Random thoughts of the day

I have gotten very into reading books about IVF.  Reading about other people going through the same thing I'm going through is comforting, it makes this very lonely process feel just a little less lonely. 

I just finished a mini-book called The Baby Chase: An Adventure in Fertility by Holly Finn.  Holly is the girl who wrote that Wall Street Journal article I shared earlier in the week and she goes to Dr. Schoolcraft, or as she calls him, Doc S.  One of my favorite quotes from her book is: "IVF brings you to your knees and dares you stagger to your feet again.  It forces you, even as you steel yourself for more shots and setbacks, to remember the gentleness in you and the true reason you want to bring another human into this world."  Another good quote is "The longing for a child isn't diluted when having one becomes a struggle.  The desire stays as strong as it was.  It's you who becomes weaker, like a fish wearing itself out on the line."  Those are both really powerful and struck a chord with me.  Sometimes it's hard to put into words what you're feeling, so it's comforting when you find someone who has been able to do that. 

Last good takeaway from the book is something I've been struggling with lately: "In the end, infertility can make you feel less human.  As cultivated as we are, we hold on to deep-rooted dogma that our worth is tied to how well, and how much, we reproduce.  I've seen women and men shrink like salted slugs during IVF treatment.  The whole process makes you feel unlovable.  But don't we know that the number of children you have has no correlation to how appealing you are?"  As my pants have gotten tighter from all of the hormones, the lack of being able to exercise the past month, and whatever muscle I had has turned to lumpy fat, I try to remind myself of that.  Brian often suggests I go to the gym to walk on a treadmill to stay active - to me that is code for you have lost your appeal, please hit the gym and firm up.  I'm sure that's not what he means, he means well, but in my hormone induced state, that's how I interpret it.  Really praying for strength the next few months, and courage to keep going.  It will be worth it. 

Wall Street Journal article on Infertility

My mom found this article that mentions one woman's journey with Dr. Schoolcraft.  It is really well written so I wanted to share. 

A few things she said in the article really hit a chord with me.  When she said people are quick to say that you should adopt and how they are quick to forget that basic human need to reproduce miniature versions of themselves. I really relate to that - I am so sick of people saying that we should adopt because they know so and so, and when they went to adopt they got pregnant magically because the stress was gone.  Maybe one day we'll get there, but at this point, I can't give up on wanting to see what our biological children would look like, act like, and be like.  A few weeks ago my mom gave me some baby pictures she found of me when cleaning up the house.  I often look at those pictures and get teary because when she gave them to me she said "that's what your baby will look like!"  I pray I get to see that one day. 

Regroup with Dr. Schoolcraft

This morning was our regroup appointment with Dr. Schoolcraft to discuss what went wrong with our embryo development.  Waiting for the doctor I was very nervous and had a lot running through my mind.  I knew nothing would dramatically change, but was hoping but nervous for some clarity on what happened.  When he came in to meet with us he said that he wasn't sure what went wrong.  Everyone in the lab was confused by it as well.  They had ICSI'd 50% of our eggs and IMSI'd the other 50%, and neither group did exceptionally better than the other group.  They used two different media, and neither of those groups did better or worse either.  He said it falls under possible reasons.  Eggs poor quality either from my PCOS or from responding poorly to the stimulation drugs or sperm poor quality, even though ICSI & ISMI should have only been picking the best quality sperm for the job.  He said most embryos can last until Day 3, so between Day 3 and Day 5 is commonly where you see things go south if they're going to.  He said he is very surprised we don't have 5 or 6 based on what he saw, and he believes if we have to do this again in the future we should hit closer to that mark.  If we go through this again, he will change up the stimulation protocol to an antagonist protocol (I think that's what he said - it's where you use a different drug than Lupron for the suppression).  He said the hyperstimulating wouldn't have made the egg quality poor, but my body maybe didn't respond as well to this formula of stimulation - creating too many eggs, but of poorer quality.  He said the general public with PCOS will only get about 33% good embryos from a cycle where a non-PCOS person might get 50%, but that still should have left us with 10 embryos!  There were a few times I had to bite my tongue to say to him "you're the best in the world and you can't tell me what is wrong with us?!"  He seems to get the most difficult cases pregnant, and yet us who should have been a slam dunk was not...

