Yesterday’s post (The Unthinkable) generated quite a lot comments regarding the embryos. Apparently most other people’s clinics required that a decision be made in advance about what would happen to any frozen embryos if the couple died.

All I can say is this: if it was in our IVF paperwork I don’t remember seeing it. Which doesn’t mean it wasn’t there. I do remember, at some point, considering whether any unused embryos would be given to research but I think that came a few weeks later when I thought I was going to get my baby and not need all six.

Again I will remind people that we did a SURPRISE IVF. It was not planned. That cycle was supposed to be injectables + timed intercourse. But my ovaries made a surprise comeback and I ended up with 6 follicles in play. OldRE adjusted my dose downward to try and get just one or two to pull ahead but it didn’t work. At that time we weren’t sure my ovaries would EVER produce like that again. I was originally told IVF wasn’t an option because I didn’t have enough eggs left. Our choices were cancel or convert to IVF. So we converted. OldRE adjusted my dose upwards to try and coax out a 7th and 8th follicles but that didn’t work either.

It was a Wednesday afternoon when we decided to go for our surprise IVF. Six eggs were retrieved the following Monday morning. That Thursday and Friday in between were spent frantically ordering new meds, signing all manner of forms that I doubt I even read and getting all manner of bloodwork done for both of us, as well as an additional semen analysis for Right Guy.

I’m actually really glad that it played out that way. I’ve watched other people stress and obsess over upcoming IVF cycles – particularly the first one. I didn’t have to go through that. I didn’t have TIME to stress or obsess too much. I was on auto-pilot. I didn’t have time to think about what to do with potential frozen embryos. In fact, I didn’t expect to have any. With only 6 eggs retrieved I never expected ALL of them to fertilize and then ALL of them to make it to day 3.

And no one expected what followed. At the time, it was inconceivable that three years later I would have no children and 2 frozen embryos left. Most people move a lot faster in this game.

Also, my old clinic, at the time, did not have a billing system in place for frozen embryo storage (they set it up later). Neither does my current clinic which is why my embabies are kickin’ it rent free at the moment. The new clinic is much more on the ball about all this. And also, surprisingly, much more expensive.

So anyway, for what it’s worth, I think that the reasons no one asked about this before lie somewhere in the middle of surprise and not being set up for long term storage.


I once had a doctor tell me to get pregnant right away or I would never have kids.

I was twenty.

He was old-school and this was way back when they knew NOTHING about endometriosis. Except that it existed.

My endometriosis has never been that bad, fortunately. And I decided not to marry the guy I was with at the time after envisioning our life together. The one where I had kids but was completely miserable because he and I were totally wrong for each other.

I always knew I would have issues getting pregnant. I never understood what, exactly those issues would be, but I knew they’d be there. But I guess I also thought they would be more… defined. More clear cut. As in, you CAN’T have kids so don’t bother trying. Or you CAN but you’ll just have to work at it a bit. Not this seemingly never-ending spiral of you can’t, oh wait you can but you can’t carry, or maybe you can but you have to go about it just so, or maybe you can’t, or maybe we just don’t effing know.

Fast forward. Wrong Guy and I decide to TTC. Within a few months of ditching the birth control pills I’m in horrible pain and end up on Lupron while he’s in Afghanistan. When he comes home we pretend to start TTC again. I say “pretend” because, although I was no longer on Lupron I also wasn’t ovulating. Lupron is the devil. Fertility work-up shows he’s shooting at about 10%. Doc says there’s no chance we’ll get pregnant with a sperm count like that. Then he tells me he’s in love with someone else and asks for a divorce.

Ah, the ups and downs of life. And my prospects for kids. It all really is a roller coaster.

Behemoth roller coaster in Canada

Fast forward again.

Still devastated from the divorce, I work my ass off to get my life back on track. I go to grad school, graduate, get a good job and buy a house. All in preparation for one day adopting on my own. At that point I’d given up on romance/partnership/marriage.

So, of course, that’s exactly when I meet Right Guy. And start to think maybe, just maybe, there’s still time and a chance to do the natural family thing.

Cue hot flashes. I ignored them for far too long. I was too embarrassed to admit them to Right Guy. I remember him commenting how sweaty I was one night. I said it was just the crowded bar we were in. I finally confessed to him after waking up soaking wet in his bed in the middle of the night – I had soaked his sheets. Caused by my night sweats. All I could do was cry and apologize profusely for “wetting” his bed and dirtying his sheets. He just held me.

Later we discussed it. Being a doctor he offered the “I’m sure it’s not menopause” speech. Him being a doctor was partly why it took me so long to tell him. It’s weird (well it WAS weird) to be diagnosed by your partner. Anyway, I made an appointment with my GYN. Who also gave me the “I’m sure it’s not menopause” speech. But ordered bloodwork just to check. And came back with the “It IS menopause and you’ll never have kids” speech.

