Thursday, April 30, 2009

Wow & K's Penthouse Uterus

Wow is really all I can think to say. When I told J that 78 people commented that they regularly read my blog his response was "wow, did you say 78?" Yep and that doesn't include my non-blogging friends who can't post comments without signing up for a account. I can literally feel the love and positive thoughts flowing our way and it makes me smile. I can not thank you enough for coming out of the shadows to say hello and for following my journey!

It warms my heart to hear that so many of you watched my tribute video to Myles and that it moved you in some small or big way. It is music to my ears to hear you whisper the soft syllables of my son's name and to hear you say that his fight was an inspiration to you. Although I wish that my words did not resonate with so many of you, I am happy that you are able to find comfort in knowing that you are not alone in this struggle. You are all brave women (and men) who face each hurdle with as much grace and dignity as possible. Please don't ever forget that. For those of you who read, but do not know the pain of infertility or babyloss I must say thank you for trying to learn and understand. I wish more people were willing to look into the sad eyes and broken heart of an infertile and attempt to empathize with our daily struggles. For those of you who are following my blog because you are inspired and moved by K's generosity and strength I must tell you I'm right there with you. There isn't a day that goes by when I don't say praises for K and her wonderful, supportive family. K is an amazing, brave woman and a damn good teammate! I am grateful for whatever brought you hear and keeps you coming back. It's an incredible feeling to know that I have a such a strong, supportive army of people surrounding me as I continue to walk through the "flames" in pursuit of our dream.

Um, no I don't mean the smutty kind of when I'm talking about K's uterus (although it did look rather sexy on the ultrasound today), but rather the posh, highrise luxury apartment kind. I joked with K at the beginning of our journey that her uterus is like a penthouse and mine is more like a dilapidated shack. Well today K's uterus maintained its penthouse reputation and looked perfect on the SHG. My RE said that the D&C didn't seem to cause any problems for K's uterus and that we are all clear to go ahead with our cycle in June! We are over the moon and now anxiously await our calendar, which I was assured we'd have by the end of next week. :)

Tuesday, April 28, 2009

Come out, come out wherever you are

Thank you so much for your open and honest comments regarding my recent post. It was nice to hear how many of you try to make sense or tragedies or for the majority of us how we are unable to make sense of them. I'm currently reading The and plan to read The of N.ow in the future and am hoping that both are able to bring me a bit of enlightenment. But for now I will just be as I am discontent with not understanding the bad things that happen to good people.

After reading the comments by some first time commenters (some who identified themselves as longtime readers) it got me wondering who else might be reading but not commenting. I know that several people IRL read my blog, but few of you comment. I would LOVE to hear from all of my readers, so please just post a hello comment to this thread. I'm not looking for profound words or anything, just a simple hello. If you don't blog, you can still comment using the "Anonymous" option. Also, I'd love to know how you found my blog and why you read it. I often wonder why people read my blog. I wonder is it because it's like a car accident that you can't stop staring at or is it because you are just rooting for me, "the underdog", to have a happy ending. Either way I'm just curious what brings you to my small place in cyberspace to hear about my struggles, particularly becaue it's not always rainbows and roses here. Now don't be shy. Please step up to introduce yourself! I can't wait to "meet" all of you! :)

Sunday, April 26, 2009


I read my comments for today's post and want to thank those of you who've shared your thoughts regarding these issues. After reading Mary's comment I want to apologize and clarify what I was trying to say. I am sorry if I gave any of you, my blogreaders, the impression that you were the ones saying the trite platitudes. You are NOT! Anyone who takes the time to read my blog and follows my journey is sincere when they wish me well. This includes the girls on the message boards who have followed my journey over the years. I was referring to the newbies on threads I frequent who don't even take the time to read my siggy to get a snapshot of my TTC history before they tell me that they "know it will happen for me someday" or some even say things like "someday you will be a mommy". Well you can guess how much that one makes my blood boil! I am very fortunate to have such a strong following here in the blogosphere and can't thank all of you enough for your continued support and encouragement. I was just annoyed with some recent insensitive comments to me and others on some message board threads. I am grateful that there are brave, caring women IRL and in the blogosphere who are willing to walk with me through the flames. So, thank you!

Mary, I apologize for making you cringe after reading my recent post as that was not my intention. I have to admit that I don't know who you are on SC (what's your screenname?), but I do appreciate your support here on my blog and on the boards. There are some girls on SC who aren't sensitive to the heartaches of others and that was what was annoying me. There was a particular incident recently on SC where one of my friends who's going through hell right (her water broke for one of her twins at 17wks) and some newbie ignored this and went on and on about her new triplet pregnancy without even saying she was sorry for what my friend is going through. It just pissed me off and put me over the edge. It wasn't/isn't you or any of my other friends on the boards. Please accept my apology and gratitude for your support.

