Goodbye 2016

It's new year's eve and the 8th and final night of Chanukah. It's been an incredible, crazy, and difficult year.

On to 2017 and its adventures.

Gift

I was scrolling through amazon one night a few weeks ago and found a cute necklace so I went to the online shop and saw one that particularly caught my eye: a four-leaf clover where the leaves are each an individual heart decorated with crystals. I sent a link to my husband for his thoughts and then forgot about it, but he remembered and gave it to me as a gift on the fifth night of Chanukah.

To me it's the perfect charm to remember our four tiny embryos that didn't become babies. As a whole, it's a four-leaf clover which according to some traditions is a symbol of good luck. My husband isn't a fan of superstitious lucky charms, but he knew I liked this so instead of getting the necklace in traditional green he got it in purple. It's beautiful and I love it. He gave it to me on a day where I was feeling particularly down and it made me so happy. 

Planning

I can't do a baseline as soon as January starts because it takes time for insurance to be verified. But I can try to fit in the day 3 blood work and the mock transfer as soon as I want.

They won't do actual fertility treatment until authorization is in, but they can do pre-tests if I sign a waiver saying that I understand I'm responsible for payment in case insurance doesn't come through.

My period is technically due this week but since I'm on pills I can try to push it off a week. If pushing off works, then my CD1 will be Jan 2 or 3. I don't remember how many days after stopping pills the full flow starts so I need to make sure to time it correctly so that day 3 doesn't fall out on Saturday. I need to be off pills in order to do day 3 blood but after that I can get back on pills and then schedule the mock transfer for sometime between days 5-12. That puts next period around week of 1/23 so it's possible to still have a January baseline assuming insurance is verified before that.

If I can't push off my period a week (too much breakthrough bleeding) then I'll have to have it this week, then the next one would be mid-January for the two tests, and then have another period, and then baseline would be mid-Feb.

I'm trying not to stress about it either way.

In the past I used to be able to relax between cycles. After each failure we'd have some plan forward and with it renewed hope. I can't seem to relax this time because I don't have any solutions for future transfers. There's no point at which I'll feel like I can just relax.

We're probably going to try the extra meds (anti-inflammatory and blood thinners) in the next transfer, even though all tests point to there being no issues to warrant that. It's something to try so I'm willing to try it. I'm worried about the side effects, especially the potential weight-gain from prednisone.

I'm going to try Medifast for the first few weeks of January. I've thought about using this method to lose weight in the past but dismissed it because it was gross and expensive. That's still true. The difference now is that I'm at the point where I'm willing to try anything. I also want to see fast results. I'm going to try it for three weeks and see how it works out. The plan is to try to stick to the diet until baseline, whenever that is. I feel like baseline and the start of shots are kind of punishment enough that I deserve to go back to salads, fruit, and regular servings of roasted vegetables :)

I've been visiting someone admitted to the hospital at 30 weeks with serious pregnancy complications. It's weird to be in the OB ward. The situation is scary and precarious; I don't wish it on anyone. It still doesn't make it any easier to walk the halls seeing women achieve goals I've yet to accomplish: get pregnant, stay pregnant, deliver a healthy baby and build a family. I'm so over this ttc phase. I just want past it. I want to move on. I want to have my babies and enjoy with all that comes with it. I know it's not all glamorous and I'm not expecting it to be easy, but I want all the crap that comes with the magic of parenting. I want it all. Is that too much to ask?

Happy Chanukah

The holidays are an understandably difficult time for people who want children and don't have any. This is true in any culture. In the Jewish community, life revolves around children. They are the light and life of everything.

We were lucky to spend the first night of Chanukah with extended family. Since the first night landed on Saturday, we lit at home before going out. For the first time in many years we were misty-eyed about our lack of progeny. From there we went to the party where everyone mixed together. Kids, adults, chaos and noise - just family together. It helped cheer us up, and it brought up an important awareness that we know we want children in our future regardless of what path we end up using to get there. We don't want to be the odd childless couple who just kind of happens to be in family photos. We're going to try what we know until either it works or we decide to try something different.

For the first few years of our marriage while we were we young  and struggling financially, we just weren't ready for kids. We postponed starting IVF until we felt we were in a responsible place to bring tiny people into the world. We also had in the back of our minds that IVF was a beast and it took a few years to get mentally prepared for it. So during that time it never bothered us that other people had kids and we didn't. We figured that when we were ready, we would do IVF and just start popping them out. It never occurred to us that we'd still be trying two years in. It never occurred to me that I'd get pregnant twice and lose both pregnancies.

I used to regret not having started treatment sooner. That if only we had started sooner I'd have more of an edge somehow. But I've since come to the acceptance that things happen when they need to happen. And if that's the case, then if we would have started sooner, perhaps we'd just be in this ttc phase longer. For some reason I may never understand, maybe we weren't supposed to have children until now. I can only hope the future holds a different story.

For all those who celebrate, Happy Chanukah and/or Merry Christmas. May you have a beautiful holiday with family, friends, love, and light.

Countdown to the future

As December comes to a close I can't help but think back to this time last year. On Dec 15 we got our second negative beta. At the time we didn't know that two more IVFs, two more FETs, and two ERA biopsies were in our future. We didn't know that two chemical pregnancies and the loss of those embryos and hope would be coming up. Would we have changed anything if we'd known?

It was around that time that I realized this will take longer than anticipated and I started searching for support online.

I'm worried about the future, both immediate and distant. I don't know what it holds and that scares me. We had to fill out all the IVF paperwork again (something else that expires yearly) and sign off on the fact that we understand this medication can cause cancer and other ailments. When the tradeoff is having a baby, you take the risks. But we now know it's not a guarantee. They used to say at the clinic that everything is fine and we should just keep transferring. Yet the other day the doctor mentioned something about donor eggs. Donor eggs? What for? We're not there yet, why would you say that? His answer was that he can't possibly imagine what else is going on. He threw it out as as an underhanded comment, not an actual suggestion, but it's a different tune than the "just keep transferring" one he's been singing until now.

We're in trial-and-error phase. It's the suckiest and worst feeling. We're going in to the next IVF knowing that we may not have any embryos to transfer. We know going in that even if we transfer they may not stick. We know going in that a positive pregnancy test doesn't mean you're finally getting your baby. We know going in that failure is possible, almost probable considering our track record.

I've shed countless tears and asked a thousand questions but I still don't have an answer as to why the four transfers failed. I still don't know what will help us achieve a healthy pregnancy. I continue to watch everyone around me grow their families and move on with their lives while we're stuck in this limbo. For who knows how long. It's our own personal hell. Not able to move on, not able to let go.

The funeral for our rabbi was held today. The funeral hall holds about 400 with overflow seating. There were about 600 people there, standing room only. Several people eulogized the rabbi and talked about his life. His greatest joy were his grandchildren and great-grandchildren, even though he's had numerous other accomplishments in his 90+ years. He left behind an entire legacy. What a blessing.

In reflecting back to this time last year, I think ahead to this time next year. We should all be alive and well, but what else will be going on? What does 2017 have in store? There's no way to skip ahead and wikipedia the plot, is there? The suspense is something else. But there's also anticipation. If there's a chance of failure it means there's a chance for success - that's the glass-half-full in me talking. I've lost the confidence but I still have some faith.

May the new year bring us renewed HOPE. Personal peace. Patience. Acceptance for the things beyond our control. Courage and stamina to see this through. Strength and energy to cloak the envy. Lots of laughter and love. Adventure and success. 

For anyone else still in the trenches, I wish for our 2017 to be the best one yet.

Ok, Universe. We get it.

It's funny to think that anything is within our control.

I was stressing about the first earliest baseline appointment, trying to plan a cushion to the things I know may delay us (i.e., insurance). I didn't factor in that in this shitty world of fertility treatment, another maddening perk of being on the failure merry-go-round is having all of your tests expire yearly.

I have to redo day-3 blood work. Both of us need to repeat infectious disease blood work. I need to have another mock transfer between days 5-12. All this unmedicated, leaving a logistical nida nightmare. It was suggested to wait until new insurance is verified, so this can't even happen in the January cycle. Which means the earliest baseline we're looking at is mid-Feb, base-case scenario and no other delays.

This news frustrated me so much. Shortly after, I heard the news that our rabbi passed away. He was in his early 90s and his health declined sharply in recent months, but it was still sudden and unexpected. It was the trigger that got the tears flowing. They weren't far from the surface anyway.

What I'm hearing is that the universe is telling me to work on my patience. There's no point in even trying to rush anything because whatever is supposed to happen will happen. This acceptance is like a tidal wave of relief. 

Just be. Live in the moment. Whatever will happen will happen.

Choices

I've been stressing about the possible options moving forward.

The fact that we don't know what can help means that we're just going with trial and error until something sticks. Nothing we tried worked until now, which means everything else is an option.

I found it helpful to write out all the pros and cons of each option, however minuscule.

