Six Months (At A Time)

I selected the wrong name for this blog last spring. We had been accepted into the Attain program, which gave us up to three fresh and three frozen IVF cycles for the price of about two cycles. I actually thought that I could do three fresh cycles in six months. (I didn't anticipate the opportunity to do a frozen cycle because my doc said it was unlikely.) After two unsuccessful cycles in five or six months -- the second of which was a complete train wreck -- Attain kicked us out of the program and refunded us 70 percent of the money. Financially, we came out ahead of where we would have been if we paid for both cycles outright. Emotionally, I was feeling pretty defeated. I had been counting on that third and final attempt.

After the failure in August, my doctor in Atlanta suggested we consider egg donation, adoption, or a second opinion. I was ready for adoption. My husband was ready for egg donation. So we went for a second opinion.

In Colorado. She sent us to the best in the country -- the Colorado Center for Reproductive Medicine and Dr. William Schoolcraft.

I approached the second opinion with Dr. S. matter of factly, in order to protect myself from further disappointment. I really wasn't open-minded about the possibility of treatment at CCRM because I couldn't imagine that they could offer anything I hadn't gotten in Atlanta. I just wanted him to tell us that our Atlanta doc was right so we could move forward and try to sort out the adoption vs. egg donation dilemma. Well I was wrong. Schoolcraft seems to have a quiet "bring it on" kind of attitude about our case. He thinks he can help us. After a phone consult, a whirlwind trip to Denver for a one-day workup (we were literally in Denver for about 16 hours!), and a follow up phone consult, we decided to try one more IVF cycle.

I'd like to summarize how I came to that decision in another post -- I'll do an Atlanta vs. Denver Infertility Smackdown -- because if anyone from Atlanta ever reads this blog, what I have to say might be interesting reading.

So here we go again. I should start stims in five days if all goes well at my appointment on Monday.

Back to the blog name change. Six Months (At A Time) feels right to me. I thought of other names like "Babytrain to Crazytown" or something like "Womb Available" or "Race to the Womb"... But this name will remind me to live in the present and not get too far ahead of things. There are many ways that my thoughts don't take things Six Months At A Time. Sometimes I dwell all too much on how old we'll both be when our unconceived child graduates from high school or how old the child may be when we die, because no child should lose a parent too soon. I lost my dad when I was 33 and that was way too soon for me.

I like the idea of imposing a six-month limit on my musings about the future. If this were truly possible, I would not dream about next Christmas and whether I'll be enormously pregnant and unable to travel to see our families. I would not think about my colleague who has confided that she is also TTC and I would not worry about which of us is going to succeed first and how we would work out our possibly overlapping maternity leaves (my boss would absolutely freak out about that one).  At this point, I would not worry about the possibility of a late-term miscarriage or multiples that weigh just a couple of pounds apiece.

All of these things are part of the grand reality check of trying to conceive a baby through IVF at age 39 with a soon-to-be 50 husband, but they aren't things I should ponder frequently or seriously.

Here's to Six Months (At A Time)!

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.

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.