Joy Comes in the Morning...or the Mourning

It's been almost a year since I posted anything.  And it's been a busy one at that.

After our miscarriage, school was out a few weeks later, and then a week after that we spent about 8 days in Tennessee and Georgia with my mom and sister in the Smoky Mountains on vacation.  We had a blast.

At the beginning of August we transferred another two embryos, and after several negative at-home tests, my beta HCG at the lab came back positive on the first day of school.  The numbers were lower than with our first pregnancy, so I didn't expect baby to hold on, but she did.

I'm sitting here in my husband's office with my two-week old daughter lying on the bed beside me, starting to get hungry and grumping at me.  She's absolutely beautiful, a true work of art that was surely knit together by God.  She was born on March 22, a full five weeks early, at 1:10 a.m.  She weighed 5 pounds, 12.8 ounces, and was 18 1/4 inches long.  Her first few hours were harrowing, as we thought she may have to be life flighted to the nearest metro area for further treatment because she was struggling so hard to breathe, but she rallied, and after five days in the hospital, she got to come home with us.  She's been growing like a weed, and I'm patiently waiting for her to get to 7 pounds so I can use my baby carrier with her.  Her stroller should be here within the week, too, so we can get outside and enjoy the Wyoming spring weather and I can get some exercise, too.

Anyway...I wanted to write down her birth story so I don't forget.  It all happened so fast, and now it seems like it was so long ago, I hope I can remember...

Two Thursdays before Daley was born, we were having parent-teacher conferences.  One of my colleagues had told me that when you're having REAL contractions, you feel them low in your belly and around in your back, and that's exactly what I was feeling.  I was glad I made it through conferences, and the actual contractions that I were having didn't have a pattern and were really far apart.  The next day I had one of my twice-weekly OB appointments.  Dr. V. did a non-stress test, and baby was in the middle of one of her power naps, so after an hour on the monitor at the clinic, he sent me down to the labor and delivery unit at the hospital to continue being monitored.  I drank some juice and woke her up a little, and we were sent on our way.

The next day, however, I was having more contractions, and baby wasn't moving as much as we'd like, so Dr. V. had me come into the L & D unit again to be monitored.  Ryan and I were there overnight as I received IV fluids (after about 8 IV stick attempts) and started oral meds to help stop my contractions.  One of the amazing nurses checked my cervix and found that I was dilated 1 cm, which, considering I was 6 weeks early at that point, wasn't good.  Dr. V. put me on modified bed rest for the remainder of my pregnancy (which ended up being way shorter than we would have liked).

After the next week of lots of contractions, trying to drink gallons of water, and those two doctor's appointments, Saturday rolled around.  I was up all night with intensifying contractions, and I had been keeping track of them all night, and all day.  I hadn't slept, and around 7 p.m. I had Ryan call the doctor on call.  He said with our history we could choose to come in or not, it was up to us, because I probably wasn't making any cervical changes anyway.  I stuck it out for another hour before I couldn't take the pain any more, and Ryan and I went in.

Much to my surprise, I was in active labor, and when I was checked, I had dilated to 3 cm.  This was concerning because Daley had been breech on our ultrasounds, most recently just a few days prior.  Dr. K did an ultrasound bedside to check her position, and praise God, she was head down, just like she needed to be.  I had been all prepared for an unwanted c-section.  He asked if I wanted him to deliver or if I wanted him to call Dr. V.  I told him I'd love for Dr. V. to deliver, as he's been a huge support, and I'm kind of complicated anyway, and about an hour later, Dr. V. showed up.

By the time we went in, I was already in need of some pain relief, and was hoping that since I was at 3 cm dilated, I could get an epidural.  Unfortunately, another patient (who happened to be one of the second grade teachers at our school--there were 4 of us all pregnant at the same time, and 3 of us due within about 10 days of each other) needed an emergency c-section, and the anesthesiologist was tied up with her.

Two hours of intense contractions later, with my amazing husband letting me squeeze his hand through each of them, I got my epidural...which didn't work.  By this time I was into the transitional portion of labor, and my contractions were hard and fast and frequent.  I think I was dilated to a 6 or 7.  After another hour of labor, the anesthesiologist was back and gave me a spinal.  It only took about another half hour for me to finish dilating and be ready to push.

