Sad and a Little Pissy

In my last post, I described the June 14th lining check as “something we had to get through.” I had no idea what a loaded statement that was…

During the ultrasound, the tech said my lining was measuring a little over 6 mm. I immediately turned to Brennen, my human Wikipedia on female reproduction. He gave me a “That’s ok” nod as the tech proceeded to measure my follicles. They needed to be small, and they were. A win! As I got dressed, Brennen was busy on his phone, looking up what my lining should be. I had never had a lining quite that thin. I usually measured around 9, so a thin lining wasn’t a potential problem on our radar that warranted any pre-requisite research. Before we walked out of the room, he said, “I think we’re OK. It’s still growing, and you haven’t even started progesterone.” So with that reassurance and my trend of problem-free uterine linings, I assumed we would get good news that afternoon. I sent a few thumbs-up selfie Snapchats to my friends and family and headed back to work.

Then around 4:00, I answered the phone, with pen and paper in hand for my transfer directions, and heard Nurse Memphis say, “So that lining isn’t really where we need it to be.” ARGH! “I had a feeling,” I admitted, although I had tried my best to ignore it all day. Doctor’s orders were to stay on the Estrace for one more week to see if the lining thickened and to come to Memphis for a lining check. The nurse told me, “Even if it’s still a little thin, it may be pretty enough to proceed.” So that was the plan – keep popping the estradiol pills in hope that I develop a fluffy, pretty lining. Transfer postponed.

For a week, I did just as Dr. Memphis directed. I also took some advice from my acupuncturist and started drinking Raspberry Leaf tea and eating iron-rich foods that would either thicken my lining or clog my arteries. Then Tuesday night, we made the trip to Memphis.

We were only at the clinic for about 20 minutes – just long enough for me to get my blood drawn for estradiol and progesterone checks and for a date with “Wanda.” I don’t think I have ever been so nervous about an ultrasound. We’re getting pretty good at knowing what the uterus looks like on the screen, so when it popped up, we both perked up and said, “There it is!” It was beautiful, according to the ultrasound tech. Three pretty layers and measuring at 8.75 mm – right where it needed to be. We drove back home on a high note.

Later that afternoon, my phone lit up with a call from Memphis. “You’re lining looked really good,” the nurse said. “Duh!” I proudly thought. Then came the but. My progesterone was high which indicated that I had ovulated. Transfer cancelled.

We all know someone who got pregnant while on birth control, right? Birth control loads your body up with estrogen early in your cycle, which is supposed to shut your ovaries down and keep you from ovulating. But even with all that estrogen in your system, in rare cases, an egg will spring forward from a follicle and send you into ovulation. Thus the story of a “birth control baby.” Estrace has the same task before a transfer. It’s estrogen, and it shuts my ovaries down. But there are those rare cases, and this month, I was one of them. I mean, seriously?! My ovaries have super powers that defy the odds and release an egg amidst an ass-ton of estrogen. But unfortunately the buck stops there. Otherwise, we wouldn’t be in this infertile situation in the first place.

So anyway, it’s back to the starting line for us. I’ll start my cycle in a week or two then proceed with birth control…again. Then comes the Estrace…again. This time around, Doc is putting me on Lupron injections that will (hopefully) keep me from ovulating.  But first, we wait.

Before I get into what this means for us emotionally, let me say that this is not an invitation to a pity party.  I promised myself that I would never write a blog post about what not to say to an infertile couple because 1) there are a gazillion articles about this subject out there already and 2) we’re never going to open up the conversation about infertility if we keep shutting it down with rules. But I will say this – sometimes the best thing someone can say is, “This sucks.” Just a recognition of how shitty the situation is goes a long way! My best friend is my best friend because when I share bad news, she sends me memes of cats saying curse words! And encourage us with reminders of how strong we are. Yes, that may sound a little self-absorbed, but if people are going to feel sorry for us, let encouragement grow from that pity, not sad puppy dog eyes and an empty sentiment about how everything happens for a reason.

Sorry if I sound pissy. But heck, I am pissy. I’m tired. I’m frustrated. I’m beaten down. We both are. Yesterday was the closest I’ve felt to giving up. I know we won’t give up, but that hope we had after a successful retrieval and a positive test (even though it resulted in a miscarriage) fades a little more with each cancelled transfer. We’ll get better, though. We’ll cope and push through. We just have to let this sadness run its course. One of the most inspirational quotes I’ve found during my IVF Pinterest-ing didn’t tell me about trusting God’s timing, having hope, finding strength, or believing in miracles. It simply told me it’s ok to be sad.Own the Sadness

So that’s what I’m going to do right now…be sad and own the hell out of it.

