Conceal, Don’t Feel

Infertility reminds me of the struggle that Elsa had to go through:

A kingdom of isolation

Don’t let them in, don’t let them see

Conceal, don’t feel, don’t let them know

Put on a show, make one wrong move and everyone will know

 

So many people who struggle to get pregnant feel like they have to hide it or it is something to be ashamed of. That thought truly makes me sad. People who get cancer don’t have to hide it from the family and friends, why should they have to hide this? It is a legit medical condition, nothing to feel shame about.

I feel that I’ve been extremely open about our trek with infertility. I generally post about things either the same day or soon after. That can be a little tricky sometimes. It means that whoever reads these posts knows intimate details about something that is usually between just two people. It also means that those who read this know when it is time for the big deal blood draw: the pregnancy test.

In general, the thought is that you don’t share news of a pregnancy until you’ve passed 12 weeks (or ever for some people) and are out of the so-called “danger zone”. Most miscarriages happen within the first 12 weeks, though they can happen at any time. I kinda get the reasoning behind that. You don’t want to get people’s hopes up and then have to break bad news to them. If you recall, and have been following me that long, that very thing happened to us at the end of 2014. It was our first treatment cycle with our RE, and by some miracle I got a positive beta. I was so elated that I just had to share the news right away. Alas, the joy did not last as the pregnancy was deemed unviable and I had a medically induced miscarriage. I was sad for myself of course, but also sad for those I had already told. I now had to tell them that no, I’m not actually having a baby. It was one of the hardest things I’ve ever had to do. It is something I would not wish upon anyone.

On that sad note, I wanted to share with everyone that I may have to do that again. It will be hard, very hard to do, but I will do it if necessary.

5dp5dt

Those is the IVF community know exactly what the title of this post means. For those who don’t, it means “5 days post 5 day transfer”. It basically lets others know that you transferred a 5 day old embryo 5 days ago.

For me, that means going into my clinic for a hormone check. Hormones play a big role in pregnancy. Like you kinda need them to have one. Throughout the first half of a womans cycle her body is creating estrogen to grow an egg. It peaks around 350 (if you don’t get pregnant). After ovulation, the ovaries then start producing progesterone. In my case, I take medication to make both.

When we went in on Tuesday for the embryo transfer my estrogen was at 389 and my progesterone was at 21. Those are pretty solid numbers as most REs (reproductive endocrinologists) like progesterone to be above 20. Today my estrogen was at 342 and progesterone was at 28. Those are even better numbers.

 

Here is where I start to get a little weird. I’m sure most of you will not understand, but some of you may.

Since the transfer I have often been rubbing my belly and thinking to the embryos. I haven’t yet spoken aloud to them, because that just seems silly (not that thinking to them isn’t silly, but you know, I’ve gone a bit crazy). In my mind I imagine that they’ve decided they don’t like each other, so took spots as far apart as possible to burrow. I have pet names for them, which I will not share. I don’t even think David know what they are. This morning I felt like I got some insight into them. I believe the one on the left side is a boy, and takes after his daddy. When I got out of the warm bed into the cold bedroom to get ready to go I had a bit of pain on the left side, like the embryo was complaining about how cold it suddenly was. Just like David does.

Yup, I’ve completely lost my mind.

 

At this point, either one, two or zero embryos have implanted and begun to grow. Actually, that happened about 3-4 days ago. I have been firm with myself and decided to not purchase any home pregnancy tests. I used my last one during the last round and haven’t bought any more. I will wait until I go in for a beta (the blood test that measures HCG, same as a home pregnancy test but with the actual level, not just positive or negative) to find out if this cycle has worked or not. It’s going to be hard, and I’m going to have to find ways to keep myself busy this week.

Best of luck to me!

An Infertility Journey Update; Protecting My Heart

Hold onto your hats, this post is gonna be a two parter!

 

Part 1: An Infertility Journey Update

At this point I like to think of it as more of a trek than a journey. Journey is too nice a word. Trek sounds tough and challenging, which is how life has been for the past 22 months.

Yup, we starting trying for a baby nearly 22 months ago. Wow. Looking back I was so damn naive.

As for what is going on now, we started a new FET cycle on January 21st. That means we did more tummy shots, more baby aspirin and more estrogen. If you remember my last post about estrogen pills I made it sound pretty horrid. Luckily, this time around has been much easier. I definitely feel less cray-cray, and I feel that I have a better handle on my emotions overall.

