Wednesday, May 29, 2013

Back on for 2

Thanks to your comments and texts I was encouraged to email Dr. D. I let him know that I respected his opinion, but still desired to transfer 2 embryos, and asked if he could bring up my case at the next RE team meeting. He sent me an email this morning that the team decided it would be OK for me to transfer 2 embryos. I met with my therapist this evening and we discussed transferring 1 vs 2, and I believe transferring 2 will be the path of least regret. No one can't predict the future on this difficult infertility journey, so the best I can do is listen to my gut and chose the option that I believe will give me the least regret in the long run.

Today is my and K's 3 year anniversary. I am so lucky to have him. He makes this whole journey worthwhile and I don't think I could make it through all this heart ache without him. We went out to dinner and discussed transferring 1 vs 2 embryos. His main concern is the finances involved with potential twins. Money is fairly low on my list of concerns at this point, but I understand where he is coming from and tried to address his concerns. I did remind him that transferring 2 embryos can result in 0, 1, 2, or 3 babies. Transferring 2 embryos is no guarantee of twins (although I wish it was!) He said that he is OK with transferring 2 if that is what i really want. We did finish the dinner by reminiscing on all of our favorite wedding and honey moon memories, so it wasn't all infertility talk :)

Wednesday, May 22, 2013

Single Embryo transfer

Well after I wrote out all of my reasons why we wanted to transfer both of our remaining embryos I found out today that Dr. D only wants to transfer one. He said that he doesn't think I qualify for transfering 2 since the first transfer was "succesful" in that I did get pregnant. He gave his reasons for wanting to transfer 1 and I gave my reasons for wanting to transfer 2.

He is fairly confident that I will get pregnant again with a single embryo transfer and doesn't want to expose me or my potential babies to the increase risk of twins. I understand these risks and understand that a singleton pregnancy is perferred. I am scared of the potential adverse outcomes of twins; no one wants to increase their potential children's risks of cerebral palsy, necrotizing enterocolitis, and periventricular leukomalacia, or have a NICU stay and the potential of taking home only 1 or neither baby, or 2 sick babies.  K changed his mind about transferring 2 when Dr. D mentioned the risks to me with twins. K doesn't want anything bad to happen to me. He would rather take the potentially longer but safer route. I understand what he is saying, but at the same time I worry about the damage that happens to me the longer I go in this journey. Yes, I am not physically injured, but this process has taken a huge emotional tole on me. I feel like I am living a life of waiting. I can't enjoy the present. Likely this has made me more willing to take risks in the hope of achieving a baby quicker. Dr. D says he thinks I am too caught up in the process to look at things objectively. He thinks I want to adress this too agressively, which may cause unecessary harm. I understand what he is saying, and I agreed to only transfer 1, but I am still not happy about it. I can't predict the future. I know that if I did get pregnant with twins and something went wrong I would feel horrible about it.

We did also discuss my reasons for wanting to transfer 2, and I did get fairly upset because our priorities aren't the same. Dr. D thinks the chances of transfering 2 and ending up with twins is greater than the chances of transferring 1 and have another nonviable pregnancy (however, he isn't the one who has to go through the potential loss, and he did say that there is a possibility that 1 or both of our remaining embryos could be chromosomally abnormal). He agreed that they do not like having only a single blast left for a future transfer because thaw rate is not 100%, but he says if that happens the worst thing that happens is that the cycle is cancelled (which would be a big deal to me!) and I would be set back 3 months (but that is a long time when you have been waiting so long and want a baby so badly!).

I did agree to only transfering 1 by the end of the appointment, although I did so begrudgingly. He did say if I still realy wanted to transfer 2 he could bring it up at the next patient plan meeting, where all the REs discuss the how to treat a patient, but I declined. I could still change my mind if I want to, but I believe the other REs would agree with his plan to only transfer 1.