The first thing I did was go to pdfcalendar.com and print out a 12 week calendar starting at 1/15. I laid out the potential timelines. Being generous for a cushion in case insurance verification takes a while, I estimated a potential baseline at 1/23. From there, it branches out to several options:

• For a new IVF, we're looking at a potential egg retrieval date at about 2/9 
• If we transfer right after, potential FET 2/15 
• If we wait a cycle, potential FET 4/5 
• For only FET, possible transfer on 2/10 

I kind of hate the idea of a possible timeline that doesn't have a transfer until April. Why April? History has shown that it takes my body about 2.5 weeks after an egg retrieval to get my period. They can't start the FET protocol until after a bleed. Once the period comes, it's back on birth control for three weeks before they start the FET meds. That's approx 7-8 weeks total. So, April. I don't want to wait until April to try again. That's four months away! Pesach starts on 4/10 so I'd have a transfer like a week before? I really don't like that.

We talked about all the options and discussed each one. My husband is more gung ho about doing another IVF now than I am. I'm ok either way but I might also be ok just doing the FET. The arguments for it are that it's better to bank embryos while I'm younger; getting it out of the way, since we'll probably have to do it again if we want more children; sooner we get it done, sooner we can keep trying if FET 5 fails. The argument against it? We've been so focused on thinking several steps ahead, but it hasn't really gotten us anywhere. Maybe I should stop being so greedy about trying to get "more children" and just focus on having one first, one at a time. In thinking back about our past trials to try to bank embryos, after the first IVF cycle where we got two healthy embryos, it took three more cycles until IVF 4 to get any additional healthy embryos. Yes, two back-to-back cycles (#2 and #3) resulted in zero transferable embryos. So even if we do IVF now, there's no guarantee it will results in any additional embryos. There are no guarantees at all in this, part of which is what makes it so frustrating.

In the grand scheme of things, waiting an additional 7 weeks for a transfer is not a big deal. I know that. I can be patient if need be. But if we're waiting that much time before we can transfer and then that transfer fails, it's devastating that we've lost all that time.

And that apprehension about waiting is the truth hitting where it hurts. It's not the time I'm really worried about; it's the fear of another failure. I'm continuing to go through the motions and doing what needs to get done, but I have no faith in the protocols anymore. I don't know if it will work. Maybe ever? I don't know. I'm worried and scared. All we can do is continue to do our part, brace for the worst, and hope for the best.

Follow up and then some

Our follow up appointment this morning went as well as it could. Our doctor is a nice person and says the right things to make us feel comfortable. He tries, but he doesn't have answers. If it were up to him he'd say to just keep everything the same and try over and over doing the same thing until it works. If treatment was painless and free of charge, yeah maybe we'd go that route. But since it's not, I feel the need to research the hell out of our options and try something different if the first things didn't work.

We went over several options. He doesn't seem confident that any of them are our silver bullet, so to speak, but is willing to give anything a try. He was patient and answered all our questions. I never felt rushed or dismissed, but I also didn't feel satisfied that we have exhausted all of our options. Here's a summary of what we talked about:

• Blood thinners, baby aspirin, steroids, and anti-inflammatory medication
• Intralipid therapy
• Weight loss
• Fresh IVF or another transfer
• Hormone levels
• Age
• Next steps

Blood thinners, etc.

According to the doctor, the data isn't conclusive one way or the other. If it does work, there's no way to say this is why. He said side effects are minimal, if any. He said he would do both a bloodthinner and an anti-inflammtory combo. I asked about only using one because of the slight chance of side effects on the baby like cleft palate while on steroids. He'd be ok with doing only one, but his suggestion is if you're already gonna do it, go all in with both.

Intralipid therapy

He says that he wouldn't even know where to recommend going for this. The data is inconclusive and there is no current practice for any of the physicians in the clinic to recommend this. He knows about it but does not believe there is any value to this expensive therapy.

Weight loss

It's not the first time I'm hearing this. There's no way to know if this is a factor or not, but it's within my control (somewhat) and so I'm not dismissing it. I know it's the only thing he can come up with because everything else is testing normal. If I can lose weight I will, but I'm not pushing off treatment for this. 

Fresh or frozen

We have a unique challenge in that we need to have our embryos PGD tested. In a regular IVF cycle where you don't need genetic testing, you get to transfer on the 5th day after the egg reterival because your lining is primed due to the medication. Since we have one remaining embryo already tested, it presents with a few options: 

• Option 1: just do a FET
• Option 2: do a fresh IVF and transfer 6 days after the egg retrieval 
• Option 3: do a fresh IVF and wait a cycle before the FET

I originally went in thinking we'd do option 2, with a fresh IVF and then a transfer as soon as possible. The doctor said that there is a slight chance that the extra estrogen from the stim cycle might cause a decreased chance of success, so I think we might do option 3. I know it's only a slight chance, but regardless of how small, I don't want to risk it. We have some time to decide. 

Hormone levels

I asked the doctor to review all my hormone levels and double check if everything looks good. No anomalies spotted. Thyroid, prolactin, etc. all ok. If there is a problem it's not showing up here. 

Age

I'll be 33 in March. I'm feeling an immense amount of pressure to not only have a child, but also give it a sibling. Nothing we've done to this point got us any closer to that goal. Some people think that they want a baby. I don't just want a baby - I want a big family. Dreaming big, even if it seems greedy.

We talked with the doctor about doing another IVF before another transfer in order to bank some embryos. He seemed confused at first, so I explained that if we want to have more kids then the next transfer we do, if it works (big if) I'd have to take off about two years from treatment, one for the pregnancy and one for breastfeeding/recovery/having an infant to care for at home. If I'm ever lucky enough to take home a baby, I want to enjoy it as much as possible before having to worry about the next one. I said I was worried about my age and that isn't it better to bank some embryos at my current age rather than waiting?  I'm getting ahead of myself, I know. I should probably try to focus on just #1 before anything else. 

He responded that I don't need to worry about that until age 37 or 38, especially since I've been a good responder until now. I'm not sure how much I believe him about that. I get that he's the professional and he's used to seeing women in their 40s trying to get pregnant, but the only thing I have going for me right now is that I'm still relatively young. Why not use it to my advantage if I can bank some now? 

My other thought process is that iyh when we are trying for #2, we'll have a #1 running around. If I don't have to wait, I'd rather get an IVF/egg retrieval out of the way now instead of having to deal with it later with a toddler. Again, I know I'm getting way ahead of myself, but this is part of my thought process. 

Next steps

So now we have to decide what we want to do next. We have so many unanswered questions and too many unknowns. Here's what we do know: 

• We want to continue trying. 
• We have one healthy embryo in the freezer. 
• We know I can get pregnant. Embryo implanted and continued to grow. Therefore we will focus our efforts on keeping a pregnancy rather than implantation issues.
• We know our insurance coverage won't kick in until mid-Jan at the earliest. 
• We know that since insurance won't kick in before my next period is due, we're looking at a late Jan or early Feb cycle.
• We know that we are nearing our lifetime maximum benefits for fertility treatment coverage so a lot of our treatment moving forward may have to be out of pocket at the reduced insurance rate. 
• We know we want to bank more embryos before doing a transfer. 
• We know we want to wait after the IVF to do a transfer.
• We know we have two options for the next transfer: 
• Change nothing
• Add bloodthinner/steroid protocol
• We know that losing weight is an option. 

Based on that information, we will discuss in the coming days what we want to do and take it from there. 

To his credit the doctor is willing to discuss any option. He's seems mildly interested in helping us succeed, but he's a skilled clinician who is professional and efficient at his job. He told us to take our time to think about things and let him know if we have any questions, asking us to include a phone number in our email if we want him to call to discus anything. 

I think the temporary plan now is to wait for my next period, start an IVF cycle late Jan, wait a cycle and transfer in Feb with the bloodthinner etc protocol. In the meantime to try to lose weight. I'll let that pickle for a few days and if it still seems like a good idea and we both still agree then we'll go forward with that.

I'm a little bit over all this. I'm feeling deflated and drained. This last loss really took a lot out of me. I don't have the same hopeful optimism. The fear of failure is so great that instead of calculating due dates after a transfer, I calculate how soon we can try again in case of a loss. I don't think I'll ever have a sense of relief where it relates to pregnancy.

We spent a large portion of our 20s in debt and unemployment due to the 2008 recession and it took us a while to climb out of it. We're now spending the best time of our 30s suffering with infertility. I feel like we were late to bloom and we're wasting the best of our youth just trying to stay afloat. Where did we go wrong? What did we do to deserve this? More importantly, how do we overcome? If not overcome, how do we shift our goals and priorities to still lead happy lives?

I don't have answers. I just have an emptiness. When I start feeling happy a guilt creeps in. I don't know why or what for, but I feel guilty for trying to be happy. Maybe in a way it feels as though being happy invalidates all the sad things we're going through. I think I just need to not rush the time it takes to let things heal.

We talked about going on a trip to try to get a little space and fresh surroundings, but it's the same issue again that comes up. The more money we spend, the less we have for treatment. Our 10 year anniversary is coming up this summer and I've been saving for a major trip for almost 4 years. It now seems like we may need to use those funds for more treatment. It's unfair and it sucks, but I feel like I have to try everything before giving up. I don't want to live with regrets. We will iyh celebrate our anniversary wherever we are together, but there's only a finite window to build a family. I wanted to compromise and have a quickie getaway nearby, but anywhere nearby that's worth traveling to during this season still has zika issues. It feels like we can't win.

