The power of positive thinking ...

Sorry for the delayed update! Heather and I went to see Dr. Nash on 11/21. He is very nice, and we were quite impressed with him. We discussed the whole egg donation process. Heather and I both have to take birth control pills to sync up our cycles. Once we are synced up (hopefully by January), Heather and I will both take several different meds. Her meds will be similar to the injectible meds I took during the insemination cycles. The goal is for her to produce many mature follicles that can be retrieved and mixed with Brian's sperm via in vitro fertilization. My meds will effectively suppress my hormones and chemically prepare my body for the embryo transfer. The goal is to do the embryo transfer by February, which means we could potentially be welcoming a Fall baby!

Heather, Brian, and I met with a counselor who specializes in infertility last Saturday. This is required by Dr. Nash's office, for anyone who is preparing for in vitro fertilization and specifically using donor eggs and/or sperm. We talked about the complexities of using donor eggs, and the unique complexities of using a known donor (Heather).

Since I don't have periods anymore, I have to take 10 days of Provera, a pill which will make me have a period. I just started those yesterday, because Dr. Nash wanted me to wait a couple weeks to make sure I didn't start a period on my own. I didn't. :( Once I am done with the Provera and my period starts, I will start the birth control pills. Heather has already been taking birth control pills for a couple weeks. Heather already had bloodwork done. The bloodwork has to be timed correctly, and it must be drawn on day 2, 3, or 4 of the cycle. All of her blood levels look great, which means her ovaries are working well and she should respond well to the fertility meds. :) I will have the same bloodwork done after I start my period, although I already know how those levels will turn out based on all the lab draws I've had over the last year and a half.

After I start taking birth control pills, Dr. Nash wants to do a procedure called a sonohysterogram. He will insert a catheter through my cervix into my uterus, and inject saline solution. Then, he will do a transvaginal ultrasound to visualize my uterus while it is filled with saline. This will allow him to see any fibroids, polyps, or other abnormalities that could potentially interfere with a pregnancy. Hopefully he won't find anything abnormal.

I know this road may be bumpy, with plenty of potential detours, but I am feeling more hopeful than I have in quite a few months. I can't believe that this time next year, I might actually be a Mama!

I read several infertility blogs, and I came across a post that really spoke to me. I am going to change it up a bit to fit my situation.

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People keep asking me, "What will you do it if doesn't work?".

C'mon people, give me a break.

It IS going to work ... I've come too far for it not to.

And what kind of thinking is that anyway? What answer are you expecting me to give you?

Hope for the best, prepare for the worst.

I want it to work, more than I've ever wanted anything in my life. I am hoping for the best. I just really don't have the time or energy to prepare for the worst, to worry about what if it doesn't work. That whole way of thinking is completely counterproductive, in my opinion.

The power of positive thinking.

Please, stop asking me what I will do if this doesn't work.
It doesn't help me to force me to think about that.

Instead, please share in my joy and optimism.
Please think good thoughts for me.
Please wish and hope along with me.

I remain hopeful.
I remain positive.

In my mind, there is no other way to be.

Appointment is made!

After lots of thought and discussion, Heather, Brian, and I have decided to switch to a different reproductive endocrinologist. Dr. Nash (and his practice, Reproductive Gynecology, Inc.) comes highly recommended by several friends of Heather's and mine, and the best part is that he has an office in Columbus (where I live) AND Akron (where Heather lives)! So, Heather and I can go to whichever office works better for our schedules. This will make this whole process much easier. I am definitely sad to be leaving Dr. Schmidt's practice, but I think this is for the best.

Heather and I have an appointment together on Monday, 11/21, at the Akron office. At that time, we will find out more about how this will all play out. I'm excited, nervous, and a whole bunch of other emotions. It's hard to believe that this is really happening!!

still here.

This pretty much sums up the way I'm feeling right now. We've been taking a break from all things fertility and infertility. After a year and a half of spending practically every waking minute focused on trying to get pregnant, we've spent the last couple months trying to focus on everything but trying to get pregnant. We just needed a break. We were exhausted. Getting pregnant has not left my thoughts for the last couple months, but I have tried to not talk about it as much. Somehow, that helps me try to convince myself that I am focusing on other aspects of my life. While trying to focus on other things, I still somehow held onto the hope that the unthinkable might happen and I might get pregnant on my own. Unfortunately, I don't even have periods anymore (except when they are induced by fertility meds), so that doesn't seem to be in the stars for us. We celebrated our 10-year wedding anniversary by taking a trip to Bar Harbor, Maine a couple weeks ago. It rained the whole time we were there, but we still had a wonderful time. As I enjoyed a glass of wine or a margarita on vacation, all I really wanted was to not be able to have those drinks because I had a baby growing in my belly. 

I'm ready to focus on having a baby once again. I had a chance to spend time tonight with two amazing babies (Brandon, the almost 10-month-old bruiser with a head full of black hair and the most munchable cheeks and thighs I've ever seen, and Iris, the 6-month-old petite peanut with the prettiest smile and dimples ever), and that definitely made me jump right back on the bandwagon. :) My sister, Heather, has told me once again that she absolutely wants to be our egg donor, and Brian is on board with this. So, it looks like that is the direction we will go. As much as I would like to do this with CCRM, it just doesn't seem feasable. None of us (Brian, Heather, and I) have the ability to "drop everything" at our jobs and fly off to Colorado at a moment's notice, which is how it would be. The stress of trying to orchestrate that would certainly not be conducive for trying to get pregnant, anyway. So, we are going to go with Dr. Schmidt. I trust him completely and know that he is an excellent doctor. I have to schedule an appointment for Heather with Dr. Schmidt, so that is the next step. We will go from there. This is a very costly venture, though I certainly cannot put a price tag on having a baby. That said, we are trying to figure out how to come up with the money to pay for this. As great as our insurance benefits have been thus far in the infertility journey, they all but stop once donor eggs come into play. I have gotten mixed information on what is and is not covered going forward, but the general consensus is that the majority of this will be out of pocket. The general ballpark figure seems to be around $15,000 - $20.000, for everything (procedures, meds, appointments, and labwork for Heather and me). That is for one cycle. We will also have to pay to store any extra embryos (for possible future babies) as well as future IVF cycles with the aforementioned embryos. 

So, things are moving forward, and I am wishing and hoping that 2012 will be the year that we get our miracle baby and become parents ...

the end of a dream.

I had my phone consultation with Dr. Schoolcraft (founder of Colorado Center for Reproductive Medicine) yesterday at 5PM. He was incredibly nice. We talked for about a half hour. He asked me to tell him about my infertility journey, so I did. When I was finished, he told me that he agrees with everything that Dr. Schmidt has done with us, and he also agrees that there is nothing more we can do with my eggs. He said that he has seen a surprising number of thyroid cancer patients in the last few years who are not able to conceive. He is certain that the radiation treatment is the cause of this infertility. He told me that my only chance to get pregnant is with donor eggs. Although some part of me already knew this to be the case, it was still heartbreaking to hear him confirm my worst fear. I had to leave for work right after I hung up with him, and I had a crazy busy night at work, so I didn't have a lot of time to let all of this really sink in. It's sinking in now. I can't believe that I will never be a biological mother. I feel like a failure ... not just as a mother, but also as a wife. My broken body can't give Brian a baby. I am so incredibly sad. As much as I tried not to get my hopes up about yesterday's phone call, I really did have hope that Dr. Schoolcraft would be able to help me. Infertility is such a roller coaster of hope and disappointment ... two extremes that mix and mingle on a regular basis. I'm tired of the disappointment. I am feeling such regret about not trying to have a baby when we were younger. What were we waiting for?! Oh, if I only knew in my 20's what I know now ...