Dreary Sunday and Random Questions

I really don't like waking up to rain and thunder on a Sunday. It's depressing. I spent about an hour lying in bed cuddled up to J who was up all night watching the NFL draft and playing video games. While lying there I kept thinking about some of the same things I often think about, but haven't posted on my blog. I've been avoiding the topics for fear of offending, hurting, and/or losing some of my blog readers. However, as I thought about it this morning I decided that this is my safe place. The place where I am supposed to be able to say anything that I want, so I've decided that I'll go there today.

The first topic that I repeatedly mull over has to do with religious beliefs. I know that it's not socially-acceptable to question people's religious beliefs and that is not the intention of this post. I feel the need to preface my statements with the disclaimer that I understand and appreciate differences in beliefs. I am putting this out there to find some enlightenment and insights only! I am not putting this out there to have people feel as though they need to defend their beliefs. So, with that said here goes ... Over the course of my 4.5 year battle with IF I've heard many people IRL and in the blogosphere mention that my struggle, their struggle, or someone else's struggle is part of "God's plan". Or they say that our struggles are "meant to be". Typically this is said to me in some effort to comfort me or to make me feel better. I can only presume that people who subscribe to this belief system find peace and comfort in those ideas, but I do not. I actually find it to be quite hurtful and offensive. To me this belief implies that God sets a plan for our life prior to our birth. This would mean that God would micromanage the lives of the 6+billion people on Earth not to mention all of the other billions of creatures that inhabit this planet. I have a hard time with that. It just doesn't make sense to me, but I want to try to understand it. So, if you subscribe to the belief that there is a set plan for our lives determined by a higher power and that all that we experience in our lives are a part of this plan (i.e., "meant to be"), please help me understand this.

The other thing that I struggle with is disingenious people who pretend to care about my struggles. I DO NOT think that anyone who regularly reads and comments on my blog falls into this category, but I do find many of these people on the TTC message boards that I've frequented for the past 4 years (and sadly a few IRL). I understand that we are all self-involved by nature and I accept that, but pretending to care just pisses me off! Do these people honestly think that I need their faux support? Maybe they actually think that I find their support to be sincere? I wonder if they think I will find comfort in their trite platitudes? In reality it actually makes me laugh out loud when some newbie who's been TTC for a year and miraculously gets pregnant on her own tells me that I "shouldn't worry because it will happen for me too". These people don't take any time to really examine what I've been through or what anyone else has been through, but rather just use the same blanket statements of faux encouragment to everyone. It's annoying and laughable to me. Yes, I am bitter and I don't make excuses for it. I just don't want people to pretend to care when it's clear they don't. I'd rather they didn't say anything! I'd like to know if I'm alone with these thoughts or if any of you have experienced this too.

Friday, April 24, 2009

Good News

K got a visit from Aunt Flow early this evening! I had a feeling if we let up some pressure she'd be coaxed out of hiding. K will start bcp on Sunday and on Monday we'll schedule K's SHG, which I'm hoping can be done at the end of the week. At that time we should get our official calendar. Both K and I are dying to see that! I talked to the IVF scheduler today and was told that our paperwork is on the desk of the RE who handles 3rd party reproduction, so that should be checked off the list by early next week. Yesterday morning J gave his sample and did his infectious disease testing, so one more thing checked off the list. I think the ball is picking up some speed!

Thursday, April 23, 2009

Stage Fright

I think K's uterus is feeling a tad bit of stage fright. I told K that we need to try to relax and not put any extra pressure on her uterus as it's been through a lot the last few months. Although I am anxious for AF to arrive, I can rest assured that it will be here by the end of next week given her p4 last Friday.

Last night I decided that I needed to get K and I something special for the day of the ET, so I made each of us a t-shirt. They are coordinating, but unique. I can't say much more than that for now because I want to surprise K with the shirt, but once they arrive I'll post pics of them. We are going to look even cuter at this transfer! :) Can you tell I'm excited for the days to fly by and for early June to be here?!

Monday, April 20, 2009

Bloodwork and Hope

My clinic sent K to have her hcg levels tested on Friday in addition to her progesterone levels. They called K today to let her know that her beta hcg was back to zero and her P4 was 15, so she has ovulated and will get a period in the next week or so. Tonight K has some "pink slime" when she wiped, so we think she might have full flow tomorrow or the next day. I am excited to schedule her SHG, so we can get our calendar! All you IVF vets know how important it is to us to get the official dates!

It's funny because I'm actually hopeful and optimistic again. I've said it before and will say it again ... my highs are high and my lows are low. I range from being completely hopeless to having so much hope that I allow myself to daydream about what might be. I have a dirty little secret to share ... I went to an on-line IVF due date calculator to find out the EDD if K gets a bfp with an ET on 6/15 (I'm estimating our ET to be around this time). The EDD for a singleton would be 3/2, which I could've guessed as I did my FET on 8/14 and my EDD with Myles was 5/1. I figured that most people would think I'm nuts, but when I told K she told me that she'd already figured it out herself! :) I love how we think alike so often and that we are both thinking positive thoughts!

