Making Announcements - Getting Personal

The time is getting close where we will start making our announcements to friends and family that aren't already in the know. I think...

http://mashable.com/2012/04/18/social-media-and-the-news/

We keep putting it off. At first we wanted to wait until after the first trimester when the risk of miscarriage was still quite high. Week 13 rounded the corner and we decided to wait until we saw the specialist. Once that occurred we were introduced to all the bad things that could happen and decided to wait until after the initial tests. Then we wanted to wait for more tests (ie, the amnio). We still haven't gotten the results from that yet, but we expect them and another ultrasound this week. If all goes well, we will start widening our circle of who we tell.

But when do we make the announcement to our big group of friends??? Is that something you do on facebook? That would seem weird, but it would be equally weird to deal with people who want to know WHY we didn't let them know, when they start (hopefully) seeing baby pictures. Perhaps even more so. My worrying mind can just imagine people thinking "didn't we just see her at so-and-so's drinking wine, flat belly and all?" (Ok "flat belly" may be an exaggeration, because after 3 IVF treatments in 1 year my belly is no longer flat, but I am working on it.)

Ahhhhhh and all the questions we will get from so many people. I don't mind them from our-close friends and family - heck most of them already know my SIL is our surrogate or at least know that we have been trying with surrogacy - but what about the regular friends? We have A LOT. The idea of people publicly posting awkward questions or privately emailing me in droves, and then imagining people gossiping behind my back, is quite horrifying. Even if they don't. Which they will, because it's human nature.

Plus - I really don't like people knowing my business unless it's on my terms. The idea explaining I had cryoablation surgery many years ago (and many other things) makes me cringe. Not explaining it means people will ask if we adopted, or worse, will think my husband cheated. (Not that there is something wrong with adoption,but it is a particularly hard discussion for me because of my own history with it. For the record, I think adoption can be wonderful.) From what I can tell, very few people know the ins-and-outs of IVF and even less know about surrogacy. I'm sure some people would even privately wonder "did she just not want to get pregnant?" as I see written over and over in comment sections of India surrogacy articles.

On the other hand, I think it's important to share my story; if not just to help others. Recently I had a male friend get married and I realized that they would want to have kids. The wife just turned 40 and I could tell that they didn't have the faintest idea what AMA was. Even a friend whose wife went through IUI a few years ago (took on the first try, but they had several miscarriages prior to that) seemed blissfully unaware of the difference between a woman getting pregnant at 38 and one getting pregnant at 41. They were talking about putting off the second child for another year or two. Of course both of these friends I gave the 5 minute run-down, but forcing your experience down someone else's throat is quite different than someone else reading your story because they want to. In fact, I distinctly remember being MAJORLY offended when various women told us that we better get it in gear if we wanted kids. (Ahhhhh - how naive we were back then!)

Oddly enough, I happily shared my story with the lady at the bank the other day who was genuinely interested. It started out simple enough when I was getting our house re-fi papers notarized and the bank lady asked if we were planning on having any children.  Not having told many others I was ready to burst with the news to SOMEONE that we have twins on the way. Still, I didn't want to startle the woman so I eased into it with the ole ego-boosting  "well I have I 21-year old" that always gives me the shock face I adore (wasn't always the case).

From there, the conversation naturally slipped into "we have twins on the way" which led to surrogacy, then our India adventure, and then explaining the entire IVF process. She was a young lady (26) and apologized for being nosy, but she was so sweet and thoughtful in her questions. She explained her aunt was in her late 30's and seemed sad that she may never have kids. She also explained that some women in her family were pressuring her to have more kids now, while she could, even though she wasn't ready. In the end, she told me I should be on Lifetime to help other women. (Her manager had been on Lifetime for something else - lol.) That conversation was so easy and the young lady made me feel great, but I know that isn't always the case in these situations.

The easy answer to addressing friends' questions would be to point them to this blog, but I really don't feel comfortable with that. At all. I've been brutally honest here and I don't need casual acquaintances knowing things of my past or people scouring through to see if they are mentioned. That's a can of worms that I really don't need on any level. I have very close friends that I have never mentioned here and at least one that I have spoken unfavorably about. This is a blog of my experience, the good and the bad, and rather than worry about what I write in the future or sanitizing things I have written in the past, I'd prefer to keep it that way.

So what do you think? How do I tell the masses? We are fortunate enough to have quite a large social circle, mostly because of my husband, but that certainly leads to uncomfortable situations about things such as this. What to do what to do? What would you do (or what did you do)? Any advice is surely appreciated. 

