Fertility vacation

All things fertility have been progressing slowly, and shhhh...don't tell anyone, but this time I don't mind. 

I've been distracted with company and home renovation projects (mostly painting). It feels good to think about other things. 

Some of the company that came were my friends that I wrote about a lot in the month of May. I worried a bit that things might feel a bit awkward after asking for more support, but they weren't. Phew! 

We had a wonderful time. The weather was great, we rode bikes and went on a 3 hour boat cruise, ate tons of yummy food and had a bon fire. We sat on a floating couch thingy that they bought for us for hours. It was my idea of perfection.  I'm feeling very grateful for the time we've been able to spend here and for how things worked out with them.  

If we hadn't all talked before they visited, I know this weekend (if it happened at all) may have been tainted with resentment towards them. I'm thankful that the lines of communication were opened. 

This week, we had another meeting with Dr. S. 

The purpose of the meeting was to find out more info about our CCS results. 

We were wondering if they could determine anything from the abnormalities ie) if they were from sperm or egg issues? He said they had no way of knowing his information. 

The 3 normals we had were 3 of our highest rated embryos. They were previously rated:

6BA

5AA

5AB

He suggested re-testing our no results. 

We asked again about if he thought if we should transfer 1 or 2 embryos and what his rationale was for his response. Last time when we didn't have our CCS results, he suggested two. 

Surprisingly, said two again. He said this is because of the number of embryos  and transfers we have had in the past. He said we didn't know for sure if the ones we transferred were normal or abnormal.  

This was very different advice than what we got from Dr. Gustofson with our last transfer (at the same clinic).  He suggested one when we didn't know if they were normal or not. 

(Side note: In my heart, I believe that most if not all of the embryos we transferred in the past were abnormal. Of course, I have no proof of this. I believe this however , because seven of them were donor embies where there were known miscarriage issues. The next six were our genetic embies (with all of our issues) and the last one one was the donor egg (where we know that at least 5 of the last 11 were abnormal- so who knows if that one was normal or not). 

Regarding our last DE embaby, I'd be interested in knowing if it was more or less likely to have been because of a genetic abnormality after finding a heart rate? I didn't think to ask. 

In our meeting with Dr. S, there were a few annoying contradictions. They were about medications and protocols.  There was also some contradictory info between what Dr. G said the last time and what Dr. S said, and what Dr. G said made more sense. 

Dr. S is slipping out of our good books.  We're going to stick with him, but D and I are feeling a bit frustrated with him. He's supposed to be the best, but he tells us different things at each meeting. I feel like it's because he has barely reviewed our file before our call.  He says one thing, I remind him of what he said before and why, and then he changes his tune.  We have very high expectations of him and this clinic, yes, but I know the contradictions would be something I would be annoyed at if they happened somewhere else too.   For example, how many times should I have to remind them that I can't take the pill because of my family history and my risk of stroke? Gah! 

Anyways, Overall, he said that he was glad we did the CCS, which he previously described as something he didn't recommend and "overkill". 

I think transferring two normal embryos (which Dr. S says almost all of his DE patients do) might be overkill. Who knows though, we're still thinking about it. 

Now, I will continue to wait for my HCG to drop below 5.

I had a test recently and I'm still awaiting the results. After it has dropped, I'll need one more test and then my fertility vacation will be over.  

Quick and dirty

We had another regroup with Dr. S.  It lasted all of 7.5 minutes.  He answered our questions, but didn't offer anything more except to tell us that he thinks we are 'thinking clearly about this".

Here's what he told us:

• He thinks we will lose 1 to the thaw, that would have died anyways when we tried to thaw it for  transfer.  He didn't think we would lose many more on the next thaw, but didn't give us a number. 
• It will take 2 weeks to get the results of the testing. 
• When asked how many of our 10 embryos does he think will be normal?  He said he doesn't know.  He said that the sperm is a question mark here.  (But - let's be honest, the eggs could be questionable too, although admittedly less likely so). On average the donors have 20% abnormal embryos. (That's great news). 
• Should we look at 1 or 2 with CCS?  He still thought we should transfer 2 with my history.  (Interesting). 
• If we transfer 1 normal and we lose it we should start seriously thinking of a gestational carrier.  Ouch.  Okay. 

Someone asked for the ratings of our embryos.  Here's what we have:

10 embryos frozen. Eight were frozen on day 5 and two were frozen on day 6. The grades are: 4AA, 5BB, 4BB, 3BB, 2/3, 4AB, 4BB, 2/3, 6BA and 6BA.

I emailed the nurse and said we're going to go ahead with the CCS.  

Dr. S was the same as he always has been with us, he answered what we wanted to know, but didn't give us anything more.  I find that kind of annoying.   

Dad's here tonight and tomorrow,  so that's all I can write for today.   We're having a good time. 

Going for the kill?

Overkill... that was Dr. Schoolie's word for whether we should consider CCS for our remaining 10 embryos when we asked him a couple of weeks ago.

We were satisfied with his answer at the time, but I've had some time to think about it and now I'm not so sure.

I believe that knowing how many normals we have left will dramatically change how we proceed.

Scenario 1: No CCS, The original plan. 

• If I miscarried again, we wouldn't know if it was because of an abnormal.  
• It would be more difficult to determine when it would be time to retire my ute. 
• I don't think I have enough stamina left in me to go through any more losses.  Especially if the loss was due to an abnormal embryo, that never would have most likely never had a chance of making it.  
• I could have a baby on the very next shot, and save ourselves the cost of CCS.  Oh, to dream!  (10 embryos is $6,875 + $1,000 because they were previously frozen = freaking gag me.)  
• I would be seriously considering transferring 2 embryos at a time, at Dr. S's recommendation.   Having multiples and the complications and loss that could happen because of this scares the crap out of me. 
• My clock is ticking.  I can't stand the thought of doing this all for many more years.  Six years has been enough.  Miscarriages and FETs take time.  My body seems to get pregnant even when the embryos are abnormal.  Of course, I don't know this for sure.  Especially for our last cycle.  I am quite confident that my first two miscarriages (from our own IVF and the donor embryos) were because of abnormal embryos.   In all reality, to do 5 transfers with our 10 embryos would take over a year.  If more miscarriages or cancelled cycles were thrown into the mix, it would probably be double that. 

Scenario 2: CCS reveals all DE embryos are abnormal:

• This could happen.  This is us after all.  And Dr. S says there is a small chance of this because D has wonky sperm. 
• We would be devastated.  I don't even want to imagine this. We would have flushed a lot of money down the toilet on this DE escapade.   However, knowing this information would prevent us from:
• Throwing good money after bad.  Meds, lost wages, travel costs and FET costs.
• Emotionally, it would be less painful to get one big dose of bad information than have it spread out over many BFNs or miscarriages.
• Knowing this would save us a lot of time.  