Sunday, April 19, 2009

The ball has been nudged

K, J, and I just filled out our FDA paperwork again. None of us has syphillis, uses recreational drugs, or has had sex with a man who's had sex with a man in the past 12 months. If you ever given blood, you know the questions. I completely understand why the paperwork is necessary, but it seems silly to us that we'd have to fill it out again when we just did it in December. Well it's done now and the clinic will have them this week, so we are set for the next 6 months.

J and I have our physical forms that we need to take to the doctor to be completed for the FDA. I'm guessing that my gyn will just complete it without seeing me again, but J has an appointment tomorrow. Later this week J is headed to the clinic to give his sample to freeze and do his infectious disease testing. I have to do my infectious disease testing no more than 30 days prior to the ER. K will do hers when she has the SHG.

So, for now we wait for K to get her period. Today K has been having some junk food cravings, which is a sign for her that her period is on it's way, so we are hopeful that the witch will arrive this week. Then K will start bcp on cd 3 and we'll schedule the SHG. At that point the ball will be rollling and I think we are all anxious for that. Today I am excited and hopeful for the next cycle!

Thursday, April 16, 2009


Lately I've been feeling the pain and anguish of the social isolation that accompanies infertility. This isn't the first time that I've felt this loneliness nor do I doubt it will be the last, but rather for some reason it's suddenly been thrust at me with an enormous force. I feel a vast rift that exists between me and those around me. I feel like an outsider who's looking in. I feel like I'm walking alone in a world where I don't belong. I am alienated from just about everyone in my life for the mere fact that they are fertile and I am not. I'm sure to many who've been fortunate enough to never walk the lonely path of infertility it may seem as though we have a choice. However, those of us who deal with the day to day struggle with infertility understand that we don't.

We are constantly reminded of our inability to achieve and/or maintain a pregnancy. We turn on the tv and we are inundated with commercials about pregnancy tests, diapers, etc. We have to sit and quietly listen to those around us talking about pregnancy, babies, motherhood, and children. We put on our "fake happy faces" and try to show our support while we are dying inside. We listen to people complain about how terrible the morning sickness is and how little sleep they are getting with a fussy newborn. And we can't help but think how we'd die for that.

Although I often feel alone and isolated in real life, I feel an enormous amount of support, empathy, and true understanding from all of you in the blogosphere. It's here where I can be me and where I can feel what I feel without worry of judgement. I can not thank you enough for being here for me and for so many others who face the daily struggle with infertility.

Wednesday, April 15, 2009

IVF #2--Update

I got a call from the IVF scheduler and she said that we are on schedule do to IVF #2 in June. We are looking at an egg retrieval (ER) the week of June 8, which would mean that I’d start stimming around 5/30. If I had the ER on 6/8, that would put the embryo transfer (ET) on 6/13. Of course these are estimated dates because my ER date is dependent on the number of days I need to stimulate my ovaries. Dr. S is shooting for 10 days of stimming this time because last time I stimmed for 13 days. We anticipate a blast transfer again.

The IVF scheduler said that J and I have to do the infectious disease testing again, but that K and her dh don't. She also said that they require frozen sperm be used to fertilize my eggs when using a GC, but couldn’t tell me why other than to say it’s an FDA rule. Additionally, Josh and I need to do the phone interview questionnaire again.

I feel good now that we have a plan in place and will feel even better when we actually get our calendar! The nurse said that once we complete the FDA-required disease testing and questionnaire we’ll get our calendar.


Tonight I talked to the person at my clinic who handles 3rd party reproduction. She said that everyone involved, including K and her DH, needs to redo the infectious disease tests. Additionally, she explained that the FDA has a requirement that the infectious disease testing must be done within 7 days of the sperm sample, so my clinic prefers to do the testing and collect the sperm sample and freeze it well before the cycle begins. Thereby eliminating the risk of not having the testing back in time for the ET when the fresh sperm would be used. With FET they could do the infectious disease testing after and if J had something previously it would've shown up.

Please cross your fingers and send up some prayers that K gets a visit from AF in the next two weeks, so we can get this show on the road. Being the queen worry wart that I am I'm worried that K won't get AF ... I worry that she'll end up having retained products of conception or some horrible thing like that.

Monday, April 13, 2009

Period after D&C?

My clinic won't schedule K's SHG or give us our IVF calendar** until she gets a visit from AF. Tomorrow will be 4 weeks since K had the D&C. So, we are wondering how long it took others to get their first period following a D&C. Also, if you could share what it was like that would be great. I'm not much help in this area because I didn't get a period following my D&C, but that's because I never get one (thanks PCOS!). I appreciate you sharing this with us.

**I should mention that I WILL get a hypothetical calendar from my clinic before the day is over! I've found that persistance and a tad bit of pushiness slathered in butter is helpful in the IF world. I have being sweet, yet demanding down to a science! ;) K and I are both planners and like to know what's in our future, so we just need to know when we might be doing an ER and ET!

