Tuesday, August 31, 2010

Unexpected family news

I've had my share of pregnancy announcements over the last few years, but I always felt rather "safe" within my family.

On DH's side, he has 2 older brothers. One married an older woman who is past her child bearing years (and has 3 children from a previous marriage), and the other has a 9-year-old son. He and his wife *could* have another child, but from comments they have made, his wife's rather serious health issues, and the fact that their son is nine has made us always feel pretty certain they were "one and done."

On my side, I have a single 25 year-old brother. I also have a half brother twelve years older than me. He married and divorced in his twenties, and then re-married about five years ago. This is the long-lost brother I mentioned in December where I described the situation: "He and my dad (and thus, my family) were not in contact with him for a ten year period while I was in high school/ college, but he got married 5 years ago and our connection was re-established. Needless to say, with such limited contact, he is my brother but he is also like an acquaintance. DH, my parents, and I went out to visit him & his wife 2 years ago, and now they are coming out here to visit us this weekend." The update from that post is that we had a really great visit in December, and I think we all felt like we were starting to bond. We particularly liked his wife - she was sweet and really fun to hang out with.

However, a few months after our visit in December, my brother called to let us know that he and his wife were getting divorced. We were all saddened to hear this news, and my ever-cynical brother seemed even more cynical about life and relationships. They are currently separated and waiting for their divorce to finalize.

So, of the above mentioned people, can you guess who we got a pregnancy announcement from?? Really, any of them would have been rather shocking and surprising.

But, yes, my older half brother called to tell my dad he's going to be a Grandpa. The mother of his child is somebody he apparently has known since 5th grade but we have never met or heard of. She is also in the process of getting her second divorce, and already has an 18-year-old and 13-year-old from her previous marriage.

While I am happy that he is happy, and happy that this is a child - what a miracle - it was hard news to swallow today. It sounds like a fairly dysfunctional situation to bring a baby into....so I hope he and his new girlfriend can make it work. But, really, when I am honest with myself I know I am simply jealous - jealous that she got pregnant at forty-one, jealous that they got pregnant under such non-ideal circumstances, and, most of all, jealous that he got to call and tell my dad he's going to be a grandpa.

I want to make my dad a grandpa. :(

Monday, August 30, 2010

Snippets

This weekend we drove 16 hours round trip for a good friend's wedding. In fact, DH was the best man in the wedding. It was a joyful weekend....but we are soooo tired. I was a last minute "wedding coordinator" at the ceremony, and that was much more difficult and stressful than expected! I think it will take a few days for us to recover, but it was wonderful.

We met a couple there who had adopted a sibling set of 3 children from Africa. We talked with them for quite a while at the rehearsal dinner, and it was such a treat to talk to people on the "other side" who can once again remind us that there is another side to all of this. And they had quite a long journey! They started TTC 19 years ago, did infertility treatments with our same RE (they are from our area), decided to adopt 13 years ago, were matched with their children 12 years ago, and brought them home 6 years ago. Yes, they waited SIX YEARS to bring their children home. This story would have scared me if they hadn't been filled with such joy, and they said as difficult as those years were it was so worth it for their kids, and that those are the kids God wanted for them. Wow.

****

Today I spent time with a woman I met at church a few months ago who I found out is most likely facing infertility. They have been TTC 10 months, and are about to start IF testing next month. It was great to swap stories and pray together, and I felt like I could counsel her a little about testing and treatments.

She and her husband are praying about whether to actually pursue treatments or adopt, and it sounds like she is leaning towards adoption. I confess I felt a little jealous that she already has such excitement and joy to take that path to build her family...and it made me feel like something is wrong with me for not desiring to adopt at this time. Am I holding something back from the Lord? Am I selfish in my desires? Is it crazy that after this long and this many TTC failures I'm not ready to look into it? However, I also have been reminded more than ever this month that God is directing our steps...and I have been praying that he WILL fill me with peace and a desire to adopt if/ when it is time. God has a purpose for us to be doing treatments right now, just like he may be guiding this couple to adopt rather than do treatments. I guess the struggle is feeling like treatments are the "less Godly" or "more selfish" path somehow.

