Monday, December 31, 2012

Looking Back and Looking Forward Infertility Style

This year has been a whirlwind of emotion, struggle and ultimately, defeat. For women suffering from infertility, the holidays are always horrible. For me, this year, I feel it doubly so. I want to recap what I've been through this year, just to slam it all into perspective.

November 2011: Doctor informed me that I have to wait two more months before I can start treatment. This was a horrible setback, since he had set me up to believe we could start right away.

Jan 2012: Our first IUI cycle. We go in with high hopes, as most IUI patients do. I think to myself, "Well, they are putting the sperm where it has to go, so how hard could it be?" I had no idea then. I find out the cycle was a bust on Feb 7th.

Feb 2012: Our second IUI cycle. This one goes over much better than the last. I have more follicles (three!), and the husband has a better sperm count. I am more optimistic than before, hoping that more is better. On March 9th, a day after my birthday, I find out that the cycle didn't work. Onwards.

March 2012: Our third IUI cycle. This time, I have four follicles, and the husband's count is okay. I'm not as optimistic. I get into the office on the insemination day only to find out that I have already ovulated three of the four follicles. I try to cling to some hope, but find out April 10th that the cycle hasn't worked. At this point, the doctor suggests that I move on with IVF. The nurse calls me at work and asks me to make a decision. I remember crying in the back office, asking myself how I am going to get through IVF, but ultimately make the decision to do so, as it's the next logical step. They start me on birth control right away, with no breaks between the IUI and IVF.

May 2012: Our first IVF attempt. I think to myself, "They are growing my baby outside of me and putting it back in, right where it has to go. How hard could it be?" I see now I should stop asking myself that question. This cycle goes over less than ideal. I go to my retrieval in a ton of pain, and when I wake up, they tell me they only got three eggs. Two of the three have fertilized, and they put the two back two days after the retrieval. On June 7th, I learn that our first attempt has failed.

June 2012: I am put back on birth control for our second attempt. I keep trying to tell myself what other seasoned IVFers have told me: the first time is an experiment. It's more likely to happen the second time.

July 2012: IVF #2. Meds are adjusted as they think I ovulated early the first time around. They keep me on Lupron longer to suppress ovulation. The doctor has hope for me and expects to retrieve 7-10 eggs. I go into my retrieval without any pain at all, and when I wake up, I am told again that they only got three eggs. The nurse tells me as I am waking up that I should think about losing weight, and that my follicles are collapsing before they can get to the eggs. I cry the whole way back home. Only one of the eggs fertilizes, and they put it back two days after the retrieval. I have very low hopes from this point on. I just know that it isn't going to work, and worse off, I'll have to put myself through this again, since I have no frozen embryos. I find out on August 10th that this cycle has failed.

August 2012: My doctor tells me that my egg quality is suffering due to my weight. He also tells me to go home and lose thirty pounds before they will try again, unless I want to look into donor eggs. I am sent home, now feeling guilty that I am the cause of my infertility. I settle in for my first unmedicated cycle in almost a year. I remain hopeful that I can do this on my own. Fifty days go by without any ovulation. I call in for a provera script to end the cycle. I also decide, toward the end of this month, that being told to go home and lose weight is not acceptable, and I arrange for a second opinion.

September 2012: I seek that second opinion and find it at a new clinic. The doctor there doesn't think anything is wrong with my egg quality, and instead, the protocols used on me the last two times weren't ideal for me or my eggs. He tells me about what he plans on doing, and does caution that if this cycle goes awry again, that I  might have to look into donor eggs -- but he really doesn't think that's the case. I decide to leave FCM and join SGF.

October 2012: I am put on birth control right away to start IVF attempt #3. I have also managed to lose almost fifteen pounds since August.

