Tuesday, December 30, 2008

No Expectations

For the first time in many years I am looking forward to the New Year with no expectations. It's hard to believe, but it is true. I have plenty of hopes and dreams for 2009, but I am so over expecting any one outcome. These past few years have taught me there are just no guarantees for anything in life. People get cancer, people get sick, sometimes they heal and sometimes they don't, cycles fail, businesses fail, economies collapse, people die, there is birth, there is death, women miscarry, couples divorce, miracles happen, there is prosperity, there are hard times, holidays come and go, the seasons change, people lose their jobs, lose their homes, people land the job of a lifetime, build their dream home, move, buy, sell, lose weight, gain weight, there are storms and catastrophes, friends are made, friends are lost, life goes on...

2008 was a hard year for us and many of you. I can't pretend to know what 2009 will bring, but it is foolish to believe it will all be better just because it is a new year.

I am ready to put 2008 behind me and welcome in 2009, but I refuse to put a mountain of expectations upon it. I have learned the hard way and had my heartbroken too many times. I have spent too much time doing 'fertility math' and thinking when this happens or that happens I will be pg, have a 'x' month old, etc...

A new year is a wonderful new beginning, full of hope, but it is in no way a cure all. 2009 will arrive and I will still be infertile, Sean's dad will still have cancer, life will go on. A new year is not a guarantee that this will be "my year." I hope it will, I pray for it, I dream about it, but I no longer expect it.


Happy New Year my friends! May 2009 be a blessed year for you and your families. May your hopes and dreams come true!

Monday, December 22, 2008

The Story of Us ~ December 22, 1996

December 22, 1996. That is the day that changed my life forever. I was 17 years old and it was the first weekend of Christmas break of my senior year of high school and my friends and I had a full weekend of partying on our calendar. Friday night was a 'private' party at a coffee shop that led to all kinds of mayhem including me in a cute little cocktail dress on my hands and knees in the snow puking my brains out. Saturday was our usual round of bars that we knew we could get into underage. On Sunday, Liz, Aimee and I decided we were still in the mood to dance and have a beverage or two, so we decided to check out a bar we had been hearing ads for on the radio, Fat Cats. They were known for their Sunday night dance party and they were near the college campus so we knew that increased the chance of being able to get in. We hunted down an ID for Aimee, dressed to impress and decided to check out Fat Cats. It was one of those nights where everything just fell into place.

We got past the bouncers with no problem, and settled in for a long night of dancing and drinking- bars in Buf.falo are open until 4am! Soon after we arrived, I ran into some friends of one of my ex-boyfriends. We chatted for a few and I was secretly hoping that Dan (ex-boyfriend) might show up at some point. Why not? Some fun and free drinks to boot! Dan never showed (THANK GOD), but Corey and Brian did come back over to find me and tell me that someone was asking about me. I made my way across the crowded bar and there stood the hot, red-headed, 21 year old goalie from their hockey team. I remembered him right away! When I used to go to the games with Dan, the goalie with the amazing blue eyes and sparking smile had always caught my eye. He introduced himself as Sean and commented about how he remembered me from hockey and just had to talk to me. We ended up talking for awhile and before long I was itching to dance with my girls. He followed me to the dance floor where we 'danced' to "Let me clear my throat" and "Pony" (it was 1996 after all). We got pretty close and I believe we may have kissed once or twice. I also spilled my sex on the beach all over his really nice cream colored Tommy Hilfiger shirt and he made some dick comment about how it had cost $80. I let it slide, I was intrigued.

Liz decided she was ready to go, see she was dating a MUCH older man and she wanted to go find him at another bar. I was not ready to leave, so we broke the cardinal rule; she left the bar alone and Aimee and I stayed and accepted a ride home from Sean in his purple Mustang! Liz ended up having a pretty crazy night of her own, so I don't feel too badly looking back. Sean was a perfect gentleman and even took Aimee and I to breakfast. After he dropped us off, we spent the few remaining hours before daylight on the phone. He revealed that he had always been interested and thought it was a shame that I had been dating a loser like Dan. I confessed that his blue eyes had captured my heart a long time ago. His shirtless appearance in the locker room after the games never hurt either. We never acted on our instincts at the time, I was with Dan and he had a girlfriend, Heather that I used to chat with at the game. Little did we know that Dan would turn out to be huge loser, Heather a psycho stalker and Sean & I would end up living our happily ever after.

