Great – now I am headed for ovarian cancer

A friend sent me an October 27^th article from the Los Angeles Times that reports women who undergo IVF have a much higher chance of getting ovarian cancer. While it is definitely concerning, the article points out that,  “But it is rare: women's risk for ovarian cancer increases with age, but even so, between the age of 50 and 70 years old, just .58% of women will get such a diagnosis. So increases in risk, even when they appear large, do not make ovarian cancer a high likelihood.”

Still, there is something unnatural about pumping oneself up with all these hormones again and again without consequence. I am no scientist but believe there are definite risks with the increased exposure. For the FET, I patched myself up with estrogen patches every other day and took vaginal estrace to get my estrogen levels to an unnatural level. In my daily life, I do my best to avoid additional exposure to estrogen-receptor plastics which have a myriad of health risks so question how the IVF exposure is harmless. Even the meds I used – Vivelle- is prescribed for post-menopausal women and at a much lower dose – two patches per week.  I was using 12.

I also remember when post-menopausal women were told to take estrogen or risk heart disease. My mom was one of them and four years later, got breast cancer. Just like the ovarian cancer tumors reported as a result of IVF, it was slow growing and easily treated with chemo. Again, I am no scientist but lets be honest, we are guinea pigs.  The doctors still have no fricking idea of the long-term impact of IVF drugs.

And crazy enough, it doesn’t mean I wont try again. I do want another baby and at 40 with a biological clock that could wake up a city, its hard to not try something that has a 40% chance of working.

Whats next....

We are 7dpBFN5dt. This past week has been great in some ways. Without a plan for the first time since this all began, I am taking comfort in letting a higher power take over for my obsessive, compulsive drive to force myself pregnant. We all know how well that worked out for me.

After the tears dried and I drank some wine, went for a couple runs, Dave and I decided to just see how things play out. Lots of women in their 40s get pregnant. I just never really gave it the time. I went to see Dr. Liang who back in July told me I didn’t need IVF. As she needled me up, she reminded me of all the 40somethings she has helped have healthy babies after miscarriages, failed IVFs, etc. “This time you listen to me,” she said. I also ordered the Clear Blue Digital Fertility Monitor and stocked up on preseed to help us along.

Dr. Surrey called on Monday for the post-BFN call. Really there was nothing to say. There is no way I am going back to CCRM for another cycle. I did the whole CCS process that seems to work for every other person on the CCRM Fertility Community board and even with 50% chance of success, I still got a BFN. He couldn’t offer some new protocol that was sure to change things up. The fact is that I respond well and besides a couple tweaks, there isn’t much he would do. I did ask him if they ever looked at women in their late 30s and early 40s that got pregnant easily and what their AMH, FSH, etc were. Surprisingly, its never been done so women with low AMH, sky FSH and 1 resting follicle may get pregnant all the time, the REs just don’t know it. Made me realize that for those of us without an easy fix – blocked tubes, anovulatory, high TSH, etc – the REs are pretty much flying blind. Some things may work better than others but still we are just guinea pigs.

Being who I am, I still reached out to Dr. Rosen to get his thoughts. He, of course, advises I do one last IVF. Even after three failures, he still believes I can and will get pregnant again. He has been successful with every other friend I have referred to him and all have been in much worse shape than me. The only change he would make is to try a HCG infusion before transfer. Its brand new and showing good results. I promised to enjoy not being pregnant – drink wine, coffee, sushi, get him my records from CCRM and call him in January.

Adoption is still an option. I want to say that I am okay with it but that is a topic I will get into on another day. For now, I am just going to enjoy what I have. Last night, Miles climbed in between Dave and I and proclaimed “We’re family!” before kissing each of us with a giant MWAH! We are so very lucky.

The end

It didn’t work. I am not pregnant and it sucks. Last Friday, I was so sure I was, I allowed myself to believe. And it felt so real, so right, in a way that I didn’t before with the other IVFs. My boobs hurt, were bigger and veiny, I was nauseous, tired and there was pressure in my lower abs. I could hear the nurse give the news, planning out next week with the second beta and scheduling when the first ultrasound would be (two days after Christmas). Baby Spencer, as Miles called him, would be born in early September if we were lucky so would be three school years behind Miles. I was giddy to the point that I just almost whispered my news to the manicurist and even a mom from Mile’s preschool. And in that vein, I POASed two days before the beta, right before Miles’ nap, confident that I would see the one word on the digital test I’d been waiting 2 years for –pregnant.

Instead, once one I paid $7.50 for the test to be told that I was not pregnant. That I had spent close to $30,000, made four trips to Denver, injected myself with untold number of hormones, gulped daily vitamins, fretted about follicle sizes, number of blasts, CCS tests, agonized over lining, progesterone and estrogen levels, rearranged travel plans a zillion times – all over a period of eight months for absolutely nothing. With odds of 50%, I once again fell on the wrong side. Poor Miles. Instead of the book before nap, I threw him in the crib and walked out, ignoring his pleas.

Dave coaxed me to hold on to some hope. That I tested too early. I scoured the boards to find example of those that had the same results on a digital test 7dp5dt and went on to a BFP. The odds weren’t good. Two days later, my beta would likely be a minimum of 80. If HCG doubles every 48 hours, mine should have been 40, enough to register on a digital HPT. That I didn’t use morning urine provided some comfort.

In the end, it was good that I had the early warning. I had the blood test Sunday morning on our way down to Santa Cruz for a Holiday day out with Thomas the train. Miles had been talking about it for weeks. The call came a short two hours after the test right smack at the beginning of the train ride. I’d just joked with a pregnant lady about to pop, alongside her two-year old twins. Santa Claus was making the rounds on the train. Elves were jingling bells and carols were blaring out of the speakers as the train powered through Santa Cruz. The tone of her voice was enough. I didn’t need to hear the words. I hung up before she could tell me to stop taking the meds. I’d already ripped the estrogen patches off my abdomen.

I wish I could say I was there and present for Miles but I couldn’t stop crying. We were done. Some higher power judged up not up to having another child. I’d wasted time, money and energy for naught. Somehow I have to figure out how to make sense of it, how to move on and let things play out as they will. I need to be happy for my son, be present in my life and find my way back to the things that bring me happiness.

Another IVF is out of the question. The hormones I’ve already exposed myself to sicken me. And in reality, the only ART that ever worked for me was Clomid. Maybe the cruel joke at the end of this nightmare will be a natural pregnancy and perhaps if I would have just had the patience a year ago, it would have worked out.

At least for the day, I managed to pull myself together. The sea air will do that for you. I drank my first coffee in months and then jumped into Miles’ first minature golf game before the merry-go-round. On the way home, Dave and I put a couple ski trips on the calendar and picked up a 2001 Brunello for dinner. And today, I went for my first run in months. It feels rebellious but comforting.

6dp5dt

In fertility speak, I am six days past a five day transfer. In reality it was a day 6 blast, not a 5 day, but I don’t know if they do day 6 transfers. And it was an FET. Anyway,  once I got over the delays, additional costs, snow storms and wind storms, it was an amazing experience.

I flew out to Denver last Thursday. While I waited, I became the person that doesn’t take off their IPhone. I made an FET playlist to keep my spirits up but really I could barely stop crying.  I’d made up the list from recommendations from partners in this IF nightmare so in addition to the great words, I felt the strength of the sisterhood. Particularly, Hold on Tight by ELO – thank you, Mal!

