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