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.

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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