never.lose.hope.

Almost a month has passed since I had my third miscarriage. Brian and I met with Dr. Schmidt last Thursday (8/22). He was genuinely sad about my miscarriage. We spent about 20 minutes with him, and I heard his voice waiver a few times during our appointment. He is an amazing doctor. He makes me feel like I am his only patient, and I know that he truly cares about Brian and me. I have had three miscarriages with three different egg sources (the first miscarriage was my egg, the second was Heather's egg, and the third was our anonymous egg donor's egg). At this point, the common denominators in all three miscarriages are my uterus and Brian's sperm. I have been able to implant the embryo in my uterus and get pregnant, but with all three miscarriages, something goes wrong after implantation. We have 4 beautiful, high quality frozen embryos left over from our IVF cycle with our anonymous egg donor in July, and Dr. Schmidt said that he is absolutely determined to do whatever it takes to get me to carry a pregnancy to full term. He said that there are a number of blood clotting disorders and autoimmune issues that can cause recurrent miscarriages. He ordered a whole bunch of blood work to test for all of those possibilities. He warned me that the lab would be drawing "a lot" of blood. I wasn't quite sure what that meant, but I found out last Friday ... more about that a little later. Dr. Schmidt said that he almost hopes that I will test positive for one of these issues because they are easy to fix. If I have a blood clotting disorder, I will have to give myself a once or twice daily heparin (Lovenox) injection in my abdomen before the frozen embryo transfer and throughout the pregnancy. If I have an autoimmune disorder, I will have to take prednisone (steroid) before the frozen embryo transfer and into the pregnancy. There is also another treatment for women with recurrent miscarriages ... it is an IV infusion of a substance called intralipids (made up of soybean oil and eggs). From what I've read, I would have to go to an infusion center once a month for a 90-minute IV infusion from before the frozen embryo transfer until the end of the pregnancy. With this treatment, there has been quite a bit of optimistic evidence of successful pregnancy in women who otherwise miscarried during the first trimester. Dr. Schmidt said that even if I don't test positive for any of these issues, he may still have me take the heparin injections, prednisone, and intralipid infusions. The other possible cause for my recurrent miscarriages is that Brian may be a carrier of some type of genetic/chromosomal abnormality. Even though his semen analysis has revealed high quality sperm, that same analysis would not be able to tell us if there are chromosome issues. There is a blood test called karyotyping, which is basically a chromosomal analysis. That blood test would tell us if there are any genetic/chromosomal abnormalities that Brian may be passing on through his sperm.

After our appointment with Dr. Schmidt, we met with one of his nurses, Kathy. She is so wonderful. She actually got choked up when we talked about everything. She also makes me feel like I am her only patient. She gave me the order for the labwork and also gave us some consent paperwork to fill out for the frozen embryo transfer.

I went to the lab on Friday morning to have my blood drawn. Dr. Schmidt wasn't kidding when he said they would be drawing a lot of blood. They drew 12 vials of blood!!! The results should be back in about a week, and one of Dr. Schmidt's nurses will call me to discuss the results. Depending on those results, we may also have Brian do the karyotyping blood work. That blood test can be very expensive if insurance doesn't cover it, but fortunately, our insurance does cover it! :)

We are hoping to do the frozen embryo transfer in the next couple months. I am so scared to go through this all again and possibly face a fourth miscarriage, but I am also so hopeful that we will finally figure out why I keep miscarrying and hopefully will be able to keep it from happening again. We want to be parents more than anything, and we will do anything we have to do to make that happen. If it turns out that Brian carries a genetic/chromosomal abnormality or we aren't able to get pregnant with the embryos that we have left, then our journey to get pregnant will be over and we will pursue adoption. We weren't ready to talk about adoption until recently, but we have started talking about it in the last month. The whole prospect of adoption is very overwhelming to us, but I have a few friends who adopted, so I am going to contact them to find out how to start the process.

When we first met with Dr. Schmidt over 3 years ago, I never would have imagined that we would still be childless today. Part of me feels like the universe is trying to tell Brian and me that we just aren't meant to be parents. But, a bigger part of me knows that I should not think that way, and that I need to just keep the faith. If we end up with a child, no matter how we get there, that child will be so, so, so loved and cherished ... not just by Brian and me, but by everyone who has stood by us and supported us throughout this journey. While I am not sure how our journey will end, I am certain that we will be parents. That's all that matters.

heartbroken, again.