I feel like if we just can keep going we can thrive, not just survive.  We just need a little bit of luck to get through this latest rough patch. I also need to remember to learn to enjoy the journey. I feel blessed that we have the opportunity to try again. Our life is currently being made up of these memories and it is what we make it. We are so fortunate to have the things we do - I'm too superstitious to list them here - and I am thankful every day. 

Fine

Physically I'm starting to get back to myself. I have no pain, no bloating, no fatigue, no symptoms at all. For the first time in a while I feel great.

My mental state is different than before. It's not better or worse, just different. This morning I went to a bris/baby naming ceremony and for the first time in as far back as I can remember I didn't cry. Not that I wasn't moved, but I just didn't cry. This is very unusual for me because I tend to cry at everything.

Maybe I'm all cried out? Maybe I've become numb? Maybe our challenges have made me stronger? I wasn't sad or jealous, and I don't think I'm dead inside - I just didn't feel like crying and I made the choice not to. It's a weird feeling to be able to control that. I was looking around the room at the menu and centerpieces and making mental notes of how, if we are ever lucky enough to host one, our celebration would differ. I guess all those times in the past few weeks I felt like crying and couldn't just taught me better control? I don't know.

Looking ahead, I got a price estimate for future treatment from our financial counselor. Our options are to start another IVF or FET with the last embryo. Our appointment with the doc is scheduled for later this week so I hope we have some answers either way. It sounds like we may not be able to start until mid-Jan regardless because they need to verify my new insurance which can take up to 2 weeks. I honestly don't understand why it takes so long since everything is electronic these days and we had to submit our insurance preferences by 11/15 so what takes so long? I have some choice words I'll keep to myself on the subject.

In the meantime we're back to "normal" life, like before treatment. We're on mandatory break and there's nothing we can do now. It's kind of nice. The holidays are coming up and I have winter break to look forward to.

Shabbat shalom!

Remembering

I cleaned out my purse this morning and found the picture the embryologist gave us of our embryo on transfer day, nearly a month ago. I've saved the picture each time we transferred, but for some reason I felt the need to carry it around with me. When we lost the pregnancy I couldn't part with it just yet.

I was thinking of doing something with the four embryo pictures, like framing them or putting them in a book. Is that morbid? It might be a little weird but I want a physical reminder of the babies that may have been, not to mention how much money those photoshoots cost...

I don't think my husband cares either way, but I know some people say that it's a way to harp on the past instead of focusing on the future. What are your thoughts?

FET 4: Last beta

Bloodwork results from today showed hcg back at negative levels. This officially closes the chapter on FET 4. Goodbye forever, tiny embryo.

We're now on break from all treatment until after the year starts.

Envy management

In June, Savannah Guthrie on the TODAY show announced she was expecting her second child. I remember the date because later that day I got a call from my nurse telling me I was pregnant for the very first time in my life. Unfortunately, my pregnancy didn't continue past the week. A few days later Dylan Dreyer on the same show announced her pregnancy.

Fast forward to present day. In the interim 6 months, we went through a chemical pregnancy, two biopsies, and another failed transfer ending in the second chemical pregnancy.  Savannah and Dylan continued to show off their growing bumps daily along with web stories and baby-themed segments. Friday was Savannah's last day at work before going on maternity leave. Both she and Dylan are due in December.

Am I jealous? Probably at least a little bit. It seems like these women have it all: great career they enjoy, seemingly breezy fertility, beautiful wardrobes to get them through their changing bodies, and tons of money to support their growing families.

But in reality, I don't know what's going on behind the curtain. Savannah is going to be 45 at the end of the month, her husband is 48. She'll be in parent teacher conferences through her 50s while other parents same age are celebrating college graduations for their kids. So she's a little late to the game. I don't know what she's going through or what kind of struggles she faces. She's paid to paint a happy picture for the public because it sells ratings. Plus at her age I don't think it's far fetched to believe she had some assistance getting pregnant. Maybe if not the first time, possibly the second. I really can't judge, nor do I want to. Dylan talked on the show about how she and her husband talked about actually not wanting kids in the past. Then she turned 34 and changed her mind so they started trying and ta da! I love her personality and sweet demeanor. I'm jealous that it seemed so easy for her to get and stay pregnant but I don't hold it against her. Different people face different challenges. I only bring this up because their pregnancies are so public and I see them daily when I'm getting ready for work. I honestly wish both of them all the best.

I don't feel that just because I'm going through a tough time other people should too. I strongly believe that each person has their challenge. I have mine and I wouldn't want to trade it with anyone else. I just see that the same things we're struggling with are seemingly so easy for others and I pray for assistance with our path.

For the few weeks I was pregnant none of it bothered me. I didn't care seeing people's baby or sonogram pictures on facebook; I didn't mind taking a stroll and seeing people walking with their strollers; it didn't bother me to see baby bumps everywhere. I figured my time was around the corner - only a few short months until that was me too! It's amazing how much your current situation changes your mindset. And in hindsight, it was glorious to feel so content and at peace even with the constant anxiety simmering on the back burner.

To that end, it was part of the reason the last loss was such a big blow. It wasn't only that it didn't work. It was that we were left with no answers. We have no idea what caused the sudden drop in hcg so we basically have no clear idea of how to fix it.

I've been doing a lot of research and I'm finding out more information about lovenox and prednisone. It sounds like the shots are painful and there are precautions one needs to take while on them. It also sounds like they're an expensive option and insurance doesn't necessarily cover this therapy. Obviously if this is the answer then we'll find a way to make it work. Of course. But we don't know if it's the answer.  It gives me hope to read about people's experiences. One person in particular posted, "After multiple miscarriages, I tried lovenox despite not having any diagnosis that would warrant it and it worked."

It's reassuring to see other people overcoming their fertility issues and having healthy babies.  I need to remember that each person's journey is their own and mine will happen the way it's supposed to regardless of what's going on around me.

It might be the extra research, the fact that the toughest part of period from hell is behind us, or that I got out of PJs for the first time since Thursday (not the same ones; I did shower), but I'm finally starting to feel better. I'm hoping bloodwork and results tomorrow can help us close the chapter on this.

Thanks but no thanks

AF arrived in earnest, 6 days after I stopped all meds. I had painful cramping all day and the period from hell is living up to its reputation.

I'm glad I took Friday off. The mental break helped a lot. I stayed home today too while my husband went to shul. I bought the food for shabbat and we spent a quiet day at home. We talked about all the possible options we know about. We have our questions for the doctor. I hope we're on our way to crawling out of this depression.

In the afternoon some visitors came by. One pulled me aside and offered to be a surrogate. Huh? What?? I was so taken aback. I know it was a genuine offer of help. I know she thought it was an innocent suggestion. It came from a good place. But it really, really upset me.

To the blogger who posted about this a few months ago about a family member offering to be a surrogate, I apologize for not being more offended on your behalf! I didn't understand until now. The more I think about it the angrier it makes me.

I need to focus on healing and getting revved up to do this all again. When I hear a suggestion like that, it makes me think that you've easily given up on me. 

Thinking about surrogacy is a huge, intense decision. It takes deep, meaningful conversations and coming to terms with some serious sacrifices. Women don't turn to surrogacy lightly and to throw it out there is just.... hurtful.

I don't know what our path holds. We may or may not consider different options in the future. For now, that's not where we are. I'm not ungrateful that someone cares enough to offer it; I'm just not in a place where I am ready to hear it.

For the time being, if your opinion is about adoption or surrogacy, please keep those thoughts to yourself.

FET 4: Beta 4

It's the chemical pregnancy that just won't go away. Hcg level this morning was 5.4. Ugh.

In general I'm a pretty positive person so the depression hanging over me is heavily weighing me down. I want to move past this but it's just too soon. The fact that we can't close the chapter doesn't help. I have to go back on Monday to confirm levels go down to zero.

I've been trying to research things to ask the doctor at the next appointment. So far I'm planning to ask about lovonox and prednisone, though I'm seeing a lot of quite horrible side effects of these. What else? I don't know enough to know what to search for.

Spotting has started. I assume AF is right around the corner. Ibuprofen in large quantities is helping. I took off Friday. It was a really long week trying to keep a brave face at work. I need to be able to cry and grieve and sit with my heating pad and think about all the things that suck about this so that I can get it out of my system and move forward.

I know I'm not ready to give up. It's still fresh and actively happening and I already know that I'm willing to go through it again if it means a chance at success. I fully believe that whatever is supposed to happen will happen, and I need to do my part to get there.

I so appreciate the support we've been getting. It's not so much what people say, it's that they care so much. When they say something like, "I wish there was something I could do," it touches my heart to know how much they are invested in our success. Every voicemail, text message, email, or visit is another tether helping us carry this burden, easing the weight off our shoulders little by little. Even if I didn't respond I got it and appreciated it so much.

Time will help heel these wounds. Faith will strengthen us for next time. Hope will keep us going until it's time for our miracle.