I went in for my third progress ultrasound with no expectations at all. I was figuring I’d have to go back later this week for another one. I was therefore totally shocked when I saw the measurement on the ultrasound. 8.2. Wow. Last time around my lining only got up to 7.9 before they started me on progesterone and had me do an HCG shot. I am amazed that my lining grew so well this time. And I’m still going to grow it for another few days before the HCG shot and start of progesterone. I believe that I will do both on Thursday. My doctor is currently out of town, so we’re delaying the transfer until he gets back.

As of this afternoon I am scheduled for a transfer on Tuesday morning. We will again be transferring two snowflakes (a term in the IVF world for frozen embryos). My mom has rearranged things in her schedule to come up and take care of us during my 48 hour bed rest sentence. Yay!

 

Part 2: Protecting My Heart

One of my cousins once told me that during this process it was important to protect my heart and I agree completely.

For those who aren’t infertile, pregnancy and babies are things to celebrate with lots of happiness. For those who are, however, both of those things can, and generally are, extremely hard to handle emotionally. I know that it sounds like I’m being “dramatic”, but infertility is P.A.I.N.F.U.L. It hurts. All the time.

For me personally, being around pregnant women and babies is very hard. I love love love babies, but hurts me to see them, especially when they’re cute. It’s even harder to see pregnant women, knowing how terribly I’ve failed at gaining that for myself.

Here is my most recent example: At David’s company they do birthday dinners for all the employees, and spouses are invited to go. I knew a few weeks ago that one was coming up, and I was seriously dreading it. Why, you may ask. Because none other than the birthday girl herself is pregnant (if you’re reading this, sorry J if you’re offended by me writing about this). I was very seriously considering skipping this one, as I knew I would be at the peak of my medication, which makes me extra emotional. I texted David that morning asking how late I could let him know if I wanted to go or not. He said 4. I texted at about 3:45, letting him know that I was feeling good enough to go. It took a lot of courage for me to say yes, knowing that I would have to see her for at least two hours and possibly have to hear about her pregnancy.

Luckily, I found a great way to cope. My thoughts through the whole night surrounded around “don’t look, don’t touch”. I just kept reminding myself to look only at her face. I’m very thankful she didn’t sit next to or directly across from me, as I would have had to get up and sit somewhere else. I definitely felt a little sad, but it surprisingly wasn’t bad. Then the part I was most not looking forward to: saying goodbye and hugging. I was extremely careful to just hug around her shoulders and keep my body a safe distance away. And to my delight there was no contact! (Sorry J!) This would have normally been a very emotionally sucky night that would have ended in tears, but not so this night.

I’m hoping that this new found information will make life just a touch bit easier.

When “slightly pregnant” turns to “definitely not pregnant”

I went in for a second blood test today and it came back completely negative. I figured as much would happen. It seems my body has absolutely no interest in being pregnant. Lucky me.

Once I start a new cycle I’ll call the clinic and find out what the next step is. We very fortunately still have 5 frozen embryos to try and get a baby or two from. Hopefully one of them will work!

We’ve already decided that once those 5 embryos are gone, that’s it. We’re not going through this whole process again. It is an incredibly painful journey that sometimes just doesn’t have a happy ending, even for someone who walked into a fertility clinic at 24 years old and was told they would not walk out without a baby.

Slightly Pregnant

Now you may be asking yourself “what is slightly pregnant?” or “how can someone be slightly pregnant?”.

Modern medicine is a fascinating thing. In olden times (the early 1930’s) they used to inject a rabbit with a womans blood to see if she was pregnant. Nowadays they do some magical test with blood to see how much HCG shows up in it. Technically speaking, anything above 5 is considered pregnant, though within the first 12 weeks it should get to over 200,000. So if your HCG level was, say, at 6, yes, you would technically be pregnant, but not necessarily for long. It would most likely end in an early miscarriage.

I caved yesterday and took a home pregnancy test. It flashed its little hourglass symbol at me for a few minutes then informed me “not pregnant”. I was slightly surprised, but not completely. Why would my body all of a sudden decide to cooperate and get pregnant? Yeah, it wouldn’t.

