Sensationalism of Surrogacy

The NY Times posted yet another disheartening article about surrogacy, Building a Baby, With Few Ground Rules. I absolutely despise how the media treats infertility and surrogacy. Both are typically presented in such an extremly biased, one-sided, negative light and it's utterly maddening to me. Some of the stereotypes that the media likes to perpetuate include the following ... Infertiles are horrible people who should "just adopt" or aren't supposed to have children (natural selection). Surrogates are horrible women who "steal" other people's babies. Surrogates carry other people's babies for the money. Intended moms are depicted as women who don't want to lose their girlish figure by having a baby and/or are too career driven to take time to carry their own baby(ies). Intended parents are highly educated affluent members of society while surrogates are impoverished and uneducated. This is just a few of the horrible things that the media likes to use to grab reader's attention and make a few bucks. I find all of these stereotypes to be disgusting and extremely disappointing. I challenge members of the media to do a better job. I challenge them to present the positive aspects of both infertility and surrogacy.

I have been involved in a battle with infertility for 5 years and during this time I've met some of the kindest, most compassionate women I know. These women are waging their own war with infertility and are also going to great lengths to share their lives with a child. Along the way these women have likely encountered harsh criticism for their efforts not only from the media, but sometimes from family and friends too. Early in my war I dealt with this more often, but with every battle my skin thickened and I managed to better deal with the criticism. I decided that most of the critism I had encountered came from people's ignorance about the emotional, social, and financial struggles of infertility, which is why I became so vocal with my own struggle. I felt that if I could educate people using my experience they would be less likely to criticize others going through infertility and more likely to lend support and encouragement. I just wish that the media would follow suit.

I wish that the media would present some of the positive stories that exist in the world of infertility and surrogacy. I wish they would see some of the faces of the 10% of US women who have difficulty getting and/or staying pregnant. There are about 6 million of us out here, so it's likely that most people know someone who's been waging their own war against infertility (often alone in secrecy). I challenge newspapers, magazines, and news programs to focus on the women behind those statistics and show the goodness in them.

I also challenge the media to present one of the beautiful, surrogacy journies that exist. There are plenty of them to choose from. I would even volunteer to share ours and K's story. Our story is one of love, compassion, generosity, and gratitude. We have a wonderful relationship that grows stronger with each day. The two little boys who are going to enter this world in February because of K have an amazing life story to tell and will be the luckiest boys on the planet. Without K our boys wouldn't have a future story to tell and we wouldn't be able to experience parenthood with a living child. Surrogates offer up themselves to help loving people become parents who otherwise couldn't. Many form life-long bonds with their intended parents and get to watch the babies they brought into this world grow up. Surrogacy creates families and to me there isn't anything more beautiful than that. This should be what the media shares with the world about surrogacy!

Free Meds!

I have 3.5 boxes of Endo.metrin that I'd like to donate to someone going through infertility treatments. Endo.metrin is a vaginal form of progesterone that is quite expensive if you have to pay for it out of pocket--we paid around $550 for a couple of boxes. You may remember that we were quite fortunate to get some donated Endo.metrin from my sweet friend Cortney, which we used, but had already ordered our own Endo.metrin. We might have used it all, but K opted to quit the Endo.metrin and stay on the PIO (I know crazy, hah?!). Therefore, we have all of these leftovers. My clinic will take the meds, but I prefer to donate it to someone who doesn't have infertility insurance coverage. So, if your RE is requiring that you (or someone you know) use Endo.metrin and your health insurance won't pay for it, please leave a comment with your contact information because I'd love to mail it to you!

K's PUPO

Just as I had hoped the ET was perfect. K and I wore the cute surrogacy t-shirts I made us, which everyone seemed to get a kick out of, and we had fun! K's penthouse uterus was fluffy and readily accepted the new tenants--two Grade A+ blasts (i.e., Grade 1.1 at my clinic, which is the highest score they give). One of the embryos was hatching (pictured below on the top right) when the photo was taken an hour before the transfer. The embryologist expected the other embryo to be hatching by the time of the transfer. Both of my embabies are absolutely beautiful and although I'm biased K, Dr. S, and the entire embryology team at our clinic agreed.

