Gripes

A friend just announced she is pregnant with her third child.  I find myself fighting back tears and also feeling like a lousy friend.  Of course, I'm happy for her, but I'm more miserable for me.

It also sucks that I have to wait months because I decided to demand certain tests, and they've timed it so I have to wait out multiple cycles, which puts everything at the holidays - something I was trying to avoid.  So, I either wait more months or screw my family's holiday plans up.  I could travel, but I shouldn't be lifting heavy luggage, etc.  I'm supposed to do no strenuous activity during those waiting days, so walking all day on a vacation wouldn't fit that.

I'm still pissed at my doctor.  They said I'd wait a week, which would have meant today, Friday, and I could have the tests and have worked it into my next cycle.  i would start pills tonight, after the bloodwork, and really have only missed a few weeks.  Now it's another four.  I feel like it was a whole big "you want tests?  I'll give you freakin' tests!" kind of thing.  Like, what's up with the glucose test and my taking hours out of my day instead of doing an A1C which is supposed to be more reliable?

I'm asking for that, but I feel like each time I ask for something different, I'm becoming more of their adversary.  The Hubs and I are even arguing over treatment nowadays - we're both stressed out about it.  I agreed to have a second opinion if he does the research and finds the doctor, but I know that won't happen. He doesn't have time for that.

So, I have this house full of baby clothes and baby gear and baby toys and no baby.  It all surrounds me.  I think of going ahead and selling it or giving it away, but what happens if we are able to have another baby?  It just sits in my basement and mocks me.  Every time I go downstairs, I see these things which in my heart I believe we will never get to use again.  They climb up the walls and stare down at me, looming large and blocking out the light.  When I clean, I always find some tiny toy from when Bud was extra small.  Or something she rediscovered from storage and has brought upstairs to explore.  It's like living with a ghost baby.  It just shows the hole in our family even more.  There's no place for it to go, so I just get these reminders every moment of every day that I have no more babies to celebrate.

Others can get drunk on spring break and get knocked up.  Me, I can't spend tens of thousands of dollars to do it.  I have some of the best medical help in the country, and I can't create a life.  I can't give the two people who are most precious to me in the world something they so desperately want.  And that hurts.

I worry I have squandered money on what was never to be.  At least we're not in as much debt over it as some couples are, but I could have used that towards the child we do have.  Sometimes there's this laughtrack going on when I think about how much I want this.

And, please, no more asking about why I don't just adopt.  I'm not waiting four years (the Hubs would be in his 50's!) and spending tens of thousands of dollars more to adopt a child from another country.  My family can't stretch for that.  In fact, it's pissed me off that I have people in my life who act like it's so easy.  Maybe if that's the original route we were to take, 8 years ago, but it's not and that avenue is closed for us.  I'd like for you to accept that and stop think of me as someone who breeds for her own ego and not to enjoy a child.  That's insulting and demeaning to my daughter and any future children we may or may not have.

wow, I'm really on a rant today.  Pain pisses me off.

FET postponed, Tests ordered

Ah, decisions.  and this is why it is ridiculous that they don't want to see you until 7 weeks after your egg retrieval.

First, I put off starting medication for this cycle so i could suddenly go to my friend's wedding.  That moved everything by two weeks, so I would have begun shots today, Friday.  Which ended up being good, i think.  Otherwise, I would have been well into medication before sitting down with the doctor on Wednesday, day before yesterday.

We discussed the normal things - what else could be done to improve success, etc.  She mentioned that I could take a baby aspirin each day as that wouldn't harm anything.  She also mentioned a procedure that has helped implantation in some very, very small studies - an endometrial biopsy.  They would take a little scraping of the lining of the uterus just before I would come off birth control pills, before my bleed.  The theory is that as this is healing, it's also making the womb more receptive to implantation.  There have been studies in Israel, Brazil, and China.  My doctor said that the studies were so small and on women in their thirties (vs. me at 40) to warrant trying it, although she has when a patient has requested it.  She did not recommend it since I would probably want anesthesia and she thinks the risks inherent in anesthesia outweigh the untested gain.  If you look at the studies, you'll see that most claim to double the rates of implantation.  That's worth it to me!

