This sums it up pretty well

From Someecards:

Not my secret, but totally could be

Today on PostSecret:

Lap consult scheduled

February 7 we get to make another exciting day trip to Long Island (there really needs to be a sarcasm font) for a consult on my repeat lap.  I am so not looking forward to doing the prep for that again, but I'm really just hoping things go smoothly (as in we do not get another massive blizzard) & we can maybe sneak in surgery by the end of February since I took the 1st week of March off for vacation (no plans, just chillaxin' for hubby's spring break) anyways.  My last lap was almost 4 years ago & they found nothing, but who knows?  I have an infertile friend who was told it was all good only to have a CCRM consult where they took out a ton of endo. 

 

Once I get my period post lap, we can cycle, so in theory I could be stimming in as little as 2 months.  I'm guesstimating based on prior experiences that if that was the case I could end up with retrieval/transfer right around my 35th birthday.  I wonder if I'll get a special gluten free cake that says "Congrats on being AMA now too!"?  

 

I plan on taking FMLA time when the IVF cycle itself starts.  Even though most monitoring can be done locally & they say stress does not affect outcomes, I call bullshit.  And honestly, I have such hatred for my job that anything I can do to lessen cortisol levels will be beneficial to my mental health regardless of pregnancy or not.  My therapist agrees this is a smart idea thankfully so if HR decides to be assholish (I doubt they will be) I have back up. 

 

When we do cycle we will do either a micro Lupron or straight Menopur stim.  Lupron was the only med I've been on (and I've been on a boatload) that ever gave me side effects (I was a zombie; slept 12 hours a day & was still exhausted) so I'm kind of "meh" at the idea.  However, women who are shitty stimmers like myself often do well on such a protocol.  It's kind of similar to what we did for IVF #2 (the only good stim I had) & honestly, I totally trust Dr. B: I know many women who have had way worse issues than us end up with a kid (or more!) working with him.

 

In addition to the stim we will be adding 2 other meds: Prednisone & Lovenox.  Prednisone is a steroid that will supposedly help with my immune issues & make my body not so hostile to an embryo.  It also has the lovely side effect of making you legit psychotic (ever hear of "roid rage"?) & we don't give it to patients @ work unless absolutely necessary because of this.  I've already warned my husband; should be fun.  Heh.  Lovenox is a blood thinner used to help with implantation.  An infertile interwebs friend had some of these drugs left over & was nice enough to mail them to me.  I hope they work as well for me as they did for her.

Immunology bloodwork results

I received a phone call from Dr. B this afternoon.  Yes, he said 4-6 weeks for results & we only did the bloodwork 3 weeks ago.  What’s this, a doctor that calls you himself & does it sooner than the time frame given?  Be still my heart!

For the 1^st time in almost 6 years of TTC I can finally utter these words: we have answers.

Starting off, my husband & I have some haplotype issues.  Specifically, the concerning one is we have a matching HLA type (AA haplotype).  Fascinating yet bizarre.  Genetically, we are quite different (he is Tamil, I am a mix of Portuguese, Hawaiian & Irish) so one would like Darwin’s theory of genetic diversity leading to fitness.  Guess not. 

The good news here though is our chromosomes are normal which I was slightly concerned about since Vid’s parents are second cousins.  Gotta love (or not, in reality; ha!) arranged marriage. 

I also have a high level of anti-nuclear antibodies & an 8.1 extended haplotype as well as TH2 dominance which point to my body attacking foreign bodies, a.k.a. embryos.  Also, based on the T2 he is recommending a repeat lap to check for endo as in his experience there is a huge correlation.  Given my testing positive for so many inflammatory immune things, he said he’d be remiss not to order it.  The dude he recommends is on Long Island so I will have to check with my insurance & pray it’ll just be a matter of an out of network co-pay.