On the plane, I sat next to an older woman who also played on her IPad most of the time. Somehow we got to talking and she, too, had her first child at 37. And in the ways these conversations go, she shared that they truly wanted a second but she couldn’t conceive. A trip to the RE found that she had severe endometriosis, so bad that for a time, it was thought she had ovarian cancer. She was happy with a hysterectomy – she wasn’t going to die. She could raise her child. Gives perspective. And is happenstance, she worked as a fertility nurse for years at RSC in Orinda. I shared my story like she was an old friend, the strength of the sisterhood growing stronger. Her name was Molly, just like my great-grandmother. A great name for a little girl.

Luck stayed on my side when I arrived in Denver, covered in 8 inches of fresh snow. Even though Super Shuttle insisted on filling our van to capacity, I kept my FET playlist going and thankfully was the first to be dropped off. Like my retrieval, my transfer at CCRM was an entirely different and positive experience to UCSF. When I arrived, I was taken to my own room – at UCSF, it was a screened off room – and immediately wrapped up in warmed blankets. I had arranged acupuncture so had a 45 minute pre-transfer session. Then the transfer came to me – again compared to UCSF where I had to walk to and from the transfer room. The nurse brought me the Valium and about 30 minutes later, Dr. Surrey came in, followed by a the embryologist with a very large machine carrying my beautiful normal. The embryo had thawed perfectly intact and before my eyes was hatching. Beautiful! After the transfer, the nurse brought a bedpan – no chances taken, but kinda uncomfortable. Thankfully the Valium kept it all good. I had another acupuncture session to close it in and then told to rest for another 30 minutes on my back. At UCSF, I got up off the table post-transfer, went to the bathroom and walked out the door, completely alone. CCRM insisted on taking me downstairs in a wheelchair and nearly lifting me into the hotel shuttle.

I spent the rest of the day and Saturday, following CCRM’s bedrest guidelines. In a reclined position with legs no lower than your hips and upper body at no more than 45 degrees. I got up only to go to the bathroom and answer the door for room service. And I had perfect weather for it. I woke up to a snow storm on Saturday and spent the day watching Netflix, reading books and staying warm. Aside from a visit from my sister and law and brother with lunch, I was alone with my embryo and it was perfect.

On the way home, I continued the pampering. Rather than jump back into real life, I requested a wheel chair in the Denver airport. I gotta say it felt more than a little like cheating when my driver pushed me to the front of the security line, right behind the 90 year old blue hairs. I kept waiting for someone to point out that I looked perfectly capable of walking from moving escalator to the next. And when I got off the airport in Oakland, I kept my gaze lowered lest I see somebody I know especially when my driver actually went and found my luggage on the carousel while I caught up on email.

So now we wait. I am on thrice daily progesterone suppositories, daily estrogen suppositories, every other estrogen patches, and Lovenox shots. I want to say that I feel something but it could be the hormones. I cant compare this to past IVFs when I felt cramps and twinges because it was right after the retrieval and those weren’t BFPs anyway. My beta is Sunday and I am still not sure if I will POAS before. I am oh so hopeful and at times, almost giddy that our time as come.

And if doesn’t work, which there is a 50% shot that it wont, it will be okay. Or as Dave says, it wont be but we will make it through.

FET Prep – Daily schedule

Four days to go and I am busy. I am in countdown mode and everything matters. The vitamins, hormones, sleep and relaxation. Its become my full-time job to remember what to take and when ensuring my body absorbs what it should. I mostly remember but wrote it out today so Dave could really understand the minutiae that has taken over my brain and why dinner is not ready when he walks in the door. Oh and in between inserting tablets in my hoo-ha, swallowing pills, and slurping clumpy brown "tea", I am chasing a preschooler, cajoling him to eat the meals I lovingly make and fighting an uphill battle that he not draw on the walls, tear apart his train table for the 100th time, or throw toys at the wall with an evil grin.

Wake up – Drink Dr. Liangs herbs mixed with hot water. Must take on an empty stomach 1-2 hours before any other vitamins

7:30 am – Remove 4 Vivelle patches. Find spots on my abdomen to place next set of 4. Insert 1st Endometrium tablet vaginally. Remember to use pantyliner.

8 am – Take 1^st Tetracycline tablet. Remember that I cant have milk products for the next hour. Make sure to put on sunscreen – tetracycline makes your skin more sensitive.

9 am – Take morning vitamins – Folic acid, Vitamin D, Baby Aspirin

12 pm – Insert 2^nd Endometrium tablet. Take 2^nd Tetracycline tablet.

3 pm – Take 3^rd Tetracycline tablet

5 pm – Second dose of Dr. Liangs herbs before dinner

6:30 Take 4th Tetracycline tablet. Insert 3^rd Endometrium tablet.

Yoga for Fertility workout followed by Uteran massage self-care and Yoga Nidra.

Bedtime – Take 1 Medrol plus vitamins – Prenatal, 2^nd Folic Acid, Calcium and Vitamin 2. Insert Estrace tablet vaginally.

Thankful

Today is Miles third birthday. His birthday, always around Thanksgiving, makes me feel extraordinarily thankful. For his healthy, exuberance, and just that we have him at all. The morning that he was born feels like a lifetime ago. I remember the complete joy and thrill of welcoming our son into this world and utter lack of fear that while I recovered from my c-section, he was being stabilized with IVs and on a respirator. In fact, other than a fearful kiss on his wet forehead, I did not see Miles on November 25, 2008. Dave took pictures and I had to wait twenty-four hours until I could meet my little turkey in the NICU. Then it was another 48 long days before we could bring our bundle of joy home.

Throughout the IF journey, I have met so many amazing women struggling for their first child. It always gives me pause at how fortunate we are that we have not just a child, but Miles. I never knew the power one person could bring to change your life and know that all of this effort – the delays, losses, setbacks and frustration – are worth it ten times over in having a child. I am just so damn lucky for what we have and regardless of what happens next, plan to hold onto that gratitude.

And I am also thankful that we have a new FET date of December 2nd! Before Miles woke up to birthday kisses, I was at CCRM for lining check and bloodwork. The extra estrogen and uber herbs from Dr. Liang kicked in. My lining is up to 8.2 and my estradial is at 1549 (from 200 three days ago). Yay! So I will be back in Denver next Thursday for the Friday transfer. Hotel, car and airfare are booked. Now just gotta figure out the childcare. Anyone want to babysit?

And other delay

So just when you think its okay to pack for the trip, plan out the free weekend that is only days away and even relax a bit, IVF throws me for another loop. Today, I had my lining check and estrogen check. At my first estrogen check, it was low but CCRM increased the Vivelle patches to four every other day, from 1, so I assumed I’d be fine.  Assume something else you can never do in IVF.  Shannon, my nurse, called at 4 and as soon as she told me she had to wait to hear back from Dr. Surrey, I knew things weren’t going to be good.

Not only is my estrogen still low (200 when it needs to be 300) but my lining is too thin (7.3 when it needs to be 8).  And there goes my carefully laid out plans that may I remind you, I’ve already changed. Dr. Surrey wants to push my transfer back a week to December 5^th.  Mondays are a little hard as it requires me to find someone to watch Miles for two days while I am gone. Grandma and Grandpa who are here now aren’t up to spending another week with us just to help out. After some begging and pleading, Shannon agreed to  Friday the 2^nd provided my lining and estrogen look good this Friday.

So because we are going to be in Denver anyway for Thanksgiving, I get to visit CCRM one more time for the appointment. And bonus, no extra costs – its already covered in the thousands I already forked over. Of course, its not money in the bank, I will need to spend another few hundred dollars to fly back to Denver again! But this time, I am waiting until we are 100% certain the FET will happen before buying my ticket.

