Friday, March 19, 2010

IVF #2, Negative

Just got the call: officially not pregnant. Again. I'm so angry I don't know what to do. I had such hope for this cycle....everything went so well, the embryos were so healthy and strong. I really thought this was going to be our time, after almost 6 years I really thought we would finally be parents. I just do not understand why my body keeps failing at something that is so natural and easy for so many others.

Tuesday, March 9, 2010

IVF #2, Transfer

Our transfer was on Sunday, and it went very well. Dr. G called me on Sunday morning to give me the report on the health of our embryos: my clinic uses a grading system where Grade 1 - AA is the highest grade. Dr. G explained that grade 1-AA embryos are very, very rare. He told me that we had one grade 1 - AB blastocyst, and one grade 1 -BB blastocyst that were both looking spectacular, AND 2 more blastocyst stage embryos that were not far behind and looked really, really good, AND 2 more embryos that were ALMOST at the blastocyst stage and still thriving.

We agreed that since I'm 39, and this is probably our last hurrah, we would transfer 3 blasts instead of just 2. Dr. G said he felt in my situation the danger of becoming pregnant with triplets was only about 5%, and the chance of twins is about 30%.

So, we transferred the two grade 1 blasts and one of the other blastocysts. The transfer was much more comfortable this time around because I didn't drink so much water! It was so very painful for me the first time we did IVF, so I decided not to drink as much water as they recommended this time around, and it worked out much better. I've always thought I had a small bladder, and apparently I'm right, as it certainly didn't take 32 oz. to fill mine up. I drank maybe 16 oz of water before the transfer, and the doctor said my bladder was "perfectly full" and really helped to visualize everything via ultrasound.

The other new thing this time around is that the embryologist came back into the room while I was "resting" for the required 5 minutes afterward, and handed us a framed photo of our beautiful embryos. This of course, made me cry even harder than I already was. I have done nothing but stare at the picture since we got home on Sunday. I think it must help to sort of visualize them in there, making a happy home....

I just this minute got a call from my nurse, informing me that as of today, we have TWO frozen embryos!! I'm so surprised, and so excited! The doctor told us on Sunday that they would watch the remaining three of our embryos that we didn't transfer, for the next two days in the lab, to see if they would continue thriving, and that if they were robust enough by day 7, they would freeze them. But, she said it was only a 50/50 chance that they would make it. So, I'm so pleasantly surprised to learn that TWO of them made it!! I'm so proud of them!!

Anyway, I'm only in the very beginning of the two-week-wait, and I already feel like time is just draaaagggginng on. The 2ww always feels like torture to me. Nothing left to do but pray, each and every day.

Friday, March 5, 2010

IVF #2, Day 3 after retrieval

Working from home today, and just got off of a conference call and received an update from much beloved Dr. G. via voicemail: "K, just wanted to call and see how you're feeling, and to let you know that your embryos are looking WONDERFUL. Of the 11, all are still thriving, and 10 of them are considered grade 1 (1 being the best grade), and the other one is not far behind. I'll call tomorrow to check on you and give you another update. Things are definitely looking good this time!"

In our first IVF, we only had one embryo that was considered grade 1. So, I know that having many high-grade embryos is not by any means a guarantee of success, but any way you look at it, this is good news and a reason to smile all day long today.

Frighteningly, hope is alive and well at this point, although something inside of me, even still, is bracing for the inevitable crash.

Thursday, March 4, 2010

2010, and IVF #2

On January 15, 2010, we found out that our 4th IUI had failed, and after consulting with Dr. G, we decided to do ONE more round of IVF. Financially, it only makes sense that this is our last IVF attempt. It is SO expensive, and we're getting excited about pursuing adoption, but we can't afford to do both at the same time! We decided that if this last round of IVF doesn't work, we will close the door on this phase of our lives. For 5 years we've been chasing the dream of becoming parents through biological means, and it just feels like we've done everything we possibly could have done, to that end. It feels like the right time to bring the physical treatment phase to closure. Although I know I will be devastated if this doesn't work.....there's a part of me that feels good about being able to say - never again - to the appointments, the injections, the rearrangement of work schedules and vacations and holidays to accommodate treatment, to the up and down roller coaster of wondering each time if we'll get lucky, etc. I know that adoption is going to present MANY challenges, but at least we can put the past 5 year's worth of treatment oriented challenges behind us, finally.

