Nighttime thoughts

It's 4 AM and I can't sleep because my cold is keeping me up. Or maybe the meds. Or maybe the anxiety of another blood draw in just a few hours. So here are a few thoughts, mostly unrelated, keeping me company at this hour:

In a few weeks this blog will turn two years old. We calculated that if our first transfer would have worked, our first baby would have been nearly 18 mos old and we'd likely trying for #2 at this point.

There's a part of infertility that feels like you're constantly being held back. The flip side is that you feel everyone else has moved on. No one I know is still in the trenches. No one in real life or in the blogosphere I've met over the past few years. I don't hold it against anyone for moving on - it's what we're all trying to do. But it gets lonely getting left behind. It's also making me wary of trying to connect with new people.

Ironically, the people that have little kids have more of an active social life because they make time to go out, "date night" style, to get a break from the non-stop grind of parenting. We turn in early partly because of our personalities, but in part because the treatment just wipes me out and I can barely keep my eyes open past 8 pm.

Someone posted a link on fb connecting IVF with breast cancer. Obviously correlation doesn't equal causation and I didn't click on the article to find out more because it's a terrifying subject to me. I already have so much history of it in my family - I can't imagine that adding all these hormones is doing good things. But what's the alternative? Another terrifying thought to keep me up at night.

I stopped doing my eyebrows. I'm not sure why. It started by wanting to have them grow out slightly because the lady did them too thin the last time. But when it was time to go get them cleaned up again I just... didn't. It looks horrendous but I'm not motivated to go get it done. I usually do threading and it hurts so I think I'm just being a sissy and not wanting to anything extra that would hurt these days. I'm not big into makeup and I've been blessed with good skin so my biggest maintenance is managing the facial hair. I'd never let the upper lip get this bad but the eyebrows are in a free-for-all zone. It's been two weeks. We'll see how long this lasts.

I've stopped watching what I eat. I'm nauseous again these days and I often forget or skip eating which can't be healthy. I need to get back on the wagon but between cough drops and tissues I don't have the energy to care. I hope this cold goes away before retrieval so I don't have to deal with both simultaneously.

I wasn't allowed to hold or kiss my nieces and nephews at a family party yesterday because no one wanted me to spread my cold germs. Most of the kids had runny noses from day care anyway, but I understand why people would want to be cautious. It broke my heart though, if I'm being entirely honest. Then again if my own kid was healthy and I had a cold I would likely try to keep the germs to myself so I do understand.

Every year during Chanukah I try out a new recipe, usually dessert. Last year it was homemade cannolis. The year before that it was a salted caramel chocolate cupcake. This year I'm thinking maybe cream puffs or eclaires. Still looking for interesting recipes.

We're in between shows right now. We finished watching all of the original Will & Grace from 1998 - they are my favorite characters of all time. We're caught up on all our regular shows like South Park and Last Man on Earth. I have a season of Survivor I saved for retrieval recovery. We try out different stand up comedy specials on Netflix every so often but we have a short attention span and if they don't catch our attention in the first five minutes they've lost us forever.

We still haven't decided about a trip in Jan. We're stuck between wanting to do the trip and not wanting to spend the money. We're worried Tr*mp will do something insane while we're there and we'll be unable to return to the US. Now that I've seen the endocrinologist early, we're no longer bound by that appointment to wait until February for a transfer. We're concerned about the uptick in terror due to the new announcement about Jerusalem status as capital. If we don't do an Israel trip, where's a comparable alternative that won't feel like a consolation prize, especially since anywhere beautiful is still questionable zika-wise.

I read an article the other day about student debt: The Great College Loan Swindle. I'm one of those people who signed on the dotted line not really understanding the long term consequences. My undergrad loan is under control. I pay less than $100/month and will be done in a few years. My graduate degree is another story. I have a crushing monthly payment that barely covers the interest, let alone the principal, so it never goes down. Part of the reason I stay in my current job is that it qualifies me for PSLF, Public Service Loan Forgiveness. Now I'm hearing that Tr*mp has called for the program's elimination by 2018. If that's the case I'm totally screwed. This, coupled with the new tax laws about not being able to deduct student loans or medical expenses, makes everything in my life a lot more difficult. I've never hated a president before because their actions never affected me directly as much as they do these days.

So that's it for now. Gotta try to get some sleep before starting the week again. It's going to be a busy one.

Reasons

As baseline for IVF 7 approaches I've been getting a strong desire to do a transfer instead of a retrieval. I've got baby fever and just want to be pregnant and get the show on the road toward 9 h&h months and be over recovery and just enjoy my baby.

But I know it doesn't work that way. Not in my world. Transfer doesn't necessarily equal pregnancy and so we have to make decisions for the long run.

