Hoping for the best, Preparing for the worst: The Clinic’s Final Decision

October 24th, 2013: The big day!

Today is the day that we head back to the clinic to find out the RE and the team’s opinion about how we move forward.  I’ve spent the last 3 weeks going through each and every scenario, and how it would work.  I also have every scenario’s questions laid out in my mind to ensure we get all the answers we need.  Knowing the RE didn’t seem to be interested in surrogacy for us, I needed to know every medical reason behind each option and how it might work.  This was the only way we could make decisions about how was can move forward.

Dan and I got to the appointment, and I was trying to prepare myself for the news- and to be honest, I wasn’t exactly expecting great news.  Could I do another IVF round again?  How…? Emotionally, mentally, and physically I wasn’t so sure I could handle it.

To doc sat us down and opened with, “After review with my team and your medical history, we believe we’d be very supportive if you wanted to move forward with a gestational carrier”.  WHAT?!!!

This was the one scenario that I didn’t plan for.  The last appointment made it pretty clear that this wasn’t something that he was excited for.  My mouth actually dropped.  He laughed and said he thought I’d be happier with the news.

It wasn’t that it wasn’t exciting, but how did this come about?  What had changed?  The doc explained that after reviewing everything, we didn’t have very much medical evidence to base our decisions on.  We were basically guessing at best.

He explained that there was a very high chance of OHSS for me due to the amount of meds I require, and the extremely high levels of estrogen that I kept having.  This would not be supportive for the transfer, and additionally, could actually lead to us being cancelled- meaning either no retrieval or no fresh transfer- both not good.  Secondly, there was no medical evidence to support that is would work if we continued.  He said that we might be right, but then so might he.

He emphasized the importance of the ‘right’ carrier, not just any carrier.  Third party fertility was very difficult and not clear cut in Canada due to our laws.  This was not something to do on a whim with such anyone.  He felt that the close-knit friendship I had with the potential carrier, as well as her family situation was actually optimal for a gestational carrier.

The other issues that weighed into the decision was if I was able to get pregnant, we still may have problems during pregnancy and birth due to my bleeding disorder and the anti-depressants (which we now an even higher dose than before- thanks infertility!).

I honestly had no response for the doc.  This was the exact appointment I had dreamed about getting, but was not expecting at all.  Dan asked a bunch of questions, which, quite frankly, was very un-Dan like.  He is normally more of a nod and listen type of guy.  But he was the pinch hitter in this appointment as I just sat there stunned.

The doc said we needed to talk to the IVF nurse to discuss specifics, but we had his blessing and off he went.  My heart was racing, I had a huge smile plastered across my face, and I couldn’t stop squeezing Dan’s hand- this was it!  We’re going to have a baby!!!

The IVF nurse came in and went over how to move forward.  First things first, did we understand the financial impact? Well yes, I already had a colour coded spreadsheet at home with our guess-timates of cost.  Then, out came the sheet.  Holy sh*t… I perhaps forgot that OHIP would cover nothing.  At all.

Every appointment with the doc, blood tests, ultrasounds etc would all need to be paid for.  And man, did those fees add up.  We remembered the IVF fees, the counseling fees, the legal fees, the expenses, the post pregnancy expenses, but totally forgot about these.  The general estimate for typical surrogacy arrangements in Canada was anywhere between $60,000 – $90,000.

We swallowed and smiled.  Yes, the fees were ok.  Nothing was going to make my smile disappear today.

Our plan was that Jen would need to come into the clinic for an assessment by our doc.  He would go over her medical history and determine if she was a medical fit.  If she passed that test, she would get the privilege of having a sonohysterogram and blood work.  If she passed that hurdle, next was the psychiatric analysis.  If we all made it through those appointments, then we’d be off to the lawyers to sort out a surrogacy contract.  Once we have that, we would have to sync up Jen and my cycles, then off we go- I’d get medicated, grow awesome eggs, get them retrieved at the same time as getting Jen’s uterus ready for the embryos, pray the eggs fertilized, pray they make it and continue to grow them in an incubator for 3-5 days, then implant them back into Jen.  Then pray for sticky vibes and hope they stick and she would get pregnant!

Easy peazy….??! Breathe in.  Breathe out.

By the time I made it the 30 steps from the conference room to the front desk, I had texted Jen and my parents with the good news.

Even though we hadn’t had our official sit down with Jen, I got a bit ahead of myself and booked her for her initial consultation two weeks from now (to the tune of $250.00… :S) and left my credit card number.

To do: Call Jen and set up a little family meeting to discuss her carrying our child, go over all the information we had received and try to ensure we understand each step then come up with a new updated budget, oh, and raise our credit card limits.  Bright side is that we’re about to get a ton of air miles…!

On we go! Surrogacy here we come!!

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Found this… Infertility, IVF, Depression, Surrogacy… all scary things to put out there onto the internet for anyone to read. But this quote sums up what my hopes are!

One Step Forward, Two Steps Back

The next week was a long, difficult week for us.  We tried to process the idea of loosing something I’d always taken for granted- having a baby.  I was home from work.  This was both a blessing and a curse.

As time moved forward, and the longer I had been away from work, the more anxious I got about returning back. I was still very depressed, tired, achy, and wanted to sleep the day away.  On the other hand, getting back to work would keep my mind occupied.  Plus, I love my job.  I kept telling myself I’d go back tomorrow.

Then the evening would hit and I would be so anxious my mind would be racing in circles.  My job took my full concentration.  What would happen if I went back and made a mistake?  What if I missed something?  There were potential negative consequences for others if I made an error.  This thinking was enough to push me back into my cave of loneliness and I’d crawl back into bed for yet another day.

Days became a week, then two.  I needed to go back.  My calendar was fairly light for the next week ahead so thought it might be a good time to ease back in.  I promised myself that Monday would be my first day.

Monday came, I made it to work, and nothing terrible happened.  Tuesday followed, and I was back into the swing of things.  Focusing on other issues made our problems fade into the background… at least during my working hours.  Evenings I’d return home and feel lost at what to do next.