I thought it would be interesting to chronicle the last 5 years in a succinct list:

October 2004 - Married! Me -33, R - 35

October 2004 - May 2006 - TTC the old fashioned way. Me - 33 to 35, R - 35 to 36

July 2006 - September 2006 - Clomid/timed intercourse cycles - No response from ovaries. Me - 35, R - 37

January 2007 - April 2007 - IUI#1 - BFN (longest stim cycle on record at Fertility Clinic #1 - 65 consecutive days of FSH injections) Me - 36, R - 37

July 2007 - August 2007 - IVF#1 - BFN (Moved to Fertility Clinic #2 and much beloved Dr. G. Best decision ever!) Me - 36, R - 38

September 2007 - May 2009 - BREAK (Gall bladder surgery, major house repairs - impact on budget, lost almost 100 pounds...) Me - 36 to 38, R - 38 to 39

July 2009 - IUI#2 - BFN. Me - 38, R - 40

August 2009 - IUI#3 - BFP! Me - 38, R - 40

September 2009 - Miscarriage (Non-doubling HGG numbers in early pregnancy, presumed ectopic, given methotrexate injections to induce miscarriage) Me - 38, R - 40

November 2009 - IUI#4 - BFN. Me - 39, R - 40

January 2009 - IUI#5 - BFN. Me - 39, R - 40

March 2010 - IVF#2 - ????????? Me - 39, R - 40

Wow, that all looks very tidy and speedy, laid out like that in a list. But it feels like an absolute LIFETIME since those first Clomid cycles at my OB/GYN's office. Oh, how naive I was back then!! And so very impatient!

So, here we are at the tail end of IVF #2. 14 eggs retrieved on Tuesday. Of the 14, 11 of them were mature and all fertilized. As of today, Day #2 after retrieval, all 11 embryos still thriving. Hurray!

We'll wait now to see how may make it blastocyst stage - Day 5 transfer is scheduled for this weekend on Sunday, and after that, it's all over but the cryin'.

All we can do now is pray!

Thursday, September 3, 2009

I have been thinking for quite a while that I was finished with this blog. So it was surprising to me tonight when I felt an urge to document some things here. But, I have come back here on several occasions when I was reflecting on our infertility history and couldn't remember the exact sequence of events that led up to a particular milestone, or when I couldn't remember the date or time frame of an event. So, I thought that I'd probably regret it if I didn't get some of the details of our latest attempt chronicled here, if only so that I can read back through it at some much later date, and get whatever I need from it....

So - we started treatment again in July, and we decided to start from the beginning again. Since I have lost a considerable amount of weight, our doctor agreed that my body might react differently and with less medication than during our previous attempts, and that it made sense to perhaps start with the lesser expensive IUI treatments before advancing on to IVF again. So, I took 150 mg of Clomid along with a few low doses of injectable FSH medications (which were graciously donated to us by dear friends who are now 7 months pregnant with the fruits of their latest cycle) and we did an IUI procedure (our 2nd ever) on July 10. On July 24 we found out that it was unsuccessful. We started another cycle immediately, and had IUI procedure #3 on Aug 10. Here's what happened after that:

Saturday, Aug 22 - Unlike all previous attempts, this time I was nonchalant, completely sure that the IUI hadn't worked, and I did not pee-on-a-stick each and every morning for the last week of the 2 week window. I had been planning to only pee on ONE stick the morning of the beta, just because I couldn't deal with the suspense of having blood drawn and waiting for 6 hours for someone to call me to tell me my fate. But, on Sat afternoon, I went into the bathroom to pee and my last remaining pregnancy test was sticking out of a basket in my bathroom and it caught my eye, and I thought - well, what the hell, I'll just take this ONE test and then I won't have anymore in the house to tempt me, and I'll buy just one more on Monday night to take on Tuesday morning before the beta. So I peed on it, and immediately two lines came up, and reflexively, I almost threw it in the trash as I have countless other times before, thinking that it was negative, as usual. But at the last second, with the stick poised over the trash can, my heart leaped into my throat, and I thought - WAIT a minute. Two lines? Doesn't that mean something good? But, you know, on some of them you need a plus sign, and I couldn't really remember what brand of test I had taken, so I snatched up the instruction sheet, which I had thankfully saved, and tried to make sense of what I was seeing. My heart was pounding, pounding, pounding and the more I looked at the two lines the more I couldn't believe it. I raced down stairs and threw the test onto R's desk and asked him to read and tell me what it meant. He looked at it, and then he looked at me, and we stared at each other and I cried and we held each other for a few minutes, which was sheer joy, sheer elation, thank you GOD for this moment......And then I grabbed my keys and raced to the grocery store where I bought not one but 8 more tests. Because I couldn't believe it was true. I needed more reassurance. What if the one test I used was faulty? What if it was defective, had been in the humid bathroom too long, or I dropped it and broke it before I used it or what if it just LIED to me? I had to be sure, so I came home and drank 2 bottles of water and paced around until I could pee again. Then I peed on 4 sticks, all different brands, and every one of them came up immediately and strongly positive. No pussy-footing around, right away, clear as a bell. No squinting and holding the test up to the light, If you hold it this way it KIND of looks like a second line, right there? No, none of that. Straightaway positive as they could be.

The rest of Saturday, Sunday, Monday, Tuesday, Wednesday and Thursday morning passed in a joy filled haze. On Tuesday morning I went in for my first beta. I wasn't the slightest bit nervous, because I reasoned that 5 pee sticks couldn't possibly be wrong. I knew there was enough hcg in my system to ensure happy news when I got the phone call that afternoon. And sure enough, my nurse called and congratulated me, and told me my hcg level was 637. Holy shit! It might be twins! We fought the urge to tell everyone we knew. I felt like I wanted to take out an ad on the nearest billboard, After FIVE years, we FINALLY did it! WE ARE GOING TO HAVE A BABY! A BABY! Us! We are pregnant! We told WAY too many people. Family and all the people we really love, but still, I know now, way too many people. We were just so overcome with this news, it was incredible, unbelievable, we felt like we had won the lottery. We talked about things that we have NEVER allowed ourselves to talk about since waaaay back when, 5 years ago, when we first got married and naively thought that all we had to do was stop trying NOT to get pregnant and we'd get pregnant. We talked about what we'd do with all the furniture that is in the spare room in order to turn it into a nursery. We talked about possible names, we talked about child care options, we talked about what the baby might look like, whether each of us wanted a boy or a girl.....I started reading "What to Expect When You're Expecting" again, which I also hadn't allowed myself to read since right after we were married. I can't remember a time when I felt so thankful, so happy, so hopeful and was a magical week.

Thursday, Aug 27 - I was ridiculously sure of myself going into my second beta on Thursday morning. I knew that my levels of hcg were supposed to have risen at least by 60% in two days. I had calculated that meant my number needed to come back around 1050 or more, and I was honestly absolutely positive that I would surpass that number with ease. I wasn't even nervous. How are you this morning, the nurse asked me as I rolled up my sleeve. I'm FANTASTIC, I said, grinning like a cheshire cat. Supremely overconfident, and supremely naive and stupid, as it turns out. When my phone rang that afternoon to receive the results of the blood test, I was so excited to hear how my number had come back, and was anticipating going online to see if all the hcg charts still thought I was going to have twins. When Dr. G himself began speaking, instead of one of the nurses, I instantly knew it was bad news. He told me my level had only risen to 679. Not a good sign, he said. I could hardly breathe I was so shocked. I hadn't prepared myself AT ALL to hear bad news, hadn't even thought it could be a possibility. He went on to say that the level on Tuesday had been so high, and he thought it was possible that initially two embryos had implanted, but perhaps one of them had stopped growing, and that the other one was still fine. He said that they had definitely seen cases where that happened, and the remaining embryo went on to become a beautiful full term baby. That I shouldn't worry myself to death over the weekend, and that I should come back in on Monday for another blood test and an ultrasound to see what was going on in there, and hopefully my number would jump up and everything would be fine. I got off the phone, called R, and totally lost it. Was sure for about 3 hours that it was all over. Left work early, raced home to be with R who was also off that day, and laid in bed with him crying for over an hour. R is a steadfast rock of support in situations like these, and as he always does, he pulled me up out of it and helped me to see that there was every reason in the world to believe that it was just as Dr. G had said, our remaining embryo was strong and everything would be fine on Monday.

