The Day Before

We've made it to the day before our first ultrasound.  We originally were hoping to get in for the sono on Monday but with D's work schedule we really needed an afternoon appointment so they scheduled it for tomorrow afternoon.  I *should* be 6 weeks and 6 days.  To say I'm nervous or anxious is a huge understatement.  I'm basically sick to my stomach when I even think about sitting in the waiting room much less walking into the sono room.  I alternate several times an hour between thinking everything is fine and that it's doomed.  Here's what I've been telling myself for reassurance.

1.  I've had no bleeding AND my progesterone levels have been good so I'm not taking any shots or suppositories that could essentially be keeping me from bleeding if something is wrong.  

2.  I've had no major cramping or pain.  I have had twinges but I would call them mild and they only last for a minute.  I did have some back pain this weekend but it wasn't severe and could have been from me laying around and doing literally NOTHING all weekend.

3.  My boobs still hurt.  Once again no progesterone supplements that I can blame this on.  They are definitely bigger and still hurt consistently. Although some times during the day much worse than others.  

4.  I'm more tired this time than I"ve ever been.  I've heard a lot of pregnant women talk about how they are so tired they just completely Can.  Not.  Function.   While it definitely hasn't been that extreme for me I have been more tired than usual.  

That's all I got.  Really no nausea or morning sickness.  No food aversions although sometimes nothing at all sounds good to eat.  

So that would lead me to reasons I would believe things aren't okay

1.  It's me.

That's all I've got.  My past and history are the red flags and really the only signal to me that everything isn't okay.  But it's a pretty big one.  I have definitely been trying to stay positive and hopeful and I think I've been doing a good job.  While also recognizing how scared I am and trying to be realistic.  While the thought of the sono is absolutely terrifying at least we'll have some more information one way or another.  So between now and then all of your prayers are greatly appreciated.  

The Imposter

I started this post yesterday but since I have the results from beta #4 I'll lead with that.  It came back at 13,760 and my progesterone was 26.  My nurse who called me said the numbers looked "perfect" but I was panicked because if it continued to double it should have been higher.  But after some consulting Dr. Google I found this which provided some comfort.


"As your pregnancy develops, the hcg increase slows down significantly. Between 1,200 and 6,000 mIU/ml serum, the hCG usually takes about 72-96 hours to double, and above 6,000 mIU/ml, the hCG often takes over four or more days to double. It makes little sense to follow the hCG values above 6,000 mIU/ml as at this point the increase is normally slower and not related to how well the pregnancy is doing."

So I'm going to choose to believe my nurse that everything is progressing fine.  We scheduled an ultrasound for a week from today.  I should be 6 weeks 6 days at that point.  I'm not even going to try to go in to my feeling about walking back into the sono room.  That is for a post for another day.  Below is what I started last night......


These past few months have been filled with so many different emotions that there's no way I could tackle them all in one blog post (nor do most of you have the attention span to listen to that much rambling!).  But one of the major issues/feelings I've been struggling with lately is feeling out of place.  You see for the last couple of years my primary focus has been on our infertility.  As soon as I got my diagnosis (elevated FSH) I began researching like a crazy person.  It didn't take me long to find this amazing community and to jump head first into absorbing all of your stories and advice.  Soon there after I began my own blog and started forming some solid friendships based on these shared circumstances.  I found comfort in the fact that I wasn't facing this alone and that there were others out there that understood how I felt.  Others that had walked in my shoes and not only survived, but found a way to make their dreams come true.  In July when I found myself pregnant naturally after I got over the initial shock I thought "maybe I am one of the lucky ones".  Not that I consider 2+ years of infertility treatments and failed cycles "lucky".  But maybe this miraculous occurrence was it for us and we wouldn't have to face the stress and anxiety of another cycle (much less spend the 10's of thousands of dollars!).  When I left the devastating ultrasound where there was no heartbeat I distinctly remember thinking how stupid I was to think I could actually escape my infertility.  And although I was devastated by that loss I remember how comfortable it was to slip my cloak of infertility back on.  This is what I know, what I've become comfortable with.  I understand protocols and hormone levels and I know what our odds of success are.  So while I wasn't exactly excited to be back on the bus at least my seat was one I was familiar with.

Fast forward to two weeks ago when I got my second positive pregnancy test.  I touched on my initial post how my first reaction was one of anger.  I just could not believe this was happening AGAIN.  All the pain from the last miscarriage was still so raw.  I just sat there crying thinking I can NOT go though this again.  I won't survive it.  But of course I did.  We got the first beta and then the second and then the third.  Slowly symptoms started to appear.  My breasts got more and more sore, food became less and less appealing.  I started going to bed earlier and noticing I was increasing more tired.  Of course with each passing day and each milestone you begin to hope more and more.  