She gave me a book that has really impacted her called Adopted for Life by Russell D. Moore. I am looking forward to reading it, and I DO prayerfully want to be open to the possibility of adoption. Maybe God will use this book to grow this desire? Has anybody else read it?

***

My cycle this month has been surprisingly nice - very little spotting and I have felt "right" hormonally. Obviously I have no measure for that, but I am pleasantly amazed and enjoying it. I have had so.much.spotting every month since we began TTC, and have had even more than usual the months following a medicated cycle. However, my body must have liked the few meds I was on for the Frozen Egg Cycle!

Wednesday, August 25, 2010

SA results

I talked to the RE today and got the results for the SA. They came in as expected and correlated with the types of numbers we saw during out IUIs.

Count: 45 million (normal > 15 million)
Motility: 11% / forward progression 5% (normal > 40% / 25% forward progression)
Morphology: 8% (normal > 3%)**

Motility is our only issue, but it's pretty severe and motility is considered to be the most important measure by many doctors (unless the count is really low). However, the RE said he's seen pregnancies with numbers like that, and told me to use birth control whenever we've had all of our children - ha! That is so hard to imagine ever doing again ... and a little hard to believe, but it made me laugh. :)

In a way, though, it doesn't seem like our MFI is that severe...I don't know. But we've been TTC for over 30 cycles - which includes 4 IUI's and 3 IVF's - and have never seen a BFP. But I'm no fertile myrtle, either, I guess.

** I used he new SA guidelines released recently

Sunday, August 22, 2010

We're getting old

I bought this and set it up for DH:



He was taking so many different vitamins that it was getting too difficult to manage. He made me promise it would always be hidden and put away. Ha!

Saturday, August 21, 2010

The veterans

Today DH & I went down to the RE's to do an SA test. Of course we have had a number of these done in the past, but we have not had the actual analysis done in over a year. Our RE wanted to have an up-to-date one, although I'm not too sure it will change anything since we're doing IVF with ICSI already.

Anyway, as we were leaving the "special room," I was holding the "special bag" in my hands. We stepped into the hallway, and ran into a young couple who had just finished their IVF Egg Retrieval. The wife was in quite a drugged up state, but they both looked so excited and happy. We walked slowly behind them, and then came into the main hallway outside the clinic. They had 4 or 5 family members waiting excitedly there (!), who then announced they had to get a picture of them on there special day. They quickly framed the shot, and I realized I was probably in the background...holding the "special bag." I panicked and darted behind an indoor plant, which fortunately caught the family's attention, who offered to let us pass before they took their photo.

After DH & dropped off the sample and finished laughing about the awkwardness of potentially getting us - and our little white bag - photographed by some other family, I pointed out that this must be their first IVF. Their excitement, hope, and the family celebration seemed so removed from DH & I....

DH said, "I feel like we're such veterans. I can't imagine that scene anymore. And I wasn't even embarrassed that we were walking by all those people with the 'special bag.'"

I thought back to IVF #1. While it was really only 5 months ago, it also feels like so much has emotionally transpired over those 5 months that it could have been a year - or more. We didn't bring any family with us to the clinic that day - I think we are a little more private than that - but we did meet the IL's for breakfast before my first Embryo Transfer. And I did have them take a picture of us at breakfast as I thought, "Today is a special day - we are meeting our embryos! Let's commemorate this! And maybe this can go in the baby book...."

I truly hope that couple today gets to put that picture in a baby book in a few months. I love the hope behind a picture like that, but I don't think we will be taking of any of those in the future - it's just too difficult to delete that happy, hope filled photo when you walk away with an empty uterus.

Friday, August 20, 2010

Encouraged

I am encouraged that God is working in our situation. He is working in us, in others around us, and in ways I probably don't know, see, or understand...but he has been encouraging me with this truth.

