Sunday, November 28, 2021

IVF Cycle 4 - The Beginning

 It's almost been a month since I had the bloodwork appointment where I was a little pregnant. In most ways, the month has flown by--on top of my regular work and school routine, other things such as travel for conferences, the LSU/Arkansas football game, travel for fun, and Thanksgiving have kept me busy. What I haven't been doing is going to any of the races I signed up for in November. I've also decided I am done drinking alcohol for a while, which hasn't been a huge change in my day-to-day routine but has been surprising for some people in social situations. However, as many of my friends will attest, I love a good mocktail as much as I love a cocktail.

Despite staying busy, I haven't been quite able to shake the grief that's followed the chemical pregnancy from our first frozen embryo transfer. I know these things take time, and I also know that I'll never be exactly the same after experiencing this loss (and the [in]fertility journey more broadly). It seems like I get a little closer to normal every day, but some days are definitely tougher than others. As evidence that I can still smile and have fun, here are a few photos from The Office Experience that Brooke and I went to in Chicago. (If you're a fan of The Office and are going to be in Chicago between now and January 17, go check out the experience! We loved it.)

Brooke and me in Michael's office

Enjoying the Finer Things Club--I'm smiling under the mask

I was supposed to go back to the doctor on November 19 to prepare for our fourth IVF cycle, but when I looked forward in my calendar, I realized I was going to be out of town for the Association of Fraternity and Sorority Advisors Annual Meeting during the late stims/possible retrieval portion of the cycle. I want to attend the annual meeting for a number of reasons, including hopefully promoting my dissertation study, but I also didn't want to lose a month. Fortunately, when I realized this was going to be an issue, I called my nurse and got approval from my doctor to stay on the Nuvaring for an extra week. With everything pushed back a week, I went back for an ultrasound and bloodwork on November 26. Everything looked as expected, so we start Lupron injections tomorrow at 5 am. Full stims will start on Wednesday.  

I'm approaching this next cycle with a mix of emotions. Our doctor told us when we first started seeing him that we might not hit the right cycle (I forget his exact words) on the first try. The second cycle was the best by far (two euploid embryos as opposed to zero), and I'm hoping we will see similar (or better!) results from this time around. I remain grateful that this is something we are able to attempt multiple times, but I also can't help but wonder why Richard and I--or anyone else for that matter--would have to endure such a long and difficult road to (hopefully, but still not guaranteed) biological parenthood. I probably won't understand on this side of Heaven. We will continue doing everything we can and then hoping for the best. Please remember us as we embark on our fourth round of ovarian stimulation and (hopefully) egg retrieval. 

Something that made today great: Video chatting with Ashley, Emma, and [briefly] Brittany
Time I woke up: 11:45 am

Friday, November 12, 2021

FET Cycle 1 Wrapup

It's been two weeks since my last update, so I guess it's time for another one.

When I left off, I'd just gotten the news that my first beta result was 25, which was a gray area, or "a little pregnant." This was not the news we'd hoped for, and despite wanting to not stress out all weekend, I stressed out all weekend. On Friday night, I took a home pregnancy test for the experience of seeing what a "little pregnant" test looked like. Something just felt wrong all weekend. I met my friend Megan for late lunch/early dinner on Sunday afternoon, and I could barely eat. On Sunday night, I decided to try another test, and the second line on the test--the one that separates the "pregnant" from the "not pregnant"-- was all but gone. In two short days, our pregnancy faded away. The test from Sunday is still sitting on my bathroom counter with the second line barely there; it is simultaneously a reminder that I was once pregnant and a reminder that I'm not pregnant anymore. I probably need to throw it away.

After consulting with another friend who's had a failed transfer, I decided to message my nurse and ask if I could come in for bloodwork on Monday instead of Tuesday to save myself the waiting and the progesterone shots I would have needed if the pregnancy has been viable. This is probably a bit dramatic, but I felt like I was on a death march. My nurse responded early on Monday morning, and I went in at 9:00 for the bloodwork. 

The nurse called Monday afternoon to let us know that my HCG had dropped to 5, which is considered negative. She told me I could discontinue the medications I was on and wait for my period to start. Looking to the future, she said that before we attempted another transfer, my doctor wanted to do an Endometrial Receptivity Analysis, or ERA. There's more information on this website, but to put it simply, I will do a mock transfer cycle (complete with the meds and shots) but not actually transfer an embryo. Instead, they'll take a sample from my endometrium (uterine lining) to see if we actually timed the transfer correctly, if I need more days of progesterone, or if I need fewer days of progesterone. Looking at the calendar, that meant that another actual transfer before the end of the year was not in the cards.

