Everything was looking great up to today. My estrogen had risen much more appropriately than the last cycle that was canceled under this protocol--it went from baseline 27 to first bloodwork-only monitoring 80.
So I wasn't super nervous about today's monitoring. I felt like I was off to a good start, although I'm not super uncomfortable from the FSH drugs. I had some sense of worry leftover from the last cycle, but was confident today would look good.
Wrong.
Guess what's back? My fricking enemy, fluid. Little bubble of fluid at the top of my uterus. And my lining is thin. Hard to say how thin because measuring with the fluid is cheating, but 6.2mm is not what they were hoping for. And fluid? Forget it.
I was told whilst stirruped that they were going to bump up my meds, hoping this was an "estrogen issue." I don't really know what that means, but I had to do a quick overnight-shipment order of the Follistim since I now have enough for tonight only, not enough for tonight and tomorrow. I was told it's not over, they think they can get that fluid gone with a more robust estrogen boost. So I was upset, understandably, but not super upset.
Okay, that's a lie. I cried my way down the 90. I can't BELIEVE the fluid's back and this freaking fancypants protocol is failing me, AGAIN. (Probably more accurate...my body is failing me, again.) I can't BELIEVE I have about a 50-50 chance of getting canceled again. I can't handle this anymore. I don't know what to do, because I really, really wanted to get these embryos into a uterus and give them a chance, since we, you know, created them and all.
My solution to feeling overwhelmed and sad and frustrated?
1) Watch a movie on the couch covered with the Christmas Quilt made by Bryce's mom. Make it The Best Exotic Marigold Hotel, because it's funny and heartwarming and people in their golden years don't talk about infertility or babies or anything. (Great movie, by the way...go watch it if you need a pick-me-up.)
2) Do something pamper-y. In my case, I had a situation where yesterday one of my students commented on my grey hair. Like, "I didn't realize how much grey hair you have! It's a LOT!" Then another students said, "We have to be nicer to her. Those grey hairs are probably from us." Gotta love 8th graders. Anyway, it prompted me to want to color my hair. And today, when everything is quickly sliding downhill into a steaming pile of shit, I decided I would GET my hair colored. Something I haven't done in around 10 years. If I have to feel crappy on the inside, I can at least look good on the outside. I just had to swallow the guilt at coloring my hair at a salon in the middle of the day when I should be at school (but I had to take the full day for the appointment in Buffalo, so why not?).
I felt a little better, until I got a phone call while my hair was being paint-brushed with permanent dye around my greys and I was getting a lovely preview of what I'd look like bald (surprisingly not unattractive, by the way).
It turns out that my estrogen DROPPED. It went from 80 on Monday to 71 today, despite 150 of follistim and 5 of the mysterious Solution X. That is NOT good. So they want me to do bloodwork only on Saturday.
I know what this means.
They are leaning towards cancelling if the bloodwork sucks. Because there's no point in making me drive out to Buffalo if my estrogen is still in the toilet. They know the fluid is there, and unless my estrogen goes up, then I am going to be low estrogen, thin lining, fluid CANCELED. Done. Finito.
On the positive side--the raise in my dosage could rescue the cycle, maybe. I could have great estrogen and then have to come in on Monday. Oh no, which means that I need to have sub plans ready on my desk just in case I'm out Monday. Arghh.
It's not over yet. I can just hear the fat lady warming up. I just don't understand this at all. Why can't I even get CLOSE to transfer anymore? What has changed? Why does my body suck so much? Why can't I just reach this resolution? If I get canceled, I am going to lose my mind a bit. Or a lot.
Please send virtual love notes to my uterus and my ovaries, that they may do what the frick they're supposed to do between now and Saturday. That should offset the telling-off I have been doing.
Ironically, as I got in the car to drive away from my hair coloring experience, the song that immediately came on the radio was "Don't Stop Believing" by Journey. A song that once would make me feel really warm and happy inside, make me think surely it's a good sign. But now it just reminds me of how stuck I am, of how much believing I've been doing and how little that has done for us. I would like to believe this cycle can be rescued. I just want to move on to what's next. I just want to believe we can be parents, and not be stuck in this Sisyphusian hell.
Thursday, January 22, 2015
Monday, January 19, 2015
#Microblog Mondays: Stabby Little Moments
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This week, social media has not been my friend:
1) A Pinterest feed from a newly prego acquaintance that I'm pretty sure I'm going to have to block (but have no idea how)... I do not need my feed clogged with a flood of "How to stay skinny/fit/gorgeous when pregnant" pins that raise my ire because while I'm all for being fit (even though it is a state that eludes me) and healthy, it seems that the 9 months or so is perceived as a huge hurdle, maybe even inconvenience, to the otherwise hotness that needs to be maintained and regained, stat.
2) A photo posted from a party had by ladies from my cohort at Fertility Yoga where they celebrated the at-long-last baby of one lady and all got together to celebrate...but only the mommies (favorite comment: "It's just like old times, except the very big difference that we're all mommies now!"). Except some of us aren't, but no worries because those of us who didn't "Make it" kind of fell off to the wayside by both parties--there's a camaraderie between the Other Side Moms that I can't connect with. Still painful, because it reminds me just how long I've been outside of this circle.
3) Posts that flood my facebook feed that by themselves are fine but en masse make me a little sad, not to mention comments like, "Being a mom is the BEST JOB EVER" that make me feel horribly inadequate since I think I have awesome qualifications but it's like I just can't seem to match my skills up just right to truly be considered.
Bryce had his own stabby moment today, WITHOUT the benefit of social media.
He ran into a coworker he hadn't seen in a while at the gym, who informed him that he and his wife were expecting a baby. All good, except for this gem: "Yeah, we started trying a few months ago, because we decided we didn't want to run into those problems you can have when get too old, and it worked!"
AAAAAAAAAAAAAARRRRRRRRRRRRRGGGGGGGGGGGGGGGGGHHHHHHHHHHHHHHHHHHHH, on behalf of Bryce, on behalf of me, on behalf of whoever else this person may unwittingly say this to who is thinking on the inside, since it's not necessarily known on the outside, "Yup--there sure can be problems, and getting older doesn't help."
