What's next

So here's where things stand. My miscarriage started on Tuesday evening. I was bleeding heavily for about 24 hours and it slowed down over the weekend. By the time I went to get my hcg rechecked on Monday, I hadn't been on PIO for five days and the bleeding restarted heavily again getting rid of all that fluffy lining that was prepped for the pregnancy. My hcg measured 57. I started having really uncomfortable cramps in addition to the heavy flow. I tried tylenol but it did nothing. I had a hard time walking and even sitting at my desk was a challenge. Ibuprofen helped. It was really bad for two days before it started getting better. I think it's slowing down but it's still bright red with clots. I now understand that my period won't come for at least 4 weeks after my hcg is measured in the negative numbers. So it's going to be a while before we start anything again.

So.... what's next.

We met with our new doctor today. It was an ordeal getting there, thanks to the latest nor'easter.  I wasn't cancelling. If the doc was in we were going to make it. It was scary at parts because the snow was heavy and slushy, making the drive awful, but we got there and home with little incident, thanks to their office calling and offering an earlier appointment that opened so we got in and out before the streets became impassable.

Besides for waiting for my period, we have a long To Do list before we start another IVF:

• Start vitamins. She suggested fish oil for both of us. In addition, vitamin D3 and something else specific for me to improve egg quality (nothing shows we're getting poor quality eggs, but because it's going to be a while before we start anyway it can't hurt). 
• Schedule husband for testing by a urologist specializing in male infertility. He was tested for the regular stuff back when we first started and it all came back normal but she wants something specialized besides for the standard stuff. It's the first time a test was suggested for him instead of me; we're pro. We're on the calendar for first available appointment: May. 
• See a specialist for recurrent early loss. We're on the calendar for first available appointment: October. 
• Send records of pap spear and breast exam. Regular stuff they want to make sure I'm not ignoring. 
• See if I can get embryo reports from my old clinic. Nothing was mentioned in my medical file, which I think is weird. I emailed my old doc for info. 
• Infectious disease bloodwork needs to be repeated every six months. 
• Besides for the medical stuff, I need to get authorized by insurance which needs a period start date to verify, and I need to register with my insurance fertility hotline. 

Some of this is because we're switching clinics and we're starting everything from scratch. It's an ordeal and part of the reason we hesitated switching as long as we did. But we're at the point where all in.

I can't imagine we'll get to an IVF before summer. I guess I'm ok with that because I don't want to keep cranking them out with no results. We left today's appointment feeling drained and hopeful at the same time. There are new things to test; there are new things to try; there are specialists we can see and ask questions and possibly get to the bottom of why our transfers keep failing. At the same time it's so frustrating that these ideas weren't brought up before. Maybe it's because this new doctor knows that the traditional stuff doesn't work so she has the benefit of skipping it all and going to worst case scenario. But I can't help feeling angry at our old doc for just phoning it in and not caring enough about our losses to think of ideas of things to try. Whether or not it's true, it felt like he couldn't give less of a shit about whether we succeeded or not. While I had my reasons for not switching earlier, I'm upset that we spent as much time as we did under his care. If we'd succeeded it wouldn't have mattered that he wasn't a good fit for us. But we didn't and he lost a client. 

Emotionally I guess I'm doing ok. I used the snow day to start cleaning for pesach. It's going to take a while before I feel like myself again. For one I need to stop bleeding so that I don't get a reminder of what happened every time I go to the bathroom. At least the crying has stopped. I get misty when I talk about what happened but for the most part I can keep my composure for a full 12+ hours at a time. New personal record since it happened. It's been really rough but we're getting through it one day at a time. Sometimes it's one hour at a time. When it was really bad we were checking in on each other every few minutes. Time still passes. Life goes on around us and when we're up to it we join in. I'm trying not to fall into a depression. I know it's not entirely up to me but I'm holding on to whatever control I have over it.