I think I pushed through about 4 or 5 contractions and she was here.  I didn't know if we'd had a boy or girl right away because they took her to work on her and get her breathing.  I think the best part of the whole experience was hearing my husband say "Oh, Marce" as our little Daley Grace was born.  My OB and the nurses that we worked with were absolutely incredible.  I can't say enough about how well Daley and I were taken care of.  Dr. V. suggested a pediatrician for Daley, and I think she's wonderful, too.  She's so reassuring and takes the time to answer our new parent questions.

God has blessed us.  We've found our joy through our mourning of all the years we lost due to infertility and the loss of Critter and our other embryos.  I've been typing for a while now, and I don't want to do anything but go and gaze into my sweet daughter's face.

She was worth the wait.  And I'm stuck between wanting her to stay this little and wanting her to be older so we can play and interact more and have fun together...I suppose that's the joy/sorrow of parenthood...

Mother's Day Lament

This year...this year was going to be different.  We were going to have a reason to actually celebrate Mother's Day for ourselves.  It, unfortunately, wasn't to be.

Backing up a little, Ryan and I went through our IVF freeze-all cycle in December.  We retrieved eggs and created babies on December 13th, and ended up with 13 REALLY good embryos out of the 35+ eggs we retrieved.  By day six all of the eggs that fertilized never stopped growing, which, according to the embryologist, was kind of a miracle.  At any rate, just the best ones were frozen.  Five were frozen singly because they were excellent quality embryos, and another 8 were frozen in pairs because while they're still GOOD embryos, they're not of the utmost quality.

We waited until early February to transfer an embryo.  We transferred our BEST quality embryo on February 7th, and had our blood pregnancy test on February 17th.  The test came back negative.  Our RE (reproductive endocrinologist) said there were several factors that could have contributed to the loss of the embryo.  It could have been attributed to my weight--because of it the lining of my uterus just isn't as "sticky," or, most likely, the embryo itself was genetically abnormal.  They aren't able to tell if an embryo is genetically normal or not without sending the embryos across the country and without significant cost, and we opted not to do that with ours.  So...it was on to the next.

Ryan and I decided that we would transfer two embryos the second time around.  On April 3rd, we transferred two more beautiful embryos, and I had my blood pregnancy test on April 14.  I already knew I was pregnant, though, because I'd gotten up for my mid-sleep piddle at 2 a.m. and peed on a stick, and was ecstatic when I saw two blue lines appear.  I tried to wake Ryan up to come look at the test, but he was hard to rouse, so I turned on the bedroom light, much to his dismay, so he could look at it.  He grunted, rolled over, and went back to sleep for an hour before his alarm went off.

Before I went to work that morning, I went to our local OB/GYN's office to get my blood drawn and very impatiently waited for our answer.  I called my mom and my sister and let my closest friends know (which is pretty much everyone I work with).  Over the next week and a half we had the pregnancy hormone in my blood tested several times, and while my level grew significantly each time, it didn't double like most women's levels do.  My RE wanted us to come down for an ultrasound so we could be sure the pregnancy was in my uterus and not in my fallopian tube or somewhere else it didn't belong.

We drove to Pleasant Grove with heavy hearts, not hopefully.  However, when we saw our little one on the screen, just as s/he should be, we were ecstatic.  We got to see the yolk sac and the fetal pole, which was right on track.  And we went home and prayed for our baby to continue to grow, even though our doctor gave "Critter" only a 50/50 chance at life.

This past Thursday, May 8th, we drove to Pleasant Grove again, this time with our hearts more hopeful.  We were praying for a bigger Critter and a strong heartbeat.  The minute our little one appeared on the ultrasound machine screen I knew there wasn't a heartbeat, and I knew that all the hope we'd had was for naught.

And now tomorrow is Mother's Day.  I haven't miscarried naturally, so I get to spend tomorrow with Critter, even though s/he has already spent almost two weeks in the arms of Jesus.  I am scheduled for a D & C on Tuesday sometime so our wonderfully compassionate doctor can take Critter and be sure that I am healthy.  We have decided to have Critter tested for genetic abnormalities, and hopefully we can have a definitive answer as to why s/he stopped growing, and we can better choose how to move forward.

