On being hopeful

Hope is such a mysterious and sometimes elusive thing. Friday night I googled something about FET and one of the top FET links that came up was something from the blog of another CCRM patient. I clicked over there and was absolutely drawn in by her storytelling abilities. And she was so positive! Her FET was last October and it worked. It was her last chance and she transferred her very last embryo. And it worked! The great thing is, she was so, so hopeful and positive beforehand. She wasn't disappointed when she learned the outcome. Was her joy at the good news even more full because she'd already been in a positive place?

I thought about her positive energy several times yesterday, wishing I could be so positive. I don't know if I just don't have it in me at all or if I can't let myself go there because I've had too many disappointments to grieve over already (dad's brain injury and death 9 years later being the chief disappointment -- that absolutely changed my outlook on so many things, including my faith and my beliefs about how God works in our lives, answers prayers, etc.). I worked really, really hard after dad died to reclaim a positive and hopeful outlook on life. When I met my wonderful, sweet, funny husband and became part of his very cool family, hope was restored in a big way. Although my dad and four grandparents died within the span of 11 years and my own family was reduced to just a few special people, I was given a new family and learned that there's always an opportunity for renewal, one way or another.

But I still find it difficult to be super-positive and upbeat about the FET results that will be known on May 1.  My hope is laced with caution.

Perhaps I could decide now that it will be more fun to be hopeful and positive. I'll just throw my caution to the wind. The journey of the next few weeks would be much more fun and light-hearted, but if it doesn't work, will the disappointment be greater?

Summer plans

I think my good news from a week ago has finally found a place to settle in my heart and mind. Last night over dinner with one of our best friends, in reference to what I'm going to be doing when my husband is out of the country the second week in June, I said, "I don't know what I'm going to do yet, because I'm going to be pregnant." It just rolled off my tongue so easily! If we transfer two embryos and each has about a 70% chance of making it, I just know it's got to work. Obviously, it may not, but work with me here. I sound hopeful for once! Let's just enjoy this, okay?

In other news, I am leading the charge on finally getting started on a major backyard renovaton project we've been dreaming about for a few years now. Because Atlanta had a 500-year rain last September, all hell has broken loose in our sloped backyard. It is a huge mess involving our deck, which is literally about to fall off the side of our house, and a retaining wall at the bottom of the slope, which is right next to our pool, into which mud could slide any day now. Do we have the cash for this project? Of course not. But we have to do parts of it because the water is only going to cause more and more damage to our property. And mud in the pool could be a real disaster.

So just to keep myself motivated on this project, I invited all of my husband's immediate family (9 people) to come to Atlanta for Memorial Day weekend. It is DH's birthday and he is turning 50! I'm planning to totally surprise him with a party -- a backyard party. He loves his family and so do I, so I hope it all works out. He's not an extrovert, so as I was thinking of what he would like to do for his big milestone birthday, and I thought he'd be thrilled to have his siblings, their spouses, a much beloved niece and nephew, and dear mother show up to celebrate. I can't wait. I'm secretly telling the contractors about this celebration, but in DH's presence, I keep saying, "This has to be done by Memorial Day Weekend. I must float in my pool when summer kicks off!!" He hasn't questioned my insistence because he loves to float in the pool more than I do.

Nothing much more to report. In IF-land, I'm waiting for AF to arrive next week so I can get started on this FET-prep protocol. My drug-free weeks are about to be over.

Enjoy the weekend, everyone!

Six on Day Six

And then there were six.

The lab called today to report that yesterday (day 5) they biopsied and vitrified four of our embryos and then today (day six), there were two more to biopsy and vitrify. When she said "four" my heart sank, but when she told me about the two today, I felt better. I was a little bit disappointed because I was sort of hoping for another astounding report (I imagined perhaps 7 to 10 making it to blast), but when I really thought about what we have achieved, six is wonderful.

Again I asked for the details and she told me the grades: 3AA, 4AB, 5AA, 5AA, and two "two-thirds." Has anyone heard of this "two-thirds" grade? She explained it and then I asked her to explain it again. She said they are early blastocysts and they can almost tell where the intracellular mass (cells that become the baby) will be, but not enough to give them a real grade. However, they are good enough to make it to the next round. The very nice lab lady said that anything higher than a BB is considered a good embryo.

I asked about the ones that didn't make the cut and she said there were two ones, two that looked the way they should look on day four (so they were a few days behind) (there was a name for that but I can't figure out what it was -- I googled it and still couldn't get it -- it started with an M and sounded like oreo), and 3 arrested.

I also asked if she thought this was good overall, considering we started with 17 eggs. She said it is about what they would expect. I was sooo glad she didn't end that statement with "for someone of your age." That was so nice. Does anyone else cringe inside when you sense that phrase coming?

So if this were American Idol, my entire reserve of eggs stood in line for days to audition in front of Simon, Randy and Cara; 17 eggs got the chance to actually sing for them; 14 made it to Hollywood; and now six have made it into the finals.