We spent the next few days hanging out whenever we could and talking on the phone the rest of the time. We went Christmas shopping for our first real date. He took me to Ruby Tuesday's afterwards & I did not order anything. How stupid! Did I really think I was impressing him? Too bad I am not closer to that girl today, see I can overeat Sean on most days. Oops!

When I went to work a few days later, I was on Cloud 9 and I told the older women I worked with that I had met the man I was going to marry. I just knew.

Christmas was supposed to be the first chance for us to meet each other's families, but we got a wicked storm and my Mom was not comfortable with me driving around with a near stranger in a hot little sports car. We ended up talking the night away and he asked me to be his girlfriend on Christmas night, just before midnight.

He met my parents at a holiday open house a few days later and this photo was taken - our first ever:


The rest, as they say, is history. 12 years and 13 Christmases later, here we are. We have had our share of ups and downs. We had a long distance relationship from 1997-2001. I was away at school and Sean spent every other weekend driving 7 hours to visit me. He proposed for the first time in December of 1997, you can read about that
here. We have survived my Dad's cancer and his heartbreaking death, my mom's cancer diagnosis, surgery and survival, the loss of one grandparent, his Dad's cancer diagnosis, countless surgeries, a college 'infidelity' (a stupid kiss in a bar), a few minor breakups (I call them growing pains now), high school graduation, prom, college graduation, a few weddings and a funeral or two along the way, vacations, hard times, prosperous times, 7 moves, building 2 homes, remodeling a home, a few career changes, raising a puppy, a big huge Irish/Italian Catholic Wedding, family disagreements, a car accident, a family crisis or 2, and we opened a business and closed a business. Of all of that, I believe the hardest thing we have been through, the thing that defines us the most is our infertility. This past year and its 3 failed IVFs has been the toughest of all our 12 years together. I do believe like everything else that we have been through that it will strengthen our relationship and bring us closer together.











Sean is my best friend. My soul mate, my missing piece. He is my strength, my rock, my safe harbor. He knows me inside and out, he loves me unconditionally. He makes me feel beautiful. He makes me feel safe, and loved and protected. He spoils me rotten. He is the most selfless person I know. He lets me take up 3/4 of the couch and the bed and the blankets. He loves my crazy family as unconditionally as he loves me (well, almost). He is laid back and easy going and the perfect compliment to my type A personality. He is the best Daddy to Libby in the whole world and it makes me realize just how lucky our children will be to have him as a Daddy. We have grown up together in so many ways and fallen more in love every step of the way.

In many ways, I feel like Sean saved me. I was prone to partying and heading down a rocky road when I met him. I was dating losers and generally being a foolish 17 year old girl. I feel so lucky to have met him when I did and been able to share the last 12 years growing and learning and loving with him.


On this Christmas, I still feel he is the greatest gift I have ever been given...


*edit - I am still earning how to use the scanner, obviously! Need to learn how to get rid of white space and crop!

Friday, December 19, 2008

A Plan

I know it has been a little bit since I had anything worth while to say. I have been doing ok, I guess. I am not in the Christmas spirit, not even a little bit. We did not even decorate the house this year. We had very little shopping to do, which was good. I am going to make homemade candy this weekend and I did do holiday cards, but that is about it. My kids are finished with exams and I am finished tutoring until January and am looking forward to the little break. We head up to Bu.ffalo on Tuesday.

I had my WTF appt on Monday with Sh.ady Grove and while it was somewhat informative, I found myself walking away feeling frustrated. Dr. M was compassionate and asked us to keep trying. He agreed that the Ganirelix protocol did not do what we were hoping (more eggs) and that we would go back to a long Lupron if we ever did another fresh. He seemed kind of stuck on the fact that we are "new patients" to him and we "only" had one failed cycle with him and we were hoping he would look more at the big picture. He totally dismissed immune issues, beta 3 integrin (sticky glue), and basically did not see the need for anymore testing. Overall, he suspects a chromosome problem and said we are more prone to one because of the severe male factor. However, he doesn't think we are candidates for any type of genetic testing at this point. He said we don't make enough embryos to risk sending them out. He is not a big fan of PGD and said that they are still in the learning stage of CGH. They will be offering eventually, but no time soon and in his opinion, we are not making blasts, so no CGH for us. This is where I was getting frustrated because I felt he wasn't offering us anything new to get us over the hump. His overall plan:

1. Join their shared risk program - $22K 6 fresh cycles, unlimited FET, 100% refund.
2. Bring our 6 frozens over and include them in shared risk.
3. Try to thaw all embies and grow to blast.