Want to read more #Microblog Mondays? Go here and enjoy!
Sunday, January 18, 2015
The Last One (or is it?)
I wasn't lying when I said I was at peace with our decision. Honest, I wasn't. I am at peace, and I know that this decision to use our frozens, be done with treatments one way or another, and start the registration process for domestic infant adoption wouldn't be easy but it was absolutely the right call at this time.
It's just really hard to be in this In Between space, now that I'm jabbing myself with needles 3x a night and my body is hopefully responding to the drugs and setting me up for a transfer. I think I can pinpoint why I am having such a difficult time.
This could be The Last Cycle. Or, it could be the Next To Last Cycle. And I won't know until days before transfer, maybe even the day OF transfer. That's a little difficult to prepare myself for, and while I am trying not to worry too much about what could happen, it's just kind of my way to prepare myself for all possible outcomes. Even though it's probably not very constructive. Strike that, it's completely not constructive.
I think if I knew for sure that this was it, the last cycle, I could feel a little less unsettled. It is striking to me how much loss I am feeling, for as much as I am looking forward to NOT DOING THIS ANYMORE. Every needle prick, every purple-green-gold bruise that blooms on my stomach due to the Lovenox, every moment where I realize I HAVE TO GET HOME TO STICK MYSELF, every drive to Buffalo... I am reminded that I am so sick and tired of this process and the (so far) inevitable disappointment that it brings. I work so hard to make this work, and I am rewarded with loss and pain and emptiness. So, I do feel a sense of GOOD RIDDANCE.
However, I can't help but hope that maybe this time things will work out okay. It is a tiny tiny incandescent bubble of hope in an otherwise dark place when it comes to treatment, that is being gradually shoved over with flickering hope for the adoption process. How can I not wish that this time will be THE time, as unlikely as it seems? We have changes in the protocol in the form of a little blue pill that is NOT estrace, that poor Bryce had to pick up yesterday and felt (real or imagined) disdain radiating from the pharmacy clerk. I've been reading up on this protocol, and there is an article here that talks about it (who knew it's been around since the 1990s???) although a slightly different variation than the one I'm on. It could be promising, but it's not a miracle cure. So my hope rises a bit because SOMETHING NEW, but then drops again because what if I'm one of the women for whom it doesn't work? Or what if it would take 3 cycles to get it optimal, and I have just this one? Or maybe two? My mind starts circling down a dangerous drain.
In no way does this make me want to do another fresh cycle. It just makes me sad because there will always be something new, always be a protocol that could possibly maybe work for us, because that's why we've kept going to this point. It hasn't worked. Could it work? Maybe, but our personal trending line says no, not likely. The temptation is always to try the next best thing, but after round after round after round after round after round of next best things and nothing to show for it but the incredibly aggravating size of our "medical expenses" folder for 2014 taxes, it's just not worth it. But I can mourn the loss of possibility, even if it is so small that it would fit a flea.
This is not to say that I wouldn't love to be proved wrong and have a successful cycle. I'm just so burnt on riding a positive train through the whole cycle only to be crushed at the end. I will still be crushed if I get a negative call in February. Especially if it is the Last Ever Call. That finality will be tough. But, also weirdly freeing.
Right now, it's just tough. 100% tough. I am doing a cycle in which I have very little confidence. It could be the last cycle, or it could be the second-to-last cycle and I have to go through this rigmarole again. The uncertainty, the not-knowing, is not pleasant. If I knew it was my last, last cycle, I think maybe I could prepare myself better. But I can't quite treat it like the final cycle, because we could miraculously get good embryos out of these 2PNs. It's such a crapshoot and it makes me nervous, the not-knowing. Or, I could get a call on Day 2 of growing them out and they could say, "It looks like we could have 3-day embryos but it's hard to say if we'll have blasts." We originally said we'd hold out for blasts, but now I am wavering. I know of an awful lot of cute babies who were 3-day embryos, or even 2-day embryos. Plus, these embryos were frozen on day 1, without vitrification, and the cohort that's gone before them has been disappointing. So... even though they being thawed and grown in a fancypants, state-of-the-art lab, they may have had a rough start and that's enough to stunt their progress. So is it cheating to do a Day 3 transfer? Delaying the inevitable? Or is it giving them a better chance? I DON'T KNOW. I am thrilled that we are doing these first because we have what we know are gorgeous blasts waiting in the freezer, and if these don't make it then we aren't left stuttering in the middle of a sentence that never ends. I am, however, increasingly nervous about the thawing and growing-out days and my ability to stay sane during that time.
Of course, there's also the fact that I didn't even get close to transfer last time, but supposedly the blue pills should help with that, as well as my Femara-less protocol. We can hope that was just a crap cycle and this one will go without a hitch, all the way to transfer.
This in-between state isn't just for this cycle... it's impacting our movement on the adoption application as well. Remember how before we decided this was the end, that I was hesitant about putting energy into two processes at once? I guess I know myself pretty well. I am having a hard time dedicating time and energy to both processes when I'm feeling so sad about our losses. Everything I've read says that you need time to mourn your loss of a biological child before moving full steam ahead with adoption, that it's fairest to you and to the baby you are creating a family for, together. We've done so much mourning already--we have no chance anymore of a biological child who is 50/50 both of our genes. That's gone. If the 2PNs don't work out well, then we officially lose Bryce's genetic contribution, and while we've been mourning that, now it will be totally beyond the realm of possibility. Then, our last effort for pregnancy will be my genes and our sperm donor's genes... and if that doesn't work out then we will be done, done, done. So we're mourning piecemeal, one string of DNA at a time.
It does reaffirm how excited we are for a totally new process, for a renewed sense of hope in creating a family, for being equal partners in every way to fill the emptiness in our home and our hearts. That the genetic loss has already been underway eases our mourning process. In theory. In reality, I am finding that my feelings are pretty raw and sad now that we are really in the final throes of our dream to experience pregnancy as a couple. Still able to see the promise and the joy that can be ours through a different pathway, but it's hard.
