Monday, November 6, 2017

Study Time

Before the twins and my IVF journey to get them, I did months of oral medications to try to induce ovulation. With a diagnosis of PCOS, that is my problem: I have eggs! I just can't get to them.

When my twin sister had success on clomid I thought for sure I'd follow in her path within a few short months. I suffered through the side effects, which I remember including hot flashes and some mood swings (including an embarrassing emotional outburst at work). At one point I suffered with almost continuous nausea and frequent vomiting which I attributed to the clomid so was switched to its sister, letrazole (turns out it was actually the metformin I was also taking that caused the nausea), and I think eventually ended up back on clomid.

Between these two medications, I was on the roller coaster ride of hormones for about 9 months (much longer than most people try) without ever a sign of ovulation. Never. Not once.

After my failed IVF attempt this spring I felt I just couldn't bring myself to do more IVF. When the office calls to give the bad news they also want to know the plan moving forward. I think the nurse was surprised by the finality of my answer. "I think I'm done."

I mentioned I would consider maybe trying on my own for awhile, maybe with clomid again if that made any sense at all. I assured her I did not have any unreasonable hopes that this would work, but it would be something I would possibly consider.

Shortly after, I received a call from the head of Reproductive Endocrinology. He kindly apologized for the sad news. He mentioned a study he was heading on the use of clomid and letrazole used together. Content with the idea that I was done and might as well get used to the idea, I agreed "all in the name of science." I figured who better could they learn from than me, one who continued to puzzle them with my lack of unexplained success.

Taking the medication was a little FLASH from the past, or should I say, HOT FLASH from the past. Phew. Luckily I was on a relaxing trip to Vail, CO while Abe was at a conference because I didn't sleep a wink before 5:00 am four out of the five nights we were there. I also about had an emotional breakdown, which I realize now, was probably related. HORMONES!

During a follow up ultrasound we discovered I had indeed ovulated, the first time ever documented. Surprise! However, when I took the pregnancy test at the end of the one-month study, it was negative.

As I said before, I didn't have high (or probably any real) hopes for the study. After all, the success rates at our hospital for two rounds of IVF is close to 80%. To offer more perspective, the odds of pregnancy the good ole' fashioned way is only about 25%, even if you are Fertile Myrtle and whatever you would call her virile partner. And as I mentioned before, I was an experienced clomid and letrazole user with zero history of response. You could say I am the anti-poster child for these medications.

But, I had a suspicion. And instead of writing off my normally absent/irregular cycle as just that, about 10 days later I woke Abe at 3 am with this:


I have no previous experience with this but I think that's a positive


It truly is another miracle. I'm not sure which is bigger, the twins or this new rainbow baby, but I guess miracles don't need to be ranked or quantified. The fact this time was physically easier (and cheaper) doesn't discount the miraculous nature for me.








Tuesday, May 30, 2017

Yesterday Once More



May 22, 2017

Today was my blood test, the end of the infamous "two week wait."

Abe's mom came over early this morning and she helped me get Mister and Sister ready for a walk. We took our stroller to the hospital for a quick lab draw, met up with Daddy for a short time, and came home. On our walk Abe called with the results.

It was a familiar conversation.

Abe: "It came back negative."
Me: "Oh, okay.
(Abe: silence)
Me: "Well, not surprising I guess. Hmmm. (Awkward pause)"
Abe: "I guess I should go get ready for my next case."
Me: "Okay, I love you."

We have had this conversation 5 times now with only slight variations in the script. Maybe that is what made it easier to hear.

So how am I feeling now? I didn't have much emotion at first. I left the twins with my MIL to feed them breakfast while I took some quiet time to process. The tears didn't come until I told a few family members the news. I am so used to disappointment in this way that I feel pretty okay with not being pregnant right now. But the finality of it is something to mourn and for which I shed a few tears. I had kind of expected before the news at the transfer (that the embryo hadn't done well in the thaw) that this would work, that this cycle would work now that my body "knew what it was doing," and that we had a third baby ready to come join our family -- the baby we lost in the womb coming for another chance at a healthy body.

