Monday update

Preliminary results from last week's biopsy were incredibly frustrating. On one hand inflammation seems to have cleared up -- but I don't put much stock in that because prelim results last time said the same thing but actual results had a different story. On the other hand, results also said that my lining is pre-ovulatory. WTH. I don't even understand what that means since it was literally timed with bloodwork and medication. Late last week my doctor asked me to come in for bloodwork to verify whether or not I already ovulated. A day later my actual period arrived, so doc was confident about timing. She said to wait for actual ERA results before being concerned. If results are inconclusive regarding ovulation/lining/timing we may have to repeat the ERA.

Chanukah was last week. It was a beautiful, low-key, high-cal holiday. We hosted two parties. One for family, one for friends. I attended two work holiday parties (including two gift exchanges) and we went to two additional parties. It was a lot. I had so many doughnuts and I'm not at all sorry.

My pottery class is winding down. I enjoyed it a lot and decided to take a second class in the winter session. I told a few people about it and they're like, "What? for that amount of money you could buy 10 vases!" Clearly these people don't get it. For me it's not about the end product, but about the journey getting to it. It's art. It's a hobby. It's something else to think about for three hours a week instead of worrying anxiously about the what-ifs. And at the end if I happen to get a vase or a mug out of it, all the better.

Since we didn't get to go to Atlanta because of the procedure, I'm trying to see if we can do a Florida trip in January. I need a change of scenery and now that we got our points back, I want to use them. It doesn't look like there's a transfer any time soon in our future anyway.

Some upsetting news about a family member thinking of moving. I know they have to do whatever is best for their family but my nieces and nephews are really important to me and I'll be sad if they end up moving away. It's not sad news, just a difficult transition for me.

I decided to pull the trigger and join the gym. It needs to happen. I have to work out more often and it's just not happening at home. My goal to start is to get in 30 min 3x week. Eventually I want to be working out 4-5x/week for at least 45 min each, but I know I need to work my way up to that because if I bite off more than I can handle I just won't go at all. Reaching goals start one step at a time.

ERA/EMMA

On Friday I went in for the biopsy. It was a short day and even though I took the day off work I crammed in a lot of errands after the appointment so I never had a chance to type it up.

My appointment was scheduled for 9 am. The waiting room still had a few monitoring stragglers but they seemed to be running on time. The doctor called me back herself, not a nurse or a med assistant. They first did the obligatory pee stick test to make sure there's no pregnancy. By the time we were settled it was about 9:30 am when the actual biopsy was taken. I've had it 4 times before (once while under during this past summer's hysteroscopy) so I knew what to expect.

As the doctor and nurse were getting things ready, we chatted about next steps and she answered a few of my questions. We went over paperwork, signed a few forms, and did the procedure. They needed to go back in a second time because there are several samples going out to a few places and they wanted to make sure to have enough. It's so uncomfortable and painful as they're doing it - the best I can describe it is getting so cramped up that it feels like you might have to poop even if you don't have to go. It's a weird feeling. As soon as they stop the pain goes away and is replaced with period cramps that get milder as time goes on. I didn't even cry this time from the procedure.

Then we talked specifically about the results. If it comes back that the inflammation is cleared up, then the next step is a transfer. If not, then we'll take the information the results give and apply it next cycle, pushing a transfer to late-Jan or later (depending on what treatment is needed). My doctor said that at that point she herself will be on maternity leave. I said congratulation and smiled - genuinely happy for her. She said she'll still be involved and will give me her cell number. At that point I started to crumble. It was partially a delayed reaction to the hurting procedure, partially because she just cares so much. I started to tear up, and when I knew the waterworks were coming, I knew I could no longer talk without going into full sobbing. She thought that I was upset because I was feeling abandoned but it was the opposite - I so much appreciated how much she cared. She said that if my transfer happens to fall out during her leave that she'll try to come in for it. I managed to squeak out, oh you don't have to do that. To which she responded that she wants to. That just made more tears come and all I could do was nod.

