Our best and worst moments...

It’s been a long time since I updated this. It’s been a tough few months and it was hard to sit down and tell it all…

Not long after we rang in 2014, we returned to RMA to begin another round of IVF – what we knew could be our last round. I was feeling so tired of it all and ready to move on with my life. I took birth control pills for about a week and then began “stimming” January 12. After the stress associated with the previous month’s progesterone injections, doing these tiny shots in my belly was like nothing. And, as always, it didn’t take long at all to get used to all the mixing and the routine again. Things progressed pretty much like before – when I compared my estrogen levels each appointment to where they were at the same time in the last cycle, I was only about a day or 2 behind. Dr. N wanted me to have a “slow and steady” cycle in an effort to keep my estrogen levels lower and reduce the risk of hyperstimulation in hopes that we could do a fresh transfer this time. In my mind, unless I was already physically sick before transfer day, I was doing a fresh transfer. I really regret that we didn’t last time.

Before I knew it, we were coming for daily visits (the last 2 of which were on the weekend so we had to go to Harrisburg Hospital – always an adventure – ugg!). By January 26 I was ready to trigger and my egg retrieval was scheduled for January 28. Again, Jared and I drove to KOP the night before to stay in the nice hotel across from the office.  This trip includes the funny story where we are 50 miles from Harrisburg on the turnpike and Jared realizes he forgot his overnight bag at work – HA! Despite the extra long time in the car, I was much more relaxed this time. It was nice going into the procedure knowing what to expect. I was even able to warn the anesthesiologist that my arm, not my hand, was the way to go for my IV.

When the anesthesiologist was running through my health history and I was saying to no to all the questions (no heart problem, lung problems, etc), she said, “So generally you’re in pretty good health” and I responded, “Yeah…except I can’t have a baby.” The look on her face was so sad I almost felt bad for saying it. I also remember that while we were waiting to get started in the OR, she asked, “What happened to all your eggs from last time?” She and the nurses were shocked when I told them we went from 33 eggs to 1 embryo. Apparently, my crappy eggs are quite unique.

I think I might have started to wake up during the procedure, or at least I dreamed that I did. When it was all over and they wheeled me into recovery, I was in more pain than I remember from the previous retrieval. (Although last time I might have been so relieved that it was over that it seemed that I was in less pain.) I also felt that I had a harder time waking up this time – I was still dozing in and out when sitting in recovery. We got 26 eggs – I was perfectly pleased.

In recovery...

The next day, the lab called to report that 15 normally fertilized. I was also okay with the number but realized quickly that at this time last cycle we had 26 fertilized embryos and wound up with 1 – not good odds for this round. We just had to hope that my eggs were better quality this time and that more would make it. I was beyond anxious about the next day’s call because this is when things had really started to fall apart in the previous cycle. The report finally came – we had 11 left but not all of them looked good. A few looked good and a few okay. She said that depending on how they looked the next morning, there is a decent chance they’d want us to come in for a day 3 transfer. (Day 3 transfers are done when the embryos are not doing well – the hope is they will grow better back in the uterus. Day 5 transfers are considered optimal by most doctors but day 3’s used to be the norm.) Honestly, I was totally fine with this – I was just happy that we were going to have anything to transfer at all. As an aside, this call pretty much proved that I do indeed have an egg quality issue that would continue to plaque us as long as we continue with treatment.

The next morning we were up early waiting for the call…they told us they would call by 8 because we had so far to travel. It was a little after 8 when Dr. N called. She said that she wished things were more conclusive but that we had 2 options: do a day 3 transfer that day of the 3 best embryos (more embryos since 3 days transfers are less than ideal and the embryos were less than perfect) or wait for the 5 day and hope that we have something good left. She said the embryologist told her we could end up with at least 1 or 2 on day 5 (but they, of course, couldn’t guarantee we would have anything left). I was so irritated that this decision was being put on our shoulders and that we had zero time to think about it. In the end, I had one overwhelming thought – we cannot take the risk that we won’t have anything on day 5. So off to King of Prussia we went!

While I was being prepped for the transfer, one of the embryologists came down with the picture of our best 3 embryos that we were transferring. She also had our lab worksheet and went over everything from start to finish, including what we had left. She was so kind and reassuring (needless to say, she was NOT the same embryologist we dealt with last time). She must have been able to tell that we were kind of bummed because she said that we should not be upset about these embryos, particularly the one in the middle that had no fragmentation. And the others had the better type of fragmentation, where it is all contained to one area. She said that she has seen embryos worse than this make a baby. That definitely felt good to hear.