Much to my surprise all 10 embryos were still growing today. The clinic froze one blast today and is watching the other 7 blasts until tomorrow. They anticipate freezing at least one of those embryos, but aren't sure about the others. My clinic has very high standards for the embryo cryopreservation--only embryos graded 2.2 or higher with 1.1 being the highest are frozen. This means that they only freeze embryos graded A's and B's. I have to admit that this is hard for me to stomach given that many women get pregnant with lesser quality embryos, but there's not much I can do about it. Honestly I just try not to think about them throwing out my embryos graded below a 2.2.

I felt completely calm today, which is pretty unusual for me, so I'm taking this as a positive sign. I am nervous to say it, but I'll whisper it ... I'm feeling very good about our prospects this cycle. Both K and I are full of hope! Dr. S was optimistic about our chances of a pregnancy with our first transfer and is even more confident that this transfer will result in a pregnancy. Our betas are 6/29 and 7/1, but K will POAS well before the betas (I stocked her with 8 tests)! We are both anxious to see a + hpt!

Me and K in the lobby of the clinic sporting our t-shirts.

K waiting to accept her new tenants.

Me, K (with embryos inside), and Dr. S after the transfer.

Me, K, two of the embryologists, Allison and Will, after the transfer.

Me, K, and the embryology team after the transfer.

K doing the post-transfer acupuncture session.

Right now K is at home resting--they give Val.ium, which made her a bit sleepy on the ride home. My clinic requires 48hrs of bedrest following the transfer, so I made a fun bedrest basket of goodies (e.g., snacks, magazines, novels, DVDs, aromatherapy lotion, candle, comfy pj's and slippers) to keep K occupied over the next 2 days. I also made meals for supper for K and her her family, so they wouldn't have to worry about what to eat. K's oldest boy wants to stay home from day care tomorrow to help take care of his mommy and I plan to take them lunch. So, between me, her wonderful hubby, T, and her vibrant boys, K and K, K and our little ones will be well taken care of. (I think K might do a post from her bed tomorrow, so look forward to that!)

A blast transfer it is

K and I just got word from the clinic that we'll be doing a day 5 transfer on Thursday, June 18 at 10:30am. We won't know until Thursday if we're transferring 2 or 3. We are both very excited and anxious for Thursday to get here! I'm hoping that June 18 turns out to be a lucky date for us!

Fert Report

I learned yet again today that it pays to self-advocate and speak your mind. The embryologist called me this morning per Dr. S's instructions to let me know that of my 13 eggs retrieved 12 were mature and fertilized with ICSI and 10 little embryos are growing strong as I type this! Last cycle I had 19 retrieved, 16 were mature and fertilized with ICSI, and we ended up with 8 blasts to freeze, so if this cycle is anything like last I'm hoping to have at least 5 blasts. I was so worried that I'd only have a few mature and even less growing, so I'm very pleased with this news! The embryologist told me that in both of my IVF cycles I've had higher than average fert report and said that she expects me to have some great embryos to transfer to K this week. Tomorrow we'll get a call to let us know if we are doing a day 3 or day 5 transfer.

Egg Retrieval

Dr. S retrieved 13 eggs this morning. I was hoping for a few more, but quite frankly I was worried we'd get less. So, I'm pleased and am hoping that 13 is a lucky number for us! I expressed my concerns to Dr. S concerning my disappointment and he said that he was quite pleased with my response and considered 13 eggs retrieved to be nothing short of successful. He is hopeful that we will have some great embryos to transfer to K.

Below is a picture of me as I was waiting to have the ER and a photo of the things I brought with me to help me stay relaxed. The cotton balls have an aromatherapy oil called Panic Button on them. The oil is a combination of lavendar and neroli (citrus) and smells amazing! I brought it with me to every single one of my IVF procedures. The nurses always comment on how much they love the smell and actually ask me if I'll be bringing it. The worry stone was a gift from my wonderful friend, D, who gave it to me right before FET#2 along with another stone that says "Inspiration". Both stones were given in Myles's memory to bring me hope and inspiration as we try for another baby.