The doctor left and the nurse was finishing up with the packing of the biopsy. She brought me tissues and said she understand how hard this is because it took her six years to get pregnant. She said, "I was on that table 19 years ago." When she left I let myself cry for real while I got dressed. I took a minute to calm down and left. Cried some more in the car. I've repeated the story a few times over Friday and it makes me tear up every time.

It wasn't the physical pain of the procedure that got to me; it was 100% the emotional part. It's a really hard journey. Finding a doctor who is so committed and professional and exudes so much care at the same time is truly a blessing.

One second of the exchange with my new doctor was more compassion we've had during our three years at the old clinic combined. Speaking of, on Friday morning I randomly received a check-in email from my last nurse at the old clinic asking what's up. I'm debating whether or not to answer. I don't really owe them anything, let alone an answer. On the other hand maybe I want them to know that they missed such an important piece of my treatment.

So now we wait a few weeks for results and see where the path leads us next.

Natural cycle: continued

When I got the results from monitoring last Monday, things were going slower than anticipated. That continued to be true all week. Day 18 was Friday and I was called back for monitoring. It was swamped. There was only half the staff because of the holiday weekend but just as many people in the waiting room. The doctor who did the ultrasound measured the lead follicle at 17 and said "We'll likely see you tomorrow" but wanted to wait for labs to come back to make sure.

Coming in on a Saturday is tricky for me. Some people avoid it all together but I'll use whatever religious loopholes are available in order to keep the cycle on track and still keep Halacha. Just because I choose not to drive on Saturday doesn't mean I can't arrange for someone else to drive me. Because they were so swamped on Friday, I expected to wait longer to hear results, but after noon passed I was starting to get nervous. If I need to make arrangements then I need to know soon, especially since a lot of people were out of town and my default go-to person wasn't available. At 1 pm I called the nurse's line and left a message. At 2 pm I paged the nurse on call. All the while worrying about the what-ifs and different scenarios.

Worst case scenario, I do need to come in this Saturday and I don't have a ride in place. Best case they would tell me to come back Sunday for more monitoring. All the while keeping in mind that whatever happens this weekend, 6-7 days later is next weekend where not only do we again have a Saturday issue, but we also have plans to be OUT OF TOWN. Never did I imagine that the cycle would be this long or I would never have made plans to fly somewhere else.

Finally at 2:30 someone returned my calls. They were waiting for my doctor to weigh in because even though she was out for the holiday she still wanted to be informed on everything and decide the next step (isn't that amazing?). My doctor made the call that based on my blood work results, I should take the ovidrel on Friday and come in 7 days later, the following Friday, for the uterine biopsy. It took me by surprise because I thought the lead follicle needed to be at 20 for something to happen but I guess it didn't. Luckily I had ovidrel from my Aug IVF cycle that was still in my fridge. I took it at 3 pm and made sure to note the time in case it becomes relevant in the FET cycle.

So one stress averted - don't have to go in on either Saturday. The next stress is scheduling the actual biopsy. I was advised by the nurse to call the scheduler on Monday to make sure to get on the schedule for Friday. I've been calling all morning and left two messages so far and no one is responding. I'm assuming they're catching up from the weekend, but c'mon. You're a medical office and someone should be picking up the phone. I'll keep calling but it's frustrating. We're trying to see if they'll take us early enough that we can still make the getaway over the weekend. It's a slim chance but I don't want to cancel before I know for sure.

I know they likely won't have appointments before 9 am because of monitoring. The flight is less than 2 hrs but it's a short Friday. With unpredictable delays and getting through an unknown airport, even without checked luggage, I don't want to risk getting too close to Shabbat. I'm comfortable flying before noon, but there are no flights before 1:30 pm on the airline we're already booked on and switching to another airline will cost about $720 for one way. While I'm fairly certain we're canceling the trip I'm having a hard time doing that and letting everyone know before booking the actual appointment.

Natural cycle

We started the natural ERA/EMMA cycle. The protocol calls for an ultrasound on day 10, plus possible blood work. Once the follicle reaches 20mm in diameter, if an LH surge is detected, then biopsy will be scheduled 6 days later. If no LH surge, then I need to take Ovidrel and the biopsy will be scheduled 7 days later. Whatever we do for the ERA cycle will be repeated for the FET. 

