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Lucky Number Seven

30 Sep

We got good news today!  I tested positive yet again.  This time I skipped the POAS and just went straight to the blood test which showed my hcg has a strong start with a count of 508.   What a welcome phone call that was!   I am trying to contain myself.  I know the odds were against us as we only implanted one, so I am counting myself very very lucky.

We still have a long climb ahead of us, but for now I am just that our little “perfectly chromosomally normal” embryo is happily growing along.  I can’t believe it made it all the way to implantation after all the poking and freezing and thawing it’s been through.  So grateful, so hopeful.  This time little one, I believe in you.  :  )

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.

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.

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.

Pregnancy #6?

13 Feb

This morning I got an unequivical no.  I am crestfallen after trying for a third month.  I knew my luck on getting pregnant naturally (with Femara) wouldn’t last forever.  We are officially throwing in the towel on trying naturally again and moving to Plan B (IVF).  It’s a big step and one I never wanted to take and naively thought I wouldn’t have to given how “lucky” I was to get pregnant quickly before.  It’s  hard tear-filled morning.  Is there any light at the end of this tunnel, seriously?

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?

Alone in Happy Land

24 Jan

We just came back from a weekend away from friends at Lake Tahoe.  It was both wonderful and really hard.  As the only couple without kids I struggled as they joyfully introduced their kids to snow and happily snapped photos of them in their extremely cute snow suits.  Meanwhile none of them know what we are going through for the past four years trying to start a family.  Since they’ve had kids we’ve kind of moved apart and stopped talking about real problems.  While it is great that they want to be so positive all the time and their lives seem to be zipping along nicely, it makes me feel completely isolated.  My choice is to paste on the smile and join the happiness or be alone.  It seems clear that if/when our story ever changes that they would be supportive and happy for us, but when it comes to pain and grief, we are expected to just deal with that on our own.  At this time I feel like I need supportive friends more than ever, and instead I find myself feeling bitter that I have to bottle myself up until I have good news.  Anyone relate?

Note- We are crossing our fingers again this month after 2 negative cycles.  Hoping this month (our last month of trying naturally) finally leads to a BFP!