A new day, a new doctor

First of all, I want to start by saying thank you to all of you amazing ladies out there who have posted such thoughtful and helpful comments this last week. I feel very different this time around, and I think a big part of that is having so much support. I know how many people go through infertility and loss with little to no support, and I feel like I’m beyond lucky.

Emotionally I might be doing pretty well (at least for now), but physically I’m doing HORRIBLY. The nausea has hit full force and I’m barely keeping it together trying to function. It starts before I get out of bed in the morning, as I’m woken up by waves of nausea. It’s always worst when my stomach is empty, so first thing in the morning is a huge struggle. I force myself out of bed and brush my teeth half doubled over (because it’s worse when I’m standing up straight). Somehow I make it through a shower (the heat has a negative effect too) and to the kitchen to eat breakfast. I always feel a little better with a full stomach, but it only lasts for an hour or two. No matter how much I eat, the nausea will be back an hour or two later, and I have the choice to stuff myself with more food and face gaining enormous amounts of weight, or suffer. I’ve been falling on the side of stuffing myself with more food, consequences be damned.

If I could just be curled up on a couch all day (like I am today), I think I could manage okay. But having to get dressed and go to work, where I have to pretend everything is totally peachy, is really pushing me to my limit. I count every single minute until the day is over, then start dreading the next day. I’ve finished 4 of 10 work days before my next ultrasound, and I’m barely holding it together. I’m not sure what I’d do if I wasn’t working part time, maybe I’d have to consider unpaid leave.

I have to say though, the hardest part of feeling sick all the time is that I’m SO ANGRY that I feel this way. I’ve had to do this FIVE times!! Is it not unfair enough that I have to have miscarriage after miscarriage, do I also have to be punished with months and months of feeling like I have the flu too? I’ve done the equivalent of a full pregnancy’s worth of first trimesters, feeling more nauseous than most pregnant women ever feel. If I actually had the flu I could stay home, or if I was a normal pregnant woman I could get away with telling people. But instead I have to pretend everything is f*ing fine, and go about my life like nothing is wrong. It just feels like kicking me over and over when I’m already down.

In less angry news, I’ve spent a lot of time over the last few days thinking about my options, however few, going forward. As so many of you commented, there are options out there, and the question for me always goes back to just how much time and money am I willing to risk on a longshot? Adoption has always been our backup option, our plan B. And the thing about adoption is it’s close to a sure bet. It’s expensive and seems insanely hard, but we know that we could do it and in the end we would have a child. We’ve already done a lot of research, so we know what agency we would probably use, how much it would cost (we could set an upper limit), and most of what’s involved in the process. It would also feel like we were taking control finally, after 3 years of having absolutely no control over anything. Plan B doesn’t have to be the end of the world, maybe (maybe) I could even get excited about it eventually.

BUT. I can’t do any of that while I’m bogged down by unanswered questions. I’ve always said if I had some sort of explanation for my losses I could start to move on. When you don’t know whats wrong, it feels like an answer or a solution could be right around the corner. What if I just asked one more question? What if we did just one more test? What if we saw just one more doctor? Maybe the answer is just sitting there waiting to be found, and all the horror of the past 3 years will melt away as we suddenly have a miracle cure. There are always more articles, more blogs, to read and get ideas about possible explanations. I could truly fall down the rabbit hole and never come out chasing answers that ultimately might never exist. I’m already feeling the frustration of the having wasted this last full year on a single attempt. If we’d moved on after our loss last December, like we said we would, we could have a child by now. So, as badly as I want answers, I feel like I need to be careful not to be too drawn in to the possibility that one more (test/doctor/treatment/attempt) could be the magical solution. It’s a fine line, because I don’t want to give up too early when there are valid things left to try, but I don’t want to waste the rest of my life chasing a hopeless dream either.

With that in mind, we have decided to see just one more doctor. We made an appointment with a doctor who is a definite proponent of the embryoscopy procedure. We were super lucky to get in to see him so quickly, our appointment is next Thursday (the 12th), so it won’t be too late to still do embryoscopy if he convinces us there is information to be had from it. From his website, it’s clear that he has a different opinion about RPL than Dr. O., and as much as I respect Dr. O, I’m beyond fed up with the attitude that we have to ‘just keep trying’ because there are no more answers to be had. Ultimately he may be right, but I need to at least try asking one more person. I strongly suspect that this new doctor (Dr. A), will have something different to say, and then the question will become, who do we beleive? When all you have to go on is one person’s opinion versus another person’s opinion, how do you know who to trust? I guess we’ll cross that bridge when we get there.

So, today what I’m working on is the list of questions we want to ask Dr. A. The bottomline question is, what do you think our options are? But, to get to that point, my hope is that we can look at the ‘evidence’ so to speak, in the form of my history and the details of my losses, and see if they provide any clues to the type of problem we’re dealing with. From what I’ve heard/read of him so far, I think that he may be the type of doctor who is willing to think things through this way with us, rather than just saying ‘no way to know, just keep trying’.

All of you have been super helpful already by giving me suggestions for things to think/ask about. I’m going to list the ‘evidence’ and questions that I’ve got so far (with your help) below. If you can think of anything else that I should ask about, please let me know. I’m feeling a little more optimistic at the moment, hoping that either we can make some progress with this doctor, or if not, we will feel like we’ve asked all the questions and heard all the opinions there are to hear, and maybe this will help us move on.

