Monday, June 14, 2021

IVF Cycle 3 Wrapup

Since Richard works nights, I cook dinner around 4:00 during his workweek. This afternoon shortly after 4:00, the phone rang with a call from our fertility clinic. I guess I was distracted by the couscous I was boiling because my brain tripped up and declined the call. When I tried to call back, I got the answering service, which only forwards after-hours calls that are medical emergencies.

I waited a few minutes for a voicemail to appear, then I sent my doctor a text to see if he'd tried to call me. He replied, "Calling you in a sec," which commenced the longest four minutes I have experienced in a while. Somehow, I just knew it was bad news. It felt as if the bottom of my stomach had fallen out. Then, I reminded myself that our embryo was beautiful, so the news was probably good.

Finally, my phone rang.

"Hello?"

"It's another high mosaic."

I was right the first time.

I talked with my doctor for a few minutes about how having two in the freezer is actually pretty good. I told him it doesn't feel good at all, which he said he understood, but we've ultimately had relatively good results for my dismal (my word, not his) AMH level. We discussed the possibility of trying a few IUI cycles before attempting an embryo transfer, and I said I'd talk with Richard about it and let him know. Richard and I will most likely go ahead and try IUI, and we go for a scan first thing tomorrow.

I have a few people (mostly close friends and family) that I try to update about our progress before I post on social media. I can usually come up with a silver lining or at least something to say before I drop the bad news bomb, but I couldn't do it today. I'm over it. So, everyone got a variation of this message, the main variation being inclusion or exclusion of an expletive about the hole I want to crawl into.


There just aren't words to describe how much this hurts or how unfair it is. I am furious, sad, and numb. I feel a little bit like the vase of flowers from last week that's still sitting on our kitchen table. Some of the flowers have started to wilt, but I'm letting them stay anyway. Sometimes in life, we have to sit with the less beautiful aspects for a little while, even if that means our life doesn't look like we want it to. When we're ready, we can replace the old or unpleasant bits with new experiences, just as we can replenish a vase with fresh flowers. 

Continuing last week's theme of feeling the feelings, I'm giving myself permission to feel all of the feelings. This time, that includes taking a step away from social media and most likely blogging. I need time to deal with the ugly stuff. I'll be okay--I always am--but I need some space to process. Please continue to remember Richard and me in your thoughts and/or prayers.


Something that made today great: I'm making good progress toward starting my dissertation--including progress made over donuts and coffee with Tori today.
Time I woke up: 8:15 am

Tuesday, June 8, 2021

IVF Cycle 3 / CD 32 / 7 Days After Retrieval

Six days after the egg retrieval, the embryology lab calls to give an update of how many of our embryos made it to the blastocyst stage. The statistics tell us that 30-50 percent of fertilized eggs make it to this point, and I always do the calculations to project our next outcome as soon as I hear a new number. With 6 fertilized eggs, we'd expect 1.8 to 3, so 2 to 3. From there, fewer than 50 percent of embryos are found to be normal/euploid.

In our first two cycles, we fell where expected with the number of blastocysts we could test. Our first cycle had one out of four (25%) fertilized eggs make it to blastocyst, and our second cycle had three out of seven (43%). Based on our history, I never doubted that we would have at least two to test from the third cycle, which would hopefully give us one more normal one in the freezer. Then, we could start preparing for our first transfer.

Instead, I was caught completely off guard when the embryologist called yesterday morning and said we had one ~beautiful~ embryo that was sent off for testing. She was so excited about how beautiful the embryo was, which is not something I had heard in our first two cycles. All I could think about was the next calculation--fewer than 50 percent--and what that meant for our one embryo. Then I thought about the last time we had only one embryo and how that turned out: one highly aneuploid.

I said before the retrieval that hope was what we were left to do when we have done everything else. After the retrieval, I talked about how releasing control (relaxing) also releases anxiousness. I will at least acknowledge that hoping and relaxing helped me with the waiting period between our fertilization and blastocyst updates. Part of the point of shifting my focus to hoping and relaxing was that we had done what we could do and could no longer change the outcome, but I guess I lost sight of that somewhere. I let myself believe that hoping and relaxing control would bring the best possible outcome when what I needed instead was a reminder that anything that happened would not make our results better or worse.

I have struggled with the news since I first heard it. When we had one blastocyst in our first cycle, I hoped so hard that it would come back normal, and instead, it was mostly abnormal. I know that every cycle is different--I tell myself that all the time--but I am so afraid of the same outcome. There is nothing I can do to change the test results, so I just have to wait, hope, and try to relax. The sample should have been shipped off today, and we expect to hear something in 7-10 business days. Right now, that feels like a long time.

I'm in an ugly cycle of feelings as I continue to process another cycle with one blastocyst. I try to be grateful and remember that there are families who have no blastocysts, no fertilized eggs, or even no eggs retrieved at all. The fact that we have made it to the blastocyst stage each cycle puts us ahead of many people who struggle with infertility. There are families who only get one shot at IVF because of the financial burden, and others never attempt IVF because they would have to sacrifice too much to afford it. Our savings and student loan repayments have taken a hit, but we are okay. 

