Six months

Well, it's been six months now since I started this blog. I was thinking I'd have some resolution to my infertility problems within six months. Unfortunately I underestimated the amount of time needed to sort things out.

We did get kicked out of the Attain program the other day. I wasn't surprised. It was all matter-of-fact when they called. The person I spoke with said they were discontinuing us because we didn't have a transfer.

Barring a miracle, it would seem that any child of mine is not going to be genetically linked to me. I've had almost two weeks to think about this, so I'm not all to pieces about it, but I am very sad. I always dreamed of having a little girl and naming her after me, my mom, my grandmother, and my great-grandmother. We all have the same first name and a different middle name. I go by my middle name and my mom goes by the first name. I guess I could name a little girl who's not genetically mine after four generations, but that seems like a stretch somehow.

Our options now are IVF with donor eggs and adoption. Both are extremely likely to result in a baby. I'm leaning toward adoption but my husband wants to take it slowly. I can understand that he doesn't want to give up the genetic link to his child. I am just tired, though. I've been feeling depressed and a little bit hopeless at moments. I am sick of doctors' appointments. I want to start running again. I don't know what to do. But I don't have to decide today, so that is the good thing. I just have to sit with this information and see if a course of action becomes apparent over the next several weeks.

Two strikes...

Today I learned that our second IVF attempt was unsuccessful. They did the egg retrieval yesterday and only got 3 eggs. I knew that wasn't good news and I wasn't surprised at all when the embryologist called this morning to let me know that none of them fertilized. This protocol my doc chose this time -- more agressive than the first attempt -- simply didn't work. We had good numbers of eggs but my estrogen and progesterone were all over the place. The E2 was only 600-something so it makes sense that we only got 3 eggs.

I don't understand why my eggs and his sperm just don't want to get together! We are crazy about each other, so what's the deal with our eggs and sperm?? Last time only 2 of 7 eggs fertilized.

I am really confused about what comes next. This cycle of treatment was really difficult -- lots of side effects to the meds I was on. Glucophage destroyed my appetite and gave me great aversions to foods I normally crave.

I am tempted to throw in the towel and get on with my life... But I'm afraid that one day I will regret not trying all 3 times. We have 3 times paid for with the Attain program we're on.

My life will be so different if we don't have children. I'll probably end up as an executive who spends too much time at work. The unknowns are actually greater with kids -- will I be a full-time stay at home mom? Will I work part-time? Will I find a way to balance working full-time and being a mom? Will I be able to keep advancing in my career and be a good mom?

When I put it like that, I prefer the unknown, with opportunities to have some variety in my life. Becoming an executive who spends too much time at work doesn't sound very appealing. Time will tell.

For now I will grieve the loss of this cycle.

Moving on after miscarriage

It's been a rough time for me lately. I did end up having a miscarriage, but no D and C. I sort of wish I had a D and C because I've been bleeding off and on for like 5 or 6 weeks. Every time I think it's done, I get surprised again.

My doctor is monitoring my HCG -- they have to make sure it goes back to zero. A week and a half ago it was 32. It is CREEPING down! I go back in three days for another check. Hopefully it will have hit zero by then.

I have had a wide range of emotions during this time. I had been so proud of my "even" approach to all of this. Well, that is out the window. I've felt sorry for myself, I've felt depressed, I've felt jealous of a friend and her husband who told us she was 10 weeks pregnant at the same moment we said, "Yes, it looks like the IVF worked." (She is still pregnant, and looking so. Grrr.) I've felt confused about whether this is all worth it, I've wondered if I really want to have a child, I've thought and thought and thought about how OLD my husband and I are. Maybe we should just choose to be childless and get on with our lives. I read something about making that choice -- to be childless -- on the Resolve web site.

At one point, not sure how to pray about all of this, I thought that this would be my prayer:

God, I'm going to do IVF. If it doesn't work, you are going to have to practically drop a baby into our house. This is what I'm doing. Anything else has to come from you.

I went to a seminar about relationships during infertility treatment and met some great women who are all struggling with the same thing. Turns out, most of them know each other through Resolve support groups in the area. I was encouraged by meeting all of them more than the content of the session.