There are good reasons to wait for a transfer:

• First, if we do another retrieval then we potentially have more embryos. It's better age-wise and recovery-wise. Before winter break is the best time to do a retrieval so that I have time to recover physically and emotionally from the hormones.
• Second, I'm doing well on my diet and really want to give it a chance to get to my goal weight (now 19.6 lbs away). I've been yo-yoing back and forth for years and I want to hunker down and get it done. I know my weight will jump back up after retrieval when I don't have the energy to exercise any self-control -- especially since it will be right around Chanukah -- but I know I can do it if I focus, and what better way than using a healthy preg as motivation. I'm far enough removed from the last loss to let myself believe it's an actual possibility, not just an irrational fantasy.
• Third, I'd really like to give a chance to see the endocrinologist before a transfer if possible. Our appointment is scheduled for end of January. Originally that timeline was perfect when it included a Jan trip. Now that the trip may not be happening there's no need to wait until Feb to do a transfer.

Those reasons are what's keeping me from pushing for an immediate transfer. My husband believes retrieving now is better but would support a transfer instead, especially if I said I can't handle another retrieval now. I don't want to be the reason the retrieval is canceled so as much as I hate the process I'd rather not think about it too much and just get it over with. Sometimes knowing what to expect is good and bad. In this case I know it will suck, I know it will hurt, I know I will be miserable and emotional... but I also know that it will pass and that even though it will suck for a while, it won't be forever.

Emotional side effects

I recently had a tiff (via text because we're millennials ;P) with someone close who tries to be sensitive but misses every so often. My resentment started out leaking through my words via text over time and then escalated to near hostility. It was time to air things out and we had a discussion.  While I said a lot of things I've been holding back for a long time, I don't think she totally got what it is that bothers me. Part of the resentment is that she's currently expecting #2. Through no fault of hers, I've been comparing our lives since her first pregnancy announcement coincided with our first failed treatment. It's not her fault this is so hard for me. But it's hard to put into words what repeated compromise and resentment can do to relationships.

I'm not sure anyone who hasn't been in this situation completely understands. At the same time I'm fully aware that I'm hyper sensitive, and this is really hard. I realize that I'm expecting a lot from people and that when expectations are set so high I'm setting myself up for disappointment. It's impossible to expect people to read my mind and know what words or actions can help or hurt. When people talk about "infertility" as a general concept they have absolutely no idea how difficult it is from all aspects.

I feel like my options are to (1) distance myself and have no interactions so as to avoid hurt, (2) tell someone what bothers me, repeatedly as it happens, and risk resentment on their part and lack of action to change anything because they just don't get it, or (3) continue as is and not say anything while lowering expectations significantly. Until now it's been option 3 but with too high expectations.

I don't know what the right response is. I don't know how to correctly handle it. Is there a right way to deal with this kind of social interaction? It scares me to think how much longer we'll be in this chapter of our lives, dealing with the nasty side effects of an already awful situation.

There's a Bonei Olam event next week. It's a fundraiser for a non-profit organization that offers grants toward fertility treatment to couples who meet the criteria, with the program promising to be a "beautiful evening of inspiration and success stories" of couples who have been able to build their families. While we've never received financial assistance from this organization, I still think it's an important organization to support. I would also love to meet other couples like us who are still in the pre-Success stage and still going through it, and goodness knows we can all use a little inspiration. The problem is that I'm worried the "inspiration" will backfire and I might fall apart in a room full of people. My husband isn't interested in going and my friend whom I'd normally drag to these things has a calendar conflict. I don't want to go alone; I don't even know if I want to go at all.

Choices

The financial counselor that has screwed me over in the past is no longer there, thankfully. I took my questions directly to a supervisor to make sure I understood my options.

As we debate next steps whether to do IVF 7 or FET 6, I want to know exact numbers. What are the costs? What programs are available? Are we getting the biggest bang for our buck?

As I mentioned before, my clinic has several "Shared Risk" programs. One such program has the option of doing up to 6 fresh IVF and unlimited transfers from embryos from those cycles. They make you transfer every viable embryo from one IVF before doing a new cycle, up to six times. After six IVF cycles and all the transfers from those cycles have been transferred, if you don't have a take-home baby they refund 100% of the money (not meds, of course). Any embryos I have in the freezer right now wouldn't count toward the program. So while I can't count them in the "unlimited" transfers, they also won't hold us back from doing fresh IVFs. That's fine with me. Even though it includes everything except meds, it's a lot of money up front. There's also an additional fee if we want to do back-to-back cycles without transfers in between. Once you get a take-home baby the contract is complete, regardless of how many cycles you've done. Let's put a pin in that for a minute.

My insurance won't cover a fresh IVF as long as we have embryos in the freezer. Since we are interested in "preserving fertility," as they like to call it, we've opted to do fresh cycles even when there were transferable embryos in the freezer. At this point we have two embryos we can transfer (IVF 4, 4/16; IVF 6, 9/17).

