Plodding on is harder than stopping.

31 October 2010

Today would have been my estimated egg retrieval date if I had made it that far. It's almost surreal looking back at all the events of the past week/month/year. One minute I was an IVF patient, the next I was downgraded to a very expensive IUI with a 5% chance of success. Not no hope, but so heartbreakingly small to even hold onto.

Cancellations suck, but I'm convinced IVF-IUI conversions are even harder in many ways. Continuing with the 4 daily injections, returning to the clinic for ultrasounds and blood work, shelling out more money, having the Dr. ordered intercourse at a prescribed time, having the IUI, and then the 2 week wait before you have complete closure on the cycle. It requires an incredible strength and endurance that you have to draw from somewhere when you feel you've got nothing left in you. The easier path would have been to throw in the towel, get drunk, move on, and get things together for next time.

It's like I trained and signed up for the 10km run where I had a good chance of winning a medal, and accidentally got switched onto the marathon course part way through the race where just getting to the finish line is the reward, but there's nothing tangible to take home. And because I'm running slower than expected, the volunteers are already sweeping the course and the aid stations have run out of energy drinks and snack to keep me motivated. Once in a while there are draw prizes and there's a small chance of taking something home that way, but you can't pin expectations on that.

Then everyone likes to tell their miracle success stories and tell you not to give up on it yet. When you are living and breathing it, those stories seem to irritate rather than provide comfort. When my Dr. tells me that the last 3 IVF-IUI conversions at my clinic ended in pregnancies, I feel like an even bigger failure if mine does not.

The irony is that my latest ultrasound actually showed a 5th follicle , but it will likely not catch up, it's very small compared to the others. The lining is now up to 12mm but I still have a few more days to go until ovulation so the IUI is scheduled for Tuesday afternoon.

My next big step will be hauling myself back to my work with other people's babies, and all the nosy co-workers. Again, it's going to require strength from somewhere, I'm just not sure where it will come from yet.

Our plan is to take the next 3 months break with a "less is more" attitude. No more trips to Victoria for appointments. I've discharged myself from acupuncture for now, and will just take the DHEA and vitamins my RE suggests, but nothing more. I'm done with well meaning advice for now. Honestly I spent the last 2 years doing everything "right" and nothing has worked. I'm reclaiming my body for after renting it our to science for the past year. This landlord is moving back in, and changing the locks. Hubs and I will get ski passes this winter and get our normal lives back for a while.

Thanks for Coming Out, Better Luck Next Time

28 October 2010

This IVF cycle has officially been canceled due to the dismal ovarian response, and an endometrial lining issue. I feel like I'm living all the nightmares I've had over the past couple of years. Everything I kept being told not to worry about seems to be happening. I feel so lost.

I knew it was bad news when the RE asked us to sit down with him in his office after the u/s. For the first time in many months of getting bad news at the clinic, I broke down and cried in front of him. My RE assured me that he would not have done anything differently than the fill in doctor recommended. He does not think upping my dose would have changed the outcome. My ovaries pooped out just when they've been called to duty. I'm only 33. Shitty hand to be dealt.

The game plan is to do an IUI on Monday as a last ditch salvage effort, but the odds are very low with the lining issue. They told me that the last 3 IVF to IUI conversions the have done resulted in pregnancies. That is great for those patients. Somehow that just does not make me feel better about my situation at all. Sort of like those stories people love to tell you about their best friend's cousin who ate cantaloupe and low and behold after 7 years of trying got pregnant with triplets.

After I wean off my dexamethasone, he wants me to start on DHEA for 3 months, have another hysteroscopy and D&C (done properly under anesthetic in the hospital), then attempt IVF again in Feb or March. He might tweak my protocol, but I am already on an aggressive one so he'll have to do some thinking. I don't know if I've got it in me to be quite honest. We'll see.

Seating Arrangements

27 October 2010

I've been so caught up in my latest drama, I haven't had a chance to blog about this yet, so here we go.

On Sunday we had a little ivf.ca meet-up in Victoria. We picked a fairly large restaurant that would be a bit on the noisy side, so we could talk uterus without generating a lot of attention. When I called to book the reservation, they asked if it was a birthday party or other special occasion because they have an area that they set aside for groups. I told them, the was not a special occasion, it was just a group of friends getting together.

Obviously they didn't hear me completely on that one because as we sat and chatted, we noticed that the large group next to us was having.... {drumroll here} what else but a baby shower! What are the chances? Winnie the Pooh was passed around, cute little sleepeers were displayed, and silly games were played. Meanwhile we were engaged in injection and wanding chat while trying to ignore the obnoxious neighbours.