The day of our last HCG check, a week and a half ago, we met with our doc for a consult. She is going to change the protocol for our next attempt. It's more aggressive. We have to wait for my period to start naturally. Who knows when that will be, since I'm still lightly bleeding from the m/c.

Last week, my god daughter, who is 10, came to stay with us for five nights. She was a volunteer with the children's summer camp at the organization where I work. I've known her since the day she was born. I was her first babysitter. I love this kid. She's the closest thing I've got to a child. Having her here helped me remember why we are doing this. I think we'd be great parents. We have a lot of love to give. Our lives would be enriched deeply by having a child in the mix. So we will see.

I am skipping church this morning because they are having a baby dedication AND it's Father's Day. My dad died four and a half years ago. I just didn't think church would be a good choice for me today. My husband is there but I didn't want to do it. I've been thinking a lot about my dad the past few days. He was a great dad. He spent lots of time with me and I know he loved me a lot. I am proud of the characteristics I inherited from him. It makes me feel connected to him when I sense that something within me was also in him. I miss him a lot. I love you, Dad! Happy Father's Day.

Rather Belated and Dramatic Update

I had planned to update my blog once a week or so, but I've definitely failed since the embryo transfer. Much has happened.

Three days after the transfer, I had severe pain when I woke up in the morning. I couldn't stand it so I called my doctor and they said to come into the office. I spent 1-2 hours there with a doctor who is a man of few words but a very kind person. After he pressed on my abdomen so much that I threw up on the floor (totally embarrassing -- they just weren't prepared for that, I guess), he did an ultrasound and consulted with my doctor, who was also in the office that day but tied up with other patients. They decided to send me to the ER, about a half mile away. Once there they gave me morphine and I had some relief from the pain. They thought that my ovary was twisting and cutting off the blood supply but when they sent me to radiology for ultrasounds to assess what was going on, everything was normal. (Other than the fact that my left ovary was the size of a grapefruit and normal is the size of an oyster.) They still admitted me. I was there for two nights because the pain reoccurred briefly the next day. I saw four doctors from my practice during that time, and it seemed everyone had a different theory about what might have happened. In addition to ovarian torsion, ovarian hyperstimulation and ruptured follicles were two other possibilities. All told, I missed four days of work because of this. (Not a good thing.) I kept my boss informed and on the day I missed an important meeting, I gave her permission to say that I had had an adverse reaction to some medication, which is a vague way to explain what truly happened. If I'd never taken the stimulation shots and meds, it never would've happened.

So I went back to work the next Monday, 9 days post transfer. My doctor wanted to see me for a follow up that Wednesday, so they scheduled the pregnancy test that day, too (one day earlier than it had previously been scheduled). I could not believe it, but it was POSITIVE!!!

However, there is a 35% chance of miscarriage for someone who's 38 years old. Based on the HCG level on 4/29, my doctor (who called me with the good news personally) said it's not likely to be twins, even though we transferred two embryos. I was only cautiously optimistic because of that 35% statistic and because the embryos were't the highest-quality embryos to begin with. I was also a little bit freaked out.

They want the HCG levels to double every 48 hours so they retested on 5/1 and it had more than doubled. Yahoo! That was last Friday. Over the weekend I began to really think about the reality of this. We told a few close friends and our moms.

They retested the HCG on Tuesday, so it should have doubled twice between Friday and Tuesday. Unfortunately, it had not, and the nurse who called to tell me this used the word "abnormal." She scheduled me to come back 48 hours later for another test, after which the PA called me and spoke in a "very concerned" voice. She said the embryo may not have the genetic capacity to survive. She also said they wanted me to come back today for another HCG and other labs that will help prep me for an injection that will dissolve the pregnancy without having to do a D and C. She also mentioned the possibility of an ectopic pregnancy. I asked if we can do an ultrasound to confirm there's nothing there before doing the injection and she said it is too early. I got a little testy at this moment and said, "Well I'm not taking that injection if I don't know for sure." We scheduled blood work for this morning along with a consult with one of the docs. My wonderful doc is on vacation this week!!

