Infertility

Infertility

Thursday, August 20, 2015

Making the right choice

As we wait for my HCG level to come back down I've been struggling lately with our next steps.  When we first found out that we were pregnant naturally we were cautiously optimistic.  I mean we'd been pregnant before and had nothing to show for it so we knew that a positive test did not equal a baby in our arms.  We agreed to look at that pregnancy as a "bonus" try for us.  If it worked out then it was truly our miracle.  If not, then we would move forward with our plan to go to CCRM.  Well as you all now that bonus try did not work out.  So here we are starting over again.  And even though my heart is still grieving the loss of our miracle baby my determination has returned.  We are not ready to give up on our dream of having a family.  But I am questioning our chosen route.....

When we met with Dr. Schoolcraft for our regroup after my ODWU I would say he seemed optimistic.  There were no red flags from all of the tests that we had ran that day.  He wanted to put me on their "poor responder" protocol which is really similar to what I've done in the past but instead of suppressing me with birth control and three weeks of lupron injections CCRM has seen better results by priming patients like me with estrogen.  I was/am excited to see what this change could bring for us.  Obviously my hope is more mature eggs and better quality embryos.  Due to my old clinic's crappy genetic testing we know that we CAN produce genetically normal embryos.  But I've always struggled getting my embryos to the day 5 blast stage.  The whole reason for coming to CCRM was the hope that their amazing lab could help with this.

When I say I'm questioning our route it's not going to CCRM.  I still believe that's the right place for us.  If we are going to do this it needs to be with the very best.  However during that regroup with Dr. Schoolcraft I brought up their Family Building Plan.  He agreed with me that it would be a good option for us.  However being completely OOP with NO insurance coverage it's a very expensive option.  About $45,000 expensive not including meds (which without any insurance will run around $6K for each cycle) and travel expenses.  Ouch.  We have a huge chunk of money saved but we are short of that amount.  My amazing parents have offered to make up the difference for us which we are so incredibly thankful for.  But I'm really struggling with what happens if we do this and drain all of our savings, tap my parents for money, and it doesn't work.  Maybe we don't get any normal embryos or maybe we do and we transfer them all and despite the fact that none of the tests are indicating there's something wrong with my ability to carry there really is.  And we need to go the surrogate route.  We are open to donor eggs and to surrogacy if that's what it will take to get our family.  However we have no way to afford either of those options after a FBP cycle at CCRM.

I had a long talk with my dad about the situation last night and he gave me some great advice.  He said let's just focus on the next step and if it doesn't work we'll deal with that at that time together.  It's great advice and probably what we need to do but I can't seem to stop worrying about the what if's.  I want to be positive and hopeful but I feel I also NEED to be realistic .  And after all these failures there's a good chance that we won't be successful this time.  I've been wondering if maybe we just do one cycle at CCRM and if that would be enough to give us direction?  But if we complete one cycle and we don't get any normals will I always wonder what if we had completed the FBP?  Or if we do get normals but only one or two and the transfer results in a BFN or another miscarriage will that really confirm we need a surrogate?   We all know having genetically normal embryos GREATLY increases the chance of success but it's still not 100%.

I know that no one can make these decisions but me and D.  It's just so overwhelming when it's the most important thing you will ever do.  CCRM girls I'd love to hear your thoughts on how you decided your path there and what was right for you.

Monday, August 10, 2015

Starting Over

We got the results from the Repeated Pregnancy Loss panel back and everything was normal.  On Wednesday we will see where my HCG level is at now.  Once it returns to below 5 and I get a period we can start our cycle at CCRM.  My protocol there is an estrogen priming one.  So after my period starts I'll test for ovulation and once I get a positive ovulation test I'll start my estrogen patches.  Then we add in three days of Ganerleix injections and then I should get another period and we start stims right away.  It will go fast once I get that initial period - I just have no idea how long that will take.

Emotionally I'm doing okay and I feel ready to move forward.  While the pain and grief are still there I don't feel like it's consuming me anymore.  This morning I woke up feeling.....determined might be a good word.  This has been a hard road for us with a lot of unanswered questions.  But we both agree there's nothing more important to us than building a family.  And until we cycle at CCRM I don't think we can truly know what our best option is.  There's a lot of ways our cycle(s) with them can go.  Obviously my hope is their world class lab can help us get some high quality normal blasts to transfer.  If my gut is right and the root of our struggles is my shitty egg quality then that should be our solution.  However I know just because an embryo has tested normal does not guarantee success.  We may transfer a normal embryo and still not find success.  I could miscarry again.  Or it could just be a BFN.  At that point I think we start to think seriously about a Gestational Carrier.  We might not even get any normal blasts.  Which at that point we will start to look into donor eggs.  In some ways though we've been through three fresh cycles, and a total of five transfers (plus our naturally pregnancy) it feels like we are starting from scratch.  Which I guess in a way we are with CCRM.  And even though we've suffered nothing but disappointment after disappointment I am hopeful.  I'm hopeful that their protocol which does not include suppression will be helpful for a "poor responder" like me.  I'm hopeful that their amazing lab will yield better quality embryos from my crappy eggs. And as I mentioned before I'm no longer naive enough to think that a year from now this nightmare will be over, I am confident that we will know more than we do now.  That our path to our family will be more defined and within our reach.  That there will be light at the end of this dark, long tunnel.