That's it. He wasn't very optimistic about an FET - puts it around 20-25%. I was frustrated. I felt like he was kind of dismissing our frosties and putting more emphasis on shared risk and more fresh cycles.

Our consult at our old clinic with Dr. P was really, really great. Everyone was so happy to see us - it is so warm and friendly. We got hugs from the nurses and receptionists and billing and everyone was sorry to hear we had another failed cycle. I thought I was over needing the warm and fuzzy, but it felt so good to feel so cared for.

Dr. P was completely understanding about us seeking a 2nd opinion and doing IVF elsewhere. I was nervous about that and he put my mind at ease. We talked about the failed cycle and he also said no more anatagonist protocol for me. For another fresh he said long lupron or possibly microdose. He said he was going to pretend that all three cycles failed with him and treat us accordingly, which made us happy because any way you slice it, we have still had 3 failed IVFs. He thinks we are still very good candidates for IVF and have a good prognosis. He also feels that we have some great frosties and is much more optimistic than Dr. M about it. He is excited about doing an FET because he thinks I might just be one of those people who responds well to an FET.

Dr. P is a little concerned why I am so prone to polyps and is wondering if it indicates a possible lining issue. He agrees there could be chromosome issues, but is hesitant to jump right to genetic testing. He said PGD is a very flawed science. It misses a lot of abnormalities, there are a lot of false positives and false negatives and PGD has not been found to increase pregnancy rates in IVF patients. He thinks it has its place if there is a known genetic issue that they are screening for. He admitted to not knowing much about CGH, but would be open to genetic testing under the right circumstances. He thinks we need to focus on getting some blasts before we worry about that though. He also dismissed immune issues/testing and beta 3 integrin. Dr. P doesn't believe there is good science or data to justify testing or treating either. Supposedly, after more than a decade of research on both, there is no increase in PG rates for those undergoing immune therapies or Depot Lupron for Beta3. He also feels there is a huge conflict of interest that only one lab in the country does the beta 3 screenings and they also publish all the studies. He discussed how results can vary wildly cycle to cycle and he believes if it worked and truly increased success rates, every RE in the country would screen for these 2 things. He doesn't believe in testing for the sake of testing or "going fishing" as he put it. I just don't know what to believe in this department as there are so many varying opinions in the field.

Anyway, without further ado, his plan:

1. Repeat SIS on Tuesday to check lining. B/W to screen for insulin resistance and check my prolactin.
2. Order a DNA karotyping for me. Revisit genetic testing pending results.
3. Do a mock cycle before my FET. This means prepping my lining for an FET using Estrace and Endometrium, but instead of doing a transfer, he will do an endometrial biopsy instead to check my lining. I am not sure exactly what he is looking for, but he said "abnormalities" and to see how my lining responds to meds. It always looks great on u/s, but he wants to see it under the microscope. He said tweaks can then be made and if there are abnormalities, they are treatable. I have never really heard of this before, but if it means learning more, then I am all for it.
4. Do an FET cycle after mock cycle. Thaw all 6, culture to blast, transfer 2 or 3 blasts. He feels confident we will get some blasts. Fingers crossed.

Overall, we walked away feeling much more confident about Dr. P's plan. He seems more thorough and more optimistic about the success of this FET. Plus, I feel good knowing my embryos were created there, frozen there, and were the result of 2 good cycles. I walked out feeling like my questions were answered and like the weight of the world had been lifted from my shoulders.

I have b/w and SIS on Tuesday and I will do my mock cycle in Jan. FET in Feb pending results all the testing.

I feel like my mood has improved slightly since meeting with him and as I have said before, I do best when I have a plan. Now, I hope we get some answers!

Whew, that was loooooooooong. The end.

Thursday, December 11, 2008

I've been tagged!

Not much new to say. I am in TOTAL denial that Christmas is two weeks from today. More on that in a future post. Time for a meme!