So the application has been languishing a bit. I would really, really like to have it done before the end of January, and be officially registered by February. I would like an official start on this new adventure as the old one is gasping for its last breath. I have had friends who've gone before me say how helpful it was to have an optimistic new start in the works when they received their final bad news. They were still incredibly sad, but it wasn't a hopeless pit of despair. Things were in the works.
And if we're successful, by some crazy miracle? I don't apologize for my lack of positive thinking vibes on this cycle. I really do believe we have such a small chance for success, and it is somewhat easier to think of this as a step we must take to get to our family. Maybe it will bring us to our family, but more likely adoption will. But, if we manage to be successful, I will be happy, once I believe that it's for keeps. And I will strangely feel guilty for wasting someone's time, even though that's totally not what we meant (or what it is). I also don't ever want to be used as an example of someone who started adoption paperwork and then got pregnant, see how that works? NO NO NO. Someone just (innocently/ignorantly) said that doing adoption paperwork results in pregnancy to us. NO NO NO. If we're successful, it will be because of the new protocol, and magical lining up of tiny little stars that are incredibly difficult to align. It will not be because we registered with an agency. It will not be because it was our last cycle (or second-to-last, argh), or because I felt not excited and so wasn't as stressed (who are we kidding? I'm totally stressed because I'm feeling such dread), or because I did or didn't cut out a single cup of coffee on my weekend days. It won't be because of what I did or didn't eat, or the earrings I wore, or the color of my underwear. It will just be a straight-up miracle of timing and conditions. And one I have a hard time believing will be for us.
So, as you can see, this is a tough spot to be in. I have my first blood draw post-follistim tomorrow, so we'll see if my estrogen does a better climb than it did with the combo femara protocol. We'll see if the bottle of hilarious little additions make a difference later in the week, when I drive again to Buffalo for ultrasound monitoring. (Incidentally, I had to drive on Friday to pick up their Solution X medication and get bloodwork, and the forecast was totally clear until 5:30 in the morning, when we had a lake effect snow weather statement. IT TOOK TWO HOURS to get there, in white-knuckle conditions, and I was completely late both to bloodwork and back to school. Yup, definitely taking full days off for monitoring this time. The weather and the thruway hate me.) I'm not sure what to hope for -- a swift end to this process that has been nothing but cruel, or an unlikely miracle. Maybe both, in unequal amounts. I just hope for a smooth cycle and no more surprises, I guess. I hope that what we're doing brings us closer to a home filled with giggles and gurgles and burping cloths, instead of the deafening silence we currently enjoy. Just bring us closer to family. Okay, Universe?
It's just really hard to be in this In Between space, now that I'm jabbing myself with needles 3x a night and my body is hopefully responding to the drugs and setting me up for a transfer. I think I can pinpoint why I am having such a difficult time.
This could be The Last Cycle. Or, it could be the Next To Last Cycle. And I won't know until days before transfer, maybe even the day OF transfer. That's a little difficult to prepare myself for, and while I am trying not to worry too much about what could happen, it's just kind of my way to prepare myself for all possible outcomes. Even though it's probably not very constructive. Strike that, it's completely not constructive.
I think if I knew for sure that this was it, the last cycle, I could feel a little less unsettled. It is striking to me how much loss I am feeling, for as much as I am looking forward to NOT DOING THIS ANYMORE. Every needle prick, every purple-green-gold bruise that blooms on my stomach due to the Lovenox, every moment where I realize I HAVE TO GET HOME TO STICK MYSELF, every drive to Buffalo... I am reminded that I am so sick and tired of this process and the (so far) inevitable disappointment that it brings. I work so hard to make this work, and I am rewarded with loss and pain and emptiness. So, I do feel a sense of GOOD RIDDANCE.
However, I can't help but hope that maybe this time things will work out okay. It is a tiny tiny incandescent bubble of hope in an otherwise dark place when it comes to treatment, that is being gradually shoved over with flickering hope for the adoption process. How can I not wish that this time will be THE time, as unlikely as it seems? We have changes in the protocol in the form of a little blue pill that is NOT estrace, that poor Bryce had to pick up yesterday and felt (real or imagined) disdain radiating from the pharmacy clerk. I've been reading up on this protocol, and there is an article here that talks about it (who knew it's been around since the 1990s???) although a slightly different variation than the one I'm on. It could be promising, but it's not a miracle cure. So my hope rises a bit because SOMETHING NEW, but then drops again because what if I'm one of the women for whom it doesn't work? Or what if it would take 3 cycles to get it optimal, and I have just this one? Or maybe two? My mind starts circling down a dangerous drain.
In no way does this make me want to do another fresh cycle. It just makes me sad because there will always be something new, always be a protocol that could possibly maybe work for us, because that's why we've kept going to this point. It hasn't worked. Could it work? Maybe, but our personal trending line says no, not likely. The temptation is always to try the next best thing, but after round after round after round after round after round of next best things and nothing to show for it but the incredibly aggravating size of our "medical expenses" folder for 2014 taxes, it's just not worth it. But I can mourn the loss of possibility, even if it is so small that it would fit a flea.
This is not to say that I wouldn't love to be proved wrong and have a successful cycle. I'm just so burnt on riding a positive train through the whole cycle only to be crushed at the end. I will still be crushed if I get a negative call in February. Especially if it is the Last Ever Call. That finality will be tough. But, also weirdly freeing.
Right now, it's just tough. 100% tough. I am doing a cycle in which I have very little confidence. It could be the last cycle, or it could be the second-to-last cycle and I have to go through this rigmarole again. The uncertainty, the not-knowing, is not pleasant. If I knew it was my last, last cycle, I think maybe I could prepare myself better. But I can't quite treat it like the final cycle, because we could miraculously get good embryos out of these 2PNs. It's such a crapshoot and it makes me nervous, the not-knowing. Or, I could get a call on Day 2 of growing them out and they could say, "It looks like we could have 3-day embryos but it's hard to say if we'll have blasts." We originally said we'd hold out for blasts, but now I am wavering. I know of an awful lot of cute babies who were 3-day embryos, or even 2-day embryos. Plus, these embryos were frozen on day 1, without vitrification, and the cohort that's gone before them has been disappointing. So... even though they being thawed and grown in a fancypants, state-of-the-art lab, they may have had a rough start and that's enough to stunt their progress. So is it cheating to do a Day 3 transfer? Delaying the inevitable? Or is it giving them a better chance? I DON'T KNOW. I am thrilled that we are doing these first because we have what we know are gorgeous blasts waiting in the freezer, and if these don't make it then we aren't left stuttering in the middle of a sentence that never ends. I am, however, increasingly nervous about the thawing and growing-out days and my ability to stay sane during that time.