I was so hopeful to never have to share sad news here again. But, here I am. Sigh.

Brian and I chose an anonymous egg donor a few months ago, and we were so excited to move forward. Our egg donor responded well to her stimulation meds, and on July 5, 13 eggs were retrieved from her. The lab called the next morning to let us know that 12 of the 13 eggs fertilized normally. 6 embryos made it to blastocyst stage, and on July 10, two beautiful, high quality embryos were transferred into me. The remaining four embryos were frozen. The long wait began. On July 19, a blood test confirmed that I was pregnant. We were overjoyed!! I had repeat blood draws on 7/22, 7/24, and 7/26, and my pregnancy hormone level kept increasing just like it was supposed to. On Saturday, 7/27, to my surprise and dismay, I started bleeding a little. My heart sank. I had a terrible feeling. The bleeding soon turned into light spotting, and the spotting stopped completely by yesterday afternoon. I tried so hard to stay hopeful. I went for what was supposed to be my final blood draw today. When the nurse called this afternoon, I could immediately tell that something was wrong. She confirmed my worst fear. My blood level was supposed to at least double from Friday's level. Instead, it dropped by almost 400 points. She told me what I already knew ... I miscarried on Saturday. I can't believe this has happened again. Brian and I are crushed. Life can be so, so unfair.

hopeful update ...

I can't believe it's been almost 5 months since my last update. When I last posted, I mentioned that we were trying to decide between using an anonymous egg donor and a dear friend who offered to be our egg donor. We ended up choosing to use an anonymous donor. So, we met with Dr. Nash in late January to get the ball rolling. We were disappointed to find out that we were going to be on a waiting list through his office until at least August (at the very earliest) to be matched up with a donor. I was pretty frustrated that he didn't mention that at our appointment in November, so that we could have gotten on the waiting list then. The other option was to go through an egg donor agency in Cincinnati, but that would have added an additional $5,000+ to an already very expensive medical bill.

So, we decided to go back to Dr. Schmidt, our first reproductive endocrinologist. He's the one we were with from 2010 until we decided to use Heather as our donor in late 2011. He is an amazing doctor, and I absolutely love his nurses and staff. We met with him in mid-March to discuss using an anonymous egg donor. It was so nice to see him and be in his office again. I always felt more comfortable there. He said that they had several carefully and rigorously screened egg donors ready, so we should be able to start within a few months. He also mentioned another option of embryo adoption. Couples who have used IVF to conceive and had leftover embryos to be frozen end up completing their families and adopt out their remaining embryos to couples who want to have a baby. I looked into some of the agencies that do this, and while the cost would be less than using an anonymous egg donor, the process is pretty complicated and extensive. These agencies treat the embryos as a child, which means the process is like that of a child adoption. There would be extensive applications, social workers making home study visits to our home, and on and on. That is one of the reasons why we aren't interested in adopting right now, so we decided not to pursue that.

The nurse who is in charge of the egg donor program at Dr. Schmidt's office emailed us several donor profiles in mid-April. Each profile is a 10-page questionnaire filled out by a donor. It gives physical info like height, weight, hair and eye color, bone structure, etc. It also provides extensive detail on medical/social/psychological history for the donor and her blood relatives. Towards the end of the profile is a section where the donor writes why she would like to be a donor and gives her sentiments to the potential recipients of her eggs. That section made me cry for each donor. They wrote some very touching and kind things. So, Brian and I sat down and looked through the profiles several times. It was difficult to decide which one to choose because they all looked great. We finally decided on one and contacted Dr. Schmidt's office in late April. Sadly, she wasn't available because she had just been chosen by another couple earlier that week. So, we went back to the profiles and chose another donor. Sadly, she wasn't available because she is getting married this summer and moving out of state. So, back to the profiles we went. By that time, a few new profiles had been added. We chose one of them, and as the saying goes, "third time's a charm"! :)

We are moving forward with this donor, and we are cautiously hopeful (truth be told, I am as excited as a little girl on Christmas morning, no matter how hard I try not to be) that everything will work out. She is young, very healthy, and her ovarian function is perfect. So, we have every reason to believe that she will respond very well to the ovarian-stimulation meds and produce some beautiful, healthy, high-quality eggs for us. I mentioned in a previous post that I am not going to share specifics on this cycle the way I did with the cycle Heather and I did last year. As much as I loved all the support and love surrounding us during those early days, it was too sad and difficult to have to share the sad news with so many people when I miscarried. So, I will just say that we are well on our way to preparing for this IVF cycle, and I am wishing and hoping that we will have some wonderful, amazing, joyful news to share by sometime this Fall. Stay tuned ... :)

new year, new hope ...

