Sunday, 26 January 2014

Maya and the Little Voice

A week or so before Christmas, we had a little party at work.  It was just a mid-afternoon holiday get-together for the dozen or so of us that work in the same area, with a few snacks and drinks.  Or so I thought.  When I walked into the office where the festivities were being held, I was greeted by dozens of bottles of various kinds of booze lined up for the choosing.  When I voiced my surprise, my co-worker Maya announced that she had brought in the contents of her liquor cabinet, because as of Tuesday she was going to be pregnant.

I knew that Maya and her same-sex partner had been using IVF with a sperm donor to conceive.  I also knew that they'd previously had at least one miscarriage, and that it had been her partner who had been carrying the baby.  I however didn't know that they'd tried again, nor that they had decided to switch up who would carry.  I smiled politely and wished her good luck, all the while thinking that maybe getting rid of all of her booze was perhaps a little premature.  After all, there's nothing like a good stiff drink after a BFN.

Well, if I'd thought that clearing out her alcohol was a bit odd, Maya's next comments really threw me for a loop.  In a perfectly serious voice, she told me that if I didn't mind having a baby that looked like her, I was welcome to her leftover embryos.  I chuckled a little before realizing she meant it, thinking that this comment also gave me a new piece of info: they'd done another egg retrieval, with her eggs this time.  She's 38.  I said thanks, but then suggested that maybe we should wait and see how her transfer went first.

"Oh, well, the doctor says our embryos are really great.  We have five of them, and we're only putting two back, so you're welcome to the other ones.  Seriously."

Now I was curious.  Thinking that five 5-day blasts is nothing to scoff at, I asked what day her embryos had been frozen on.

"I don't remember the date.  Sometime a month or so ago."

I clarified that I was asking what day of embryonic development.  Did they freeze on Day 3 or Day 5?

"It must have been Day 5.  They're all really great embryos.  They all have four cells."

This is the point at which I realized that despite obviously having gone through a retrieval and transfer cycle with her partner and another retrieval recently herself, Maya didn't have a sweet fucking clue about IVF.  Internally I was rolling my eyes and shaking my head, wanting to tell her that there was no way her embryos were Day 5 at only four cells.  Either that, or she had some damn shitty Day 5 embryos.  Instead, I wished her good luck again, poured myself a generous drink from her stash, and changed the subject.

Two weeks later, she was pregnant.

Thinking about Maya's attitude before her transfer, I can't help but marvel at the unbridled confidence she had that the transfer would work.  What must that be like?  To not even entertain the thought that it might fail, to the point that you're offering your leftover embryos?  Doesn't she have the Little Voice?

You know the Little Voice.  It's the one that whispers all those negative thoughts, despite your absolute best efforts to stay positive.  To envision yourself pregnant, or holding your baby.  The Little Voice whispers that you are stupid to hope.  It tells you that everything else has failed, and this will fail too.  That your embryos are abnormal, or that there's something wrong with your uterus that will prevent implantation.  Worst of all, the Little Voice tells you that the embryo you had placed in your uterus yesterday is already dead.  You just don't know it yet.  The Little Voice tells you that a happy ending is something that happens for other people, but not for you.

You tell the Little Voice to shut up.  You try to drown it out by closing your eyes and visualizing your embryo, the little squirming ball of cells that is part you and part the man you love, snuggling in tight in the fluffy lining of your uterus.  Holding on.  Implanting.  Growing.  Living.


Last week, Maya came into my office to speak to a colleague.  I asked her how she was doing and she responded that she was starting to worry.  She wasn't having any symptoms.  I told her not to freak out too much, and that I knew plenty of women who'd gone a long time before having any pregnancy symptoms at all.  

Unfortunately, Maya had picked the right time to start worrying.  A few days later she stopped by my desk again, stating sadly that "the glue didn't stick".  She had started bleeding; the pregnancy was over.  I expressed my sympathies, and chatted a bit with her about their next steps.  She and her partner are planning to try again in the spring with her remaining embryos.  I can't help but wonder if next time, she'll hear the Little Voice like I do.  For her sake, I hope not.

Sunday, 19 January 2014

Timing is everything

Our frozen transfer date has been set for next Saturday.  I'm a week away from my last shot at having a baby that'll actually be related to me.  

