Small but Pretty

We transferred one 4-celled embryo this morning. 6 or 8 cells is what's typical for a 3dt, but my RE assures me that he has definitely seen successful pregnancies from 4-celled embryos.  I'm hanging my hat on that.  My embryo probably just didn't like the lab and will start dividing like crazy now that it's back home in me.  It's just a late-bloomer who's homesick.

Even though it's small, it sure is pretty.  My clinic grades embryos using 2 numbers.  The first describes the number of cells at the time of transfer and the second number describes how even the cells are and how much or little fragmentation is present. Three is the highest grade possible and that's what mine got.  It had little to no fragmentation and the cells were all about the same size and shape. It's a looker, alright.  

All in all, putting both measures together, the RE said he would call my embryo "Average."  In the past, my overachieving self would have bristled at that word, but no longer.  At this point, I'll take average.  Average is just fine with me.  Considering there was talk of canceling this cycle, average is beautiful.  

We're batting a thousand!

Our one egg fertilized so we have one embryo at the moment. I'm scheduled for a transfer on Monday morning. My clinic will call tomorrow with an update on the embryo quality. That is my next worry, but for now I'm trying really hard to enjoy the possibility that this might possibly work. I know the chances are tiny with one embie, but it's better than what could have happened. One day at a time, that's my new motto.

One Good Egg

I just got back from ER and it didn't go nearly as well as it could have, but I'm not completely out yet.  I'm hanging on by my fingernails. They only got one egg-one measly egg. The RE who performed the retrieval said he tried several flushing techniques on the other follie, but there just wasn't anything there. So it looks like I did get a single dominant follicle again this time, but it brought along what amounts to a cyst to keep it company. I hate my ovary at this moment.  It does nothing but mock me.

 I'll get a fertilization update tomorrow.  DH kept saying that all we need is one good egg and he's trying to stay positive.  A friend of mine said that someone has to beat the odds and maybe it will be me.  I'm feeling less and less hopeful about that possibility.  I'm still hoping, but I'm not really expecting much of anything.  

A Reprieve

I'm triggering at midnight for an egg retrieval on Friday.  I still have 2 follies but my E2 went up to 400 today so my RE decided to go for it.   I had been preparing myself all day to hear that the cycle was canceled.  DH and I decided to try to forget about it and just go for a drive in his jeep with the top down.   The sun is shining and it's unusually warm for spring in New England.  We ended up at a local farm stand and were picking out vegetables to grill tonight for dinner when the call came.  When I answered and it was the nurse, I thought, "Damn, my RE is a big jerk for not calling me himself to tell me he's canceling my final cycle."  Then she told me she had instructions for me and I was in disbelief.  I'm more relieved than excited.  I'm trying really hard to take it one step at a time.  Nothing is guaranteed, but today's results sure are better than the alternative.  

Slipping Away

Slipping away-that's what I sense this cycle is doing.  Today's b/w and u/s were not so good; not bad enough to cancel yet, but bad enough that the C-word was brought up.  I have 2 follies measuring 18.5 and 19.5.  My E2 level is only 267.  I was hopeful after the u/s, even with only 2 follies, because I thought I only needed to have 2 follies over 18mm to do egg retrieval.  I wasn't thrilled about 2 measly follies, but it's better than I've done that last couple of IVF cycles when I had a lead follie jump ahead of all the others.  Apparently my RE is not feeling so hopeful and he made sure his nurse brought up the possibility of canceling because of the low E2 level and number of follies.  She said he "usually likes to have more than 2 to work with."  Well, so do I but we can't always get what we want, can we?  I told her that this is my last cycle and I'd really like to get to retrieval.  I may have to do battle tomorrow after more b/w and u/s.  Ugh.

Hanging On-Barely

My scan and blood work this morning weren't great, but they weren't bad enough to get me bumped to IUI yet.  My E2 has increased to 146, still really really low for 9 days of stims but higher than it was 3 days ago.  And the follies are still small, but 3 are getting close to the 12mm mark when my clinic begins measuring follies.  The u/s tech actually measured them anyway and said they were 9, 9, and 10.  Again, not where you want to be after 9 days of massive doses of FSH, but better than having a lead follicle at this point.  

When the nurse called this afternoon, she told me to continue the lupron and stims until I come back on Tuesday.  I asked if my RE considered taking me off lupron since that's what we did during my first go-around with this protocol, with a different RE, and it seemed to help.  She said he wants to give it another couple of days since things seem to be moving in the right direction. He would reconsider the lupron again after Tuesday's scan.  I think it's probably the lupron that has kept a lead follie from developing this time so I understand his reluctance to remove it, but if the follies don't grow then that's no good either.    

I wonder what's the longest one can stim.  If I keep going at this rate, it should be about 16 days or so for me.  Is that possible?

Thank you for all the kind comments to my previous post.  My anxiety got the best of me.  I can't promise that it won't happen again before Tuesday so beware.  

