Look for the Signs

Looking back in my life and my marriage, I have never been a big believer in "signs". If I am honest, I try to look for reassurances that I am on the right path or "feelings" that we are where we are supposed to be, but I don't specifically trust "signs". I typically trust in prayer and faith that God is in control either way.

Going back a little, I think my dislike of signs is probably due to my engagement ring. You see, a few months after I got engaged (to the most wonderful man in the world) I started to get irritated skin on my ring finger. Irritation turned into bumps, which turned into blisters, which led to me painting the inside of my engagement ring with clear finger nail polish for several months. Eventually, I did allergy testing and learned that I am allergic to gold. Yes, actually gold. They thought it was the nickel mixed in with the white gold, but no... it's really the gold. Anyway, my sweet husband ended up paying more money to get my ring reset in platinum and needless to say the bumps and redness have been gone ever since. We have also joked ever since that it's a  good thing we don't believe in signs because what does it say if you are allergic to your engagement ring. 

Well friends, this week I want to believe in signs!

January 18, 2012: We attended our IVF Class. We had made the huge decision to pursue treatment and IVF was our first attempt at any type of assisted fertility. It honestly felt like a new beginning because we were so hopeful that this would be the path that led to our first child.

Well fast-forward (or look back and read past posts) and obviously the IVF didn't work. We struggled, we prayed, and then we got excited about adoption being the path that God has planned for our family. I feel incredible peace about this decision and I cannot wait to meet the child and birth family that will become such a significant part of our lives.

January 18, 2013: We got a call from our agency about a potential match. I know almost nothing about the situation except that the expectant mother is due in 3-4 weeks!! (Holy Cow!! I can't even believe it when I write it down) Our agency wanted us to know about this possible situation because we were making plans to turn in applications at other agencies and they didn't want us to unnecessarily waste time or money (which I appreciate). However, we were warned that there was so much more to be done before this was an "official" match. They are still working to located the birth father and until that occurs we will not be in a position to meet with the expectant mother. They also warned us that even if things continue to move along smoothly, they are doubtful that all the legal issues will be handled by the time of birth therefore the child will likely need to go to interim care. Then...they said they would be in touch when they knew more.

So today my friends, I want so badly to believe that this is all a "sign" of great things to come. That our preparation for growing our family that started on January 18, 2012 was really just a stepping stone to God's plan of preparation that started EXACTLY one year later on January 18, 2013. Either way, I am working to keep my focus on Him and trust that even if this situation doesn't work out, our great God still has incredible plans for us and our family.

So, please keep us in your prayers. Most importantly keep this birth family and this child in your prayers.

...untill we know more,

jenn

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WTF...

Today was our follow-up appointment at the RE to discuss our failed IVF cycle. More lovingly referred to as a WHAT THE FUCK appointment, as in what the fuck went wrong?

So, when asked the token question our RE simply replied that he doesn't know. Everything about our cycle looked great. My Estrodial level rose perfectly, my lining was think, transfer was easy, etc. His only exception was related to our fertilization rate, which was only 7 of the 15 eggs. He said he would have wanted 9, however the difference of 2 embryos was not that significant. The only negative thing he could really say about our cycle is that we didn't get pregnant.

So, we discussed the possibility of a frozen embryo transfer (FET) in the future. We have one embryo that was frozen and it is a D/A quality. Our clinic defines embryos by 2 grades. The first D means the most expanded and the A means the highest quality. Just for reference, the two embryos we transferred on our fresh cycle were B/B. That means 2nd worst grade for being expanded but 2nd best quality. 

So, our 1 frozen embie is the best one of the whole cycle, which is great because sometimes embryos drop a grade in quality when they thaw, which means we could end up with a D/B.
Anyway, the disappointing news about a possible FET cycle is that embryo's only have a 60-70% chance of surviving the thaw. Meaning we could do 6 weeks of medications and building up hope, only to have the cycle cancelled on transfer day because our grade A embie doesn't survive the thaw.

