I Feel Broken

Normally, I’d google a keyword related to the theme of my post, but today I don’t think I can even find a visual to convey how truly broken, destroyed, or despaired I feel. Nothing new has happened. I just think that the reality of the past 15 months has finally hit me. Like the denial has worn off. I’m probably in a bit of a mood as well, I suspect.

The past 15 months…..

has changed me

I no longer enter a room filled with optimism or a smile on my face.

I no longer enjoy each day like it’s filled with new opportunity.

I am weary of conversations with people because they always seem to ask when DW and I are gonna have children… And I hate lying, and I really really wish I could just tell everyone what we are going through because the burden of it is overwhelming me. I wish I could get some sympathy (different from pity) because I feel like I’m filling with sadness that is weighing me down and I need someone to carry my pack for a while so that I can heal.

I am no longer vibrant and interesting to talk to. I’ve had many moments lately where I contribute nothing to conversations, which is very unlike me. I used to be described as charming and very personable. It makes me wonder if maybe all of those really awkward people I’ve met in social gatherings were going through something painful like this.

I’ve got this baby snatcher vibe going on. No joke. I won’t elaborate, as I might creep out some of my mama blogger friends on here. But basically, my baby envy has increased significantly. I’m cradling and rocking my little dog like a baby, holding her body close to mine, hearts close together. I’m tearing up just thinking of how badly I yearn to hold my own baby, and how it’s taking too long.

DW is upset with me for being upset. She is going through her own grieving and blaming process. Blaming herself and her body for the two miscarriages, and grieving the fact that it is time to move on to using my body for the last 3 embryos. (Remember that the only reason we were doing IVF was for her to carry my embryos). She feels that she has more of a right to be upset because “[I] still get to try”, and she doesn’t. In a way, I do agree with her point of view, but I see us as a team who has failed. I feel like the odds have been against us. I feel like the game has been rigged and the rules haven’t been fair, and sometimes I wonder what the hell is the point in playing anymore.

Now I know there are many others who have been at this for longer, and I hope I am not coming across as entitled or whiney. I admire you for your continued perseverance and optimism, and for supporting us along the way (even if you occasionally roll your eyes), but my struggle is real. It penetrates into the depths of my core, to the point where I haven’t been able to enjoy life as it exists right now.

Baby making has broken me.

Updated Plans

So I’ve got a bunch to update you on. We had a review appointment on Wednesday with the RE, to discuss DW’s two recent miscarriages.

The RE really didn’t have much to say. I brought all of my questions, typed into notepad on my iPhone, and we went through them all. He has no answers for why DW didn’t stay pregnant. He did say that it was unusual given our excellent conditions.

The embryos or the uterus, who is the culprit?

He looked at the embryologist’s notes on our 5-day-blasts, and they are excellent quality, and all survived the thaw, which is also an indication of quality. He said that genetic or chromosomal issues are weeded out very quickly in these early phases, and that since I’m young, the quality of the eggs is unlikely to be the problem. But of course, not all eggs were meant to become live births.

He suggested two possible next steps:

1. Aggressively investigating into DW’s immune system and uterine health through more blood tests (one of which costs $600, and can only be analysed in the States), and a hysteroscopy to visualize uterine abnormalities. If her immune system is found to be overactive (essentially attacking the embryo like it is a parasite), then a combination of immunosuppressant therapy (intralipids) might happen so that she could still carry. A colleague of mine has gone through this treatment (with the same clinic), 3 times I believe, and it didn’t work. If it’s polyps/fibroids or some scar tissue, we could probably have them surgically removed (my guess).

2. I carry.

Obviously, option 2 makes more logical sense at this point, given the circumstances. However, there is also the factor of DW’s feeling physically connected to these future babies, which is the whole reason for us going down the path of IVF in the first place.

So, we decided on both paths, concurrently. We will do the investigations and see if DW maybe has some polyps/fibroids/scar tissue/uterine abnormalities or too many natural killer cells or other immune issue, and we will get me ready for an FET at the same time.

Some of the ducks are already in a row, and some of them the clinic has taken out of the rotation so that we have to put them back. It is really frustrating because I’m sure that it’s just a money grab on their part.

For example, my endocrinologist called yesterday to tell me that my thyroid levels are right on target (so no adjustment needed). Yay! She basically gave me the green light to giv’r this cycle. Also, my period just started on Thursday, so I could’ve started on the estrace today.

But instead, the clinic wanted to repeat their big ass blood screening panel to test for everything under the sun (that they had done in May 2013 and January 2014), as well as another sonohysterogram.

Yes, I bolded that. Another SONOHYSTEROGRAM. I think it’s completely unnecessary because I had one done last year, and nothing has changed. I also think it’s unnecessary because he was just up in there in January during my egg retrieval, and the main reason for it is to check the patency of the Fallopian tubes, which isn’t even involved in an FET. Plus, it’s another hundred dollar cost out of pocket for us.