Tuesday, August 4, 2015

One Week

It's been one week since the world came crashing down.  Funny I think I've written something like this before here.  I'm constantly surprised by the things the human soul can endure.  On a brighter note I'm also surprised by the compassion and love that people can show.  It has NOT been an easy week.  However my family and friends rallied, as they always do.  My best friend showed up at my house the day after even though I told her not to.  She brought food, and diet Coke, and wine, and beer for D, and Ben and Jerry's ice cream, and season six (the BEST season) of Friends.  She did my dirty dishes.  Is there a better definition of a best friend?  Our families continued to reach out to us even when we weren't responding to their phone calls and texts.  They consistently showered us with love and concern.  I heard from so many of our sisters in this community.  My dear friend Jane, who has a brand new baby at home, fielded my endless questions regarding the actual miscarriage and what happens next.  My rock, my sweet Amanda checked in with me every day and sent me a wonderful care package.  I got emails from bloggers who have been following me but have never commented before.  No, it was not an easy week.  But despite it, I still feel blessed and thankful.

After we received the news Tues morning that there was no heartbeat I did not take my daily doses of progesterone and I actually started spotting Tuesday night.  I had regular period bleeding all week.  I became convinced that maybe the miscarriage would just be this steady bleeding.  I was wrong.  Friday early evening I started getting some bad cramps.  The bleeding got heavy.  To the point that I really couldn't leave the toilet.  In reality it actually happened pretty fast.  Less than 2 hours from start to finish.  I don't want to get super graphic with you guys but if someone is reading this and going through the same thing I also want to give them some sort of a heads up.  I finally passed the baby and it was not just some tissue or a clot like clump (though I had some of those as well).  It was very clearly a sac with something inside.  There were basically two cords attached to the sac.  I think one was where it was attached to my uterus and the other was the cord going to the yolk sac or placenta.  In total it was all about the size of the palm of my hand. There was one large chunk of tissue before that and another after.  I was NOT prepared for any of this as the baby was measuring 7 weeks and I had read if you miscarried before 8 weeks it could just be similar to a very heavy period.  Obviously that was not accurate for me.  Even though it was terrible I am glad that it's over.  When I woke up on Saturday morning I felt.....better.  Still, obviously, very very sad.  But relieved that the worst was over and I had survived.

I got my HCG level checked yesterday and it was at 1800.  I'm not sure how I feel about this.  Compared to where it had to have been this is obviously a big decrease.  And I'm hoping now that the actual miscarriage has happened it will decrease quickly.  I do feel confident that there's nothing left that I would need a D&C for or that would keep those levels from decreasing.  After Friday night I'm not sure how there could be anything left.  CCRM sent me orders to get it checked again next Wed.  My nurse there (Cindy for anyone at CCRM) has been absolutely wonderful.  Before we can move forward the level needs to return to below 5 and I need to have a period.  They also ordered a Repeated Pregnancy Loss panel that I got blood drawn for yesterday.  It will take a couple days to get those results.  And honestly I'll be shocked if anything comes back abnormal.  My gut tells me my shitty eggs are the main issue but I'm glad they are running the tests anyway.

If someone could tell me that I need donor eggs or a surrogate to get our baby I'm at the point where I would happily embrace either of those options. And while I'm not ready to give up I do wonder how much more disappointment we can take without breaking.  Unfortunately I don't think we'll truly know if we need to go either of those routes until we cycle at CCRM.  Which really just amounts to a lot more time and money.  Due to the prior mentioned shitty eggs the plan at CCRM is their egg banking "Family Building Plan".  Which is three retrievals (approx. 8 weeks between retrievals) where they freeze the embryos at the 2PN stage.  After the third retrieval they grow all of the embryos out to day 5 and then providing you still have some left, they do their CSS genetic testing.  It's a couple weeks to get those results and then IF you have normals you can start prepping for a transfer.  The entire process takes anywhere from 6 - 9 months depending on your protocol, potential set backs (cyst, delayed periods, etc).  For the last 2 + years after every disappointment I've comforted myself that if I could just fast forward a year form now this will all be over.  At this point in time I'm pretty confident that a year from now this will not be behind us.  And that, my friends, is a very depressing thought.

So more of the same here - waiting.   D is now completely freaked out about us getting pregnant naturally.  He is 100% against that and feels we need to be very cautious.  I'm not sure how I feel about that.  No I do not want to go through this again AT ALL.  But I also have a hard time stomaching purposely preventing pregnancy.  I'm just not sure what the right answer is here.  Which seems to be a common theme in my life right now.  Thank you to all of you for your concern and your kind words.  You were all the light in the darkest of times this past week.