ERA progress

The weekend was nice; rainy and low key. There was a major storm on Saturday afternoon/eve that caused major flooding in nearby areas. It didn't affect us directly other than some flickering lights, but the pictures coming out of the affected neighborhoods are insane.

Fifth shot of DE was on Sat night and tomorrow is the appointment for lining check. I have to remember to drink a lot tonight and tomorrow morning before the appointment in an attempt to help with the bloodwork.

Today I was with my closest group of friends and the conversation steered toward baby names. One was saying something to the effect of, "I was thinking of this name... but you can't steal it!" to which the others responded with, "First come, first serve!" In other words, if you want dibs on a name you gotta have the baby and name it. I joined in the conversation and joked along with everyone, but somewhere inside I was really sad. Specifically because this is a conversation my husband and I have often - we like discussing names and in nearly 10 years of being together we've never agreed on a name we love. Still, it feels like a "safe" topic that allows us to talk about the future without triggering too much emotion.

Everyone in today's group knows about our struggle but for some reason it didn't occur to anyone that this might be a sensitive issue for me. I wouldn't have known either until it was. I can't expect them never to talk about these things and it's not like any of the names my husband and I discussed came up, but still. When one person with a 6-month-old joked that she better get started on her next baby to reserve her name of choice it reminded me that we're still no where near a transfer date.

I'm tired. I'm tried of waiting. I'm tired of wanting. I'm tired of disappointment. I'm tired of the same newsreel over and over again. I'm ready for a change of story and a happy plot twist.

Shmirat halashon

Someone asked if I want to join a shmirat halashon group that was started on Friday. A woman started the learning in the zechut for a refuah for her husband who was diagnosed with cancer.

I shrugged and said, "Sure, why not?" and became one of 5700 women who joined in less than a week. Whatsapp has a limit of 250 people per group so they had started multiple groups and by the time I joined they were up to more than 20 groups!

I may have exaggerated the pie chart a little.

I know that learning two halachot a day may not eliminate all the LH from daily life but even if this makes a dent it's already a win. It's a true challenge for me because I love juicy gossip. Not so much sharing it, but more knowing insider info on people and happenings.

In the zechut of this learning may this woman's husband have a complete recovery and may we merit to have healthy babies.

Fourth DE shot down. One more before a lining check.

Weekend

We had a nice weekend but it was hot. H. O. T.  We walked to lunch on shabbat in 98 degree weather. It was a 2 mile walk from shul and we were walking with other guests with strollers so the walk was even slower. Once we got there it took a while for everyone to get situated, hydrated, changed, etc. The walk home was also warm but not as bad. We got home close to 7:00 PM and then Sunday was a fast so the weekend was kind of a goner. 

Sunday's fast wasn't so bad. The worst part was having to take the del estrogen shot on an empty stomach. It wasn't so much the medication, but rather feeling the needle in my muscle and getting nauseous from it.  Luckily the fast was over soon after and eating helped. 

We're down 3 DE shots. After 5 shots there's a lining check to determine whether I can start the second shot, PIO.  So far we're moving along. In the back of my mind I have to continue reminding myself that this isn't "a waste of a cycle" even though we're doing everything exactly the same as a transfer. Except that on the day we would normally transfer, we're just doing a biopsy and nothing else.

It's been so hot I haven't been able to work out outdoors. I'm not just being spoiled - it was 100 degrees outside and the "feel like" temp was close to 110 degrees.  I'm hoping to try a few CrossFit videos online this week. 

I'm excited for the Olympics to start! Four years ago we got a second TV literally because I insisted on watching the Olympics and my husband was so bored. Best shalom bayit purchase ever.  Also keeping me happy these days is Jerry Seinfeld youtube clips. Love him - he's hilarious!

2016 so far

Remember how everyone started out 2016 so hopeful and full of enthusiasm? THIS was going to be our year. This time it would be different! It wasn't just an ordinary January - it was January 2016. Nice, even number. The sweet sixteen of the decade. There was optimism and ambition and anticipation... so sure were we that the thing we want most is just around the corner. We could almost taste victory as we waited anxiously for the big things to happen to us.

Yet here we are, with over half the year gone, and it hasn't quite turned out the way we expected. It seems like I'm not the only one who feels this way about 2016.

