Thursday, December 18, 2008

Surrender

I thought for sure that going into a transfer after the retrievals we've been through, would be exciting. I am not excited.

I thought that I'd be glad that the time is over for super ovulating, getting eggs, waiting, getting test results, only to repeat. I'm not.

I thought I'd be hopeful that this time (this time!) it will work. I really could use your hope.

I know that God has a plan and a purpose for my life. Maybe I'm lucky that I know that, maybe I seem arrogant ... I don't mean to. My purpose is to bloom where I am planted and to love those around me with Christ's love ... that's it. I ain't no Billy Graham. I'm just me. When you think about it, it's kind of a nice purpose because it's easily transferrable. (E.g., If my purpose in life were being an amazing tennis star - that would near end when my knees gave out). I know that God has used this season in my life. I know that He is preparing me for things to come. I know that God has molded and changed me only because I have experienced the pain of recurrent pregnancy loss and infertility. This, I know.

I know that in the end (however you define 'the end') God has my best in mind. I know that He is infinite and I am finite and I cannot know His ways. I know that He will turn all things to good for those who love Him. I know that our God is a redemptive God and that He will restore what the locusts have eaten.

However, I have to keep telling myself that He loves me and that He is not punishing me - the area of worth, that is where I struggle. I have to keep telling myself that I'm not a huge disappointment to Him thinking that that is why He's allowed us to lose 4 babies.

I think of this upcoming pregnancy opportunity and I try to make sense of all of these truths, thoughts, and feelings. I want to believe that this will be successful, but I wonder if it will. I've been here before, 4 times ... I know how my story has always ended in the past. I know that now we have the best of the best and that God is in control (and I'm not and the doctors aren't) and that if we don't get successfully pregnant that God still loves me ... but if it doesn't work, I'm not sure how I'll react - I simply cannot imagine it.

It's still just hard to be hopeful in light of repeated past experiences. I believe in God's goodness, but I've experienced a lot of disappointment in Him. That's hard to reconcile.

I think of how I'll be in X weeks - will I be elated and fearful or will I be depressed and hurting? It's like a speech or a really important test that you've anticipated in life ... I know that in X number of days it'll all be over and there's nothing I can do (besides prepare) to change the outcome. It will be over.

I can't imagine this cycle working and I can't imagine it not working. I still just pray that it will work, but am terrified that it won't.

I have no idea what's going on, I have no control over what's going on ... all I can do is surrender.

But that's easier said than done.

Anybody wanna take my place? Do this for me? I'm scared.

***

Edited to add: I have no idea how you ladies who have been through failed fresh or frozen cycles have gone through this. I admire you.

Wednesday, December 17, 2008

A sigh of relief

In late July I had my annual womanly appointment. Everything went quite well. In late August we completed our near train wreck of a retrieval cycle.

A few weeks later I found a lump - a lump in my breast.

Of course, I started scouring the Internet trying to learn about the connection between fertility medication and breast cancer. I was freaked out, but was trying to maintain my cool.

I emailed my OB/GYN and she agreed to see me right away. She confirmed the lump and sent me for a mammogram and ultrasound. When I got to radiology to schedule the appointments, they scheduled the ultrasound but denied me the mammogram because their radiology department makes it a policy not to do them on women under 35 - due to breast tissue density.

Anybody see the recent Oprah where Christina Applegate discussed her breast cancer and double mastectomy? Yeah, this was all coming down for me right about then.

I had had a fertility cycle where they super ovulated me and they only got 1 lousy egg ... and now because of the need for these treatments - I might have cancer? It was a rough patch, but these days I'm used to a little drama.

I finally got to do the ultrasound and as I'm putting my clothes back on the tech barged in and handed me a green slip with the word "normal" on it ... she said, "see you again when you're 40," and that was it.

Luckily, I have a friend who is a general surgeon (I know, sounds like I hob nob, doesn't it? I don't.) He suggested that when you find a lump you should have three forms of confirmation that things are ok, and that it wasn't alright that the radiology department did not follow through on doctor's orders for the mammogram. He said that if I was still concerned, it would be best to request a referral to a breast surgeon and so I did.