I have also been encouraged to TRUST that God will show us when to stop treatments, and believe he will give us peace and assurance. If he doesn't give us a baby first, that is. :)

So I give you full permission to remind me of this on the hard days that may be ahead, or if it seems like I am forgetting this profound, sweet, and loving truth.

That's all I've got for the week. God is good. Have a nice weekend!

Monday, August 16, 2010

A new day

Last week's appointment with the RE felt like a fresh start. A new day. A new cycle. It snapped me out of my depressed, emotional, and fearful state and in an instant I became a little hopeful again. (Am I crazy for being hopeful?)

I am still riding on the high of that appointment. I know as IVF #3 gets closer, the baggage of the past 3 BFNs will tempt me to fear, doubt, and despair. But for today, I am simply happy. DH & I are very much enjoying our non-depressed and non-TTC month. We are not doing anything particularly special, but enjoying the small things like laughing late into the night, sipping on a glass of wine, worshiping together at church, and having extra free time during our youth ministry break for the month of August. Life feels good and I am trying to soak it all in.

Thank you riding this roller coaster of emotions with me.

Thursday, August 12, 2010

What a difference an appointment makes

I have so much to tell you, I don't know where to begin or if I will remember everything. And I apologize in advance for how long this is. But let me just start by saying how humbled I am by the grace of our RE AND our God...

Our follow up appointment with our RE began somber. I was tense and emotional, and as he began by saying how sorry he was, how hard he knows all of this is, and how hopeful he still is for us I fought back tears.

He said from a medical standpoint, he sees no reason to stop treatments. He pointed out (for the 100th time in the last year) that I am "young and healthy." He even joked that he knows he has said that to us a lot, so if we get annoyed we can tell him to stop. But who doesn't like to hear how young and healthy they are (even if you start to wonder if it even matters after three IVF BFNs...)? Testing wise, he wants another SA since we haven't done one in awhile, and we discussed a possible laparatomy to remove a fibroid that he has been on the fence about. However, he ended up doing an extensive ultrasound and said he really does not think it is effecting the uterine lining at all, and does not recommend surgery.

I asked about many of the tests you ladies suggested.
  • S.perm DNA Fragmentation: In his opinion, this is a useful test if we would consider donor s.perm if the results came back poor, although more recent studies have shown that even men who had very poor test results still fathered children through IVF (although at a lower rate). He also pointed out that the only potential "treatments" for this are a varicocele repair surgery (which we have already done), a testicular biopsy to extract "less fragmented" s.perm (but he says this is very invasive, painful, and controversial), and an antioxidant vitamin therapy. He suggested that DH simply start taking the vitamins "in case" it would help, and gave us a list of vitamins to include.
  • Immunological testing: Our RE was very opinionated about this. :) He said it is a very controversial topic in the medical field, but he has done extensive research on it and does not believe it really effects the outcome of IVF cycles. He also said the testing is expensive, and often times women will test negative but will be told to still do the medications that treat the immunological issues "just in case." He showed me three articles on the topic (one of which he wrote), and told me if I am ever at another practice and they want to do the testing, to ask if I could just take the medicine without the testing. :)
  • RPL blood work & endometrial biopsy: He does not see these as necessary in my case.
The bottom line is he says his hands are "a little tied" by the fact that we are limiting fertilization, and we just can't know which eggs are the best. He specifically described our last fresh cycle, and how he and the embryologist teamed up to try to determine the "best" eggs. Normally he simply retrieves all of them in no special order, but in our case he picked the three largest follicles and had the embryologist examine those. Once they determined there were eggs in those follicles, he had her set those aside to be the ones fertilized. However, as they retrieved the rest the embryologist discovered that some of the smaller ones actually looked like better quality eggs. It was interesting to hear, and I think the point of the story was that they were trying to do what they can to "pick" the best, but they really can't tell by looking at the eggs or follicles which ones those will be.

We knew this going into our IVF cycles, and we knew we were limiting the potential success somewhat by fertilizing only a few eggs. But I think discussing it in this way reminded us that it *may* just take a few more tries to find the golden egg and s.perm combo. There is no way of knowing that, but at least we felt a little encouraged in our efforts to try again.

