Heartbreak

Friday morning when I woke up I discovered I was bleeding. It was bad. I had to wait until 8:00AM when the RE's office opened to call. They told me to come in for blood work but I knew it was over. I skipped my English class, called into work and went to the clinic. Of course there was a hugely pregnant woman on the elevator ride up with me (there's an OB/GYN group next door to the RE). They drew my blood and then I went home and spent the day crying. Doug stayed home from work with me, he's not one to cry but he was just as upset. By 3:00PM the nurse called to confirm, my HCG level had dropped to 33, miscarriage was happening, come back Sunday for another blood draw to make sure it's going down.

One of the worst parts was having to email/text/call the family and close friends who have been so supportive and cheered me on during this process. I'm okay if I can keep myself occupied by knitting or reading or watching tv, but if my mind wanders slightly I'm back in tears. Saturday I told Doug we had to get out of the house, so we drove to Nashville. There's been a Dale Chihuly exhibit at Cheekwood (Nashville's Botanic Gardens) and we had previously talked about going to see it. Well it was not such a great idea. The exhibit was lovely but there was a Day of the Dead festival also going on and everywhere we turned there were babies, children, pregnant women - it was painful. We had lunch and then went to the Frist Center to see their new Impressionist exhibit from the Musee d'Orsay. We had to wait for the 3:15 entrance and guess who's right in front of us in line? Another hugely pregnant women and her small child. Really. I could not get away. I also started feeling light-headed and weak, I went to the bathroom and discovered more bleeding (apparently this is normal). Doug drove home and we listened to a David Sedaris audiobook which made me laugh. When I got home I had several supportive emails from friends and a phonecall from my best friend since the 3rd grade, we talked for a long time and she kept me entertained with stories of her nursing school experiences.

I'm feeling all those traditional signs of grief, shock - anger - depression. I seem to do well for a few hours and then the wave of grief will hit me so hard to almost takes my breath away. To have had this small glimmer of hope so cruelly ripped away feels indescribable. I think about how much money we've spent (again) on this and I want to cry even more. We're supposed to meet with our RE in a few weeks to discuss the next step. I want to know if he thinks we could have success with IUI with donor or if we should move on and consider embryo adoption. We could probably swing another round of IVF if we hadn't used up our lifetime max on infertility drug coverage. Bravelle (the drug that I stim with) cost us $60, without insurance it would have been around $5,000 - for a two week supply.

Traditional adoption is still an option too but it's so expensive ($20,000-$30,000) that it would be cheaper to do another round of IVF or a few IUI cycles. I know that when people say "You should just adopt" they're trying to be helpful but instead I want to punch them in the face. Adoption can sometimes be just as difficult, if not more, than IF treatments and you still aren't guaranteed a child in the end. 

I've read online that it can take 2-3 cycles for your body to be strong enough to support pregnancy again, that would put us at January/February to try something again. I know my body needs time to heal but having to wait even longer and not being able to do anything to move forward is frustrating. Like I've said before with infertility there's a lot of waiting.

This is hard, really, really hard. I am thankful to have the support and love of family and so many friends. I'm lucky to have Doug, who is a great husband and partner and will someday be a wonderful father. But all the love and support in the world can't take away the pain and sadness. It will get better, I don't know when but it will.

The Land of Limbo

On Wednesday I went in for my blood draw and then went to work for an agonizing four hours. I left at noon and went home to take an HPT so Doug and I could prepare ourselves for the result. Well I expected a snow-white test - but there was a faint line. We were confused. We went and bought more tests, again two more tests with faint lines. We tried not to get too excited. Time ticked by while we waited for the blood test results. Finally we got the call, yes it is positive but your HCG is 22 (not good, insurmountable odds for an actual, viable pregnancy) so it could go either way. Limbo. It felt like the 2000 election, no clear winner. I rubbed my abdomen and tried to convince whatever was in there to hang on. I couldn't decide it if was better to get have gotten a negative or to have this teensy, tiny glimmer of hope, it just seemed cruel.

Friday I returned to the office for another blood draw and HCG test. I was not optomistic. Around noon I got the call, the number increased to 48, still could go either way. So the number did double in less than 48 hours (which is good) but it was still low. Sunday morning off I went back to the office for blood draw #3. The phlebotomist had a hard time finding a non-punctured vein to draw from. At one point I thought I was going to pass out because the first place she tried didn't work and she had to stick me again IN MY WRIST. So again I went home to wait it out. Before noon I gave Doug my phone to watch and got in the shower, thinking they wouldn't call until later. Well of course three minutes into my shower Doug comes to the bathroom and brings me the phone. The result? 123. This is good and the nurse sounded confident, I on the other hand am not. No more blood draws for the next two weeks, my veins are happy about that but I'm kind of scared. I need reassurance that there's still something going on in there. Monday the office called and scheduled me for an ultrasound on November 10th - 14 days away. This two week wait my be worse than the first one. 

