Hysteroscopy Results

I went to bed early last night so I didnt allow myself too much time to dwell on the procedure that awaited me this a.m. I woke about 3 a.m. and couldnt go back to sleep as my mind raced. I finally fell back asleep for a few hours and then it was time to get the show on the road.

I showered and put on my lucky socks and bracelet. 

 
My mom and I drove down to the clinic and I popped my first Valium when we got there, the next 2 about 20 minutes later. They took me back, checked all my vitals, I used the loo, and changed into my cap and gown (hopefully Ill be graduating soon!) 

 
I was in pretty good spirits about it all, I only shed a few tears right before my mom left and I think it was an effect of the Valiums (I seem to cry easily on it).  My RE came in, along with my RN, and her assistant. We small talked as they adminstered my IV. Within a few minutes I started to feel a little loopy. 
This time I stayed awake throughout the whole procedure even though I got the same dosage of narcotics I always have in the past. Maybe I am just used to them by now. Either way, it wasnt too painful, more uncomfortable than anything. I did my best to listen to what they were saying and look at the screen beside me that pictured my uterus. 

Drum roll please….my uterus is clear! The mass is gone. Completely. It was described as looking perfect!

Everyone was so excited! Its been awhile since we have had something this positive happen to us. I cried happy tears and thanked God over and over. Im still in shock to be honest. I prepared myself for it to go the other way today, but it didnt. We are so incredibly grateful. 

Ive been sleeping the day away as the drugs wear off. I am headed back to work tomorrow, and then Monday Ill be headed back to the clinic for my post-op appt, my day 3 ultra and blood, and start of stims. Thank you for your kind words and support about today! Prayer works. 

3 More Sleeps

Until my (hopefully last) Hysteroscopy. It may seem almost pointless to some to even do it at this point; I have already started the suppression part of my cycle with Lupron injections, ordered all my other meds, and paid for the FET itself. Why bother putting me into a drug induced state again to see what my cavity looks like? 

Simple-we just want to know what we are dealing with. Thats it. We all have already agreed we are moving forward regardless of if the mass is completely gone or not, so its not about that. Although it would be nice to know that the treatment the past several months did work if it did. I cant imagine not finding that much out.

Anyways, I have my outfit (socks & lucky fertility bracelet included) all picked out for my procedure…how sad is this that Im now into infertility fashion? I guess a girls gotta do what a girls gotta do. Lol. Will post some pics of this attire after the procedure to bring you a few smiles. 

Oh, and is it pathetic that Im looking forward to the day off and the loopiness that comes along with all the poking and proding? No nervousness at all, Im ready for the twilight. This aint my first rodeo… Bring it on! 

FET 3 Protocol

Let me start out by saying that I had my final, 3rd injection of the Lupron in my behind yesterday…hooray! I am so glad I have reached this milestone. I am also so thankful to God that my side effects have been very minimal, which was a huge fear of mine going into it. He has 100% answered our prayers with this.

After my injection, I sat down with our list of questions with my RE. She pulled up the scan I had last month when I was bleeding and compared it with the scan I had that showed my mass a few months prior to the Lupron treatment. Good news-the mass wasnt showing on the scan from last month. Of course we cant be sure it is completely gone until my Hysteroscopy in a few short weeks, but its a great sign so far. If its not gone, its at least shrunk! Another answered prayer. 

We discussed immune therapy with intralipids and IVIG, the differences between them, my antiphosphilid results, the studies, etc. Based on my panels and our discussions, and although they offer them at one our of their clinics, I wont be doing these treatments at this time. I feel good about this decision.

Next up was the Crinone v. PIO talk. Ive always been on Crinone for my transfers (fresh & frozen) whereas the recommended protocol for most FETs is PIO. My progesterone levels have always been great, even when we experienced losses. I pretty much refused them in fear of hitting a sciatic nerve or something, (I know not likely) but I have chronic, horrible spinal issues to begin with, and couldnt stand the thought of any additional back pain. My RE was always OK with our decision because of my reasoning. However, I am now ready to go all in and give myself those ugly intramuscular ass shots everyday for 12 weeks (I hope!!) at this point instead of using the Crinone gel. I dont want to look back and feel there was ANYTHING more I could have done. This means no more vivelle either, DEL it is. I know so many of you ladies do it, and I can do it too. I just had to be ready and I am.  I know its not that bad and Ill be just fine!

We are still undecided on the Lovenox, or blood thinner this time around. We talked about it and it could go either way. I am pretty sure this will be a last minute, go with your gut decision. I have plenty leftover from our last FET.