Scenario 3:  CCS reveals some normals:  

• Dr. S said 3-4 normal embryos would be a realistic expectation when we started the DE process based on how many embryos we have.  
• We would know what we were working with.  How many transfers to possibly expect. 
• We would only transfer one at a time.  Less risk to me and babies. 
• We wouldn't have to transfer the other 7 abnormal embryos. 
• Less emotional heartache, especially if there was one or more miscarriages. 
• Financially, we could avoid the meds, travel, lost wages and FET costs for (maybe) 3 transfers? 
• Math: If we transferred 2 at a time, assuming all survived the thaw, we would be doing at 3 extra/unnecessary transfers.  FET is $5,005 costs, say $2,500 for meds (Lovenox is expensive), and $1,000 for travel.  These are low estimates that do not include testing that would need to be updated.  The grand total is $25,515 vs. the $7,875 cost of CCS.  
• Physically,  I would not have to take the drugs or have the side effects for those transfers.  Amen. 
• If I knew that I miscarried a normal embryo. 
• It is very important information to know, but not the complete picture.  I now know that 50% of early miscarriages are with normal embryos. 
• Knowing this information would be more difficult for me emotionally because of the implications using my uterus.  
• If I put all of the normals into my body and they don't work, I will have to face the music that I've done all I can do with my body and it's time to move on to something else.
• We could transfer a normal embryo and have a baby straight away.  (I'm ready for this, universe! Pretty please?)
• If we had a child from these embryos, we would know exactly what we had left (if anything) in the freezer.  If we didn't have anything left, but had one child, we might make the decision to end this journey hell trip there. If we had 2 embryos left, and we transferred them, I would of course have my hopes up for another child.   Knowing how many normals we have would give me a big reality check through the rest of this process if we were lucky enough to have one baby.  
• If we try some normals, and have one or more miscarriages, we may be able to transfer our last normal(s) into a gestational carrier (if someone I know will do it - don't think we can spring for the $100k for a GC). 
• Okay, you can have a good laugh here, because I am.  But if we had several extra embryos (ha!), we plan to donate them to another couple.  This is because we were recipients of donor embryos and we would like to pay this generous gift forward.  If I knew that I had say, only one normal embryo left, no matter how many kids I had I would just transfer it.  If we didn't CCS and had say, 4 remaining embryos, after our family was complete (again, I laugh at myself that I'm even writing this), I would probably be thinking of donating them.   Those last 4 could be all abnormals.  I don't want to give another couple abnormal embryos.  And, I don't want to be involved with donating any embryos if I can avoid it.  (PS- Did you know that to have the option of donating the embryos CCRM charges approximately an extra $750 in blood work - that was a nasty little surprise.)

Risks to the embryos:

• We are waiting to hear this from Dr. S during our second regroup on Wednesday. 
• Some of our normals might not freeze well a second time, or survive thaw at transfer time.  We could harm an otherwise normal embryo.

We have a lot of hope still tied up into these 10 little embabies.

We'll see what Dr. S has to say about all of this Wednesday.  I wonder if he'll change his tune?

What do you think? What have I missed?

Yesterday and Today

Hang onto your hats, folks.  This is going to be a long one.

What happened yesterday:

Driving to our clinic we talked again about what whether we thought we were going to receive good news or bad news?  We talked about both sides of things, but our conversations definitely were swayed towards thinking that things might work out.

Walking up the steps of the clinic, I asked D when the last time he was there?  There's usually no need for him to come with me for my monitoring appointments.  He told me that it was probably the last time we got bad news there.  That he didn't have a good association with this place because they always give us bad news.   I don't totally share the same feeling, I guess it's because my visits have been much more watered down from those bad moments.

As the ultrasound proceeded, I knew almost right away that something was wrong.  I kept quiet, hoping I would prove myself wrong.  The sac was so big and so glaringly empty.  I wanted to give the nurse time to think and look more before saying anything.   She scanned back and forth, again and again.  I was hoping she would find it.    I was hoping that D wouldn't notice right away, but he sensed something was wrong also.

The nurse called for D to get the second, more experienced nurse.  She came in, and poked around with the ultrasound wand for a bit.  D peppered her with questions which drove me crazy.

"What do you see?  Is there anything there? Do you see a heartbeat?"  He asked all of the questions that everyone knew the answers too, but noone wanted to say.

There was talk amongst the nurses about the potential of two yolk sacs, which I didn't see.  They measured, and then remeasured and then I saw it on the screen.  A tiny font with powerful meaning, 6w3d.  There was no little flickering bulb.  There was nothing.

They rechecked their calculations of how big the fetus was supposed to be based on transfer date and blast stage.  D and I both knew there was no point, it should have been 8 weeks, 3 days.

The second nurse interrupted their silence and calculations with a statement that we all knew was coming, "There's a problem.  I'm sorry it's not good news.  At this stage we should see a little baby.  A little face, little arms, cardiac activity".

D went into shock.  He put his hands over his head, and said things like "Are you sure, can you check again? How could this happen? There was a heartbeat last week. We took all of the variables out.  This was supposed to work." I have never seen such fear or horror on his face, ever.  Aside from the emptiness on the screen, it will remain the thing that is burned into my memory the most from this terrible day, I am sure.

I wanted to answer all of his questions, tell him to be quiet, and freak out, all at the same time.  But instead, I laid on that table silent.  Part of me knew that he had to hear the answers to his questions from a nurse anyways, and I did not have the energy to answer him.

The nurses told us how sorry they were and how they wanted this to work out so badly for us.  They hugged me and I started to cry.  Abruptly, D  said he had to go to washroom to collect himself.  I've never seen him do that before, and I was very worried about him, but I was wearing a paper skirt and couldn't do much about it.

Everyone left me in the room to get dressed.  A minute later, D opened the door while I was naked from the waist down, standing in front of the door.  He entered quickly, and then proceeded to fall down to the floor, resting his head on the chair in the room.  It scared the hell out of me.

I was worried about making a scene.  How sensitive of me, I know.  I told him to calm down, and to sit on the chair while I got dressed.

The nurses ushered us to the office.  They had suggested that I call CCRM and see if they wanted any additional blood work done.  I knew I would not be able to get the words out.  I asked if they would call for me.

For anyone who deals with CCRM, you know that it is a complete annoyance trying to get anyone on the phone from the nursing desk.  However, if you call the business office, they will pick up on the first half-ring.  Call the nursing line, and you are pretty much just destined to get voicemail.  It's why I choose to correspond by email.  I can re-read their answers as many times as I need, and there is no phone tag.

I suggested that they call the main line and use the option for another doctor's office calling.  I gave them a bunch of CCRM numbers and just hoped they would figure it out, and they did.

While waiting for the call, the nurses were so kind, offering us water and tea and expressing their condolences.

Finally, the emergency line worked, and we got our instructions from CCRM.  They wanted me to have progesterone, estrodiol and HCG drawn.  (Which by the way came back as 989, 23.6 and 50,125 respectively).  

While getting them drawn, the sometimes hot, sometimes cool phebotomist looked at me and told me she was so sorry.  Her mascara was making thick black streaks down her face.  She gave me a big hug.  This made me cry again, this time a little more uncontrollably.  My arm shook as she tried to get the needle in.  I told her I was sorry that this was a part of her job.  She said some nice things to me.  I know she went through IVF, and she's drawn my blood for years, and she somewhat gets the pain of the situation.

The nurses were visibly and rightfully worried about us driving home.  They encouraged us to stay a while.  I think they were especially nervous looking at D, because he was a complete wreck.  I was scared looking at him too.  The suggested we get lunch somewhere or just stay in the office or the parking lot for a while.

I knew that I was going to have to be our driver, by the state of what he was in.  We took a moment in the parking lot, and called D's mom to break the news.  I told myself to just block everything out until I got home.  Just drive safely and get us home.  I knew I'd be ok, as long as we got going right away, and as long as D didn't break down on the way home.

Thankfully, he didn't, because I don't think my heart could have handled anymore.

