Struggles with Infertility

Being a parent is not something that everyone has as a goal in life. But once you decide that you want to be a parent, and you are unable to, your life can either unravel, or you can try to find meaning in your struggles. This blog is me trying to find meaning.

Sunday, September 25, 2011

IVF Shared Cycling - Part III

Our last appointment for the day was with our doctor and nurse. They met with us separately and the whole process took about two hours.

Our original and agreed upon plan was to split whatever we got 50/50, or biased in our favour if we ended up with an odd number of eggs. What we didn't realize is that there are three different types of eggs you can pull from a follicle: mature, borderline and immature. I think I mentioned these earlier, and perhaps mentioned that about 70% of mature eggs fertilize, 40% of borderline eggs fertilize, and immature eggs are destroyed. Let's just think about the mature eggs because those are really the only ones that count. Of those 70% that fertilize, about 70% of those make it to a good quality embryo on day 3. So if you start with six eggs, you end up with three or four high quality embryos, of which you would transfer two and freeze whatever is left. Around 70% make it through the freeze thaw cycle, so there is a chance you can lose these ones too.

The doc thinks I will probably produce six to eight mature eggs, and a number of borderline eggs. If this was not a shared cycle, we'd have plenty to go around. But it is shared, so we had to decide who gets all the good ones.

The point the doctor made was that if I get pregnant with this cycle, Lara has to wait upwards of two years before I can cycle again (after I have the baby and breastfeed), while I only have to wait two months. Thinking of it that way, the doctor suggested that Lara be the primary, and therefore, she gets all the best eggs first. The number she threw out there is six mature eggs. Lara and Roland get six of however many mature eggs I produce, and we get the rest, giving them the best chance at a successful pregnancy. So, if I produce eight mature and four immature, we end up with two mature, and four immature after they take their guaranteed portion.

Over the last few days Derek and I have discussed this, and I've done some soul searching, and I think this is the right thing to do. I think I am ok with waiting a few extra months if I need to, whereas Lara told me that they'd pursue other options if they can't use me. I'd like to give them the best shot at using Lara's genetic material first.

So, we just have to figure out the details, put it down on paper, have it witnessed, and send it to the clinic. Getting it on paper prevents two very hormonal women (remember all the medication we're on!) from getting in to a fist fight after egg retrieval if anyone should change her mind (and I'd totally win, by the way).

Just to wrap up, Lara got her prescriptions for her mock cycles (she has to do two) and starts October 4th when her and Roland get back from Jamaica (lucky jerks!). She'll be on Estrace (estrogen) and Prometrium (progesterone) to simulate a normal cycle. She has an ultrasound on day 13 to check her lining and make sure she's responding properly. Once her two cycles are done, we can move forward with the IVF(s). Based on her schedule and the fact that the clinic closes for Christmas, we're now looking at January for cycling rather then December.

So that's the whole situation. People keep telling me that I have so much patience with this, but really, what else can I do at this point but keep waiting?

Saturday, September 24, 2011

IVF Shared Cycling - Part II

Day two. First appointment of the day is the psychology appointment. The purpose of this appointment is to help them ensure we are all on side with this whole process. The appointment itself took about 30 minutes and the psychologist seemed really interested in our situation. The Calgary Regional Fertility Clinic has free services for everyone going through the program, which is a huge benefit that I'll be taking advantage of.

Following the evaluation, the guys had to do their analysis. Derek is an old pro at the deposit in a cup game, so was giving Roland a very colourful commentary on what to expect. It seems like situations like this call for a little humour, and Derek is gifted with this skill, so although it was an uncomfortable situation, it really wasn't that bad, especially since the guys didn't end up in rooms next to each other. Luckily for Derek, we were able to get in early - before I had to go to my ultrasound - and I could go in with him. Yes, the ladies can go in to help. Considering all these poor guys have in there is a slim selection of magazines (Big n' Busty, Barely Legal, etc.), and the porn on the TV really isn't that great (the TV was broken anyhow), having the wife in there can really help move things along. Just make sure you don't contaminate the sample with saliva ladies - that's right, no actual BJ's (or sex!). Use your imagination.

Once we were done there, I had my ultrasound. We sent the guys downstairs for coffee and Lara waited with me. The purpose of the ultrasound was to take a look at my antral follicle count. AFC is a way for specialists to get an idea of what my ovarian reserve is (how many eggs I have left). Apparently, I'm perfect (I already knew that), and have nine on the left and 14 on the right. The total number of antral follicles can correspond with expected response and IVF success rates. 23 falls right in the middle of the 'good' count, and I 'should have an excellent response to ovarian stimulation'. This is really good news, and sort of puts me at ease about everything just a little bit.

Next was our mid-day break before our final meeting with the doctor and nurse to go over our game plan. Unfortunately, our original plan was pretty much vetoed by the doctor and now we have some very tough decisions to make. But, more on that later. I have a horrible cold today, was up late last night, and need to get to the lab for my CD3 blood work. Also, the homework I've been putting off while Lara and Roland were here. Good times!