If you’ve been following my blog for a while, you’ll remember that the sonohysterogram was extremely painful for me. I bled substantially on the paper sheet that covers the medical table, as well as in my underpants on the drive home. They said that it shouldn’t hurt and that I could return to work that day, but despite taking Tylenol before the procedure, I ended up sitting in the car crying from my angry cervix pain and uterine cramps, wishing that DW could drive me home.

I still get nightmares about that sono.

From now on, I shall refer to it as the sononightmarogram.

Anyway, since they insist on repeating this damn sono (booked for the 20th), we can’t do the FET this cycle.

So I guess I’ll continue to play ball hockey twice a week and party like a rockstar during World Pride, at the end of the month.

Meh. I’d rather be trying to have a baby….

Embryo Transfer #2 = Miscarriage

(From http://community.fertilityflower.com/blog-home/pregnancy-loss-art/attachment/mabith-miscarriage-quilt-version-2-2010-3/)

I have a difficult time trying to describe how we feel, not because I’m lacking in words, but rather because I am overwhelmed with such intense feelings. It’s like there is a Wordle in my heart, dense and under high pressure, weighing me down. Each day a new emotion is added to the list.

This round of FET was particularly frustrating because the nursing team at the fertility clinic FUCKED up on two accounts:

1. Dating of DW’s beta – no big deal but if they are messing that up, what other time-sensitive stuff did they also mess up?

2. Her medication. DW had major irritation from the Endometrin (vaginal progesterone suppository), and so they instructed her to replace the 300mg of Endometrin with 300mg of oral Prometrium. I had a weird feeling about it because often specialists instruct patients to take the prometrium vaginally rather than orally because of absorption issues. I had her call them again to confirm that the dosage and route was equivalent to the 300mg of Endometrin. They confirmed it and she followed as they had instructed. A few days later, she started spotting, which is sometimes normal, except that the spotting became red blood and then a full period-like bleed. At about the same time, the intense nausea that she had disappeared and she started having cramps. Really intense cramps.

Trying to make sense of all of this, I found this: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695240/#__abstractid1101714title

Which finds that oral Prometrium will test in expected concentrations in the blood, but very little of it actually makes it to the endometrium of the uterus, which is where it is needed.

A lack of progesterone will make your uterine lining shed.

Now, I’m not sure if there is a threshold amount of progesterone that is required and if we were okay in that respect anyway, but 300mg of oral Prometrium actually is like 30mg of usable Progesterone and is no where close to the 300mg of Endometrin which absorbs almost completely into the uterus.

Anyway, we’re in a strange place right now. Part grieving, part blaming (ourselves and the clinic), part next steps.

IVF and FET have a much greater chance of success than the IUIs we were doing last year.

DW wants another go at it (FET), because she feels like she won’t be a stakeholder in these babies (if they ever become real), but two miscarriages in a row necessitates more investigation into why she isn’t keeping the pregnancies. At the same time, we only have 3 embryos left, and my womb hasn’t had a try yet.

What to do?

Right now my daily life is very difficult to navigate through. I teach at a really rough school, where the kids are extremely disrespectful to teachers and administration. I was successful in transferring to a different school for September, but I still need to ride out the last month and a bit of this year.

On a daily basis, I have extreme moments of stress because of my job. In addition to that, everyone around me is pregnant or having babies. A friend/colleague of mine just found out she is having twins, and is griping about it. All I want is a piece of that, and I feel like with each failed attempt, my image of having children gets blurrier.

I am struggling with a lot of emotions and expectations and I feel like my own needs aren’t being met. The problem is, that I am so far down each of these holes that I can’t even find a way to climb out.

Embryo Transfer #2

So here are the stats:

Weather: beautiful sunny and warm day (20 degrees Celsius)

Uterine Lining: 12.7 mm (as measured by “wrong hole” ultrasound tech)

Acupuncture was done before (on the car ride to the clinic) and after (while resting in the lounge chair) transfer by moi.

Pineapple eating started yesterday.

Embryos: Two 5-day blastocysts transferred: one AB, one BB

Here they are:

Here’s them coming down the waterslide (catheter):

And here’s them resting in Darling Wife’s wonderful womb:

After the transfer, we went for some 9am Korean food: Gamjatang! We both love this pork bone soup so much, and hope that the embabies like it enough to stay 🙂

Egg Retrieval!

So at 5:35am, we rolled into the clinic parking lot, Black Eyed Peas blaring in the car, us bouncing to “Pump It Harder”.

We were immediately escorted downstairs to the recovery room, where I was asked to change into a gown and undress from my waist down. I was also given little disposable slippers and a hair net that didn’t fit over my dread bun.

Then the nurse asked me some questions and put an IV in my arm. The doctor was running late, so we just waited for a bit. Below is a picture of DW in her outfit for the retrieval, as well as the recovery area:

We were then led to the treatment room, where I was asked to lie down and place my legs in a strange contraption. DW was in the room with me, as were two nurses and one of my favourite ultrasound technicians.

Three different drugs, which the nurse kept referring to as the “cocktail” were injected into my IV line, and within a few minutes my body started feeling heavy. The doctor came in just as the drugs were starting to set in. He inserted a speculum, ‘prepared’ my vagina, and then began the retrieval.