I think there's a limit to what we can expect to happen TO us and what we actually go for. I recently finished Survivor season 29 and I was so impressed by the winner. Spoiler alert - I'm about to mention her name. I watched Natalie and her twin sister Nadiya on the Amazing Race a few years ago and I found them to be so annoying. They were shrill and aggressive and way too outwardly competitive to be fun to watch. But as a die hard survivor fan I watched the season anyway. When Nadiya got voted off first from her tribe, it was mainly because her tribe mates had similar prejudices against her based on her Amazing Race performance. Rightly or not, that reputation followed her to Survivor. Her sister Natalie was on the winning tribe and had time to form alliances which allowed her to secure a place for the long haul. Natalie also won me over. She was soft spoken (hunger and fatigue??) and very strategic. She wasn't greedy and gave up her reward and personal comfort on multiple occasions to further her game. She still kept some rewards and she worked hard for the immunity challenges she won. There were several times that her closest ally got voted off and she had to scramble to solidify new relationships. She didn't lose her mind or go off on people; she used the time she had to find immunity idols and make bold strategic moves.

A lot of people I know are working on their post-baby body, trying to get back in shape after having kids. Here I am still working on my pre-baby body to get ready to have healthy pregnancies. I could be doing more. I should be doing more. I'm not sure what's holding me back.

I very much have an "all or nothing" mentality that I've been working on modifying. I've started shifting that mentality because I realize life is not about all or nothing. If I only have 20 min to work out instead of 90 min, it's better than not working out at all. I should be able to have a cookie without having 3 more following it. I used to not try at all because I wasn't sure I'd be successful. I recently saw the interview of Sara Blakely who has a different view of failure, one which made her incredibly rich as the founder of Spanx.

I know that I can succeed at anything I put my mind to. I have enough self confidence, common sense, and skills to know that for sure. The question is what do I want to accomplish. For now, I'd like to set a realistic, achievable goal of losing 20 lbs (up from my 10lbs plan because, hey, let's dream big). I have a specific number in mind that I want to weigh when I go in for the FET #4 baseline. Even though I'm not sharing it here, I have it written down on a sticky note on my desk.

I know that these are the steps I need to accomplish that:

1) Work out at least 60 min 3x week
2) Limit calorie intake
3) Stay accountable on a daily basis using myfitnesspal.com

As for timeline, I'll say October 1 which gives me 10 weeks and sounds realistic for healthy weight loss. It's a start. It's a goal. It's a project.

Not only will this give me a target to focus on, but it will also help me feel like I'm doing something productive to get my body ready for the next FET. I hope that this coupled with whatever results we get back from the ERA will allow us to finally have a successful transfer and healthy pregnancy.

I'm pumped for this challenge. I feel that I can accomplish this goal and I'm the only one standing in my way. 2016 is not over yet! There's still time to MAKE it the best year yet. Let's do it!!!

Superfluous fluff: what holds you back?

Last night my husband asked if I ever feel like Judaism holds me back and it sparked an interesting conversation. The question was rather does the fact that we choose to be orthodox and follow halacha make me feel constrained in any way? To answer the question, not really except in one aspect. More on that soon.

For some background, he was learning about the mitzvah of p'ru urvu, literally translated as be fruitful and multiply, referring to the commandment to have children. In order to fulfill this mitzvah, one must have at least one boy and one girl. Anything else doesn't fulfill the mitzvah regardless of how many children or grandchildren one has.

Logically, if one has a genetic mutation that may cause a child to have a fatal disease, one would think that they are exempt from this mitzvah, right? He couldn't find any rav that says that in source. No one will come out and say you're exempt. You have to make the decision whether you want that mitzvah point regardless of how disabled or how slim the chances for survival are for said child.

In our case, we know we have a 50% chance at having a severely disabled child. While we are both normal, healthy adults, our child could come out with significant, possibly fatal defects. There is a spectrum and the disability could be very minor or very awful which would result in the necessity of multiple surgeries and endless stays in the NICU. I can't do that. At a certain point it becomes less about me and my mitzvah and more about this tiny baby coming into the world for a lifetime of pain ahead.

There's no way to know in advance which point on the spectrum the child will land, and it could be different for each child. Back when we were engaged and just learning of all this, we had decided that we would do everything in our power not to get pregnant with a disabled child but that if we did get pregnant naturally, there would be no abortion. Birth control may be a gray area in Judaism, but abortion is nearly black and white. Even if it wasn't, I knew that it's against my own personal belief. I wouldn't be able to handle it mentally and emotionally knowing I was purposely aborting my babies, potentially over and over depending on how many times it took to get pregnant with a healthy baby.