(And yeah, I’ll probably be a little pissy too.)

It’s Been a While

It’s been a while…

My last post was about two months ago, right after we found out our embryo transfer was canceled due to my elevated prolactin level. So what did we do? Well, I turned 30, and we went to the beach! We needed that getaway. It was like hitting the reset button for us. My mom was worried that I was running away from emotions. “Breanne, don’t think it won’t still be here when you get back,” she warned. “It” I guess was infertility, disappointment, an impending breakdown, something. And on the way to the beach after we hit a deer on the interstate and drove over a nail (2 different instances), I have to admit that I was thinking, “Ugh she was right! This trip isn’t going to help anything,” because let’s face it, moms are right 99.9% of the time. But this time, she was wrong (sorry, Mama). That trip was just what we needed!

We got back home on Mother’s Day, which was surprisingly easier than last year. Scratch that – it was less hard. Last year on Mother’s Day I ended up deleting the Facebook app from my phone and bummed around my parents’ house all day. I couldn’t even bring myself to go to church and sit in the congregation as all the mothers stood up proudly so their kids could present them with Mother’s Day happies they made in Sunday School. We had just started coming to terms with our infertility and were on the brink of the first round of IVF. That day was pretty dark. And you’d think that a year later, still with no baby, would have been harder, but like I said, it was surprisingly “less hard.” This year, we had more hope. We had a great retrieval. I was pregnant for a few short weeks this past winter. We have good looking embryos in the freezer. And we had a suntan. There was a lot to be thankful for, and if there is one thing this process has brought me, it’s a change in perspective.

The week after Mother’s Day, Aunt Flo arrived, which triggered another prolactin test. Since the canceled transfer, I had been taking Cabergoline twice a week so that my pituitary gland would chill out and stop secreting an unnecessary-at-the-moment breast milk hormone. We let out a HUGE sigh of relief when the results came back at 4, 8, gosh I can’t even remember exactly what it was….but it was low enough that we got the go-ahead for Transfer #3 (again)!

More good news came our way when Nurse Memphis instructed me to stay on the birth control (for down regulation) for only 9 days. 9 days! In my past transfer plans, I was on birth control for 3 or so weeks, so we had already planned that the transfer would probably be in July. But nope, our tentative transfer date is JUNE 19!!!!

Last week, I went to my OB for my baseline ultrasound with my favorite ultrasound tech. Everything looked good, so I’m now taking Estrace (estradiol) and am still on schedule for that June 19th transfer. Next up is an appointment Wednesday to make sure my lining is thick and my estradiol is where it should be. After those results get faxed to Memphis, I’ll get the call with the official transfer date and instructions on progesterone injections. Whoa, that’s next week! As I type it I get a little flutter in my chest that takes my breath away for second. And that’s significant because it hasn’t completely hit me that this transfer is around the corner; it’s happening slowly.

After the canceled transfer, I was miraculously able to push infertility to the back of my mind. Ok, maybe not all the way back there, but far enough that it wasn’t a subject that consumed my life. For a month, there was no shot regimen. No schedule taped to the fridge. No doctor’s appoints. No ultrasounds. No surgeries, thank God. There was just one pill every Sunday and Wednesday. I was enjoying having a piece of my life back that didn’t involve me worrying about growing follicles, a thickening lining, or implanting embryos. And I wasn’t even nervous about my high prolactin. I had been on the medicine before and responded well. We figured that would be the case again. Even once I got my schedule for the transfer mid-May – birth control for 9 days, baseline on 5/31, lining on 6/14, transfer 6/19 – it still didn’t feel…real? I’m not so sure that’s the right word. It’s always real. But I just haven’t readied myself to welcome back all the feelings that come with an upcoming transfer, and I don’t want to go back to the place I was two months ago. This is me totally trying to take control of my emotional well-being. Before the canceled transfer, I was sick with worry. The elevated prolactin proved my body wasn’t ready. The heartburn waking me up in the middle of the night to vomit proved my mind wasn’t ready either. But lately, I’ve felt like a completely different person. That’s why I haven’t blogged. Every time I tried, I thought of something else I should be doing instead, for fear that I would drudge up the worry and stress and probably get some heartburn out of it too. Now, as I write this with the tentative transfer a little over a week away, I still can’t see far enough ahead to picture June 19th. I’m just not there.

