Update: Our Fertility Journey

Happy Friday, friends!

I can’t believe it’s been 6 weeks since my last update, but I don’t have much to share since the retrieval.

As I mentioned in my last post, I have been taking Lupron Depot since the beginning of July and the only side effect that I have experienced are HOT FLASHES.   That’s right, in the middle of summer with all of this humidity, I’ve been dealing with a roller coaster of sweats and chills.  I have at least one an hour, but in most cases I have 2 to 3 an hour.  They start with a burning sensation in my forehead and work down my entire body.   I know it’s gross but I get beads of sweat on my face, neck, arms, legs, stomach…all over.  I even sweat through my shirt sometimes…disgusting.  Once the hot flash passes, I get cold.  That repeats throughout the day and the night.  I haven’t slept well in over two months.

We went to the doctor on August 1st for a mock transfer and to discuss next steps for our zygotes.  I will admit, I was a little shocked about how that conversation went.  In my mind, we were going to have multiple IVF tries with the 7 frozen zygotes, which was really comforting.  I had never been through the thawing process, so I assumed that we would have several transfers.  Well, I was wrong.

Apparently, there is an 80% survival rate for thawed zygotes, which means we will end up with 5 or 6.  They will then develop for 3 days before the clinic tests them for quality.  At that time, the doctor will make a decision to either transfer or allow the embryos to develop until day 5.  Based on the history of how my embryos develop, the doctor thinks we will transfer day 3 and depending on the quality, we will transfer what we can.

I was shocked and I instantly started to worry.  This is it.  This is our final round of IVF and rather than having multiple transfers, we will have just one.  This is the end of our journey to have a biological child and that is so scary.  Rather than allow myself to stress and worry about it, I turned all of my energy into positive thoughts.  Since that day, I haven’t allowed myself to think anything but good things.  This is going to work.  We are going to get pregnant.  We are going to have a baby.   I continuously turn to God for comfort and strength.  I read my daily devotion as a reminder that He has a plan for us and I have to trust in that plan.

September is a big month for us.  On Tuesday the 30th of August, I go in for ultrasound/blood work and I start estrogen patches.  I’m on the patches for several weeks until I start progesterone oil shots on September 15th.  Our zygotes will be thawed on the 16th and transfer will be either the 18th or 20th.  I can’t believe it’s so close.  I’m so excited!

Thank you again for all of your love and support.  I’ll update you all again once we have transfer date.

With all my love,

Tiffany

Our Fertility Journey…Part IV

This is the final part of our journey towards having a child.  This will get us to where we are today, but I will keep you updated over the next few weeks.  You can read Our Fertility Journey Part I, Part II and Part III here.

___________

The holidays were by far the most difficult for us since being married.  We found out we weren’t pregnant after our 2nd round of IVF and it was our first Christmas without Rudy’s dad.  For the first time in his life, Rudy wasn’t home with his family for Christmas and that was hard for him.  It broke my heart to even think about how he was feeling then to add the disappointment of no pregnancy, I knew he was having a hard time dealing with everything.  Although there was a lot of heartache, we made the best of Christmas and were ready to start a new year.

It was time for us to go in and talk to the doctors about what went wrong.  I dreaded this conversation.  I just knew they were going to tell me that they didn’t know what else to do for us.  That they had tried everything they knew to try.  That I needed to accept that having a baby is not going to happen for us.

So on January 6th, we walked into the clinic once again.  We reviewed the cycle details and once again, everything was great until the poor egg quality and embryo development.  Rather than saying, we don’t know what else to do, they had another answer.  They wanted to do exploratory surgery for endometriosis.  Now remember that spot the doctor saw in my last ultrasound before my last retrieval…they never said this, but to this day, I think that is what trigged them to want to do this surgery.  They explained that endometriosis can sometimes be associated with an inflammatory state and may hinder reproductive outcomes, even in IVF.  If they found endometriosis, then they would remove it entirely and suppress it with BC until we were ready to repeat IVF.  Once we were ready for IVF, they would repeat the protocol from my 1st IVF cycle.  If no endometriosis was found, then we would need to consider other options such as donor eggs, adoption, etc.

