Tuesday, June 24, 2008

Anti-Ovarian Antibodies and me

So, the doctor confirmed it.

This is likely the cause for my elevated FSH levels, my low AMH, my dwindling AFC ... and ultimately the impending early menopause. It comes as little surprise given that my mother experienced sudden-onset early menopause at age 36. But still it was no less enjoyable to hear the words from my doctor, they go like this:


"Hi Polly, it's Dr. Brockenborings, are you in a place where you can talk?"

for those of you that don't know ... when a doctor takes the time to call your cell phone (rather than sending an email or letting one of his clinical staff reach out) it can't be good ... when he asks you to get some privacy ... he's expecting an emotional breakdown.

"Your Anti-Ovarian Antibodies test results are back and they are positive; the levels are quite severe."

translation? I have antigens in my body that are attacking my ovaries. My body is destroying itself, the reproductive part of myself.

"Women who test positive for this are at an increased risk for developing premature ovarian failure"

AKA: what my mom had, what all my hormone level tests have been pointing to for months, the failure of womanhood, my disappointment with myself as a wife, ... the bane of my existence.

"There is no treatment for this"

Why don't cha just kick a girl while she's down? Now you all see why I had a minor freak out about a year ago when I learned that I had elevated FSH and what that meant. It means that I'm on the road to hot flashes, night sweats, and weight gain ... and I'm on the express train!


In our phone conversation, he did indicate that they like to treat the patient rather than the test results - so I guess until my body confirms that I'm in menopause, we are going to keep treating me like I'm not ... that is, except for the highly aggressive fertility treatments ;-) But it looks like hormone replacement therapy will be a topic for my thirties, rather than my fifties. I'll be battling the risks of osteoporosis and heart failure with more vigor than my virile reproductive age counterparts. And the obvious, baby making ... it's now or never.

My endocrinologist told me to schedule a follow-up appointment to discuss this. I guess when you have one autoimmune disease (which I already do, I have Hashimoto's Hypothyroidism) my doctor indicated that you're more prone to developing other autoimmune disorders. So I need to know what to look out for.

I knew this was going to happen. It really didn't surprise me at all. I gotta wonder why I couldn't keep it together for the rest of the afternoon at work? All the signs were pointing in this direction, I guess I was just in denial, hoping that maybe the blood tests (all 4 of them) were just coincidentally off base. I guess not.

Saturday, June 21, 2008

Happy first blogoversary ... to the cynic

Can anyone guess what my blogoversary wish is?

... try again.

It's funny, I'm such a cynic. Each year on my birthday, before I blow out the birthday candles on the birthday cake (fruitbasket style, most years) I of course get goaded to 'make a wish!' ... so I gently close my eyes and pause for a moment, as a smart alec grin crosses over my face, and then I tilt my body forward to blow out the (growing) candle forest. As the smoke clears I look around the table, with many familiar and loving faces looking back at me with contentment, as if I've satisfactorily performed the annual birthday wish ritual.

... little do they know.

Once everyone leaves my husband inevitably (and I'm not kidding you, EVERY year!) ends up asking me (and generally it happens while we're cleaning up the house or washing dishes from the party guests ... you know the scene) ever so innocently ... "so honey, what did you wish for this year?"

Let me tell you, faithful reader, he's asking because he knows it's the same thing I wish for every year. He knows who he married ...

"Please tell me you didn't wish for a vacuum cleaner again!" he growns.

But every year I disappoint. Every year I wish for a vacuum cleaner.

Why do I do this? Because I'm a cynic. I'm a cynic with a short list and here it is ... I think these are the reasons why I don't play along like a good girl:

  • Wishing and thus daydreaming are for the foolish. And in case you didn't know this about me already ... I am the captain of Team Practical.
  • Maybe it's because I've had so many unanswered wishes (but haven't we all? what makes me so rotten over it?)
  • Honestly, I think it's just a means of protecting myself. Heck, I can't get hurt if I don't lay myself out vulnerably, now can I?
What ever the reason ... I'm almost ashamed to admit that I do something so silly.

Well, without further ado ...

(come on, you knew this was coming!)

Happy blogoversary to me,
happy blogoversary to me,
happy blogoversary dear cynic,
happy blogoversary to me!!

Allow me to celebrate my one year blogoversary! ... Now please excuse me, I'm going to go check my hall way closet ... going to see if I find anything interesting in there.

