Monday, February 28, 2011

Ships Passing in the Night

Today's IUI just cracked me up. Because my husband and I had schedules packed with meetings today, we decided that we would just do our "thang" on our own schedules. So, my husband did his part in the morning and I did my part, well, around noon. It was the first time I have ever done a procedure without him there to hold my hand and partake in the process. It was odd, but we are 99% sure that this IUI isn't going to work because I only have one follicle and am ovulating on the ovary with the fallopian tube with the "questionable" flowage and probably make crappy eggs to match my husband's crappy sperm. I just wanted to feel like we were giving our eggs every last shot to get pregnant...even if we aren't doing IVF. Plus, it only costs $500. Why not? Wouldn't it make a GREAT story if we did get pregnant??

We still have no certainty about our next steps. I am hoping that our meeting with CCRM and Shady Grove next week will clear a few things up. I am feeling more and more comfortable with donor eggs, but still worry that the child would have issues with not being genetically related to me. As my therapist said, who are we to say that our child's life will be "ruined" because they weren't genetically related to me. We all have something we have to overcome in life, I guess. I want to be sure that I am making a morally responsible decision and have fully processed the effects this might have on the child. For me, the bottom line is that I want a child and will love whatever child I have because every child is a blessing.

Thursday, February 24, 2011

Back to the Basics

We still have no idea what we are going to do. We have a meeting scheduled with CCRM on March 7th (my sister has a meeting with them the same day). I have been exploring donor eggs and met with a local clinic that has a pretty large program with 70% success rates with donor eggs. The doctor talked to us for 1.5 hours and was not convinced that we were at the donor egg junction yet. He said that donor eggs would get us to having children sooner than continuing our IVF journey, but that I didn't have a miserable response and produced good enough quality eggs to get to blastocyst. He said that I wasn't in premature ovarian failure, but rather a grey area within diminished ovarian reserve where I had the AMH level and antral follicle count of a woman in her late thirties/early forties. He said that he would give us a 10-20% chance of another round of IVF working out. Plus, he said that we should consider doing the FET with our last frozen embryo because sometimes the embryo is better able to implant in a body that is not "hyped up" on drugs.

So, what to do this month? A natural FET? An IUI? Given the short time frame, I think we are going to do a natural IUI this month as I am nearing ovulation and have 2 good looking follicles at 15 and 16mm. We asked whether there was any point in trying naturally or doing an IUI given my husband's low morphology and the doctor said pregnancy rates in general did not vary despite the inclusion of men with low morphology in the sample (this contradicts everything else I've read). Plus, we know that my husband's sperm can fertilize eggs as 3 of the 6 eggs from our cycle with Nugget fertilized without ICSI.

My sister has gotten SOME good news. Her antral count was eight this cycle and her FSH is really low (0.4), but her AMH is also really low (0.3). Also, they were worried that we may have fragile X, but her results came back negative. I'll get my results in a couple of weeks.

So, that's my news. Sorry for my lack of commenting the last two weeks. I have been dealing with my own crap.

Tuesday, February 22, 2011

Another Blow

Last week, my sister had an appointment with a reproductive endocrinologist because she hadn't gotten her period after stopping her birth control pills and they put her on provera and she didn't get her period then either. I was a bad sister, lost in my own drama...I didn't call her. When my sister told me that she was going to the RE, I told her not to worry about it...I had several friends that didn't have their period and had successfully gotten pregnant through Clomid, IUIs, or IVF. (In the back of my mind, I was resentful that she was going to move so quickly to getting pregnant because she only had this *tiny* problem.) I armed her with a list of questions to ask the RE and some information about our situation so that he would have an understanding of any potential genetic issues relating to fertility.

This past weekend I went to visit my family. On Saturday night, while sipping some wine and watching Nugget play, my sister said that the appointment with the RE hadn't been too bad, but that it probably would take a little bit of effort for them to get pregnant. We didn't talk about it any more that night.