I thought several times about posting an update on my blog and one thing always stopped me.  Being infertile and getting pregnant on your own once - that's a fluke.  That happens.  We celebrate that and are here to cheer the person on and support them with our thoughts and prayers.  But getting pregnant twice in a row......  where does that leave me?  I worried that my news would be hurtful or annoying to my sisters who are still in the trenches.  I've always had this vision of once we finally had a successful transfer and made it WELL past the first trimester I would magically have the courage and strength to speak out about our situation.  I would become the advocate that I've always wanted to be for infertility.  Part of the reason that this blog is anonymous is because my husband isn't comfortable with having this very personal issue public.  But there are other reasons as well.  I'm not sure my heart can handle the response from people who aren't educated on infertility and it's treatments.  I'm not sure I can handle the well meaning advice from people who haven't walked this path.  I've also constantly struggled through every failed cycle feeling like I'm disappointing those closest to me with the failure.  Between that and carrying around their sadness I feel like I would drown.

But infertility awareness is something I've become so passionate about.  Having this community and knowing there's so many other women struggling with this has been life support for me.  And I WANT to give back.  I always thought once I had my miracle baby I would be able to do that.  If this pregnancy is viable and God willing we end up with our miracle baby does that disqualify me from the club?  I still FEEL infertile.  My test results and history prove that I am.  If I get and manage to stay pregnant naturally I"m not sure where that leaves me......
 

Looking Back

This month has been a time of reflection for me.  For the first time on this journey I've allowed myself to look at where we started, how far we've come, and of course how far we have to go.  2 1/2 years, 31 months, 961 days.  It's a small period of time in the grand scheme of life.  But for us this time has passed with pain, heartbreak, and small pockets of hope that were snuffed out so quickly.  Each passing month, let's be honest each passing day, is one day too long that we've been in this fight to grow our family.  It feels like so much longer than 2 1/2 years.  However when I look back at this time in our life this is what I see:

3 fresh IVF retrievals
5 transfers of 8 embryos
1 natural pregnancy
1 chemical pregnancy
2 miscarriages
Countless blood draws, tests, procedures, ultrasounds,injections, and drugs
Hours of worry
An ocean of tears
Endless waiting

I wouldn't wish this heartbreak and pain on anyone.  But, as it usually goes with life, there is also a silver lining.  Although when I measure these past 2 1/2 years I do it in treatments, cycles, and disappointments when I look at the above list I see something else.

Unconditional love
Strength beyond comprehension
Endurance that can't be measured
Hope that refuses to be extinguished
Persistence
Fight
Support
Encouragement

Although this rocky road was NOT in our plan when we said I Do, today I look at my husband in a whole new light.  This man has stood by me when it would have been so much easier to walk away.  He has seen me at my worst, dragged me out of dark hole after dark hole.  He's held me when I cried, made me laugh through my tears.  Our love, our marriage, is so strong. And for that I am grateful.

They say you don't know how strong you are until being strong is your only choice.  And that is exactly right.  It takes strength to endure the disappointments and get up every day to continue to face them.  It takes endurance to start yet another cycle of pills, injections, uncontrollable hormones, and so much unknown. To hope when all the odds are against you, when others are telling you to give up.  To have the kind of persistence to try again.  To continue to fight this battle when your body and soul are broken and so very tired.  Some may call me stupid but I am proud of these characteristics that have come to define us.

Finally when I look back at what we've been through on this journey I see support and encouragement.  No, not everyone understands what we are going through or why we continue on.  And they don't need to, it's not for them.  But others, our families, our closest friends, and this amazing community continue to offer support and encouragement.  They are the light for us in this dark tunnel.  It's what allows us to continue on.  For that I am so very thankful.  

I find myself looking to all of you again for your support and prayers.  This month I find myself pregnant, again, naturally.  As we prepped the second time for our first cycle at CCRM this time I took a pregnancy test before starting injections after what happened last time.  And it was positive.  To say I was shocked doesn't even begin to describe my feelings.  In this space where I can be transparent I'll tell you our first reaction was anger.  We had managed to get through the hell that was the last miscarriage.  I was physically recovered and we were mentally ready to start our journey at CCRM.  We knew they are were our best chance.  And now not only was this another delay but most likely more of the gut wrenching heartache and disappointment.