Of course, there's also the fact that I didn't even get close to transfer last time, but supposedly the blue pills should help with that, as well as my Femara-less protocol. We can hope that was just a crap cycle and this one will go without a hitch, all the way to transfer.
This in-between state isn't just for this cycle... it's impacting our movement on the adoption application as well. Remember how before we decided this was the end, that I was hesitant about putting energy into two processes at once? I guess I know myself pretty well. I am having a hard time dedicating time and energy to both processes when I'm feeling so sad about our losses. Everything I've read says that you need time to mourn your loss of a biological child before moving full steam ahead with adoption, that it's fairest to you and to the baby you are creating a family for, together. We've done so much mourning already--we have no chance anymore of a biological child who is 50/50 both of our genes. That's gone. If the 2PNs don't work out well, then we officially lose Bryce's genetic contribution, and while we've been mourning that, now it will be totally beyond the realm of possibility. Then, our last effort for pregnancy will be my genes and our sperm donor's genes... and if that doesn't work out then we will be done, done, done. So we're mourning piecemeal, one string of DNA at a time.
It does reaffirm how excited we are for a totally new process, for a renewed sense of hope in creating a family, for being equal partners in every way to fill the emptiness in our home and our hearts. That the genetic loss has already been underway eases our mourning process. In theory. In reality, I am finding that my feelings are pretty raw and sad now that we are really in the final throes of our dream to experience pregnancy as a couple. Still able to see the promise and the joy that can be ours through a different pathway, but it's hard.
So the application has been languishing a bit. I would really, really like to have it done before the end of January, and be officially registered by February. I would like an official start on this new adventure as the old one is gasping for its last breath. I have had friends who've gone before me say how helpful it was to have an optimistic new start in the works when they received their final bad news. They were still incredibly sad, but it wasn't a hopeless pit of despair. Things were in the works.
And if we're successful, by some crazy miracle? I don't apologize for my lack of positive thinking vibes on this cycle. I really do believe we have such a small chance for success, and it is somewhat easier to think of this as a step we must take to get to our family. Maybe it will bring us to our family, but more likely adoption will. But, if we manage to be successful, I will be happy, once I believe that it's for keeps. And I will strangely feel guilty for wasting someone's time, even though that's totally not what we meant (or what it is). I also don't ever want to be used as an example of someone who started adoption paperwork and then got pregnant, see how that works? NO NO NO. Someone just (innocently/ignorantly) said that doing adoption paperwork results in pregnancy to us. NO NO NO. If we're successful, it will be because of the new protocol, and magical lining up of tiny little stars that are incredibly difficult to align. It will not be because we registered with an agency. It will not be because it was our last cycle (or second-to-last, argh), or because I felt not excited and so wasn't as stressed (who are we kidding? I'm totally stressed because I'm feeling such dread), or because I did or didn't cut out a single cup of coffee on my weekend days. It won't be because of what I did or didn't eat, or the earrings I wore, or the color of my underwear. It will just be a straight-up miracle of timing and conditions. And one I have a hard time believing will be for us.
So, as you can see, this is a tough spot to be in. I have my first blood draw post-follistim tomorrow, so we'll see if my estrogen does a better climb than it did with the combo femara protocol. We'll see if the bottle of hilarious little additions make a difference later in the week, when I drive again to Buffalo for ultrasound monitoring. (Incidentally, I had to drive on Friday to pick up their Solution X medication and get bloodwork, and the forecast was totally clear until 5:30 in the morning, when we had a lake effect snow weather statement. IT TOOK TWO HOURS to get there, in white-knuckle conditions, and I was completely late both to bloodwork and back to school. Yup, definitely taking full days off for monitoring this time. The weather and the thruway hate me.) I'm not sure what to hope for -- a swift end to this process that has been nothing but cruel, or an unlikely miracle. Maybe both, in unequal amounts. I just hope for a smooth cycle and no more surprises, I guess. I hope that what we're doing brings us closer to a home filled with giggles and gurgles and burping cloths, instead of the deafening silence we currently enjoy. Just bring us closer to family. Okay, Universe?
Monday, January 12, 2015
#Microblog Mondays: Mourning in Home Depot
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In the interest of getting all parts of our lives moving forward, after seeing The House (which has sold, thank goodness, and no longer haunts us quite so intensively), we decided we'd seriously look into selling our house in the near future so that we can find and buy our forever home. So, we met with a realtor, who (sight unseen) said that if we felt our kitchen was outdated that we should update it before putting our house on the market, that we would definitely reap the benefits of that upgrade. How ironic, that we may finally get a beautiful kitchen that works for us in this house right as we're saying goodbye.
Tonight we met with the designer in our local Home Depot, and gave measurements and picked out possible cabinet styles and colors and countertops and all that jazz, and then sat and stared into space while she drew up the schematics--well, sort of stared into space.
Bryce was wearing this little hat (he has virtually no hair so his head gets cold and Home Depot is drafty), and he leaned back in his chair and yawned. For some reason, the way his face moved, and the way the hat was on his head, I could just see exactly what a baby would look like that had his facial features, a baby that was contentedly yawning in our arms just like he was (well, maybe not JUST like he was, as Bryce is now sporting a full beard and that looks kind of funny on a baby).
I was suddenly completely overcome with a wave of incredible sadness. We have one questionable shot left of having a baby that has those features, with the 2PNs in February, and then that shot is officially gone. Which we knew, but somehow, seeing a little apparition of that baby-that-could-be in the middle of Home Depot really brought home the incredible loss that we are most likely facing, and how much mourning is buried inside me.
Want to read more #Microblog Mondays? Go here and enjoy!