So, Brian and I have some big decisions ahead of us. Should we pursue donor eggs? Should we use the eggs of someone we know, or someone we don't and will never know? Should we go to Dr. Schmidt (who only does 20-30 donor egg cycles per year), or should we go to Dr. Schoolcraft (who does over 200 donor egg cycles per year and has the highest success rate in the country (90-95%) for donor egg cycles)? So many decisions. My head is spinning, and I just want to stop thinking about all of this for awhile. For now, I just need to figure out how to say goodbye to my dream and start our next journey ...

renewed hope ...

In this post, I talked about the Colorado Center for Reproductive Medicine (CCRM). I called them this morning and just got off the phone with a very nice staff member named Mirna. She talked to me for 15 minutes! We talked about the phone consultation with one of the doctors. She said that the consultation is normally $250, but since the doctors aren't licensed to practice in Ohio, the consultation will be FREE for me! I was completely willing to pay the $250, but what a nice surprise! She said that because the doctors aren't licensed to practice in Ohio, the phone consultation will only involve discussing my situation and the doctor's recommendations. Treatment wouldn't begin until the doctor saw me in person in Colorado. I explained some of my situation to Mirna ... she said that the doctors have had great success with patients who don't respond well to traditional medication protocols (also called "poor responders") and who have high FSH and low AMH levels (that would be ME!). I was encouraged to hear that. So, while I'm trying not to get too excited, I am feeling optimistic again after feeling pretty hopeless for the last couple weeks. Some more good news ... our health insurance company (United Healthcare) covers CCRM, and Mirna said that UHC has excellent coverage for their practice. Yay!

So, I have a phone consultation with Dr. Schoolcraft on Tuesday, August 2 at 5:00 PM. From what I've read, his success rates with poor responders and pre-menopausal women are up to 70%!! He trained under one of the pioneers of in vitro fertilization, and from the testimonials I've read, he is the doctor that couples go to when they are at the end of the road. I am super anxious to hear what he has to say. He will review my medical records before we talk, and he will have them in front of him when we are on the phone. We will talk on the phone for a half hour to an hour. I will post an update after our phone call! Maybe Brian and I will get another chance at a biological child after all ...

what you say vs. what I hear

*I read a post on www.whitneyanderick.com today, and I could have written every word myself. I am adapting it a bit, because her post addresses both miscarriage and infertility, and mine is only addressing infertility.

I can’t believe I’m going to address this topic and be so open, but it’s on my heart right now. I have a really, really hard time with pregnant women. There, I said it. I always feel I like I need to explain myself, because from the outside looking in, I can’t imagine what people think of me. I just want you to understand how I feel and what goes through my head.

• When I see your belly, I see the lack of my own. 
• When you say, “I’m seven weeks pregnant,” I hear the voice in my head saying that I would give anything to be seven weeks pregnant. 
• When I hear your big announcement, I know I will never have one, even if I do have a child someday. My announcement will be riddled with beta hCG numbers and the need to take things day-by-day instead of a happy proclamation. 
• When I see your joy, I feel my pain. 
• When I see your husband holding your child, I see myself as a failure that I can’t provide that for my husband. 
• When I see your family photo Christmas card, mine feels empty. 
• When you come home from the doctor with an ultrasound photo, I come home with a book called “Empty Arms.” 
• When you go to the doctor, it’s a happy time. When I go, it’s torture to be so surrounded by pregnant women and baby photos. 
• When you complain about your kids, my heart breaks a little more because I would give anything to have kids.
• When you say, “Being pregnant sucks” or “I hate this morning sickness,” I say, “Bring it on!” 
• When you say, “We weren’t even trying,” I hear the universe laughing at me. 

It’s not you, it’s me. No, really, it is me. I’m not trying to turn everything you say or do to be all about me. I don’t want to think about ME. I don’t want to think about pregnancy. I don’t want to think of my problems and my failures. I would love to escape everything. These are persistent thoughts that come bubbling up even though I do my best to keep them out. I do not possess Vulcan mind capabilities.

Think of it like this. Do you know an alcoholic? Is it a good idea for them to be around booze? Should they hang out at a bar? It’s too hard.

Or, what about a war vet? Do you think many of them want to re-live what they’ve been through? Do they want to see war movies? Does hearing fireworks make them jump? Do certain triggers give them flashbacks? Again, these things are too hard for a veteran.

Well, pregnancy is too hard for me. I have to protect myself. So, if I don’t seem happy for you, it’s not that ... I’m just trying to protect my broken heart (and body) and keep myself sane.

thoughts on adoption

I can't begin to count the number of people who have told me to "Just Adopt". While I know that many of those people say these words with the best of intentions, they are still very painful words to hear. I am not ready to adopt. I don't know if I ever will be. I know that adoption is a wonderful choice for some people, but I don't know if it is the right choice for Brian and me. I can't really put into words why I feel this way, but I just do. I am still grieving for my biological child ... the one I will most likely never have ... the little boy with strawberry blond hair and deep blue eyes like his Dad ... the little girl with curly brown hair and bright blue eyes like her Mom. I am in the depths of grieving, and I don't know when the grieving will stop.

I read a lot of infertility blogs, and I came across a very insightful blog post this morning. The blog is http://www.whitneyanderick.com, and here is the post:


Telling someone to "Just Adopt" is a bad idea
There are two myths surrounding trying to conceive and adopting and I will try to tackle both of them.

- “Just adopt.” 
- “You should just adopt, then you’ll get pregnant.”
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Myth #1: If I know someone who’s having trouble conceiving, maybe I should tell them to just adopt.  Or, ask them if they’ve considered adoption.
Fact: No, you should never give this unwanted advice.

As a woman who has not wanted to adopt in the past and as someone who is considering it now, I can absolutely say hearing the words “just adopt” is unwanted and painful.  Thankfully, I’ve only heard it a couple of times over these last five years.  One of them came from a nurse practicioner at my OB/GYN clinic.  I wish I was kidding.  If anyone should be sensitive, I think it should be women’s health professionals, but alas, that is not always the case.  And, this was four years ago before we even had any diagnostic testing or began any infertility treatments.  She had no right to tell me that, and was medically negligent in my opinion especially when we had lots of options at that point and had no reason to believe that we wouldn’t ever be able to conceive.

Let me explain why suggesting adopting to an infertile is not a good idea:

• When you are still trying, whether or not you would consider adopting, it’s painful to hear.  My husband and I desperately want a biological child. Period.
• It comes across as “why don’t you just give up already…this is never going to happen.”
• This is a deeply personal decision and not something to be bantered about as if you’re talking about the weather.
• When people say “just adopt,” they think it’s an easy solution.  You want a child.  There are children to adopt.  It’s not that easy.  It takes the right people and a lot of soul-searching.
• In many cases, it requires grieving the loss of a biological child.  This is difficult for people to understand.  This has been extremely hard and I’m in gray area right now.  I feel like I’ve been grieving, but I haven’t completely given up hope either.
• The financial aspect of adopting is staggering.  There are many who have failed to conceive and their hearts are open to adoption, but they simply can’t afford it.  General costs to adopt are around $20,000 to $30,000.  Add that to the $20,000 or more than many of us have already spent on fertility treatments and you can see why it’s financially impossible for some couples. And, additionally hurtful when you tell a person to just adopt, and although they want to, they can’t afford it.
• It’s hurtful to those whose first choice to have a child is to adopt. It was never a back-up plan for them.
• It’s very insulting when it’s coming from someone who has a beautiful child sitting at home with mommy’s eyes and daddy’s nose.  Easy for them to say.