The doc we saw was great, though, and he answered all of my questions and my husband's questions. He scared me regarding the ectopic pregnancy possibility -- it's the leading cause of pregnancy-related death! He assured me we would do an ultrasound before we did the injection, so I was pleased that I didn't have to argue with him about that. SO this afternoon when we got the HCG report, it is increasing more now. After 24 hours, it has increased by half, which means it's on track to double by tomorrow! That's good news to me, but the PA is still very cautious and concerned. Meanwhile, around lunchtime today I had some really bad abdominal pains, my chest had a dull pain, my arms felt weird, my heart rate increased, and I just felt funny. Awful. My boss and my assistant ended up driving me home. That was embarrassing. But I just wasn't sure what was happening and I was pretty scared about hemorraging after the doctor's appointment this morning.

So now I'm going in the morning for yet another HCG and an ultrasound. I don't know if the u/s is for the pains or just because the HCG is doing better. I'm not sure. My husband and I actually heard different things this morning regarding a possible rise in HCG. I thought the doc said if the HCG rises today (and not astronomically) it's more likely to be an ectopic pregnancy. If it fell, it's more likely to be a regular old miscarriage. The doc said the incidence rate of an ectopic pregnancy after IVF is like 1%. I guess I may be very special. He also said he has seen numbers like this result in a healthy baby, but not often.

Emotionally, I kind of hit the wall Tuesday afternoon when the nurse used the word "abnormal." That was the first time I heard bad news and I pretty much fell apart. I left my office and went outside to sit in the fresh air for a bit and I called my best friend, who's had six miscarriages. I just wanted to leave work and go home and cry but she helped me decide to save the drama with my boss for another day (who knew it would be today?!). I am feeling kind of numb now. Before the levels increased nicely today, I'd pretty much resigned myself to the reality that Eenie isn't going to make it. That was an easier place to be, emotionally, than on the roller coaster of hope and reality. Several people are praying for us and at least one person has great confidence that Eenie will survive. This has sparked some interesting theological discussions between me and my husband. (We're both somewhat skeptical about such prayerful confidence -- I am especially that way.) His coworker's son, who is 11, prayed that the cells would grow so fast, it would be the fastest growing baby in the world. This was yesterday. Maybe Eenie's getting ready to take off, thanks to this little boy's prayer! Stranger things have happened.

That's enough for now. I'll try to do better about updating more frequently. Hope this is helping someone out there, if anyone is reading.

Meet Eenie and Meenie

Last Wednesday we had the egg retrieval and got seven mature eggs. I was sedated, so I didn't remember anything at all. After the retrieval, I spent the day at home sleeping. Thursday morning on the way to work, the embryologist called with a report. When he said, "unfortunately" my heart sank. Only two of the seven eggs fertilized. We had planned to name them "Eenie, Meenie, Miney, Moe" so this meant we just had Eenie and Meenie. When I told one of my coworkers, I started to cry, which told me that I was more upset than I realized. I didn't have time to think a lot about it at work though, so I emailed my mom to let her know and dove into work. Mom's reply -- that Eenie and Meenie are survivors -- was encouraging.

That night I reread the paperwork I had signed weeks ago -- a 17-page document that explained the process. You know, you read the stuff ahead of time but until you're living it, it just doesn't all sink in. I read all of the things that could happen to make an IVF cycle unsuccessful and I also did some reading online. There's a clinic in Chicago with lots of good info online. Their site is www.advancedfertility.com. This reading was all a good reality check. As a result, I was prepared for a call Saturday morning that said not to come in because Eenie and Meenie didn't make it.

I went to the acupuncturist at 8 on Saturday and when I told her I was half-way expecting that call, I could tell she was disappointed with my attitude. She emphatically said that although people think this is hocus-pocus there are studies that show that our energy effects everything going on out there. I thought, "Oh great. So if Eenie and Meenie die, I killed them." Of course I didn't say this to her. I assured her that I'm hopeful as well as aware of the possibilities.

But you know what? The call didn't come!