Hi there! It's been awhile since my last post. When I last posted, Heather and I had both just had blood draws. My blood draw was to check my TSH (thyroid stimulating hormone), and Heather's was to check her AMH (anti-Mullerian hormone, which is a very accurate predictor of ovarian reserve). If you recall, her AMH was on the low side when it was checked before our IVF cycle last Spring.

Sadly, Heather and I both got bad news from the blood results. My TSH was very high (~13) ... TSH in a metastatic thyroid cancer patient (me) should be less than 0.5. Because my TSH was so high for no apparent reason, there was some concern that my cancer may be back. Dr. Nash referred me to my endocrinologist (the doctor who manages my thyroid cancer), and she increased my Synthroid dose. She also told me to come back at the end of November for a recheck of my TSH. She advised me to hold off on trying to get pregnant until we make sure my TSH is back to normal. Getting pregnant with a high TSH level puts a woman at a very high risk for miscarriage.

We also found out that Heather's AMH is now very low. Dr. Nash said that we would probably have about a 10-15% chance of getting pregnant using her as our egg donor (vs. a 65-70% chance by using a donor with healthy eggs and good ovarian function). This news is incredibly sad ... not just for Brian and me, but also for Heather and her partner, Steve. If they decide to have children at some point, they may have some difficulty. Dr. Nash doesn't have any idea why Heather has unexplained infertility. So, we made the difficult decision to not use Heather as our egg donor again. As much as we wanted to, we all agreed that it would be too heartbreaking if the outcome was bad.

I went for my TSH recheck at the end of November. Thankfully, my TSH is back down to "normal" ... it came back at 0.363. Dr. Sipos (my endocrinologist) thinks that my high TSH in October may have been a lab error, because it's unlikely that the level would have come down so much in just 6 weeks. So, I worried a lot during those 6 weeks, but I am so happy that I have one less thing to worry about now.

We've been in limbo since November. As par for the course for this whole journey, we once again have to figure out a new plan. One of my dear friends has offered to be our egg donor, which is such an incredible, selfless thing to do. We haven't decided yet if we are going to go with her or if we will just go with an anonymous egg donor. Either way, we are planning to try IVF one more time, hopefully sometime in the next few months. We have decided not to pursue adoption at this point. So many people keep asking me "why don't you just adopt?". Adoption is a very long, complicated process, with no guarantee of a child. In our minds, adoption would be like starting a whole new journey from the very beginning, and to be completely honest, we're not sure if we have the energy to do that. We have been on this infertility journey for 4 long years, and we are mentally exhausted. We are hopeful that this one last IVF cycle will give us the baby we have been dreaming of for so many years. If it doesn't work out, then we are going to have to figure out a way to move on as a childless couple. I hope with everything in me that we won't have to go there.

Please think good thoughts for us as we begin this last part of our journey. We are so, so, so hopeful that 2013 will be our year ... the year we become parents at long last.

long overdue post

I would have been 32 weeks pregnant this week. Yes, even now, I still think about that milestone each Monday. I realize it's been several months since I last posted. To be honest, I have started posts quite a few times and never finished them. It's been too hard. It's true that time heals, but it never forgets. As the weeks pass, the pain numbs a bit ... doesn't feel as raw ... but it is still there. Even on a really good day, I still have that sadness in my heart. I wonder if that will ever go away. I'm guessing it won't. Maybe it will just continue to fade as the days fade away, and maybe someday I won't cry every time I hear that someone is pregnant or see baby pictures on Facebook. Maybe someday I will even be able to go to a baby shower again. I hope so. I don't like feeling sad. I am by nature a happy person. April 25th stole some happiness from my heart that will never be replaced.

Brian and I just got back yesterday from a wonderful long weekend in Wrightsville Beach, NC. We went there to celebrate our 11th wedding anniversary. My parents' dear friends, Julie and Roger, graciously offered us their condo at the beach for a getaway, and we had a fantastic time. There were definite moments of sadness when I thought about how big my belly would be getting at this point, how I would be feeling the baby kick often, and how this trip would have been a babymoon for us, but we still enjoyed ourselves and it was so nice to get away.