Amniocentesis and another 2WW.

From: http://www.webmd.com/baby/twin-pregnancy-types

Thursday we had our amniocentesis. What a nightmare. It was really important for us to have one, but holy crap that stuff is scary.

The doctor certainly didn't help. It was that same irritating douchey specialist from the other week.

I guess I should back up a bit since I've been MIA.

The cell-free DNA test ended up coming back inconclusive. That's right, the test that the doctor recommended and then we found out afterwards that the manufacturing company doesn't always recommend for multiples or donor eggs (and since this is surrogacy, my eggs are considered donor) - came back inconclusive. Shocking. They wanted my SIL (our surrogate) to come back in for another. She called me and gave me the update. The nurse was really pressuring my SIL to come back in for another try at this test that is only partially covered by insurance.

After thinking about it, I told my SIL not to get it. It didn't make sense. Why should she have to take extra time off from work for a test that was not going to tell us anything different than the amniocentesis that we had already decided we were doing. Why should we pay even MORE money for a test that didn't give us anything different? Why should we put her through an unnecessary poking that could very well end up being inaccurate or inconclusive. I told her to not worry about going back for the test.

And then she called back. The nurse was EXTREMELY insistent that she come back for this test. At this point I because very irritated (not at my SIL, but at this Dr.'s office.) It was clear that they wanted us to do this test to try and convince us against the amnio. I told my SIL not to stress about it and I would straighten everything out with the Dr.'s office.

Ready to rage war, I started making phone calls. First I called our old fertility clinic ACRM. Our nurse that took over our case when our original nurse was promoted was nothing short of awesome, and I wanted to ping her for her advice. Then I walked outside my office, took a deep breath, and called the specialist's office.

The nurse that spoke to my SIL was not available, but another person in the office was able to call me back fairly quick. That conversation did not go as expected. Actually - it went quite well. The nurse (I think she was a nurse - but we will call her one anyway) was awesome. She is similar in age to me and she confided that she would consider the amnio if she was in the same situation. She explained why the other test was inconclusive and agreed that if we were going with the amnio, then it was not necessary to get the cell-free DNA test - especially so close together. We talked for quite awhile and she restored my faith in this part of the process.

Hubby and I decided that maybe it would be better to have the amnio done at an office closer to us. Maybe staff at a Decatur/Atlanta office would be more professional that some of our previous encounters at the Fayetteville office (like the bad nurse my SIL talked to). Heck, I'll bet the Fayetteville office, even though quite modern and large, has never even seen a mixed Indian/Caucasian couple, much less one using surrogacy. It would be the same doctor (groan), but hopefully no sight of other staff members with similar issues. (Atlanta is completely different than most of the rest of GA.) We would still do the regular appointments closer to where my SIL lives, but we felt safer with the amnio in a more diverse setting.

Fast forward to Thursday: amnio test day. Meep.

We knew that my hubby would be about 15 minutes late due to work constraints, but we really wanted the time to be more convenient for our SIL and let her set it. So when the doctor came in after the initial ultrasound, hubby had not arrived yet. The doctor started off with "are you sure you still want to do this?" and I had to resist the urge of having a fit. Both SIL and I answered in the affirmative.

The doctor then explained that since there were twins, the first injection would have an add-on of dye. The barrel part of the syringe is interchangeable and thus one needle can be used to insert dye, screwed off, and another barrel placed on to gather the amniotic fluid. This insures that you are hitting the same place and that you don't have to puncture multiple times. The purpose of the dye is when they go to do the second amnio on twin B, they make sure they get the fluid from twin b and not twin a again. Apparently the sacs can be all over the place.

Guess what happened? 

Removing fluid for the second amnio showed blue dye. The doctor stopped and asked us if we wanted to continue. By now my husband has arrived and we have to explain what the blue dye is and what it means. It also, all of a sudden, occurs to me that 2 punctures to the same sac means we have just doubled that baby's chance of miscarriage. And the doctor says that if he hits it a third time it will triple it. And if one miscarries, then it can make the second one miscarry.

I sat shaking. Oh - and I haven't even MENTIONED how horrible this looked for my SIL. The first one didn't look painful until they removed the needle, but the second one definitely looked painful. What to do what to do? I felt paralyzed. Secretly I wished my husband would make the decision for us, but I knew that wasn't fair. My SIL turned to us and said she was fine if we wanted to continue. She continuously amazes me.

While the doctor started rambling on about some of our other options, I quietly thought to myself. There was a pause and I explained to my husband again, because I felt it had been glossed over, that the second puncture had increased the chances of miscarriage and a third would triple it. I stated it again to make sure my understanding was correct. The doctor said it was and my husband started asking more questions. Again I reach internally and quietly thought to myself.