We had our WTF appointment at the end of the week.  Dan and I talked daily about what questions we had, what we needed to understand, and what we had decided- we were done with trying.  Our evenings turned into mini-counseling sessions.  Dan and I would try to talk through everything focusing on what was next.  (Ok, I talked through everything.  Dan did a lot of nodding.)  One thing we knew was that we couldn’t just jump into something else, we had to mend ourselves from this process first.  Throughout the week we talked about next steps.  We had decided to look into surrogacy as our next step, but the clinic didn’t know that yet.  What would they say about our new plan?

The night before our appointment it occurred to me- I needed to completely change my way of thinking.  Instead of focusing on ‘getting pregnant’, I know had to focus on ‘making a family’.  At one time, those meant the same thing.  However, now, I knew they were two very separate things.  Getting pregnant was only one solution.  Changing this mindset would take some time, but thinking about things this way made me feel like there was some light at the end of the tunnel. 

This wasn’t the end, this was just the end of trying ourselves.  More importantly, this was about the be the beginning of a whole different story.  Our story.

WTF Appointment Day:

Dan and I pulled into the clinic and gave each other the ‘we can do this’ smile.  We held hands and walked through the door.  This past year and half may have beat us down, but we made it through.  One thing was for certain, our marriage had never been stronger.  If we could make it through this, we could make it through almost anything.

We sat down with our RE and he said he was sorry about our disappointing news.  He then started into how he was going to change our protocol for the next round in hopes that it would take significantly less time to get my body to produce follicles (eggs).  I kept trying to jump in but he continued on and on about different medications we could try to help etc.  Finally, I stopped him.  I asked him to back up.

Why didn’t it work?  What went wrong?  Was it me?  Was it the embryos? He simply shook his head.  Science had come so far, and the doctors and scientists knew so much about everything before you actually put the embryos inside me.  Once they were inside, we just had no idea what went wrong.  There was no medical answers.  It could be my body rejecting the embryos, it could be something wrong with the embryos, or it could be simply bad luck.

Then I just came out and said it.  We were done.  We simply couldn’t do it anymore.  It took an entire year straight to do only 4 cycles (when most people would get to do 12).  The emotional, physical, and financial toll was just too heavy.  If the doctor didn’t have any reason why it wasn’t working, then what would change if we did it again?  My body was simply revolting at the idea of carrying a child.  No matter what we did, my body seemed to protest it.

I then told him about Jen’s offer of surrogacy and said that we were interested in exploring this option further.

He just shook his head.  What kind of surrogacy he asked?  We were thinking about Jen being a gestational carrier.  This meant that it would be my eggs, Dan’s sperm, and her uterus.  The child would have no DNA connection to Jen, we would ‘simply’ be using her body as an oven.

He took a deep breath and shook his head again.  This was not a simple process he explained- had we looked into it?  Did we know what it entailed?  And if we wanted to do it, we would still be required to make eggs again which was one of the most difficult parts last time.  He explained that while our clinic was one that would work with surrogates, that all of the docs would have to agree that Dan and I made good candidates.  This was not a simple hurdle and was not decided on lightly.  In order for the clinic doctors (the 5 of them) to approve us for moving forward with surrogacy, they would basically be saying they felt there was virtually no chance of us being successful by ourselves.  He wasn’t sure if we met that criteria yet…

I was stunned.  I had thought that we had figured out the perfect option to move forward with.  We had someone who was willing to investigate the process further.  We were with a clinic that would work with gestational carriers, and fertility treatments were simply not working for us.  And now the doc was all but saying no?  I was crushed. 

I asked him if he felt that Dan and I could conceive.  He said that there was no medical evidence at this time telling him that we could not.  I asked then if there was therefore medical evidence that we could?  He looked at us thoughtfully… and slowly said no.

He said, “In a perfect world, we wouldn’t have to worry about the costs associated with these treatments.  If we were in Holland or even Quebec, these services would be covered by the government and we would like to do three fresh transfers.  Once a couple has done three fresh transfers and was not successful, it was at that time that the clinic would say that we were unable to conceive.”  We had done one fresh transfer, and two frozen transfers plus an attempt at the less invasive IUI.  Not exactly his formula above, but it also wasn’t like we hadn’t given it our all.

The doc sat there in silence for a minute then said, “I know that your situation is very unique.  We have had issues at every step of the way and we know that you are not a typical infertile couple.  Let me think about this a little more and I will take it to my team to discuss.  We will discuss if we feel you are appropriate candidates for surrogacy and get back to you.”

Defeated, I nodded.  We shook his hand and left the clinic.  I finally thought that we had an opportunity to move forward… and now we were in exactly the same place we were a year and a half ago (only thousands and thousands of dollars poorer).

When we were going to get a break?  It appeared my ideology about this being the beginning of a new story for us meant nothing.  This looked like it was simply going to be the end.

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Picking Up the Pieces

Is it possible to mourn for something you never had to begin with?

The day we got the negative test is basically a blur.  I honestly don’t remember how I got home from Pita Pit or what happened next.  I do know that I ended up curled in the fetal position sobbing in our bed.  It just felt surreal.  Did this actually happen?  We had put everything into fertility- physically, emotionally, spiritually, psychologically, and financially.  The science behind it seemed so logical and the doctor’s were so optimistic with our case.  Hell, from the start, we didn’t even think we had fertility issues.  Yet here we were.  Broke, devastated, and an a completely empty uterus.

I stayed in bed with a cocktail of anti-anxiety meds and kleenexes for the next couple of days.  My mind just could not compute that this had just happened to us.  It was so easy to be angry with the rest of the world and adopt the ‘poor me’ mantra.  How could women who didn’t want or care about their children continued to be blessed with them?  How could the rest of world take for granted the miracle of life that was being with held from us?  It just didn’t seem fair.  We are a young married couple who are unquestioningly in love.  We have good jobs, a loving home, supportive family and friends, and so much room in our hearts to dedicate ourselves to our child.  Yet, here we were at a dead end.

