Wednesday, December 17, 2008
I had the greatest day today. I took the morning off work to attend Elise's little dance performance and Christmas party. It was so much fun. I love that I was able to balance work and family today. Most days I am completely out of balance. I had a leisurely morning and got to be here to see Elise wake up and seek out our elves, take her to school, etc. After I dropped her off I had a bit of time to kill, so I went to Starbucks and sat inside reading a mindless gossip magazine and sipping a vanilla latte (with whip cream of course). Then I went back up to the school for the dance performance and party. It was so good to feel like a parent who is fully engaged. So often I feel disconnected.
I arrived in the office around lunchtime, feeling completely rejuvenated and I got a ton of things accomplished. It really reaffirmed my thoughts that I would love to eventually only work part time.
I came home and did an art activity with Elise, read her a story, and tucked her into bed. Then Jamie and I settled in together to watch one of our favorite shows on TV. Just a really nice day overall.
He just got up to take a shower, and I was sitting her finishing my glass of wine and watching the news. And it just hit me. I'm so sad. I can't understand why it works this way. It's been a perfect day. I have no reason to feel any discontent whatsoever. Yet I find myself fighting back tears.
Things aren't logical right now. I never know what feelings to expect from moment to moment. I can go literally weeks without thinking about things - or I might think of it every day for weeks. Sometimes it seems to come out of nowhere. Other times I think I will be sad and then I am not. I wonder how long it will be this way.
Tuesday, December 16, 2008
And it occurred to me...what is worse than not being able to achieve pregnancy. Learning that the baby you've been carrying and bonding with for 20 weeks has no chance of survival outside of your womb. And then after much prayerful consideration, making the decision to continue the pregnancy and giving birth to a baby that you only get to hold for a short time before she passes away in your arms. Giving the situation over 100% to God.
I can't even begin to comprehend that level of grief. Any pain and anguish that I may feel as a result of infertility just seems to pale in comparison. If you want to read this family's story, I really recommend Angie's blog. She is a beautiful writer and a beautiful person. Her faith and trust in God is remarkable. Surely if she can make it through, we all can.
Tuesday, December 9, 2008
We are crazy busy again (I think this is just a permanent way of life now), and I have plenty of happier things to enjoy. I'm going to try my best not to think about all of this and enjoy Christmas with my family. There is plenty of time in 2009 to deal with my infertility. It is what it is, and I can't change it.
Jamie wants to us to try the natural way this cycle, so I agreed to that. I am going to start taking my temperature again and I'll keep my chart updated (you can click the ticker above to see it). For the few that actually follow this mess, that will be something to check even though we aren't really doing anything to increase our odds for a while.
I was reading the Stories of Persistence on the Infertility Blog (linked on the right) last night. That was kind of neat.
Thursday, December 4, 2008
I think I actually feel okay about giving up all the clothing. I've been saving those maternity clothes for 5 years, and at this point it feels selfish to keep them to myself for some hypothetical pregnancy that may or may not ever happen when others can use them right now. I had been planning to donate them anyway, so when I found out that people I knew could use them, giving them away just felt like the right thing to do.
As I went through the bags to pack them up, I remembered little details about my pregnancy with Elise and when I had worn them. It made me a little bit sad, but it was also kind of a warm feeling to reflect on those memories. It's not something that I allow myself to do all that often. I didn't even cry.
I wonder if this is a step towards accepting that our family is complete? I'm not really sure yet. Some days I don't want to try anymore, and other days I feel like I could keep trying for years. It's a process that is unpredictable for me - I can be doing great and then all of a sudden something can trigger an emotion and this huge flood of sadness just rushes over me. Sometimes it happens at really inopportune times - such as glancing over at a new mom feeding her baby in the stands at a football game. All of a sudden in am in tears and trying my hardest to act normal so no one will notice and think I'm insane for crying at a football game!