I sure as hell would have anesthesia.  The stories I've read have varied from no big deal to screaming bloody murder and passing out on the table in pain, so I think the anesthesia is the right choice.  And I think the endo biopsy is the right choice - may as well try it!  Well, doc and co did not seem happy with this.  oh, to book the only OR they had for this procedure, oh, to have to do it so fast since I'd need it by Tuesday (which could have been solved if I could have been seen weeks ago for follow up),  and I could be bumped because the transfers had to come first, etc.

I stood up and said, yes, after second guessing myself and my instincts and my husband saying he wanted a second opinion from another doctor and my explaining that this is the fourth fifth person I'd have seen regarding fertility issues and the second fertility clinic (loathed the first one) I've tried.  So, unless we're looking out of town or state and want to invest a crapload more money, we're SOL.  We've prepaid for the FET and I don't want to lose that investment.

My second opinion has really been doing research online, reading abstracts of reproductive health papers (and sometimes the papers themselves), talking to women who have gone through this, reading forums, etc.  I don't blindly follow my doctors as a certain Hubs seems to think at times.  I know he's frustrated and scared.  He wants to rail against something and there's no definite foe or magic answer to find.  As I was discussing this issue with some trusted ladies in my circle, a few brought up tests.  I'd been tested for autoimmune disorders and clotting, of course, right?  Because that's what every doctor did before you walked down that expensive IVF path, right?

I remembered that I had asked about it before.  And I had asked about autoimmune issues and clotting disorders again in my email after the second failure, but we didn't discuss it during our meeting, so I sent a follow up email after telling them that I wanted the biopsy.

I was told that because I had carried a baby to term and had never miscarried, that those issues wouldn't be applicable and would be treated with a baby aspirin.  I relayed the info and the aforementioned ladies were indignant on my behalf and pushed that I advocate more strongly for myself.  I trust their opinions.  Some have walked to this cliff edge and more than one has jumped off of it, so they know.

I sent an email this morning saying I understood their logic, but that I now want to be checked for these issues before proceeding.  Arrgghh - well, this means you'll have to change your calendar and put transfer off for a few months and we can't give you a date because you'll have to come off the birth control pills, bleed, then have the test, then have a period, and then start the pills again and go through all this and am I up for that?

And, since I mentioned I didn't want to regret not doing all I could, they'd like me to repeat another test - a two hour fasting glucose.  And now see a dietitian (really???  you don't think you could have freakin' pushed this before the first IVF cycle when there was more time??  especially as seeing that I've been at the same plateau the entire time you've seen me as a patient in the last three years?) as well as see either my GP or a specialist because I've had high blood pressure the last couple of times I've been in.

Fine, doc, I will jump through your hoops.  As I've mentioned, i'm locked in.  I can't pull out and go elsewhere unless it's another integremed/attain clinic and then it's out of state.  And I will do my research and have an adversarial relationship as I feel that I'm the only one really pushing to find answers and to try.

I've been ripped up about all of this for days, questions piling on top of other questions, trust issues, stress, timing, etc.  It's probably best that this now means a transfer between Thanksgiving and Christmas.  Which would suck for our schedule, so it may really be in January.  And now this won't overlap with the beginning of school, kick off of treasurer duties, fundraising season, and the search for a therapist that can work with insurance craziness of denial despite my daughter needing them for her motor skill disorder.  So, stress has abounded. (see: high blood pressure and specialist).

No, I don't fulfill your criteria for further tests and I want a procedure that hasn't been vetted as much as you'd like for its success .  But I'm not a statistic.  We beat the odds once by having a fantastic daughter - who's to say we're not an outlier again?

Negative in so many ways.

I'm sitting in my sadness.  I'm not doing anything today.  The Bud and I are having a Don Bluth marathon courtesy of netflix.  Fortunately, she seems to be digging the downtime.