Our RE then asked us what we are thinking about future attempts. He said he knows this is emotionally difficult and very expensive, and he wants to do what he can to work with us. We told him we had enough saved for one more cycle - and we had imagined this would be a fresh cycle - and then we would be done.

And this is where I was floored. And amazed. And left wondering if this was God's provision - God opening a door?

The RE said that he is going to seriously work with us to reduce the cost of this cycle. No ICSI charge. Reduced lab fees. No doctor's fee. A nurse will see how much Follistim she can track down for us. And he said he wants to work with us either until we have a baby or we are emotionally ready to stop trying, even if that means free IVF. Probably some of you reading this do not believe that what I just wrote is true - I know it is crazy. And I honestly don't know if that was a figure of speech to express how extensively he will work with us, but all I know is that DH and I felt so incredibly humbled that he would do this for us. We have done nothing at all to deserve such a gift...in fact, we almost feel like we don't deserve it more than an average couple because we are actually making his job HARDER by limiting fertilization. It would be perfectly reasonable to us if he charged us full price (his prices are fair to begin with and we can't expect a discount), or, worst case, he decided he couldn't work with us anymore. But, instead, he is offering to work with the resources we have to do what he can to help us get pregnant. DH & I both felt incredibly thankful, and inadequately attempted to express our appreciation.

He said, "I know it sounds Pollyanna, but I have established my practice. At this point in my career, I just want to get as many people pregnant as possible."

The plan for next cycle: Same protocol (Antagonist). Full stim to retrieve as many eggs as possible for freezing. Start stims for sure on cycle day 2. Possibly fertilize 4 eggs this time (DH & I still need to prayerfully consider this - but with our history we feel the possibility of all 4 fertilizing/ developing/ becoming babies is low, and the RE said even if all 4 did he would be willing to transfer them). If we fertilize 4, do a 5 day transfer.

As we waited for the RE to do the ultrasound, DH looked at me and started laughing. He said I looked so happy now, and it was quite a contrast to the last week and a half. I almost felt guilty for feeling happy - I do not want to place my hope or emotional state on the roller coaster of IF treatments or the encouragements of a doctor. But I was happy. Ironically, DH felt more angst after the appointment. I think he wants to see this as a black and white issue in our lives (3 cycles and we're done), but suddenly it is becoming much more fluid (already it's 3 fresh cycles PLUS a frozen...and now the RE is alleviating our financial concerns....could there be more cycles?).

As we drove home, DH was very quiet. Eventually he said he has been praying, and that, for now, he thinks we should move forward with one more fresh cycle as per the original plan. But he said as he thought about "the plan," he knew the line was indeed determined by finances....so perhaps if that is taken out of the equation he doesn't necessarily know when we will stop. We don't know exactly how the money part of this next cycle (or two? or three?) will work out, but he said that once we spend the money we have left and the RE does not want to "work with us," we will be done. This seems reasonable.

Of course, we are hoping there will only be ONE more attempt, and all of these questions about money and where the end point is will be a moot point. As difficult as it was to face the end of IF treatments, it is also strangely difficult that the ending has become so blurry (especially for DH). Will we have a point when when we simply "know" we are done? Will God lead us to a new and different path to build our family even if we *could* do another IVF? I feel like there is a slightly different dimension of trusting God in our new position. And I have honestly {and happily} been shaken up by this new development....God knew we would have 3 failures. God also knew we would have this conversation with the RE. I have wondered - if God wanted us to conceive, why didn't he do it within the parameter of three fresh cycles that we had prayerfully decided? If God doesn't want us to conceive, why is opening this door to potentially try more times than expected? I am humbled and amazed at how this has reminded me that God is working. Even if we don't conceive, he has clearly created this unusual path for us for a purpose. This journey has become one that I would have never guessed or imagined, making it all the more apparent that God is leading it.

Wednesday, August 11, 2010

I cried so hard I laughed

Last night DH & I had a much needed heart-to-heart.