When we got home, C, my CCRM nurse called.  She told me the second worst news that I'd heard all day, that Dr. Schoolcraft "takes these things very seriously and wanted me to repeat the ultrasound in a week to be sure."  She told me to stay on all of the same meds.  I questioned them twice that day about this.  Did they look at the ultrasound report? Did they see how far behind things were?  Did they see how empty the sac was?  Isn't this just unnecessary torture?   Can I go for the second ultrasound sooner?  They would not budge from that plan.

After sharing this news with D, I practically threatened him to not get hope because they were saying these things.  With our first miscarriage, he held out hope for much longer than was medically advised, and it caused him a lot of pain.

So begrudgingly, this week I will continue my meds.   This weekend I will also decide things that nobody should have to decide, like whether I will opt for a D&C vs. a cytotec miscarriage and if we will try to karyotype the fetus.  I'm not sure if that's possible, or if the information we would learn from it would help us regardless.    Hearing this was a genetically normal little boy or girl would smash my already shattered heart more.  I'm not sure I could stand it...


How I spent today:

I spent the morning crying in my bed, and in my closet of all places.  I got sick of looking at my depressing self and got dressed (I'm using that term very loosely).  D made lunch.  It was a warm sunny day outside and he convinced me to go outside with him.  I didn't want to, but did it anyways.  He and our neighbour moved our swing into the backyard, from its winter hibernation spot.  I hid inside while that went on, so he couldn't see my puffy-from-crying face.

Wrapped in a thick blanket, and armed with our phones, I laid on the swing while D played with my hair.  It's one of our favourite things to do.  Today D was a little more himself, calm and rational.  We both are still very, very sad, frustrated and angry.  We talked.  I had more tears.

I read your messages, and was so grateful once again.  It is such a relief to be able to confide in people who have been there, and know pain of infertility and loss.  You all give me such strength and a sense of peace in this storm.

Mid-afternoon I made the short trip to a nearby coffee shop and bought my favourite hot drink, which I hadn't had in ages due to my caffeine restriction (1/2 french vanilla cappuccino, 1/2 decaf - yum!).  We consumed a large amount of donuts.  I'm taking myself off caffeine restrictions whether CCRM likes it or not.  Chocolate and coffee are not optional in my life right now.

As far as grieving goes, I know there are bad days in my future, but I think today was a complete success.


On a different note.... In the news:

I've been doing a lot of surfing today.  These three things struck my interest, and I thought they might be interesting to you too, if you haven't already come across them.

1.  Way to go Ontario, Canada for a big step in the right direction:
http://www.theglobeandmail.com/news/politics/ontario-liberals-set-to-boost-in-vitro-coverage/article17912481/

2.  A concerning virus affecting a huge amount of internet passwords:
http://www.cnet.com/news/how-to-protect-yourself-from-the-heartbleed-bug/

3.  Aspirin and pregnancy.
http://www.medicalnewstoday.com/articles/275317.php

When your worst nightmare becomes your reality, again, and again

I spent yesterday reading your comments in between sob-fests, pity parties, watching 80 mind numbing cooking shows and shovelling take out food down my throat.

Thank you doesn't even begin to touch on the gratefulness I feel for your generosity of heart. I showed D your comments, and he said, "Wow. Those are some really great people".  He's so right.  Thank you for your gentle words and helping me keep my head above water.

Later today, I hope to write about what happened during our ultrasound and after, but I need just a little more time to process it all.

Right now, I fear that the depressed/anxious girl that has been living comfortably in my brain for weeks (years?) has now received the fuel she needed to become a full blown, raging control freak. She's yelling "I told you so! This is never going to work, muhahahah! Nana-nana-nana!" At the top of her bitchy high pitched voice. 

She was right this time. She won, again. She went up against 6 MOTHER fucking years of research and treatments, too many doctor's appintments to count, enough money to buy a long row of new cars or feed the homeless in my city for a year.  And, now,  impressively a 21 year old's donor egg and one of the best fertility clinics in the USA.  She won.  I don't want to even fucking believe it. 

Even though I feared this happening from day one, I am somehow still in shock. 

I'm not sure how to continue now.  I always fought for my body, thinking that it was an embryo quality issue that we had before.  However, now something new has been added to the equation.  Now I add a beautiful hatching 5AA DE blast to the list of babies that has died in my uterus.  No, I don't know that it was chromosomally normal.  And maybe even if it was, it would have died.  I don't know what to think.

Right now I just feel stupid for having chased this dream for this long.  Maybe I should have seen the writing on the wall a long time ago.  Maybe I should have listened to that little voice in my head.

If there's one thing I've learned about grief and coping with loss, it's that today no decisions need to be made. Today is about eating, sleeping and just getting through the day.  

Why couldn't this have just worked for once?

First ultrasound, 7 weeks, 3 days

I had the ultrasound done at a hospital, where Dr. Highrisk is located.   I was worried about the technician not telling us right away what she saw.  However, when I was called back, we immediately had new problem.  They wouldn't let D come with me.  I practically begged for them to let him come with me, saying that we'd had 6 years of infertility hell and losses and I needed him there.  After asking the two different people that were helping me, both told me no, that it was "hospital policy".  I hate when people say "it's our policy".  When I was in the financial industry, I was trained that saying that to a client without further explanation equated giving someone the finger.  Surely this was a reason to make an exception? Unfortunately, they didn't think so.

So instead, I braced myself to be alone.

Right then, I'd wished I'd just went to our satellite clinic.  That would have never happened.

D said later that it felt like an eternity in the waiting room.  He said all he could think about was what he would say to me if there was no heartbeat.

When the nurse left me to get ready for the ultrasound, I decided I would try to help myself by slightly tilting her screen towards me, allowing me to see if I laid a little lower on the table.

As I was waiting, I thought to myself, "if there was ever a time for me to have a panic attack, this would be it".  My anxiety was through the roof.

The first thing she did when she came on was move the entire machine forward, so she could work, essentially making the screen completely out of my view.

I decided I would stare intently at her face.  I wanted to see if her expression would give anything away.   It didn't.  Then, she broke her silence and smiled and said that she saw the flicker of the heart, and then turned the screen towards me.  I'm not a public cryer, but tears started to flow down the sides of my cheeks.

Relief.

There was a heartbeat!!!

90 BPM and the baby and sac measured normally.  I can't remember what the measurements were because I was in shock, crying and trying not to break into a complete hysteria.

She asked me what Daddy's name was and she said she would go get him.  She said Daddy! My heart melted a little more and more tears came.

When she called for him in the waiting room, he said that he thought it was bad news and that I was a hysterical mess and they needed him to calm me down.

I knew he would think it was bad news, so the first thing I said to him was "It's ok.  There's a heartbeat." And then she showed him too.

At first I was worried about the fuzziness of the blob, but then I realized that the ultrasound machine they were using was not as advanced as I'm what I am used to.  The image was much less clear than our satellite clinic's, and way less clear than CCRM's.

After, we had a regroup with the doctor.  He was certainly not Mr. Personality.  I'm not sure what to make of him.  He didn't ask for a history, more than what the nurse took earlier.  He didn't have much to say, he just answered our questions.  When he answered us, he mostly just stared down at the papers in front of him.

When I asked him about weaning off my Lovenox and Aspirin, he didn't really have an opinion.  I was surprised.   He said there are no known risks to the baby and that it probably wouldn't hurt me to stay on it.  I feel that I am only taking it because of a) my sister's stroke and b) because I'm on tons of hormones.   Once I am weaned off the hormones, I may decide to stop taking it.   He says there's no weaning, that I can just stop it cold turkey if I want to.