This is the point in our meeting that reaffirmed to be how crappy this whole IVF cycle can be. Not only did our cycle fail, but now I have one super perfect embie, but if we try and transfer it in the future, we will only have a 60% chance of making it to the actual transfer, then if we make it that far, we will only have a 60% chance that our super perfect embie will implant.

I want to be positive but it sounds like a recipe for disappointment, stress, and heart ache.

So, the recommendation from the RE (which honestly I agree with and appreciate) is that if we move forward then it should be another fresh IVF cycle. He wants to switch from an antagonist cycle and instead do a lupron cycle. The only reason for the switch is because the antagonist cycle didn't work last time. An added bonus of the lupron would maybe be improved egg quality, thereby improving the chances of fertilization. He said the sperm quality could also be contributing to the fertilization rate, but beyond taking calcium and zinc, there is little we can do to improve the sperm any further. Anyway, we would hopefully get pregnant with IVF #2 and then have some embryos left to freeze as well. Then in the future if we ever wanted to do a FET, we could thaw embies from cycle #1 and cycle #2 hopefully giving us at least 2 embies to transfer after the thaw.

That's the basic facts about where we are. It makes sense to me and seems like a rational progression of treatment. It also makes me sad. It disappoints me that we would be starting over yet the results could be the same. I know IVF is always a risk but I just can't help but wonder today if the risk is too high right now.

We aren't going to rush a decision. We are going to pray about it and think about it over the next few weeks. We also have an appointment with a local adoption agency on Monday to discuss a possible home study. I am excited about moving forward and I am thankful that in spite of our BFN disappointment, our marriage is stronger than ever. God is good and I remain faithful that he has a plan for us that will exceed all of our expectations.

jenn

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the beginning of the end...

I must begin by saying I have several half written blogs from the past few weeks of our cycle. Somehow I could never seem to finish them, although I wish I had kept the blog a little more up to date through our stimming, retrieval, and transfer. Maybe someday I will finish them and post them...maybe not.

Tomorrow is our Beta. This is the day that I kept waiting for and now I wish it would just be over. Last night around 6:30 I started lightly spotting. I fell apart rather quickly. The tears just wouldn't stop and the pain was all encompassing. Last time I cried like this was when I found out my sister was pregnant on Thanksgiving, while Kevan was out of town and not here to hold me. Last night he was here but couldn't say anything to ease the pain. I went to bed at 7:30. Since daylight savings occurred last week it was still light outside, but I just wanted to be in the bed. I struggled to sleep and woke often through the night, then this morning I stupidly took my temperature. I gained false hope as it remained high. ~I say false hope because since this morning google has taught me that BBT's stay high due to a combination of progesterone and other hormones. Sadly, that 1cc shot in my ass each night is probably keeping my temp up no matter what.

Anyway, I have been spotting all day. TMI...it's brownish in color, not red, and it is definitely spotting not full flow, but it is also accompanied by cramps and overall period-blah feeling. I tried to work but I know I was sucking at my job, so I took half a day off and went to lunch with my IF friends. They were helpful and even spoke up on behalf of all infertiles to a cashier who was making stupid comments about a new mother in line behind us. I was paralyzed and thought I might cry at Panera, but my girls were there for me. It was truly nice to be in a place where I didn't have to pretend to be happy or fully-present in the conversation, I could just be there exactly how I was honestly feeling today. Now, I have been sleeping on the couch for 1.5 hours even though there is no way that I am tired, I just don't want to face the world any more.

I know that sounds dramatic, but I didn't expect it to end this way. I expected to call tomorrow and deal with the results via phone, husband by my side, and honestly, I felt like it was going to work. I mostly had let my guard down and allowed myself to be excited that this was really happening. After all, why shouldn't it work. We have male factor problems that they feel confident they can fix with ICIS, so why shouldn't I be able to grow a child with the assistance of a little technology? But in spite of all of that, it didn't end any differently. After all this time and all this effort, I did not feel prepared for the option that it would end the same as every other month...me alone in the bathroom, looking down in defeat, at a darkened tissue that was announcing once again that we had achieved nothing.

