I know you’re probably not a fan, but…

There’s a section in the Twilight series books that is actually pretty profound (I’m hoping I didn’t just lose all credibility there.). For each new chapter as you turn the page, you see one word: the month that is passing/has passed on an otherwise blank page. So as you turn the page, all you see is – for lack of a better description – the character shutting down; shutting out the world. Silence.

It evokes a strange, muted response in the reader; to turn page after page and see only that. A sense of being alone, like one would be in the country on a gray, snowy day, where even the birds make no sound. And even if they did, the thick blanket of snow on land and tree would absorb and drown out any such insolence.

For a long time after my last post, this was my world.

 

June.

 

July.

 

August.

 

September.

 

October.

 

Until here we are, a little over one year later.

I lost that pregnancy on a rainy day in the ER. My follow up appointment with Dr. Albrecht and subsequent ultrasound showed an empty uterus. It was eventually made worse a few weeks later when we heard my stepson’s bio mom was pregnant and had been given my exact due date in January. They currently have a 5-month old little girl. I’d like to say bio mom was mature and didn’t flaunt the pregnancy or birth; however, I can’t because she wasn’t. It was not an easy go of things.

But time moves on and wounds heal. Though the scars are certainly within me, I’m no longer as lost as I was after this last miscarriage. And with healing comes hope. With hope comes looking ahead once more. Making plans. This time for my favorite month and my husband’s favorite number: September 13.

More to come.

An Unplanned Ultrasound

Well this was unexpected. And not very welcome.

The night before last, I was sitting on the couch when I decided to get a drink. I stood up, and as I did, I felt a warm gush between my legs; almost like a “pop” of fluid. Since I had just inserted Crinone, I was assuming that a blob of it had fallen out (hey, maybe I didn’t get it high enough “in there.”). I reached a hand down to investigate and, when I looked, saw that it was covered in bright red blood. I stood there for a long moment – I don’t know exactly how long – unable to move or form any sound. In my mind was a constant stream of, “no no no no no no no no…”

Once I snapped out of my little chant, my next thought was, “ARE YOU FUCKING KIDDING ME RIGHT NOW?? This can’t be real. This isn’t real.” I wasn’t cramping at all, which was fueling my utter disbelief. However, after some more inspection, it looked as though the gush was still going and was still quite real. I immediately called my husband, who was on his way home from work. (Side note…I feel bad in retrospect; he answered and all I could blurt out between sobs was, “I’M BLEEDING. A FUCKING LOT. COME GET ME.” Talk about scaring the everloving shit out of one’s spouse…) I grabbed my purse for the insurance card and ID in my wallet, and went out into the rain still dressed in pj’s and my house slippers. Hubby was about 10 minutes away, and soon picked me up in front of our house. I called Dr. Albrecht on the way to the hospital, still sobbing, and explained what was going on. He told me to just get there and have the ER doc call him. It was then that the cramps really hit me hard, and I started crying even harder. After all, isn’t it general knowledge that cramping and bright red blood = bad mojo?

I won’t go into all of the details of our 5 hour ER visit, as a good portion of the time was spent alternately crying, staring at the clock, and squeezing the crap out of my hub’s hand when the pain got really bad. About half way into all of this, they finally gave me morphine (Oh, blessed Morphine!). By the way – just as an aside – you know in war movies where a hurt soldier is given morphine and he immediately subsides into a blissful, pain-free silence? Yeah…movie makers fucking LIE. It took a good hour for it to kick in (during which time I endured a 15-minute transvaginal and a 10-minute abdominal ultrasound; the ladies will know the hell inherent in that sentence.), but once it did, I was happy enough. The tech wouldn’t give me any information about what he saw, but Hubs was able to sneak a peak at the screen. He said he saw my gestational sac and something inside it (HAPPY DANCE).

Later in the night and after speaking with Dr. Albrecht, the ER doc came in to give us the news. I am currently still pregnant. My hcg was a little over 5,000, and a gestational sac and yolk sac were present on the ultrasound. As I am only 5 1/2 weeks, that’s all we would expect to see on u/s this early. Aaaand then she kept talking. Turns out I also had a 2.5 cm subchorionic hemorrhage bleeding out. This is a hematoma (pooled blood) that builds up between the uterine lining and where the placenta has attached. From what I understand, they are fairly common in women who have had IVF. I’ve also been told that cramping is normal with a SCH, as the pooled blood/clot will irritate the uterus.