Evidence:

  • Strong pattern with almost all losses: bleeding at 5 weeks, heartbeat at 6 weeks, no heartbeat at 8 weeks
  • Very heavy bleeding, starting early- what could be happening so early to start the bleeding?
  • Almost all were missed miscarriages, even by 9 weeks there has never been any sign of anything progressing naturally
  • Almost all embryos looked bad or ‘weird’ in some way on ultrasound (anything from no yolk sac to weird oblong shaped gestational sac)
  • No signs of fever/allergic reaction when pregnant (sometimes thought to be related to immune causes)
  • Very high AMH- most likely not an egg quality issue
  • ‘Wierd’ uterine stuff: asymmetrical lumpy lining with this pregnancy, former very small septum
  • Periovarian mass
  • Very slightly elevated TSH (2.92 pre-pregnancy) and hypothyroid symptoms during pregnancy

Things to ask about:

  • Embryoscopy- will it help us differentiate genetic versus uterine issues? In other words- will it tell us if it’s me or the embyros?
  • Could the bleeding itself be causing the losses (some sort of excessive bleeding issue? failure to clot?)?
  • Could this be a sperm quality issue (e.g. imprinting)? Is there any way to test?
  • Could this be related to my thyroid, even though I’m on thyroid meds now? *more on this another time, I’m feeling totally different this pregnancy, none of the extreme fatigue/low blood pressure/low pulse I’ve had in the past, so it certainly seems like the thyroid med is having an effect. But, the pregnancy is still failing, so it doesn’t seem like that was the cause.
  • In your opinion, without having done embryoscopy, is your impression that this is genetic or uterine (me or the embryos)?
  • Do you agree with us that the statistics about the odds of a successful pregnancy after this many losses don’t really apply to me? This is a tough one, but I feel strongly that my pattern is so strong that without figuring out whats wrong, I will never have a successful pregnancy. I think the statistics are more relevant for people who have had different kinds of losses, or something different has happened each time.
  • Should we do more thorough immune testing?
  • And finally, what do you think is our best chance of a successful pregnancy? If the answer to this is do nothing, just keep trying, then we have our answer. Adoption it is.

Anything else you guys can think of???

All out of options.

Without further ado, in the words of Dr. O, the outcome of our ultrasound today was “not optimistic”. Coming from him (the eternal optimist), this is basically the same as saying it’s hopeless. At 5w6d, there was a yolk sac, but no visible fetal pole. In a normal person, this could just be chalked up to it being too early. But for me, it’s ‘not optimistic’. There were some other lovely findings too, including a ‘periovarian mass’ and a weird asymmetrical thickening of my endometrium. His interpretation of these was they are ‘interesting’, and we shouldn’t ignore them. It doesn’t appear that they’re related to the pregnancy though (or what’s wrong with it), so it’s hard for me to care too much about them right now. He tried to reassure me that the mass ‘probably wasn’t cancer’ (probably?), but even that didn’t get a rise out of me. If it’s not related to figuring out what the hell is wrong with my ability to reproduce, it’s not much on my radar right now.

Honestly, I was super relieved to hear that the pregnancy was not totally normal. It sounds counter-intuitive, but I was really worried they were going to tell us that it looked totally normal and we shouldn’t give up hope yet. Then I would spend the next two weeks letting the hope sink in, and be extra special crushed when it (of course) wasn’t. Instead, now I get to spend the next two weeks before the next ultrasound feeling absolutely miserable with nausea (did I mention it’s awful now??) and dragging my feet to muster the energy to act like a normal human being at work all day. In fact, right after the appointment today I had to go back to work and stare at my computer screen, interact with other human beings, and basically pretend not to be a person-shaped ball of anger and frustration. That was fun.

Up until today, my emotions have been conspicuously absent. I went from being an emotional wreck in week 4 to being completely numb and emotionless the moment I started bleeding. I didn’t cry, I didn’t obsess over it, it just….was. But I knew that couldn’t last. And sure enough, my emotions chose the middle of our appointment with Dr. O to reappear. One minute I’m asking him logical rational questions, and the next my lips are shaking and I can’t eek out words. The thing is, I’d been keeping it together up to that point mostly by thinking about what comes next. As soon as I read the article about embryoscopy, the idea has been growing in my mind that we might be able to figure out whether my problem is uterine or genetic (assuming those are the main two options). It was a quick jump from there to, well if it’s genetic, we have options! We can try donor egg, sperm, or more likely, donor embryo. If it’s just our genetics screwing us over, we can fix that by throwing some other genes into the mix! The feeling of finally having options gave me such a feeling of lightness, it almost drowned out the pain of another loss.

I should have known better than to get my hopes up though (haven’t I learned by now???). We asked Dr. O about the possibility of doing embryoscopy, and he was not exactly supportive. He said he would be willing to do it if we really wanted to (and he’s done it before), but he doesn’t see any point. Basically, he thinks that it’s almost inevitable that our embryo would be developmentally abnormal, because, (duh) it didn’t develop. He doesn’t agree with the papers that I’ve read saying that abnormal development implies a genetic problem (karyotypic or otherwise). He feels that a uterine factor could cause the same abnormal development as a genetic factor. So, it wouldn’t give us any information if we did it. In fact, when really really pressed, he said he thinks my problem (and most people’s problems for that matter) are uterine, not genetic. This is just an opinion of course (he admits there’s no way to know for sure), but ultimately if we decided to do something like donor embryo it would have to be just because we beleive the problem is genetic not uterine. In other words, it would be an enormous roll of the dice.

So what’s wrong with rolling the dice? We’ve already done it 7 times, right? In my mind the difference is that with donor embryo (or donor egg, or donor sperm), it’s not just us involved anymore. The genetic parent’s of the embryos we’d receive worked insanely hard to create them, wanted them very badly, and donated them out of the generous hope that they would have a chance at life. Who am I to take their (probably perfectly viable) embryos and toss them in to my death trap of a uterus? It’s not a risk I’m comfortable taking unless someone can give me a decent reason to beleive it will work.

Given that, I’m now feeling like doors are very quickly being slammed shut in my face. Where last month there were at least a few doors left open (trying on our own, donor embryo), these are quickly becoming obsolete. I’m almost completely sure (lets say 99.5%) that we won’t be trying again on our own. I don’t care what the statistics say, I no longer beleive that I am capable of creating and/or carrying a viable pregnancy. Ever. I simply don’t beleive it anymore. The pattern is too strong. Every time I get pregnant it will happen the same way, unless we figure out what’s causing the problem and treat it.

Dr. O reiterated that there are simply no  more tests or treatments available though, and so trying on our own is pretty much out. If donor embryo is out too, we are at the end of our rope. The words I was trying to get out through the tears to Dr. O were “I just wish we had some sort of option left, we just want to have some chance”. So, I guess it’s the time we’ve been dreading. The time I spent years going through more wasted cycles and wasted pregnancies to avoid. The time when we have to accept that it is what it is and move on to the only option left: adoption. Now if I could just figure out how the hell to accept that, that’d be awesome.