I feel frustrated that my clinic in no way prepared me for this outcome. They drilled into our heads that we should definitely wait for a Beta instead of "peeing on a stick"  but no attention was given to the fact that good old Aunt Flo might come knocking before you are even scheduled for your Beta. Plus, now what am I supposed to do tomorrow? I know that if I am still spotting we will go for our Beta as planned and still be anxious before calling our voice mail because you always hear about those miracle people who still get BFP's after days of spotting. But honestly, as this day drags on and the intensity of my craps increased and color of my spotting darkens, I know where this is headed. So, when Aunt Flo comes on full force by the AM, do I go and get tested like a good patient even though all hope will already be gone...because if she comes full force in the morning, there is no embie that could survive the gushing of a full cycle day 1 shedding.

I just feel broken. Frustrated that it ended with me in the bathroom, like it does every other month, even though this month we paid thousands of dollars, said millions of prayers, and let so many people into our circle of trust (all of whom I will now have to tell that we failed, and then I get to endure their looks of pity). I feel exhausted that we are now starting all over. I know that this was a step in our journey but I hate the idea of enduring more decision making about adoption vs. trying to unfreeze our one lonely embie and hope that somehow that one can implant when these two couldn't?

All that being said, I can't help but still feel confident that God has great plans for us. I trust that if this cycle doesn't work, then it was because He knows that we will be parents another way, at another time. I just wish we didn't have to continue to endure so much hurt and heartache before we could figure out the plans He has for us. Come on burning bush...haven't I earned I clear sign that points to motherhood??

jenn

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Suppress Yourself

This morning I went for my suppression check, even though honestly I am not sure what that means. I keep telling people that the Docs want to make sure my system is "suppressed enough" from the birth control pills so they can have total control of how much to ramp things up with drugs...I think that's right but who knows.

It was the fastest appointment I have ever had at the clinic which was amazing. They had told me it could take up to 3 hours, however we knew it would probably be shorter since I already did my trial transfer at my hydrosonogram appointment. When I got there I waited like 30 seconds, got taken for blood draw which lasted like 5 minutes, and then waited on the ultrasound tech for like 10 minutes. It was good to run through the protocol of blood draw, ultrasound, and meet with the nurse, since that will be my schedule multiple times next week. Everyone was nice, however the ultrasound tech gave me a firm lecture about how she wouldn't tell me anything about my follicles, so I shouldn't even ask. I get where she is coming from and I know it's better to lay the ground rules upfront, but gosh lady, I hadn't even thought about asking you and now I feel bad that maybe I might want to ask you in the future!

After only about 40 minutes at the clinic I met with my IVF nurse. She was great!! We actually didn't get to meet her at our IVF class appointment so talking to her today put me at ease. She asked basic questions, reviewed my protocol, and then encouraged me to ask any questions I might have. For some reason, I just didn't really have any. I reviewed how to take the shots and how cold they really needed to stay since they are supposed to be refrigerated, but those were the only things I could come up with. She was laid back the whole time and told me my questions were too easy, so I should feel free to call if I thought of any more.

Then I was sent to the financial lady for my lump sum, all inclusive payment. The best thing I can say about this part is that at least there were no surprises. The cost what we knew it would be from the beginning, so I can't really blame them for collecting their money up front. Finally, I checked out at the front desk, picked up my voice mailbox code, and was free to go after only an hour!!

Overall, I feel good about the whole thing, at least as good as I can. I am trying not to stress or over analyze every detail because it seems like everything is really just a "wait and see" approach. I mean every question I have re: timelines and appointments is dependent on how well I stimulate, which we won't know until I start injections and then attend a follow appointment next week. If I am honest, my main worry right now is just about unexpected events...things I have no control over. Like, what if i don't stimulate as well as they think I will, what if we really do have some female factor infertility issue that they haven't found yet, what if we should have done PGD, what if the shots make me sick and unable to work, etc, etc. But just like all other things in this world, I have no other option but to put my faith in God and trust that if things are difficult, then He must have a purpose for my brief suffering. And that regardless of the outcome...this is all part of His plan, which is always going to be better than anything I could have dreamed!