Yes I am lucky

So last Thursday at my Junior League meeting (yes, I joined the Junior League which is so not me but I really like it), the get-to-know-you icebreaker was to tell everyone where you live and how old your kids are. As usual, I was the only one in the room to have one child. This caught some attention. “You only have one?” one woman called out, “Wow, you are so lucky!” All of the other women gave each other knowing glances and laughter. Yes, just one is so lucky. I wont deny that but please, have the sense to not say that to a woman of a certain age with a small child.

I am sure this nice woman meant no harm but seriously just because you got pregnant with your three kids on command does not mean its so easy for the rest of us. Beneath my smile, I am slowly dying inside. I shouldn’t need to share why I am off to Colorado each month but wish that before people speak, they could just f**king think that perhaps just one is not a choice.

Perhaps I was more than a little sensitive. That same morning, Miles started talking about his little sister and brother, named Spencer (also a Thomas train). He has always loved his friends baby brothers and sisters but had never expressed his own wish for one. Knowing that this is now part of his awareness raises the stakes on this transfer even more. Its not just for me and Dave anymore. I don’t want to let him down.

Final Stretch

In IVF, nothing ever, ever goes according to plan. For the FET prep, I opted not to take BCPs the month after the retrieval. It gave me the illusion that we might conceive naturally (and trying is fun) and more importantly, BCPs give me awful headaches and I’d rather skip extra hormones. The benefits of BCPs is that it pretty much ensures when you get your period thereby the date of your FET. My cycle is typically pretty regular so I assumed I’d be safe. Wrong! My period came a week late. Our best laid plans of doing the FET before Thanksgiving had to be changed. So it goes but the important point is that we still have our normal and will transfer within a couple weeks!!

This is our last big effort. If this fails, then we officially move onto adoption. Since our homestudy, I haven’t been able to take the next step on birthmother outreach. Mostly because its not cheap. Five thousands dollars on the low end to fifteen thousand for the high-end, promise-you-a –baby-in-six-months agency. I’ve talked to four lawyers and two agencies and learned a great deal about the process. That is a good thing if we need to go down this path.

At the get-go, we were told that we had to accept our child would likely have exposure to alcohol and drugs. The sad fact is that most birth mothers don’t follow the same health protocols that those of us trying to get pregnant. The homestudy application required us to list what drug and alcohol exposure we’d be willing to accept. I assumed a little bit of alcohol was fine given that my OB told me that when I was pregnant. And cigarettes, pot, heroin, crack, cocaine were absolute no-nos. And I was wrong. Apparently alcohol is the very worst thing for a fetus. Worse than cigarettes, pot and even heroin. Calls to multiple pediatricians backed up that claim. Wow! That was a surprise.

But I am getting ahead of myself. We are still in the IVF game. I am not ready to adopt a knocked-up potheads baby. My baby is still frozen in a Colorado lab. I have four Vivelle patches glued to my abdomen and will shoot myself up with 5 units of Lupron before I go to bed. Tomorrow, I will drink my fertility smoothie, do my 20 minutes of fertility yoga followed by the self Uteran massage and listen to the Yoga Nidra for Fertility. I am focused.

Bitter

In Miles preschool class, five of his classmates mothers are pregnant. Another six have siblings under six months old. The rest already have older children. I am the only one with just one. Well there was one other but she moved her son to a different school.

This wouldn’t be so bad but it’s one of those schools that is all about community. And that community likes to jump in and help a family in need. A family in need is one that has a newborn. So biweekly these days, I receive emails congratulating yet another family on the birth of yet another fricking kid and asking that we cook a meal to help the tired parents.

No! I am sorry I cant do it. I cant smile at their bulging bellies, ooh and aah over their wrinkly newborn or even feign empathy watching them negotiate a Snap and go while their three year old runs into the street. I am bitter. Bitter that for them, this is the hard part. I am tired of waiting and trying, of hoping and praying and being pissed off and bitter at the mothers of my son’s friends. Why is it me that has to inject myself with endless hormones, gulp down herbs, go for weekly acupuncture and everything else one is supposed to do and still come out empty-armed?  Age? Maybe although one of the moms is also 40 and conceived as soon as she started using a Clear Blue Digital Fertility Monitor. Oh if it were so easy!

OK done with the vent. And yes, I know I am lucky I don’t have cancer, we live in a nice house, I have a great husband and my son is the cutest thing in the world.  But it still doesn’t seem fair.

Whats important

Today was about Miles. After being born at 30 weeks, he spent 46 long days in the NICU. While he has grown and thrived, we almost forget that he was a preemie. That we spent the first year watching his every development and comparing him to his peers, worrying that he didn’t crawl until he was a year or walk until he was 18 months old. Because he talks clearly, jump off stairs, read books, complete puzzles, counts to 30 and knows how to use my iPhone, I want to believe it is all in the past.

Today was our third and final follow up at the Whitney Clinic. The first was when he was 8 months corrected (based on when his actual due date), the second when he was 18 months corrected and this one at age almost 3. We meet with a nurse practioner, child development expert, neurologist and social worker which makes for a long morning for a little one. Up until now, it was clear, he was not quite where his peers were but overall, there was no cause for alarm. According to the neurologist, he wasn’t close to being on the [autism] spectrum and though behind he was right on track for his corrected age.

That was until today. I watched in amazement as my miracle child under the direction of a child development expert, completed puzzles games for 4 year olds with the concentration of a 5-year old. And as any almost 3-year old would do after 45 minutes of concentration and being woken up too early, he started to get over-excited which in Miles world is hyper-active. This led to the next part of the evaluation of gross motor skills in which he ran the hallways, kicked and threw a small purple plastic ball and climbed up and down stairs, stopping only to jump off the highest one. Exhausted and over-stimulated, he flopped to the ground leading the therapist to comment that he still “tottered”.

This led to her sharing her concern that he is very behind in his gross and fine motor skills and suggesting that he get Occupational Therapy (OT). Later the neurologist suggested he might have apaxia (a disorder of the brain and nervous system in which a person is unable to perform tasks or movements when asked, even though: The request or command is understood). This was after Miles was pronounced Lalala as WaWaWa. I commented that as a child I had a lisp and had speech therapy. He responded that I probably had apaxia as well and really it was not a big deal but as parents, we need to be aware so we can help him as he deals with these issues. He too suggested Occupational Therapy while sharing that Miles is a precocious, intelligent child.

I was expecting this last appointment to be the icing on the cake, not that my son needs expert follow up. I don’t want to hear that his prematurity is still affecting his life. He is thriving, isn’t that enough? Cant we just move on already? I say this knowing just how unscathed we’ve been compared to our NICU cohorts. Still its just another reminder of  a time I’d like to forget. We will get a final report in a few weeks with a formal recommendation for OT.

This afternoon Miles screamed at me to push him “faster, Mommy, faster, like a rocketship” on his new swingset.  A reminder of how lucky we are even if he still totters and asks for a wuwuby before bedtime.

Going back to Denver!

Well, looks like we are still in this race. The call with the CCS results came today - a week early. Out of four blasts, we got one normal. Woohoo! Of the other three - one was T21 or Downs, T16 - would have been a miscarriage and 1 was what Dr. Surrery called chaotic. While I would have liked to have more normals, learning this just emphasized why the CCS is so important. That T21 embryo looked great and at UCSF they might have chosen it, unknowingly, and if it implanted, I would have been back at square one two years later and out another $30k.