The timeline for the FET is a bit longer than I would have liked. Since I never had regular periods in the past, I likely will need provera to induce my next period, after which I would start estrace for the FET. However, Dr. D wants me to wait to start my 10 days course of provera till June 23, which would mean I wouldn't get my period till July 5th or so. Then I would need to take at least 19 days of estrace, so tentative transfer July 23. I am a bit worried because the last day of embryos transfers for this entire up-time is July 26, so if we had any set backs (i.e. period takes longer than the usual 3 days after provera to start, or my lining doesn't thicken and I need extra days of estrace) then the whole FET may be cancelled until August. I wish that they would let me start the provera at least a few days earlier.  My miscarriage started May 10th, so June 20 will be 5 weeks from then, and July 5th would be 8 weeks after the miscairrage. The only hope I have of starting earlier is that they said if I got my period on my own in June, we could discuss beginning the FET at that time. I hope that my body recovers and even though I don't normally ovulate or cycle, maybe the pregnancy will have reset my hormones and I may cycle on my own.

Tuesday, May 21, 2013

The aftermath

So tomorrow is my follow-up appointment with Dr. D to check on how I am doing and discuss moving on to my FET.

The misoprostol for the missed abortion was an anxiety filled event, but I am still happy with my choice, and luckily I had several friends who gave me advice, listened to me worry, and helped me anticipate what would happen. I took 4 pills vaginally Friday morning after the bad ultrasound - passed 2 clots with cramping, but no bleeding. Then 4 more pills Saturday morning - nada. At this point I called the resident at the hospital and begged to try one more dose to try and avoid the D&C, which he obliged, so I took 4 more pills Saturday night and only passed about 4 clots with no real bleeding. I was rather distraught that the whole process hadn't worked and scheduled a D&C for Friday, with the hopes that maybe things would still occur naturally before then. Thankfully on Monday I started to bleed bright red blood and a lot of clots, which lasted through Friday (4 days total), so despite my efforts for this to take place on the weekend, I was bleeding a lot at work. However, by this point I was mostly just relieved that the bleeding had started because I knew that I had not bled enough over the weekend.

I have taken 3 hpts over the last 10 days and my hcg is definately decreasing. With the first test the test line was as dark as the control, and now with the most recent test the test line is light enough that I would consider it positive (if I really wanted it to be positive, like 12 dpo), but is fairly light. I am hoping that in a few more days it will be negative.

My body seems to be a bit whacky hormonally. My face is breaking out :( and I just want to eat junkfood.

K and I have talked about what to do next. We are wanting to move forward and do the FET during our clinics next up-time, which I think would be in July, but we will find out for sure tomorrow. At this point we are leaning toward transfering both of the frozen blasts that we have. There are several reasons why we are considering this:

1) We want to maximize our chances that the transfer will results in a BFP and pregnancy. We would be overjoyed with either 1 or 2 babies. I know that are increased risks with twins, but I feel comfortable with the statistics given the quality of medical care in my area.

2) We only have 2 frozen blasts. Even if we plan to transfer 2, there is a chance that only 1 will survive the thaw.

3) If we only transfer 1, in the future we will have to do a FET with only 1 blast (Our shared-risk covers FETs for all frozen embryos, so we wouldn't start another fresh cycle till after transfering all of our frozen blasts). If it didn't thaw correctly we would have nothing to transfer, which would be really upsetting/frustrating and set us back several more months because we need to start another fresh cycle.

4) We paid for IVF out of pocket. Luckily we qualified for a shared risk program. If I don't get pregnant and carry past the 1st trimester with at least 1 of the 2 blasts we have left then we get our money back. We could then rejoin the shared risk program and retry IVF. Hopefully the next time my protocol can be maximized to result in even more eggs/embryos and we could consider doing PGD at that point if necessary. Obviously I would much rather get pregnant with this FET then redo IVF all over again, but even if I get pregnant I feel like my family won't be complete without several children, so I will need to do IVF again. If I have to redo IVF this year, then at least most of the costs will be covered, and hopefully we can get enough eggs/embryos that we wouldn't have to do it a 3rd time in the future. Transfering 2 embryos now will either result in pregnancy which will hopefully result in a baby or no pregnancy, at which point I would know that I need to do IVF again now, before I potentially relocate in a year for residency.