All I can think of right now, is how on Tuesday, my little one isn't going to be my little one any longer.  I know s/he really isn't there anymore, and the only way I can kind of explain how I feel is it's like that last look before they close your loved one's casket and you know you never get to see their earthly body again.  I will never get to see or hold my Critter this side of Heaven, and that is our reality.  I have to wait.  And I kind of feel like we've waited long enough.  I'm mad at God.  Right now, I can not say "it is well with my soul."  I want to know how much more we have to endure before we get to be parents.  We desperately want to love on our babies...

So...tomorrow is Mother's Day.  I am unbelievably grateful for my own mother, who loves me and encourages me with her quiet strength.  I am grateful for my mother-in-law, who spends hours in prayer on our behalf.  I am grateful for all the other moms in my life, who love me like I'm their own, who comfort me when I'm sad, push me to better myself, and give of their hearts and time freely to make my life a little sweeter.

And for a few more days, anyway, I get to be a mom to this precious little life who got to be mine, if only for a little while.  The grief chokes me sometimes, and I can't breathe, and the only thing I can do is cry uncontrollably.  I'm terrified for Tuesday, even though I know it needs to be done.

Please pray for Ryan and I as we go through this season of grieving for our little one.  Please pray for a safe surgery on Tuesday, and the beginning of healing.  Please pray for the rest of our freezer babies, waiting to join our family.  Please pray that we can put one foot in front of the other, and remember how to breathe...

The Plan

Sorry I didn't get this written down yesterday.  It was just a long, busy day, and we were both exhausted.

We got to UFC a little ahead of schedule yesterday, which, believe me, never happens.  After a few minutes, they called Ryan back for his semen analysis.  After that appointment, we met with the financial counselor and had our blood drawn by Abby, who could be the most awesome phlebotomist I've ever known.

Last we met with Dr. C.  She did both saline and regular ultrasounds on me.  We also sat down in her office and talked game plan.  And this is it, after conversations and phone calls yesterday.  Things have changed a little bit:

*My uterine lining actually looks pretty good.  When Dr. C. is in there for our egg retrieval, she's still going to do a light scraping.  I think this means they're going to knock me all the way out, which is good.  No intubation, thank heavens.

*We are not even going to try a fresh embryo transfer.  Dr. C. just returned from an international conference with world-renowned reproductive endocrinologists.  She said there was lots of discussion about patients with higher BMIs and fresh versus frozen embryo transfers.  The current research, along with advancements that have been made in freezing and thawing embryos, suggest that a frozen embryo transfer, allowing the patient's estrogen levels to regulate, are the best protocol for us.

*Unfortunately, Ry's semen analysis was a little different from the last time we had one completed.  Because of this, Dr. C suggested we use ICSI (intra-cytoplasmic sperm injection) to help create our babies.  This, and the fact that we are doing a frozen embryo transfer adds significant cost to this cycle, which really, really stinks for us.

*I scheduled several of the required ultrasounds.  During the two-week stimulation period, I will need around five of them.  The one will take all day, because I have other things to do at the office.  The rest I will be getting up really early, driving to the Murray office for my 8 a.m. ultrasound appointments.  I have one day where I have to go to Pleasant Grove, and that is going to stink, but, I guess I'll make a day of it.  It's nice that for most of our appointments, we don't have to go all the way to Pleasant Grove.

*All of my blood work came back pretty good, except for my thyroid.  Dr. C. upped my dosage of my thyroid meds a little bit in preparation for a pregnancy.  Good news---neither of us are HIV+.  I knew you were really worried about that.  lol :)

*For those of you familiar with stimulation meds and dosages, I'll tell you what I know.  This protocol will not have any lupron, thanks heavens.  I'm already taking Ortho-Cyclen to help calm my ovaries, which, according to the ultrasound, have tons of follicles.  Hopefully they'll generally go away before the cycle.  I will be on 225 of Follistim two times a day.  This is about twice the dosage I've ever had.  It's gotta work.  With that much Follistim, our meds are going to be REALLY expensive.  I'm going to ask if we can order them as soon as possible.  We're almost to our deductible, and then everything else is free.  That's always a good thing.  In addition to the Follistim, I'll be doing 1 vial of Menopur (I've never had that before).  On day 6 of the stim, I may begin Ganirelix, which is a drug to keep me from ovulating.  I'll also be taking a baby aspirin every day, and I need to take prenatal vitamins as well.  Both Ryan and I will be taking a course of antibiotics in November, and he takes one really strong antibiotic the day before our egg retrieval, because he has to give his "donation" on that day to make our babies.