I went in this morning for a blood test to confirm the results. I was expecting either a complete negative or a very very low positive. My doctor called and informed me it was the later. My HCG level this morning was 9. So, slightly pregnant. Not necessarily going to stay that way. Probably not going to stay that way. That means I get to go back in on Monday morning for another test. If it’s 18 or higher we could be moving in the direction of a pregnancy. If it isn’t, then definitely not a viable pregnancy.

We shall see.

A Frozen Cycle

After a failed fresh round of IVF, it was time to move to a cycle using our extra frozen embryos. It varies by clinic, but mine felt confident letting me move straight into one. The basic format is as follows:

  1. Start birth control
  2. Stop birth control
  3. Start injections to prevent egg growth and ovulation
  4. Start estrogen pills to trick your body into thinking you’re growing an egg
  5. Stop injections
  6. Start progesterone, in whatever form your doctor advises (gel, suppository or injection), do a massive injection of HCG
  7. Embryo transfer! Do another massive injection of HCG
  8. Wait.

We started this cycle way back before Thanksgiving, almost exactly one month ago. Cycle lengths have to be flexible based on how the body responds to the medication.

In addition to the things listed above, I also had about 6 monitoring appointments, which consist of a blood draw and ultrasound to make sure everything looks good. Doctors generally prefer the lining of the uterus to get to at least 8 mm thick before they consider doing a transfer. That makes sure that it is nice and cushy for the very tiny embryos and they can find a good place to implant and grow. This cycle, mine refused to grow. For a normal woman, the lining grows by 1-2mm per day. Mine was less than 1 over the course of 3 days. We ended up extending our original estimate by almost a week to give my lining time to grow properly.

Once my lining was finally up to 8 mm, then the fun started happening. And by fun I mean pain. So you remember the three different way to get progesterone? This cycle my doctor wanted me to do suppositories and injections. The injections tend to work better than suppositories, so I was okay with that. What I was not okay with was doing both, so I asked if we could just do a higher dosage of the injections. Luckily my doctor agreed and increased the dosage to 1.5 cc instead of 1 cc.

Oh yes, back to the pain. I had read about the injectable PIO (progesterone in oil) and it seemed very scary. There were tons of recommendations to make it hurt less. Everything from warming it up first to pinching the skin really firmly, to stretching the skin as much as possible to using ice and using a heating pad. It was a lot to take in. So I asked my nurse for advice. She recommended pinching firmly and injecting slowly.

For those who don’t know, David has to do basically nothing in this whole process, so I made him do all my injections. It is a totally fine experience for me, but for him, he’s stabbing his wife with a needle every day. Not one of the funnest things to do with your wife. When we got to the PIO though, it became a whole different story. The needles we’d been using up until then were about an inch long. The PIO ones? About 2.5 inches, and thick. Oh yeah, and they have to go in the muscle in my butt.

On the plus side, they don’t hurt at all when the needle goes in or the liquid goes in. On the negative side, after the first one I was okay for about 4 hours, then the pain started. It is a constant pain that does not go away before the next injection. After the second injection it was pain on both sides as we switch injection sites every day. So now I just have pain all the time. If I get pregnant, this child/these children will literally be a pain in my butt. I will have to continue the injections until between 10-12 weeks until the placenta takes over making it. Wee fun. I know it’ll be worth it if it works though!

 

Just a few short days after starting the PIO, it was transfer day!

IMG_0290

I was up bright and early to get one last workout in. Gentle walking can help increase blood flow to the uterus and help with everything going on.

IMG_0291

I normally do at least 30 minutes with much more vertical feet than this, but I didn’t want to raise my core temperature too much, or stress myself out too much, so just 15 minutes this time.

IMG_0293

We’re ready to go! Our clinic is in Beverly Hills, which means it can take anywhere from 18-60 minutes to get there. I figured since we needed to be there at 9:30, it would be safest to leave at 8:30. There ended up being almost no traffic, so we had time to stop for gas and a coffee for David.

IMG_0294

My bladder has to be full for the doctor to know where to put the embryos, so I was told to drink 32 ounces of liquid between 9 and 9:15. I was also told this last time, and ended up having to drink more at the clinic, then having some other unpleasant things happen, so I decided I would try and drink 64 ounces of liquid before we got there. I almost made it, but not quite. I was probably a good thing I didn’t, because it ended up being too much and my bladder was too full!