5) I am not sure about this last point and still need to research/think about it more. Just going off of my gut feeling, I feel that if I get pregnant with twins and one of them is chromosomaly abnormal and fails to grow after implanting but the other baby is healthy and continues to grow, the loss would be easier on me then having 2 separate pregnacies with 1 ending in a baby and 1 ending in a miscarriage, which could happen in either order. However, I do have a fear that if one is chromosomally abnormal then the loss could affect the other baby and I could lose them both. That is probably my greatest fear and the primary reason why I would consider transfering them seperately. My reassurance against this concern is that I have not seen this happen commonly on the blogs I read. I have seen many instances where one twin stops growing or dissapears from one early ultrasound to the next, but the other twin has always been ok.

My other question for my appointment tomorrow is whether or not I should take Metformin for my FET. I was put on it originally when I failed clomid and started femara and was left on it for IVF because they said it could help with egg quality, but I stopped it with the miscarriage because I couldn't motivate myself to take any medicine. I restarted it last night, but need to find out if there is a benefit to taking it with the FET? I will let you know how my appointment goes tomorrow.

Thursday, May 16, 2013


I have been having a lot of feelings that I am not proud of.

Normally, I am very compassionate and empathetic. Part of the reason I didn't like OB/GYN, for example, is because my patient's suffering touched me so deeply. I brought that sadness home with me whenever something went wrong. 

But lately, instead of feeling sympathetic when I hear of other people's loss/struggles, I feel bitter, because I compare it to my own and find their's lacking/easier. I know this sounds ridiculous and not very nice, and really it is not even an appropriate/possible thing to do. When I take a step back, I know I can't compare my own pain to someone else's pain, but in the moment I can't help but feel that I have been wronged, that I have had it worse. I don't feel bad for the person who is suffering, I feel bad for myself.

For example, I had a classmate who was upset that his great-grandpa is sick and might die. I should sympathize with him, I know how much it hurts to lose someone. But instead I am pissed off that he still has his parents, and grandparents, and a great-grandparent(!) gosh darn it. Or similarly, I have a sick pregnant patient, but instead of being sorry she is sick, I think "well at least she has a baby."

And when I think like this I know that if the majority of people around the world looked at my situation they would say how can she be so pissed/complain so much/feel so wronged when she has such a great husband, a good education, a stable career, a roof over her head, her health, etc. So many people in world have had horrible, terrible, gut wrenching tragedy and injustices afflict them. When I truly think about it, I know that the majority of the people in the world have it worse off than me... Why am I so caught up in my own grief?  Why do I feel like I have had it worse? I know I have so many great things in my life, but I can't see past the things that are bad.

When I think of my mom, I think of her suffering. I relive all of the bad things that happened in her last few months. I see her sick in bed. But she was only sick for 1 year of the 23 that I had with her. And her last few months had many happy moments. I don't know why the horrible memories are the ones that come to my mind, often unsolicited. I wish I knew how to move past those memories so I could remember the good times.

I do believe in God, but I can't find any peace. I don't have any religious solution to my suffering. After a tragic event, the religious people in my life generally say things like struggles help bring you closer to God or suffering helps you learn to rely on God. But right now that answer just makes me angry. Am I so distant from God, that I need so many struggles in my life to bring me closer to God? Am I that bad of a person, or am I that bad on relying on God, that I need so many reminders that I need to rely on God instead of my own understanding? And even if it was even partly true, would God let the people I love die just to teach me a lesson?
So now you all know that I am not being a very good person right now. I feel very woe-is-me, and I am embarrassed by my feelings. Losing Beansprout has triggered a lot of feelings of losing my parents. I need to figure out a way to move past my grief, or at least not to be completely consumed by it. I don't want the bad things that have happened in my life to make me a bitter person. I still want to be kind and loving and compassionate. 

