June 2, 2010

Still numb

Posted in Infertility tagged , at 9:45 am by lifebytheday

Back from a nice long weekend, but unfortunately, reality didn’t disappear while we were away.

Yesterday, S and I met with Dr. T to talk about next steps.  To be completely honest, I wasn’t – and still am not – emotionally ready for another cycle, but my cycles are so long (between the BC pills, Lupron, and my seesaw response) that I feel like I need to keep the ball rolling.  S and I have agreed to do one more cycle, and if that doesn’t work, we’ll need to think seriously and carefully about a Plan B. 

It may sound like I’m okay with that, but really, a little piece of me dies every time I have to acknowledge that we might not ever have biological children.  Which, instead of making this easier and better as time goes by, instead is making me feel more and more dead inside.

We asked Dr. T if there were any other tests we could or should do to figure out if my eggs are the problem (he said no), and whether he thinks that the seesawing of the medication caused the embryo quality issues (again no).  He said that my up and down E2 levels reflect the little follies trying to grow and being suppressed, not the lead follicles growing and stopping – which makes sense.

Aside from the fact that we obviously didn’t get pregnant, he thinks that the cycle went well – implied, “as well as can be expected with my issues.”  He reminded us that I am so far outside the norm that I can’t compare myself to anyone else, but thinks that it isn’t unreasonable for us to try one more time. 

We pushed him a little to suggest what we should do if this cycle doesn’t work – to which he replied that we should take it one cycle at a time – but he also agreed that we should start to discuss and consider a plan B because of the higher-than-normal risks and lower-than-normal potential with each cycle. 

He confirmed that we should be looking at egg donation over surrogacy, since my response is so tenuous and we’ve not ever had perfect quality embryos – and obviously have never been pregnant – but there’s not (yet) any evidence to suggest that I can not carry a child.  He also mentioned adoption and other experimental therapies, as additional options down the road.

He also strongly suggested that we talk to a therapist that specializes in infertility.  I’ve seen someone before (not a specialist) and was disappointed, but I know that this is something I need to do.  I’m really floundering, and am hoping that I can find someone to help me process my thoughts and emotions.  S has a hard time accepting that he can’t be everything that I need, and it’s hard for me to explain.  I know that he is always there for me, but I just don’t want to end up being the weak link in our marriage.

I just never thought this would be me – that 4 years and 4 IVF cycles into treatments – that we would still be without a family.  I never thought that this blog would turn so depressing – I even used to try and avoid blogs like mine is now, so that I could try and stay positive while going through treatments.  So for those of you still hanging around, reading my depressing thoughts, I’m sorry. 

I even purposely named my blog something non-IF related, so that it would still be relevant when I was pregnant and parenting down the road.  Now, those things might never happen, and I just don’t know how to move forward from here…

January 31, 2010

The light at the end of the tunnel

Posted in IVF tagged , at 11:35 am by lifebytheday

First of all, thank you all SO much for the warm thoughts and kind words…I feel so very lucky in my group of friends.  You all seemed to know exactly what I wanted to hear…even when I didn’t know that myself.  Although I’m still sad and disappointed, things are starting to look up.

On Friday evening, while S and I were sitting around watching tv, I got a call from my RE…you know, the one I hadn’t heard from my entire cycle?  I had called earlier in the afternoon to make a follow up appointment and was told that his earliest available appointment was on March 4th.  Sorry, not acceptable.  So then I asked to be transferred so that I could leave a message for him (I knew that he was away last week) and was told that patients weren’t allowed to leave messages for the doctors, but that I could leave a message with his nurse.  I was flabbergasted.  “So you’re telling me that I’m not allowed to leave a message for MY OWN doctor?”  Apparently not.  So once I got past that, I was transferred to the nurse’s line and left a very stern message asking for a return call from Dr. T.  45 mins later, I got a call from the nurse telling me that he’d be calling and to leave my cell on.   

Four hours later, around 8pm, I got a call.  Dr. T had wanted to wait until he knew neither of us would be interrupted so that we could talk as much as we needed, for which I was surprised and extremely grateful.  I put him on speaker so that S could hear, and we talked for almost 20 minutes.  Some of the key takeaways:

  • I am an extremely severe case, and will require careful monitoring and likely constant tweaks to the meds (and will always be at risk for cancelation, due to my extreme response)
  • He was very concerned to hear how early in the cycle I had been feeling pain and bloating, and implied that a cancelation would have been likely even without the false ovulation
  • He doesn’t think that we need to take a break, and actually told me to keep taking the Lupron to get my ovaries suppressed more quickly, so that we can jump right back into the BC pills (and hopefully not have to be on them as long)
  • I’m to track how I feel (bloating-wise) and call next week with a report, and also to call if and when I get my period.  If it hasn’t arrived within the next 7-10 days, he’ll likely induce it.
  • He’s going to closely review my past three stim cycles with his team, and will consider starting me on a lower dose of Gonal-F, and perhaps only Gonal-F and no Repronex.  Not using Repronex might cause the same quality issues that we dealt with my first two cycles, so that’s also a consideration.

I also expressed my concerns with how my care had been managed – i.e. as a team, but without any one person who seemed to know the whole picture.  I told him that I obviously didn’t begrudge him time out of the office, but that each morning, I felt like I had to remind the RE(s) on call about the severity of my situation, and answer questions they should have known.  This was really hard for me to do – I don’t like to rock the boat (and don’t want to be known as “that girl” amongst the staff) – but I spoke up for the sake of our future children, and for other women who might not have the confidence to do so.  Dr. T made it clear that his team works very closely together and claimed that everybody had been aware of my situation, but apologized and said that they’d do better next time…that if I wasn’t happy, then they hadn’t done their job.  I know there was more than a little feather-smoothing going on there, but I appreciated the sentiment.

The other really interesting thing that came out of our conversation was a Plan C, that Dr T wanted to make sure we knew he was keeping in his pocket.  Apparently there is a program at McGill University (in Canada) – the only one of its kind in the world – for people (like me) with severe PCOS.  They actually harvest the eggs before maturity – using NO stim meds – and then mature the eggs OUTSIDE of the body.  Then the rest of the IVF procedure continues as normal.  Apparently they have had some great success rates, and Dr. T wanted us to know that might be an option down the road.  Strangely, S felt really encouraged by knowing that this option was available, but all I could hear when he was telling us was…$ $ $ $ $ $ $…I mean, only program in the world, outside of U.S…? 

In any case, Dr. T told us that we absolutely shouldn’t give up, that as a 27 year old woman, we have plenty of time and options available to us.  Usually that pisses me off more than anything else, but this time I really took it to heart.  After realizing that we were officially entering the “over 3 IVF cycles club” I forced myself to think about whether we should change our plans going forward, maybe consider adoption or something else.  After much thought and prayer, I realized that I’m just not there yet…more than anything, I want to have that little girl who wraps S around her little finger and reminds him of the woman he fell in love with, or that little boy that I see in S when he’s being silly or grouchy.  I want to have that feeling that my mother has told me about since I was a child, the feeling of love unlike any other, for a person that is a combination of you and your partner in life and love.  I absolutely don’t judge anyone who does adopt, in fact, I think they’re probably stronger than me, but at this point in my life, I’m still craving my biological child. 

So for now, I’m trying to stay upbeat and focus on the positives in the situation.  If this cycle wasn’t meant to be, at least we found out a month earlier than if we went all the way through to transfer and 2WW, and got a negative anyways.  I have to admit though, my prayers have gotten a bit desperate.  “Please God, don’t tell me that biological children aren’t part of your plan for us…”