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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A new kind of Therapy

I attended acupuncture for the second time this week and I although I had a little more trouble zoning out or sleeping, I still left in good spirits. I feel good about taking this time for myself. I acutally am wondering if that might be the real secret to this acupuncture thing. Is it possible that people are benefiting, at least in part, by just stopping and taking an hour or two out of their busy lives for relaxation. I mean, this world is so focused on running from one thing to the next and worrying about the future, is acupuncture just a coping skill that gives us the time and the environment to be calm, to reflect, and to make an effort for our health and well-being?

I really have no idea how acupuncture works except that somehow it improves the flow of your Qi, which is the energy that flows though your body similar to your nervous system or blood vessels. I understand that this interlinking system is the reason that a needle in my shin or foot might cause increased blood flow to my ovaries, ie. the needle does not have to be at the site of the problem because your body is an integrated system. Regardless of how it works or whether it is merely a coping mechanism that helps reduce stress and thereby promote one's well-being...I like it and I think I will continue to go, maybe even after this IVF cycle works!!

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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