Be Your Own Advocate

I hope you all know how grateful I am for this community.  When I set out to see what the infertility blog world was all about my sole reasoning was to have someone to talk to who truly understood what we were going through.  But the more women I met, the more involved I got, I began to realize there's so many benefits that I didn't expect.  Most recently this community has given me the confidence to be my own advocate.  When I got my diagnosis I immediately began researching, which is what actually led me to the blog world.  While I recognized I would never be an expert I wanted to at least understand what all of these tests and procedures were about, what the drugs I was injecting into myself did, and what the potential risks and outcomes were.  I quickly got up to speed on my diagnosis, my options, and the procedures and drugs.  However even equipped with all of this knowledge I still lacked the confidence to even ask some of my questions to my doctor.  There's been times throughout this journey that I questioned a choice he made or wondered if another option might be better.  But for the most part I just conceded to the fact that he was the one with the initials after his name, the years of experience, and the expertise.  But thanks to you guys for the first time I felt strong enough to speak my mind.

The re-test of my TSH level came back at 2.9.  My doctor was comfortable with that level and opted not to treat me.  However, after researching and some great advice from many of you, I got the courage to challenge her about this decision.  A lot of the studies I have been reading suggest the optimal TSH level for a woman trying to get and stay pregnant is between 1 and 2.  At 2.9 I was BARELY under what my Dr. was comfortable with.  I couldn't find any information that discussed your level could be too low.  But what I did find was a lot of studies that linked chemical pregnancies and early miscarriages to elevated TSH levels.  Now, while mine is clearly not "elevated", it is above what they were calling the optimal range.  So after stewing on it for the weekend I composed an email this morning to my doctor.  I included some of the more powerful articles I had read, and reminded her of both my early miscarriage and my chemical.  I explained that I didn't want to challenge her, I only wanted to give this transfer the best possible chance we could.  In what was surprisingly a quick response she agreed to put me on 25mcg of thyroid replacement and to re-check my levels in 3 weeks.

I feel good about the fact that I pleaded my case and even better about the fact that we are going to try and get it down to the optimal level.  Most importantly I'm so glad that I can move forward confident that I've down everything I can to make this cycle a success.  Meds start tomorrow - 4 weeks from transfer.  Let's do this.

Understanding

Well as you've probably guessed from my radio silence my beta dropped on Tuesday.  It went from 9 to 5.2.  I went back this morning and it was down to 4.7.  I  have to go back again on Monday and hopefully it's down to zero.

I could sit here and tell you all about how I'm not going to give up, how I trust in The Lord and His plan, how I know that we will be parents one day.  But that wouldn't be an honest representation of what I'm feeling right now.  Right now, in this moment, I've lost hope.  I can't help but to question if we will EVER be parents.  That maybe it's God's will for us NOT to be parents.  My heart is broken, my spirit is crushed, and I am so very tired.  The weight of this struggle is just too much.  I feel like I am drowning in sorrow.  And there's a part of me that just wants to float to the bottom.

The hardest part of all of this for me is watching D struggle.  It literally tears me apart to see him hurting so badly.  And I can't help but feel responsible.  All I can think of is that he deserves better than this.  I hate that he has to experience this and I'd do ANYTHING to take his pain away.  But it's not something I have the power to do.  

So here we sit.  Childless.  Running out of options.  Running out of money, and definitely running out of hope.  We'll meet with Dr. H tomorrow and see what he has to say.  I know he doesn't have the answers I so desperately seek.  Yes, "normal" embryos have a 70% success rate.  So the odds were in our favor.  But 70% is not 100%.  There are other things that can go wrong and obviously it did.  Could it be my uterus?  We've never had any indication but I'll be asking about running some tests to confirm that before our next transfer for sure.  But the fact of the mater is he can't provide me with a reason or explanation of why this didn't work.  And he can't provide me with a guarantee that the next transfer will work either.  There's no peace to be found.  Honestly there won't be until I hold my baby in my arms (if that day ever comes).