My mind is constantly running, I find it difficult to concentrate on anything but "Is the number going up?" or "Is there really something in there?". I can't even say the 'P' word. My internet sleuthing (I know, I know I need to stay off the internet) has led met to conclude most low HCG levels don't end well, some do, but rarely it seems. I know I need to stay positive, it's just so scary. Plus in the 5+ years we've been dealing with infertility we've never really caught a break. It almost always seems like something goes badly. Even though I should be relishing my first ever positive test, I'm too freaked out to enjoy it.

The impossible dream

The other day Doug and I were talking about how most people take their fertility for granted. Most people either get pregnant without even trying or decide to try and bam - they’re knocked up. Over the past five-and-a-half-years I have become completely disillusioned; I can’t even imagine what it would be like to be able to get pregnant without involving a team of specialists in the process. Once you go through infertility and specifically In-Vitro Fertilization, you realize what an amazing miracle it is for anyone to get pregnant - ever. There are so many tiny processes that have to happen in order for the sperm and egg to rendezvous successfully and produce an actual, live baby nine months later. I told Doug that I could envision myself in law school before I could envision myself pregnant. It’s been such an out of reach dream for so long I can’t even imagine it anymore.

Tomorrow is beta day. I am 100% freaked out about it. I go in at 7:30AM for the blood draw and they’ll call us with the results by 3:00PM. I had considered doing a HPT in the morning but decided if it was negative I’d still have to go to work for four hours and be upset. Instead I’ll wait it out and once I come home at noon I’ll do a HPT and Doug and I will look at the results together.  That way if it is negative we can be together to deal.

Infertility is hard and ugly and unfair. Your heart feels broken most of the time. You spend more money than you like to think about on high-tech procedures that still don’t guarantee you a baby.  You pump your body full of drugs that you pray aren’t going to give you some awful disease in twenty years. You spend days on the verge of tears because the thing that seems to come to everyone else so easily seems impossible for you. Infertility sucks.

I’m going on ‘radio-silence’ tomorrow; we’re going to need some time to process whatever the outcome is.

On being a crazy person

I'm at 9dp3dt today. I've had mild cramps for several days now which makes me want to cry. I'm afraid my period is on its way and the only thing preventing it is the progesterone. I've felt like crying since I woke up this morning and being at work is not helping. Everyone is annoying me, I feel like yelling at them "Don't you know what I'm going through!?" but I won't. Instead I'll sit here in my office, spending the day alternating working and fishing around on FertileThoughts.com or IVFConnections because I am a woman obsessed. The combination of the hormones, the nerves and the anxiety makes me feel like a crazy person. I just want the waiting to be over so we can either decide what the next step is or be really, really surprised. 

Besides the cramping I have broken out with tiny red bumps on my chest and across my forehead. My bum is still sore from the PIO shots, although I have to say Doug has gotten really good with them. Most nights I only feel a slight sting. I only have four estrogen pills left to make it through tomorrow but I'm not refilling until I know something definitive. I'm also supposed to be ordering progesterone suppositories because if the test is positive I'll need to start them Wednesday night - but I haven't done it yet. Mainly because they're $70 and I'd rather not spend $70 on something I might not need until I have to. I'd be really pissed to spend $70 on the suppositories only to not need them and you can't exactly return suppositories.

Last week in the throes of negativity, I made a Word document that outlined what are next steps should be if this cycle fails. The first step of course is a WTF appointment with Dr. K where he tells us what might have gone wrong (if anything) and I ask questions like "are all my eggs old and dried up now?"  and " is menopause impending?" I used to think two IVF cycles would be my limit, but now I don't know. Financially, I cringe at the thought of spending another $12,000-$14,000 on something that isn't guaranteed. Emotionally, I don't want to totally give up on the idea of having a child that's genetically linked to me. IUI with injectables is an option, but I can't imagine that statistically IUI would work if two IVF cycles didn't.

Highs and Lows

It's Wednesday. It's 4dp3dt (that's four days past a three day transfer).Yesterday morning I went in for blood work to check my E2 and progesterone levels. On the elevator up two ladies told me how nice I looked and they really liked my dress, yay. Upon entering the RE's office I was met not by the regular sweet phlebotomist but instead by the world's angriest phlebotomist. My veins are c r a p p y and this lady was not nice to them as all, she totally slapped my arm until it was red and then tied that pressure thing around way too tight. Wench. The nurse called me yesterday afternoon to tell me the blood work was fine and continue the estrogen and progesterone. She didn't give me the exact numbers, which is probably better because I would have spent hours obsessing and Googling what they meant.