I think the only exception to this rule would be when someone who has adopted has a heartfelt conversation with you and asks if you have considered it.

____________________________________________________________________

Myth#2: “You should adopt, then you’ll get pregnant”
Fact: Adopting has absolutely no bearing on your ability to conceive.

This is last thing I want to hear and it makes me feel like beating my head against the wall.  Yet, everyone has a story that they tell where this happened to a friend of a friend of a friend.

Here’s why:

• Adopting will absolutely, positively 100% not help me get pregnant and stay that way.  Infertility is a disease that needs to be treated just like any other disease.
• It’s hurtful because it implies that if we stop stressing about getting pregnant and pursue adoption, then we will conceive.  Not true.  Read my post - Just say no to “Just Relax.”
• You have to want to adopt.  It’s not for everyone.  It’s not to be taken lightly.  It’s not the means to an end.  It’s an end.
• It’s not some easy step to check off your list in your quest to conceive.  Get my uterus examined — check. Take ovulation drugs — check.  Check hormone levels — check.  Adopt a child– check.  See how ridiculous this is?

I hope this has helped to explain why these myths can be so painful to women like me.

daydreaming

I've been daydreaming about taking a pregnancy test this week. In my daydream, the test is positive (of course). We are going to the lake this weekend to spend time with my parents and sister and celebrate Father's Day. In my daydream, I give my Dad a "Happy Father's Day, Grandpa" card on Father's Day, and that's how we share the amazing news with my family. I also daydream about giving Brian his first Father's Day card.

My daydream will stay a daydream. My period started today, and my heart is broken once again ...

a bit of good news ...

I had another ultrasound yesterday morning. I was feeling stressed out before the ultrasound for a few reasons: first, I was afraid the cyst got bigger and this cycle would be a bust. Second, we are going out of town on Friday for a Saturday wedding (I am making the wedding cake and cupcakes) and I was afraid the timing wasn't going to work out. If insemination would need to happen this weekend (when we are out of town), this cycle would also be a bust because going out of town is not optional. So, I was feeling very anxious going into the ultrasound.

I had a different doctor for the ultrasound ... I have never met Dr. Williams before, but I have heard great things about him, and he's actually the one who helped my sister- and brother-in law conceive their three wonderful children. There is another doctor (I won't mention names) who literally causes my heart to drop when he walks in the door to do my ultrasound. He has a pretty poor bedside manner, and he is extremely rough with the ultrasound wand, if you know what I mean (TMI, I know ...). So, I was apprehensive when I saw a new doctor come through the door. But, Dr. Williams was great. He was gentle like Dr. Schmidt, and even better, he said that the "cyst" was actually a big fat follicle!! Apparently they can look similar on the ultrasound screen. My estradiol level almost doubled since Friday (it's up to 142 now), so that was enough to convince him that the growing dark circle on the screen is in fact a follicle and not a cyst! I was very happy to hear this! I also have 3-4 smaller follicles that could still potentially be "the one". So, this cycle is turning out to look somewhat promising. Once again, my hopes are high, and the roller coaster ride continues.

So, tomorrow morning (6/2) will be insemination. I gave myself the HCG trigger shot at 9:15 last night at work, so I should ovulate right around 9:15 AM tomorrow. I have to work tonight, so I will meet Brian in the morning after he goes to the lab, and we will have our special pre-insemination breakfast (haha) together. We will be back at the office at 9AM for insemination. Then, we will begin the agonizing 2+ week wait until I can take a pregnancy test.

Once again, it's time for optimism, wishing, and hoping ...

today's ultrasound

I had my ultrasound this morning. I got there early and was the first patient to arrive at the office. Normally, once I am taken back to the exam room, the doctor comes in almost as soon as I get myself situated on the exam table. Today, I had about a 15-minute wait to sit there, half naked and covered with a paper "blanket", alone with my thoughts. I sat on the exam table and daydreamed that Dr. Schmidt was going to come in to do the ultrasound and tell me that I had 10 big follicles and we were going to turn this into an IVF cycle. I actually got tears in my eyes, thinking about how amazing that would be. Then, reality happened. Dr. Schmidt did come in to do the ultrasound, but the news I got was worlds away from my daydream. He saw a few very small follicles on each side and one giant cyst on my right ovary. I have been experiencing a good deal of pain on my right side for the last few days, but I was hoping that the pain was a good indication of how many follicles I might have. Sadly, this is not the case. When I saw the cyst on the ultrasound, I was afraid Dr. Schmidt was going to say that this cycle would be a bust. Fortunately, he said that he wants to continue the cycle since he sees some promising follicles. One of the nurses called this afternoon with my estradiol level (85 ... not high enough) and instructions for the next few days. I have to continue the injectible meds through Monday, and I will go back on Tuesday morning for blood work and another ultrasound. If the cyst has grown much larger in size (or has ruptured, which I really hope doesn't happen), we will probably not be able to go through with IUI this cycle. Very sad.

I recently heard from a friend who shared that she and her husband struggled with infertility when trying to conceive their two beautiful girls. She told me about the Colorado Center for Reproductive Medicine (CCRM), in Denver. It is supposed to be the best fertility clinic in the country. She told me that she has a friend who went to ORM (where I go) for several years, was unable to conceive, and was basically told that she and her husband were out of options. They ended up going to CCRM and now have beautiful twin girls. :) This gave me a glimmer of hope. So, I researched CCRM. They offer a phone consultation (it sounds like they get patients from all over the world) with one of their reproductive endocrinologists for $250, and then you proceed from there. I talked to Brian about this, and he didn't seem too excited. I can understand where he's coming from, but I am hoping that maybe he will think about it some more. We will be celebrating our 10th wedding anniversary in October, and we have been trying to decide on a vacation destination. Maybe we can travel to Denver for our anniversary. ;) CCRM has been on the forefront of some of the newest advances in reproductive medicine, and they have helped many couples conceive when they were previously told that there was no hope. I can't stop thinking that maybe they can help us. I probably sound like a crazy person, but I just can't stop hoping that somehow, some way, we can conceive a baby. So, I'm contemplating doing the phone consultation, just to see what they have to say. I am feeling guilty that somehow I will upset Dr. Schmidt and his nurses, but it's nothing personal. I have to believe that they have had patients go to CCRM before ... it's just getting a second opinion, right? At least it's something to think about.

That's all for now. I'm hoping that the cyst on my ovary doesn't grow or rupture this weekend (I've heard that a ruptured cyst is extremely painful), and I am willing those follicles to grow, grow, GROW!

hope

In my last post, over a month ago, I said that my period was supposed to start any day. Well, it never did start. Since my ovaries don't work very well anymore, my periods are extremely irregular and can be few and far between. This is a cruel twist of fate when trying to get pregnant, because it leads to false hope that there might actually be a pregnancy. Subsequently, I spent way too much money on pregnancy tests in the last month. Needless to say, I have had more than my share of "Not pregnant" and "-" results. A couple weeks ago, I decided to call Dr. Schmidt's office regarding my period not starting. Carol (awesome nurse) called in a prescription for 10 days of Provera, which induces a period within two weeks of starting the med. My period started yesterday (5/17). I talked with Carol this morning, and I will be starting the meds tomorrow ... four days of estrogen-blocking pills followed by an undetermined number of days of injectible meds. My first ultrasound will be next Friday (5/27). As hard as I am trying to not get my hopes up, they are already in the clouds. I can't help it. I have this fantasy that my ultrasound next week will show lots of follicles ... enough to transition this cycle into an IVF cycle (Dr. Schmidt mentioned at our appointment in early March that this is a possibility, although slim ...). That would be amazing. I wish there could be some way to stay emotionally detached from all of this and not get my hopes up at all, but I don't think I'm made that way. I always try to find a glimmer of hope in any situation, and I'm holding onto that glimmer right now.