I believe we overpaid for a combo IVF/FET which includes one transfer for every IVF in the global fee. I don't want to pay for the FET out of pocket; I want them to go get authorization for it from my insurance. Why should I pay for it if I still have benefit dollars I can use up? Insurance only denies coverage for IVF while there are still embryos in the freezer, but I still have coverage and the clinic should get authorization and use it!  For this last cycle I paid for a combo IVF/FET per the advice of the now-fired financial counselor. When I spoke to the manager I asked for a credit for the FET portion of the fee I paid. If we decide on a fresh IVF cycle, the credit will go toward a new cycle and I will only be charged for the IVF part of the global fee. If we decide to do a transfer, they will submit to insurance for authorization which they said they will as soon as they have a start date. How's that for fun?? I saved nearly $4,000 just for spending 15 minutes asking questions. Take that Geico.

While I feel like getting more embryos is the way to go, I'm not sure I feel that way for the right reasons. As long as they're in the freezer, they're safe and there's hope. In the past five transfers we've ended up with only disappointment and heartache so I hesitate to pick a transfer. I don't want to "waste" embryos. It's obviously flawed logic because if we don't transfer we have no chance at a pregnancy and baby which is the ultimate goal here. Embryos on their own are not babies. When we only had one in the freezer, the choice was easy: don't be left with nothing, keep retrieving. But now that there's more than one, does it make sense to keep doing IVF? I don't know anymore. The right path isn't clear when there's no guarantee one way or another.

In April 2016 when we got 3 healthy embryos to transfer from IVF 4, I thought it would be the last time we'd ever have to do a retrieval. Then this time in IVF 6 when we had 14 embryos on Day 5 I again thought we'd never have to do another retrieval but then only two made it to biopsy. Maybe I have to stop thinking that we're never going to need to do more retrievals. Then there's my age to consider and while I'm not old yet, at 33 the "advanced maternal age" of 35 is just around the corner. There's no way to know how my body will react to a pregnancy, if I ever get that lucky, and no way to know how many transfers it will take to get pregnant with number 2.


I've tried to focus on working on getting one baby at a time, but it's impossible not to think about the future. I know there are no guarantees, but with embryos in the freezer I would be a lot calmer to enjoy baby #1 before needing to rush back in and get started again to try for a sibling. I never thought there would be a specific number I have in mind of how many I need in the freezer before I feel comfortable transferring. I thought I'd be ok with having one. But now that there are two, I want to keep two. Knowing what I know now, I don't know if I'll ever feel content with anything regarding fertility treatment. There are just too many unknowns and things beyond our control.

We got results earlier than we anticipated, which meant that we could still decide to not skip a month. I wasn't so happy with taking a break. If we decide we want to do IVF I want to get it over with. But I recognize that we still need to live our lives. It's been non-stop for over two years.  We just need a break to be normal for a few weeks. Not be depressed, not be niddah, not feel nauseous, not be in pain or uncomfortable. We're aiming to do a small vacation end of October and that would've needed to get rescheduled if we restarted treatment earlier. In addition, my coworker who is now on maternity leave will not be back before December and I know there will be a lot of slack to pick up while she's out.

Back to the Shared Risk program, I don't think I'm going to want to do more than two back-to-back IVF cycles in a row. Maybe after the break we can do one more (at a reduced fee based on my conversation with the manager and the newfound credit on our account) and then start transferring. A transfer would be easier and if it fails we can always do the fresh IVF after.

If this journey has taught me anything it's that there are no guarantees and there are no wrong choices. If we do a transfer and it works then we have a baby and we've won. If we do a retrieval and get more embryos to transfer then we've won. We already know either one of those can fail, or worse start out hopeful and then crush our hearts. We've been there done that: high embryo counts that never develop into blasts; pregnancy that took but ended as a blighted ovum. So I don't know what the right path is; I can only hope that the one we choose leads us to our ultimate goal of having a family.

Just thinking. I don't have the answers, but these are the choices.


G'mar chatima tova.

Appointments, errands, progress

For the first time since May 19, the date of the ultrasound which changed everything, I started really feeling like myself.  I still carry the baggage around but at least I'm starting to see beyond the fog. What attributed to this change? I can't pinpoint an exact moment it happened, but I think it has a lot to do with things going on this week. 

Sunday we did something out of the ordinary for us and went kayaking. It was way out of my comfort zone to plan a bbq and go with a big group and figure out all the details of who's bringing what. I ended having a slight meltdown yelling to my husband about someone on the way, but after that it was such a non-issue and ended up being a lovely day. 

 

I bookended appointments both Tuesday and Wednesday before and after work that it basically became the week of -ists: dermatologist, dentist, therapist, cardiologist.  My friend suggested that maybe I missed having daily doctor's appointments. It does seem like it, right? It's not intentional, honest.

I started Tues morning with an appointment at the dermatologist. They removed a cyst/mole of sorts that I've had for years. It was entirely cosmetic but I haven't wanted to deal with it in the past because stitches would interfere with mikvah, plus the location on my thigh would make it annoying for fertility treatment with docs poking around. I figured now is a good a time as any since those are both currently irrelevant. It was a quick and easy appointment and I got to work early. After work I went to see the infertility therapist. I could write a whole post about that appointment, but I'll summarize it instead. Pros: it was good to talk to someone who knows all the people and terminology. Even though she's not directly related with the clinic, she knows all the doctors and nurses. She's sympathetic and easy to talk to. The office is well organized and convenient. Cons: I didn't really see the point. She's not going to fix anything or change the past. In her assessment she says that I need to give it time. I left feeling ok and scheduled for another appt in a month. I don't immediately see the benefit but I'll see her again on the chance that there may be one. Biggest con is that she doesn't accept insurance.

