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.