My AMH is on the low end of normal @ .79.  According to all the charts I’ve seen on Dr. Google, that is about average for a 40 year old woman.  I will be 35 in 2 months.  It’s not low enough to be considered DOR but basically the sooner we get pregnant the better (no shit!) because when I am actually 40, we’d most certainly have to venture into donor eggs.  I have no interest (or funds) to do that.

The shocker: I have fucking celiac disease.  My husband, you know, the one who shits like a buffalo & has the gas to match whenever he eats anything with gluten?  Nope.  Totally odd.  He grew up in South India where it’s a rice-based diet & never has GI issues when he visits home & eats the traditional diet.  I’ve been begging him for years to get tested & he never has.  But now we know.  And I, the queen of carbs who has a gut of steel (seriously, I’ve eaten in some very shady road side stands in developing countries with no issue) has fucking celiac.  This was me today upon hearing the news:

I am so sad it’s pathetic.  I don’t want to live in a world without bagels or pizza.  Yes I know there are gluten free options out there but they’ve hella pricey & often taste like ass.  Alas, having a kid is more important @ this point than having a bowl of pasta.  And once I give birth, I am eating ALL THE CARBS in celebration!

Still alive

Hey, so, yeah...it's been a while.  When last I blogged a little over a month ago we had just met with Dr. Braverman to hatch our master plan. Then, lots of things happened:

We ran away for Thanksgiving as tradition dictates (we've done it every year except 1 since we've been together) to Niagara & Toronto.  

Then early this month Vid's mom took a bad turn & ended up in a coma for 4 days which she somehow managed to come out of.  Seriously.  So he's trying to figure out a way to get over there sometime next month for another visit.  

My job has reached the point of intolerability.   I seriously cry when I wake up in the morning several times a week.  My therapist actually suggested I quit if it were financially possible. Yeah, no.  But I am sending out resumes into the ether, hoping to land something less stressful with increased pay.  Should be easy in this economy, right?  LOL!  

And my niece came home last week after 3 months & 3 days in the NICU, with a mic-key button, which is wonderful news but also a challenge obviously.  It remains to be seen what kind of delays, if any, she will have as a result of her premature, traumatic birth.

Then Christmas was yesterday.  It was pretty chill actually.  So.  Much.  Food.

So yeah, lots of things.

Today we did immunology bloodwork.  Thankfully, the company Dr. B uses is actually headquartered nearer to us in Boston so we were able to do it at their main office & therefore didn't have to drive 3 hours to NY.  Yay!  We did what they call the "Fertil panel" (no "e"; fancy!) & should get results in 4-6 weeks.  I had 12 big vials & 16 little vials taken, while Vid had 1 big & 4 little taken.  Guess which one of us closed their eyes & sweat like a pig for the duration of the bloodwork while their spouse kept rubbing their back so they wouldn't pass out?

Yeah.

A meeting with the Pope (kind of)

We took a day trip to NY to meet with His Holiness, Dr. Braverman, yesterday.  We left @ 5 am & thankfully the traffic gods smiled upon us, as wel as the weaher gods.  Afterwards we went shopping @ the giant Indian grocery store nearby & had a nice South Indian lunch (Vid's people) before heading back home.     

 

Overall, it went well. DH was impressed with his office set up (4 monitors = comp sci prof's dream) & his liquor bottle collection, LOL.  He was very approachable with a good sense of humor & also wasn't afraid to use big words with us.  I like big words!

We're starting out with testing for karyotyping & basic immune stuff. He's also testing my AMH. The nurse will call to set things up next week, hopefully locally to us, or @ least nearby in Boston where Reprosource has an office, which is way closer than Long Island.  He says results should be in by around New Year's or so.

For IVF #2 we did "low & slow" with a Clomid kickstart, adding Follistim, Cetrotide & Menopur which by far gave us our best results. Based on this he thinks we need a flare type protocol but is not sure about micro flare Lupron given wh...at a disaster IVF #1 was. He also suggested maybe straight Menopur.

