Monday, January 26, 2009

My blog's namesake

This video is quite intimate.

I thought about not sharing it, but then I realized, that this is **why** I started blogging about our infertility in the first place - to help get the word out there that infertility affects a lot of people and it's extremely painful.

(Ok, let me interrupt to say - no, they did not pick a very flattering still for me, now did they? Argh! My 15 minutes of fame and I've got the ugly cry ... great!)

This excerpt is from my October 2008 New Life Weekend, when I originally posted these words, I just shared the words, but here I post my heart.

At the end of the weekend they asked the attendees to write a letter about what the weekend meant to them, during the weekend I really wanted to get unstuck from dealing with the idea that my husband and I might never have children, here I share how the weekend impacted me:

New Life Weekend: Wise Old Man from New Life TV on Vimeo.

I think the hardest part about watching this video for me is knowing that back then I was under the impression that I only had a very short window of opportunity to conceive - thinking that I was quickly headed to POF. Now, given that my mom went through menopause at age 36, it's still very likely that I could go into menopause prematurely, but given that CCRM has told me that my AMH is very high - it's likely I won't go into early menopause ... and the end of this roller coaster is nowhere in sight. I was kind of looking forward to a limited window of suffering.

But in reality, I too can make a decision to close that window and end the suffering - I'm not passive, it doesn't have to "happen" to me.

The door is not shut yet, Berilac and I have talked about it and prayed about it, and we spent some time talking with Dr. Schoolcraft about the results of our most recent huge embarrassing failure of a cycle ... Next stop: Denver. I will join the ranks of the infertile elite and cycle at CCRM.

I guess I'm not getting that minivan, huh?

Monday, January 19, 2009

Officially negative

I can't begin to describe what the past 9 days have been like. For the first few I wasn't even able to answer phone calls, much less talk to anyone. I cancelled all my plans and just sat on the couch staring at the TV. It wasn't until I needed to get back to work 4 days after the transfer that I finally took a shower.

My emotions have ranged from despair to anger (notice that there's no hope on that scale of emotions ... yes, luckily I took Anniep's suggestion of dealing with the poor results sooner rather than later - and that really helped me to cope with today's call) I had no idea this journey would take me down these roads emotionally. I never knew life could be so tasteless, so sad, so dark. I honestly can't tell you one thing, one activity that brings me joy - I think this is depression.

We took a blood pregnancy test today and it came out with the big goose-egg, so we appreciate your prayers but I guess there isn't one who is righteous among you ;-) just kiddin'. For those of you that don't understand what this means - this cycle has officially ended with a negative pregnancy test.

I am angry with God and I'm really doubting my ability to hear Him. I feel like we have weighed every decision against the Word, I feel like we have prayed, sought wise counsel, and let our community in to share the burden with us. We have purposefully made decisions that were not selfish nor in our best interest to have a baby (or seven) but rather we chose to honor God and make choices that would keep our integrity in tact.
  • When a woman has had a miscarriage she is encouraged to wait 3 cycles before trying again - we could have been impatient and started the very next cycle - but 4 times we didn't.
  • When we had 7 mature follicles in an injects/IUI cycle we were at risk for a high order multiples pregnancy - some women would still proceed with the cycle and do selective reduction of fetuses in order to bring the count down to "tolerable" number ... we cancelled the expensive and emotionally trying cycle to avoid this.
  • When 4 specialists agreed that the solution to our fertility problems was to use genetic testing on embryos we declined and did our research - finding a very expensive, very time-consuming treatment (genetic testing on oocytes) that didn't give us the best chance - but it allowed us to address some of our problem, while at the same time allowing us to sleep at night with our decision.
  • When we just wanted to move forward with pregnancy attempts - we took a step back, knowing that the genetic testing on oocytes would take the better part of a year. Rather than jumping back into the process like we wanted to - we exercised patience, a year of it. (Seriously, you'd be hard pressed to find a woman who is trying to conceive that would willingly wait a year to attempt pregnancy - ok, unless she had faced a molar pregnancy but in that case she risks getting cancer if she tries before a year is up.)