After my acupuncture treatment I ran home to start drinking 64 oz. of water -- you have to have a full bladder for the transfer -- and to take 4 Advil and one Zanax as prescribed by my doctor. We arrived at the clinic for our 10:15 transfer at 9:45. I was excited but still bracing for the moment of truth when we learned whether it would be Eenie and Meenie or just Eenie. After changing into a gown (and my husband changed into scrubs so he could be in the OR with me) they did a quick ultrasound to see if my bladder was full... It was NOT! So the nurse asked me to keep drinking.

A few minutes later I was ready so we met the embryologist, who gave us a photo of E & M. She explained that they grade the embryos on a scale of 1 to 4. One is excellent and 4 is not good. Both E & M were 3s. She called them average. (Of course I thought, "No embryo of mine is average!!") She said they are both eight cells, which is exactly what they want to see on day 3 (day 3 after retrieval) but they have some fragmentation, which could make it difficult for them to implant.

We watched on the monitor as the doctor inserted the catheter into my uterus and injected E & M in there, too. He pointed out the little white dot on the screen, which was E & M, and then he circled it and printed it out. He said the placement was excellent.

They said -- and things I read on that web site noted above also said -- that they are perfectly viable embryos, even though they are fragmented. So the likelihood is less than if they were not fragmented at all, but the doctor said a twin pregnancy is a possibility.

I went back to the acupuncturist for a second treatment after the transfer and by that time, the Zanax had REALLY kicked in. I was feeling it in my head. My husband took me home afterwards and I laid on the couch the rest of the day. Today I got up and went to church and then to the local museum (for a quick 30-minute jaunt through a famous exhibit that was closing today). After that I had planned to run some errands but was feeling tired. I had a big nap on the couch and have pretty much been laying around since then. I didn't want to overdo it, so I figured since it's the weekend, I may as well take advantage and do all I can to rest up.

I've felt an odd "tightness" in my uterus today. Not exactly cramping. Almost like someone has a string tied to my insides and is pulling it together. It is way too early for any sort of symptoms so I'm thinking this is just an after-effect of something I've subjected my poor body to in recent weeks -- high-powered drugs, a needle through my vagina that sucks the eggs out of my follicles, two acupuncture treatments in one day, the transfer.... Who knows?

I am on progesterone and estrogen and have to occupy myself until next Thursday, April 30, for the results. I'm feeling fairly patient at the moment. I'm just really glad I got to see this cycle through to the end. I was going to be upset if it was cancelled because I would've felt like we didn't get a full shot this go 'round. We're on one of those financing programs where you get three tries (more if you have eggs to freeze) so I want to make the most of each attempt.

I should be able to keep myself pretty busy with work, so hopefully I won't get too emotionally erratic during the next 11 days. Will keep you posted!

Seven days of stimulation shots and counting . . .

On Friday, my doctor said, "I don't think you're going to need 12 days of meds." She saw 7 follicles on one ovary and 2-3 on the other. She seemed pleased, but I'm not sure if she's just one of those people who's always positive and encouraging. Not that I think she'd mislead me into thinking things were good if they weren't. My next ultrasound and bloodwork is tomorrow morning -- Easter Sunday morning. There's a chance they'll trigger me Monday, which means the retrieval would be Tuesday. But I think it will go one more day, at least. I will know more tomorrow.

I am also doing acupuncture. I went this morning. She told me that the day of the transfer, a lot of women -- in an effort to do everything they can -- go for two treatmeants. One before and one after the transfer. Who knows if that makes a difference or not? It would be an extra $270, I know that.

I am trying to stay calm but I feel my anxiety level rising at moments. Work is super-busy right now. I think I'll be glad about that after the transfer when I need to keep myself busy. This next week, I'll just be trying to stay calm.

Stim shots and such

The big box containing $4,000 worth of medication arrived late last week. I started twice a day shots of Lupron on Sunday along with a five day prescription of Letrozole, which I had with each of my five IUIs. I'm also on Dexamethasone every day until retrieval. Then Tuesday I added a shot of 375 units of Follistim, administered with a pen that you dial to get the correct dosage and a shot of one vial of Menopur, which you have to reconstitute before it's ready to inject. Thank goodness for the educational CD that shows you exactly what to do. I'd be lost without it. So that's four shots and two pills a day right now.