Sunday, April 12, 2009

Grief, Easter, and Too Much Baby Stuff

My dear friend, S, sent me an email today that touched me (thanks S!). I was having a horrible day (I'll get to that later in this post) and this email came at the right time. S recently read an article by Dawn Anna, a mother who lost a daughter in the Columbine tragedy 10 years ago, and was struck by the following quote:

"There is nothing wrong with being on your knees. There is nothing wrong with being down in the darkness. There is nothing wrong with staying there as long as you need to. I know one way to start crawling towards the light. The hole in your heart will never get smaller. Never. So there is only one way to make it feel smaller. Grow your heart bigger every day."

I appreciated this quote and was happy to hear another Mother who's lost a child say this. I feel that my friends and family don't understand that no matter how long its been it since Myles's death it's still horribly difficult to face each day without my child. That some days are dark and other days are darker. That the pain never goes away and that you'll always have a hole in your heart. Yet despite all the pain and sadness you can learn to live your life and use your grief to transform your life. I do not think that Ms. Anna is saying that we should appreciate our losses and be gracious for the lessons we've learned (I despise that mentality), but rather that it's a part of our lives and we have the choice to let the grief consume us or we can use the grief to enrich our lives.


So, why is was my day horrible? Easter isn't a holiday that I'm particularly fond of or that is a big deal in our family. However, last year Easter became an extraordinarily difficult holiday for me. Myles died in February and the first holiday following his death was Easter. This year was equally difficult. J and I stayed home alone today. I couldn't bare the thought of watching the kids in our families today. Instead I spent the morning and afternoon in tears thinking about what should've been this year. Had Myles survived he likely would've been collecting Easter eggs like so many other children were doing this year. It makes me sad to think and wonder and wish.

To make matters worse I had an overload of all things pregnancy and baby the last two days. At my in-laws yesterday I heard way too many stories about how grandchild A did this and that and the other thing. I even got to hear "just wait someday you'll have to deal with that" and "your miracle baby will come". Yesterday my dear friend, J*, gave birth to baby #3 and this afternoon my dear friend, L*, called to tell me that she's expecting #2 in late September. I'm not upset with anyone for these things, but rather just feel like I was getting bombarded by baby stuff on a day when all I wanted to do was escape the baby stuff. I am seriously excited that the day is almost over! The next holiday that I have to survive is the queen of all horrible holidays--Mother's Day.

*J and L you know I love you both and that I am truly happy for you and your families. As I've told you both before it's hard to deal with births, babies, and pregnancy announcements. It's a reminder to me of what we've lost, what is difficult for us to achieve, and what seems to always be just out of our reach. Congrats and hugs to both of you!

Saturday, April 11, 2009

K's Decision ...

Last night I received an email from K asking if I was home and we had just walked in the door from seeing a movie. She told me to check my email and my stomach turned. I have the tendency to immediately assume the worst. I opened my email and saw that I had two emails from K. One was sent a couple hours earlier and the other had just been sent. I opened the first email to find K asking me questions about our estimated timeline. She said she figured I had one knowing how I am, but surprisingly and maybe even shockingly I didn't/don't. I was trying to excercise patience and not make any specific plans until I heard back from K as to whether or not she'd be continuing this journey with us.

The next email said K and her husband had spent the evening discussing her desire to continue the journey with us. K's husband, T, expressed his continued concern and worry for her, but in the end said that he would support her in any decision that she made. So, K then said "I really have no reservations about doing a repeat if you still want Jason Mraz says in one of my favorite songs...'I'm Yours'." Tears started rolling down my eyes and I could hardly read the email to J. We are both so excited to be able to continue this journey with K. We started this beautiful journey with K and her family and we want to end it on a wonderful note with them.

I feel very strongly that K is going to get pregnant again. With all 4 frozen transfers we did we had at least one of the totsicles implant, so we are hopeful that with a fresh transfer at least one (maybe even two) will implant. We are hopeful that a handful will be healthy and that next time K will be able to deliver us a baby. I feel as though K and her family need redemption and the way that they will get that is by seeing our journey through to a healthy, live baby.

On Monday I will call my clinic and I will tell them that we are ready to move forward. Dr. S wants to do another SHG on K following the D&C, so that will likely be the next step. I think we'll be doing an ER & ET in early June as I know Dr. S will be in the country and available per our meeting, but I have to call the IVF scheduler to get the ball rolling. Ideally I'd be starting stims at the end of May. I'm so happy that we now have something definitive to look forward to! For the past month I've been sitting and spinning in my negative emotions while we were waiting and now I feel like I can look to the future with hope!

K as I told you last night J and I are so lucky to have you and your family in our lives! We love you and can't thank you enough for what you are willing to do for us!

Thursday, April 9, 2009

Pathology Report

K called me to tell me that her appointment went well today. The ob seems to think that the light spotting she's having is "normal" considering how much blood was in her uterus at the D&C. My good friend, Dr. E, who's also an ob said it's possible for her to spot/bleed right into her next period, which is what K's ob said too. If she's still spotting in a week, then she'll have a beta hcg draw. Otherwise the ob was pleased with her healing, which of course made me breathe a huge sigh of relief. I wanted nothing more than to hear that K was on the mend, at least physcially.

