Everyone knows that the hormone rollercoaster is a given when you are in the thick of your cycle, but what about afterwards, when you get that BFN?
I decided to go back to Dr. F, my famous acupuncturist, who I took a break from for a year. He can help me with hormone stuff that Em, my other acupuncturist, can't, though he is clueless about IVF. After Dr. BloSunMyCha would not monitor my DHEA levels, I asked Dr. F to do it. I had to go off the pregnenolone I had just started taking for a week. I'll get the test on Wednesday. It can't come soon enough.
I think I'm having a hormone crash. I'm getting PMS symptoms and taking no hormone precursors to jump start my system again. I do think I ovulated, but my BBTs have been all over the map. My ovaries are confused.
I read two blog posts today that freaked me out. First was about a C-section incision busting open. I thought, ew, I don't want to do that, but chances are I would have to have a C-section because of my previous myomectomy to remove fibroids. Then, I read a post about a woman's PPD with anxiety. Talk about flashback, but I had that PPD/anxiety when I was pregnant. No one warns you about that. I've made myself sick on chocolate and lack of sleep in the last day and a half. I feel nauseous and panicked. If I didn't know better, I would think I was pregnant.
It seems that my expensive fertility treatment habit is now turning into an expensive car wreck habit too. Yeah, had another car accident last Wednesday. I'm ok, physically. The car isn't. I got a new lesson in trauma reactions, one I could do without. I froze in reaction to being startled while driving. Not good when there are other things moving around you that don't stop.
Following up to my post on Evil Pee Sticks for FSH this week, my blogroll popped up this post today from the High FSH Info Blog. I discovered this blog when I was trying to find the IVF clinic in Massachusetts of Dr. Car.done. Em, my acupuncturist, told me a story of a client of hers. She was young, late 20s/early 30s, but had high FSH. She did try cycling at BigShotFertilityClinic, but she ovulated while stimming and had to be twice cancelled. She finally decided to work with Dr. Car.done's clinic because another friend of hers got pregnant there.
There are two camps of REs. The first camp believes that once you have one high FSH, you are doomed for the rest of your life to have poor egg quality. All the REs I have been to are in this camp, including BigShotFertilityClinic. Those of you who commented that I can get this test done with my RE or Gyno, of course I know that after having gone through two IVFs and many other fertility procedures, but I don't want to be branded for the rest of my fertile life by a high FSH. That is the reason I would buy the evil-FSH-pee-sticks.
The second camp of REs, like Dr. Car.done, will do IVF on patients with high FSH, but only in cycles in which the FSH has dropped to an acceptable number. They believe that you can get pregnant in a cycle when your FSH is low. The client I described above had her FSH tested monthly. Once her FSH was low, she started her stim drugs for that cycle, no suppression ahead of time. She did end up getting pregnant.
The first FSH test I had done was very high, almost 18. Since I had it done at a lab that was not at a fertility clinic, I did have to repeat it at my clinic at the time. After getting the first donor egg speech by RE#1, I was devastated. I scoured the internet for information and found a reference to Randine_Lewis' book "The Infertility Cure". After reading in her book that "eggs do not have an expiration date", I had hope! I started acupuncture and Chinese herbs immediately. After a couple of weeks, I had my FSH tested and it was 6. However, my estrogen was high, over 100, so I was not out of the woods with a poor egg quality/DOR diagnosis. My theory is that the fibroids were causing my estrogen to be high. I went on to have them removed and passed a Clomid.challenge test with flying colors at age 40, which I did acupuncture and Chinese herbs through. My RE#3 didn't know what to think of that first FSH, but he was kind enough to brush it off as a lab error.
When I went gluten free, I had to learn how to cook meat. You see, I was a vegetarian before the gluten free days, and I was eating wheat three times a day. It's hard to be a gluten free vegetarian when you can't eat dairy, soy, or corn. I gave all those foods up when I was battling the fibroids and trying to save my uterus. I still do not eat much soy or corn, though I don't eliminate them completely.