Taken by my MIL as I cried in my room
However, I also feel like God has been reminding me the past few weeks how lucky I am. I have two miracle babies who are wonderful and sweet and make me smile every day. I love how they sing "Twinkle Twinkle" wih a variety of lyrics, from singing about stars, ABC's, BAA BAA BAA's, EI-EI-O's, or even Ma MA MA's, and give each others sweet hugs and kisses. I think He has been telling me, "You have enough. You don't have to keep doing this anymore. You are already so lucky."

So I choose to have faith in disappointment. I would love to have another baby. Just one. (I don't need to get greedy!) Crazy as I feel saying it even to myself, I would love to experience pregnancy again (I guess with the hope it would be easier this time!). I am disappointed I will probably never get that amazing birth experience, meeting and holding my baby in the delivery room without the many negative emotions I experienced last time. I was hoping to successfully nurse without all of the frustrations of before. I am sad thinking I wont get another chance to savor the smell of my new baby or the amazing feeling of cuddling him as he sleeps.

I'm not sure where we go from here. There is a common mentality that I will probably just get pregnant on my own. I'm not counting on that (although I do personally know other IVF mamas where that has been the case). In many ways, it feels easier to decide that I am done. To cut my losses and exit the roller coast of emotions permanently. Or at least for now. If I decide I want to ride that wild ride again, I can always purchase another ticket. Right now I am already dizzy and nauseated and will probably feel like I am still spinning at home in bed for awhile.

Either way, I'm not sure I am ready to throw out all of my baby stuff just yet. Whether that is me holding out a glimmer of hope or for sentimentality's sake, I'm not sure.

Monday, May 29, 2017

Our Hail Mary

May 11, 2017



Our embryo transfer was today. 

At 9:45 am I was picking up Abe from work and I received a call from my doctor. He told me our embryo had split after the thaw and that it "wasn't looking too great." He wanted to give me a "heads up." In the meantime, we would see how it looked in a few hours.

My appointment was at 11:15. My favorite doctor and his fellow (the same one who got me pregnant before -- a good sign?) came in before I changed for the procedure. He sat on the bed (a bad sign, I thought -- a technique taught to doctors to build rapport or to be more personable when giving bad news). They showed us pictures and explained that sometimes embryos don't do well after thawing (we had been lucky up to this point to have all of them survive the thaw). We now had two embryos after the one split. I was hoping he would say they looked good and now we had the chance for twins, which I would gladly do again. (Also has me wondering if we could implant them at separate times and have identical twins with different ages. Weird! -- I don't know that they could re-freeze it.) However, they felt that one looked like it was degenerating and the other looked questionable. It didn't seem to be growing like they expected it would.


#1 shows the split embryos
#2 shows the questionable transferred embryo
#3 shows the non-transferred, non-viable embryo


They offered us to "cut our losses" and we could go home, or we could proceed with the transfer knowing it had a low chance of working.

We decided to try. The biggest negative was continuing with the shots. I reminded them I was an old pro and they laughed in a knowing and apologetic way. Abe said, "Well, we will give God something to work with!"

They gave us 5% odds.

I started to process the idea of a failure for the first time. When we got back in the procedure room I felt infertile. Again. I had forgotten those feelings for about 2 years. I felt bad I couldn't give Abe his big family. I felt sad that I felt like we "didn't even have a chance" this time. I felt broken. And I remembered the many times in this room full of excitement and the disappointments that followed so many times over.

I also felt more modest this time. Out of practice I guess. The procedure took less than a minute -- much easier to get the catheter that delivers the embryo in place than ever before. My uterus must have changed because they always commented before on the difficulty. My bladder wasn't as full as the other times so the five minute wait after the transfer wasn't unbearable as before.