Later, while discussing the evening in bed with my husband, he said that my mom had told him that my sister has the same "diminished ovarian reserve issue" and that her antral follicle count was FOUR. In addition, her husband has the EXACT same morphology problem as my husband (2-3%). I couldn't sleep all night. As context, my antral follicle count is seven to nine and I am 3.5 years older than my sister (she is 29).

The next morning I called my sister and told her that we had to talk. She confessed that she hadn't wanted to tell me the truth because she was worried that I would be "negative" and she didn't want to lose hope yet. I hated to tell her...I hated to show her the horrible statistics for diminished ovarian reserve...that the clinic where she was being treated only saw 2 women with diminished ovarian reserve in 2008 and NEITHER got pregnant. I told her that her antral follicle count was lower than mine. That they usually only do IVF if you have at least 5 follicles. I told her that there was hope and showed her some "success stories" for diminished ovarian reserve, but those are few and far between.

How can this happen to us? My mother had 4 children the first try...and had her last child at 34. Both of my grandmothers had no problems getting pregnant? How can one family be so stigmatized?

But, most of all, I am angry at myself for not learning about my condition sooner. I could have prevented myself and my sister from going through this pain.

Why? Why do we have to struggle so much?

Wednesday, February 16, 2011

Is it over?

This is not the journey I started out last December. Or even three years ago when I started this blog. Oh, to go back to those giddy days where blogging was about sharing my "success story" in overcoming male infertility and being active during and after my pregnancy.

This is the blog of a woman who at 32 has been told that she no longer makes any quality eggs and that she is the 0.5% of the population who goes into premature ovarian failure. This is the blog of a woman who is being told that she could try IVF but that she only has a 5-10% chance of success. This is the blog of a woman whose heart is broken and wonders if she will ever be the same again.

Where we go from here, I'm not sure.

Do we do one more cycle at RMA-NJ because they made such beautiful blastocysts? It would only cost about $8K because we have some insurance coverage and a friend was generous enough to give me her drugs.

Or, do we spend $20-30K and do a cycle at CCRM in Colorado or CRMI in New York?

Or, do we move on to donor eggs at $30 to 50K?

Or, do we move on to adoption at $10 to 50K?

None of these are good options. Continuing cycles feels like torture. We know it probably won't work. Should we just save the money (this is my ever rational husband's proclivity)? Or, do I need these cycles to feel like I got closure?

I was originally leaning toward adoption, but the more I read about it...the more ambivalent I feel. With adoption, there is always another family there...they talk about the immortal wound of being rejected by your birth family. With donor eggs, we would be able to have some genetic link to our child. But, there would still be that shadow of the biological mother. It is odd to be looking at profiles of women and assessing them on their personalities, appearance, etc. In looking at these profiles, I am looking for myself. And, sadly, there is no-one that has my unique combination of thin face, closes-et eyes, brown hair, hazel eyes. Let alone my personal interests, areas of intelligence, and college degrees. It would be selfish of me to not consider the impact of these decisions on my child...never to know his/her genetic mother, where he/she got the arch in their nose or their innate interest in gardening and biology, etc.

I'm not sure where to go from here and whether I am going to continue blogging my journey through this deeply private and painful time. Several people from this blog know me by acquaintence and one if a very dear friend. I'm worried of the judgement I will receive for these decisions I am contemplating and do not wish to be the whispers of gossip. I ask that if you know me in the real world, that you keep this secret for me, and make nothing alluding to my blog or our struggle on Facebook.

I would appreciate any thoughts about what we should do with our next steps. If we pursue another cycle, we should do it quickly because time is of the essence.

Friday, February 11, 2011

Thursday, February 10, 2011

Glimmer of Hope

During my November cycle, 8 days past 5-day transfer, my waking basal body temperature was 97.6. Today, 8 days past 5-day transfer, my waking basal body temperature was 98.14. That's a small glimmer of hope, right? Right? (She says desperately!)

Or, could my "temperature" just be because I am using a different progesterone suppository?