The whole timing thing has actually worked out well for a change.  When I started this cycle I was a little worried, because judging by my first FET calendar I would have been scheduled for the transfer while M is away on a business trip.  My initial gut was to just go ahead anyway, but for a guy who actually missed our first transfer M was surprisingly insistent on being there this time around.  We even had a bit of a heated exchange about it, since if the timing wasn't going to work out for a January transfer he wanted me to put things off for a another month.  Of course that was the last thing I wanted to do after all the waiting we've already done.  Luckily it was all a non-issue, since it's apparently not that big a deal to have me "coast" on Estrace for a few extra days before starting my progesterone.  My clinic is also pretty strict about three days of bed rest post-transfer, which would be impossible with me needing to walk Buddy while M is out of town.  Even though I'm not sold on the science of bed rest (and hence didn't really follow it the first time, although I definitely took it easy) I'll probably try it just for the sake of doing whatever I can since M will be back to be my bitch take care of me.

It's also good that the FET is scheduled for a Saturday, since the past couple of weeks at work have been some of the busiest I've had in a very long time.  I worked last weekend to get ahead on a bunch of stuff, and while I haven't been putting in overtime this past week (again, impossible since I have to get home to walk the dog at a reasonable hour while M is away) it's safe to say that it's not a great time for me to take a ton of days off of work.  The fact that I'll only need two days off instead of four is definitely a good thing.  

I've been thinking a lot about whether I would consider myself "stressed", and whether what's been going on at the office is in some way making this a less than ideal time for a transfer.  While I know that we in the IF community are the first ones to say that stress doesn't cause infertility and to reject the advice of "just relax", I think we all also realize that excessive stress is a bad thing that should be limited if possible for a whole bunch of health reasons.  So am I under "excessive" stress?  I don't think so.  While my workload is heavier than usual, I'm actually relishing having lots to do since I'm someone who absolutely hates having too much down time at work.  To me, I'd rather be super busy than spend 8 hours twiddling my thumbs, and I find that a busy day at work translates to a higher energy level when I get home.  I have the momentum to keep moving and get things done, which means a cleaner house and less neglected chores, whereas if I've just been sitting bored at my desk all day I'm more likely to crash on the couch and do nothing when I get home.  I like to think that right now I'm in that sweet spot where I have just enough low-level stress at work to energize me, without turning into the high-level "pressure" kind of stress that's unhealthy.

Oh, what the hell do I know?  All I can say is that right now I feel good, and having lots to do at work is preventing me from obsessing about the transfer and spending all day Googling things like blastocyst freeze/thaw rates and implantation success rates based on embryo grading.  Down that path lies madness, and none of it will do one whit to change whatever's going to happen next Saturday.

Next Saturday.  Shit.  After all this time, it's finally almost here.  Gulp.

Sunday, 12 January 2014

Selling out: my pre-FET GF cleanse

I've never been one for fad diets.  As much as I've spent a large portion of my life "dieting" (sad, I know, and not even really necessary), I've never followed any specific plan other than counting calories and trying to eat less bad stuff and more good stuff.  Atkins, South Beach, low-carb, no carb, Paleo, primal...they all confuse me with their seemingly arbitrary restrictions, and quite frankly any diet that tells me I can't have something at all (even in moderation) is bound to fail.

Now, before everyone starts shouting at me, I realize that going gluten-free (GF) isn't a diet per se.  Of course, unless you're putting yourself in the poorhouse by gorging yourself on expensive GF substitutes, quite often you'll lose weight on a GF diet because you're cutting out calorically dense foods like bread, pasta, and most baked treats.  Which is great, if that's what you're going for.  But for a lot of people, going GF isn't something they're doing to lose a few pounds.  It's something they have to do because their health depends on it.  One of those people is my sister.

My sister was diagnosed with Celiac disease when she was pregnant with my niece.  Unlike a lot of people with Celiac who have digestive issues, my sister was totally asymptomatic apart from a longstanding issue with anemia that even iron supplements couldn't fix.  Turns out that's because her gut was so damaged from gluten that she couldn't absorb it properly.  Once she got pregnant, it seems that her Celiac kicked into high gear and she had a lot of trouble eating anything at all for a while.  It went beyond normal morning sickness, but fortunately her doctor figured it out relatively quickly and she's been healthy ever since going totally GF.