One of the meats that used to really baffle me was pork. I have since learned how to cook some great pork meals, and this is one of them. Even my "vegetarian" husband loves this recipe. The great thing about pork is that you can find some cheap cuts of pork that are yummy. In a difficult economy, I've been buying more of these less expensive cuts. You can make this recipe with pork chops or pork shoulder steaks. The latter are inexpensive. I can find pork shoulder steaks periodically at Whole Foods Paycheck. You might be able to get a butcher to cut a pork shoulder into steaks for you as well.
In my opinion, the only way to cook juicy pork chops is on the grill. I've tried cooking them in a pan, but they always end up overcooked. This rub is the best!
Spicy Pork Chops
For 4 pork chops or pork shoulder steaks. It is helpful to have a small spice grinder for this. I have a mini Cuis.inart that cost me $20 and works great for grinding spices.
2 Tbsp cumin seeds 2 Tbsp coriander seeds 2 Tbsp black peppercorns 2 Tbsp ground dried chile (I like mild chili, but mix in some chipotle for my spicey loving family) 2 Tbsp kosher salt 1/4 cup olive oil
Grind the cumin seeds, coriander seeds, and black peppercorns separately in the spice grinder so they are part powder, part chunky. Grind more or less to your preference. Mix all ground spices together with the chili powder and kosher salt.
Start heating your grill if you haven't already done so. Pat pork chops dry with a paper towel. Brush one side of a chop with olive oil, then sprinkle the mixture over it and pat in. Repeat on all sides of the pork chops until you are finished.
Make sure your grill is oiled before cooking the pork chops. Take a paper towel, fold in quarters, and soak with olive oil. Use tongs to hold the olive oil soaked paper towel, brush the paper towel over the grill and coating it lightly with oil. I usually do this while the grill is heating.
Once you grill is hot, 400 degrees, grill the first side about 5 minutes and the second side about 3 minutes. How long you grill will depend on how thick your chops/steaks are. To check for doneness, make a small cut about an inch away from the bone. The meat next to the bone will always cook the slowest, so if you want your pork chops juicy, they might be a little rare next to the bone. The pork should have a hint of pinkness. If it's still read, cook for another minute and check again. The chops will cook a little bit more once you remove them from the grill, so no need to make sure they are completely cooked through on the grill. Enjoy!
Once upon a time, there was a girl named Phoebe...
Ok, this is no fairy tale, though I wish it were. Here are the basic things you need and want to know about me. My blog is about my baby making journey, cooking, gardening, natural living, and whatever I feel about blogging about. Phoebe is not my real name, but I think it's kind of a cool name.
I am now 43 (updated 8/2009). It took a while for me to find Mr. Magic, and we got married two months shy of my 39th birthday. My first RE visit was just before that 39th birthday. I always knew I would need high tech means to get pregnant with Magic, my husband, but I was very naive about what that meant. I thought, yeah, I'll just do IVF. Little did I know how difficult it would be and how much agony and pain it would bring me.
Magic had a vasectomy 15 years ago after the birth of his second son, thinking he was done with baby making, but saved some of his sperm, just in case. In that 15 years, he was divorced and we were married. A reverse vasectomy now will have little chance of being successful because the amount of time that has lapsed from his original vasectomy directly correlates to the amount of the antibodies that are produced against Magic's sperm.
My baby making journey, which has so far resulted in no baby, has consisted of:
1 IUI 1 IVF converted to IUI 1 IVF 1 FET
I have had my own reproductive problems myself. I had surgery for uterine fibroids, a half a pound's worth, before any RE would touch me. Fortunately, changing my lifestyle and getting serious about taking care of myself have kept anymore fibroids away.
High tech fertility treatments are completely against my own personal philosophies, but since it is the only way I can get pregnant, I suck it up. At this point, it feels like a very expensive hobby.