So...that's "The Plan" for right now.  It's so weird that in just a little over a month we'll be hard at it.  I'm kind of glad we're not going to do a transfer in December, because it would probably be the week before Christmas break, and my kiddos at school will be nuts.  After the transfer, I have to be on 48 hours of bed rest.  Hopefully we can arrange to do the transfer on a Friday afternoon and I can just take the weekend to be lazy.

Please continue praying, friends!  I'm reluctant to allow myself any sort of hope.  We've got a month before things get serious.  November will be busy, hopefully, and I can keep my mind off of this little glimmer of "maybe..."

Aaaaaand We're Back

So...it's been a while.  We were kind of lost in the wilderness for awhile there, but now we've been delivered.  Kind of.

The first weekend in August, Ryan and I participated in a 5k for the Pound the Pavement for Parenthood organization.  A doctor from the Utah Fertility Center was there, and when they were announcing winners for prizes, I wandered my way over to her.  I told her my story, and she said that I should have my records sent and come in for the free consultation they were offering for participants of the 5k.

So, two weeks ago I met with her (on our way to the Luke Bryan concert).  She looked over the records with my friend Aja and I, and the records from the last IVF cycle we attempted at the U were particularly interesting to her.  She said, even though my estrogen levels plateaued, if she had been monitoring my cycle, that she would have went ahead with an egg retrieval.

She said we'd start me out at relatively high dose of Follistim and Menopur, which both work to stimulate my ovaries to produce multiple eggs.  I have a lot of eggs (I feel like I should cluck here...), and she's a little concerned with ovarian hyper-stimulation syndrome (OHSS), where your abdomen swells full of fluid, and it's generally gross, and can require surgical intervention.  Dr. C. said that there is a special kind of trigger shot (which matures the eggs so that they're ready for harvest) that can help prevent OHSS, and depending on my ultrasound and blood test results, they'll give me that.

The doctor in Denver suggested harvesting eggs, making embryos, and then freezing them for a month so that I could heal and have my hormone levels stabilized.  Dr. C. said that we might be able to just do a fresh transfer depending, again, on my hormone levels.  If I do end up needing a D & C, we'll need to make freezer babies and do a frozen embryo transfer later.

So the plan is on October 18 to have a phone appointment with the IVF nurse to answer any more questions and get my calendar as to when I have to take what medications, go in for ultrasounds and blood work, etc.  Then, a week later, Ryan and I will go to Salt Lake for our big appointment where he'll do his business for an analysis and back-up for the day of retrieval, and I'll have blood work, a regular ultrasound, and a saline ultrasound so the doctor can see the inside of my uterine cavity.  That will be the determinant as to if I need a D & C or not.  My guess is that I will, unfortunately.  The good news is they can do that while I'm out for my retrieval.

So, we're moving forward again.  I think this is going to be it.  I can't handle any more.  Either it works, or it doesn't, but I think we need to move on with our lives, and build our family a different way if that's what we decide to do.  Dr. C. says we have a 75-80% chance of getting to retrieval this time, and the clinic has a 50-60% pregnancy rate with fresh IVF cycles.

Please pray for us as we continue down our road towards parenthood.  I watch Ryan sometimes, and I think about how he'll be such a wonderful father--fun, affectionate...I just can't imagine him not being a dad...

One-Day Workup

Ryan and I just got home from our one day workup at Colorado Center for Reproductive Medicine in LoneTree.  It was a trip, that's for sure.  We got innundated with information, so hopefully I can regurgitate a little bit of it here so I can remember.

We both left CCRM feeling a little bit like cattle.  We checked in and then were ushered to a conference room with four other couples (we were younger than all of them, thank heavens).  We were given a binder full of information and then a nurse went over it with us.  After that, we had a consult with our nurse, and we met with Dr. Famous.