So, our "break" is officially over. I feel excited, hopeful, and scared. As much as Brian and I needed the "break" from fertility stuff, I felt lost and in limbo the whole time. For the last couple months, I have been avoiding friends with kids (especially babies), because it's just been too hard to be around them ... self-preservation, I guess. I feel like I have been a bad friend, especially to several friends who have recently had babies or gotten pregnant. I think this must be hard to understand for anyone who has not struggled with infertility, but I am hoping for understanding and forgiveness.

I guess that's all for now. I will update after the ultrasound next Friday. Any and all positive thoughts and energy are always appreciated. :)

not much to say ...

Several people have asked me for an update, so I decided to post one tonight. I haven't posted in awhile because there hasn't really been anything to report, and because I haven't really had anything good to say. We are still on our "break". I don't think I ovulated this cycle. I did the ovulation predictor tests faithfully every day a couple weeks ago. At first, there was no pink line. Then, there was a faint pink line. The next step would be a dark pink line, which would indicate that ovulation would happen soon. There were a couple days of faint pink lines, but I never got a dark pink line and instead just went back to no pink line. So, who knows what happened. In any event, I am expecting my period to start any day. We haven't yet decided when we are going to start the insemination cycles again. I will have to call Dr. Schmidt's office on the first day of my period. So, it will either be in the next couple days or in about a month. To be honest, I am actually feeling very scared and anxious about starting the insemination cycles. I guess it's because if these insemination cycles (however many we end up doing) don't work, I will never have a baby with my eggs. So, in terms of conceiving with my eggs, this is the end of the road. I know that we still have other options ... IVF with donor eggs or adoption ... but I am really struggling to come to terms with the reality that my chances of having a baby with my eggs are very slim and are running out.

According to Elisabeth Kubler Ross, there are five stages of grief ... denial, anger, bargaining, depression, and acceptance. I have been alternating between anger and depression lately. I wish I could just get to acceptance and move on to whatever is next, but I am stuck in anger and depression. I feel like I am surrounded by pregnancy and babies in my life. I have loved babies and pregnancy for my whole life, but I am ashamed to say that right now, babies and pregnancy make me incredibly sad. I so desperately want one of my own that I have started feeling bitter towards people who are pregnant but don't want to be, or even people who had no trouble getting pregnant or weren't even trying to get pregnant. I am not normally a bitter person, and I HATE that I feel this way. I don't know where these feelings are coming from. But, they are real. I am not trying to offend or upset anyone reading this who has a baby or is pregnant. I guess I am just struggling with my feelings right now.

That's about all I have to report. I'll update again when we start the next insemination cycle.

disappointed ...

Well, we are on our "break" from fertility treatments. As expected, time has dragged on, and I am feeling very antsy. It doesn't really feel like much of a break to me. Anyway, Dr. Schmidt instructed us to keep trying to get pregnant on our own. So, I used some ovulation predictor tests a week and a half ago, and sure enough, they indicated that I was going to ovulate. I was pretty excited about that, because I was just assuming that I wouldn't ovulate at all without the meds. So, I've been waiting the last week and a half, just hoping that there would be some sort of miracle and this might be our month. Naaaaaaaaaah. My period started last night. At work. Like it always does. Not surprised, and yet still very sad.

*note: I previously wrote a couple paragraphs here about an interaction with a coworker yesterday. I decided to remove those paragraphs because I am not sure who all reads this blog, and I didn't want to hurt any feelings.

I have at least 5 friends who have gotten pregnant in the last 6 months. Learning about each one has been incredibly difficult (no offense to any friends who are pregnant ... it's nothing personal, it's just so hard). I want so much to be happy for everyone, but instead I just find myself being sad for me. I hate that I can't get pregnant. So much.

some answers

Well, we met with Dr. Schmidt today. He told us that he doesn't believe that IVF (using my eggs) is, or ever will be, a viable option for us. In order to do IVF, I need to be able to grow a minimum of 8-10 mature follicles in a cycle, and the most I've ever grown is 3. There are several steps in the IVF process, and with each step, some eggs usually die. If we start with only 3 eggs, there won't be any left to put back into me. He believes that even with stronger doses of the injectible meds that I've taken before, my ovaries will not respond appropriately. He said that the decision is ultimately up to Brian and me, but he thinks that it will be a waste of time, money, and our mental health. As hard as that was to hear, I appreciate his honesty, and Brian and I agree with him. 

When I asked him what could have caused my ovaries to fail so prematurely, he said that he believes it was the radiation treatment. Even though I have suspected that all along, it was still very hard to hear. I fought back tears at that point. My voice got shaky, as it always does when I am trying not to cry. I hate that. He is not concerned about the quality of my eggs (he said that age is the main determinant of egg quality, and I am not old enough yet for my egg quality to be reduced), but he is concerned about the quantity of eggs that I have left. The radiation treatment most likely caused my ovarian reserve (number of eggs in the ovaries) to be depleted, leaving me with a low number of remaining eggs. The two blood tests (AMH and FSH) that I discussed in previous posts are the two main indicators of ovarian reserve. My AMH is extremely low (I learned today that my value is actually <0.16, which is the lowest value possible), and my FSH is very high (mine is 21.4, and the paperwork from the lab indicates that a postmenopausal level is >25), and this is how Dr. Schmidt knows that my ovaries are failing. Still, my ovaries are not quite menopausal yet, so there appears to be a glimmer of hope ...

Dr. Schmidt said that we really have two options at this point ... IVF with donor eggs or a few more cycles of IUI. He said that my ovaries responded well enough (although not great) to the injectible meds with IUI, and he believes that I will continue to respond well enough. He said that this is really the only option we have left to conceive with my eggs. He said that my chances of getting pregnant are significantly lower now that my ovaries are failing (yet another thing that was difficult to hear ... cue the shaky voice), but he still believes it is possible. Brian and I both agree that we should do a few more cycles of IUI. If there is any possibility that we can still conceive a child with my eggs, then we are all for it.

For now, Dr. Schmidt highly recommends that we take a break for a few months. He said that a break will be very good for our mental health, since he understands the emotional toll that this has taken on us. When I shared concerns about my time running out, he said that a few months won't make a difference. He said that he wouldn't recommend taking a whole year off, but a few months will be good for us. I suppose I agree with that. He said that a handful of couples have gotten pregnant on their own during their "breaks". While I am not getting my hopes up for that, I certainly can't think of a better ending to this whole journey.

So, we are going to take a break and regroup. I'm thinking we will take a break for maybe 2 months and then start back up again. We will try 2 or 3 more cycles of IUI (assuming that I continue to respond to the meds), and see what happens.

I expected to feel some sense of relief after meeting with Dr. Schmidt today. To be honest, all I feel now is very, very sad. I guess we just need to move forward and hold onto the hope that a miracle could still happen for us ...


"We must accept finite disappointment, but we must never lose infinite hope." ~Martin Luther King, Jr.

big day

This afternoon at 4:00 is our appointment with Dr. Schmidt. This will be the first time I've been in his private office (as opposed to an exam room) since we started this journey on July 7, 2010. My cancer follow-up appointments every six months (where I have an ultrasound of my neck and go over blood work results to find out if my cancer is back or has spread) are nervewracking, but I have never been as worked up about going to a doctor's appointment as I am about this one. Since last Thursday, I have been trying to prepare myself to hear Dr. Schmidt say that my only chance for getting pregnant is with donor eggs. I still don't think I am ready to hear it. I am thankful that Brian will be there holding my hand ... no matter what Dr. Schmidt says, we will get through it. I need to keep reminding myself that if we truly want to be parents (we do!), we will figure out a way to do it. One of life's toughest lessons is that things don't always go the way we planned. I will update later ...