Then I go see an RE who says that it’s a long shot, but it could happen. I start HRT (hormone replacement therapy) and the hot flashes subside. I start to feel somewhat sane again. But I don’t ovulate on my own. The eggs, they are gone.

We try some Clomid. It makes me ovulate. Sort of. As long as I use an estrogen primer (you can’t be on estrogen while taking Clomid but you can use it just before you take the Clomid). Gradually my eggs begin to reappear. I go from two antral follicles to about eight. Go me!

But I’m still not pregnant so we move on to injectibles. That cycle I think I started with THIRTEEN antral follicles. Which is how I ended up with SIX eggs in play and did a last minute conversion to IVF. And then got a BFP!

Woo hoo! This worked! I am going to have a BABY!!!!

Um no. I’m not. Instead of a baby, I’m going to spend ten days in the hospital and get chemo (methotrexate) and spend a total of five months psuedo-pregnant as we watch my beta HCG fall back to zero and get more chemo whenever it decides to stop falling. And, oh yeah, now I have another fertility hurdle called adenomyosis and this crazy ectopic might happen again. Oy.

Irony of all ironies? I start to ovulate on my own. No more hot flashes. But my uterus is damaged so I’m not allowed to TTC.

Pops dies of his 3rd cancer.

One full year after our surprise IVF I am cleared to TTC and do a FET. I get pregnant AGAIN!!!

Wow. Apparently I get pregnant pretty easily. Well, as long as I do IVF.

Um, no. Not so much. It’s ectopic. AGAIN. But this time it’s a run of the mill ectopic. More or less. The chemo doesn’t work fast enough and I end up in surgery having my tube removed. But I was allowed to go home afterward so no hospital stay at least.

My body returns to regular ovulatory cycles with no hot flashes. But I’m benched for three months.

The very first month we are cleared to TTC what happens? The hot flashes return and ovulation, while still happening, is not occurring regularly.

Sometimes I really want to graph the major events in my life. In 3D. So I can capture not just the highs and lows but all the twists and turns. I bet it would look like the craziest roller coaster EVAR.

roller coaster toy

Well maybe not EVAR. My life has really not been that horrible in the grand scheme of things (I’ve always had a roof over my head, a loving family, etc). There have just been a lot of ups and downs and twists and turns. I love roller coasters. But I always wanted a normal, run of the mill life.

I think what bugs me most is the suddenness and/or the unexpectedness of the ups and downs and twists and turns.

I didn’t see the divorce coming. People usually see it in hind sight. Although I can see a few things now that I didn’t see then, none of them spelled D-I-V-O-R-C-E. I was totally blind sided on that one.

Pops’ cancer? I can’t say that was a total surprise in and of itself. It was more of a surprise that he survived it. Twice. We kept expecting him to die. And he kept not dying. That was… mostly… a good thing. But then you get to a point where you start to think, “Maybe he’s not going to die of cancer.” And that’s when he did.

Same thing with my infertility. My body keeps doing strange things. I don’t know what’s real anymore. Am I really entering menopause in my 30s? I thought so before and my body somehow ‘bounced back.’ So now that it’s tanking again, I have to wonder, “Is this really it? Or will I make another comeback?” There’s really no predicting it. It defies modern medicine.

There is a part of me that just wants it to be done. Get me off this ride. Make it stop.

But I’ve posted that before: Get Me Off This Crazy Ride
Jane, get me off this crazy thing

But that’s silly. This is life. Life is not going to stop being crazy. Something new, and potentially crazy, is just around the corner. It might take you up, it might take you down. Or sideways. Or upside down. Life is like Space Mountain – a roller coaster in the dark. You can’t see where you’re going, you’re just along for the ride.

Conservative Clinic

September 10, 2010

Going through IVF last month has really made me realize that my Fertility Clinic is rather conservative. But I’m OK with that. It can be infuriating sometimes but I understand why they do it.

They rarely do 5 day embryo transfers despite what I’ve read about the increased success rates. Their reason? The embryos do not like being outside of the mother’s body. Although it’s easier to identify on Day 5 (as opposed to Day 3) which embryos will turn in to a baby, it’s apparently much more difficult to keep them alive those 2 extra days. So my clinic chooses to put them back in their natural environment as soon as possible instead of risking losing them all together.

