The odds

I first started fertility treatments when I was 36. Diagnosis was unexplained infertility. The typical treatment is Clomid with an IUI. For women of my age, I had a 50% chance of getting pregnant in three months at which point, it is no longer very effective. I scored on the first try.

At 38, my odds of a chromosomal abnormality of a chromosomal abnormality were 1/102 or roughly 1%.  I hit that jackpot with flying colors. Through CVS, the boy I was carrying was diagnosed with Trisomy 18, which technically means a third 18^th chromosome (we all have 26). Unlike Trisomy 21 (better known as Downs Syndrome) which I had a 1/173 chance of, babies with Trisomy 18 have a 50% chance of dying in utero. Those that make it will spend their short hours or days fighting for breath before succumbing to their disease.

If you look at the sart.org stats for UCSF (diagnosis unexplained infertility; fresh ocolytes), my odds of success with IVF are approximately 48%. Pretty good. And considering I managed to fall into the 1% for the bad news, how hard could it be to find myself on the positive side of 50%? Its like flipping a coin. That’s the problem, its just like flipping a coin, and as we all know, you can flip a coin two times in a row and get tails both times.

Throw into that every cycle is different. You bet the $17,000 IVF cost that your over-stimulated ovaries will release healthy, ready to fertilize eggs. You bet that of the millions of sperm, your team will choose the right ones to inject creating a viable, Grade AA embryo. You bet that your lining will be just cushiony enough for those fertilized embryos to snuggle up.

And sometimes you lose. Even when everything looks perfect. When the RE gives personalized attention every step of the way, your body performs, the embryos don’t fragment and your transfer is on Valentines day.  There are no guarantees in IVF.

There are worse thing in the world. Life will go on. Many women go through far more to become mothers and many give up before they discover that joy. That is known but for a time, it doesn’t make it better.

A night out

For those still counting, I am on day 11 of the 2ww. Monday is my beta – fertility speak for blood test. I wont lie. Its been a rough time so when a friend invited me to see Prince last night at the Oracle Arena, I jumped at the chance. If it were only that easy, as my dear husband reminded me.  Every night around 10 pm, he gives me a shot of progesterone in my butt to support the embryos that we hope are still growing inside me. Given that I was going to a concert, I might not be home until midnight. Would it be okay to take it a couple hours later or earlier before I went out.

Oh the inconveniences of IVF never end! It took me two calls to UCSF, two different nurses and two different answers. The first, who rushed off the phone to search out her own Prince tickets, gave a firm no. It must be given at the same time, every night. The second nurse, who informed that the first was merely an IVF coordinator and not the in-cycle nurse, and has no authority to give those directions, said it was a-okay. A couple hours here or there made no difference.

Permission granted! And then another crisis. Dear husbands car (well actually my car from pre-marriage) died on the Bay Bridge at 6 pm. Once he reassured me he was safely off the bridge and didn’t cause an accident or major traffic delay, I frantically called every babysitter, including the ones I swore off due to heavy perfume and other oddities not worth getting into, because who knows when he’d get home now. One no after another – that’s what you get for using college students that either have a life, need to study or are already booked – and I despaired. At 7, there was no way, we’d make it to Oakland in time.

He walked in the door at 7:20 pm just in time to sit down and read Miles the last books of the evening. An hour later, my friend and I were happily in our nose-bleed seats in Oracle Arena, sharing the excitement with our friends on Facebook and listening to what we thought was Sly and the Family Stone or something like that. Prince came on at 9. Rocked us through songs of my high school years – Little Red Corvette, 1999, Purple Rain, Jungle Love and much, much more until we left after the last encore at 11:30. Click here to see the whole set list.

And at 12:30 am, the shot was delivered. Only two hours late. A great respite from thinking about the 2ww!

 

Jacked up

Don’t f*ck with me this week! I am a woman jacked up on a sinister mix of progesterone and estrogen working furiously to nurture and support the hopefully growing embryo(s) in my uterus. Today, I tore off the head of the poor woman who answered the UCSF answering service. She had the unfortunate job to tell me that the worthless  records department that had failed to send my files to CCRM for my consult tomorrow a week ago was out for the holiday. Don’t get me started on the f*cked up state of UCSF’s back office. By the time, I slammed the phone down, nearly shattering my screen, I was in tears. I turned to scream at my dear husband who just begged me to please calm down. I responded by screeching the Subaru out of the garage delighting my 2 year old and sending the dog cowering into the backyard.

Hours later, DirectTV received my wrath. How hard should it be to set up a Payperview so I can just sit and enjoy a movie at my convenience. Did I mention, it was the second night in a row, I didn’t get to watch The Social Network and I am tired, very tired of Law & Order reruns. Once again, my sweet husband attempted to jump in between me and the victim of my rage on other end of the phone. For that, he got cauliflower thrown in his face.  This time, it was a $5 credit on our bill for the next three months to pull me back to my senses.

Until 8:30 am tomorrow morning when UCSF records office opens…..