In the world of IF, its hard to plan ahead, even a couple months. Coincidentally both my parents, my sister and brother planned to be in Denver for Thanksgiving. We'd hoped to be able to join, do the transfer and celebrate Miles' third birthday on the 25th. But not wanting to jinx anything, we hemmed and hawed if we'd make it so it feels good to have a plan for at least the next two months.

So we are cautiously optimistic. Dr. Surrey gave us 50% odds of success. A flip of the coin. Last time I heard those odds, it was the likelihood that my second pregnancy would result in a live birth. We know how that ended.

And the race continues....

All I can say is thank the lord I could drink this past week. My sweet little embryos are growing in a lab 1500 miles away and all the while I am kept in the dark. It felt like Miles being in the NICU and I couldnt call the nurse every morning to get a detailed report on his weight and number of pees, poops and apneas. I created them for goodness sakes - I want daily reports. Which ones are still with us, do they look strong, what can we do to help the weak ones, is the embryologist giving them enough attention....please give me something!

But alas, after weeks of daily phone reports on my progesterone and estrogen numbers, I hear nothing from CCRM, save for a call from the business office to tell me they are having a problem running the $430 charge for the anesthesia. I expected this. I had been told I wouldnt get a call until Tuesday but it still wasnt easy. I missed seeing the familar 303 area code pop up on my iPhone, the nurse's bright cheery report and the assurance that all was well.

And finally Tuesday arrived. I held my phone close to ensure I wouldnt miss the call. While my son played and grabbed trains from screaming small tots, I stared at my iPhone willing it to ring. Every fifteen minutes, Dave texted and wondered if maybe I had the day wrong. Finally, finally after Miles finished lunch, my favorite 303 number popped up. 

She made it quick. Out of the eleven embryos, 4 made it to blast. Three are good quality, one is so-so but can definitely result in a pregnancy. Two others were still growing today but not enough for them to be able to biopsy. Of course, I question if I can keep those slow-growing potential future children just because they cant biopsy them. Does it mean they cant result in a pregnancy or just that they cant biopsy them? I never got a clear answer. It will have to wait for my regroup with Dr. Surrey tomorrow morning.

Net, net. We still look good. I had been told that around 30% of embryos make it to blast or Day 5 so we are on target. Now its 40% of blasts are normal so fingers crossed that we get our 1. The race continues.  I like to think we are at Mile 15. Broken down a bit but still strong.

Mile 10

Sticking with the marathon theme, if this were a marathon, I’d guess we were at mile 10. Things are looking good but as I always say, you never know whats going to happen until mile 18. Even if you look great, feel strong, the shit usually hits the fan when you hit mile 18.

And so far, we have had a pretty awesome run. My stimming in Denver continued to go very well. At my first appointment last Thursday, I had 12 follicles, all growing at the same rate which is what they like to see. My estrogen was also right on target so much that the doctors lowered my dosages of Menopur to 75 units from 150 and gonal from 225 to 75 for a day then to 150 ongoing.  By Monday, which was day 10 of stims, I had a 26 mm follicle and 10 others in close range so it was time to trigger. Unlike my last cycle, I did not have to do a gonal trigger as well as my follicles were right where they wanted them. Just one shot of 10,000 units of HCG in the butt given by DH at midnight and I was done with shots (total of 42 over 20 days but whose counting).

The retrieval was Wednesday morning at 11. And what a great experience compared to UCSF. I was immediately taken to my own room where I was covered in heated blankets. The nurse put a hot towel around my arm to prep it for the IV. Compared to UCSF where I sat next to three other women waiting for a retrieval, all of us in hospital gowns,  in the middle of the surgery center (to be fair, UCSF also offered hot blankets). Like UCSF, the IV did not go in easily. In fact, it took 4 tries until the anthesiologist made it work. Apparently, I have delicate veins. I finally saw Dr. Surrey for the first time when he dropped by to say hello and ask me to sign another round of consents about the myriad of risks from the retrieval. With that, the anethesiologist started the happy drugs and I was wheeled into the operating room (compared to UCSF where I walked in, put my own feet in the stirrups and then was drugged up). Next thing I remember is waking up happy 30 minutes later, starving and begging for a latte. The embryologist came by later to tell us they got 15 eggs, much better than I expected!

Dave’s job done, he left to pick up Miles, and head back to California. I was wheeled out where my dear friend drove me back to my brothers to convalesce. Thanks to my sister in law, I finally got my latte and I spent the afternoon watching Keeping up with the Kardashians. The CCRM lab called right before I was boarding my flight home with the fertilization report. Of the 15 retrieved, 11 were mature and ALL fertilized!!!

I want to be excited. I want to imagine those little embryos growing and multiplying, to one day be as cute and mischievous as their big brother. But I must remember we are far from the finish line. We must now wait 6 days to see how many of our adorable embryos make it to blast. Last cycle, I had 11 fertilize, we transferred 4 on day 3 and the rest arrested so I am realistic. CCRM does better than most clinics at getting embryos to blast which is why we are there. And from everything I have seen, they are much more on top of things than UCSF so I hope the same of the lab.

As I said, we are looking good at mile 10 which is a good thing. Five days and we will know just how much we have to work with for the CCS testing.

And we are off!

I used to be a marathoner.  My mind could never get around that I had to run 26 miles.  Even 15 sounded like a lot! So to get through it, I would break the race up in pieces – 10 miles, 15 miles, 20. If I get myself to each leg, the next chunk didn’t seem so bad. Of course, six more miles after running twenty is never easy but that is a different story.

So with this third round of IVF, I decided to take to go back to my marathon approach. Unlike my past two rounds, we wont be doing a transfer right away. In fact, there are so many hurdles to even getting to that point that I have to focus on the here and now. So far, I made it past the first three legs. 21 days of BCPs check. A period, check. And thankfully a successful baseline – cysts ,low E2 and progesterone levels. Last try, I didn’t even make it past this point. And today, I start my stim meds. Two units of Menopur in the morning and twelve hours later, 225 units of Gonal F plus 5 units of Lupron. The next goal post is my first monitoring appointment on Tuesday at a local clinic. Assuming that goes well, Miles and I will fly out to Denver on Wednesday. From there, we hope for continued growth and retrieval. After that, its about fertilization reports, how many (if any) make it to blast and then two weeks later, if any of those are normal. If we are lucky to get a normal, the next step is a FET but I am getting ahead of myself. One step at a time.

Surprisingly, I am pretty relaxed about the whole thing. I am more nervous about flying solo with Miles than my response to the meds. What will be, will be. We had our second and final homestudy meeting with the social worker today so nice that we are also moving forward on the adoption front. I’ve been reading several books to gain a better understanding of what we can expect. Sadly, I have yet to find a blog story or book about adoption after a biological child. My best example is my own brother and his wife who foster adopted a 10 month old boy after having twins who were 6 at the time. All I can say is that I don’t know who is luckier my brother and his wife or their son. There is so much love, its pretty much impossible to see a difference between him and his big sisters.  Just one big happy family which is all that Dave and I want to have, regardless of who births the baby.

But one step at a time. We will get there by staying strong, breathing and not trying to go to fast.