"The human spirit is stronger than anything that can happen to it." ~C.C. Scott

premature ovarian failure (POF)

Cathy (another of Dr. Schmidt's wonderful nurses) called me a little while ago and said that she got the rest of my labwork results. The main result that they were waiting for was AMH (anti-muellerian hormone). This is an even more accurate indicator of ovarian reserve than FSH. My AMH level is 0.16 (almost undetectable). "Normal" is over 1.0. Cathy said that this number makes it very unlikely that my FSH level was a lab error. My high FSH level plus my low AMH level mean that I have officially entered premature ovarian failure (POF). This essentially means that my body is in early menopause. My ovaries no longer function properly, and the few eggs that I do have left are probably not viable. This explains why my ovaries have not responded appropriately to the high doses of strong ovary-stimulating medications I have taken for the last 8 months. Cathy said that Dr. Schmidt is not one to give up without a fight, so it is still possible that he may want to try the most aggressive IVF protocol on me for one cycle to see if he can stimulate enough eggs to make some viable embryos. But, she said it is more likely that he will suggest doing IVF using donor eggs instead. I am going to ask him to be completely honest with me, because I don't want to waste an IVF cycle (our health insurance company covers 2 IVF cycles completely per lifetime, and any cycles after the 2 covered cycles are completely out of pocket ... one IVF cycle costs approximately $12,000-$15,000) if there isn't a realistic chance that my ovaries will respond to the meds.

So, at least I have some answers now. I will have more answers after we meet with Dr. Schmidt on Wednesday. I am feeling a profound sense of loss right now. I guess you could say that I am grieving for the loss of my fertility as well as the loss of a baby (from my own egg) that I always thought I would have. Cathy said that she can't believe my numbers are so off the charts, considering my age (she called me "young" ... I am definitely not feeling the slightest bit young right now, but I appreciate her saying that). She raised concerns about the radiation treatment that I had two years ago for thyroid cancer, which is what I have been afraid of all along. My biggest regret now is that I didn't look into harvesting my eggs before the radiation treatment. I don't know what I was thinking. I guess there's no point in dwelling on that ... there's nothing I can do about it now. I'll just wait and see what Dr. Schmidt has to say on Wednesday.

sad, confused, overwhelmed ...

I received an order in the mail (from Dr. Schmidt) for about 15 different blood tests that I needed to have done on cycle day 3 (the third day of my period) if I ended up not being pregnant this time. This blood work needs to be done in preparation for IVF. There are lots of things they need to check for before jumping into the land of IVF. I had my blood drawn on Monday morning (2/21). They had to draw 8 tubes of blood!!

Anyway, I called Dr. Schmidt's office several times this week because I was very anxious (and afraid) to find out my current FSH level. My FSH level back in July 2010 (when we first started infertility treatments) was 12.3. That is elevated, but still manageable. Carol (my favorite nurse) called me this afternoon with my current level. I could tell as soon as I heard her voice that the news wasn't good. My number is 21.4. My heart sank to my toes when I heard the number. Based on everything I've read, most reproductive endocrinologists (fertility doctors) don't even attempt IVF once the number is greater than 20. I didn't know what to say except "wow". Carol said not to panic (too late!), and told me that there is a chance that the lab made an error. Yes, I suppose that is possible, but I'm not holding my breath. She said that Dr. Schmidt also looks at another blood test for anti-mullerian hormone. That was part of the workup from Monday, but the result won't be available until next week. She said that even when the numbers seem terribly dire, there are still options. I can't remember what else she said ... I think I was too stuck on 21.4. If that number is correct, then my ovaries are essentially no longer functioning, and I have no chance of getting pregnant with my eggs. That means our only remaining options are IVF with donor eggs (my amazing sister, Heather, has graciously and sincerely offered her eggs to me), surrogacy (not something I really want to consider, for a number of reasons), or adoption. I am feeling terribly sad. I can't seem to wrap my head around how my FSH could have skyrocketed so much in only 8 months. I have been browsing the internet tonight for answers and more information, but this has just left me feeling more confused and sad.

We will be meeting with Dr. Schmidt next Wednesday (3/2) to go over the blood work results and discuss our options. I guess I will know more and have more to report after that appointment.

really.really.really.really.sad.

I am typing this post with tears running down my face. In the midst of one of the worst nights I've ever had at work (all three of my patients developed major issues that almost got them transferred to the ICU), my period started with a vengeance. I went in the bathroom to cry three different times during the remainder of the night at work. In the past week alone, I had three dreams that I was pregnant. They were so vivid that I even remember the details of watching the pink line appear, crying tears of joy, and calling people to tell them the amazing news.

On this week's episode of "One Born Every Minute" (an 8-episode documentary on Lifetime that was filmed at the Labor & Delivery unit in my hospital), one of the featured couples was 17 years old. They didn't plan to get pregnant, and didn't even seem very excited about having the baby. That was really hard to watch. Life is so unfair sometimes.

I have terrible cramps (so bad that they are making me nauseated), I didn't sleep well today, and I have to go back to work tonight (and rereading this blog post, I realize that I am sounding whiny and feeling sorry for myself. Ugh. I will be back on my feet again soon ... I just need to feel sad right now.). This infertility journey is the pits.

feeling optimistic, but still being realistic ...

One week from today, I will be taking a pregnancy test (assuming my period hasn't started by then). I am still having some pelvic cramping, which is a good thing. While I am feeling hopeful and trying to stay optimistic, I am also thinking ahead. If I am not pregnant now, we have decided to move on to in vitro fertilization (IVF), which is the end of the road for fertility treatments. I have done quite a bit of research on IVF, and the success rate is 50-60%. The quality of my eggs has always been suspected as the cause of my infertility. I have read several research articles about the effect of radioactive iodine (the radiation treatment that I had in 2009 for thyroid cancer) on eggs. There is some speculation that this type of radiation can damage eggs, which is what I have been afraid of all along. With IVF, my mature eggs will be extracted from my ovaries, and that's when Dr. Schmidt will really be able to determine the quality of my eggs. While FSH levels (see this post) can be a good indicator of ovarian reserve, the quality of the eggs can't be determined until they are taken out of me. So, if I am not pregnant this month, it will be good to finally know what's going on with my eggs.

I left a voice mail for Dr. Schmidt's nurses this weekend, asking what I need to do to prepare for IVF, in case I'm not pregnant. Patty (one of the wonderful nurses) called me this morning and confirmed that Dr. Schmidt agrees that it will be time to do IVF if this cycle wasn't successful. She said that Brian and I will need to meet with Dr. Schmidt to discuss everything, and she scheduled that appointment for 3/2 at 4:00. Of course, I will be more than happy to cancel that appointment if I am pregnant, but I'm glad to have it scheduled. Patty told me that I will have to skip a cycle if I'm not pregnant, to get all of the paperwork signed, meet with Dr. Schmidt, and get of all the medications ordered. Plus, I will start taking a daily intramuscular injectible medication called Lupron about a week before my next period (after the one that will start next week if I'm not pregnant) begins, and continue taking it for at least two weeks. This medication completely shuts down my body's production of FSH and LH. That way, my follicle growth and subsequent egg retrieval can be controlled more precisely. Timing was very important with IUI, but it is critically important with IVF.

