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What’s new

24 Sep

After our last heartbreaking loss, a long break from blogging and a lot of  confusion and soul searching about next steps we are back to trying again.  In August we went ahead with another IVF cycle.   Since we transferred and lost the only two that had tested chromosomally “normal”  back in May we had to start all over again.  We tried a few different things this time hoping for something better.  The two big changes were a new test and a new diet.

For this new cycle we requested chromosomal testing on Day 5/6.  In our first IVF cycle in April we tested on Day 3 (per our Dr.’s recommendation) and since then multiple sources have advised that that type of testing is not reliable.  Even though our IVF Dr. has a lot of confidence in Day 3 testing, he seems to be pretty alone.  The theory is that there just aren’t enough cells on Day 3 to get enough information.  In comparison, on Day 5 there are hundreds of cells and more evidence that the tests are consistant and reliable.  In any case, just surviving to Day 5 is a test of embryo health in itself.  So we agreed to to move ahead for another cycle with the same IVF Dr. but this time with Day 5 testing, which meant that we had to do a frozen transfer instead of fresh stretching the whole process out over multiple months and upping the number of steps, expenses, etc.  The lesson I learned, don’t bother with Day 3 testing.

The second twist we added was a change in my diet.  I gave up gluten, dairy and coffee and followed a pretty strict PCOS diet for the time leading up to the egg retrieval.  Despite all the things I’ve done on this journey, this was by far one of the most intensive.  Since I had a real goal with a deadline I was able to manage it, but it was still very challenging.  In addition to my own natural temptations for all things bready/cakey and creamy it was challenging.   My IVF Dr. recommended “cutting down” on dairy and carbs because of my diagnosis of polycystic ovaries, but it was really my idea to go cold turkey like that.  It was one of the few things I had heard might help so I figured it was about time to try something since I was feeling desperate for any action I could take to up our chances.  Since egg quality and embryo quality are the likely suspects with women of my age it felt actually empowering to do something active and take control of my diet.

It was hard enough on my own, but in social situations, travelling, going out to eat, etc. it became something I had to address.  At first I was really shy about what I was doing, but people got curious and it just made it easier to be up front.  I just said I was giving up dairy and gluten for “fertility-reasons” and that was pretty much all I had to say.  One thing I learned- people love talking about foods they are avoiding and why.  And for the first time friends and family could actually “help” me on this journey by making suggestions for gluten-free, dairy-free alternatives.  So much of this journey I am on my own, so whenever someone voluntarily prepared or offered gluten-free/dairy-free foods (esp. desserts) I was so touched.

So what happened?  At the time of our retrieval we were able to collect 16 eggs, a higher number than our first cycle.  Of these 11 made it to Day 5 for testing.  An astonishing 50% came back as chromosomally normal!  He warned us in advance that we should expect only 30% at the most and I was prepping myself for an even lower number.  So in the end we had a higher number of embryos retrieved, with higher quality (more making it to Day 5) and a whopping 50% normal rate which is statistically way above what you would expect from someone of my age.   With such high numbers we didn’t get any clarification about why we are having so many losses, but it did at least help give us confidence that something is working right and we can put the thoughts of an egg donor to rest for now.  Since the only big change in the protocol from last time to this time is my gluten-free/dairy-free diet, my Dr. is crediting this with upping our numbers and quality and as a result I am (sadly) still on the diet.  Perhaps it was just a coincidence, perhaps it made a difference, who knows…

With 6 embryos banked,  our Dr. recommended that our best chances were still with a surrogate.  However, given that there were more than 2 banked he thought it was reasonable to give my body one last shot at baby making.  So that is where we are.  We transfered a single embryo last Thursday.  Per his recommendation, we didn’t want to waste more than one of our supposedly perfect embryos on my iffy uterus.  It made it out of the thaw ok (something I was worried about) and is hopefully making magic in my nether regions as we speak.  Our first beta is this Sunday and I am praying for some good news.

This second cycle was a lot less dramatic than the first.  I got over my bitterness giving up natural conception, something I thought we had going for us.  And I knew what to expect with the injections and procedures.  Instead of wallowing in “poor  me” I felt like I had matured to just take it and move ahead.  After considering egg donors and surrogates, “conventional” IVF seemed so normal and gave me hope that maybe there was still hope to carry my own genetic baby.  At this moment, both doors are still open and I have been able to delay that decision.  Surrogacy is still out there as an option, (a very complicated and expensive option), but I couldn’t go there without at least giving this one last shot.