Monday, Aug 31 - after an eternity of time over the weekend, we went trembling into the fertility clinic for the 3rd beta. I was almost shaking I was so nervous. As I sat down in the chair to offer up my vein for the blood draw, one nurse asked the other, confirmed or suspected? My nurse answered, suspected, and then handed me a sheet of paper detailing the benefits of taking Methotrexate to dissolve ectopic pregnancies. What? Ectopic? huh? I hadn't even thought of that possibility until that very second, but gee thanks so very much for suggesting it. On the way down to the ultrasound room, I tried to explain to R why I was crying again, and why they seemingly suddenly thought our pregnancy could be ectopic, and then we both tried to figure out why they thought it prudent to provide us with the information and a consent form for methotrexate before we even had the effing ultrasound for christ sake. During the ultrasound, R stood there holding my hand while the doctor explained (not my beloved Dr G that morning, unfortunately) that although it was VERY early and they couldn't tell anything absolutely for sure, that she definitely saw what could very well possibly be, and most likely could maybe be, a pregnancy sac. But no, they couldn't rule out an ectopic pregnancy based on the ultrasound, bc it was really much too early, I was only 5 weeks that very day, and it's just so early to really tell anything definitively on ultrasound you see. Aaaaaarrrrrrggggghhhhh. R was steadfastly positive, as he always is, and focused on the fact that the doctor had ended on a positive note, "as far as I can tell, this is a pregnancy sac, and I would say that you definitely should NOT take the methotrexate at this point. We need to see what your hcg numbers look like this afternoon, and then we'll have a better idea of how we should proceed.." So, R and I both went off to work and I waited in horrible suspense for the next 4 hours for the fertility clinic's call. This time it was the nurse who called, but her news wasn't any more positive than Dr G's had been 4 days before: in 4 days, my hcg level had only risen to 713. She didn't offer any color commentary on the predictive nature of this number on our unborn child, but rather stated in a very serious tone that Dr G wanted to see me and perform an ultrasound HIMSELF in three days, and that he had arranged to meet me at the clinic on Thursday at 8:15, as long as that worked for my schedule. As if there were ANYTHING more important to me than this pregnancy! Sorry, getting my nails done at 8am, could Dr. G do 10, 10:30? yeah right.

