FET #3: Transfer Day

After waiting almost a year & a half since our last transfer, & 2 years from the first, yesterday was FINALLY the BIG day! 

Our transfer wasnt scheduled until 1 pm in the afternoon, which had both positives and negatives to it. More time to get things in order, on the other hand more time to let my mind wonder. 

We woke up around 8, took the dogs for a walk, & did my daily injection on PIO. Next, we went to the grocery store & got a couple last minute items that we hadnt got over the weekend. When we got back, I showered while he cooked us brunch. We ate eggs, chicken breast, tomatoes, & wheat muffins.

Then I showered, prayed with my mom over the phone, read devotional with hubby (which ironically for the first time ever discussed infertility) & popped in my Circle + Bloom transfer day CD. I have been listening to the sessions religiously this cycle and was super excited to put this one in!!! Praying, reading, & meditating where exactly what I needed to calm my nerves. 

At last, it was time to get ready to go! If you know me, you know I usually dont wear make-up unless Im heading out for a fancy dinner or something of the sorts. Well, I decided to do myself up yesterday. As I was putting on make-up, hubby was like, “are you putting on make-up?” Haha! I replied with, “yes, arent we getting ready to make a baby? Under normal circumstances, if we had just started trying, I would be getting prettied up for you!” We both chuckled. 

Thanks to all of the suppport we have in our life, I was decked out from head to toe in items we have been given for his cycle. I had on my pineapple headband (hubby), my pineapple earrings (bestie), baby charm bracelet (cousin), a Pandora ring (my mom), hope necklace (aunt), 4 leaf clover necklace (blogger), bad ass undies (me), and stork socks (me). I also had an angel in my pocket from one of my co-workers, along with a yellow bracelet. I felt very special & surrounded by love. 

Hubby & I decided to stop by the water before we went to the RE’s office. Its just a few minutes away, and its in a beautiful, more ritzy area. What a gorgeous day out! The sun was shining with a breeze, truly a spring day in Florida. We took some selfies, skipped rocks, and talked about the future. On our way to the car, I popped my valium. 

  
As soon as we got to the office, I could tell they might be running a little behind. They are very quick for regular appointments, but for retrievals, transfers, & the like they arent. Im not complaining; I dont want them to rush me when Im back there! Anyways, they finally took us back around 1:45.

The nurse took my blood & my vitals, then we headed back to transfer room. I got in my sheet skirt (so cute…not!) and put on my cap. Shortly after, the embryologist came in to show us our embies (now named Itty & Bitty), and tell us how they did thawing. Nervewracking part. She showed us a pic of 1 embie (our AB graded) & you could see it was clearly hatching already! She was really pleased with how it only took it an hour to do so once thawed, as compared to normally 3 hours. Here she is…

  
When I asked how the other one did, she was like “what other 1? Arent we only doing 1?” Hubs and I just stared at each other, and I cant remember who spoke up first. We informed her we are transferring 2. She acted like it wouldnt be a big deal, as she could see my stress level rising a bit. She left to go talk to my RE.

At this point, hubby got up and asked me if I wanted to pray together. I was so thankful for this. He prayed over us, as I listened, and it was just perfect. A few minutes later, my RE came back in, and apologized, saying there must have been a miscommunication between the nurse and her somewhere. She said they would de thaw it now, and hoped we wouldnt mind waiting another hour. 

When 3 pm finally rolled around, the embryologist came back in with embie number 2’s photo. He survived just fine too! Most of his hatching will take place inside of me since he wasnt out thawing as long. 

  
By now, my valium had long worn off & we were ready to get this show on the road! My RE, nurse, & medical assistant (I asked if she could stay, it was the first transfer she got to see!) all piled in the room about 3:30. They inserted the catheter, filled my bladder, & as we watched the screen, on the count of 3, we saw Itty & Bitty released back into their home!!! So cool to watch. 

During the transfer, my RE said my uterus has looked better than it ever has before. Thank you God! When it was complete, she gave us my discharge instructions, wished us well, & said she would see us soon. After that I still had to lay with my feet up for about 20 minutes, and by now it was 4 pm! The time delay was worth it though. 

We eventually got home at about 5 and had dinner. More chicken breast, salad with carrots, cucs, mushrooms, & tomatoes, followed by an avocado & banana smoothie with pineapple core & brazilian nuts for dessert. Hubs put in Pippi Longstocking for me & I watched that, smiling often! I havent seen it since I was a child & I bought it just for this occassion. 