After we quietly walked back to my room in my socks to change, we kept our tradition of going to an Indian Buffet for lunch. (I mention the socks because somehow that feels important. There is a vulnerability of being in a public building without shoes, but also a coziness and warmth of only wearing socks. Is that weird?)

I had the romantic notion of not telling anyone until I was pregnant and starting to show. After the procedure, we decided it was such a long shot we could use the prayers so we decided to tell our families. I think everyone is trying to be optimistic/hopeful/supportive so we got a lot of "exciting"-s and "congrats"-s. In the moment I felt this should be more like condolences since this was my last (perceived?) chance of growing our family but I understand their thought process.

As I have spent more time in the day I have thought of that little baby I assumed we would get. As hard as it was, I want to experience pregnancy one more time. I want to savor one more little baby and all of the precious moments that went so fast before. I want to have a normal delivery and feel the magic of meeting my baby without the fear and separation anxiety of the NICU. I want one more round, less rushed and frantic than two often was (although I understand maybe a mom of three never get that!).


But...

I felt at peace. I felt like an answer to prayer to see and experience the immense joy and wonderful personalities I already have at home, today more than other days. Their laughs and smiles at simple silly things like the name of dinner and their sweet and purposeful kisses today as if they knew I really needed them were like messages from God.




They are miraculous. And enough. If I don't get another baby we still have a perfect family.

Abe and I are putting it in God's hands, one more time.



Sunday, May 28, 2017

T-1 to Transfer Day

May 10, 2017

Do I really want to do THIS again???
I was HUGE and that was HARD.
We were at Costco last night and I picked up a bottle of pre-natal vitamins. The checker asked if we were having another baby. I wondered how he was on to me and didn't know how to respond (he was a stranger so I could probably be honest, but then again, what???) I realized I must look pregnant (something I have commonly been told/asked in the past), especially with my recent weight gain. Then I realized it was just the pills. Ha!

* * *

Tomorrow is the big day, my round #6 of IVF, FET (frozen embryo transfer) #5.

I still don't know what time I need to be there...I better double check this afternoon.

Honestly, I haven't thought about it much. I've been doing my progesterone shots since May 6. I dread them every night although they honestly haven't been bad and easier than before. (Tip: the cold of an alcohol swab on the adjacent skin is a nice distraction.) But besides my TID (three times per day) estradiol pills and the nightly shots I kinda forgot about it. Abe even mentioned something about "Thursday" and I literally said, "Oh yeah, Thursday!"

Am I blocking it from my mind in some subconscious defense mechanism? Am I such an "old pro" at this IVF thing it just doesn't phase me any more? Or maybe life as a working mother of twins is enough to keep my mind busy I haven't had time to ruminate on it all?

I don't know the answer but it is strange to think tomorrow I may be pregnant. And if I find out in a few weeks that I am not, then I am probably never going to be pregnant again. I don't know how I will respond when I actually process that.

So prayers that things go as they should tomorrow, whether that means God has another baby for us or not. And prayers I will be able to gracefully accept whatever that answer is, because right now either answer is a little scary.




Saturday, May 27, 2017

Needle Phobic People Beware



Injection target area for PIO 

April 23, 2017

After that initial day of feeling off, I seem to be doing fine. Phew! It seems like it is a really long build-up this time. I don't remember being on the estradiol this long before starting the injections. It must have been the same protocol before but it sure feels like a long time until May 1 when I increase the frequency of the estradiol and a LONG time before I start the progesterone shots on May 5 or 6. Luckily, I'm not super anxious about that!








May 6, 2017

More needles!

























I started my PIO (progesterone in oil) injections tonight. Back at it! The huge bag of needles
brought back the realization of how long I will be doing this again if it works (10 weeks!). I tried calculating out in my head how much of my life I have spent injecting a thick oil filled with hormones into a target on my butt (sorry, hip) and it comes out to about 5 months.

I feel less dread and emotion than I expected and it really wasn't painful like I remembered. But it did have that familiar strange and tight soreness that only injecting a mL of hormone impregnated oil can bring.

