Day-3 Report

Worst cycle yet: 1 8-cell, 1 7-cell, 1 4-cell. The doctor called and said we would be ridiculous to do a Day-3 transfer (his words) because we would gain no new information about our ability to make normal embryos. He said we have to take it day by day and won't have the information we need about whether we should do a fresh transfer this cycle or do the PGD-package until Day 5/6 (Wed/Thurs).

He said there are a couple of factors impacting whether we will do a fresh transfer this cycle: 1) there are only 2 days each cycle where my body is receptive to a blastocyst based on my lining and progesterone levels, so we have to make sure my body is in the "right place"; 2) the blastocyst has to be at a synchronous stage as my body in order to do a fresh transfer; 3) the results of the PGD have to indicate a normal karyotype.

Tomorrow the office will call and let me know whether the embryos are progressing at the right speed to do a fresh transfer.

He said that my age range typically has 1-2 normal embryos (given my number of eggs, other factors, etc.). However, my body may not be normal given that is has a low number of follicles/eggs for my FSH and AMH levels. He said the PGD is accurate within a 10% range in terms of assessing the quality of my embryos, i.e., if none of my embryos are normal, than likely no embyros will be normal in future cycles. So, PGD is a definitive result as to whether we make viable embryos and have any more biological children.

This past weekend I was a wreck. I was so hopeful about this cycle...hoping that we would get a higher fertilization rate...hoping that the different protocol and clinic and DHEA and accupuncture and no exercise would help. But no. We got even fewer embryos than in prior cycles. I tried not to mourn my ability to have any more biological children...but I'm feeling like that may be our diagnosis. How can this happen at 32??

Ug

Will post more later.

6 eggs.
5 mature.
3 fertilized.

We're debating doing PGD, freezing and keeping any normal embryos (that's IF there are any), and doing another cycle, PGD, freezing any normal embyros, and then doing a frozen embryo transfer IF we have any normal ones out of the two batches. RMA-NJ has this 2 for one PGD deal ($7K), which is why we are considering doing this.

F*CK.

That's 6 more f'ing months of IVF treatment I just described.

Trigger Happy

Just a little update...I triggered last night (after watching The Kings Speech and nearly getting lost in the blizzard!) at 10 pm with 2 ovidrel. I've never used ovidrel before...

And, retrieval is tomorrow.

I am still undecided about PGD, day 3 versus day 5 transfer, etc. I figure we'll make a decision after we find out the number of mature eggs and the fertilization report.

To PGD or NOT to PGD

I've been having doubts lately as to whether we should be doing PGD. We don't have any known genetic disorders which could be affecting our ability to get pregnant. My genetic testing still isn't back, but my husband's was 100% chromosomally normal male. I think we've just had bad luck/protocol/eggs. I'm not sure we'd get much out of testing the embryos if there is only 1-3 (as we have had in prior cycles). Plus, it costs $4,500. No small sum! We could put that $$ toward paying for another cycle. I'm also really wondering if maybe Day 5 transfers just don't work for us. Our son was a Day 3 transfer...

I had such high hopes for this cycle. Doing accupuncture, taking DHEA, going to a new clinic with a new protocol. I know it's not game over yet, but with 5 measly eggs, I'm not feeling so great. There is a small part of my heart that thinks I only had 6 eggs with my son's cycle...and they all fertilized...and maybe smaller number of eggs is good for me. My right ovary only has 1 measly follicle and the lefty has 4. There are a few more follicles in the 10-13 range, but I don't know if they will be mature and/or big enough at retrieval time.

In other news, I am doing an EXCELLENT job of entertaining myself.

Monday: Lovely pedicure in pale pink (which I proceded to smudge putting my shoes on later...).

Tuesday: Promising remorse-free shopping with no time restrictions, yet I still managed to have a panic attack after spending $200 and 1 hour in the mall. Every cent I spend translates into bottles of follistim and I felt deeply guilty for my 300u purchase. I left with 2 lovely oversize tops to wear with my leggings. Am I too old for leggings???

Wednesday: Movie night?? Originally was going to see "No Strings Attached" but don't want to spend 2 hours looking at Natalie Portman's face thinking about how she's pregnant and I'm not. Maybe "The King's Speech" to join the Oscar buzz...

But, generally, it is lonely sitting at my computer all day, eating my meals in solitude. I'm convinced that I am diaphanously apparent to all those surrounding me. The moms at Whole Food can tell I've got BAD EGGS. Business men at brunch can clearly see that I've desperately driven to another state in hopes of success.