Monday, June 16, 2008

Marinating in wait

I thought I was a pretty patient person. It took me 9 years to gradate from college ... with my bachelor's degree. The extraordinarily long Saturday afternoon checkout lines at Costco don't get under my skin. I once spent six hours taking public transit to get to and from a Sunday morning church service (and church is nearby and the sermon was short!) When I'm teaching somebody something, I actually enjoy the awkward silence that comes as I watch the wheels of understanding crank in their head. For many things in life, my patience allows me to enjoy the new found spare-time that surfaces in those drawn out experiences ... not so with infertility.

When you have lost four babies and many months out of the year represent: one of your pregnancies, one of your losses, or one of your estimated due dates ... you don't want to experience another minute of being without the child, the children, that you and your husband so desperately want. It is very painful to experience those sad milestones with only grief in your heart.

For those of you that don't know: infertility = waiting, and it's so hard.

I get desperate and angry ... and really, I'm obsessive. I don't do patience well in infertility. I want to will a baby into my life. Maybe I can accidentally forget one of the cycle-prep birth control pills that I'm taking so that I can just get pregnant now. I get fuming and stubborn with Berilac when he refuses to comply with my suggestion of changing our fertility plans 180 degrees just because I read an article one day that advertised the latest and greatest way to have a baby. I spend time calculating things like 'if my cycle unfolds like this, and I get pregnant on this day, then I'll be due on this day' (Yes, I have it mapped out to the day).

All of this fussing around is getting me nowhere. I'm making no progress. There's nothing I can do to make the forty-some-odd days fly by faster, until my next egg retrieval.

Romans 8:24-28 says:
For in this hope we were saved. But hope that is seen is no hope at all. Who hopes for what he already has? But if we hope for what we do not yet have, we wait for it patiently. In the same way, the Spirit helps us in our weakness. We do not know what we ought to pray for, but the Spirit himself intercedes for us with groans that words cannot express. And he who searches our hearts knows the mind of the Spirit, because the Spirit intercedes for the saints in accordance with God's will. And we know that in all things God works for the good of those who love him, who have been called according to his purpose.
This struggle is full of waiting. Romans 8:25 says it best: But if we hope for what we do not yet have, we wait for it patiently.

So here I am waiting. What else can I do? I can't change that. So how can I approach it differently? Am I really going to choose to struggle and suffer more. (And boy, I'd like to - I'm extra good at moping.) But I really believe that God has something better for me in this time. Instead of thinking: "I can't stand sitting around doing nothing while I wait for this next cycle to come - I'm going to strangle somebody," I'm trying to replace that thought with: "Each day that I wait, I am one day closer to meeting the child or children that will one day be in my life." So although I feel like I'm acres away from making progress on the IVF front, regardless, I'm getting closer and closer to our blessing(s!)

While I wait, I'm trying to reconcile this with God. Not exactly a "why me?" scenario, but more of a "what are You doing??" Sometimes I'm angry at God, sometimes I feel like I pray with no response, and sometimes I have no idea how to even start a prayer. I can't even bring myself to put the words together, Romans 8:26b says: We do not know what we ought to pray for, but the Spirit himself intercedes for us with groans that words cannot express. How many times have I found myself curled up into a ball, sobbing ... like the silent sob - the one where your hubby can't hear you when he's laying right next to you, but your body can't not convulse ... that's serious crying. So I'm going to be real while I wait.

And I'm going to be hopeful and I'm going to cling to His promise from Romans 8:28: And we know that in all things God works for the good of those who love him, who have been called according to his purpose. While I'm marinating in all of this, I'm not going to try to lie to myself. This might not end for us in a child of our own. When this passage is talking about God working together for the good for those who love Him, He's not saying that those who love Him will get their very own biological child. And that's a hard pill to swallow. So I'll work it down my throat, while I'm waiting.

Marinating in wait: patiently, honestly, and without fooling myself.

Sunday, June 15, 2008

For nothing is impossible with God.

"For nothing is impossible with God" ... this is a scripture verse from the Bible.

When I think about this verse I think - well yeah, God can easily save people, allow people to part waters, speak when they cannot, heal the blind, etc. But what I'm dealing with is more clinical than that. (read: bigger than God ... frightening that I even have that thought!)