My original beta HCG test was scheduled for 14 days past transfer day – not 14 days past retrieval. That seemed awfully late to me. But since I got a positive home test much earlier, I ended up going in for my first beta 3 days early. In my case, an earlier test worked out fine. But my Cycle Buddy, @IVFQueen, was not so lucky. Her clinic had her come in at 14 days past retrieval (I think). It turns out she had a chemical pregnancy and that beta came back at 12. But she couldn’t know if that number was on it’s way up or on its way down. So she spent two days waiting in agony to find out. I suspect this is one reason why my clinic prefers to test later. And why they had me come in for a 3rd number. They want to see it go over 300 to be safe.

My first ultrasound is scheduled at 7 wks. I’ve heard of others who go in during their 5th or 6th week of pregnancy. Some of them hear a heartbeat that early. Some of them don’t. The ones who don’t are left waiting in agony. Again, they are left wondering if it was simply too early or if there’s a problem. Another two week wait for my ultrasound is going to be PAINFUL. But I feel confident that the outcome will be definitive on that day. Or as definitive as it can be.

My RE once told me that she is open to trying anything and everything that her patients want to try. But she will only suggest treatments that are based on empirical evidence – treatments that have been thoroughly tested and proven to be effective. I think I like that attitude. Not afraid to try new things, but also not quick on the draw to try the latest, unproven, possibly fad, treatment. One example was DHEA. She discussed that with me. She said they don’t routinely use it because the evidence of its efficacy is controversial. She also said it causes severe acne. But she was willing to try it if I wanted to. Fortunately we didn’t have to.

So anyway, while I go crazy waiting for this ultrasound I just have to keep telling myself that it’s worth the wait. They’ve done right by me so far so I have to keep trusting their judgment.

The Whirlwind

August 19, 2010

tazmanian devil in a whirlwindTo say that this past week has been a whirlwind is an understatement. This cycle started as Injectibles + Timed Intercourse. Then it almost got canceled. Instead of canceling, I was converted to IVF. I was converted 8 days ago and today I had my transfer. How crazy is that? I’ve somehow managed to pull off IVF in a week AND I might still make my work deadline tomorrow. Am I Wonder Woman?

Last week I essentially had 6 mature follicles. They let me go an extra day before retrieval in the hope that I might get 1 or 2 more. But in the end they retrieved 6 eggs. And then the magic happened.

Not only did I never really expect to do IVF EVER – I hoped, but never really thought it would happen – I never ever expected it to go so well. My RE wants to redo my bloodwork if this doesn’t work. She’s just as surprised at this response.

Eggs Retrieved: 6
Eggs Fertilized: 6
Day 3 8-cell Embryos: 6 (actually I think one was 9 cells)

I now have 2 transferred and 4 on ice. I just can’t believe this worked SO WELL. Dare I hope that this is it?

My ovaries have proved they have some super powers. Now can my uterus?
wonder woman

chance card

I feel like I’m playing monopoly. I’m on Connecticut Ave (just before Jail) and somehow I pull a Chance card that says “Take a walk on the Boardwalk” and I whiz all the way around the board. I skip IUI entirely and GO STRAIGHT TO IVF. Um… wait. What?!

boardwalk cardIt was a HUGE decision to make and I had to make it in about an hour. But we’re going for it. It just makes sense. I’ve had an amazing response on my first injectibles cycle. Even before I started the shots I had a high (for me) AFC (antral follicle count) of 13. This morning I had 7 follies 12-15mm. (well one of them was 11.9). Here are the choices my RE gave me:

1a) Cancel this cycle. She considered the risk of high order multiples too great.

1b) Right Guy and I discussed moving forward anyway and just relying on selective reduction if we needed it. I already have the Ovidrel and the plan was for intercourse at home anyway. This choice was not sanctioned by my RE but we felt it was worth considering.

2) Try some shots of pure LH to see if that would stop the smaller ones from growing more while maturing the larger ones. I would have to drive to another city (20-30 mi) to acquire this medication and there’s no guarantee that this strategy would work so I’d still potentially end up back at option #1.

3) Convert to IVF. Gulp.

We have chosen option #3. And after making this decision, my RE says she thinks it’s the best option. She never thought she’d be having the IVF discussion with me. She’s completely mystified. She described my ovaries as “an anomoly.” She’s hopeful that this will work but says if I don’t get pregnant on this IVF cycle she will want to retest some of my levels (specifically AMH). This is not supposed to happen with numbers like mine (AMH=0.1 & FSH =16). So now she’s questioning the numbers. Although, if the numbers are correct, this is likely my only/best shot. So I’m taking it.

Double gulp.

But it looks like it’s going to happen. And soon. Egg retrieval will probably be this Sunday or Monday.

If anyone is curious about the exact protocol I’ve been one that has worked so well I’ll post it soon and then update here to link back to it.
Here’s a link to the protocol specifics and results before IVF conversion: Bravelle + Menopur.