Please God, Just Kick Me While I'm Down

Let me preface this post by saying that I am a truely awful person.

My sister is pregnant. You know, the one with only 4 antral follicle count and an AMH of 0.3? Whose husband has 3% morphology (just like my husband)? The one that did her first IUI ever, which was also her first cycle of trying to get pregnant because she doesn't ovulate on her own. That sister.

I just want to say THANKS God for kicking me while I'm down. For making me feel for a couple of weeks that I wasn't alone in the world and that our problem was genetic and out of my control. Instead, no. My husband and I are just freaks of nature that can't get pregnant despite having a higher AMH, better antral follicle counts, and trying with all of our hearts for the past 1.5 years to get pregnant.

I wish I could have a better perspective about this. Or, even be happy for my sister that she didn't have to go through the hell we went through.

But, why not me, too? Why do I have to suffer so much?

Now, I feel even more alone than I ever felt before.

Stupid Doctors with their Stupid Medical Degrees

My RE nixed the idea of doing a cycle this month because he's afraid of there being a dominant follicle if we don't do estrogen priming or birth control. He reassured me that I would be culling from these antral follicles next month. Yeah, right. My antral follicle count last month was 9 and this month it's 18 and I'm supposed to believe that it's going to be high again next month? Not likely, bup. I may not have a medical degree, but I know a freaking miracle when I see one.

So, we are going to do the staid, responsible thing and listen to the stupid doctor with his stupid medical degree.

Also, some points of interest from my meeting with CCRM, RMA-NJ, and Shady Grove last week:

CCRM: Said I have diminished ovarian reserve, likely genetic. Says he would give me a 30% chance of success. Says we have 3 options: Day 3 transfer w/ co-culture, Day 5 transfer w/ PGD, or donor eggs. He said he would do an estrogen priming and antagonist protocol with some human growth hormone. He doesn't think there is anything else wrong with me (immune issues, uterine lining issues). Great bedside manner, not narcissitic or aggressive.

RMA-NJ: I love this clinic and I wish we could do another cycle there, but they just don't have the experience with diminished ovarian reserve and we only have $5K more in insurance coverage up there. He said we should do one more cycle or at least use our frozen embryo and then move on to donor eggs. He was also very confident in their ability to ship down an embryo if we chose to do a FET locally.

Shady Grove: Great first appointment. The doctor was totally open to trying different protocols and my input (which is not an experience that I have had at other clinics). We are going to do one last cycle with this clinic because it would be basically free between my insurance, my husband's insurance and my friend's drugs. We are going to do: estrogen priming (with a estrogen patch) and antagonist protocol on the maximum dosage (450iu follistim, 150iu menopur). We're also going to do an aggressive Day 3 transfer with 3-4 embryos and freeze any leftovers on day 5 (ha ha, like that's going to happen). We're also going to do PICSI (a new process to select the best sperm), ICSI, and Assisted Hatching. We're also going to do lovenox for good measure. He also wants to repeat my HSG because my results were questionable and tubal issues could impact implantation. So, yeah me! One more HSG!

That's the plan, Stan.

Do the antral count bop

I was going to get on this morning and post about poor poor pitiful me with my (of course) failed natural IUI (HUGE surprise, right??). And, then I was going to whine about how I couldn't figure out whether we should do one more cycle of IVF or move on to donor eggs. And, then whine some more about how all the doctors we talked to last week (CCRM, RMA-NJ, and Shady Grove) all said we should give it one more shot.

But, today...I went in for my Day 3 bloodwork and antral follicle count.

Hold your breath, people. This is freaking Ah-MA-Zing.

On the left: ELEVEN
On the right: SEVEN

That's right, a grand slam total of: EIGHTEEN antral follicles. That's like a NORMAL (ish) 32-year old!!!!

WOW.

Everybody: do than antral count bop!!!

I'm doing it alone in my office and would love some company.

DHEA must be working it's wonders.

I'm supposed to take this month off to do another HSG, but I might see if we can do a cycle NOW and use this amazing follicle count!!! Maybe we could just freeze the embryos, do the HSG next month, and then if normal transfer them.

Whaddya think???

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.

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.

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?

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.