There are a couple of resources helping me through this:

  • This BabyCenter SCH FAQ and Support Group
  • Also on BabyCenter, this massive listing of stories from women who have had a SCH and gone on to have a healthy pregnancy
  • A couple of ladies from my Reprofit and Reproductive Immunology Facebook groups who have been through this

And these are screenies of my ultrasounds. On Monday, I was dated at 5w2d, which is right on track for my dates. Pictured are the SCH, gestational sac, and yolk sac (*doing a little cheer because Bean is still in there*):

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I’m stubbornly considering this another bracket win because 1) my baby is still there, and 2) last time there was no yolk sac; present here!

I have an appointment with Dr. Albrecht tomorrow afternoon for a follow up scan. I haven’t had any more bleeding since Monday night; only brown/dark red spotting. I have had cramping, though. I’ve been told this is also normal after a SCH bleed. I’ve been on bed rest for the last couple of days, and tomorrow will be a half day at work. Dr. A did say on Monday night that I can continue all my normal activities right now, but I’ve felt a lot more comfortable taking some time to put my feet up. There is still a chance I could miscarry, but I’m holding out all hope that we will get through this and Bean will keep growing. If any of you out there are of the praying persuasion (or fairy dust sprinklers or fire dancers), I could definitely use some prayers/good vibes sent my way.

I think the scariest part for me right now is not knowing from the above scans where Bean attached, and what percentage of area the SCH is taking up. I’ll hopefully have more answers tomorrow.

In the meantime, it’s time to sleep.

 

 

 

 

 

So far so good

Other women have told me that the anxiety over one’s pregnancy doesn’t really go away until the baby is actually in one’s arms. So far, that has proven true, but at least it does lessen a bit.

My RE’s office is perfectly happy with my hcg numbers so far:

  • 6dp5dt: 26
  • 8dp5dt: 81 (doubling time: 29 hrs)
  • 10dp5dt: 134 (doubling time: 66 hrs, but I hit the 1.6 mark: see below)
  • 13dp5dt: 513 (doubling time: 37 hrs)

If you’re going through something similar, and you’re a search engine freak like me, you can check your hcg doubling time here. To note, my RE told me that they like to see hcg go up by 1.6 every 48 hours; that’s the textbook increase. When asked, he said that the “double every 48 hours” thing came from OB/GYNs and patients just rounding up to 2 from 1.6. So if you’re numbers don’t double exactly, but they hit the 1.6 mark (like mine did from 8-10dpt), you’re still in the green. The nurse at my RE’s office offered to give me one more blood test for hcg; I had to decline with a hard “noooooo” in order to keep my anxiety in check. Let me rest in a happy place for a little bit.

Progesterone in my blood is on the lower end (8 – 9), but that is to be expected – and is normal – since I’m on Crinone (Crinone delivers progesterone right to the source – the uterus – instead of traveling through the blood). Estrogen has been a consistent >200, which is good. Fun fact to note: my nurse told me that with donor cycles, once the ovaries detect hcg, they kind of “wake up” and start creating a corpus luteal cyst that will create progesterone until the placenta takes over. Normally, a corpus luteum is left after ovulation, but since donor recipients don’t ovulate, we get a late bloomer. How flippin’ cool is that?!?!

The next step now is an ultrasound at 8 weeks to get a look at my little guy or gal (I’m convinced it’s a gal). For now, I’ve emailed Eva with my numbers to confirm pregnancy; I’ll email her again when a heartbeat is confirmed, as they use this information in their stats reporting on DE IVF. They’ve also emailed me with a freeze report; after I left, they were able to freeze 1 x grade 1 hatching blast and 3 x grade 2 hatching blasts. We have FOUR frosty embabies! As I mentioned in a previous post, I’m SO glad we went with PICSI instead of ICSI this cycle.

So…I’ve made it past the first few brackets (a good friend likened the first trimester to a Final Four-style bracket. LOL. It fits…don’t focus too much on what’s in the future; focus on the step/game immediately in front of you. When you win that one, celebrate! Then move on to the next.), and I just want to celebrate this victory! 🙂

And the results are…

There is a Jewish prayer we say upon learning of a pregnancy. It includes the lines, “We tremble with fear and joy. Deep inside me a seed is growing. I am afraid, and I am filled with ecstasy.”

6dp5dt

I couldn’t say it better if I tried. The prayer captures exactly the dueling sentiments that come with the territory of multiple pregnancy failures and years of infertility. This emotional dichotomy seems unavoidable, however, given my history. I am so happy to see that at least one of the embryos took, and has implanted into my womb. I am also terrified of knowing how this will progress. Chemical? Another blighted ovum? A healthy pregnancy? There’s no knowing, no crystal ball to alleviate my anxiety. The most I can do is pray, take the day moment by moment, and – with my husband by my side – plunge into the next few weeks to see where time will lead us.