November 2012: IVF #3. This time it goes over much better than the first time. I remember laying on the table looking at the ultrasound monitor and seeing all my follicles. The nurse tells me that when I get closer to retrieval time, I'll have to take a nap while they count all the follicles. I nearly cry in joy and relief to see that I am not as dysfunctional as my previous clinic made me feel like. I actually feel like there could be some home. At retrieval time, I wake up in lots of pain and immediately worry that I ovulated early somehow. Getting to the hospital is even more painful, and when I woke up from surgery, I was in tears because the pain was so bad. My doctor himself comes to tell me that they retrieved eighteen eggs. In my drug-induced happy state, I can't stop telling my husband that they retrieved eighteen eggs, and that nothing was wrong with me after all. Out of the eighteen eggs, fifteen are mature and nine of those fertilize with ICSI. All nine of them make it to day five, and we choose to put back one and freeze the rest. I actually have something to freeze this time around! But, I find out December 3rd that IVF #3 didn't take, and I'm crushed again. This time, I take comfort in the fact that I have frozen embryos, and I won't have to do another fresh cycle.

December 2012: I've come such a long way since my IUIs. My doctor tells me that he thinks I should do another fresh cycle to change the medications slightly and stockpile more embryos, but I choose to move on with a frozen embryo transfer (FET) instead because I am mentally and physically exhausted. The other doctor informs me that I qualify for a study they are doing on endometrial biopsies on women with implantation failure, and how it increases the chances of implantation. I agree to be in the study. We also decide that we will be putting back two embryos this time around, since nothing else has worked so far. I start birth control again on December 10th and have my first biopsy done on December 20th. My next new cycle is expected to start the first week of the new year, and then it's back to waiting and hoping. Oh, I've also lost twenty pounds by this point.

And that brings me to today, December 31st...New Year's Eve. I thought by now, I'd have a baby of my own. I thought way back in January that an IUI would work, and I'd be okay. Gosh, how off I was from the truth of the situation. For eleven straight months, with only one unmedicated cycle in that time, I have been going through some sort of ART (Assisted Reproductive Technology).  Eleven months. I would have never, ever thought I'd be here, with empty arms, eleven months later. Three IUIs later. Three IVF attempts later. Nothing.

It's horribly depressing, but at the same time, I am trying to look forward. I have my frozen embryos. We are going to put back two. I have a new doctor who knows a protocol that works best for me, so even if I have to do a new fresh cycle at some point, at least I know it will not be a complete bust. I had one doctor pretty much tell me that I couldn't get pregnant using my own eggs, and my new doctor showing me that there's nothing wrong with my egg quality at all.

I am in a much better place mentally as well. Last year was very trying for me. This year, I have a new school to teach in with co-workers who are supportive and interested in what I am going through. My principal gives me a hug whenever I see her now, and she tells me that it will happen for me. Even some of my male co-workers check in on me, when I know they could not be any less interested, haha.

My husband has a better job now. He's happier too. We are in a better place financially, and though we haven't managed to sell our house yet, we have paid down our mortgage so it seems more feasible and less impossible.

And most of all, I have my husband. Yesterday, we celebrated our two year anniversary. For the past week, we've been on our very belated honeymoon, which was awesome. But, I can't help but to think, through everything we've been through, and everything I'm going through, he still stands by me and supports me. As corny as it sounds, he is my rock, my stability, and my support. No woman should have to go through what I am going through, but I am thankful every day when I remember that I have a husband who is willing to go through it with me.

Hopefully, in February, I'll be able to look back at this post knowing that all I've done has come to fruition. Hopefully, I'll have some good news then and won't have to start up another cycle. But even if I do, I know I'll be okay. As my therapist repeats to me over and over again: I will be a mother. It might not happen the way I thought I would, but it will happen.

It will happen.

Sunday, December 30, 2012

When You Know You Are Crazy

This is how you know you are crazy...

