Wednesday, December 17, 2008

A simple plan?

I finally had my phone consult with my doctor yesterday and came up with probably more questions than answers, but, for now, we have a plan. He wants to talk again after we get the results back on the genetic testing of the embryo (which should be a few weeks). If it comes back abnormal, then we are going to go ahead with a CGH cycle (I'll explain in a minute). If it comes back normal, I have no idea at all what we will do. He said he doesn't even know what that will involve because obviously I don't have implantation issues, my TSH was under control, and everything was going smoothly. So, I'm a little scared. I voiced my concerns over the lack of viable embryos we've been producing and he said it is probably just an age thing...that I don't appear to have the dreaded "diminished ovarian reserve" because we still get a good number of embryos and they appear to be of good quality, but I may actually have already started diminished ovarian quality that comes with age. He said that if it is chromosomally abnormal, that this may have just been normal-everyday-bad luck. The kind of "it can happen to anyone" crap that is always so shocking when it happens to YOU. So, the plan is that we wait for the results and then likely start a fresh cycle of IVF, which should start in about 2 months...maybe sooner, maybe later.

Now, CGH. I'm not going to give all the technical terms and stuff like that. I'm going to put it in general layman's terms and if you want more info, google it. It is a type of genetic testing that only 2 fertility clinics are currently doing, as far as I know. We will start by doing a regular IVF cycle, up to egg retrieval. The eggs will be fertilized by ICSI (injecting the sperm directly into the egg) and then they will be allowed to mature for 5 days. On day 5, they will carefully remove a cell or two and then flash-freeze the embryos for preservation. Those cells will be carefully labelled and sent to a special lab that tests all 23 chromosomes for abnormalities. This takes about 2 months lately because of demand. We will get a report on how many have actually come back normal (if any did, and you never know). Then we will prepare for a frozen embryo transfer where we will de-frost those normal embryos and place them back "home". The success rate for my age group for this is approximately 89% (but that was quoted on a fellow blogger's site and I'm not sure where she got that number). I've heard others say it is about 80-85%. So, that will be our last big shot. Hopefully we will get enough embryos and they will be strong. I say this will be our "last shot" but I doubt it - especially if the insurance works out and decides to pay for 6 cycles entirely ($10 copays) which is what they claim.

In the meantime, I've started DHEA in order to try to improve egg quality/quantity. My doctor suggested it and said that some studies have shown success, but he isn't sure...but it probably can't hurt. So, I start 25 mg 3x a day today. Wish me luck. I get so nervous on the androgen type medicines. I'm afraid my hair will fall out (and I'm growing it to give to locks of love) and I will start growing facial hair, and get a big pot belly from all the male hormones. But, he assured me the dosage is really low. And, at this point, what haven't I done? And, even worse, what won't I do? Jeez, I used to be so normal.

In any event, I'm going to try to enjoy the rest of this month. Since I have a forced month off after this one, I am free to enjoy some wine during the holidays, so I am taking advantage of that. I still can't bring myself to have even a cup of coffee for fear of egg quality repurcussions, though, truthfully, I still miss coffee every single day. Isn't that sad? Oh well...I hope everyone is having a great holiday season.

Saturday, December 13, 2008

Wednesday, December 10, 2008

time off

Thank you so much for all of your comments. It means so much to me that you all understand and sympathize. I've had a really bad couple of days but we are making slow progress forward. I am scheduled for a D & C on Friday, but may miscarry before then unfortunately. I am hoping that I make it to Friday just because I think it will be so much worse at home. But, either way, it will happen. The doctors want to test the baby for genetic abnormalities since that is what they assume the problem is. They said that this is how it happens...usually they get a good ultrasound, beautiful strong heartbeat one week and the next week the baby is not moving with no heartbeat. So, given that, they said that it happens and has nothing to do with me or Brett, just bad luck, I guess. The really sad part is that my sac separation bleed had completely healed so I did good taking it easy and allowed my body to heal - so that played no part at all in this miscarriage. The baby simply had something wrong.

I didn't get to speak to Dr. G yesterday but Dr. Surrey called me to talk (Dr. G is on vaca, apparently). He suggested a D & C and said in a few months we should come pick up our 2 frozen embies. He said what happened with this pregnancy has no indication at all of the embryos that we have frozen, but I'm not so sure, why did only 1 of the 4 make it even this far? But, Brett and I cried and talked and cried more and decided that since we have new insurance starting in January that says it will cover 100% of in-network IF procedures, and Dr. G is "in network", that in about 3 months, after healing time, we will do another fresh cycle at CCRM. It is hard to think ahead right now...and hurts me to even consider, not to mention how scared I am of something like this happening again. I'm not even sure how you make it through something like this once. Have to work that part out. But, I just have to have a "plan" so I can relax, mourn, heal, and then move on without constantly thinking "what should I do?"

I know some people probably think we are nuts for already considering another cycle. I mean, when is it going to be enough, right? But, we were so excited about our little baby and the prospect of a house full of kids...that we can't give up. Also, I do have to keep telling myself that, according to the doctors I've consulted after my local IVF's, this was my first "real" cycle, and the only one I should consider, and it was a success....mostly. So, we have to go for one more...maybe do PGD or CGH and see what happens. I'm scared. I'm hurt. I can't stop crying. But, I have to start to consider everything, I guess. We are also looking into adoption. Maybe we'll do both if they will let us.