I've reached a point now where some permanent changes have taken place. I think there will forever be a part of me now that gets a twinge of jealousy when I hear a story about someone getting pregnant by accident or on the first try. I will always feel a bit of resentment for the fact that things have not come easily to us...even if we do eventually have another child. It's a change in myself that I don't like. Bitterness is not a flattering characteristic. It's not the way that God would want me to behave, and yet it's something that I can't really control. Or I haven't learned how to control yet. I just don't think I'll ever be completely the same again.
Jamie and I talked a few nights ago, and if we aren't pregnant this cycle, I really want to take a break at least for December. I am so tired of going to the doctor every 2 weeks, and the drugs are making me bloated and irritable. I want to enjoy Christmas and worry about all of this in the new year. He agreed, mostly for my sake I think.
Sunday, November 23, 2008
I posted the question in the Infertility forum on Mommy's Online and got some great, quick advice from other ladies. So, the verdict was that I would go ahead and take the trigger shot today.
That was an interesting experience!
I locked myself in the bathroom to keep Elise from walking in and getting freaked out. I thought if she saw me stabbing myself in the stomach with a needle it might upset her. LOL Of course she was standing outside the door yelling, "Mommy! Mommy! The door is locked!" the entire time.
I read the instructions like 10 times before I made my first attempt. I don't mind needles at all and I'm not afraid of shots in the least. However, it is a bit unnerving to have to administer your own shot. The first time I tried, I guess I didn't push hard enough, because the needle didn't penetrate my skin. So, on the second attempt, I had to apply a bit more pressure. It really wasn't painful - the needle is really small. It just stung a little bit. It is sore now at the injection site, but all in all, I think it went pretty well.
Friday, November 21, 2008
We were told that I need to take the trigger shot on Sunday night, which the doctor thinks will cause me to ovulate sometime around Tuesday morning. She wanted us to be using the OPKs, because she thought I may end up ovulating on my own. Not sure what to make of that, since Dr. Dunn said not to bother because the estrogen would confuse my system and I would need the shot to ovulate.
We will follow up with Dr. Dunn again at the end of the cycle.
Friday, November 14, 2008
Jamie and I met (again) with Dr. Dunn last Friday. He went ahead and ordered a scan, just to see if he could tell if I ever did ovulate in spite of my medication mishap. They couldn't tell on the scan, so he ordered bloodwork to check my progesterone level (this would tell him definitively if I ovulated or not). I am not sure what to make of this, but my lining was 11mm during the scan. We left his office with a plan in place.
If I had ovulated, I was to wait for my next cycle to begin.
If I had not ovulated, I was to begin taking Femara again immediately.
As it turned out, I had ovulated. So, I waited. I didn't have to wait long, because a new cycle arrived on Tuesday.
So, here is the protocol:
- 5mg Femara (TWO pills a day - important distinction!) from CD 3-7
- 2.5mg Estradiol from CD 10-12
- Scan on CD 11 (day 13 would have been better, but it falls on a weekend) - at the scan they can see how things are progressing and adjust the Estradiol if necessary. I am guessing the scan will also determine when I will administer the trigger shot to induce ovulation as well.
I don't feel pessimistic about this, but I don't feel particularly optimistic either. I'm just kind of going along. I guess Dr. Dunn still thinks we are on the right track since he hasn't suggested any more potent drugs yet. So, at this point, I am still a willing participant.
As everyone knows by now, I am completely enthralled with the Twilight saga at the moment. It's been a VERY welcome distraction from reality. As strange (or pathetic?) as it is, it's actually made me feel happy. I am starting the fourth (and last) book today. I think I may be onto something. I normally don't make a lot of time for reading, but I think even after I finish this series, I might start doing more reading. It's been strangely therapeutic for me.
Monday, October 27, 2008
No mature follicles.
No improvement in the lining.
The nurse said to just skip the trigger shot. There is no point since I'm not producing an egg this cycle. We meet again with Dr. Dunn on November 7 - ironically one day short of being exactly one year post op.
I had to return to work after the scan, and that was pretty tough. Thankfully Lisa was comforting as usual. I don't know if there is much more the doctor can do for us. I don't know if increasing the estrogen and trying injectibles will be an option or not.