Remember all that stuff I wrote about being ready for however this IVF cycle turns out.  Well, I guess I lied because right now I'm in the middle of a panic attack thinking about tomorrow and what it might bring: no growth, a lead follie, bad news, cancellation, THE END.  I can't catch my breath.  I hate this infertile life.  Why can't I be normal?

Progress Check #1-Starting Small

I had my first ultrasound and blood work appointment for this cycle today.  After 6 days of stims, my E2 was 41.6.  That's low, low, low.  And I had 8-10 follies on my one ovary, but all were under 12mm.  So I'm not off to a stellar start, but I'm actually pretty happy about those results.  A bunch of small follies is better than one big lead follie and a few little ones, which is what I've had the last couple of IVF cycles.  So I'm not cancelled yet. I go back on Sunday for more blood work and another ultrasound. Then I'll have a better idea of where this cycle is headed.  

Split Personality

I know my blog has had a split personality lately as I go back and forth between adoption and IVF.  I feel like my life is split in the same way.  On one side I'm feeling kind of, sort of hopeful about my chances of getting pregnant, which means I'm in a state of total denial. My chance of a BFP for this cycle, according to my RE, is about 5%.  That's a 95% chance of a BFN.  Yet, still that little twinge of hope has made an appearance. I've pictured the two pink lines and the call from a happy nurse, telling the people who love me, feeling the happy ending. I'm not blind to the fact that Mother's Day is just around the corner. Wouldn't that be perfect?

At the same time, I've felt incredibly sad this week. I feel like I'm in mourning. I'm grieving the pregnancy I may never have, feeling my baby kick inside me, my growing belly, the big ultrasound, the baby shower, the hospital, the breast feeding.  I've even sought out belly pics and u/s photos to give myself the chance to cry even more, like this mourning is something that I need to do.  I guess I'm just preparing myself for what I'll feel if this cycle doesn't work.  It's as though the possibility of never being pregnant is suddenly finally real to me.

Tossed in with all of that is adoption with its own set of feelings: hope that DH and I will one day get to be parents, sadness that it means our child will start off life with us having suffered loss already, worry that our child will somehow feel like second choice, fear of an adoption falling through, excitement for a process that doesn't involve injections, monitoring appointments, and monthly disappointment.  It's just another roller coaster, isn't it? 

Then there's always the possibility that my split personality could simply be the result of the massive amounts of hormones with which I'm injecting myself.  Hmmm. . .

Here we go

I finally got AF yesterday.  I went for bloodwork today and got the call from my RE's office to start stims tomorrow morning.  Here we go. . .

Touched by Adoption

DH and I spent our Saturday at an amazing adoption conference. It was sponsored by a local adoption organization which supports all members of the adoption triad. It was incredible to see so many people, all in one place, who had been touched by adoption in some way. There were sessions for birth parents, adoptive parents, prospective adoptive parents, adoptees, and even extended family members.

The first session we attended was called Domestic or International : How to Decide? It was presented by Ellen Glazer who counsels infertile couples. Three couples with whom she has worked shared their stories of adopting their children. Here is an article that one of them wrote called Christopher's Mom.

There were two things that struck me during this session. The first is that international adoption seems to be ending as we know it. Ellen said she always used to start this presentation by telling couples not to consider time and cost factors when making their decision about domestic vs. international because there was little difference. She said that's no longer the case. Many countries have closed to adoption for the time being and many others have very long waits. It seems as though lots of people are moving into domestic adoption for that reason. It just doesn't strike me as though this is a great time to adopt.

The other thing that I noticed was that the feelings shared by the presenting couples were similar to one another. All of them described being beat down by infertility. One said, in explaining her skeptical approach to starting the adoption process, that nothing else had worked, why should she believe that adoption would? Another said that it was hard to get excited sometimes, even after being matched, because she'd been let down so often before. Both are now mothers of baby boys. What they were describing is exactly how I've been feeling. It's so hard to trust that anything will work out, when so much that we've tried has failed. It was comforting to hear, yet again, that my emotions, fears, doubts are all normal.

The second session we attended was called Grief and Loss Behaviors in the Adopted Child. I felt slightly out of place as most of the other participants were current adoptive parents. The focus was on the losses that adopted children suffer, especially those who are adopted at an older age or who experience neglect or abuse before adoption, and on the behaviors that may result. Basically the presenters focused on the attachment cycle and what happens when that cycle is broken. Since DH and I are looking at adopting through our state's child protection agency, we were particularly interested in this topic. When the presenters stated that some of the damage that is done cannot be fixed, I have to admit that I had a mild panic attack. They said that doesn't mean it can't be modified or made bearable, but it can't be fixed. When a child is abused or neglected before the age of one, his or her brain development is forever changed. It didn't make me rethink adoption through social services, but it did make me go out and buy the book Parenting the Hurt Child and start reading it.

The third session was actually a presentation about adopting through our state's child protection agency, which is what DH and I have applied to do. Two single adoptive moms shared their stories of adopting their daughters. One adopted her child at three years old. The other's daughter was five years old when she was adopted. This was a wonderful presentation without any sugar coating (both girls are in regular therapy and had/have serious emotional issues), but there was also lots of focus on the rewards of adopting. One of the best aspects was that there were several knowledgeable people in audience. There was one couple who are in the middle of adopting a seven year old boy and had really done their research. They shared lots of information about navigating the system.