Raw and emotional

Everything seems to be a trigger, like the mundane things people take for granted. The fb fall family photoshoots are a big trigger for me, to the point that I had to take a fb break.

I cry when I think of how great the numbers were and how suddenly and abruptly it ended. We couldn't do anything to save our baby.

It was lightly raining all day and at one point I noticed that the pre-school nearby took the kids out on a walk in their raincoats and rainboots. They were splashing in the puddles outside my office window and just being adorable enjoying themselves in the rain. It took all I had not to fall apart in a pool of tears right then and there.

I totally thought that the ERA was the silver bullet. When we got those results I thought we finally had an answer. Three FETs were gone but at least we had a solution - we learned that the transfer day was wrong and I thought it was the answer. It may have been the answer to one issue: implantation. We passed that phase because we got great numbers. It was keeping the pregnancy going that became the issue.

I've read online that people treat repeated miscarriages with meds like prednisone and lovonox. I don't know much about these meds other than the fact that it's an anti-inflammatory and a blood thinner. Is my body rejecting the embryo? Definitely something to ask the doc at the wtf appointment. I scheduled it for week after next when my husband has off and can come with me.

I started taking calls again. Earlier in the week when family or friends heard the news and called I let it go to voicemail. I just couldn't. I was ashamed and disappointed that I didn't have better news to chat about. But I appreciate the calls and it helps to talk to people, even if they do most of the talking because I can't through the silent sobs.

The stats talk about how there's an 85% chance of a live birth for every three transfers. We're at 0% for four transfers. It's all the more painful because we don't know WHY. We can't pinpoint a problem so we can't work to fix it.

I know He has a plan. I know that whatever is supposed to happen will happen in the right time. But it's hard to accept a plan that includes this much pain. It's difficult to hold on to hope when I feel like we're being punished, over and over. It gets so much harder after every loss.

Lost

Spent most of the evening crying on my husband's shoulder. It's the tough times that show a person's true colors and he's been nothing short of amazing.

I tried to think of next steps but I just couldn't. It's too overwhelming. What guarantee do I have it will ever work? What if I choose to walk away now? Four IVFs. Four FETs. Countless medications and shots. For what? What do we have to show for it? We're back at square one.

I'm tired. We've been at this so aggressively for nearly 18 months with back to back procedures and failed attempts. I'm tired of the failures. I'm tired of the crushing heartbreak.

Even as recently as June 2016 I was less jaded, having "only" had two failed FETs, before the chemical pregnancies started.

In the past six months I've gotten daily PIOs in my butt, painful and bruising intermuscular shots. Two ERA biopsies chomping on my uterine lining to get some answers. We've had two pregnancies confirmed, only to have them end abruptly shortly after.

And what now? We did everything we could and it still isn't working.

My doctor doesn't seem to have any reason to change protocols. While the clinic has been professional and responsive, I'm done with their sterile factory environment. I'm just done.

I don't know what comes next. Do we do another IVF to collect more embryos? We've had mixed success with those in the past. It's expensive and painful. But what's the alternative?

We have one healthy embryo left. Do we transfer? Do we save it and try to get more? What can we change, if anything? I don't think they've created a test yet to tell me why I got pregnant and had great numbers but that the pregnancy spontaneously failed.

I don't know. 

I don't feel supported by the doctor. I don't have the tools to figure it out on my own. I don't have a direction to move in. I can't see with blurry vision through the tears. I can't see past the darkness yet.

FET 4: Beta 3

Hcg levels are down to 26.

It's over.

Another chemical pregnancy.

I don't know why this keeps happening. Not sure what we did wrong. I don't know if there was anything we could have done differently.

I can't stop crying. I'm home for lunch break and I need to get back to the office soon, especially since I got in late from traffic and waiting over 40 min for bloodwork this morning.

I don't know how to fix this. I don't know why this happened.

One step at a time

Part of me wants the extended weekend to last as long as possible. The weeks ahead are going to be busy at work and it's going to be non-stop until mid-December, so the break has been nice. Another part of me is anxious to get to the clinic for Monday's bloodwork and hear the next update.

Since the Wegmans incident there have been less and less symptoms. Cramping is nearly gone. My husband and I kind of stopped talking about it all together. The Wegmans incident really scared us. Every so often I'll get a twinge or feel something in my lower belly and remember, but for the most part we're trying to keep it in the back of our minds until we know more.

I haven't worked out since last Tuesday. We've taken walks around the neighborhood but nothing to work up a sweat. I've kept my feet up and drank a lot of water and tea. Spotting stopped but I dread going to the bathroom, worrying I might see something new. The bloating has gotten better, no headaches, no fatigue. My appetite is gone which is unusual for me but I'm probably just full from all the liquid trying to stay hydrated. The only symptom to report is a phantom tight-undies feeling. It feels like my pants or my skirt is just a hair too snug, but I know it's not the clothing because the feeling happens in the shower sometimes too.

Thinking about the what-ifs is exhausting. I find it emotionally draining to think about all the things that could go wrong, but I want to enjoy what could possibly be the beginning of our child's journey into the world. I'm trying my best to put the worrying on the back burner and try to take things as they come.

Happy Thanksgiving

I love Thanksgiving. It's one of my favorite days of the year. I love that it's a no-stress holiday. I love that it combines things I love: family and food. I love that the one legal holiday turns into a nearly 5-day weekend!

Spotting slowed significantly overnight and changed to brown, so I take that as a good sign that its stopped and this is just whatever's left over. I've googled as much as I can and everyone on the internet says cramping is normal. They also say that bleeding isn't automatically a miscarriage, but to monitor closely. So my doc knows about it and I've done everything I could. Possible harmless causes are either implantation or the meds, none of the other explanations the internet offered were relevant. At this point whatever is supposed to happen will happen.

I tried to think back about my day yesterday wondering about what could have contributed. I realized that with all that was going on -- getting bloodwork, running errands, cramming everything I could into the half-day before we were dismissed for the holiday weekend -- I'd been basically fasting the majority of the day. I drank a bottle of water on my way to the clinic for bloodwork, but other than that I wasn't hungry and didn't think of eating until after 3:00 pm. The Wegman's incident (as we are now referring to it) happened about 12:40 pm and after that I really had no appetite. Is that the cause? I worked out on Tuesday, for the first time since transfer, and felt extra cramping but nothing too intense. Was that it? We'll never know. But I'm going to be more mindful about making sure to stay hydrated and take it easy.

I did my best to relax yesterday evening and fell asleep around 9. I was up early this morning but it was still dark and decided not to start my day just yet. I feel like the only thing I can do to help things is to just take it easy and keep my feet up, so I'm enjoying my pajama day on the couch and in bed, getting up occasionally to baste the turkey or get a snack. Thanksgiving and the long weekend couldn't have come at a better time.

The cramping has subsided a lot and I barely feel it when I'm sitting or lying down, unlike yesterday when it was active all day. I didn't think anything of it because I'd been having cramping since transfer day. I plan to park it until bloodwork on Monday and hope for the best.

While it may sound cliche, I feel truly blessed this Thanksgiving. Wishing you and yours a very happy turkey day!

FET 4, Beta 2: The Good, the Bad, and the Ugly

The good news is that my numbers doubled: they're up from 448 to 954.

The bad news is that I've been having intense cramping and around lunch started spotting heavily. I called my nurse in a panic and I was told that spotting is normal. She said there are a few reasons for bleeding at this stage, such as the meds causing it. She said that while it seems alarming I should try to relax and just keep taking the meds. It was reassuring enough to keep me from crying but not enough to make me stop worrying. Next appointment is Monday for third beta so if I'm in pain or have heavier bleeding I need to call the after hours line.

The ugly is that I had just gotten to Wegman's for some pre-holiday shopping when I decided I should use the restroom quickly first. It was there that I discovered the bleeding so in my freakout I just ran to my car to call the clinic. I didn't get any of the groceries I meant to buy and didn't realize until later in the day.

We're cautiously optimistic. The numbers doubled, as they should. But as soon as I saw the red my happy bubble burst and I realized that this could all end at the blink of an eye. I'm happy the numbers doubled and that there's still a chance that this will be ok, but I'm so worried. I'm trying not to assume the worst just yet.

FET 4: Beta

It's been a long and exhausting day but there are important updates and limited editing below.

Left the house at 7:00 AM and made it to the clinic by 7:30 AM. Waited for 25 min before being called for bloodwork. Back in the car at exactly 8:00 AM. Made it to the interview place by 8:40 AM which gave me time to find parking, look over some papers and use the restroom before the 9:00 AM interview. I met with three sets of people and talked non-stop until 10:45 AM. From there I went to meet a friend for coffee. I got home at 12:25 PM at which point I got the call from the clinic.

You know how they like to see a number above 100? You know what my number was? 448.

4. 4. 8.

The doc said the number, and I'm like 148? That's great! He's like no and repeated it. I'm like 248? Wow! I finally got it on the third time. 448!!!!!!!!!!!!!!! Is that even a real number??? I didn't know numbers that high were even an option for first beta!

We told our parents and a close friend following our story. If you know me IRL please keep this news to yourself - we're obviously not ready to go public yet.