He did a pretty in depth exam/ultrasound & found something interesting: the blood flow in & out of my right ovary is very restricted. He asked if I knew how many eggs were retrieved there vs. left as well as mature eggs out of left vs. right & I said I don't know. I told him I feel it when I ovulate out of lefty but never out of righty. While he doesn't suspect endo it's in the back of his mind & depending on other tests I might have another lap.

When it comes to my weight he does not think it's what's preventing me from becoming pregnant. He does suggest going back on Metformin since it can normalize leptin levels which tend to be higher in obese folks who don't have IR. Leptin affects the release of LH among other things.

For the hubs, based on his sperm frag test & low morph he says to try the FertilAid & see what happens. Clomid might also help with the morph. Ensuring my other half takes his pills will likely be the most challending part of all.  He doesn't think Vid being the product of a cousin marriage is an issue. Also suggested a course of antibiotics prior to cycle which we also did with IVF #2.

More about the war on infertile fat people

 

Over the years I've been blogging you know how passionate I am about advocating for better treatment of those of us with elevated BMIs who are also dealing with infertility.  Too often, otherwise healthy fat folks are told to lose weight & magically we'd get pregnang on our own.  I've posted several articles written based on data gathered from studies on overweight & obese women.  This time, it's the men's turn:

 

A study cited in Renal and Urology News (November 2013) found that "While those who underwent surgery had increased sexual function as well as increased luteinizing hormone, follicle-stimulating hormone, and testosterone, their semen parameters went completely unchanged."

 

So just like the study I wrote about a year ago about women who underwent gastric bypass surgery not having their fertility improved by the surgery, the same apparently goes for men.  Furthermore , just like their female counterparts, infertile men had a libido increase that may be explained by the fact they were given false hope that this surgery would allow them to finally become a parent.  Once again, if the researchers followed them more long term, the level of sexual desire probably decreased with each cycle they didn't impregnate their partner.

 

I'm not minimizing the fact that obesity likely does play a part in some people's infertility.  We all know it's associated with many medical problems besides an inability to conceive.  However, if an overweight or obese person doesn't exhibit any of the associates comorbidities, then why suggest people go through ultra-invasive, extremely risky surgery to correct a problem when there appears to be no evidence it will acheive the desired, supposed affect of improved gamete quality?

Infertility conference recap

In all my years as an infertile I've never attended the Resolve of New England.  I've always wanted to but the cost made me pause.  Then, I found out you could attend for free if you volunteered.  So, I did.   I was a room monitor which basically meant I did a head count of the room, collected feedback forms @ the end, kept the speaker on time & trouble shot any issues that came up.  Using "strategery", I volunteered to monitor the sessions I wanted to attend for information purposes, so it was a win for RNE as well as myself. :)

I met the new doc @ my RE's office & she's super chill. Probably my age? From Greece originally. She's also on the board of RNE. I told her about starting up a peer group in Providence soon & she said she would be willing to let me use office space for it.  Did I mention that I am going to be a peer leader?  Yeah.  Because I don't have enough going on.  But seriously, I'm looking forward to it!

I met the dude who invented the sperm frag test Vid recently had done! He gave me a sperm pin, lol. I got a ton of cool swag (pens, sticky notes, lip balm, stress relief egg, a book on love & infertility).  Here's a pic to prove it really happened:

I also met a really nice Indian couple who were also unexplained & had gone through 5 (!) IVFs so far. I've already been e-mailing back & forth with the wife. She is also thinking about going to Braverman for immuno testing too.

Some stuff I learned:

• 2nd hand smoke is as detrimental to gamete quality as smoking yourself is. Yet another reason for me to be looking for another job since most of my patients are smokers (people with a mental health dx smoke @ a rate 3x that of the general population).
• PICSI does not increase fert but does decrease m/c risk.
• B6 levels are naturally higher in fertile women. My B vit levels are low normal as I'm a vegetarian. However, due to my having beta thalessemia my body does not manufacture iron well & I've probably avoided having to have blood transfusions in my life since I don't eat meat. A lot of oral B vits have iron additives which could be dangerous. Given this, might be time for vit injections according to the RE who did the talk.  What's another needle @ this point?
• High omega 3 levels are associated with increase in prostate cancer & increased morph issues (interesting since DH eats a ton of seafood).