We were both super tired by 8pm, so I listened to my Circle + Bloom CD one more time, & actually fell asleep in the process. Ill take that as a good thing! I did wake up a few times through the night to pee as usual, but the difference this time was that my mind started to race when usually its shut off during the wee hours. I felt a few cramps and of course, tried to analyze them. Soon, I fell back asleep. 

Today (2dp6dt), I have already meditated to my CD. Later, I plan to read my new book, color, watch the new series I bought, etc. Hubs is back to work, so its just me & the boys here. My mom might stop by too. 

Please keep us in your prayers while I am PUPO!! Thank you!

Transfer Day “Stuff”

One benefit to being an IVF vet is that you know what to expect on transfer day and can prepare for it (for the most part).  

Since this is our 4th transfer (4th times a charm!), I feel more prepared than ever before. I am not really talking mentally, although I do feel good about that too. I am referring more to the fun (oh Lord, did I just say fun!?) side of all this I guess? If there is such a thing?! 

Anyways, here is what I have planned so far for FET #3, transfer day #4 (still a few weeks away)-

Transfer Day Shirt-Of course none other than a pineapple would be acceptable (followed by eating some pineapple core)! 

  

Transfer Day Pineapple Socks– ordered online & never worn before! Waiting for the big day to sport these.

  

Transfer Day Pink & Blue Baby Charm Bracelet-passed down to me by a family member, and fellow IVFer who had her miracle twin babies. She wore it during her journey, and now I am wearing it through ours.

  

Transfer Day Drink of Choice… Organic, Sparkling Pomegranate (carbonated water)- This old wives tale drink is delish and we have a pretty good stash ready to go post transfer. 
  

Transfer Day Snack of Choice…Brazilian Nuts! Another old wives tale for sticky feet. All stocked up!

  

Transfer Day Reading-recommended to me from a few ladies in my IG community. This book is so adorable & perfect for any couple trying to conceive! 

  

Transfer Day Therapy- Circle + Bloom meditation continues. Except now its transfer day/post transfer listening time!!!

  

Im sure a few other transfer day things will be planned as we get closer, but I just couldnt contain myself from being excited and thinking about it all today!! 

Prayers for a nice, thick lining at Mondays appointment. 

CD 1…3 Days Late

I have been awaiting my monthly friend that reminds me each month I am not pregnant.  Like clockwork, she comes every 28 days. But not this month. This month she decided to come 3 days later than usual.  I guess she decided to play mind tricks, allowing me to actually question if I could be pregnant.  

Yesterday, the stark white test confirmed it couldnt possibly be true, and then her appearance reaffirmed that today.  The disappointment was minimal; it was pretty expected at this point.  So, with that being said, I have emailed my nurse and set up my first Lupron injection for this week.  Finally. 

As the night comes to a close, I begin to think about how quickly these next 3 months on Lupron are going to fly by. I think about how our FET will likely be here before I even realize it. Some fear arises inside me, mixed with excitement, followed by thinking, ‘bring it, 2016 is going to be our year.’  

Phillipians 4:13 

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.  

Decision Time

We have been praying for peace about which RE to go with, as we wanted to make our decision by the end of this week. Enough dragging it out already, we are ready to be done with this step and move on.  As you very well know (and may be getting sick of hearing about), we have been unsure of whether or not we wanted to stay at our current clinic.  While there are many things we love about them…Things We Love there are also things we don’t… Always Room for Improvement

Earlier this week, we met with the new RE ( New RE FET consult ), and he reviewed his plan for a future FET, the results of our HSG, and did a lining check where he saw the “something.”  I failed to mention the FET protocol he prescribed in my prior post.  I think I was too worked up about the “something”  to go into much detail at the time.  Anyways, he was not for a natural, a.k.a. un-medicated cycle.  His reasoning was that he feels that they can do better than I can do on my own. Hmmmm, I don’t know about that.

Anyone who has been following along knows we ideally want to be as drug-free as possible due to our negative experiences on the meds, especially the estrogen.  When I told him that taking it can feed the growth of masses he argued that my body is producing it anyways.  But if you ask me, the estrogen I am producing naturally is not the same as the synthetic stuff he wants me to go on that I have been on before.  So basically, the protocol would be the same at his place as it had been for our previous FET’s.  Although the protocol would be the same, the price is still $1,000 more than our current RE.

