Options After IVF Failure

The last week has been tough.

I'm not even sure how to describe it. I've been really busy with a work-related conference and haven't had time to think over things too much, but when I do, it's not good. Yesterday was Saturday and I think I cried about five times. B and I are getting along fine, and he's been more supportive, but I think he just doesn't know exactly what to do. I'm not real good at telling him, because I don't know what to do myself.

One thing I have been thinking a lot about is next steps. What do you do after three failed IVFs? If I'd had even one great embryo, I might be willing to consider another round, with the third and final protocol available. However, it doesn't seem a wise use of money or time, considering the low yield, poor fertilization, and less than ideal quality of embryos.

So we are left with the following options:

1. Traditional adoption: sometimes I do feel drawn to adopt, and wonder if this is where I really was meant to end up. The physical process of pregnancy has never particularly appealed to me, and I am more interested in being a parent than in being pregnant. However, my concerns about the prenatal environment are strong. I worry about the long term effect of drinking and drug use on a child. Although I know plenty of adopted kids turn out okay, both B and I can list so many cases of adopted kids being messed up, and it often seems separate from their upbringing or other parental influences. Of course, what is nature and what is nurture, and how much is genetics versus the hormonal development in utero? There are no clear answers. But on a practical note, I get shaky inside when I think of doing a homestudy, compiling a website or portfolio about us, and paying $30K for this process. After the trauma of years of infertility and failed IVFs, I don't know how well I can stand up to all of this right now. Being examined and judged? It just turns me off completely, and I feel that my bitterness about the unfairness of life and fertility will be increased through this process. I am just not ready. If someone handed me a child, wonderful. But the rigors of adoption? Not appealing.

2. Using donor eggs: hmmmm. This is probably our first choice at the moment. Using donor eggs is usually an option for older women who cannot conceive using traditional IVF/ICSI. I seem to be an anomaly, being only 32 years old and not having premature ovarian failure. On paper, my AMH and FSH are fine (well, low for a 32 year old but not at all low for a fertility patient). This raises the perpetual question of whether it really is my eggs that are the problem, and not B's sperm that accounts for our poor embryo quality and fertilization rate. For this reason, I am not sure using donor eggs is for us. It is VERY expensive- but it would be amazing if we could get enough embryos for this cycle and for a second child in the future. We are meeting with my doctor tomorrow and I intend to try to see how good of an option he thinks this is for us. Even if he does encourage us to try it, we are only willing to do one of the refund programs. There is no way we are going to spend $22K-ish and have a failure. There are refund program where you can get 70% back if no pregnancy occurs. This seems a reasonable option, though of course I am terrified that we will get great eggs, and then have crappy fertilization. At least then we'd have some answers, I guess. This option does appeal to me in that we can use B's sperm and I would carry the child. We can control the prenatal environment, and we'd both have a biological tie to the child- his would be genetic, and mine wouldn't be genetic, but I would carry the child, and be able to breastfeed. It's so expensive- we would seriously be impacted financially, but we can do it if we are up for the risk.

3. Using donated embryos: a third option, and the cheapest but perhaps the lowest odds of success. Since I wrote about this at length in my March 5th entry, I won't go too into depth again. We are still interested in this option, but we're feeling overwhelmed at the details of actually arranging it. Using the self-match website brings up so many questions about logistics, and my clinic doesn't have any embryos available. The clinic in Cary that advertises "available embryos" actually has a one year wait. We do have an appointment in two weeks at a clinic in Raleigh that also says they have embryos available, but I'm half expecting that to be untrue as well. However, we will go, and see what they say. The low cost is appealing, but we also know the success rates aren't the 60% that donor egg carries. The women will generally be older, so there are lower odds, and they are leftover embryos so not as ideal as fresh ones from a donor who is in her early 20s. Anyway, it's still an option, and probably #2 on our list of most desired paths to take.

Overall, I am feeling very emotional, and I cry often, but I am doing what I can to take care of myself: spending plenty of time alone because I am not yet ready to talk to people about this, eating well, sleeping enough, and getting good exercise. Yesterday we walked in the woods again for over two hours, and today I plan to go to one of my favorite classes at the gym. Later, I'll make one of my favorite meals, tofu broccoli lasagna. All I can do is keep trying to be kinder to myself than I am used to, and being realistic about the fact that I need to keep moving forward.

IVF failure wasn't supposed to happen, not to me, not now. But I hope that one of these three options brings me to peace and brings me a baby. I know I am meant to be a parent and not to live child-free. I just have to keep figuring out how to get there.