For now, I’ll just be saying this over and over….

I am pregnant.

Nothing bad has happened today.

Focus on the present, and leave the future alone.

[Partner’s together:] We stand breathless before the Power of Creation that works through us to bring forth new life. We tremble with fear and joy.

[Pregnant Woman:] Deep inside me a seed is growing. I am afraid, and I am filled with ecstasy.

[Partners together:] May this promise of life come to be – our child. We trust in the source of life, this power which grips us within and yet transcends us. Protect this fragile new beginning. May we find love and strength to nurture this gift of fertility and life. Sheltered under wings of love, may we grow to be partners with the source of life in the miracle of creation.

 – Rabbi Sandy Eisenberg Sasso

Transfer Complete

I remember watching an interview once, in which Tori Amos mentioned that being pregnant is feeling like your body is an ecosystem.

It took a couple of hours after transfer this time to feel it, but I know what she means; even if I am not “officially” pregnant. I walked out of the Reprofit clinic feeling normal – if not a little sore in the bits – and wanting to grab a bite to eat. I hopped on the tram, then walked around a bit, and settled on a 2nd floor restaurant near my hotel called Padowitz (the gulas there is AMAZING, btw.). After eating, I padded around the streets a bit more before heading back to the Grandhotel Brno where, as I was walking up the steps, the feeling hit me that I had some precious cargo on board. My body, for the moment, was not just me. I was providing a safe haven for two fragile, microscopic embryos that may or may not decide they like me, fully attach, and continue to grow into little humans. It’s an odd feeling.

But I should start at the beginning. Flying in to Prague on Sunday was almost like flying in to home after being away for a while. The feeling of recognition and giddy excitement to smell the air and hear the language was really quite overwhelming. I landed at about 3:15 and immediately caught the bus to the subway lines. **Note: I’ll have to update my “Czech Transportation” post, but there has been construction/addition to the green line. Instead of taking Bus 119 to Dejvická, Bus 119 now takes you to Nádraží Veleslavín, which is the new transfer point from the airport bus to the green line. All else is the same: transfer from the green line to red at Muzeum, and exit at Hlavní Nádraží to catch the train to Brno. (See below)

Prague Subway

I got in to Brno around 7pm local time and checked into the Grand. After food and a shower, I passed out until the next morning. As a side note, at the Tesco next to the Grand, you can get wonderful, relaxing Czech herbal bath salts by the name of  Tetesept. They come in a variety of formulas; for muscle aches, relaxation, cold relief, detox, and many more. Dump a packet into a tub of hot water, and you’re in for some soaking bliss. I still haven’t found anything like them in the States, so I’ve made sure to stock up when I’m here. Anyway, after a jelly feeling-inducing bath, I made my way to the clinic.

Everyone was as nice as I remembered them, and the clinic just as bright and clean. I checked in and had a seat while waiting for Dr. Hana (LOVE her!). While waiting, I also presented Eva with a box of Cheez-Its I had brought from America. She loves the crispy snack, but they don’t have them here in Czech. If you go to Reprofit, and want to make a woman happy, bring her a big box of Cheez-Its. Lol.

Once in with Dr. Hana, we went over my embryo report. I had received an email on day 3 of embryo cultivation, letting me know that out of 10 eggs, 7 fertilized. I had 3 x 8-cell embryos, 2 x 7-cell embryos, and 2 x 6-cell embryos. On transfer day – day 5 of embryo cultivation, Dr. Hana let me know I had 1 x grade 1 expanding blastocyst, 1 x grade 1 blastocyst, 1 x grade 2 blastocyst, 2 x compact morulas, 1 x morula, and 1 x 8-cell. That last embryo was considered as arrested development; I would have transferred the two grade 1 embryos, and they would wait to check on development on day 6 to see if any of the other embryos will be good enough to freeze for a possible future FET (frozen embryo transfer). I also received a report (personal info removed) and an information sheet:

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And for the main stars of this show? At the top is an expanding blastocyst; the mass of cells in the center (called the Inner Cell Mass, or ICM) will (hopefully!) become the fetus, and the cells along the outer rim (called the trophectoderm or TE) will become the placenta. You can see the clear layer around the embryo; that is a thinning zona pelucida (protective layer/shell around the embryo…it thins out just before the embryo is ready to “hatch.”). The bottom embryo is a blastocyst; it is in the very early stages of beginning to expand – the ZP is still quite thick – but you can see the beginnings of separation into an ICM, TE, and a fluid-filled blastocoele cavity. I found the Advanced Fertility website very helpful in reading about my blasts.