 

The beginning of the end

Two days ago, at 5w2d, I started bleeding. Bright red blood along with some decently strong cramps. It only lasted for a minute or two, but it was enough to show that the process is starting. This is identical, practically to the minute, to my other miscarriages. Everything is peachy until 5w2d, and then it all turns to shit.

I have an ultrasound scheduled for Tuesday, which I expect will involve a heartbeat. The first one always does. But then the bleeding just continues to get heavier and heavier and we all know what the outcome is. It usually takes 4 weeks or so from the start of the bleeding before I have a dnc scheduled and the whole thing is over. 4 weeks of feeling horribly sick, depressed and hopeless. Here we go again.

I can’t say I was that surprised when I saw the blood. I had been checking religiously. Scrutinizing the tp every time I peed. But I had managed to convince myself that it was possible that it could be different this time. I wouldn’t say I was totally optimistic, but I was being negative either. I was even talking to the embryo, telling it to ‘please please please please be okay this time’. G was much more involved this time too. In the past he’s been so detached, not wanting to get his hopes up. But last week (after an emotional breakdown on my part) I convinced him we both needed to be present this time, even knowing it might go badly. I spent so long wishing to be pregnant again, I didn’t want to ignore the experience while I was having it. So G was asking me about every tiny symptom, and he even started calling the embryo peanut. It’s been a totally different experience, feeling like I’m not the least bit alone in this.

I don’t know why, but I haven’t cried or gotten emotional. And it’s not because I think it’s going to be okay. I’m 98% sure this is over. I think it just hasn’t hit me yet. When I saw the blood, I called G in to the bathroom to see (I know, gross, but he said he wanted to see), and we just sort of stared at it for a minute and said, ‘okay, well I guess that’s that’. We got into bed and had a long talk, but mostly we talked about what comes next. I have a feeling that at some point it’s going to hit me that this is happening now, and I will have to deal with it.

So what comes next? Ultrasound this week, more waiting and bleeding, then eventually another ultrasound with no heartbeat (I know I sound morbid, but it’s just the reality). Most importantly, this will hopefully give us the opportunity to do the embryoscopy procedure I wrote about before. The last thing I wanted was for this to happen again, but if it had to happen again I want to know as much as humanly possible about what’s going wrong. I know I’m getting my hopes up because there are a lot of factors that have to work out to do the procedure (doctor agreeing to do it, not having a natural miscarriage first, not having so much bleeding they can’t do it, etc), but I just so badly want to know what’s going on it’s driving me insane. I just keep thinking if I had some clue what was going on, I’d be able to come to terms with it. Not to mention having an idea of how to proceed from here. After my hopes get dashed over and over, it seems like too much to ask to even be able to get some answers.

On top of everything, now I’m getting sick. G has had a cold for the last week, and we tried so hard not to share germs, since I didn’t want to risk getting sick while pregnant. I managed to keep it at bay until today, but now I feel awful. Interestingly though, I don’t feel like I have a cold, I feel like I have the flu. My chest is super heavy, I’m dizzy and weak, and the nausea I’ve had for the last two weeks has increased dramatically. I don’t know if it’s just that the combo of morning sickness with a cold feels like the flu, or if there’s something else going on, but I feel like crap. I’m just SO not in the mood to be feeling so sick on top of everything else right now.

‘Not negative’ to positive

I have had the most insane week. I feel like I’ve barely had time to breath, and I’ve had a billion things running through my head to write about, but I haven’t had two minutes to sit still, let alone write. The craziness isn’t over yet either, I’m on my way out of town for the coming weekend, then I’ll be home for two days before leaving again for thanksgiving. So while I have 5 minutes, I wanted to update you guys on the whole ‘not negative’ thing. All of you have been so wonderfully supportive, I don’t want to leave you hanging for another week. I’d worry if one of you guys announced you were pregnant then disappeared!

So here’s how my week has gone so far:

  • Monday: Spent most of the day at the vet with one of my kitties. She’s had a series of issues that we just couldn’t quite pin down a cause for, so she needed an xray. After a whole day and an enema later (poor baby :(), the only thing they could find wrong with her was constipation.
  • Tuesday: First beta: 60. So far so good!
  • Tuesday night: Barely slept the entire night. No good reason for it, I was exhausted, I just couldn’t fall asleep for the life of me. I woke up pretty miserable on Wednesday and zombied my way through the day.
  • Wednesday: We went to yoga in the evening and I was feeling nice and relaxed. Until we got home. Guys, I am apparently a giant hormonal mess. I bent over to put a cat food bowl on the floor and banged my head coming back up. Somehow, this led to me sobbing like a giant snotty 3 year old. Not because it hurt, but just…..because? Then I proceeded to yell at G for the next 20 minutes because….I have no idea. I just did. He was looking at me like I was some sort of alien creature. In 6 pregnancies I’ve never been emotional like this.
  • Wednesday night: Barely slept again! This time it was because I woke up in the middle of the night positive that I was having cramps and that I was going to be bleeding like crazy when I got up in the morning. I don’t know if it was just part of a bad dream, or if I really did have cramps, but I was completely convinced it was all over.
  • Thursday: After two nights of not sleeping and a night of crying, I had bags the size of Texas under my eyes. Stumbled my way through getting ready and went in for beta number two. The result: 215. That’s a doubling time of 28 hours. Crazy fast. Here’s the thing, in the past I’ve always had insanely high betas. I don’t remember numbers, but they always end up being off the charts high. It’s never been an issue of multiples, and besides that I can’t find any good reason why levels would be so high. Everyone always talks about how great it is to have high numbers, and what a good sign it is, but that’s never been the case for me. So, I was kind of hoping for more ‘average’ numbers this time, just as a sign that something was different. Honestly I have no idea if my hcg levels have anything whatsoever to do with my miscarriages, so there’s no reason to worry about this, but you know how that goes.
  • Thursday evening: On my way home on the train tonight I was thoroughly enjoying catching up on some of your blog posts when someone snatched my phone from out of my hands. I knew what was happening, and I had a good grip on the phone, so I held on, saying ‘NO NO NO’, trying to fight him for it. I managed to hold on for maybe 5 seconds, but eventually he was just too strong and he got it. He jumped out of the train door just as it was closing, leaving me shocked, pissed, and phone-less. The thing is, if I’d been thinking more clearly I would have screamed for help, or kicked him, or something, and I might just have been able to get him to lose his grip. There were tons of others on the train with me, but because I didn’t scream out, they didn’t know what was happening until it was too late. I made a police report, but there’s about zero chance I’ll be getting my phone back.