Given this history, gluten intolerance was pretty much the first thing I got tested for when we started having problems conceiving.  Though I've never had any digestive issues at all, I found myself in the unlikely position of hoping that I had asymptomatic Celiac as well, since it was something I could fix.  Take bread out of belly = put baby in belly!  Simple equation!  As we all know, for me it wasn't that easy.  My Celiac blood panel came back clean, and a later test at a naturopath's office (just for good measure) yielded similar results.

I got 99 problems, but a 'wich ain't one.

Which brings me to the crux of my dilemma: going GF when you don't absolutely need to for health reasons.  On the one hand, the increasing number of people who are eating GF has meant huge growth in the availability of GF foods, which is a great thing for people like my sister.  She's no longer relegated to one aisle in the grocery store like some kind of digestive leper.  But the flip side of that coin is that GF is taken a lot less seriously, because most of the people eating this way won't die (or even get seriously sick) if a speck of gluten gets into their food through cross-contamination.  Lots of restaurants are now claiming to offer GF menu options, even though their allegedly GF potatoes are fried in the same oil as their gluten-filled breaded chicken.  My sister has been served croutons on a Caesar salad accompanying her GF meal, and had to specifically ask for a new salad rather than just having the waiter take it back and pick off the offending bits.  This would be unacceptable if the customer had a life-threatening anaphylactic reaction to, say, shrimp.  But being GF has become so common, nay, so trendy, that it isn't taken as seriously by food manufacturers anymore.  This is despite the fact that people like my sister, with true Celiac, will get sick even if it's not immediately visible.

It may sound like it, but I really don't intend to crap on people who have genuine digestive or other health problems caused by gluten intolerance, even if they don't have full-blown Celiac.  If going GF makes you feel more healthy, then by all means do so!  And I'm all too aware of the fact that there are a lot of women in the online IF community who've finally had success with cycles where they went totally GF, despite the absence of any obvious pre-existing problems caused by gluten.  So there's that.  I just have personal issues with people jumping on the GF train for absolutely no reason other than the fact that it's the latest thing that they think will make them skinny, or because they believe that gluten is the source of all health problems, or whatever.

Anyway, the gist of all of this is that I've decided to go GF for the next two weeks leading up to my FET.  I feel like such a sellout!  And yet it's a relatively easy thing to do, so why would I not try everything possible given that this is our last shot with my eggs?  I have to admit that I'm not sold on the idea that it will help, but I'm also curious to see if a GF regimen will have any impact on other inflammatory issues that I've been dealing with (namely, hereditary psoriasis that's been getting steadily worse over the past year or two).  My doctor seems to think it's worth a try.  To make myself feel mildly better about it, I've decided to tie it in to a general clean-eating regimen linked to my latest fitness program, which is much more focused on weight training than on cardio.  I've stocked up on fruits, veggies and lean protein for the week to come, and am staying away from GF breads or other snack substitutes (because they're not strictly "clean" due to the chemicals required to stabilize them).  At best, I'll find myself pregnant in a month's time, at which point I'll become an insufferable advocate of a GF lifestyle to deal with infertility.  At worst, I might start seeing some strength gains and more muscle definition.  Can we call that win-win?  Yes, let's.

Monday, 6 January 2014

It's on like Donkey Kong

If Donkey Kong was female.  And infertile.  And having an FET.

Never mind.  None of this is like Donkey Kong at all, now that I think about it.

My clinic called and instructed me to start taking my Estrace today.  So now I'm back to inserting those little blue pills where the sun don't shine for the next couple of weeks.  I specifically asked them if it was possible to time things so that the transfer takes place after M gets back from his business trip later this month, and they said that shouldn't be a problem at all.  They'll just have me keep taking Estrace for a little bit longer before I start progesterone.  Easy peasy!

The only other change from my last FET is that I've been instructed to start taking one baby aspirin daily.  I've heard of lots of other women taking it during cycles, and while the exact benefits aren't fully known, it's believed to help promote placental blood flow which should hopefully improve my chances of implantation.  Whatever it takes, right? 