Friday, September 23, 2011

IVF Shared Cycling with my sister - Part I

This past Wednesday and Thursday, my sister Lara and I, along with our husbands, Roland and Derek, attended a number of seminars and appointments as part of our upcoming IVF shared cycles. If I haven't already explained, Lara also has IF, though hers is due to cancer treatments as a teenager (she had Hodgkin's Disease a couple of times). Over the last year, we've decided to go ahead with a shared cycle, where I donate some of my eggs to her at the same time we're doing our IVF. Our original sharing plan was kaiboshed by the fertility doctor, but more on that later (I'll probably break this all down in multiple posts over the next couple of days).

First, the seminar. We are going through the Calgary Regional Fertility Clinic, and it is required that all parties attend a 2 to 2.5 hour seminar that reviews what IVF is, what being a donor consists of, and all the risks, etc. We arrive a few minutes before 7 pm after me stressing out about being late (I really hate being late for anything, especially stuff like this). There are about eight groups in the room, and everyone was a donor group (one woman is donating, the other is the recipient). The thing is, Lara and I are a really unique situation. Apparently, we are the third group to come through the clinic since 1984 with a situation like this - where the egg donor is also doing her own IVF.

Our doctor, Dr. Scott, lead the presentation, and our nurse, Kathy, as also on hand to answer questions and speak to us a bit about what to expect. Dr. Scott is my type of doctor - straight forward and to the point, with out a bunch of BS. The Calgary Regional Fertility Clinic has a relatively high success rate (it's all published) and she was able to give us some numbers: on average, IVF retrievals result in 12 to 14 eggs (mature and borderline). They are, on average, able to retrieve 70% of the eggs from the follicles, and of those, 70% fertilize. The live birth rate is about 50% per IVF cycle. These are pretty good odds considering our chance of conceiving naturally each month is between 1% and 3% (and Lara's chances are 0%). The rest of the presentation reviewed the actual process (they use the long lupron protocol, if you are familiar - I'll explain my protocol in a later post), the mock cycles Lara will be doing, and the egg retrieval process.

Ok, now my complaint. Since this was a donor clinic as well as an IVF, you'd expect that the donors probably already have kids of their own - proof their eggs are good. This I understand. What I don't understand is why you'd bring your three year old to the seminar. A seminar where at least half the people in the room are infertile and probably sensitive to these things. A seminar that lasts at least two hours and starts at 7 at night. Even this infertile understands that kids get cranky, and a three year old will have a very hard time sitting still and quiet for two hours. I could not believe it, and I think most of the rest of the people there couldn't either. After about a half an hour of the doctor trying to talk over the kids babbles, she finally asked them to take her out of the room. Go Dr. Scott! And then, one of the women in the group had to fumble in her purse because her cell phone kept ringing. I don't know...for me, this is one of the most important things I'll do in my life, and my attention was undivided. Apparently they felt differently.

Tomorrow I'll post about the guys having to do their semen analysis at the same time and the weird conversations on the drive there. Ever share masturbation tips and tricks? T'was an interesting conversation.

Wednesday, September 14, 2011

Hysteroscopy, Partial D&C and Endometrial Biopsy Party!

A few months ago I had a sonohysterogram and they saw 'something' that looked like it might be a false passage. A false passage in the uterus is just scar tissue or similar tissue that is in a place where the catheter (for IUI or IVF) might get drawn in to. If that were to happen during an IVF, for instance, the embryo would have nothing to latch on to (no endometrial lining) and the procedure would fail. So, my doctor ordered a hysteroscopy to check things out.

A hysteroscopy is a procedure where the doctor dilates the cervix, inserts saline or gas, and then shoves a camera with a light on it to check out the innards. I really should have asked for a picture - I would love to frame that and put it on the fireplace! "What's this, um, picture of?" "Oh, that's my ute! I was 6 DPO here!"

Anyway, the hysteroscopy was done to check out this possible false passage, and in addition to this, she was doing a partial D&C and endometrial biopsy. I requested the biopsy to check for infection or other anomalies in my lining. Those kinds of issues can cause miscarriage, and since I've had two uterine miscarriages, I figured she may as well take a sample while she was in there.

Why do they keep hospitals so damn cold? Once I had undressed, redressed in a bleach-smelling gown and robe, and snuggled under my paper thin blanket, I was frozen. Luckily, anxiety warms me up a bit. Also, I stupidly brought my University text books so I could do some homework. Ha, I'm so idealistic. Yeah, none of that got done.

They gave me an OxyCodone about 45 minutes before the procedure and I was walked in to the room a few minutes early. I jumped up on the bed and the room started stirring in activity. Nurses, doctors, the anesthesiologist, and the kitchen sink crowded in to the room. Multiple things are happening and I'm just trying to keep my composure. Everyone was so nice and made sure I was comfortable and aware of what was happening. The anesthesiologist put in my IV and they strapped my arms down on the boards. Unfortunately, the decision was made that I would be doing this under IV sedation, so I was awake and responsive. Faster recovery and less risk, so I get it.