Remember who your nurse is

Here we go again. Start #2 at CCRM. This time I am on a full 21 days of BCPs. And per CCRM rules (at least the nurse I had last time around), once you start the pills, no more caffeine or alcohol. That includes chocolate. So aside from a square or sip here and there I am being good. And when I called my nurse to complain about the headaches (side effect of pills), I expected a “I’m sorry, just deal with it.” Instead, she first recommended Tylenol but if that didn’t work, some (not too much) caffeine might be helpful. I ignored that my acupuncture had already taken care of the headache, skipped the Tylenol and enjoyed a few squares of Scharfenberger. When I questioned that my old nurse told me absolutely no chocolate or wine (which she also condoned in moderation), she laughed and said “Remember who your nurse is!” So I think we are starting off on a much better note this time around.

In addition to the usual prep, I have also started a daily yoga for infertility practice. After an unsuccessful search in San Francisco, I accidently stumbled on Kat Atkinson in Berkeley who actually leads workshops on yoga for infertility. She came over for a private session and gave me a great 25 minute restorative practice that supports fertility. As for supplements, I added DHEA and COQ10 to the daily herbs, Vitamin D, Folic Acid, prenatals, and calcium I was already taking. It would be easy to follow if it weren’t that my herbs have to be taken on an empty tummy and at least 2 hours before/after any vitamins.  Keeps my day very regimented but that I am doing something.

If this weren’t enough, DH and I also decided that we were going to start the adoption process. Today was our first meeting with a social worker for our homestudy. We thought it was going to be easy until she asked what races we were open to and how open we were to alcohol, drug or nicotine use. Basically, if we want a Caucasian baby from a birth mother that has not imbibed, we might be waiting a few years. It was something we hadnt talked about and while we consider ourselves pretty open-minded (we live in the Bay Area after all), really thinking about the implications of raising a mixed-race child. When asked if we would be okay if we got pregnant and an adoption went through – ie we get 2 babies – how we’d feel, our answer was an unequivocal “we’d be thrilled!”

Our plates are full and we are moving full steam ahead to our happy ending. Whether that little squirt grows inside me or some knocked-up marijuana smoking teenager, I’ll take her/him. And thankfully the chocolate is approved along the way.

The outside world

This whole nightmare would be a whole lot easier without the outside world to contend with. I could focus on the positive, believe in the power of my body, trust in my doctors and let the memories of the TFMR fade. And alone by myself I do all of that and it works until I am reminded of the fragility of it all.

In the last week, two of my friends celebrated their second child’s first birthday. A wonderful occasion and so thankful to be included in their joy if it weren’t another ugly reminder of what should have been. I too got pregnant at the same time as them, in the fall of 2009, and like them suffered awful morning sickness and dread of having two under two. And had my dear son not had Trisomy 18, we too would be joining in the party. I would have spent the last year struggling with an active and spirited toddler and a needy and wonderful newborn rather than having spent tens of thousands of dollars on treatments and endless hours researching, shuttling and questioning. Most of the time it doesn’t hurt. I am happy with my life but the one-year marker is just another stab of what might have been.

If that weren’t enough, seeing one pregnant after another is just pure torture. You would think if all of these women could do it so effortlessly and had much greater maternal ages than I, then what is wrong with me? To top it off, my dear friend, who’s second daughter is celebrating her first this week, just announced to me that she now is pregnant with her third at nearly 42- an accident. From a fertility standpoint, she did everything wrong. She drank wine and coffee heavily, ran and was under enormous stress. So once again, she will give me the advice, “just drink and don’t think about it!” Ugh, if it were only so easy!

So I just put on my brave face, smile through the birthday parties, pat my friends pregnant bellies and offer up my nice supply of maternity and baby boys clothes. It sucks but someday, somehow, there will be an end to this.

The end goal

Whats important? A baby or being pregnant. The end goal is the same. A beautiful addition to the family, a little soul to kiss, cuddle and nurture. A little person to feed, burp, change diapers and keep me up at night. A sibling, partner in crime, and source of wonder for Miles. 

I haven’t throw in the towel on getting pregnant but its time to consider my options. Both Dr. Rosen at UCSF and Dr. Surrey at CCRM gave me the same advice. Don’t wait. Do IVF now and thankfully are both positive that it will indeed work. From Dr. Surrey’s viewpoint, its not that I cant get pregnant, its that with CCRM’s CCS testing, I can get to my normal embryo faster. Or find out that there are no normals and not waste anymore time on IVF. The plan is to start after my second AF following the miscarriage. I’d hoped to start sooner but hey, its another month to try naturally.

As much as I’d like the idea of getting pregnant without all the drugs, at this point, I just want the damn baby. I want to be nauseous, I want my pants to be too tight and not to be able to stay up past 7 pm. I want to watch my belly grow, feel those first flutters than full on kicks and endure the unrelenting heartburn. And I want to be sleep-deprived, to be awoken time and time again by a hungry, gassy baby who’s only comfort is mommy. And none of that matters if I get pregnant naturally or by IVF.  Just like it doesn’t matter if you have a natural, vaginal birth or C-section. Sure, I’d prefer natural but it’s the healthy baby that matters.

And to take it a step further, if it’s the baby that matters, why not adopt? Take the pregnancy out of the equation and if I can still reach the same end goal, would that be okay too? That I am not quite sure about yet but part of it rings true so Dave and I decided to take the first step in the adoption process, a homestudy.

Restart

Here we go again. Because of my age and how early my miscarriage was, the one good thing my OB said was that we didn’t have to wait.  So if my miscarriage was my CD1, I am now approaching the LH surge and ovulation. And sure enough, my body knows what to do, producing beautiful, clear, stretchy cervical mucous. The OPKs which I have welcomed back in my life confirmed with a light blue line that indeed I was surging but I wasn’t quite there. No smiley face yet but Dave and I are still putting the sperm in place and using preseed to help them get where they need to go.

Amazingly, I am calm, happy and positive.  Hard to believe just two weeks ago, I couldn’t pull myself out of bed and now I am raring to go. All it took was a little cervical mucous to remind me it aint over. My body knows what to do. I just need to have faith and nurture it along.

BFP....Psych!

I waited 8 days after my period was late to take a test. I calculated my ovulation was a week late so why torture myself with a negative test. Finally at 2:30 am, I broke down. My boobs hurt, I couldn’t sleep and I could no longer make excuses why AF hadnt come. There was a good reason. I was pregnant.

Suddenly, a weight had been lifted. There would be no trips to Denver. I was no longer cursed. My body indeed worked without the help of fertility drugs. The Mayan masseuse worked miracles. By 7 am, my online crew was sending my congrats, I had texted photos of the positive test to friends in Philadelphia, Atlanta, Ohio and New York. And I was busy giving advice on how to reach Esther for a massage and what to expect. It was my happy ending. How it was supposed to be after everything we had been through these past 15 months.  The due date was February 1, three days before Miles should have been born so I had conceived the same cycle. And if the Hong Kong psychic was right, the baby would be born in 2011, a little early but maneagable. To say I was over the moon would be an understatement. I was walking on air with a perma-grin.

A week later, I noticed that my boobs weren’t so big, I wasn’t exhausted and the nausea hadnt set in. I chalked it up to that I wasn’t far enough along and every pregnancy was different.  Besides I was busy, very busy, packing boxes night and day for our big move and taking care of one very active toddler. I didn’t have the luxury to go to sleep at 7 pm.

Then the spotting came, two days after we moved into our new house. I tried to say it was implantation but deep down I knew, it was very different that what I had seen in my past two pregnancies. My doctor brought me in three days earlier than my scheduled visit to alleviate my stress. Then she couldn’t find my uterus and sent me to pee. The second look wasn’t any better so she brought in another doctor who indeed saw my uterus but nothing there. She consoled me that it was too early and left me with a photo of my empty uterus and a lab slip to check my HCG and progesterone levels. She called later that day. My HCG was at a mere 385. Normal low would be a 1000. Things weren’t looking good. And I was still spotting.