IMG_0296

We both get hospital gowns, booties and lovely hats! We’re ready to go! Too bad the doctor isn’t!! He was on an international conference call, which meant we had to wait around for him to finish. With a full bladder.

IMG_0298

This is my post-valium, gotta pee face. Where are you doctor and why are you taking so long!?

IMG_0303

Oh! That’s why I need to pee so bad! The big black part surrounded by a white outline? Bladder. Huge bladder. I was thankfully allowed to relieve some of the pressure, but only for 10 seconds. It helped immensely!

IMG_0305

Post transfer, feeling good. I got to experience a first for this round. Last time I had a catheter in my bladder, but I didn’t need one this time. After the transfer the ultrasound tech asked if I’d like a bedpan. I told her to check back in 5 minutes and I’d let her know. Three minutes later I asked David to go and get her so she could get one for me. I knew I wasn’t going to make it the full 20 minutes they have you lay after the transfer. It was my first experience using a bedpan, and let me tell you, it was amazing. When you’ve had about 50 ounces of liquid with someone pressing on your bladder for about 5 minutes, you just don’t care. I need to pee, and I need to do it now.

IMG_0306

Here I am, waiting for the nurse. After you get dressed, and the husband goes to get the car, they ask if you’d like to go to the bathroom. Again. Even if you just went. I of course said yes, and am glad I did. Now I’m sitting and waiting for her to come back to wheel me down to the curb where the hubby waits with the car.

IMG_0310 IMG_0366

Because it is so close to Christmas, I didn’t want to inconvenience my mom by asking her to come up for my 48 hours of bedrest, which end on the morning of Christmas Eve. That means that David is in charge of taking care of me. He made a lovely lunch of mac-n-cheese with spam, broccoli and mushrooms. After lunch I had a nice nap to sleep off the valium. Later he made me a snack of cucumbers. And dinner obviously, but that didn’t get photographed.

IMG_0311 IMG_0312

Cordelia loves to snuggle, especially when the weather turns cooler. She isn’t too bummed that I have to be horizontal for 2 days! She’s also fairly good about respecting the tummy. Once I block it, she won’t try and lay on it. It’s a rule we have for after transfer. We don’t want her stepping on me and doing anything to hurt our chances of success.

 

We have successfully completed a FET (frozen embryo transfer) cycle! Now all there is to do it wait, get a blood test to make sure progesterone and estrogen are at the right levels and adjust meds if necessary, then do a final HCG blood test. Good luck us!

Crazy Lady Pills

At the beginning of the month I started a new, different round of medication.

I started with one pill a day, and over the course of a week increased it to three pills a day. I’ve been back in for a few blood tests to see how well the medication is working. It isn’t quite doing its job. My last appointment was on Sunday morning, and luckily I got results quickly since they’re only open for a half day on the weekends. Unluckily, my doctor recommended upping the medication from three pills daily to six pills daily. That meant fitting in four more pills that day when I had only planned on one.

If you look up medication side effects online they’ll generally have things like: may cause dizziness, nausea, sore throat, fever, etc. They fail to have things like: may cause extreme irritation with husbands breathing and crying during your show when waiting to see if people will turn off their Christmas lights. Yes, that second one just happened to me this evening. I really did get teary when I wasn’t sure if the people in the town would turn their lights off. On a tv show.

I like to call this pill my “crazy lady pill”. It has truly turned me into a crazy person. During my normal, pre trying-to-make-a-baby life, my hormones were relatively level. Most women experience increasing and decreasing levels of hormones throughout their cycle. I don’t have hardly any variance. Dealing with hormones is a very strange experience, for both me and David.

I’m hoping that at my next blood draw there will be a marked increase and I can back off the drugs a little bit. Oh I am so hoping for that!

“Perfect” Embryos

I have had multiple people tell me that the embryos we created are “perfect” and “look amazing”.

 

That is all well and good, but only if they actually do something once they’re in my body. This time around they decided to do nothing. It wasn’t totally unexpected, as I was overstimulated, but still very hard news to hear. I think I knew in my heart that it hadn’t worked when I started feeling pregnancy symptoms. I know that sounds weird, but every time we’ve tried, I’ve felt that it for sure worked because I was nauseous or crampy or my back hurt. But then the tests were always negative.