I'm grateful that we still have 2 frozen blasts that tested normal.  That's about all the positivity I can come up with right now.  As I mentioned in an earlier post while I'm SO thankful for my frozen babies it doesn't stop the pain that is associated with this transfer.  It's now 6 babies that we've transferred and lost.  Six.  That seems like more pain than anyone should have to bear.  Three fresh IVF cycles, 4 transfers, and still nothing.  We won't be able to cycle again until Dec. which is the month that we did our first IVF cycle.  Never in my wildest dreams did I imagine we'd still be in this position at this point in time.  Call it being naive, but through every step of this process I kept thinking it was the last step.  This journey has changed me.  I'm scarred, damaged, broken.  And regardless of if we ever get a baby I will never be the person I was before experiencing this.  Just one more heartbreak to add to the list.

Scratch

It's been a crazy week for me, as I've been traveling for work but I wanted to send out a quick update as I'm feeling pretty anxious this morning.  I had my "scratch" on Monday morning.  It was as unpleasant as it sounds.  Basically Dr. H took a catheter and shoved it up into my uterine lining and took a chunk out of a specific spot.  He then felt the need to show me the blood and tissue he removed - could have done without that!  But the point of the procedure is that when we go to transfer Frosty he'll be able to see the spot where he took the tissue and will aim to deposit him/her right into that little indentation which will hopefully help Frosty implant and burrow in  Fingers crossed.

I go in tomorrow for an U/S to check and see how my lining is looking.  The only thing I've been taking to help with it is IM injections of estrodel every three days.  It doesn't seem like much.  I thought I would be on suppositories as well but I'm not.  Hopefully my lining is looking good and we can continue moving forward.

Although my blog is anonymous there are family and friends that I've shared the URL with.  Because of that I won't be posting my exact transfer or beta dates.  When I miscarried in March everyone who knew that we were pregnant and also knows me in real life, knew the date and time of the 7 weeks ultrasound.  I feel so blessed to have so many people who love us, support us, and are cheering us on.  However when we got the bad news I was obviously hit pretty hard and all of the calls and text messages just overwhelmed me even more.  I think it would have been easier if I could have had time to process the news and then informed people when I was more settled.  So that's my game plan moving forward with this transfer.

I hope no one feels like I"m trying to shut them out or that I don't appreciate each and every one of you who follows this blogs, sends positive thoughts and prayers, or reaches out to me to tell me that they are thinking of me.  IT MEANS SO MUCH TO ME!  I'm so grateful for all of my amazing friends and family and it's what gives me the strength to keep trying.  So from the bottom of my heart thank you all so much.  As for the wonderful people that I've never met but have connected with through this amazing community your ability to understand exactly what we are going through has been a light in the darkest tunnel for me.  Feeling like we aren't alone on this journey has made it more bearable.  I appreciate all of you so much!

Facing your Fears

Well today I'm heading back to my clinic for an ultrsaound.  I haven't gotten my period yet after the miscarriage and they want to check for cysts.  Honestly I can't get past the ultrasound part to even comprehend what it does mean if I have a cyst.  I'm assuming it will postpone our next cycle for the FET.  Which sucks, but like I said all I can think about is being back in that room and what happened last time I was there.  Logically I know there's many, many more ultrasounds in my future with IVF and hopefully someday another pregnancy.  So I need to face this fear and just get over it.  I just can't stop thinking about everything that happened last time I was there and all of the emotions seem to come right back.  But I'm ready to move forward and this is part of the process so I just need to suck it up and get it done. As we all know battling infertility has lots of dark moments and difficult situations so this is just another one that I'll face on our journey to a family.  I would do anything, absolutely anything, to make that happen.  So I guess I'll take a deep breath, grit my teeth, and get this over with hopefully as quickly as possible.  I'm grateful, yet again, for the fantastic staff at my clinic who will be by my side and make this painful experience a little bit easier.  D is going to come too, even though he probably shouldn't take the time off of work.  I didn't even have to say anything he just knew how difficult this would be and told me he'd be there.  I feel very lucky and blessed that I don't have to travel this road alone.

There's a small stupid part of me that was hopeful that we'd conceive naturally during this cycle.  I know that our chances of this happening are so slim but I couldn't help but hope.  You hear all of the stories about how you are the most fertile after a miscarriage.  But I'm almost positive I didn't ovulate this cycle at all and even though my period is late I feel absolutely normal.  I've had no cramps, no sort of symptoms of any kind.  I couldn't bring myself to take a test and see another negative today.  So I'm just moving forward with our appointment today and I guess we'll know soon enough what's next.

