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How important is biology?

25 Jun

Coming back after our Maui vacation it was really hard to face all this again and even to come back to blogging.  For a week I felt like I was a different person and was able to take a real break from the grief and stress.   It all started right up again when I returned.  Just like before, when my mind wanders it goes straight to the grief/stress/feelings of hopelessness.  After my one week break, at least I know there is another side of me in here that can be happy and relaxed and isn’t defined by the events of the last 4 years.  Because of this I came back feeling restored with batteries recharged and much better prepared to face the ongoing and seemingly long road ahead.

So here I am looking ahead and considering our options.  Before we left our IVF doc recommended we move on to surrogacy or egg donor suggesting those as more likely to work after my 6 losses.  Shock set in, tears were shed and the fantasy of the miracle of bearing my own biological child one day died.  Since then I picked myself up and started shopping for donors and surrogates and have now entered the world of the donor agencies, screening profiles and taking stock of how much all of this stuff costs and how much just goes to the agency itself and lawyers.

On Friday (two days ago) I had a follow up with my original RE, the one I had my previous 3 natural pregnancies (via monitored cycles and Femara).  She and I have been working together now for over two years.  After seeing her so much over the years (and her seeing so much of me, ALL of me, from ultrasounds, 3 D&C’s and 1 laporoscopy, + other visits) I have a deep trust for her and I think she knows me and my body better than anyone (even me).  In our discussion she took another perspective and felt like surrogacy was maybe a bit farther than we needed to go.  She suggested looking at 5-day chromosomal testing with an IVF cycle.  The thought is maybe with 5-day testing we could actually get more embryos than we did with the 3-day testing we did for our first cycle.  According to the research, some that look abnormal on day 3, may look normal on day 5 and vice versa.  Of course, this raises the question of why didn’t we just do 5-day testing the first time!  Our IVF Dr. seemed to think the pros of doing a fresh cycle outweighed the cons of the 5-day test that requires freezing.  So here is the plan, we are moving ahead with another cycle with 5-day testing.  PRAYING for lots of embryos.  If we get 4 we will put 2 in me and leave the others for a surrogate.  The beauty of frozen (if we have any that survive) is that we don’t have to decide everything right now.  However, if we only get 2, I might not want to risk them being implanted in me. Or maybe we will find out the embryos are all abnormal and won’t waste time on a surrogate.

Meanwhile we met with a surrogacy/egg donor agency on Saturday.  It oddly gave me a lot of optimism about our options if we want to go that route.  We started talking even about egg donors.  That process is so much less expensive and more manageable compared with surrogacy.  Also there are way more donors.  Both my IVF doc and my RE seem to think that maybe I can’t carry MY embros, but there is a chance that maybe it would work with a donor.  the reasoning is that we tested positive for something called DQ-alpha.  My husband and I have a high match (we aren’t genetically different enough).  Because of this (the theory goes) my body doesn’t recognize the embryo as a baby (which triggers a pregnancy response) and instead thinks it is a strange part of me and kills it off.  If that is the case either egg donor or surrogacy would solve it.   Surrogacy is a safer bet, but a way huger deal.  It all comes down to what is more important, the genetic relationship or the pregnancy/birth experience.  So that is the choice swirling in my brain right now.  I have little information to go on to make the decision and very few role models of people who were successful with either one after recurrent loss.  In fact for recurrent loss I am only familiar with two outcomes- miraculous inexplicable success that just randomly happened OR adoption.  Do you know of any other outcomes?  Also I don’t know of any cases of egg donor or surrogacy successes.  They are rare enough, but particularly rare after recurrent loss.

Meanwhile I am praying that I will get inexplicably lucky and have success without having to make this choice.  Don’t we all pray for this?  I don’t know anyone else who was debating between these two.  Normally you have one issue or the other and the choice is that or adoption.  Mr. Star is still squarely against adoption leaving me to choose one hard thing or another.  Tomorrow night is our wedding anniversary (8 years!) and we are spending it appropriately at the Stanford Seminar- “Options for Building Families” which explores all these third party alternatives.  It is perfect for us because we are basically exploring them all.  I am going to make a leap and guess that all the panelists are happy with their decisions and love their children.  I’ve never heard anyone say I wish I hadn‘t adopted or used an egg donor, etc.  I think when the baby arrives and the bonding starts your brain responds and you really are genuinely thrilled with the outcome.  Hopefully a healthy does of amnesia comes in as well helping you forget the pain you experienced getting to that point.   In a way I feel like whatever works in the end is what was meant to be and I will be genuinely happy with whoever the child is that results.  In the meantime I struggle with having to make difficult choices of what path to take, hoping for the one that after such a long journey leads us to the shortest and least painful path.