Today, we met with our current RE (where our 3 frosties are housed) for an ultrasound, and FET consult.  Going into the visit, we felt like it was almost a last ditch effort.  We wanted to see what she would want to do differently moving forward, if anything at all.  Many of you are aware of my anxiety, and a major fear of mine is how I would feel being at the same place in the same rooms where I have lost our 5 babies.  Needless to say, I have been carrying around my homeopathic anxiety drops, and I was pretty sure I would need them going here.  Heck, I needed them earlier in the week as I sat in the waiting room for the new RE so why would it be any different today?

We were greeted pleasantly upon arrival.  We know the staff very well, and it’s been awhile since I have seen them all.  Before being called back, the nurse handed me a rough draft of a letter that my RE wrote for us.  This letter was required for the financial grant we want to apply for.  Our paperwork (all 21 pages) is ready to go, with the exception of this letter. I asked for the letter a few weeks ago through email, and even though we weren’t sure which clinic we would end up at, I wanted to get the ball rolling just in case.  I know this may sound a little child-like or game-like, but I didn’t want to ask again about getting this letter after my first request.  I wanted to see that they would do it without being hassled for it.  I wanted to be handed it today, and I was. The nurse asked me to look it over, and if it was to my liking, they would sign it and type it up on letterhead for me.  I thought it was great…here it is…

  
About an hour into the visit, I was pleasantly surprised when I realized I had not felt any anxiety or any need for my drops. We started off with the ultrasound. I am currently in the Luteal phase after ovulation, when the progesterone my body naturally produces should have compacted my lining a little.  In other words, it wouldn’t normally look as thick as it had before or during my LH surge.  This made me nervous.  How much thinner would it be?  Well, the good news folks is that even compacted, it still measured an 8.5!  Talk about exciting.  Thank you, God!

The not so good news is that she did see the “something” in my uterus as well.  Although I don’t want this “thing” there by any means, it was additional reassurance that both her and the other RE are on the same page with what they see.  When two sets of eyes see the same “thing” at different times, you know it’s got to be “something.”  She also said she was not sure what it could be like he did.  Her recommendation was to do another Hysteroscopy to explore it.  I figured this much.  After loss 3, we agreed that before we ever did another transfer again we would do a Hysteroscopy before it anyways.

I got dressed and went into her office for the most important part–the plan for moving forward.  We started off the discussion with how I have been–my visits with my therapist and my family Dr.  She was very pleased to hear that I have been seeing Dr. G for therapy, as some of her other patients do too.   

Soon after, we jumped in to the protocol for a FET.  I thought I might be hearing things when she softly said, “I know in the past I have not been all for an un-medicated cycle, but I really feel like a natural cycle would be best for you now.”  Wow! What? I hadn’t even mentioned the thought of an all natural cycle to her in months upon months. My hubby and I both assumed she would hand us the same old calendar with the same old BC, Lupron, E2, and progesterone on it, but thankfully we were wrong; we didn’t even have to initiate the discussion of what we wanted.

Of course we asked her why she felt this way now.  She explained that based on how we have been tracking my lining it seems the best idea. My lining gets thinner on estrogen–the exact opposite of what it is supposed to do when on it during a cycle.  We have checked it for 3 consecutive months now, and it has been thick enough to be considered ideal.  When on estrogen, and we are talking aggressive amounts, it is thinner.  Plus, she agreed it can feed growth of masses and with our history it doesn’t seem like a good idea to chance it.  I cannot begin to tell you how elated we were to hear all of this. 

She went on to say that we are not the typical patients, and that what works for the majority isn’t working well for us.  In addition, she provided literature on new studies that are showing all natural FET’s are quite successful, especially for a patient who has already been pregnant off IVF each time they transferred (ME!).

We talked about transferring 1 embryo versus 2 and all agreed on 1 as the best bet at this point.  We conferred about who would do the monitoring ultrasounds should we choose to move forward, another important factor for us.  We would only be getting them done by the RE herself-no nurses. At the other RE’s clinic, the nurses would be doing them for us, not the RE. I should note that it’s not like we don’t trust the nurses at these clinics…we just feel that having the person who will be transferring that embryo looking at my uterus each time is better.  We did have a slight problem arise in the past that has influenced this way of thinking.  

Another topic of discussion was in what case a natural cycle could get cancelled. The great part about this awful thing (cancellation of a cycle) is that when it is natural, no meds have been wasted or much money spent at all.  Plus, the overall cost of an un-medicated cycle is much cheaper to begin with anyways (about half the cost of a medicated FET).

We sat down to look at calendars next.  We didn’t get the generic calendar handed to us that we have in the past.  Instead, we sat down with 3 blank calendars, August-October, in front of all of us. 