The Waiting Room

Since our early miscarriage I've been living a life without pills, timelines, injections, and doctor appointments.  I have to admit I spent the first week or two constantly feeling like I was forgetting something!  But, I am finally enjoying being medication free.  So that brings the question of.... where are we on our journey to a baby? We are where every girl in IF land finds herself - The Waiting Room.  We are simply waiting for my period to come.  If it arrives by next Monday then we can start on BC and will be eligible for a May FET of our 1 little embryo.  If it doesn't arrive then we continue to wait and will have to be bumped to June cycle.  I am at peace with whatever happens.  Of course I want to continue to move forward, but waiting another month won't send me over the edge. It seems I've finally accepted that I truly have no control over any of this.  And I've learned that the waiting (for your period, your beta, your baby) is the hardest part.

My stay in The Waiting Room over the last four weeks has been rough.  I've been mourning the loss of the baby that I carried for 7 short weeks.  I've been dealing with grief, anger, and unbelievable sadness.  But throughout all of these emotions one thing has remained constant and that is our desire to have a child.  My good friend Amanda recently wrote an amazing post (as most of hers are!) about Hard Choices and next steps.  Her post pushed me to start looking ahead instead of dwelling on the past.  The options she laid out for herself and her husband are exactly where we are at.  And after much discussion I think my husband and I are on the same page with how we want to move forward.

Even though we have our reservations about just transferring one embryo we have decided to move forward with the FET as our first step.  Financially it just makes sense.  We are very lucky in the fact that D's insurance does cover part of our infertility treatment.  But even with that help a fresh IVF cycle is significantly more expensive than a FET.  So it's hard to justify spending the money for another fresh cycle when it *could* not even be necessary since we do have 1 embryo left.  Yes, we transferred three last time and still have no baby but it only takes one.  So we'll start there either in May or June depending on when AF wants to make her appearance.

Looking beyond the FET (because I'm a lady that always has a plan) got more complicated.  Our options are to try a 3rd fresh cycle at our clinic at the very highest protocol, transfer to another clinic (options include another clinic in our state or some place like CCRM), donor eggs, domestic adoption, and international adoption.  As of right now it doesn't appear that carrying a baby would be the problem, but it's more my egg quantity/quality.  So I don't think surrogacy would be a fit for us since someone else's uterus won't help my rotten (forgive the pun) eggs.  So after much discussion D and I have agreed that we aren't ready to give up on having a biological child yet.  D's insurance provides coverage for up to 4 fresh IVF cycles over the course of your life.  We've used up 2 of these but still have 2 left.  While we all know CCRM has amazing statistics, we would also have zero insurance coverage.  So we'd be looking at approximately $30,000 without travel (correct me if I'm wrong CCRM patients!).  Since we can do IVF in our state for about a third of that cost it seems logical to exhaust our options in state with coverage before we move on to that option.

So then the decision becomes do we stay with our clinic or get a 2nd opinion?  I adore the staff at our clinic and I do like our doctor a lot.  It sounds like he's more involved than some other doctors at different clinics.  He does all of our monitoring u/s's and we meet face-to-face for WTF appointments.  I have his email address and he gets back to me within 24 hours if I email him questions.  He started me out on a protocol that was slightly more aggressive than their standard protocol due to my elevated FSH level.  After our 1st cycle had, let's just say, less than stellar results, he bumped me up to a higher protocol.  Basically they rate their protocols 1-10.  I started at a 6 and then our 2nd cycle was at a 8.  It did yield better results as we had more eggs, a higher level of fertilization, and 6 embryos that were contenders at Day 3.  We transferred 3 of them and let the other three grow to Day 5.  Two of those 3 arrested and one made it to blast and was froze.  (This is the embryo we will transfer for our FET).  So better results than the 1 embryo we had from cycle 1.  If we do another fresh cycle at our clinic my expectation would be he would increase my protocol to a level 10, the very highest.  Which would hopefully yield more eggs, more embryos, and more chances for us.