For those keeping count at home, though, the other issue is our number of euploid (normal) embryos: we're down to one. Regardless of when we do the ERA, we knew we'd have to make a decision about whether to go for another retrieval or try to transfer the second embryo. This was something we wanted to discuss with our doctor, but we also wanted to take some time to process what had just happened and what was about to happen. We called back on Wednesday and scheduled a time to talk with our doctor on Friday.

Meanwhile, I had to decide whether I wanted to cancel my plans to attend the Association for the Study of Higher Education (ASHE) conference in San Juan, Puerto Rico. I wanted to go, but I was nervous about what would come next. Ultimately, Richard agreed to travel with me, so I canceled my flight, booked a new one for both of us, and scheduled Scooter for boarding. I also made the decision to go ahead and tell my supervisors what was going on. Truthfully, I'd been minimally productive at work since Friday afternoon's news--I completely threw in the towel and took Monday afternoon as personal time--but my supervisors were supportive and encouraged me to do whatever I felt I needed. I tried (with mixed results) to do what was critical and put everything else on hold.

After I learned that I was going to miscarry, I thought a lot about what that would be like in an unfamiliar place compared to in my own home. I pictured myself bleeding and sobbing while I wondered if the baby had come out yet. Regardless of where it happened, I realized it was going to be rough. Even the fact that I could prepare for the moment felt strange. I've reflected a bit, and I think it was better to know what was coming than to be caught off guard. I worried that it would be painful, too. It was like a different version of the same death march I had been on, but at least there was an end in sight. 

I started bleeding on Thursday. While I found myself wondering if I'd just flushed what could have been our child down the toilet, I never cried. It was slightly more painful than my regular periods, but I managed the pain with over-the-counter meds. I was oddly at peace, and I truly think it helped that so many people have been praying for us. I also appreciated the change of scenery and the fact that Richard was there with me.

We talked with our RE on Friday morning about next steps and determined that we would go for a fourth retrieval before attempting another transfer. Despite everything we've been thrown this year, Richard and I are still hopeful that we will be able to have children using my eggs and his sperm. Our doctor had several anecdotes about couples going through IVF and then getting pregnant naturally, which is a lovely thought but one that feels completely out of reach at this point in our process. With our desire for multiple children and only one normal embryo in the freezer, another retrieval seemed to make the most sense. I'm not getting any younger. So, we're at the beginning of IVF cycle 4.

Coming home from the conference was a bit of a challenge. I have felt very left behind as we continue down this road. I'm also learning that I feel the best when I am totally distracted. I want to think about conferences, work, and anything but [in]fertility. I don't have the energy or emotional bandwidth to work at the level I would like, but I've mostly been working until I'm tired enough for bed. This is effective for me in most ways, but I also realize that there is now a volatile can of emotions just waiting in the wings to explode. Below is a picture of me presenting some of my dissertation research (as research-in-progress) at a [different] conference this week. I think I look happy and proud. I love my dress, and my hair and makeup were on point too, despite the number that the New Orleans humidity did on my curls. But when I zoom in on my face, I see how tired I look and how much hurt is in my eyes. I have tried to bury this immense grief because I can't shake it off. The best I can do is suppress it.

Despite my sadness, there are several positive things that I can say about all of this. The failed embryo transfer and chemical pregnancy have absolutely affirmed the strength of my marriage and the dreaminess of my husband. The years of trying have been difficult, but this year especially so. Richard assures me that he's going to love me no matter what, and we're going to get through this. Even if I already knew all of that, it's good to hear again. Similarly, I have felt lots of love and support from friends and family in the form of Facebook messages, Facebook comments, text messages, and calls from family and friends. There are so many people who have offered sympathetic thoughts and words of encouragement while I've been down in the dumps. I'll also give myself a little bit of credit and state that even though I don't feel fully like myself, I'm pretty darn strong, tough, and resilient...and that's pretty cool. 

So, time marches on, and we're moving forward with it. I picked up a Nuvaring from a CVS in San Juan last Friday, and our fertility medications will deliver on Tuesday. I return to the RE on Friday for an ultrasound and bloodwork, and I think we'll get our calendar for this cycle at that appointment. I never thought I'd be a repeat IVF-er, but my hopes are high for the upcoming cycle. Please remember us as we prepare for whatever is next.

Something that made today great: I had a lovely dinner out with family tonight. 
Time I woke up: 9:00 am