  
At the other RE’s we did not look at calendar’s, it was verbal, and I tried to input as much as I could into my cell phone as they told me dates.  Anyways, we compared doing a September transfer versus an October.  An October transfer was the only option at the other RE if we wanted him to do it, not any of his partners (the 6 partners rotate transfers and his week isn’t until October again).  We decided that September would be too soon for us, especially getting another H/S done beforehand.  This being said, regardless of clinic, October will be our month.  Yes, you heard me right, we will be transferring our future baby in October!

It could have only been God watching over us today.  As we sat and went through the dates and times for things, everything was falling into place.  I will barely miss any time off, and not by my doing; it just happened that way.  We do not have a “set date” for a transfer, something we hated having in the past and would still have at the new RE’s if we want him to do it. 

Since we are un-medicated, we cannot nail down an exact day until we get much much closer.  My body is in charge this time, not the meds.  We do have an idea of the 2 week time frame the transfer will be in, but that is all for now.

As we left today, we felt total peace and a sense of joy, just what we prayed for! Most importantly, we feel confident in our current RE’s hands as we move forward.  In no way do we regret getting a second opinion at all–in fact it has helped us to feel the confidence we feel today.  

As you can see, we have made our decision to stay where we are at.  We welcome all the positive vibes from our wonderful friends and family about our decision! We are so excited for what our future has in store– Jeremiah 29:11

Always Room for Improvement

Right off the bat, I should say that I know no person is perfect, and no IF clinic is perfect either. Perfection should never be the expectation. However, in any profession, if you aren’t reflecting and trying to improve or do better, that could be a problem. Experience only makes you wiser if you learn from it and apply it to future situations. I know this from being a teacher the past 5 years.

This being said, we have made a list of things we think could be improved upon at our current clinic, or any clinic for that matter.  Here is what we have so far:

1. The most advanced uterine tests should be performed on all patients before IVF. This means a Hysteroscopy should be done on every patient prior to IVF.  You heard me right.  That is our opinion after the hell we have gone through. We are proof in the pudding that an SIS and HSG aren’t always enough.  If we had done this procedure from the start, there would be no questions in our minds or our RE’s if that fibroid had truly been around for all 3 losses or not.  
2. PGD should be offered to all patients before they begin IVF.  Looking back, we were never informed of this option & I wish we had been. We cannot do PGD testing now with our remaining frozen embryos, as it can only be done in the days following the retrieval.  We never knew about this option until we miscarried and started searching the web. Suddenly, we started seeing all of these women who did PGD before transferring.  I mentioned it to my doctor at that point, and found out it was too late to genetically test our embryos.  Since we looked good on paper (under 35, appropriate weight, etc), perhaps it was assumed we would succeed & not need this expensive option added on. If we were to miscarry again, I do not know if I could go through another transfer. Instead we have discussed a surrogate. How much more confident we would feel knowing we were transferring a genetically normal embryo into a surrogate than not! While I get that PGD is not 100% accurate, it should be offered to the patients if it is a service the clinic provides.
3. RE’s should discuss the worst case scenarios upfront with their patients before they begin IVF.  When we began IVF, we were so set on it actually “working” that we didn’t think of anything before that point or after that point. We didn’t discuss that only embryos making it to day 5 or 6 would be kept.  We never talked about the chances of chemical pregnancies, miscarriage, or RPL.  We had no idea we would go through the torture of beta testing and what would need to happen with all that if we ended up pregnant.
4. The RN’s should not do all of the ultrasound monitoring during an IVF cycle.  This is probably common at most clinics simply due to the amount of patients undergoing treatment.  It was never an issue to us before we miscarried either as we do trust our RN.  However, our nurse ended up missing something early on in one of our cycles that our RE probably wouldn’t have if she had been the one doing the ultrasounds to begin with. Moving forward, we have told our RE we will not be monitored by anyone other than her and she has agreed this is best.  If our RE would like to have the nurse with her for another set of eyes, great! Bottom line…I want the person who will be transferring those embryos into my uterus monitoring it before hand. No exceptions.
5. All viable embryos should be considered for transfer.  At our clinic, only embryos that make it to day 5 or 6 are transferred.  On the day of the retrieval you are handed a piece of paper that says “be here on day 6 at _____ am for embryo transfer.”  I know several women who have had successful day 3 or 4 transfers, so I do not think it is fair to limit to just a day 5 or 6 transfer. Thankfully, our 8 embryos made it to day 6, but what if they hadn’t?
6. After retrieval, the embryologist should provide daily updates on how the embryos are doing.  I never once talked to the embryologist for an update. I received a voicemail the day after retrieval with a brief summary, but that was it. Those days after the retrieval are sooo stressful as it is, and remember we had to wait until day 6 not knowing anything. In my opinion, not knowing anything until you show up for the transfer is adding a lot of unnecessary stress to the situation.
7. Get input from the patient about their IVF treatment plan.  Sit down and show patients all of the different “protocols” available for an IVF cycle. Short, mini-stim, antagonist, un-medicated, etc. Tell them the success rates with each. Explain what type of patients you have seen do well on each type of protocol.  Understand that this should not be a “one-size-fits-all” approach.  Ask them questions about their bodies, and act like they are educated. Through this process, I have learned that I know my body better than anyone. Just because Susie did well off all of the drugs you gave her, doesn’t mean I will. Show me what is available, whether it is your preferred method of treatment or not.
8. Clinics should disclose what will happen if you do get a positive beta post IVF.  We never talked about the cost to continue a pregnancy if we achieved one.  We had no clue we would be spending thousands more on medications after the actual IVF cycle itself ended.  Medications are only paid for up until the beta test in case you get a negative.  If you get a positive, you will need meds for 6 more weeks, at least.  That adds up to thousands more.
9. Designate clear roles within the practice.  Since it is so easy to communicate with everyone at the practice (listed as a perk yesterday!), you never know exactly who to talk to about things. For example, we have had prescriptions not called in, called in twice by different staff members, etc. It would be great if each person had a clearly designated role or each patient had a clearly designated go to person.
10. Wellness services should be provided at clinics. Everyone goes into treatment hoping it will work the first time.  But, that is not always the case.  Actually, majority of the time it is not the case.  After all of the emotional and physical trauma, we wished that our clinic offered things like acupuncture, counseling, etc.  Don’t get me wrong, when asked, they provide recommendations, but we have ended up finding our own specialists in these areas.  It would be great if clinics started including these in their treatment packages.