I know we'll carry this one for a while. Every time we transfer the results are a little better than the last time but then the loss is so much worse than the time before. It's so difficult to pick up and dust off and start again every time. It's difficult but not impossible. I have to stop comparing myself to other people my age and see what they have. I have to stop thinking of the what if's if we had made different choices. I have to stop thinking about the losses that didn't make it and what would have been if they had. The past is the past. I can't change it. I can only make choices and decisions on things that haven't yet happened: that's what I need to focus on. One day at a time, one minute at a time if I have to, as long as we're moving forward and not stuck in the past.

Thank you for the emails, fb msgs, and texts. It means so much to know that we're not alone in our sadness and pain. Whatever messages were sent were greatly appreciated. Every time we shared the story with someone else it felt like another set of shoulders carrying the burden with us. 

One year ago

Last year on June 20 marks the first time our fertility treatment took an encouraging turn: it was our third transfer and the first time we got a positive beta. We were ecstatic yet cautious because beta was only in low sixties. We believed it would work because it was the first that stuck. Unfortunately, it was the first of three miscarriages. The second beta a few days later showed that the numbers had gone down and instead of a pregnancy we spent the summer doing injections for two consecutive ERA biopsies.

In November, we were encouraged again with our fourth transfer when our beta came back in the four hundreds. Wow! We continued to hope as the numbers more than doubled at second beta. Then the rug got pulled from under us when I started spotting and the third beta came back in the 20s. It was discouraging and disheartening. I'm not sure how we went on but somehow we got through it as we processed our feelings through a second chemical pregnancy.

Then we started IVF 5, followed by FET 5. This time it really stuck. We had great numbers. Numbers doubled and got so high we were told to schedule an OB ultrasound. We got past the first ultrasound with no issues at all. We were nearly 8 weeks along and thought this was actually the real thing. And then there was the second ultrasound. The day started with excitement and ended in utter devastation. The following week included a D&C to remove the "product of conception" and four weeks after that brings us to present day.

One year.  It's been a rough year. A really, really tough year.

Each try brings us a little bit further along only to end in disappointment. It's really hard to keep going through the bogus successes. Each time we get good news I worry about when the disaster will strike. It's dreadful.

Pregnancy loss is truly horrible. Part of it is wanting something so badly, and admitting that you want it by pursuing it with all your heart, body, soul, and bank account, and then failing. Part of it is not only the failure of what is (treatment) but also the failure of what could have been (child). Part of it is feeling older every time there's a failure and feeling the biological clock ticking, no matter what age you're at. Part of it is the mental anguish of putting faith and hope in a system that has really sucky odds, with more losses than wins.

I'm learning that it takes more than just moving on logically and physically to be able to try again. I learned that I need to be able to visualize us being successful in order to be able to start up everything again. Each step individually is no big deal: coordinating the meds; figuring out insurance and payments; starting injections; going in daily for monitoring; the daily wait for results; egg retrieval anxiety and recovery; embryo progress reports; genetic test results. The big deal is all of it together all at once in the time span of only a few weeks while being hormonal and emotionally invested. It's more than wanting to build a family; it's also wanting to not feel stuck in an awful chapter of your life playing in repeat.

I  was always led to believe that I am capable of achieving anything I put my mind to, but that doesn't account for being unable to solve problems beyond our control. I'm not ready to stop trying but I'm also not ready to start again. Beside for worrying about when my period comes so we can try again, I worry that my body will be ready before my mind. I'm not going to rush it though. I know going in that there's a very real chance the next try may also not succeed and I need to be ok enough to handle that.

I used to completely believe that if we try enough times we will be successful. But with every loss I grow more cynical. I fear that one day I won't be able to believe that anymore. I stress about being able to continue affording treatment. I dread what this is doing to my body long term. I panic when I think about everything we've gone through and second guess every decision that led to this point. I'm scared that we may one day have to face a reality that it's just not working. It's what keeps me up at night. It's what makes me panic. It's what keeps me from believing that there's a path to building our family because today I just can't see it.