So it bothered my husband that no matter what we do, we may not complete this mitzvah of p'ru urvu and he felt like he can't win. I shared that in my view, we can't win 'em all. They say it takes a village, and in this case I think it can be meant literally. There are 613 mitzvot and we as a tribe can fulfill them all, but there's no way that one person can individually. For example, I said, "I can't be king and you can't be niddah." That's just how the cookie crumbles! Another example I gave was that we have so many friends with only one gender kids - all boys or all girls. They also didn't get the mitzvah point for p'ru urvu because technically they're still missing a gender. It doesn't make their kids any less special or miraculous. At the end of the day they all get married and have their own kids. Everyone fulfills their part and together we get to the 613.

I'm a lot less strict regarding halacha than he is and a lot more laid back about technicalities, so maybe that's why I never feel restricted. There is one thing I feel restricted and that's Survivor. It's my absolute favorite show and I would LOVE to be a contestant on it. But there are too many parts of it that I'm limited by Judaism: Shabbat, tzniut, kashrut, negiah... the list goes on! I would be so good at the strategy and manipulation, I could do puzzles and challenges, make fire, build shelter, find idols, and I would be great at the social aspect of it. But I can't go into a challenge not being able to eat a bug because it's not kosher, or not being able to cast a vote at tribal council because it's Friday night and I'm not supposed to write on Shabbat :) The thought of trying to explain all these limitations to Jeff Probst is hilarious to me. It's a very silly restriction and not really a restriction because I can obviously do without. In short, I don't really feel restricted at all. But I digress.....

I don't care so much about the technicalities of p'ru urvu, possibly because it's not even my mitzvah; it's his responsibility. Even so, I want a baby because I want a child. I understand that he will become a smartass one day and talk back and have tantrums and be expensive and exhausting. I know. I can only imagine how hard it would be, but I also know that the reason I want it can't be described in words.

I was telling my husband I want it all: the bris, the pidyon, the celebration, the parties, etc etc etc. He said not to get our expectations too high because what if there isn't a pidyon and what if we're so disappointed. I said that after all the years of waiting and treatment and then the 9 mos of pregnancy living with heightened anxiety and then surviving the stress of labor, if we are ever zoche to have a healthy baby in our arms, none of that will matter anymore and there is just no way we could be disappointed. I can dream big and hope for the best but we both know that the healthy baby is the important part; everything else is fluff.

IYH soon by us.

Our path

I need to keep remembering that I'm on my own timeline and not to compare to others' journey. I'm specifically talking about someone close to me who got pregnant in June and we would have been due within a week of each other.

I know we have a plan, we have our own timeline, we're working on getting answers. While we're dealing with the ERA, she's working through the challenges of the first trimester: physical symptoms, grappling with the reality of what's to come, telling people and being excited, and so on.

My journey took a different path and I have to remember not to see hers as a constant reminder of what could have been. When my pregnancy didn't progress, I got left behind and I lost a buddy-at-war in the thick of TTC. I know we have people who love us and support us in many ways. I also know that it just wasn't meant to be. I do believe that everything happens for a reason. Gam zu l'tova. We have a new path and we're moving forward with hope.

I try to think of the future in vague terms because things can change in the blink of an eye. One year ago we were just starting treatment. One year from now we could be well past it. Who knows. The only thing I do know is that I can't control the path, only enjoy the ride and do my best to hold on at the twists and turns.

ERA: Baseline

This morning's appointment could have gone better.

Usually when you check in at a baseline appointment they like to verify that you've been financially cleared to start. For some reason, the FET code was put on my file: maybe there is no ERA code? Maybe to ensure that it's an identical protocol? I don't know. Maybe that ensures that bloodwork, ultrasounds, etc. are all following that protocol. If that's how they want to do it, fine. But the cost for a FET is much higher than that for an ERA biopsy and apparently no one mentioned the ERA to the front desk. So the front desk staff kept saying that since I'm there for an FET baseline I owe the entire amount for an FET. I was trying to explain to them that I'm not doing an actual transfer and that a transfer may not even happen for a few months.

They got the financial counselor involved and she was saying that she had emailed me the cost and the date it was due. First of all, no she didn't. All she emailed was the cost for each procedure without a due date, but since this isn't my first rodeo, I know the cost is due at baseline. Second of all, I'm not doing an FET! It was sorted out eventually but it was annoying to deal with, especially since the counselor didn't take me back to an office to discuss it, we were discussing it right up at the front desk. Luckily there weren't many patients at the time and the waiting room was empty, but still. I don't like this counselor. This isn't the first time she's messed with my account (I had an incident with her in February).