I did get pregnant from IVF #1 redo (IVF #2?) at age 41. I had serious fucked up problems with my pregnancy that was directly related to doing IVF. I know I would not have had these problems if I got pregnant naturally. One of them was that I had severe prenatal depression and anxiety and was not getting treated for it. I did try taking Pro>zac, but I had a paradoxical reaction to it, meaning it made me more anxious instead of calming me down. In retrospect, I should have been on anti-anxiety medication and a different type of anti-depressant, not an SS.RI type anti-depressant. However, because I was so out of it, I didn't have the energy or will to find the right kind of psychiatrist to treat me, and Magic didn't know what to do. It's difficult when your normally in-control-assertive wife suddenly turns into a withering mass of protoplasm. The doctor who did prescribe me the Pro>ac was my RE, and he did not monitor me. Big mistake when treating someone for mental illness, which is why I could not go back to him, and why I eventually changed fertility clinics and moved my frozen embryos. I probably should have been hospitalized, except on the outside, I was functioning. On the inside, I was falling apart. Even after I eventually got better, I have found it extremely difficult to find psychiatrists and psychologists who treat prenatal depression and anxiety, let alone any doctor or health care professional who understands it. Mental health care is seriously fucked flawed in this country, especially for pregnant women.
Unfortunately, my pregnancy had an unhappy ending, and I do not talk about the details of my loss on my public blog. I was traumatized by the whole experience, and the less I have that trauma out there in the world, the better it is for me. I know that my story could probably help someone, but I get nothing from retelling my story except re-traumatization. I do have a private blog that has my story that I created as an outlet for myself and my healing. I only let longtime readers/commenters access. You have to get to know me first before I will allow you access. If you request access to my private blog first to get to know me, I will have to respectfully decline your request.
I love receiving comments and I love the support I get and give by conversing with other bloggers. I do moderate all my comments. I usually publish all the comments I receive. On rare occasions, I will remove any comments that I deem nosey, mean-spirited, or unsupportive. If you return to my blog and see your comment gone (really, why are you coming back to check on your comment?), that should probably be your clue that I thought your comment was nosey, mean-spirited, or unsupportive. Rather than write another comment that is nosey, mean-spirited, or unsupportive that I will also remove, please simply click away from my blog.
Most of what you really need to know is here on my public blog. Thanks for joining me on this crazy ride.
I was pretty upset after our follow-up appointment with Dr. BloSunMyCha. I didn't think the news was very good, but after doing more research and reflecting on it, I guess it wasn't that bad. I think what makes me nervous is staring down the barrel of a gun. That's what embarking on another IVF cycle at 42 or 43 feels like. I described the IVF stats to my acupuncturist yesterday like this:
IVF at age 40: Stats are dismal at 40. IVF at age 41: What, are you fucking crazy? IVF at age 42: Shoot me now.
Em, my acupuncturist, pointed out to me that 35% pregnancy rates at 42 isn't that bad. True, this is BigShotFertilityClinic, after all, but those stats still make me nervous.
I felt good about our embryos being "normal", at least as far as they could tell, after thaw. Embryos with above 70% cell survival rate are considered normal, and ours had 80% cell survival. I made "normal" embryos at age 41, so I could possibly do it again. I asked Dr. BloSunMyCha if they would have done assisted hatching if we had allowed it. He said that they normally do AH with FET. This statement was in direct contrast to what he said to me when I told him that we could not agree to AH in good conscious if it increased the chance of identical twinning. I felt crappy about not agreeing to AH after our meeting, but realized that we would not have agreed to it anyways, so no point in second guessing ourselves. The only way to know if our embryos are normal is to do genetic testing, which I discussed in my last post.
One thing I love about blogging is finding other women who have also been to BigShotFertilityClinic and finding out what they were told about genetic testing. I have since learned some comforting news. It appears that I do not necessarily need 10 embryos at day 1, but at least 10 eggs at retrieval. I can do that. I've already done it once. My FSH needs to be lower than 10. I have no idea what it is since it hasn't been tested in two years. My anti-Mullerian hormone (AMH) needs to be above 0.6. I have never been tested for that, so no clue there either.
As long as I pass Day 3 testing, we can move forward with another cycle. Day 3 testing will include FSH, LH, estrogen, and AMH. If my FSH isn't sky high, I can move forward. The new protocol is Estrogen Priming Protocol with human growth hormone and probably max stims. No BCPs! I think I still stick with the antagon type protocol too, which means no lupron either!! I'm happy about the protocol, if there is something to be happy about doing another IVF cycle. I'm allowing myself to do Day 3 testing and make our decisions from there.