I told Dr. S about my dislike of their policy of not sharing a fert report with their patients and more or less begged him to have the embryologist call me with a fert report. I explained that as a queen worry wart I will spend the week assuming that all eggs were either immature or didn't fertilize and that we'd have nothing to transfer next week. Dr. S agreed to have the embryologist call me tomorrow, but he said that she would only give me general information and not specific numbers. However, I plan to do my best to get her to give me more specific information.

A few weeks ago K asked if Dr. S would be willing to tranfer 3 embryos rather than 2, so I dicussed this idea with him after the ER. I assumed he'd say abolutely not, but much to my surprise he seemed receptive to the possibility. We discussed the risk of triplets, which is a risk we're willing to assume, and we talked about how we'd let the quality of embryos determine whether we transfer 2 or 3. Dr. S indicated that he'd be uncomfortable transferring 3 Grade A embryos, so we'll wait for the embryos to help us decide on the day of the ET.

Finally, I decided to find out if 13 is my lucky number and although it wasn't (it was 97) I discovered that June 18, 2009 is a my lucky date! This date is the potential date for our day 5 transfer, so I'm taking that as a good sign.

Trigger tonight & ER on Saturday

I went into my reproductive clinic this morning yet again for a follicle scan. I have 7 measurable follicles on my right ovary and 10 on my left (+ several smaller). The biggest follicle was 19mm, so it seems as though I'm ready to trigger tonight at 11pm. My egg retrieval is set for 11am on Saturday and the ET to K's wonderful uterus will be either Tuesday or Thursday. I am hoping for a blast transfer because I'm a huge proponent of blast transfers, but know that day 3 transfers can bring good things too (just ask my dear friend, Kris!).

I noticed on my scheduling sheet the NP wrote "13" in the line for follicle count. I guess of few that she measured must not be contenders for the ER and I have to say that I felt quite defeated when I read that number. My RE was so confident that I'd have a similar response, so I expected my follicle count to be more like 20. The NP assured me that this cycle was just as good if not better than my first. She said that my E2 is much more "normal" this cycle, but I didn't even ask the number because it's just one more thing for me to stress about. Last cycle the it didn't even get to 300 and we had 16 mature eggs. The NP went on to say that they were tweeking my protocol in hopes of further improving egg quality and weren't really worried about quantity. I know that quality is more important than quantity, but I still worry. Despite my worries I am very hopeful that we will have a retrieve several good eggs and will end up with a handful of exceptional embryos!

No trigger tonight

Today's follicle scan (day 12 of stims) showed that my follicles are still growing, but that they aren't quite ready yet. So, it looks like I'll continue stimming tonight and will likely trigger tomorrow night for a Saturday ER. I had around 16-17 measurable follicles (+ several smaller) on the scan today and I have to admit that I'm disappointed. Last cycle I had around 21 measurable follicles by cd 12 and at ER the RE aspirated 25 follicles, but 6 were empty. I'm worried that if I have six empty follicles again that doesn't leave me many eggs to work with and I have to expect that a few will be immature and/or won't fertilize (we're doing ICSI). Oh and a handful of embryos will die while they are growing them in the lab. I'm not new to the IVF game and I understand that there's attrition at each step of the process, so this has me freaking out that I won't have many embryos this time. I wonder if I'll have 2 to transfer and I wonder if I'll be fortunate to have any to freeze this time?! Last time we froze 8 blasts. As a normally logical person I understand that my fears seem illogical, but I can't help myelf. I am a worrier--actually the queen worry wart to be precise. I feel incredibly guilty for complaining about this because I know that it could be much worse and that many girls in the blogosphere would kill to have this many follicles growing. I don't want to seem ungrateful because I'm not. I know I'm fortunate to be a good responder, to make high-quality embryos and to have such a wonderful teammate in K. But the fact of the matter is that I can't stop worrying and stressing.

My other stress is how disruptive this cycle is to K and her family. K took off work anticipating a transfer around on 6/13 or 6/15. Now because my body, well specifically my reproductive organs, just does what it wants the transfer will either be 6/16 or 6/18 depending on embryo growth and development. We anticipate a blast transfer, but you never know. Of course K is wonderful and tells me not to worry, but I feel terrible. Uggh! I just hope it's all worth it in the end.