It’s officially over

14 May

Well, pregnancy #6 ended almost as soon as it started.  I just got the call that my beta was only 35.  At least now we know for sure that it’s over.  As sad as it is, at least I didn’t have to find out yesterday, on Mother’s Day.  It was nice to at least have hope on that day for a change.  I am really at a loss as to what to try next.  We pretty much did it all in this last try and I am running out of hope that anything is going to work with my broken body right now.  My body is literally a death machine.  I can’t find out what’s wrong with me and so I can’t seem to fix anything. I feel like I spent the last year trying to diagnose my situation, spending gobs of money, talking to all these new doctors, doing tons of tests and treatments and taking tons of drugs and then here we are again.   This just confirms what I thought all along, that IVF won’t help us, it will only make the loss more painful.  Good bye my chromosomally perfect little boys.

And now there are ten

22 Apr

Yeah! We made it through the retrieval!  15 eggs were collected, 14 matured and 10 were fertilized.  Now comes the chromosomal testing.  How many of these are actually chromosomally normal?  I am guessing we will lose at least another 5.  I know we only need a good one or two, but watching the numbers drop is a bit disheartening.  Three days from now (Wed.) we will both hear the results of the testing and do the transfer.  We can choose how many to implant at that point.  The decision may be made for us.  If there is only one left, that will be it.

Meanwhile we’ve changed to the new protocol of drugs which involves one injection of progesterone nightly.  I had my first last night and was expecting the worst.  I’ve heard these are really painful.  I was ready with my heating pad Mr. Star did some massaging.  It was the first time he actually gave me an injection which was a whole new step.   If we are lucky enough to have a successful IVF cycle it will be that way for weeks, so I better get used to it.

The one thing that surprised me after the egg retrieval was this new liquid restriction.  I am not allowed to drink more than 1 Liter of liquid a day.  I can not have water, only Gaterade or Propel.  I still have 3 more days of this.  I see my 1 liter bottle on the counter and I stare at it thinking, this is all you have left for the day.  It feels a bit like I am trapped in the desert.  The reasoning behind the restriction I was told was to prevent too much bloating in the ovaries..  When they retrieved the eggs liquid was extracted and the concern is that if I were to have too  much water those empty reserves would just fill up with liquid.  At the same time we are having a record heat wave, so I find myself obsessed with thinking about beverages.  Strangely alcoholic drinks are ok, so I was able to enjoy a glass of a wine and cocktail last night when we were out.    This is just a really weird step in the process I didn’t expect.  I am probably taking it way too seriously.

Today I am spoiling myself with a Reiki session!  My Resolve support group facilitator is also a certified Reiki practitioner and I am planning to see her today.  I had my first session with her a few weeks ago before the IVF process started.  I had been told that you can’t describe Reiki, you just have to do it.  So I did and it was AMAZING!  I had no idea what to expect, but figured it couldn’t hurt.  I found it to be an incredible physical and emotional release.  I felt like a new person afterwards.   I have no idea how my body will respond this time.  After having my eggs forcibly extracted from my body some holistic healing sounds a really good idea.  Plus I love talking to Linda who herself went through IVF to have her twins and has a very positive and comforting presence.    Looking forward to restoring some balance.

Weekend with the Elephant

15 Apr

This weekend it seemed like the Elephant in the room followed me from place to place.  I got that look yesterday at my friend’s birthday party for their 2-year old.  As couples would enter the party, we’d ask “how are you?”  and “look at little sarah…, etc.”.  They’d light up then look at us dumbstruck.  I’ve gotten so used to the face I feel like I can read their mind.  They see that we are not pregnant and remember we have no kids and draw a complete blank.  Since they can’t ask us how OUR kids are doing they just smile and move on like they saw a ghost.  It’s all very awkward.  I know some people are able to make jokes about it, or will even cough up to “we’re trying” or “we’re hoping soon” or something like that.  I haven’t been able to do that.    The best I can think of is, “we’ve been trying for over 4 years and have unexplained recurrent pregnancy loss”.  It sounds way too depressing, so instead I say “we’re doing great”.    When I was first married, the question would have been “are you planning to have kids?” or “when are you going to have kids?”  Now I just get the uncomfortable look of confusion & pity, like they don’t know what box to put us in.  Since we are not parents, what else is there to talk about,  oh, look, is that someone I know over there? let’s see…

