Be Very Merry

Since I can remember, I’ve always been in love with Christmas.  I love everything about it; the decorations, the music, the weather, the traditions, the presents, the feelings.  There really is no other holiday that can compare to it.

I woke up 6dp6dt (IVF slang for 6 days past a day 6 transfer), and it was Christmas Eve morning.  As I sit here writing this today, I still get giddy thinking about that morning.  My hubs left for work early so he would be home in time for our festivities later that night.  As soon as he left,  my mind starting going crazy wondering if we were pregnant or not.  I couldn’t take it anymore.  I walked to the bathroom in slow motion.  It was not even 7 a.m. yet.

I got out the pregnancy test and stared at it for a few minutes.  I could feel myself trembling.  I knew it was so early to take a test, and I hadn’t told him that I was going to take it.  In fact, we still had 4 more days until the blood test, which meant I technically wouldn’t be 4 weeks pregnant for 3 more days. I kept weighing out the pros and cons of testing that morning.  I finally came to the conclusion that if it came back positive, it would be the best Christmas present ever, and if it came back negative, it could simply be too early.

I peed on the stick and set it down ever so gently.  I left the bathroom for what seemed like an eternity.  I crawled back into bed, and talked with God.  About 5 minutes later, I slowly entered our bathroom again.  I know so many of you know how that walk feels.  In an instant, the result can bring incredible joy, or excruciating heartbreak.  I flipped on the light and leaned over the test to see if there were 2 lines or not.  There they were…2 dark lines…we were PREGNANT!!! It worked. I could not believe it!! Thank you, God!!

positive-pregnancy-test

I recall as clear as day, standing in the bathroom, in front of the mirror, test in hand, laughing out loud while I was crying. Then running out of the bathroom, shouting and dancing with our dogs.  This was definitely the craziest I had acted yet off a positive test.  LOL.  I got dressed right away, with no idea of where I was going.  All I knew was that I wanted to find a way to surprise my hubs with the test later that night when we exchanged gifts.  And lucky me, since it was Christmas Eve, everywhere had opened at the crack of dawn.

First stop, Target.  I walked up to the jewelry counter, and blurted out excitedly to the first lady I saw, “I’m pregnant, and I want to surprise my husband, and put the test into a box like a present!” She thought it was a “wonderful idea” and started looking for a box right away.  She had 1 red bracelet box left.  I’ll never forget her words when she saw it was the last one, “it must just be meant to be!” I thanked her and left.  Next stop, Babies R Us.  Even though we had received presents from others, we had never bought anything for the babies that we lost in our prior pregnancies. Today was different. And so was this pregnancy I decided.  I found the perfect bib that I could put into the box with the test and was on my way.

I headed straight to my mom’s next.  I walked into her room, and plopped down on her bed. We conversated for a few minutes until I couldn’t help it anymore…I looked at her funny, and she laughed, and questioned me with a “what?” Then I smiled back, and replied, “I’m pregnant.”   We both agreed that this time around it would be different.  We hugged and laughed and of course, began to talk about the future.

Soon I headed home, so excited to put my husbands present together. I placed the bib and the test perfectly into the little red box.  I taped it up, put a big silver bow on top, and placed it under the tree.  I couldn’t wait to give it to my husband later that night.  After our family festivities ended that night, and we were home just the two of us, I put on our usual Christmas present opening CD.

As I sat down with him this year, I realized this was our 14th Christmas together.  How blessed were we to have had each other this long and to still be in love.  I felt so content in this moment.  We exchanged 1 by 1, as we always do.  We got to the last present, the red box with the silver bow.  I was grinning from ear to ear when I handed it to him. I am not one to usually be at a loss for words, but there really aren’t any that can describe that wonderful moment we had the opportunity to share.  It was one that we will never forget, our Christmas miracle.

Transfer Day!!