This was a lot to take in.  I went into the appointment hopeless, knowing that we had tried everything.  We even said that the last round of IVF was our final try, but now the doctors are talking about a potential underlying cause and I all of the sudden had hope again.  But why are we just doing this surgery?  Why are we just now discussion endometriosis?  Isn’t this something we should have considered earlier?  I’ve been at this clinic 2 years now and this is the first time I’ve heard endometriosis come up.  Yes, I was angry that they are just now considering this as an issue, but I was hopeful again.  I may have a chance here.  Maybe I just need to be “cleaned out” and then all will be great.

Without hesitation, Rudy and I decide to sign the consent forms for the surgery that day.  The doctor was going to look at the surgery schedule and email me with possible dates as soon as possible.  Within 24 hours, she emailed me 3 possible dates, one of which was January 21st.  They had a cancellation for that day, but I had to decide that day (January 7th) if I wanted that date.  Within an hour, I was booked for exploratory surgery!

Before I knew it, it was the 21st and I had to be at the hospital very early that morning.  My dad and stepmom insisted on coming, so they were driving 3 hours that morning to see me before I went back.  We arrive at the hospital and I had to go through the typical preparation.  Once I was all settled and hooked up to IV, they allowed Rudy, my dad and stepmom to come back and visit.  I had a lot of emotions that day.  I was nervous.  Nervous they would find something unfixable or find nothing at all.  Finally, it was time to go back.  I said bye to my family and I was off to the OR.

The next few hours are a bit blurry due to the anesthesia, but I do remember the doctor telling me that she found and removed severe endometriosis and she did see the cyst from the ultrasound, which she also removed.  Since they did so much cleaning up, she instructed me to take it easy and rest over the next few days, as I would be sore.  After a week, I was able to remove the bandages and I was back to normal…physically at least.

I don’t know what happened, but after surgery I went into a deep depression.  You would think that I would be happy and excited.  Hopeful that I have a fresh start, but I wasn’t.  I was really sad.  I would cry myself to sleep at night.  Cry getting ready in the morning.  Cry on the way to work.  At work.  On the way home from work.  No one had to say anything to me, I just had to let it out.  I had no desire to do anything or be around anyone.  I didn’t return phone calls, text and I know I pushed Rudy away…I just wanted to be left alone.  I remember thinking that I needed to see my niece and nephew.  They always made things better…they would definitely make me smile.  So we went to visit my family and it was so hard.  Being there just made it worse.  It was a reminder of what I didn’t have.  I got in the car that Sunday morning and cried all the way home.  I couldn’t snap out of it.  The emotions of everything finally caught up with me and I was in mourning.  Mourning of what could have been.

I finally realized that there was only one way I was going to get through the depression…God.  He was the only one that knew what I was going through.  The only one that understood the emotions.  The only one that could save me.  So, I downloaded a daily devotion called ‘Jesus is Calling.’  It was mid-February, but I decided to go back and read the devotions starting January 1st because I needed it that bad.  Within a week of reading my devotion, I started feeling better.  God saved me.  He continues to save me every day.  I am still reading my devotion and I am reminded daily that He will guide me through this.  I have to let go of everything and put it all in His hands.  He has a plan for us.  That is my saving grace.

After going through everything at my clinic, I was ready to get a second opinion.  My best friend wanted me to come talk to her doctor and I thought it was finally time to take her advice.  On February 29th, I went to the fertility clinic in Charlotte.  Rudy was actually out in California spending time with his mom since it was the year anniversary of his dad’s passing, so I asked my bestie to go with me.  Thank goodness she agreed, because I was a mess.  As soon as the doctor said, “You have been through a lot” I lost it.  Tears rolled down my face.  While I was feeling better, I still wasn’t 100% and now I had to talk about everything.  So I did.

We talked in depth of my journey up to that point.  He never said that my clinic was wrong, but he said that he would have done things differently.  He mentioned supplements that I could try to possibly improve my egg quality.  He explained that he would have never transferred embryos in while my estrogen was so high.  Just so many things that he said, made so much sense.  It made me question everything up to that point, but also gave me hope.  I immediately called Rudy to explain what the doctor said…luckily, my bestie took good notes.  I was excited!  The only negative and its not negative, it just creates a little challenge is that the clinic is in Charlotte. But, if this was the direction we wanted to go, we would figure that out.