Stimming Update

I had my first follicle tracking scan today and I'm responding to the meds, but slowly once again. My "tired" ovaries seem to need quite a bit of medication to really get things cooking. My e2 is only 51, but that doesn't bother me because with IVF #1 my estrogen only got up to the 200's even though we retrieved 16 mature eggs (I know it's totally weird). I'm on 150IU Bravelle and 150IU Menopur in the morning and 300IU Bravelle in the evening. I go for another scan on Friday morning, but I'm guessing that I won't be ready for ET next Wednesday. If I had to guess, I'd say that ET will be pushed back a day or two. K goes for her lining check tomorrow and we're expecting a nice plush lining because she's been having an abundance of cervical mucus!

Babyloss Mammas Are Survivors

"My Mom is a Survivor"
By Kaye Des'Ormeaux
(Dedicated to mothers who have lost a child
and have somehow survived.)

My Mom is a survivor, or so I've heard it said.
But I can hear her crying at night when all others are in bed.
I watch her lay awake at night and go to hold her hand.
She doesn't know I'm with her to help her understand.
But like the sands on the beach that never wash away...
I watch over my surviving mom, who thinks of me each day.
She wears a smile for others...a smile of disguise!
But through Heaven's door I see tears flowing from her eyes.
My mom tries to cope with death to keep my memory alive.
But anyone who knows her knows it is her way to survive.
As I watch over my surviving mom through Heaven's open door...
I try to tell her that angels protect me forevermore.
I know that doesn't help her... or ease the burden she bears.
So if you get a chance, go visit her...and show her that you care.
For no matter what she says...no matter what she feels.
My surviving mom has a broken heart that time won't ever heal.

I'm thinking of all of you who've loved and lost your babies. This weekend will be tough for all of us, but know that we are strong. We walk through life with a broken heart with only a memory of our babies to keep us going. We love our babies just as much as our friends and family who are fortunate to have their children with them here on Earth. Despite the "great sadness" that surrounds us we manage to forge ahead. It's not easy most days, yet we dig deep and find the smallest shred of inner strength to keep on going. We are survivors!

For me my memories of Myles keep me going. I remember what an amazing little "soldier" he was and what a courageous battle he waged. I remind myself that I promised Myles that I would emulate his strength and that I would continue my fight. I fought for Myles and am grateful for all that I went through to have him. I know in my heart that my continued fight and all the pain that comes with it is not in vain. I am determined to beat infertility once again and despite all the devastation we've faced I'm still optimistic (yep, that's me the eternal optimist) that one day with K's help I will win this war. I am a survivor and I will triumph!

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.

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!

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.

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.

Spring

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!)

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".

Acupuncture Dilemma

As always I'm so thankful for all of you, my wonderful blog readers who are here supporting us and cheering us on! I honestly don't know how I'd get through all of this without knowing that there are others out there who truly "get it". You don't tell me that "it will be okay" or "it was probably for the best" or "someday I'll be a mother" (grr, that one hurts the worst). You don't ask me if we are "now going to adopt?" You tell me that you are sorry, that it sucks, and that it's not fair. You make me feel a little better in the midst of my sadness and despair. Today we're doing okay ... not good, not great, just okay. I put on my happy face and pretend for the world because when people ask me how I'm doing they don't really want to know! They want me to say I'm doing fine or preferably good, but honestly how on earth would someone who's struggled with years of infertility and who's just gone through miscarriage #5 with our wonderful surrogate be feeling? Um, to me the answer seems fairly obvious ... frickin' horrible!