However one of the options that D is interested in is transferring clinics.  There's another clinic a couple hours from our home that has a pretty good reputation.  We both know people who have worked with them and gotten pregnant.  I chose our clinic based on my own research, the research and referral of a close friend, and the fact that they are located right here in our hometown.  D thinks that it can't hurt to get a 2nd opinion and I  can't really argue with him.  If we go to a consultation at this new clinic and the doctor tells me his protocol would be similar to what we are doing for me it's a no brainer - I stay where I"m comfortable.  Now if he suggests something vastly different from what we have tried that's when things get interesting.  While I"m intrigued by trying something new that could potentially get better results I'm also hesitant.  What if this new and different protocol fails miserably and we wasted one of our precious 2 insurance covered cycles on it?  We have seen improved results with Dr. H and there's no reason to believe that by doing another cycle with them at the highest protocol we wouldn't get the same or better results.

In order to try and keep this post a reasonable length (ok, I may have already surpassed that) I have agreed to at least attend a consultation at the new clinic.  (Even though I feel like I'm cheating on MY clinic)  It seems like it's a proactive step and something we need to do.  Once we hear what their recommendations are then we'll try to make the best decision for our potential family.

Until then you can find me lounging in The Waiting Room.  I'll be enjoying coffee in the morning, regular workouts, "snuggle" time with my guy whenever we feel like it, and a glass of wine or two at night.  Hey - the least I can do is make my Waiting Room as comfortable as I can right?

How Do We Heal?

I'm sorry I haven't written in a while.  I just haven't had much to say.  It's been almost 2 weeks since the ultrasound that crushed our dream.  I survived the bleeding and it actually wasn't too bad.  Which isn't surprising since it looks like we lost the baby around 6 weeks.  But considering the emotional pain I was am in it felt like it should have been more of an event.  Slowly my thoughts and focus have started to move away from the baby and miscarriage to other aspects of life.  Last night was the first night I didn't cry myself to sleep, which seems like a big milestone.  I've found my motivation to try and get rid of the 10lbs I've gained from 2 back to back IVF cycles.  I laughed for the first time in what felt like forever on Friday when I shared an ice cream cone with my silly dog and she was so excited (yes I'm that person who shares food with their dog - don't judge.  She's the only baby I have).  Life is slowly getting back to normal.  And when I think about that it brings fresh tears to my eyes.  I don't want my life to go back to normal.  To what I've always known.  I WANT to be pregnant.  I want to be experiencing changes and feelings I've never had.  To be planning for a future that includes a baby.

Instead I find myself trying to heal from what has been the most painful experience of my 33 years.  And I have absolutely no idea how to do that.  The grief and sadness is always there.  Sometimes I can push it away and other times there's no controlling it.  I've noticed that when I think about us having a child my mindset has switched from "when" to "if".  This thought makes my broken heart feel as if it will never be whole again.  And while I'm not ready to give up on us having a family (which is the only dream I've ever really had) I just can't shake the feelings of hopelessness.

Which leads me to our next steps.  We had our WTF meeting with Dr. H which was SO hard.  While it was nice to see the wonderful staff at my clinic it was hard to go back to where our world came crashing down.  But these people have been with us every step of this journey and they are so caring and compassionate.  I am grateful for every one of them, as they have truly made this difficult battle a little easier on both of us.  Dr. H didn't have a whole lot of insight for us.  As he put it, everything that we can control went right and we were successful with getting me pregnant.  He explained that this in itself was a victory since so many women have problems even getting pregnant.  Now our mission becomes keeping me pregnant.  He thinks the miscarriage happened because the embryo that implanted was not chromologically (is that a word?) healthy.  He explained that at Day 3 even embryos who look perfect still have a high percentage of arresting.  However, for those embryos that make it to Day 5 almost 90% of them are genetically normal or healthy.  That being said his recommendation was for us to move forward and transfer our 1 Day 5 grade 2 embryo that we froze.  I know you hear mixed messages about the success rates of frozen vs. fresh.  Dr. H said that their success rate with frozen transfers is higher since my clinic only freezes Day 5 embryos.  Based on the fact that our 1 embryo made it to Day 5, and that one of it's "siblings" implanted, he thinks our success rate for a FET would be between 60 and 70 percent.  D and I both have our doubts about transferring just 1 embryo since we transferred 3 and we are right back where we started.  But Dr. H addressed these concerns by saying that transfer DID work.  And this embryo is much further along and we know a lot more about it than the 3 we transferred last cycle.  When you factor in that a FET runs us around $3K (vs. $15K for fresh IVF) it seems like the right thing to do to transfer this one and hope it works.