This morning I had the consultation with the breast surgeon and she was so comforting and caring, she was very interested in our entire history and I'll tell you it was quite reassuring that on the questionnaire they make you fill out for a lump consult ... that it doesn't ask you about your fertility medication usage (which would imply that they believe it's a risk factor - a topic for a whole other post!) though it did ask about miscarriages and age of menarche and a whole slew of reproductive questions that kind of surprised me (but I guess not, when you consider that infertiles, or women that choose not to have babies, have a higher risk of reproductive cancers).

Ok, anyhow ... she did another exam, she affirmed what I had found. She reviewed the ultrasound with me and explained why it looked "normal". She affirmed that I took the right steps to being cautious, and she scheduled a follow up in 6-8w just to ease my comfort. She says she sees many women each week who are in the middle of fertility cycles who come in with complaints of breast lumps - she said the meds can temporarily cause them. I was reassured and yet I wasn't. She said that the lump is in a critical breast feeding location and *when* I get to breastfeed, I will need that section of my breast; doing a lumpectomy on that area would remove an entire quadrant of my breast!! She indicated that it should go away on it's own as my breasts change through pregnancy and life.

Before she left she let me know that it would be ok to have the 6-8w follow up if I was pregnant, and she told me how encouraged she is that this will be successful for us - the pregnancy I mean. She really didn't see how it couldn't work if we were testing eggs and since I get pregnant so easily ... little does she know that we've also got the greater part of the Bay Area praying for us!

I left this morning's appointment with a sigh of relief and now I'll make peace with my lump ... until it goes away.

Tuesday, December 16, 2008

A word about the tickers

I remember when Amy from Maybe Baby was gearing up for her fresh IVF in February 08. In late December or early January her site was filled with tickers and I LOVED it!! I’m a numbers person, I like the data.

Whenever I visit a blog (especially if I’m relatively new to the story) I like to know where we’re at so I’m not surprised with a “well, my surgery went well today” … you see, having a marker in the form of tickers, for where we are in the process, helps me help you support me. So really, it’s all about me.

My husband thought it was a little extreme and then he realized that this is what’s going on in my head, so better to have it out there for him to keep at the forefront of his mind. Helps him to stay in touch with what this must be like for me.

I think it would be “normal” for someone to have a countdown to the activities and even the pregnancy test … but the second trimester ticker? Well, that’s because if we are blessed with a positive pregnancy test – that does little to set the fear at ease. In the past, getting pregnant has been “easy” … so many times we’ve seen the positive pregnancy test and so many times our hearts have been broken just weeks later. If we are blessed with a positive test – there will be celebration, but hopefully we can give a sigh of relief when we’ve made it to the second trimester … and even then, I know I will be anxious about making it to the 50% shot at life mark – 24w and then viability at 28w and then I’ll be concerned that the baby will strangle themselves on the cord. (Delightful pick me up for your Tuesday morning, no?) Man, how I wish my heart wasn’t soured with multiple losses – I really do have a lot of hope for motherhood, it’s just that this whole successful pregnancy thing seems like an unattainable goal.

I wonder how many women who have had easy pregnancies can understand what I’m going through.

And lastly the tickers are there to generate excitement. Mostly, I feel hope and fear, the hope is a choice and the fear is overwhelming. So I’d like to look at these things as exciting upcoming events – as I anticipated Christmas when I was a girl, so I want to anticipate this with the same enthusiasm.

And I loved mapping out the events for you. I know how important it is when we pray specifically for things. I know that so many people can get lost in all the complex procedures and tests that we’ve gone through, so my list makes for a good reference for those who feel lacking in the right words and phrases.

I can’t believe it’s just over three weeks away … we’ve been waiting well, since our last cycle in August for this. Wait, or was it after our first cycle in April. No, I think it was in February of 2008 when we first signed up with this clinic to pursue this technology … nope, it was more like January after our fourth miscarriage. Ok, perhaps it was Sept 07 after our third miscarriage? Or maybe February 07 after our second miscarriage? Ok, it had to have been in Sept 06 after our first miscarriage.

Let’s be honest, ever since I saw that positive pregnancy test in July 06, although I was surprised, shocked, and a little upset about being pregnant, I wanted that baby. My heart has been longing and breaking for a very long time. That ticker countdown started over two and a half years ago and now we’re 3 weeks away - three weeks away from the beginning of a successful pregnancy or three weeks away from heartache and reevaluation – and to be honest, I’m not sure how much more of this I can take, I was ready to get off of this merry-go-round years ago. Lord, I am broken and exhausted - please bless us with a child.