Want to read more #Microblog Mondays? Go here and enjoy!
Wednesday, January 7, 2015
It's Always Snowing in Buffalo (Consultation Update)
We have decided that we are master planners when it comes to driving to Buffalo in the winter. If it's going to be a super cold, super snowy, super windy day... that's the day we'll have an appointment that we planned weeks ahead of time.
Today it took me almost 7 hours to drive to Buffalo and back for our consult. Part was planning for bad weather, part was HORRIFIC roads due to bad weather, and part was that our appointment was late to start and then longer than expected.
But I would bet that you don't really care about the weather or the driving conditions so much in this post...
The consult went very well. We had my trusty purple notebook with our notes written diligently over sushi lunch, and all of our points to discuss and ask about. We started by catching up and chatting as friends, but I saw our doctor's eyes flitting to the list during this time, and hoped that phrases like "get this shit over with" weren't catching his eye early.
So, the reason for the extra month of Pill... hormone therapy to help my lining restart. The theory is that that last cycle sucked pandaballs because my lining was screwy from healing up from the hysteroscopy in November. That taking down the adhesions at the tippy top of my uterus was more traumatic than originally thought, and so that's why the fluid and that's why the lining failure.
Which led to me saying that the ultrasound didn't show any fluid, and how did we know another month would help, which led to the very frustrating fact that my OB/GYN did NOT send the ultrasound report over. So um, local monitoring is now out the window because I trust them not. (Maybe even birthing our baby, should we get there, is out the window...because if you can't follow up on a nonessential but still kinda important ultrasound communique, then can I trust you for the rest of my care???) I shared the details I remembered, but this wheedling of, "But everything looked pretty good last week" led to the BIG STATEMENT.
I started saying that we were feeling strongly that we didn't want any more delays, that we weren't going to do any more fresh cycles, that the frozens were it... and then I dissolved into tears. I was not expecting to not be able to deliver our statement on where we are with treatment myself. I passed the notebook to Bryce and he finished saying what needed to be said. He did a wonderful job, with sensitivity yet firmness. He's so good at handling things like this.
I'm pretty sure our doctor looked a little sad, but he understood. He said he knew this was coming ever since the hysteroscopy when I showed him the domestic adoption book in my purse. And then we had a conversation about how hard it is to have to be the ones to pull the plug on this endeavor. That to not have a definitive "this isn't working for you" decree from a doctor was really hard, because there's always hope but we've lost the ability to physically and emotionally continue down this path. We don't believe anymore. We can have some hope for these last two cycles, but it won't be easy, since it's like a death of a thousand cuts. And still, we are not being told that this is impossible. We are a mystery, because we've had good cycles and then we've had bad cycles but there's no consistency. We are NOT beating a dead horse, since that horse keeps changing in terms of protocols and genetic components. But we are too exhausted to keep hoping for a golden cycle when things are so murky. Pulling the plug ourselves sucks. We wanted to be broken up with first, in an odd but utterly understandable way.
After that was over, we talked protocols, possibilities, and all that jazz. And we're NOT doing another month of Pill. We ARE doing the 2PNs first. We ARE holding out for blasts, as much as that pains me because it really lowers the chances that we'll have anything to transfer, but stranger things have happened. It is entirely possible that we could have our last cycle in February. (Transfer will be first week of February, most likely.) Which, while a bit distressing initially, is wonderful. I tearfully shared that it could do me in to still be cycling in May, what with my birthday and Mother's Day within days of each other (and neither being particularly happy days lately). That we need closure, whether that's a long-awaited pregnancy or the finality of an end to this course of treatment.
As far as the scarring goes, he said that the amount was truly minimal and it is at the very top of the uterus. He said I am not at any risk for hemorrhage, rupture, or late miscarriage beyond what anyone else my age would face, and that age is only affecting genetics, not my uterus. That was reassuring. He explained if the scarring was more severe, or on the sides, that would NOT be the case, but that my location and minimal severity is not worth worrying about. Whew.
The final kicker for getting the cycle going now was an impromptu saline sonohysterogram, which I was SO not expecting and I am STILL feeling crampy and icky over, but it was totally worth it because it showed ABSOLUTELY NO abnormalities in my lining, no scarring visible, no polyps, nada. Everything looked great. Bryce's hand got squeezed quite a bit, because that is NOT a cozy test for me, but it was good to get that confirmation. I was scared it would show bad news, but I was pleasantly surprised. Maybe this will be a trend.
So, the new protocol is Femara-less, because we do suspect that didn't work out well for me given my AMAZING rise in estrogen from baseline to first monitor of 22-37. (Hint: that's pathetically UNamazing.) So we do the stimming FET protocol, but with Follistim only. If I get 5-6 follicles it doesn't matter because we're not doing anything with the eggs... so as long as I don't hyperstim we're good. Still Lo.venox, still terbu.teline, still PIO... but a slightly hilarious addition to help with bloodflow. A little blue pill typically prescribed to men. Apparently it's a vasodilator, which dilates the veins and allows for more blood to flow to the uterus, not just, um, other organs. Hilarious. Especially because my stepfather just retired from the company that makes this medication, so I feel a special kinship to it. And can't stop giggling. Because I am not so secretly 12 inside.
All in all, a good visit. A terrible drive, and some white-knuckle moments in the commute on the way home especially as the sun went down, but worth it. We are headed towards resolution of this leg of our journey. We are excited, maybe for a possible pregnancy but more for that finality. I didn't think it would feel so good (after the tears of course) to have an endpoint set. To accept that this may not end how we originally hoped it would. But that another pathway waits for us, one that we welcome with open arms, one that holds a lot of promise. So we are in a bit of a limbo, but leaning toward a new beginning. It feels right.
The last thought? A beautiful comment our doctor made, which just exemplifies why we love him so much and why we're willing to drive through snow tornadoes to see him. When saying we were at the end of treatment, that we couldn't do this anymore once the embryos were gone, he asked us if we were planning on shifting our focus to adoption. We replied that yes, yes we were, and we were actually pretty excited about it. His response?
"Good, I'm so glad. Because it would be such a shame to deny a child the privilege of having you for parents."