He said he usually only sees people after four weeks when they are this early, but he kindly offered that if we wanted to come in more often, and it would help us be less anxious that he would see us in two weeks instead.  He said he would do the ultrasound himself.  We jumped on that opportunity.  Four weeks would seem like an eternity.

We're just letting this all sink in now.  This is new territory for us.  We've never been here before.  Never had a heartbeat.  We're feeling so very grateful and relieved.  This might really be it.

Doctor hunting

CCRM asked for me to find an OB, and have my first ultrasound with them after March 27th.

Some people, fertiles and infertles  have everything mapped out about their pregnancies and babies before they arrive.  We could never bring ourselves to do this.  It wasn't something that brought us hope, but rather highlighted our infertility.

So, even when CCRM suggested I look for an OBGYN when we started our last cycle, I didn't.  I figured worst case scenario, that I could go to my last OBGYN, even though I haven't been there since I was 28 years old.

I remember my last visit to that doctor vividly.  He told me that my FSH test was normal (later I learned it was meaningless because I wasn't instructed to have it on day 3).  He explained D's sperm analysis, and in a low, hushed tone, mentioned the word "STERILE" and wrote it down on the page in caps.  I don't feel like revisiting those memories any more than the million times I've already have.   However, I did daydream about telling him that after 6 years, since I last saw him, guess what? This is a DE baby with D's sperm!

I asked my friend, a local maternity ward nurse, who she would recommend?  She told me that she wouldn't choose my last OB.   She instead suggested two others.  One was female, the other was male.  Recommendations being equal, I decided to go for the female.

I needed a referral from my family doctor to see the new OB.  His secretary told me that I'd need to come in for an appointment to get a referral.  I suggested that he might make an exception for me, explained a little bit of the situation and she said he'd call me back after reviewing.   Later that day, he called to offer his congratulations and we had a discussion about why I was looking to go to that doctor in particular.

He suggested that I go to the local high risk OB instead.  This surprised me.  I think the blood thinners I'm on and my family history of stroke make him nervous.  It felt a little like over-kill to me, but I figured I would go with it.  I thought, a more highly trained doctor isn't be a bad thing, right?   I figured if Dr. Highrisk didn't want me as a patient, that I could get him to refer me to the other less specialized female doctor that I wanted.

Dr. Highrisk is the only one of his kind in the city I live in.  He's a busy guy.  His receptionist is a busy gal.  And from what I can gather, they don't answer the phone very often.  When you get voicemail, it instructs you to not leave more than one message a day.  Every day that was ticking by, waiting for my call back, was stressing me out more, knowing that my ultrasound appointment time was getting farther and farther out in the future.

Wondering if there is a heartbeat, or anything going on in that ute of mine is driving me crazy.   Over and over I can't help but having flashes of when we had the twins, all of the excitement and then things crashing down,  when we realized we were staring at two very empty sacs.   This week, D called that that experience "the worst horror of his life".  In part because of the situation I'm sure, and in part because of how badly I crumbled after.

I wondering how this ultrasound is going to be? What kind of day are we going to have that day?  With only one embie in there, I'm reminded that there's one shot, once chance at a heart beat.  Knowing that when we get our ultrasound that we'll be 7 weeks along and it will not be too early to see the heart beat if there is one.

I tell myself, as some others in my life do "You got what you wanted, a BFP! This is real! Now be happy! Be excited!  Enjoy the moment!" But that's just not how I'm feeling.  I can't decide if it is infertility that has done this to me, or is it my now my personality after being in the trenches for so long? I never used to be a negative Nelly.  But I didn't know just how ugly the world could get then either.  It frustrates me and saddens me deeply.

Anyways, back to the doctor stuff.  Yesterday, after talking it over with D, I decided to physically go to Dr. Highrisk's office at the hospital.  I was going to say that I was in the area, and that I just wanted to check in...blah, blah, blah.   If I needed to encourage the secretary to give me an earlier ultrasound appointment than what she first offered, I planned what I would say.  Trying to find the right words for a likely desensitized secretary to feel empathy towards us could be difficult.  I settled on something simple.  "We've had six years of infertility and early losses, is there any way he could squeeze us in sooner?".  I hoped it would do the trick.

When I got there, the front desk of the hospital didn't want to let me in without an appointment.  This was probably heightened because the hospital is under an influenza advisory.   I told the receptionist that it was complicated, that I had a referral to be there, but I couldn't get in touch with them.  They let me in.

When I made it to the doctor's office, I breathed a huge sigh of relief.  The receptionist was as sweet as can be.  Her name is Joy.  She was one of those people whose name matched her personality so well.  She was tremendously helpful.  She said she remembered my name, but couldn't find my referral in her big stack of papers.  After searching for a few minutes while apologizing, she found it.  It was missing information, so she had set it aside.  It turned out to be information that would not have been known by my family doctor, and would have taken some time for them to complete.  I was able to provide the information, and fill in some of the blanks.  Phew! for this reason alone, I was glad I went in.

After consulting with the doctor briefly, Joy said he wanted to draw a beta and he could meet with me that day, if I could wait.

So, I had my beta drawn.   I later learned that Joy wanted me to see the doctor so he could prescribe some progesterone support, because of my early losses.  I told her that I was on hormones, that I was being monitored.  We decided that it would be best for the doctor to see the results of the beta (she told me they wanted it over 5000), and then go from there.   She would call me with the next steps.

Once at home, D and I did some figuring on the beta.  I've been trying not to stress about the beta. CCRM has only checked my beta twice.  When I asked my nurse why, and she said that unless it's being done every 48 hours, that it doesn't show anything meaningful.  That it doesn't show the health of a pregnancy.  My local clinic checked betas much more often.  I liked that better.

It didn't seem like 5000 would be possible with the numbers that I've had, even with some generous math.   I wondered if 5000 was some important threshold to be at when you're 5 weeks along.  Was it some deal breaker kind of number?  I've never researched these things very much.  With the embryo donor twins, my betas were sky high.  When I miscarried the embryo from our genetic material, the numbers were strikingly low.

Joy called me later that day, and asked me to come in again on Friday for blood work?  She said my beta was around 2900, and the doctor wouldn't schedule an ultrasound until it reached 5000.

We had a little sigh of relief that something is still going on in there.

Friday's beta will be another piece of the puzzle.  Maybe it will put us at ease, just a little more?

I wish I could just pack up my anxiety away for a little while....okay, forever! Scram, Anxiety! Don't come back! And take your stupid friend Depression with you!

I dream of the day where we see a little heart beat flickering on the monitor.   To see what we've never seen before, and maybe to feel a way that we haven't felt in a long way too.

Calendar confusion

Since December 19th, I've been trying to figure out if I've ovulated, or if I'm in my luteal phase.  And yep, it's January 10th.

I know, it seems kind of basic, right?  Something that should be simple.  Something that a top notch fertility clinic could figure out?

At CCRM, a regular donor cycle would normally start out with some birth control pills and in the luteal phase, Lupron would be added to quiet my hormones to prepare for the next month's transfer.

Except, I can't use birth control pills because of my family history with stroke.