The fluid was gone and we were feeling so blessed. Our transfer was on for the day originally planned.  We went out to dinner the day we got the wonderful news, which was the night prior to the transfer. We celebrated the fact that God was allowing us to move forward with this FET cycle. I can’t say that we weren’t still nervous, because we absolutely were. For one, we were frightened I would not get pregnant.  Ironically, we felt this way because the embryos had implanted the prior 2 IVF cycles and we thought it had to not work at least 1 time. Almost everyone we knew in the realm of IVF had at least 1 cycle that a pregnancy was not achieved.

And of course there was the fear that if it did work, I would miscarry again.  I was especially petrified of this thought.  My hubs is the most amazing partner I could ever ask for, but for a man, a miscarriage, or even the thought of one, is different.  I am not in ANYWAY saying that it isn’t devastating to a man, because it is.  I have witnessed this first hand. Rather, I am simply saying by nature, in regards to a pregnancy loss, men don’t worry or hurt the same way we women do.

We woke up the morning of December 19th, and had a big breakfast in honor of the big day.  We didn’t get up super early because our transfer wasn’t set until 1 p.m.  You heard me right! We had to wait all day.  Our prior transfers had always been first thing in the morning, which was really nice.  Less time to sit around and ponder all day. To pass time, we walked the dogs and cleaned the house a bit.  I knew I wouldn’t be cleaning it for a while if I ended up pregnant.  My house had pretty much been in ruins for almost a year now.  Each time I had been pregnant (or miscarrying), I was off of my feet. My hubs tried to do the best he could to keep it clean, but my idea of clean is slightly different from his.  And anyone who knows me, knows I like to keep a clean house (I take after my mother).

We also went grocery shopping that morning and stocked up on some food for the week.  After a transfer, I was incredibly paranoid of doing anything that could cause the embryos not to implant, or even worse, if they did implant, miscarry.  Normal things like cleaning the house and carrying groceries now became a concern for me.  I know what you may be thinking-miscarriages don’t happen from things like this!! I am not saying they do… I am just telling you what is going through the mind of a recurrent miscarrier. Unfortunately, once you have experienced a loss, you don’t think the same way about being pregnant as before.  Truly, you are tainted.  Or maybe scarred is a better word for it.

1:00 finally rolled around.  The embryologist came in and gave us the picture of our day 6 embies.  Both had survived the thaw again! One was actually even beginning to hatch.  The doctor and nurse came in shortly after.  They informed me that I was the last transfer for the 2014 year.  Then they asked if a medical student could come in and watch the procedure.  At this point, do you know how many professionals in the field of medicine had seen my girl parts? Needless to say, we said sure.

IVF3

You know the routine from here…dim the lights, fill the bladder, clean the cervix, and turn on the soft music.  Begin the ultrasound on the abdomen, insert the catheter, locate the catheter on the screen.  Make sure the catheter is in the right spot in the uterus.  Call in the embryologist with the embryos.  As all of this is happening around you, you are holding your breath so you don’t move a muscle.  Think about how delicate and precious an embryo is.  Once something happens to it, that’s it.  There’s no repairing it or getting it back.  This being said, I even began to worry I might sneeze.  Sneezing became a fear.  Boy, the things you take for granted sometimes.

Well, I didn’t sneeze and the second catheter went in with ease.  The doctor released the embies and there on the screen we saw the 2 little bright white dots.  We were all smiles as we held hands.  There’s a special feeling, almost a certain kind of peace, that comes with seeing your embryos finally being placed in your uterus.  When you conceive naturally, you never get to see your sweet embryos in utero.  I say this only because if you are trying to find positives in a process sometimes filled with negatives, this is one.

After resting for about a half hour, we set up our first beta for exactly 10 days later and headed home.  As usual, I was on bed rest for 48 hours, with all intentions of taking it easy well after that.  Winter break had officially begun at work, and I was off until January 6th, 2015.  With Christmas not even a week away, all of our decorations were up and all of our shopping was done.  Really, all we could do now was sit back and wait, and of course, pray.  The 2 week wait had just begun.

The Weeks Leading Up to FET #2

My favorite time of the year was here. Winter in Florida had finally arrived. 60’s at night, 70’s during the day, ideal weather for a hoodie and some comfy leggings (maybe even a pair of boots).  Who wouldn’t love this weather?  Just like northerners look forward to the summer every year, likewise, we Floridians, look forward to the winter.