For the last 9 days I've been asking God "why?" ... I have been battling with the rationale that if I do everything right then God will give us a baby ... but that's just not true. If God is going to bless us with children, it will be in His time and in His way.

But I still wonder why the heck we went down this long (albeit seemingly pointless!) road. Berilac and I don't know the answer to that but what we do know is that we have incredible peace about the decisions we've made thus far and we are humbled that we have chosen to honor God when the temptation is so great to try to take this situation into our own hands.

When God says no, the Word indicates that the response is to praise Him while we continue waiting. We believe that our actions thus far and our attitudes - are praise to Him! So now we breath in and out, put one foot in front of the other, keep on marching ... and see what tomorrow brings.

Oh, and thank you so much for the many, many comments on our last post. They were inspiring and brought tears to my eyes on so many of these past 9 days where I could hardly move. Thank you for your love and encouragment, thank you for your prayers.

Saturday, January 10, 2009

Ah, disappointment ... my old friend.

I was wondering how long my streak would last. I would say it's horrible and painful, but sadly it's just strangely familiar.

We will not have to worry about triplets, and we won't even have to worry about twins, we do have to wonder if we will even get pregnant this cycle - and if we do, if we'll just end up miscarrying again.

Instead of having 3 embryos of varying quality today, we only had 1 poor quality embryo.

Ideally, we would have had 3 6-8 cell embryos and instead 2 of our little babies arrested at the 2PN stage (in other words, they did not develop since Thursday - NOT AT ALL). They will allow those little ones to develop until day 6 and if they cleave at all they will freeze them for us, but if they don't (and they very likely won't) they will just remain arrested (dead). We are so sad about losing these 2 little ones.

So what we do have is 1 embryo. And yes, I know "it only takes one" but our 1 embryo only has 5 cells, when it should have 6-8, it is graded a 3 on a scale of 1-4, 1 being the best. The embryo has 50% fragmentation and it's GES score is 50 out of 100. Today we transferred back 1 poor quality embryo. From the research I've seen, there is an 8.8% chance of implantation (getting a positive pregnancy test) but I've had lots of those with little results. The data doesn't reveal anything about live birth rate when transferring an embryo like this - my guess is, it's not good. I guess it's a good thing we played it safe with a day 3 transfer, huh? (And yet another strike for monkey shop RE).

The one redeeming quality is that this embryo was derived from one of the CGH normal eggs - so that's good.

Here is our poor little embryo:

For those of you not sure what you're looking at, here's what our little embryo should have looked like today:

I'm feeling very tempted to just emotionally move on - so as not to go through a huge down if we don't get pregnant or end up having another miscarriage. I'm not trying to "think positive," I'm trying to not be entirely negative. Oh yeah, and the other "positive" thought I had today was "at least we have more information" (that's always what RE's say when women get bad news) but then I realized that I'm more confused now, than I was before.

The thing that I don't get is how in the world we've been able to get pregnant naturally EVERY MONTH WE'VE ATTEMPTED if we:
  • can barely retrieve any eggs in an egg retrieval cycle

  • come up short on number of "normal" eggs

  • have 2/3's of our embryos (derived from NORMAL eggs!!) arrest before they even get a chance to implant - we get pregnant with abnormal embryos naturally, how come they lived long enough to survive the fallopian tubes and make it to the uterus??

  • have a very poor quality embryo with high levels of fragmentation only 3 days after conception

Oh well, all I can do now is lay around on bedrest. And let me tell you that changing into my pj's at 11AM and crawling into a warm bed in a dark hotel room ... seemed like a great place to start dealing with my sadness. This will definitely not help me avoid depression ... great.

If God wants this to be successful - He will certainly need to pull out a miracle.

I wish I had better news for you today.

Friday, January 9, 2009

Tomorrow's the big day!

When I called Berilac and told him the fert report yesterday the first words out of his mouth were: "congratulations mommy!" and then he asked ... "are we having triplets?"