We're thrilled. I was so happy with the news. But it doesn't feel real yet. I couldn't sit still at home so I went in to work for the afternoon. They were actually texting me questions and because it's a short week they were time sensitive, so it was easier to just come in. It's fine - I enjoyed being around people with my little secret. In fact, meeting new people and learning about the new position in the interview made me appreciate my current job and team members even more.

It still doesn't feel real and every few minutes we remember and we're like, is this real? Is this really happening?? We're so cautiously happy, knowing that it's still so early and anything can happen. But for the time being... officially pregnant. Thank you Hashem. Thank you everyone who said tehillim.

Next bloodwork is Wednesday to confirm the number is doubling.

FET 4: 11dp6dt

Well, here we are.

It's the night before beta. Still officially pupo. Last night of the unknown for FET 4. I'm proud to say that I've stuck to the no-testing pledge. Not a single HPT peed on in the past two weeks.

I've had cramps on and off the past few days. They've gotten less frequent and more intense. I feel it more when I stand up from after sitting a while. I think the cramps are from the PIO, regardless of whether something stuck or not. Otherwise no symptoms that I can tell.

My cold is almost all gone, thankfully.

I'm nervous for tomorrow. I spent some time today doing research for my interview, but I'm not nervous for it. If they like me for me then I'm the right fit for the job. If not, then it just wasn't meant to be. I want to do well, but I'm not freaking out about it.

I'm nervous about it being a top-heavy day, with everything crammed in the morning. I need to wake up earlier than usual so that I have a chance to beat traffic on the way to the clinic and get there in time. If at all possible I want to avoid getting stuck in the queue waiting for bloodwork. It's the shortest and most significant part of my day. There's nothing I can do about the results and it's the thing I'm most nervous about. From there I have to get through traffic to my interview. At some point I have to remember to call in sick from work.

I was randomly googling thoughts and came across this poem which captures a lot of the same things I'm feeling.

I'm ready for some good news!

The Plan

It's 10dp6dt and I haven't tested yet.

I believe not testing helped keep me from over obsessing. Actually, it just shifted the obsession from the testing to not testing. But not having a physical or visual daily reminder made it possible to put aside the continuous loop of thoughts for a few hours every day until I remember, at which point I get a tiny jolt of anticipation about the "what-ifs." I realize that, like with every other time, I'm still expecting it to work. And every time it didn't work in the past it was all the more surprising and disappointing.

I've prepared for worst case scenario: planning to take the day off in expectation for the results phone call and didn't sign up to bring anything for Thanksgiving just in case we don't want to go. Yet I'm hoping for best case. I hope it works.

But what if it doesn't? I could live in denial but the reality is that if it doesn't work then the only thing to help from sinking into a deep depression is knowing what comes next. We have one frostie left from IVF 4 and we have a few options.

• Option 1: Move ahead with FET 5 with no changes
• Option 2: Move ahead with FET 5 but first do an endo scratch
• Option 3: Save the last healthy embryo and do IVF 5

It's distressing to think that after all this we may have to start over. It helps to prepare mentally even though I hope we won't need it. We are less than 48 hours from knowing one way or the other. 

The first time we transferred we didn't tell anyone. In fact we had conversations and disagreements about it because he wanted to tell his family and I felt that it was too soon - no one shares that they're pregnant at two weeks! I felt like it was an invasion of my privacy to share what's going on so early. But when it didn't work we had to share bad news. It was terrible. Second transfer we said we'd share the news after the first ultrasound. It never got that far because it didn't work then either. 

Third transfer we ended up sharing between first and second beta, mainly because we wanted so desperately to share good news and we weren't sure that we'd still have good news after second beta. Turns out we were right and once again we were disappointed. It was important to have the support of family and friends who knew. It helped us keep grounded and hopeful. 

And now? Everyone knows. Obviously not everyone; I can count on one hand how many people know. We're hoping we can get power of prayer and strength in numbers. Here's hoping!!!

FET 4: 7dp6dt

Day 7 post transfer
Day 3 of Wicked Cold, downgraded from Monster Cold

Feeling a little better. Helps that I was able to sleep a little last night. The intense sinus pressure on my face loosened up and my sense of smell went from 0% to 30%, so we're getting there. The pain moved from my face to my throat, but hopefully it will end there. Other than cough drops I've been on round the clock tea and chicken soup. I've been avoiding sugar since it usually increases inflammation and I can't taste it anyway so why waste the calories.

I started feeling some period-like symptoms. Cramping could be a good sign, but it's also possible it's a side effect of the PIO. It started around the same time last transfer but I forgot about it until I went back and reread some posts. I'm also having crazy dreams. Beside the rated R versions, in one dream I took an HPT but remembered I'm supposed to be waiting til beta so I hid it before looking at the results. In another, we got the positive results and my initial dream-knee-jerk-reaction was, "Oh well, I guess I can't leave now." Haha wth?? I can't remember ever having those thoughts in waking memory so what's that about? Where does my mind want me to go??

Haven't tested yet. I'll wait. I won't be patient or happy about it, but I'll wait.

FET 4: 6dp6dt

Day 6 post transfer
Day 2 of monster cold

In short, a few exciting things:

• Did a glass blowing workshop today. I made a wavy bowl. It needs to cool off slowly because it might crack if cooled too quickly so I'll pick it up in a few days. So fun.
• Have an interview scheduled for Monday morning!
• Not feeling preg. I know it's early for symptoms. I also know it's possible that being congested is masking symptoms, however minor. 
• Haven't tested yet.

Beta and interview are same day, back to back. I'll have to take the morning off for the interview, and it will likely be close to 11 am by the time I get in to the office. By then it will be almost time to get beta results. Last time I got not great news I left the office at lunch with a "migraine" and didn't come back. If the news is good, I have no issue going in to the office. If it's not good news, I'll want to be home. So I'm considering taking off the whole day. 

I have the time and my supervisor wouldn't give me any issues. I don't know why I'm so opposed to taking time off. I'm always trying to save it, but this is exactly the kind of thing it's being saved for. I can always take off and then figure it out at the time.

FET 4: 5dp6dt

Today in a word: miserable.

My back pain is gone. In its place is a monster cold. I caught a cold and it's making me miserable. Stuffed nose, clogged ears, intense sinus pressure, and sore throat. I know I can take Tylenol so I will probably take some so I can sleep. I know that if my husband had this cold I'd tell him to stop being a big baby and that "it's just a cold." But goshdarnit, I can't focus on anything with this leaky mess. At some point during the day my tissues became sandpaper on my nose. I left work an hour early - I just couldn't anymore.

Speaking of work, someone made my Monday extra special by messing up one of my spreadsheets. In trying to sort the sheet by alpha order, this coworker sorted only one column, leaving all the other columns unsorted. This wouldn't be a big deal if the coworker didn't then save the spreadsheet before undoing this error. FFFFFFF. Not only was it a big deal eff-up, but I didn't have access to my backup. I asked IT if they can recover the old version of the spreadsheet. They could, but only from last night so all the work I had done this morning would be lost. We figured it out - basically had to recreate the whole thing. I stayed calm and worked through it. But seriously, if you're not sure how to use Excel, you can ask. At the very least, Google it! And for the love of Oprah, don't save something once you're messed up.

In pupo news, I haven't tested yet. I don't think I fully thought this through because it gets harder, not easier, not to test every day. Every day it's a challenge. By day 5 last cycle I already saw a clear, albeit faint, line. Tomorrow morning will be 6 and I know that if something took it would show up. But I'm really trying not to test. I tested last time and what good did it do? My mood for the day entirely depended on the results and it was a daily roller coaster. In the end what good did it do - nothing. It just raised our hopes so much only to be crushed later. I want to avoid it if possible. If I test tomorrow and it's blank, I'll be devastated but still hopeful that the next day will be different. I'll try to rationalize it and figure out when is too early. I can't do that to myself daily. In another week we will know for sure.

Technically I'm supposed to go in on Tuesday for the beta, but because of the holiday they moved it up a day. They like to limit the number of people who come in on holidays and weekends whenever possible. They scheduled it in a way that if I have to come back two days later for a second beta, it wouldn't be on the holiday itself. Works for me - one less day to wait. 

FET 4: 4dp6dt

I figured out the trick not to take HPTs. Once I get rid of fmu the urge to test completely passes. I have an irrational certainty that anything other than fmu will jeopardize the test results with diluted pee from later in the day. So I just have to get past the next 8 mornings.

Last night, Kate McKinnon sang Halleluja in the cold open on SNL dressed as Hillary Clinton and as a tribute to Leonard Cohen, the writer of the song who passed away this week. It was powerful and moving. I cried when I saw it the first time.

It spoke to me on many levels. I loved that it didn't lose any meaning in its simplicity. It was in part a eulogy to a legend songwriter. It was a mark of respect for the campaign Hillary fought but lost. It was a mark of compassion for all the people hurting over the election results. Regardless of whether this is the end of seeing Hillary politically or not, it was encouraging to hear McKinnon as Hillary say, I'm not giving up and neither should you.

It reminded me of Hillary Clinton's actual concession speech, also emotional and moving in its own right, in which she said, "This loss hurts, but please never stop believing that fighting for what's right is worth it."