 

Wednesday was also busy. I started the day getting my permanent crown put in post root canal. Another thing happily crossed off my list. Then I went to a brit/baby naming. This was a friend who got married for the second time and just had her first baby. We were asked to kvatter but turned it down. I stopped accepting for non-family. It's nice to be asked but bittersweet. Anyway, one of the baby's grandparents is a big deal in the community so the place was packed. There were easily 300 people there - it was a big party. Everything was decorated in "baby boy" colors and decor. It was beautiful and I felt overwhelmed but not so much that I had to run out. Or cry. It was encouraging rather than not. I'm not sure I can explain it. After that I went to work and called the dentist because the crown put in earlier needed adjusting. I ran back to the dentist at lunchtime to get it fixed, then grabbed a bagel and headed back to work for a few hours before going to the cardiologist for the stress tests.

 

My office is closed next week and I'm planning out the week so I don't have too much down time to mope. I also have several vacation days I'll lose in Sept if I don't take them so I would really love to take a vacation. My husband has the opposite problem - he's barely got enough vacation days to scrape together a weekend getaway. It's so discouraging to try to plan a trip and keep hitting a brick wall (for time off, expenses, zika-free location) but I've been freshly motivated to try to make it a reality. We're still trying to save a lot of my husband's vacation days for a big trip but right now I'm focusing on getting a breather and a change of scenery, even if it's just a couple of days.

 

Today marks 5 weeks since the d&c. Still waiting for AF to show up. I'm still not sure what to do with the next cycle: IVF 6 or FET 6. Both are good options. Both are intense in different ways. Both have pros and cons. I can also skip a cycle to extend the break and just take more time to think about it, though the idea of delaying indefinitely doesn't sit well either. 

Stuff

I'm in the middle of a book called "Stuff: Compulsive Hoarding and the Meaning of Things" by Randy O. Frost & Gail Steketee which is a really interesting read. I'm personally a big fan of decluttering and not holding on to stuff I no longer use. There's no reason something should take up space in my house if someone else can benefit from it. But unrelated to me, it's interesting to learn about other people's connection to things and their inability to part with them.

I'm constantly thinking about upgrading our furniture, renovating the house, updating our appliances, or buying a better car but I hesitate to pull the trigger on big-purchase items. In the world of fertility treatment you never know when you'll need extra cash. So while it would be nice to have shiny new things, we don't need them so I pull back from actually spending the money. I still find it fun to search online for things I like, putting them in a cart, and then walking away. I find that my taste also changes over time, so sometimes I go back to the cart months later and I'm glad I didn't get them. I'm very aware of living within our means.

At the moment I'm trying to figure out how to renovate our bedroom furniture for less than $1,000. I want new furniture, maybe some hooks, and new sheets/blankets. Also we only have a clock on the wall so maybe some art. It's the dressers and nightstand that's taking up a lot of time searching. I can't find one I like that fits in the budget. Either it's beautiful and expensive, or affordable and crap. So the search continues.

I've also really relaxed my specifications for a car. My requirements are now: reliable, seat warmers, big trunk, and a hook for dry cleaning. If a car has that, I'm good. I don't care about brand, size, color, speed, look - none of it matters. I hope we get a second car by spring.

Sometimes I think about what it would be like if we sold the house and bought a condo. We'd pay off all our loans and live debt free. We'd have less space, but that's the point of living minimally. But I like my house and it's supposedly an investment that gains value over time so instead of having liquid assets, it's all in the house. I'd rather pay off my mortgage and stay here rather than go to a condo, even if living debt free is enticing.

Just some thoughts while reading this book.

IVF thoughts

Thursday evening was really tough for me. I was feeling all the sads. I had a rough day, noticing triggers and feeling sensitive about my lack of progeny but I held it together until the evening.

For example, at one point during the day my boss turns to me and asks, "Hey how old are your kids now?"  It's such a given that someone like me at my age would have kids. I seem the type to have kids. And it's unlike my boss to forget something like that, but it happened.

It wasn't just that. I was at a Lunch and Learn that afternoon and introduced myself to the person sitting next to me. She said she signed up for this to "get out of the office and maybe be inspired for baby names." Wth? Out of 40 people, I happen to be next to the person who is expecting. I wasn't sure I heard right and didn't want to assume, so I didn't mention it. I also didn't have it in me to feign interest in this stranger's pregnancy, even though she was clearly interested in talking about it.

There were little things like that all day. In the evening I was upset that we can't make the Israel trip work. Beside for not having the days off, we just don't have the chunk of overlapping time off work to make it happen this year. It was the last straw and I just broke down in sobs. In part for feeling stuck in this phase. In part because I'm hormonal again. In part because I'm scared for this cycle. In part because I'm sick of wanting something so badly and continuously putting my heart on the line only to have it crushed time and again.