We have decided that we are going to do one more IVF cycle using my sister's eggs. Heather has graciously agreed to be our egg donor again. We aren't sure of the exact timing yet, but we are hoping it will be sometime in the next 6 months. I have decided that I am not going to post the details here like I did last time. Actually, I am going to continue to blog here, but I am going to make the posts private until I reach the beginning of my second trimester (assuming all goes well). As much as I appreciated all the love and support when things ended sadly, it was so hard to have to tell so many people our sad news. So, I think this is for the best. I have to be honest and say that I am terrified for this journey. Knowing how heartbreaking it is to miscarry, and knowing what an emotional roller coaster the whole thing will be, it somehow seems harder to do this a second time. But, we both desperately want a baby, and we want to give this one last try. I hope to update with a very, very happy post sometime in the not-too-distant future. :) 

what might have been ...

Today would have been the first day of my second trimester. This was supposed to be the week that we would be telling everyone our wonderful news. Instead, all I have left is grieving over what might have been. People keep telling me to stop counting the weeks. I can't stop. Every Monday is a reminder of what could have been, and I don't know how to stop thinking like that. This is already a very emotional week, and to make it even worse, Brian is gone for 8 days on a fishing trip in Canada. I know he is having a wonderful time, but selfishly, I wish he was here with me. It's just bad timing, I guess. I miss him so much, and I especially miss hearing his voice. He has been my rock through these difficult days. He is in a very remote area of Ontario, so he can't even call me to check in. This is the longest we've ever been apart in the 14 years we've been together. We have definitely never gone more than a day without at least talking on the phone. So, my emotions are all over the place right now.

I decided on Thursday that I am going to take a break from Facebook for awhile. Facebook is a constant birth announcement, or so it seems. I got home from a rough night at work on Thursday morning, and I decided to check Facebook for the first time in a couple days. Within 5 minutes of browsing my news feed, I saw two birth announcements and three pregnancy announcements. Those things have been difficult to see ever since we started this journey, but seeing all of that after a bad night at work was too much. As much as I enjoy Facebook and its ability to keep me connected with so many people, it's too difficult to see so many people enjoying the one thing I want the most but don't have ... a baby. I'm hoping this decision will make life a little easier for me right now.

One day at a time ...

muddling through the healing process ...

It's been two weeks and one day since my pregnancy ended. We are trying to find our way back to "normal". Some days are better than others. Mondays will always be hard, since they were my week marker. It's hard to believe that I would have been 10 weeks this week ... almost done with the first trimester. Mornings seem to be the hardest time for me ... I have been having vivid dreams that I am still pregnant, so waking up from those dreams is incredibly difficult.

I had my post-op follow up appointment with Dr. Nash yesterday. When he came into the room, he said that he didn't have any answers for me about the miscarriage. I assumed this was because the fetal tissue biopsy wasn't back yet. Sadly, he told me that the biopsy had been botched, and we would never have any answers. Apparently, fetal tissue that is being sent for biopsy must never have preservative added to it, because the tissue must continue to grow in the lab. For whatever reason, someone put preservative on my fetal tissue after the D&C, thus ruining the chance for the biopsy. Once the preservative has been added, nothing can be done. Dr. Nash was visibly upset about this, and he said that he personally spoke with everyone at the surgery center who was involved with my surgery. He said that no one is taking credit for the mistake. He believes that the preservative was not added at the surgery center (since they all know well not to do it), but that it happened at the lab at the hospital (the hospital where I work, ironically), where the tissue was sent for biopsy. I am very upset and disappointed that we will never have any answers about this miscarriage, however there is nothing that can be done at this point, and we just have to move forward. The appointment yesterday was pretty brief. He wants me to take a pregnancy test on May 20 to confirm that the pregnancy hormone is completely out of my system. That same day, I will begin 10 days of Provera, which is the medicine that induces a period. I will have a period about a week after the medicine is finished. About a week after my period, Dr. Nash wants to do a sonohysterogram (saline ultrasound) to make sure my uterus wasn't damaged from the pregnancy or D&C, and to make sure there is no residual fetal tissue remaining in my uterus. After that, we will sit down and have a long talk about where to go from here.

I am going back to work tonight for the first time in a month. I am thankful that I had the last two weeks off, because I got to spend some quality, healing time with my family. It will be strange to be back at work, knowing that the last time I worked, I was still pregnant. I hope I do ok. I cry a lot more these days (even when I try not to), and I hope I don't cry at work. We are just taking things one day at a time now ...