So, the nurse suggested to use ovulation predictor kits (she suggested the clear blue easy kind with the happy face).  I told her that I was worried that it wouldn't work for me.  I've never had luck with the OPKs in the past.  Not that I've used them that much anyways, because when I found out I had ovarian issues, I also learned at the same time that they were so severe that an ovulation kit was really not going to help my cause.  With D's low sperm count, trying to use those kits every month seemed futile and emotionally exhausting.  Not to mention a waste of money.  So I never used them more than a few times, back when I didn't know how messed up my body was.

I asked my nurse if it would be worth the risk to just take a low dose birth control pill for the one month instead?  After all, I was on the pill for 10 years before and didn't have any side effects.  The nurse agreed that this sounded reasonable and checked in the doctor.  He said that he didn't feel comfortable with me taking the pill.

So we trekked onwards with our OPK plan.  As a back up, the nurse said she would send be for blood work if we got past a certain part of my cycle and I had not picked up a surge yet.

I monitored all of the way through the Christmas holidays, consistently and properly, but I did not get a surge.  So, on the 30th of December, I cut my Christmas plans short and traveled back home to get my blood work done and have an ultrasound to check my lining.  My lining was homogeneous and there was a 21mm follicle.

Later that day, my nurse called to say that my local clinic didn't draw LH and they got an FSH result instead.  She said not to worry though because my other levels (estrogen and progesterone) were still low, so they didn't think anything had happened.   She told me she thought that I was about to ovulate on my own because of the 21mm follicle.   Because of the error, I had them re-run my results form the 30th for LH.  The LH came back low (in the 8's).

Due to the New Years Eve holidays at my local clinic, I went back on Monday January 2nd to repeat blood work and ultrasound.  Cue horrible snow storm.  School buses were canceled due to the snow and very low temperatures.  People weren't able to dig out their cars out to go to work.

The roads were ok for the first 30 minutes of my drive but then turned wretched.  There were so many cars in the ditch.  I battled the roads, and drove white knuckled to my clinic.  The one hour drive took me close to an hour an a half.  When I got there,  all of the lights were off because they had closed the office due to the storm!

Luckily, there was one nurse there who was able to draw my blood.  Phew!

I was concerned because my requisition was only to have LH drawn this day.  I was cycle day 27 for crying out loud.   I called the emergency line for the CCRM nurses and discussed my concerns.  Wouldn't they want estrogen and progesterone too?  Or how about an ultrasound? My CCRM nurse wasn't in, but after some debate amongst the on call nurses, they told me that the estrogen and progesterone results wouldn't  have changed that much, and I didn't need them.

I felt better hearing that.

Until the afternoon when the CCRM nurse called.  She wasn't my regular nurse, because mine was off for the holidays.  She said to me, "I don't really know how to interpret your results.  They only sent in your LH, which hasn't risen much from your last draw.  I don't know what to tell you.  I think we should wait until your nurse is back tomorrow".

In my head, I said every swear word I could think of.  "What do you mean?" I said. "I called for the emergency line this morning asking if I should have these exact tests!"  I was fuming mad. I drove all of that way through the ice and snow and didn't even get what I needed to have done.  I could have melted all of the ice in town with the heat steaming out of my ears.

The nurse asked me to have them re-run my results.  But I'm not able to do so because there was no one working at the clinic due to the storm.

She says, "Don't worry.  I'll have your regular nurse call you first thing in the morning".

When I don't hear from my nurse in the morning, I called her.  She phones me back at 6pm my time and says "Sorry I was waiting to get the blood results back from your local clinic, but they never showed up".

I explain to her politely what has happened.  We decide that I will call my local clinic when they reopen in the morning and have the results re-run.

I anxiously await her call on the next day with an interpretation of what is going on.

However, when she calls, she doesn't have much to tell me.  Except they aren't sure if they missed my ovulation (uummmm, ya!) and she inquires about whether I've been doing the did the OPK correctly and if I bought the brand she suggested.  I'm so infuriated! This is why I didn't want to use an OPK to begin with.  She told me she had reviewed my case with other nurses and a supervisor.  I asked "did you check with the doctor?". She said no, that he's only returning from vacation today.   I didn't bother to ask why she didn't consult another doctor there, but should have.

I asked her to please review this with the doctor and call me back.  She said she would.  I told her that we have a lot invested in this, emotionally and financially.  I wanted to know what is going on? Should we consider scrapping this cycle and opt for a different one?  I don't want to start this with huge doubts about if my medications were even started at the right times.

Late the next afternoon, I phoned the nurse in the later afternoon to see what the doctor had said.  3 hours later, I got a call back.  She said the doctor had not looked at it yet.  She told me that she once again reviewed this case with her supervisor and she said there are two likely options.

1.  We don't use Lupron this cycle.  My progesterone has been consistently low.  They will control my progesterone exposure to get me a period (I've never had a problem getting my period in the past, it's been late many times but has always shown up).

2.  They use the Lupron and coordinate it with Prometirum for 10 days.  In approximately 3-4 days after that I will get a period.  They will time the Lupron in the last 5 days of my Prometirum.

I'll admit that I don't totally understand the ramifications of these two options yet.  This is all new to me.

She wanted me to go in for more blood work and an ultrasound again today.  This will tell them what happened to my lining and that follicle.

To make things just a tad bit more annoying, CCRM didn't give me a requisition for today's blood and ultrasound, and I forgot my phone at home.  My nurse didn't want to do the ultrasound or have blood drawn without the requisitions saying it was "bad medical practice" for her to do so.  I think my sweet little local nurse had a point, but she also had a little tone in her voice letting me know that she was throwing a dig CCRM's way.  Not necessary Ms. Nurse.  Just ask me to get the freaking requisition.

By the time everything got straightened out, I'd spent an hour in the waiting room.  There were kids everywhere.  Seriously.  When I left the clinic two women walked in with FOUR children.  What the hell? There were kids at every row of seating. I chose to sit near a couple and her 3 year old son.  Both parents were barely paying attention to the kid.  I cringed inside.

I watched a nurse come out with a cute chubby cheeked baby and bring her to the receptionists to oogle over.   I was assuming she was the result of one of the clinic's treatments.  I continued to watch the 3 year old beside me try to get his parents attention.   The nurse came out to talk to the mother of the 3 year old.  She let her know that her appointment will be another 30 minutes yet.  She says "He's going to do her ultrasound today because of what's going on".  The patient says she just needs to know, "Can you do my ultrasound right now she says?"  From their muted conversations, I gather that she must be pregnant and bleeding.  I start to feel really bad for assuming things about her, and her parenting.  I realize why she and her husband aren't being responsive to their 3 year old.  It's because they are waiting to find out if she's miscarrying.

I finally got called into the ultrasound room.  I stop to talk with the nurse at the desk and I see the woman's ultrasound pictures on the desk.  They are requesting more blood work for her.  I see two small  but empty looking sacs on the pictures.   It reminds me so vividly of where we were two years ago getting that exact news.  My heart breaks for them.  And it breaks for me and D all over again.   I realize why my sweet nurse had a little bit of attitude this morning.  She's feeling emotional for them too.

My lining appears homogenius again, and that the follicle appears to have collapsed.  There are 3 smaller 3mm follicles forming.

I'm hoping this will all make more sense when my blood work comes in.  And that my nurse can give me a good explanation of everything and that I will be able to assertively ask the proper questions of her.  

This is getting a little too real... money for eggs and babies

Things have been moving along with our egg donor and adoption plans. I can tell by our bank account. 

Our homestudy is well on it's way to be completed.  The social worker is taking off for a month, but says she'll have our report completed in early January, which is fine with me.  On the egg donor front we've got the paperwork almost completed, and the donor is scheduled to do her one day work up soon. 

