Sunday, January 8, 2012

Next Steps

After a failed cycle, there are steps I go through in order to cope. First, I am very sad or angry. Usually sad, then angry (although this time it was the other way around). Then I go through a punishing phase. This sounds unhealthy, but I swear it's not. I get so pissed off at all the time wasted doing good things for my body when it clearly did not care to reciprocate. I feel the need to do everything possible that was forbidden before. I drink tons of coffee. I drink tons of wine (or tequila if it's Friday night). I eat crappy food, like french fries and un-organic apples and candy. Tasty, processed, refined sugary candy. I take advil if I get a headache (which I most certainly get thanks to the alcohol and caffeine and sugar) without worrying if it is screwing up my lining. I basically take a week or so and undo everything that I did to make my chances greater, and punish that stubborn body of mine for not cooperating with me on this one simple (not-so-simple) request. Then I can throw myself into my plan for my next cycle and begin the preparation and deprivation and uber-healthy habits all over again, in hopes that it might actually be helpful this time.

This last lost cycle had the benefits of the holiday break falling right after our negative. I could really go to town on the bad-habits front, because EVERYONE is eating crappily and drinking too much and trying to fix it with extra coffee and ibuprofen the next day. I looked like everyone else. I definitely didn't feel like everyone else, though. Emotionally I am feeling just a bit (major understatement) beaten down by this whole process. I am exhausted and feeling just slightly hopeless and sorry for myself. I am wondering why it is that we are just not hitting the baby roulette even though we have substantially upped our odds through technology. When you figure that the average fertile couple has only a 20% chance of conceiving in any given month and with all this medical intervention we had up to a 50% chance, it is a miracle that people get pregnant within a month or two of trying and here I am, 7 IUIs, 3 fresh IVFs, and 1 frozen transfer later with nothing to show for it. But whatever. The pity party is part of the steps. As long as I don't stay in this place of relative darkness, weepiness, and frustration, I can keep moving towards our goal.

With each failed cycle or loss, I need to make a new plan to have something new to look forward to. I need to know what we're doing to fix whatever didn't work and move forward in a productive way. In the past I wallow first, then plan. This time I jumped right into the planning, mid-wallow. I need to get going on our next cycle so that I can get this show on the road--if there's truly no good reason for why we aren't getting (viably) pregnant and it's really just a matter of rolling the dice the right number of times, then I want those dice on the table as soon as possible.

So here is our plan:
1) I want to be ABSOLUTELY SURE that there is nothing wrong with that uterus of mine. I am having a hysteroscopy in January to get eyeballs on the inside of my uterus. I realize that I have had a normal HSG (x-ray with dye that is truly meant for checking if your fallopian tubes are clear but also can show if you have anything weird hanging out in your uterus), and two normal saline sonohistograms (ultrasound with saline that fills up your uterus and can show if you have funky things hanging out in there that could interfere with implantation). I realize that I had a laparascopy that, in addition to removing my sad little ectopic pregnancy and my defunct right tube, showed a beautiful outside to my uterus (minus the small amount of endometriosis that was hanging out on the back of the exterior that has since been removed). But I want ACTUAL EYEBALLS peering into my uterus, making sure that the images from x-ray or ultrasound weren't somehow hiding a culprit. The hysteroscopy is a surgical procedure (surgical because I'm sedated, not because of an incision) where my doctor will dilate my cervix and then use a 4mm scope to visually survey the contents of my empty, empty uterus. If there's anything untoward in there (polyp, fibroid, some other insidious but benign entity) it can then be removed. They are also going to do a light scraping of my lining. Or, as I like to think of it, freshening up my baby room with a new coat of paint. I've got dusty wallpaper in there now and I'd like to get some nice sticky paint up that will encourage a baby to hang out for a while. ("Hey thanks, Mom, all I really wanted was some fresh new digs! Now I'll totally stay until I can come meet you guys face to face!") This theory may not be 100% airtight, but it's worth a try. Even if this hysteroscopy reveals a frustratingly normal uterus glowing with health, then at least we will know before dropping an obscene amount of money and putting my body through the trauma of all the drugs that we truly are just very unlucky.
2) I've had bloodwork done to check that I don't have some weird clotting disorder or genetic flub that could be keeping my embryos from implanting. I've been told before (and now) that most likely an issue like that wouldn't keep me from getting pregnant, it would only keep me from staying pregnant, but I think I'd like to know if that's an issue before I have a chance to be pregnant again anyway. Who wants to find out they have a weird blood issue after they've miscarried a precious and long-awaited pregnancy? Not me. So I want this bloodwork, again even if it's just to confirm that we're again just really, really unlucky.
3) We are having our consultation to get on the books for a March transfer. Why March? Because I want a shot, a chance, at a 2012 baby. If we wait until April we're looking at a January due date. 2012 will come and go for sure without a baby on our Christmas card. We won't even have the tiniest chance. So March, I want March. Unfortunately that means that we're doing our egg retreival and transfer in the one month I don't have a break, but quite frankly I don't care at this point. I have to do what I have to do to succeed at having this family, and if it's not convenient in the school calendar then so be it. I'm sure other people don't schedule their medical treatments around break times. I have passed the point where anything but having this baby with Bryce comes first on my priority list. March it is. And, if we do a similar protocol to the one we did over the summer that resulted in a (ill-fated) pregnancy, my time with the needles will be significantly shorter than it was for the frozen cycle. For the frozen I was shooting up daily for about a month and a half. For the lupron-free protocol that resulted in such pretty embryos, I think I did shots for not even 2 weeks leading up to retrieval and then 2 weeks of the progesterone butt shots after that. Shorter. More productive. Less distruptive. Hopefully more successful.

So there it is, the plan from a purely medical standpoint. I am fully aware that all of our exploratory business could be for nothing, that the hysteroscopy could be normal and the bloodwork could be normal and I could be left with truly no good reason why we haven't been able to seal the baby deal. But it is absolutely worth it to me to make sure, to exhaust all reasonable options, before we go into this fourth fresh IVF cycle and fifth embryo transfer. Even if everything just confirms that we just keep pulling the short stick, at least we'll know there is a long stick in there, hiding somewhere. And we will find it. Hopefully in time to have one of those beautiful Christmas card/birth announcements come out in December 2012.

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