 

 Embryo transfer day!

 

A bonus to this embryo transfer is that Dr. N, who is mostly only in Mechanicsburg, was in KOP for procedures for that weekend so she was the one to do it! It was so great having her there. Everything went totally smoothly. It was just as uncomfortable as last time because my bladder is so full. But we felt that we had made the right decision and we felt at peace. Dr. N even printed us a picture of the ultrasound and pointed out the spot where the embryos were placed. I loved the idea that, as unlikely as it was, there was a physical possibility that I could get pregnant with 3 babies. I didn’t feel scared about it because I knew the odds were so unlikely. But twins would be heaven!

Our 3 little ones...I so hoped they would all be girls who would make us crazy!

 

 

 Pic of my uterus when the embryos were transferred

(the big black blob is my full bladder!)

 

After 2 days of “lay around and be lazy house rest,” it was pretty much back to life. I was recovering pretty well from the retrieval but, of course, was on a litany of meds and hormones. I decided not to exercise at all this time during the wait for the blood test. I figured it was only 9 days or so – not a big deal. Also, during the wait, I began to have second thoughts about not trying again. I knew I definitely wanted to wait several months but I began to be open to this not being the total end. 

Last cycle, I had period-like cramps the day before the test which I attributed to my period trying to break through the progesterone I was on (which stops the uterine lining from shedding). This time, 2 days before the test, I started to just have that “feeling” that my period was coming – not cramps per se but just heaviness in my abdomen. I was so upset – I kept breaking into tears at church that morning and just moped around the house. The way I was feeling I thought maybe my period would come despite the progesterone (as it had once before, after my last IUI).

The day before the blood test I felt pretty much the same but still no period. I pretty much resigned to myself that it was all over. I started pinning new treadmill workouts and was planning how I was going to lose all the weight I had gained doing IVF. That night, I was awakened in the night by what I recall as some of the worst cramps I have ever felt. I thought for sure my period had arrived. It hadn’t. I was so mad thinking that I had to deal with this pain now, and then again in a few days when my period came for real. I broke down and took 3 ibuprofen to kill the pain (which is a no-no during the wait, Tylenol only). The next morning, I put a bottle of wine in the fridge and was planning to drown my sorrows after the call.

When I went into the RMA office (I have to go get a lab sheet to take when I get my blood drawn), I asked one of the nurses if Dr. N would leave the results in a message if I didn’t answer. I don’t think I was planning to intentionally not answer, but I didn’t want to have to worry about missing the call. She said that she would leave a message if that’s what I wanted. After the draw, I did a little shopping around Mechanicsburg and then headed home.  I was so much calmer than last time because I felt there was no hope. I even got a half regular coffee on the way home (instead of all decaf)! I felt mentally prepared to move on.

Around 2:00 Jared called from work. He told me that Dr. N had just called him – she said she was going to call me in a few minutes and asked if he would call me first and try to get me to answer when she called (since I had asked about leaving a message that morning). Immediately, my heart skipped a beat. Of course, my first thought was that she wanted me to answer because she had good news. But then, trying not to get excited for nothing, I reasoned that she might just be worried about how I would take the bad news and wanted to talk to me about it.

Waiting for the phone to ring was excruciating. Luckily, it was only a few minutes.  When it finally rang, before I answered, I saw aloud to myself: “It’s going to be okay.” It was Dr. N – she said she was so glad that I answered and that she was calling with good news. Then I heard a bunch of voices yell, “Congratulations!” She told me it was all the girls in the office calling to tell me that I’m pregnant. I cried. I felt in that moment like I had floated up out of my body and was just watching myself have this moment – this moment that I have dreamt about so many times.  She said everything looked good, my HCG level was 50, and that I needed to come back in 3 days for another test to make sure the number is doubling. I am sure she said some other things too, but I was on such Cloud 9 that I don’t really remember.

I cried when I called Jared. Just saying those words: “I’m pregnant.” It was out of this world. He was also shocked and, I think, a little overwhelmed. We have waited and waited for this moment and it was finally here.

That afternoon was so surreal – I just sat at home, watched TV, and played on my iPad. I was a relaxed pregnant woman. I immediately felt like an eggshell too (and felt guilty about the ibuprofen and caffeine I had ingested earlier – whoops). My mom (who was, of course, elated) stopped by later and invited us to go to dinner with her and my stepdad to celebrate.

