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.