During all of it I was pretty darn calm, but the moment I got home I turned into the hormonal ball of tears again, alternately crying and yelling at G for various unknown crimes. To top it all off, I had promised to make a birthday cake for G’s nephew, and tonight was my only time to make it. I was already 45 minutes late starting the process from making the police report, and completely exhausted. At first cake making was going smoothly, and just as I was congratulating myself on keeping it together enough to make a cake after everything else I’ve been through this week, I make a huge mistake. Now the cake is half the size it should be (the top layer had to be tossed), my kitchen is COVERED in cake guts, and I simply do not have the energy to clean it up. The miniature cake is frosted and in the fridge though, and in a few minutes I get to get into to my gloriously comfortable bed. I sure as hell better be able to sleep tonight.

Tomorrow we drive a couple hours to meet SIL and family at an indoor waterpark for nephew’s birthday. Nephew is 3 now, and I call him my little reminder, because he was born right when we first started trying. So yeah. Happy 3 years! I have no intention of telling them about my ‘not negative’ yet, but G kindly informed me that no one will notice that I’m not drinking/watersliding/hot-tubbing because they have kids to pay attention to. Read: you are essentially invisible when the all-important children are around. At least how it sounded to my hormonally-hyped up self. Hence fight number one. 

Seriously though, I’m holding myself together by just a few threads at this point. I go back and forth between completely freaked out that five minutes from now the pregnancy will be over, and slightly optimistic that it will work out. Now that steps 1 and 2 are passed (betas), the next step is to make it to my first scheduled ultrasound without bleeding. This will probably be in two to three weeks, and I’ve never made it that far in without bleeding before. I always start bleeding around 5 weeks, and no matter what the ultrasound eventually says, the bleeding is the beginning of the end. I have trouble visualizing making it to the next stage, but I know that that’s at least in part because I’m habituated for bad news. I’m trying to keep myself cautiously optimistic and avoid the highs and lows. It’s really not working very well yet, but hopefully a good night’s sleep will help.

Not negative

I tested today. 10 dpo. And it wasn’t negative. I’m having a lot of trouble getting from it’s ‘not negative’ to it’s ‘positive’. It just feels like it could blow away in a strong wind.

Last night G and I stopped on our way home from dinner to pick up a pack of FRERs, because this month I just didn’t have it in me to wait for 12dpo to use my cheapos. Usually G is all about waiting because he hates how upset I get, so he’d rather put it off. This time felt different though, he was expecting his birthday present, and he hates waiting for presents. This morning, I stalled getting out of bed, knowing that I would have a terrible day when I saw the negative. Even as I watched the test develop, I just knew it would be bleach white. I waited for a minute or two, didn’t see anything, and got up to brush my teeth. A minute later, I peeked back over to the test.

The line wasn’t dark, but it wasn’t the lightest line I’ve ever had either. There wasn’t any squinting, it was clearly visible. I called to G, ‘Honey, come here. It’s not negative’. The second thing I said was, ‘I didn’t f*ck it up this time’ (at least so far). My overwhelming feeling was just relief. Relief that I am still able to get pregnant, and relief that this month won’t be another month of the same.

After the last two chemical pregnancies, I’m hyper aware that this might be over any minute. I’m only thinking a few days and a few steps at a time. Step 1, re-test in a day or two to make sure the line is still there and not lighter. Step 2, call for a beta, probably Tuesday. This is as far ahead as I can think right now.

Holding pattern

I’m 7 dpo, and the antsiness is setting in hardcore. I keep opening up my ovu-tracker app or looking at the kitchen calendar wondering if by some miracle another few days have passed while I wasn’t looking. I was doing so well being patient during the tww the past few months, and all that appears to be out the window this month.

The problem is I’ve put a lot of pressure on this month. The longest it’s taken me to get pregnant in the past is 5 months, and this is our 5th month of trying this go-around. I remember very clearly that by the 5th month last time, I was going totally crazy, positive that my reproductive organs had crapped-out completely. So, the only way I’ve been maintaining some form of sanity (a meager one) this time is by reminding myself it’s taken this long before and still happened. If it doesn’t happen this time though, we’ve moved into entirely new territory. The territory of ‘oh shit, there’s something else wrong here’.

5 months has become an important landmark to me because of this, but when I started doing some reading it turns out its not completely arbitrary. From everything I’ve read, if you’re putting all the things in the right places at the right times so to speak, it should happen within 4-6 months. I’ve done everything I could possibly do this month, bbt and CM charting, minimal caffeine, extra folic acid (on top of a normal prenatal), acupuncture, full-fat dairy, I even started eating fish once a week or so for the omega-3s, despite being vegetarian for 15 years (yup, apparently I’m even willing to bend my principles a little if it will get me a baby). The stars aligned and we tried 3 whole times during my fertile period, and my CM did its grossly fertile thing. If it doesn’t work with all of that, things are just not looking good.

Rather than being totally depressed or anxious about what it will mean if this month fails, I’ve actually been pretty darn optimistic for most of the month. I even went so far as to promise G I’d be pregnant by his birthday (in December). I know, what was I thinking putting that kind of pressure on myself? It happened when we were laying in bed after our last ‘attempt’, knowing we’d done all we could. The topic turned to his birthday, and what he might want as a gift, and I, apparently in a post-sex high said “I know, I’ll get you a baby for your birthday!”. Dumbass. Well, at the time we both thought it was funny, but he’s brought it up a few times since, as if he believes it’ll happen. I had to put a stop to it eventually, explaining that it just feels like a lot of pressure for something I can’t control at all.