I know my discouragement is not warranted, but I didn't know how inappropriate it was.

You see "For nothing is impossible with God" is found in Luke 1:37 ... what could this verse be referring to? Again, I'm thinking salvation, unsurmountable tasks to be taken on by humans, right?? No. Luke 1:36 says: "Elizabeth your relative is going to have a child in her old age, and she who was said to be barren is in her sixth month."

So the entire piece is:

Elizabeth your relative is going to have a child in her old age, and she who was said to be barren is in her sixth month. For nothing is impossible with God. (Luke 1:36-37)

When God tells us that nothing is impossible for Him ... he uses infertility as the example! How stunning is that?

I'm in awe. I'm humbled. I'm speechless.

Thursday, June 5, 2008

If we build it, they will come

Almost two years ago I remember staring at the positive pregnancy test as I sat in the bathroom stall at the Petco down the street - I was in utter disbelief.

When Berilac and I first got married we talked about waiting 3-5 years before starting a family. I was 24 when we got married; I thought having babies between the ages of 27-29 is perfect!

For our third wedding anniversary we drove to Mendocino and B&B'd there for a beautiful weekend. There's not much to do in Mendocino, so we spent hours brunching and meandering from quaint shop to boutique - it was a special time. One morning during our adventures we walked past a froo-froo baby shop and I gently nudged Berilac in. We ooh'ed and ahh'ed over the cute little onesies (ok, I was making most of the sounds) and we found an adorable lacey, French, overpriced onesie for our future baby girl. We spent some ridiculous amount of money on something similar in size to a pair of socks. I was so excited. I started to think about the cute little pictures of me from my toddler years, with my fine wispy blond hair rolled up tight into those old pink rag curlers (remember those?) as I stood by the Christmas tree smiling ... I could totally imagine what our daughter would look like, she'd be adorable.

It was around that time that I stopped taking birth control pills and starting charting to avoid. I wanted to make sure my cycles got back to normal before we started trying. For the next year Berilac and I discussed charting to achieve and kept deciding the timing was still not right. But ultimately it was up to me - as I was well aware of my cycles and I could have lied to him (telling him we could have unprotected sex because we were in a safe time of the month) but he was not completely comfortable with really trying and I didn't have the guts (or the deceit) to make myself open to conception.

At year four we decided to not, not try ... though let's be honest for any woman who has been charting for more than three months - you have an idea of how your body works. I would know if we were having sex in the fertile window ... and for a year, we never did. I made sure of this. Berilac and I were going through too much at the time. (We were living and working with 100 miles between the two and on the weekends we were doing a head-to-toe remodel of our home, DIY-style.)

Enter my experience at Petco two years ago.

A few weeks prior to this event Berilac and I had "risky" sex. I figured if some women can struggle for years to get pregnant then we can have one month of "risky" sex without getting pregnant. Our first month of sex within the fertile window and we got pregnant. If I hadn't been so mad for getting knocked up days before I started a new job, I might have appreciated this miracle that so many women would have longed for. But no, I cried.

After I wiped away a few tears, I headed back to the Walgreen’s to get a couple more pregnancy tests, the kind that read "Pregnant" or "Not Pregnant" ... I don't need to decipher these crazy lines in my potentially fragile state. And this time I'll get more than one, just to confirm and reconfirm ... again. This time though I decided not to pee on a stick back in the Petco or a random gas station (I was running errands at the time I learned that I was pregnant - heck one of my errands was to pick up a pregnancy test because my period hadn't come) so I decided to knock out two errands at one stop. I headed to Barnes and Nobles and made a bee line straight for the bathrooms. There in that stall it was confirmed - I could buy "What to expect when you're expecting" and a "Baby Names" book as a gift for Berilac. I found the appropriate books and raced home to wrap them up along with a cute card and that dainty little onesie we bought years prior up in Mendocino. The gift bag was perfect and the wording in the card so cute and clever, hinting to Berilac that he was going to be a daddy soon.

During the next three pregnancies there were some times when people loaned me a "Your baby week by week" picture book or in one case I got a gift of a pregnancy journal (that I actually used with the hopes that this time things will be different). I had so much faith before we had our first miscarriage. I was actually worried about not being ready for a baby. After my first miscarriage it was my goal to 'have faith' rather than lose hope and think the worst. But it was with these few items that my future planning stopped. Since buying these few items: the onesie, the books ... I haven't purchased anything else for our future child(ren). In fact, I have made a point not to.