So far, no real reactions to the meds, which is good. I'm trying to sleep 7.5 to 8 hours a night, which is wonderful. That doesn't happen that often for me.

I'm excited about the next few weeks, to see what we'll learn. And the possibility seems so real, I can't help but be excited about it. I'm trying to temper those feelings with occasional reality checks... IVF isn't a success on the first try for many people. I've looked at the calendar to speculate when the retrieval and transfer might be and then I've looked ahead 2 weeks. Seems like I'll know if it worked in early May.

I actually asked two of my best friends with small children if either one of them had any baby clothes. It was kind of surreal because that was a first. I've been waiting off and on for like 12 years to get a positive pregnancy test, but I've never seriously thought about hand-me-down clothes from my friends' kids. (I wasn't trying to conceive for 12 years. Not at all. It was off and on -- mostly off -- during my first marriage and then for the past two years.)

It is nice to feel hopeful.

No, I haven't abandoned this blog

If there's anyone out there reading this, I'll give a quick update along with a promise for more posts soon. I start the stimulation shots in six days, so I'll be writing about that soon.

Last week I had an hysteroscopy and what they call the "trial transfer" -- two tests that must be done between days six and 12. I almost missed them because I showed up at the wrong location of my doctor's practice (they have at least four locations and I typically go to two of them, depending on the procedure, timing, convenience, doctor's availability, etc.). I just flat missed the message about which office to go to. I walked in upset about being 7 minutes late and then I got REALLY stressed when I realized the test might not be possible because my doctor was going into surgery and there wasn't time to drive to the office where she was. Luckily another doctor -- albeit one I'd never met -- was willing to fit me into his schdule at the location where I was. Everyone there was so nice, understanding, and accomodating. I was a bundle of apologies and full of gratitude for their flexibility because that was the last day for me to get those tests done during the 6 to 12 day window -- I was leaving town for a conference that night.

Tests were somewhat painful, caused a few days' worth of light bleeding, but overall, went okay. The hysteroscopy actually involves inserting a camera inside my uterus -- I got to see color images of my insides... Fascinating! Doctor said it was more pink than he would've expected so he prescribed 10 days of doxycycline, an antibiotic, to clear up any inflammation or infection. I asked him what that really means -- what is the impact of the pink inflammation -- and he said it could indicate that embryos won't attach. I immediately thought, "Is this why I've never been pregnant?"

I didn't have much time to worry about it because I left town that evening and four days later, am still at my conference. Two more days to go at this meeting and then I go home Wednesday evening. My $4,000 order of meds should arrive Thursday and I start doing 4 injections per day on Sunday....

More later!

A Serendipitous Meeting

This morning -- out of the blue -- I met someone who just last week found out she's pregnant after her first IVF cycle. We were both volunteering at a 10K, cheering runners at the finish line, so there was plenty of time to talk. She was so upbeat, positive, and eager to encourage me. It was interesting to talk with her because her excitement made me a bit nervous and I sensed that my lack of enthusiasm was disappointing to her. I wasn't openly negative, but I'm trying to be realistic about IVF and the chance that it will work. I sensed that she wanted me to be really excited but I just couldn't go there. My clinic's pregnancy rate for 38 to 40 year-olds was nearly 41% in 2008... Oh, I get it now. I just looked up the pregnancy rate for women below 35 for my clinic and it is nearly 67%. No wonder she was excited. She is 31, I think. She goes to another clinic in town but they probably have comparable success rates.

The good thing is, I didn't feel jealous of her. I actually felt nervous, like, ohh, it's still early. I hope it takes. Miscarriage isn't uncommon. But she was so sweet, she got my email address and already sent me a note so we can keep in touch.

Having a support system is crucial. It's so great when women encourage each other rather than criticize. It's nice when you meet a perfect stranger and you have an instant connection. I'm grateful for those experiences.