On the sad front, the embryologist called yesterday afternoon to let me know none of the embryos were able to be frozen. I was pretty upset about that even though we knew the chances of having any left was pretty slim. She did reiterate that they transferred the three best ones and they looked better than our previous embryos. So there's that.

Emotionally I'm trying to hang in there. Last night I went to my knitting group and was surrounded by nothing but love and support. However I still came home and had an ugly cry in the bathroom. I felt flooded by the overwhelming possibility that it might not work and fractured my heart a little bit more. Eventually I blew my nose and wiped my puffy face, got my shot and went to bed. 

Physically, I'm really sleepy, which I'm guessing is from the hormone overload my body is receiving. I'm also feeling tiny ovary pangs, maybe they're shrinking back down to size? To top it all off, I got three zits yesterday which is kind of what led me to my ugly cry because I always breakout before my period starts. Must.stop.obsessing.

I know you have a little life in you yet

Today is two days past our three-day transfer. Saturday morning we went into for the transfer. We were the only people having a transfer on Saturday so we had the surgery center to ourselves, which was really nice. The nurse was great too. Doug and I got to spend some time together waiting for the RE and the embryologist to come in for the transfer. After emptying and refilling my bladder (fun!) and taking the valium (way more fun!) Dr. D, who is the third doctor in our clinic's practice, came in to talk to us. As of Saturday we still had 9 embryos, three were 8-cell, grade 2, which I think was pretty good, and the other five were so-so. After talking to the doctor and based on our previous failed IVF cycle and my elevated FSH levels, we decided to transfer the three best ones, the 8-cell, grade 2's. Doug and I had talked before about transferring three but I assumed because of my age they wouldn't let us, but they did. So yes, there is a chance of triplets, but it's a risk we're both willing to take. After we decided to do the three, the embryologist had to do Assisted Hatching on the third one before the transfer started. Shortly thereafter Doug got suited up in scrubs and hairnet and we went into the surgery room. Doug got to sit and hold my hand during the transfer, which was only uncomfortable because my bladder was full and there was a speculum. Apparently the pathway to my uterus was a little curvier than she expected so it took a little longer to get them transferred but they got in there. Afterwords, we got the petri dish they'd been growing in and pictures of them, which is totally surreal. 

 

I had to lie flat for 30 minutes after so I tried to find some 'appropriate' embryo transfer music on my iPhone. But is there really an appropriate soundtrack for an embryo transfer? I settled on this song from Kate Bush, which is in the movie "She's Having a Baby" which I thought would be a good omen. It also makes me bawl every time I hear it

After I was cleared, I got loaded up in the car, driven home and made our bed my fortress. I spent most of the bed rest knitting, watching terrible television and playing on the computer. Saturday and Sunday I had visitors, phone calls and text messages and it meant so much. This IVF cycle has been different from the last one in a lot of ways, but the biggest different is the overwhelming amount of support we've felt. There hasn't been a day that's gone by since I started this cycle that someone hasn't asked me how I was doing. Having that kind of love and support has meant so much to me. 

Tomorrow morning I go in for estrogen/progesterone blood work so hopefully those numbers will be good. I'm taking estrogen twice a day and the progesterone shot at night. We'll also find out tomorrow if any of the leftover embryos made it freezing or not. If we had just two make it to freezing I'd have a better peace of mind, but we'll see. My HCG bloodtest will be on the 20th. Instead of nail-biting and fretting I'm doing a lot of deep breathing and positive thinking.

Dr. Downer and Dr. Fong

I'm back at work today following the retrieval, which went pretty well I suppose. Really the worst part was getting the IV because my veins are for shit. Luckily I had an excellent nurse who was able to get it started on the first try. My anesthesiologist, Dr. Fong, was kind of great, he was an older Asian man with a thick accent but when I told him how sick I was after waking up last time he said he would make sure it didn't happen again. God bless him because there was no 'number 3-ing' yesterday - a marked improvement from my last egg retrieval. I got to change into the backless gown and despite bringing my own rainbow socks from Sock Dreams I had to wear the gray footie socks the surgery center gave me, blah. Doug got to come back and sit with me until they took me to the surgery room. Everything seemed fine until Dr. Downer came in to talk to us. Dr. Downer is not my RE, he's the other half of my RE's clinic. He did my last retrieval but beyond that I haven't had much interaction with him. First off he said "I'll be honest I don't know how many eggs we'll get since last time we got four." Buh? Last time we got 12 eggs but only 8 were mature and 5 fertilized. I reminded him of this immediately. Also he talked about how low my estrogen was. By the time he left I felt like all the air had been sucked out of the room. My doctor, Dr. K, has been much more optimistic about our changes for success. Dr. Downer just made me feel hopeless. Sigh.