So right now we are back to waiting.  How I hate the waiting.  I need to have a period and then we start me back on birth control while we wait for cycle to start.  The FET protocol is pretty easy.  I'll take Lupron injections to keep me from ovulating and then I'll do E2V estrogen injections every other day leading up to the transfer.  Once my estrogen levels and lining are where they need to be we'll do the transfer.  Then it will be the standard PIO injections and estrogen/progesterone suppositories until we get the beta results. Sounds like a walk in the park compared to my last round of IVF.  Unless something strange happens and my period comes early it doesn't look like we will make May cycle so we are most likely looking at June.  And honestly I'm okay with that.  I know I need time to try and heal and to grieve.  And as I mentioned earlier if I can get some of this weight off I think I will feel a little bit more like myself.  As far as the hope I have for the FET it's running pretty low right now. I know it only takes one but after all we've been through it's hard not to focus on the fact that we are running out of time, money, and options.  Which puts a lot of pressure on this lonely little frozen baby.  I pray that it's God's plan for us that this is it.  I pray that He can provide me some peace and some hope.  I pray for a miracle.

Endless

Time seems endless these past few days.  I haven't been able to bring myself to go to work so I've been working from home yesterday and today.  I started bleeding yesterday, which was both a relief and a terrible, terrible (emotional) pain.  Waiting for it to happen was it's own form of torture but enduring it is another.  I spoke with my nurse yesterday and we set up a follow up appointment with our doctor for tomorrow morning.  Nurse Jenny thinks that he'll want to do some other testing (possibly genetic testing on D and I to make sure that we aren't too close of a match to form healthy embryos) and maybe a hysteroscopy.  She claims they have great success with pregnancies after that surgery.  I feel like that may be the case in unexplained infertility but they've also said that my uterus is "beautiful" so I don't really think that is the problem.  Honestly I haven't thought much about next steps.  I'm not ready to give up, but haven't had the heart or the hope to actually think about where we go from here.  We do have 1 frozen embryo.  It made it to 5 day blast and is a grade 2.  However after transferring 3 and not having it work out, transferring one seems almost like a waste of time to me.  I guess we will just see what he says.

I'm having a really hard time talking to anyone who knew about the pregnancy.  In fact, I didn't speak to anyone until Sunday.  Then I finally called my best friend and my mom.  Up until then I'd only been communicating through text message.  It's just such a lonely feeling.  And everyone is so sad and so concerned about us.  While I appreciate that I can barely handle my own sadness, much less everyone else's.  I feel like the weight of it all is crushing me.  D's mom wanted to come on Saturday and I told her I wasn't ready to see anyone.  Same with my parents.  I just feel like there's no one who can truly relate to what I'm going through.  My two best friends both have children and while one of them did endure a miscarriage, she now has 3 beautiful children of her own.  Not to mention she never had a problem getting pregnant at all.   Somehow I'm sure this would be easier to endure if I knew that I would be able to get pregnant again easily.  Instead I sit here wondering if we'll ever have a baby, what I did to deserve this, why this is happening to us, and when, if ever, it's going to end.  We are definitely running out of options, time, and money and it seems so hopeless.  I was just so ready to put this behind us.  And now starting all over just seems so overwhelming and exhausting.

I know I need to find a way to return to the real world.  I emailed my boss and told him about our appointment tomorrow and that my plan was to come into work after that.  Which the thought of actually doing that makes me sick to my stomach.  But logically I know I can't just hide out forever.  Life goes on and I have to find a way to keep living it.  My only salvation has been my husband.  I've been a clingy, crying, mess for the last four days and he's been my rock.  I know he's sad and struggling with his own emotions but he's somehow managed to put them aside to focus on me.  He is the one thing in this world that is keeping me going.  How I love that man.  How I long to give him a child........

Broken

There was no heartbeat at the ultrasound today. I miscarried. 

I feel broken. Heart broken, physically broken, emotionally broken. I don't understand why this is happening to us. I don't know what is wrong with my body. I don't know how we move on. 

I feel like we are never going to have a baby. And it feels so unfair. I'm angry. And I'm sad. I'm so sad. I feel like D has been tricked into this childless marriage and it clearly was not what he signed up for. I feel guilty. And the weight of my disappointment, his disappointment, our parents disappointment is crushing me. I have failed everyone. Again. 

I have no idea where we go from here. I feel hopeless and helpless. And so very alone.