Thursday, Sep 3 - I went by myself to the clinic this morning, feeling defeated and depleted. Dr G performed the ultrasound, and he was incredibly thorough. It took twice as long as it usually does. He said that he saw several cystic areas that might or might not be pregnancy sacs. He said that normally, at 5 and a half weeks, that he would expect to see white lines differentiating a pregnancy sac, which he didn't see on mine, and that he would also have expected the sac to be larger. The several areas that he saw in my uterus which MIGHT be pregnancy sacs were all quite small. Still, he said, knowing that this pregnancy is very much wanted, I want to give this every possible chance...let's see how the numbers come back this afternoon, and I want to see you on Monday, when you'll be 6 weeks, for another ultrasound. He said that at 6 weeks, on ultrasound he would expect to see a large pregnancy sac with a yolk sac clearly visible in it. If we didn't see that, and my numbers continued to creep upward, he would recommend starting the methotrexate. If there were any chance for this to be a viable pregnancy, he said we would have to see the numbers rise quite dramatically this afternoon, and we'd have to see that pregnancy sac with encompassed yolk sac on Monday. So, I left really feeling like there was very, very little hope. And more than that, feeling so terribly frustrated that this horrific suspense continued to drag on. The typical rollercoaster of infertility, only in a condensed way that I hadn't experienced before now. When the numbers came back this afternoon, 774, Dr G again called me himself, and said that given the lack of conclusive information from this morning's ultrasound, and the modest at best increase in my hcg level today, that he strongly recommended that I go ahead and take the metho injection. He told me that he felt there was almost no possibility that this pregnancy was viable, and that if we let it go on, there was a risk of my tube rupturing, if indeed it turned out that it was an ectopic pregnancy. He didn't feel there was any reason to wait and do another ultrasound on Monday. I cried, and called R, and drove myself bleary eyed back to the clinic. The metho injection is not only intramuscular, it has to be injected in two different injection sites in order to increase the absorption potential. Apparently the protocol for this is for the patient to assume the position, standing with trousers lowered and with palms braced on the examination table, while not one but two nurses armed with extra long needles face off behind you and stab you at exactly the same moment on opposite sides of your posterior. I had gotten intramuscular shots before when we did IVF, but R always gave them to me, and I always iced the injection site beforehand so that I never had to feel anything. Unfortunately ice wasn't part of the protocol this afternoon, and those two shots hurt like hell. I am proud to say that I didn't cry until well after the shots were over, when one of the nurses reached out and patted my arm and told me she was so sorry that she had to do it, and that she knew my heart was hurting worse than my rear end. That small act of kindness was too much for me, and I had to sit in the exam room with a box of tissues for several minutes before I could collect myself enough to walk out to the front desk, where I was told I needed to make a date for another two needles full of metho on Monday. That should make for a delightful Labor Day holiday - a trip around the beltway at 8 am to get two more intramuscular injections. Could this get any better?

So, there's the whole sad story. I feel completely wrung out now, and my eyes are are puffed up to the size of extra large marshmallows. Right now I wish more than anything that I could will my body to go ahead and get the mechanics of the miscarriage out of the way RIGHT AWAY. I'm told it could be two weeks or more before my body will decide it's finally time to expel the embryo, or materials of conception, or whatever I'm supposed to call it. I wish I could make it happen tomorrow, I would gladly stay here locked in my bed or bathroom suffering with cramps or pain or whatever may come, for hours on end, if I could only just get it over with right away. I can't stand the idea of walking around in this strange state. Still technically pregnant, but decidedly not. But like everything else about infertility, I have absolutely no control. My body will do whatever it will do, and I'll just be along for the ride.

Perhaps I will post more when this is all over. We're going to the beach in a week, I can only pray that I won't spend my one week's vacation this year dealing with the mechanics of an inevitable miscarriage.

Edited on 12/2 to add dates and corresponding beta numbers, purely for my own future reference:

8/25 - 637
8/27 - 679
8/31 - 713
9/3 - 776
9/7 - 507
9/10 - 324
9/15 - 91
9/22 - 0

Wednesday, April 29, 2009


Strange to be back here again, yet, here I am. Thought I might as well start logging my thoughts on infertility again, as I've finally taken some action today, after a very long hiatus. I went back my beloved RE this morning, for the first time in almost 2 years.

It was a surreal experience, sitting in front of him and listening to him recite my 5 history from notes on his computer screen, "Clomid in 2004 and 2005 with no response....protracted IUI cycle in 2006 resulting in an egg reduction procedure and mild ovarian hyperstimulation....IVF cycle in 2007, 14 eggs retrieved, all mature, all 14 fertilized, half of them abnormally. unsuccessful. recommended another round of IVF with addition of ICSI and assisted hatching..."

I sat across from the good doctor feeling somewhat accomplished. I'm 80 pounds lighter than last I saw him. I told him that for the first time in my life I had been having "regular" (40-ish day long) periods. I told him I had been waiting for a miracle. He smiled and said that response was common, human nature, understandable.