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I wish i was a seahorse

2 Jun

We had our follow up consultation with the IVF doc yesterday.  I left the fall feeling crest fallen.  He advised that given our history that it wasn’t worth it to try again.  He thought it would be a waste of time.  Instead he recommended that our best shot at biological children was with a gestational carrier.  He confirmed what we thought all along.  There is something wrong with me that we currently have no treatment for.

The alternative to the gestational carrier would be to try IVF with an egg donor.  From there Mr. Star and I debated the pros and cons of each.  Since it sounds like our embryos are fine (as far as we know) the gestational carrier makes the most sense.  Also I think in the long term, having the biology will outweigh the carrying/giving birth connection.  At this point I think my embryos would be safest in anyone other than me.  Hell, I think even Snookie could be a good surrogate at this point.

While I had suspicions of this all along I also had deluded fantasies that if we just kept trying one of these days something would work.  Even now I have fantasies that we will get pregnant naturally and magically have a healthy full term baby.  I’d heard so many anecdotal stories that ended with this.  Why couldn’t that happen to us?  The statistics seemed to be on our side, at least in the beginning.  70% of women who have had 3 losses go on and have a healthy pregnancy.  Remember that?  Once it gets to 6 losses the odds are down to only 40%.  So after 10 are your chances only 0%?  Maybe statistics in this case are not very helpful, or even applicable.  The statistical odds of having 6 miscarriages are so low that I don’t think anyone can really explain what someone in that situation can expect.

Changing gears really feels like giving up, especially considering how long we’ve been on this path.  Part of me is grateful for his honesty and not getting our hopes up for another try that would also end in failure.  Maybe this is just what we needed to finally stop trying and give up on having a baby the “normal” way.  Normal at this point just means I conceive in some way or another and carry to term a biological baby.    Giving up natural conception to IVF was a huge blow.  Now giving up the pregnancy is the next.  Logically we should have gone to adoption years ago.  But Mr. Star didn’t and still doesn’t think we are at that point.  And I had my own struggles with the concept of having a biological mother out there who is “the real mother”.  So we are left with two options both super expensive and both assuming a major loss for me either to my biology or to my role as the carrier.  And it goes without saying that both are giant blows to our bank account (and my ego, what’s left of it that is).

To top it off, after this dismal phone consultation I had a rough rest of the day.  I had an appointment to see a my new counselor for the second appointment but somehow I mixed up the time and arrived 30 minutes too late.  The receptionist told me after I arrived (and drove 25 minutes in rush hour traffic) that she needed to reschedule and that I was late.  I thought I arrived right on time and was more than ready to have a chance to talk about all this stuff going on for me with someone.  Instead I felt like I had the reverse of counseling. I got back in my car totally upset and angry and now having to drive 25 minutes back home in rush hour traffic knowing the whole drive was a waste and it was my fault.  To top it off, they told me that she had to go because “she has to pick up her daughter”.  I barely know this person, but now I already know she is a mom with a young daughter.  I can’t help but think of this the next time we meet.  I really don’t want to know this about my c0unselor.  Seriously!

And finally we had plans for dinner with friends.  They brought their 2-year old with them and I just spontaneously burst into tears.  It was totally awkward and everyone was averting their eyes and trying to change the subject to something funny.  Normally we get together afterwards to hang out, but they didn’t even bring it up.  It was like I was left out to dry with my grief and burned a bridge at the same time.

Modern Family: Baby on Board

24 May

Last night Modern Family took a big leap that won me over.  When I saw the episode title “Baby on Board” I thought, oh no, this is going to be another one of those sitcoms that makes having a baby look so easy.  The previous episodes hinted that Cam and Mitch were expecting a second baby, but completely glossed over the how part.  I figured they could gloss over this as they had that TV magic that causes babies to appear at the perfect time whenever the plot needs to introduce one.  The same magic that misleads impressionable naive viewers like myself  (pre 2008) into thinking that we too will be able to have a baby easily when we want.