We moved conversation on to the Zika virus. Ugh. My RE showed me some things recently released by the CDC. Although no mosquitos with it have been found here in Florida yet, it is predicted they will be here by the spring due to our climate (right when we transfer!). There isnt much we can do, other than wear bug protectant, stay indoors at night, away from water, and wear condoms when we have intercourse. If hubby got bit, he could easily give it to me. You can get bit and be asymptomatic too. No immunizations will be available for a long time it seems, as I asked because I seriously considered waiting it out to transfer. 

I live next to two empty lots and have some water behind my house. We usually get eaten alive during the summer months.  Its horrible. Needless to say, I think Ill be investing in a HazMat suit soon to be safe. Doubt that, but I have already started reading into Essential Oil mosquito repellent blends I can apply and such. I wont be using and inhaling a chemical based product everyday when pregnant thats for sure. We arent sure about our Bahamas cruise either now with this crap. Going to play this one by ear and see how things play out over the next few months with the virus. Trying not to stress about it, just be proactive. Not like we can control nature. 

On my way out I saw my very pregnant nurse. You might recall me posting about this a few weeks back and how incredibly tough it was. This time when I saw her, I hugged her and told her congratulations. I didnt plan to do it, it just happened that way. I think I just needed time to process it all. God made it really easy for me to be happy and at peace when I saw her this time. Again, an answered prayer! 

Anyways, I called WIN fertility for a bundled FET price quote, got all my presciptions handed to me for upcoming bloodworks, and so forth. The most exciting part of the day was setting up my calendar and transfer date! It made it all feel so real again. We will be transferring almost 2 years ago to the day of our first transfer.  I am ready and praying for all good things. Really, just praying its His timing now, because if its not, I know it wont happen. 

What We Will Do If…

We find out during my hysteroscopy that the mass has NOT shrunk from these Lupron injections? 

This has been the topic of conversation the past few nights in our household. 

We easily reached an agreement that might sound absurd to some–

We will transfer our embryos anyways. 

Yes, you heard right. 

Why? Well, for starters we already tried surgery in May of 2015 to remove the mass and it failed. We do not want to go that route again and we have informed our RE of this decision already and she respects it. 

Secondly, we will have tried medically managing the mass through the Lupron. If this did not work, we will not do it again obviously. 

Third, plenty of women have successful pregnancies with fibroids or masses in their cavities. Even my OB and RE support this fact. 

You might be wondering why we even cared about the mass to begin with then?

Why not have just transferred months ago? 

The answer is simple…

After 3 miscarriages, we all wanted to give it our best shot. We want my uterus to be as healthy as possible for a baby. 

If we hadnt ever miscarried, and just found a fibroid, we probably would have just transferred as many do. But that was not the case. 

Moving forward, we now know that we have done everything we possibly could have done. We pray it works for us. 

A Scare

Things have been relatively uneventful on the Lupron Depot the past 2 months as Ive said. That was until last week. 

When I first started my menstrual cycle early last week, it was right on time and rather light. I expected it to be light as my RE told me it would be and I also read that it would be.  And my cycles are light to begin with anyways.  

Well that “lightness” lasted about 3 days. Then it got pretty heavy, and that has continued on and off now for about 8 or 9 days. Usually my cycle only lasts 4 days max. Ive lost track of exactly how many days its been going on to be honest. 

I figured I should inform my RE of what was occurring, so I did, and she ordered me to get blood drawn ASAP. There was an immediate concern that the Lupron might not be doing what it should be doing… *SIGH*… seriously?

  

Side note: I cringed when I saw the word “STAT” on the order.  Havent seen that since my beta hell days.  

Well, I got my results back, and thankfully, all of my levels are as they should be if the Lupron is (trying) to do its job shrinking this mass. However, Im still bleeding. My RE doesnt think this is normal, so I am headed in for a scan in a few days just to be safe and cover all our bases. 

Dont ask me what safe would be at this point, because I have no freaking clue. Over the years, Ive learned not to ask too many questions ahead of time, because it can all change at the drop of a hat anyways. I am pretty sure I heard her say something about checking my lining, but I just said “okay.” Ill figure it all out soon enough when I see her. 

Praying that it looks as it should because gosh darn it already….shouldnt something just be easy?!?!

Lupron Delay

So the plan was to start Lupron injection #1 yesterday immediately following our Ohio trip. You probably remember that we had decided to wait until after our trip to begin to minimize any side effects while away. For anyone new following along, I will be taking the Lupron Depot for 3 months in hopes of shrinking the mass in my uterus that is thought to have *possibly* caused our last pregnancy loss. 