Once I was cleared to start, they took me back for blood and the tech couldn't get a draw. One stick - nothing. She went to the other arm, nothing. Second stick back on the first arm - nothing. I had water before coming in that morning but nothing else. She said I should go to the ultrasound first and then come back. I was getting worried because by now it was getting late and I had a 9AM meeting that I didn't want to be late for. I grabbed another cup of water on the way to the ultrasound hoping it might help things with bloodwork.

I went for the ultrasound and the doc came in pretty quickly, but she's like, "Ok so I see you're getting ready for a transfer!" And I had to correct her also - nope, just a biopsy. In the back of my mind I'm trying not to get nervous that not everyone is on the same page because I know they're not going to thaw any embryos by accident.... right? I hope not.

After that I went back to the lab for bloodwork and a different tech was able to get it with one stick. I was out about 5 minutes after that and due to light traffic made it to my meeting with time to spare, leaving enough time to text my husband the ridiculousness of the morning's adventures.

I got the results later this afternoon and we're good to start. I hope the rest of the cycle goes smoothly and is nothing like this morning's appointment.

Lose to win

I stepped on the scale this morning and didn't like what I saw. I was supposed to lose weight, not gain it! I had an eff-it attitude last week about diet and exercise and this is the result. I'm annoyed with myself because I knew it was happening and didn't do anything about it. I'm up four lbs from last time I weighed in. I could say it's water weight or some other excuse but I know I didn't work out last week and I didn't bother counting calories. Sometimes I think it's good to take a break from strictness, but ugh... hate these results.

I feel great and am happy with how I look so I can't use either one as a motivator to try and lose weight. I have a lot of self-confidence and never struggled with body image issues, but I know that to be healthy and carry healthy pregnancies I need to keep losing weight. So the struggle continues....

I thought about trying South Beach diet for a week just to shake things up, but it's very restrictive. I do better with limiting calories rather than limiting full food groups. I've had past success using myfitnesspal.com and counting calories. I think I just need to reintroduce soups and salads into our rotating menu which are filling and low-cal.

I want to get to a point where I'm eating normal and healthy without constantly thinking about weight, but I don't think that's an option. That's why people gain back all their weight: they stop thinking about it and stop actively maintaining which is how the weight creeps back plus more. Over the past three years I've lost 30 lbs. I've managed to keep most of it off, oscillating with the scale plus or minus 5 lbs every so often, but not ever getting past a certain point up or down. It's good and bad: I haven't lost any more but I also didn't gain it back so I consider it a win. I was hoping to lose another 10-15 lbs, especially before a next transfer. I don't know if the hormones are playing a factor in this, but I'm sure they're not helping matters. I know I retain weight when I'm on pills and I can only imagine what the shots are doing. It's not an excuse, but I try to keep realistic expectations.

I used to have a gym membership but I got rid of it in favor of working out at home and outdoors. In the past few weeks I've been debating whether it might be worth it to go back. While I prefer walking/jogging outside in the fresh air and not dealing with driving to a gym, I miss working out in air conditioning and the group fitness classes. The gym has membership dues and I don't know that I'll use it enough to justify the cost. Plus, I know that staying fit and active is important but to lose weight it's the eating habits that need immediate change.

So I don't yet have a plan and tomorrow is my baseline appointment for the ERA biopsy test. At times it feels like there's so much waiting time between appointments and procedures and yet every baseline appointment seems to sneak up on me. We're at this again? Already?

I think I will start by making a menu for the week. Planning is three-quarters of the battle and if I set myself up for success I'm a lot more likely to do well. I'll also plan to wake up half an hour earlier and get in a walk before the day starts. If I really want to lose weight before a transfer, I have to get serious about it and putting it in writing helps make me accountable. It's a start. 

Endometrial Receptivity Assay and Halacha

In prep for the ERA biopsy, we looked into whether this procedure would create an issue with regard to halacha.

Because of the nature of the procedure being time sensitive, it is by design scheduled during tahor days. Fertility treatment is already a game of "Red-Light, Green-Light, 1-2-3" with regard to niddah. Beside for the hormones messing with mind and body affecting interest, there's also the tangible issue of hormone-inducing spotting every so often. Taharat hamishpacha is a challenging mitzvah even in the best of times, and even more so when tahor weeks become shorter and shorter.