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After transfer, as mentioned above, I sought out some food and walked a small bit before heading back to my room. I started some mild cramping a few hours after transfer, but like the ladies on the Reprofit Facebook page said, I’d just had my bits poked and prodded…cramping was to be expected. At that point, still exhausted from travel and time change – with a belly full of yummy food – I took to my bed and stayed there for a good long time. Sleep, then reading, then sleeping again, for the most part of 24 hours. It felt very good to laze around and rest! Though today I did get outside to walk around for about an hour, in order to get my blood flowing. I must say, this is MUCH better than my previous two trips here. Those times, I was up and walking/traveling only a couple of hours after transfer. It’s quite nice to kick back and relax while the babycakes (as my stepson calls them) settle themselves.

Aaaand……it’s a waiting game. I am currently 1dp5dt (one day past 5-day transfer). For my first DE IVF, I had exactly enough patience to make it to 4dp5dt (mostly because I absolutely knew that any test before that would have very much been negative). Even then, it was a real squinter and didn’t show properly until 5dp5dt. We’ll see how long I last this time. 🙂

So for now, I bid you adieu, and will update with more as it comes to me.

Plans in motion

“A dream you dream alone is only a dream. A dream you dream together is reality.”

– John Lennon

I just have to mention how much I love my husband, and how thankful I am for him. Through this whole long, sucky struggle with infertility, he has been by my side. Holding my hand, crying with me, experiencing the roller coaster ride with me. I couldn’t have asked for a better partner in this. I know infertility can break couples apart, but I truly feel it has brought us closer together.

Okay, sappy ode-to-my-love aside…when we decided to go back for a second round of DE IVF, we put the process into motion quickly. It didn’t take much to liquidate a portion of our retirement through TIAA Cref (a phone call and some papers to sign), and the funds were transferred to us within a few days. Based on where I am in my cycle, and because my husband’s work schedule is going into overdrive in mid-April, we will be traveling to Brno separately. It’s definitely not ideal, but as he said, we’re going for a reason; this is technically a business trip.

Travel

I picked up our tickets through Justfly, as they have consistently given the lowest prices I’ve seen vs. other travel sites (Expedia, Kayak, Priceline, etc.). I also decided to fly Aer Lingus this trip instead of Lufthansa. DH and I have always wanted to go to Ireland, so I scheduled a 22-hour layover in Dublin for both of us. We’ll both get to spend the night there, and see the city before flying back to the US in the early evening. It’s not the long trip we want (and will eventually take), but it will be amazing to walk around Dublin even for a day.

DH will be in Brno from Apr 9-13 to give a sperm sample at the clinic for freezing (and use to fertilize our eggs). He’s planning on spending a day or two in either Vienna or Prague again, as well. Our first trip there was 1) the first time he’d been to Europe and 2) the first time he had ever been in one of the huge, grand art museums. He’s excited to walk through again! (Not even kidding…he started packing his backpack a few days ago! Looked like a kid in a candy store…bless. 🙂 )

I will be flying out Apr 24-29, with the plan to explore a bit, as well. I also have already scheduled a 90-minute IVF relaxation massage with Henry J. Bartonek. He’s well-known among Brno’s international infertility patients, and for good reason. First, the massage is only 800 CZK, which equates to about $33 USD. Second, it’s just amazing. I walked out of my massage feeling open and airy, without a care in the world. I felt like puddy. Basically, like I had just smoked a bunch of weed. I highly recommend.

As for hotel, I’ve cut out the hotel for us in Prague since we know our way around a bit better; arriving early and taking a train (which I’ve already booked online) straight from Prague to Brno will save us a little over $400 in hotel expenses. I’ve booked the Grandhotel Brno again because we both love the location (across the street from the train station…SO convenient for later arrival into Brno).

I’ve done something a little different for travel with electronics this time. DH and I lugged a laptop over the last couple of times, and it was 1) heavy and 2) a giant pain in the ass with airport security. So I picked up a folding bluetooth keyboard with a smartphone/tablet stand to pair with our phones or iPad, and an Anker Power Bank with ancillary cords. The folding keyboard means our mini-computer (who are we kidding, that’s what phones/iPads/tablets are these days) can be easily stashed in a purse or the front of a backpack for easy access. The power bank allows us to recharge our devices up to 6-7 times before the bank itself needs to be recharged. Games on the plane, y’all!

