Many Months Later: An Update from our Single Child World

Well, it's been nearly four months. I have been meaning to post an update here for a long time, but first I felt too miserable to recount it all, and then I got very busy at work for the last two months.

But. Here I am. And in a very different place than last time I wrote.

Right after July 4th, I went back for another lining check, and my cycle was canceled. Ended. Done. The weird thing is, I never actually spoke my doctor in Atlanta. But in previous phone conversations and by email, he confirmed that there is something going on in my uterus (more endo, or scarring from my c-section) that is preventing a lining from growing, and the next steps are to consider a surrogate, or get the hysteroscopy and see if it's something that can be addressed or not. I still feel I don't 100% understand all this. I also feel there were inconsistencies in my lining readings, and miscommunication between the local clinic and the doctor in Atlanta.

In any case, my husband had already made it known that he's done. Absolutely done. Sadly, he didn't even call me or return my desperate calls or texts that morning of the final appointment. Not for about an hour and a half. That's a horribly long time for me to not have had that support. He was out of town, visiting his parents, with our toddler, and I was alone.

Me? I don't know. I have not been doing too well over the past three months. I was bad, then got some therapy and went back on the birth control pill (because I have endometriosis, and also I don't want the "what ifs" nagging at me) and then seemed to be doing better. But then a few things happened: I stopped individual therapy because my husband and I were fighting like crazy so we started couples therapy, and I simply didn't have time for both. I believe we hit such a rough patch because of his lack of empathy and support. To be fair, he's never been as emotional as I am. When I was struggling for 2.5 years to get pregnant with my son, I leaned heavily on my support group friends. This time, I don't have that support. I know they are out there, but I don't seem to know anyone in real life who is my boat- wants a second, but can't. Also, getting back to my husband, he says he's thought for years that a second child might not work, because we had so much trouble getting to #1. I was.. more optimistic. And he was more realistic, as it turns out. So I don't think he faced the crushing surprise and disappointment that I felt. He had always said he wanted a second if it was just the case of a few transfers, but my cycles had turned out to be immensely stressful, expensive, and chaotic.

So, his lack of empathy and wanting me to get over it faster than I could have been so hard. My lack of support from people in a similar place is a big contrast from previous infertility treatment cycles. Then, my best mom friend got pregnant really, really easily, and was incredibly insensitive in complaining and talking about it ad nauseam. We haven't spoken in over a month, haven't hung out since August, and I've been taking it really hard. Although we had differences- she seems to view being pregnant as some big accomplishment, like it's her major contribution to society- we were also good friends, our kids got along, and we hung out 1-3 times a week. So I am very lonely on top of everything else.

Writing all this out is actually making me feel kind of ill, so I'm going to wrap it up. I've been spiraling downwards for awhile, but now I am making some positive changes. Just last night I started a low dose of anti-depressants/anti-anxiety medication (the big Z), and today I feel sick, drunk, and unhappy. But I have heard that if I stick with it, it will be worth it. I've been trying to keep exercising 1-2 times a week, I've been reaching out to other friends who are empathetic and kind people, and I've ended our couples therapy because I felt it was doing more harm than good. Right now, if our relationship is going to work, first I need to pull myself out of this unhappiness.

I still wish it had ended differently. I wanted, I dreamed of another child. But from a practical viewpoint, there are huge benefits to having one. We're more financially secure than we've ever been, now that we're not doing endless treatment cycles and worrying about another daycare payment. We've decided to take two nice vacations a year, starting with Alaska this June and maybe Costa Rica or Mexico this January or February. We can do these things, logistically and financially, with one child. We both get plenty of precious reading and solitary time, since we can trade off with childcare on weekends and give each other breaks. Our son is now at the age where he is not so needy, he can play with the neighbors or by himself, but he's also super fun to do interesting things with. We have real conversations and adventures, and my attention doesn't have to be divided or diverted by a baby.

Probably no one is even reading this anymore, and sorry to not have a happy ending, but I hope and pray that someday I will feel like this had a happy conclusion- at least, that I made the right choice in stopping the endless sinkhole of fertility treatment, and that I can have a happy, satisfying life with my One and Only child, who has taught me a kind of love that I am amazed by every single day. Here's to a healthier outlook, this medication helps me quit obsessing over what could have been, and my marriage recovers this rocky stage.

More later, perhaps.

Where Did Hope Go? Update on FET

I'm not doing any work anyway, so may as well post an update on my fertility saga here.