So I asked whether the procedure itself would render me niddah. Uterine bleeding will almost always result from an endometrial biopsy. Since this bleeding is caused by injury, the opinion of the posek on yoatzot.org, Ravi Henkin, is that it does not render a woman niddah. In addition, for all procedures that enter the uterus, the size of the instrument that enters is also relevant. As long as the catheter used for the endometrial biopsy is smaller than 19mm, the instruments entry into the uterus would not itself make one niddah.

I was told that the bleeding may go on for about a week, and for that time can be attributed to the procedure, but by that point I will have stopped all meds and will be expecting an actual period.

For anyone interested, this website is a great source of information. I love the Yoatzot.org website and appreciate that they are available to answer these questions.

Patience

Bloodwork from the RPL workup came back all within normal range. I would have been surprised if we got any other news since we never had any reason to believe otherwise. I'm still glad we did it now anyway and got a definite answer.

I also ordered meds and got the timeline for the ERA biopsy. Originally the first date they had open was mid-August. I have a patience problem as it is, but even more so having to wait so many weeks for a non-transfer, delaying a potential transfer even more. My nurse said she'll try for an earlier date if the schedule allows and an opening became available in early August so we got that date.

I'm trying not to stress about time. I know I have a patience problem and stressing about it doesn't help. I'm working on it. It's been a long year with a lot of treatment so what's another month for the ERA biopsy. I've gone back and forth regarding pros and cons so many times I've started second guessing its necessity.

The reason we're doing this test is to verify the "transfer window." There is a window between days 4 and 6 of your [medicated] cycle for an embryo to stick, so all transfers happen on day 5 per protocol. For some women, their body responds differently and their uterus is more receptive on another day. The ERA biopsy will give one of these results: receptive or non-receptive. If we get back a receptive answer, then we'll know that the protocol has the ideal time to transfer. If we get non-receptive, the results may point to a more optimum timetable and the doctor will repeat the cycle again based on the personalized window of time to implant. Supposedly you're supposed to repeat the test until you get a receptive answer. My doctor said that he's never had to do it more than twice on someone. The paperwork I've read on it has stats that show 74% of women get receptive the first time, and 26% get non-receptive with a recommendation for a suggested window. About 1% of women tested get back an answer saying non-receptive without any suggestion for a new window to try.

Either we find out I'm receptive on day 5 and we can transfer knowing it's the right day; or we find out that we've been transferring on the wrong day all along and hopefully get a new chance at success with a modified protocol more adapted to my body. My husband and I, as well as everyone we've discussed this with, all agree that it's worth going through this process to verify the transfer window. It's worth the time, the expense, and the delay for a chance at piece of mind.

Some days I don't know what's keeping me motivated. Some days I wish we can go back to "normal" life before treatment, or fast forward to post-treatment and on to the next stage of our life that includes kids. Sometimes being in treatment, and thinking about all the what-ifs and playing out all the scenarios and pros and cons of the next steps can be mentally exhausting. Even so, or maybe partially because of that, I am motivated and determined to do everything in our ability to make this happen. The rest is nature, luck, and maybe a little smile from Hashem.

Beach day

Late last week I found out that my office will be closed on Monday due to power-related repairs so my husband took off Monday too and we planned a short getaway. We chose Ocean City, MD because it has the beach, we were able to get accommodations at the last minute, and it's a fairly quick drive. 

We got home last night happy and slightly toasted. Even with waterproof SPF 50 sunscreen being reapplied nearly every hour, we still came home sporting some fierce burns. We had a large hotel room with a fridge and microwave, and a balcony with a direct view of the ocean. It was a great - so glad we were able to get away.

Sunrise in Ocean City, MD 

Mid-afternoon view from our balcony

View from my face ;)

Follow up appointment

We left the appointment today feeling good about next steps. What our RE lacks in phone/email skills he makes up for in person. We talked for almost an hour this morning and at no point did I feel like he was distracted or impatient. He answered all of our questions and then some. Even though we didn't walk away with a lot of new information, we have a clearer picture of our options moving forward. The discussion included:

• Natural vs. medicated FET 
• Endometrial Receptivity Assay (ERA) 
• Endo Scratch 
• Thyroid, prolactin, Vit D levels, etc. 
• Hysteroscopy 
• Transferring more than one embryo 
• Immunologic implantation dysfunction (IviG) 
• Additional embryo testing beside PGD 
• RPL workup 
• Getting a second opinion 
• His phone skills 

In a natural FET there are a lot less hormones but a lot more office visits because you have to be very closely monitored. The risk is that they do not do transfers on Saturdays or Sundays so if you happen to ovulate at a time when transfer would be one of those days then the transfer gets canceled. They don't do enough natural FETs to justify staffing everyone over the weekend and so there would be no one there to transfer.