I also feel so OUT OF PLACE. I have no friends, no colleagues, no business, no family in the region and feel as if I am conducting some sort of anthropological study of the humans here. Trying to figure out how to blend in despite feeling sorely misplaced. Which is really a larger parallel to finding my place in this fecund world where procreation is a choice not always a blessing. I miss my husband and, more than anything, I miss my little Nugget and his marker smudged palms.

All By My Lonesome

I'm all by my lonesome up here in NJ. From my window in my room, I can see a train station, which brings a smile to my face because I know how excited my little Nugget would be to see it!

I got in around 7pm last night and drove around the town to get my bearings. I identified all my staples for this trip...Whole Foods for warm soup at lunch, Starbucks for my Chai Tea Lattes, a nail salon where I may venture to fix my talons, a bookstore for evening browsings, and a mall to indulge myself in some schedule-free shopping. Of course, I'm teleworking, so my days will be full.

The eggies are not growing so well. Only 4-5 that are above 10mm at this point. The doctor today callously said, "you have what you have and you can't do anything about it." Well, thanks for the lesson in the obvious. Not that it makes me feel any better.

EXERCISE

I am going B-A-T-T-Y over here. I am trying to do things differently this cycle. Doing my meditation. Doing DHEA. Doing LOTS of antibiotics (both me and my husband) and a steriod. Doing a whole new protocol at a whole new clinic in a whole different state.

And, NOT EXERCISING.

It is DRIVING ME CAH-RAZY. I've been walking a couple of miles a day, but sorry folks, that is NOT exercise for the girl that used to do track workouts and lifting and yoga and long runs and spinning and ellipticalling. I feel jumpy. Lethargic. And, I'm not really digging this new layer of fat on my upper thigh. My pants feel too tight. It's funny, but even though I'm not working out, I still have a huge appetite. I'm not sure whether to attribute this to stress or the hormones. Regardless, it is making me feel yucky.

I'm seriously thinking about cheating and working out. Just a little elliptical. Please???

I guess I'm having a hard time with this intellectually because I worked out the cycle that I got pregnant with my son. And, I know people that worked out A LOT and got pregnant (running marathons and the like)...including people doing IVF. I really believe that if you are going to get pregnant, you will get pregnant. That exercise isn't going to make the embryo decide to stop growing. Plus, I can't find any evidence supporting a negative impact on IVF success rates. Of course, there's the study about how women that have exercised for the past 7 years or so have overall lower success rates...but that's it. All that exercise for the past 7 years is water under the bridge now.

Yes, I am looking for permission to exercise. Yes, I know this is not the most evolved way to make a decision. Yes, I know deep down that really I am the one that would be making the decision.

Arg.

I need to go buy new pants. Thank god for leggings and skirts and sweatpants.

It Shouldn't Be

I decided to spend the $350 and go to my local clinic. As I lounged in bed until 7:45, I decided this was a *VERY* wise decision and well worth every cent.

But, it was upsetting this morning when I realized that I knew all the nurses and the doctors called out my name and asked me how I was doing. And, all the people in the waiting room were new, anxious.

I was the veteran.

With no badges evidencing my success.

P.S. And, to only make matters worse, my antral follie count was only 7. AWESOME.

I didn't want to be there. Doing this again. In the exact same place I was a year ago.

Bye Bye Cranky

If you haven't been able to tell by my last month's worth of posts, I've been mucking around in some dark and dreary emotional bogs. Questioning the foundation I laid for my life's structure (selection of mate, selection of career pursuit, etc.), my end goal vision for my life's efforts, and the ideals upon which I made all these decisions. I am finding it easier to fall into the mass-produced, commercialized, non-introspective version of accomplishment: big house, happy marriage, several kids, money-making career, car with appropriate logo, bling, bling, bling. Sign me up to be one of the mindless masses. I vowed to become some version of a Stepford wife: fully botoxed, brow-lifted, and boob implanted. Quit my job, spend copious amounts of time working out, and learn how to properly apply make-up, do hair, and select "cute" outfits. For, if I could become someone's version of a "perfect life" … maybe it wouldn't bother me so much that my life wasn't so.