Today I had another ultrasound to see if we can try to get me pregnant again- when I think of the most recent series of event, I include the negative pregnancy test in March after a frozen embryo transfer with a five day delay due to lining problems, then a cancelled cycle in May when my uterine lining absolutely didn't respond to medications, then three weeks of antibiotics, and now ten days of using the estrogen patches instead of pills.

I went in today fully expecting no growth again, and for today to be the end of medications, ultrasounds, and for us to be a single-child family. Well, my lining DID grow. Not a stellar result, but enough to do a few more days of meds and check again on Tuesday.

So you'd think I'd be happy, right? Instead I am.. tired. Tired of all this crap. It's been months and months of ups and downs- mostly downs- and both of us are actually really coming around to the idea of stopping treatment. Having one child is sounding very appealing to me. I was an anxious pregnant lady, and the newborn days were not kind to me. Financially we can afford a second, but it will be tough, and we can afford some awesome vacations with our only kid and to retire much earlier with only one- I've been checking out Alaska trips with the refund we'll get if we quit treatment. And a few days ago I held my friend's newborn and I was happy to cuddle her.. and then equally happy to hand her back.

So, what does this mean? I feel like I have to at least continue meds till Tuesday and then see what my lining is like, but I'm trying to figure out what is going on with me, who so desperately wanted another child just a month ago. Am I insulating myself from hope by blocking all positive thinking? Or did I really just change my mind? How does one decide to have or not have a second child? Will I regret not moving forward, if we decide to stop, because the infant days are short and a family is for life? I am on a waiting list for a therapist because I honestly cannot figure out what I want. It's very confusing. I endured years of infertility and surgery and treatment to have my now-28 month old, and cried my heart out when the March pregnancy test was negative, so why am I so ambivalent now? WTF is wrong with me?

Update on lining troubles and FET future plans

Fertility update and mind dump coming.

Since our last cycle was canceled due to my uterine lining not growing enough, I have been ok. Sort of. I've been taking more Valium than I should, and crying more often than I'd like. But, I don't want to focus on that right now.

I have been offered two choices: surgery to evaluate and possibly repair my uterus, which may have sustained unknown damage during my c-section two years ago or might just be invaded my endometriosis again (Asherman's Syndrome is a possibility), or simply try a different form of estrogen supplementation- the patch, which is what I used back when I got pregnant with my now-toddler, and see if that thickens my lining.

We had a long talk and we've decided to try the estrogen patch option to see if that does anything, but if not, to stop. The surgery option is outpatient surgery and I've had surgery before, but neither of us is excited and frankly I am terrified. Furthermore, it will cost a lot, and is no guarantee either- ie. it could be for nothing, and it's totally unnecessary beyond fertility. My long term health is fine, beyond regular endometriosis symptoms that I can control by staying on the pill till menopause.

So, these are the facts. We'll try this one last option, but not go to extreme lengths. These are my husband's wishes and he was the one who originally wanted a larger family. As for me? I don't know. I keep asking God and the universe and myself: what do I want? I know I am scared of surgery. I know I want another baby, but I also can see the myriad benefits of just one, and of moving on with our lives. I do not especially want to be pregnant again. I never want to breastfeed again. I am worried about the finances of having two kids and working.

But: how do you KNOW what is best for your future? How do you choose something that will affect you the rest of your life? How do you turn down the unknown path? What do you do when you squint into the distance and it's just... murky? I don't feel that I am being called to have another child, but I also think of those could-be embryos and what they would be like and I feel sharp, deep, intense grief and longing. Of course, we might find out because we plan to donate them to a family that can't afford the treatment we did, but still, they won't be our children once we turn them over. So, I guess I need to sit with this, but I don't want to sit too long. I want to move on and I just need to figure out how to turn away from the road not taken. How does one do this?

Second FET Cancelled

As I wrote last time, my first FET resulted in a negative beta. My lining was thin, but they let me go forward. My doctor was convinced that it was just bad luck. Even in the best case scenario, FETs only have a 50/50 success rate.

But, the bad news wasn't over with that cycle. We tried a non-Lupron protocol this time, just estradiol pills, and unfortunately my lining was even thinner. Like, a 4. Nothing. We canceled this cycle.

So, it looks like I might be at the end of the road here. My doctor is trying one last thing, which is three weeks of doxycycline and then re-checking my lining to see if it made any difference. Sometimes inflammation can cause lining to not respond to estradiol. I don't know why I'd have inflammation though. 