I love the characters Cam and Mitch and I did want their dream to come true, but it seemed totally unrealistic for them to be having such an easy time adopting, twice!  The first baby arrived with almost no explanation as to what they went through.  I figured it was just my bitter infertile side coming out, so I chose to let the episode unfold rather than give in to my cynicism that gets in the way of me enjoying baby/birth-related TV episodes.  Resigned to see yet another couple have a happy ending, even if it seems unrealistic, I found myself totally surprised when the episode took a turn.  As Cam and Mitch were waiting as the birth mother gave birth, out of nowhere the grandmother appears and tells them in Spanish that the adoption is off and she is going to take care of the baby instead, rather than give it to strangers.  What?  Is this the cute and fuzzy sitcom I’ve come to know?  How could they build up the arrival of the new baby and then leave Cam and Mitch empty handed like that?  How could they build this perfect picture and then tear it down?  I was sad for the characters, but I found myself cheering inside.  Seeing mainstream TV characters crying in despair about how hard having a child is and how this just keeps happening to them was incredible.  I felt for that moment that they were speaking for me and for a moment validating and normalizing my everyday crazy talk.  At the same time it disproved the misperception/lie that adopting is an easy plan B as implied by the common phrase non-IFers like to give ” why don’t you just adopt?”.  Maybe after seeing this episode one less person will give that terrible unwelcome advice.

As they were describing their agony I felt for that that brief moment like the mainstream world acknowledged and recognized the grief and frustration of what setbacks to family building feel like.   Adoption loss, pregnancy loss, infertility- those of us experiencing these things can all relate to being angry, sad, frustrated, stressed out and beat up by this exhausting and demanding process that seems to take everything we have.  Ultimately I want to give kudos to the writers for forgoing the easy crowd pleasing baby arrival and keeping it real.  You guys get it.

What next?

29 Jul

I felt pretty depressed and crappy these last few days.  Sad about where I am in this path.  Looking back and wondering where the time has gone.  Pissed off at my rotten luck and my lack of answers.  We saw our RE yesterday and talked for a very long time.  This was our first visit since the D & C and she didn’t even take a look under the hood.  It was a meeting to refer us to a clinic that offers immunology testing and treatment.  They don’t do that in house at their clinic so it’s almost like we’ve hit the end of the road.  I had been planning a big ramp up to IVF with PGD but now that we have these test results (normal 46, XY, ie. healthy baby boy) I don’t know know what to do.  If we HAD done IVF with PGD, we would have implanted this healthy boy embryo and sure enough I would have miscarried it.  It makes no sense.   What does make some sense is the hope that maybe finding an issue that may be treatable with my immune system may help.  It at least has some logic to it.  We’ve ruled out all the other possible causes of pregnancy loss.  Perhaps my immune system is just rejecting my babies as it would a transplanted organ.  No research or studies is going to help.  My doctor said the only way to know what is going to work is to try it.  It’s come to this.  I figure it’s worth it.  If we are able to do these treatments and skip IVF, even better.  While I am open to anything right now, donor eggs, sperm, embryos, surrogacy, etc. I really want to give the natural biological thing a shot.

On the waiting end my hcg levels are still up there (190).  I guess if I took a pee test today it would still come up as positive.

Meanwhile my mom just emailed me something about adopting Russian orphans.  Clearly she had given up.

On a happy note we watched Cedar Rapids on Netflix (a comedy that most people missed in the theater).  Totally funny!  Tim:  “How do you make the tiger dance? Man: You gotta show them a little teet

Day After D & C and Final Ultrasound

7 Jul

I am feeling surprisingly upbeat despite what’s been going on.  I have to say that everyone’s comments have been SO appreciated.  This whole experience has been so surreal and having online blogging friends like you guys helps me stay sane and reminds me that we are not alone on this path (even though it often feels like we are).

All in all the experience itself was fine.  I definitely got closure.  It started with my last ultrasound.  I was surprised to see that one week later nothing had changed, there was still a sac, an embryo and a heartbeat- but it was definitely not normal and not measuring up to a normal 9 week pregnancy.  It measured only 6 weeks in size and appeared abnormally formed – not like a normal embryo/fetus should.  The heartbeat was still going in the low 90’s which really surprised me.  This pregnancy has had the best track record of a heartbeat compared to my previous pregnancies and I was amazed to see it struggling for life to the bitter end.  Although it doesn’t prove anything I did get some encouragement that maybe if we just had a healthy embryo in their that my body could actually carry it to term.  Seeing my body support even this crappy pregnancy so well, it makes me think maybe there is still a chance to make a healthy baby in me with the right raw materials from the start (ie. IVF with PGD testing first).  This feels like a big relief as I was seriously researching surrogacy thinking it might be my only option other than adoption.

Next steps are to just wait for the test results.  I am optimistic to hear SOMETHING new.  We are guaranteed to not repeat our last disappointing and un-usable test that showed a healthy female.  “Healthy female” may have been the pregnancy or it may have been me and there is no way to know, so the test was basically considered invalid.  This time we are testing my cells and the pregnancy cells separately in a more extensive test (PDG) from a fancier lab- Gene Security Network.