I felt the needle as it poked through each ovary, and as it was maneuvered to access each follicle. I got to watch it in the tv in the room as well. It was over just as quickly as it began, and I don’t remember about two-thirds of it presumably because if the drugs (at some point the doctor asked the nurse to give me another dose of the “cocktail”).

In no time, it was over. It took about an hour and a half for the drugs to wear off though. In that hour, I was very sleepy, we hit a grocery store, and I puked in the car (thank goodness for doggie poop bags in the glove compartment).

Once we were home, DW pampered me with unlimited fetches, and hit up three more grocery stores to get things that I wanted/needed.

The pain has been on and off since we’ve been home. Mostly a stabbing pain that comes on randomly, but it also hurts a lot when I pee and poop. Sudden movements are risky as well. So today, I’ve been a couch potato, and have run out of PVR’d shows to watch.

Here are today’s stats:

21 mature eggs were retrieved (they didn’t bother with the smaller ones).

7 will be used for old-school fertilization (put egg and sperm in a room and see if they hit it off)
12 will be used for ICSI (intracytoplasmic sperm injection)
2 were deemed low quality

Tomorrow we find out how many fertilized!

Egg Development Thus Far

I am going to keep a running account of my egg developments as they occur. This is mostly for myself, but if others can be comforted in having an example of what my body’s journey is, that is fantastic.

CD 3 baseline (on 20 units Lupron, no Gonal-F yet): 7 follicles on the L, 6 follicles on the R

[start 200 units Gonal-F on night of CD 3, continue 20 units Lupron]

CD 6 (after 3 days of 200 units Gonal-F): 8 follicles on the L, 6 follicles on the R, all itty bitty

[CD 6 (stim day 4) doses adjusted to 250 units Gonal-F, and 10 units Lupron]

CD 8 (stim day 6): 12 follicles on the L, 6 follicles on the R, all still small (2-8 mm)- things are starting to feel really swollen in there.

CD 10 (stim day 8): 12 follicles on the L, 8 follicles on the R, all still small (4-10mm)

CD 12 (stim day 10): 25 total follicles, 6 about 12mm.

CD 14 (stim day 12): 30 total follicles, 20 of which are over 10mm. Lead follicle is 17mm

CD 15 (stim day 13): 38 total follicles, 15 follicles on the R, 23 follicles on the L. About 21 are 12mm or bigger.

[Gonal-F dosage reduced to 200 units]

CD 16 (stim day 14): same as previous day, with follicles in the middle range growing by about 1 or 2mm .

[evening at 6:45- HCG trigger]

After Thirteen Days of Stimulation

Pharmaceuticals for Reciprocal IVF

14 day Lupron kit: $243.07
14 day Lupron kit: $243.07
450IU Gonal-F: $501.03
2x900IU Gonal-F: $2104.22
2x900IU Gonal-F: $2243.20
Doxycycline: $17.38
Ovidrel: $99.55
Fat around my belly to inject into: Priceless

IVF Medication Review: Marvelon

Both DW and I have had a really rough time on the Marvelon, and have been so happy to finally stop taking it a few days ago.

These are symptoms and side effects we each report:

DW: constant spotting after week one, cramping with spotting, pimples on the face, weight gain, larger breasts, mood swings, heavier cramping and bleeding than a regular menstrual period.

Moi: bad headaches, especially during a Marvelon period (I normally don’t he headaches at all), moodiness, cravings for sweets, weight gain, larger breasts, pimples on back (never happens for me), heavier bleeding and the terrible cramps during period (I don’t usually have cramps during a normal period).

We both got our periods about 48 hours after our last pill.

Why I Didn’t Get Pregnant

At our appointment yesterday with the RE, he discussed how it was unusual that I didn’t get pregnant via the IUI’s that we did. He reviewed my blood work, my sonohysterogram, my ultrasound results for each treatment cycle, and could not find any reason why it didn’t take. I ovulate on my own, there were no structural challenges (e.g. fibroids), and there were a good number of follicles present each cycle. The only thing he could conclude was that either: there was some kind of adhesion or endometriosis near the opening to the fallopian tube that they couldn’t see, or that there is an autoimmune disorder that is making my uterus an inhospitable environment for implantation. DW and I pondered for a while, and wondered if maybe it could be due to a) the massive ovarian mass that I had in 2010 that was 1.5 x 2.5 cm, which was so unusual that it caused my physician and specialists to suspect that I might have ovarian cancer. It ruptured on its own, but could have left scar tissue behind. Or b) my Celiac Disease, which is being treated with my strict gluten-free diet. Who knows.

DW’s bloodwork has come back normal, and apparently she has “very young looking ovaries”, according to the Russian ultrasound technician. Her sonohysterogram revealed a possible blocked left fallopian tube, which we wonder if resulted from her abdominal hernia a few years ago, as it happened on the same side. It might have affected her ovulation, if we were to try natural cycles with her eggs.

Either way, going the route of Plan B is the best plan of action given our stats.