I have been on a cruise for the past seven days. I have also been spotting light pink off and on. On Christmas day, my mouth tasted like metal, and I had my husband check to see if it was bleeding for some reason. But nope. I also start feeling sickish this night. It's not really nausea, but I didn't feel like eating. I thought back to a couple of weeks ago when I was wondering if I had ovulated on the birth control because I had ovulation signs. I had a cheap pregnancy test in my suitcase from like a year ago, and I thought "What the hell! I'll give it a shot." So, I peed on it and left it to develop...but then we ended up going out for Christmas. I didn't get back to the test until some time later, and when I did, I found this:

So, there's a faint line, but, I can't trust it because it is past its time, and it could be an evaporation line. So, I put it out of my mind and keep it to myself. A couple of days later, the pink spotting comes back. I decide to tell my husband. We joke about how ironic it would be, since I'm on birth control and we weren't trying at all. In the back of my mind, I think of what a miracle it would be.

Fast forward a day. At night time, I start feeling sick again. This time, though, I feel like I am actually going to get sick. I almost do, twice, and spend some time on the bathroom floor in front of the toilet, just in case. It's not sea sickness, as the boat was sailing smoothly, and really, it was just happening at night time. I get into bed and somehow fall asleep.

The next day (or was it the same day?), I have to pee every half hour. It is annoying, and I start to wonder if I should go see the ship's doctor. Eventually, at night, it stops. The spotting continues. My husband asks me if I'm still having symptoms, and I tell him I am, but try to put it out of my mind. At this point, though, I'm really starting to wonder.

Today was our last day of the cruise. We pulled into port, went home, and I went to the drug store to get a test. I take the test.

Nothing. Nothing at all. No line.

It was crazy to think about anyway. That sort of think doesn't happen to me. I am not one of those miracle stories. But for a little while, my husband and I had hope, despite the overwhelming odds against us.

If I ovulated, I have no idea what day it happened. I just know a window. That first test I took would have been around 7 DPO, pretty early for a BFP. By now,  five days later, if I was pregnant, my levels should be enough to have a good, solid line. But instead, I have a blank test.

Tonight is the last night I take birth control, then I go into the doctor's later on this week for my baseline appointment and my second biopsy. All I can do is move forward, even if this feels like some sort of cruel joke.

Sunday, December 23, 2012

Do You Believe?

I forgot about the psychics I had spoken to over the summer. The one of them said that when it comes to my TTC, that the number four kept coming up, then the number two. At first she said something about four babies, and I just laughed at her, but then she told me she definitely sees two happening at once, and maybe four all together.

The second psychic told me that I'd find out I was pregnant in January, and that we'd have a very independent, self-starter little boy.

Last night, I was thinking about this and realized I have FOUR embryos frozen, and we are transferring back TWO. And, we will be finding out sometime at the end of January if it worked or not.


Thursday, December 20, 2012

Biposy #1 Done

I have to say, with the exception of the pain on the morning of my last egg retrieval, and the pain right after it...this biopsy was the most painful procedure I've been through so far. I squirmed and moaned in pain, and although it lasted about thirty seconds, that was thirty seconds too long. I cramped up for a little while after that, and it hurt to drive back to work. I'm feeling better now, but I'm still crampy.

That really sucked, and to top it all off, in two weeks, I'll have to do it again.

I keep telling myself this will all be worth will all be worth it...

But at the same time, I keep asking myself what sane person puts themselves through this much torture.


Wednesday, December 19, 2012

WTF Appointment #3: Options

Today, I had my WTF appointment with Dr. W.. She went over some new details and options that I hadn’t previously known about.