And if I dig a little deeper, maybe the reason for the mental block is that there is still one more obstacle to get through. One more checkpoint. And that’s my appointment Wednesday. In the past, these appointments were just something we had to get through to get to the transfer. Now that we’ve had a transfer ripped away from us so easily, these appointments are SOMETHING WE HAVE TO GET THROUGH to get to the transfer. See the difference? Maybe not. It barely makes sense to me…if at all. So as June 19th approaches, just pray that I stay cool and collected once it finally hits me. And when it does, I’m sure it will hit like a needle in the butt cheek…literally.

Transfer #2 – A Second Chance

Last time Breanne posted an update, she was shouting from the rooftops about her thick uterine lining (a phrase I never thought I would type).  Now, she’s hunkered down in a hotel room in Memphis on bedrest, so I’m handling this update on our transfer.

Monday evening after work, acupuncture, and a progesterone injection, Breanne and I hit the road to Memphis.  She had a suitcase packed with nothing but pajamas, a box of gluten-free cupcakes courtesy of my parents (Thanks, Mom and Dad), and plenty of Christmas music on her iPhone to pass the time. For those of you that know Breanne, you know that she loves Christmas.  And I don’t mean the normal kind of love.  I mean the already-has-all-of-her-Christmas-shopping-done-in-mid-November kind of love.  So with “Let it Snow” playing in the background and the air conditioner on full blast, we made our way up I-55.  Like a pitcher on a hot streak, we didn’t want to change up our pre-game routine, so we ate a late dinner at Memphis Barbecue Company on our way.  We’ve stopped there every time we’ve come up to Memphis for IVF.  If this round works, I bet it was the BBQ.

The morning of the transfer before we left the hotel is a bit of a blur, and I didn’t realize it was a blur until I started writing this post.  It’s almost like we were on auto-pilot.  I think we both had so many emotions running through us that morning – anticipation, excitement, hope, fear – and they all somehow cancelled each other out, leaving us numb and just going through our pre-transfer checklist.

We arrived at the clinic at 10:00 so that Breanne could have her blood drawn for a progesterone check; then, we spent the next thirty minutes in the waiting room where Breanne chugged water.  Evidently, a full bladder helps the doctor view the uterus on the ultrasound monitor so he can guide the catheter.  So there Breanne was, playing a chess match with her bladder all morning, trying to decide when to take her last pee before the procedure.  Checkmate: Bladder.

The transfer is a much less invasive procedure than the retrieval.  For the retrieval, Breanne was put under anesthesia; for the transfer, she only got a Valium.  The transfer basically involves the doctor guiding a catheter into her uterus and then injecting a solution holding the embryo right up next to the uterine lining.  That way, when the embryo hatches from its shell, it’s close enough to the lining that it can implant and begin to grow into a baby.  Because the procedure is less invasive, I was allowed to be in the room with Bre.  I just had to throw on a lunch lady hairnet and some massively oversized scrubs.  But when you’re 5’7, just about everything is oversized.

When the doctor finally came in for the procedure, he gave us a picture of the embryo we had been dying to see. Suddenly, we weren’t numb to our emotions anymore.  We were overwhelmed with hope.  Right away we could tell that this little guy was a higher quality embryo than the one we transferred in our first round.  It was more advanced and, without getting too scientific, had better cell differentiation.  The embryologist gave it a grade of 4AB.  The “4” indicates how far along the embryo is in its development.  At stage 4, it’s considered an “expanded blastocyst,” which is exactly where you want it to be for transfer.  The first letter in the grade represents the quality of the “inner-cell mass,” the group of cells that will eventually form the fetus.  This part of our embryo got an A!  It takes after its dad.  The second letter in the grade is the quality of the outer cells that will develop into the placenta.  This was a B.  Not perfect, but still pretty darn good!  For reference, the one embryo we had and transferred after our first round was a 2BC, so we knew we were already ahead of our first round.

The doctor left us alone for a few minutes while they prepped the procedure room, and we stared at our embryo.  It’s hard not to get emotional looking at the little clump of cells that could grow into our precious little boy or girl that we have fought so hard for. And I’ll be honest, I teared up.  Not many people get to see their children at this stage.  Going through this infertility struggle has been unbelievably difficult for both of us.  I bottle a lot up inside trying to be strong for Breanne, and my emotions wind up coming out when I least expect it.  I actually broke down in our Customer Service Manager’s office a few weeks ago (sorry Bennie!).  But getting to see this little 5-day old embryo before it hopefully grows into our beautiful baby made us feel so lucky…and me so emotional.