Sadly, the answer is almost certain to be no. Some stats:

  • 50% of embryos derived from CGH normal eggs will not survive to day 5.
  • 10% of CGH normal eggs are not, in fact, actually normal
  • The inconclusive egg has a 50/50 shot at being normal.
  • There is a chance that the sperm selected were not genetically normal.
  • There is a 1-2% chance for triplets when you transfer 3 day 3 embryos.
  • 25% of day 3 embryos make it to live baby.

But who knows? God is in control and He's bigger than numbers ... if you have a doubt, check out what my AMH was in March and then see how much it grew by October!

Last night when Berilac announced his arrival home he shouted: "daddy's home!" It was so cute! We both were in awe last night just thinking about the fact that we have 3 little babies up in Sacramento. Their gender, hair color, predispositions ... all already determined. Our little ones are waiting for us!

We talked a bit about how many we're planning to transfer and from what I understand we will have very little time to make the decision. They will tell us how many we have and at what growth stage they are at ... and we are conducting the transfer within 15 mins of learning this information ... at least, I think that's true??

I just hope that Berilac doesn't cave when the monkey shop RE suggests we only transfer 1 embryo ... yeah, those babies are best off in my womb ... so hand them over!

Tomorrow's schedule:
7:00AM: McDonald's breakfast (some ladies swear by this practice - greasy foods help the embryos stick!)
8:00AM: Arrive at clinic for transfer prep
8:30AM: pre-transfer Acupuncture
9:30AM: post-transfer Acupuncture
10:00AM: hang out, lying flat for a bit.

Then we head to our nearby hotel for 48 hours of bedrest, complemented with fresh pineapple ... if you don't know about this, don't ask and if you do ... I've been waiting for months to chow down on some pineapple - so although I know it's a bunch of baby dust heresay (although there *is* a bit of truth to it) ... I want my pineapple!

In the afternoon sometime, I'll let you know how our very first transfer went. Here's hoping those little babies will get all tucked away for a long 10 month nap.

Thursday, January 8, 2009

Operation Fertilization ... Successful!

Yep, you read that right ... Praise God!

All three eggs successfully fertilized and today we are the proud parents to three little zygotes (2PN status) ... and it gets better ... they have all developed just past that point and have released their second polar body. (Basically this means that they are further along in their development then they should be - which from all the research I've done, is much better news than worse news).

Our three little em-babies will be tucked safely away in their incubators until Saturday morning where we will get an update on their progress. We should have three nicely developing embryos to transfer on Saturday.

Berilac and I are beside ourselves with joy.

Last night, I sent a prayer request email to many friends and family (and many blog friends too) and the response was overwhelming - this journey really makes you feel isolated and today I feel surrounded ... so thank you for your prayers, your love, and your support.

Between now and Saturday we need to decide how many to transfer and tomorrow, since I won't have any embryo development news to share, I'll share our thoughts.

Thank you again for your overwhelming out pour of love.


And as a side note: it feels so nice to finally report good news - wow is it different. I hope this trend continues.

Wednesday, January 7, 2009

Operation Thaw ... Successful!

Word on the street is ... that all three of our eggs survived thaw!!


And all 3 were successfully inseminated with ICSI.

The collection this morning went well (obviously) and tomorrow we find out how many actually fertilize and have a chance at life.

Berilac and I are both thrilled.

Please continue to pray for our three little ones.

Tuesday, January 6, 2009

No drama today

Thank goodness - I exhaust myself.

We are doing a day 3 transfer on Saturday morning at 8:30AM. And I am so happy (and relieved) to have that decision behind me ... now all I have to do is make the decision on how many to put back! Though, I think the decision will be made for me (meaning not all will survive to day 3 so I'll put them all back) and even if all 3 did survive, I'm thinking we'll just put them all back. We've been praying about it for awhile now and through the chaos, we just want to give them all the best chance at life ... right there in my sporty little uteri.

We head up to Sacramento tomorrow for a little lovin' quickly followed by some egg defrosting and egg fertilization (or so we hope). I know that tomorrow we will learn how many eggs survive thaw but we won't find out until Thursday how many fertilize. I am not even going to ASK what time of day I can expect the call - because then I'll stress out when they miss their deadline, I'd rather just be pleasantly surprised when I get a call. (or at least I hope it's pleasant news!)