I immediately asked her about my egg quality, since I was so worried that my previous doctor had told me that my egg quality may be bad. She said that my results for my past IVF were typical of a woman my age with PCOS, so that was good news to hear. Of the four embryos that I have frozen, three are rated “good” and one is rated “fair.” She told me about a former patient that she had that only ever had successes on her FET cycles. All of her children have come from her frozen embryos from one IVF attempt. She has a boy, a girl, and a set of twins. :)

Next, I asked her about intralipids again. I brought this up to Dr. Y. before, and he was sort of dismissive about it. I’ve later learned that Shady Grove in general is pretty dismissive about autoimmune issues. There is a growing theory that failed implantation and recurrent miscarriages are caused by the body’s NK cells to attack the embryo as if it was an invader, much like your body would attack germs, for instance. Some clinics offer intralipid infusions about a week before transfer to deactivate the NK cells and give time for the embryo to implant. My clinic does not offer this option, but, I can order intralipids online, if I can find a nurse who’d be willing to administer the infusion for me.

Dr. W. told me that Dr. Y. might give me a script if it would put my mind at ease, but they don’t do the infusions in the office. But then, she told me about another option that has been recently (within the last year) offered to women with implantation failure. She explained that their practice has been doing endometrial biopsies shortly before the transfer date. By causing minor trauma to the lining of the uterus, the body redirects its attention to the site of the trauma, so more blood flow enters the uterus, and the lining is nice and plush and thick. She said that although the study has only been done with thirty women, the practice is really starting to believe it to have some positive effect on the process, and most of their patients had met with success. She told me that it wouldn’t hurt to try, so if she talks with Dr. Y. and he thinks I qualify for the procedure, we will add that to my timeline.

Dr. W. sounded very positive about this and this outcome of my next attempt. She told me that women my age have the same change of success with a fresh IVF cycle as they do with a frozen embryo transfer, and that if I am putting back two this time, that my success rate will be higher.

I told her that I was getting frustrated, and sometimes I wish I would have had one confirmed pregnancy, just so I knew it wasn’t impossible. She knew where I was coming from and assured me that they are going to keep doing their best by me.

So, my next appointment is on 1/3. From 12/23 to 12/30  I’ll be on my honeymoon in the Bahamas. I’m going to allow myself to rest up and prepare for what will hopefully be my last time doing this. Yay!

Thursday, December 13, 2012

Falling Stars

Tonight and tomorrow there will be a meteor shower. On the way home, I caught two, very bright falling stars. I wished for a baby on both of them. I hope one of the two wishes comes through for me. Or both.

Two falling stars.

A sign of things to come, you think?

Saturday, December 8, 2012

Strange Dreams and Some Musings

Last night, I had strange dreams about a period from hell that destroyed my friendships. Don't ask. This is most likely because my new cycle has started with a vengeance, especially with a whopper of a migraine on Thursday night which had me down and out for the count.

I've been thinking about my choice to transfer back two embryos. For those of you playing along, when you transfer back two, there's an 80% chance of pregnancy and a 50% chance of twins. I will be happy with just one baby. I do not mind two babies, but it scares me. It scares me because I don't have family that lives by me, so I don't have that support to help me with that.

We are also stuck in a little, tiny house that we want out of so badly. If we have twins, I'll have to convert all of my office into a nursery, thus leaving me without an office. With just one baby, we were going to convert half the office into a nursery, since I need my writing space if I want to, you know, continue my writing career.

And don't even get me started about day care...

These are logistical things, and I am not stressing out about them because every twin mom I've spoken to has told me that they've "worked things out" and everything was fine for them in the end. I think that is true in our case. Just as long as I get a healthy baby (or two), I'll work it out somehow.

My other concern is that I always wanted to be pregnant more than once. I don't want to go through the experience one time and hang it up. Lots of people like to say, "Well, if you have two, you can get it all out of the way!" And I find that to be insensitive. That's not how all women view it. I don't want to "get it out of the way." I?

After everything I've been through, part of me thinks of how I might have to bring myself to go through it all over again for another baby. Maybe it would be best to "hang it up" if we have twins, and pursue our dream of adopting instead. I don't know. It's a concession that, in my mind, I'm starting to seriously contemplate.