Hind sight is always 20/20. But we hope this list is helpful to those searching for a clinic to call home!

Waiting Game

Getting the balloon out of my uterus on Tuesday may have been one of the most physically relieving moments I can ever remember.  The removal was painless, along with the quick ultrasound making sure all looked as it should after the evil balloon went bye-bye.  

Thankfully, I only have 3 days left of my antibiotic remaining, I no longer need any pain pills, I am back to work, and happy to report that the bleeding has almost completely subsided.  I really do feel like a new woman!

We can finally say that I have done both the diagnostic hysteroscopy and the operative hysteroscopy.  Another check off the list.  To recap, after our 3rd pregnancy loss, the diagnostic hysteroscopy discovered the uterine mass, and the operative hysteroscopy removed it. The plan is now to go back in and perform another diagnostic hysteroscopy after my next period (still on the pill!) later this month. The purpose of this will be to make sure the mass was truly removed and has stayed gone.

Even though we know the surgery itself went well, we are still awaiting the pathology results of the actual mass. Speaking of waiting, it seems like we will be doing a lot more of it now. Like we haven’t done enough already.  At my post-op my RE told me she wants my uterus to have “time to heal.”  I know what many of you are thinking…this is a good thing! She should want to take time for it to heal! I get it.  Most RE’s tend to push the next cycle on the patient like what are you waiting for? Let’s do this! I’ll take your money! Not the case.  The patting on my shoulder as she quietly spoke meant 1 thing…she doesn’t want to do another FET for a while.

I came right out and asked her,  “How long?” Not an easy answer.  After the upcoming diagnostic hysteroscopy later this month, if all goes as planned, I will go off the pill.  I will then go in for a lining check in June, and at least July.  Maybe August. This will give us an idea of how my uterus is healing after all of the trauma it has endured the past year or so.  After that, we can decide on the next plan of action.  I know I will need another diagnostic hysteroscopy around August (about 3 months post surgery) to make sure the mass stayed gone. If it hasn’t, I don’t know what we will do, because I don’t think I can (or should I say I wont) undergo another operation like I just did. 

You might be wondering why the mass would be likely to come back. My diagnosis of Adenomyosis can never fully be cured unless I got a hysterectomy. Having Adenomyosis means I can be prone to adenomyomas, or masses.  However, many patients with Adenomyosis do not have adenomyomas.  