It takes 15 days for the results but we won't start a transfer cycle until it's confirmed that the inflammation is cleared up. We'll need to wait and find out the results of the EMMA to see if there is still inflammation present and, if so, treat it correctly once and for all.

Over the weekend I got a text from someone telling me to keep a mutual friend in mind while she undergoes emergency surgery. Her baby was born two weeks ago and she's suffering from some unknown infection or delivery complication. I have no idea what specifically but the situation sounds terrifying. The more horror stories I hear about pregnancy and delivery the more I feel like I should be reconsidering whether it's something I want to fight so hard for. There's so much time to think that it's impossible not to let the mind wander to the worst case scenario. I don't think that's what would make me back out but it's very scary and has been preoccupying my mind lately.

Rough day

Today was a hard day. I worked late and got home around 9:00 PM. My stomach was bothering me and I was in and out of the bathroom all day. I ate just a plain yogurt (probably a bad idea in hindsight), banana, and apple all day. I wasn't hungry because I was busy and occupied.

I got the official timeline from my nurse. There were some notations on the bottom that I thought were just leftovers from the template she used for the last patient or something. I asked about them and she's like, "Oh, those are your biopsies." Wait, what? I had no idea what she's talking about. I asked about it and she said, "With the implantation failure we do perform 2 endometrial biopsies...The biopsy is meant to "wake up" the lining." Yeah, I'm familiar with the terminology what I don't get is why it's in my timeline and why is this the first time I'm seeing it? Did I miss something?? I was very confused. It took me completely by surprise. I remember discussing it at our WTF appointment in the summer after failed FET 3, but it was never decided that we'd do it. In fact, the doc wasn't even convinced that this would help and was just mentioning it as an option. He was  adamant about changing only one thing at a time though. So we went with the ERA option because it would give "concrete" information. We changed protocol for FET 4 based on the ERA results. When that failed, we added the extra meds prednisone/lovenox for FET 5. I'm still unsure where it was decided to add the endo scratch anywhere. My husband doesn't remember it being discussed after the July appointment either. I'm paying too much money for them to treat me like some statistic and randomly add crap to my timeline without asking or even telling me about it.

In addition, we got back PGD results for our embryos. One. It's hard to be upset at a beautiful healthy embryo. And yet I can't stop crying. I'm so, so grateful it wasn't a busted cycle with zero. But one? Just one? All that money and blood, sweat, and tears for one? We went through all that for one? I'm feeling guilty for being upset about the one. I know some people would love to get a healthy embryo from their own eggs/sperm. I know people go through multiple cycles just to get one healthy embryo PGD-tested and ready for transfer. Even so, knowing what I know about our transfer history I'm upset that this cycle resulted in only one shot.

And then since I was crying already, I couldn't stop. I cried for the failed transfers. I cried for the nights of anxiety. I cried for the years we've been childless. I cried for the unknown. I cried because my birthday is tomorrow and not only am I getting older, but the pressure of "what are you doing for your birthday?" has become overwhelming -- the answer is nothing. It's a regular day that happens to be the anniversary of when I was born. I should be calling my mom to say thanks and call it a day. The one thing I wanted to do was travel and we can't do that. I cried that we can't go on a trip. I cried that we don't have money for renovations. I cried because my husband didn't realize I hadn't eaten yet and ate all the good parts from the crockpot meal I put up in the morning since I knew I'd be working late. I cried because the tissues were rough. I cried because the president is a lunatic. I cried because I don't like feeling sorry for myself; I'd rather be a badass. I cried because I want to share good news with my parents so badly. I cried because I'm relieved we got a good embryo from the cycle. I cried because we only got one embryo from this cycle. I cried because I'm scared for the transfer. I cried because I'm worried for the future.

As I was crying I was surfing online and came across a line: "A winner is just a loser who tried one more time." We are not on an easy path. Hope guides us as we stumble along, trying yet one more time.