It's not that I don't have hope that it'll happen one day, it's more about not torturing myself with all of the paraphernalia lying around. Sometimes it can be overwhelming just to see car seats, baby strollers, and pregnant bellies - now imagine if I had those types of reminders falling out of my storage closets ... no thank you!

So I've been avoiding the baby stuff. And you can probably extend that to include I avoid not only having that stuff in my house, I avoid that stuff at other people's houses, and definitely at department stores!

Then, guess what I noticed right down the street from the fateful Petco just a few days ago? There's a Babies 'R Us going in just minutes away from our house. They are in the middle of constructing this monstrosity. In the last place we lived Babies 'R Us was 2 hours away. At first, I considered this just another slap in the face (another place that easily makes me feel uncomfortable) ... but then I started realizing how convenient it will be to register for my baby registry in a few short months with a store so close by.

I'm starting to think "if they build it, we will come" ... now I'm not saying I can go out and buy a boppy or a baby jumper - one mental step at a time, ok?

Tuesday, June 3, 2008

Holding out hope

When I got the news about the one normal egg - I was numb. At first I was kind of ok with the whole idea of only getting one ... until I told Berilac about the results ... and he was really disappointed. Then I realized that I must have been stupidly naive to be grateful for one egg and I got really scared and anxious. Thanks honey *roll eyes*

In the last few days I've been trying to process it more and I came up with these positive thoughts:
  • It's one more normal egg than I've had in the past!
  • If this had been a "traditional" IVF and we would have fertilized those puppies ... ONE of them could have easily made a normal baby (and I could have had a normal baby in me right now!!)
  • Not ALL of my eggs are bad, despite having four miscarriages ... not ALL of my eggs are broken!
  • We were statistically right on. In the previous trials of this technology the results showed that for FERTILE women (in their 20's no less!) come up with 30% normal eggs for any given IVF cycle. So what is 30% of 5? It's 1.5 ... statistically a FERTILE woman would have had 1.5 normal eggs on this cycle. Well, I came up with: 1 normal egg, 3 abnormal eggs, and 1 "inconclusive" egg (the testing could not be completed due to lack of material so the egg could be normal or abnormal hence the .5!! The Dr and the Embryologist both want to fertilize it and if it makes it to day 5 we'll transfer it.)
So each day I'm getting more and more excited about our one good egg. My hope is that in the next retrieval we have a better protocol and more eggs retrieved but really, I'm just hoping for one more good egg.

Berilac and I have decided that once we get two normal eggs we are going to attempt an embryo transfer, praying that our two eggs survive thaw, get fertilized from Berilac's men, divide normally, and survive nicely to day 5 for a transfer. Yes, I know ... there's a lot of opportunity for failure there but I'm hopeful that if they survive the thaw then they'll make it to my uterus. If we have two normal eggs and one inconclusive, and they all make it to day 5 - we'll transfer all three.

So hopefully we can do an embryo transfer in late October or November. We need to wait this long because we have to wait the 6 weeks to get the egg testing results from the second batch of eggs. Sure, it's not anytime soon, but it's better than NEXT year! Previously we were thinking that we needed to get all the retrievals in before we transfer any embryos ... but really, we're not looking to bank eggs (as the news story would have you believe) we really just want a baby - just one, we're not being greedy. So we will try after two retrievals - and hopefully two normal eggs. If that transfer doesn't work, then we might go back for the third retrieval or we might do traditional IVF (now that we know that I do have normal eggs - it's an option!!) Some of you might be wondering why we just don't do a transfer now with our one good egg. Well, statistically, only one of two eggs should survive the entire process - so we'd rather work with two eggs than one.

Now, what in the heck am I going to do to keep busy while I wait for my next retrieval and my next pregnancy?

Well, we do have more activity in the whole "what the heck is going on in our bodies" front. I am seeing a hematologist for the first time (for my Compound Hetero MTHFR diagnosis) on 6/19. I am going to go through alloimmune testing in mid June. Berilac will be doing sperm testing in July and then I start my next cycle.

I just wanted to keep you all updated on the haps ... maybe the next post will be more interesting with some reflection and thoughts - today, you get the facts. "Just the facts ma'am, just the facts!"