I told my husband that I seriously do not want to go back on birth control in the future. I don't want to stop my body from doing what it already can't do. Does that make sense? I want the chance to always be there, because it was never there for me so far. I'd love a baby to happen naturally. I really would. This is another reason I don't want to "hang it up." It's a desire that is deeply rooted in me right now. Sure, I'll be SO BLESSED with an IVF baby. So blessed. And I wonder if other women who have gone through the throes of IVF feel the same way about this...but there's something about the need to just be able to do it on my own that continues to grow deep inside me, and I can't ignore it.

 Yesterday, when I was walking back to my classroom, my principal was in the hallway. We really didn't have the chance to talk since I told her the IVF attempt failed. She said nothing to me, but held her arms out to hug me, and hugged me for a good moment. Then, she said, "It will happen. I know it will." And I told her what I echo in my head every time I am feeling defeated. I tell her about a friend of mine who had to go through IUIs to get her son. She said to me that in a way, she was happy that her previous IUI attempts had failed, because if they didn't, she wouldn't have the son that she currently has. She wouldn't have *that* boy.

It's a beautiful way of looking at all of these set backs so far. Maybe the four  embryos I've gone through so far just weren't meant to be my baby. Maybe God has planned for all these failures so that when I do succeed, I am succeeding with the exact baby that was meant for me and my husband. And that baby (or babies) will be so wanted and welcome when it happens.

There's my wisdom for today.

Don't let bad periods ruin your friendships.

Friday, December 7, 2012

FET Schedule

Because Kali asked so nicely:

12/10 - Start BCP
12/30 - Stop BCP and call with first day of new cycle
1/3 - Baseline Appointment
1/3 - Start Estrogen shots. I'll take these every three days.
1/14 - Ultrasound for lining check
1/16 - Start progesterone shots
1/21 - Expected Transfer Date

Of course, these are all subjective to how well I do, so it might not fall exactly on those dates.


FET Cycle!

Well, I am starting my FET cycle on Monday. I'll be on birth control for three weeks, then the real cycle will begin.

Now that I am moving forward again, I'm feeling so much better about everything. The doctor also suggested we try transferring two this time, since I've not met with success from any of my other treatments.

Here we go again!

Wednesday, December 5, 2012

What Now?

So, I disappeared for a good day or two. This was good for me. I know I left you with a bomb of a post, but I was emotionally distressed, which all came to a head yesterday when I had a nice little nervous breakdown. But, I am feeling much better now. Mostly.

Except the fact that I've been nauseous and light-headed all day long. It started in the morning at school. I was so sure I was going to puke all over my classroom that I grabbed paper towels and moved the trashcan closer to my desk. I was shaking too. I forced myself to eat my mangoes for lunch and drink some water, which stopped the shaking, but the nausea continued and still continues now. I don't have a temperature.

I stopped the progesterone and estrogen on Monday, after it was confirmed that I wasn't pregnant. I have never felt this way after stopping progesterone before, but at the same time, I've also never been on estrogen, so I'm curious if maybe withdrawing from the estrogen is what is making me feel sick? I don't know. It's just a theory.

Or, maybe it's some left over effects from my meltdown yesterday. I woke up with a headache this morning, then slept for another hour or so, and it went away for a little while, then started to come back. I took some excedrin and then it disappeared for good.

Anyway. Enough of that. You may be asking "what now?"

I think part of why I was so upset yesterday was because I hadn't come to that decision yet. The doctor suggested doing a brand new, fresh transfer. His theory is that now that he could see what was going on, and how I responded, that he believes I'm just a slow responder, and he would like to do the same protocol with lower doses over a longer period of time. Okay. I get that. I understand it. But, I do not want to do it.

So, I decided that I will prepare myself for a FET, or a frozen embryo transfer. I would like to transfer two this time, to increase my chances of pregnancy, since I have not managed to get pregnant after transferring two embryos on day two, one embryo on day two, and one blastocyst on day five. That pretty much bumps me into the category of "advanced maternal age" women as far as suggestions on how many to transfer back for the best chance of success. I think Dr. Y. will probably agree with transferring two back, if he doesn't suggest it to me first, that is.