Anywhooo, I did not start the Lupron as originally planned. I am currently on CD 17, a.k.a. in the ovulation phase of my cycle. Lupron can be highly damaging during pregnancy, in fact, in the past my hubby and I have had to sign waivers about it at our clinic. Im sure some fellow IVFers can relate to this. 

Since I ovulated just this past week, there is no possible way to know if I am pregnant right now. I know, I know…Fat chance of this. BUT miracles happen and it cant be risked. Crazier things have happened. 

So, long story short, if our vacation baby dancing didnt work, I will be starting the Lupron around the week of the 15th this month.  This delay pushes back my Lupron end date a little too (end of March), but I am OK with it. I dont mind putting off feeling like crap a few more weeks or so and enjoying the holidays as much as possible! 

The Verdict is In

We will start the Lupron depot intramuscular injections December 1, immediately following our Thanksgiving vacation. The 2nd injection will be a month later, around December 30th, and the 3rd, another month later, around January 27th. 

Our H/S and SIS combo will take place towards the end of February after the Lupron has had a full 3 months to work its magic. 

If all goes *well* and the mass is gone, our FET will be right in the beginning of April 2016. And of course if all goes *well* then, we will finally be bringing home our Christmas miracle.  Can you even imagine that?!?

Thanks for the feedback on my prior post about when we should start the injections. You all had some amazing points and ideas, and I dont know what I would do without you all. 

A Renewed Sense of Hope

As of lately, I havent had much good to report in terms of our IF/IVF/RPL struggle. Today, for the first time in awhile, I feel like we have some better news to share. 

My formal, sit-down, post MRI appt. with my RE was today.  Although I had briefly discussed the results with her via email prior to our meeting, this was an in depth review.  

We started out reviewing the recent images together. I had already looked at these on the CD I was given at the hospital after the MRI, but none of it made any sense to me.  I couldnt even tell my intestines from my uterus and so on.  Seriously, it looked like an alien.  We pulled up before and after images from the last mass removed back in May.  We compared the images, and they looked very similar then and now, as far as the shape, location, etc. 

Some background before I go any further

Before my surgery back in May, my RE said she thought it was an Adenomyoma that we were going to try and remove. Of course, there is no sure fire way to know 100% what it is until it is sent out after removal. When we got the path back from the lab, after removal, it came back as a submucosal fibroid.  Hmmmm…

We (my RE included) were all very surprised by this report, as it didnt look like one at all.  But what were we going to do? Fight the labratory? Ask for the mass to be sent to me? I dont think so. They dont even speak to people there, trust me. The lab has no connection to the RE- it is an entirely separate entity.  If you even try calling a lab, good luck.  

That brings us to current time. We noticed during my last H/S in September that something was back in my uterus yet again. We ordered an MRI and the official read of the current mass- Adenomyoma. Might I add, in the same exact same location as the last mass.  Hmmmm…

So my friends that “fibroid” back in May was NOT really a fibroid-it was an Adenomyoma as we all originally suspected.  There is no way a fibroid was in the exact same spot as an Adenomyoma now is. Fat chance! 

That would mean the lab was wrong.  How is it possible that a lab could inaccurately diagnosis a specimen sent to them? Well, for one, they are human. Two, its my luck. But here is the real deal on how a misdiagnosis of an Adenomyoma vs.  Fibroid happens–my RE said that when they check for fibroids, they are looking for endometrial tissue and if they find it, they sometimes just classify it as a fibroid.  Both masses have endometrial tissue, but fibroids are much more common than Adenomyomas.  

I do believe this reasoning on their *uck up is true, because when we got a second opinion over the summer at another RE’s and I showed him the path report and the photos, his exact words were, “that is not a fibroid.” I argued with him, explaining that the lab said… and he interrupted me quickly with and I quote, “they are just testing for endometrial tissue.” 

Pretty amazing that labs can get away with this type of work if you ask me.  Nevertheless, I I feel confident this is a regrowth of an Adenomyoma versus a fibroid, and that we have in fact been dealing with an Adenomyoma all along.  So does my RE, the radiologists, and all of the RE’s at her practice.  

To be sure, today, we compared numerous images of fibroids versus adenomyomas; the outcome- my mass looks NOTHING like a fibroid. I do not want to ponder this matter any longer. We have had so many unanswered questions and curveballs throughout our journey.  This FINALLY feels like a solid diagnosis to us, and we plan to leave it at that.  