The ERA biopsy protocol is similar to the FET. Birth control for a few weeks, followed by shots as a "pretend transfer." They mimic everything you do at a regular transfer then instead of transferring an embryo, they take a biopsy of your uterus and send it off for testing. They're testing to find out if the transfer window they use for you is in fact correct. If it is, test comes back normal and you can transfer next cycle. If not, repeat everything again for another cycle except delay biopsy for a day. The idea is to narrow down the most receptive time for your uterus to accept a transfer. I asked what happens if after the second time it doesn't come back normal? He said he would have to take it to the panel of doctors at the clinic since it hasn't happened yet. So at the very worst we'd be delaying by two/three cycles while we do this testing. It is also expensive and not covered by insurance ($850 each biopsy).

Endo scratch is where they irritate the lining of the uterus a week before transfer. The idea behind this is that the uterus starts to heal itself and makes it more receptive to an embryo. There isn't sufficient medical data backing this up. He offers it if we want to try it but says he's skeptical that it actually works. Even if a transfer works he says he can't necessarily attribute it to this. There are no known downsides to this - it doesn't delay a transfer and insurance covers it.

We reviewed all of my hormone levels and all are measuring normal with no changes from 6 months ago, when they were also checked.

I asked about his opinion on getting a hysteroscopy (sticking a camera into the uterus to take pictures) and his response was that the benefit was so small and the risk was so high that he doesn't recommend it. I have no symptoms to indicate that there's any issue; usually they recommend this for someone with unexplained bleeding. It's not worth doing this minor surgery where the risk of perforating the uterus or finding something that not actually an issue is much higher than the tiny chance of finding anything the HSG or transvaginal ultrasounds have been missing.

He says there is too much risk to advise transferring more than one embryo. There is a higher risk for premature birth, pregnancy complications, and possible stillbirth. The only pro is that it's better financially because you're saving one FET by putting two in there. He said that the embryo quality is high for both embryos and whether or not anything sticks has to do more with uterine receptivity than the number of embryos.

We briefly discussed IID with IviG therapy but it's so beyond anything I could need at this point that it was pretty much irrelevant. This is something that's offered to women who have gone through dozens of procedures with multiple losses.

There is no additional testing offered beside for PGD. If there is any chromosomal abnormality with the ones we're transferring (or with me or my husband), there has not yet been a test created to check it. We're literally doing everything we can to ensure healthy embryos.

As a way to make me feel like we're not leaving any stone unturned, he offered to do a RPL workup which is a blood test offered to women who have had recurrent pregnancy loss. This is generally only offered to people who have had multiple miscarriages before the 10 week mark and tests to find out if there are clotting issues which might interfere with the placenta growth. It's easily treated with baby asprin and lovonox but they need to know it's an issue in order to treat it. This isn't something he necessarily recommends to someone who has had "only" three failed FETs, but I appreciate that he brought it up and if it's just a simple blood test I'm happy to rule anything else out. Why wait for more losses if this is just a blood test and so easily treatable? Did that this afternoon and results should come in about a week.

He brought up getting a second opinion saying that if we want to see someone else that he doesn't hold anything against us or get offended. I'm not interested in starting over with someone new at this point, but I think it's good to hear he wouldn't take it personally if we did. I don't know that there's anyone better and at this point I think it's too soon to shop around.

He apologized for last week's hectic schedule which didn't allow him to speak longer. I told him that I completely understand I'm not his only patient but that when he does talk to me I'd prefer if he was in front of a chart instead of trying to wing it from memory. I wasn't trying to make him feel bad or get an apology - I honestly just want to be able to get accurate information when we talk. I feel better now that I brought it up. I think it was important to me to not let it go unmentioned because it was a big deal and I don't want a repeat.