If I am mass free, and my uterus is healing okay, I still really don’t want anything to do with another August transfer anyways. We did an August FET last year, and miscarried for the 2nd time.  I do not want to relive all of the same dates again with a new transfer.  It still hurts too much.

And September will be 9 months from our last transfer, when baby Isaiah, & his brother or sister would have arrived.  So, for that reason, I am not sure how I feel about a September transfer either.  Shane seems to think we could take either of those dates that hurt so much and turn them into positives. I am not there yet with my thinking.

Now that some of the dust is starting to settle, I guess the harsh reality is starting to sink in.  That reality is just how much time will have passed before we can even consider becoming pregnant again. And the truth is more sacred dates will continue to silently come & go.  

Hopefully, we pray, we will be able to bring home our baby sometime in mid 2016.  But of course even as much as we try to stay positive, doubt creeps in, & we cant help but wonder if it will ever really be our time.   

Finding the Rainbow After a Storm

Today was our post-op appointment after the hysteroscopy done last week.

The pathology results from the biopsy came back with 2 findings: 1.) chronic inflammation, & 2). placental plaque, or tissues.

The chronic inflammation is probably due to all of the zillion procedures that have been done.  The placental plaque or tissue, on the other hand, was not what we were expecting. Somehow, someway, there is still placenta left in my uterus from a pregnancy. Don’t ask me how.  In fact, it was not even able to be seen on the hysteroscopy, it was only detected through the biopsy.  If something “rare” were to happen, you already knew it would.

So, the plan is to remove, or try to remove this “invisible” placenta when we try to remove the Adenomyoma in a few weeks. Removing the Adenomyoma will go something like this: Under general anesthesia, the doctor will once again enter my uterus with a camera through the cervix, locate the mass, and “shave” it down with a special tool, that she called a “wand” at one point. A wand! Ha! Like this is a fairy tale or something.

After she shaves the mass down enough to where it appears flush with my uterine wall, she will inject Vasopressin into my uterus to make it contract.  The Vasopressin will force any “hidden” Adenomyoma to seep out.  Sounds disgusting, I know.  I guess entire Adenomyomas are not always fully visible, which brings us to the next point.  Our doctor said, and I quote, “there is a chance I may not be able to safely remove the entire Adenomyoma” or that “the cavity will appear normalized at the time of the surgery, but there will be residual tissue left that can grow back.”

She will take get out as much as she can safely, without damaging my uterus, and send it out to pathology to confirm that it was indeed an Adenomyoma.  She will also insert a balloon in the place where the mass previously was (in order to prevent scar tissue from forming). The balloon will stay in my uterus for about a week as it heals (maybe I’ll fly away). Of course, she said I won’t even feel it, but I doubt she ever walked around with a balloon in her va-jay-jay.

About a month after all this jazz (in June sometime), we will have to do another diagnostic hysteroscopy/biopsy, just like the one last week.  This will confirm that the Adenomyoma is fully gone, along with the placental tissue.  It’s hard for me to think about not being able to fully remove it.  I guess because we know it has to come out entirely, or we cant even consider getting pregnant.  And even if it is fully removed, there is always the chance another one will grow back.  And there is not timeline as to when, or how quickly.  This is very frustrating to say the least, especially since there is a pretty good chance this caused us to miscarry the last time.  You know I don’t believe in percentages, but if I had to give you one on whether this mass caused the loss or not, I’d say I’m 90% sure it did.

The doctor thinks that this Adenomyoma has probably been festering for a little while now (at least before the last transfer). In fact, the “fluid” that popped up back in December, that almost cancelled our transfer, we can most likely thank Mr. Adenomyoma for.  Fluid can be related  to many things, among them, less commonly, an Adenomyoma. Of course there was no way in knowing this was the relationship then-I saw every single ultrasound, SIS, and HSG with my own eyes, and this mass was not visible. So how can we not help but ask why, God? Back in December, we prayed and prayed for that transfer to be cancelled if it wasn’t right.  Maybe we didn’t see the signs.  I don’t know.  I’m not sure if we will ever know.  But, we can’t keep looking back, we can only look forward and hope.  Looking back hurts.  And getting angry doesn’t help either.  I know God never wastes a hurt.  My mom reminds me of this frequently.  If we can help one person, or couple out there, then at least some good can come out of this loss.

We received this card not too long ago, when we least expected it, from someone we do not know on a close basis at all.  It made me cry.  Tonight, when nothing seems to make sense, this card makes me remember how God is using us through this journey to touch other people’s lives.  Knowing that makes me feel better about “why.”  

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!!

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.

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.

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!