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CAVEAT: Please do not take this to mean that I am disparaging of stay-at-home moms, rich people, people that own big houses, people that have had cosmetic surgery, etc. I am more poking fun at the caricatures of success promulgated by mass media, People Magazine, and The Real Housewives of XXXX, among others. Let's just say I've spent too much time watching T.V. this past weekend and there is a lot of junk out there! In fact, I do dream of staying home with my little guy, being able to work out whenever (once a running addict, always a running addict), etc. And, what's not to love about a big house? See how conflicted I am???
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Thankfully, the clouds appear to be lifting, as my husband mentioned the other day that I no longer grunt in response when he says hello in the morning. In fact, he said that I even gave him a smooch without him even having to remind me to use my "human skills" and express affection to those we love. (Admittedly, I am by nature the less affectionate partner…and become even more troll-like when in a funk.) I've also begun again to recognize the beauty in the life I have created: a husband who knows and loves me and can make me laugh hysterically; friends I can lean on; a comfortable house with happy colors; a career where I get to use my brain (well, almost 50% of the time). However, in going through all of this, there are some gleaming cracks to which I need to attend. I am not sure of the wisdom putting off this self-maintenance until we reach closure on our attempt for another child. I'm not sure I can pursue both at once. But, they are niggling at the back of my mind and I wish someone would straighten them out for me.

Enough about that.

Today is supposedly CD3. I got my withdrawal bleed on Sunday after quitting the pill on Friday. Interestingly enough, my improvement in mood coincided with quitting the pill…

I don't get the antagonist cycle. It doesn't feel real that I have started the cycle because I haven't DONE anything yet. No drugs. No doctor's visits. I guess all of this will change tomorrow…

The big debate this week was whether I would get up at 4 am tomorrow morning to drive up for my first monitoring appointment with the clinic in NJ. My sucky insurance company will only cover me for treatment at one clinic, so any visits to the local clinic will be entirely out of pocket ($350).

What do you think? Is it worth $350 to skip 8-10 hours in the car and an early AM wake-up call? I was thinking not…but then woke up to icy weather conditions this morning and groaned at the thought of having to drive a significant numbers of hours ALONE in this crap.

Root Cause Analysis

In my family, the solution to a problem is to find the person/event/thing to blame. Once the duely accused has been accurately identified, the issue at hand is considered to be laid to rest, no further analysis required. My husband believes this is an intellectually inferior analysis as it assumes that in placing blame the problem is solved. He also holds that this sort of logic fails to cover the "sh*t happens" category of life challenges and results in a lack of ability to gain "perspective" and move forward.

Over the past few months, I have been trying to conduct my own personal root cause analysis of our infertility.

The simple answer would be to blame my husband for his poor sperm quality. And, some days I certainly do that. But, that doesn't explain my "diminished ovarian reserve." I try to convince myself that I can still hang Fault on him because if his sperm didn't SUCK so much, we would have gotten pregnant when I was 28 and first "pulled the goalie." Thus, I would have gotten pregnant respectively at 28 with my first and 29 or 30 with my second. No problems. Life would be Easy Street.

I then take this sort of thinking one step further: my selection of a mate and wondering about prior ex-boyfriends and their progeny-making potential. Would I have a brood of Bengali-American mini-me's with my college boyfriend/best friend/love? Or, would I have outdoorsy, simple kids with my high school boyfriend after spending a few years abroad. This alternate life "sliding doors" fantasy leaves me feeling distant and guilty about questioning the life path I have chosen in marrying my husband. My feminist self chastizes for falling into the pre-industrialized world-view that my life's aspirations should be pinned up the potential achievement of my husband. The greater sin seeping into my mind is that my life would have been better without my husband. That if I could tell the young me in the bar the night that I met my husband that I should STAY AWAY from that charming young boy with the wry wit and golden tongue because I would be chosing a life with pain and strife. I am sure that my idealistic young self would say that "pain and strife" is found in every life path and that the more important selection would be of a partner with which to bear the burden. Older, callus me would tell younger, idealistic self someday I would find the love of a child more important than romantic love. That if I was asked between saving my husband or saving my child before my house burned to bits, I would emphathically choose my child.