It was all a bit surreal. Anyway, we are planning to do another meet-up soon. This time we'll specifically ask if there is a baby shower going on before making the reservations.

One Little Blood Test

26 October 2010

So, on my way home this morning, I had to stop in at the clinic to pick up some more meds, and I decided to ask my nurse if she had a minute to sit down and talk to me. I told her how concerned I was about the lack of communication back from the RE and that it just wasn't sitting well with me wondering if he would have upped my dosage or not. I made it clear that just being left in the lurch like this was not OK.

She was reassuring and said not to stress, she firmly believes that I am responding better than the first ultrasound indicated, and just thinks I'm just off to a slow start indicated by the initial estradiol level being a bit low. Staying the course on the same dose is fine in these circumstances because there is still time for adjustments to be made if need be.

She said they haven't been able to be in touch with the RE either, so it's not that he is ignoring me. Right now the decisions are being made by the replacement doctor and we can't change that.

Then she had a bright idea. She offered to run an estradiol on me and get the results back to me later today. At least that would give me some reassurance that follicular development is taking place my ovaries, even if I have to wait until Thursday for an ultrasound to find out exactly how many. Thank you!

We trucked off to the lab across the road, to have the stat order blood work done. I got the call back from her a couple of hours later just as I was getting home and unpacking the car. E2 is 1465 -right on track, so there is definitely something happening in there. Breathe out.

It's amazing how something as simple as a little blood test can make all the difference.

Heading Home

26 October 2010

Well, as for IVF I'm still in limbo until at least Thursday. I have not heard back from my regular RE despite my e-mail attempts. The fill-in Dr. is does not want to see me at all. So, I'm really feeling like an abandoned patient right now. At least the clinic nurse returns my calls. She is more reassuring that things may still change. I don't know what or who to believe anymore. So many questions are swimming around in my head.

Our original plan was to stay down here for the week to reduce all the driving back and forth to the clinic for all of the ultrasound monitoring I was told I'd be having. Since they don't want to see me for ultrasounds, we're heading back home to wait this out.

Yes, there could be more going on in my ovaries than meets the eye. Maybe my follicles just had stage fright, and we'll have a couple more cast members appear next time. There's just no way of knowing.

It took everything I had to stay the course with my meds as I was told. Part of me wanted to be naughty and inject myself with a higher dose by "mistake", and the other part wanted to quit them entirely cold turkey and save my money. The sensible part ruled the day though in the end.

We can't make decisions until we have all of the information.

4?!

24 October 2010

We're back to maybe doing IVF again. Sigh... After 4 days of stims, I had an ultrasound this morning with the fill-in RE and she could only find 4 follicles between 7 and 9 mm. My estradiol was also lower than expected. The nurse thought they might bump up my dose of Gonal-F to see if more follicles could be recruited, but the fill-in Dr. decided to keep me on the 300 dose because she said I wouldn't absorb any more than that anyway with my high FSH. I can't help but wonder if my regular RE have made a different decision. I e-mailed him just in the off chance that he checks his messages while he is away. I'm not back for monitoring again until Thursday morning which seems so far away. I'm so worried about this cycle getting canceled, but I'm supposed to "relax" and hope a few more follicles come out of the woodwork. With at least 5 they'll consider continuing, 4 or less we'll have to convert to a very expensive IUI. I know, you are all going to comment that it's still early, and don't give up yet. Still, it's starting to sink in how much the odds are stacked against me. Devastated []

The Trade In

22 October 2010

When you think about trading you old car in, usually you think of the shiny new car that you will be upgrading to. Not so when you are doing IVF.

I don't know if you remember, but when the clutch on my car went in the summer we decided to not do anything about it and to juggle with sharing my husband's vehicle until we had a better idea where the fertility treatments were headed. When we knew we were moving on to IVF, we decided that it wasn't worth pouring more money into my old car. My grandmother also offered to loan us her car for the interim when we both needed vehicles at the same time. So, we listed the car for sale as is for $1500. Yesterday we got an offer for $1200 and I'm really hoping the sale goes through.

All I could think about last night was -hey, hey that will buy me 3 more days of meds! I'm trading in my pale blue Toyota Corolla not for new wheels, but for 3 pale blue Gonal-F pens. What a deal.

Introducing The Superheros

19 October 2010

Time to breathe a sigh of relief -I actually get to start my IVF!!! I was so worried I'd be canceled, even right up until I had my meds in hand and was taking the first injection, I didn't believe it was really happening.

