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.  

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".

A Plan, Stan

I'm happy that our IVF calendar has started.  Yeah for progress!!!

I'm on cycle day 5 right now.  The plan is that I'm going to continue to take DHEA, CoQ10 and estrogen until cycle day 16, at which time I'll add in Endometrin.  On my next cycle, I will start my stim meds.  I'm glad things are progressing!

We have also made tentative plans to go to CCRM for the laparoscopy (and possible tubal ligation) in April.  I was really hoping that it was going to be in March.  However, Dr. Schoolie says that they can't do it right after stimming because my ovaries will be too enlarged.

I thought about having the surgery this month, however I don't want to waste the time I've spent taking DHEA and CoQ10.  A couple doctors have told me that the effectiveness of DHEA is when it is taken for 2-3 months, but not longer.  My naturopath cautioned not to take it for too long.  And, I don't want to piss off my body with a surgery right before I try to make some eggs.

Apparently, 2-4 weeks after the laparoscopy I can do a FET.  I've asked them for clarification on this, I mean which is it? And how do they know? It will mean the difference of one cycle.

Typing this makes me realize that this may not be the step to rush through.  I want  my body to heal and for the best possible circumstances.  If this means patiently waiting for my body to heal for a few more weeks then so be it.

It's disturbing to me that we likely won't be doing a FET until JUNE!?!  Another six months slipping away ?!?! Gah.

In March we will have our CCS report back.  If it isn't good then I will spend the time finalizing an egg donor.  I guess I better start looking into that more soon.

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.