Two days later, it was officially over. My happy ending was literally bleeding out of me complete with debilitating cramps. It didn’t help that Miles was sick and I was 20 miles and a heavily trafficked bridge away from my friends, babysitters and comfort zone. Suddenly the weight was back. I dreaded seeing pregnant women with toddlers younger than DS in tow, I curse even my dear friends who have easy 1-2 pregnancies with nary a worry and easy births and wonder where my positive-no fertility-drugs attitude has gone.

The wait

The two week wait is never easy.  Even when I am scrambling day in and day out to keep the house clean for showings, taking a happy-one-minute-screaming-the-next toddler from activity to activity, hosting twenty plus family members from around the country and slowly organizing our house for the big move, still, I know the days, minutes and seconds until my period should arrive.

I took a new approach this month. I threw out the OPK (ovulation predictor kits), ignored the no-caffeine, no alcohol policy and exercised how I wanted. We had sex around the time I should have ovulated but skipped the twice a day. I did keep up the twice a week acupuncture and daily herbs. DH even went to the acupuncturist per her instructions. I maintained my positive, healthy attitude gained from the Julie Indichova books. If it will be, it will be. I don’t want to do IVF. I can do this naturally.  I believe in my body and know its capable of nurturing a healthy child.

Then as usual, my body starts f**king with me. My cervical mucous seemed more fertile around day 19, very late for me who usually ovulates on day 14. Two days later on day 21, I woke up with a pain in my pelvis, sign of ovulation. Then a few days later, my breasts started to feel tender. Before termination but now it happens before AF comes. 

So for a week, my mind jumps from hope to despair. I am tired, I think I am pregnant. My boobs hurt. Could go either way. I don’t even dare look at my boobs close up. If they are veiny and bigger, I am pregnant. If they are not, well maybe every pregnancy is different. I am not spotting. I usually spot a few days before AF. Good sign but I ovulated late. I don’t want to think about this but each twinge, yawn or visit to the bathroom invites speculation. I allow myself to hope then remind myself of the despair that will come with one drop of blood.

Its day 28. DH and I anxiously awaiting offers on our house and AF. So far, there are three offers to review and no AF.  Two more days and I will POAS.

A deserved break

I realized that since my termination in January 2010, my sole focus had been to get pregnant. Each month I planned around my ovulation, when I would find out and expected due date.  After two months of trying, I went straight to the RE to start IUIs and after 4 failed IUIs, I insisted on starting IVF ASAP. After the first failure, we immediately got back on the bandwagon. Even in our one natural cycle I flew out to CCRM for the work up and then had multiple subsequent blood tests. And all along, I have been going to regular acupuncture appointments, taking herbs and an ever increasing number of vitamins. Not to mention the growing restrictions on my diet and physical activity.

Since my cycle was canceled, I can honestly say that I feel a weight has been lifted. I am not stressed about drinking a glass of wine, sneaking an extra piece of dark chocolate or working out too hard. It is wonderful, oh so wonderful, to enjoy a natural cycle, free of hormones and let my body do what it supposed to do (ok with a little help from acupuncture and herbs). I know my ovulation is coming but I am not peeing on sticks, charting or looking at my mucous. DH and I are just enjoying the act without making it a job.  Will it work? Who knows but for now, its what I need. It allows me to focus my attention on moving, selling our house, my nephews upcoming wedding and most importantly the amazing son I already have.

While I definitely don’t agree with everything in Julie Indichova’s books Inconceivable and a Fertile Heart, after reading them I found a faith in my own body. I trust that I will get pregnant again. It may not happen when I want it to but it will and I will have a healthy baby.

The things we do

The desire for a baby has taken me down many roads I never imagined.  And today, I added one more. My friend, Suzanne, who at  41 was also dealing with secondary infertility told me about this woman in the Mission District who does a massage to lift your uterus. She’d heard about it from her cleaning lady who said got pregnant the first cycle after going to her. Her cleaning lady’s friend, another case of secondary infertility, also got pregnant after seeing her. Then Suzanne went and what do you know, she got pregnant the next cycle.

So when my cycle got canceled, the first thing I did was make an appointment. Suzanne warned me it was uncomfortable and the woman, Esther, didn’t speak much English. I imagined she worked out of her home and that it might just be like an abdominal massage. Unpleasant but manageable. Was I in for a surprise!

She led me down an alley behind her house to a small shack closed with lock and chain. The tiny room was filled with Mexican chotkes, two large display cases with vitamins for sale, and a large flat screen monitor on the wall. Her table was a plank held up on one end by a concrete block. In broken English, she referenced a picture of the uterus and ovaries on the large monitor and described how over time our uterus drops and there needs to be space for a successful pregnancy. Her job was to create space.

And creating space is not pleasant. In fact, it is excruciating. Using Bengay and Vaseline on my belly, Esther pushed and pushed, digging into my lower abs, coaching to me to relax when I screamed out in pain. Apparently, my uterus was very low because Esther had to work quite hard to move it up. I begged for mercy several times, just for a moment to breathe, but I focused on the end goal. The baby and if this is the pain I have to get through to hold him or her, its more than worth it. And it’s a whole hell of a lot better than shooting myself up with hormones!

After it was over, including an even more painful thigh massage, Esther wrapped up my belly in an old pillow case I’d brought. She instructed me to leave it on for 2 days, no shower and to take it easy (yeah right!). And then Esther proclaimed me okay and to call her if I was not pregnant in 2 months.  Fingers crossed!

Inconceivable by Julie Indichova

 I am not sure how I missed this book before but I am so glad I found it. Inconceivable is the true story of a woman who at 42, found herself with high FSH and little hope of conceiving a second child. Unable to do IVF, doctors pushed her towards donor eggs as a last resort. Instead of taking their advice, she followed her gut and made radical changes in her life – diet, yoga, cleansing, visualization –saw her FSH drop by half and eventually conceived naturally at 43.

After finishing the book, I was ready to swear off sugar, refined flour, dairy, meat and anything else that did not help better fuel my body. I committed to a morning, veggie shakes, half an hour of yoga a day, daily visualization and mind work to understand my mental blocks.  And reading through the glowing testimonials both on her web site – www.fertileheart.com - and Amazon, it appears that this approach works. One woman after another tells of attending one of Julia’s workshops or reading her book after years of IF and then getting pregnant within a month or two. The majority of the women are in the 40s and have been told by doctors that there is little hope for them. Thanks to Julia, they find the balance and mostly the belief in themselves that they, not the doctors, are in control and allow a beautiful life to be born inside them.

Thankfully, my FSH is not so high (7.3 and falling from 8.8 last year) but my womb is still empty.  Inconceivable struck a chord in me that I could do this, that my body is capable, that I don’t need all of these fertility hormones, that we can do this on our own. So when my cycle got cancelled, I didn’t feel the letdown I expected. Yes, I am turning 40 next week but somehow after reading the book, I believe it will happen. Not on the timeline I would like but I will be pregnant and I will deliver a healthy child.

Canceled

Before every IVF cycle, the nurse typically gives you a calendar telling you what to do when. When to start and stop your birth control pills, when to start Lupron and how much, when to start stims and how much, appointment times for the baseline ultrasound and rough estimates for follow up appointments and expected retrieval date. During my cycle, its my bible, at least until I start Lupron.