All I want is a normal vacation. I want to have time to relax and time to see new things. I don't want to blow thousands of dollars on a whirlwind trip I won't have time to enjoy. But the other places I want to go (i.e., that have a beach and warm weather) are off limits because of effing zika. If I travel to Florida, my clinic requires waiting 8 weeks prior to attempting pregnancy. If I find a tier C location I want to go to, we'd be using up vacation days that can't use later in case we can make an overseas trip work in the summer. But we can't plan for the summer because we don't know what will be treatment-wise.

It's frustrating not to be able to plan. It's frustrating that our personalities or jobs (read: his) don't allow for spontaneous travel. I can usually keep my emotions in check but I think my hormones are playing a big part in this mess. I was going from feeling sad to giddy in seconds. One second freezing but then I'd turn on my space heater and start to sweat. My mind was foggy and I couldn't focus.

For anyone who has gone through multiple cycles before success, it's a mixed bag of feelings going in to a new cycle. On one hand, you have the history of the previously failed cycles weighing heavily on your shoulders: the memories of anxiety waiting for results, the rush getting to appointments in the mornings multiple times a week, fighting traffic and worrying about being pushed to the back of the queue if you're late, the bloating and discomfort, the pain of the retrieval and recovery, and the highs and lows of embryo reports leading up to biopsy day.

On the other hand, it's a cycle in a bubble. In other words, past success or failure has no bearing on the results of this cycle, which means that there is fresh hope. There's also the experience under your belt, so you know how to mix meds and injections aren't daunting. You know to log your shots so you don't lose track of inventory. You know to drink water before bloodwork, not only the day of but the night before, to help prevent "flat" veins. You know to keep a spare pair of socks in your purse because it can get chilly in the room waiting for the ultrasound. You know to prepare meals for day of and day after retrieval because you'll likely not feel like doing much those days. You know to prepare soup and gatorade for the day and day after. You know to expect mood swings and not to freak out when they happen. I'm sure there are more that I'm forgetting.

At the end of the day it's a stressful several weeks but over quickly, hopefully. The two weeks of shots, followed by a stressful week of embryo growth and updates, followed by anxiety for two weeks waiting for PGD results.

If one day I'm lucky enough to become a mother I'll know all these sacrifices were worth it. I know that there's no way I'd trade a vacation over treatment so at the end of the day I am doing what I want; I just can't have it all right now. One day, maybe.

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. 

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: 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.

2WW thoughts....

I woke up this morning at 4:30 AM to use the bathroom and wasn't able to fall asleep afterward. It's unusual for me to wake up in the middle of the night, but once I'm up I'm up for good. I started thinking about all the steps that we need to get through in order for this to be real.

The beta needs to come out positive (high number? I don't know much about this stage and beyond). Then there's a second blood test to confirm numbers are rising. Then there's an ultrasound to check for heartbeat. At some point after that I assume I get released to my OB/GYN for the rest of the pregnancy, which comes with its own slew of appointments and tests: anatomy scan, diabetes check, etc. etc. There are probably a bunch of things that happen that I have no idea about since we were never there before.

There's no guarantee that pregnancy will last full term without complications (protein in urine? high blood pressure? preterm labor?) and then labor and delivery need to go well and the baby needs to survive infanthood with the dreaded SIDS lurking around every corner. Once it starts eating solids you have to make sure it doesn't choke on a grape or a button lying around or randomly sticks a fork in an electrical socket.

Even once you're past all that and your kid becomes a walking toddler, happily playing on vacation, some monster can come out of the water and snatch him away. If puberty and bullying don't get to him first, he might become a young adult hanging out with his friends who ends up in a club with a terrorist and a semi-automatic weapon.

No matter what we do, we cannot predict the future or protect them forever. It scares me all the steps that need to go right in order for this to happen for us to have a health child. It scares me more to think about the responsibility entrusted to us if having a child does become a reality.

I'm no expert, but I'm going to guess that these thoughts are part of the reason I couldn't fall asleep again at 4:30 in the morning.

Transfer preps

I recognize that there's not much I can do to guarantee the transfer succeed, but there are still some things I can do to help me feel in control.

I decided to try to lose 10 lbs before the transfer. I have a month and, if I have to wait anyway, I want to make the best of the time. I thought about doing Medifast since it seems to have good reviews for quick weight loss. The products are EXPENSIVE (almost $800/month) and look disgusting. I can almost guarantee I'll buy the products, try them, and then immediately not want to do it anymore. In any case, I should learn to make better eating choices for long term benefits. Not only that, but I don't think filling my body with chemicals right before a potential pregnancy is the right way to go.

So with those considerations in mind, I decided to try to do a low-calorie/high protein diet for the next two weeks, to start. I can pick and choose my own meals mainly based on fruits, vegetables, and lean proteins and as long as it's within my calorie range, it should have similar enough results to Medifast. I'll have to prepare everything in advance, which is a big difference than just taking a pre-packaged meal, but for $800 in savings I'm willing to give it a try.