When we sat down for dinner he asked me to just talk - tell him why I am sad. At first this seemed rather silly...he knows very well why I am sad. He knows exactly what I'm sad about. How many times can I go on and on about all my sad feelings? But as I started to talk and cry, I could tell my idea of trying to "keep it together" and "not be a downer" with him had only caused distance. I feel like he won't want to be around me if I am continually sad, but he told me he actually feels pushed away when I am hiding my sadness (and not very well at that).

So we talked and cried. DH got angry. He is mad at our infertility, mad that our lives seem stuck, and said he just wants to be done with infertility. But then he's mad that stopping doesn't mean we will be done; it will simply change to another difficult journey. But he doesn't want to just stay in this childless place either. All I could do was nod, cry, and tell him I feel the same way. It was nice to see him angry.

We also discussed stopping treatments after this next IVF. I had felt like DH's stopping point was rather arbitrary, but after our discussion I could see that mine was more so. And in my heart I know we can't go on like this forever. DH pointed out that after one more fresh cycle we will have exhausted all of the money we have saved and set aside for infertility treatments, and he feels like stopping at that point will be wisely using the resources God has given us - the money we had prayed about using for this purpose - and trusting God to do his work within that parameter. If we continued beyond this, we would have to borrow from family. As much as it hurts to make a decision, I do agree with DH. Unless the RE offers us a free frozen egg cycle (ha!), we will stop treatments after one more attempt.

A couple hours later we went to bed. I had cried so much that my eyes were swollen and my head ached, but I felt a glimmer of peace and hope that God would take care of us and, in the end, everything will be ok somehow. DH & I cuddled and laughed.

But then DH made a funny noise in his throat. He didn't even realize it, and honestly, it wasn't even funny. But I started giggling. And then it turned into hysterical laughter when I tried to tell DH why I was laughing. At first he chuckled with me at my silly reaction, and was probably a little happy just to see me laughing. It was so strange...I laughed and felt like I had no control over the laughter. It very much reminded me of a scene in a movie, when somebody is beyond stressed and their emotion bubbles over into rather crazy laughter. I felt a little crazy. And as I almost started freaking out over my craziness, the laughter started changing to hysterical sobs. I alternated between laughing and crying (cue psycho movie scene). And then I ended in tears, not even sure why I was crying. DH held me and I think he was scared I was seriously losing it.

As I calmed down a little, I recited the verse I am memorizing as a comfort to DH & I myself: For thus says the Lord: He who created you, O Jacob; he who formed you, O Israel: Fear not, for I have redeemed you, I have called you by name, you are mine. When you pass through the waters, I will be with you, and through the rivers, they will not overwhelm you. When you walk through the fire, you will not be burned, the flames will not consume you. (Isaiah 43:1-2)

It was a very bizarre experience, but I am thankful to say I woke up this morning feeling like my self. My normal self who is sad but ok. I think it was almost a surprise to me see just how much all of this is effecting me....how much emotion is stewing under the surface. I am thankful that although I feel like I could be overwhelmed by the waters, that God has promised to be with me and protect me. And I am also thankful to have my husband by my side.

Tuesday, August 10, 2010

Appointment delayed

DH decided this morning that he couldn't leave work for our appointment today. I considered going alone, but ultimately felt like it would be much better to have him hear everything directly and be another set of ears. I also felt like I just couldn't handle being there alone, and the thought of it made me cry. I also cried because DH was so unaware of our schedule and seemed like he didn't even want to go. But it doesn't take much to make me cry these days.

We rescheduled for this Thursday.

Monday, August 9, 2010

Follow up appointment tomorrow

Tomorrow we have our follow up appointment with the RE. I'm dreading it. I just don't want to face our BFNs, and I don't want to be reminded of the fact that we are almost done with treatments.

Thank you for your thoughtful comments and suggestions. A few of you suggested asking for immunological testing and a Recurrent Pregnancy Loss (RPL) bloodwork panel, and I think I will ask the RE about these items. I know I {obviously} have had no miscarriages, but at this point I want to do anything that we can to help the next attempt be successful.