Lisa tagged me a few days ago and I thought I would participate. So, 7 random facts you have been dieing to know about me! Ha!

Rules:1. Link to the person who tagged you.2. Share 7 random and/or weird facts about you.3. Tag 7 random people at the end, and include links to their blogs.

1. I am an 'only' child with 1 half brother, 5 half sisters and 8 brothers and sisters-in-law. I am very close to my in-laws, but I do not know all of my half siblings. I have only met some of them once or twice and it makes me kind of sad.

2. Since I graduated from college in Dec. 2000, we have lived in 7 different apartments/houses etc... We built 2 of them and owned 3 of them. Back and forth between Buffalo and Baltimore a few times too! I feel like a professional mover. It's not over either, because the house we currently live in is a rental! We love it, but know we can't stay forever. I thoroughly enjoy renting though - never more so than when my landlord comes over to fix something expensive like the furnace or does fall yard cleanup ;)

3. I love date night with my husband. Barnes and Noble is a favorite destination. Once or twice a month we head to BN, look around forever, gather reading materials, grab a coffee and a treat and sit in the cafe and read and chat for a couple of hours. Love it!

4. My best friend, Amanda, and I had a huge falling out after my wedding. We did not speak for over a year. We 'got back together' (as we like to say) in 2005 and our friendship has never been stronger. She is my chosen family and I can't imagine my life without her ever again. Infertility has given me a new perspective on the circumstances surrounding our breakup and I see it through a totally different lens today.

5. I have struggled with my weight since college, but being diagnosed with infertility has brought it to a whole new level. I am a total emotional/stress eater and this experience has wreaked havoc on my health and eating habits. I have gained over 50lbs in four years. I hate it. I need to make some changes.

6. Sean & I will celebrate 12 years together this Christmas. I can hardly believe it. I was 17 and he was 21 when we started dating. It feels like yesterday. He first proposed when I was 18. I said yes, my parents FLIPPED and we decided to wait until after college. He waited 4 more years to pop the question again - he was a little gun shy! We finally got married in 2004. Sean is the best thing that ever happened to me.

7. I did not love college. I was homesick and lovesick (see #6). Sean spent every other weekend driving 7 hours to visit me and I lived for those weekends. My college was not a great fit for my personality. I received a wonderful education, but socially - eh. I put my nose to the grindstone and worked my butt off to graduate in three and a half years, I couldn't wait to begin my life with Sean.

Ok, I know you were riveted! Prepare to be riveted 7 more times, by visiting the blogs below! Now, I tag:

1. Amanda @ piecemeal people -of #4 fame!
2. Michelle @ In Pursuit of Parenthood -her blog inspires me & I want to know more!
3. Jennifer @ Mommy Wanna-Be -she needs a distraction!
4. Jill @ Desperately Seeking Spawn- every time we chat we realize we have more in common & I wonder what her meme will reveal!
5. Mo & Will @ Life and Love in the Petri Dish - they need a 2ww distraction!
6. Leslie Lane @What you're not expecting when you're trying to expect - we think alike!
7. Lisa @ Wayward Stork - she is getting ready to wind down her blog and I must know more before she leaves the blogosphere.

Friday, December 5, 2008

Decisions, Decisions...

After many tears, a great deal of soul searching, and many conversations with each other, friends and family, I *think* we have come to some conclusions about what our next steps might be.

We are very lucky to have 6 frozen embryos from our 1st two cycles. For whatever reason, our old clinic did things kind of backwards and if you had any good looking embryos on day 3, they froze them with the thinking that they can be grown to blast when they are thawed. Here is what we have in the freezer: (scale 1-4 with 4 being the best)

1 @ 10 cell grade 3+
1 @ 9 cell grade 3+
1 @ 8 cell grade 3+ - fragmented
1 @ 8 cell grade 3+
1 @ 7 cell grade 3+
1 @ 6 cell grade 3+


Not bad, right? So, we are going back to our old clinic where these embryos were created and have a consult on 12/17. Our ideal plan (which has been proposed by my docs before) is to thaw all 6, hopefully get a few to grow to blast and transfer the best ones. We have no guarantees that anything will make it to blast at all, but we feel strongly about giving these embryos a chance to grow and thrive. I feel great that some of these embies are from the batch that created a blast or two from the crappiest among them.I also learned they can be refrozen if they look good! FCOM's FET success rates for 2007 were 42%, which is certainly enough to be hopeful about!

