Ends and Beginnings

Last IVF cycle, back in February, my 97 year old grandma was not doing well, and we thought it might be the end. My mom sent me this email:

End of life is a very difficult thing.  I am hoping that the end of my mother's life will coincide with the start of my granchild's life.  Wouldn't that be a fitting gift of the cosmos? Did you know that you were conceived on my 32 birthday?  That is a cosmic gift too.

Well, my granny pulled through, and when I saw her in April, she was doing okay. But today she died, after a bout of pneumonia following a broken hip. We didn't know it would happen so quickly, although she hasn't been strong for awhile and her dementia was getting worse and worse.

I am glad that my mom was there with her when she passed away, though sad that my mom had to be alone for this. My aunt and uncle were on the way from New York but this happened before they got there. I had just been talking to my mom this morning about whether and when I should come up, since the funeral will be later this summer when we can take her ashes up to the gravesite in New Jersey. But then she passed away before we expected, and now she is gone.

I am at work, but finding it hard to focus on any work, between this and my beta test in less than 48 hours. I know there is no connection between most things, but my mind went back to what my mom had written to me in February. Maybe the cosmos finally will send a gift our way.

Transfer Day

I've done three IVF transfers before, but yesterday morning was the first time I've ever walked into the clinic and not wanted to burst into tears. For the first time ever, I grinned as I greeted the receptionist: I was going in for a five day blastocyst transfer- a good, strong, healthy embryo!

My friend went with me, and we got settled into the transfer room. The nurses checked my bladder and it was full enough (I was afraid I'd pee right on the table there!). The doctor and the embryologist came in, and they gave me the amazing news: of the 7 eggs that fertilized from the 8 that were provided, I had one amazing, grade AA embryo to transfer and 4 great quality blasts that had already been frozen! There are also two more that might also have been frozen today (note to self: email nurse and check to see if that happened or not).

This was above and beyond my wildest dreams and I cannot express how thrilled I am with these numbers. The clinic's nurses were all so nice, and my doctor and the embryologist were wonderful. When they projected my perfect little embryo on the screen, I couldn't help but start crying. I think my friend was crying too, just because it all seemed so magical and special. She held my hand and it felt like something truly otherworldly was happening. When I saw the bright dot at the end of the catheter released into my uterus, it felt like all of my struggles and troubles with my own eggs was almost redeemed by this one perfect embryo. I know it's weird, but I already felt like it's mine.

No, I did not transfer a cat embryo. This is just my friend's adorable kitty, and my adorable embryo.

Anyway, I don't want to get too involved or too fixated on what may or may not come to be. The doctor said with an embryo this good, my chances are about 70% success. But he cautioned me that 70% means that still 30% of cycles, even with this perfect embryo, result in a negative. I am hoping and praying that I come out on the good side of the odds for once, but I am somewhat comforted by the fact that I have either 4 or 6 blasts waiting for me, if this cycle should fail (and if not.. they are waiting, if I should want them in a couple of years...).

It was hard to watch this cycle go better than planned, when my own have failed so miserably. But I am trying not to think about this, and to instead focus on the positive. I test a week from tomorrow, and all I can do is wait, hope, and stare at the photo of my one, perfect embryo. It feels so good to have hope again.

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.

Waiting is Hard

My friend sent me a video on self-compassion and it was really helpful to me right now. Especially right now, I can use a reminder that I often say things to myself that I wouldn't say to others... I should be kinder to myself, and work on being a good friend, or the friend I'd like to be to others.

 I'm okay sometimes, but I'm really depressed a lot of the time lately. A good deal of it may be the progesterone and estrogen that I am on (a patch and a suppository each morning- oh my god am I hungry all the time too!). But a lot of it is feeling like a huge failure. It's bad enough that I couldn't get pregnant after trying for over two years now, but now I keep telling myself that I am an IVF failure as well. Many of the women in the support group that I was close to all got pregnant from their first IVF- and meanwhile, my third one was pretty much a bust. Not having three IVFs work does seem to be unusual, and not what I had expected to happen. Of course I had the two embryos transferred on Sunday, but neither was good quality.