Now, with all that being said, it appears this adenomyoma has indeed grown back since the operation in May.  It stayed away for about 2 1/2 months in total after the operation.  Keep in mind, before the operation, my RE told me there was a chance this mass growing back may happen (if she couldnt get all of the cells from it out).  She made it clear to us then that she did NOT want to damage my uterus in anyway=not a lot of digging and scraping to get it out.  I do appreciate that.  

Do I wish she got it all? Yes. Do I want to have a bunch of scar tissue or damaged cavity from her getting it all? No. And I dont, thankfully, because then I would be super pissed it was back.  But I am not mad at all today, for 3 reasons-

1. As mentioned, we now have a firm diagnosis of what the mass is. 
2. My uterus looks great overall. Surprising right? Ill explain more below. 
3. There is hope!

Looking Good

I dont know if anyone out there has had an MRI of the uterus, but let me tell you, it really gives you a clear view of it all…more than any HSG, H/S, or SIS can.  The only troublesome area is the small spot where this Adenomyoma is. The rest is normal size, shape, and so on. Thank God.  This is good news my friends!  

Here comes the hope! 

We can try to shrink this mass using Lupron for 3 months. We discussed success rates, side effects, etc.  and when it boils down to it, my husband and I think it is at least worth a try.  We are feeling very hopeful, and at the same time, cautiously optimistic about it.  

The Plan

We ordered the script for Lupron, and my nurse is going to try and get my insurance to cover it, meaning it probably will not be in for a few weeks.  This is not the typical Lupron you inject yourself with subcutaneously in the abdomen before an IVF cycle. I wish! I have been on that dose of Lupron plenty of times, its not bad at all.  For this though, I will go into their office once a month and get an intramuscular injection in-you guessed it-my ass.  Ugh.  I guess its like regular Lupron on steroids (super strong). 

I will be honest-the side effects described are not pretty. Hot flashes, night sweats, nausea, insomnia, etc.  I am trying to remain hopeful I do not get the worst of it.  I am focusing on my fresh IVF cycle, and how I never got sick like a lot of women do, and also my pregnancies were pretty much the same.  I am usually pretty good at fighting off side effects, so we will see.  If they become too much to bear, there are some options of things I can do, but I am not going there yet, one day at a time. Either way, I know it will all be worth it in the end if we can finally bring our baby home.  

Best Case Scenario

The Lupron shrinks it down & we transfer immediately after I stop it, knowing the Adenomyoma stayed gone for about 3 months, we could get through the first trimester without it coming back during that time (hopefully, nothing is guaranteed).  This would mean a spring transfer and maybe our baby in time for the holidays next year! 

Worst Case Scenario

This Lupron does not shrink it.  We would then be faced with a few options-

1. Try to surgically remove it again & transfer right away after (again, this would be just a temporary fix, trying to get us through a first trimester without it, knowing it will likely be back soon).  We would also be risking damage to my uterus again going this route.  
2. Gestational carrier – I will post about this separately, but we did discuss it in detail today and I got tons of info. on it.  

I failed to mention that I discussed getting a second opinion from another Dr. with my RE today.  One that specializes in uterine masses to be exact.  She showed me the areas the other REs at her practice specialize in and are board certified in- several of them being uterine issues like mine.  If they have already reviewed my files, and specialize in this area, why would we bother going anywhere else? What will they tell me these REs havent? I really dont want to become more confused and I am so tired.  Most importanty, we feel content today, like we are moving forward, and thats what matters most.  

Are You There God? It’s Me, Angela…

Hysteroscopy #4 was Monday.  I know in some cases no news = good news, but that is not the case.  I wish I had better news to share.  We prayed and prayed for it.  We have waited almost a year from our last transfer for it.  However, it didn’t come.  And I can’t say I am surprised….What’s another major disappointment at this point?

Our upcoming October FET is off.  Cancelled.  Done.

During the hysteroscopy, my RE found that the mass that was surgically removed back in May returned.  The “something” on the ultrasounds really was “something” after all.  It only took 3 months for that f’n monster to grow back ( you will have to excuse my language).

I woke up from the twilight anesthesia with tears rolling down my face.  Not from any physical pain—just mental.  It reminded me of the feeling I had when I awoke from one of my D & C’s…EMPTY.  I could hear bits and pieces of the “oh no’s, “dammits,” and “shits,” from the staff during the procedure, and in my half alive state, I knew all too well what it meant.

I recall pushing the nurse off of me when she kindly tried to help me get dressed..hell, this wasn’t my first rodeo—I could do it myself. They showed me images and comparisons, blah, blah, blah.  They encouraged me not to give up hope…again, blah, blah, blah.