The ob gave K the pathology report from the chromosomal analysis that was done on the embryo. The karotype showed 46XY, which for you non-sciency folks means normal male. This news is bittersweet for J and I. We lost a normal little boy, a brother to Myles, so that is very hard to stomach. However, this news provides further evidence that I DO make some good embryos, so I can feel better going into IVF #2 and doing another ET to a carrier.

K who is not normally an emotional person burst into tears at the doctor's unveiling of the news. I can only imagine what went through her head, but am fairly certain it was a combination of guilt and blame. I tried to explain to K that "bad things happen" and that NOTHING she did or didn't do could have caused this. I don't know how to explain it, but I am certain that it had nothing to do with K's beautiful uterus. I hope that K really believes what I'm saying and tries to remind herself of this over and over again. I know from experience that guilt is an ugly beast to battle, so please keep K in your thoughts.

I'm not sure how I'll feel about this news tomorrow. It may hit me hard that we could've had another little boy come October had the universe been kinder to us. But for today I will focus on this news as a sign of hope. We now KNOW that at least 2 of my 8 embryos were chromosomally normal, so it is possible and likely that we will make a few more good embryos. And there's a good chance that we might actually get to bring a baby home.

Wednesday, April 8, 2009

Breaking the silence

My dear friend Lisa is feeling alone in her long, brutal infertility struggle. This makes me sad and angry. Lisa has a great support sytem in the blogosphere, but IRL no one knows of her struggles. I can't help but be upset and frustrated that Lisa has to suffer in silence without any support from those closest to her. It's not fair and it's one more reason why I despise infertility. No one else who's battling a disease or medical condition is made to feel that they have to suffer through it alone in silence, so why does Lisa feel that she has to do that? Obviously the answer is not an easy one to establish. The reasons are likely as complex as infertility itself, but it is my personal opinion that the underlying issue is the negative stigma that surrounds infertility. Infertility is one of those topics (just like baby loss) that makes people squirm in their seats and I'm not sure why?

Infertility is already full of shame, guilt and feelings of failure. Infertiles feel broken and defective. Because of our "defect" we feel alienated from our friends and family who are not defective. We, infertiles, are outsiders trying to navigate our way in a fertile world. It's not an easy path to travel publicly, so I can't imagine how difficult it must be to travel it silently.

All infertiles suffer alone to some extent as we are constantly inundated with reminders of our inability to have children from media and those around us. We have to endure the torture of baby showers. We have to listen to our friends discuss their "oops pregnancies." We have to hear our friends complain about their kids. We have to hear just how lucky we are that we get to sleep in or do this, that, and the other thing because we don't have children. All of this is said as we sit silently wishing, wanting, begging, praying and hoping that someday, maybe just maybe, we will be so lucky to have a baby of our own.

I imagine that infertiles like Lisa who suffer through infertility in silence are further alienated and alone. Infertility is consuming and literally takes over your life. For many of us having a baby becomes the one and only thing that you think about. Infertility literally becomes a large part of who we are and it reshapes our personalities.

Infertility is a complex disease like any other that for many can be successfully combatted with treatments. For some like Lisa and me it's a long-term battle that is exhausting physically, emotionally, and financially. Such difficult struggles with any disease are aided with love, support and encouragement, but this can only be provided when others know of your battle.

I have found that by going public with my infertility struggle I have received love, support, and encouragement, but I've also opened myself up to criticism, judgement, and an much unwanted advice. Early on in my journey I heard some of the worst so-called advice: "just relax and you'll get pregnant", "drink some of the water around here and you'll get pregnant", "if you adopt you'll get pregnant", "have you tried x, y and z?", and my all time favorite is "my husband just looks at me and I get pregnant" (seriously, how is that helpful?!). I remember how hurtful all of these things were to me, but fortunately I rarely hear those things anymore. This is not to say that I don't hear other hurtful things, such as "why don't you just adopt?", but it's much less often than in the early stages of my journey. When I went public with my infertility struggle I accepted (and still do) the risk of getting such unwanted advice, yet I still cringe when I hear it.

There is no one right way to deal with and battle infertility. Some people, like me, prefer to do it publicly and others, like Lisa, choose to do it silently. I just hope that it is Lisa's own personal choice to battle this ugly disease in silence, but I have a feeling that some of her decision has to do with society's negative perception of the infertile. Therefore, it is my hope that by publicizing my infertility battle I am helping others to understand the disease and by doing so help to dissolve the negative stigma that surrounds infertility. I hope that my very vocal, honest, and often uncomfortably raw discussion of my infertility struggle will help encourage others to break their silence and come out of the shadows into the light.