At the same time, I find myself helplessly frustrated and angry about how unfair this all is. When I started seeing my therapist in early 2020, she introduced me to the idea that infertility is a version of grief. Every month, I was grieving what I thought my life and family would look like. I started seeing a therapist after we'd been trying for nearly two years, and Richard and I were both worn out with the monthly routine of being brought down by crying spells. It was exhausting for me because I was going through it and for Richard because he couldn't do anything to fix it.

We started trying to conceive when I was 29 years old. If someone had told me that I would be sitting in my house with my 33rd birthday approaching, and there would be no nursery or child's bedroom because there would be no baby or child, I don't think I would have believed them. The upper limit for when I expected to have a child was 31; 33 and never been pregnant was nowhere on the radar. June is a particularly challenging month with infertility grief because it's the month of our wedding anniversary and my birthday. Something about wrapping up another year of marriage and life without "solving" the infertility problem is discouraging. I feel the same way in December when the holidays are upon us and we wrap up another calendar year still hoping and waiting. It doesn't stop there, though; March and September give me similar feelings as I put pressure on myself because, "If I'm not pregnant this month, I won't be pregnant before my birthday/this year." 

Ugh.

I'm trying to give myself some grace and permission to feel all of the feelings that emerge in this process. After all, that's the kind of advice I give to other people when they're going through anything difficult. I often tell people I'm there if they need to talk, scream, yell, or cry, but I'm not the best at taking my own advice. I'm working on that too and am so appreciative of the friends and people who remind me that it's okay to own my feelings.

My little letter board reminds me that we have one more update to come, and the news could always be good. It's entirely possible that we will find out we have another euploid blastocyst. After all, our embryo is beautiful! However, I can't help but wonder what happened to our other five and how we were dealt this unpleasant hand. Earlier today, I expressed to Richard how outraged I was that we only had one blastocyst when the numbers predicted two or three, and Richard reminded me that we were only off by one. I try to be gracious when he is right or brings up a valid point, but that one stung. 

My goal is to stay hopeful about the future, thankful for what we have, and distracted from wondering what our next result will be. Easier said than done, but I am trying!


Something that made today great: Taco Tuesday at Blue Corn...yum!
Time I woke up: 9:30 am

Thursday, June 3, 2021

IVF Cycle 3 / CD 28 / 2 Days After Retrieval

The second devotion in the Hope Strong book I wrote about on Monday night is called, “Anxious: Just Relax.” In my devotional-reading frenzy on Sunday, I marked a quote that stood out to me: "Releasing control (aka relaxing) releases anxiousness." I'll be the first to admit that I like to exercise a significant amount of control over my life and its course. 

Spoiler alert: infertility is really horrible for controlling your family planning, and it wreaks havoc on other aspects of your life with its appointments, injections, and procedures.

I wouldn't consider myself on the extreme end of tightly wound or high strung, and I often identify adaptability and flexibility as personal strengths in interview settings. Still, I like to be in control while I'm going with the flow...if that's possible. What was most notable to me about this quote was that it defined "relaxing" as "releasing control." When I think of relaxation, I frame it as binge-watching a TV show and eating ice cream on my couch or going on vacation somewhere and not focusing on work, school, or other stressors. That's different from releasing control.

“Just relax” is among the magical baby-making advice I have received from well-meaning people, and I sort of resent hearing it. In concert with the idea of reserving hope for when you've done everything else, though, relaxing by releasing control makes a lot of sense. Accordingly, I have been working on releasing control this week.

At the egg retrieval on Tuesday, we retrieved seven eggs. After the procedure, I slept and stayed in my pajamas most of the day other than when we took Scooter for a walk. Richard and I ordered dinner from Olive or Twist, and the poutine was particularly delicious. I am proud to report that I didn't fret even a little bit about what was going to happen with the eggs (though I did hope that all seven would be mature and fertilize). I slept with my phone on silent and missed the call from the embryologist giving our fertilization report, which is unlike me. Fortunately, she left a voicemail to let me know that six of our seven eggs were mature, and all six fertilized with ICSI. Yay!


Following that bit of happy news, I allowed my relaxation to extend through Wednesday. I could be worrying about how many of our fertilized eggs will make it to the blastocyst stage, but so far I have avoided that. I know what the statistics predict--30 to 50 percent, so 2 or 3 out of 6--and always hope to outperform the expectations. However, I'm at the point where I have to release control and hope for the best, so that is what I am doing.

I was back in business today, including starting the day with a run around the LSU lakes with a friend from Slow Mode Running Club. After a shower and some breakfast, I went to campus in the late morning and stayed until 4:30 doing some reading and planning for my practicum course that I'm doing this month. I'm still waiting on some data, but I'm excited about the progress I have made.

In IVF news, our next update will come on Monday when we find out how many made it through day 5 to the blastocyst stage. I have graduated from the "Every cycle is different" mantra to these cycle-specific mantras in the meantime: "Grow and divide--make it to day 5!" and "6 has some mighty tricks (mainly turning into maybe babies)." Also, calling blastocysts "maybe babies" is one part of IVF that makes me smile.

Overall, I would say I am doing well. Richard and I were pleased with the results of the retrieval and continue to hope for more good news. If we have a few (or maybe just one) euploid embryo from this cycle, I think it'll be time to talk with our RE about attempting a transfer, which is very exciting! But first, we will hope, relax, and wait.

Something that made today great: I made good progress with my practicum research!

Time I woke up: 6:45 am