard pill form so it should be easier for my body to absorb. 
• DHEA has been taken in studies with cancer patients in dosages of up to 1600mg.  The research also said that in general it should not be taken for more than 6 months at a dosage of 50mg.  I'm going to continue with my dosage of 75mg per day. 
• She said the research doesn't show much support for L-Argenine and so she suggested I skip it. 
• I asked her to look up any other supplements that could help.  She said the other naturopathic remedies and supplements seek to alter hormone levels.  She didn't think it was a good idea to do them in combination with fertility treatments I plan to undergo and I agree. 

I told her that taking a handful of pills with every meal makes me feel old.  She didn't have a suggestion for that.  

All in

It seems I'm coming down from the emotional high that I had when leaving Colorado.   I kind of feel lame writing that - as if going to a fertility clinic could ever be a high, but, I guess I'll take what I can get.

I got my period yesterday, so it seems that the countdown is officially on.  I'm hoping to have all of my paperwork compete to attempt an IVF stimulation cycle in January, and a FET (hopefully) in February.  There's been a lot of tears (all mine) since November in getting to this point.  I'm scared of flushing a big wad of money down the toilet and coping with the emotional fall out if there are more negative results.

As I put it to D the other night while on a walk, this is it.  We are now all in as it relates to having a genetic child.  If this doesn't work (we're giving ourselves two IVF cycles depending on the results of the first CCS screening), this door will officially be closed for us.

Saying we are all in kind of makes me gag a little in side.  And I think I know why.  I've always been a procrastinator.  After some life coaching afforded to me in a previous career made me realize that my procrastination stems from wanting perfection.  Basically, it goes like this.  Something is hard or outside of my comfort zone.  If I procrastinate long enough, and don't have enough time that I am saving myself from disappointment if things don't work out.  There's always the thought that "I could have done better if I... had more time/tried harder", etc.

That's not the case for IVF.  I can't say that we've really procrastinated on a lot of things.  We've been chugging along this path for five years now.  Always in line for more tests, more procedures, more results.

These will be our last attempts at OE IVF.  And it makes me very emotional to think about it.  We are flying across the continent, to go all in.  This is it.  I've never felt this way before because there's always been more embryos, more chances left, more options out there.  God, please help us.

I've been following a blog for several months (http://lifeandloveinthepetridish.blogspot.ca) which I've grown to love.  She's a woman who persevered through much more than I think I could with all of this. She's survived cancer, seven IVFs and six, yes, six miscarriages.   One of the things the author has talked about is regret management.  I like the idea of this.  Hers involved a lot of very interesting things.  Mine are more basic.

1)  I've started exercising.  Today was my first day, and I joined a boot camp style fitness class.  I'm doing this to help stabilize my mood and to feel better about myself.  Because if this is all a bust, I'm going to need all of the help I can get.  It's been long enough that I've been making excuses (fertility treatments work great).  I will be stopping when I'm stimming, but until then it's a go.   At least I'm hoping to keep even with the house over the holidays.

2) I'm starting acupuncture. This is for overall health and to try to increase blood flow to my uterus.  At CCRM, during my one day work up they told me that I have "reverse flow" with the main arteries around my uterus.  They would like the flow to be under a 3.0 but my results were 3.62 and 3.5 left and right respectively.   When I go back to CCRM I'm going to have another doppler ultrasound to see if any of these things have changed my blood flow.

3) I've given up caffeine, even decaffeinated drinks and chocolate. When I had my doppler ultrasound, I wasn't allowed to have caffeine for three days prior because it reduces uterine blood flow.  Man, oh man. This has been hard for me.  I love sweets.  And it's Christmas.   I cheated once last Saturday and had a decaffeinated coffee, but other than that I've been caffeine free since November 29th.  I love a warm creamy drink (I'm drooling right now just thinking of a tall white chocolate mocha or coffee with french vanilla sweetener, literally).  This is difficult for me.  

4) I'm continuing with my supplements.  DHEA (3 x 75mg per day), CoQ10 (3 x 200mg per day).  1000 units of vitamin D (CCRM tested and I am slightly deficient).  And a prenatal vitamin with DHA.  This may slightly change when I see the naturopathic doctor today.