I don't test until the Saturday after this one, but I know I'm not pregnant. We've spent so much money and time and heartbreak on this. Sometimes when my grief consumes me, it's all I want anymore. I feel so burdened by the grief that I can't do much else to improve other areas of my life. I just feel trapped and sad and there is nothing I can do to change my basic biological inability to have what comes so easily to most people.  Of course we will adopt, but I feel so exhausted already, and adoption involves FBI background checks, a home study by a social worker, psychological evaluations, and upwards of $30,000 that we don't have just laying around. It could be years. It all feels so very unfair. I guess I need to take this to a professional, though even that seems a lot of work. But I will do it. For now, I just need to wait out the next 9 days and see.

Two Week Wait: Week One

Last time I wrote was Trigger Day. All went fine with triggering, and I had no nausea the way I did the first time. I did have some mild cramping all day Wednesday, but no big deal.

Thursday was retrieval. We got there bright and early, 7:30 am. I was excited and anxious, ready to be done with the monitoring phase of the cycle and eager to hear how many of the possible 7 eggs I would have retrieved.

For some reason, though, I was much more nervous than in the past. The retrieval room was much scarier than my old clinic's. As much as I didn't like my old clinic, they had a great set-up in their IVF suite. They had dim lights, the room was warm, and they played soft music to help calm the patient. At my new clinic, not so much. They started the anti-nausea drip in my IV, which made me extremely dizzy. Not in a bad way, it was almost fun  :)  but it was a little disconcerting. Anyway, the actual room was NOT warm and fuzzy the way my old clinic's room had been. It was bright white, sterile, and COLD. As I got on the table, my knees were knocking like crazy. They also could have waited a minute longer for the amnesia drugs to kick in. They inserted the speculum, which doesn't hurt but is never fun, and that is the last thing I remember.

Apparently I slept for a while afterwards. When I woke up, the nurse told me and B that they had retrieved 6 eggs. I was groggy and tired, but happy enough with that number. We went home and I slept much of that day.

The next day, I got bad news. Out of my 6 eggs, only 5 were mature. Okay, that was fine. But here is the bad part, that even the Fellow warned me I would not like: although we used ICSI, I only had TWO fertilize. TWO. That is really no better than any of my other cycles.
Cycle One: Six eggs retrieved, 1 fertilized normally, 1 fertilized late
Cycle Two: Four eggs retrieved, 2 fertilized with ICSI
Cycle Three: Six eggs retrieved with 5 mature, 2 fertilized with ICSI

ICSI typically should fertilize anywhere between 60-80%. With me, I've now had 50% and this time I had 40%. Pathetic! Why was I pumping myself full of drugs, going through a scary medical procedure, and then having ICSI totally fail me, with no more embryos than I've ever achieved before. So, so disappointing. I don't know how many times I cried on Friday.

But we went in on Sunday as planned. Upon arriving, I did acupuncture. I was told that my two embryos were ready to go. They were both, sadly, only 4 cells. By day three, they should be 6-8 cells. The fragmentation was 75% and 25%. That first number is bad. Low implantation potential. The second number is okay, pretty good, pretty average from what I have read.

I came home Sunday, so sad and disappointed. I had really hoped that a new clinic and a new protocol was going to bring better results. I had to ask for a Valium on Sunday for the transfer, because my nerves were so shot and I was so anxious and sad.

However, upon closer examination of the photos on Sunday, I did start to feel a bit better. My embryos are only 4 cells, but one of them looks much cleaner and crisper, with less fragmentation that any of the other embryos from previous cycles.

So, I'm still sad, and we've decided that we won't try a 4th cycle if this one doesn't work. We just feel that we have a quality/quantity problem and a fertilization problem to boot. Who knows if it's my egg quality that prevents the sperm from coming in, or if there is a serious sperm issue. It doesn't matter, but what it means is that we don't make good embryos. And we've tried two clinics and two protocols, one which all three doctors I interviewed back in October had recommended. I think we are at the end of the rope here.

So, I am hoping that one of these embryos is nestling in, but ultimately I realize that the chances are not very good. I have cried and grieved so many times, and I have to get off this crazy bus.

For that reason, we've talked about adoption, and how we think that is the next step. We don't want to wait too long before pursuing it either. I want a baby, I've already waited over two years, and I want my heart to heal. I do not think remaining childless is going to get any easier.