Those two people gave us most of our information.  Our nurse was amazing, and I've already called her once.  She was really personable and knowledgeable.  Dr. Famous had gone more thoroughly over our information, and had a list of things we needed to do before our actual cycle.  I need to have an updated pap smear, since its been 2.5 years.  I also need to have a letter from our nutritionist saying that I understand how to eat right.  I also need to re-consult with the maternal-fetal medicine specialist I met with two years ago to be sure I'm still healthy enough for a pregnancy.  Dr. Famous also wants me to talk to the MFM specialist about losing weight and maybe changing some meds around.

After those two consultations, we moved onto the testing phase of things.  Ryan had to go down to the lower level of the clinic for his business, and I was whisked off to have my baseline ultrasound and doppler test.  My ovaries both had about 15 follicles, which is classic symptomology for poly-cystic ovarian syndrome.  The doppler part of the ultrasound was a little abnormal, but the tech said that many women have decreased uterine blood flow, and it can be helped tremendously with acupuncture.  I also had a hysteroscopy done with Dr. Famous.  He said my uterine cavity looked pretty good except for that my lining was uneven.  He said that once I was out for my egg retrieval, he would probably just do a D & C, and I'd get a two for one deal out of the bargain.

We then ate something (because I hadn't eaten all day)--luckily the "lunch lady" can order something from a gluten-free sandwich shop, so I had a sandwich, and COFFEE!

When we were done eating, we went for our bloodwork.  We are doing some genetic testing right off the bat, and I had some hormonal type tests done as well.  I had ten vials of blood drawn, and Ryan had two.  They have to send my genetic testing to another lab.  We're holding off on doing the communicable diseases testing because its only good for six months (more on that later).

After that, we were all done with the medical side of things.  We met with the business office, dropped $1000 off with them, and then talked to a representative from Fertility Labs of Colorado to sign consent forms for them to treat us.

I guess to summarize, here's the deal:

1.  I need to get my outside appointments scheduled to get my pap smear done (if they'll let me...I hate our local clinic.  They are absolutely ricidulous), meet again with the Maternal Fetal Medicine specialist, and talk with the nutritionist.  I need documentation from all of these people that we are ready to proceed.

2.  We are NOT proceeding right this instant.  Dr. Famous doesn't think that a six-month delay will affect our fertility in the negative.  In fact, he thinks the opposite.  Six months gives me time to get my health under better control.  My goal is to lose 50 pounds before the end of May.  It's kind of a lofty goal, but Dr. Famous says even losing ten or twenty pounds is advantageous, and losing fifty might even double our chances of having a successful pregnancy.

3.  Dr. Famous is going to use a completely different course of treatment because I've been so hard to stimulate in the past.  He's adding drugs to my protocol, and, unfortunately, my injections won't be given sub-cutaneously (small needles in fat) any longer.  I will have to use the big needles to give myself injections intramuscularly.  That's like when you get a tetanus shot, etc. 

4.  Unfortunately, we will also not be doing a fresh embryo transfer, and that adds about six weeks onto our treatment.  We will stimulate, retrieve eggs, create embryos, and then freeze them.  Obese people have better results with a frozen embryo transfer because your body has a chance to heal between all the stimulation hormones, retrieval, and in my case, that free D & C I'll be getting.

So that's where we are.  Like I said, we feel kind of like cattle, but its been that way everywhere we've been.  I think at CCRM they get all of the up front things done, and the doctors do lots of stuff behind the scenes and after hours.  We have a regroup appointment with Dr. Farmous after my next cycle starts and I have some more blood work done on day 2 or 3, freeze the blood, and ship it to CCRM, because they require those tests be done at their lab.

They seem really willing to work with us so we don't have to go back and forth so much since its such a long drive, and actually, the frozen embryo transfer will be nice, I think.  We can plan our vacation between retrieval and transfer, and that will be nice.

Overall, we are both positive moving forward.  Dr. Famous said we could start our cycle ASAP if we wanted, but that if the goal was to have a healthy, successful pregnancy, that this would be the best option for us, and that's what we're going to do.

Also, I had coffee today after 3 days without, and I also had chocolate.  And it was good.  And now I have to phase it out of my diet because it restricts that uterine blood flow.  I can live.  If it means a baby in this house, I can do it.

I also had chinese food today after three months without it.  We went to P. F. Chang's in Loveland.  They have a lovely gluten-free menu, and it was DELISH.  I will definitely be going back.