In the middle of all this, a friend from a local support group sent me a link to an article about a way to investigate miscarriages. I’d never heard of it, and immediately gears started turning in my head. Basically, what they do is after you’ve had a missed miscarriage (I suppose you’re sort of out of luck if it happens suddenly), they go in with a camera and actually cut through the sac and look at the embryo itself. I’m sure there’s a lot of factors that go in to whether you can do this or not, and whether or not it will work, but this article made it sound like a very simple procedure that theoretically any doc could do.

And what they see is whether the embryo looks essentially normal or not. If it looks normal, you’d assume that the problem was something external, like an implantation problem, or an immune issue of some sort. If the embryo has clear malformations, then you’d assume that the problem is probably genetic or developmental. Now, I’m not sure you’d know exactly what to do with this information, because it doesn’t really tell you much about how to treat it, but I would DEFINITELY want to know at least this much information if I could. It would make an enormous difference in my mind to have some clue about even what type of problem we have. For example, it would suddenly open the possibility of donor embryos or surrogacy. Not that I’m saying I would necessarily jump to doing either of those, but they’ve always been off the table in my mind because we have no idea if my problem is me or the embryos, so how do you know which one to even consider?? This would open doors to start considering if they should even be on the table at all.

Another reason to do this type of procedure is that you can be sure to get cells from the actual embryo for karyotyping, without having to worry about maternal contamination (ie, when you accidentally get the mother’s cells instead and the test comes back normal female, but it isn’t representative of the embryo). In my case, both of my embryos that have been tested came back normal male, so whatever our problems were, they weren’t chromosomal. What they found in this article though is that only something like 40% of the time when they observed a malformation in the embryo that was likely caused by a genetic problem it was picked up by karyotyping! This shouldn’t be shocking because there are just so many things that could go wrong genetically, and aneuploidy (the wrong number of chromosomes) is just one. What was shocking to me is that no one ever talks about this! When my embryo’s karyotypes came back normal, my doctor was surprised, but then basically wrote off the possibility that we have a genetic problem. I’ve even asked before, couldn’t it be something genetic besides a chromosomal problem? His answer is always, well yes, that’s possible, but basically shrugging it off as unlikely. Well, if this data is correct, karyotyping only ever had a 40% chance of finding a genetic problem if there was one!

This has all been swirling around in my mind the past few days, and honestly there’s not much I can do with the information yet. I’ll either be pregnant this month or not. I’ll either have another miscarriage or I won’t. So, what we’ve decided is that if I am pregnant this month, then awesome, we’ll take that for what it is and try to be optimistic about it. We will hope that either the things that have changed since my last miscarriage (less stress, acupuncture, thyroid medication, higher dose of progesterone) will make a difference, or that for some unknown reason that has nothing to do with those things,  it will go differently this time. If not, and I have another miscarriage, we will start to ask questions (and possibly be really pushy) about considering this procedure. If it gives us any sort of half answer that will be amazing.

And, if I’m not pregnant, we’ll call the doctor and see about figuring out why. I’m not sure if they will take me seriously since the standard is 6 months (or maybe I’ll just bend the truth and say it’s been 6 months), and I’ve been pregnant naturally so many times already, but I simply do not have the patience for another month of the same. Either way, things will be moving forward in one direction or another next month. So yeah, now I just have to manage to make it through the next few days….

***Update: In case anyone would like to read the article about embryoscopy, here it is. Also, there are other articles out there I’ve found today searching for ’embryoscopy’ and ‘miscarriage’ on google scholar ***

 

Flirting with chinese medicine

I had my very first acupuncture appointment ever today. I never thought I would do acupuncture, I’ve always thought of it on the same sort of level as numerology or something. I’m a skeptic, and I’ve just always believed in what could be demonstrated by evidence and data. This is what infertility can do though. I’ve lost all sense of control over my body and how it functions, so I’m grasping at whatever I can to feel like I have some sort of power over the future.

So here’s how it went down, just in case you’re one of the few infertiles left who haven’t tried acupuncture (I mean, seriously, it seems like was the last hold out). I filled out a somewhat detailed medical history, and then proceeded to wait 30 minutes before a room was available for my session. Once it was finally available, we walked in to a very comfortable room with a padded bed and an ikea rocking chair. The acupuncturist, let’s call her Beth, is a former member of our infertility support group, and has done acupuncture for just about all the members of the group. They all had wonderful things to say about her, including that she’s your number one cheerleader throughout the process of getting/staying pregnant, so it feels like you really have someone on your side. She was certainly very nice, and seemed genuinely interested in helping.

We talked for about half an hour, and it was nice to be able to talk through some of the medical details of my history with someone again. It’s been a year since I saw Dr. O, and he was never really interested in hearing my ‘theories’ of what my problem is, simply because there’s absolutely nothing he can contribute. That is, if I ask, what do you think it means that I have so much bleeding when I’m pregnant, is that a symptom of the problem, or is it the problem itself? Or if I’d say, well, the fact that X has happened every single time probably means Y, right? All I’d ever get out of him was, there’s just no way to know for sure. Of course he’s right, there isn’t any real way to know what any of it means for sure. But I can’t help but think maybe there are clues there, and if only he’d play along maybe we could find some sort of pattern hiding in the mess. I just want someone to be as anal about the details as I am, even if it is just conjecture. Anyways, I’ve gone off on a tangent here.

So, she listened thoroughly, and offered some feedback about several things I’ve been wondering about lately, including taking extra folic acid and baby asprin. I’ve already been doing the former (because it can’t possibly hurt), and I’ve been considering the latter. She didn’t really try to give me medical advice, but agreed that they aren’t dangerous and that it’s reasonable for me to consider.