It feels utterly impossible to describe in words what it feels like.  My heart was broken.  Completely shattered… and I wasn’t sure I’d be able to piece it back together again.  To make matters worse, Dan, who had always been my optimistic rock, took it just as hard.  He tried so hard to keep it together, to put on a smile to encourage me to come back to the living… But this blow was just too hard to take.

That evening, we just lay in bed together with our faces inches apart, crying.  Our dream, a simple dream of having a family, was over.  No words could console us.  We just needed time to mourn.

 

Day 3: The third day after the news, I pulled myself together, put on dress clothes and tried to return to work. If I could just get back to the business of every day life, then perhaps I could give my brain (and heart) a rest to try and forget… even just for 7 hours a day.  I put everything into my work, but I just couldn’t keep it together.  My colleagues, most of whom knew what was going on, came by to give me a hug or say they were thinking about me. I couldn’t even fake that I was ok.  I’d burst into tears at the drop of a dime.  I was hvaing problems concentrating, making decisions, and was just utterly exhausted. 

At lunch, I decided to walk to Pita Pit so I could at least get a comforting hug from Dan. We share our building with public health and they had just put up a several posters that morning in our elevator.  With one look, I had a complete break down and ended up sitting in the corner of the elevator bawling my eyes out. 

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Am I pregnant? No. I am not.

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I just couldn’t do this.  I lasted three hours and I just couldn’t do it.  I went down the parking garage to drive home… but was far too upset to drive.  So instead, I reclined my chair in my car, and laid down there in the dark trying to relax. 

I made it home and emailed my manager to let him know that, again, I’d need to be off sick again.  Work had been so supportive, however with each day I took off meant that someone else was stuck trying to cover my work.  We are all so busy so I felt like I had to come back. 

Day 4: I tried working from home.  I was trying my best but wasn’t doing great- my thinking was working a little was better than nothing, right?  That afternoon, a colleague called my cell.  She has had some medical issues herself and wanted to chat with me re: sick time.  Known for her bluntness, she gave it to me straight.  Work would would survive if I got hit by a truck tomorrow and never returned.  I needed to stop thinking about work, and instead focus on me.  Focus on healing.

I needed that kick in the butt- I needed someone to tell me that while I did a good job, work wasn’t going to fall apart without me.  I emailed my assistant and my manager and let them know that I’d be going off sick… for at least a week.  I would check back in later and let them know how I was doing.  Looking back, I am so thankful to my colleague.  I definitely needed some time to grieve. 

Day 5: I just could not shake this terrible grief that I felt.  I felt alone.  Powerless.  Furious. Defeated.  Angry.  Misunderstood.  Depressed.  Anxious.  Distressed.  Heartbroken.  Miserable.  Things were not getting better.  But how could they?  My body, and now my mind, was broken… and I wasn’t going to be magically fixed.

Day 6: I decided I needed help.  I called my family doctor and got an appointment for that afternoon.  When he walked into the room I just burst out crying and told him our sad story up until then.  I asked him for more anti-depressants because these ones were obviously not working.  I couldn’t kick this.  I couldn’t just cheer up.  The future seemed dim at the very best.  We chatted for an hour in his office.  We talked about my support system, my future options, and how to best move forward.  That’s when he said it… Adele, you are in mourning- the same you would be if you lost someone close to you.  Mourning?  To mourn, didn’t I actually have to lose someone?  If that someone was never even born, how can I experience mourning?

We talked about the five stages of loss and grief and it fit perfectly.  I had been in stage one- denial and isolation for the first couple days.  I was so overwhelmed by my emotions that I questioned if this was even possible.  It felt like a bad dream that I would one day snap out of.

Stage two- Anger had reared it’s ugly head.  Anyone who was having a child, had a child, or once was a child was on my list of people I hated… everyone. It just wasn’t fair that I was here and others weren’t.  

As we continued to chat, I realized I was somewhere between stage 3 and 4.  Bargaining and depression.  I had spent my last days re-thinking my cycles and wondering if there was anything we could have done differently.  I was also questioning our decision to stop trying… I remember we had good ideas on why to stop then, but now, I couldn’t help but think ‘what if’ we just tried one more time?  The depression had hit at full force and I just felt like I was stuck in the bottom of a deep cavernous pit with no hope of climbing out.

My doctor prescribed a heavier dosage of my already high amount of anti-depressants and asked me to check in with him next week. 

I went home and tried to process how to mourn for something you never really had.  Not an easy task.

I booked another appointment with the clinic to discuss what had happened and what to do now.  We needed to have some closure and I hoped that the doctors could provide us that.  The WTF appointment was next week. Next steps seemed too far away to think about, but we also needed to hear medically what went wrong.

 

Our Last Shot

This is it.

This is the last one.

The more I rationalize it, the more I realize that this is for sure going to work.  Isn’t that how life works?  Right when you finally give up, everything falls into place?

I’ve been going to fertility acupuncture three times a week and after waiting what seems like forever… my uterine lining is finally thick enough to get going with this frozen transfer.  We have two popsicles left (aka frozen babies).  The transfer is going to be on my Dad’s birthday, September 3rd so that has to be good luck right?

September 2nd, I get the call from the clinic to update me on the status of the thawing of our children.  Bad news.  Again.  Why this continues to surprise me, I’m not sure.  But sometimes it makes me laugh that I think something is going to happen how it is supposed to.  One of the two embryos has all but died in the thaw.  The other, however, is doing great.  Well… we’re down to 1 embryo.  But that’s all it takes, right?  Dan spent the next several hours trying to calm me down.  We only need one embryo to make this work.  This IS the one.

September 3, 2013- I head in for for the first of the two acupuncture appointments.  These are ‘special’ so of course they cost extra- 2 treatments in one day for only $325.00.  Well, considering we’re paying $1500 for the transfer, another couple grand for the fertility meds, we’re paying storage for the embryps, plus $250 a week for acupuncture this far… what another $325?  It’s only money… right? :s

The traditional Chinese doc says to stay warm and to drink warm fluids. Ok, off we go to Tim’s to wait until it’s time to head to clinic.  I have a French Vanilla Cappuccino and try to relax.  Dan hops back in the car and we cruise on over to the clinic.  Holding hands the whole way, we do the hand squeeze- you know, the holding hands hand squeeze that is means we have each others back.  And we do.

The transfer was fairly uneventful.  I changed into the hospital gown, Dan helped me onto the table and into the leg straps.  In proper FET fashion, I was about to pee my pants due to the required full bladder.  They confirmed the embryos were ours and the ultrasound tech started to manoeuvre the wand around my abdomen.  My favourite RE (other than our doc) was on, and my favourite ultrasound tech was in the room with us.  This had to mean something positive right?  With Dan holding my hand, the doc inserted the catheter into my uterus and with the tech’s guidance, measured the perfect distance from the top of my uterus to place the embryos.

They told us where to look and counted to three.  1, 2, 3…. out came a burst of white just a couple millimeters from the top of uterus.  They transferred both embryos.  The one hadn’t officially ‘arrested’ yet so there was no harm in placing that one in too. It was over faster than it started.

There.  Done.  I was now officially pregnant. 😀

After waiting a minute of so for everything to settle, I hopped off the table and ran to the washroom to empty my bladder.  I felt so cheery and excited.  I went to the tech to get our ultrasound of the babies, and she said she hadn’t realized that we wanted one.  Looking disappointed I looked at Dan- with an encouraging smile he said we had pictures for the other rounds, so maybe this round was going to be different for us.  Yes, we’d done this several times now. .. I just knew that this was the one.  The transfer went so smoothly and the 1 embryo was top quality.  Dan drove me back to the acupuncturist and he completed the second treatment for the day.

As I lay there on the bed listening to calming music my mind drifted to all of the excitement to come.  The announcements, the nursery, would it be a boy or a girl?  After an hour in the dark room with needles sticking out of me every which way, he came in and instructed me to stay warm.  Whatever that meant.  I went home and rested for the rest of the day.  I had minimal cramping and stayed all snuggled up in cozy pj’s and in my bed.  Keeping warm as instructed.

Since this was the last shot, I was pulling out all the stops- women on fertility forums always were talking about eating a pineapple core after the transfer.  Apparently some nutrient in the core is supposed to aid in the implantation of the embryo.  Yep, you know you’re officially desperate when you are crunching down pineapple cores swearing it’s going to help you get pregnant.  If there was a chance it was going to help, then sign me up.  We bought two pineapples and cut the cores into 5 segments for the 1st five days after the transfer.

I spent the next day taking it easy and working from home.  I wasn’t going to risk any extra stress or activity for this one.  It was so hard to keep focused on work.  Suddenly, everything baby was so much more interesting than grievances and LTD appeals.  Gender reveal parties (yes- I secretly want one- I’m a loser!), baby shower themes, and what to pack when you’re heading to the hospital were suddenly priorities.  One day down… thirteen more to go until my beta test.

I went back to work the next day. Trying to keep myself busy enough to forget about the miniscule baby who was either digging its way into my uterine lining… or not.  Impossible.  Still eating my pineapple core, I was also continuing to go to acupuncture on the schedule the traditional Chinese doc had recommended.

By 3 days post transfer I found myself wandering through the pregnancy section of Indigo.  There were so many books to choose from.  To be honest, I already owned several of them.  But I was sucked into the aisle and couldn’t leave.  I picked out the most detailed book I could find (which my friend later referred to as ‘the encyclopedia of all things pregnancy’).  It was pricey, and knowing we were seriously short on cash I had a sudden pang of guilt.  I called Dan and asked if I could spend $60 on this amazing pregnancy book that I absolutely needed(!). My rationale was that it started from the last day of your last cycle- so I would get an entire chapter of my ‘pregnancy’ day by day.  Even though a lot of the things described were forced through science (egg retrieval, fertilization, transfer) I could read all about the development and what was happening inside me.  I walked to the cashier and she smiled and asked if the book was a gift- I said no not really getting where her question was leading… She suddenly had this megawatt smile and said, “Congratulations! It must be SO exciting! I love seeing newly pregnant women when they are buying their first book!”.  Unsure what to say next, I smiled and muttered a thank you and avoided eye contact at all costs.  Was I a fake?… there was a baby inside of me, I just wasn’t sure whether it wanted to stay yet.

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I got home and instead of making dinner I became fully engrossed in the science and miracles behind pregnancy.  The neat part was that this book actually talked about IVF and what stages lined up with the natural cycles etc.  I was legit allowed to read the whole first chapter in ‘preparing’ yourself for pregnancy etc and caught up to seven days after fertilization.  Crunching on a pineapple core I was fascinated by the corresponding pictures and details.  It just seems so crazy that a person can actually just have sex and make a baby- all the moving parts that have to align so perfectly, it baffles me.  Here I am with science doing every single little thing for us, all my body had to do was accept the little guy and let it burrow into my uterine lining.  The more I thought about it, the more I was certain this round was going to work.  My new nightly routine was set- I was going to read where our embryo was in it’s growth each night before bed.

Days four and five post transfer were fairly unexciting.  I continued eating the pineapple core and reading about the development of our embryo.  On day six, everything changed.

The Dreaded Psych Appointment…

After 9 months of fertility and medical testing, then 8 months of active fertility treatments, and an empty wallet & uterus, I was at my breaking point.  It was clearly demonstrated by my constant sobbing for over a week without even knowing if the latest transfer worked.  Our RE essentially told us that we (me!) had to go see the in-house psych doc before starting us on another cycle.

After finding out the bad news yesterday that our FET didn’t work, I was actually feeling a lot better.  Not knowing if it was going to be bad news yet again was the worst part.  Dan and I got ready to head into see the doc.  I really just wanted to wear pjs and not shower… but assuming he would be reading into every aspect of the visit, I dragged by butt up and into the shower.  Trust me… this was an accomplishment.

At the age of 19, I was diagnosed with depression, which was later diagnosed as chronic depression.  This meant that I stay on anti-depressants all the time, forever.  Up until now, I had never had any issues- my mood was great, my appetite better than good, I loved taking part in activities and keeping up with friends.

In the last couple months, I had slowly been transformed back into the me that I didn’t want to remember.  The me where I would much rather curl up in bed and never leave.  The me where some small miniscule thing not going perfect was enough to derail me completely.  Let me paint a picture of how my thought process worked.  I use the simplest of simple of examples: Stubbing my toe.  Now stubbing my toe on a normal, non-fertility time in my life would simply hurt.  Now, there might be a chance of a foot hop with a not so proper swear word, but that would be it.

Stubbing my toe while depressed: Stubbing my toe would turn into me being pissed because I ruined my pedicure… which would make me so upset because the money we were spending on fertility meant that I couldn’t actually get a pedicure… which would make me devastated because I would start counting the money we have spent and focus on the absolutely nothing we had to show for it but bad memories and wasted time… which would devastate me because I would think about all of the physical and mental pain going through fertility cycles… which would push me over the edge because I’m not pregnant and would need to do another cycle to try again…. which was hopeless because with these cycles even the simplest things didn’t go as planned…. oh not going to plan, that pretty much sums up everything that is going on with my life.  Cue me sobbing uncontrollably and staying in bed inconsolable for hours on end…. especially when Dan wasn’t as upset as me.  Doesn’t he get that our lives are ruined and never going to get any better?

You get the point… not pretty.

Well off we go to the psych appointment at the fertility clinic.  I had heard good things about the doctor, however, I wasn’t exactly sure how this was going to work.  I had been to my share of doctors re: depression, however, what did it mean to go to a doctor re: depression when I was already on anti-depressants?

We got called into the back room with this little old man.  He introduced himself and said he’d had an opportunity to talk to our RE regarding our unusually difficult cycles.  He sat us down and started to ask questions.  Me, being me, basically got right down to it.  I told him I know exactly what was wrong.  He stopped and asked me to explain.

I told him I’m a Type-A personality.  I love plans.  In fact, I take extreme pleasure in making to-do lists and short and long term plans.  Oh, and I generally get what I want.  I work my ass off and make sure that my plan works out.  I’m dedicated, passionate, hard working, and love having control.  That would be the issue.  I have zero control of fertility.  Nothing is working how it is supposed to.  The nice little 28-day cycle diagrams on the walls in the clinic didn’t mean anything to me as by day 28, I’d just be getting into the swing of things- not finding out if the cycle was successful or not.  Worse yet, the doctors didn’t even have control!  They had no ideas about what was going on and why I didn’t react to the drugs.

So take a control freak and put them in an incredibly stressful situation where they have no control, at all.  That equaled me.  An emotionally devastated 26 year old woman who could think of nothing else but the feel of an empty uterus.

The doc smiled and we chatted about life- how and where I grew up, school, work, our marriage.  You name it, it was on the list.  At the end of the session he basically said what we already knew- we had a great and supportive marriage, great relationships with family and friends plus lots of support.  However, I wasn’t dealing well with not having control.  He suggested that I already seemed to have recovered well from what our RE had described my emotional state yesterday, and he gave us the go-ahead to move on with a new cycle when we felt we were ready.  This time, however, we’d have to go back and continue to chat with him.

Sounded easy enough to me.  We walked out of the room and through the fertility halls.  I turned to Dan and said, let’s do this.  He wasn’t sure what I meant… I walked up to the IVF nurse and asked her what day I could start another FET cycle.  We had two embryos left.  My plan consisted of us getting pregnant ASAP and get this part of our lives over with.  I wasn’t going to wait.  I didn’t have control about much in this process, however I could have control over my start times.

The good news here was that because my body is so messed, I don’t have cycles.  Because I don’t have cycles, I do random starts.  So against Dan questioning me if I was ready, I booked my first monitoring appointment to get this show on the road.

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Failed cycles behind me, and a new Frozen Embryo Transfer to come.  I’m getting pregnant damn it. :S

Another 2WW (From Hell)

It has officially taken me a month to get around to writing this part of our journey… Not that I haven’t thought about it each one of those days.  I just didn’t feel I had the energy to do it.

The next few months were the lowest of the low for us, and I wasn’t doing very well.  Surrounded by friends and family that loved and supported us, I was stuck in my own head filled with negative thoughts.  The constant disappointments were compounding on top of one another and, regardless of the anti-depressants I was taking, I slipped into another depression.  So… here it goes.

…. 2WW (#3)

Today was the day.  While this Frozen Embryo Transfer (FET) had gone relatively well compared to the other rounds we have done, it still wasn’t ‘easy’ as I had hoped.  I was excited to get into the clinic and have the transfer.  Patience is definitely not one of my strong suits.

On August 15th, Dan and I went in for our transfer.  The transfer itself was actually quite simple and easy.  We arrived at the clinic and they took us back to the procedure area.  I changed into the hospital gown and with an extremely full bladder I lied on the bed.  The ultrasound tech came in to see if my bladder was full enough… I felt like I was about to pee all over the table and she said I was good. (Thank God! Because there was no way I could wait much longer).  I lied in the chair with my legs in the brackets and prayed not to pee on anyone.

The RE popped in and went over the rig-a-ma-roll re: names and the embryo labels etc.  Yes, thank you for putting our own babies back inside of me.  Now that would be bad.  :S

Once ready, the ultrasound tech puts the ultrasound on my belly to guide the catheter that they use to insert the embryos.  With my bladder full, my uterus is pushed down and elongated so they can see exactly what they are doing.  After several measurements, they tell us to watch the monitor and they insert the two embryos.  We can see two white spots ejected from the catheter!  I’m officially pregnant!  If pregnancy is having a living baby inside of you, then I’m pregnant!!

They take a couple of shots on the ultrasound and print them out for us.

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The white solid dot in the pic are our two embryos 🙂

After relaxing on the bed for a minute, I jump up to go to the washroom because by now I can barely even think I have to go so bad!  We take a couple minutes to look at the pictures they gave us and talking about the ‘buddy’ effect they described to us.  One of our embryos wasn’t doing well and most of the cells had arrested, but we hoped that it would assist the other embryo which was very strong implant and attach!

Off I went home to rest in bed for the rest of the day.  We were officially in our new house so I cuddled with our dogs in the bed and Dan went back to work.

After two days of resting, I was back on vacation again.  The one thing that looking back I would have changed from the IVF round was that I was quite active and stressed with work and fertility during the 2WW.  I wanted to try and rid myself of stress so I decided to head back up to the cottage.  I drove back up north and my Mom was up there with two of her long-time friends.

I continued the crazy schedule of 3 vaginal suppositories and 8 estrogen tablets vaginally each day of the 14 days wait.  My body hated the estrogen and I was having every pregnancy symptom there was- my boobs hurt, I was nauseous, etc etc.  Honestly, it’s the evilest thing ever.

I would spend hours laying on the dock in the summer re-reading the same page of my book 30 times as I tried to decipher what each twitch, gas pain, and symptom meant.  I was in a pretty good mood until about 6 days post transfer.

I couldn’t wait any longer- I had to pee on a stick!  In the forums for IVF people talk about what day post transfer they got a BFP (big fat positive) on an at home test.  The earliest that people said they saw it was when the age of the embryo plus days post transfer equaled 10.  The embryos were 4 days old and I waited 6 days… the rationale seemed solid in my mind. Dan tried to convince me not to do it, he said to just be hopeful and wait.  I couldn’t do it.

As soon as I saw the negative result of the test, my life seemed to crash before my eyes.  I knew it then, I wasn’t pregnant.  It was really early to even be testing….  if I was normal, it would still be 4 days before my expected period, but in my head, I knew the magic second line would not appear on my tests.

I essentially cried for the next 4 days at the cottage.  If I wasn’t crying, I was curled up in a ball in bed sleeping.  My Mom tried to continue to encourage me to think positively and talked about the reliability of the tests and the timing.  Dan tried to calm me down over the phone for more hours than I want to imagine… but it didn’t matter.  I wasn’t pregnant and I knew it.

What was wrong with me?  They are literally putting little babies in my f*ing uterus and my body still wouldn’t work.  My entire world was so focused around getting pregnant.  We had spent basically all of our savings at this point, and months of pure emotional and physical hell, and we had absolutely nothing to show for it.

What makes someone a woman?  Because the whole reproductive system that was so eloquently explained to me in grade 5 wasn’t working the way it was supposed to.  I started to look back at our decisions leading up to this… Having a family was just as important to Dan as it was to me, and now he was stuck with me.  Me, the one with the useless body.  Letting me down was one thing, but letting Dan down was a whole different level of misery.

It was now 10 days post transfer and I couldn’t wait a minute later.  10 days plus the 4 day embryos equaled 14 days. This 2ww just got shortened by my creative math.  I drove home in the evening from the cottage and tried to prepare myself for the blood testing the next morning.  The night before going in, I felt this slight sense of hope.  Maybe I was being ‘Nancy Negative’ as my Dad would say… maybe I was all worked up over nothing.  The docs said we had great chances, so why didn’t I believe that?  I was so optimistic going into this round, so what had happened in these last few days?  It was official- I was going to be pregnant tomorrow and we are going to look back on my last couple (not-so-pretty) days and laugh in the future.

August 26:

The next morning we drove in for an early appointment.  I was sitting waiting for my blood work to be done in the glass room and my primary RE happened to walk by and ask how I was.  I hadn’t even had the test yet and I just burst out crying in the waiting room.  I’m not talking a little tear here and there… I mean a full out sob fest and I couldn’t catch my breath to even answer what was wrong.  Dan spoke up and said I was convinced I wasn’t pregnant and hadn’t been doing very well.

We stood me up, walked me to the room to get my blood drawn and then asked to see us in his office.  We wanted me to let him know what was going on.  I really had nothing to tell him that was new.  My body hated me.  This whole process of IUI/IVF had gone nothing but bad, nothing was working, we had virtually no money left, and the thought of having nothing at the end of this was so devastating I couldn’t even put it into words.  He chatted with us for a minute then said that we didn’t have the results yet, so try and stay calm.  However, he felt like it the result was negative, we definitely needed a fertility break to try and regain my sanity.  He also said before starting anything again, he wanted us (read: me) to see the psychiatrist at the clinic.

I, still sobbing, agreed and Dan walked me to the car.  Dan asked when the next appointment was for the psych doc and he had a cancellation the next day.  We took it.

We drove home.  Dan rubbing my leg as he drove, and me sobbing in the passenger seat.

Later on that day, around noon time, we got the call from the clinic.  I answered the phone before one ring even finished.  It was our IVF RN that we had developed a relationship with.  Her last words to me as I walked out of the clinic that morning was that the last woman who came into beta day upset like me turned out to be pregnant.  So try to stay optimistic.

With her first words, I knew.  All she said to me was that I was right… it was negative.  She was sorry.  After that… I’m sure we exchanged a few words, but I don’t remember any.  I just hung up and curled myself into a ball in bed and cried… and cried.  I asked Dan to text our families and a couple close friends who knew we would find out today.  Having to talk to anyone and say out loud that we weren’t pregnant meant it was real.  I wasn’t there yet.

After a couple of hours of Dan holding me while I sobbed, I was suddenly feeling quite calm.  It was like the not knowing part of the last 2 weeks was worse than just knowing that it hadn’t worked.  I felt like I had some closure now and we could start figuring out the next steps.  I couldn’t explain it- I was devastated it hadn’t worked, but I felt like there was a renewed sense of hope that we still had 2 frozen embryos left and there was still a chance!

I spent the rest of day watching movies with Dan on the couch and relaxing… and not knowing what the psych appointment that was booked for the next day would bring.

Frozen Babies

“Frozen Babies” isn’t just an intriguing title I thought up, it is exactly what I’m about to describe.  If anyone told me that Dan and I would now be putting our hopes for a family in tiny 3 days grown embryos (babies) that are frozen in a freezer somewhere in a fertility lab, I think I would have fainted.

However, here we are.

After my negotiated waiting time of six weeks, I was finally starting to feel a little bit like me again.  The massive bloating, aches and pains had subsided after about 3 or so weeks.  My bruises had disappeared.  And perhaps more importantly, my heart had begun to heal.  I was filled with hope again and was looking forward to getting going.

I work long hard hours at my job and had accumulated a whole lot of vacation and comp time.  As Dan had just opened his business, he was unable to take any time off.  He, being the amazing guy I married, encouraged me to take my vacation and go up north, to our family cottage in Muskoka, to take some time to truly relax.  My parents were also on vacation so I could spend some quality family time.  I was loving my time up north and was spending my days reading a book on the dock in the sun.   On July 26th, I drove the 3.25 hours home for our long awaited fertility check up. 

I did my blood work and transvaginal ultrasound, and patiently waited for the results.  Our RE indicated that if my hormone levels had not settled or my lining was still thick, we would have to continue to wait.  Our RE popped in with a smile.  He said my tests were back to normal and we had the green light to get started.

Today was officially Cycle Day 1.  He called in a nurse to explain how a Frozen Embryo Transfer worked.  This was all new to me.  She gave me the good news- Frozen Embryo Transfers, or FET, were generally like a fertility holiday compared to the pain and procedures needed to do a fresh cycle of IVF. 

This time, we already had the eggs that were previously extracted.  They had already been fertilized and made it through 3 days of growth. It was at this point when the lab took them and cytogenetically froze the living embryos.  The fertility community calls these various things, my two favourite are ‘frosties’ or ‘popsicles’.  

I don’t really know how to morally explain what I think about this… The easy answer is that it’s easy to judge this when you aren’t backed into a corner.  I would have loved to have had an opinion before on FET just to compare it with now- but frankly, I’d never heard of it!  Now, this was our only shot.  The end result, however, was that we felt comfortable going ahead with this process as the other option would have been to grow all the embryos, select the best two, then let the rest die.  Embryos can only live outside of the body for a short period of time. 

So, we had the babies ready to transfer.  We just had to build my uterus to get nice and thick.  I needed to trick my body into thinking I was in the middle of a ‘normal’ cycle so that my body created a welcoming environment for the embryos. 

The first stop was to the cash register and we had to pay the clinic prior to going ahead with the treatment.  Cha-ching $$!  I can’t recall exactly, however I believe the cost of the actual procedure wasn’t that bad, somewhere around $1500.

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Next was a trip to the pharmacy in the clinic to buy medication ($$$!).  In order to get my body to start to build a thick cushion for an embryo to stick to, I needed to start taking Estrogen supplements.  These were little blue pills (not THOSE little blue pills!). 

The deal was that I was to take one pill in the morning, and one at night for 10 days (total 4mg a day).  Then, on CD 10, I would come back to the clinic to check on my uterine lining.  The goal was to get it over 8mm but no more than 14mm.  I was sitting around 4 mm and had a bit to go.  The hope was by CD 10 my lining was thick and we could do the transfer 2 days later. 

I didn’t have to come back to the clinic for 10 days?  Hell, this WAS vacation.  I could do it.  So I went down to Pita Pit to visit Dan and his new store, had lunch, then drove the 3.25 hours back to the cottage.  I spent the next 10 days taking my pills as required and enjoying the sunshine and family time at the cottage.  My Dad knowing how much I hate driving, offered to drive me down and back for my CD 10 appointment.  The only issue was that the appointment was for 8am.  So off we left at 4:30 am to make the 8am appointment. 

CD 10: Blood work and Transvaginal Ultrasound.

I waited on the results in the clinical room while my dad slept in the car.  The idea of joining his daughter in the clinic for an appointment to try and get pregnant perhaps was where the line was drawn.  My Dad and I are very close, but discussing transvaginal ultrasounds perhaps was a bit too close.

The RE walked in with bad news.  My lining had not grown, at all.  I was on a low dose, however many patients react to only 2 mg of estrace (estrogen).  I was on 4.  She upped my dose from 4mg to 8mg daily.  Now 2 pills in the morning, 2 pills at night.  I had to come back in 2 days.

Upset that the ‘easy’ part of this treatment was, yet again, not so easy for me, I walked back to the car to tell my dad the bad news.  I was so hopeful and excited about this round.  It was going to be easy and quick… and successful.  This was not the start we planned.

We hopped back in the car and drove back to the cottage.  By noon, we were back at the cottage and I was trying to forget that my stupid body that hated me.  It wasn’t so easy.  My hope and excitement quickly turned to dread and worries.  Was this going be as bad as the other rounds?  Quite frankly, the ups and downs of hope then disappointment when my body refused to cooperate were untenable. 

CD12: Another 3.25 hours drive leaving the house at 4:30am to make the 8am appointment.  Blood Work and Transvaginal ultrasound.

More bad news… My lining has grown, but hardly.  I was at 4mm and needed to progress to at least 8mm.  I was now at 4.5mm.  Greattt.

The RE then decided we were going to get aggressive.  She knew my story of extremely long cycles with no luck from previously and wanted to try to get my body ready asap.  I think my defeated face when she told me the 4.5mm also helped.

She was now doubling my dose.  I was on 2 pills in the morning and at night for 8mg daily.  Now I was up to 4 in the morning and 4 at night (16mg daily… aka a LOT!).  The second change was that instead of taking them orally, I was to insert them vaginally.  She said this was a better way to absorb them and would hopefully kick start everything.

I walked down to the pharmacy and purchased more meds then hopped back in the car for another 3.25 hour trip back up north.  We were back up north by noon and I was already trying to forget fertility.  It didn’t work. 

The idea of inserting these pills vaginally was a new one for me… uhhhh, ok.  Like do I literally just shove them up there?  The answer was yes.  But the best part was they are blue… and so from this point forward, everything was blue.  Trust me, it gives you a jolt when you urinate blue… Wonderful- I’m now a smurf.  A non-pregnant smurf.

My vacation was ending and on CD 14 I drove home to the clinic for another appointment. 

CD 14: Blood Work and Transvaginal Ultrasound

It worked!  My lining was now up to 8mm and we were cooking with gas!  We were ready to go.  The nurse came in to explain the rest.  She explained that tomorrow the lab would choose two of the four remaining embryos and thaw them.  Thawing embryos was not an exact science so we just had to hope.  There was a very good chance that one or both may not survive the thawing.  The clinic would call us once thawed and let us know how it went.  If one died, we could always select another one to thaw out as we did have 4 left. 

Additionally, I was now to start giving myself progesterone suppositories to mimic the progesterone that is normally released by a bursting follicle.  These suppositories were three times daily… vaginally.  Then the fun part, the nurse explained that we had to have at least 2 hours between when I inserted the estrogen and the progesterone so they would both absorb.  Superb… a party in my pants!

My new schedule:

8am – Progesterone Suppository (white chalky pill)

11am – 4 estrogen tablets (little blue pills)

3pm – Progesterone Suppository

8pm – 4 Estrogen Tablets

10pm – Progesterone Suppository

Wonderful… I literally had to set alarms on my cell phone and spent the majority of my day running to the washroom with my purse.  Furthermore, the estrogen was now taking full effect on my body.  My levels had sky rocketed and everything now ached.  Even lightly brushing my body felt like you were stabbing me with knives.  I couldn’t sleep because of the aches and pains.  Not to mention, welcome back emotional hell!

CD 15: The lab called with the news.  One embryo survived the thaw perfectly.  It was now growing in an incubator and was doing great.  The bad news was that our other embryo that was a 12 cell previously, was not doing well.  10 of the 12 cells had arrested during the thaw and we only had 2 left.  The chances of this embryo implanting (and getting me pregnant) were very unlikely. 

Hearing this news I started to cry.  Can nothing just go as it should?  Why does everything have to have some bad news component to it?  This also meant very hard decisions.  The clinic explained that they would still recommend transferring both embryos tomorrow- there was something called a ‘buddy’ effect and the second embryo might assist the healthy one in implanting.  The other option however, was to let this one arrest (die) and try and thaw out another one from our remaining two.  There was no guarantee that the new one would survive, and that would mean we’d only have one embryo left in case this round of FET didn’t work.

How do you make these impossible decisions?  We decided to hedge our bets with the one healthy ‘frostie’ and one not so great ‘frostie’.  Now we wait for tomorrow to do the transfer. 

This could be it… we are getting pregnant!

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Our WTF Appointment

I believe the official medical terminology for this type of appointment is called a ‘follow-up’.  However, the fertility community endearingly refers to the appointment right after a failed IVF cycle as a WTF appointment.  For good reason.

Dan and I, after over 2.5 months of one IVF cycle, just got the devastating news that we aren’t pregnant.  It didn’t work.

After the initial shock of the phone call, I started into a cycle of complete disbelief.  I really really thought this one would work.  We did everything right.  I obeyed every recommendation of the doctors.  We endured physical and emotional hell… it was supposed to work.  We had fabulous embryos.  They were perfect quality.  They were doing great.  There was TWO of them… double the chance of success.  My lining was thick.  I took every suppository at the exact correct timing- several times a day.  I didn’t drink caffeine, didn’t drink alcohol, didn’t smoke, tried my best to stay stress free.  Did I go back to work too soon?  Was I under too much stress because of the move?  Did the stress from the terrible egg retrieval cause something not to work?  We must have done something wrong, right?

We had our wtf appointment just 3 days after we found out the bad news.  I walked into the appointment with so many questions-  I have actually typed out the list as it’s impossible to remember everything once you sit down. Our RE wasn’t surprised at my typed list and with a half smile said, “Ok Adele, what have you got?”.

The easiest question was what went wrong?  This was also the hardest answer.  The RE explained that we could track and evaluate everything throughout the entire process until you actually put the embryos into my body.  After that, we can only hope and guess.  He said there could have been a problem with the embryos, there could have been a problem with my lining, my body may have just rejected them for unknown reasons… or maybe there was nothing wrong at all and it was just terrible luck.

After all the money we spent and all the degrees behind his name, the best answer we could get was… ‘well, we don’t know.’  REALLY?

All of my list of questions went out the window.  The answer to basically all of them was ‘I don’t know’.  Our doc told us there was no medical reason why were currently weren’t pregnant.  Even though we had numerous issues throughout the process, none of the them should have affected the final outcome.

Greaaaat.  So what now?

The first thing the doc told us was that my body desperately needed a break.  After over 6 months of injecting incredible amounts of medications into my body, it had had enough.  We needed a break.  The RE suggested we give it 8 weeks to get all of the chemicals etc out of my body.  I’m not the best at waiting so I suggested a counter offer of 4 weeks.  He laughed at me and shook his head- apparently patients don’t generally bargain with their doctors.  The final word was he would meet me in the middle at 6 weeks.  However, the deal was that I would have to come in at 6 weeks and have my blood work and a transvaginal ultrasound done.  If everything was back to where my baseline numbers should be, then he would give the okay to get going again.

But what did get going again mean?

We were about to go into a new round of treatment, again.  This time it is called a “Frozen Embryo Transfer” (FET).  The theory here was that we were able to extract 6 good eggs and fertilize them.  We grew all six embryos for 3 days then implanted the two fresh embryos into me.  However, we still had 4 embryos left.  We opted to freeze the other four.  We were now going to thaw out another two embryos, and hope they survive the thaw.  If they did, then we’d implant them into me again.

Now, just wait six weeks and pray my body goes back to normal.  … six weeks….  A long time when you want to be pregnant yesterday.  However, it was also six weeks for us to try and save up what money we could for further treatments.  Patience… not my strong suit.

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My life in a nut shell.