Sunday, October 26, 2008
I screwed up my medication. I was supposed to be taking 2 Femara pills from cycle days 3-7. Instead I am a huge screw up and only took one. I didn't realize it until it was too late. As a result, I am not expecting to see multiple follicles at my scan tomorrow.
The Viagra has made me really sick for the past 10 days. Within 30 minutes of taking it, I can feel the blood rushing to all parts of my body, and it's an intense and painful feeling. It's making my gums bleed a lot when I brush my teeth, to the point where I can still taste blood for about an hour after I brush. I've been up all night for the majority of the nights since I began taking it. Oddly enough, since I started the estrogen, I have been sleeping through the night again. I don't know what the deal is, but I am thankful for some relief. I'm really disgusted that I am going through all of this, and it could be for nothing thanks to my Femara mishap.
I called the nurse as soon as I realized I had messed up, and she talked me down from the ledge. She told me that this happens, and we need to just move on and not worry about it. She wanted me to continue all the other meds as planned, and she told me that we'll just see how I respond to a half dose of Femara.
I go for my ultrasound tomorrow, and I'm terrified. If they tell me the lining is not improved, I don't even know where to go from here. Maybe a higher dose of estrogen? Or maybe there is nothing more we can do? My stomach is in knots.
I've beat myself up over and over for messing up. This should be THE most important thing in my life right now. Yet, I am so over-extended with work and other responsibilities that I was careless. I decided that my life is way too disorganized, and as a result, I've spent the entire weekend decluttering my house. I'm hoping this will help me also declutter my mind. How could I do something so stupid? After all that we've been through.
Saturday, October 18, 2008
- Femara - cycle day 3-7
- Viagra - cycle day 3-12
- Estradiol cycle day 10-12
- Ovidrel (shot to trigger ovulation) - cycle day 13
The Ovidrel may move around a bit depending on what my mid-cycle scan shows. I am going on October 27th (cycle day 13) to have that scan performed. If all looks good with mature follicles, I will trigger that evening. I've been reading more information on Viagra for lining issues. It was briefly addressed on an infertility blog that I will now link over on the right side of the page. There is a lot of good information there.
I suppose I should be more enthusiastic about this cycle, trying new medication, etc. The truth is that I've really lost the wind from my sails lately. It seems like there have been more tears than usual, and the beginnings of acceptance are creeping in. I'm talking about the acceptance that this just might not happen for us. We've been trying for a long time now, and I'm still in the game for now. But I need to establish some type of ending point to this, because I feel like my life is on hold. Not in the literal sense, but in my head. I realize now more than ever how important it is to treasure every single moment and every stage of Elise's childhood. This journey with infertility is taking a small piece of that joy away from me, and I don't like that. I need to start living my life to the fullest, and right now I feel like I can't do that because I am constantly waiting for this huge, life changing event to happen. Every month when it doesn't happen, it breaks my heart a little bit. There definitely has to be an end - whether it involves a pregnancy and new baby or an acceptance that it wasn't meant to be. I need one or the other to happen sometime in the relatively near future. Jamie and I talked about it tonight. He agrees, but neither of us are sure when it will be. We talked about the summer, because that would be the 2-year mark since this all began. But nothing is set in stone other than the beginnging of that realization.
Friday, September 26, 2008
Next time we will be doing:
Femara from cycle day 3-7
Viagra from cycle day 3-12
Estrace from cycle day 10-12
Trigger shot on cycle day 13
The Estrace and Viagra are for my lining and the Femara will stimulate the ovaries to produce multiple eggs again (hopefully). The trigger shot will be needed to tell my body to ovulate, because when we add the estrogen, it will confuse my brain into thinking that I am further along in the cycle than I actually am.
We don't know when we'll get to try again now that we have the cyst. I will get a baseline ultrasound at the beginning of each cycle until it's gone. When we get the all-clear, we'll start the protocol above.
This is getting REALLY old.
Sunday, September 7, 2008
Good news: 2 mature follicles, one on the right measuring 21 and one on the left measuring 20.