She then spent a little time explaining, in a very general way, how acupuncture supposedly works. I say supposedly, because at this point I started to hear the voice of charlie brown’s teacher (wah wah, wah wah wah…). I shook my head like I was paying attention, but I didn’t even bother listening. The thing is, if I beleive acupuncture has an effect on fertility, or pain, or whatever else, it will be because it has some inadvertent medical effect. I simply don’t beleive that there are humors or whatever they are (see, I really didn’t pay attention), that control our bodily functions. What I do beleive is that perceptive people might notice that taking some sort of action, or treatment, has an effect on health, and then, in the absence of modern medicine, build up an explanation around it. In other words, it might work even if they don’t really know why it works.

After talking for a while, I got up on the table and she felt my ‘pulses’, and looked at my tongue. Now, I can beleive that there are signs about health in these. I also think they are probably rather subjective, so you might be able to feel/see a difference if you are looking for it. She gave me a short explanation of what she felt and what it meant, then started inserting needles. As much as I’ve always hated needles, I wasn’t that nervous about these needles until she started talking about them. I’d been so nervous about the fact that I was going to an acupuncturist at all, that I hadn’t had a chance to worry about the needles themselves until they were right in front of me. A number of people had told me that it wasn’t painful, and they were mostly right. I didn’t feel the needles in my head or arms, and only felt small pricks of pain in my feet. After a few seconds they started to itch a little, and by the time a minute or two had passed I couldn’t feel anything anymore.

Then came the hardest part. Laying still for 40 minutes. According to everything I’d heard/read, this is supposed to be the best part. There’s relaxing music and you can just take a nice nap if you want. Well, I am not physiologically capable of napping (unless I’m pregnant, and then I could nap all day…), and I don’t find laying still fun. I immediately felt antsy, like I needed to move just because I wasn’t supposed to. I thought, how the hell am I going to lay here for 40 minutes?? Plus, due to some mild degenerative disk disease, I get a lot of back pain when I lay flat. I try not to ever lay flat in bed, and the last time I had to lay still on my back for that long was to get an MRI. By the end of the MRI I was in excruciating pain. I started to get really nervous, so when Beth came back to check on me a few minutes later I asked for a extra pillow for under my knees.

Back pain problem solved, I proceeded to lay still and try to relax for the remaining 30 minutes. I did eventually relax, although my mind was still spinning and I kept hoping it would be time to get up soon. Beth returned to remove my needles, I got dressed, and that was it. She warned me that I might feel sleepy for the rest of the day, and I suppose I’m a little sleepy, but overall I feel pretty normal.

I made another appointment for next week, and I’m definitely keeping an open mind about the whole thing. I don’t think it can possibly hurt to give it a shot, and I do beleive that it’s possible it might help, even if it’s just a placebo effect of some sort. I’m feeling more optimistic about my chances of a BFP this month than I have in a while, so any tiny thing that can nudge me in the direction of finally getting pregnant is great. Then, I’ll worry about the staying pregnant part when I get there.

Fears and doubts

Today A Calm Persistence wrote a post where she talks about self-doubt, wondering if she is going to be a good mom, and if this might be why she doesn’t have a baby yet. This thought is something that’s been hiding out in the back of my mind for a long time. It’s not the kind of worry that pushes to the front and forces you to think about it often, but instead hides out where you don’t notice it, waiting to pop out at you when you’re not expecting it. It usually pops out at me when I’m already feeling insecure to begin with.

Really, there are so many things I’m unprepared for. What if I somehow manage to make it through infertility, just to find out that I’m a terrible mother? I feel like I can handle the baby years. Having a newborn sounds like a ton of work and unbelievably exhausting, but predictable. I know I’ll feel overwhelmed, and only get a few hours of sleep a night, and I’ll be excessively worried about whether I’m doing it all right. But these are all predicable struggles. It’ll be tough but do-able. What terrifies me is what comes after. Raising a child.

What if I can’t manage to discipline my kids and they run wild? What if I yell too much, or say no too much, or pass on my most terrible qualities? What if I’m too terrified of something bad happening to them that I can’t let them out of my sight? What if I’m too self-centered and can’t put my own needs behind theirs? What if there are social situations that trigger my anxiety and I fail them instead of fighting the anxiety and handling things head-on?

Some days I’m so worried about these things, and so sure that I’m not capable of it all, that I can convince myself that I’m not supposed to be a mom. That infertility is the universe’s way of saying that it isn’t meant to be. Some things just tend to work out for the best, and maybe it is actually for the best that I can’t have a baby, even though I can’t see right now. Isn’t my desire to have a child just a selfish instinct in the end? Maybe I should be thinking more of the best interests of my potential child rather than my selfish need to have a baby.

The rational part of me knows that this can’t all be true; so many people have kids and have no clue what they’re doing. They parent entirely by instinct (which may or may not be good instinct), with no intentionality or thought-process. I may have no experience yet, but I’ve spent so much time thinking about how I would parent. I’ve thought about what I would do in different types of situations, or how I would handle circumstances that come up. I’ve thought about how I would discipline them, how we would spend time together, even what foods they’d be allowed to eat or not eat. I’ve had 3 years to think about this since we started trying, but really, I’ve been thinking about these kinds of things ever since I started babysitting in middle school. I may end up being wrong about all of it, but just having put that much thought into parenting must give me some sort of head-start, right?

I know that these types of fears are normal for first time parents (or wanna-be parents in my case). But, infertility adds a particular kind of edge to the worries. We’ve spent massive amounts of time, money, and effort to end up with a child. If we finally get there and then fail, it seems like an extra special kind of failure. Not only did we fail our child, we also spent tons of time, money, and effort to have the opportunity to fail. Pretty pathetic. Plus, we have all this time to worry about the choices we’re going to make. When you decide to have a baby and get pregnant quickly, you only have so much time to freak out before it’s too late. We get endless amounts of time to worry about our potential abilities as parents before it ever becomes an issue.

At the moment, there isn’t much I can do about any of this; I’m not giving into the worries and giving up, but the thoughts will still be there hiding out and waiting for my low moments to pop back out.