Next, they walked us into the procedure room and strapped Breezer in.  The nurse looked through our chart to once again verify who we were (a lot of verification goes on during the transfer process which is very much appreciated).  She laughed at how our names were so close, and Breanne, in her Valium-induced state of relaxation said, “Oh, it gets better!” and proceeded to explain how her maiden name is also Hancock.  The nurse jokingly asked if we were sure we weren’t related, so to break the tension I said, “Well, if this baby comes out with a third arm, we’ll have our answer.” Hard to tell if that joke landed or not.

The procedure went about as smoothly as it possibly could have.  Our doctor was incredible – he walked us through every step of the process so we could follow along on the ultrasound monitor.  And being able to both be in the room meant so much to us.  Breanne has had to fight so much of this battle on her own.  She’s the one getting poked and prodded almost every day.  She’s the one who has endured multiple surgeries in order to give us a fighting chance at a child together.  But in that moment, getting to hold her hand through this precious piece of the process, I’m not sure I’ve ever felt so connected to one person in my entire life.  As the doctor transferred the embryo, we could see a little glow appear on the screen.  The embryo is microscopic, but the solution it was in could easily be seen on the monitor.  And when we saw that glow, we both teared up (again).

After laying flat for 30 minutes following the transfer, Breanne was finally allowed to empty her bladder (hallelujah!)  She told the nurse it was the greatest pee of her life. The doctor gave us our post-transfer instructions, which involved a lot of bed rest for Breanne.  Once doc was finished with us, I went to go get the car to pick Breanne up.  About halfway to the car, I heard a woman’s voice calling for my help.  Once I walked over to her, I saw her and her husband trying to get a stroller to fold up so they could load it in their car – I’m guessing it was their grandchild’s stroller.  The woman said, “You look young – I bet you have kids.  How do you get one of these strollers to fold up?”  Not wanting to share our whole infertility story with a stranger in the parking lot, I awkwardly laughed and tried to help.  When I couldn’t figure it out, she said, “Well I thought you’d be more helpful – you look like you have a couple kids, don’t you?”  Guess I need to work on my dad bod…  After I swung by the hospital entrance to pick Bre up, we had to stop to let two very pregnant women walk across the street.  It was as if the universe was taunting us, but we laughed it off.  No negative vibes for our little embryo on board!

In order to make sure she followed the doctor’s instructions (and to allow me to get back to work), Breanne’s mom met us up in Memphis and is currently staying there with Breanne until tomorrow morning, then they are heading home.  Thanks, Connie!  If anyone can keep her in line, it’s you.

I’m not gonna lie – it’s been really hard being away from Bre over the last few days.  Knowing (and praying) that our embryo could be implanting as I write this is crazy to think about. Yet being 200 miles away from each other sucks. I’m just ready for tomorrow evening when we can start spending the rest of this 10-day wait together.

Thanks so much to the dozens of you who have messaged us, encouraged us, and prayed for us over the past few days.  If that little embryo can sense the love y’all have sent our way, he/she will definitely want to stick around!

 

A Time to Chill

Today, we received wonderful news!

During Round 1, we had 9 embryos on transfer day and transferred one.  The next day, we got the call that the other 8 did not divide and grow correctly and were not viable.  It was heartbreaking news, and since the start of Round 2, our main concern has not been whether or not I’ll get pregnant but whether or not we can make viable embryos. See, we had been told that our poor embryo quality was likely the result of my poor egg quality.  And after Round 1, we thought that I couldn’t produce enough eggs in an IVF cycle to give us a chance of getting a “good embryo.”  Obviously, that concern was put to rest when Round 2 produced a whopping 41 eggs, 26 of which were mature and ready to be fertilized.  So naturally, we felt like the next bridge to cross was to still have healthy embryos to freeze on Day 5.

Well, Day 5 was yesterday, and as Brennen said in his post , our embryos were slow growers and weren’t quite ready to freeze yesterday morning.  So we had to struggle through just one more sleepless night.

My phone rang this morning around 11:00, and we jumped.  Brennen muted the Law and Order: SVU marathon that we had been using to preoccupy our minds and left the room.  We had decided that if we didn’t have any embryos left, I wanted the news to come from him, not the embryologist.  If you know Brennen, you know he has a pretty large voice for a pretty little guy.  I heard a “That’s fantastic!”, and a few seconds later, Brennen emerged with tears in his eyes and the biggest smile on his face.  He hung up the phone and told me the magic number.  Then, he grabbed me, hugged me tightly, and told me he loved me.