BINGO!

A Letter to All the Pregnant Women in My Life

An interwebs infertile friend recently posted this; I nodded along through the entire thing.  I don't normally copy & paste others' work, but this was way too good (as well as appropriate for where I am mentally) not to share.  You may nod along as well if you're still in the trenches of infertility:

It’s not you, it’s me.

I’m not like your high school boyfriend who heard that phrase in a romantic comedy and repeated it to you just days before taking your best friend to prom. I really mean it. Everything is me. You are wonderful. You are careful with me. You are kind.

I sit, every minute of every day, with the knowledge that I may not be able to have a family, and that even if I am able to have a family through adoption, I may not ever be pregnant, carry a pregnancy to term, give birth, glow, hurt, heal. There are moments, brief and beautiful moments, when I am so in love with my life that I forget about infertility and I feel actual joy. Those moments never happen around you. I can’t forget around you. Back when I had hope, I could find excitement in your growing belly and happy plans. Now, I just don’t know how to.

Most of the time, I am walking around in one of two states of emotion–both distant from my pre-infertility emotional self, both distant from joy. One of those states is a disconnect. Disconnection from my emotions is how I live through this; it’s how I get through every day. I want to compare it to wearing a bandaid to protect a scab, but it’s not quite like that. It’s more like a helmet covering a thin layer of flesh over an otherwise raw and exposed bundle of nerves, delicate and tender and requiring care and protection. I can talk about what I’m feeling while I’m not actually feeling the emotions. It’s the closest I get to being able to share what I feel with others.

Then, when the helmet comes off, it is not pretty. That is the other emotional state I sometimes find myself in, filled with intensity uncommon in my adult life, feeling emotions that make me uncomfortable and unrecognizable to myself. Anger, jealousy, hurt, resentment, despair, loss. I prefer to experience those alone. Which is lonely.

I don’t know how to engage with you, my dear friend, the way I used to. With my helmet on so tightly, how can I connect with you during this most important time of your life? With my helmet on so tightly, I feel like everything I say is a lie. But, with my helmet off, there’s nothing about me you’ll want to be around and there’s nothing about me that is comfortable for me to show around you. It cannot come off.

So, I miss you. Each time a friend begins to “try” I withdraw a bit more. When they succeed I become a little more alone. Over three years of this, the losses have accumulated and I have steeled myself for them a little better each time, faking it with a bit more success. I don’t want your happiness to feel like a loss to me, but it is. At least for now.

I read constantly that it is impossible to get through this without losing girlfriends, but I really don’t want to give in to that. In my lowest moments I see how infertility might take away everything. In my better moments, I hold out hope that when I come through this I will still be loved and able to give love.

What is it like?

What is it like...

• to find out you're pregnant
• to see 2 lines
• to have the RE call you with good news for a change
• to watch your betas double
• to see a little blob on the screen with a beautiful flutter
• to feel nauseous & happy @ the same time
• to see a plain old OB/GYN
• to hear someone else's heart beat next to yours
• to be able to tell someone that it actually worked this cycle
• to be able to look at baby items with hope & happiness
• to be able to use the excuse you're eating for more than just you now
• to see your belly grow
• to feel their kicks from the inside
• to have others buy you a shower gift for a change
• to decorate their long empty nursery just as you imagined it
• to make a birth plan
• to experience labor & delivery
• to hear their 1st cry
• to hold them in your arms instead of just your heart
• to see your name on a birth certificate listed as "mother"

What is it like?