My lower back has been bothering me. Last egg retrieval I had some unexplained pelvic pain around the same time frame as now and when I went to get it checked out they said it was nothing - and it did go away on its own a few days later. I'm wondering if this is more of the same, basically post-surgery . I was thinking it might be something with the mattress so we took a look at the frame and it was messed up. There was a piece broken so we took it apart and left the mattress on the boxspring until we have time to replace it. I was actually planning to do a complete overhaul of the bedroom over the summer and I haven't had a chance to do research yet, so I might just leave this until then and move up the timeline a little. I hope the frame bandaid helps in the meantime.

Tomorrow is Mother's Day and it's the first one I've thought about in terms of my own non-motherhood. I'm not sad or looking head or wondering or thinking about anything. A little numb, I think. Just a thought that occurred to me.

Three!!!

Of the seven embryos we sent for testing, there are three healthy embryos. I'm a mix of happiness and anxiety. These three tiny embryos are a scarce and precious resource. Right now we have three opportunities to get pregnant. Logically, I know that they have to be transferred in order to take advantage of that opportunity, but last time we transferred nothing happened and the opportunity was lost along with our hopes and dreams. It happened twice and it was devastating each time.

Three embryos doesn't mean three babies. There are so many things that have to go right for it to work. They have to survive the thaw. They have to stick at the transfer. They have to grow for 9 months. They have to make it through the delivery. Then it's a baby. That's when you know it was a success.

Even so, we're absolutely thrilled that we have three embryos to transfer and we're celebrating the opportunity that lies ahead.

The first IVF cycle we did resulted in two healthy embryos and at the time I completely took it for granted. Of course we have embryos - isn't that what this whole thing is about? Let's stick one in there already so we can move on to #2 faster. Well, neither stuck and we had to start all over. IVF 2... IVF 3... IVF 4...

Here we are, three cycles later and only now do we have something new to transfer. I'm definitely not taking these for granted. I know I'm doing everything to help them stick, but I also know it's ultimately not up to me. I can't blame myself if it doesn't work and I can't take the credit if it does. Each baby is a miracle, even the ones that people get for "free" and don't have to think so much about.

Someone on fb posted this article about why it's ok to be amused at these people's infertility announcements. They are kind of cute: spencerandwhitneyadoption.blogspot.co.uk and someone who has been through the treatment actually understands why it's funny. This couple ended up adopting and they seem very happy. The comments on the fb post from other people who experienced infertility were sad, like the one mom who said that she never got to surprise her husband with the pee stick. Obviously she's happy that she was able to get pregnant via treatment and have healthy babies, but people feel like they're missing out on something.

That used to be my mindset, but I don't think I have the luxury of being miffed at not having a youtube-esque announcement. I'll be happy if and when I get pregnant, overjoyed that it worked and anxious every second that it shouldn't suddenly end unexpectedly.  I know family members are waiting to hear results and part of me really wants to keep this a secret. Just our secret. That's another luxury we don't get. We expect them to be there for us to support during the bad times; it's only fair to share the good news too.

I think that's the rationality behind why I don't like telling anyone that we're trying. Not only because I hate sharing the news that we've failed, but I also don't want to feel obligated to share pregnancy success so early on. Again, may this be my biggest worry.... I hope I get to have a pregnancy announcement to share, regardless of how soon.

Is everyone pregnant?

I used to think I'm not the jealous type. Lately I've noticed that when people announce their engagements, I mentally calculate and assume they, too, will be parents before us. It's a terrible habit I need to cut out but I noticed that I do it automatically.

One person I'm friends with on Facebook was known for complaining about her dating life and how she wasn't getting anywhere with all the losers she was dating. Those rant posts would come up on my newsfeed regularly for nearly three or four years. Then she got married and nearly instantaneously the rants turned to frustrated parenting posts. Unfollow.

There's another couple who got married a week after us and got pregnant on their wedding night. They now have four children and post frequent sweet family photos. Unfollow.

Two of the four other childless couples in my friend circle on fb have succeeded in having healthy pregnancies and are now parents. The third one got pregnant and kept it quiet on social media, trying to be sensitive to others still struggling, but someone else spilled the beans on her wall so now it's out. The forth couple is struggling with multiple losses and I know they've gone through IVF and PGD -- I hope that some of that Facebook baby dust is contagious and that they get their miracle baby soon. I noticed that the IVF awareness articles bother me as much as the family pictures. I don't want it to be relevant to me, I don't want to be different. Unfollow.

I have a friend who got divorced a year after I got married. She focused on school and career and in the meantime her ex got married and had a kid. I know her childlessness is different than mine, but I also know it hurts her to think what her life could have been like today had things worked out differently. She's dating someone seriously now (almost 7 years later) and I'm already doing the math in my head...

There's no way to Unfollow people in real life. You can only avoid it to a degree. Can't avoid it at the grocery store. Can't avoid it at work. Can't avoid it at shul where the preg ratio is probably 1:3 of healthy female adults.