Brennen and I have shared so much of our infertility journey publicly.  Like we’ve said all along, it has been our therapy and part of our healing process.  Through this blog, we’ve really tried to convey the realness of this struggle so that those who have never suffered with infertility can understand the heartbreak, and those that have can find strength and solace in our story.  But now, we’ve come to a part of our story that we’ve decided to keep to ourselves – our frozen embryo count.

Before we began IVF, Brennen and I talked about the ethical dilemmas involved in the process.  In fact, prior to both our IVF cycles, we had to fill out fairly extensive paperwork on what to do in the event of our deaths, divorce, and all sorts of situations that would put our embryos’ fates in question.  We talked and prayed earnestly about it and are comfortable in all the decisions we have made so far and in the path we have laid out for the rest of our journey.  However, in such sensitive circumstances, we would like to shield ourselves as best we can from any judgment. That’s why we’ve decided to remain private about this aspect of our story.  Just know that we are good people, will be good parents, and all our little embryos will have a purpose.

A final thought – We still have not decided if we’ll transfer one or two embryos, although the majority of our family is campaigning for two.  It’s funny because we used to have to field the question “When are you gonna have a baby?”.  Now, it’s “How many are you gonna put in?”  We’ll decide on that later.  For now, we’re just gonna do what our little embryos are doing and chill.

 

 

Hurry Up and Wait

You would think that as much waiting as we’ve had to do during the IVF process, we’d get better at it; but I guess practice doesn’t always make perfect.  We received a call this morning from the embryologist to update us on the development and growth of our embryos, so we wanted to pass it along.  Before we do that, we want to clear up all the numbers we’ve thrown around lately.

Number of eggs retrieved on Monday = 41

Number of mature eggs fertilized using ICSI (sperm injected into the egg) = 26

Number of embryos on Day 1 after fertilization = 21 (5 of the eggs didn’t successfully fertilize)

Number of embryos on Day 2 after fertilization = 21 (11 rated A- to B+, 10 rated B to B-)

That’s where we were as of Wednesday morning when the embryologist called us.  We had gone from 41 eggs to 21 embryos.  We didn’t get an update on Days 3 and 4.  On Day 3, the embryo cells continue to divide.  On Day 4, differentiation occurs.  During differentiation, some of the cells form a border around the edge of the embryo; these cells become the placenta.  Another group of cells clump up in the middle and will eventually become the baby.  You can clearly see these two groups of cells in the embryo that we transferred during Round 1.

 

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Transferred Embryo from Round 1

 

From what we’ve read and been told, a high rate of embryo arrest occurs on Day 4 during this differentiation stage.  We’ve heard it referred to as the “die off day.” So naturally, we expected our number to drop from 21.

This morning (Day 5), Breanne’s phone rang at 9:45, and we flew to it with me yelling, “Let me answer! Let me answer!”  The embryologist informed me that we had 6 embryos – 3 that looked really good and 3 that looked pretty good.  However, they weren’t quite ready to be frozen.  It sounded like great news to me, but when I told Breanne, I could see the worry in her eyes.  Like last time, it looks like we have some slow growers.  And last time, our embryos didn’t make it.  She made the connection pretty quickly and just sat in bed staring across the room.  I let her stare for a little while then asked, “Well, what are you feeling?”  She responded, “Chocolate.”  That’s not exactly what I meant, but it summed it all up.  I went and bought my wife lots of chocolate.  So much, in fact, that the lady at Livingston Sweet Shoppe asked me if we were having a party.  I said yes to avoid looking like too much of a fat kid.

The embryologist told me he would check the embryos again this evening, and if they were ready to be frozen, he would call.  If not, he would check again Sunday morning and call us.  Let me just stop right here and say that waiting on a phone call that may not even come is miserable.  As the eternal optimist in the relationship, I hung up with the embryologist this morning feeling really upbeat.  But as the day went on, my excitement turned to nervous anticipation.  Breanne’s sister called around 6:15 this evening, and I jumped.  I could feel my heart in my throat.  Her phone hasn’t rung since.

It’s 8:30 now, and at this point we aren’t expecting a phone call until tomorrow.  So, it looks like tonight will be another night of Tylenol PM and Netflix until we can’t hold our eyes open anymore.