Then, after the total joy of the news calmed down a bit, a new sensation began – absolute fear. I was now overwhelmed with worry that something would go wrong – chemical pregnancy or miscarriage. Jared and I decided that maybe we could relax a little more after my second blood test showed that my number was improving. It was a very long 3 days! Friday’s level was 108.1 – ugg. So, yes, it doubled but barely. (Not to mention, stupid Googling me read that some say levels should double every 48 hours and other say doubling every 48-72 hours is okay – so I felt concerned that my level did not double in 48 hours.) The office said this number was good but they wanted to see me again in another 3 days for another test.  More waiting!

First positive test I've ever had!

 

I felt even more anxious waiting for the results of Monday’s test. I think I had myself convinced that something was wrong. They finally called – HCG was up to 308.6. I was so relieved! I felt for the first time like I could breathe a little bit. My first ultrasound would be in a week (though she warned me that we shouldn’t expect to see much other than a dot in my uterus).

I continued to feel scared every day. We were so excited to tell people the news but tried to keep it close in case something happened. I also felt pregnant – mostly tired. I wasn’t sick at all but my boobs were terrible sore and felt huge. I was anxious waiting for the nausea to kick in. February 24 we had our first ultrasound and saw the gestational sac. Dr. N said everything looked good and that we should be able to hear the heartbeat the next week.

We were so proud of our little bean...

 

At the next appointment, she began the scan and when I looked up at the screen, I knew right away something was not right. It looked exactly the same as the previous week – just the black dot. Dr. N explained that, at this point, we should be able to see the fetal pole and the heartbeat and she wasn’t seeing either. The pregnancy had stopped developing.

Just like when they told me I was pregnant, I felt like I floated up out of my body and was watching myself in this moment…except this time, it was the worst moment of my life. I kind of thought that if I remained scared throughout the pregnancy that something bad could happen, that nothing bad actually would happen. But not the case – it was my very fears come true.

Dr. N. went on to explain that it was likely due to a chromosomal issue (ie. crappy eggs!) and that we had a number of options – we could wait and miscarry naturally, they could give me meds to help the miscarriage happen faster, or I could have a surgical procedure (ie. an abortion) to remove the remaining “products of conception”. Everything was so surreal - like this couldn’t be happening to us, not after all we had been through.

We opted to do nothing – to “let nature take its course.” A part of me just didn’t want to deal with it so doing nothing was the obvious option. The rest of the day was horrible. Jared took off work and came home with me. We decided being alone at home was probably not the best idea so we went to lunch and then went shopping for our bathroom update project we had been working on. We just did our best to distract ourselves. There was also the dreaded task of information those who knew I was pregnant that, in fact, I was no longer. I remember saying to Jared that I wish I had known today was going to be the worst day of my life so that I could have mentally prepared for it.

Over the next days and weeks, I tried to focus on work and we both threw ourselves into the bathroom project. There were definitely days that I did not want to get out of bed – but I always did. I slowly began to just feel ready to move on from everything related to getting pregnant.

One thing that was particularly hard about the loss was how people acted. When we found out we were pregnant, I felt like everyone we knew wanted in on it – I was getting texts all the time…”So excited!” “How are you feeling?” etc. But as soon as it was over, the silence was deafening. I have definitely learned a lesson from this for my own life – even when you don’t know what to say, saying SOMETHING is always better than saying nothing.

"The friend in my adversity I shall always cherish most. I can better trust those who helped to relieve the gloom of my dark hours than those who are so ready to enjoy with me the sunshine of my prosperity. - U.S. Grant

This past weekend I had the miscarriage. It started late Saturday and Sunday was the worst of it. I am thankfully that my loss happened very early so there was very little to miscarry. It was still the top 3 worst pain I’ve ever had (next to my HSG and SIS procedures) – there was about 15 minutes that I was just on the floor crying. It was very frightening to go through and I am so relieved that it’s over.

So what now? Number 1 on my agenda is to lose my IVF/pregnancy pounds and get back in my pants – I have had a very serious relationship with my 3 pairs of yoga pants for way to long! I am beyond ready to feel physically like myself again. After that, it’s all about continuing to heal and taking time to enjoy our life and to decide what our future holds. Will we do IVF again? At this point, I really don’t know. I hope that in a few months I will feel renewed and capable of trying again. But right now, I couldn’t consider it. The pain and gut-wrenching sorrow we have been through over the past 2 and a half years – it’s just too much.

"Sometimes you may wish you could go back in time, to when it was easy to smile, and your heart wasn't broken into a million pieces."