Overall we're feeling good about next steps. My husband and I are on the same page about wanting to do the ERA test. We're not totally in agreement about the endo scratch. Even though the endo scratch sounds like something I would try, I think it's pointless if we don't narrow down the transfer window first. He thinks it's a waste of time regardless. If we do the test and it comes back normal, at least we'll know we tried and will have no regrets moving forward with another transfer regardless of the outcome. If it comes back not normal then we'll get a possible answer as to why things weren't sticking. Either way it sounds like it's worth the pain, expense, and delay of another transfer. We can't do both: it's either the ERA or the endo scratch. Once you do the ERA you're mimicking the transfer so you can't throw in a monkey wrench into the system by introducing something new at the actual transfer. Since the endo scratch is unproven and we don't get an any answers from trying it, we're going to try the ERA and see where it takes us. 

This means that we're not transferring anything in July, possibly not in August either. So if I have the time anyway, I'm going to make an effort to use the time wisely working out and losing weight. Even 5 or 10 lbs off will help me justify the delay for the next transfer. I know I don't need justification, but for an impatient person such as myself, it helps keep my mind focused by having a tangible goal within my control. Exercising helps me feel good and eating healthy can only help. I'm going to set a goal for 10 lbs and reevaluate if I reach it before it's time to transfer (that should be my biggest problem!).

Happy Birthday, America

Every year we do something for 4th of July, like a BBQ or a family gathering. In the past I've made the flag cake with the blueberries/strawberries/whip or a berry trifle. This year I didn't feel like it, even though there are so many fun things online to try.

This morning I made some pancakes and eggs and we had a great breakfast. The weather is rainy and gross so fireworks will likely be canceled. Ok with me. The failed FET, the constant terror attacks all over the world, the weather... just feeling bummed out. Maybe next year we'll be in more of a celebratory mood.

Symptom-wise things are back to normal. By that I mean that for the first time in a month there isn't any activity from my uterus; all is quiet and I'm back to how things were pre-cycle. Tomorrow morning is the appointment with the doc and my husband is going to take a few hours off work so we can go together. I asked for the soonest appointment available and that happens to be in another city. It's almost three times as far as the regular office we visit. We'll have to make sure to leave early enough to avoid traffic and have enough time to get there.

Overall the weekend was nice. One incident on shabbat stood out in my mind and really upset me. I was outside in the shul playground pushing my 2-year-old niece on the swings. Services were almost over and they were setting up the kiddush outside. There were a bunch of mommies and kids all over the playground. There was a baby (non-walking, maybe a year old?) in the path underneath the swing we were using, eating the wood chips from the playground floor, that I wanted to move for his safety. I asked around the mommies if they know whose baby it is and no one knew. I went to move the baby anyway if only to get him to stop eating wood chips. As I was moving him away from the wood chip area to the grass I kept asking people as I passed them if they knew whose baby it is. No one seemed to know who left their baby unattended under the swings to eat wood chips. Not wanting to leave my own charge unattended, I kept asking people as they came by and one guy responded, "Oh yeah, he's mine. I forgot about him!" and with a light chuckle took the baby. I don't think he was kidding. Asshole. It made me so upset that this guy has so many children that he can't keep track of and we weren't even able to even get to 5 weeks of pregnancy.

There's no way to compare, I know. There's probably a reason for His plan even if I'm not privy to the details. I don't know why we've been challenged with this, and I don't want it to make me bitter. Yet seeing this guy being so cavalier about this baby really rubbed me the wrong way.

Tonight I found out about another pop. Someone very close to me who has been trying naturally since the fall, and suffered one chemical pregnancy herself, is expecting. Had FET #3 worked, we would be due within a week of each other. She knew a few weeks ago but held back from sharing the news because mine didn't take. I'm so happy for her. I'm so glad she did tell me, and I'm grateful she was sensitive enough not to tell me right away when she found out, which was when I found out that my pregnancy failed.  The announcement did make me cry. It was a cry of sadness that our babies won't be the same age rather than jealousy or resentment. It was a cry of heartache that she felt the need to hold back with the happiest news of her life because the crappy news of my failed pregnancy overshadowed yet something else. It was a cry of grief for what we lost. It was a cry of despair of the challenges ahead and the lack of any guarantees.

I want to keep hope alive. I want to believe that at least one of the embryos we have in the freezer will become our child. I want to stay strong and keep trying. But it's hard to be brave when the emotional wounds of the last failed cycle are still so fresh. No one has the magic formula. No one can tell me the future. No one can be strong for us. We need to keep feeding the faith, keep hope alive, keep thinking positively, keep believing that one day it may be us. IYH soon by us.