Patty told me this morning that my progesterone level from my blood draw on Friday was 12.4. If I remember correctly, that's the highest it's been since I started injectible meds. Patty said that as long as the number is over 3, ovulation definitely happened; as long as the number is over 10, pregnancy can occur. So, I am encouraged by this number. :)

If I am not pregnant this time, I will need to have blood drawn on the 3rd day of my period, to check my FSH level (see the first paragraph of this entry for more info about FSH levels ). My FSH was last tested in July, and it was a reasonable level at that point. It is possible that the number has increased since then. If it has increased too much, this will indicate that my ovaries are no longer functioning well enough to allow me to get pregnant with my own eggs. At that point, we will have four options: IVF using donor eggs and Brian's sperm; surrogacy; adoption; or deciding that we are ok with not having children. It's very hard for me to even think about having to choose one of those options, but it is always in the back of my mind.

For now, I am going to keep on keeping on for the next week, hoping that my period does not start, and wishing, hoping, and crossing every crossable body part that I get a BFP (big fat positive) pregnancy test next Monday. So, here's to wishing and hoping ...

waiting, waiting, waiting ...

This feels like it has been the longest week ever. I can't believe insemination was only a week ago ... it feels like it was a month ago. Time truly seems to slow down during the 2+ weeks between insemination and pregnancy test/period.

I've been having some pelvic pain and bloating in the last couple days. It's not like anything I've felt before during this part of my cycle, so I called my doctor's office to ask about it. I explained that the pain initially felt like it was more on the right side, but it has now become more low and central. Carol (amazing nurse) explained that the pain could be a couple different things. First, the right-sided pain could be the result of some of my follicles not releasing their eggs and instead turning into cysts. These cysts grow rather large and collect fluid. They also cause fluid to collect in the abdomen. They can cause a significant amount of pain and are not uncommon when the ovaries have been stimulated with fertility meds. These cysts are what Dr. Schmidt looks for when he does the baseline ultrasound every cycle on day 3. If there are any cysts present at that time, I have to skip a cycle. :( So far, this has not happened, and I hope it never will. What a double whammy ... to not be pregnant AND to have to skip a cycle. That would be so sad. :(

The more central, low pelvic pain is a good thing, according to Carol. She said that implantation can take place as early as 5 days after ovulation (which would have been Wednesday), and there can be pelvic pain associated with implantation (since this triggers a whole bunch of hormonal changes as well as the placenta starting to grow). She said that if this pain continues, it is a very good sign and may mean that I am pregnant. Of course, I was over the moon when I heard that!! Now, I can't think about anything else. I can't believe there might actually be a little bean (or two, or three ... haha!!!) growing inside me right now. I am SO trying not to get excited, but I just can't help it. So now, I am just wishing and hoping that this pain continues!!

I will be getting my blood drawn later this morning, to check my progesterone level. This level will confirm that I ovulated, and the higher the number, the better. I should get a phone call from one of the nurses on Monday, letting me know the results of the bloodwork.

For now, I just have to be patient ... wish it wasn't so hard!!!

the waiting game ...

Yesterday was our big day. Brian had to be at the lab at 7:30 AM, and then we enjoyed breakfast together at Cosi (yum). We had to be back at Dr. Schmidt's office at 9 AM. Dr. Schmidt's smiling face always makes me feel good. He came in with the vial of liquid baby-making gold and said that this was going to be the month I get pregnant. I sure hope so. He had some trouble getting the catheter through my cervix and angled forward into the top of my uterus, so the insemination process was more painful than usual. I ended up bleeding for most of yesterday and am still feeling crampy (he said that all of this is normal and wouldn't affect my chances of getting pregnant at all).

I will start taking Prometrium (progesterone vaginal suppositories) twice a day starting tonight, to make sure my progesterone levels are high enough to sustain a pregnancy. I will stop taking the Prometrium on 2/16, in case I am not pregnant. That way, I will be able to have a period. If I am pregnant, I will have to start the Prometrium again and take it for the entire first trimester (and possibly longer).

I will have my blood drawn to check my progesterone level on Friday (2/11), and I will give myself an HCG booster shot that day, too. My official pregnancy test day is February 21. That day seems so far away. I really struggle with being patient when it comes to this whole infertility journey. It's so strange knowing that for the next 2+ weeks, my body will know whether or not I am pregnant, but I will not. I'm starting to feel pessimistic already. :( I'm just so afraid to get my hopes up.

3 big fat follicles!!! :)

I had my ultrasound and estradiol blood draw today. To my surprise and amazement, my follicles are ready!! I have 3 big follicles in my left ovary. A follicle is considered mature once it reaches 15 mm in size. Mine are 14 mm, 20 mm, and 21 mm. :) Dr. Schmidt shared my excitement today. He told me that it appears we have finally found the right cocktail of meds for me. To give a comparison, my follicular phase (the amount of time between the first day of my period and the day of ovulation) was 19 days last month (and even longer in previous cycles) and will be 14 days this cycle. That may not seem significant, but it is a really big deal. In a "perfect" cycle, the follicular phase is 14 days. I have never had a perfect follicular phase in my life. So, this is huge. I was on cloud nine driving home from the doctor's office. Unfortunately, it took me awhile to come off cloud nine enough to fall asleep today. Last night was my first of three 12's in a row at work, and I only ended up getting about 5 hours of choppy sleep today. :( But it's ok. Maybe the sleep deprivation is a sign of things to come in about 9 months? ;)

So, Carol (my wonderful nurse!) called this afternoon with my instructions for the next few days. She told me that my estradiol level is 164. In some past cycles, it never even got that high. In the cycles when it did get that high, it took a lot longer. So, I am going to do one more night of injectible meds (1 of Bravelle and 1 of Menopur, instead of 2 Bravelle and 1 Menopur) tonight, and then I will do my HCG trigger injection tomorrow night at 9 PM. Then, Friday will be the big day. We have to be at the lab at 7:30 AM for Brian to do his thing, and then we have to go next door to the office at 9 AM for insemination. I am trying my hardest to not get my hopes up, but of course those attempts are futile. Everything seems to be going right this time, and I can't help but believe that this is a good sign.

So, here we go again ... :)

insurance nightmare (with a happy ending)

We have our health insurance through UnitedHealthcare, but our prescription coverage is through CVS/Caremark. CVS/Caremark has a specialty pharmacy (mail order) that supplies fertility, chemotherapy, multiple sclerosis, etc. medications. I have been so impressed with them (and the coverage for fertility meds is amazing ... Dr. Schmidt's nurses have told me that we have some of the best prescription drug coverage they've ever seen!) since I started the injectable meds. I just call them to order the refill, and they overnight (for FREE!) the meds to me so I get them the next day. I've never had any issues with them ... until this week.

After I had the ultrasound with Dr. Schmidt on Monday, I met with Carol (one of his nurses) to go over the new injectable meds (she showed me how to mix them, inject them, etc.). She told me that she was going to fax the prescriptions to CVS/Caremark that day, and I should call the next day to arrange delivery. So, I called CVS/Caremark on Tuesday afternoon. The person I spoke with told me that the medications required prior authorization. When I asked for more information about that, I was told that my doctor had to provide this prior authorization before the prescriptions could be filled. I called Carol and left her a voice mail explaining this (I was in panic mode at this point, since we were running out of time to get the meds to me so I could start them today). It was late afternoon at that point, so she called me back on Wednesday morning. She said that she had just waited on hold with CVS/Caremark for over a half hour before finally getting a live person. That person then transferred her to someone who assured her that the authorization would be faxed to her that morning so she could complete it and fax it back. I was really starting to panic, but trusted that the fax would be sent that day. Carol called me back at 3:00 and said that she had she spent over 2 hours that day on the phone, being given the runaround about this fax that she never received. She asked me to call CVS/Caremark at that point, and try to get something done from my end. I was so upset (not with Carol ... she went above and beyond). She gave me the phone number of the person she had been working with, and I tried to call this person. Of course, it went to her voice mail. I then called the number that I call to get my refills mailed to me, and the person I spoke with was not helpful at all. She said that my only option at that point was to pay out of pocket and hope to be reimbursed by them (NO guarantees) after the fact. She told me that the meds would be almost $3,000 out of pocket. I lost it. I was a crying mess at that point. There's no way I could come up with that kind of money on the spot, especially without a guarantee that I would be reimbursed. I cried all afternoon that day. I was so afraid that this wasn't going to be resolved by today, meaning that this cycle would be ruined. 