In my perfect world, my body will right itself over time and we’ll get pregnant on our own. I’m also working on my relationship with God and coming to terms with the possibly that having biological children is not in His plan for us. I still struggle everyday –seeing pregnant women, seeing baby pictures on Facebook, seeing anything maternity or baby related on Pinterest – it still hurts so much. I pray someday that will go away – that I won’t get sick in my stomach when I see someone’s pregnancy announcement. But for right now, it’s all about one day at a time.

"Fear not, for I am with you." Isaiah 41:10

Farewell 2013...and good riddance!

When Friday evening before our embryo transfer rolled around, I was feeling surprisingly calm. Jared and I stayed in – I made dinner and then baked a chocolate cake (from scratch! – so indulgent and so fun). We knew the call would be coming Saturday between 7 and 8 – letting us know if our embryo had survived. The transfer was scheduled for 10:45. I just kept praying.

 

My 'night before transfer' therapy!

I was thankful that I fell asleep right away that night. Unfortunately, it didn’t last. At about 2 am I was awake – with cramps. In my half sleeping-half awake state, I was in a panic that I was going to lose my lining. (In retrospect, it was probably a side effect of the progesterone.) I was also stressing about the fact that we must have nicked a nerve during my shot that evening because the side of my right thigh had gone numb. It was just an anxious night. I gave up on sleep around 5 and got in the shower. Once Jared got up, I put our bed sheets in the washer. I figured I’d want fresh sheets to either relax after the transfer or lay around in all day miserable.

When 7 am rolled around, my heart was raising. Jared and I were treating my phone like a bomb – scared to look at it. I was upstairs putting the fresh sheets on the bed when the bomb rang. It was the embryologist – the one I don’t really like who delivered the first bit of bad news after our egg retrieval. She said the embryo was thawed and it “looks pretty darn good.” I could breathe again. I yelled down to Jared, “She made it!”

Because nothing is ever easy, another issue we were dealing with on this day was an impending snow storm. Luckily it hadn’t started yet but we packed bags in case it got bad and we had to stay over down in King of Prussia. But our embryo had survived and we were off!

In a few hours, we arrive in KOP and I already had to pee like crazy! Of course, this was as instructed – my bladder had to be full for the transfer. I actually overdid it with a peach Snapple and ended up having to cheat and let a little out. No matter what, it was miserable. When it was time they took me back to the same little changing area as when I was there for my egg retrieval. This time Jared got to come and was outfitted with covering for his clothes, shoes, and head. I had to change into a cloth gown and put on surgical socks and head covering. They reviewed all my vitals and the doc doing the transfer (not mine, another from the practice who I had met before) came and said hello. Finally, the embryologist came in with a pic of our little embryo. I remember her saying “I know you guys have been through a lot…” I guess our horrible cycle is infamous. After all this, she looked good and we were so ready to get her in my uterus.

All ready for the embryo transfer!

 

When it was time, they walked us back to the same big, scary room where I had my egg retrieval. I was actually so glad Jared got to see it! They put the embryo up on the screen quickly so we could see it live before the transfer. It was pretty blurry though. From here everything happened so fast. I was trying to savor the special moment but all I could think about was how badly I had to pee. The process is super simple – just like an IUI but with a sonogram scanner being pushed into your belly. The doc apologized in advance for how uncomfortable the pressure on my bladder was going to be but she told me the worse it is for me, the better it is for her to see. I let out a couple “oohs” and “aahs” but really tried to be a trooper. We watched on the screen as they put our little bean in my belly and it was all over in 2 minutes. They had me lay there for about 10 minutes and then we were free to go. The embryologist assured us that the embryo cannot “fall out” and equated it to a grain of rice in a peanut butter sandwich, haha!

Our little grain of rice...

 

We were so pleasantly surprised that the snow actually held off for us – we made it home right before it started! I was to take it easy for the next few days and it was nice being able to relax at home, hoping and praying that our embryo was continuing to grow and thrive. 

Luckily the wait for my blood test was only 9 days. I wasn’t really watching for any symptoms this time around because I knew it was just too early for there to be any. I was following some food and lifestyle protocols that I had read about: eating pineapple, walnuts, avocado, and lots of protein; keeping my feet warm at all times; abstaining from caffeine (and alcohol, of course); trying to eat and drink warm foods. I also was just walking and not running as the doctor said no strenuous exercise until after the test.  And, of course, I was praying and praying.