Bad news: Lining is only measuring 5mm.
The nurse said she's not happy to see the lining measurement, but it's not impossible to become pregnant. We know this will not work in our favor. I think it's good to at least be able to focus on what is most likely causing the problem. I've been reading a lot about the use of viagra suppositories to treat lining issues. A friend of mine who has done IVF told me that they took her lining from 8mm to 14mm in only 3 days!
I'm guessing that this cycle will probably be a bust, so I am making a list of things for us to ask Dr. Dunn when we go back on the 19th. I'm definitely going to see what he thinks of using viagra. I feel confident that if we can get my lining above 8mm, I can get pregnant. I think.
Sunday, August 24, 2008
I began the Femara this evening, and I will take it through Thursday. I go back for another ultrasound on September 3rd. We are hoping to see several mature follicles and a lining measuring 8-10mm.
I'm praying that Femara will do its job. I asked Jamie if he thought it would work on the first cycle. He said, "Knowing our luck, probably not." I'm glad he said it, because I was thinking it. Still, I am trying to have a positive attitude, because as Jamie loves to remind me - the mind controls the body.
I could use a lot of prayers, because at this point, being positive is not something that comes naturally for me.
Will update on the 3rd after the ultrasound.
Sunday, August 10, 2008
Normal Volume is 1.0 - 6.5 mL per ejaculation.
Normal Count is 20.0 - 150.0 million per mL.
Normal Motility is 60% or higher.
Normal Morphology is 70% or lower.
Count 216.1 million per mL
The morphology is a little high, but that is more than offset by the count. The dr. was very pleased with the results, and we are now satisfied that my issues are the only obstacles we have to face. That is an enormous relief, because we are hoping my issues can be fixed with minimal interventions and drugs.
Dr. Dunn mentioned endometriosis again at this appointment. He said I had Stage I when he did my surgery, and it was just a few points away from being Stage II. This does statistically decrease the odds of pregnancy in each cycle.
So here's the plan:
Since I face a statistically lower possiblity of pregnancy, we are going to start doing things to increase my odds from another standpoint. I do ovulate on my own with no issues, but our first step is going to be medication that stimulates the ovaries to ovulate, sometimes producing multiple eggs. More possible targets = higher odds of pregnancy. Clomid is one of the more popular medications of this kind, but it is not what I will be taking. One of the side effects of Clomid is a decreasing of the cervical mucus (which is what creates a hospitable environment for sperm) and a slight thinning of the uteran lining. Thinning of the lining is the LAST thing I need, obviously. This is what makes Clomid an unattractive choice for me. I will be trying a cycle on Femara instead. This drug operates a bit differently from Clomid, but gives the same end result.
Clomid aids ovulation by binding to estrogen receptors in cells and tricking the brain into thinking that estrogen levels are low. When this happens, the brain tells the ovaries to work harder, thus creating more eggs and/or stronger ovulation.
Femara aids ovulation by interfering with the conversion of testosterone into estrogen in the body. So, rather than tricking the body into thinking estrogen is low, this drug actually does cause lower estrogen levels. In doing so, the ovaries are stimulated.
I'm a big student of Google University, but I had never read about the differences between Clomid and Femara. I learned something new!
We are instructed to wait out the remainder of this cycle. When the next cycle begins, I am supposed to call the nurse and come in for a baseline scan. I assume they will be checking the lining at that appointment. Then I begin Femara on cycle day 3 and continue to take it through cycle day 7. I will go for another mid-cycle scan around cycle day 13 or 14. At this ultrasound, they will be able to measure the follicles that my ovaries have produced and tell how many eggs I will most likely release. We are supposed to use an ovulation predictor kit and have timed intercourse (oh how romantic). Then we will see what happens. We'll meet with Dr. Dunn again at the end of the cycle to assess how things went, how my body responded to the Femara, etc. What we hope to learn is that my body does just what it should on the Femara - or better yet...that we are pregnant.