I am happy with this decision, and I'm confident in it because I've also been doing lots of research about estrogen levels and successful implantation. I think this would be best, since my body can "even out" and my hormones won't be out of whack.

There are two options for FETs, a natural FET and a medicated one. A natural FET allows the woman to ovulate on her own and produce her own hormones. This sounds good, except that my cycles aren't normal, and I don't always ovulate on my own -- which is the whole cause of my infertility. Unless they gave me Clomid, it'd be anyone's guess on how long my cycle would actually be.

A medicated FET would mean that I'd have to take estrogen and progesterone, and start out the cycle with birth control pills, most likely. I'd also take Lupron or an antagonist shot to stop myself from ovulating. Yes, that means more needles, but it is way, way less than what I was doing before. I'm okay with this. It also means way less appointments, as I'll only go in a couple of times to make sure I'm not ovulating, and to see if my lining is thick enough to transfer.

I will know more about this when I talk with my nurse, and she can speak with my doctor. I have to call her when my new cycle begins, which should happen tomorrow. My temperature has gone from 98.8 to 98.3 in the last two days, so it's bound to end sometime.

And then we move forward. :)

Thank you for all of your support, and please understand that sometimes I write my posts while in a heightened emotional state. That's what my blog is here for -- to document ALL of my journey, even the sad, irrational parts that I wish weren't a part of it. 

Monday, December 3, 2012

Officially Not Pregnant...Again.

And it didn't hurt any less being told so either.

The nurse didn't call me. My doctor called me. He said, "I am sorry, I don't have good news." I told him I already knew. Then, he asked me what insurance I had. I told him, and he asked me what my IVF coverage was like. I informed him that I am covered, in full, up to 100,000 in my lifetime. I'm beginning to realize now, what a small, small number that is. And I think, so does Dr. Y.. His suggestion to me is to do a whole, new, fresh cycle, instead of transferring the frozen embryos. His reasoning is that if I go through my coverage allotment, frozen embryo transfers (FETs) are a lot less cheaper to pay out of pocket than fresh cycles. I think his hurt me more than hearing that I definitely wasn't pregnant. I don't want to do this again. I don't have it in me to do it again...

He also said that he wants to change up my protocol a little more. Something about using lower doses for a little longer, and keeping the Lupron trigger. I also do not want to do this. I don't want to have to give myself shots every night for any longer than I did before.

I don't know what to do. I can't think straight right now anyway.

Why do I have to be such a broken person?

What did I do to deserve this? Surely, I am not being punished for no reason, right? So what did I do?

Please tell me, so I can make some sense of this.

What did I do?

Sunday, December 2, 2012

Pre Beta Day

I took off tomorrow. Although I am feeling a little better about the fact that this didn't work, I still wanted to have the day to myself. This way, I can grieve and not have to put on a happy face the whole day, while my heart is breaking.

I don't think I am going to take my progesterone shot tonight. There really isn't a point. I used my last digital test this morning, and the oh-so-rejecting words "NOT PREGNANT" showed up. You know, just to remind me by kicking me in my gut that I am still not pregnant.

Sometimes, I go into a dark and bitter place. [Edited to remove this part due to continued melodrama. This is my blog, not yours. This post is about me, not you.]

And then I get even more bitter that more friends of mine are getting pregnant, and I'm being left behind...watching their happiness while I suffer in my sorrow. Sometimes, it is so hard to be happy for others when you are just so sad inside.

We are now going on 26 months of trying to conceive. 26 months ago, I thought this was going to be easy. I could have a two year old by now. Instead, I have nothing to show for but these blog posts and an empty dream that feels like it is never going to happen.

I know I need to remain positive, but sometimes, it is too difficult.