I had a blood test early this morning, and my nurse called this afternoon with the results.  She seemed upset and told me she was so very sorry.  It's nice to have someone professional who obviously cares and genuinely sympathizes.  The test shows that, once again, the embryos did not even implant.  It's not a case of early miscarriage - they never had a chance.  It's like my body is toxic.  I am full of blame for myself and wonder if I'd skipped having wine between retrieval and transfer, had done some cleanse, become a vegetarian, whatever - something to make my body pure - would it have changed anything?  I truly feel that I have done something wrong.

I told Bud a short while ago.  She told me that we had one more chance and we would try hard and hope that it worked.  As I told her last time, I said the babies stopped developing and weren't in my body anymore.   I've been upfront with her during this process.  She's seen the shots and she's had the multiple appointments affect her schedule, she's seen the emotional impact.  She's asked questions along the way "How do they get back in your body?"  and I've also tried to explain that this isn't the way most babies are made.  Oddly, she hasn't asked how they usually are. I am honest with her and try to use descriptions that a four year old (almost five!) would understand, keeping my descriptions brief and allowing her to guide the conversation.  I think it has worked well for both of us.

I'm just so tired.  The nurse told me that if I wanted to proceed with the frozen embryo cycle, I'd have to start back on birth control pills on Wednesday, then, a few weeks later, do an ultrasound then begin lupron shots again and estrogen patches and later progesterone suppositories or intramuscular injections.  I'm not sure I'm ready for this all over again.  Or those blinding headaches from the birth control and lupron.  I wonder if I'll suddenly stumble across some way to assist implantation if I wait.  Even if we start in two days, the earliest transfer would be in six weeks.  I'll start the pills at least - I can always stop if I change my mind and want to wait.

Part of me wants to move forward just to finish.  Just to be done and sell or give away the baby gear, toys, clothes, in the basement.  To make Hub's office into a den/playroom as Bud has started needing more playspace and I've started needing a place of my own to decompress at times.  Having two embryos in the freezer is both a blessing and a curse at the moment.  This could have all been over.  Or it may be that one of them is my saving grace.

For now, though, I'll be grateful for my little girl and her being mellow with me, and a husband who emails me lots and lots of "smooches".  It's all I can handle right now.  I think I'll go curl up on the bed until he's home, while the Bud enjoys her fourth movie of the day.

what is normal anyway?

I am cramping more and seem to have a menstrual flow.  I say "seem" because it is so odd to be spotting 5dp5dt (five days past a five day transfer) and then get a period three days early.  I'm a 14 day luteal phase girl usually.

I think of the things I've put on hold or cancelled or not committed - a beach trip with very dear friends, the overseas wedding of my best friend (I'm SO sorry, E.), the Disney trip with favorite family members.

And it bothers me that I've raised the hopes of my husband and daughter through this process.  I am somewhat numb.  I notice that I have some tears but nothing really coming through.  I was blabbering to the barista at our coffee shop and realized that I am holding on to my mind by a thin thread.

And, what bothers me, is that on some level I'm relieved.  I won't have twins. We're not turning our lives upside down.  I have two frozen embryos left and I feel like I need to transfer them, but I have little hope that they will work.  I'll do just one at a time, though.  (BTW, the rates for frozen embryo transfer  - FET- success are about the same as a fresh cycle nowadays.  Amazing how quickly technology and science advances.)

I'm puzzled and angry.  I didn't drink, I monitored my food and caffeine and medications.  I did guided relaxation and massage and acupuncture and put my feet up.  There is no magic recipe.  Some folks try so hard and it never happens.  I really thought we'd have a larger family than this.  Thank God we have one fantastic child already.  I think of my friends who have had a surprise pregnancy, even on birth control.  Although it must have turned their life on its end due to its unplanned nature, I do think how lucky they are.

And then there are the posts online that talk about "I was so sure I was getting my period - I was bleeding and cramping and then a BFP".   I don't think that will be me.  The only way to know will be a blood test.  My doctor's office will be reluctant to do one more than a day early, but I think I'll push, just to wrap this up.