Anyway, that's it.  Please pray for us as we embark on this heavy-duty weight loss journey and continue on our quest for a baby.  Also, please pray that this bleeding and cramping stops from that scope.  Blech.

Thank you, friends.

Consult With Dr. Famous

I had our phone consult with Dr. School.Craft from Colo.rado Center for Reproductive Medicine last Friday, after a phone mix-up on October 4th.

It went really well.  From reading other patients' blogs, Ry and I had come to the conclusion that he wasn't going to be very friendly.  I was okay with that, because friendly hasn't gotten us any closer to being parents than we were four years ago.

Dr. S. started the phone call by asking me to tell him our infertility story.  I just told him that we'd been trying for about four years.  Over the course of those four years, we'd tried timed intercourse, timed intercourse with Clomid, several intrauterine inseminations with both Clomid and Femara, and we'd had three cancelled IVF cycles with protocols of lupron, Repronex, and increasing doses of Follistim. 

He said that we have options.  He said if we chose to come to CCRM he would use a different protocol of medications for an IVF cycle for us, getting rid of the lupron (which is an ovarian suppressant--it supposedly keeps me from creating too many follicles), and adding some different stimulating medications that I haven't used yet.  He said that in-vitro maturation is also an option for us since I tend to have lots of resting follicles, but that IVF is probably a better option since there tend to be more successes with it.

Dr. S. also said that losing weight would be a good idea, too.  Losing weight for me means that the drugs have to go through fewer pounds to get to my ovaries, which makes sense.  He also said that losing weight would be helpful for when it came to doing a transfer, too, because implantation rates go up when you weight less.

So...right now we're waiting for chicky time to show up so we can schedule our workup in Denver.  We have to go down for one day the second week of my next cycle for testing and to actually meet Dr. S.  He will do a 3-d ultrasound to check uterine blood flow and also do an outpatient hysteroscopy to check my uterine cavity for any abnormalities.  Ryan has to do his business, and we have to do a ton of bloodwork to test hormone levels and do some chromosomal testing.

Or, maybe there will be a miracle and we'll be pregnant this month and won't have to deal with any of this anymore. 

HAHAHAHAHAHA!

The Limbo Funk

It's 10:15 pm, and I should be in bed.  I'm up, though, tired, but up.  I came home from my dental appointment this afternoon and slept for an hour before supper so I could actually feel my mouth and not choke to death.

I'm in kind of a baby funk.  I don't want to hear any more about anyone's pregnancy or children.  Our own quest for those things seems overwhelmingly futile.

I've been talking with an adoption coordinator from Bethany Christian Services.  She's been very supportive, but she said that it would probably be a wait of at least two years for a baby.  Wyoming Children's Society, whom we've also researched, says that their average wait time is 12 to 24 months.  *sigh*.  I can't imagine being 34 and just starting my parenting journey.

Ryan and I also have a phone consult on October 4 with Dr. William Schoolcraft from the Colorado Center for Reproductive Medicine in Denver.  He is a world-renowned fertility specialist.  He has credentials in two areas that we are interested in.  He specializes in treating women who are poor responders to ovary-stimulating medications.  That would totally be me.  He also specializes in a relatively new treatment option called in-vitro maturation.  The process before embryo transfer is the difference between in-vitro fertilization and in-vitro maturation.  In-vitro maturation utilizes no injectable medications and is much more inexpensive than in-vitro.  The patient takes oral medications, and immature eggs are retrieved from her ovaries, and mature outside her body in a petri dish, and are then fertilized and the resulting embryos are transferred. 

We don't know if this is going to be an option for us or not, and we won't know until we consult with Dr. Schoolcraft.  I hope he can give us more of a concrete path to follow.  If he says he can't help us, that will be a definitive answer, and we are done pursuing the medical route.  We won't prevent pregnancy, by any means.  But it is what it is.

My friend Sara adopted from a foster care situation, and gave me the name and number of our local caseworker.  I contacted her and hope to meet with her before she goes on maternity leave.  I missed her return phone call tonight because I was sitting in the dentist's chair.

Anyway, that's where we are.  We're in limbo.  We don't know which way we're going, and tonight, waiting to be completely exhausted, I don't seem to know which way is up.  I'm in a funk about the whole thing, and I wonder if I can even be a good mom sometimes.

Okay.  I'm done now.