I believe in the fight. I believe it's worth it. It will take a little longer, but I believe we'll get there. 

FET 4: 3dp6dt

Early Friday I was walking down the stairs and something happened to my back. I wasn't carrying anything or twisting, but a muscle between my right shoulder blade and spine got twinged and caused intense pain. I couldn't take a deep breath or move my right arm without getting a sharp jab. I was more alarmed than anything else, and emailed my nurse to find out wth.

I put a heatpad on while waiting to see if I could make it to work. I tried stretching and moving slowly to try to loosen the muscle. The nurse emailed back that they can only recommend Tylenol or Extra Strength Tylenol, but if it gets worse I should contact my PCP.

Thankfully over the course of the day it loosened up (yay for working out aiding a stronger back?). With heat, massages from the husband, and stretches it was way better by the evening. By tonight, it's almost all better. I didn't end up taking any meds, but was fully prepared to if needed. Whatever bad effects Tylenol may or may not have on pregnancy, I couldn't have excruciating pain possibly affecting implantation. I don't know what caused it, but it really sucked. Maybe a delayed side effect of Tuesday's massage? Who knows.

In other news, haven't tested yet.

FET 4: 1dp6dt

Day one post transfer. Haven't tested yet ;)

I've had mild cramping since the transfer. That happened the last time, too. When I feel the cramping I worry that something is wrong. When I don't feel it, I miss it and also worry something is wrong.

I had very light spotting this morning and tried not to freak out. The discharge papers they gave me yesterday said it was a possibility and normal if it happens, so I'm saying off Google.

I'm trying really hard not to obsess about it. So much so that I try to not think about it but then worry I might forget something, like taking a shot or remembering my prenatal pills or avoiding alcohol/sushi/deli/other anti-preg poison. Putting reminders in my phone helps.

I'm sad for America. I'm still processing the results of this election. One thing it does is help keep me distracted. The less I think about the transfer the less likely I am to test early. I'm going to try to hold out until beta, or at least as long as possible.

Transfer day

Officially PUPO.

I worked half day and crammed all the important things I had to do in just a few hours before leaving. My mistake was drinking too much water during the morning. By the time I emptied my bladder for the last time there was still some in my system working its way down. So when I added the required 16 oz pre-transfer, by the time we got to the clinic I was very uncomfortable.

Luckily, they got us in quickly. They always ask you to come 30 min before your actual appointment time. We left extra time to get there in case of traffic and got there early. We were called back right away. My blood pressure was really high - I was very nervous. There was no wait at all, and we were in and out in almost 20 minutes. Simple. Done.

In prep for the transfer I ended up getting the pom juice and nuts. I couldn't not. I don't want to feel like I left anything on the table. After we left, my husband and I went to a cafe before he went back to work just to defrag. I went home to watch TV. I have the time off work I can spare, so why not.

The election results are ridiculous. How did we not see this coming. I'll accept that he's the president-elect but I'm not happy about it. People are calling Hillary crooked, yet she's been cleared by the FBI and Trump is the only one with a scheduled date in court under federal indictment for scamming people at Trump University. Maybe he will surprise us all? Maybe America will get better? I don't think so, but only time will tell.

Now we wait.

HPTs

I haven't decided whether I will take home pregnancy tests this time. I remember what a roller coaster ride it was every other transfer.

I didn't keep as meticulous records of the first FET 2ww, but I remember it being negative pretty early on and not ever changing. It was obvious it didn't work. 

The second FET was right after a retrieval and when I tested it came out positive several times, but I think that was because I still had residual HCG in my system from the trigger shot. It's possible it was another chemical, because I remember calculating the days past the trigger shot being 17 days later and still showing a faint positive. According to Google, HCG only lasts in your system up to 14 days so I took it as a sign of working. However, beta came back at less than 1 so it clearly didn't work.

Then there was FET 3 where I started testing almost immediately. I think day 3 or 4. At first it was such a stark white it almost seemed like a negative white, if that's even a thing. But then the next day there was a faint line that you had to squint and then cross your eyes and hold it up to the light just so to see, but it was there. Then it got slightly darker every day after that, and I knew. I knew that something stuck. I knew it worked! But then around day 11 or 12 the line stopped getting darker. I shook it off saying that it was probably just diluted pee, or not FMU, or something else. I was in denial and not ready to accept the bad news. It was close enough to the beta that I was ok just waiting for the bloodwork instead of continuously testing. Sure enough beta came back positive, but low. The clinic likes to see above 100 as the first number but considers anything above a 50 to be positive; mine was just above 60. We tried to hold on to hope but by the second beta two days later it was over. It's still hard for me to go back to those posts. It hurts to relive those days. Hard to believe it was just this past summer.

So I'm hesitating about testing this time. I don't want to deal with it either way. How do you not test for two whole weeks?? Are there really women who hold out for the beta? At one point I was thinking of testing in the morning before the transfer just as a baseline. Is that obsessive? I'd say so. But what's the alternative? Not testing? Not thinking about it? Not knowing?? I don't know if I can do that. What's my motivation for not testing?

The clinic strongly advises not to test because of the chance of false positives or false negatives. But really, what difference does it make to them. They talk a big game but they're not the ones going through it - they have no idea what the stress is for someone to not know if their dreams are about to come true or if their world is about to crash in on them. 

It's a very fine line between utter joy and complete devastation. That line is pink and lives right next to the control line on a pee stick!

In other news, happy voting day! Regardless of who becomes our next president, American wins when this election is over.

Pre-transfer jitters

I finally broke out the aerobic step I bought a few months ago. It's embarrassing how long it took me to get motivated enough to actually use it. But I did and, along with a great YouTube video, I worked up an awesome sweat before work. They say one good deed leads to another and it's true for this too, because I even took the time to prep breakfast and pack a healthy lunch. 

My new diet philosophy is 5/2: eat well 5 days during the work week and then enjoy the weekend with less restrictions. I see the most results when I low-carb but it's hard to keep that up for too long at a time, so this might be a good compromise. I've definitely enjoyed the weekend so now it's time to do the 5 'good' days. I feel like it's easier to be more structured at work so we'll see how it goes. I'm also using the free app from myfitnesspal.com and it's really helping to keep me accountable.

Today the clinic called to give us the exact time for the transfer. They always have egg retrieval surgeries in the morning and then after lunch they do transfers. The schedule depends on how many egg retrievals they will do that day, and that depends on today's bloodwork from monitoring. From past experience I knew that the surgery schedule comes out around 4 PM.

Shots are going fine. I think my butt is getting numb quicker this time because of past damage to the area from previous PIOs. It used to alarm me when the area went numb after several shots, but now I'm just embracing it and trusting that it will eventually wake up again. I was hoping it would make shots less painful but it doesn't. #itiswhatitis

Last transfer I did a recap so I can remember what I did. I'm already doing most of it - trying to eat healthy and keeping active at least 3x/week. I'm eating pineapple because I like it, so it's part of my regular snack rotation. I'm debating whether to buy pom juice and nuts again... I doubt they did anything the first time and I didn't really enjoy them. I guess it will be a game time decision when I go grocery shopping tomorrow. I booked my massage for the day before transfer. I feel like it helped me relax so for that reason it was worth it. Whether or not it helped otherwise I'll never know, but I feel like I'm doing something proactive to try to help implantation. And then there's the added day of PIO before transfer, thanks to two ERA cycles, two biopsies, and nearly $2k later. I hope that this is the ultimate trick that helps this work.

I'm anxious and excited. It's hard to put into words how much I want this to work. It's hard to admit how much I want it to work because for some reason it feels like that much more of a failure if it doesn't.

Whoops!

In the relief and excitement of being cleared to start PIOs, and therefore locking in a transfer date, I accidentally took my delestrogen shot a day early on Thursday. In the three prior FETs and two ERAs I've never mixed up the medication calendar. This was a first!

I emailed my nurse in a panic. She told me how to adjust the schedule to move forward and said it was no big deal. She kind of made fun of me, saying that she's never had someone so excited about a shot. I didn't care, I was just relieved I didn't mess anything up!

We had a nice weekend so far. The weather has been gorgeous. We went to a friend's birthday party on Friday night. It was lively and so nice to hang out with friends. Tonight we went to see one of our favorite comics, Sebastian Maniscalco. I love seeing live comedy but sometimes I forget how much I hate crowds. It was still great.

Earlier in the day, we were sitting in the backyard chatting on the swing and it hit me that this time it's not a dry run. The last two cycles we did were for the ERA and after several weeks of shots there was a biopsy and that was it. We haven't had a transfer since June. But this is happening. The dreaded 2WW is nearly upon us. If things go well, the 2WW extends beyond that to more anxiety and milestones and life as we know it changing forever. That's best case scenario. If things don't go well, we're looking at a depressing Thanksgiving holiday coming up.

I hope this is it for us. I hope the information from the ERA is what we needed to succeed. I hope we have good news to share soon.

FET 4: Lining check

This was my day.... unedited.

7:30 AM - Lining check was this morning. Doc said lining was just at the minimum of 8 mm. What? Seriously? Of all my appointments ever, lining was never an issue. The last ERA cycle lining was close to 12 mm or something. Why is this happening?? Bloodwork uneventful.