There was another man, there because he was interested in adopting a second child, who had attended the conference last year and decided to give the child protection agency a shot. He and his partner had a six month old girl placed with them within a month. Parental rights were terminated by the courts a month later and the adoption was finalized during National Adoption Month in November. That's the situation I want. Of course, I don't believe it will happen that way for us because of the emotions, doubts, and fears mentioned earlier. However, DH and I are moving forward anyway.

I was a bit sad when leaving the conference because I really enjoyed connecting with others in my situation. I wish there were a way to continue this connection all the time. I haven't been thrilled with the adoption forums I've found in the same way I have been with the infertility forums I frequent. I'm sure there are some great adoption forums out there-I just haven't found them yet.

IVF#4 Note: I'm still on lupron and waiting for AF. I've been slighly nervous because I haven't felt any side effects and haven't even had a single bruise from the injections. I kept wondering if something was wrong. Then when I went to do my injection tonight I noticed a little black and blue on my belly. I was thrilled. It's like if I see evidence that it's having an effect on the outside of my body, then it makes me think it's having an effect on the inside as well. Silly infertile mind.

Speaking of BFPs

I just found out today that one of my best friends in real life, M., got her BFP today on her second cycle of trying. Strangely, I'm doing better with this news than you might think. She's just a couple of months older than I am and has been married seven months.  Honestly, I don't know if M. believed she would ever meet someone, and when she did I was so happy for her. She told me two months ago that she was going to start trying and asked for any advice I had.  I suggested charting, given her age and her PCOS diagnosis.  She expected to have problems and figured the charts would give her a head start when she went to an RE after 6 months.  

M. called me last night to check in and told me she was 3 days late.  Because she's been charting she knew that she ovulated this past cycle and had a good shot at being pregnant. She told me she felt bad telling me because she knows how hard it's been on me and another friend of hers who is in the middle of an adoption nightmare.  I told her that lots of crappy things happen to good people, and it's nice to finally hear about something good happening to a good person like herself.  I commanded her to pee on something the next morning and call me with the results. 

Well, she called this morning and left a message while DH and I were at an adoption conference (which I'll write more about later).  She had peed on four tests by four different manufacturers (what can I say? M's an overachiever like me) and all four came up positive.  Her due date according to FF is December 9.  I have to admit that hearing the possible due date is the only part that made me tear up.  I thought, "Wow, M. will have a baby by next Christmas," and then I realized that there's a good chance DH and I will spend another Christmas childless.  That hurts.  I told DH that while M. was getting the two pink lines I'll likely never see, he and I were learning strategies for dealing with the little stealing, fire starting, attachment disordered child we'll end up adopting (again more about that when I write about the adoption conference).  

But other than that thought, which keeps returning to kick me periodically, I really am happy for M. Maybe it's because she's one of my dearest and well-loved friends who has been through some really rotten times in her life. Maybe it's because she was so concerned about my feelings in sharing her news and has been extremely supportive throughout my troubles.  Maybe it's because with her PCOS diagnosis she could have easily been dealing with infertility and dodged a bullet.  Maybe it's because I can't even begin to imagine myself in her shoes, pregnant on my second cycle, and so it's not as though her BFP could, in my twisted infertile mind, have been mine.  

I can even imagine myself at her baby shower.  How's that for coping?

BFPs

Lately I've noticed that I just can't immediately send out jumping green men anymore when a BFP is announced, even if it's a fellow infertile making the announcement. Just a short while ago, I remember writing that I'm thrilled when a fellow infertile gets a BFP. Thrilled isn't the word I would use to describe my feelings anymore. I feel slightly ashamed to admit that my first reaction isn't happiness. Instead my reaction is to get the same pit I feel in my stomach when any BFP is announced, but maybe a little worse when it's an IFer. Why worse? Because I know that few infertiles will get pregnant, and it feels to me like my individual chances diminish with every infertile BFP that's not mine. Only so many people hit the lottery; if your next-door neighbor hits the jackpot doesn't it seem less likely that you will? 

I think part of my reaction to the recent rash of BFPs is that I'm feeling more and more on the outside on my infertility forums. Many of the women I started with on infertility forums have graduated to the other side. There are a fair number of us original members left, and our numbers are sadly always being replenished, but it just seems like every day more and more of the women who I've come to know and love are moving on up (insert the Jeffersons' theme song here). Maybe that's why these BFPs hurt rather than bring me joy. I'm very afraid of being the last one standing. Plus, I selfishly don't want to lose all of my friends.

I will say for myself that once I get over my initial reaction, I swallow hard and reply to the big announcement. I'm not unhappy for my infertile sister, just sorry for myself and where I stand facing the end of the ART road. I'm still not strong enough to send jumping green men. I hope a note of congratulations, and a lingering sense of shame on my part, will suffice.