I'm hoping for the donor to start taking stims within 2 months.  We'll have 1 month for the CCS testing to come back (If we decide to do that again), and then the next month (maybe February) we'll be all set to go with a transfer. 

I'm gagging at the amount of money this is going to cost.

In case any of you were wondering:  

To the donor agency:

Set 1: Administrative Fees:

$5750.00 – Administrative Fees for coordination of cycle

$ 400.00 – Donor legal consultation

$ 300.00 – Supplemental Donor insurance

..................... Total: $6,450

Set 2: Donor Fees:

$6000.00 – donor fee

$  400.00 – estimated donor expenses (local mileage, prenatal vitamins, birth control etc.  These fees are due in check form and any portion not used would be refunded to you at the end of the cycle.) 


.................. Total: $6,400

To CCRM:
$23,955.00 + $3690 (ICSI, IMSI, PICSI) + $6,800 CCS testing

.............. Total: $34,445

Meds:  $5-7000
................ Total: Let's say $6,000

Grand total: A gagging $53,295 or $46,495 without the CCS.  We might need to forgo the CCS. 

F*ck.  And that doesn't include our travel to CCRM or lost work time for my self employed hubby. 

Or, what we've already flushed on 5 years worth of embryo adoption and our other fertility treatments.  

On the adoption front, they tell us that we can expect the pleasure of paying around $20,000 after homestudy expenses.  The agency also informs us that the birth mother can back out and leave us stuck paying the majority of that fee.  Whaaaaat?  that better not happen because I don't think I could handle it.  I can't even think about being in that boat, especially after paying for all of this egg donor stuff (not to mention the emotional problems associated).  

Don't get me wrong,  I'm very thankful that hubby has a job that has even allowed us to consider egg donation as an option.  I realize the fortune that we have being able to try to do this, no matter how hard it's going to be.  But, I still can't bring myself to feel happy about draining what's left of our savings.  I also can't help but dwell on wishing baby making for us was just a roll in the hay. 

...And I wonder why I'm feeling depressed all of the time. 

Working through another checklist and sisters

We're working our way through another checklist in an effort to get cleared by CCRM to choose a donor.

Part of me is annoyed that a lot of the testing we've had once, twice or eight million times before.  Oh, and paid the bills that many times too.   I'm hoping some of the things they've asked us to do is because our new donor nurse has overlooked some of the tests in our file.  But really, I feel like I'm done with having tests in general.  I'm sure all of you IFers feel the same way.

One of the things we checked off our list yesterday was our psych consult.  I think we passed it with flying colours, having gone through the embryo adoption process before.  I'm glad that is over with.  The psychologist was very nice.

The one lingering decision for us is around openness/contact with the donor.  D doesn't care if we have contact.  He things that we've been through enough and we just need to move on and not make every step we take perfect.   I feel the same way too, but potentially, I think this is too important to overlook.

I want this door to remain open for our (hopefully) one day child.  I personally don't have a desire to maintain a relationship with the donor, but I do want the option there for our child to reach out to her one day.  For whatever reason, to ask medical questions, or to help sort out some identity questions.  I think it's important.  I recognize that we may have a kid that doesn't care.  But we might also have one that does. Which is why I want the door left open for contact from us.

This part of CCRM's database I find underwhelming.  The nurses have access to whether donors have chosen to be "identity disclosed" as they put it.  But you have to specifically ask for that information with each donor.  To complicate things, right now their database of caucasian donors is surprisingly slim.  (While I would be open to parenting a non-caucasion child through adoption, I think it creates too many questions to be give birth to a child that is not caucasian when both D and I are.)

So I'm left pondering if an agency donor is a smarter choice for us, because there would be more options for openness.  As an added bonus, you can sometimes see a picture of the donor as an adult, which would be nice (but not necessary).   On the other hand, CCRM does have this really nice egg vitrification donor program, where you can get eggs that are already frozen.  That would takes a lot of stress out of things knowing that the eggs are already there, and we wouldn't find a donor that isn't fertile.  We don't want to push our luck with this anymore than we already are.  We see 'egg vit' donors as one less thing to worry about.   Decisions, decisions, decisions.

On a different note, I want to say that I really, genuinely appreciate your support here.  The support in my real world life has been not what I have needed lately.

This is a time where I really feel I need extra support.  These feel like a huge decisions.  And if I'm being real, I'm mourning.  The loss of my genetics is a big loss for me.  It's a loss that I didn't anticipate having to mourn twice in my life.  And you know what? I'm not sure it got much easier the second time around.  I just know what to expect this time.

My sisters in particular have let me down with their support.  I had a talk with D about it.  The one sister is busy starting a new job.  So I get it, she's busy.  But the other sister knows how this process has been so far.  She came to CO with me (which I appreciate tremendously), but afterwards it's been silence from her.  I texted her to let her know the outcome of our embryo testing and IVF.  She sent me a heart and said "that's me sending you my love".  She's a social worker/addictions councillor.  I feel really let down by this.  I move between feeling like I should just be grateful for what she's able to give, and pissed.   This is a huge deal for us.

I also know that if I reach out to her and/or tell her about how I feel about this, that any support she gives me afterwards will feel hollow.  So I keep my mouth shut.  But I find myself feeling resentful and I don't like that either.  What should I do?

So, I come to you, friends.  And for that I truly am grateful.  You are here listening patiently and lovingly. And offering your support and words of advice.  Thank you.

Don't know where to begin

I've thought about this space every single day since my last post.

So much has happened.  I'm going to try to condense it...  

We went to CCRM for IVF.  They were following 7-8 follicles for the egg retrieval.   I stimmed for 14 days.  I thought that I was going to stim for longer, but my estrogen basically flat lined for 2 days and Dr. Schoolcraft decided to do the trigger.  The largest follicle was 18mm.  The rest were in the mid teens.  

We were still hopeful to have a similar number of eggs as we had at our previous clinic (Recap: It was 14 months ago.  They were following 7-8 follicles then, and we ended up being surprised with 11, 6 x  day 5 embryos resulted.  We did not do CCS).    

This time we only ended up with 4 eggs at retrieval.  We had big heavy lumps in our throats that we tried to swallow.  

We crossed our fingers and toes and hoped that they would fertilize and our embabies would be ok. We reminded ourselves of what Dr. Schoolcraft said in the consult.  In our minds, we were only going for 1 normal embryo.  

2 eggs harvested were immature and they tried to mature them in the lab.  We were thankful for this as they would not have been able to do this at our previous clinic.  

After fertilization and maturation of the eggs, we ended up with 1 embryo (from a mature egg) and 1 embryo from an egg that they matured.   Sadly, the embryo from the immature egg arrested on day 5. 

We debated on what do do with the CCS testing.   The doctor had suggested previously that we consider embryo banking if we got less than 4 embryos to test. 

We felt that the result of the IVF was so poor that we didn't know if we wanted to even do it again.   We wanted to talk to Dr. S again but he was unavailable.   We didn't even know what to ask but felt really lost. 

We decided to test the embryo ($6800 - big ouchie).  We did so because we thought that if the embryo was normal it would change our thinking.   Dr. S ordered the arrested embryo to be tested as well.   However, there was not enough material to test. 