***warning, it gets a bit technical here - for those who are interested (aka in the same boat!)***

Today I had an appointment with a Hematologist. I start Lovenox tonight.

So now I'm on: Levothyroxine (for my Hashimoto's Hypothyroidism), Dexamethasone, Cipro, Folgard, Prenatal Omega-3's, Prenatal vitamins, twice weekly Delestrogen IM shots, this morning was my last day of Lupron (yippee!) and tomorrow night I start the daily dreaded intramuscular shots of PIO!

The Hematologist was a nice lady. She put me on 40 units of Lovenox for prophylactic purposes (so what is it, a placebo?) and she confirmed that I need only take 2.2 mg of Folgard. She told me I did NOT need baby aspirin in addition to the Lovenox and she had me re-do my APA panel (as there have been new tests added to it for recurrent loss since 7/07) she wants me to do recurring CBC's to make sure my platelet counts are under control while I'm on the Lovenox and she will not run Level Xa's on me.

***ok, jargon officially over***

I'm starting to get excited. I realized the other day that I have to start pretending like I'm pregnant soon - you know, no alcohol, no caffeine, no soft cheeses, eating all-organic, etc, etc. Starting as soon as tomorrow, but definitely by Saturday. I can't believe it's actually here. I so pray that everything goes smoothly and we find ourselves with 3 perfect embryos come Saturday morning!

Monday, January 5, 2009

You don't have an "oh shit" plan?

Yes, I swore ... that is how pissed off I am.

(But before I get onto the rant of the day, can I just ask ... did you not like my last post because I was being much more playful than I have been in the past few months and you weren't used to it ... or are you all really thin and it's just easier to say nothing than ... geez, too bad I can't relate! Really, it doesn't matter this latest cycle incident has got me moved on to bigger and better!)

Back to my foul language ... I had to swear ... what kind of monkey shop are they running? I am referring to my Sacramento clinic. This morning Berilac and I got up at 5:15AM to head up to Sacramento at 5:30AM. We got into town at 8AM and had plenty of time for breakfast before our 9AM ultrasound/bloodwork appointment.

Everything was going just swimmingly - the phlebotomist only had to take one puncture to find and retrieve the blood specimen (most labs take 2 if not 3 pokes before the well gushes) then we headed into our ultrasound to learn that my endometrium needs to be at least 8mm to proceed, and mine was a beautiful 10mm with that sought after triple stripe - yay!

We had an opportunity to meet with the doctor to discuss the advantages/disadvantages of day 3 vs. day 5 transfer because although we were originally leaning toward doing a day 5 transfer ... we've since read an article by Dr. Sher that indicated that perhaps day 3 was better (not to worry, I sent my doctor Dr. Sher's article as I was telling him that we were now leaning toward a day 3 transfer vs. a day 5 transfer). When the doctor sat us down he told me that he never actually read the article I forwarded him and he presented me with other documents by Dr. Sher and Dr. Keskintepe (which is fine) but he explained why he thought we should do a day 5 transfer over a day 3 transfer (embryos survive better in lab culture than a uterus when they are day 3 because the natural environment for them is not the uterus but the fallopian tubes, as well, the natural killer cells [they sound dangerous] will have less of chance to develop if you wait to transfer, blah-blah-blah) ... ultimately he told us we could do a day 3 transfer if we insist, but that he recommends a day 5 transfer.

Well thank you doctor for your wisdom, I'll log that away.

They were ready to escort us out when I requested a "further instructions" meeting with my nurse coordinator - you see my calendar ends today, with my ultrasound and bloodwork and in the little box marked January 5th it says "expect further instructions" ... so I wasn't about to leave without the promise of those much needed instructions.