4 More Days.. and Plan B

I had a pretty good weekend. A nice date night with B on Friday night where we tried this amazing Singapore style restaurant that we now are wondering how we didn't know about for the past 7 years! As an appetizer we had lettuce wraps that were served DIY- they give you the large lettuce leaves and a filling of tofu and onions and mushrooms, all marinated and delicious, and you get to make the wraps yourself. It was fun and tasty.  On Saturday I hung out with a friend all day- we went to the farmer's market, had a nice brunch in town, went used book shopping, etc. She is trying to get pregnant now and thinks she might already be. I have mixed feelings: of course I would be happy for her, but it's a little painful to watch someone at the beginning of their journey and remember how naiive I was, thinking of course it would be easy. I wish her none of our troubles.

On Sunday a friend came over and we did "fertility yoga." She used to teach it and I think she now trains instructors. In any case, I am not normally a big yoga fan, but it was so good to move my body for the first time in awhile. I've been abstaining from exercise for the past few weeks, to try to help with any possible implantation. But it was great to do some gentle yoga moves, with the sun pouring in and warming us both in my cheerful purple guest room (a.k.a. someday baby's room). Sunday night we had dinner with friends and none of them have kids.

So, I stayed pretty busy all weekend. I did not have time to laze around and feel sorry for myself very much. That is definitely a good thing.

As test date gets closer, I'm prepared for disappointment. I do not have my hopes up too high. Of course it would be the best thing ever if this could work, but I know the chances are not great.

However... we do have a plan B! Of course we will investigate adoption, but we are also starting to learn about embryo adoption. My main fears with adoption are: the birth mother's care of herself while pregnant (as we have heard many, if not almost all, birth mothers are using some amount of drugs or alcohol while pregnant), the massive financial cost (where on earth will we get the money needed?), and the intense process of applying, background checks, home studies (all sound so draining and we are already so weary from 3 IVFs). The lack of genetic connections with an adoptive child is not on my list of concerns. So that's why we are interested in embryo adoption. If we can have me carry the baby, we can control the environment since of course I will take good care of myself. We can avoid the financial toll since from what I read, it's not too much more than the cost of a frozen transfer (a couple of thousand versus $30K). And home studies and background checks are not always required.  I do not feel bad morally if we do not adopt a child that has already been born. A long time ago, or in another country, there was/is a need. But now, with there being years-long waiting lists and more demand than need, it's not like it was.

We still have many, many questions. But it is nice to have another option on the table.

Not Willing to Let Go

I always thought I'd know when to quit. Logically, it makes sense to stop the hamster wheel, get off this train, whatever. I had two lackluster cycles and we're out about $10K already on treatment and medications. It's drained us emotionally, physically has been tough, and has affected me at work. B is entering a really stressful next two years as he starts business school. We're worried about money all the time due to his tuition. It probably makes sense to take our limited funds and spend them on a sure bet, adoption, rather than continue on a very unsure bet, more IVF.

Yet.

I cannot force myself to feel that I am done with IVF. I only had two tries, and I have never felt good about my clinic's care. I also feel that if I gave my left ovary some more time, perhaps it would play ball, as the doctor says.

I see that it's about $10K for two tries at NCCRM. They have better outcomes than my clinic. I always wished I'd started there instead.

I know that I was feeling okay about adoption, but I'm not really. I'm just not.

I think that I should meet with Dr. F one last time (appointment is scheduled for next Friday) and also have a consult at NCCRM. Bring my records and ask them what they would do differently. What my chances are like, with two more tries. Ask them if I were their daughter or if they were me, would they keep fighting this seemingly uphill battle, or would they put their funds towards adoption instead.

I should call NCCRM. I should just do it. I know B is not in favor of this, but he is not totally opposed either. And perhaps I could use my own savings a bit. I know it's supposed to be there for an emergency, but this seems like one.

Or should I just let.... go?

Torture. Plain and simple. Torture.

Most Depressing Post Ever

This morning I found out that I am not pregnant. 

I thought today couldn't get any worse, but suddenly, everything has. 

We have been kicked out of the Attain program. We get $9000 back.

B has announced that he is done with medical intervention and the doctors, tests, treatments, and drugs. If we want to continue another round of IVF, we'll have to use our whole $9000 refund plus a lot more for a single cycle and drugs and ICSI, and then only have a 50/50 chance anyway. With the not so good outcomes of both of my cycles so far (low egg count, low fertilization even with ICSI, and nothing to freeze either time, never even made it to day 3 transfer, etc.), he says it's wiser to take the $9000 refund and put it towards adoption, which is a safer bet than another $10,000 plus on a 50/50 chance at best. 

I think, logically, he is correct. But I am in shock. I had forgotten Attain could kick us out, and never really considered what it would mean.

I am not sure how someone processes these thoughts, so I have decided to do nothing for the time being. I just never considered how it would feel to Stop. Like, I will never, ever get "accidentally" pregnant when we stop "trying" because I am going back on the pill and never coming off of it, which is what my doctor recommends due to my endometriosis. So, this is it, perhaps.

Not sure there is anything that can be said, but I guess the adoption people coming to our Tuesday RESOLVE meeting could not have picked better timing when it comes to me.

Worst. Day. Ever.