But despite this treatment, he said it's likely that I might not be a candidate for further transfers. He didn't have any really great explanation why. Perhaps my uterus sustained some infection and/or scarring during my c-section to have Leo. He said this is not common knowledge, but actually scarring and adhesions can result in infertility in more than 2% of c-sections. But, he's not sure, and I'm not interested in exploratory surgery at this time.Frankly, I am terrified of more procedures. And tired. Oh so tired. 

Amazingly, I have had someone offer to be my surrogate. But I don't think we are interested. Honestly, having an only child is looking better and better, the more we think about it. Though I have moments of intense sadness when I look at my toddler and wonder what the other four embryos would have been like.

At this point, I'm just taking my doxycycline and waiting for my next lining check in about three weeks and if it's a no-go, we'll be seeking homes for our embryos. 

I am feeling... so confused. Why can't I grow a lining? I have never had great linings, but a 4?!!?  Also the argument that my uterus is scarred doesn't sit that well with me, since my last lining was enough to move forward with FET #1. So why now the sudden non-response to the estradiol? Why isn't my doctor interested in other forms of estrogen?

Dr. F, my former doctor and the one who I saw again when I had my monitoring done, seemed taken aback and called my uterus "special." My Atlanta doctor also said this is unusual. I have not gone down the google rabbit hole.

I am not distraught like I was before, with the first FET. I am constantly thinking about it, but not feeling the same sharp, biting grief. It's more like a dull thud this time. I can't quite explain the change. I just feel... tired. So tired of the constant struggle. And though I do not believe anything is "meant to be," I wonder if there isn't something positive about stopping now, and focusing my energy and love on the child I already have. My head says yes. I am not sure what my heart says. My heart leans towards fighting this lining issue. I don't know what will happen, but I will have some answers in about three weeks. 

One Week Post Failed FET

As expected, my beta last Friday was negative. Zero, zip, nada. I quit taking my progesterone even before the doctor called me, because why waste the $20 each suppositories for nothing.

It was a hard, sad weekend. My mom was here and she just does not get it. She didn't say anything wrong per se, but she was fine with just having one kid and doesn't understand my yearning for another, or my sadness when I think of that perfect, lost embryo. So I tried my hardest to not talk about it, which maybe was for the best anyway.

Things I have been doing to take care of myself:
-letting myself just be sad, mostly on my own, in my own head. I have informed my friends who knew I was doing a cycle, though mostly by email because I don't feel ready to talk to most people about it yet.
-eating well but also allowing myself more treats than usual. I lost several pounds from having pneumonia but I predict I'll gain it back just through chocolate consumption this week alone.
-being sure to get 8 hours of sleep a night.
-after a frustrating attempt to find a therapist because my former one and two others are all not accepting new patients, a therapist neighbor got me connected to someone who can see me on Tuesday and I'm grateful for that. I need time and space to talk and cry and not feel guilty for my feelings or making someone listen to me. The sad part about where I am now in life is that my husband and I have very little kid-free time to actually sit down and talk, and he's not the best at this sort of thing anyway, since he's very focused on not giving up and just moving ahead. I am still stuck in the feelings of now. I had a great group of friends from my infertility support group when I was trying last time, but of them, two don't think they want another child and three did manage to get pregnant again with no intervention. They are good people but not what I need right now.

Things I haven't been able to do to take care of myself:
-exercise. I love and rely on the gym to make me feel better, but I am only 3 weeks out from a walking pneumonia diagnosis, and still feel a significant amount of discomfort in my chest/lungs. So as much as I want to go tire myself out with intense cardio, I am not sure when I will feel ready for that. I am not really a yoga person because I get bored and fall asleep, or would rather relax with a book or Netflix if I'm not going to be exercising anyway.
-really talk to anyone about this. Of course my husband gets it, as he deeply desires another child too. But his ability to be supportive is limited by his intrinsic nature of cheerfulness, and propensity to look forward to the next cycle instead of dwelling on the failed one. This is too hard for me right now, so we just avoid talking about it too much. I hope that I will find the therapist helpful next week.

My current plan is to take this month off. When I had the WTF talk with my doctor on Friday when he called with the negative beta results, he seemed surprised I'd want to take a month off. However, then he heard me cough, and agreed that some time to heal is not a bad idea. He did tell me that the pneumonia did not cause my negative pregnancy test, but these are precious, expensive embryos and I don't want to have any doubts that I'm not giving them the best possible chance, so for me that means waiting.