Yesterday was my follow up visit to the clinic after the horrific sono/biopsy-turned D&C. My ovaries were behaving themselves and had enough antral follicles (they still won't give me an exact number ). My Aunt Freida had started the night before and was doing a nice job of tidying up the funky lining. I asked the RE what he thought was going on with my lining before and he said "I have no idea, but your biopsy was normal, so I think we should go ahead with the IVF cycle as long as your estradiol and progesterone levels check out OK". They took my blood and asked me to come back to the clinic in a couple of hours, and if all looked good I could purchase my meds and start taking them that night. I went off to my counseling appointment, which couldn't have come at a better time.

When I arrived back at the clinic the nurse announced "your blood work was all NORMAL!". They packaged up the next few days with of meds, and ran through the schedule again: microdose Suprefact, and Dexamethasone starting Monday night, then on Wednesday add Gonal-F and Luveris. $1600 later, I have 3 bags of medications and syringes to get me to the next appointment.

My husband gets a kick out of the drug names. I began imagining them as various characters last night as I lined them up on my counter like I used to line up my figurines as a kid. We have:

Suprefact -the superhero. This guy has a flashy name for a flashy reason. He gets everything kick started. Actually when you read the directions on the box it says "for use in adult men for palliative treatment of hormone dependent advanced carcinoma of the prostate gland". LOL

Dexamethasone -The faithful dog to keep things calm, and encourage things to stick. My husband thinks the name sounds like methadone. I'll probably need some sort a withdrawl program after being on all of these injections for the past few months.

Gonal-F -another superhero of IVF. This time a female one. Her jobs is to super-size the ovaries of course. Gonal-F and I go way back and have a good bond. I hope she continues to be good to me.

Luveris -the trusty sidekick for Gonal-F. Where she goes, he goes.

These superhero team members are all working together to fight off the evil IF dragon. Stay tuned for the next episode...

Aunt Freida

17 October 2010

Well, I've finished my 26 day birth control pill marathon. Now my schedule says to expect a bleed in the next few days. It's not the real Aunt Flo, but her cousin Aunt Freida instead.

Where is she? When will she turn up? Will she look and act just like Flo? I think I was a teenager the last time I was on the pill and getting visits from Freida instead of Flo. Oh well, I've broken out the white pants again, and will head to the public swimming pool soon with no menstrual products. I don't know if these things work for Freida, but they sure seem to bring Flo on.

Tomorrow is my ultrasound that will either give me the go-ahead for IVF or a back to the drawing board again. It all depends on whether Freida does her job and clears this funky lining out nicely. Come on old lady, you can do it. Bring your broom and get busy !

It's Krawlin' Twins!

16 October 2010

While riding the ferry home yesterday I spotted my hometown jazz singer Diana Krall and her kids. I quietly pointed them out to hubbie to respect her privacy.

"She's got twins?" he whispered back. "Yes", I said, "3 year-old fraternal twin boys".

"How old is she?" was his next query. "Let's see, we grew up in the same neighbourhood, and she was old enough to babysit some of my friends so I'd have to say she's mid-40's -maybe 46".

"Did she use IVF?" he pondered. "Well, she's never admitted it and claims that twins run in her family, but it does lead to speculation".

Lots of the celebs in their late 30's early 40's seem to have twins. What is in the water? Lots of Gonal-F I believe. Sometimes I wish a few more of them were open about it, but I can completely understand why they are not. The public scrutiny would be too much to bear on top of stress of cycling and maintaining a career.

Oh well, I secretly winked at Diana Krawl behind her back yesterday as salute from one infertile woman to another.

The Curse of Unexplained

14 October 2010

Well, one week ago was my horrific procedure and the results of my endometrial biopsy are finally in (insert drumroll here) .... "THE BIOPSY WAS NORMAL" said the nurse in her cheery voice.

Of course this is good news, because it means that if I pass the test of Monday's ultrasound, I will get to continue with this IVF cycle without delays. On the other hand there is a little twang I feel every time I get test results back and everything is "normal". For years nearly every test has come back with normal results, or minor things that should not be an issue for conception. The doctors always think this is wonderful news, and I'm supposed to be pleased about it too, but I can't help but think something is not normal or I would have been pregnant long ago.

This is the curse of unexplained infertility. You are always searching for something to blame, and when there is no known medical reason, you blame the next thing in line -yourself.

Sometimes I wish the Dr.'s would just make something up instead. It would be easier to accept something like: "Your fallopian tubes are connected to your stomach, so you keep digesting your embryos" or "Your husbands sperm took a holiday in Mexico and just can't seem to earn their SCUBA tickets". It would be easier to justify why we are doing IVF.

Fingers crossed tight that there are no more speed bumps in this cycle, and we eventually end up with an unexplained baby. "Honestly Aunt Martha, we didn't have intercourse, this baby just magically appeared in my womb".