How can you not love that?
Today it took me almost 7 hours to drive to Buffalo and back for our consult. Part was planning for bad weather, part was HORRIFIC roads due to bad weather, and part was that our appointment was late to start and then longer than expected.
But I would bet that you don't really care about the weather or the driving conditions so much in this post...
The consult went very well. We had my trusty purple notebook with our notes written diligently over sushi lunch, and all of our points to discuss and ask about. We started by catching up and chatting as friends, but I saw our doctor's eyes flitting to the list during this time, and hoped that phrases like "get this shit over with" weren't catching his eye early.
So, the reason for the extra month of Pill... hormone therapy to help my lining restart. The theory is that that last cycle sucked pandaballs because my lining was screwy from healing up from the hysteroscopy in November. That taking down the adhesions at the tippy top of my uterus was more traumatic than originally thought, and so that's why the fluid and that's why the lining failure.
Which led to me saying that the ultrasound didn't show any fluid, and how did we know another month would help, which led to the very frustrating fact that my OB/GYN did NOT send the ultrasound report over. So um, local monitoring is now out the window because I trust them not. (Maybe even birthing our baby, should we get there, is out the window...because if you can't follow up on a nonessential but still kinda important ultrasound communique, then can I trust you for the rest of my care???) I shared the details I remembered, but this wheedling of, "But everything looked pretty good last week" led to the BIG STATEMENT.
I started saying that we were feeling strongly that we didn't want any more delays, that we weren't going to do any more fresh cycles, that the frozens were it... and then I dissolved into tears. I was not expecting to not be able to deliver our statement on where we are with treatment myself. I passed the notebook to Bryce and he finished saying what needed to be said. He did a wonderful job, with sensitivity yet firmness. He's so good at handling things like this.
I'm pretty sure our doctor looked a little sad, but he understood. He said he knew this was coming ever since the hysteroscopy when I showed him the domestic adoption book in my purse. And then we had a conversation about how hard it is to have to be the ones to pull the plug on this endeavor. That to not have a definitive "this isn't working for you" decree from a doctor was really hard, because there's always hope but we've lost the ability to physically and emotionally continue down this path. We don't believe anymore. We can have some hope for these last two cycles, but it won't be easy, since it's like a death of a thousand cuts. And still, we are not being told that this is impossible. We are a mystery, because we've had good cycles and then we've had bad cycles but there's no consistency. We are NOT beating a dead horse, since that horse keeps changing in terms of protocols and genetic components. But we are too exhausted to keep hoping for a golden cycle when things are so murky. Pulling the plug ourselves sucks. We wanted to be broken up with first, in an odd but utterly understandable way.
After that was over, we talked protocols, possibilities, and all that jazz. And we're NOT doing another month of Pill. We ARE doing the 2PNs first. We ARE holding out for blasts, as much as that pains me because it really lowers the chances that we'll have anything to transfer, but stranger things have happened. It is entirely possible that we could have our last cycle in February. (Transfer will be first week of February, most likely.) Which, while a bit distressing initially, is wonderful. I tearfully shared that it could do me in to still be cycling in May, what with my birthday and Mother's Day within days of each other (and neither being particularly happy days lately). That we need closure, whether that's a long-awaited pregnancy or the finality of an end to this course of treatment.
As far as the scarring goes, he said that the amount was truly minimal and it is at the very top of the uterus. He said I am not at any risk for hemorrhage, rupture, or late miscarriage beyond what anyone else my age would face, and that age is only affecting genetics, not my uterus. That was reassuring. He explained if the scarring was more severe, or on the sides, that would NOT be the case, but that my location and minimal severity is not worth worrying about. Whew.
The final kicker for getting the cycle going now was an impromptu saline sonohysterogram, which I was SO not expecting and I am STILL feeling crampy and icky over, but it was totally worth it because it showed ABSOLUTELY NO abnormalities in my lining, no scarring visible, no polyps, nada. Everything looked great. Bryce's hand got squeezed quite a bit, because that is NOT a cozy test for me, but it was good to get that confirmation. I was scared it would show bad news, but I was pleasantly surprised. Maybe this will be a trend.
So, the new protocol is Femara-less, because we do suspect that didn't work out well for me given my AMAZING rise in estrogen from baseline to first monitor of 22-37. (Hint: that's pathetically UNamazing.) So we do the stimming FET protocol, but with Follistim only. If I get 5-6 follicles it doesn't matter because we're not doing anything with the eggs... so as long as I don't hyperstim we're good. Still Lo.venox, still terbu.teline, still PIO... but a slightly hilarious addition to help with bloodflow. A little blue pill typically prescribed to men. Apparently it's a vasodilator, which dilates the veins and allows for more blood to flow to the uterus, not just, um, other organs. Hilarious. Especially because my stepfather just retired from the company that makes this medication, so I feel a special kinship to it. And can't stop giggling. Because I am not so secretly 12 inside.
All in all, a good visit. A terrible drive, and some white-knuckle moments in the commute on the way home especially as the sun went down, but worth it. We are headed towards resolution of this leg of our journey. We are excited, maybe for a possible pregnancy but more for that finality. I didn't think it would feel so good (after the tears of course) to have an endpoint set. To accept that this may not end how we originally hoped it would. But that another pathway waits for us, one that we welcome with open arms, one that holds a lot of promise. So we are in a bit of a limbo, but leaning toward a new beginning. It feels right.
The last thought? A beautiful comment our doctor made, which just exemplifies why we love him so much and why we're willing to drive through snow tornadoes to see him. When saying we were at the end of treatment, that we couldn't do this anymore once the embryos were gone, he asked us if we were planning on shifting our focus to adoption. We replied that yes, yes we were, and we were actually pretty excited about it. His response?
"Good, I'm so glad. Because it would be such a shame to deny a child the privilege of having you for parents."
How can you not love that?
Monday, January 5, 2015
#Microblog Mondays: Donor Gamete Inequalities
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In thinking about the embryos we have left, our two DS blasts and our six DE 2PNs (day one embryos), I was also thinking about the incredibly different processes for the two types of donors. For the donor eggs, we had to go through a lot of hoops (psychological evaluations! paperwork! high cost!) but ultimately ended up with very little information about our donor--just a one-page profile sheet and we'll never have any more.