In the event that I do not get multiple eggs on the Femara, we may need to try something different. Dr. Dunn said we might even end up trying a Clomid cycle if the Femara is unsuccessful in producing the kind of results we want to see. If both the more "minor" fertility drugs fail, then we may have to resort to injectibles. This is when our odds of multiple births really begin to increase substantially. I have some major worries about multiples, which is a topic for a different post. Needless to say, I really am praying that the Femara will do the trick. Our odds of twins are only 5-10% on that drug.
So we should be off and running in about 2 weeks.
Saturday, July 26, 2008
Dr. Dunn told us back at our last visit that he wanted us to try on our own for 3 cycles, and then he wanted to test Jamie. He was due to get a semen analysis back in May, but since we were breaking anyway we put it off. We didn't really discuss it much, because it led to a heated exchange each time the subject would come up, but I am sure both of us were hoping to get pregnant during our break and not have to deal with it. Of course that didn't happen. I'm really having a hard time coming back out of denial yet again and facing more testing. It has been a really rude awakening for me.
Jamie went in for his semen analysis on Friday, which was what he described as a totally humiliating experience. I can relate to a degree, because sitting with your legs spread in stirrups while a man who is not your husband sticks his head and face down in your vagina is a little humiliating too. The stress level in our house is high, and I hate it.
I am supposed to go in for more bloodwork, because they like to have current tests in your file at all times, and my original ones are now over a year old. The semen analysis results will come in on Thursday. Once I go in for my tests and all results are in, Dr. Dunn will sit down with us again to come up with yet another plan.
I think I have cried every day this week, and I'm so tired of this. I've reached some sort of breaking point. I am not an outwardly religious person, but I do have a personal relationship with God. For the most part, it is something private that I keep to myself. I have prayed about this a lot. In the beginning I felt led to seek treatment, but the more time that goes by, the more I feel like there is a lesson that God is trying to teach me. He keeps telling me that He is in charge. I am not in control. Things will happen according to His plan. And He is telling me to wait - to be patient.
Unfortunately, He is not telling Jamie to wait. Jamie is still very driven to seek medical intervention - any intervention, whatever it takes. I am just not in the same place, and it's causing a lot of friction and hurt feelings.
So, that is where we stand right now.
Monday, May 5, 2008
Well, shit. Thanks a lot.
So now the ball is in Jamie's court. I've been poked, cut into, prodded, and violated. It's his turn, and at the moment he has a lot of excuses as to why he should wait. The current excuse is that he needs to wait until baseball playoffs and school are over.
Monday, April 28, 2008
I think I've been in denial for a while now, trying to convince myself that I was fine with having an only child even if it came to that. I've been focusing on all the things I can do since I'm not pregnant - enjoy my wine, exercise, drink my morning coffee, not watch what I eat. In fact, I think I've been over indulging a bit.
Along with the whole one year anniversary thing, I've come to the realization that we are looking at - best case scenario - a 4.5 year age gap between children. And it could easily be more. I'm so afraid that my kids won't be close enough in age to play together, keep one another company, and be friends to one another. That is very upsetting, because the desire to give Elise a confidante is one of the reasons I want to add to the family. It's certainly not the only reason, but I'm in a panic all of a sudden. I feel like I'm running out of time.
I'm going to be 30 this year. While I'm mostly really excited about that and embracing it, I have to acknowledge that my fertility is not being enhanced by the extra year. Statistically speaking, I don't have a whole lot of child bearing years ahead of me.
With all these concerns running through my head, I almost feel like the walls are slowly closing in around me. Time is becoming of the essence to me, and everything is totally out of my control. And at some point, I'm going to have to deal with that.
Friday, February 29, 2008
Much to my surprise, my lining measures 7mm. That is quite an increase from the 3mm that it was measuring only 4 months ago pre-surgery. Dr. Dunn told me that if we were in the middle of an IVF cycle, this would be sufficient and he would not cancel the cycle. He said something about being able to see 3 layers (which is good). I didn't catch all of that, but it is a good thing!