Also, I don't have any more cramps (of course, the moment I type this...they'll start back up again.)

This is TMI, but just wanted to let you guys know in case this ever happens to you while on progesterone suppositories: I appear to have a yeast infection due to all the moisture from the "leakage." The nurse say I could take 3-day monistat, but to only put it in 1/2 inch and to use the external cream and that should clear it up.

One more day...18 more hours until I take a HPT.

Wednesday, February 9, 2011

The Bubble Burst

Ah, fear and sadness, my old companions. You have rejoined me again for my journey. How foolish I was to think that I could escape a "two week wait" (nine days this time) without you.

I started to feel a little crampy last night, which I have felt with my prior cycles this year. My optimism and hope were such quixotic feelings. I wish I could feel steady and confident, but we all know that you can have great blastocysts that never turn into a viable pregnancy.

I want the next two days to be over. I feel like the time is t.i.c.k.i.n.g a.w.a.y at a sluggish pace.

Also, Friday will be nine days after transfer, fourteen days after retrieval…is that too soon for a HPT to show up? I usually don't test before eleven days post transfer.

Monday, February 7, 2011

Stop It

I keep telling myself to stop being excited and entertaining the possibility of a positive pregnancy test...but I can't help myself. I feel so positive this two week wait. It's unlike any of the others...I would usually go through a period where I felt neutral, then horribly negative and crying all the time, then delusionally optimistic, and then I would get my period or the negative pregnancy test. This time, I feel different. I feel like it is going to work.

I don't have any of the "symptoms" I usually have during the two week wait...the sore boobs, the extreme fatigue. I have a tugging feeling in my lower abs, like I pulled a muscle or something. Of course, I could have actually pulled my muscle. Not sure how though, considering I haven't done ANYTHING active since last Tuesday. The only symptom I do have is a higher basal body temperature in the morning. During my prior two week waits, I would typically have a basal body temperature of 97.2 to 97.6. This cycle, my basal body temperature has been 97.8 to 98.1, which is really high for me. Maybe I'm wearing warmer clothing to bed because it is so cold in our house, or maybe my husband the bear is emitting more heat. Who knows.

I have been waking up at 3-4am EVERY morning and unable to go back to sleep because I am SO excited at the prospect of ending this awful journey. To be able to travel again, feel more like hanging out with our friends, do some project around the house.

I must stop it, though.

Beta is 2/11/11. Another reason this clinic rocks. They only make me wait 9 days to do the beta, rather than 14 days like the other clinic!!

Saturday, February 5, 2011

Definitely Getting a Tax Write-off this Year

For medical costs, at least.

We spent:

$27,530

including...2 fresh cycles, 1 frozen cycle, 3 medicated/monitored cycles, therapist(s), accupunturist, and massage.

Jeez.

I could think of a million other ways I would have liked to spend that money, but it is gone now.

Friday, February 4, 2011

Embryologist Report

When we talked to the embryologist on transfer day, we mentioned that we had transferred 6 "good quality" day five blastocysts or morulas over the past 3 IVF cycles (2 fresh, 1 frozen) and had no luck. She questioned our basis for determining whether they were "good quality" embryos and said that each clinic had it's own standards for blastocyst quality and RMA-NJ's standards were higher than most clinics. She asked whether we had any pictures of the embryos from the prior cycles that we could share with her and we said we would email them to her when we got back. I sent them to my nurse yesterday morning around 8:30.

About an hour later, the embryologist called us back (quick response time!). Her first words were: "Oh, Runningmama, those embryos didn't have a chance." She then proceeded to walk me through each embryo and explain why they were/weren't good. The pictures below go in chronologically reverse order. The embryos on the far left are the ones that we transferred in on Wednesday, our hatching blasts. The middle picture is from November and the picture on the far right is from the cycle in August. For the November cycle, she said we transferred in one not so healthy looking morula (not two morulas like they told me), which she gave a 20% chance of making a baby, and two arrested blastocysts, which means they had a 0% chance of turning into a baby. In August, we transferred a morula (the one with the cell coming off the top) and a blastocyst (not two blastocysts like they told us). The morula had already excluded a cell, which was a sign that it wasn't a healthy embryo. The blastocyst was misshapen, but barely starting to form an inner cavity so she thinks it might have had a slight chance of turning into a baby. She said that she would have been devastated if this was all that she had to work with on Day 5 and wouldn't have transferred these embryos or, if she did, she would have told us that they had a very little chance of survival.