Somehow I forgot that change and flexibility are key elements of IVF. Just because the schedule says that you will get your period between Monday and Thursday and to schedule a baseline on Friday means that it will happen. It should happen but in my case, it did not, causing even the CCRM nurse to wonder what could be wrong.  Maybe my lining was thick enough from only 12 days on the pill to have a heavy flow? Maybe, just maybe I was pregnant already?

In true CCRM fashion, a different nurse, a different plan. The first one tells me to keep on waiting and just call when I get my period. The second orders me to immediately take a pregnancy test and if that’s negative, go to my baseline. “We have to see whats going on in there.” She said. And in case you were wondering, I am not pregnant so this morning, it was back to UCSF for my baseline and bloodtest.

The good news. My AFC is 12 and my lining is very thin. So thin that the UCSF doc does not think I will get a period. Happens, he says if  you aren’t on the pill long enough. The bad news I learn later. My estrogen is 78 and my progesterone is 18.  Even if my estrogen was close (they like it under 50), my progesterone needs to be around 1. Yikes! So what does this mean? The illustrious Dr. Schoolcraft who was on call this weekend recommending canceling the cycle, that is unless my period miraculously comes before Monday.

Surprisingly, I am relieved. I still take my meds through Monday but I have moved on.  Cycling this month in Colorado meant spending my 40^th birthday jacked up on hormones instead of celebrating with friends. I had opted on missing out on my best friends from college’s visit to San Francisco for the famous Passport wine weekend in Dry Creek valley. It seemed worth it at the time. If we missed this month, we wouldn’t be able to cycle until July with a transfer in September. So now I feel free. Free to indulge in a bite of chocolate, a glass of wine and truly enjoy the last days of my third decade.  I guess that is what my body truly wanted.

Here we go!

Three thousand dollars in meds (just to start), $200 plane ticket and way too much for everything else at CCRM, but we are on our way. I started birth control pills last week and two days ago, began daily Lupron shots and dexamethosone pills. The goal is to quiet my ovaries before starting the stim shots next Friday. My first two blood tests and ultrasounds will be at UCSF and then I fly out to Denver on the 27^th. Fingers crossed my body responds as well as the past cycle.

Turns out that all of those vials of blood were useful. CCRM found that I have elevated clotting levels (no idea what the exact terminology is for my diagnosis). What that means is I will be on Lovenox, a blood thinner, before the transfer and if pregnant, through the first trimester. Crazy but I am happy they found something and there is something that they can do about it! Much better than more of the same which would be happening if we stayed at UCSF.

Now that I am in cycle, caffeine (including chocolate), alcohol and high impact exercise can no longer be my friends. Same goes for the herbs my acupuncturist prescribes. (Full disclosure I took the herbs during my last cycle. Best response but no BFP.) I did sneak one square of my favorite dark chocolate last night (and another the night before). Whats life without a vice or two and chances that this is the deal breaker….well, I don’t want to think about that!

Its the lab, stupid

The bad news. I got my period or AF in girl speak. My hopes at a natural miracle gone, its time to get the next IVF started. But given that its me and I can leave no stone left unturned, I went to talk to Dr. Rosen one more time in the hopes that he might be able to convince me that CCRM wasn’t my best option.

I will say he came close. During our 45 minute chat (eons in doctor time), I truly felt that he would do everything in his power to get me pregnant and was confident that I would have another child. And I wanted it to be him. He begged me to put all of my stress on him so that I could relax more and enjoy my life. He even instructed me to drink coffee and a couple glasses of wine a week Wouldn’t that be nice? Dr. Surrey, by comparision, spent a short 15 minutes with me and confident as he was in my chances, I didn’t see him taking that kind of time to get so personally involved in my case. And I know wine and coffee are absolutely taboo at CCRM.

I left UCSF with a plan. We’d take off the month so I could celebrate my birthday. Drink, run, gorge on chocolate and forget about trying to have a baby.  We’d start in May and do a frozen embryo transfer in June. No chromosomal testing like we have planned at CCRM.

Then I remembered why I chose CCRM in the first place. I knew it was a factory, the doctors prescribed protocols but showed up only at retrievals and transfers and that I would have to be pushy to get the best care. On top of that its not convenient, its more expensive but there is a reason women from all over the world who have had multiple failed IVFs and are at the end of their ropes go there. The lab.

Only three clinics in the country offer the same degree of chromosomal testing and while we might not “need” it, it will certainly improve our odds. It doesn’t matter how much I like Dr. Rosen. What matters is that I want a baby, another child for my husband and a sibling for my son. And CCRM, bedside manner aside, is our best option.

Tests, tests and more tests

At last count, I’ve given 16 vials of my sweet red blood to CCRM’s exclusive program. I’ve been tested for everything from Vitamin D to AMH to the entire Thrombophilia Panel.  On top of that I’ve signed fifty pages of consents, many of which were opting out of even more blood tests screening for the most elusive chromosomal abnormalities. And this doesn’t include the tens of other tests I don’t need to have because they have already been done. Or the ridiculous amount of my past history that must be received before moving forward.

Every time, I think I have finally gotten them everything, my lovely nurse, Rhonda calls to remind me of what she has yet to receive. And it appears that CCRM, as competent as they are with fertility, cant seem to keep track of paperwork. It started from the initial phone consult back in February when I got a call the day before saying my records had never been sent. Infuriated, I took it out on the poor records lady at UCSF who swore she had faxed all 68 pages and probably in fear of my wrath, did it again (and again when CCRM couldn’t find it). This time I was at CCRM when the faxed was received and even confirmed it the sender. Two weeks later after Rhonda sent me orders for a 20 vial blood test which I swore I had had and asked yet again if she had seen the results and she brushed me off saying it was a different test,  lo and behold, it arrived on her desk and she called to tell me to hold off. And just in time, I was packed in the car and ready to lose a couple pints. Rhonda did say she was sorry and that I would need some more tests run – only 8 vials.

Its enough to drive you crazy! Add in the roller coaster of home buying  - I wont get into our loan process or the hoops I’ve had to jump through to get approved. And I will skip the details of selling the house in a declining market in which our agent now predicts our home will sell for $125k less than she estimated six months ago. Come on, this is San Francisco and there are very few homes on the market! I will also leave out Miles’ latest toddler antics in which Thomas and friends are constant sources of bribery.  So what if he only eats when he is planted in front of a Thomas video. At least he gets his veggies.

All of this led my very astute husband to suggest that maybe we are rushing into CCRM. Perhaps we could wait a month or two or three. Try the old-fashioned way, take the stress off and relax a little. If only it were that easy. The fact that I turn 40 in a month holds little sway. Somehow he missed that we, well I, have limited time before the window closes and each month counts. I try to figure out alternatives – an IUI here, another IVF – but in the end, each failure gets me back to CCRM but with older eggs. It wont be convenient, it wont be easy and from what I can tell, no one there is going to hold my hand through it but it really is our best shot.

Just three years in...

Three years ago today, my husband vowed to be there in good times and bad, to wipe my tears, to comfort me with his body and spirit and nurture my best person and of course, not drink bad wine. We didn’t know what the future would hold or how much our relationship would deepen in the next three years. While we had already been introduced to UCSF, we were neophytes and had no idea how lucky we were to get away scott-free with a pregnancy on our first IUI.

I like to think of year one as Miles. Seven months after our wedding, our dear son was born via C-section at 5:47 am.  Ten weeks early and just three pounds, five ounces, Miles taught us quickly the challenges of parenthood. The 45 days he spent in the NICU were some of the toughest in my life even though his stay there was easy compared to many of his cohorts.