I also have one mature follicle on the right side, which is great since that is the best tube. It was measuring 19. We were instructed to continue using the ovulation predictor kit (OPK) and have intercourse on the day of my LH surge and the day after. My test yesterday was negative, but today's is coming up positive, so we have to get down to business! I can't believe my mom is going to read this...sorry mom!
Dr. Dunn wants us to continue to try on our own with the OPKs and charting for 3 cycles. At that point, if we are not pregnant yet he wants Jamie to do a semen analysis. He sent us home with the "kit" and instructions just in case. I think Jamie is really hoping it does not come down to that! So am I.
Monday, February 25, 2008
I noticed today when I was surfing Mommy Zone that some of the women who started TTC with me are now about to have their babies. One in particular is almost 36 weeks along now. So, it will only be a few more weeks, and women who began the whole TTC journey at the same time as me will be having babies. And I'm still here.
Some days I get so tired of thinking about it that I really just want to give up on the whole idea. We have a great life, and I have a wonderful daughter. Why put myself through all of this? But I just can't accept things as they are yet.
I feel stupid being so melodramatic.
Thursday, February 21, 2008
So, my main question is, "Now what?" A bit of hopelessness is beginning to set in. I posted my question on an infertility board where doctors respond directly to all posts. This was part of the response I got when asking how I might respond to a newer treatment that has been shown to help with lining issues (Viagra suppositories):
Unfortunately, With Asherman’s syndrome, There is such widespread destruction of the basal endometrium (from which fresh endometrial cells must be generated), that improving blood flow with Viagra is often unsuccessful in improving estrogen-mediated endometrial development sufficient to achieve “adequate” improvement in endometrial growth. In such cases the women should consider stopping all treatment, adoption or resort to Gestational Surrogacy.
It is important to recognize that Vaginal Viagra does NOT work in all cases. In fact about 1/3 of women so treated will fail to show any improvement. This is because with certain causes of a “poor endometrium”, the basal endometrium has been permanently damaged and left unresponsive to estrogen (e.g. severe endometrial scarring due to inflammation, trauma or surgery).
I posted a follow-up question, but have not heard back yet. I'm just feeling confused, because Dr. Dunn seemed so optimistic. Surely there has to be SOMETHING they can do. But I have no idea what it would be. Another surgery? I guess I will get some better answers next week.
Thursday, January 31, 2008
Friday, January 4, 2008
I had forgotten to take Advil before going in this time. I didn't think it would really matter, since last time I could barely feel anything. It was considerably more uncomfortable this time. The doctor was having a little bit of difficulty inserting the catheter in a way that sealed the opening to the cervix, so on his first try, the water was leaking out. The second time was a charm luckily! It wasn't too terrible, but I definitely wished I had remembered my Advil.
It was completely worth a bit of discomfort to get such an excellent report. He was able to get the catheter all the way up into the uterine cavity this time. I could see a huge difference looking at the ultrasound screen (and I am obviously just a lay person). The entire cavity filled with water this time! He noted absolutely NO obstructions whatsoever. The path was completely clear to both tubes. Obviously we don't know if the left tube is open or not, since the only way to see that would be through another laparoscopy. But given how great the cavity was looking on the ultrasound, the odds are pretty good that it's open. Even if it isn't, we could still conceive via the right tube.
Dr. Dunn said that as far as he is concerned, we can begin trying to conceive again! He say it may take some time for my lining to completely recover (so I am not expecting to get pregnant immediately, although anything is possible). It is a good sign that my cycle was heavier this last time, but he cautioned me that part of that was due to the Premarin. He said not to be too surprised if my next period is a bit lighter. He wants to see me back in 2 cycles to do a check of my lining on CD12 (right before ovulation). This will let him know how it is doing, and hopefully we will see that it is regenerating and thickening. In the meantime, we can give it our best shot and see what happens.
This is such a huge relief and a big weight off our shoulders. We were both really worried that another surgery would be necessary. It's looking right now as though that is not going to happen. I'm not 100% in the clear until we see a thick lining, but for this stage in the game, this is the best news we could have gotten.