5) I'm going to continue to eat mostly home cooked meals with lots of veggies and lean proteins.  For my morning smoothie I'm going to start adding more greens.  Right now it's frozen raspberries, a banana, a frozen spinach puck, orange/veggie juice and greek yogurt.  I'm experimenting with adding celery and cucumber and kale.

As for drinking wheat grass or any other disgusting concoction, I just don't think I can handle any more changes.

This is it.  This is me.  I'm all in.  And it's scary as hell.

What IF

Oops, I just realized that this didn't get posted.... it's from a couple of weeks ago.

In my mind, one of the more annoying side effects of infertility (IF), are the 'what ifs' of IF.

Truthfully, I'm a person who could drive herself crazy just on normal life decisions, let alone making big ones with huge pieces of missing information.  I like to think, then over-think each decision.  Then rehash it after I've made the decision.  I even annoy myself doing it, it's a miracle D can stand it too.   I think one of the things that attracted me to him was this ability to analyze the situation, and make a quick decision.  When things don't go his way, he usually doesn't feel regret about them, he just changes directions, and moves on.  It's a lovely way to live.

Of course our biggest what if is about if there will be little feet around our home sooner or way-later?  We're already 5 years into this journey.  I wonder what our lives will look like in 5 more years.
(Side note - I'm a moment of relative positivity about our infertility, and so I'm feeling like it's not a matter of if we are going to become parents but when.  Tomorrow I will probably post something precisely the opposite because that's how I roll.)

There are so many choices that D and I would like to make. 

One big one is related to our home.  Specifically, what city we will live in. The cities we are choosing between aren't close, they are about 5 hours apart.  And, basically it boils down to his family or mine.   We live close to his right now, and have for our entire relationship.  We both went to university nearby.  We've got some good friends here and his family which is basically just his parents and Grandma.   My family is larger, and is expanding as my cousins begin the years where most of them will marry (and I'm assuming procreate easily...ah... why does my mind always go in that direction...but anyways).   

My heart is where my family is.  Before we married I told him that I may want to move back home.  He told me he was ok with that.  8 years later that little itch I had before to move is turning into a full-blown case of the chicken pox. 

Once we decide where to live, there will be the choice about how large of a home to buy.  How many bedrooms. 

The second biggest choice right now is that D would like to go back to school to do a PhD.  Lately we've been discussing which schools would be good for him, and finances, etc.  It's a big commitment on many levels including to a geographic area.  And it would also mean that I would go back to work, at least until we start our family.   I never imagined parenting with him as a student.  We would be going from the most flexible lifestyle (he's self employed with a lot of freedom), to something with a pretty demanding schedule, and him working on the side.  

I feel like there is an added level of 'if' built into every decision we make, or don't make for that matter.

Post-consult

I'm back. 

Colorado was great.  It was everything we hoped it would be.  I kind of felt like it was a fertility-wonderland, complete with a waterfall.  The staff were very professional and we felt that we got some new information.  I'm happy that we went.   

We still haven't made a decision on donor egg vs. trying our own egg.  Honestly, I'm still on the fence.  If money weren't an issue, I would 100% give an IVF with CCS a go for two cycles.  But, being real, money is an issue.  If we spend $60,000 (the rough cost of trying two IVFs) and don't end up with a baby I'll be feeling really depressed and kind of stupid.  The only reason why I prefer own-egg is because in many ways it just feels simpler.  No explaining one day of where they came from and no issues of loss for the child.   I suppose I just don't feel very confident in my parenting skills, because I haven't got the chance to practice them yet. 

It's funny to me how we are back to (almost) the same decisions that we were making over years ago when we decided to adopt the embryos.  

It's very frustrating and difficult to make these decisions. I just want to be done with this part of my life and move on to the part where I am a mommy. 

Some of the things I really liked about CCRM:

- They are organized.  Check in at the desk, have a test, check in again, have another.  We had back to back appointments all morning and things went very smoothly. 

- I felt Dr. Schoolie was kind and was honest with us about our options. 

- The staff seemed to be really well trained and experienced.  I liked that many of the technicians really took time to explain the procedure they were doing, and what they were hoping to see.  

Some of the things I don't like:

- They messed up on drawing enough blood for a thrombosis panel.  I had 16 vials of blood taken, and that still wasn't enough.   16 vials tops my previous record of having 13 drawn at once.  I wonder what my fertility-lifetime total would be? 

- They called me back and said that they doctor isn't sure about whether to recommend a laprosopy and tubal ligation for my left side.  It seems that my HCG showed some hydrosalpinx (sp?), but there was some spill (which means that there is no blockage) however they weren't 100% sure if there is a blockage or not.  Basically the doctor said it was my call on how to proceed with this.  After a few days of marinating on the topic, I've decided that this isn't enough information to make the decision.  I need a doctor's recommendation.  Isn't that what I'm paying  for?!?  I'm honestly a little flabbergasted that they haven't given me more information on this to make the decision.  Oh well.  I guess no clinic is perfect.  That's why I've called back for more information. 

I'll write more later.  I just wanted to break the silence, and get some of my thoughts out. :) 

He's IVF

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My mommy-card

I have this friend who is a really great Mommy, her name is Megan.  You'll just have to trust me on this one.  She has two gorgeous little girls.  The youngest is only a few months old.  A couple of weeks ago,  the precious little one pooped herself almost right out of her jam-jams.  A late night clean up ensued, which resulted in Megan holding a stinky diaper with one hand and a clean, but now very slippery baby in the other.   Something terrible happened, and the baby slipped out of her arms and landed on it's head.  Gulp.

Fast-forward a few days.  Everything seemed fine, but the baby still had a very large goose-egg on the back of her head.  So Megan called me to come over and watch her 2 year old while she took the baby to the hospital.  Thankfully, the doctors tested the baby and said that she was fine.

I could tell that she felt worried, stressed, terrible and embarrassed that this had happened.   I would too.  I felt bad just thinking about how she must feel.  She kept saying that "her Mommy-card should be revoked".   I tried my best to console her.

While I was still there, she called her mother to tell her what had happened.  Her mother is not always the most supportive person, and Megan has struggled in her relationship with her over the years.  In their discussion, she mentioned the same thing to her mom about her mommy-card.   Her mother, who has raised 4 children quickly responded, "No honey. You just earned your mommy-card".

I thought it was a wonderful thing to say.  I wish I could have said it.

It got me thinking about my mommy-card.  I hope it's just stuck in the postal system somewhere, about to get sent on its way.

PS) Colorado here we come! We are travelling tomorrow! I'll post when I return.  Hoping and praying for some good news :)

Caffeine free

The work up is on Wednesday.  I'm happy the day is finally just around the corner!

The pre-work for the one day work up at CCRM advises not to have any coffee, decaffeinated products or chocolate for 3 days prior to the ultrasound because it can affect blood flow.

I don't drink coffee every day.  But I do like to have a hot drink every day.  I like to tell D (who doesn't drink coffee etc.) that I am not addicted to these things I just like them.  This might just be the real test to that statement.

Something in me right now wants to drink 10 coffees just because I can.   Oh and no sex either.  Sounds like a fun weekend.    Operation no caffeine begins Sunday.  Oh well.  As my friend would say, it's a first-world problem.

The missing piece

I left my professional career for a few reasons. The main ones were because a) I felt like it was sucking the life out of me, b) I wanted to be a stay at home mom, and c) I was convinced that I needed only some time and (ewww, I hate to admit this),  a little less stress to figure things out a.k.a. solve our infertility problem, become pregnant, give birth and live happily ever after, the end.

What started as a one-year leave of absence from my employment turned into a resignation and four years gone by.   I’ve cherished a lot of the time that I’ve had.  And I've been through some pretty rough stuff too, including coming this.close to losing my sister to a massive stroke and helping her rehabilitate.  I’ve been able to do some things and learn about myself in a way that I don’t think I could have, had I remained in the rat-race.  At my job I was work-alcoholic fueled by coffee, anxiety, and positive reinforcement.  It wasn’t a pretty combination.

I spent a portion the last four years going back to school.  It started as something to do and a strategy to keep my grey-matter from becoming mush.   A few courses turned into a few more, and the next thing I knew I had signed up for a full year of classes to complete a degree.  I’m tremendously grateful for the opportunity to learn just for the sake of learning.  I think it might just be one of the greatest luxuries in the world.  I love learning.  I just wish more of it stayed in my head!

One of the first courses I completed was also one of the most valuable and fascinating. It was a class in positive psychology.  We studied questions such as “what makes a happy life?”  The professor taught us that this question is probably the wrong one.  And eudaimonic wellbeing is really what we should be talking about. 

A person could think of it as happiness = pleasure, and eudaimonia = human flourishing.   Eudaimonia is arguably made up of several things.  One of which is having meaning in your life.  

(This website provides a detailed explanation if you are so inclined.  It’s a bit of a read, but it is definitely faster than taking a course in positive psychology!

http://www.positivepsychology.org.uk/pp-theory/eudaimonia/34-the-concept-of-eudaimonic-well-being.html)

I often question why I want to be a parent.  Sometimes I think that maybe it is just a biological need, and can’t be explained?  I wonder, if I am just trying to fill this “meaning-void” with a little one when it could be filled with something else? Like maybe a different career?  I wonder if parenting is going to live up to my expectations? I wonder about my marriage. Parenting can be stressful. Will D and I get along as well as we do now, or will we grow closer in our new roles?

D and I agree that our search for parenthood is tied closely with our search for meaning in this life. I strongly desire the full-circle life experience that only parenting is able to provide.  I want to grow in my view of the world by seeing it through the eyes of a child.  Sometimes when the IF road becomes really rough, I wonder if I could instead find meaning in another life pursuit to compensate for a life that is childfree?  If all of the time, effort and money were spent somewhere else, would I have a better sense of wellbeing?

As we debate important decisions about OE or DE in our upcoming journey, I can’t help but wonder if it is silly for us (personally) to be chasing a genetic connection to a child?  Is it going to change the amount of meaning we get from being parents?  Nope.  Will it bring us less pleasure? Doubt it.  

Maybe for us DE is a better choice, as it has a higher probability of making us parents (and sooner)?

The Journey, So Far...

I typed out a nice neat little index page with page numbers for Dr. Schoolie when I submitted all 250 pages of our medical reports.

Going through the process of organizing my records was a tedious and emotionally exhausting task.  Each portion brought up memories of how we felt at each turn.  It also made me feel frustrated that there wasn't a more efficient way to navigate through the difficult waters of IF.

May 2008	Semen analysis:  1.6 million
	Normal pelvic ultrasound
	Hormone levels tested but not on cycle day 3.
June 2008	Semen analysis: 1.6 million
Aug. 2008	D has bilateral testicular biopsy under the direction of urologist.  Findings: bilateral hydrocele and meiotic arrest.
	D has infection after this procedure, and is treated twice with antibiotics (for two weeks each time). Up until 1.5 years after this procedure, D has infrequent “stabbing” pains in his testes.
Oct. 2008	Dr. Nada, Enocrinology consult, no findings referred to another endocrinologist.
Nov. 2008	Scrotal ultrasound: focal hypoechoic regions within the superomedial aspect of both testes measuring 1.2 and 1.4 cm.  Likely related to previous biopsies.  Bilateral small varicoceles are demonstrated.  Small right hydrocele.  3mm cyst on left epididymal head.
Dec. 2008	D- Endocrinology consult with second endocrinologist found no abnormal results. CBC normal.
Jan. 2009	New clinic #2 Semen analysis. 0.6x10 6/ml
Feb. 2009	Semen analysis (washed), total motile count 4 million.
	Day 3 FSH: 23.8 IU/L Day 21 Progesterone: 48nmol/L
	Genetic screening and other blood work (day 21 and other).
	2nd opinion with Urologist.  His opinion was that the testicular biopsy was unnecessary, and that the results showed only a focal diagnosis.   No further recommendations.
Mar. 2009	Hysterosalpingogram: Right fallopian tube patent, left tube irregular, curved, tortuous and dilated, left tube appears blocked.  Antiverted, anteflexed uterus. Right ovary 2.5cm x 1.3cm, left 2cm x 1cm. Small irregularities in uterine lining.
	Diagnosis: Premature ovarian failure, advised to consider donor programs.
April 2009	New Clinic: #3 Dr. Snowflake
June 2009	IVF cycle suggested to be changed to IUI.  Cycle cancelled: My sister had a massive stroke at age 28 (from an undetermined cause).
Sept. 2009	Day 3 FSH: 6.5 IU/L
	Operative Hysteroscopy to remove small amount of scar tissue near embryo transfer site.  Pathology Report: Endometrial curettings (1.0ml of hemorrahigic tissue and mucoid material): proliferative endometrium.
May 2010	Sonohystogram, results normal. (Dr. Snowflake).
Nov. 2010	FET #1: Transferred 1 donor embryo (from couple #1), rated “cleaved 4-6 cell”. HCG <1.0
Feb. 2011	Adopted 6 blasts via Snowflakes Created in 2005
April 2011	New clinic: USA, Dr. M Frankenstein
	Semen analysis: Grade A, low count, borderline morphology.  Semen frozen (unused as of Oct/12).
	Monitored for one natural cycle: Doctor says follicles didn’t mature as expected. Decided to proceed with adopted embryos.
	Day 2 FSH:  19.6 mlU/ml Follicle count: 7?
July 2011	FET #2: Donor embryos, 2 unrated blasts.  Embryologist says they are unrated because they were still collapsed 2-3 hours after they were thawed. HCG <1.0
Sept. 2011	FET #3:  Donor embryos, 2 blasts 6BA & 5BB  HCG <1.0
Nov. 2011	FET #4: Donor embryos, 2 blasts 4AA & 4BA, HCG = 75, (6 days after transfer), 1547 (13 days after transfer).
Dec. 2011	Miscarriage confirmed at 8 weeks
Jan. 2012	D&C after incomplete natural miscarriage
	Started 75mg DHEA/day
Mar. 2012	AMH tested: 0.42ng/ml
	Day 3 FSH 17.5 mlU/ml
April 2012	IVF with ICSI (own eggs) Medication: · 40 units of Leuprolide on cycle days 3 and 4. 300 units of Gonal-f for 16 days, the last 8 days of stimulation 150 units of Menopur. · See cycle sheet for other meds. · 500mg Flagyl & Doxycycline for both of us in case of subclinical infection (2 weeks).  Started one week approximately before transfer. Retrieved 9 mature eggs + 2 immature eggs, 7 fertilized, 6 survived. Ratings on day 5: 1.     EBL: C1 2.     BL: B1 3.     EBL: A 4.     Mor: B1 5.     Mor: A 6.     Mor: “?” 7.     Mor: A
	Semen analysis for ICSI
	2 transferred, 1 blast 4AA and 1 early blast (unrated) HCG = 38.4 (10 days after transfer). Bright red spotting 14 days after transfer (HCG =278), miscarriage 22 days after transfer.
	Tested natural killer (normal), DQ Alpha (normal) and MTHFR (positive for heterozygous copy of A1298C mutation).
May 2012	Day 3 FSH 11.1
June 2012	Semi-natural FET cycle attempted. Ovulated on day 11, doctor not expecting this early, cycle canceled.
July 2012	FET #5: own embryos, 2 transferred, 2x day 5 morulas, A & B1. Started new protocol of 81mg ASA, 10mg prednisone, 40mg Lovenox at time of transfer.  500mg Flagyl & Doxycycline for both of us in case of subclinical infection (2 weeks). HCG 1.8, then declined.
Sept. 2012	FET # 6: own embryos, 2 transferred, early blast with “?” rating and blast rated 3AB. Changed protocol (81mg ASA, 10mg Prednisone, 40mg Lovenox) starting one week before transfer. HCG <1.0
Nov. 2012	Consult with Dr. Schoolie.