8:12 AM - The appointment ended pretty quickly so I had about 20 min before needing to be at work. I was thinking of running to Starbucks but then had a better idea. Instead of standing in line at Starbucks, I went to the nearest early voting place and stood in line there! The lines were long but they were moving pretty quickly so I was in and out within 30 minutes. #MakingHERstery #imwithher #gotasticker

11:04 AM  - I'm trying not to freak out. I know that it's the minimum but I think it's on the right side of minimum. That's what Google says, anyway. I just really don't like being on the edge like that. They did mention it has the triple line so at least we have that. This was never an issue, why is this happening now? I'm so nervous about next steps. What does this mean? Will they cancel the cycle? Delay? Do they give it another chance to grow and then check again? If that's the case, what happens to my 6 days of progesterone? Ahhhh! I'm so worried. I can't focus on anything. They took blood to make sure I didn't ovulate so they're going to wait for results to call me.

11:53 AM - No update yet. Still thinking about it.

12:01 PM - I woke up this morning at 5:12 AM and am now reconsidering the decision to quit my newish 1-cup-a-day instant coffee habit cold-turkey.

1:43 PM - It's still early. They should call soon. On the plus side, "not thinking about it" translated into incredible productivity at work.

2:36 PM - Why haven't they called yet?

3:12 PM - THE CALL!  Lining is at 8.69 mm and E2 at 467.  Anything above an 8 is "excellent" and good to start PIO. YAY!!!  I asked about other cycles where lining was so much thicker and the nurse said that it can vary between cycles but as long as it's over 8mm it's fine regardless of how much higher. It's basically a pass/fail and I passed.

3:13 PM - decorating nursery in my mind jk

So excited! I know I should be guarded and protect my heart from another potential failure but I'm just jumping in with both feet. So until our first beta tells me otherwise, I'm happy to get this show on the road!!

 6:30 PM - PIO shot. Oh right, this again.

Carpe diem

I recognize that to be entirely happy with my decision not to leave my job right now, I need to find something else that will keep me busy and happy.

I've been searching online and came up with several ideas:

- Art class of sorts: glass blowing, pottery, woodworking
- Exercise of sorts: kickboxing, barre, yoga, archery
- Part time job (doing what?)
- Learn to play an instrument
- Start and manage a bookclub
- Make wine or brew beer
- Learn to properly care for and use a firearm
- Write articles to be published

Just for s+g I also applied for two government jobs. Their benefits and perks are excellent so it would be a worthwhile switch. In the meantime, I'm going to focus on finding a new passion project.

If I had $5,000...

Every so often I like to think about what I would do with an extra $5,000. It's not millions of dollars winning the lottery which is so unlikely to happen. Five thousand dollars is technically an attainable amount of money, like a new job sign-on bonus or a crazy tax refund. It could happen.

Obviously I could only do one of these things, but in no particular order:

• Replace kitchen appliances
• Fancy yard landscaping
• Car down payment
• New furniture
• Living room
• Dining room
• Bedroom
• Home repairs
• Update fence
• Kitchen floor
• Kitchen granite 
• Bathrooms
• New roof
• New air conditioning
• Add bedrooms basement
• Redo floorplan upstairs
• Lasik eye surgery
• Invisalign 
• Vacation
• Throw it at the mortgage
• Put it in savings or lock it in something that earns interest

I think of all the money we spent on treatment and wonder if we'll ever have extra for any of these things. They're not needs, they're wants. We can absolutely go without most of them but it's fun to dream. I like having a wishlist and adding to it every so often. It may be boring but it's mine.

We've been living intentionally frugally so that we can do what we need to do to build a family while still trying to be financially responsible. It's kind of ridiculous to think about trying to stay out of debt when I still have an insane amount of student debt, but it's the principle of the matter. It's easy to let spending get out of control so we do our best to curb it as much as possible. The holiday season kind of put a monkey wrench in the budget so we're going on a temporary spending diet. It's a pretty trim budget to begin with but I know we could be more careful about grocery shopping and food waste so that will be our goal for November.

Thursday Thoughts

I'm feeling UGHGHGHGHGHGH. I don't know what I want.

We went straight from the holiday season into two events at work. Even though I work at a Jewish institution, nearly 90% of the employees are not religious. So while they know all about the holidays and everything they entail, they don't necessarily celebrate. For them, the past few weeks were vacation. Which means that they're ok with planning events on the day we come back.

For me, I'm exhausted. I'm getting over the holiday stress. I'm trying to catch up on work stuff I didn't do at home during the holiday season. I'm trying to catch up on laundry and dishes and getting the house back in order. I have a brain fog I can't shake and it's frustrating me.

We had the event last night and while I didn't mind working the event, I knew I had a million other things to take care of. I'm kind of over busy work. I don't want to deal with dumb minutia of someone else's ideas. I want to implement my own ideas and be excited about the tasks I'm doing because I came up with the path to do them.

It's times like this that I revisit the idea of getting a new job. I've talked about it before, here and again here. I want a new challenge, but I don't know what the challenge is. I want to have an interesting job that I find interesting and I can be proud of telling other people about it. If I think about it honestly, I don't really believe in the methods or agree with a lot of the organizations choices.

I like my direct supervisor who I work with on a regular basis. It's partially because of her that I've stayed as long as I have. My supervisor's boss, who is also technically my boss, is not someone I respect. I don't think I have any more to learn from that person. In fact, there are things I actually don't like that I want to make sure I don't learn, such as not respecting people's time.

I'm back to the age-old conundrum: do I leave and give up a lot of non-salary perks, like having a flexible work environment, many days off, short commute, etc. or do I try to find something more satisfying that has clearer potential for growth? It would help if I knew what it is that I wanted to do, or at least what my passion is. Ten years ago when I was in an entry level job I didn't think I'd be in an entry level job still trying to climb my way up a rung.

It could be I have a complex. I believe I am such a good employee that I should not only be getting promoted regularly, but that people should also be knocking down my door trying to recruit me to their company. I definitely think very highly of myself, rightly or otherwise. At the same time I am reminded of how grateful I am to be employed. On one hand, I have it so good that people are envious of my job and its perks. I am lucky and I recognize it. On the other hand, why should I settle? I could have it even better with a job I like, great perks, and an amazing salary!!! Right? Maybe?

I truly believe that I am able to accomplish anything I set my mind to. The challenge is getting started and figuring out what it is that I want to accomplish. What do I want? Do I want to stay in the same field? What are my priorities? Do I want to make lots of money? Do I want to work from home? Do I want to manage people? Do I want an anonymous cubicle job where everyone just leaves me alone?

I don't want power, but I want autonomy. I want repetitive work I can do while I zone out, but I also want exciting challenges where I get to be creative. I want to have responsibilities but only ones I like. I want a high paying salary. I want excellent health and medical benefits. I want an easy commute or the ability to work remotely. I want the opportunity for growth. I want to work as part of a team with a strong leader I can learn from. I want to manage competent, dedicated people. Am I asking for too much? Does this even exist?

When I was in college I knew exactly what I wanted.  I loved school and knew my exact path moving forward. I finished my degrees with honors.I finished my MBA with so many student loans but I didn't care because I knew I'd get a high-powered job and pay them off in no time. Somewhere along the way I detoured into the non-profit sector and kind of lost my ambition and confidence when we started treatment. 

The water-cooler rumors have it that there will be a major shift in my organization in the next 5 years. The details are vague but what I believe that means is that a lot of the higher ups will be retiring, opening a lot of positions in management. Is that enough to get me to stay? Am I patient enough to wait that long for a change? Will I be happy with whatever the change will be, assuming there's a lot more information that doesn't get trickled down via rumors?

Then there's the whole baby thing. Is it happening? Is it something to plan around? It's the proverbial elephant in the room. I started treatment thinking it will work eventually and so I should be patient because WHEN I get pregnant I'll want the work flexibility. But it's been a year. I've put my career on the back burner for a while now because of something that may happen. At this point I'm not sure it will happen so soon, if at all. I'm not sure I want to put things on hold for it anymore. If it happens, then I'll work it into my schedule, whatever that may be. I don't know that I want to pause life while I wait for my babies. In reality, I think I'm scared that I'll put 100% into having kids and if it doesn't work out, I'll not only end up childless but also in a career going nowhere because I waited too long to make a move.

I'm a believer in living life without regrets. I don't want to look back and say "should've" for anything. I know I will not regret putting everything I have into trying to have a family. I know I won't regret that. I want to make sure I'm making strategic moves for my career as well. I would definitely pursue an opportunity if it landed on my lap. The question is at what point do I go out and start pursuing a new challenge?

I think this transfer could answer a lot of these questions. The outcome may determine a few factors leading down a specific path. If I get pregnant, then the decision is made to stay put and keep the flexible schedule throughout pregnancy and until daycare starts. If it doesn't work, then I'll likely need to do more IVF rounds in the future, which means that I may as well start looking for another job with better health benefits that could cover future cycles. We'll see. Maybe there's secret option #3 I'm not thinking of that will reveal itself later on.