In contrast, for the donor sperm, we had to fill out information in a search field on a database and then purchase the sperm. No psychological evaluations, the cost was higher than I thought but a FRACTION of the eggs, and the paperwork was minimal. And we got TONS of information on our donor--we have voice files of interviews, we have physical descriptions and childhood photos, we have questions he answered in written form, and if our child is conceived from this material and decides that he/she wants to meet this donor and have a tete-a-tete in person, once, HE OR SHE CAN DO THAT because he's an open donor.
Now, I get the difference in cost due to the difference in the process to actually, um, extract the gametes. One is an incredibly involved process involving injections and surgery and time off work, and the other involves...less hardship than that, by far.
BUT...why didn't we need a psychological evaluation for sperm? Why is it so easy to get SO MUCH information? What does that say about male contributions versus female contributions? To be honest, it makes me mad, for my husband's sake. It devalues his role, his contribution. It says sperm is less important than egg, doesn't it? That we didn't need to sit and discuss the decision with a mental health professional in order to proceed, just click "add to cart?" Shouldn't the requirements for subbing in donor gametes for either player be the same, on the recipients' end?
Want to read more #Microblog Mondays? Go here and enjoy!
Sunday, January 4, 2015
My Husband Is A Genius
While waiting for our sushi lunch to come, I pulled out my trusty purple notebook and said, "Okay, let's get our questions/discussion tone set for the consult on Wednesday." Ha, see what I did? I waited until we had no choice! It was like a mini-car-hostage situation.
We have both been saying, "We have to get our questions and our statements down on paper for this appointment," but we have both been dreading actually doing it. Not quite sure why, other than that to put it to paper and prepare for a discussion that probably isn't what our doctor is expecting makes it all real and it's not really a fun conversation.
But, we did it. And in discussing, Bryce came up with a BRILLIANT idea. Just brilliant.
We have a statement we want to get out, to start. Basically, we want to make it 100% clear that there is absolutely no more fresh cycling happening. These frozen embryos are it. (We'd intimated this after my last surgery, the one with the scarring, but were at 90%, so didn't put it out there definitively. Now's the time to be definitive. NO MAS.) We also want to make it clear that the mode we're in is not, "OMG, this is the time for our MIRACLE! Do whatever it takes! If it takes another year, we're in, just GET ME PREGNANT!" It's more like, "GET THIS SHIT OVER WITH, because we are exhausted in every possible way and actually really excited about getting the adoption ball rolling, but we want this behind us." To clarify: This doesn't mean we wouldn't be thrilled to have a miracle occur. We are in no way saying that we want to destroy these embryos or not give them the best chance, but the time to go nuts and do experimental things that drag our resolution out, whatever that might be? NOT NOW. If you look at statistics for IVF success, there's this funny trend. Your chances go up for a certain number of cycles, and then after that? If you haven't been successful, your chances of being successful go down dramatically. Now, this isn't to say there aren't success stories after a zillion cycles. I know some of these people who have received their miracle (a phrase I actually hate, because what? I'm not deserving to also get a miracle from whoever/whatever's handing them out? What got ME blacklisted?), but I also know a lot of people who ended their treatment journey after many cycles without a sustainable pregnancy. I am no longer willing to keep trying for that golden moment. Even though technically we get a restart each time we do something drastically different, we've made enough changes without any significant gains that I just don't think it's possible. I can hope it's possible, but that's hard. I want to end this feeling of going in circles. We feel like we're actually further from parenthood, not closer, on this route. But, it could happen, and we'd be thrilled, but honestly also confounded. But happy. (And scared to death of a shoe dropping.)
After that uncomfortable bomb is dropped, which hopefully at this point is less of a bomb and more of a slightly awkward firecracker, we have questions. Mainly, what the hell do we gain by one more month on the Pill? I had my midcycle ultrasound and that pesky fluid is gone. What will change in the next month? What do we truly gain? Because if it's not significant, we want go time to be now.
Other questions -- what are all of the potential risks that I face and our baby would face if I got pregnant with the scarring? Are we nervous for no good reason? Lay it out there, bare bones, so we understand that either a) my situation is in an area where risks are minimal or b) my situation is technically risk minimal, but the risks we incur at low percentages are scary enough to give us pause. How is our protocol changing? Why, oh WHY, didn't that magical stimming FET protocol not work for me? And by not work for me I mean BOMBED HORRIFICALLY, rotten tomatoes thrown, no good at all? Boooooooos from the crowd bad. Why? Was it the Femara? Was it my estrogen level? WTF? We never really got answers on this previously. I actually really want to know what the estrogen levels were for the other women where this worked well, because I felt mine were WICKED low at the start. But what do I know?
And then, lastly, Bryce came up with his amazingly genius plan. We have been agonizing over these 2PNs. These six, one-day-old, frozen in our old lab, donor egg embryos. Six does not equal six to transfer. They have to be grown out, and it is a huge mystery as to how many, IF any, we will have to transfer when it's all done. We were saving these for last, as a last-ditch effort, because they are such a question mark. However, the thought of ending treatment on a cycle where I prepare my uterus only to have NOTHING to transfer? Horrible. Anticlimactic. A terrible way to end what at that point will be 5.5 years of ART. Our 11th transfer. (Oh god, it sounds so awful when I lay it out there.)
Bryce's solution? Do those first. I looked at him crosseyed, and then he explained:
"If we do these first, they can grow them out and we'll KNOW how many. If it's close to all of them, then we end up using as many as we ethically can and refreezing the rest, knowing that's a gamble. If it's two or three, we transfer those and have the DS blasts left for another try. If it's one, we could mix with the DS and transfer three [Not crazy about this one, since then genetics are questionable and unknown, and we'd like to know for the sake of our child]. If it's none, then they thaw the DS blasts that morning and we still get a transfer, and we end with the good embryos. It's over. No preparing for nothing, no disappointing dud cycle, we get to end on a high note (sort of), but no uncertainty. And maybe we're done quicker and we feel relieved about that."