My RE said she wanted to consult with the 4 other specialists at her practice about what to do at this point, which brings us to today.  Their “meeting of the minds” took place this morning.  I sat by my phone waiting all day for the call to come in.  For some STUPID reason, up until today, we believed it might be a possibility that we could still proceed with our FET in October. It hadn’t been indefinitely ruled out on Monday…we had left it all hanging on the professional consensus today.

The call finally came around 4 p.m.  The consensus was that not ONE doctor thought we should move forward.  In fact, we won’t be moving forward for quite some time.  In fact, we most likely won’t even be bringing a baby home with us in 2016 at all.  If ever.

The recommendation is for an MRI of the mass next.  This has to be done by some specialist at some hospital.  My RE gave me all the details, none of which I remember any of tonight as I sit here and type this. Originally, I intended on writing things down and asking things during our call today, but none of that happened.  I dropped my pen, listened, and put my hands on my head as I blankly stared into space.

The MRI will rule out a few things (of which I don’t even give a damn enough to get into right now) and depending on the results, the plan of action would go 1 of 3 ways:

1. Have another operation —looking at springtime for a possible transfer date with this scenario
2. Lupron suppression for at least 3 months- looking at springtime for a possible transfer date
3. Gestational Carrier

I guess it was only a matter of time before #3 was thrown directly on the table.  Because at this point, we all know options 1 and 2 may very well fail.  Shit, option 1 already did fail once.  

When she told me I may never have the opportunity to feel life inside me again, I felt all the blood rush through my body. She could barely get the words gestational carrier out…I was pretty much like “go ahead, give it to me.”  I can’t describe how I know I was pulling it out of my RE…I just do.  After 2 years of being in direct contact, I know her and she knows me.  She kept saying how sorry she was.  Yea, us too.  No girl grows up dreaming of IVF, miscarrying, or let alone, a surrogate.

I think this might be one of the hardest posts I have written.  Before writing this, I cried and yelled at my mom on my drive home.  I should add that I only did all this because I know I can let it all out with her.  She tried to tell me it’s not the end of the road, it’s not over, she loved me, and all that.  She tried to support me the best she could.  I mean, really, at this point, who knows what to say to us anymore.  I get it.

I don’t want to hear it’s all okay, because in our world it is not all okay.  There are no rainbows here today, folks.  And yes, you may tell me they are on the way, to keep my faith, and hope…but that doesn’t change today.  Another let down.  Time keeps on passing us by.  It’s been a LONG road and I would like to think we have done OK being patient on it…so I must ask…are you there, God??? Remember me?!?

So, tonight, my husband and I just laid in the dark crying.  All too familiar.  We talked about how we let our hopes get up again, how we feel so lost.  Yet again…  1 step forward…20 back.  There was a lot of silence.  What can we say? I feel like this may be our biggest crossroad yet.  We talked about giving up on all of it.  Who knows.  The conversation ended with how maybe we need to get the hell out of here and go away, from everyone, just the 2 of us.

Hysteroscopy Eve

Well, H/S # 4 is Monday morning.  After loss #3 back in February, we decided that we would do another H/S before ever transferring again, so it makes sense that we have one right now.

H/S #3 in June, just 3 months ago, came back all clear after my operation, and thus, we didn’t think another H/S would really be needed this quickly.  We originally thought that having H/S #4 would be more for peace of mind and reassurance that all was still looking good before transferring again.  Wrong.  As you know, images from my HSG in late July and my ultrasounds in early August showed “something” irregular lurking around in my uterus.  So, here we are, actually needing the H/S again this soon after the last.

Our October FET is completely riding on the results of this H/S.  If there is “something” small, like a polyp, that can easily be removed while I am in a twilight, she will remove it, and we will move forward with our upcoming transfer.  Or better yet, there will be nothing at all showing and we will go forward.  However, if there is “something” large found again, like the mass back in March, she will not be able to remove it on the spot, and our October transfer will not be taking place.  I have no idea what will end up happening if the latter occurs– I don’t know if I am ready to go through another operation like the last one.  I am trying not to put too much thought into that for now, but realistically I know it could go either way tomorrow…50/50 chance.

We have learned that patience is necessary throughout all of this.  My husband and I have been together over 15 years now, and married for over 8.  We have been trying to have a baby for over 7, and we have been wrapped up in IUI and IVF cycles for 3 years now.  God is good and only He knows when the timing is right.  It might be next month, but it might not be.  All we can do today is pray for His blessings and protection to surround us….we would love if you could do the same for us! Thank you so much.