My current plan-du-jour is to get my body ready for the Day 3 testing. I don't think I will be ready this next cycle, though Dr. BloSunMyCha would let me. Besides, I need to get my follicles ready. My plan is to do the Day 3 testing the cycle after this next one, which would be the end of May. If everything looks good, then we would make plans to move forward with IVF #3. Right now, I'm thinking the actual egg retrieval would happen mid-July, which would give me three solid months to work on egg quality.
I've cracked open my already worn copy of "The Infertility Cure" by Randine_Lewis, going straight to Chapter 10, Advanced Maternal Age. There are some great stories in here about women getting pregnant in their forties with the help of Chinese medicine. I have read this chapter many times before. The one statement that sticks in my head is that the time it takes for a resting follicle to develop into a full-blown egg ready to be released is up to 150 days. FIVE MONTHS!! I'm giving myself three months, knowing that the last three months I have already been taking pretty good care of myself. I'll be writing future posts on what my egg quality improvement protocol will be. Heck, I've already started, but I know I'll be doing some more tweaking.
The challenging part will not to get stressed about this whole process. I'm trying to approach this seemingly huge undertaking that it will be good for my health, regardless of whether we actually go through with another IVF cycle. I will also be using this time to "fund raise". Grovelling will probably be involved, as well as looking at ways to sell off things of value.
I had two days this week when I felt really happy just as I was. I wondered how long it would last and if I could just be happy with my life as it is. It only lasted two days. I'm not ungrateful for my life. I know I have a lot of good things going for me without children. I've always wanted to feel that happy whether I was going through fertility treatments or living child-free.
The grief I have been feeling at this latest loss is greater than I would have expected. Part of the grief is seriously looking down the child-free road. I thought this FET was it, and I could not possibly take another IVF cycle. The truth is, I did a lot of healing in this FET cycle. It forced me to face my trauma and work through a lot of it. I've come a long way from how scared and freaked out I felt in my first IVF cycle. The truth is I can do this. But this truly is it, one more shot. Do I have to be ok with the child-free path, because otherwise, am I going to put too much pressure on myself going through another cycle?
Yesterday was the follow-up with Dr. G. Neither Magic nor I felt good coming out of it. I did get my question answered about the difference between the two clinical trials of genetic testing that BigShotFertilityClinic is doing. We do qualify, but there is a catch.
Both CGH (Comparative Genomic Hybridization) and microarray are two types of microarray genetic testing that looks at all 23 of the human chromosomes. First, the difference between CGH and microarray are that they are done at two different labs. BigShotClinic switches between the two depending on which one is having better quality control and less "no results" at the time. They make these decisions weekly. Therefore, you don't know which one you will be doing until you start your stims. CGH amplifies all 23 chromosomes and tests them where as microarray tests parts of the sequences on all 23 chromosomes instead of all sequences of the 23 chromosomes (I think). Both tests are used on day 5 blasts, and then the embryos are vitrified (special freezing technique) until you get your tests back in about 6 weeks and do an FET. This is my even more simplified version of Dr. BloSunMyCha's layman's version, so I'm sure I'm not entirely explaining this well.
The catch is that you have to have ten embryos on Day 1 or ten fertilized eggs. At my age, it's doubtful I will meet that criteria. I was happy to have six embryos on day three last time. The other alternative is to do Polar Body Testing, which is done on day 1, but it only tells you about the genetics of the egg, and not the embryo. Polar Body Testing also has a much lower pregnancy rate of 20 to 30% compared to 80% for CGH or microarray.
The other catch is that BigShotClinic does not do sex selection. They basically transfer back the best embryos, regardless of sex, and they do not tell you the sex until after they transfer them. I didn't ask exactly when they tell you the sex, but I'm sure it would be sometime after a positive beta. If they have normal and excellent quality embryos of the sex you prefer, they will put them back.
Waaay back when we had our first serious talk about baby making with my third RE after my surgery, we discovered a sperm selection program for gender called Micro_Sort. However, I did not meet the age criteria, which was 38 and younger at the time. I think I was 39 at the time. My research from last night shows they upped the age limit to 39. Bottom line: if you are "old" you take what you get. Can you say age discrimination?
Dr. BloSunMyCha recommended 3-day transfer with us, which I am fine with, but he recommended putting back four to six embryos at my age. This does not make me happy. I do not want to risk multiples again. Pregnancy rate for my age is 35% at BigShotClinic, with still a 20% chance of twins. The stats are not good, but considering that what happened to us last time was very low statistically, then maybe I still have a chance.