During what felt like the longest November ever, I taught during the days, and at night, I practiced yoga or received acupuncture. In fact, I was going to acupuncture 2 times a week (not cheap!!!), and yoga 3x a week for a solid month.  My goal was not only to reduce my stress levels, but to get the blood flowing to my uterus, which in turn would help thicken my lining.  At home I was also practicing yoga. Every night I had my “legs up the wall.”  All you yogis out there know exactly what I am talking about!  I would sit, butt up against the wall with my legs up for at least 30 minutes, all the while praying my lining was growing.

yoga-leg-up-the-wall-pose

After that, I would pour a glass of red wine (something I never did with other cycles–you get risky after you are a pro!), and take a candle light, lavender bubble bath.  I remember feeling incredibly tired day after day, especially come mid-November, when I starting taking all of the hormones again. There were many days when all I wanted to do was just take a hot shower, eat dinner, and curl into bed after work.  But I pushed, and kept going. I kept thinking about December 19th, our “big” day; for this was the day we would start our family.

All of the therapeutic practice paid off. By the first week of my ultrasound monitoring, after only 1 week of estrogen pills and patches, my lining was already at an 8.  Yep, that’s right, an 8! The thickest it had ever been.  And the best part was I still had 2 more weeks for it to continue thickening.  FYI: Lining doesn’t get thinner, or shed, until a menstrual cycle.  This being said, we knew my lining, at minimal, would be an 8 for the transfer.  As it ended up, I never even needed to take the vaginal Viagra, which I couldn’t complain about (even though we already paid for it).

The week following my first ultrasound, on what just so happened to be Black Friday, my lining was up to a 10.  We walked out of that appointment just staring at each other in awe.  We couldn’t believe it!  The doctor and nurses couldn’t either.  They were actually clapping and cheering.  We thanked God over and over again.  When they asked me what I was doing differently this time, I said, “praying harder.”  We tried our best to give God the glory any chance we could.

December was here. At our 3rd ultrasound, my lining measured a whopping 12.  Anyone in the world of assisted reproduction knows how awesome this is! I had finally made a thick, cozy bed for those embryos to burrow into. I was actually proud of my body, which I hadn’t felt in quite some time.  At this point, I stopped taking the Estrace vaginally and switched to a lower dose orally since my lining didn’t need to grow anymore.  I scheduled 1 more ultrasound for the next week, just to make sure everything was perfect before I started taking the progesterone.

The morning of the final ultrasound did not start out well.  First, let me tell you that every one of our ultrasounds were scheduled for Friday mornings at 7:30 a.m. so I could be on time for work. Even though it meant getting up at 5:30 a.m., and leaving the house by 6:30 a.m. to get to the appointment on time, it was better than missing work.  Bright and early that Friday morning, I stopped to get gas before I got on the turnpike and headed to my appointment.  After I pumped the gas, my car wouldn’t start.  I called my hubs since he was still at home.  Of course, I was crying hysterically!  A woman, on tons of hormones, the week before her 3rd IVF transfer, stranded at a gas station, in a skirt, and it’s barely 50 degrees.  Not good.

out_of_chocolate

He was there within 15 minutes.  He tried to jump the car, no luck.  It was obvious that not only was I going to be late to work, I was going to be late to the ultrasound too.  And the kicker was I couldn’t even call the doctor’s office to tell them I’d be late because they don’t answer the phone until 9 a.m. (don’t ask me why!!).  We had two options: A.) He takes me to the appointment, then takes me to work, and finally, one day, gets to his job (God only knows by that time it would be noon-everything literally takes hours in Florida), or B.) He drops me off on his way to work to get a rental car, I go to the appointment, and then, eventually, to work.  We chose B.

I got the rental car and arrived at my appointment, needless to say, an hour late.  I stormed in completely flustered, waiting for someone to even try to tell me they couldn’t see me because I was late! Thankfully, everyone was understanding and the nurse saw me right away. I figured once she took me back, I would be in & out within 20 minutes. Quickness is the norm with these blood and ultra appointments during a cycle. But today, that was not the case. Today, I had what appeared to be fluid in my uterus. Fluid in my uterus meant our cycle could possibly be cancelled.