Since placing the blame on my husband results in a less than appealing self portrait, I try to blame the socio-cultural values which provided me with the logic of denying the human body's biological preference for procreation in the late teens and 20's. Of finding value in establishing one's sense of self, adventure, and career prior to pursuing the nuturing of a young child's heart and mind. Even more, I find myself resenting that the stronger convention for me wasn't to get married young and have babies while I was still a baby myself. Why didn't I see how much "cooler" it would have been to be younger than all the old, ancient moms? Why did I think that my kids would like me more if I had an interesting life before they were born? Why did I think my kids would respect me and my time more if I had an established, interesting career and vocation? Why did I think that I would feel more satisfied with my life if I had these experiences prior to having children?

I find myself questioning the value of having a career at all. What exactly did I think that I was going to ACCOMPLISH with my career? Why didn't I know that the only thing that would matter to me in my life would be to have children?

At the base of my root cause analysis is the scariest thought of all: that somehow I am to blame. For not knowing myself enough. For not knowing how important it was for me to have a family and make decisions accordingly. For not having the foresight to see the culmination of my life's decisions resulting in pain and anguish.

I find it a heavier weight than I'd like to bear, failing life's game of chess.

Less Room in my Heart

Lately, I've been feeling like there is less room in my heart. Like I am some version of the Grinch with a heart two sizes too small. I am convinced that I am the only forsaken one and everyone else lives these smiling, happy, perfect lives. The constant inner dialogue--or rather bickering--in my brain between the "good" me and the "bitter" me is endless. And, more often, I am finding that the "bitter" me is winning.

I took this lovely on-line infertility stress test the other day (and we know how accurate and reliable on-line tests are). Turns out I should probably be institutionalized. Or at least have intraveneous happy drugs. Or live on my therapist's couch. I swear I'm not exaggerating. They should have just labeled me as "certifiably kah-razy person" who is not handling the stress of infertility well. Um, are you really serious? Is it NOT normal to feel sad most of the time when going through multiple failed IVF treatments? Should I be estactically happy when people tell me they are pregnant? IS there anything to research on the internet BESIDES infertility treatments? (DO you know how many times I've googled the phrase "success stories after multiple failed IVF treatments?" Enough times to know that if I refreshed my computer every 15 minutes for the next three weeks nothing new is going to pop up.) Did the person that created this test EVER go through infertility?

Back to the original point of my post: not everyone is living gloriously perfect lives. As much as I would like to believe this because it would validate my "woe is me" depression and bitter-mean thoughts sprinkled upon undeserving prey.

CASE STUDY A THAT LIFE IS NOT PERFECT FOR ALL THOSE WITH BFPs:
My friend who got pregnant on her first round of IVF...and who I couldn't bring myself to call the first week after her BFP? Turns out she has a really slowly rising beta, had her doctor tell her at 5 weeks there was no fetal pole, only to reverse this diagnosis at 6 weeks, and has been continuously bleeding due to a blood clot. Not perfect. Not easy.

CASE STUDY B THAT I AM NOT THE ONLY ONE THAT EVER HAS BAD THINGS HAPPEN:
My other deliriously fertile friend who gets pregnant the first month she tries and even managed to get pregnant with twins (NATURALLY) the first month they started trying for #2. She's in pre-term labor at 29 weeks.

Life is not perfect for everyone else. If we ever do manage to get pregnant, life will not be perfect for me.

This is a horse-pill for me to swallow at the moment because I'd rather be this adolescent whining about how NOBODY understands my PAIN and NOTHING anyone else is going through can POSSIBLY be as hard as what I am going through. (Note Sarah McLachlan music in background.)

Where Have I Been?

• Avoiding the fact that we've spent a year doing fertility treatments with no positive results.
• Avoiding pregnant people.
• Avoiding people with small babies.
• Avoiding the email in my in-box inviting me to participate in the elite field of racers for the DC Marathon (ha, double-ha...can I even run 1 mile at my old pace right now???)
• Avoiding failed New Year's Resolutions.
• Avoiding the fact that I have to return to work full-time to help pay for more fertility treatments or adoption.

But, I've also been trying to enjoy the two weeks off with Nugget. I feel so thankful to have him and have loved my time with him. If we ever do get to have another child, I hope that I can take a few years off of work and just enjoy the children.

Baking Christmas Cookies:












Practicing Taking Pictures with my Pretty New Lens:











Watching Nugget Enjoy Spending Time with His Grandparents:











Watching Nugget Enjoy His Bounty of Christmas Presents:











I will write more later. There has been quite a lot of drama going on with our insurance company. One day we're covered for a cycle in NJ. The next day we're not. It's so draining. Oh, and we didn't strike gold with our natural cycle this past month. Sigh.