Back in the saddle

I had my WTF appt today.  It went well. Doc is as stumped as I am why I can't seem to get pregnant. Vid is going on FertilAid (speaking of which, recs of where to order it from?) to see if we can work on the slight morph & oxidation issues. Also, I made an appt to get a consult with Dr. Braverman in November, which was the soonest I could get in on a Saturday since it's a 3 hour drive (so long as the traffic gods smile upon us).  I told her about the Braverman consult & she was interested to see what he says. She has had people get further testing with him before & appreciates his outside the box thinking, especially with those of us who are unexplained. To her obviously the whole immunology thing is controversial but intriguing. I'm not sure how long it takes to get the testing done once we have our initial consult on 11/16 but I told her if possible I'd like to cycle over the holidays based on what Braverman recs & she was good with that too.  I can't believe I'm still on the crazy train.  What the hell is wrong with me?

My niece is here 11 weeks early

My sister went in for a regular OB appt yesterday (Monday) after work. The baby's heart beat was off kilter so her doc sent her to the hospital for further monitoring.  While there, the baby's heart beat got really scary so they decided to do an emergency c-section.  I found out when my mother called me to ask me to take pick up her dog to stay @ my house because she was on her way to the hospital to meet my sister.  It didn't register @ 1st in my mind.  Then, when I hung up the phone, I started sobbing uncontrollably.

She was 29 weeks as of Sunday.  The baby was born blue with kinks in her cord but they were able to stabilize her & sent her to a hospital with a NICU across town.  Maggie weighed in @ 2lbs even.  My sister was transported late last night to the same hospital.  As of tonight the baby is on 30% oxygen via CPAP but is otherwise stable.  I don't even want to think what could've happened if she had not had an appt yesterday.  Her pregnancy was completely normal until 3pm yesterday.  My nephew was born @ 38w6d weeks vaginally & unmedicated with no complications FWIW.  My sister is doing fine & will likely be home this weekend.  I want so badly to go give her a hug but there's no way I could handle being on a NICU floor which makes me feel like shit.

Not pregnant.

Over the course of 63 months (5 years, 3 mos)::

• I have experienced approximately 70 menses based on my 27 day cycle
• I have seen 4 REs @ separate 4 RE practices (all of the offices in my city)
• I've only felt comfortable working with 2 of the 4 REs ( in other words, the other 2 were douches) & the one who I really connected with of course is not currently practicing
• I have gone through 8 IUIs, all of which were negative
• I have transferred 5 embryos over the course of 3 IVFs & 1 FET, all of which were negative
• I have spent approximately $20,000 in co-pays for the privilege of getting my period which I am perfectly able to do on my own
• I still do not have an answer as to why we cannot even get pregnant, let alone worry about staying pregnant

As I see it, right now we have 3 options:

•  Go see Dr. Braverman in NYC.  This may or may not be covered by our insurance.  I've had several infertile interwebs friends work with him who speak highly of him.  But even the gods of reproductive immunology can't get everyone pregnant.
• Look into adoption.  Vid is still wishy-washy on it.  I've already waited 5 years to become a mom & by the time we could afford it it may be another 5 years of saving to do so from India.  And who knows if we would even be deemed "fit to parent"?
• Live CFNBC (child free not by choice).  Stop all treatments.  Don't look into adoption.  Pretty much live the way we do now, but just give up all hope.

Right now I'm still pretty raw.  I went out this morning to run a few errands & had to leave Dunkin Donuts without ordering because there was a newborn there.  I was supposed to go to an autumn craft fair with my mom & aunt today but again, I just can't, in case I end up surrounded by pregnant bellies.  I am already contemplating calling out sick from work on Monday.  I already hate my job but being infertile makes is excruciating.  I just don't feel like I can function in society right now.  I am broken.  I can honestly say I no longer believe in a higher power.  I wish this was all just a bad dream but it's not: it's my life.  I hate my life.   

Another celeb comes out of the IF closet

I don't watch the show & honestly don't know much about her, but Aisha Tyler is me in so many ways.  I've said it before: infertility is a sisterhood, a club that nobody wants to be a member of.  I just want to reach through my computer screen & hug her!