Side note: I worked three 13+ hour nights in a row this week (M-T-W), and was barely able to sleep on Tuesday or Wednesday during the day (because I was so worried about this). So, the sleep deprivation was not helping matters at all. 

I was driving to work at 6:30 on Wednesday evening when my phone rang. It was the person at CVS/Caremark. She was very apologetic and explained that since it's the beginning of the year, almost everyone's insurance company requires prior authorization for specialty (including fertility) meds, so the authorization department was very backed up. Fighting back the tears (unsuccessfully), I explained to her that I HAD to have those meds by today, or this cycle would be ruined. She said that she had gotten permission from the authorization department to call Carol the next morning (Thursday) and take verbal authorization instead of a fax. She assured me that once this verbal authorization was obtained, I would be able to order the meds to be overnighted to me for today. My tears of sadness turned to tears of joy (all of these hormones make me an emotional mess, and I am not normally a crier!!), and I thanked her profusely. I called Carol and left her a message explaining everything. She called me the next morning and said that she did the verbal authorization, and everything was good to go. I thanked her, thanked her again, and then thanked her one more time before we hung up. She has been amazing. I had left her a tearful voice mail at some point this week, and when she called me back, she said that she got tearful listening to my message. They all care about their patients so much ... such a refreshing change from some doctors out there. 

I called CVS/Caremark and arranged for delivery. I asked for the total due, and the person I was speaking with told me $200!!! What amazing coverage ... remember, I was going to have to pay $3,000 out of pocket!!! The person on the phone assured me that the meds would be overnighted that afternoon and I would receive them by 3:00 today. Things were starting to look up again.

This morning, I got an email from CVS/Caremark saying that my prescriptions could not be processed because they were not authorized. WHAT?!?! The tears flowed again as I called them to find out what was going on. I waited on hold for almost a half hour before getting a live person. The person I spoke with said that the meds had indeed been mailed out yesterday, and the email was a mistake. As she was waiting for the shipping information to come up on the computer, she said there was a chance that the meds were delayed in transit by bad weather, and I wouldn't get them until Monday. *Cue tears again* I sat there with tears running down my face, waiting for her to confirm a delay or no delay. She put me on hold for about 5 minutes, and finally came back and said that my package was in Columbus, and it would be delivered to me by 3 PM today. I should have been ecstatic upon hearing this news, but I knew that I wouldn't relax until that package was in my hands. 

I had a bunch of errands to run today, but when I pulled into my driveway at 4 PM, that beautiful package was sitting on my front porch. I felt the stress and tension disappear from my head, neck, and back muscles. What a stressful week. 

I gave myself the first injection this evening. OUCH! Up until now, none of the other injections really hurt at all (other than the initial pain of the needle going into my skin). This one burned and stung like crazy as I injected it into my abdomen. Yikes! It's going to be a long 10 or so days of injections. Oh well ... if this gets me pregnant, then it will be worth every ounce of pain.

I've been having significant ovarian pain (both sides, although the right side is worse) since yesterday afternoon. I spoke with Cathy (one of Dr. Schmidt's nurses) today regarding the pain. She said that it was most likely caused by my ovaries producing several follicles. I haven't had that pain at all until now, so I am feeling optimistic that the meds may be working better this time.

I recently realized that I have become "that person" ... the one I swore I would never become. I have known people who went through fertility treatments, and I have spent plenty of time reading posts in online infertility support groups. I used to think some of these women were a little nutty ... becoming so focused on getting pregnant that they lose sight of other things in their lives ... figuring out several weeks ahead of time when ovulation will be occurring and making sure that their schedules are open during that week since you don't know until the last minute when insemination will be ... dreaming about being pregnant ... etc. Indeed, I have become that person. It's kind of comical, I guess. I know that I am not alone. So many people struggle with infertility, and they feel the same things I'm feeling. I just wish I could figure out a way to accept the fact that I may not get to experience pregnancy. I'm not at that acceptance stage yet. Dealing with infertility seems a lot like grieving. There are five stages of grieving ... denial, anger, bargaining, depression, and acceptance. I have experienced each of those so far, but I haven't gotten to the acceptance part. I get so angry and sad sometimes, thinking about how many babies are born to parents who don't want them. Then there's us (and all the other couples who struggle with infertility), who would give anything to have a baby. It all just seems so unfair. I guess life isn't fair, though ... right?

I think about my parents and how much I want to give them a grandbaby. They would be the most amazing grandparents. I think about Brian and what an amazing dad he would be. He is a kid magnet. He attracts kids everywhere we go. Kids think that he is just a big kid. :) I think about my sister. She would be the most fabulous aunt. I just feel so out of control in this journey. I have no control over this situation. We can do everything that an infertility textbook says to do, and we still may never get pregnant ... and if that happens, we may never even know why we couldn't get pregnant. It's all just so surreal.

Enough rambling. I'm trying to stay optimistic. There's no other way to be. 

new protocol and once again feeling hopeful ...

I had my baseline ultrasound today. I am always touched by how genuinely sad Dr. Schmidt is when he sees me at this time every month. He also thought that last month was really going to be the month. He told me today (as he does at this baseline ultrasound every month) that he wouldn't be putting me through all of this if he didn't truly believe he can get me pregnant. That is always so reassuring to hear from him.

Dr. Schmidt decided today that he is going to try some different meds on me this month. I am going to take the Femara pills (like last month) today through Thursday, and then I will start the new meds on Friday. I will be taking 1 vial of Menopur and 2 vials of Bravelle (subcutaneous injections in my belly) each day until it's time to ovulate. The dose may be increased if my follicles aren't responding appropriately. These meds contain FSH (follicle-stimulating hormone) and LH (luteinizing hormone), while Follistim only contained FSH. Dr. Schmidt is hopeful that these new meds will make me produce more and bigger follicles. He also thinks my estradiol levels (this is what is checked each time I get bloodwork during the next couple weeks) will be higher than they have been all the other cycles, and this is also a very good thing. Both of these meds are made from the purified urine of postmenopausal women (and one of the books I read said that these postmenopausal women are actually nuns somewhere in Europe!!). Craziness!!

So, once again, I am feeling optimistic. I love that Dr. Schmidt likes to change up my protocol when the last one didn't seem to do the job. These new meds sound more promising than any of the ones I have taken before. I am SO hoping that this will be the month. After my period started on Saturday, I calculated what my due date will be if I get pregnant this cycle (I do this every month). If I get pregnant this time, my due date will be my sister's birthday ... October 29th! I think that is good luck. :)

So, my next ultrasound and first blood draw of this cycle will be next Tuesday, 2/1. February is my birthday month, so I hope this will be my best birthday yet! :)

ramblings

I got my first period when I was 10 years old. Ever since then, I have had very irregular periods accompanied by bad cramps. I spent the majority of my teenage years and a good part of my 20's taking birth control pills to regulate my periods. I always dreaded that time of the month.