Tuesday, April 7, 2009

Therapy & Courageous Conversations

Today I had my first appointment with a new therapist and have to say that I really, really liked her! She scheduled 1.5 hours with me, but I ended up being there for 2 hours. I had much to talk about with 4+ years of IF, multiple miscarriages, IVF, life-threatening HELLP, Myles's premature birth, Myles's death, surrogacy, and miscarriage with a surrogate. I'm sure it was a lot for her to take in. Towards the end of our discussion she asked me if I've always felt responsibility and guilt for things that happen to me and/or those around me? Apparently this was a reoccurring theme in my story. I thought about it for a moment and realized that I do assume responsibility for many things, including those out of my control, and as a result I drive myself crazy with guilt. I feel responsible for putting J through this nightmare. I feel responsible for Myles's early birth and death. I feel responsible for "wasting" four snowbabies on my uterus because of my selfish desire to carry another baby. I feel responsible for ruining K's formally blissful experience with pregnancy. I feel responsible for putting K and her family through all that they've been through. I feel responsible for asking too much of my friends and family. And I feel guilty and sad for my part in all of these things. My therapist told me that this is something she wants me to work on over the next 2 weeks. She says it's way too much to place all of that on myself. She says that I have to acknowledge that I didn't have control over most of these things and that I need to attempt to let them go. Umm, I can identify and acknowledge, but am not quite sure how I'm supposed to let go of this?

Today I spent the afternoon at a workshop called "Beyond Diversity", which focused on deinstitutionalizing racism and eliminating racial achievement disparities in public eduction. The workshop is based on the book entitled Courageous Conversations and was quite enlightening and has opened my eyes to institutional racism that exists in our schools. The speaker was dynamic and shared several quotes that resonated with me. Although I did think of these quotes in the context of racial disparities and bridging the gap to provide all students an equal opportunity to learn, I couldn't help but think of these quotes in relation to my own personal struggles.

"We will never be able to fix what we can't face." --Author unknown

This quote reminded me of my struggle with guilt and assuming responsibility for all the bad things that have happened. I think that by acknowledging the issue is the first step toward me being able to "fix" this line of thinking (or so I hope).

"We see things not as they are but as we are." --Douglass Fitch

This quote reminded me of the ups and downs of infertility and how that affects my line of thinking in regards to my future. If I am feeling down, then thoughts of my future are centered around hopelessness and despair. I feel certain that another child isn't a part of my future. If I'm feeling "good", then my thoughts of our future are hopeful. I tend to feel strongly that we will have another child. All too often I'm a "feeler" and this overrides or masks the "thinker" in me. J is a thinker and he rarely has this problem, but how I see things is largely affected by how I am feeling emotionally.

"We prepare ourselves to respond, but not to listen." --Franklin Covey

This quote made me think of those people who pretend to listen to what I'm saying, but in reality are actually just waiting for an opportunity to tell me what they think (or more so what I should do). I think we all do this to some extent. When I'm having a heated discussion with J I often miss most of what he's saying because rather than intently listening to what he's saying I'm actually going over in my mind what I'm going to say to him. I think this is a natural tendency, yet I realize that it is incredibly ineffective communication. This is just a reminder to me that I need to focus on being a better listener and hope that others will do the same.

Sunday, April 5, 2009


I used to love spring and the awakening of life that accompanies it, but that was before infertility, miscarriages, and Myles's death. Now spring is just a reminder of what should've been. My first baby's due date was April 17. Myles's due date was May 1. It doesn't help that Mother's Day follows these dates and I absolutely despise Mother's Day! I have for the last 5 years. Last year was by far the worst Mother's Day ever and I'm certain that this year is going to be just as bad. Yes, I'm a Mother. I know that, but it's not the same. If I want to spend Mother's Day with my son I have to go to the cemetary. I don't smile and laugh and play with my child on Mother's Day, but rather sit and stare at his headstone while tears roll down my face. Mother's Day for babyloss mamas and infertiles is a sad, horrible reminder of what we don't have.

(BTW ... I saw my first TV commercial for Mother's Day on Friday night and I'm not looking forward to the onslaught of such adds after Easter!)

Friday, April 3, 2009

The Imperfect Science of Medicine

Currently I'm reading Complications by Atul Gawande. If you haven't read it, I highly recommend it. Gawande is a surgeon and uses case studies to discuss the imperfect science of medicine. He discusses the fallibility of doctors, the mysteries and unknowns of medicine, and uncertainty itself. As I'm reading the book I can't help but think about my experience with infertility and the doctors who have treated me. I understand and accept that my RE is human, yet I often expect him to have all of the answers. It's a strange inner struggle that comes from my need to be in control, but as I've learned over the last four years I am far from in control.

Last night and this morning I've been reflecting on our appointment. I have to admit that I'm not really all that satisfied with the notion that we just need to keep trying and hope that one of the good ones is transferred, but at this point the only other viable option is to move on to CCRM or SIRM and neither of us is emotionally ready for that at the moment (not to mention the expense and logistical issues involved). I guess I'd be more comfortable with our plan if the future transfers were going to be to me. I know that I can handle a potential miscarriage because I've handled 4 of them, but to ask someone else to risk going through that is tough. As Dr. S reminded me miscarriage is a risk of pregnancy and anyone who attempts to achieve a pregnancy must assume that risk. I get that and I know every surrogate also gets that, but until you go through it you don't know how you will feel or how it will affect you and your family.