He did say partway through the regroup that we were focusing too much on next cycle, when he feels good about this embryo that we have frozen.  I asked him what our odds were and he said he would give us 40-45% chance of success.  That sure sounds bad after our initial 70% chance of success had we had two good embryos to put in, but he said this embryo is pretty miraculous to survive what no other embryo in the bunch could.  I am praying for some peace in my mind and in Brian's mind and some positive attitude adjustments for us.  This could very well be our baby and we can't give up hope yet.

After we met with him, we met with our nurse and set up our frozen embryo transfer (FET) schedule.  Our FET will be on Friday, September 16, a day after my birthday.  In a few weeks I will go in for some hormone level checks, if all checks out, I will start Lupron injections again, then once I get my next period I will start the estrogen patches and progesterone suppositories to get my lining nice and thick for the embryo to stick to.  8 weeks and counting...

The light at the end of the tunnel just got a lot further away

I think those things that don’t even cross our minds as possibilities but then happen are the things that devastate us the worst.  I was prepared to be disappointed if the embryos didn’t stick once implanted, but this was something that had never even crossed my mind and I think that’s why it hit me so hard.

I’ve been googling it this morning to see if other people have had this problem and I found a few threads where this happened and in both cases the woman had similar medical issues to me and B.  It’s so bizarre.  I think it just dredges up those fears of what if we can’t have natural children.  Why am I even here if I can't have children?  That's what I've wanted my whole life. 

I talked to my sister last night, and she said that whatever it was that stopped those other embies from developing, that ONE embie survived and kept dividing, and that makes it a fighter.  All I can do is pray that she is right and that is our baby.

We have a regroup appointment with Dr. Schoolcraft Monday morning, so it will be really good to get his perspective on what went wrong.  I think I'm at the anger phase of grief because I'm so angry that everyone was so confident that it would be such a success for us.  We were told by every doctor, nurse, geneticist, embryologist, that we should only ever have to go through that once, and we would have enough embryos to create our entire family.  I'm angry that we paid a LOT of money to go to the best place in the country, and wondering if they did something along the way to impede this?  I just have a lot of anger this morning, a lot of sadness, and a lot of questions.  It's going to be a long day! 

Day 6

The ideal embryo for implanting is what they call a blastocyst "blast". This usually happens on Day 5. Because I'm doing a frozen transfer, the embryologist said they let them go until Day 6 to allow as many as they can to reach the blast stage because some are slower to develop. On Day 3 last I got an update, we had 15 embryos make it to that stage that looked good. I was expecting about 10 to make it to blast. I hadn't gotten a call all day, so I called and left a message this afternoon. I finally heard back at 4:30pm right as I was getting ready to leave work. Only 1 embryo had made it the blast stage, and just barely. I am completely shell shocked. The embryologist said this is very rare that you would have so many at day 3 and only 1 "early blast" at day 5. It's so early that they can't even grade it. The embryologist said that there is still a good rate of success with these blasts. Earlier today I was thinking about how in love I was with each and every one of my embryos and we might end up with 10 kids to give them each a chance at life! Now I get to pray for 1. 1 is all it takes, I know, but the rate of success for 1 is only 50%, and I'm not even sure they'd give us those odds with it being an early blast. I need to schedule a follow up with Dr. Schoolcraft, but right now I'm just searching for answers, and there are none. My nurse suggested that Dr S might advise us to do another egg retrieval to try to give us more to freeze. That is not good for many reasons 1) another million dollars, which we don't have 2) the physical and emotional toll of shots, hormone injections, surgery, etc all for this to potentially happen again. I just really really pray this one embryo is our baby and will give us a healthy baby. I just feel like I've been hit by a truck right now and wishing for answers which will have to wait, or we may never know.