Now that we've had a couple of weeks to absorb the news our anger and confusion has morphed slowly into hope.  While realistically I know that we have a high risk of miscarriage there's still something inside of me saying this could be IT.  I pray throughout the day and at night when sleep eludes me that I'll get to meet this life that God has blessed me with.  For regardless of what happens with this pregnancy I am blessed to carry this life for the short term or the long.  I tested two days before my expected period and when I got the positive immediately called my OB.  I went in for a blood test and my beta was at 66.  Two days later (the day my period was expected to arrive) our beta had more than doubled and was at 166.  A week later we were over 3600.  With each passing day and each milestone I find more hope in my heart.  The fear is still there and will overtake me at a moments notice if I let it.  But I am strong,  I have endurance,  I will persist.  I will fight.  And I will hope with everything in me that this is it for us.

Your thoughts and prayers are greatly appreciated during this time.  We'll have a fourth beta this week and if all is progressing as it should our fist ultrasound will be next week.  

Faith vs. Logic

Hello world.  It's been 7 weeks and I'm so relieved to report that my HCG level is FINALLY back down to 1.  We tested the Friday of Labor Day weekend and it came back at a 7.  Ugh.  One more trip last week and it's finally, officially over.  We are now just waiting for my period to start and we can re-start our first cycle at CCRM.  I am more than ready to get things rolling.  We still haven't made any decisions on the Family Building Plan vs. a single cycle at CCRM.  I really think we are just going to wait and see how the cycle is looking and what the recommendations are.  For us it will most likely be a last min decision the day of retrieval.  I am asking and trusting that God will guide us to make the right choice.

That's something I've been given a lot of thought to lately.  Faith and trust in God and His plan.  I recently spent some one on one time with a close friend of mine and while talking about moving forward with CCRM she had a lot of hard questions for me to answer.  Basically she can't really understand after 3 retrievals, five transfers, and one spontaneous pregnancy why I think CCRM is going to be able help us.  And while it's a stab to the heart it's a logical question.  She's not the first to raise the question of when enough is enough and won't be the last.  I wish more than anything my situation was black and white.  But it's colored so many in between shades it's hard for me to even distinguish any more.  Yes, we've been through 3 fresh cycles and in each one we retrieved more eggs than the cycle before.  I've had an early miscarriage, a chemical, and finally this last spontaneous pregnancy that resulted in a miscarriage after we saw a heartbeat.  Where the shades of gray fall are with all of the different aspects of each of those cycles.  With the miscarriage the embryos were not CCS tested so we have no idea if they were genetically normal.  With the chemical pregnancy the embryos were genetically tested but on Day 3, which Dr. Schoolcraft informed me could be fatally damaging to the embryos.  If we had done five transfers of all "normal" embryos I would be ready to move on to a GC (even though nothing in all of the millions of tests they have ran is indicating I would have any problems carrying a baby).  If we had retrieved and tested all of these eggs/embryos and none of them came back normal I would know that it's time to look into donor eggs.  But for me it seems to be a mix of both.  I did get genetically normal embryos, but they were most likely damaged by the day 3 genetic testing.  So now I feel like my judgement is clouded and that there's no clear next path.

My simple answer for my friend is I have faith in CCRM because of their lab.  Even my genetically normal embryos from my local clinic weren't perfect or even great quality.  My hope is that CCRM can help us produce MORE mature eggs and their lab can help us get more, QUALITY blasts.  My hope is that our "golden" egg will be found here, providing I really can carry a child.  And while we are definitely open to using a GC or donor eggs, until we cycle at CCRM I don't feel like either path is clear for us.

But to my friend's point there's a very good possibility that we'll cycle at CCRM and it WON'T work.  And that is going to be absolutely devastating.  It's taking every last penny we have to cycle with them and if we get through this and discover that we do need a donor or a GC there's not going to be any money left at this time to explore that option.  And that absolutely terrifies me.  But when it comes down to it this entire journey has been blind faith.  There are no guarantees.  No amount of hard work, dedication, or shear desire will make this successful.  We have no control over the outcome no matter what supplements I take, food or drinks I give up, or how much I exercise or take care of my body.  Yes there's things we can to do help but ultimately it's out of our control.

So to me it becomes a choice.  I can give up or I can have faith.  Blind trust in God and His plan.  Even after ALL of our failures and everything we've been through I still feel in my gut that I am meant to be a mother.  Honestly (and I may just be in severe denial here) but I still feel like I will carry that child.  There's definitely days that I'm more sure than others, and there's also days where I feel like giving up.  But one thing I know for sure is at this time there's too many unknowns.  And only one way to truly get some answers.  Whatever the outcome I'm ready to know.

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.

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.

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.