And then what?  What do I do with two frozen embryos?  Jump in again?  I don't want to be much older or have much more time between children.  Wait indefinitely?  Try again in the winter?  To tell you the truth, the only reason to wait would be to go to Disneyland and know I could ride the rides with Bud. I've never been and I want to experience it with her.   Oh, and that whole don't make rash decisions when you're grieving thing.  Yeah, that's probably important somewhere in there.

I don't feel like the walking, bleeding, festering wound I did the first time around.  You know, so tender that the mere look of a friend was like a scraping over my raw heart.  I'm supposed to go camping this weekend with our daughter's preschool.  I really like these families (sometimes I wonder if they realize that I would like to be closer but I don't know how) but I remember how vulnerable I felt for weeks after last time - can I handle that again in close quarters, no escape, no drop and dash as I try not to look anyone in the eye because I know I'll start crying again?

No need to make decisions now, I suppose.  I did the mechanical process, now I'll do the emotional grieving process somehow.  It hurt so much last time, I think this time it will be harder because I want to bury it.  But maybe it will seem more normal.  The more normal I act, the more normal I'll believe it all has become.

seeing red

cramping.  brown smears.  bright red spotting.  Shit.  It's five days past five day transfer.  too early for a period, right?  even though mine came at seven days past a five day transfer last time?

Please oh please let this be implantation spotting and not my body rejecting this.

wow!

I had two embryos transferred this morning.  Expanded blasts, level Good, grade B/B for each of them.  I was told that there is a 66% chance of getting pregnant with implanting two at my age, and a 40% chance of that for twins - about the same percentage as not getting pregnant at all.  I would say that it is actually a greater possibility to have zero than twins.  I had zero with the last IVF with a similar 65% chance of getting pregnant, but only one embryo transferred.

I had the Hubster drive me to acupuncture immediately afterwards.  I did see a study cited out of a BC clinic that said gals in my age group (over 38) show a stronger likelihood of pregnancy if acupuncture is performed the same day as transfer.

I'm not holding my breath.  I am on modified bed rest, enjoying movies while Bud is enjoying the grandparents.  We had delivery for dinner, so I got out of cooking, too.

We also froze two embryos today - expanded blasts, Good, B/B and Good B/C.  I may be wrong and one is Fair B/C.

And we are culturing three more embryos - that's right, as of today, all SEVEN were still developing!  Two are unexpanded blasts, automatically graded poor because they haven't advanced, but, I think B/B and B/C. As for the third, we have a perfect morula which needs to be cultured possibly longer.

So, if this time, IVF #2, doesn't work, we're already set for Frozen Embryo Transfer #1.  I guess we won't know any time soon when our family is done after all.

I am nervous about the prospect of twins, but I feel that with the failure of the earlier IVF, the maternal age factor, the low AMH score, as well as my history, we'll be lucky to get one out of this.  I'm taking it one day at a time.  We'll figure it out the same way any other family with multiples figures it out, if we do have twins.

I am "testing out the trigger", as some say.  I ordered some cheapo pregnancy tests (25 for $8!) and will take each day to watch the trigger line fade from the positive pregnancy test.  Then, if it comes back or gets stronger, we'll know if there is a baby in there.

And right now, TWO babies in there!

a little more info - Saturday, Day 3

We still have seven embryos!  The one which was lagging behind at 2 cells has now caught up and is 8 cells like almost all the others (the ideal number).  A different embryo, however, has arrested at four cells.  It may continue to grow, or it may be done.

At this point, statistically, we'll probably have three on Monday.  No, we will not transfer all of them!  But, I am leaning towards two.  We'll make the final decision with the embryologist on Monday.  I'll be under anesthesia at 10am, and then off to acupuncture once we are done.  Studies show that, for my age group, it raises the odds of implantation to have acupuncture on the day of transfer.  We didn't do it last time, but, we have the ability to do it this time, so we will.

I'm just taking this one step at a time. And planning last splurges before I have to do the pregnancy diet.  I'm trying to be more removed and take this moment by moment. I was so very sad last time.  And I don't know how quickly I would want to share news one way or another this time.  It's all so up in the air!