We weren't surprised when (even after waiting 15 minutes) when we sat down at our nurse coordinators desk and she turned the screen around to show us our updated calendar - it had NO NEW data on it at all ... so we sat there with the nurse while she typed in each line of change. But before she could complete our calendar she needed to know if we were planning on a day 3 transfer or a day 5 transfer? We, of course, having only received information from our doctor minutes earlier, hadn't yet decided if we wanted a day 3 or day 5 transfer. So she told us that she couldn't provide us with medication dosing/instruction until we picked a day. So of course I got frustrated and confrontational asking her if she thought **I** was supposed to plan the cycle or if we would allow the development of the embryos to dictate the plans (as that seems like a better idea, don't you think?)

The nurse had no idea what I was talking about.

I tried explaining it to her a few times asking her if we could hope for the best (day 5 transfer) and plan for the worst (day 3 transfer) ... ultimately she needed to check with someone else via phone and their collective response back was "no" ... we need to decide if we're doing day 3 or day 5.

So I had her call her accomplice into the room, so that I could speak (condescend) to both of them at the same time. And I did it ... I dropped the S-bomb ... me. I said to her: you see we'd like to plan for a day 5 transfer and if on day 3 we learn that we only have 1 surviving embryo, then it's time for the "oh shit" plan ... meaning "oh shit, what do we do? we only have 1 embryo??!?" ... well, in that case (and many, MANY women have been in this situation and have opted for the day 3 transfer when the day 5 transfer just wasn't attainable) my clinic says .... we can't do that.

So basically - they have no "Oh shit" plan ... again I ask ... what kind of monkey shop are you running here?

Berilac and I spent 2 hours driving home and talking about "all we had learned" (read: listened to more inconsistent infertility B.S. from doctor who wants to do things his way, so ultimately we gathered no real data) at our appointment and how we can't believe that before move forward with fertilizing eggs - we have to decide which day we will be transferring.

We have NEVER fertilized an egg in vitro ... how the HELL am I supposed to know what the quality will be?

How am I supposed to know that if I transfer on day 3 I won't be:
-putting us at risk for high order multiples?
-risking the embryos as they really should be in the fallopian tubes and not in my uterus so the dish was a better environment?

Or if I elect to transfer on day 5, how do I know that I won't be:
-killing our embryos because they were too fragile for life in the petrie dish, but not the womb?

Why do I have to make this decision? Other women don't seem to have to???

If you couldn't tell, I'm sufficiently pissed and ready to get some real help from a real clinic ... does anyone wonder why CCRM will be our next stop?

Thanks for any words of wisdom.

Sunday, January 4, 2009

Back fat

... now is that one word or two?

Back fat ... seriously, a majorly dreaded female reality ... unless of course you're really thin.

Now, I myself am on the border between thin and normal, but these days, I know back fat.

When I got pregnant the first time, I was at my all time high in terms of weight. That was the pregnancy that lasted the longest - so maybe there's something to be said for that. In April my company had a health faire where they measured (among other things) your percentage of body fat ... and the guy told me I was on the border between thin and normal and I could stand to gain a few pounds. A couple of egg retrievals later and I'm no longer on the border of being too thin - heck no, not with the back fat I'm sporting!!

Since April, I know that I had been gaining weight, the scale doesn't lie. And I know that IVF cycles will essentially shove your body into early menopause (thus bringing your metabolism to a shrieking halt!) but it has been awhile (well before the holidays) that I braved a scale ... so I wasn't entirely sure how much I'd gained.

But the other day, when I was slothfully laying around in my pj's, during my ample time off from work, I rolled over on the couch and noticed that something was still lodged underneath me, and that something ... was ME! In the form of a roll of my back fat.

It was frightening.

Since then I've been checking the neck roll. You see, last time I was heavier (really, I'm not heavy, I'm just heavier than I'm used to being) I earned this roll at the back of my neck, when I would tilt my head back in the shower to wash or rinse my hair, I would feel a roll on my neck, that, when properly manuvered would pop!! And turn from being a roll high up on my neck - to one lower down. If this doesn't make any sense to you ... then thank your lucky stars! And just forget I mentioned it ... if it does, know that I've been on the prowl for the neck roll for awhile now too.

And with the holidays and lots of yummy foods, combined with weeks of birth control pills, delestrogen IM's, lupron shots and specific instructions NOT to diet while on this cycle ... combined with TWO WEEKS off of work and minimal amount of effort to get off the couch (ok, except to rent more movies) ... I was so afraid to head to the gym this morning and get on that scale.