Since I started going to Dr. Schmidt, I have developed a love/hate relationship with my period. For the most part, I still hate my period ... now more than ever, since it means another failed cycle. But there have been a few times during this process when I have anxiously awaited my period. This week was one of those times. After my blood test on Tuesday confirmed that I wasn't pregnant, I wanted my period to start right away. I waited and waited, and it finally started a couple hours ago. This is the beginning of a new cycle, and I am happy to have a fresh start. Of course, I am going into this new cycle hoping that this will be "the one". With each progressive cycle, I feel a little less optimistic. I guess you could call it self preservation. When I don't get my hopes up as high, they can't come crashing down as much when I don't get pregnant. Of course, no matter how hard I try to not get my hopes up, they go way up anyway. I guess that's human nature. In any event, I will see Dr. Schmidt on Monday morning for my baseline ultrasound. I will also start either the Follistim injections or the Femara pills that day. I'm guessing he will have me start with the Femara pills again, since I seemed to respond well to those last month. 

Here's to a new cycle ...

confirmed: not pregnant :(

I got a call from one of Dr. Schmidt's nurses this morning ... the blood test confirmed that I am not pregnant. Very sad. :( Now, I just have to wait for my period to start, and then we will start over again. We are going to do one more cycle of IUI. If that doesn't work, we will meet with Dr. Schmidt to discuss our options. I'm guessing we will be looking at IVF (in vitro fertilization) if this next cycle of IUI doesn't work. Now, I am going to hurry up and wait ...

big fat negative :(

Today was the big pregnancy test day. I was beyond excited that I made it to the test day without my period starting. My cramps from Friday seemed to subside over the weekend, and I began to think they were pregnancy cramps instead. I got more and more excited as the weekend went on. I even bought the extra expensive pregnancy tests this time ... the ones that actually say "pregnant" or "not pregnant" instead of just the one or two lines. I was so sure this was the month that I would see "pregnant". It wasn't meant to be. The test was negative. When "not pregnant" showed up on the little screen, my heart sank. As always, my hopes and excitement were crushed very quickly. I called my doctor to report the negative test. My voice shook as I told the nurse my sad news. She was sad for me and said "it gets harder every month, doesn't it?". She couldn't have said it more perfectly. It truly does get harder and I feel sadder every month. The nurse told me to go get a blood draw today just to confirm. I did that this afternoon. So, tomorrow I will know for sure. I am very sad today.

I hate cramps

Well, it's about that time when I stop feeling so optimistic and can no longer ignore those dull, all-too-familiar cramps. I started to feel them yesterday and kind of denied that they were there. Today, they are hard to deny. I have a feeling 1/1/11 may not have been such a lucky day after all ... :(

good books about infertility

I forgot to add in my last post that I have been reading some really good books that deal with infertility. I have read one in its entirety, and skimmed the other two (with the intention of reading them soon), and I have been very happy with all three. It is very comforting to read that others have been in my shoes and ended up getting pregnant. I also learned some new things (this was a pleasant surprise, because I have researched infertility ad nauseum on the internet). In case anyone reading this is struggling with infertility or knows someone who is, here are the titles (and links to the books at Amazon):

Waiting for Daisy: A Tale of Two Continents, Three Religions, Five Infertility Doctors, an Oscar, an Atomic Bomb, a Romantic Night, and One Woman's Quest to Become a Mother

Navigating the Land of If: Understanding Infertility and Exploring Your Options

So Close: Infertile and Addicted to Hope

Happy New Year!

Insemination went well this morning. We arrived at the lab at 7:30, and Brian went in to do his thing. :) I waited in the car. It's fun to people watch during this time. We were one of the first cars to arrive, so I watched several others pull into the parking lot after Brian went in. With each car that arrived, I watched a guy get out and head inside while his partner stayed in the car.

*Going off on a tangent for a minute or two ... this whole process is so surreal to me. Guys really have it easy (relatively speaking, since I know for certain that no part of dealing with infertility is easy) in this whole infertility journey. They get to do something that is enjoyable, while we girls have to endure quite a bit. Each cycle, there are at least 5 internal ultrasounds (each of which is very unpleasant, and no matter how many I've been through, I always dread them), and each ultrasound is preceded by a walk to the lab next door to have blood drawn. Then, there's the actual insemination process. While I wouldn't call it painful, it's certainly not very comfortable to have a catheter inserted through the cervix and up to the top of the uterus. Oh, and don't forget all of the side effects from the numerous medications ... severe moodiness (poor Brian is so patient with me), bloating, cramps, hot flashes so bad that I want to jump out of my skin, emotional swings, etc, not to mention daily injections in the belly. Don't get me wrong ... every minute of this will be worth its weight in gold if I get pregnant. And then there's the month-to-month emotional roller coaster ... each cycle starts out with so much hope and optimism, which ebbs and flows until insemination. Leaving the office after insemination, I feel so incredibly optimistic, and while I'm telling myself over and over not to get my hopes up, of course my hopes are up in the clouds. Then, the agonizing 2+ week wait begins. Those days drag like you wouldn't believe. Then comes the devastation of seeing that dreaded red spot on the toilet paper or in my underwear, even before the big pregnancy test day arrives. The crushing realization that another cycle has resulted in complete failure is such a sad and lonely place to be. Oh, how I long for the month when I actually reach the pregnancy test day without bleeding, and oh.my.gosh, see a BIG FAT POSITIVE!!!! Oh, the tears of joy will flow. I am getting teary just thinking about that day. Even in my darkest moments of this journey, I DO believe that day will come for me. I have to keep believing. Once I stop hoping and believing, this journey becomes futile. *End of tangent (even though I could go on and on ...)


So anyway, about 20 minutes later, Brian came out and got in the car. I never quite know what to ask him about his experience in the lab. He answers my questions, though some answers come more reluctantly than others. :) In any event, that part is done, and it's time to go have some breakfast and hang out until we have to be back to the office at 9:00. We went to a nearby Bob Evans and enjoyed a leisurely breakfast. We headed back to the office at about 8:45, and sat in the waiting room with about 8 other couples. I have to say that this whole experience has brought Brian and me so much closer. Our relationship has reached a new level since we started this journey. Dealing with infertility has certainly brought us sadness and stress, but I feel like we have bonded so much, too.

After about a half hour, the nurse called us back, we went to a room, and I did the usual "strip from the waist down and sit on the exam table with the paper sheet over my legs". Dr. Schmidt came in a few minutes later with the vial of liquid gold. :) He is such an amazing doctor. He has such a calm, comforting nature, along with a great sense of humor. He is terrific, and I am so thankful that he is leading us through this journey. So, it was time for me to assume the position ... one foot in each stirrup and all my girl parts exposed. ;) He inserted the speculum (he warms it up first, which is really such a nice little touch) and then inserted the catheter and slowly injected Brian's super sperm (as Dr. Schmidt calls it!) into my uterus. Then, he gave me some parting instructions ... "Lay here for 10 minutes, and the next time I see you, I want to be doing an ultrasound to look at your placenta and growing embryo". :) That sounds like a good plan to me!

So, I will have my blood drawn next Saturday (1/8) to check my progesterone level. I just remembered that I meant to ask Dr. Schmidt about taking progesterone supplements, since my progesterone has been low the last few cycles. I completely forgot to ask him today. :( So, I will call on Monday. Hopefully it won't be too late to start taking them at that point. The big pregnancy test date is January 18th. :)

Brian said to me when we got home today, "Wouldn't it be cool if we conceived our baby on 1/1/11?". Yes, it would be very cool indeed. The only thing left to do is lots of hoping and believing for the next 17 days ...