I burst into tears in the office. The nurse told me she wanted me to stay until the doctor arrived to get a second opinion. Well, the doctor did a scan & thought it was fluid as well.  She said we would have to cancel the cycle if it was.  She suggested inserting a catheter into my uterus where the fluid appeared to be, in hopes that it suction the fluid right out.  We tried 3 times that day.  We tried with an abdominal ultrasound view once, and then a vaginal view twice.  Yes, I had an ultrasound probe and a catheter in my you know what at the same time.  I could see the catheter right at that fluid sac, but nothing would come out.  We tried again the following day (thank God I rented that car, mine was still out-of-order).  Still couldn’t get it out. More tears.

The doctor came to the conclusion that the fluid had to be right outside my uterine cavity.  She said she would not cancel the cycle at this point.  Can I tell you how mixed my emotions were?  I completely despised the thought of cancelling the cycle because that meant the past 2 months were pointless.  However, what I hated even more was the idea of something being wrong and going through with the transfer.  If there was fluid, and we did the transfer, it could be deadly to the embryos.

Right then, I begged her not to do it if she thought there was any fluid in my uterus. I told her I could handle it being cancelled, when in all reality I didn’t know if I could.  She must have thought I was crazy; I didn’t care.  I didn’t want anyone to feel bad for me, and thus sway their decision.  She assured me that she would not perform the transfer if she thought there was fluid in the uterus, or if the fluid increased in size or changed location at all in the next week. This being said, we set up another ultrasound to check the day before the transfer.  This was now the new “big” day.

For the next 6 days we didn’t know if we were going to be doing the transfer or not.  I started my progesterone as if we were, as I was told, and waited.  I was a nervous wreck.  Unfortunately, there is nothing else you can do to get the fluid out of your uterus, it simply dissipates on its own. Sometimes quickly, sometimes not.

We were so frustrated! In a matter of minutes, we went from being over the top about the lining to not even knowing if we were moving forward.  I know I’ve said it before, but I will say it again, with IVF there are no guarantees, and something major can go wrong at any given time.  In all actuality, just when you think you are free & clear, you realize you may not be. And so, our prayers began to change. We prayed for God to close the door if he didn’t want us to move forward.  If this was his way of telling us no, then so be it.  Over and over again, I whispered, “anything God, but PLEASE, PLEASE just don’t let us lose another pregnancy.”

The day before the transfer finally rolled around.  Another week that felt like a year.  My blood pressure was through the roof when I got there, and I was shaking like a leaf.  As soon as the doctor came in, I was crying.  The things hormones will do to you. The things you will do to have a child.  The things you will do for your dream of a family.  She inserted the probe and we stared at the screen. Then we got the news: ALL THE FLUID HAD DISAPPEARED.

IMG_2789

More Tests?!?

After our 2 losses, we had 5 embryos left in the freezer, none of which were the highest grade. I refused to do another cycle without some answers.  I wanted to know why this happened to us. I am totally a type “A” personality, whereas my hubs is not (probably why we mesh so well).  I always had been in control of what was going on in my life, and usually it followed the plan that I had created. Through this process, I was slowly learning I couldn’t be in control anymore and just because I had a plan, didn’t mean it would happen. I started to sift through all of the paperwork from the start of our journey (which now easily filled a thick binder).  I looked through numerous semen analysis’, blood tests, ultrasounds, HSG’s, SIS’s; basically anything I could to see if something was being overlooked.  Something that was causing me to not be able to stay pregnant.

paperwork

I came across the results of my genetic testing.  I started to remember vaguely that I was a carrier for Prothrombin, MTHR deficiency, Hemochromatosis, and Gaucher’s.  I started reading more about them.  I started learning that in isolation, Prothrombin and MTHR can slightly increase the chance of pregnancy loss.  I set up an appointment with a hematologist who was well known in South Florida.