Day 1

Egg retrieval was yesterday. It went really well. We arrived at CCRM at 8am and came up to the 2nd floor. Our nurse came out and brought us back to the pre-op room where we went through everything and she started my IV. I met Dr. Gustofson who seemed very nice, but I'm happy to have Dr. Schoolcraft as my primary RE. Dr. G did the surgery, so I can't say anything bad about him, just didn't have the same bedside manner as Dr. S. They gave me some "happy juice" which gives you amnesia and I immediately felt really drunk. They said people either get really quiet with it or really chatty. Apparently I was the latter. I remember being wheeled back to the OR and them telling me to scoot down on the bed and putting my legs in padded stirrups. I asked the anesthesiologist how long until the anesthesia knocks me out and he said about 20 seconds. I then told them how blind I was without my glasses when they took them off and asked the nurse what her prescription was and that's all I remember. Next thing I woke up in post-op. The anesthesiologist came over and told me I was really talkative and it took about 3x as much anesthesia to get me out as they thought it would!! That is surprising because I don't take strong pain killers or anything - the strongest I've ever taken is Tylenol with codeine, so I would think I'd go right out!

I was hungry when I woke up so they got me out of bed into a recliner and I got sprite and club crackers. I was having some pain on my left side, which wasn't surprising considering that side had about 3x as many eggs in it. The nurse brought me a heating pad which seemed to help. Embryology came up and told me they pulled out 31 eggs from me - holy cow. I had been guessing about 23. Good news and I was ready to go home.

When I got home I ate some soup and a cheese omelet that Brian made me. They told me to drink a lot of water and salt the next week to help prevent severe hyperstimulation. I then went up in bed to take a nap. I slept for two hours then took it easy the rest of the day. My mother in law stopped by with some flowers, which was so sweet. Ate some Chili's take out and headed to bed early.

This morning embryology called and said that of my 31 eggs, 27 were mature and were IMSE'd. Today, 20 of those had my Day 1 embryos! That is great news and gives us a lot to work with. If we assume about half of those will make it to day 5, I will have 10 embryos to choose from to implant, so that gives me great odds that some of those will be high quality embryos. It's crazy to think that our future baby/babies is in a petri dish right now dividing away.

The lab will call back on Monday with my Day 3 report. Then again on day 5/6 once they get to blast stage, and then they will freeze them. Happy thoughts :)

Egg Retrieval Today

Today is a big day, my egg retrieval day!  It's currently 5:45am and I'm already awake.  I slept better than I thought I would, made it until 5:30am then I was awake and no going back to sleep.  I'm excited, but very nervous.  Everything runs through my head - nervous about being put under anesthesia, worried I might have already ovulated in which case they will have to cancel the procedure, worried I'll be in a lot of pain, etc.  I think a big weight will be lifted off of my shoulders once I'm home and this is done. 

Yesterday we met with the geneticist.  Since we now have to freeze the eggs for 8 weeks, we thought that it might be worth doing the genetic testing (CCS) on the embryos to make sure they're healthy.  We originally weren't going to do that because it requires a 4 week turn around time, so you are forced to freeze the eggs, and obviously our goal was for a fresh transfer.  We got a meeting at 2:30 yesterday to find out our options.  It sure sounds great.  She said "typical" for us would be 20 eggs retrieved, 12 fertilized, 8 make it to blast (day 5) and of those 8 probably 6 will be healthy, 2 would be genetically incorrect.  That's scary to think of having two embryos that we could implant and possibly miscarry or have down syndrome, or some other genetic disorder.  However, she said women 10 years older than me would be lucky to have one good embryo, so that helps put things in perspective a little bit.  I was on the fence about it until she said price - an extra $4500 - yikes.  When you're already paying the price of a new BMW for this procedure, an extra $5K really stings.  We decided to pass, and prayers for healthy embryos!

I was really nauseous all day yesterday.  Threw up first thing in the morning, then again at 9am at work.  I ended up leaving work at 10am because I kept thinking I was going to throw up and having to run way down the hall to the bathroom (could be cubicle be any further away from the bathroom!) was not going well.  A few times I didn't think I'd make it.  Plus it's embarrassing if anyone would come in and hear your throwing up.  So I headed home and camped out in bed the rest of the day (aside from our appointment with the geneticist).  Still this morning not feeling 100%, but so far no throwing up today, and just hoping I stay healthy so the retrieval goes smoother.

The anesthesiologist called last night to check in with me about surgery today.  Turns out Brian knows him from PACU, so hopefully that will be good for me today and I'll get some good care.  

Here goes nothing...