After that I went off to acupuncture at this special fertility acupuncture clinic and the elephant followed me even there.  Only this time I was in a waiting room full of people with various fertility problems.  This time we are all avoiding the elephant with eyes averted and focused on our phones and magazines, almost pretending we aren’t there.  Meanwhile we can hear the receptionist talking on the phone with a patient about her upcoming IVF cycle and retrieval.  I find myself looking away.  I know that is why I am there, but somehow I found myself feeling embarrassed and awkward as people’s fertility issues were so casually and graphically explained within earshot as if they were commonplace.

We had our follow up ultrasound this morning with my IVF doctor.  Good news!  We have about 18 follicles growing, which is in line with what was expected based on my age and PCO diagnosis and everything seems to be going ok.  My stomach continues to be the pin cushion for “stabby time” (my lovely name for med time 2x day).   They still need to do some more growing as they are 10 mm and they need to get to 18.  If all continues on track we will be scheduled for retrieval this coming Friday.

Mr. Star got to have his big moment today giving his “sample”.  This was the first time he had to do it AT the clinic.  As if it is not awkward enough, the nurse came into the waiting room with other couples and announced “ok, we are ready for you to give your sample now”.   Dutifully no one looked up, even though we all knew what that meant.  I guess we are all used to this by now.  After it was all over he gave me the report.  Apparently the “sample” room has a sofa with animal print pillows and a TV with a VCR and DVD player.  It included a surprisingly exotic collection of porn videos that featured mostly Asian women and anal sex.  It made us wonder about the demographics they were going for and made for a good laugh on the drive home.    Points for Mr. Star for doing the deed.  I can’t imagine having to do that at the doctor’s office.  Instead I get to get my parts extracted next weekend ;  )

For fun on the drive home we stopped by the cat shelter.  Since our cat died in December we’ve been thinking about maybe getting kittens and I’ve lately been feeling SO ready to adopt.  Apparently we are a few months early though, kitten season is a few months out still.

It’s Official- IVF Begins

10 Apr

We kicked off our first-ever IVF attempt today with my first round of injectibles.  It was actually ok.  I am feeling positive that maybe I can handle this.  It was my first time injecting myself with anything and the whole concept had me really nervous.  Now that I’ve done it, it seems a little less daunting.

I feel like I should be really excited about getting back in the game, but to be honest, I am just finding myself going through the motions.   There is some relief to finally be doing this after all the waiting, but I don’t have this super optimism that something amazing is going to happen.  Maybe that happens later.  Instead I find myself thinking “Here we go again doing more steps towards a journey that just seems to keep going”.   Even if it works, the whole thing is resting on me not miscarrying and there’s no real evidence that IVF is going to help.

For this reason, I feel really mixed about this cycle.  I am excited to be doing SOMETHING but still feeling really bitter that I find myself going this far and spending so much time and money with so little proof that it will help.  I have a lot of self-doubts about taking this path.  Since last June we’ve spent most of our time prepping records, doing tests and meeting with IVF and immunology doctors and I find myself feeling empty handed after it all.  Maybe instead of doing all that we should have just kept trying naturally.  It’s been over ten months since I lost my last pregnancy and there’s this feeling that maybe, just maybe the next natural one would have been the ONE!  Instead I have been forced to wait on trying while gathering medical records, scheduling doctor’s appointments, doing countless tests and questionable treatments (even though I did it I still find LIT pretty questionable in terms of efficacy).  So it is with this heavy, doubtful and bitter heart that I am starting this process.

I took of my meds to record where we are.  My first week I am on the Gonal-F, Menopure, Cipro, Dexamethasone, Metformin, Baby Aspirin and Pre natals.  I am expecting some pretty funky side effects.  Any tips on what to expect?

 

Can we keep our pants on please?

16 Feb

It is starting to feel real, like this is really going to happen.  We brought ourselves to the IVF doc for the first face-to-face appointment and I somehow mustered up a brave face (after days of complete despair and self-pity and “why me’s”).

It began with the financial consultation.  We went in knowing the costs for the most part, resigned that this is just where we are now, paying to get pregnant, no more freebies.  Sniff.  While she was listing off the services and prices I had to brace myself to not be overwhelmed.  This is the first really expensive procedure we’ve encountered during this journey.  I feel both lucky and unlucky about that.  It is what it is at this point.