The embryo came back with results 2 weeks later.  It was abnormal.  The irregularity was on the 7th chromosome.  The nurse said that chromosomal errors are almost always (95%) due to the egg because of the way that an embryo forms.  (Coles notes: because the eggs are in the woman's body since birth, and the man's sperm is only been formed approximately 90 days prior to ejaculation they are different.  When an egg is fertilized one pair of the chromosomes are shed by the fertilized egg each from the sperm and egg.  The "glue" that holds the two pairs of chromosomes becomes stuck more easily in the egg and is prone to more irregularities.  This is because it has been in the woman's body since birth.  We didn't know this until the CCS class that week at CCRM.  Admittedly, I'm probably butchering their neat and tidy explanation.).  

We were/are very upset that we only got 1 because we feel that the sample size doesn't allow us to know if it indeed would be possible for us to make normal embryos.   

We were preparing for something bad to come as a result from this IVF.  We were imagining creating 6 or more embryos and getting them tested only to be told that they were all abnormal.    We were told by Dr. Schoolie that we'd have a baby or an answer.   Now we have neither.  Kind of. 

Cue a huge emotional response from me and D.  Exhausted.  Exasperated.  Frustrated.  Pissed off.   In shock.  Mad. 

We had a post consult with Dr. Schoolcraft.  We wanted to know what went wrong?  Was it a fluke?  Why was I triggered when I was?  Would a different protocol help?  Does he think we should even attempt IVF again?  Was it because I didn't take the DHEA or testosterone priming this time?  Should we have waited for a higher pre-antrical follicle count?

D reminds me of what we just did.  We just flew across the country,  spent a year doing the work up and waiting for my body to cooperate, and spent $40,000+.  What do we have to show for it?  A substantially poorer result than our local clinic.  And minimal new information. 

We were rational in the regroup, despite feeling otherwise.  Dr. Schoolcraft told us patiently that he doesn't know why this happened.  That it could have just been a bad month.   That my fertility could have declined that much since my last IVF 14 months ago, that my FSH was that bad.   That we could try another protocol but it was the difference between basically switching from "tylenol to aspirin".  He told me I was on the strongest protocol.   He said if we were to do one more IVF he would give us a 20% of taking home a live baby.  If we did donor egg it would be 80%. 

We have been on this portion of our journey since November 2012.  Now, almost a year later after all of the testing and setbacks of the past year, I just feel like I had a bad month.  That I should have taken the DHEA.   I feel ripped off.   

But somehow amidst this turmoil we have made the decision to move on.  To close this door.   It's not a door that's been wide open for us ever anyways.  Maybe there is enough information now to make a decision.    We're tired of chasing the small odds.  We want to be parents. 

We want to have more than one child (in our wildest dreams).  If we spend so long trying to get baby number 1, will that mean that we won't have the chance to have number 2? 

So, on to egg donor we go.   For me, excitedly, but also anxiously. 

It's a weird feeling.   We are now back into thinking about openness and clinics and whether this will work.  

For D it's different.  He doesn't think it will work.  He's tremendously negative about the chance of success.  He wants to move on to traditional adoption but is doing this for me.  I hate it when he says it  won't work.  It feels like a punch in my gut.  No, a punch in my uterus.   

This has to work, doesn't it?  I understand why he thinks this way.   We haven't been on the positive side of many (any?) fertility odds in the past five years.   But I'm not ready to give up seeing his face in my child, or having the experience of pregnancy.  

So, onwards we go.  

Decisions and the waiting game

This is all my calendar today.   Not much on the go.  The most exciting thing was hoping for my period to come so I could find out if the cyst is gone.   There is no sign of it coming (usually I get the lovely advance notice of a week of spotting before hand).  Well that is, except yesterday's hefty dose of bitchiness directed at hubby.  He might have deserved that though, I don't know.

It was cold outside today so I spent the day grocery shopping and then making a couple of soups.  I'm thinking (hoping?) that this might be the last urge that I get to make some in a while.   Bring on the BBQ weather and food!

Hubby and I are still on different pages fertility-wise.  I didn't have the desire to write about it until now.  I was just letting it simmer for a while.   The short of it is that D wants to finish up with this round of IVF.  I feel that he is nearing the end of his IF rope and I'm trying to respect that.   He thinks it is my body that is preventing us from getting pregnant more than an embryo quality issue (ouch).   I think it's embryo quality issue, and so does the doctor.

If D can only go through this a few more times, I want to skip the OE IVF and move to DE.  He's going to be 37 soon and he's seeing the big 4-0 approaching.  I think for the first time he's feeling his biological clock ticking.

I know if I have a baby I won't regret how it came to us.  We've fought long and hard enough.  And I'm starting to wonder for what?

If OE IVF doesn't work this time around, D wants to move to traditional adoption.  I don't.  I can't explain why exactly, I just know I'm not fully there.   I want to try DE with donor sperm.

D doesn't really understand my desire to experience pregnancy.  He thinks adoption is just about the same thing.  This frustrates me.  I feel like after all that has been taken from us, I just want this one thing.   I want our baby to be welcomed into our family with the 9 months in utero that most other mothers get.  I want to control the prenatal environment.  I want to experience childbirth.

D says he needs the closure of doing this OE IVF.  He says we are too close to the finish line to quit now.  Not to mention that we have $5,000 of non-returnable Follistim just rotting away in our fridge.  He says that the money spent going after it ($25,000 for fun) will be on him (we have joint accounts, we're just talking about the guilt of spending it I suppose).  I would rather spend the rest on DE and some furniture (for a nursery!).

Something has else has happened.  The hardest part of this part of the journey lately doesn't seem to be pregnancy announcements and seeing swollen bellies anymore.  It's almost like I've become largely desensitized.   The hardest part now is that D and I don't agree on which way to proceed.

There doesn't seem to be a right path anymore.  Up until now we made the best choice together after considering the options.  While there have been many bumps in the road, one choice always seemed to stand out.   Not the case anymore folks.

Courage or stupidity

D's near or at the end of his rope with all of our IF treatments.  I'm not quite there yet, but I am approaching.  Debating our end point has me thinking about what the two ways our story could be told.

You hear or read stories about people who persevered through crazy, intense, and heart wrenching scenarios.  One that comes to mind is that of Mo and Will, who navigated their way through tremendous obstacles (cancer, and seven miscarriages among many other things).  They now have a beautiful baby in their arms.   I put them well into the courageous category, and I know I would do this regardless of whether their most recent efforts made them parents or not.   It's because they handled the journey with intelligence, strength and grace.

I'm finding as we wade through deeper waters of IF, I'm starting to judge myself more harshly.  I'm wondering if I'm no longer making smart choices. Two, three and four years into this seemed like we were fighting the good fight.  We were young and had time on our side.  Year five I felt like we had new information and were on to something new and more promising with CCRM.

As we approach year six, I wonder if we've done something terribly wrong.   Especially as D reminds me of a couple that was in our adoption course who now has a toddler because they chose traditional adoption.  That could have been us.

I wonder if I am in denial? With all of what we know (and don't know) maybe chances of success are  too slim?  Maybe the cost of pursuing treatment are now too high? I feel time running short, we are emotionally drained and financially tired, not to mention the opportunity costs of IF.

D is going to be 37 soon.  I'm going to be 34 this year and according to every doctor I've met, my ovaries are a decade older than they should be.   If we want to pursue adoption it will be a lot harder (I think) if we are a few years older.

I feel like if the next procedure worked for us, I would look back and think about what an incredible story it would be.  "It was all worth it" is what people say when they end up with what they wanted.   Nobody questions your decisions any longer.  We would say that we triumphed after a long hard fight.  That we were beaten down but we got back up again and again, and again.  That we figured things out.  We made our dreams come true.