Too much TV, you think?

Too much time off work! I pretty happily went back today, even if it was a 10-hour day.  (And yes, I was very happy to come home and watch the first AI episode featuring Ellen D.)

So I feel good about where we are. I don't have any anxiety about waiting six weeks for genetic test results and I sincerely told two people today that if zero come back normal, I will not regret doing this. I am so happy that we went to Denver. I feel like we have done everything we could possibly do to conceive a child. If this fails, I think it will be a sign that it is time to move on to another approach to building our family.

I just realized that in the past two paragraphs, I've used the word "happy" (or some variation thereof) three times. Yes, I feel happy. I am happy that our biggest hurdle to IVF success (making eggs and thus, embryos) has been jumped. The only two embryos we made before were below average on day three. Until now, I'd never made a blast and I'm pretty happy that I made six with pretty good grades! I'm happy that the stimulation phase is over and I probably don't ever have to do that again. Our plan, since we don't have insurance for this, was always to try three times and then move on. If it doesn't happen in three attempts, maybe it's not supposed to happen this way.

In addition to happy, I also feel relieved. I have been hopefully anticipating the possibility of pregnancy and parenthood off and on for.... well... almost 17 years. That's a long time to wish for something intermittently and to have almost no indication of whether your hopes will ever come to fruition. I am happy because I know that one way or another, this not knowing about something so important will be over before too much longer. (I was married before, at age 22, for 11 years. We tried off and on with no success during that time. Never sought help for the issue because I wasn't convinced I wanted kids with him. Soooo glad that didn't happen!)

So. Final "happy" count in this post: Eleven

That's a lot of happy. (Twelve!)

Grateful, Enchanted, and Hopeful

Thanks so much to everyone who commented on my last post -- and a huge thanks to Mel for mentioning me in her 172nd Friday Roundup. I feel like I'm really part of the blogosphere now. Thank you all for your kind, encouraging words.

*******

I started my meds this week. Bought most of them at a local specialty pharmacy in the ATL, except for the Lupron -- which CCRM insisted I get from a pharmacy in Denver because they mix it differently -- and the Saizen, which the local people didn't carry. I'm pretty excited about taking Saizen because I hope it will make me taller! (Kidding. Sort of. I do want to be taller but I realize that's probably not going to happen in six .33 cc doses. Unfortunately.)

The time difference between Atlanta and Denver is on my side  -- CCRM has nurses on call from 4 pm to 10 pm, which for me is 6 pm to 12 am. Good thing since I had a work event Thursday night and although I thought I had figured out how to dilute the Saizen the night before, at 11:30 pm on Thursday, I knew I didn't have it right. I called CCRM and talked to a very friendly nurse who straightened me out. Then last night when I was prepping to do the Menopur this morning, I had another question, so I called again. And again, so friendly. So helpful. They are great.

I must admit, I'm pretty enchanted with CCRM right now. I grudgingly went out there for my one day work-up, pretty annoyed that they wanted to repeat tests I'd already had done in Atlanta. But as I observed how they do things and as I have dealt with them over the phone and through email for the past two months, I am very impressed. I feel like I'm giving this my best shot by going to CCRM. If this cycle doesn't work, I don't know what I'll want to do. Mentally, this is the end of the ART road for me. But emotionally, I don't know if I'll be ready to stop and choose adoption or not. I was at that point before when my Atlanta doc sent me to Denver. I think that's part of the enchantment. I was hopeless before we decided to talk to Dr. S. I was grieving the loss of the possibility of having a genetic connection to my child. Even as we went to Denver for the one-day, I really didn't think Dr. S. was going to be able to help us. But now I am spellbound by the magic of the wizard and his lab.

Doing injections again is kind of bittersweet. I feel hopeful but want to balance that feeling with reality: this might not work. The key for me is getting enough eggs. First IVF, we got 7 eggs and only 2 fertilized. Second IVF, we got 3 eggs and 0 fertilized. Dr. S. has said we should have gotten more eggs because I had 17 resting follicles the day of our one-day workup in November. He said with 17 resting, we should get into the double digits upon retrieval. I am crossing my fingers.

We are heading out to Denver after work on Wednesday. DH is currently second-guessing our hotel selection, obsessing over all the options. I really liked the hotel where we stayed for the one-day workup, so that's where we have a reservation. I think we'll stick with it. DH is coming with me the whole 2 weeks because his work allows him to work from anywhere. I'm grateful for that because my birthday is Friday and I really would hate to spend it alone.

I wish so much that I could take a day and go skiing while we're there but I'm just not willing to take the chance on something going wrong and needing to be airlifted to Denver or something crazy like that. After my first IVF attempt, about five days after transfer, I landed in the hospital for two days because I had severe pain. (See my post "Rather Belated and Dramatic Update" from May 2009).

If anyone has suggestions of day trips, museums, bookstores, restaurants or anything cool and entertaining in Colorado, please share!

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.

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.

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.