Life feels so unfair right now. Why am I surrounded by babies, and even my IVF friends have mostly all become pregnant this year too? I am sure my friend B's cycle right now is going to result in pregnancy and I will be happy for her, but I can't deny it will hurt. It's hard not to feel like a double failure: a pregnancy failure, and now a three-times IVF failure.

I have done everything I can do. All I can do is wait and hope now, and temper that hope with realism. March 9th, you will be here soon enough.

ISO: My Period

Today is day 38 of my cycle. I am not kidding. Where, where, WHERE has my period gone?

I have only had one non-medicated cycle since my endo surgery last March, and it was 26 days. So I expected maybe a 28 or 30 day cycle... but 38 days!?!? Wtf?

If I don't get my period on day 46 or before (next Wednesday or before, and today is Tuesday), I'm screwed. It means that if I can't get my day 3 bloodwork and my water sono done before we leave next Friday for Ecuador, then I will get my period while we are gone, be unable to have the tests done, and then have to go a whole extra cycle before doing. So another 40 or more days, then do the testing, and then finish out that 40 plus day cycle. Basically, I won't be able to do IVF till March or so. I was supposed to be able to start in January, and this means an extra six weeks or more.

When I realized this, after calling the clinic and asking if there isn't anything they can do (answer: no), I had another meltdown and ended up crying in the conference room at work. B had to come get me and we went for a walk so I could calm down.

Why can't I ever get a break? It's bad enough that I have to have 8 failed Clomid cycles, 2 failed IVFs, an invasive laparoscopic surgery, endometriosis, and now I can't even have my period come in a reasonable amount of time. Day 38!?!?

I feel like I might lost all my sanity if I think about this anymore. If my period does not come by next Wednesday, I really am going to lose it.

Day 32

Day 32 of my cycle and no period. WTF? I used to have long cycles, but I thought the endo surgery would help correct that. I've only done one natural cycle since then, and it was only 26 days. I wimped out and took a pregnancy test two days ago, and of course it was negative. So now I don't know what to do except wait, and see. If I still don't get it by Saturday, I can test again, but I'm sure it will come. It would be a miracle, an absolute miracle, if I got pregnant before starting this whole IVF mess again, but miracles don't happen to me anymore. Not when it comes to my fertility.

I really just don't understand. If my long cycles and delayed ovulation were my endo, then what's the deal now, post-surgery? What is wrong with me? If we thought maybe it was mainly B's confused sperm, which the tests show being borderline for forward motility and the one non-ICSI IVF confirmed an abysmal fertilization rate, then this long cycle shows that isn't it either. My egg quality sucked during the IVFs but I thought maybe I was over-suppressed. I just don't understand. Everything else about me is so healthy, and I eat well and exercise and I wouldn't say I am under undue stress. Aughh!

In other fertility news, I am still the de facto coordinator of the RESOLVE support group, and still wondering how to handle the problem we had last meeting with a new person. Today I talked to a woman at the national headquarters, about our "difficult" new person. She talked/complained about her children (three of them! for real) and bragged about her 100% insurance coverage (and adoption coverage too). I am nervous to talk to her before the next meeting, but it has to be done. We don't want anyone to feel uncomfortable, and she really dominated the group. Not okay. Hopefully she will not come back, or has found support some other way. Sigh.

Anyway, for now I will continue life as usual, just waiting for my period, hoping it won't come, but wishing it would soon if it's gonna. I'm terrified of the water sonogram but just want to get it over with too. Also, we leave for Ecuador in two and a half weeks (exciting!) and I'd like to have our January plan set up before then.

I can't believe it's been two years. I should have a baby in my arms now, but no. It's just me, my distracted husband, and my spoiled kitty cat. Same old, same old. Not feeling very cheerful today.

All Better... and Hopeful?

So yesterday I woke up and was 90% better. Still a tiny backache but absolutely no cramps. Today is Saturday (10 dpo 8dpt) and I feel fine. It was probably nothing, or gas and an unrelated sore back, but of course I have wild hopes that it was implantation cramping.

We're off to the mountains this weekend to meet my parents, so hopefully that will be a good distraction. We come home Monday night, Tuesday I have a busy day at work, and Wednesday is test day! I am excited yet dreading it at the same time... Oh well, off to enjoy the weekend.