By our second anniversary, we barely managed a quick dinner to celebrate. Too exhausted by twice a night feedings, constant pumping and worrying about long term problems from Miles’ prematurity lingered. Everything seemed to sort itself out for a bit. Miles learned to crawl, turned one and I got pregnant easily. Then things fell apart. I lost my job, found out the baby had Trisomy 18, terminated and two weeks later, Miles was in the hospital with RSV. Miles had barely gained a few ounces back from his sickness when Dave lost his job on our second wedding anniversary in the middle of a costly home renovation. On a bright note, Miles was sleeping through the night by then and we enjoyed a great dinner and a full bottle of lovely wine.

We’d always wanted two children and assumed it would be easy to get pregnant again. This past year, we’ve watched month after month go by, one negative after the next. Escalating treatments from IUI to IVF in hope of getting there faster and still, an empty womb. We find ourselves on our third anniversary ready to travel to CCRM for a final try. At the same time, we bought a house in the burbs to be closer to Dave’s work and begin the process of selling our beloved San Francisco home.  The blessing throughout has been Miles, who turned 2, in November and is completely caught up to his developmental age. While he might try our nerves more than I like to admit, we never for a second forget our fortunate we are for his health and adorable spirit.

Tonight, I will break IF rule #1 and open a fine Brunello. We will toast our perfect little boy and the strength of our relationship, made so much stronger from what we have been through these past three years. And to the hope that the fourth year will bring Miles a little brother like the fortune teller saw and that next years anniversary be filled with sleepless nights.

They are everywhere!

I like to think of myself as one of the moms picking up my son at preschool. Dressed in my Lululemon work out gear, I rush in a few minutes before 12, make small talk, sip tea and wait for the door to open. And my son, just like the other children, comes bounding out with a huge smile, screaming Mommy! But today, I realized, I and my son are different.

I arrived a few minutes late and immediately was assaulted by three 8 month pregnant bellies. I overheard one woman, resting back on the couch, feet on the coffee table, moaning about not being able to sleep. The woman next to her, rocking her newborn in a carseat, nodded in commiseration. Another one brought her four-year old son along and the two discussed his own morning at school. I saw the nanny of my son’s favorite friend in class, and she too, wore a Bjorn with her employees baby daughter encased. I was alone. A mother of one. How easy she has it, they must think to themselves.

Times like this, I wish it was just a choice to have one. We could get on with our lives, fully content with the decision that we made. But as my therapist said, even if we find our way to that place, it will always be our second choice. How sad is that? And then I remember that my own dear husband was not my first choice nor I, his. We both married before and thankfully fate brought us together, giving us our second and in his case, third choice. So if we come to that, I am confident, we will look at it as we do each other, as the only way things could have been.

A new house

As if the stress of IVF weren’t enough, we decided to throw buying a new home into the mix. For the last nine months, DH’s commute has been a grueling 40 miles/90 minutes each way. And after months of searching for that perfect home in just the right school district, close to trails, with a walk-in closet, level and west-facing backyard and with just a little bit of character, we found it.

Today, as we poured through more than 200 pages of disclosures and inspections, I began to wonder if it was too big. Right now, we live in a three bedroom, 2 bath, 2000 square foot home in San Francisco. In Ohio where I am from, it is tiny, the size of the bathroom and walk in closet in my brothers home. But here, it is spacious, even enviable. Perfect for a family of three and still comfortable if we have our rainbow.

Again compared to the Midwest, our new house is compact at 4 bedrooms, 3 baths and 3000 square feet. When we looked at houses, 4 bedrooms was always the minimum along with the assumption there would be a second child. Yet when today, the new house still filled with the current owners belongings, 20 miles away, felt empty. I wondered if we jinxed ourselves by buying for what had not come easily to us yet. Should we have just settled for a smaller, more affordable 3 bedroom? What if it is just the three of us?

Dave said we’d grow to fill it. Either by us or through adoption. A concept he has been resistant to until today. I am still on the fence that I could handle the emotional and financial rollercoaster of adoption after enduring the one we have been on for the last year. At some point, life must move on with other things taking priority.

In the meantime, we’ve got work to do. I am gearing up for an April stimulation and retrieval at CCRM so am busy getting all the necessary tests and paperwork completed. We have final inspections and contigencies to remove on the house. Packing, and getting our current home ready for market. And I’ve decided it might be time for me to go back to work.

Worth the reputation?

So now I know what a “real” fertility clinic looks like. It is set amidst spectacular mountain scenery at the southern end of Denver sprawl. Doctors work out of a brown and gold brick building boasting the Colorado Center for Reproductive Medicine logo from both the streetfront and entry doors. It goes without saying that there is easy, ample and free parking – very important to San Franciscans. Nurses greet you with big, self-assured smiles and always make sure you pay before services are rendered. And American express is not welcome.

But really what matters is what goes on in the clinic. Our visit started on Friday. When we scheduled the workup, I’d been told that it was impossible to do everything in one day so Dave’s andrology (semen evaluation) and blood work had to be done earlier. Well, all of that took just 30 minutes and $950 and he no longer had to return with me on Monday. We were not off to a positive start.

I returned on Monday morning at 7:30 am sharp. Good thing for the coffee cart in the lobby but unfortunately, I was still off caffeine. After an hour overview of the clinic and policies with other newbies, I really got started. My $600 baseline ultrasound was performed by a nurse – at UCSF, it is always an RE or resident under supervision. While I sat in stirrups, I had a full view of my uterus and growing follicles on the screen in front of me. She showed me my c-section scar, the residuals from last months IVFs and the beautiful dominant follicle that might just might be my rainbow.

Next up was the $750 hysteroscopy procedure and my first chance to meet an actual doctor. Feet back in stirrups, speculum and a camera inserted into my uterus to get a closer look. All of three minutes later and the doctor announced that he saw nothing abnormal. We retreated to a consultation room for a 15 minute regroup where the doctor basically repeated most of what I heard on the phone during my initial consultation with the additional information that Dave’s sperm is great, if a little viscous (sticky).  I have unexplained infertility. I had a 75% chance of a getting a normal embryo and then a 60% chance of that embryo implanting – so we are back to 50/50. I wondered out loud about trying naturally – odds are 10-15%/cycle but given my age, there is a 40% chance of miscarriage.  Of course, if we don’t get a normal embryo, its unlikely we would with another cycle. That would be our answer. All for just $30,000. The doctor is smart and sure of himself while he watches the clock. After 20 minutes, my time is up.

I kept my pants on the rest of the morning as I indulged in dark chocolate, met with the business office, my primary nurse, got 10 vials of blood taken (another $1300), watched a video on CCRM’s  chromosomal testing and received consent forms to sign.  I walked out the door at 12:30 (an hour early) arms full with my information book, consent forms, prescriptions and a return box for another blood test in San Francisco.

Was I sold? Yes, if we decide to do another round. I cant get over the rigormarole we subject ourselves to just to have a second child. Shouldn’t my body be able to do this naturally?  Yet when I return to my brothers house where I have been staying and Miles greets me with “Wheres Daddy?” before chasing the cat, I know its something we have to do. 

And for what its worth, I was more than slightly peeved when a nurse let it slip that there tons of openings on Monday for Dave’s appointments and they could have easily accommodated us on 1 day. Like we didn’t have anything better to do than spend two extra days in Denver! As long as the doctors and embryologists know their stuff, I guess we can live with the admin's mistakes.