When you see those tickers, don’t think of the few days left remaining on them. Think of the perseverance, faithfulness, fight-against-the-enemy’s-lies, and hope that they really represent.

Monday, December 15, 2008

Ok people ... here we go!

I got my calendar this morning for the January transfer (note: this is not an "implantation" it's a transfer. If I get pregnant, then the embryo will have implanted, but a doctor can't implant the embryo, she can only transfer it). In finally receiving my calendar, I was quite disappointed to see that I was supposed to start my shots YESTERDAY ... but my meds haven't been ordered, so of course they haven't arrived yet ... hmmmm, and I'm supposed to remain low stress through this process? Luckily, my fridge is a regular fertility apothecary.

So now, the dates are solid - 1/5 is baseline ultrasound and further instruction, if those buggers thaw safely we will conceive on 1/7 ... is that a little too much information?

For those that are curious about protocol: today I started Lupron shots, I will continue those until transfer (sometime between 1/10-1/13). I am on .75mg of Dexamethazone until then as well. Starting on Christmas Eve eve (12/23) I start twice weekly IM shots of Delestrogen. I guess I will continue those until 10 weeks of pregnancy (here's hoping). I will begin Progesterone sometime after the 5th of Jan, though I'm not sure the exact date. I will also be on Lovenox or Heparin for this attempt, though I don't know when I will start.

For those that don't understand what all that stuff above said: I'm taking 1-2 shots per day, mostly the easy kind, but some are the kind that hurt like a punk. I will do this until it's time to lock and load the babies. These meds have been known to cause SEVERE grouchiness and have even rocked a few solid marriages, I'm sure. So if I'm even less pleasant than normal ... live with it! (Yes, I started the shots 30 minutes ago, so that behavior is excused - ha!)

We are planning on thawing all three oocytes, fertilizing them, and transferring the two surviving embryos on day 3 (and if all 3 survive, we will transfer only the two derived from CGH normal oocytes), we will freeze the third embie on day 3 ... but don't go tellin' my RE all this info - he still thinks we're considering a day 5 or day 6 transfer - which we aren't.

So that's it, I know my part from here on out ... unless things change. I am excited to finally get my calendar and get off to the races.

I want to provide a little education for those not versed in IVF speak:

1/5: Baseline Ultrasound - I will have an appointment with the doctor where they will evaluate my endometrial lining and make sure it's baby safe, they will make med adjustments if it's not.
1/7: Thaw/fertilization (Day 0): They will thaw all three oocytes (eggs!) and catch a couple of the cutest sperm Berilac can provide. They will hunt those soldiers down, capture them, and FORCE one sperm into one ever-so-eager egg. We will get a report of how many eggs get fertilized and how many embryos we have growing.
1/10: Fertilization report/Embryo Transfer (Day 3): We will get a report on how many embryos are still surviving (hopefully all 3!!) They will get graded with a letter and number score as well as with an overall score (more to come on that later). We hope that we have 2-3 good embryos. If we have 2 or more good ones, we will only transfer 2, and freeze the other. If we have 3 poor ones, we will transfer all 3.
1/11-1/12: Serious bedrest to allow for the nestling embryos to ... well, nestle!
1/17: I obsessively start taking home pregnancy tests. I will refrain from this unless I feel pregnant. The bad news of a negative test is crushing.
1/20: Blood test to determine pregnancy, and if so HCG level.

So if you couldn't tell, there are a lot of hurdles that we have to clear before we can start getting excited about this. Here is my promised list of prayer requests.

1. That my lining will be prepared in time for my 1/5 appointment.
2. That the eggs survive thaw on 1/7.
3. That the sperm fertilize the eggs on 1/7 - that all 3 turn into healthy, chromosomally normal embryos.
4. That the embryos develop and perform cellular division properly.
5. That we have 3 amazingly healthy embryos come 1/10.
6. That once the embryos get transferred they nestle on in to the nutrient rich endometrial lining for a long gestational hibernation of sorts.
7. That we become healthfully and successfully pregnant with normal blood and ultrasound results to help alleviate the already copious amounts of stress and fear we'll be facing.
8. That this struggle will soon be over.