The Tummy Tuck

12 October 2010

We stayed with an old buddy of Hubbie's and his wife over the weekend. They have two beautiful children ages 4 and 1, both conceived easily. Because I felt so rotten after that horrific procedure, and because I knew I'd be refusing offers of coffee and wine, we told them about doing the IVF mainly to avoid the "are you pregnant" or "when are you going to have kids" queries.

She is one of these people who is full of advice about things she knows nothing about. We got suggestions about timing intercourse, taking vitamins, and of course the all time favorite -relax. She even told us all about someone she knows who used a surrogate and now has a child, and thought this should be something we should consider. Oh, and you know if you adopt you'll get pregnant. Bite the tongue, bite the tongue.

The topper was during one of our conversations, she had the nerve to try to relate to my IVF experience by comparing this to the tummy tuck she is having because she just can't seem to lose the post-pregnancy weight! Silverdollar's brain thinks: Hmmm... lets see, the only similarity there, is that they both involve the abdominal region and the cost is over and above what the public medical system covers. Aside from that, I just can't see any similarity. Honestly, to have that problem! I'd give anything to trade my flat tummy for a family. By the way would that be a second helping of pumpkin pie I just saw you eat?

Here Bite On This Stick -This is Going to Hurt!

10 October 2010

Thursday was my sonohysterogram. Usually an uneventful check of the inside of the uterus. The RE said the whole procedure would be very quick and even the biopsy should cause no pain with their new technique of only taking a few cells from the lining. The saline went in and I could see the Dr.'s face looking concerned. They kept the ultrasound screen turned so I couldn't see. He told me that my lining was showing an irregularity. He doesn't think it is another polyp, but perhaps my lining didn't fully shed last cycle, but they are not sure. Then he said he'd like to scrape & suction out the irregular section of lining. Normally this is done under anesthetic, but if I didn't want to delay starting IVF he could do it right there and then. He said "I am not going to lie to you -this is really going to hurt".

He did not lie! It was one of the most incredibly painful things I've ever experienced. They are all amazed at how still I was able to remain. Honestly, I was just focused on not passing out. After it was over the RE said women who have had babies tell him that this procedure is worse. There you go! Now just put that kid in there and send me on my way. I'll labour and give birth myself. Poor Hubs was quite traumatized too.

The bit of lining was sent to the lab for testing, and the results will be back sometime this week. Hopefully it isn't anything that will affect the IVF cycle. The Dr. didn't think it would, so we went ahead with the IVF orientation session -including the cycle fee deposit.

I felt pretty crappy for a couple days following this barbaric procedure, but I feel ok now. Really bad timing to take a long road trip across the province, but we didn't want to miss out on our friend's wedding. I guess it's a good distraction while waiting for the results.

Mostly I'm just bummed out and worried about the results. I just wish something would be simple & straight forward for me in this process. No, not in my cards. Please, please, please just let me get to egg retrieval!

The Guest Lecturer

05 October 2010

I was asked to come to a the university as a guest lecturer on the topic of early childhood motor development. During the talk, we were discussing prenatal risk factors for developmental delays. The students threw out a list of appropriate ideas "prematurity", "prenatal alcohol or drug exposure", "poor maternal nutrition". Yes, all very good, and right on the money for what I was looking for. I clicked the power point slide forward.

Then the regular instructor for the class commented that assisted reproductive technologies was another risk factor. What? It kind of caught me off guard. I actually have done a fair amount of research in this area, and had to suddenly switch hats here. I shared with the class that the most recent research has actually concluded that the risk of developmental or congenital birth defects with children born full term who were conceived with ART is equal to children conceived spontaneously (I hate the term naturally). This matches what we see clinically. I could see the instructor did not agree with me on this one.

I was able to move the discussion back on topic, but it was not was not what I expected to deal with in that context. I'm not sure if I'll ever be asked back to that instructor's class again! At least there are 25 students who will no longer be misinformed on this issue.

The Great Ironies of IVF

01 October 2010

One of the greatest ironies of doing IVF is that a cycle often begins with taking birth control pills. What? Excuse me? My husband thought for sure he had heard the doctor wrong when he first said it. Taking birth control pills in order to get pregnant? He thought our days of birth control pills were gone many years ago. Not so.

Two weeks ago I was all excited to be calling in my day 1 and starting my IVF cycle. I'm half way through the birth control pill phase and now the days seem to be creeping along at a glacial pace. I hate to complain but this part really is such a snoozer. Another couple of weeks to go until I get back into the good stuff again. The hard drugs. I can't wait to feed my addiction again.

Someone suggested a chocolate advent calender to help count down the days. Maybe I'll invent one with little chocolate covered birth control pills behind each window. Mmmm... now that would spice things up a bit.

DAYS TIL IVF