You guys, I really really want to be excited about this transfer.  But the truth is I'm pretty petrified.  If this doesn't work...that's it.  It's game over for my genetic material.  I have to give up on the idea of ever having my own biological child.  And while there are certain genetic traits that it's probably better that I don't pass on (my family's signature weak chin and near-legendary lack of flexibility, for instance), I'm going to have to grieve the loss of this person that won't ever exist.  A person who is a little part of me.  Not to mention that, after already spending two years on this horrible infertility journey, I'll be turning a corner only to realize that we're not even halfway to our destination.  I'll need to start researching donor egg clinics abroad, contacting them for info, and making arrangements for new testing and treatments.  As I commented on The Unexpected Trip (a wonderfully written blog that you should totally read if you don't already), it feels like I'm climbing a hill and won't know until I get to the top if I’ve reached the summit, or if I’ve just cleared the first foothill on my way to a mountain range.

I know that there are lots of you out there who've done donor egg (and succeeded!) and I'll definitely be turning to you ladies for strength and advice if it comes to that.  But for now, I'm just going to keep moving forward, one little blue vagina pill at a time.

Sunday, 5 January 2014

New Year, new cycle

Happy New Year, everybody.  I meant to say it well before now, but it's been crazy at work lately (I know, what happened to the holiday lull??) and when I get home I've just been doing a workout, eating dinner and crashing onto the couch in my cozy pants.

This time last year I was reflecting on how crappy 2012 had been, and how badly I'd handled it by just letting myself sink into all the shit that was going on.  I made a resolution to start living my life again, despite infertility.  And I think I did a pretty good job, which is funny because when you tally it up, we had a lot of the same shit hit us in different ways this year.  To recap:

- failed IVF cycles?  Check.
- pet death? Check.
- health issues?  (Not mine personally this time, but check.)
- it came close to the wire and thought we might actually get through this year without a house disaster, but Mother Nature came through at the buzzer with an ice storm so....check.

The only thing that I can safely say that I did differently this year was try as hard as I could to change my attitude.  Am I still depressed as hell about infertility, and terrified that I'll never be able to feel what it's like to become a mother?  Hell to the yeah.  But I tried my damndest not to let that stop me from living my life, and as a result I think maybe the lows felt a little less low this year.  Or at least I came out of them a bit quicker, or something.  I dunno how it works.  But to borrow an idea from Jane, here's a list of some of the wonderful things that went right this year.

- fulfilled a lifelong dream by learning to surf during an awesome vacation in Mexico in January
- we welcomed our dog Buddy into our family in April
- ran my first Spartan race in June
- got to see my family and spend time with my niece during a trip home in July
- had a great beach vacation in Maine with M and his family in August
- stuck solidly to a healthy eating and fitness regimen that saw me drop 13 pounds this year (so slowly I didn't even realize it was happening until my pants started getting loose!)

If I called 2012 "the lost year", I guess I can look back on 2013 as the year I started to find myself again.  I can only hope that 2014 will continue this upward trend.  It's off to a promising start, as I finally got my period on January 2nd.  That's 10 weeks after my last Lupron Depot shot, for anyone who's counting.  I had Day 3 baseline bloodwork and ultrasound done yesterday, and all looks good (although my FSH keeps creeping ever higher at 14 and my AFC ever lower at 9).

Here's the wrinkle.  My RE apparently didn't write a protocol for me before the holidays, even though I called just before Christmas to ask what I should do if AF came over the break while the clinic was closed.  I was told to go in for monitoring as usual.  But for my last FET cycle, I started Estrace on Day 3.  This time, because there was no protocol on file at the clinic (and my RE's office is closed until Monday), the nurses couldn't give me instructions to start Estrace.  I think the alternative option is that I'll start BCPs on Day 5 (tomorrow, once my RE is back in and can review my chart and write a protocol) to be followed by estrogen later.  This would work out well, since M is gone for part of January and it should push the transfer back long enough that he'll be home for it when it happens.  Of course it's also always possible that my RE will say "Oops!  I wanted you to start Estrace on Day 3.  I don't want you on BCPs at all.  We'll just have to wait for next month!", in which case I'll be pretty pissed.  But no point worrying about that until I get the call from the clinic tomorrow.  As impatient as I am to get this going, I don't want to go forward unless my RE has me on the protocol that will lead to the best chance of success.  Of course I'm also terrified, as this is quite literally my last shot at having my own biological child.  But that's a post for another day.  As of right now, we're finally moving forward.  To what end, only time will tell.