So... if you can't beat 'em, join 'em! Working on it ;)

IVF 4: Day 6

This cycle is just swimming along. It's basically happening on its own with very little effort on my part. I remember the first cycle where I'd carefully prepare the medication and triple check everything. The nightly procedure would take 30 min or more, sometimes with me having to start over because I was so nervous. With this cycle, I go through it so quickly, usually with the TV in the background and forgetting it as soon as I log it. In fact, if I didn't write things down I'd likely not remember doing it at all. This morning I was scheduled to go in for bloodwork and as I was leaving the house I had to triple check the calendar to make sure the appointment was today. I'm basically coasting -- I've been here before, I know the steps, and it's just on cruise control now.

I find myself very distracted. This cycle is just one more thing happening, unlike in past cycles where it literally took over my life and all my thoughts. Things are busier at work, so that could be a factor. I'm also busy preparing for Pesach. All in all I'm not concered about phoning in this cycle. I'm still doing what I'm supposed to do, I'm just choosing not to let it engulf my every waking moment.

One of the thoughts that came to mind this morning in the waiting room was about how people dress for the monitoring appointments. I found myself judging the people who wore complicated outfits or wearing tights. In my mind, once the ultrasound is finished, I have a small window of time to get dressed and clear the room so that the next person can be set up. If you surpass the acceptable time frame because you had to put on tights or mess around with your complicated zippers, you're holding up the line! It was irrational and ridiculous - no one is spending hours getting redressed.

Pesach prep is coming along nicely. I have menus and shopping lists done. I'm debating between consolidating trips and doing all the shopping at once, or doing the non-perishables now and then leave only the fruits and veg to the week of Pesach. If the cycle proceeds as anticipated, the estimated date for the egg retrieval is 4/15 which is a week before Pesach. It's enough time to recover, but I don't want to leave any heavy lifting for that week. As it is, I'll have to do the kitchen and cooking that week so I'd rather leave as few errands and shopping for that week as possible.

My mood has improved greatly over the past few days. I was sad and depressed earlier in the week and I've oscillated to the other direction, being giddy and excited about everything. I'm expecting to swing back in the next few days but in the meantime I'm enjoying not being miserable. I had all these great ideas about things to do: learn a new instrument! Take a trip! Get another degree! The list goes on and the energy is endless. My latest thing is that I want to learn to scuba dive. We're working on saving for a big 10th anniversary trip for summer 2017 so maybe I'll work some of these ideas into that trip.

I think part of the reason I'm trying not to think about this cycle too much is because I'm worried about it. I don't want it to fail. If I don't think about it too hard there's less of a chance I'll go on the what-if roller coaster.

IVF 4: Baseline

My baseline appointment was on Tuesday and everything looked good to start, so I begin stims on Friday. My medication order came in and I'm all set to start again. The bloating I had last week is almost entirely gone - I didn't need antibiotics or anything else. I think stopping to eat crap and adding water and exercise may have helped with that. So now I'm feeling nice and unbloated... just in time to start a cycle again.

I'm worried about this cycle. I worry before every cycle, but this one seems different. It's possible that it's worrying me to have a cycle so close to Pesach. I've started menus and lists, and we've figured out our Seder plans. It doesn't mean that prep is done, but rather that I realize how much still needs to be done and recovering from an egg retrieval just days prior is overwhelming to think about.

I'm also worried about last cycle's count. We ended up with one embryo from a whole cycle but we never got it tested so we don't know if it's transferable. I'm worried about the results from this one might not be better. I really want this to work already. I'm ready to move on. I want to make it to the next steps.

When we started 2016, I was sure we'd be welcoming home our baby by December. It was just a given - of course it will work, it's a third cycle! Why haven't I learned yet? It's not a given. Nothing is a given and there's no guarantee any part of it will work. It's not even that the transfers aren't sticking anymore, it's that we haven't gotten anything to transfer yet, regardless of how much money we've sunk into this so far.

It's hard to get sucked into the what if's and the should-haves... it should have worked and I should be expecting by now. In fact, had the first transfer stuck, I'd be coming up on my due date in May. How crazy is that? I realized what a different year I've had than the one I expected when we transferred in the fall.

One thing I did learn, aside from managing my expectations, is that each cycle is unpredictable. I don't know what this cycle will bring. I'm hoping the recovery will be simple and that I'll be able to enjoy Pesach. I'm hoping it will be successful and we'll get several transferable embryos out of it. I'm hoping it will lead to a successful transfer this summer. I hope it's the last cycle for all the right reasons. 

Happy St Patty

No news to report but it's been so busy that I feel like I have a lot of complaining to catch up on.

The weather keeps yo-yoing between beautiful and miserable. That in addition to the clocks changing has really messed with my mood. I was very blah the first few days of this week when it was rainy and gloomy, and I was grumpy because I lost an hour off my weekend. I spent some time decluttering my kitchen which meant the the cabinets were clear but the countertops were a disaster with everything from the cabinets. It took a few days to clear out and sort the donations from the trash, and during those few days the house was a disaster. Having a clean house makes me happy, so when the house is messy I get crabby.