Yesterday's post

Well, I reread what I wrote yesterday. What a whiner I sounded like! I was right about going to church. It made me feel better, as did getting in front of my Outlook calendar at work today, synching it with my Blackberry, and feeling more in control of all that's going on.

I got my hair cut and colored tonight and that always makes me feel good, too. I just remembered something the IVF counselor said. She talked about incorporating extra "quality of life" activities during the stressful days of IVF. Getting my hair done falls into that category.

Tomorrow is FRIDAY!

I love roller coasters!

Let the ride begin. Yesterday I was so calm and matter of fact about everything. Today, not so much. Yet it has more to do with the rest of my life combined with the fact that I'm about to start IVF than IVF alone. There's a lot going on right now at work and at home and in a couple of my volunteer commitments.

What stresses me out is time away from work. I think I have a work ethic that is well, a bit insane. I have been in my current job for more than six years and have a good relationship with my boss. I have a staff of six people who work with me ,so my being away from the office can impact them if they need me for something. My boss knows what I'm dealing with and is wonderfully understanding about my being out of the office for doctors appointments. A couple of my team members know what's going on, but the others do not, and I'd like to keep it that way. So I say all of that in preparation for my admission that there's really no reason to stress about time away from the office. It's irrational.

So here I am, looking at my calendar trying to figure out when my cycle will start (March 19 or 20 is my estimate) and what all has to happen before I leave town for a conference on March 26: start taking birth control pills for about 12 days, have an intrauterine cavity test and a "trial transfer," as well as a teaching session with the nurse. I also think I have to make sure meds are ordered so I can start injections the day after I get back into town. Or I may have to start them the last day I'm out of town, which would mean they'd have to be delivered before I leave on the 26th. I told the nurse and the doctor about this trip and both agreed that it would not get in the way of starting IVF at this time. I hope they are right about that because I'll be frustrated to have to wait another month.

On top of that, my kitchen is being remodeled and for the next eight days I have no sink, gas cooktop, or countertops. This project started in December but we had some delays and now I'm eager to get this project finished, which means more time away from the office; in other words, more stress. We went today to lay the template of the countertops over the granite slab that we picked. It's going to be FABULOUS! But not until next Thursday when I have to work from home again, possibly all day long, for the installation. And next Friday they are coming to tile the backsplash, reconnect the sink and cooktop, etc. And all of this should fall on Day One and Two!

Okay, I'm going to stop whining. Everything will be okay. I'm going to a Lenten service at church in a little while and that should restore my perspective and give me peace.

IVF, here we come

After five failed IUIs (intrauterine inseminations), we're turning to IVF. Interesting timing, considering all the news about the Octomom and the my state legislature's consideration of a bill that would essentially put fertility clinics out of business in this state. I was hoping my instincts were right -- that the bill doesn't stand a chance of passing -- and after the hearing last week, it sounds like they were.

We had a detailed consult with our doctor, who is GREAT, a week and a half ago. Then yesterday we had the required meeting with the counselor on staff at the practice. It went fine. No tears, although she made the box of Kleenex readily available to me before we got started. My husband and I looked at each other and laughed.

But our meeting with the counselor turned into a good conversation. As I was talking about my outlook on the situation I explained that I've had a lot of grief in my life already, so I wouldn't say that I've grieved every month when we learned that yet another IUI had failed. You see, I'm not one to stockpile home pregnancy tests in anticipation of the end of the month. I actually never tested at home for any of my IUIs. I've seen friends do that and make themselves crazy over the results. I'd rather wait for something definitive like a blood test and focus on something else until it's time. I'm sharing all of this to help explain that I'm somewhat distanced emotionally from what's going on. I sound as cool as Obama, don't I?

It's really not that easy. I have my moments. But for the most part, I'm feeling okay about all of this. It's either going to happen or it's not, right? If it doesn't, I'll figure that out when the time comes.

So back to what I was saying. As I was talking to the counselor and explaining my "grief history," I told her that it would be pretty easy for me to look at all of this and decide that life is hopeless, but that I choose not to do that. I'd never thought about that so when I said it, it felt profound for me personally -- that hope is my choice. I am grateful to have made that choice.