My legs went in to the cadillac of stirrups (all nice and padded all the way up the calf) and the medication was taking effect. The room was swirling but I could hear and see what was happening. Speculum went in and they started what felt like a sand blasting of the interior of my uterus. The bad part about IV sedation is that even though you're stoned and relatively happy, you still feel everything. So, I felt the D&C and it sucked. I knew what was happening and was in a lot of pain, and I started crying. I felt bad for the anesthesiologist because he could only put his hand on my head and wipe away the tears.

Once they finished the D&C / biopsy, they did the hysteroscopy. They had an issue with getting the saline through the catheter because apparently my uterus is bent over and snugged right up to my lower abdomen, so I practically have a 90 degree bend in my cervix. The saline bag was right by my head and the nurse was squeezing it so hard I thought it would pop. I remember at that point asking her if I was supposed to be awake and in pain and I think she ignored me. Either that or I only thought I was talking out loud.

The hysteroscopy was easy in comparison and done in about five minutes. They put my legs down, unstrapped my arms, took the IV out, and rolled me in to recovery. I only had to stay an hour before I was able to go home.

I had some pretty bad cramps right after, but within a couple of hours they went away and now I just feel tired and my ute feels full. My awesome MIL arrived just as I came out of surgery to take me home. She even stopped at a Tim Hortons to get me a tea, and stuck around for the afternoon to make sure I was good. Thank you!

Results: It's not a false passage (yay!) and I have the green light for IVF (double yay!). Next up, IVF/Donor seminar next Wednesday and Thursday. I can't wait to see my sister and brother in law! Also, bring warm fuzzy socks to the hospital next time.

Oh, also, it's my birthday tomorrow, so happy birthday to me!

Thursday, September 1, 2011

Stupid Fertiles

When you are infertile, especially when it’s been years since you’ve started trying to conceive, you forgot what it was like in the beginning and start to feel resentment and even anger at these damn fertiles. With the wonderful world of ‘The Internet’ at our fingertips, and the even more awesome advent of forums and message boards, us infertiles have the pleasure of reading the accounts of those stupid (often ill-informed) fertiles with relative disdain.

1.)    “OMG, we’ve been trying for four months and nothing has happened! I’ve been temping and using OPK’s and we have perfect intercourse timing and, OMG, I’m still not pregnant! I’m so saaaaaaad. What is wrong with me?”

What’s wrong with you? Probably nothing. It’s been FOUR MONTHS. For crying out loud, a normal, healthy couple, where the woman is under 35, can take up to a year to conceive. A year! Calm down, you still have eight months to go before you need to start getting concerned.

2)    “There are two lines on this test, right? So I’m pregnant? Uh, what do I do now?”

Are you f*cking kidding me? Did you not think past the end of your nose when you decided to try to have a child? Yes, these are the people that are bringing children in to the world while I sit here with a uterus as empty as Pamela Anderson’s head.

3)    “I’m trying for my seventh child and swinging for a girl! I really hope we don’t get a boy this time.”

Lucky you, getting a whole passel of kids. What are you going to do if you don’t get the sex of your choice? Hey, I’ll take it! I just want one, and I don’t care what the sex is, as long as it’s healthy!

4)    “I’m seven weeks post partum and I just got a positive pregnancy test! My beta is too high for it to be residual HCG, so this is a new pregnancy. My OB/GYN told me to hold off on having sex for a few months, but I did it anyway. Oops!”

Haaaaaaahahahahahaha! Oops is right you stupid knocked up bag o’ flesh!  Have fun with that!

5)    “Yay! I just got my positive pregnancy test! Here’s what I did differently this month: Soy from CD 3 – 10, Vitex, B12, Prenatal, Acupuncture, Yoga, progesterone cream, OPK’s, sex every second day until O and then twice a day for four days, elevated my hips, and used Pre-Seed every time.”

I’m pretty sure the fact that you’re 28 and this is your third month of trying to get pregnant is the reason that you got knocked up, not any of that other stuff.

6)    “Hey infertile! I’ve been TTC for seven months now, so even though you’ve been TTC for 42 months and have undergone multiple treatments and tests and procedures, and have been researching for years, I know more then you, so stop trying to correct me when I say you can use an OPK as a pregnancy test.”

Ok, keep using an OPK as a pregnancy test, and when you by chance get a positive pregnancy test after a positive OPK a few months from now, come and brag about how you’re right and then look up ‘confirmation bias’.

Sometimes I feel like I just need to log off to avoid the rage I feel at some of these idiots. I mean, I’m sure I was there once (well, not quite, I did have a basic understanding of biology, that’s for sure), but once we decided we were ready for a family, I did my research. Being prepared is a good thing, so is knowing what you’re in for. Having a child isn’t something that should be taken lightly – it’s a new life, one you are in charge of for at least 18 years. Take it seriously and don’t be a Stupid Fertile.