Rudy got back on March 2nd and we went to talk to our doctor at our current clinic on March 3rd.  We just wanted to hear what she had to say.  What her plans were for next steps.  We wanted to make sure we had all the information to make an informed decision.  During the appointment, she expressed that she would repeat the protocol from our 1st IVF cycle.  No mention of supplements.  No mention of freezing embryos.  No changes.  We left that appointment frustrated, but we decided to take our time to make our decision.

We had a trip planned for our anniversary on March 16th, so we talked about it in depth during that time.  We talked to our family about their thoughts.  Then we made our decision…we were going with the clinic in Charlotte.  We knew that if didn’t, we would question “what if.”

Just like that we were on our way to start our final (and this is really the last one) round of IVF.  I went in on April 10th to give blood work.  Rudy was sent for a semen analysis. I started taking a supplement cocktail to hopefully help improve the quality of my eggs and before we knew it we were signing our life away…well, that’s what it feels like. So much paperwork.  So many decisions. But we were excited!

We felt so good about decision and we keep getting small signs that we made the right one.  One May 13th, the doctor called with the SA results.  They said that the specific level they were looking at was elevated and that means that IUI would have NEVER worked for us and that we needed to do ICSI.  It didn’t change our plans, but it blew our mind that after attempting IUI 6 times with the other clinic this is the first time we have heard it would not work for us.  So frustrating!!

So where are we today?  Well, I started Lupron injections last night. We are officially in stimulation month.  I’ll start other injections next weekend, so I will post in few weeks and give you an update on how it is going.

Rudy is actually going to post next week to give a male perspective of the process.  This was his idea and I love that he wants to share too. I have a great man on my hands!

Keeping the faith,
Tiffany

We love being silly together, so it was no exception when I asked Lindsey to take a few shots of us the other weekend.  #goofy

DSC_0696

Our Fertility Journey…Part III

I am continuing to share our journey towards having a child.  You can read Our Fertility Journey Part I and Part II here.

_________

Just weeks after we found out that we weren’t pregnant from our IVF cycle, we decided that we would start researching adoption. We talked about adoption very early in our relationship and oddly enough, we both actually wanted to adopt one day, regardless of whether or not we had biological children. So, maybe adoption was God’s plan for us all along.  I reached out to someone I knew who had adopted a little boy and was going through the process of adopting her second little boy.  I knew she would have great advice and could point us in the right direction.

We exchanged several emails and she informed us that we needed to do a home study first and then decide if we wanted to work with a agency or an advisory.  Then we needed to think about any preferences we had (sex, race, etc). How could we…a couple who wants a family so desperately, set criteria for a child that needs a home?  At that moment, with where I was emotionally, I didn’t have it in me to be selective. Regardless, we started researching agencies to do home studies and we were starting to get excited that we could have a family before long.

A week later, my friend emailed me and said she was with her lawyer finalizing things for her second son when her lawyer just happen to ask is she knew anyone looking to adopt.  He had a birthmother who wanted to place her child.  Obviously, I came to mind so she wanted to know if she could give them my information. Within hours, Rudy and I decided yes, let’s do this.  Let’s see where this goes.  I talked to the lawyer later that day and gathered a lot of information.  This was all falling into place very quickly…it was a little scary and overwhelming.

I gathered all of the information and shared with Rudy.  We were shocked at the costs associated with providing a home for a child. After doing the homestudy, paying lawyer fees, adoption fees and other fees included, we were going to be close to $35K. WOW, we weren’t expecting this and it made us take a step back.  Were we ready to give up on having a biological child?  We had some thinking to do.

After several months of thinking and praying, we decided to try IVF one more time.  This was our final try.  We knew if we didn’t give it one more try, then we would always wonder “what if?”  I called up the doctor and went in for a follow-up conversation on September 8th.  We went over every detail of every IUI cycle and the last IVF cycle.  It’s one thing to revisit the emotions of the process and to be reminded of the challenges you have faced, but it makes it even harder to accept when the doctors don’t know WHY you can’t get pregnant.  She kept saying my IVF cycle was “text book perfect.”  Perfect estrogen.  Perfect progesterone.  Excellent egg yield.  Perfect fertilization.  Everything went exactly like it should.  That is, everything except the poor embryo development.