One thing that seems a little unique in our situation is that I personally don't see any "problem areas" or "red flags" about our cycles. Other than the fact that I have never conceived, I have been happy with the way I stim and the overall quality of our embryos. So I guess there just isn't much I can think of to ask about or do for the next cycle. In fact, I am nervous that if too much changed we would perhaps have fewer or worse quality embryos. But I am not the doctor, and I think I will just trust the RE about what, if anything, should change for our next attempt.

Friday, August 6, 2010

Heart break

My RE called me on Wednesday. I was so surprised to get see his name pop up on my phone, because we I had gotten the news about my negative beta the nurse had said my RE was on vacation all week. He called me from his vacation to say how sorry he was about our BFN! I was very touched by this gesture, although it was difficult to feel very encouraged by his words since he always thinks it will "still happen" for us and is hopeful....and yet here we are. He did say we would talk more next week about further reducing fees for another try...

***

That night in bed, DH asked me what I hoped our next steps would be. I said I wanted to try again, and he agreed. But then he said he thinks we should stop after one more attempt, unless something happens at the RE's next week that changes anything.

I knew this was our plan - 3 fresh cycles. But it still hit me like a ton of bricks. I have already been crying off and on since Monday, but this conversation unleashed a new wave of sadness. I feel like it is the right decision, and I don't want to fight it. But I told him I still don't feel ready to stop trying.

DH curled up next to me and held me while I cried. Within a couple minutes, however, he was asleep with his arm around me. I'm always so jealous of how easily he falls asleep.

I always thought I would be "ready" to "move on." I do feel closer to that point than I ever did, and the thought of leaving behind the emotional turmoil of treatments and BFNs has its appeal. Also, the thought of actually and truly bringing home a baby someday stirs some excitement in my heart, whereas it is getting harder and harder to imagine that with treatments after so many BFNs. But in comparison to these feelings, it still causes greater pain in my heart to imagine never having a biological child. I just can't let go. Why can't I let go?

As I laid there, I focused on the pain in my chest. The literal, deep ache that filled my chest as I exhaled. The only thing that eased it was an occasional, muffled sob as I released it into my pillow, but otherwise the pressure only intensified. I let it intensify, not wanting to wake DH with my sobs and also strangely fascinated by the feeling. I wonder what causes this physical sensation when you experience deep sadness? And I wonder if that is where the term heart ache and heart break come from? Because it felt like my heart was breaking, both figuratively and physically.

Wednesday, August 4, 2010

Thoughts in the night

If we had not frozen eggs, we would be done with treatments right now. We had planned and saved for 3 {fresh} cycles, and we have done 3 cycles (but thankfully one was not fresh...). This thought takes my breath away.

I am thankful we have at least one more chance....but how can I hope that it will work after 3 failures?

I am in the special club of "multiple failed IVFs." I looked through the Stirrup Queens' blog roll and did some googling, and this is not a happy club with many "success story" endings.

When do we have to accept that God will not give us a biological child? That DH + Me {does NOT} = baby? When are we just crazy and throwing money away on treatments? (All rhetorical questions that I know only we can answer)

These are the thoughts that keep me awake at night. The simple questions that can roll around in my head for hours if I have nothing to distract me.

DH encouraged me to memorize an encouraging scripture this week, and I have been working on it. I am thankful for his suggestion, as it is something else {better, true, and hopeful} to fill my mind with. Here is what I have so far:

Isaiah 43:1 Thus says the Lord God; He who created, O Israel, He who formed you, O Jacob: Fear not, for I have redeemed you. I have called you by name, you are mine."

Monday, August 2, 2010

12dp3dt: BFN

I haven't gotten the official beta call yet, but I peed on two sticks since they don't often call me until the very end of the day.

One line. Again. BFN.

I'm a mess and I don't know how much more of this I can take. But I also don't know what else to do. How many times can I get back up? God, give me strength....

ETA: Got the call that the beta was negative. WTF appointment is scheduled for next Tuesday.