The doctor that I spoke with today (mine is out of the country) said that I should have had a 75% chance of getting pregnant with how great our embryos are. Apparently my body decided on the 25% chance of not.

I’m no longer thinking that having “perfect” embryos is something to celebrate, especially when two of them fail. Luckily we have 7 back-up ones waiting for us. Also luckily, we have already purchased a frozen transfer cycle, so hopefully all we’ll have to pay for is medication. I will also ask the doctor to transfer 3. They don’t normally transfer that many, but with so many failures it seems like our best option.

We may decide to take some time off and try again next year. I’m really starting to believe that I am someone who just can’t get pregnant. If doing a frozen cycle doesn’t work for us, I don’t know where we’ll turn next.

 

I fully understand why so many people who go through IVF choose not to share the journey, with anyone. It isn’t easy having so many pulling and praying for you and then letting them all know that it has been for naught. I am truly grateful for all the love and support we’ve received over the last several weeks.

Fresh versus Frozen

It has been quite a while since my last update. It has been easier and faster to just do a Facebook post.

 

But it’s time for a bigger update, since we’re nearing crunch time. Many have asked, so here is a little more about what is going to be happening this week.

 

During IVF a womans ovaries are stimulated to grow lots of follicles, which hopefully produces lots of eggs. They are then fertilized and watched for 3-5 days. After that amount of time, they are either frozen, transferred into the womans uterus or both.

 

Fresh vs. Frozen:

A fresh transfer means that after the eggs are fertilized and have grown for 3-5 days, they are transferred into the uterus in the hopes of implanting and becoming a pregnancy. These are only done if estrogen is at a proper level and the ovaries look good. If estrogen is too high, it is guaranteed to fail.

A frozen transfer means that after the eggs are fertilized and have grown for 3-5 days, they are injected with a freezing agent and stored for future use. Generally, after a new cycle has started, medication will be given and embryos will be thawed to be transferred into the uterus in the hopes of implanting and becoming a pregnancy. These are generally used for women who get high estrogen levels from the stimulation medication. It allows her body to relax a little before stressing it with a pregnancy. They’re also used if a woman wants to have another baby and has leftover embryos from previous IVF attempts.

Now if you notice, I said in the hopes of. There is no guarantee that IVF will result in a pregnancy. For some women, it just does not work. There are many factors that can contribute to this, but you have no way of know if it is going to be successful.

 

We have purchased a package deal that gives us one fresh and one frozen cycle, which means that if the fresh one doesn’t work, we can do a frozen one without paying any extra, except for medication. This package was more costly than just doing one fresh cycle, but with how previous attempts went we figured it was worth it to pay a little more and guarantee two cycles total. Of course, if I do get and stay pregnant from the fresh transfer, and it results in a live birth, we won’t be able to use the frozen cycle that we’ve paid for. It was a risk that we were willing to take: pay a little extra now, just in case.

 

I haven’t yet decided if I’ll report the results from the blood test right away, or if I’ll wait. I don’t feel that it will give anything away if I don’t say anything, though I feel that at this point if it is negative I’d probably share that.

 

Here’s to a successful fresh transfer, with leftover embryos to freeze for later use!

 

A Long Overdue Update

I have been pretty terrible at keeping this blog updated. But I’m here now and writing.

 

A lot has happened since my last post but long story short:

We’ve been doing an infertility method called IUI which involved 5 days of oral medication to stimulate my ovaries into doing something other than just sitting around. Then we’d wait for stuff to happen, do the actual IUI and then wait some more to see if I got a positive pregnancy test. We’ve done that 5 times, and they only recommend 6 before moving on to something else.

Since it hasn’t been working, we’ve moved on. When we first started at the fertility clinic I was against doing IVF, mostly due to the cost involved. We have fees for the doctor, for the surgery and for the medication. Anyone who thinks it’s free or easy to have a baby has clearly never been infertile.

 

At the beginning of next month I’ll begin twice daily injections for at least 10 days, and around the fifth to seventh day add a 3rd for up to 5 more days. I’m sure David is going to feel so lucky that he gets to stab me with a needle three times a day!

 

I’m just hoping that when all this crazy is over we actually get something from it. We don’t have very many chances at doing IVF.