But the back fat under my all too tight bra inspired me.

I was surprised to see that I'm not even close to my all time weight high ... and instead I haven't gained but 1 pound since October ... a Christmas miracle ... but I am still a bit afraid of turning around in the mirror or adjusting my too tight bra (for fear I feel the roll with my own two fingers - heck, I'd rather live in denial!) and so I pray that this transfer works and I can just glide into "gaining weight for the baby" without having to worry about needing to get a new bra because of my fat from lack of bodily care, rather than pregnancy ... otherwise, you can bet I'm jumping back into my old workout and diet routine to drop 10 lbs quick style if this cycle fails. If I can't be successfully pregnant, at least I'll be hot.

Yes, it's good to know where my priorities lie.

Thursday, January 1, 2009

Here's to 2009

If Thanksgiving and Christmas aren't hard enough ... let's throw New Year's in to the mix as well.

I remember last year at this time, we were 3 miscarriages down, in the middle of our "first" injectibles cycle. I thought for sure this was going to be our cycle. I was on 25-75iu/Follistim per day and I was developing 9 growing follicles. My doctor lowered the amount and I coasted - taking 17 days of stims to ultimately produce 1 mature follicle. We discovered we were pregnant in mid January, and by late January we had experienced miscarriage number 4. I thought for sure 2008 could not be as bad as 2007 was, what with 3 miscarriages in our pocket. But I was wrong. 2008 started off with a miscarriage and ended up being nothing but rough.

I had no idea when I signed up for fertility preservation in early 2008 (in order to do CGH testing on my oocytes) that the process would take a year! Naively I hoped that I could cycle in April, June, and August, and attempt a transfer during the August cycle or at the latest - the September cycle! Now, here I am in January, a year later, with only 2 retrievals under my belt (instead of the three we signed up for!) and poised and ready to go to CCRM if this transfer doesn't work.

The waiting has been painful.

I can't believe that in less than a week we fertilize. We are hopefully only a few days away from transfer ... TRANSFER! I can't even express how exciting and frightening this all is. I was talking with my therapist about it and we agreed that indifference (and letting go) is a good place for me right now. The stress and questioning does me no good.

So yes, you read that right earlier ... if this cycle doesn't work, we have already paid for a freeze all cycle at CCRM which we will do as soon as possible ... if this cycle doesn't work (which will be nice to rebound into, but more so, we'll get the tax benefit in 2008) but if this cycle does work, then we get our money back ... and let me say, it's A LOT of money ... let's just say this: it's more money than I would spend on a car. Heck, if this cycle does work, we'll spend the refund on a car!!

I get so scared to get excited about 2009. I feel so stupid for ever thinking that 2008 could be better than 2007 or 2006, so I don't want to embarrass myself by thinking that maybe, just maybe this year will be different. But on the other side of the coin, I think of how we're attempting a transfer that really has a lot of potential for success. And if it doesn't work, then we're headed to CCRM for a closure cycle. From there we move on to perhaps embryo adoption?? or the like ... all of these options are expensive yes, but really they are all very successful options for the most part ... perhaps 2009 won't be so bad.

And if in all of these avenues, God decides not to bless us with children, the hubby and I will run away ... literally. If we find ourselves at the end of fertility treatments, without children, we'll need to get AWAY to really think about whether adoption or living childfree is for us. (See this is where I get caught up in the worrying ... I'm already thinking about the end of 2009 and it's only day 1).

I know you might think it's premature for us to be thinking about this ... but these discussions started in early 2008. There's only so much of this we can take. There is a limit to how much loss and disappointment my heart can handle and I have no shame about running if that's what it comes to. I'll go and live out all of the dreams that those who have children - can only fantasize about!

So although 2009 will likely be filled with pain and difficulty there are a couple of ways this ship can steer (and probably more I can't even comprehend right now) so really, 2009 can't look *that* bad, right?

(with much timidity) ... here's to 2009! Let's hope it gets off to a good start.