Open enrollment

In 2015 we nearly exhausted the benefits on my husband's insurance, so toward the end of the year we did our research about plans and decided I will go on my own employer's insurance for the year.

The start of 2016 was incredible stressful because we discovered that our financial adviser gave us wrong information. In short, she told us we would be covered for the reduced rate under my husband's insurance as long as he was still on it but I didn't have to be a patient on it to qualify. Turns out that was not true, and we were stuck the entire 2016 with very slim coverage for fertility treatment.

For 2017 I want to avoid a similar problem. It's worth it for me to switch back to my husband's insurance because not only are the monthly premiums more affordable but the coverage is better. In addition, there's a very slim chance we may have some fertility benefit left over. There is a lifetime maximum on fertility benefits which we were nearing at the end of 2015. When I sign up for benefits in 2017, I don't know if that counts as a new policy. If it does that means my benefits refresh then we'll get a new lifetime maximum. If not, then I'll pick up where we left off and just use up whatever is left over. Something is better than nothing.

I will try to confirm just so we know what to expect, but in either case I'm still planning to make the switch. Even after maximizing my lifetime benefits, there is still a reduced rate negotiated with my husband's insurance company and the clinic. So even if we are paying out of pocket it's usually 50% of the rate we would pay otherwise.

How do other people do it? Are there better insurance plans? Do most plans cover all fertility treatment?

I'm fighting for these benefits but in the back of my mind I'm hoping it will all be irrelevant. The maternity benefits are amazing -- covered at nearly 100% -- and I'm hoping that my focus will be on that in the coming year instead.

FET 4: Baseline

It's happening!!! FET 4 is officially moving forward. 

The official weigh in this morning was 5.9 lbs less than last Thursday's weigh in. The unofficial weigh in on my own scale showed I weighed 6.2 lbs less than last Thursday (in the same clothes) so at least now I know to expect approx a half lb different between the two scales.

 

I was nervous about the weight so I skipped breakfast or drinking water and of course there were issues getting blood. Lots of poking, smoothing, feeling, and two sticks later they had what they needed. They told me that they have to wait for the bloodwork results to come back to make sure I didn't ovulate during the last week which made me anxious all day waiting for results. 

My nurse called around 3 pm and left a voicemail. She sounded kinda bummed so at first I thought it was bad news but she said everything looked good. First shot was tonight and off we go.

I took a break from the strict diet for a celebration dinner with my husband. I think I'll get back to it tomorrow and stick to it a while longer though. It's been really exciting to see such fast results, and while I was drinking tons of water I never really felt hungry. We'll see - taking it day by day.  In the meantime I'm glad I was able to get accomplished what needed to get done to start this. I hope it continues with less anxiety.

Nervous

Tomorrow is my second baseline appointment and I've been worried and anxious all day. I've kept a really trim diet over the past week which was difficult over the holiday but I stuck with it.

This morning I weighed myself and there was no change from Sunday's weight, which was lower than the clinic's recorded weight by 4.2 lbs. I'm worried that it's not enough. I'm worried that there is too much of a difference in the two scales, both digital, but still. I'm worried that we'll have to wait an entire month for my next cycle to get started.

All day I tried to think of ways to get an 'edge' in case it comes down to a minuscule amount. Like, I was trying to contemplate what to wear that won't add extra weight. Since I couldn't stop thinking about it, I actually weighed the clothes I wore last week (weighed myself, then weighed myself again holding the clothing) to see that they actually weigh 1.4 lbs. Getting weighed unclothed is not an option.

I drank so much water today that I'm hungry and stuffed at the same time. I trimmed my nails because it was time, but when I thought of it I was like, "Oh, there go another few ounces!" I'll find some normal, light clothing and I'll shower tonight instead of the morning so my hair isn't wet. Once I started thinking that maybe I should trim my hair I realized I've taken it too far. It is what it is. If we need to wait another cycle, so be it. I hope it's not the case.

Chag Sameach

Sukkot is here! It's one of my favorite holidays. Miraculously, everything somehow got done in time. I give most of the credit to my lists.

Menu includes...
First dinner: lemon salmon and salads, mushroom beef barley stew, sesame cake
First lunch: Eggplant parm, carrot muffins, zucchini kugel, salads, pumpkin cheesecake
Second dinner: chicken soup, sweet and sour meatballs, rice, broccoli kugel, apple cake
Second lunch: Salmon and salads, lasagna, onion kugel, pumpkin pie

I made so much more than listed, but this is a skeleton menu I'm using for reference. Two meat meals, two dairy meals, lots of salads and variety. My husband's family is here for the first days.

In weight news, I've been on a low-carb/counting calories diet. I weighed myself this morning (after a day and a half of this diet) and the number on my digital scale was 4.2 lbs lower than the number on the clinic scale. Obviously they were full of shit (apparently so was I?) and it was just post-fast bloat. Whatever. I understand there are oscillations between scales. I also know it was just a day and a half so to make sure it doesn't oscillate back suddenly I have to keep up this salad parade for another few days. I've been eating mainly vegetables, some protein like eggs and chicken, and staying away from sugar and white flour. Really easy in theory; harder to execute in reality, especially during the holidays and when the house smells so good from all the challah. No matter: I will persevere. This transfer is happening even if I have to eat iceberg lettuce for a week.

I'm in a great mood. The sukkah is beautiful and the weather is gorgeous. I'm excited for the holiday and can't wait to get this transfer started.

Chag Sameach!

False alarm

I left the baseline appointment this morning upset and frustrated.

The financial counselor didn't tell me that we have a balance due from the biopsies, in addition to the fee for the FET. So I was surprised with an extra balance due of several hundred dollars that I wasn't expecting when I checked in for my appointment this morning. I tried to speak to the financial counselor but she was so unhelpful. She didn't email me in advance telling me it was due; she had no idea that insurance is supposed to be covering it; and she has a loud voice and was talking in the front hall near reception and the waiting room, so she was talking about my business in front of other people. The most frustrating part was that even though I know I'm right, if they don't financially clear me then I can't start the cycle. I paid the fee feeling my blood simmer, wishing this is the last time I ever have to deal with this person.

I later emailed to follow up about it and she said there was an insurance submission error, so they will be resubmitting it to insurance. I asked if I will get a refund once it's all straightened out and she tried to tell me that I would not since I didn't pay it. What is wrong with you, lady?? Luckily I had the receipt and I forwarded it. Now I have to keep an eye out on my account. Ugh.

After the financial thing, I got weighed and things continued to go downhill. My clinic has strict BMI rules. I am 0.1 points over their requirements as a max. I could say it was because of the fast yesterday and that I'm retaining fluid from eating the entire day's worth of calories after 8 pm. I could say it's all the water I drank in order to make sure they're able to do bloodwork. I could also say that it's partially because I've been on back-to-back cycles and my body is so bloated from meds. I could excuse it away but I know they're just excuses. I feel frustrated for knowing this might be an issue and not being more proactive to prevent it. I feel disappointed at myself for not taking care of something that is technically within my control.

To add to today's drama, my cell phone is not accepting voicemails and I don't want to miss important info from the clinic. In 2011 I signed up for Google Voice. I have never used my phone's voicemail app since then and have never had a problem. A few weeks ago my phone automatically switched to my carrier's voicemail app. Feeling like a dinosaur, I couldn't figure out how to get it back to the Google Voice app. I keep meaning to look into it but haven't had the time. Today I realize I'm not getting any voicemails at all and realize it's because my voicemail box is full.  UGGGGHHH.  I figured out how to delete voicemails in order to get new ones, but I'm still trying to figure out why I'm not linked to Google Voice. One more thing to deal with.

There is only one weeknight before sukkot which starts Sunday night. We're hosting my husband's family for first days. I'm so not in the mood, especially since I'm apparently on a strict lettuce diet now. We still have so much to do, and since the basement flooded last week, we still have to organize and rearrange everything.

On top of everything, today is the 1 year mark since our first negative beta. It was the first major blow and disappointment of our treatment ordeal. The first time our dreams came crashing down. The first time we dealt with failure. It was the first of several disappointing days in the past year, but it was the very first one that lifted the rose-colored glasses I was wearing and made me realize that this might not be as clear cut as I originally thought. It was truly a devastating day. Today is proving to be only slightly better

Now we're so close. So close. We're three weeks away from a transfer, and yet so far. I spoke to my nurse about the BMI. It needs to come down before the do a transfer, there is no question. At first I thought there may be a chance they'll let me start and then reweigh me before the actual transfer date. But my doctor won't even start the protocol until I'm 0.1 points below what I am now.  It's 0.1! That's basically a large BM.  I'm so overwhelmed with disappointment and at the same time slightly relieved that it's something technically within my control.

My husband, in his infinite sweetness, is going to diet with me. He also said if we have to wait a cycle then it's not the end of the world. In my mind, it is!!!  How could I let this happen?! It's very sweet that he made sure I knew he doesn't blame me. Even though I blame myself.

In the meantime, we're delaying everything by a week. I will go back next Thursday for a new weight check and baseline.

Fall theme

Now I'm ready for Fall. 

#newbloglayout

#pumpkinspiceeverything