Now, I know this plan is not perfect. I know we run the risk of wasting time, energy and resources on something that may never work, but isn't that true of all ART cycles? I am not convinced that there aren't possible immune issues, chromosome issues and maybe even a lab issue, but I am willing to give it a shot regardless. What if it is none of the above? What if it has just been bad luck? What if I am one of those people whose body hates stims, but does much better with an FET?

We feel committed to using these embryos that we created. If it works, not regrets, obviously. If it doesn't, no regrets then either because we will still have options and even more answers.

For now, phone consults with CCRM and SIRM have been postponed indefinitely. If this FET is a bust, we will take that step, but for now, we are trying to muster the energy to give this FET the best shot possible. Honestly, another fresh cycle with all the anxiety and stress that accompanies it, is not appealing to me at all right now. It is not easy and I am not ready for that. I wouldn't cycle again locally and traveling for one day work ups and for almost 2 weeks for stims and ER adds a whole other element of stress to the mix and I want to be 100% sure of my decisions before taking that on. I need to walk through this door first and see where it leads me...

I know I mentioned the possibility of FET with PGD and I think that is off the table for now, unless our dr. feels strongly about it. That is money we don't want to have to spend and would rather hold onto if CCRM or SIRM end up being in the cards. We also decided not to move the embryos to Shady Grove. We think that it is a little risky to move them and they were created at FCOM and did really well in their lab, so why take a chance. Besides missing my polyp, I was very happy with my care at FCOM and to be honest, if feels a little like coming home.

We are not in a big rush, it has been a long year. We may opt for January or February for an FET. We are going to *try* to enjoy the holidays as much as we can handle and try to rest and heal. I am still having a tough time, I am feeling very raw and emotional and broken. I do best when I have a plan though and we are well on our way to one!

In other news, you should head on over to my dear friend, Jill's blog , and celebrate with her! She FINALLY got a BFP on IVF #3! Go wish her congratulations.

Tuesday, December 2, 2008

Questions

Thank you all a million times over for your support and kind words.

I started spotting and AF should be here full force by tonight. Can't wait. Post IVF period is painful torture.

I did get my beta moved up by one day, but not before my nurse said, "I'm sorry you are bleeding and getting negatives and you probably don't want to hear this, but, we have seen people in your position still get betas over 600." You're right, I really don't want to hear that, excuse me why I go throw up in my mouth a little.

Despite how I sound, I am doing a little better today. I have been thinking about why this failure hurt so badly. It shocked me a little. I wasn't exactly optimistic after hearing my fertilization and embryo quality reports and thought I was more prepared for a BFN. I think it had to do with all the other changes we made like using assisted hatching, removing my GIANT polyp, lining looking great, new clinic/lab, transferring 3 etc... might me enough to overcome a few crappy embryos.

More than that though, I think it was cumulative effect of all the failures in the past year. 3 failed IVFs is pretty fucking serious and it feels pretty grim. It is beyond the usual explanation of "wrong side of the numbers." I am not giving up, not even close, it is just a stark reminder of how much of an upward battle we still have ahead of us.

I need answers though and I am willing to do whatever I need to in order to get them. We are looking at a few options right now including:

1. Moving our six 3day frosties over to S.hady Grove. Thawing them, doing PDG and growing them to blast for a FET. I know PGD is not perfect, but it is an option.

2. Getting a 3rd opinion -possible phone consults with CCRM and/or SIRM and/or Cornell.

3. Examine possible immune issues, chromosomal issues etc...

Our insurance company has cut us off - 3 IVFs and no live birth = sorry you are shit out of luck. We are no longer investing in your broken body.

So, we need to consider the best use of our resources at this point. I know we are lucky to have any insurance at all and believe me, I am beyond thankful for it...

I also plan to have a WTF with my current doctor ASAP, but beyond letting them do my FET, I am not sure I can risk another fresh cycle without more answers.

That is where I am at the moment...

Sean has been my rock in spite of being pretty heartbroken himself. God, I love him and I cannot imagine any other life than this one, with him by my side through good and bad. He has offered to whisk me away for the holidays, but I think our money needs to go to pursuing our IVF options. He is my best friend and my heart and soul and my vows have never meant more to me than they do right now...