So, I'm having a inner struggle regarding acupuncture. I did acupuncture for about 2 months prior to IVF #1 and continued it through the last FET I did with myself. I am a huge proponent of pre- and post-transfer acupuncture because the data is strongly in favor of it. I did it with all of my ET and K did it this last FET. However, I'm unsure of how much acupuncture really impacts egg quality and blood flow to the ovaries leading up to an ER. The data isn't very conclusive. Sure you can find some studies that support it, but in my scientific opinion many aren't very sound. Several are uncontrolled, have small sample sizes, and aren't replicated. I'm aware of all the anecdotal evidence that supports the use of acupuncture during IVF and completely agree that it helps to reduce stress, but really there are too many factors that determine egg quality (e.g., age, nutrition, stim protocol), which makes it nearly impossible to impossible to determine what's producing good results in an IVF cycle.

Now with that said I am a bit superstitious. I feel the need to do everything the same with the next IVF cycle that I did with the first that resulted in 8 blastocysts. I'm having my TSH tested tomorrow to ensure that it's between 1-2 because that's where it was at when I did IVF #1 (I have mild hypothyroidism and take Synthroid). Additionally, I am planning to go back on metformin again and plan to eat a diet high in protein during stims. Also, I will start doing guided imagery and meditation again. My problem is whether or not to do acupuncture again? If my health insurance covered it and we didn't pay out of pocket, I'd do it for sure. It costs me $65/week out of pocket on top of everything else related to IVF that we pay for out of pocket. I won't go into the details of all of those costs, but any of you who've done IVF can attest to the exorbanent costs associated with it! Suffice it to say that J and I have spent somewhere around $40,000 on IF stuff over the past 4 years and we are not rich!

So, I'm wondering if you did acupuncture during your IVF cycles, specifically leading up to ER, and what impact you think it had on your cycle. I'd love to hear from those of you that did it one cycle and not another. I'd like to hear if the results of your ER were any different in terms of # of eggs retrieved, # embryos created, the quality of those embryos, and resulting ET results.

This Thursday I have my post-IVF follow-up appointment with Dr. S. I'm anxious to hear what he has to say, but I can probably already predict it. I'm hoping that I'll have the pathology test results back from the miscarried embryo, so we can chat about what that means. My guess is that Dr. S will stick to his hypothesis that my uterus is sub-optimal, which resulted in me having early, severe PE and recurrent miscarriages, and that this miscarriage with K's perfect uterus was the result of bad luck (i.e., just happened to transfer an abnormal embryo). Even if it was "bad luck" it still sucks and was/is horrible for K and her family to have to go through.

Deep Dark Place

This is where I went yesterday and am not sure when I'll return. Please beware that this is not a happy, hopeful post by any means. Today I feel hopeless and want to curl up in my dark place and not face the world with my fake happy face. The people IRL who read this won't understand how one goes to such a place and I'm too tired to explain it. Quite frankly I'm reaching the point where I'm just plain tired, actually exhausted is more like it. Like one of my dear blogger friends I too want off this horrible ride!

One of my closest friends, L, listened to me cry and go on for hours yesterday. She has to endure my constant questions about how the universe can put so much on one family ... about how unfair it is that others are blessed repeatedly and others are just beaten down repeatedly ... about how I don't believe in miracles. All of those beliefs went out the window when Myles died. At one point during this conversation L said that maybe this is hell? Maybe J and I are experiencing hell on Earth? My response was that hell couldn't possibly be any worse than the life we live, so I guess this is my hell.

I have reached a point when honestly I wonder if I'm in denial. Am I refusing to see the evidence that is stacking up in front of me? For as difficult as it is to endure the constant heartache we face it is even more difficult for me to acknowledge the real possiblity that I might not have another child.

(Please don't give me any trite platitudes or promises that I'll one day be a mother to another child. I really don't need that right now. I just need to wallow in my dark place.)

Now What?

Hmm, haven't you heard me say that before?! I feel like I've been sitting in this very same spot a million times before over the past several years, yet I seem just as lost right now as I was the first time I sat here. I hate the limbo! I hate the not knowing of what we will do next or what direction we will embark on! I like to know where I'm headed as it always brings me comfort. I'm not feeling like we don't have a travel destination, but rather just that we don't have the GPS programmed yet. I'm obviously anxious to get the GPS programmed, so we can head off in the right direction.