I told him I had said the same thing to my ob-gyn 2 months ago, who promptly responded, "You are 38. You don't have time to wait for miracles. Go back to your RE as soon as possible. Make an appointment today."

It took me two months to work up the nerve to jump back into this. In large part, I'm absolutely dreading it. A smaller part of me is starting to feel hopeful again, after only one consultation. I think that is very, very dangerous. Dangerous, but inevitable.

In the almost 2 years that have elapsed since we were officially "in treatment", my personality has changed. For the better, in my opinion. Granted, I may have been in denial during that time. But, it was a far more pleasant existence, being off of the roller coaster. I was able to set all of the constant plaguing daily heartache aside for a while. As I've said before, infertility is a problem that never goes away and has no good solution, no matter how often you analyze it, no matter how many different ways you look at it and turn it around in your mind. It's exhausting to have it top of mind every day. I don't miss walking around with my emotions and vulnerability so very close to the surface. I don't miss bursting into tears for no reason whatsoever. I don't miss feeling pitiful and pathetic and like a failure every day. I am so very fearful of going back to that place, and being that person again.

For practical reasons, I'm also dreading the logistics of getting back into a treatment cycle. I'm working longer hours and have a much more demanding schedule than I have since we began "trying" all those years ago, and I can't quite imagine how this is going to work this time around. The idea of telling my colleagues that I can't schedule any meetings before 10am is laughable.

But, we had some heart to heart talks, my wonderful hubs and me, and decided that there will never be a good or favorable time for getting back into this - not financially, nor physically, nor mentally. We must make it a priority whether we like it or not, because the statistics are stacked against us. No spring chickens, we two.

So. Here I am again. Preparing for another ride on the roller coaster...

Sunday, June 22, 2008

Has it really been 4 months?

Wow, it's been quite a while since I felt I had anything to say on this blog that would be worth anyone's time to read about.

I guess the bad news is that nothing much has changed. IVF is still our only hope, and we still can't seem to commit to a plan for how to fund another try. I still feel like our time is running out. R turned 39 this month, which means I'm not very far from 38 now. Not the end of the world of course, doesn't mean pregnancy is impossible, but certainly doesn't do anything to improve our odds, either.

I suppose the good news is that I'm not as despondent about infertility on a daily basis as I have been in the past. I think that is because the longer we are stalled, the longer I allow myself to be apathetic about it, the easier it gets to....not do anything. I'd be lying if I said I was looking forward to being embroiled in a treatment cycle again, taking the injections, conforming our daily lives around the cycle, opening my heart up to hope again, bracing for the inevitable crash....I'm really dreading having to go through that all over again, actually. But still, if a big pile of money fell out of the sky tomorrow, I'd haul it straight to the RE's office and plunk it down, sign up for another chance.

We entertained R's family this afternoon and evening....had our usual Sunday afternoon cookout, as we do most Sundays in the summer. Today there were 15 adults, 7 children, and 2 dogs running around in our little house. It was a madhouse, of course, but we loved it. At the end of the evening, R's cousin asked if her 3 kids could take a quick bath before they left. They had to drive at least 45 minutes to get home, and she knew all 3 would be conked out in the car and difficult to harangue into the bathtub once they got home.

The sight of those 3 precious and precocious little ones in my bathtub pulled at me in a way that seeing them run around all day had not. As I helped to dry them off and muscle them into their 3 sets of clean and color coordinated PJ's, my main thought, of course, is that I should have been bathing my own children in our bathtub, not someone else's. I should have been putting PJ's on kids in a room decorated with zoo animals and ABC's, not in the room that serves as our "extra den" instead.

But remarkably, bitterness and self pity did not overtake me tonight, as they so often have in similar situations in the past. I feel a sense of hope about it all....although I can't say I know exactly why. Maybe because after all this time I still believe in miracles. Because I think R and I are good people, and because I still believe that good things do happen to good people. For tonight, that's enough reason to keep hoping.