 

Medical

I had a consult with my stateside RE yesterday, and I feel the need to reiterate how amazing Albrecht Women’s Care is if you’re in the Denver area. Still under the fog of having to fight for every step with doctors in infertility, I walked in with my plan from Eva, ready to push hard, lie, beg, etc. to get kitchen sink-type treatment. Totally not necessary. Dr. Albrecht took my plan from Reprofit and tweaked it to make sure it suited my particular case specifically. I felt SO very taken care of, and it almost made me cry! He laid out a plan for me, answered questions, and even did an endometrial biopsy/scratch while I was there (and the timing was right) so I didn’t have to come in again today or Monday. This is what he set up for me:

  • CD 19 of current cylce: Endometrial biopsy
  • CD 21 of current cycle: Microdose Lupron 10 units daily (for suppression)
  • CD 1 (first day of full flow): Start Estrogen 2 mg tabs (am/lunch/pm for a total of 6 mg daily); 5 mg Prednisone daily (for immune issues); Lupron goes down to 5 units daily
  • Sometime during the first week of my cycle: Intralipid infusion (for immune issues. Also see Care Fertility for more information.)
  • CD 13: Lining check
  • CD 15: Start Crinone 8% (am and pm); Start Heparin 5,000 units (am and pm); Stop taking Lupron; Start 5 days of Doxycycline (antibiotic) for prevention of uterine infection during transfer. ***For the progesterone, the clinic recommended starting with the lining check on CD 12-13, but Dr. Albrecht wanted me to start so that I would have 5 days of progesterone on the day of transfer. He said there’s a specific window for the endometrium to be receptive to implantation, and he didn’t want to blow it. He said an embryo can chill in the uterus for a day or two to wait for the lining to be “right,” but the receptive lining will not stick around for the embryo.
  • CD 19: Transfer day

That’s it for now. More to come as this cycle progresses!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Going Back

This cycle was a negative. DH and I had a long talk, and have decided we are in the home stretch. Time for a Hail Mary.

I’ve always thought of this “journey” as a process; an evolution through time, with ups and downs, information gathering, changing, etc.. However, after several years and God-knows-how-many tries (the last few months really bringing us to a head), we have come to a point where we need to see an end in sight. We feel that the resources – emotional, physical, and financial – we have put into trying to have a child are better placed into having a fuller life with the two of us.

As such, we are giving this one final UMPF. We are going to complete the last two cycles in our guarantee with Reprofit (the Risk Sharing Program (Scroll down to “Risk Sharing Programme” in that link))…the one where we pay for two DE IVF cycles with frozen eggs, and if we still haven’t brought a baby home, the third cycle is FREE. If we just saved money, we wouldn’t be going back for at least another year. We don’t want to wait that long to move to our next chapter (whether that be pregnancy or enjoying life with just us).

So, modeling after my friend who has gone, we’ve made the extremely hard decision to tap into our IRA to fund these last trips. My friend was actually able to take out a loan against her 401k at 4.5% to pay for their trip, but that wasn’t an option for us; it was liquidate a portion or take nothing. Not a light decision to make, given that 1) while we won’t take a hit up front (taking from DH’s 403b would be a 40% hit + income tax…YIKES), we will have to pay income taxes on what we withdraw, and 2) I’m 38, soon to be 39, and DH is 35. After losing a good chunk of our retirement in 2008 (fuck the American bankers who caused that shit show, by the way), we switched everything to be very conservative. We want to be able to retire before 80, so this is no small matter to tap our savings early.

But, we are both still working. That’s the plus side. We’ll be buckling down the budget to essentially repay that money as fast as we can. And cross our fingers that the stork takes pity and sends us a little love in the form of pink or blue.

I’ve emailed Eva to get the ball rolling. DH will be flying over to Czech mid-April to leave two sperm deposits; one to fertilize the 10 eggs we currently have frozen/reserved, and one as a backup in case a third (and final) attempt is needed. I will fly over the last week of April for transfer.

My medications / protocol will be fairly simple. I’ll have an endometrial scratch toward the end of my current cycle, and start estrogen supplementation with CD 1 of my next cycle. I will also start taking 5 mg Prednisone on CD 1. I’ll have to talk with my hematologist about when to start the Heparin, but I’m guessing it will be on CD 6 (bleeding has stopped, and estrogen supps bring a higher risk of clots). Ultrasound on CD 13 to check lining, start Crinone 8% 2x daily on CD 14 if the lining is good, and have transfer (likely two embryos) on CD 19. Relax at home for a week and see what the fates bring.

Wish us luck!