Worry

Yesterday, around noon, I started having very mild cramping. Last night, it got worse. Not terrible, but bad enough that I would have taken painkillers if I weren't too worried not to. Also, sometime overnight, my back started to ache pretty badly. Today at work, the cramps mostly subsided, but the back ache got pretty bad. I sat at my desk with a heating pad for most of the day.

This evening, the back is feeling better, but now the cramps are occasionally happening again. I was terrified last night that this all means my period is coming. It would be really sad to get a negative next Wednesday, but I will be totally devastated if I don't even make it to next Wednesday. If I get my period early and all my chances are lost due to my damn luteal phase defect, I will be so upset. Last time, last cycle, the progesterone was perfect. I had like a 16 or 17 day luteal phase. I am only on 8dpo 6dpt, so this better not be my period. It's possible the cramps are gas (though I don't think so) and the back ache... just unrelated? Or could the cramping be a good sign, perhaps?

I don't know, but I'm pretty upset and anxious. Last time, I had no symptoms, so there was nothing to hyper-analyze.

I hope I wake up tomorrow and feel totally fine. We will see.

Update During the 2WW

I'm not sure why I stopped writing two weeks ago. This blog has been so helpful in expressing my hopes and fears and frustrations during my fertility troubles. This cycle was really hard, much harder than the first one, so that might be some of it. I've also been busier than usual, both at work and socially. Finally, having K to talk to has made venting on the blog not as necessary this time around. We have a little email chain going around for five of us in the RESOLVE group, and having people to give me this support has been so invaluable.

To update: when I last wrote, I'd gone to the Thursday appointment and had a low number of follicles, and a very low estrogen of 120. My first cycle, to compare, it was 362 on that day. They upped my dose and told me to come back Sunday. I went, and still only had a sad four follicles of large enough size. That explains why  my estrogen had been so low the whole time. In my first cycle, I had 8-10 playing ball, and this time I had 4-5. Part of it is that the first cycle I had 11 antral follicles to start with, and this time I had only 8. So I had fewer to start with, and they grew more slowly, I don't know why.

I was crying after Sunday's ultrasound, after I'd been told to come back again the next day and to see my actual doctor, who would make the final call on cancelling the cycle or going forward with triggering. In the middle of crying, I suddenly see B's eyes roll back in his head and he slumps, slowly, to the ground. I began to scream and cry, thinking that with my luck, he surely was dead. It was horrible! He hit a table that hit a wall, plus I was screeching, so the door to the exam room bursts open and two more doctors rush in. So we've got me, hyperventiling and pants-less on the table, a fellow and a resident in the room, a doctor and a fellow rushing in, and poor B passed out on the floor. Well, of course he was okay. He came to, and they wheeled him out on a stretcher, deciding that he'd just had a vasovagal response and he wasn't going to die! We were kept there for another 2 hours or so, monitoring his vitals, but he was feeling better and we eventually got to go home.

What an ordeal.

So, we go back on Monday, and Dr. F is ribbing him a bit, giving him a "special chair" to sit on during my ultrasound. By then we could all laugh about it. One more crazy adventure in this fertility mess. Anyway, Dr. F did what I had always thought he'd do: let us trigger that night, since I had 4 decently sized follucles. My estrogen was in the 400s on Sunday, and had risen to 679 on Monday. So, we triggered Monday night.

I didn't get sick at all on Wednesday morning, unlike the first time around. I don't know if it's because I had less estrogen in me, or if the first time it was a lot of nerves that caused it. In any case, I was okay, and retrieval last Wednesday (September 19th) went fine. Dr. F was very careful, he told B, and managed to get all 4 mature follicles.

I got the call on Thursday morning that of the 4, only 2 had fertilized. This was lower than we had hoped. So we trooped back in, depressed and sad, on Friday for transfer. No sense in waiting for a three day transfer when we only had two embryos anyway. However, we got words of hope when we arrived. Dr. F and the embryologist- mostly the embryologist- explained that last time I'd had 3 cell embryos, and this time I had a 4 cell and a 6 cell. Much better!