Along with foul mood swings I've also completely given up on eating healthy. I chalked it up to "birthday celebrating" but in reality I was just being lazy and didn't care. Cookies, take-out, snacks, pizza... whatever. Not eating out of control, but definitely not as careful about watching my weight or caring about calories. Of course all that sugar that I'm not used to is probably not helping the mood swings. I was feeling bloated and icky so I kind of reeled it in and started cooking dinner at home again. It will probably take weeks to undo the damage #sorrynotsorry.

I finished the show I was binge watching and now the only one I have to watch is the one we're watching together. I have way more time so it's annoying that I have to wait for him to watch it. It's also annoying that between Netflix, Amazon Prime, Hulu, and Youtube I still can't find something to watch. In truth it's probably that I just don't want to start anything new but I might have to.

The clinic was being annoying about payment. They said that the copay was due on "day 10 of BC pills" without a date. It's as though they need to make sure I pay up front before they schedule the IVF cycle. In the last three cycles I just made my payment on the day I came in for my baseline. Why is it different now? I asked if I need to make a special trip to make a payment and the manager said that, "The payment is due on the 10th day but if you need additional time to take care of this payment, baseline is fine." As though they're doing me a favor. Thanks. You're getting all my money anyway before doing anything, so does it really matter? Sometimes I feel like they just like reminding me who's in charge.

Purim is next week - hooray! I have prepared nothing and purchased zero groceries. Wednesday is a fast day that I'm not looking forward to, but then I get off work for Thurs/Fri.

Work is getting so busy. It's great because it's been a great distraction. I don't have time to think about everything coming up with cycle 4. I missed a meeting on 2/26 because I had an egg retrieval that day. Depending on how things progress this next time, there's a very real chance I might miss part 2 of that important meeting due to treatment. If that happens I feel like I may have no choice but to tell my supervisor what's going on. I really hope it doesn't happen -- if I tell them I'd rather do it by choice not because I feel forced. We'll take it one day at a time and see what happens.

Goals for next week:
- Declutter closets
- Make cookies and roast on Sunday for Purim
- Place medication order
- Plan out lunches and dinners to avoid take-out

 

Not for sale

There's a hashtag I noticed on Facebook that bothers me: #babynotforsale.


Posts using this hashtag range from parents showing off their babies outfits to businesses promoting sales with a baby as the center of the ad. Am I sensitive to it because of the fertility treatments? That probably has a lot to do with it.


It just doesn't sit right with me that some people take their babies for granted.

Stims

Today is the first night of stims. I'm starting with Menopur and Gonal-F. I've done this before and I know what to expect, but this time starting seems more overwhelming. Starting shots means the end of the "break." It means bloating and mood swings and nausea. At the end of the two weeks, if I'm lucky, there's an egg retrieval which means recovery and anxiety and pain.


I'm excited and scared. There are two possible outcomes each on very opposite sides of the spectrum. Success means pregnancy which signifies the start of our family and the culmination of a long time trying. Lack of success means another failed cycle. I've been there and knowing the devastating heartache and what it's like makes me almost not want to try again. It almost makes me not want to want it as bad. Rejection, failure, disappointment... everything negative. But if you don't try, you don't get the highs of the possible success. It's worth a try.


It's been exactly eight weeks since we go the news that the second cycle failed and we got the negative beta. Eight weeks minus two days since we got the results of the PGD and found out that none of the six embryos from the second egg retrieval were transferable. We had eight weeks to recover.  It started with grieving over the loss of potential, the loss of the cycle, the money wasted. Once the new year started, we were hopeful again. We were ready to try again and with the insurance drama keeping me busy I didn't really think much of the specifics of this new cycle. 


After the go-ahead from the baseline appointment earlier this week, we are ready to start shots tonight and it makes it real. This is happening again and after all the time we waited it's happening now.  Two weeks of stims, followed by two weeks of recovery waiting for my period, followed by two weeks of PIO before a potential FET, assuming there's something to transfer from this cycle. 


I've never wanted something so much that's beyond my control. I just want to know that it can work. I believe everything is up to Hashem but I also believe that I have the ability to do my part. When I wanted a better job, I quit my old one and found a new one.  When I wanted a degree, I worked hard in school and earned it.  When we were looking for a house, I did the legwork and found the house we bought. It's so clear that this is completely beyond my control because the clinic is doing everything they can - we just need Hashem to take over and let nature do its thing.  We have a strong support system with so many people rooting for us to succeed.  I don't want another failure. I want to share good news. Hoping and having high expectations are part of the package. It's the hope that gets crushed at the failure, but it's also the hope that fuels the ability to do this more than once. So I keep hoping and work on a positive attitude as we start this fresh cycle.


I really hope it works this time and we have a successful transfer, an uncomplicated pregnancy, and a healthy baby.  As I prepare for candle lighting tonight, I wonder if this time next year we might have an extra little candle.