I've talked with K about all that's happened with the miscarriage and emergency D&C. Not surprisingly K's husband was scared to death when he receieved a frantic phone call that his wife was going in for a D&C because she was hemorrhaging. As a result he feels quite strongly that K can't go through another cycle with us again. I don't blame him for having these feelings. He wants to protect his wife, the mother of his children, and the logical way to do that is to end the surrogacy journey. Additionally K's husband has some other reasons for not wanting K to continue, which I won't get into here, but all of his points are very valid. I understand that both K and her family need time to process all that's happened in the last two weeks before they make any final decisions, so we are going to give them some much needed time and space.

K and her family know that we will be moving on with our plans for IVF #2 and that we do not presume that they will be a part of our continued journey. It is important for my mental health and well-being to keep moving forward, so that's what we'll do. I will discuss surrogacy as a part of our future, but I will not discuss who will be a part of it. I need to give K and her family time to decide if they will continue on this journey with us or not. Of course we are hopeful that K will continue this journey with us, but we understand if she is unable to do so.

I told K that it's much easier for us to bounce back from the miscarriage because 1) we didn't go through the physical part of it, 2) we've been through 4 other miscarriages and are familiar with the wide range of emotions that accompany such a loss, and 3) it's not nearly as emotionally painful for us as was watching Myles die. Plus, years of being battered by infertility and recurrent miscarriage has made us quite resilient. Like I said before we stumble along this journey, but we keep getting to our feet and we forge ahead. We are "walking through flames" to get to our child. I have to say that this fall was a pretty bad one for me, in particular, because I expected surrogacy to solve all of our problems. I should've known better to think that it would be a smooth ride as nothing about this journey has been smooth. Despite this HUGE, devastating blow I still feel strongly that surrogacy will bring us a child, so working with a surrogate will be an integral part of our future journey.

I have my WTF appointment (i.e., post-IVF consult) with Dr. S scheduled for 3/31 to discuss our next step, so that meeting should help set us in motion. I hope that Dr. S is ready for me this time because I have a million questions for him! I'm guessing our protocol for IVF #2 will be similar to that of IVF #1 because I had a good response. I stimmed for 11 days with a combo of Bravelle & Menopur. My estrogen levels were low the whole time and never correlated properly with my follicle count, but my RE assured me that there are a select few women (go figure I'm one of them!) who have mature eggs as indicated by u/s despite what the E2 level indicates. He was correct. Here are my stats from IVF #1:

-21 mature follicles at trigger
-2 empty follicles at ER
-19 eggs retrieved
-16 mature eggs that fertilized with ICSI
-8 blastocysts (graded A; all frozen due to lining problems)

I'm guessing that he'll have me do the same protocol: slow and low seems to work for me! I was thinking that stimming during the school year might not be the best idea and thought about waiting until June, but maybe I'll start near the end of the school year if it works with Dr. S's schedule. I figure that the worst case scenario is that we won't have a surrogate to transfer our fresh embryos to, but realize that if that's the case we'll just freeze the embryos until we can find a surrogate. In my dream world my uterine lining would suddenly do something miraculous and grow thick so we could transfer to me, but we know that is highly improbable and very unlikely to happen.

Like a good obsessive infertile

I drove out to K's house last night, which is about 20 minutes from my house, to closely examine and photograph the pee stick she did at 3pm yesterday. I told J that I was going to K's house and he naturally asked what for. I told him that I was just driving out to drop something off. He pressed me for more information and I finally told him that I wasn't going to tell him because I didn't want to hear his critical response. J promised not to criticize me, so I explaine why I was going. With a completely shocked look on his face J proceeded to say "so let me get this straight you are driving over 20 minutes to examine a pregnancy test and take photos of it?" I said yes and he said something along the lines of thinking it was a little crazy. I fully admit that I'm a crazed infertile and that driving over 20 minutes to look at a pee stick in comparison to others seems completely normal to me. 5 years of infertility can make a girl a little nutty when it comes to reproductive stuff! I know all of you completely understand! So, without further ado here are the photos of the tests. The top test that's not labeled is the one that K did last night. I put it next to the tests from Friday and Saturday morning, which were done with fmu, and I think last night's test is as dark if not slightly darker than Saturday's. What do you think?