Last time I was already out of it when they took me to the room where they were doing the retrieval, but this time I didn't go under until I was in the room. I got a little panicky when I saw all the equipment and they put EKG monitors and an oxygen mask on me. The last things I remember was that "Beast of Burden" started playing on the MP3 speakers in the corner, my nurse read off my name and birth date to Dr. Downer, then I got really warm and I was out. I came to in recovery, feeling a little sore and dizzy. I remember before I was fully awake Dr. Downer came by and told me they got 11 eggs. I stayed in recovery for about half an hour and then they let me go to the bathroom before they took out my IV. I got dressed and rolled out to the car where Doug was waiting. I spent most of the rest of the day in bed, sleeping a little. I had oatmeal and hot tea and used the heating pad a little. Generally speaking I felt 100% better than I did the last time, not nausea and way more coherent. Today I'm a little sore and  have a slight headache but feel okay. 

I was waiting on pins and needles to hear from the embryologist this morning. She called earlier and out of the 11 eggs retrieved, 10 were mature, they ICSI'ed all 10 and 9 made it to this morning. Now we have to hope that a good percentage of those 9 embryos make it the four-cell stage tomorrow and then the eight-cell stage on Saturday. Our transfer is scheduled for Saturday at 8:30AM. We haven't directly spoken about it but I'm almost positive we're transferring two back (as long as we have two to transfer back). 

I'm still trying to think positive, despite Dr. Downer.

Thank God for Valium & Dr. Edwards

Retrieval is on for tomorrow. We have to be at the surgery center bright and early at 7:00AM. Last night Doug gave me my trigger shot, which didn't hurt as much as I had feared. I also started to take Estrace, which is an estrogen pill. They didn't tell me why I should take it but my I assume it's because my estrogen is lower than they'd like it to be. I was instructed to take a home pregnancy test this morning to make sure the HCG had been properly absorbed. It was very odd seeing an actual positive one, all the tests I've ever taken have been void of a second line.

I'm getting anxious, so thankfully I have the valium to take tonight before bed. There are so many things to worry about, Will they get enough mature eggs? Will they fertilize? If they do fertilize will they make it to day 3? Will the transfer go okay, etc. One hurdle at a time is what I keep telling myself. Plus I have no control of what happens after the eggs are out. All I can do is attempt to relax and take care of myself.  

In other IF-related news, the Nobel Prize was awarded to Dr. Robert G.  Edwards, one of the pioneers of in Vitro Fertilization. Of course it was awarded thirty-two years after the birth of the first 'test tube' baby. The sad part of the article was this “Unfortunately he is not in a position to understand the honor he has received today,” said Dr. Michael Macnamee, director of the Bourn Hall clinic and a longtime colleague of Dr. Edwards. Sad.

The news yesterday led to a other media outlets reporting stories of IVF, which I thought was nice. Then I started reading some of the awful comments from people, especially after this CNN story. Then I realized some people are just assholes. 

Running out of veins

So no retrieval today. I went in for an ultrasound Saturday and my lining is good and the ovaries look good too. Continued Bravelle on Saturday night and was instructed to take Ganirelex on Sunday morning and then come back in for another ultrasound and bloodwork. Again my ovaries and lining look good but my estrogen levels were a little low so I had to go this morning for another blood draw. I'm running out of non-punctured veins, yesterday the phlebotomist had to use a tiny vein by my wrist and it hurt like a sonofabitch. At this point we used the last of the Bravelle last night so I'm assuming retrieval on Wednesday. I certainly hope so because I feel like a whale right now. 

Saturday morning I took Doug with me to the clinic because we planned on going for breakfast afterward. We were there for over an hour, which I understand because on the weekends they're working with half the staff they normally do. There are a lot of people cycling right now so that adds to the longer wait. On Saturday there were not one, but two couples with small (like two-year old) children running a muck in the waiting areas. My clinic has a big exterior waiting room and then when they call you back you go to a much smaller waiting room with five chairs. I always leave Doug in the big waiting room because there just isn't room in the smaller one for every patient and their partner. Other people do not adhere to my belief and bring everyone in their family back there. The father of one of the small children was a grade-A jackass and did not understand the concept of the 'indoor' voice. He loudly announced to everyone that his kid 'was born here'. While that's all well and good can you at least have the common courtesy to realize not everyone wants to be subjected to you and your child? It can be really painful for those of us who have not been successful at our attempts to start a family. Not to mention he was just obnoxious and loud about everything. I wanted to murder him with my bare hands. Of course that could also be the hormones. 

I'm kind of on the verge of an emotional breakdown, I even had a big, ugly cry on Saturday regarding some family issues. I'm doing a lot of deep breathing and I wish I had time to go to yoga but even if I did I don't know how much I could do right now with the egg basket I'm sitting on. Namaste.