Brilliant. I can't use that word enough. Assuming they could thaw these DS embryos on transfer day after realizing the 2PNs have crapped out, it's perfect. We do not have a preference, DE or DS, the only reason why these embryos give us pause is because they're such wild cards since they're frozen on Day 1. But now... we can take that uncertainty out of the equation. No disappointing end to our cycling possible, other than a negative test possibility, which is a possible outcome for any cycle. Why didn't we think of this earlier?
I am actually really looking forward to having this conversation and then moving on it. I would love nothing more than to start meds in January and get going toward whatever outcome our last two (or however many) cycles will garner. Because I am SO READY to move on. I am SO READY to embrace another path to parenthood. I am SO READY for some hope and to eliminate my poor body from this equation. Wednesday cannot get here fast enough.
Oh, and my husband is BRILLIANT.
We have both been saying, "We have to get our questions and our statements down on paper for this appointment," but we have both been dreading actually doing it. Not quite sure why, other than that to put it to paper and prepare for a discussion that probably isn't what our doctor is expecting makes it all real and it's not really a fun conversation.
But, we did it. And in discussing, Bryce came up with a BRILLIANT idea. Just brilliant.
We have a statement we want to get out, to start. Basically, we want to make it 100% clear that there is absolutely no more fresh cycling happening. These frozen embryos are it. (We'd intimated this after my last surgery, the one with the scarring, but were at 90%, so didn't put it out there definitively. Now's the time to be definitive. NO MAS.) We also want to make it clear that the mode we're in is not, "OMG, this is the time for our MIRACLE! Do whatever it takes! If it takes another year, we're in, just GET ME PREGNANT!" It's more like, "GET THIS SHIT OVER WITH, because we are exhausted in every possible way and actually really excited about getting the adoption ball rolling, but we want this behind us." To clarify: This doesn't mean we wouldn't be thrilled to have a miracle occur. We are in no way saying that we want to destroy these embryos or not give them the best chance, but the time to go nuts and do experimental things that drag our resolution out, whatever that might be? NOT NOW. If you look at statistics for IVF success, there's this funny trend. Your chances go up for a certain number of cycles, and then after that? If you haven't been successful, your chances of being successful go down dramatically. Now, this isn't to say there aren't success stories after a zillion cycles. I know some of these people who have received their miracle (a phrase I actually hate, because what? I'm not deserving to also get a miracle from whoever/whatever's handing them out? What got ME blacklisted?), but I also know a lot of people who ended their treatment journey after many cycles without a sustainable pregnancy. I am no longer willing to keep trying for that golden moment. Even though technically we get a restart each time we do something drastically different, we've made enough changes without any significant gains that I just don't think it's possible. I can hope it's possible, but that's hard. I want to end this feeling of going in circles. We feel like we're actually further from parenthood, not closer, on this route. But, it could happen, and we'd be thrilled, but honestly also confounded. But happy. (And scared to death of a shoe dropping.)
After that uncomfortable bomb is dropped, which hopefully at this point is less of a bomb and more of a slightly awkward firecracker, we have questions. Mainly, what the hell do we gain by one more month on the Pill? I had my midcycle ultrasound and that pesky fluid is gone. What will change in the next month? What do we truly gain? Because if it's not significant, we want go time to be now.
Other questions -- what are all of the potential risks that I face and our baby would face if I got pregnant with the scarring? Are we nervous for no good reason? Lay it out there, bare bones, so we understand that either a) my situation is in an area where risks are minimal or b) my situation is technically risk minimal, but the risks we incur at low percentages are scary enough to give us pause. How is our protocol changing? Why, oh WHY, didn't that magical stimming FET protocol not work for me? And by not work for me I mean BOMBED HORRIFICALLY, rotten tomatoes thrown, no good at all? Boooooooos from the crowd bad. Why? Was it the Femara? Was it my estrogen level? WTF? We never really got answers on this previously. I actually really want to know what the estrogen levels were for the other women where this worked well, because I felt mine were WICKED low at the start. But what do I know?
And then, lastly, Bryce came up with his amazingly genius plan. We have been agonizing over these 2PNs. These six, one-day-old, frozen in our old lab, donor egg embryos. Six does not equal six to transfer. They have to be grown out, and it is a huge mystery as to how many, IF any, we will have to transfer when it's all done. We were saving these for last, as a last-ditch effort, because they are such a question mark. However, the thought of ending treatment on a cycle where I prepare my uterus only to have NOTHING to transfer? Horrible. Anticlimactic. A terrible way to end what at that point will be 5.5 years of ART. Our 11th transfer. (Oh god, it sounds so awful when I lay it out there.)
Bryce's solution? Do those first. I looked at him crosseyed, and then he explained:
"If we do these first, they can grow them out and we'll KNOW how many. If it's close to all of them, then we end up using as many as we ethically can and refreezing the rest, knowing that's a gamble. If it's two or three, we transfer those and have the DS blasts left for another try. If it's one, we could mix with the DS and transfer three [Not crazy about this one, since then genetics are questionable and unknown, and we'd like to know for the sake of our child]. If it's none, then they thaw the DS blasts that morning and we still get a transfer, and we end with the good embryos. It's over. No preparing for nothing, no disappointing dud cycle, we get to end on a high note (sort of), but no uncertainty. And maybe we're done quicker and we feel relieved about that."
Brilliant. I can't use that word enough. Assuming they could thaw these DS embryos on transfer day after realizing the 2PNs have crapped out, it's perfect. We do not have a preference, DE or DS, the only reason why these embryos give us pause is because they're such wild cards since they're frozen on Day 1. But now... we can take that uncertainty out of the equation. No disappointing end to our cycling possible, other than a negative test possibility, which is a possible outcome for any cycle. Why didn't we think of this earlier?
I am actually really looking forward to having this conversation and then moving on it. I would love nothing more than to start meds in January and get going toward whatever outcome our last two (or however many) cycles will garner. Because I am SO READY to move on. I am SO READY to embrace another path to parenthood. I am SO READY for some hope and to eliminate my poor body from this equation. Wednesday cannot get here fast enough.
Oh, and my husband is BRILLIANT.
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