The fact that I've had 4 miscarriages myself and 1 with a carrier weighs heavily on my mind. I realize that some of m/c with my uterus were likely due to my uterine problems, but the fact remains that we still don't know anything about those embryos that we lost. As a scientist I feel like I don't have enough data to analyze to arrive at a sound conclusion. At this point we are hypothesizing at best and we are hoping that future cycles will support our hypotheses. I have to remember that medicine is an imperfect science. Gawande reminds me that often medicine doesn't have all of the data because there are so many uncertainties and unknowns, yet they sometimes have to take a "stab in the dark". I know that there is science in reproductive endocrinology and as Gawande says there's also "intuition and plain old guessing". So, for now the best we can do is go with our intuition, hope that Dr. S's hypothesis that there are a few more good eggs will be supported, and ultimately just take a "stab in the dark".

Thursday, April 2, 2009

Today's Appointment

Today's appointment went exactly as I expected it to. I wouldn't say that anything new came out of the appointment. We discussed everything on my list and I feel good about having all of my questions answered. I don't feel 100% confident with the plan, but I rarely feel 100% confident about anything related to infertility. Here's what my RE had to say ...

Low E2 during IVF #1 - RE said that this absolutely had NO negative effect on my egg quality. He explained that women who've been diagnosed with cancer and are racing to do a cycle prior to chemo are actually given lupron while stimming to keep their E2 low and it doesn't hurt their eggs and/or resulting embryos. Again I'm just one of those women who have low E2 that doesn't correlate with follicle counts, but still have mature eggs in the follicles. We'll try to do less bcp leading up to IVF #1 to see if that helps.

Egg quality - from the embryologist's perspective my eggs look great, but just like any 32 year old I probably have eggs with extra or too few chromosomes. He said that it's impossible for them to say if I have a higher than normal number of bad eggs, but that he doubts it. He said that we know that I can make good eggs because Myles is proof of that, so he feels confident that I'll be able to make some other good eggs.

Embryo quality - embryos appear to be good ... growth to blast, high morphological grades, and able to survive freeze/thaw process. Dr. S admitted that grading embryos based on morphology is primitive, but it's all they have right now. He admitted that a % of Grade A embryos won't actually be chromosomally normal (euploid). I read a study that found around 20% of high graded embryos from women in their early 30's aren't normal. Again he reiterated that Myles was a Grade A embryo and he was perfect, so he thinks we'll get others in our next cycle.

PGD - Dr. S doesn't think this is useful to us. He explained that it works very well to identify single gene defects (e.g., Tay sachs), but that it's use to identify aneuploidy is limited. The research shows that pregnancy rates are lower in women who used PGD than those who didn't. It only tests a handful of chromosomes and it is known to inaccurately identify normal embryos as abnormal. It can significantly damage and/or kill the embryo. All of this on top of being very expensive. So, he doesn't think it's a good choice for us. I already knew all of this from my own research and from what I had learned I wasn't thinking it was something I'd want to pursue, but I wanted to hear his opinion.

CGH - Again this isn't a treatment option at my clinic. My RE said that the preliminary data is quite promising and will revolutionize IVF, but that right now it's experimental and only offered at a select few clinics for a hefty fee.

My clinic recently started a clinical trial where they use this microarray CGH procedure (similar to CCRM or SIRM) to biopsy the trophoblast of the blastocyst (the outer ring of cells that becomes the placenta) before they transfer them. They are looking to compare the biopsy results (karotype of the embryos) to embryo morphology and grade, pregnancy rates, miscarriages, implantation failures, etc... They aren't using the data to determine which embryos to transfer (at least not yet). I asked why they couldn't biopsy the embryos, freeze them, analyze the data, and only transfer the "good" ones ("staggered" IVF). He said they hope to be able to do that in the future, but that right now their funding for the study doesn't involve that. Dr. S mentioned the benefit of not injuring the embryo, which is a separate cell mass interior to the trophoblast, when you take the cells from the trophoblast, but mentioned that there are instances when the trophoblast cells do not match the embryo cells. I requested that I be included in the study because at the very least we'll get information regarding the embryo's chromosomal make-up after the transfer, which may give us some clues as to what happened and why.

Metformin - i need to go back on this ASAP even though I'm not IR.

DHEA - doesn't think I need this. He worries that overuse of this in PCOSer's can have a negative impact.

Acupuncture - it's totally up to me. He said he thinks it helps reduce stress, but that there are others ways I can do that. He said if he thought it was that important for my cycle, he'd require it and he's not. I'm thinking I may actually skip it during the stimming, but will have my GC do it pre- and post-transfer.

IVF #2 Protocol - antagonist protocol again with Menopur and Bravelle. He's going to up my Menopur dose in an attempt to help with egg quality. He's also going to start me on a slightly higher dose of meds in the beginning and is shooting for 10 days of stimming instead of 14. He said that he can be less conservative now that he knows how I respond. He's confident we'll have a similar result in terms of numbers.