Another thing that came out of my phone conversation with him is a new, lowered expectation. I knew my chances of success with the fresh embryo were about 60%, but at transfer he had given me a 70% chance because I had such a stellar quality embryo to transfer. So I foolishly kept that in my head as my odds this time. And then felt totally crushed when it was negative. Dr. S told me on the call that with a frozen, the odds are only 50/50. That is much lower than I had been assuming.

So now we're in the place of paying another $5k, by the time travel and meds are included, for what is only a 50/50 chance. And with my third best embryo at this point. This does not feel good, but what choice do I have?

I am now on cycle day 5, and when I get my period I will immediately begin the estradiol again, and transfer will be around day 19. I'm a little worried this will fall right when I am due to be out of the country for a work trip, but I am trying my hardest to not stress until I know. I hope my period is early  or late and it's a moot point, but we will see. I only stare at my calendar a few times a day, willing it to work out so I don't have to wait till freaking June to try again.

So overall, I am not in a great place. I'm eating into our precious savings, and finding myself too sad to look forward to things that normally made me happy. Of course, being with my toddler is still wonderful, but it doesn't make the sadness go away in those long hours I am trapped at my desk at work or during the long evening hours after he goes to bed. My husband keeps reminding me that we are in such a better place than before we had him, and that we have plenty of frozens left, but hope and money do come in limited amounts for me. I feel sad, and disappointed, and bitter at the unfairness. Wasn't three failed IVFs and one canceled one enough, universe? Wasn't having to forgo my own genetic child and pay for donor eggs enough? Wasn't my years of wanting a child enough? I am beyond grateful to have one, but as three of my former-infertile friends have gone on to conceive on their own, it leaves me feeling bitter and confused all over again.

Enough moping. I have a plan, and I am not going to pretend the next seven weeks will be anything but long, but I will do what I can to feel as good as possible. I hope therapy helps, and I hope this dark sense of hopelessness is not completed by another negative test. Sigh. This is so hard.

Failed FET

I have not updated this in over a year. I am sure no one is reading anymore.

But I need to write today. Twelve days ago, I flew back to Atlanta and we transferred a perfect embryo, same quality as the one that made my son. Today, I took a pregnancy test and it was negative.

This cycle was far from perfect. I had lining problems. I lost hundreds of dollars on airfare when I had to delay my transfer at the last second, because my lining was too thin again. Or was it too thin? I will never really know. My local clinic thought so, my Atlanta doctor couldn't tell from the grainy ultrasound photos, then he was gone on a critical day, and so I was delayed.

In the meantime, right after I was on estrogen for an extra five days, then given the go ahead once he saw better images, and after I re-booked the flights, I came down with walking pneumonia. I spent a week in bed. I took five days of antibiotics, overlapping with the five important days leading up to transfer and the medications I was taking for that. Then I lugged my exhausted tush down to Atlanta, when I had barely gotten out of bed for a week.

We transferred one perfect, five day blastocyst. And apparently it did not take.

I had a bad feeling, but I have been telling myself that I was being irrational. I had no spotting or cramping, as I did with my first pregnancy, but I know most people do not. The lining issues were a problem but then seemed not to be. At my transfer, the nurse commented that my lining looked good. I used such a beautiful, strong embryo. I don't know, and will ask, about the possible effects of the pneumonia, but they didn't delay my transfer and they knew about it.

So I think that the end story is, I just fell on the wrong side of the statistics this time. Even with a decent lining, adherence to meds, and a perfect embryo, someone has to fall in the failures.

The pain is sharp and numb at the same time. I held my two year old this morning and felt his warmness, and I know what a miracle he is and how he has changed my life. At the same time, I feel the loss of that embryo, that could-have-been sister or brother, son or daughter. I am staunchly pro-choice and I believe an embryo is not a child, but at the same time, it could have been my child. My much loved, much wanted one. It could have been a sweet, smiling, cuddling child. This loss is as painful as my first three IVF disappointments were. I am so grateful to have a child; at the same time, I feel the loss of a child in a more defined, concrete way. I know the smell of a new baby, and the first smile.

It's not over. I have four precious embryos left in Atlanta. I am considering: do I take a cycle off, or do I plow ahead, starting the Lupron again in three weeks? How much of a factor is this pneumonia, and will I feel better in six weeks for transfer- I assume I will by then. Can I wait and see how I am doing in two weeks? I think that is the answer.

Beta is tomorrow. I will get through today. In six hours, I will be holding my little monkey boy again. He is the best medicine, both reminder of why I am doing this and what I don't have but want again. Life is so unfair. There is no reason, no cure, nothing else I can say.