Our doctor was so shocked by the results of our cycle that the clinic used it as case study.  She had every doctor at the clinic study my file and make suggestions on what we should do next.  You put all your trust in the hands of doctors and when they don’t have answers, you begin to feel helpless.  I started questioning and my mind went a thousand different directions…was this my fault?  Am I the reason we can’t get pregnant?  No, this can’t be my reality.  I won’t accept this.  There has to be another reason.

After consulting with her fellow colleagues, our doctor suggested that use a different protocol this time.  She thought maybe the medicine was the reason for the poor egg quality.  They call the approach we followed Antagonist Protocol, which excludes Lupron.  Our doctor said that maybe my eggs didn’t respond well to the Lupron.

So on November 11th, I started my menses and birth control.  A few weeks later on the 24th, I took my last pill and went in for baseline blood work and ultrasound.  My estrogen was at 20 (perfect) and my ovaries were nice and quite.  I was directed to start 375 IUs of Follistim and 75IU of Menopur on the 28th.  Over the next week and half, I was in and out of the doctor almost daily checking levels and looking for follicles.

By this time, I had been pricked and prodded more than I could even count and Rudy was there with me at almost every appointment. He maybe missed one or two but he always insisted on going with me.   I never felt alone.   We never felt alone.   The clinic was like our second home.  We would walk in and everyone knew who we were.  It was kind of nice but really sad at the same time.  The nurses, the doctors, the front desk receptionsist, the lab tech…everyone knew us and the challenges that we had faced.  I’m sure everyone feels this way, but I really felt like every person at the clinic was rooting for us.  It seemed like they felt the pain that we felt and they wanted this for us as much as we wanted for ourselves.

Since every doctor was aware of our situation, it made it rather easy to move forward with our IVF cycle although our primary doctor was out on maternity leave.  On December 6th, I emailed our primary doctor because we had some concerns.  See, during our ultrasounds, we weren’t seeing a lot of mature follicles. I kept asking the nurses and doctors on call and at one point, a doctor told me that if we didn’t see improvement we may cancel the cycle.  Then a day later, another doctor is telling me, it’s okay that my body is just responding differently because of the new protocol.  I was beyond confused, so I needed answers. Clarity. Reassurance.

In my email, I explained that the low number of follicles was concerning.  We were seeing around 6 good ones…this is MUCH lower than the 20 we had last time and with the poor embryo development of our last cycle.  We were concerned that those 6 may end up being 0.  We understood that quality was more important that quantity, so we just wanted her thoughts since she was our primary physician.  She quickly responded that although we were seeing fewer, she hoped for better quality.  She suggested that we remain optimistic and aim for quality over quantity so that’s what we did.

On December 8th, I went in for what ended up being my last blood work and ultrasound before retrieval.  Estrogen was at 1587…great. Progesterone was at 0.629…great.  The doctor on call that day was one that we had once before and we really liked him.  He was a straight shooter and one of the more senior doctors at the clinic.  He performed my ultrasound and when he got to my right ovary, he asked, “Has anyone ever told you that you may have an endometrioma cyst on this ovary?”.

I don’t remember my exact response, but…no, I have never been told there was anything on my ovary.  What do you mean?  How have I had all of these ultrasounds over the past year and half and this is the first time someone is seeing this?  What is an endometrioma? What does this mean for this cycle?  I was obviously making it a bigger deal than he was, because he calmly told me that if they happen to “irritate it” during retrieval, I would need an antibiotic. Really?  That’s it.  So, I don’t have anything to worry about?  I wasn’t 100% sure what any of this meant, so I did exactly what you are NOT supposed to do.  I googled ‘cyst on ovary’ and eventually was led to articles about ovarian cancer.  I can admit when I’m getting carried away, so I had to check myself.  This is not helping anything and if the doctor isn’t concerned then I shouldn’t be concerned.  They are the experts and I trust them.