IVF #2 Timeline - I can do IVF #2 in June. He left the time frame up to us and told us to contact him when we're ready. I forgot to ask him how he felt about doing ER and freezing everything, so I plan to call him tomorrow.

Surrogacy Stuff - Dr. S said that he understands K's need to take some time to decide if she will continue. He felt terrible for all that she and her family went through with the D&C. Dr. S mentioned that he hopes K is able to carry for us again because she's "proven"--we know that she can get pregnant with our embryos, so if we put in one or two good ones he's very confident that she will get pregnant again and deliver us a baby (or two)! However, he said he understood if K wasn't able to move forward with us. He asked what we'd do if K can't carry for us and I told him that we have another friend who offered to carry for us if K isn't able to do so.

We didn't schedule anything yet, but I'd love to do an ER in June (which works with Dr. S's schedule). IF Dr. S is fine with me freezing all of my embryos, then we will definitely do an ER in June and do a FET at a later time when our GC is ready.

Wednesday, April 1, 2009

Questions for RE

I'm always so humbled by your kind words and compliments, but want to reiterate that I'm not really all that extraordinary. We all face fear in our own battles and we all seem to find a way to face it and move forward despite it. I have to tip my hat to all of you too because I think infertiles (and their partners) and babyloss parents are among the most courageous people walking this planet. We are all so full of fear, worry, and anxiety, yet we still manage to brave each day. Also, I can not forget the amazing women who set their fears aside to help other's have a family ... surrogates are some of the strongest, most amazing, courageous women as well!

Thank you to everyone who answered my questions regarding the D&C. K is still spotting, which I've read has happened to some women up until their period arrives. Of course most women, including me, don't have that, which worries me, but I'm tyring not to stress about it. I would feel better if K had a beta drawn to get a better picture of what's going on, but she is comfortable waiting until her follow-up with the ob next week.

Also, I'd like to thank everyone who replied to my question about acupuncture. I want to clarifiy that I did acupuncture weekly for several months leading up to IVF #1, which I continued through all of my FETs. Additionally, I did pre- and post-transfer acupuncture sessions with all of my ETs (and K did it with the FET to her). I wasn't asking if I should do it before and after the transfer, but rather if I should do it during stimminng and/or leading up to my cycle. When I did IVF #1 with acupuncture we had a good response and 8 blasts, so I'm trying to decide if I should do acupuncture again with IVF #2 (preceding the ER). I'm still trying to decide what I should do. I'm thinking that I'll do it at the very least during my cycle. I do find it to be relaxing for the most part, but get a little stressed about the added costs associated with it. I'll keep you posted on what I decide to do.

Tomorrow afternoon we are meeting with our RE, Dr. S, to discuss the recent FET with K and make plans for a future IVF cycle. I am disappointed that we won't have the pathology results back from the testing that was done on the fetal tissue until next week. I was really hoping to have it back before our meeting tomorrow. Although we won't have a definitive answer to what caused the miscarriage, we'll discuss all of the possible scenarios and focus on the one likely culprit--a chromosomal abnormailty in the embryo (i.e., an aneuploidy). I have many things on my list to discuss with Dr. S, but here are just a few of them:

  • Low E2 during IVF #1 - what impact did that have on eggs and embryos? what causes this to happen? will it likely occur in IVF #2?
  • Egg quality - how did they look? does he suspect that they have problems? can we do anything with the protocol to try to improve it? at what point would we need to consider donor eggs?
  • Embryo quality - how likely is it that most of my high-quality (A's) blasts have chromosomal abnormalities? what does the research say? at what point would we need to consider donor embryos?
  • PGD - risks? benefits? does he think it's necessary? etc...
  • CGH - (I know my clinic doesn't do it, but I want to chat about it.)
  • Metformin - i was on this with IVF #1 should I go back on it for IVF #2?
  • DHEA - can we test this? if it's low will he suggest putting me on it?
  • Acupuncture - could it have contributed to my good response in IVF #1? does he think that not doing it will affect the results of IVF #2?
  • Protocol - will we use the antagonist protocol again? will we add/change anything? will he shoot for low and slow stimming again or will he start me on a higher dose initially?
  • Timeline - when can we do IVF #2? how does he feel about doing ER and freezing all of my embryos if we don't have a surrogate ready to go do ET right after ER? (I'm guessing he'll be fine with this because we did this with IVF #1 and had 100% freeze/thaw survival of our blasts.)
  • Surrogacy Stuff - if K is able to move forward when would she be able to do an ET? what if K is unable to move forward with us? what if we have to find a new surrogate? logistics of finding a new surro? time frame of testing if we have to find a new surro? what about a dual transfer to me and a surro? (FYI--J is not down with this and made it clear he thinks it's a bad idea.) what if we don't have a surrogate? would he transfer to me? etc...

If there's anything that you think I should ask him, please feel free to provide some suggestions.