The other big news is I finally convinced Mr. Star to take me on a vacation!  Other than quick overnights once in a while we haven’t had a real vacation in years.  The last few were cancelled because of medical issues like this or because of Mr. Star’s grueling work schedule.    Since we want to go in the next month and are planning things a bit last minute we are struggling to find deals.  I  had dreams of going to Europe or even Bora Bora, but those require more time to plan and are much more expensive and stressful if we plan to do site seeing too.  For now I am eying resorts in Hawaii as it sounds low stress and is easy to get to from San Francisco.

Also this next weekend my friend is throwing another bash at a nightclub in SF and I plan to take full advantage of the experience now that the drinking ban has been lifted.  ;   )

Day 14 was today (BFN)

1 May

I took a bit of a break the past few weeks from blogging.  I had a wonderful vacation last weekend in Maine celebrating Easter with family.  I was so absorbed in everyone else’s lives that I took a bit of a break from talking/thinking about what we are up to.  It was definitely a good break.  It is too easy for me to get into my self pity spiral and just assume the rest of the world (esp. the ones with the babies) have everything sorted out.

I took a test today and got the BFN.  I actually took one yesterday too as I was feeling antsy for results.  I guess it probably doesn’t work a day early so that was kind of a waste.  Since I am a doubting Thomas with these things I took another progesterone suppository tonight and plan to give it one last shot tomorrow.  Final test.  If it’s negative again, I’ll call it a definite no for the month, put away the progesterone and welcome cycle day 1.

I made a visit to the infertility support group I’ve been in since Feb. ’10 tonight as well.  I used to love that group, but more and more I feel like I don’t fit in.  It is a Resolve group and most of the participants are doing IVF cycles or IUI.  I’ve never done either of those and can’t follow along with all the lingo.  They are so filled with great advice and support for each other, but it feels like when I describe our situation there’s not a lot of suggestions people can offer.  One woman suggested giving myself progesterone injections in addition to taking suppositories.  Another suggested that maybe I am having girls and that boys are somehow easier on a woman’s body to carry.  Interesting ideas.  Another described CCRM, the clinic she is doing her IVF through in Colorado where they are doing the most complete pre-genetic testing prescreening available.  Since my sense is that our chromosomes are the problem (givin that the only conclusive test result we’ve gotten from a lost pregnancy has shown a chromosomal issue) I think we should keep this in the back of our minds.

Next Saturday we meet with the adoption specialist.  I am very anxious about it.  I  feel like I am going because at least I can say that I explored that option.  It gives me piece of mind to atleast knowing what the options are and also to be able to speak knowledgeably about it if it comes up.  I find that if/when I reveal that we are having any trouble having kids naturally, that the common response I get is, “well, why don’t you just adopt?”.  Now at least I can say we are looking into it.  Understandably my friends and family are getting fatigued hearing about my disappointments and walking on egg shells around me.  Outwardly it sounds a lot healthier and more positive to say you are pursuing adoption than to say you are waiting for a pregnancy that sticks after 4 losses. It’s just hard to believe #5 would be magically any better than the first 4.    That said, I couldn’t forgive myself for not trying, so here we are, ready for another try hoping for magic #5.

Not ready for adoption

16 Mar

It’s been exactly 6 weeks since I had my D & C and officially ended pregnancy #4.  I am still waiting to get back on the horse and start trying again, but my cycle is nowhere to be seen.  My hcg levels are also dropping slowly.   Last I checked they were 20.  Once my cycle returns I will get it checked again to see if I am down to normal non-pregnant levels. While I try to block out the past, I don’t remember ever having to wait this long after a D & C to start up again.  Very weird, but not much I can do but sit on my hands.

In the meantime I’ve scheduled a consultation with Sara from www.adoptionpaths.com for April 9 which I am NOT looking forward to.   Kind of fearing it actually.   I was really open to adoption until we actually started trying.  Now somehow it just feels like a whole new process that I don’t have the strength to handle.  I feel so beat up from the losses and the time we’ve invested in trying to have one naturally that starting up the adoption process feels like a big kick in the stomach.  While adoption may eventually help us build a family, I know it requires me to accept my losses and basically give up hope.  I yearn to have one naturally not just because we want to start a family but also because it would enable me to heal.  Somehow this process has ripped a giant hole in me that has left me wounded and broken.  Stopping at 8 or 9 weeks again and again leaves me incomplete.  It’s like I get on the plane, but just sit on the runway and never get to my destination.  I am stuck on having a child naturally because bringing a baby to full term would be the most healing experience I can imagine.  If it was just about becoming a mother I could jump on the adoption wagon a lot faster, but right now I can’t think beyond healing this giant gaping wound and constant feeling of physical failure.