 

 

 

It’s a bright, bright, sunshiney (award) day

http://mysilverlininghome.files.wordpress.com/2013/10/sunshine-award.png

Things have been pretty quiet around here lately, which makes this a perfect time to write about sunshine awards! I feel incredibly touched to have been nominated by two fellow bloggers, Alexis at My Silver Lining, and Amber at Amber Under Construction. Both of these ladies write very thoughtfully about their experiences with miscarriage, and I always enjoy reading their posts. They are both great at something I should try much harder at, seeing the positive side of things. Which is why I’m especially touched that they nominated me. I think I usually tend to fall on the bitter rather than sunshine-y side of the infertility spectrum, although I’m working on it :).

So, without further ado, here’s the deal with the Sunshine Award:

  • Include the Sunshine Award icon in your post (check).
  • Link the blogger who nominated you (double-check).
  • Answer 10 questions about yourself (yup, see below).
  • Nominate 10 other bloggers to receive the award (will do).
  • Link to your nominees and let them know you nominated them (looking forward to it!).

Alexis’s Questions:

1) Who or what inspires you?

My parents. They are both (for different reasons) amazing role models. They are selfless, generous, strong, and amazingly hard working. I think I have some of their good qualities, but I hope with time I can become more like them.

2) What did you want to be when you grew up? How close did you get?

An actress, preferably on Broadway. I took dance classes, voice lessons, and acting classes for years, and I did lots of theater in and outside of school, and I even considered going to one of those high schools for the arts, like on Fame. I think I was pretty good at the acting part, but Broadway was definitely never going to happen :).

3) Best vacation and dream vacation (if you haven’t already been)?

Oh man, this one is super hard. The first thing that comes to mind for best vacation is the trip to Europe G and I took in May. It was amazing, but honestly every trip G and I take together is pretty awesome. We’re perfect travel buddies because we like doing the same things (i.e., not museums or shopping :)), and wherever we go we just like to wander around on foot and explore.

4) Favorite food you get at the fair?

I’m going to buck the trend of ‘deep-fried everything’ and say corn on the cobb. It’s always roasted to perfection and epitomizes the fair to me.

5) What’s your Silver Lining for the day?

This is something I need to spend more time focusing on. I have SO many things to be appreciative of, but instead I tend to whine and complain about the crappy things. My silver linings include my AMAZING husband, who could not be more loving and supportive, the three cutest cats on the planet, and a job that I actually enjoy getting up and doing each day.

6) Favorite TV show??

Haha, I couldn’t possibly pick just one :). TV is my ‘one weakness’ (tehe, if you watch Lark Rise to Candleford you’ll get that reference). I love comedies like Parks and Rec and New Girl, but I think the two best shows out right now in terms of being just plain amazingly made are House of Cards and Homeland.

7) What US state or world capital would you like to visit?

Also tough to pick just one. We’re talking about going to DC to see the cherry blossoms this coming spring, so I’ll go with that for now!

8) What would you do if you could go back to being 18 years old?

Honestly, I would get my ass into therapy. I have social anxiety disorder, and I can’t imagine how much different my life would have been if I had started treating it way back then. The seeds of the disorder where there when I was a kid, and developed to some degree in high school, but it was in college that things really got totally out of control. I went into a depression and withdrew from everyone except G (we were long distance dating at the time). I had no idea the problem was social anxiety, and I didn’t figure that out and start getting treatment until about 4 years ago. My life has been very different since then, but I can’t help but wonder what my life would be like if I’d nipped it in the bud early on.

9) All time favorite movie and why??

I’m gonna go with Disney’s Alladin. I can sing the lyrics to just about every song from memory :).

10) Favorite dessert?

Man, how am I supposed to pick just one answer for these questions?? Let’s go with chocolate cake with chocolate icing. But really I have yet to meet a dessert I didn’t love.

Amber’s Questions:

  1. Why do you blog?

Well, initially I thought I would do it to have an outlet. I thought it might help me to work through my feelings and I felt like my friends and family had reached ‘sympathy fatigue’ with hearing about me and my problems. I think it still serves that purpose as well, but what has become far more important is the community. I never could have imagined finding the amount of support and understanding I’ve gotten from all of you, and reading your posts and comments is literally the best part of my day most days.

2. What is your favorite book?

Hands down, Jane Eyre.

3. What is your dream vacation?

Honestly, I want to travel just about everywhere. Whenever I go somewhere, the minute I get back I’m dreaming about the next place I’ll go. At the moment a beach vacation is sounding pretty appealing, maybe somewhere like Tahiti or Bora Bora.

4. What is your guilty pleasure?

See #6 above :).

5. If you could tell your teenage self one thing, what would it be?

It doesn’t have to be this hard. See #8 above.

6. What is your biggest fear?

Besides the obvious (I’ll never have a baby), definitely spiders. I have a very strong physical reaction to anything that even looks like a spider. I didn’t set foot into our detached garage/shed for the first 6 years we owned our house because I was afraid of spiders falling on my head from above. Lovable husband has cleaned it up done some de-bugging so I can now go in there to grab my bike and run back out.

7. What is your biggest dream?

Have to go with the obvious here. Having a baby.

8. What are you most proud of?

Finishing my PhD. It was definitely the hardest thing I’ve ever done, and I almost quit more times than I can count. I truly believed I couldn’t do it, it was just too damn hard and I wasn’t good enough or smart enough. But I pushed on and in the end my committee was very impressed with it.

9. What is your best piece of advice?

Nothing is permanent.

10. What makes you happy?

My kitties!  When I leave the house for even a few hours I actually look forward to coming home and seeing them :).

Here are my nominees! It’s hard to pick just 10 people because honestly I enjoy reading every single one of your blogs. I’m trying to pick people that weren’t just nominated by Amber or Alexis even though I love all of their nominees as well. These ladies all make me laugh hard and/or think hard.

BarrenBetty

Dogs Aren’t Kids

In Fertility Limbo

Just Another Infertility Blog

My Hope Jar

Rainbeforerainbow

Sweetest in the Gale

The Unexpected Trip

Yet Another Bitter Infertile

Young Yet Infertile

For your questions, I’m going to cheat a bit and re-use Amber’s questions. Here you go!

  1. Why do you blog?
  2. What is your favorite book?
  3.  What is your dream vacation?
  4. What is your guilty pleasure?
  5. If you could tell your teenage self one thing, what would it be?
  6. What is your biggest fear?
  7. What is your biggest dream?
  8. What are you most proud of?
  9. What is your best piece of advice?
  10. What makes you happy?