Next came the first u/s follicle count with the Doctor.  The nurse repeated that this would be a transvaginal ultrasound with emphasis on vaginal.  After having a million of these things up in my business I forgot there was any other kind of ultrasound out there.  Her warning as if I was new to this brought me back memories of my first time… (dream sequence music here) Do you remember your first time?  I know it sounds kind of dirty when I say it that way.  I am almost nostalgic remembering  my first, back when I was like “you are putting that thing where??? ”  I’ve actually heard fertiles complain about it being one of the worst parts of pregnancy.   Ha!  I too naively thought it was a big deal, Ha, Ha, back when I was merely on pregnancy #1, so young and naive…  It’s amazing what things we get used to and accept as normal and no big deal along this journey!

Mr. Star and I eagerly waited in the exam room for the Dr. first excited and nervous and then bored, and then (at least for me) annoyed and impatient.  We waited for thirty minutes.  It’s not a big deal, esp. if you have a real chair and you get to keep your pants on.  Sorry, this is just a little pet peeve of mine that has been happening a lot lately.  Why do they ask you to disrobe so early?  I promise I can strip off my pants in 60 seconds if I get to keep them on while I wait, esp. if you need me to wait a bit longer.  Is it me, or is there no way to get comfortable being half naked and bleeding while sitting on an exam table for a long time.   Again, the things we tolerate.  What choice is there?

When the Dr. finally arrived he was really professional and calming which set the right tone.  When it came time to do the u/s we actually had some good news.  The follicle count was higher than average for my age.  He said I had Polycystic Ovaries, but not PCOS.  This sounded like good news at first, but then he was expressing concern that it may be a sign of other issues such as insulin response.  He prescribed Metformin to help manage this.  I started my first dose today (and had my first 500mg about twenty minutes ago).  So far so good, but apparently the side effects are pretty rough- nausea, vomiting, cramps and diarrhea.  I start with a low dose and work up in the hopes that I can learn to tolerate it.  I already feel a bit light headed and funky.  Damn, that was fast!  I also start the birth control pills today.  They gave me Reclipsen by Watson.  Not one I recognize, but what the hell.  It’s probably the most benign drug I’ll be taking during this experience so I can’t get all up and worried about it.

They left me with a long list of to-do’s, including scheduling another saline ultrasound.  I literally passed out during the last one from the pain.  Any suggestions on how to make it suck a little less?  So far my plan is to just beg for drugs to dull the pain and relax my nerves.

Back in the game

30 Jan

Thank you all so much for your support on my last post.  It just means the world to know that I am not the only one who feels alone in this.

After a cycle that was a complete bust (unclear if I ovulated at all, abnormal early bleeding) I am happy to report that my hope is renewed. We have a clean slate this cycle and a good start.  We got the clear to try again with Femara last week and we saw two big follicles on my right ovary on Saturday at our mid cycle checkup.  I know an OPK at home is really all you need, but there is something about actually seeing the follicles on the screen that just boosted my confidence.   After so many bad pregnancy ultrasounds these mid-cycle scans are the only ones I can honestly say I look forward to, proof that my body can do something right.  On a more optimistic side, I like to hope that if things work out I can have memories of my child before they were even conceived!

My RE said they looked ready to go any minute now, and sure enough the next morning my OPK gave me the double lines to confirm the surge.  I could even feel some aching down there in the ovary zone confirming something was definitely going on.  With three days in a row of trying, I’d say we’ve done all we can and now it is just up to time, fate and some higher power to decide if this month will grace us with a positive pee stick.  There is a lot of pressure on this cycle because we decided to move ahead with IVF for our next cycle.  I think it is the right way to go after four years of trying this naturally, but it’s a whole new ball game and not one I thought I’d  have to get into after having being able to conceive naturally five times already.  It’s not clear that we would have better odds with IVF to prevent miscarriage, but it would just (hopefully) speed up the rate at which I am getting pregnant.  Hopefully between the immunology treatments, the natural cycle and the IVF we’ll have a healthy normal pregnancy sometime soon and if we are really lucky it makes it out alive.  Two week wait here we come!

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Post Continued>

Thanks guys.  Just when I thought I had it all together I just got hit with another giddy pregnancy announcement at a group dinner.  Forcing a smile hurt as much as ever.  Do those announcements ever get any easier?