Trying to keep my chin up

My retrieval is set for Friday!  I'm ready to get these eggies out of me!  I went in this morning for my ultrasound and blood work.  I still had 23 follicles, size 17-20.  The place was pretty quiet this morning and yet I still waited 15 minutes to be seen by the ultrasound tech and then another 15 minutes to talk to my nurse.  By the time I got my blood work done it had been 45 minutes and I was supposed to be at work.  I left there frazzled it had taken so long and the street I take to the highway was closed for construction.  So I had to wind back and go the long way to work, all the side streets.  I ended up being over 20 minutes late.  Thankfully no one seemed to notice, but I was pretty stressed already at that point.  My nurse told me they had noticed some fluid in my lining today so she was expecting to most likely do the freeze all.  I was expecting that news but hoping for the best.

My new boss took me and my team out to lunch to celebrate me being on the team.  We went to Tavern and so that was a good distraction for the day.  About 3pm Annie called and told me I was cleared for retrieval on Friday, but not only had my progesterone risen from 1.4 to 1.7, but my E2 had spiked showing that I had OHSS (ovarian hyperstimulation syndrome) so I was a definite freeze all.  She said anytime you have more than 20 follicles there's a high priority you'll get OHSS, so she wasn't surprised.  I asked her if I could do the FET the following month and she said it's an 8 week process, so it will be 8 weeks until my FET.  For some reason that additional month just really put me over the edge.  I tried to call B a few times but he didn't answer (he was mowing the lawn), so I called my mom from our training room at work and started crying.  I know in my heart of hearts this is for the best, but the thought of waiting two more months for the possibility of getting pregnant was just so depressing.  Brian finally called back and tried to calm me down too.  Sometimes it's hard for me because I think all he cares about is the number of embryos, not about the anguish I'm going through.  He doesn't seem fazed by waiting 8 more weeks.  I guess this isn't his body that's been going through hell the past month with hormone shots every day, blood thinners, pills and steroids.

Tomorrow more blood work before work, then we're meeting with a genetics counselor at 2:30 to discuss doing CCS (genetic testing) on the embryos since have to freeze them anyway (when you choose CCS it's mandatory to freeze them to be tested).  The nurse said she didn't think we'd been good candidates because we're so young so the chance of poor embryos is a lot lower, but for peace of mind it may be worth it.

For now, I believe off to bed!

Some disappointing news

This has been a pretty crazy week and it's only Tuesday!  Today would have been my original retrieval date had everything gone picture perfect.  I'm okay with the fact that it didn't go as planned, it's just hard for me sometimes because I like to be a control freak and plan my life, and IVF is very much out of my control.  My ultrasound this morning showed that I still had 23 follicles between 15-19 in size.  They want the majority about 18 in size, so I am getting close, but it will most likely be a Friday retrieval, which means telling my boss for a third time that things have changed without explaining what it's for - awkward! 

I had run out of Menopur, my morning shot, yesterday.  I called to order more and didn't think it would be a big deal because in the past orders have arrived by 10am, so that would just put me taking it a few hours late.  Well 1pm today came and went and the shots still hadn't arrived.  I called my nurse and she was in the process of hunting some down at a local pharmacy downtown when B called on the other line and said the shots arrived - just in the nick of time!!  B ran it over to me at work and I ran down to do the injection in his car.  Of course Menopur is a special injection that requires 4 viles, 2 liquid and 2 powder that I had to mix in the front seat of his car - I must have looked like a drug addict to people walking by!

A few hours later, my nurse called back when I was in a meeting about my protocol for tonight and tomorrow.  I guess one of my hormone levels is too high and if it doesn't fall below 1, they will have to do a freeze all which will result in a FET (frozen embryo transfer) the following month.  I was told not to take any of my stims tonight or tomorrow morning and just to take the Lupron, Lovenox, and Dexamethasone and hope the numbers drop.  I am trying so hard to be positive and pray that if I need to wait a month to get a healthy baby out of this, that is what needs to happen, but I often want it all and want it now, and patient I am not (also, per above, not good at things outside of my control).  So we'll find out more tomorrow, but asking for prayers for a healthy child (or two) first attempt even if that means waiting a month. 

Tonight B is making BBQ chicken pizza and I plan to relax on the couch and try to relax.  Note to self - starting a new job week of egg retrieval is probably not the best idea! 