There's another part of me that sees how this story could be told in a much different light.  Perhaps as we enter six years in, we are entering a new territory.  I think I would question whether we made intelligent decisions from this point on.   Even possibly decisions about DE IVF if it didn't work either.

 

Why we went from OE to Donor Embryos back to OE

I wanted to write something about why things worked out for us in this weird order.

- At first the doctors gave us only a slim chance at our own IVF working, because of my repeated FSH levels.   They were all shocked at how high my FSH was for my age.

- We decided to do a "closure" IVF cycle anyways.  We had the money and our doctors agreed to this because I was in my twenties.  Under a mild dose of stims I produced 4 follicles.

- On the night of what I thought was going to be the egg retrieval, my sister had her stroke.  The cycle was cancelled.

- Later I learned that this was just what the nurse called a practice cycle.  They wanted to only do an   an IUI.  They wanted to amp up my meds for the next real IVF.  This was not told to us in advance and I don't think I would have ever agreed to a practice cycle due to the cost of the meds and the fact that D's sperm count is very low.   It was one of a few scary reasons why moved away from this clinic.

- During the stressful time of my sister's stroke, I decided that my response to the IVF wasn't good enough to proceed.  That if it did work it might only work once.  And I wanted more than one child, and it would be nice if those children were genetically related to each other.  I didn't care if they were related to us.  I decided (and D agreed) that we would move onto the option of magic donor embryos, the option originally suggested to us by clinic #1 before we did our closure IVF.

- We spent what felt like hundreds of years (really just 6-8 months) completing our home study and adoption course (required where I live) which was required to adopt the embryos through Nightlight.

- We adopted our first set of embryos (only 2 embryos, of which 1 survived the thaw).  They didn't take.

- We quickly adopted a second set of embryos.  The last of 6 embryos we got resulted in a twin miscarriage at 8 weeks.

- Later we learned that the donor family from match #2 experienced chronic miscarriages.  I now believe based on embryology reports and their history that they had an embryo quality issue on top of some other ones with her uterus.

- After the last miscarriage, the doctor suggested (surprising us) that we try OE.  He had heard of DHEA supplementation helping some women.  Also, several times through my monitoring they were noticing some of my own follicles.  My age was a driving force behind this decision for the doctor, because at the time I was 31.   I was reminded of my response to the small dose of meds that I took at clinic 1.  They thought it was promising.  We agreed to try, because we didn't want to do donor embryos anymore.

- At the time we thought we would pursue traditional adoption concurrently, but we decided it was too much at once.  Also, our social worker did not want us to do both at the same time. So we didn't pursue  the adoption.

- That IVF cycle produced a better response than we ever expected - we made 6 blasts that survived to transfer.   One resulted in a pregnancy, which I lost at 5 weeks.  Another was a negative and one had HCG of 1.0.  I don't even know if I could call that a chemical.   But something was trying to happen.

- At my request, I had a panel done for repeat losses. I tested positive for one mutation of the MTHFR gene.   Dr. Schoolcraft says that up to 40% of the population could have this mutation and it is not a factor in my miscarriages.  Everything else was clear.

- I did some more research and learn how hard it actually can be to get pregnant with donor embryos due to quality issues.  We have limited emotional energy left, for what we feel are not great chances, so we close this door.

- The doctor at my second clinic that (did my IVF) started to suggest things that made me feel like the doctor is grasping at straws.  Dr. Schoolcraft called some of my protocols "voodoo".  I was scared of the risks of the things he was suggesting and his lack of experience in those areas (I didn't want to be his first IVIG patient - no thanks).

- We decided to get one final opinion from CCRM.

- Dr. S at CCRM thinks we have an embryo quality issue with our past losses, not a uterus issue. He is most worried about my highest FSH number, and wonders about my egg quality.  He says if we can get one normal embryo (as determined by CCS), that he would give us a 50% chance of success in that cycle.  He said he didn't know if we make normal embryos.  He thought we might get one from one cycle of IVF.  He said that if we can do 2 IVFs that it would be reasonable to proceed with this option. He gives us an 80% chance of success with donor egg.

- We decide to do one more IVF because we feel we were close with our last IVF.  I feel like the 2 (maybe 3) pregnancies we had were evidence that my body DOES want to grab a hold of the little embies.  It does want to be and stay pregnant.  I think the embryos just weren't a good enough quality to survive.

- We think the slight change of protocols, the greatly improved lab with the CCS could make the difference for us.  Our last IVF with 6 embryos was the biggest factor for moving forward.

- We decide that we will quickly move to DE if our embryos are not good from the CCS.

- I have a laparoscopy and it shows that my uterus looks great.  The doctor tells us that if we can put a normal embryo in there he feels we have a good chance of it working.

- Now we have been sidelined with two cysts and I'm wondering if this was all a big mistake.  D's getting exhausted from this all (as I am).  I know in his heart, D doesn't think that DE will be any different.   He thinks we have a uterus problem.  I don't.  I think that we have an embryo quality issue not a carrying issue.  This is why I'm hesitant to move on to traditional adoption.   I want the experience of carrying.  I feel like IF has ripped everything away from us that was natural and good about this baby making process.  I just want this one thing to be "normal".

Support

I only talk about fertility stuff with my closest friends and family.  Oh, and sometimes with my hairdresser and dental hygienist. :) The hygienist had twins via egg donor and talking about it makes my appointments go by in the blink of an eye!

In the last month or so,  I've been updating people on our plans with Dr. Schoolie in Colorado.  However, I've been doing something different lately.  I'm telling them, "We don't have many tries left at this.  We are nearing the end of this road.  If this doesn't work, we are moving on to something else.  This might be it".  I leave out the part about what the something else is.  But we are thinking it is going to be egg donation, or traditional adoption.

I'm telling people this because I feel like people think we are crazy for pursing more treatment.  This is our 4th RE, and 5th year at all of this.  And more importantly, because I'm really scared of the emotional fall out from this one.   Seven procedures in,  I now know all too well what the day after a failed procedure (or worse, miscarriage) looks like.  The trend doesn't seem to be my friend.  Our grief is increasing with every cycle.  This is how I know we are nearing the end in all of this.   I can't see us being able to handle much more than we already have.

I think they need to know we are all-in.  That we are approaching new levels with all of this IF stuff.  We aren't wading knee deep in all of this anymore.  We are up to our necks.  Holy shit, this is it.

I've never been good at receiving support from people other than D, and through my online friends.   I hate to blame my parents, but I truly think I was raised not knowing how.   My parents showed zero affection and support to each other and surprise, surprise, ended up divorced.

I never cry in front of other people. It usually takes a lot for me to even cry in front of D.  My sob-fests tend to sneak up on me while driving my car (not the safest, I know) or when I'm home alone.

I find discussing all of our IF stuff to be difficult.  I can tell the facts about what is happening, but I rarely go into how I feel.  People don't ask, and I don't want to be a downer.

I think this is unhealthy.  A therapist once pointed out to me that I don't need to protect them.  And that I don't need to put on a strong front all of the time.    I know she is right.  I've had more than one friend tell me I'm "so strong" in how I deal with all of this IF.   I'm done with this approach.  While I don't want to be a blubbering puddle all of the time,  I want to be able to do it sometimes.   I guess I'm getting to the point where I need to do it.

I don't know how this works.  How do you get and accept support?

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.

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.