All I know is that I feel crappy about all this. I hate not knowing what to do. I hate taking a huge gamble on money we don't have. I hate not going through all this high tech process of getting pregnant, and then not having choices about it. I hated it then, and I hate it now. The only good thing that came out of yesterday is I got a pass on the Clomid challenge test. The rest will have to wait for another post.
Yesterday, I was on my way to my acupuncturist when I saw something I usually don't see around town - a pickup pulling a trailer with a donkey in it. I laughed to myself. That pretty much described my day yesterday; draggin' ass!
I have not had a drink since we got the bad news. I didn't even smoke the weed I found in a baggie in my stepson's dirty sock in the mountain of laundry I washed before our FET. It was a WTF/LOL moment when I discovered it! About the worse thing I have done is eat some cheese. I did not even stoop to chocolate, until yesterday. I could not stay awake yesterday at work, and I had bags under my eyes. Finally, I got a chocolate bar at the vending machine to see if I would feel better. I perked up a bit afterward, meaning my hormones are surely fucked.
I would like to think this reaction has to do with some wisdom I've gained at the age of 42. Drinking, drugs, and crappy food are just going to make me feel worse, and I already feel crappy enough between the grief and the wild hormone ride. My liver has gone tilt with the hormone overload and a drink isn't going to help it do it's job. Magic is getting the brunt of my hormonal-ness, with grumpiness and fits o' rage interspersed with lying-in-bed-non-functionality-depression.
I've dreaded this moment where I'm standing at a Y in the road. One direction is the child-less route, the other is another-IVF route. My confidence has been shaken after this BFN. I was also a bit surprised at how much I grieved this loss. I think, how at my age can I possibly think about doing another IVF with my own eggs? I was surprised to find how many women are doing the same after perusing the "IVF 40-44" forum on IVFConnections. I was also comforted by discovering that Wombded is pregnant at 43 with her own eggs after her second IVF. Regardless, it's not going to be easy, but I'm just not quite ready to throw in the towel, even though going through another IVF cycle is going to be only slightly better than waterboarding.
I felt some hope after seeing EM, my acupuncturist yesterday. I felt better after the acupuncture and got some more supplements that we haven't tried before, like Co-Q 10 and L-arginine. I'm back on Chinese herbs too. I know that the protocol and the lab probably help more than anything, but I do believe the Chinese medicine/acupuncture/supplements/good-lifestyle helps as well for egg quality.
The day of my beta, I asked for a price sheet for IVF. I was already considering going down this route. The money is really out of our reach, but we do have more frozen sperm, enough for one more try. Monday is the regroup with Dr. BloSunMyCha at BigShotFertilityClinic. He'll have the final say whether we can move forward or not with my own eggs. The decision probably won't be made until I am submitted to further poking, prodding, and other indignities. I just hope I don't have to do another Clomid challenge, though at least it's better than waterboarding (my new mantra).
I have heard of others having this feeling, but it is new to me. Someone is missing from our family. I feel that. I get it now, but I don't know how to get her here. I have grandiose ideas, but I have neither the money nor the will to make it happen right now. I know it's still early. I'll give myself another day before I start making appointments. Or maybe the day after that, or the day after that. I don't know if it's the spirit_baby we had been communicating with before or a different one, but she is missing.
I was in the grocery store yesterday, when all of the sudden I was overwhelmed with emotion. Watching parents shop with their babies or toddlers made me sad. I can not sit in a meeting without identifying the participants by their pregnancies I have watched them go through and their children. It's all I can do to hold back the tears. I am obsessed, but still, I can not find her.
I feel frustrated by how long this process takes. When I was in the 2ww, I realized, this is not two weeks or even nine days. It represents the three and a half years I have been working on this. All the surgeries, procedures, doctors visits, acupuncture sessions and all the waiting in between, all condensed into that wait-till-beta limbo. Now, it's like I'm in the 2ww without anything to look forward to. No appointments scheduled. No plan. Just this void in my heart.
I know why women feel they are lost at this point. Because it feels like nothing is there.