My girls

Like I do with most things in life, when I found out the baby I was carrying Trisomy 18, I turned to the Internet. There, in cyber world, I found compassion. Not that my dear sweet husband or incredibly supportive friends weren’t devastated alongside me, they just didn’t get it. They couldn’t tell me what to expect from the procedure or how long it would take to get back to normal. And they couldn’t answer the question on how soon I could try for and likely get pregnant again.

And as the months ticked by when that BFP (Big Fat Positive in Fertility speak), didn’t show and my real world friends stopped asking if we were still trying, I popped by head in a few times. By then, I joined a board of women trying to get pregnant after termination for medical reasons (TFMR), all of whom just wanted their rainbow and NOW!

Today, six of these women, I know only by screenname, have become my rocks. We follow each other cycles, offer advice on new protocols, cry for each others BFNs and are the pillow to cry on (or punch) when yet another friend or acquaintance got pregnant without hardly trying.  Nothing is too sacred – bodily fluids, anger, frustration, jealousy – and of course, more fertility tips than you could ever possible need to know. Still waiting to get a secret European honey recipe that will guarantee pregnancy.

These women’s virtual hugs after a bad day are stronger than my closest friend like yesterday when a friend made an insensitive comment about my fears during the 2ww. They have been through the same hell and like me, are now in the double hell of infertility. All they want from me and I for them is a BFP. And for that, I feel so very lucky.

The two week wait

I am 4 days into the two week wait for IVF #2. For those of you uninitiated, the 2 week wait or 2ww in fertility speak is the time after transfer until finding out if you are pregnant. To put in bluntly, its not an easy time. Up until then, you are busy with ultrasounds, bloodwork and mixing your nightly shots. REs and nurses readily answer your questions. You know your follicle count, estrogen (e2) level and uterine lining. And when the follicles you so lovingly grew are retrieved, you can relax. A little at least as you wait to hear how many fertilized and what your options are. Then it is a question of egg quality - 4,5,6,7,8 cell, grade 1, 2, 3, 4, and amount of fragmention. Then boom, a dose of valium, a glance at pics of the chosen embryos, your signature, name check with the embryologist, spread your legs one last time for the RE, speculum and their in!
And now what? The shots continue but this time in the butt and my dear husband has the honor of shooting me. No doctors appointments, no follicle counts, just a list of vague instructions. Take it easy, exercise but dont raise your body temperature ie no running, high impact aerobics, dont lift anything over 15, or well 20 pounds (not easy when you have a 2 year old) and if you feel stress, focus on your breath.  And by the way, there is nothing you can do to affect the outcome. Just wait.
So here I am, 4 days in and feeling fine. Hoping those little embies are snuggled in nicely

In search of my rainbow

In August 2008, three and a half months pregnant, I found myself in Hong Kong for a business trip. Channeling my inner traveler that used to be, I snuck off to the Kowloon night market. Since I couldnt risk sampling the street food, I bargained for fake Pradas, picked up $1 knick knacks for my nieces and nephews and sat down with a psychic. It wasnt the first time. Its one of my favorite traveling pasttimes. I write down what they say and put it away to look back to see if anything they said actually true.

Dressed in an oversized shirt that hid my growing belly, I randomly picked a man in a long line of tables on a dark street. He spoke enough English to ask me for $20 and a few pertinent dates that I no longer remember. He then wrote numbers frantically on a dirty piece of paper circling important information. "You will have two sons. One born in 2008, one born in 2011." Three years in between kids? I was too old for that. And I was due in 2009. And wow, I was having a boy. My husband and I opted to wait until the baby was born to find out the sex. He went on to tell me that I was with a good man that would provide for me. We would have a nice life without much illness. After I left him, I took a cab back to the Four Seasons, scrubbed off the street grime and in the morning, flew back home, putting aside the night before.

Three and a half months later when I was just 29 weeks, 6 days pregnant, my son was born. In 2008, just like the psychic had foretold. For a year it was something I laughed about until I found myself pregnant in November 2009. The doctor proclaimed it, "A perfect pregnancy" at my eight week ultrasound. The psychic must have been wrong, I told myself, but like any woman in her first trimester, I was on pins and needles. I guess I shouldnt have been surprised when I went in for the CVS. Moments after my husband and I giggled at ultrasound images of our baby moving around, the doctor put a hand on my arm and told he was concerned. The nuchold was much too big for a baby of his gestational age, a strong indicator a chromosomal abnormality. At best, there was a 50% chance I'd deliver a healthy baby. I didnt need to wait the three days for confirmation that indeed our son had Trisomy 18. I knew. I wasnt supposed to have a baby until 2011. I took small comfort in that it was a disease "incapitable with life" and that he was a boy. Even if we had not terminated, he would have more than likely died in utero or within hours after a premature birth.

We began trying for a rainbow - the baby that comes after a loss - as soon as the doctor okayed it. I should have known it wouldnt happen right away. The baby couldnt be born in 2010. After four months, I turned to a specialist. Four months and four unsuccessful IUIs later, we upped the ante and moved to IVF which brings us where we are today.