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Special Delivery!!

After stalking Fed Ex online, I was promptly alerted when my meds arrived today. Funny how excited I got just knowing that they were waiting for me on the front porch!! Also, amazing how quickly my anxiety grew once I realized it was 65 degrees in TN today and these meds needed to stay cold!

Luckily, I then got a call from my sweet husband, saying that he came home early and he wondered what items needed to go into the fridge and what needed to be left out...I must add that he had already put everything, including the needles into the fridge. I gave him some input and encouraged him to read the directions, which shockingly spelled out exactly what to do!

Anyway, I finally got home to find a wonderful package waiting for me...

It's amazing how much it overwhelms me, while at the same time it seems like I should have gotten more for $3000+!!

So, now I must anxiously await my suppression check on Thursday and hopefully I will get to dive into this pile of fun on Saturday!!

jenn

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Apothecary

I got the call this week confirming our medication order for our IVF cycle. Amazing how a call from a pharmacy tech in another state can make this whole thing finally feel real. Maybe it's because this is the largest lump sum of money we have had to pay so far, although I cannot complain because I know the antagonist cycle makes our med costs so much less than they could be if the RE had recommended another plan. Or maybe, it feels real because during our conversation she reminded me that I can always order less supplies now but if I order too much then I can't return anything. That comment just sealed the deal that this is the point of no return, these meds are ours and this cycle is happening, unless of course I want to waste a couple thousand dollars on medications.

Anyway, I am anxious but excited. I am not freaked out the needles or the prospect of these injections, so I feel good about finally getting all these supplies in my possession. I am also looking forward to sorting needles and arrange vials according to our plan for injections (organizing tends to make me feel more in control of life, it's a coping mechanism I developed somewhere along the way, but it's one I like). Mostly, I am just excited to be moving forward in a way that feels tangible, instead of just taking birth control pills each night while continuing to think of our IVF cycle as a future event. Having a fridge full of injectables is bound to make this whole plan feel like it's my real life and once I'm actually doing the injecting, I am sure it won't feel like a hypothetical situation any longer.

So, as I said before we are doing an antagonist cycle, meaning I get to skip the lupron and begin my injections with the FSH. Here is our pharmacy order that should be arriving any day now...

Follistim: 300mg pen x1 and 600mg pen x4 (except I am only filling 3 for now)

Ganirelex: 5 prefilled syringes

Ovidrel: HCG trigger shots x2

Progesterone: 45ml vial x3

Medrol: 4 day dosepak, 16mg tabs

Doxycycline: 4 day supply

My suppression check is scheduled for next Thursday and then injections will hopefully start the following Saturday. Who could have imagined I would be this excited and ready to start a process that I always prayed I would never have to do...amazing how time and life circumstances changes your perspective!

jenn

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Chinese torture?

Thanks to some recommendations from my friends at Resolve, I have expanded my fertility treatments. At first, when I thought of adding more appointments and more professionals to my ever growing team of treatment experts, the idea was overwhelming. However, if you ever talk with someone who goes to acupuncture about their experience, they seem to glow as they share how wonderful an experience it has been in their life. So, after hearing about the wonders of Chinese medicine for long enough, I booked my first appointment at East Nashville Community Acupuncture.

Upon arrival, it was the calm hipster type environment I expected. I drank tea and read an article about composting from some 'one with the earth' type magazine. Then I met with my acupuncturist, who was calm and reassuring from the first moment I saw her. She asked questions about my health and I provided details about a past history of migraines, acid reflux, and ADD. I explained how I had been weaning off all medications in preparation for this cycle and my hope what that since meds would not be taken for 9 months of pregnancy, that I would therefore not return to taking any medication again once the baby was born.