Saturday, May 11, 2013

Bean Sprout

K was nervous in the weeks leading up to the ultrasound, but I wasn't. I really thought that this was it. I looked through the calendar and planned out our future. Bean Sprout was due on Christmas Day - she was going to be our Christmas miracle baby. Even though I know Christmas isn't a very good birthday, I figured I could try to have her a few days early or late by sure willpower, and the good part would be that our family would all be on break so they could come meet her. I had pre-emptively made my schedule for next year easy from November on, so I would have a lot of time off the spend with Bean Sprout. I looked at how far along I would be in each rotation, imagining my belly growing. K and I talked about names. Each Wednesday I would look up the week's developments and tell K: "This week Bean Sprout has a heart beat" "Today Bean Sprout is growing arms and legs" etc.

I knew things could go wrong, but I felt that they wouldn't. I thought we had made it through the hard part: 1.5 years ttc, IVF, a positve beta.

We went in for our ultrasound early so I could talk to the billing office to find out if my favorite OB would be in-plan. One of the nice ultrasound techs, who did a lot of my follicle scans, called me back. The TV monitor over the bed was tilted wrong, like when you are trying to watch a show on your computer and need to move the screen up or down to get the colors right. I thought about asking her to fix it, but I figured I would wait till we got Bean Sprout on screen - I couldn't wait to see her. She put the ultrasound wand in and I saw the sac right away. But as she scanned through it I didn't see a baby the size I expected to at 7w1d. There was a big yolk sack, and something small to the side. I looked up and saw her shake her head. She scanned through again and said "I am sorry." Bean Sprout had stopped growing. The yolk sac was dispraportionately large, the fetal pole tiny, and there was no heart beat. Laster, Dr. D said that the large yolk sac is associated with chromosomal abnormalities.

I sobbed the rest of the day and have been crying on and off since then.  I don't understand how this could happen. We've been waiting for this for long. It hurts so much.

I knew Mother's Day would be hard, having lost my Mother this last year, but I thought it would be easier having a baby growing inside me - becoming a mother myself. I felt like my Mom was watching down on me, trying to send me a gift to help me get through, but now I know that was a story I made up. I wanted to fill the holes in my heart from losing my mother, and father, and all my grandparents, but I've only succeeded in making another hole. I have lost another person that I love - because even though Bean Sprout was only a few weeks old, I loved her as soon as I saw the picture of the blast they were putting back inside of me. I had hopes and dreams and fears for her.

It is Mother's Day and I'm waiting for Bean Sprout's body to finally exit my womb. I took two doses of Misoprostol this weekend with no success so far. I just took the last dose a few hours ago. I am hoping this works, because if not I will have to get a D&C, which I am trying to avoid.

I'm sitting here wondering if Christmas will be sad forever now?

Thursday, May 9, 2013

Bad news

Went for the ultrasound today... there was no heartbeat. Bean sprout had stopped growing. More later.

Sunday, May 5, 2013

To my blogging friends

I'm sorry I haven't posted in awhile. I don't mean to leave you girls hanging or make you worry. Things have been uneventful in terms of the pregnancy (It still feels unreal to say that). I feel like I am waiting for the ultrasound to confirm that Bean Sprout is ok. Luckily, I have had no spotting and very little cramping. I have had very little symptoms, which I am both thankful for but nervous about. Our first Ultrasound is this Thursday.

I also don't know what I should post about. I spent a year and a half trying to get pregnant and now I finally am, but I feel guilty talking about it on my blog. I know several of you ladies went through IVF right around the same time as me, but didn't get pregnant. I can't imagine how hard it would be for you to read my blog. I am so sorry about what you have been through. It breaks my heart that several of you, who have become my blogging and IRL friends, didn't get pregnant / did get pregnant but had a miscairage / had your IVF cycle delayed. I am still reading your blogs and rooting for you. I want to comment, but I hesitate because I don't want to cause you any more pain than you are already going through. I just want you to know I am thinking of you.