Can’t wait to hear all your answers!

A little grey blankie

Yesterday G and I decided to try something new. We bought ourselves a gift for our (still imaginary) baby. Does that sound like a totally morbid form of self torture? Jury is still out.

Here’s how it went down. A cousin’s baby shower has been on the horizon for a few months, and we finally hit the point where we couldn’t avoid buying a gift any longer.  We aren’t going to the shower (we live pretty far away so thankfully they wouldn’t have expected us to). The dreaded shopping trip was on my mind as soon as I woke up yesterday, and besides all the other obvious reasons why baby shower gift shopping as awful, I just kept thinking how unfair it was that after we’ve purchased so many gifts for other people, we might never be able to buy things for our own child. I’ve been dying to buy baby clothes since I was in high school and worked at a baby/kids clothes store. It kills me a little every time I have to buy something adorable for someone else’s baby, and know that I may never get to do so for myself.

As I was thinking about it though, I started to realize something. This perfectly represents my attitude in general, which is that I can’t plan for, shop for, or even dream about, having a baby, because it might never happen. The thing is, it will happen. I don’t mean this in the optimistic way that I beleive I will get pregnant and keep a baby, because I don’t fully beleive that. In fact, I don’t think its even necessarily healthy to think that, because it’s entirely possible it won’t happen. What I mean is that if we decide to do it, we can and will adopt. Adoption is terrifying and I’ve spent the past four months pushing it out of my mind completely, but if and when we decide to just do it, we will have a child.

A few months ago, during my second chemical pregnancy, G and I got so fed up we finally decided to get serious about adopting. We still felt like we needed ‘one more try’, but we felt so sure it wouldn’t work that we wanted to have everything in place to start the adoption process as soon as another pregnancy failed. It kept me a little bit more sane to know that plan B was in place. We picked an agency, talked about a lot of the decisions we would have to make, and even talked to my family about it. Then, thyroid testing happened, and the possibility that I might have found a fixable problem entered my mind. It was all over for adoption at that point. Even though I’m trying to be realistic about the chance that just taking a thyroid pill is suddenly going to fix my problem (it probably won’t), just letting that little bit of hope in to my mind has been a game-changer. I’ve been actively avoiding thinking about adoption and instead thinking I just have to be able to do this myself.

It’s not that I hate the idea of adoption itself, really. It’s that I hate the idea of the process, and what comes along with it. I want to beleive that when my baby is in my arms, I will not regret a single thing, but the process is just so terrifying/awful/unfair/expensive. Getting to that end point feels practically impossible, and during the whole process I will know that I didn’t have to be doing it. How would we survive the process and spend all that money knowing that we could have just kept trying? I’m worried that during the wait I’ll feel like I made a huge mistake, or feel insanely guilty.

Then there’s the issue of feeling like I have to share my child. Maybe I’m just being super duper selfish, but I want to feel like I’m the only mother my kid has. The thing is, with adoption, it’s not about you, it’s about the child, and knowing about/having a relationship with their birth family is usually what’s best for the child. Granted, when you have a baby yourself it’s also about the child not you, but there’s still no other family out there you have to share with. It feels like a huge responsibility to handle the birth family stuff the right way, and I just plain don’t wanna. It feels so unfair that I’d have to. And then there’s the horrible worry that I might end up feeling like I don’t bond with or connect with an adopted child enough. Rationally I don’t think this is a real concern, it seems like adoptive parents always have fears about this and it doesn’t end up being a problem. But I’m still scared. I play this horrible game where I look at kids on the train or at the grocery store and think, if that were my child would I be able to bond with them? Sometimes the answer is yes, the kid is so completely adorable I want to just grab them and hug them. But more often the answer is not so positive. Even just writing that I feel like a horrible person who probably doesn’t deserve to adopt. These are all awfully complicated things to try to put into a few paragraphs, but the point is, I’m terrified.

What does all this have to do with the little grey blankie though?? Well, the point is, by focusing on how hard and scary adoption is (well actually, ignoring it by pushing it to the back of my mind and not thinking about it as possible at all), I’m putting an insane amount of pressure on myself to be able to do it naturally. The past few months I’ve felt like I’m just not up for all that adoption entails, so I have to be able to do this myself. Every month I’m not pregnant is a reminder that I’m failing, and if I have the attitude that I have to be able to do it myself, then my failure means no baby ever. That leaves me unbelievably depressed and hopeless about the future.

So instead, what if I forced myself to remember that as hard as it might be, adoption is possible? That I will have a baby one day, however it ends up happening? I brought all of this up with G while we were still laying in bed yesterday morning, and I suggested that we try to remind ourselves that we will one day have our baby by buying something for that baby. Something small and gender neutral, that will likely sit in a closet for a ridiculously long time, but will get used eventually. He was not totally convinced, but was willing to play along.

blankieSo, when we went to Target to buy the baby shower gift, we picked out this little grey blankie. Cute isn’t it? It’s super soft, and fits perfectly with what I imagine our boy or girl nursery would (will) look like. This is the first, hopefully of many, things we get to buy for our baby. It may be a long long time, but our baby will eventually be wrapped up in it.

Like I said at the beginning, the jury is still out on whether this little experiment is going to work, or blow up in my face. It could be that before long it starts to be a mocking reminder of my failures, like my couple of maternity shirts hiding in the back of my closet. But so far, I think it’s helping. Yesterday after shopping, G and I went for a nice long walk around a beautiful park. We were both in a pretty good mood, and we talked a little about how the shopping trip went and how we were feeling. We both felt like the shopping trip was much easier than the last time we bought someone a baby shower gift. It could just be something about this particular couple, or maybe it helped to know that we were going to be buying something for ourselves too. We also agreed that we were feeling pretty calm and (mostly) at peace with this month’s BFN. In past months it’s taken me much longer than two days to get to this point, so that seems like a good sign as well. As for the future, we will have to see. The little grey blankie is now sitting on the top shelf of my closet, where it will probably sit for a very long time.