The medication is so thick it can be difficult to draw up.

The target areas are so different every time depending on which nurse you have.
I think these were the best so far... much less painful than any other cycle.


I can inject myself but I prefer the emotional support of having Abe do it for me.


I am on the estradiol pill TID (three times per day) now. You really should take all of the medications at the same time per day with a window of a few hours.  It can be hard to remember so I have to set my alarm, especially for my afternoon dose on days that I work. During the times I am in treatment it isn't uncommon for me to wake up night in a panic "realizing" I have forgotten to take a medication (usually for the entire cycle) and I must have lost the baby. Luckily, I haven't missed any doses yet in my conscious state.

I had my ultrasound appointment a couple of days ago. This is to observe the uterine lining and its response to the medications. It needs to be a certain thickness before proceeding with the actual transfer. They also checked my ovaries to make sure I haven't been shooting eggs out on my own (which could mean an unexpected multiple pregnancy if they transfer an embryo as well).

Fat chance of that, as who knows if I EVER ovulate. 

Things were looking good (my lining was thick and my ovaries were "quiet" as they say), so we are good to go ahead next week. I also met with the nurse who reminded me of the instructions (funny how it seems so fuzzy now).

I also turned in my "thaw consent." This has to be signed in the clinic with one of the staff acting as a witness, or it has to be previously notorized. I guess they have to take this eriously -- no creating offspring behind someone's back! This time was easy, "Thaw one embryo." No further instructions or decisions to make on that.

As for the hormones, I find myself very tired and unmotivated. And I am up about 5 lb --suspiciously similar to the amount of weight I gained last time! I look pretty bloated.  Maybe like I am pregnant already...?

Strangely, most of my IVF friends are pregnant now and another friend is doing her last few attempts at IUI (intrauterine insemination). Most of them conceived well before me in our journeys, so I am hoping we can all be pregnant together this time.


*I made some videos of the injections if anyone would like to see them. I have had some friends who feel pretty intimidated with how to draw up the medications, etc, so please contact me if you need help. I guess if you have a morbid curiosity, that works too.

Hormone-ee-e-es: Wow, just wow!

April 18, 2017


The medication schedule for IVF is so strict and complicated you get a calendar to stay on track!


24 hours after taking my first pills and I feel out of whack. Cranky and sad. Incredibly cranky and sad.

Nothing is wrong but it feels like the world is falling down.

It always makes you wonder if this is ME or just the hormones talking. If it is the hormones I'm in for a wilder ride than I remember!


Friday, May 26, 2017

Mum is the word

April 17, 2017

I already said this time feels different.

This time I am keeping quiet about it. This time I want it to feel like a "normal" pregnancy where I get to start showing and have people wonder if I am pregnant or just putting on the pounds. That I can simmer on my emotions by myself for awhile. That it can be my happy surprise to share or my disappointment to decide what to do with.

But I find myself a little nervous about not sharing. Last time I feel the prayers of many were on my side and I believe in the power of that. I feel like this last little embryo has to fight against the world for his spot in humanity and I have some worry without the legions of prayers he won't have as much of a chance. But I also trust that faith and prayers are strong and that God has a will. So the prayers of a longing mother and father I think have power as well and hopefully that will be enough.

I do find myself almost accidentally spilling the beans already, after just a few days, about to make comments about how I have an appointment or need to go take my medication, etc. We will see how far I can go. The transfer is scheduled for May 11. I may not have to keep this secret longer than that if we get negative results.

I am choosing to be optimistic that that won't be the case. However, it is a tricky thing to be hopeful and excited enough to have the courage to go forward with something as significant and life changing as a child. Plus, facing all of the unpleasant interventions to make it happen while trying to tell yourself to "not get your hopes up" or be "too disappointed" if it isn't in the cards, --or as I prefer to think, "God's will."

"God, grant me the serenity to accept the things I cannot change"