Honestly, getting off medication was something I had been wanting to do for sometime, however I always seemed to lack the motivation to make the appropriate lifestyle changes required to live a life un-medicated. However, I have never felt good about the fact that I am 30y/o and taking multiple medications per day, because honestly what hope does it give me for my body's ability to fend for itself when I am 60 or 80. 

Anyway, I explained my desire for acupuncture to help me manage these symptoms as well as promote my physical and emotional health while we pursue an IVF cycle. My acupuncturist voiced understanding about all my concerns and she offered support and reassurance re: the role acupuncture has played in many IVF cycles before mine. She then gave me a basic run down of what would happen and made sure I had no further questions. She then led me into a treatment room, filled with multiple recliners, soft music, and dim lights. I chose my chair, rolled up my pant legs, and settled in for a treatment that I felt sure would be an interesting life experience, if nothing else! 

I have tried to described the sensation of acupuncture multiple times since attending my first session and consistently I feel like my explanations and correlations do not provide a clear picture of what it was like. Still, in my experience I must say that the needle did not hurt when it went into my body, even though I could feel a slight prick initially. I concentrated on each needle site, hoping to pinpoint the feeling I was having, it was like something was disapating under my skin from the needle point outwards. Then when she stuck a needle in the top of my scalp and I felt the same sensation, it finally hit me how to explain it...Do you remember playing that game as a child when you say "crack an egg on your head, and the blood running down, and then chills running up". For those who don't remember, while you chant this rhyme, you knock someone on the head, then press down as you symmetrically run your fingers down the outside of a persons head, then you run your nails up their back, causing chills and just an overall weird feeling. Well, that's what acupuncture felt like to me the first time, like something was dissipating from each needle point (just like the fingers that applied pressure to my head as a child) and chills (in a good way) would follow throughout my body.  (weird way to explain it, but really it was wonderful!!)

After inserting all needles, my acupuncturist then covered me with blankets, which at first worried me that they would knock the needles out or drive them deeper into my skin further,  however she reassured me that they were flexible and not going anywhere. So, I was bundled up and tucked in like a child, then a wonderful bean bag was placed over my eyes. Soft, new age music surrounded me and I listened at a muted level by using my earbuds as modified ear plugs. It was wonderfully relaxing, so much so that I laid there for an hour and a half. I simply laid there and  prayed about God's plan for my family, then I dozed off to sleep, then I prayed for peace that could overcome any obstacles in my path, and finally I just reflecting on my place in life. I must say it was incredibly relaxing and it was probably the first time I had taken an hour and a half for prayer and relaxation without feeling rushed to move on to the next part of my day. It was just what I needed.

So, after feeling fully relaxed and recharged, my needles were removed and I was free to go. I left the community center feeling dramatically better than when I arrived. Although, it is hard to pinpoint exactly what felt better, considering I did not enter with a specific compliant and since feeling more fertile is not exactly tangible. Yet, I know that if nothing else I felt calmer. I felt relaxed like the way I feel after a massage, the kind of tranquility that you cannot achieve at home on your own. Overall, it  brought me a great sense of peace during this chaotic time and I think I am now offically sold on acupuncture.

jenn

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Back to School

On January 18, we attended the long anticipated IVF class!

Upon first hearing that we would have  a class, I didn't give it much thought because the idea was so abstract. It was part of the distant future in a world where maybe, possibly, we would complete an IVF cycle. Honestly, I was so overwhelmed by the long list of tasks we had to complete prior to even becoming eligible for class, that I couldn't even think forward to the class itself. However, in a similar fashion to how I feel about most things in this journey, each month drags on forever yet things creep up on you before you are ready for them.

So, we completed our pre-reqs and headed to class. I would like to proudly say that we were calmly late for our 8am appointment. I am not proud that we were late, but I am proud that I didn't stress out or become anxious in morning traffic. Instead we kept it light and slowly made our way to the office for the last of the pre-reqs including bloodwork and other fun stuff.