I may be intermittenly posting or not posting at all for a while. I'm not sure which will make me feel better/stronger/safer just yet. I may let this blog just fade...but I get the feeling I will take a little time and then come back and go through another cycle on this blog...we'll see.

Tuesday, December 9, 2008

It's over

The ultrasound today showed a baby that had stopped growing at about 8 - 8.5 weeks. There was no longer a heartbeat. So, now we have to talk to the doctor and figure out whether or not I wait to miscarry or go in for another D & C. We have no idea where to go from here.

Monday, December 8, 2008

major freakout

My hormone levels came in - estrogen at 264 and progesterone at 25.2. They have both declined significantly and I haven't changed a thing. They are unhappy with the estrogen level and want to see it around 300 so I have to double up the patches again (good stuff) and they want to keep me on the pio shot. I just completely freaked out. My assumption is that the placenta is not taking over at this point and I am preparing for a miscarriage. Of course, they told me that this is unlikely as my progesterone is still above what they like to see (20) but they aren't sure why my levels are going down and not up. Its worrisome. I just called my favorite nurse at the local RE's office and she was sweet (b/c I sound like a wreck I am sure) but said that their office doesn't even check estrogen at this point at all b/c it isn't that important at all and that my progesterone looked great. She said that if I feel uncomfortable that I really should stay on the pio no matter what the other doctor says, but they said to stay on it and check again in a week. So, we'll see what happens...of course, all I want now is to get into that sonogram appointment tomorrow and see that things are okay. As soon as I see that things are okay, I am going online to order my fetal doppler rental for 3 months or so just so I can check the heartbeat here and there.

It's funny, Brett and I were watching a show yesterday and it said something about how women with prior miscarriages can never relax and every little thing seems to be a crisis. We both agreed that this is true...and here is the evidence of it, right? I mean, I'm a mess.

Dog Park!!!

We had a great weekend. Spent Saturday picking out a Christmas tree, Christmas shopping, and playing frisbee at the off leash dog park! I had to add some pictures because these are just the happiest dogs ever...

And, here they are later that night...

Besides that, I have an ultrasound tomorrow morning and just spent the morning getting bloodwork done at the old RE's office to see if I can finally stop taking the estrogen and PIO (doesnt this make it sound like they've kept me on it against my will instead of the other way around?). I do think I am finally ready to stop the PIO. I've recently started getting hot flashes and think that maybe the placenta has finally started its own production of the necessary hormones (Oh, I so hope this is true!).

I also went to the endocrinologist finally. For those of you who don't know, if you are hypothyroid and on medicine, pregnancy greatly alters your medicine requirements and the hormones produced by your thyroid are so necessary to make sure your baby developes properly -especially neurologically. Anyway, he really calmed my fears. My primary care physician had me scared to death about future radioactive iodine tests, possible goiters, etc...none of that exists. I simply have Hashimoto's Thyroidosis, which just involves antibodies fighting against the thyroid itself, so I need meds. He made me feel 100% better....So all is good here.

I graduate to the OB this week!!! Cheers all around!!! Now, praying for a great sonogram tomorrow....

Wednesday, December 3, 2008

This one's just mean!!!

Yup, you got that right- the baby is the size of a "martini olive" according to the site I check in with!! First of all, I LOVE green olives. And, strangely enough, since I've been pregnant that is the one thing that I seem to "crave" - though I think I may just need the salt, not sure. Second, No fair! I love martinis!!! I double checked around because lots of sites give examples of how big the baby is and there are so many sizes of olives (especially if you are martini drinker, you know what I am talking about), so the baby may also be the size of a grape, which isn't nearly as fun until it is mashed and fermented!

So, the baby is developing nicely. His or her major digestive organs are growing as we speak - including the pancreas, bile ducts, gall bladder, and anus (fun stuff!) . These are all in place. The little guy is also starting to lose his tail! Further, he is supposedly already moving around like crazy in there, though I don't get to feel it yet (boo hiss!).

On my end, things are going well. I'm still nauseous, which is absolutely fine with me. I'm still on the vivelle and PIO in very limited doses until probably Monday. The doctors decided to be conservative because of my uterine bleed or sac separation or whatever they are calling it and keep me on them for a while longer. Fine by me (though that PIO shot is getting old!). I'm still on restricted movement. The first nurse who told me about the sac separation and blood under the placenta told me that this is common and they have never seen this cause a I felt better. Then yesterday I spoke to my regular nurse and looked for some comfort about it. I said something along the lines of "but these are very unlikely to cause a m/c, right?" and she responded, " long as you try to take it really easy, keep off of your feet, complete pelvic rest, not even a tampon if you start to bleed, and don't lift anything, you should be fine." Um....eeeek. THEN, I found out the OB next week wasn't planning on giving me another ultrasound until week 19, so I called up and explained that I really need to monitor this thing to see if it is getting bigger or smaller (b/c I haven't been bleeding AT ALL, so I'm hoping it is absorbing!). So, she agreed and we are going in for another ultrasound on Thursday. Whew. So, needless to say, I am sure all is fine, but I am still nervous. Oh, and just to warn you other new BFP girls who did IVF, um, the belly does start to show MUCH earlier with IVF. I'd heard this before, but now I am really experiencing it. It's definitely true!!!!