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?