I can't believe the old clinic never told us this. The embryologist said that perhaps the lab wasn't as experienced and couldn't tell the difference, and/or that they possibly didn't have as much experience with Day 5 transfers. I believe her...she has a lot of experience and did train at the best clinic in the United States. But, my local clinic also has pretty good statistics, so I can't believe that they would s*ck this much.

I am glad to know that the embryos weren't good and it wasn't some uterine/hormone/other issue. Of course, one can never rule those things out. At least with this cycle, we know that we are capable of making excellent blastocysts and, if it doesn't work, we will have to re-evaluate whether any other factors may be impacting our success.

Also, she said our third blast looked good (4BB) and was glad that she decided to wait a day!

The embryologist is just one more reason why this clinic is WONDERFUL.

Thursday, February 3, 2011

Meet Lucky Lexie and Marvelous Max!

I wish I could figure out how to convert a PDF to a Jpeg so I could show you this beautiful picture of my hatching blasts. Alas. Anyone know how to do that??

Yesterday was a MARATHON race up to NJ.

I was supposed to receive a call between 9-11 am yesterday to let us know whether the embryos were good enough to biopsy (2 5BB embryos!). We were scheduled for PGD on Wednesday (if the embyros were OK) and a 6-day transfer early Thursday morning (if there were any normal embyros). It never occurred to us that we might do a Day 5 transfer!! The plan was that I would get the call by 11-12am at the latest, my parents would drive from their house two hours away to pick me up, and we would all go up together. I wanted my parents to go because they were there when I transferred my little Nugget and I thought maybe they would be a "good luck charm" of sorts, since all the cycles where my husband was at the transfer hadn't worked.

At 10:30, I was sweating bullets, eating fistfuls of chocolate chips, and going insane waiting to get the call. I happened to look at my cell phone and realized it was TURNED OFF...with three messages from my clinic telling me to get up to NJ ASAP because we were going to do a Day-5 transfer. Of course, I live 4.5 hours AWAY plus the two hours for my parents to get here...so the earliest I could get there would be 4:30/5:00 pm...which was TOO late!

So, I left without them...and my parents were going to try and catch up by driving ridiculous unsafe speeds. They managed to get only one speeding ticket (real safe, right?) and arrived only 40 minutes after I did (you do the math!!). I made a record commute of 3 hrs 45 minutes.

Thankfully, the whole operating room staff stayed late so that I could get my 5-day transfer. How amazing? They were great, too. Gave us all hugs when we got there.

Here's hoping these embryos make it!! I have a GOOD feeling about this...but I've been fooled before.

Plus, we have one 4BB embryo to freeze today! What a difference a new lab and different protocol make...of course, we'll see if I actually get a positive pregnancy test.

Wednesday, February 2, 2011

Groundhog Day--UPDATED

Dear Mr. Groundhog,

Will I get the news today that my winter is going to carry on forever? That I will never see spring. That our ability to have biological children is nill?

Or, will I wake up tomorrow renewed, with hope for the future, and a chance for a child?

Please tell me, Mr. Groundhog. I can't stand the suspense. My heart is rapidly beating, I can't take a deep breath for the fear that is constricting my lungs.

********************************************
Dear Mr. Groundhog,

Thank you, thank you, thank you, thank you for the beautiful wonderful news. 2 beautiful blasts. I'm still not sure why you don't want to do PGD, but I hope that you are right, that they did self select out and we have perfectly normal embryos waiting for us in NJ.