Infertility-induced psychosis

 It's a beautiful day so I decided to hang out the freshly washed shirts to dry. Of course a bird then shit on them.  I've been told this is good luck, but  I cried.  Oh & I ugly cried 2 times yesterday for no reason.  Vid made some sort of snide remark that I don't even remember & it sent me over the edge.  And the other time I don't even know what set me off.

Also, it safe to say a lot of progesterone = a lot of cramps. I had no cramping that I can remember from the Crinone I took for IVF #1.  I had some small cramping on straight PIO for IVFs 2 & 3 but this time I am on Endometrium BID as well as the ass shot @ bed time.  Friday I had some cramps that literally had me doing breathing exercises.  

BTW my husband has actually been doing the PIO shots this time; my mom (who lives a mile down the road) did it for my previous cycles.  This is HUGE for him as I normally have to hold his hand for him to complete blood work.  The 1st shot he did he literally prayed before he stuck the needle in,.  Adorable.

I POAS this morning @ 4dp5dt. Negative. It was strategic though. The stick expires this month (you know you're infertile when your pregnancy test stash is several years old) & I knew the likelyhood of getting anything but a negative was slim to none. So now I won't be tempted to test closer to beta when there is a chance of getting a real negative yet I've satiated the need to pee on something.  

I think the fact that this is the "make or break" cycle is adding to my infertility-induced psychosis.  The fact that if this doesn't work, we need to decide what our next move will be, if anything, is terrifying.  Not that I won't likely be a basket care for my entire pregnancy is this does work.  Don't get me wrong; I have a sliver of hope, mainly because I've never done an FET before & therefore have not had my heart broken in this manner yet.  However that could all change on Friday.  We shall see.

 

 

Meet Nemo

S/he's adorable!  And hopefully snuggling in for the next 9 mos.  Beta is Friday the 13th.  Of course!

FET scheduled

Wednesday 9/4 @ 11am Nemo gets in mah belly where s/he will hopefully decide to get comfy until May of next year.  I had my 1st acupuncture appt 2 days ago to prep.  Very cool & very pricey but hopefully worth it.  I go in again for before & after the transfer.  Yesterday I also started PIO ass shots & Endometin vaginal suppositories.  Fun, hormonal times!

Sprem frag test results

 

Vid is home from India! And we have the results of his sperm frag test. They look @ 3 parameters: DNA integrity (fragmentation), the level of immature sperm (decondensed DNA) & damage from free radicals (oxidation). The 1st 2 he passed with flying colors. The last one he was in the border region. So, he will talk with the RE about antioxident supplements which may (or may not) help. While it's great he's not horribly MFI (his morph is low but everything else is ok) it also means we still really don't know WTF our problem is.

I had monitoring this morning & apparently I am about to hyperovulate. Makes sense I guess since there are fraternal twins on both sides of my family. I had 2 follicles @ over 20mm on my R ovary today. Who knows how often this happens?  Tomorrow is CD13 so that makes sense as that's my normal ovulation day. So not only can Vid's guys not manage to fertilize a single egg, but even when there are double the targets we still can't get pregnant!

Also, tomorrow after work I  meet with the accupuncturist for the 1st time to discuss what she will do.  She comes highly recommended & is part of a co-op that does a lot of work with infertility patients.  The plan is for me to see her both immediately before & after transfer, assuming Nemo thaws out ok & reanimates.

Sharing in someone's joy for a change.

I know I spend a lot of time on this blog either being depressed, bitchy, or crazy (as infertility tends to do to people) but today, I have a nice infertility-related post to share!  Below is a local news story from Ohio about one of my infertile interwebs buddies who recently adopted a baby girl with the help of Facebook.  Kristen & John endured over 8 years of TTC with multiple treatment failures personally as well as with a gestational carrier & using donor embryos.  They are such a cute little family & I just had to share: