Whiskey Tango Foxtrot

We were really anxious about our WTF appointment today. We were so worried that he’d say, “We have no idea why you aren’t pregnant, but if you just keep trying I’m sure it will eventually work. “  That would not be something we were looking forward to hearing.  We want to look towards the end of this roller coaster.  If there’s nothing else to try, we want to know it.  None of this, “just keep trying” hanging over our heads for the rest of our lives.

Dr. Awesome started off by saying that he was really disappointed and that their whole team felt confident that they’d found a solution for us in our FET cycle.  He said he went back over my records to see if there was anything that could have been missed and he couldn’t come up with anything.  I ovulate.  My FSH is a little high, but my AMH and AFC are great and I respond really well.   My tubes are open.  My uterus looks healthy on hysteroscopy.  I don’t have any adhesions or scar tissue in my pelvis.  I’m relatively young in infertility land.

I brought up everything I could think of.  I’m sure I sounded like a babbling idiot.  I mentioned the auto-immune response I had from LASIK.  I brought up the really bad (I mean really bad) mono that resulted in hepatitis when I was 15.  I asked if my well controlled B12 deficiency could be at play.  The nice doctor humored the crazy lady.

The fact of the matter is, the only thing we know I have is endometriosis.

He thinks I’m one of the small subset of women with endo that is affected on a cellular level and my egg quality is suffering from it.  This would explain our poor fertilization and need for ICSI as well.  So what he wants to do is a 3 month Lupron course to put any endo that may be lingering into a dormant state.  We’d then go straight into a fresh IVF cycle.  That way, none of the eggs I would make in the fresh cycle would have ever been exposed to any endo.  Oh, and no “add-back” therapy as long as I can stand it.  My husband has decided that since I will be in “menopause” he should be entitled to a mid-life crisis.  I think not.

We’ll also be adding some LH in with stims as well to see if that helps.

This is where I opened my big mouth.  I asked if there should be any supplements I should be taking or diet changes I should make while we have 3 months to work with.  Time to bring up the elephant in the room!  When we started this road, I was just inside the normal weight range.  After 3 IUIs, 2 IVFs, 1 FET and a lap I am smack in the middle of overweight land.  So Dr. Awesome recommended getting myself back down to a BMI under 25.  Being a man, he thought this should be no problem!

So I have 3 months to lose 17 pounds.  While on Lupron.  During the holidays.  Might as well put me in handcuffs, light me on fire, and charge admission while you’re at it, doc!  But I will do it, dammit.  You know why?  Because this is our last shot and weight is the only thing I can control in this mess.  If this fails, I don’t want to look back and wonder if losing weight would have made the difference.  So I will go back to my nutritionist’s totally depressing eating plan.  I will get my ass on the treadmill.  I will do all the meal prep and planning ahead needed to get though the next three months, including the holidays.

Bring on the salads.

Crap Day Recap and Some Photos

You know when you have one of those crap days?  We had one of those crap days today.  I found out that there was a mix up at the clinic and my FSH labs didn't get "posted" correctly so they didn't get done.  Awesome.  I didn't really want to know what they were - my insurance did.  So now I have to get off BCPs at some point and have another period, which my RE wanted to avoid, so I can get it drawn again.  I will raise holy hell if I have to pay another copay for it.  I'm still bitter about paying one in the first place.

It might be a moot point anyway.  J found out that his company is switching insurance providers.  We've been very lucky with insurance coverage thus far.  We had a crap time with drugs in the beginning, but things have gotten much better with the new clinic.  If it weren't for insurance coverage, we would not be able to try to have a child - no way we could afford it.  My husband works for an MA based company, so we really lucked out.  I know this, and I'm not posting this to rub it in.  We have no idea what the new plan will cover or what their "rules" are for coverage.  I managed to find their infertility bulletin online and I THINK we'll be okay, but I really have no idea.  I would really rather not try to cram in our last cycle before the end of the year.  We won't even know what our coverage will look like until the middle of November.  I REALLY wanted to make this last fresh cycle the best it could be.  Try not to be as relaxed as I can, not be traveling to my mom's, not be hosting my in-laws... all of these things do not mix with the holidays!  I wanted a little break!

My clinic says that 90% of the time they have no problems with out upcoming insurance company, but that they are sometimes denied for surprising reasons.  We're leaning towards sticking with our original plan and if we do a final fresh cycle, we'll hope for the best or take out a loan.  I don't know.  I'm tired of being stressed ALL THE TIME.  Anyone out there with BCBS of MA have any tips to share?

In an attempt to relax, I'm going to post photos from our trip to the mountains.  I forgot to post them earlier!

Hunger Games!

Selfishness

It's a topic that's been on my mind lately.  Does my fervent perusal of fertility treatment make me selfish?  It's an argument that the fertile crew tends to make.  They say that trying to use technology to have a baby when you've been diagnosed with infertility is selfish.  You'll find reference to this train of thought in the comments section of any public article on infertility. I'm sure you've all seen it.

But how is it really selfish?  Being selfish means that you are putting your wants and needs ahead of others.  How is my perusal of pregnancy hurting anyone else?  My husband isn't being drug behind me by his hair.  He wants this as badly as I do.  I'm not putting anyone ahead of me.  I work just as hard as I always have.  I don't ask for special favors.  I may have asked for more compassion from my friends than I typically do, but doesn't anyone who is going through a major life event?  True - by seeking treatment the grieving process has been extended and we've asked for support for quite some time.  If we had just accepted our fate and not moved forward with treatment, we wouldn't have had constant months of ups and downs.  I've only asked for support from friends, though.  Two of those friends high-tailed it out of dodge and left us in the dust, but others stuck around and continue to love us just as they always have. 

Is it because I have a hard time celebrating other people's pregnancies and births?  That's always going to be a struggle by virtue of the disease.  It isn't treatment that makes me feel grief over my lack of children, it's infertility.

Is it the overpopulation argument?  Because that's a bunch of crap.  We'll just leave that there.

Is it because people think that by not fulfilling the moral obligation to adopt that infertility has apparently inflicted on me that I'm sending a child off to face a lifetime of foster care and group homes?  If this were even an argument worth entertaining, the question remains, isn't it selfish of anyone to have a biological child rather than adopt?  And by that same vein, what does it mean when my husband and I are planning to remain childless if we aren't able to have a biological child?  Are we doubly selfish?

Or maybe it's because of the popular adage, "children are a gift."  You can't try to force a gift upon yourself, right?  By the same token, people say that life is a gift, but you don't see anyone saying, "You know what?  I'm not going to try to keep that leg.  Let the gangrene take me.  It's selfish of me to try to force the gift of life upon myself." I can see that life isn't tangible though, while a child is in essence. 

Is it the money?  Do people see those of us pursuing treatment as being flush with cash that they think could be better used elsewhere?  After all, the high cost of IVF is widely discussed.  Some of us are lucky enough to have insurance coverage, but most aren't.  Instead we make many sacrifices to be able to afford treatment.  The biological predilection is that strong.  The general public doesn't see that or get that, but money can't be the whole basis for the accusations of selfishness, can it?

So where does this selfishness notion come from?  More importantly, how can I be sure that I'm not acting from a self-centered urge.

Here's Me!

I'm participating in Stupid Stork's Video Challenge, so my movie is below.  I'm not sure how long I'll be brave enough to leave this bad boy up for!  It's entirely too long and I apologize for my wayward eyeballs.  Apparently I didn't know where to put them.

(Took it down, people!  Hiding my face from you.  Mwhaahaahaha)

October ICLW

Welcome to my corner of the blogosphere. I wish I could give you a happy hearty welcome, but things have been a bit sad for us the past week.  Here's the bulleted lowdown:

• Started trying almost 2 years ago.
• Started treatment a little over a year ago.
• Have done 3 IUIs, 2 fresh IVFs, and 1 FET.  
• Never had a positive pregnancy test.
• I have endometriosis (stage II removed in June), but we aren't sure if all of the epic failure can be chalked up to that.
• Our WTF is in another week.  If there is something different to try, we will try a fresh cycle after the new year.  If there isn't, we'll do a Hail Mary transfer with our remaining frostie and end treatment then.

This week has been rough.  Both my husband, J, and I will randomly break into tears.  We're feeling very lost and frightened about the prospect of what comes next.  We have decided to live a child free life if treatment doesn't work out.

And that's the spiel   I'm generally a pretty happy person, just not in a very happy place at the moment.  It will get better... promise.

A Tale of Two Emails

On the day of our Beta, I got some interesting emails.  The first was from my mother.  It said the following:

"I know you are at work and you are trying to hold on.  I am so sorry. 

Have you and [J] considered a surrogate?  I know I’m an old woman, but older women than me have done this for their daughters.   I’ll be your oven if you want me to be.  I’ll even give up Diet Coke!"

I seriously have the best mother ever.  When I called her to tell her that I didn't feel comfortable having my 58 year old mother (who will easily be at least 59 by the time any baby is born) risk her health by carrying our child, she was crushed.  "But I've done it three times!"  she cried.  I explained that we don't even know if surrogacy would be an answer and reminded her that a) her son is planning a wedding and b) she has osteoporosis and c) she lives over 800 miles away.  She sobbed on the phone with me.  She feels so much pain.  My sister keeps her children away from my mother.  She has three grandchildren that she has met one time each.  She isn't allowed to talk to them, see them, or send them gifts.  When I think about the fact that I may not be able to give that hole a little patch for her, it makes my bones ache.  The kicker is that she doesn't even think about that.  Her pain is only a reflection of our pain.

Then I got another message.  This was from a friend who didn't know about our negative yet.  It was from someone who has been a darned good friend, actually, and she was emailing to check in on us.  Here is a highlight:

"Just throwing this out there, but have you thought about maybe ... just enjoy each other for a while.  You never know what can happen when you just relax and maybe let it happen?"   

Thankfully she ended it with:

"...you can tell me to jump off a bridge if you want!!"  

!*@#&

I called my mother back pissed as hell.  I totally knew my mom was going to say "She's coming from a good place and she means well."  I know that's the truth, but STILL!  Instead my mom was totally with me in the ridiculousness   It was J who called me down to earth.

"She's been a really good friend to you," he reminded me.  He's right.  I'm sure this is information coming from her mother.  I could almost hear her voice when I was reading it, actually.  This sort of "relax" information is what's out there in the world.  It's what our parents believed and what their parents believed and the media likes to perpetuate it.  She really is trying to be helpful, no matter how misguided it is.  And J pointed out that I have had some supposedly good friends who have completely disappeared.  He asked me which I would rather... the friends who check in and support us, but make occasionally stupid comments, or the friends who have left us in the dust?

I'd really rather they were all like my mom, offering up their wombs in recognition of our pain.  That's a tad bit unrealistic though, so I guess I'll take the misguided but well meaning comments.  I'll write her back and gently remind her that infertility is a disease and that relaxing doesn't cure endometriosis any more than it cures diabetes... and so it goes...

Why My New RE Is Awesome

A nurse called yesterday to give us the results and told us to schedule a WTF.  Later that morning I was with a patient and saw my phone light up with the clinic's number.  Dang it!  About 30 minutes later my husband's face appeared on my phone.  Double dang it!  He never calls my cell at work because he knows I keep my ringer off (I have a fear that I will turn on a kid's implant for the first time right when my phone rings and my ringer will become the first sound they hear).  As soon as my kiddo left I called J back.

He said that Dr. Awesome called him after he couldn't get in touch with me and sounded almost upset when relaying his reaction to our negative beta.  He was really hopeful that we would have a positive since everything went so well in the lab.  He thought the addition of HCG to the medium and the additions of Medrol and baby asprin to the regimen would do the trick.  Dr. Awesome didn't have any brilliant ideas right off the bat, but he promised to comb through the records from the old clinic, look at the cycle sheets from round 1 and round 2 and see if there is anything he would do differently.  He couldn't promise that there was since I stimmed so well both times and made seemingly good embies on round two, three of which cultured to blast for our FET.  J pointed out that 6 embies have now been transferred, 4 of which were certified as dang good, so could there be an implantation issue?  Dr. Awesome was honest in reporting that we don't really know and probably never will.  My ute looked good on hysteroscopy and we treated the questionable endometritis aggressively.  There's also still a question of embryo "goodness."  As we all know, looking good under the microscope doesn't really mean much in the end.

I can appreciate that so much of what happens with implantation is crazy complex.  Hearing is the same way.  Believe it or not, there is a lot we don't know about the function of the ear and most of the time I can't tell a family why their child is deaf.  It's just too complicated to know.  Too many genes involved, cells, vasculature, ion exchanges, mechanical and chemical reactions.  I'm sure implantation is a similarly complex.  It's just so frustrating to not have answers and to not have something to "fix."  We've tested negative for MFI, clotting disorders, PCOS, thyroid issues, STDs, tubal issues, parvo... wait, that was the dog.

I'm really grateful that he called, and even more grateful that J and I are open enough with each other that he was able to ask all the questions I would have been able to come up with in such a state.  I'm glad that Dr. Awesome is honest with us and that he's willing to dig around to see if there is anything he can do for us.  In the meantime, I'll wait for our WTF and gather my thoughts.  If he can't think of something new to try, we probably won't do another fresh.  If he can, we probably will after the new year.  I'm nervous about taking a few months off because I know that our biggest benefit right now is riding the wings of a recent lap.  I also know that that magic 35th birthday is looming oh so closely.  I just don't want to attempt an IVF cycle over the holidays, we're plumb out of dough, and I need to get some weight off.  Until then, I'm going to be healthy and try to turn my body into something I can at least tolerate for the time being.  I'll work on actually liking it when this is all over, I suppose.

Thank You and Recognitions

I'm so humbled by the beautiful comments and emails.  I'm touched that so many people were rooting for us, even people whose pregnancy journeys I haven't had the heart to keep up with recently.  You are all such amazing women.  It sucks so badly that this is how we had to get to know each other.

We lit a candle in tonight and put it in our front window in honor of infant and pregnancy loss.  We figured we wanted to set out a light on loss for all to see.  Even if passersby didn't know why the crazy childless couple with the mean dog had a candle in their window, maybe they would google it or stop to ask some day.  I can't imagine what horrible pain a loss would be, no matter what the gestational age.  Tonight we remember our sisters, brothers, and their babies.  You are true warriors.

Beta

Sorry for the lack of posting.  We were out of town and I was trying to avoid my crazies.  What a bunch of crap.

Beta this morning was a big fat 0.  I was really hoping, y'all.  Really hoping.  We are very, very sad and aren't quite sure what to do next.  Another fresh cycle is tempting, but if we have more frosties... then what?  We drag this out some more with more FETs we have no hope for?  We still have the one frostie, but we're reluctant to base a whole cycle on that one little guy, unless we're ready for our Hail Mary FET, which we aren't sure about.  As ridiculous as it sounds, at this point I feel like I'm sending perfectly good embies off to their deaths.  Unfortunately I have to submit my FSA contribution info by the 26th and my WTF isn't until the 30th.

I don't know what to do.  I really don't.  We are so broken-hearted.  My poor husband cried his eyes out.  Nothing hurts more than the feeling that I've robbed him of a biological child.

They Really Are All Crazy

On Friday I spent most of the day doing some testing with our post-doc.  She's an MD, PhD.  You know, a super intelligent, science minded woman.  Like everyone else in my office, she knows what we've been up to in the department of uterine invasions.

I was giving her a ride back to my office, somehow the topic of having babies came up and I said something along the lines of, "I honestly can't fathom how anyone gets pregnant naturally at this point."  You guys, I can't believe the crap that came next.

"My husband just has to touch me and I get pregnant."
"You guys just need more time."
"It will happen, you just need to relax."
"My friend went through IVF and it didn't work, then she adopted and poof!  She got pregnant."

I'm not even sure she took a breath between the above statements.  I said, "Ming, I'm on my 3rd transfer.  This is not about relaxing or being patient."  That didn't satisfy her either.

At that moment, I was so sick and tired of our trials being trivialized.  We're coming up on two years, here.  Two years of trying is nothing to shake a stick at.  Our year of treatment contains plenty of "proof" that we have suffered.  So I laid it out there.

"They have to physically inject J's sperm into my eggs because it doesn't happen on its own."

She giggled.

"No really.  On our first round, we let nature take its course in the dish and it didn't work."
"Really?"
"Really."
"So you really can't get pregnant on your own?"
"I wouldn't go through all of this if I could."

That shut her up.

It gave me a new perspective.  A very smart woman with multiple medical degrees was somehow going through her life thinking that IVF was less than necessary.  Even she believed that fertility is a function of relaxation level rather than a biologic mechanism.  The cultural views on baby making must be insanely deep if that can happen.  How can we ever dig out from under the stereotypes and misinformation if female scientists are out there believing that IVF is for people who are too impatient to just relax?

Anyways, peace out people.  The hubmeister and I are off for our waiting game peace out up in the mountains.  See you on Beta day!

Good Stuff

• One of our embies made it to re-freeze!!!  Yippee!!!
• I learned that I'm going to be teaching a course at the University I work at.  I'm super excited about this since I'd like to get more into the academic end of things.  The problem is that it's like school on crack.  You know the ages and ages of readings you had to study back in school?  Turns out that when you're the teacher you have to know them inside and out.  Oh the agony! But I'm still super excited!
• J and I are getting the hell out of dodge this week and are heading up to the mountains for some R&R and avoidance of pee sticks.  Fall in the Smokies?  Yes please!  So I will be MIA for a bit come Monday.  I will miss you ladies.
• My baby brother is getting married!  He is engaged to a very sweet girl and we are all very excited.  I was hoping my future SIL would become my new BFF, but alas, it's hard to be BFFs with a girl who is too young to remember life before microwaves.  Speaking of me being old, they aren't getting married until Spring of 2014.  I WILL BE 36 PEOPLE!!!

Return of the Jedi: Transfer

We have two little Younglings and they look great!

Everything went really swimmingly.  This transfer was so different than either transfer at the old clinic.  With both of my previous transfers it felt rushed, like they had somewhere to be.  This time everyone took their time and even chatted and joked with us in the transfer room.  New RE did the transfer and he walked me through absolutely everything.  He went so slowly and I'm excited to report that I've had NO CRAMPING TODAY!!  It always bothers me when I cramp right after transfer.  I'm pretty sure it shouldn't happen.  Anyway, he did inject some HCG into my uterus just prior to transfer and they added some to the culture medium as well.  All the staff seemed really excited about that because apparently it's been working out quite well.  Hopefully we don't let them down!

So here they are!  Jedi 3 and Jedi 4.

They also gave us photos of all of our embryos after thaw.  I won't scan them all in, but it was a nice keepsake.

Thaw Report

All seven survived the thaw!!! Including the less than one from the "blob" cycle!!! YAY!!!!  

Now we wait until Thursday.  They were frozen as day three embies and we are trying to culture them to blasts.

Grow little munchkins!  Grow!!!