1. Sadness: It is interesting that in the usual stages of grief, sadness is not mentioned. Depression instead is one of the stages. I am not depressed (yet). I am sad. I am deeply sad that our spirit_baby did not come. Why did she not come? I fell in love with her and now I feel that she has left. I visualized her in my uterus so much that I felt like I was carrying her. It is a loss. My heart aches.
I do come home after work and immediately get into bed and lay there all night. I've been lying on the couch a lot today, but I'm reading a good book. Ok, maybe I'm a little depressed.
2. Anger: I am angry with our spirit_baby. I gave her so much love, and she gave me nothing back in return. Is she being picky about the embryo she chooses? Doesn't she know how much I have sacrificed for her? How much money I have spent? I don't have time for her to wait. I am already well past the fertility-dropping-off-the-edge-of-a-cliff age. I try not to be angry with her, but until I know the reason why she did not come, I can't help but act out in anger.
I was also angry with Magic initially. I blamed him for scaring away our spirit_baby. He was so grumpy and unsupportive when we moved the embryos. He is afraid of having more children. I know he has acted out of fear. Why won't he have a reverse-vasectomy? Why can't he share in some of the physical agony? I can resolve my anger with Magic more easily than our spirit_baby because he is much easier to talk to.
3. Denial: Well, I have not gotten my period yet, so maybe I could be pregnant? Pee-on-a-stick cuz what the heck and I have one left. I could still have my miracle, couldn't I? Negative. Start the grief process over again with sadness.
4. Bargaining: This is one step of the grief process I refuse to submit to. I will not be the desperate barren woman. I will not beg for a child. I will not sell my soul for this quest. I have done that and paid the price. I told myself before I got my beta and knew for sure that I would not let this define my life. I am more than my ability or non-ability to have a child. No, I will not reduce myself to bargaining.
Perhaps the one bit of bargaining I have done is that I have told myself, if only I could know why our spirit_baby did not come, then I would be alright. I have tried to contact her again, but I been unsuccessful in getting anything back. Maybe if I could reach her, then she will come the next time we try. Ok, I am bargaining. Fuck.
5. Acceptance: I felt a twang of acceptance this morning. I had been through all the other stages of grief. Then, as I felt this bit of acceptance, I cycled through all the other stages of grief again, but more deeply this time. I suppose this is how it will be, for awhile yet.
This morning, I woke up feeling good. I lay in bed, with some hope. I knew I had to get up for my beta. I did not POAS. When I got in the shower, those all too familiar cramps came back. I had already done some grieving, but as the day wore on, and as the time I knew I would get the call got closer, time seemed to slow down and hope crept in. I got to the point yesterday where I was tired trying to figure it out. I just wanted to know so that I could move on, one direction or the other.
In retrospect, I had a sign that something was wrong. It happened around the time we moved our embryos. I can't remember if it was before or after. One evening, when Magic and I were doing our evening ritual to connect with our spirit_baby, I had a vision of her. She surprised me because she was so in my face. I really am not used to these types of visions, but they seem to be coming more frequent. I didn't know what to think, though. She appeared wild eyed and her hair was all disheveled. I thought it was a good sign, and she was ready to come, though I was a bit worried that it meant she would be a wild child. Now, I think that something was bothering her and she was trying to tell me. I don't know what. Now that I think back, was it the night before we moved the embryos? Oh, I wish I had written it down!
I haven't felt her around for a few days. Last night, I felt particularly empty, but we did the ritual anyways. While I wasn't surprised that the result was negative, I am still sad. I'm not as sad about not being pregnant as I'm sad because I don't know where our spirit_baby went. I'm afraid she left. I'm hoping she just had to take a break. I don't know if it was her or the embryos. I don't know if something went wrong when we transferred the embryos or if she got cold feet. There is one way to find out, though it may be awhile.
In some way, I feel like this is all part of a grander plan. I don't know what that plan is. I had to do the FET before I could move on. I don't know what moving on means, but I know that I would have been haunted by leaving our embryos frozen if we had not transferred them. I couldn't bear the thought of thawing them and letting them perish.
What I am haunted by now is not knowing where our spirit_baby is. I don't feel lost. I feel heartbroken.