People, you're done reading ... now, get to prayin!

Saturday, December 6, 2008

Putting my heart on the line

The AMH results came back from both the California clinic and CCRM, the results are consistent with a high follicular count and NOT early menopause.

I.am.floored.

I mean, for 2 and a half years, I've been coping with this struggle and for the past year and half I've been trying to cope with the ever growing diagnosis of early menopause. And now, now we are being told we are not in early menopause; that there may be explainable reasons for the "proof" we found previously that pointed towards early menopause - who wouldn't be astounded?

So we're laying it all out on the line. We paid for 3 retrievals with our current clinic and instead of making good on the third retrieval (or heading out to CCRM for a closure cycle) we will be attempting pregnancy next month.

I started my protocol on Wednesday, and it's inches away from being confirmed that the actual date of thaw/fertilization (conception!!) will be Wednesday January 7th, we are aiming for a 5 day transfer on January 12th, and we are STOKED!!

So we are trying to ignore the fear of historically poor test results, poor egg retrieval results, and the loss of 4 babies and instead focusing on the hope that God is in control, that we have two "normal" oocytes, and the fact that in the past - we have gotten pregnant easily ... so this time maybe we won't miscarry?

We are choosing the risky and courageous route, instead of the easy and safe route ... it would be so much easier to just keep doing egg retrievals ... when we don't actually attempt to fertilize eggs and transfer embryos, we protect ourselves from the procedure not working or even another loss. I'm so afraid of taking the next step, only to be let down again. But I must face this fear if I want children ... I can only claim God's strength to face this giant.

We are 31 days away from thaw and 36 days away from transfer ... and hopefully, we are 45 days away from a positive pregnancy test that results in a healthy, take home baby come the end of September.

My prayer requests will be coming soon ...

Tuesday, December 2, 2008

Ahem, ahem ... is this thing on?

Many thanks to Wendy from Our Story: A Blog about Adoption, IVF, and Infertility. I love this girl! She has had to endure so much pain and loss in her continuing battle to have children and yet she still shows up to work everyday and loves on other people's children - she's a teacher! And a great artist, I might add! I have been following her story closely for awhile now and I can say that I am so excited for her most recent step in family building - adoption. She has yet to be shy about the whole process ;-) and she has shared with the infertile community so much wisdom and support - I'm sure that is why she was given this award, and it is with honor that I accept it from her. Big hugs to you Wendy.

So it looks like there is an award going out for those who are speaking out and speaking up about infertility and I am truly honored to receive the award. I really feel like going through this struggle is an opportunity to be purposeful in pain, bringing this battle to the light - so I was excited to be recognized in something I have been trying so diligently to accomplish.

My family, my friends, most of my colleagues, my church, my neighbors, and even my dog has heard some truth about infertility from these lips (and from these finger tips!) I am adamant about getting the word out that infertility happens and it is painful; it shouldn't be taboo nor should the fertile continue to think that they "know best" when it comes to resolving infertility - no, relaxing will not cure menopause - yeah, hey it's a good idea, but it's been tried already, what else have you got? I risk my heart and my emotions as I wait to hear what someone might say in response to my telling them the truth of our situation ... in an effort to pave if even just a pothole on the road for many of the infertiles who will follow in our footsteps. (Sadly, there will be more).

I think the one thing that scares me, is so heavily identifying with being an infertile that I forget how to be normal. Seriously, I have gotten into character, I'm poised and ready to pounce at any insensitive movie line and I'd love to put one of those stick figure families on the back window of my SUV that depicts me, my husband, and our little dog all lined up in a row ... and in place of the typical title "Mommy's Taxi" I simply want to say "Infertility hurts" ... but DH isn't willing (who knows why??). So I think of that day, someway, someday ... when I will have children on earth to hold and I'm hoping that I can shake a lot of the bitterness and triggers and just enjoy my life once again. I may recover from being an "infertile" but I will never stop standing up for them. To me, that's why I got the award - I'm one sicko die hard.

On that note, I am proud to nominate my own crew of proud infertiles, regardless of whether or not they share this information in person or on their blog ... these ladies speak up and speak out:

Elmojessi at One Small Wish

Much love ladies and keep on sharing!!