Then, we sat in the waiting room prior to class intently focusing on the people around us (sad but true, whether in a support group or MD office, it is hard not to people watch the other infertiles around you to confirm that in-fact they look normal therefore you too must be normal). While watching, I saw a scenario play out that I have reviewed in my mind a million times. A couple, waiting for class, ran into a friend in the waiting room, and quickly it was obvious that neither had any idea of the others struggle with fertility issues. There were awkward exchanges and finally the friend of my classmates breaks the tension with a fabulous question..."so, have you started the shots yet, cause they make you crazy?"!! It was hilarious to me and honestly they all seemed to have a good laugh too.

Then we were all called back to the swanky conference room to start class. I say it was swanky because they had lots of snacks, leather chairs, and fun goodie bags on the table. It doesn't take much to impress me, plus I have noticed that in these places that are primarily private pay - they tend to splurge a little more on the patients than our local health department. Anyway, our classmates were 2 other couples who seemed similar in age/stage of life to us, a woman with a recording device because her husband couldn't get off work, and a single lady. Yep, I said it... a strong, independent, kind of strange but obviously very determined, single woman. She had previously attempted IUI with donor sperm and for whatever reason had now moved on to IVF. I admit I was and still am kind of torn with my feelings about this woman. I admire her independence and desire, while at the same time it is hard for me to imagine undergoing this emotional roller coaster without such an incredible companion by my side.

So, the details of class were pretty basic. We reviewed different shots and practiced with saline filled syringes. We discussed a generic protocol that involved taking lupron, follistim, and ovidrel; however I learned later in our meeting with the nurse that this would not be our personal protocol, which for some reason annoys me cause I feel like I was focusing hard to learn something I didn't need to know. I am sure it didn't hurt me to learn more info than needed and I am sure that the principals are the same, however I do wish I had known our protocol prior to class instead of after.

Anyway, after a lovely class where we discussed basically shots and then the overall cost of this monster project, we then met with our new IVF nurse. She will be our point person and the main contact through the process which is great, because I feel like 1 point person will decrease confusion. We were told at this meeting that our drugs of choice will be good old birth control, ganirelix, follistim, and ovidrel. What I can gather is that ganirelix is started later in your cycle and used to prevent ovulation, while lupron drops your hormone levels down early and suppresses them for the whole cycle instead of just changing hormones right before ovulation. The nurse said that ganirelix was chosen for me because they have no reason to think I will not stimulate well (based on age and no known medical issues) and it will produce fewer, better quality eggs, thereby hopefully preventing hyper-stimulation. The other positive is that ganirelix requires fewer shots and based on what my other IF friends have told me, I want no part of the craziness that Lupron creates ie. hating everyone, crying often, and other awesome hormonal imbalances!! I also think the part 'better quality eggs' sounds good but I must admit that I am  apprehensive when they operate under the pretense that I will have no problems with this cycle. I know that to this point we have been a "male-factor infertility" couple, but I am simply afraid that they will assume I am good to go and then I will not only disappoint them, but also disappoint myself when I don't stimulate the way they expected and we have to cancel the cycle. I know that these fears are baseless and that we can adjust meds as we go, so I am trying to trust that my doctors have the right plan in place for us and that God is guiding the path that lies ahead. I am also trying to stay away from google because you can imagine that searching my protocol and finding details about other people's failed or successful cycles has already proved to be a bad idea.

Overall, since leaving class I am feeling good. My sweet husband and I are on the same page and both ready to start the process and keep moving forward. At lunch after class we discussed the pros and cons of starting soon or waiting a few months based on our social calendar, but eventually we agreed that waiting just doesn't make sense after we have already waited so long. So, although my darling hubby is still struggling with idea that 'no drinking' prior to the cycle means "no drinking" at the Superbowl parties, he is ready to move forward and so am I.

So, now we wait for cycle day 1, when birth control, extra vitamins, and antibiotics become the new normal at our house. I can honestly say that for the first time in 50 cycles of TTC, I am grinning from ear to ear when I think about cycle day 1. Finally, it no longer indicates that we failed at conceiving this month, it now means we are moving forward and we are one step closer to meeting the little person that waits in our future.

jenn

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