Almost time for IVF

My infertility battle started about a year and a half ago.  My sister had just had a baby and it sparked the desire for hubby and I to start TTC.  It was just before Christmas when my co-worker sent me a link to a website to check when I would ovulate.  At the time it seemed so clinical and took the fun out of things, but I filled it out anyway.  It showed my fertile days being right over Christmas, and it even showed which days I would be more likely to have a girl or a boy.  It seemed so easy.  Well Christmas came and went, as did 6 more months of TTC when I decided it might be time to go to my OB and see what the problem was.  I was referred to Dr. Swanson at Conceptions for further tests.  I met with Dr. Swanson and I really liked him as well as the Conceptions staff.  He said IUI would give us a great chance of conceiving based on what they knew of our infertility battle (looking back, it amazes me how little we still knew, but I will get to that later).  First two IUI's were unsuccessful, the second of which caused a large cyst from the Clomid.  I had to take a month off, which seemed so upsetting at the time - I wanted a baby and wanted one now.  After a month off, we kept going with two more attempts at IUI with Femara.  My body handled the Femara much better than the Clomid.  I got one less follicle (2 instead of 3), but I ovulated both months on my own, and my lining stayed thicker on Femara.  Regardless of the "perfect" situation, we had now had 4 unsuccessful IUI's.  Hubs and I reconvened with Dr. Swanson who said the dreaded words - IVF.  B didn't handle it as well as me and it took him several days to even be able to talk about that as the possibility.  In his eyes, we were healthy 27 year olds and there wasn't anything "wrong enough" with us to warrant such drastic measures as IVF.  When he finally got more on board, we decided that we should at least get a second opinion for IVF.  We are fortunate enough to live in south Denver near some of the best fertility clinics in the world.  We decided to go consult with Dr. Schoolcraft at CCRM.  He has patients fly in from all over the world to see him, so it seemed silly to live 5 miles away and not at least hear what he would have to say about our case.  We got an appointment 6 weeks later (he's a busy man after all!) 

At our consult with Dr. Schoolcraft I was very nervous - it felt like we were meeting a movie star or celebrity with how famous he was.  He looked at our paper from Conceptions and immediately noticed a few things that were worth a closer look.  We decided to come back for the one day workup at CCRM a week later to spend a day learning all about IVF and getting more tests done.  Some we had already done at Conceptions, which is frustrating, but it seemed worth a try.  Our one day workup was a great day.  They ran a ton of tests and took a lot of blood, but the best part was meeting our IVF nurse, Annie, and meeting with Dr. Schoolcraft.  He seemed to think with the additional information that we would be great candidates for IVF, but it made sense now why our IUI's had failed, which somehow gave me peace of mind.  Next it was time to start the meds...because of a blood clotting disorder that I have, I would have to take Lovenox in addition to the other fertility meds.

I have never been a fan of needles.  When I found out I would have to be giving myself shots I had a freak out moment.  Annie thought we should start Lupron end of June, when I would be traveling in Indianapolis for work.  Not only did I have to give myself a shot, but I had to figure out how to pack it on ice, travel with it, store it in my hotel room, and give myself a shot every night...yikes!  I'm happy to say the Lupron shot is the best of all of the shots that you take - the needle is about half as big making it much less scary than some of the others.  After the first shot, I was elated - I could do this.

I started my stim drugs last Saturday (8 days ago).  My protocol was to take one menopur in the morning, 75 Gonal F, Lupron, and Lovenox at night.  The day after the menopur I was exhausted.  I took a 3 hour nap, and I am not a napper.  That night I woke up in the middle of the night feeling nauseous, sweaty, shaky, and upset stomach.  I spent a good portion of the night on the cool bathroom floor because it was close to the toilet in case I got sick and the cool tile felt so good on my clammy body.  I was so nervous because I was starting a new job a few days later and didn't want to feel sick starting this new job.  Thankfully, I have done very well since, and after talking with my nurse she said it is common to feel sick from those first doses.

I just found out today that my tentative retrieval date I was first given (7/12) is going to be pushed at least 2 days out because my follicles aren't big enough yet.  This unfortunately creates a bit of a hiccup in the process because I have to figure out a way to explain to my new boss why my surgery date is changing (he doesn't know what it's for).  B also starts a new job the following week and may not be able to come to the transfer, which is also a bummer. 

I feel like I just typed my life's story in a few pages, phew!