Also, there was something different during this transfer. Maybe because it was Dr. F and not unpersonable, cold Dr. M, who did it last time. But this time... instead of being as scared, and being wary of pain from the catheter (which I never had), B and I actually watched the monitor screen. Dr. F encouraged us too. He explained each thing that was happening, and we saw the catheter slowly deposit the embryos into my uterus. B and I both teared up. Something felt so special this time. It felt really like our possible babies on that screen we were watching. I cried, and cried even more afterwards, as the embryologist told us we had such strong embryos, especially the 6 cell one on a day 2 transfer. She and Dr. F both held my hands, and wished me the best luck they could. The last thing she said to me, as I tried not to all-out bawl, was: "This is your time." Even typing this now, I feel tears coming. I know they did the best they could, and it's just up to luck and chance now.

One Week Down, One Week To Go

I haven't been posting lately because I don't have much to say. My transfer was almost a week ago (last Thursday morning), and my test day is just under a week from now (next Tuesday morning). I am still doing Progesterone shots every night, which is a huge (literal) pain in the ass. 1 1/2 inch needles are just no fun. My tush is so sore that it's hard to lie down or get up from that position, and I can feel it in every step I take. Still, we are being good about taking hour long walks most evenings. I am avoiding my regular weights and cardio classes at the gym, so the walking is helpful in moving around and relieving stress.

Overall, my stress levels have been totally manageable. Because the progesterone creates pregnancy symptoms and I know it's just the medication, there is none of the hyper-analyzing and second-guessing that I normally have done during the two week waits. I know it's all from the shots, and so I don't freak out.

What I do: EAT. I am so hungry, and so often! Also, not to be gross, but they weren't kidding when they warned me about constipation. But, not so bad. The hunger and tiredness and sore boobs are more noticeable. Also, the morning sickness continues, though not every morning and not terrible.

B and I are just hoping and wishing so much for good news on Tuesday. Till then, I'll try not to dwell on things too much, and just hope for the best. Only six more nights and then... test day.

Natural Cycle #1

On Friday, day 16 of my cycle, I got a positive ovulation signal (after a false alarm on Wednesday, day 14). Right on schedule, on Sunday, day 18 of my cycle, my temperature rose. So I ovulated on day 17, not too bad. That's a dramatic improvement from my last cycle, before the endometriosis surgery, when I did not ovulate until somewhere between day 20 and day 24.

So now, on 2dpo, I wait for another ~12 days to see if I'll get my period or not. I am very curious to see how long my luteal phase is, and praying for it to be sufficient.

We will see. I'll try not to think about it too much, in the meantime.

Down

I'm feeling really down tonight. I'm doubting I will get pregnant ever, or at least not for a very long time and with lots of intervention. Today is three months after my 31st birthday and we've been trying to conceive for almost 9 months. It sucks that I started trying when I was 30 1/2 and the absolute earliest I could be having a child is when I'm just about 32. And maybe not for a year or more after that, even.

Yet, meanwhile, my husband's sister managed to get pregnant "without even trying" and very likely on the first month she "didn't try" when she was 38. THIRTY-EIGHT. And two of her FORTY year old friends also have newborns. And me? Nothing. All because of my stupid, unresponsive ovaries.

And now, if I can't get pregnant this month, and my cyst is still there, what then? I go off Clomid and have another 45+ day cycle, and THEN MAYBE start Clomid again so wait another 18 days till I ovulate?? So we're talking another 65+ days till I even have a shot at conceiving??

This just feels all so... never-ending. Never, ever ending. I am so sick of months coming and going when I thought I'd be preparing to expect a baby. No one ever warned me it might be this hard.

Waiting game

Well, 28 hours after I emailed my doctor, she finally found the time to call me back. She said it does sound like I've ovulated, since I've had five high temps. She didn't know how to explain why my ultrasound showed all small follicles, except the one huge 40mm cyst. She really didn't have any explanation for me. All I know is that I must have ovulated that same day.

Anyway, the huge cyst might be a problem, so I'm to come back for a baseline ultrasound if I get my period next week. Then we'll decide if I should stay on the Clomid, and what to do about dosage.

I'm telling you, if I have to take a month off of drugs, I am going on vacation! I need a break from all this, and it's impossible for us to plan our usual Xmas get-away, since we never know if I'll be pregnant or not, and I don't want to fly if I'm still in my first trimester. Ugh, all this not-knowing is very stressful. I've been handling it better than last month, my first one on Clomid, but I'm still eager for time to speed up and for it to be day 13 already. Hopefully day 13, 14, 15 and beyond- with no period.

Good night,

SICK OF ALWAYS WAITING in North Carolina.