My mom and I went to the hematology appointment in October.  Of course, more blood work. This time we were looking at homo-cysteine levels (new test), and a full thyroid panel with TSH (which I had previously).  Everything came back normal.  However, this doctor felt due to me being a carrier for a blood clotting disorder, such as Prothrombin, I  needed to be on a blood thinner during my pregnancies.  He recommended Lovenox injections daily into my stomach for the duration of any future pregnancies to prevent a potential blood clot.  With our most recent loss, his theory was that I most likely had a blood clot that cut off the oxygen supply to the yolk sacs.

We started to feel angry that I hadn’t been on it previously.  We knew several women who had miscarried, and once on a blood thinner had successful pregnancies.  So, the question was why wasn’t I? I scheduled an appointment with my regular OB-GYN who I have been going to now for over 10 years.  It had been over a year since my last annual, and I wanted her opinion on why this was happening.  I also wanted to know what she thought of the blood thinner recommendation.  We did my pap and it came back normal.  I shared the genetic results with her, and the recent losses.  She believed that both losses were most likely genetic; about 75% of early losses, according to the “statistics” are.  She thought there was no harm in going on the blood thinner, but she told me not to get my mind set that being on it would have prevented the losses.  Not exactly what we wanted to hear. We wanted definite answers.

So, we scheduled the dreaded post-IVF consult for late October (the one for failures in the world of IVF).  Our fertility doctor told us that she would like to do a full recurrent pregnancy loss (RPL) work-up on me, along with another SIS.  This involved more blood tests, but this time it would take about a month to get the results.

We shared with her that I had recently seen a hematologist, and he recommended I go on a blood thinner for my Prothrombin status.  She pointed out that I am a heterogeneous carrier, not a homogeneous carrier, and that studies generally do not show Lovenox, or any blood thinner for that matter, will prevent pregnancy loss with this status. She said in fact, sometimes if not needed, they can cause pregnancy loss.  Wait? What?! We were now even more confused.  The fertility specialist, like my OB, felt it was most likely a genetic abnormality with the embryos that caused the losses.  Something inside of me didn’t believe it was genetic though. I did as told and got the full RPL work-up done, hoping for an answer. This tested me for auto-immune disorders such as Lupus and Antiphospholipid antibodies.  She also tested my prolactin levels.  Everything came back normal, again.  One might think you would be pleased finding out nothing is wrong-not true! Finding out what was wrong would help us have some closure and in turn, determine a future treatment plan.

The SIS to examine my uterus for polyps, fibroids, and scar tissue was next on the list.  This time my cervix was being stubborn so the doctor had to numb it with a shot to do the procedure (yes, that’s right -a shot in your cervix).  Again, everything looked fine.  Can I tell you how sick of hearing that I was?

The fertility specialist brought back up the lining issue we had (my lining only measured a measly 6 when we transferred the 2 embryos in August).  If we were to undergo a future cycle, she wanted more ultrasound monitoring, along with an extra week of medications (estrogen) for my lining to adequately grow.  She also recommended I take vaginal Viagra. I know you are probably chuckling at this one! We couldn’t help laugh ourselves.  Vaginal Viagra is apparently not just used to make men happy, it is also used to thicken the uterine lining in women, especially those in the world of IVF. You must decide up front before a cycle if you plan to use it, because the cycle must be timed appropriately around it.  We didn’t have a problem with this; I researched it and the side effects were minimal.

We decided that December could be an option for a future transfer.  During Christmas break, I would be off school for 2 1/2 weeks and have plenty of time to rest.  We had always planned that I would take time off work to stay home after the baby was born, and with an August due date, I just wouldn’t start off that year teaching.  We had also spoken with an accountant, and if we did the transfer before the calendar year ended, we would get more of a tax break than if we waited and started from $0 in January.  All of this seemed perfect.

We asked for a calendar showing the available December transfer dates, along with medication and monitoring dates.  This calendar dated from early November to January.  At this point, we felt we had done everything we could do before moving forward, even though we still had no definite answers.

This being said, we chose December 19th, 2014 as our BIG day, and we were ready to rock and roll again!