So, as instructed, I gave myself 10,000 units of HCG or what they call the trigger shot.  Thirty-six (36) hours later on December 10th, it was time for retrieval.  Once again, my mom came up and went with us and within hours, they had retrieved 15 follicles.  It was less than last time but more than we were expecting.  Off to another great start.

Once again, we opted to do ICSI to help increase our chances. They called the day of fertilization and only 5 follicles were good enough to fertilize.  Wow, that was a quick decline.  I started getting worried but Rudy helped me remain positive.  He was always so positive and constantly reminded me that I needed to be the same.

Due to last cycle’s poor embryo development, we already knew that we would transfer back in on CD3.  Sunday, December the 13th came.  The Embryology lab was suppose to call me early that morning to tell me how the embryos were doing.  I waited for the call but it never came.  I knew instantly that something wasn’t right.  We arrived at the clinic and I was anything but calm.  I just had this unsettling feeling.  The doctor came and got us.  We walked into the room and it was written all over his face.  I knew it in my gut.  In my heart.  He didn’t have good news.

Sure enough, only 3 embryos had survived and they aren’t even good enough to grade.  They weren’t strong enough to perform assisted hatching.  They were worse than last time.  Immediately, guilt set in.  This was my fault.  My eggs were the reason why we can’t get pregnant.  I’m the reason that we aren’t able to start a family.  I couldn’t hold it together.  I just cried.  Rudy cried.  He walked over to the bed and hugged me.  I needed a minute to gather myself.  I asked the doctors to give us a minute.  They stepped out and Rudy and I held each other while we discussed what to do.  Did we want to go ahead and transfer these embryos or did we want to just walk away knowing they weren’t ideal.  After what seemed like eternity, we decided to go ahead and transfer the 3 embryos.  The American Society for Reproductive Medicine (ASRM) transfer guidelines suggest no more than 2 embryos be transferred for a woman of my age (34), but due to the poor embryo quality and the previous failed IVF cycle, the doctors were okay with transferring all 3.

Since we decided to move forward, I was going to do every and anything in my power to ensure that I provided the best environment for our embryos.  I followed a very healthy diet.  I didn’t exercise because I didn’t want to chance ruining things.  I remained positive.  I didn’t allow work or anything to stress me out.  I was as close to perfect as I could be over the following 2 weeks.

Our blood work to determine pregnancy fell on December 24th…Christmas Eve.  Since the clinic was closed then, they agreed to do blood work on the 23rd.  Of course our families knew we were doing IVF, so they were anticipating results but we told everyone we wouldn’t know until the 26th.  Our hope was that we would have the perfect gift to give our family that Christmas.  We even thought about how we would tell them.  It was so fun to talk about.  It made us even more hopeful.

December 22nd came and I didn’t feel great.  I felt like I was about to start my cycle.  A little cramping but no spotting so I remained hopeful.  I woke up on the 23rd still feeling like my period was coming.  I went to the restroom and sure enough, I was bleeding.  Within an hour, we were sitting in the waiting room of the clinic.  Our nurse came out and looked so hopeful.  So excited.  Before she could ask how I was feeling, I was crying.  She knew what it all meant but insisted we wait on the blood test.  Shortly after, it was confirmed.  No pregnancy.

Once again, bad news.  No answers.  No explanation.  Just heartbreak.  Feelings of guilt.  Hopelessness.  Helplessness.  Failure.  I felt such responsibility for this.  What did I do to deserve this?  Rudy doesn’t deserve this.  He wants a family.  I should be able to provide him a family.  What was wrong with me?  Why?  Why me?  Why us?  Why now?  This was supposed to be the most joyous time of year. How was I going to tell my family?  We were supposed to have the perfect gift this Christmas yet here we were with nothing.  I had to be strong.  I couldn’t let this ruin everyones Christmas.  I had to be strong.  I didn’t want this to be the focus of the Holidays.  I couldn’t cry. I had to make everyone think that I was okay.  I had to pretend that I had accepted this as our reality.  So I did.  In casual conversation in small groups, I broke the news.  I didn’t cry.  I didn’t put big focus on it.  I just let them know and I acted as though I was okay with it…

Tiffany

inspiration