I did start to get frustrated as the days went on, especially because it was Christmas. I missed out on drinks at my office Christmas party and at a good friend’s 30^th birthday party. It’s even worse when people notice you aren’t drinking and want to know why. Like I have said before, it’s one thing to be “the pregnant one” but it just isn’t fun to be the “might be pregnant one.”  I also missed my morning caffeine and running. I was just having moments here and there that I began to grow weary of everything putting my life on hold.

Based on extensive internet research, I knew that I COULD potentially test positive on a home test at 6 days after my transfer. I peed on sticks Friday and Saturday (6 and 7 days post transfer) and they were negative. But I also knew that I could have a negative this early and still be pregnant, so I didn’t get too worked up about it. Nonetheless, I was tired of negative tests so I opted to hold off and wait for the blood test (9 days post transfer, that Monday).

Early Sunday morning I was awakened by cramps. I was devastated. It was just like every other cycle – so much hope and then it all falls apart right before test day. Even though I continued to cramp, my period never showed. My mom was convinced it was pregnancy cramps but I have read too much and knew it was likely just my period trying to come but the progesterone injections keeping me from bleeding. In the end, I decided there was nothing I could do and that it was in God’s hands. The blood test would be the only answer.

On Monday I was still having cramps but no period so I drove to the doctor for my blood test. I was actually happy that I had made it to this day…every other cycle my period arrived before the test. Since I wouldn’t be getting the call until that afternoon and work was dead with it being so close to Christmas, I spent the day doing one of my favorite things in the world – baking! I knew that if anything was going to distract me from awaiting the phone call, it was making cookies.

I knew the office usually called anywhere between 2 and 4 with blood results. So around 2:00, my heart started to race and I couldn’t concentrate on anything. I started to do things here and there but I was just shaking. It was late – around 3:30 I think – when that bomb rang. It was Dr. Nguyen. She told me she was not calling with good news. The test was negative.

In that moment, I was thankful for the cramps – that they had allowed doubt and preparedness for this moment to get in my head. I think if my heart had been totally full of hope, I would have been heartbroken. Of course, I was sad…but it’s almost like I knew what she was going to say before she said it. I was just hoping I was wrong.

I told her we were probably going to go right into another round of IVF but that I would talk to Jared about it. Then it was my turn to make an awful phone call…to Jared who was at work. I delivered the news swiftly – “no-go.” We quickly moved on to logistics – do we go again? Take a break? What’s the account balance?

When I got off the phone with Jared, I just sat there. It was quiet and I was totally alone. I let myself sob for a brief period, maybe a minute or 2, and then I stopped. It was done. Crying, to me, has become a futile exercise. I mean, I still cry sometimes when I am talking about something or relaying information – it’s almost involuntary. But just sitting and crying has become stupid…it doesn’t change anything or help the situation and it usually makes me feel worse. So I let myself have a moment and then it was done. I removed my estrogen patch, took the picture of our embryo off the fridge, and shoved my calendar and all my meds that had been sitting out in the kitchen in my med basket on the floor. It was over and I didn’t want any evidence in my sight that it had ever happened.

After the negative test, I was able to stop the progesterone shots. (I actually had planned to switch over to progesterone cream anyway.) But after I stopped, not only did I still have numbness (now even a little on the left side as well as the right), I got a terrible rash on both sides at the injection sites. It was as if each injection spot had turned into a mosquito bite! The itching was so bad it was keeping my awake at night. Weeks have passed now and my butt/legs are still feeling the effects. I am not sure I could go through the shots again.

I was amazed at how quickly I started to feel “normal” again. “Normal” being “there is no way I am pregnant right now.” It just felt like it was back to life as we know it. The next step was deciding where we go next. Initially I thought about taking a month off but after giving it some thought I realized I just wanted to power through.  If my eggs really are poor quality, another cycle would tell us for sure. I just want to get that answer so we can know if there really is any hope or not. I am also ready to be done with fertility treatments. Of course, if the next round is not successful, we will always continue to “try” naturally. But I feel that this will probably be it, at least for a long while. I am ready to have my life back and to start beginning the execution of the “no kids” life if that’s what it’s going to be.

Looking back 2013 was awful…1 failed round of Clomid, 1 cancelled round of Femara, 1 failed round of Follistim, 4 rounds of Menopur  (2 failed, 2 cancelled),  4 IUIs, and 1 failed round of IVF. So much hoping and praying and so much heartache. Maybe in 2014 everything will turn around for us. Maybe we will finally be blessed with a child. Or maybe we will finally start to move on. I just keep praying.