What I realized was that my initial fears of chromosomal abnormality had not changed. I still couldn't deal with certain outcomes, but now I was increasing the chance of making a good outcome bad. And I didn't have my comforting statistics on hand to let me know what was optimal. Ultimately I internally decided that I felt we should continue. And to nut punch the doctor if he pierced the wrong sac again. My SIL reiterated she was fine to continue today.

I overheard the doctor saying we could try again in a week or two. This made ZERO sense because then you would definitely be piercing the twin A 3x (because you would have to do the dye again) and the timing would be off if we had to make other decisions. My husband turned stonecold at this point and told him "Just do it now." Hubby looked at me and I nodded my head yes.

The doctor found another area that he sounded more confident with injecting. Complete opposite side that had not been available (baby moved) previously. My husband asked him "between 0 and 100% what it your confidence rate that you won't hit Twin A a third time?" The doctor replied "Oh you can never be 100%" and didn't answer the question. Hubby repeated the question again and doctor replied "I'm very confident". Which of course we followed up with "how much is VERY???" His reply: "At LEAST 50%." Facepalm.

The doctor had to get into a weird hand position to access the third location. The dye check occurred and this time it was clear. We all breathed a big sigh, but the room was still incredibly tense. I could tell it was painful for our SIL. I watched as the doctor withdrew the amniotic fluid and saw his hands visibly shake the entire time. I have no idea if it was because he was old, nervous, or just because his hands were in a really awkward position. I decided that it would make the situation worse to announce "WTF is wrong with your hands?!?" mid-withdraw, so I stayed silent. (I did tell hubby, mommy, and SIL later.)

It was over. We were done. We asked SIL if she was ok. She said she was. Hubby ran downstairs to pharmacy because the doctors office didn't provide any after pain medicine and we didn't want her hurting on the long drive home. Tylenol was fine the staff said. SIL said she was fine, but hubby ran to get some Tylenol anyway.

My mother was waiting in the lobby when we were done. She had graciously volunteered to drive my SIL when we realized the night before that she shouldn't drive herself. Doctor's office failed to mention this. Hubby ran back downstairs and got drinks and Reese's peanut butter cups for everyone. We talked for about an hour to make sure SIL was feeling ok, before the long drive home.

At the end, we scheduled our appointment for the next ultrasound. We decided that Fridays would work best for everyone, rather than Thursdays. The front desk lady informed us that we would have a different doctor if we went on Fridays. Without getting mad, or causing a scene, I simply replied "GOOD" and she made the appointment. 

All is Well - Hard Things to Think About

Ramble Warning. 

Depressing Statistics for Women with AMA Warning.
VERY Uncomfortable Discussion about Chromosomal Abnormality Warning

I wrote this over a week ago, but was afraid to post. It's been on my mind for awhile and still is. Since this is a blog about my experience and feelings during my journey, the honest thing to do was to post it. 

After a year of infertility treatments and tut-tuts about my age from a multitude of medical professionals, I've become a little more sensitive than usual regarding my age. To compound the problem, a years worth of infertility treatments (3 IVFs in 8 months!) and the stress that goes along with them has left it's physical and emotional mark in more ways than I care to mention. Now I am faced with the added realism of doctors constantly calling me 41 BEFORE my 41st birthday, because they have to consider the age of the embryos  when they are born. Why you ask? Because that is what counts for problems that may arise.

In the land of infertility, 41 is old and can cause a multitude of issues - age related things that most of us women with AMA didn't think of when we started down the dreaded infertility path. Besides decreasing our ability to get pregnant, our miscarriage rate increases, as does the chance that there will be a chromosomal abnormality. This last part is the current worry area we are visiting. Depending on where you look, our odds of having a baby with a chromosomal abnormality is somewhere between 1 in 13 and 1 in 15. (Note this is with fraternal twins, much different for singleton pregnancies.)

On the upside, the odds that both will have an chromosomal abnormality are about 1 and 900. 

If you've gotten this far and are totally against fetal reduction in all cases - then you should stop reading here. I will have total respect for your beliefs and how they pertain to you, but I ask the same consideration for me. All of us in the land of infertility go through our own personal hell, and we really don't need judgement heaped upon us for the litany of hard things we have to consider every step of the way.

Since I am of "advanced maternal age" AND we are having twins, we are considered a high risk pregnancy and our surrogate has to see a perinatologist. We visited the new OB/GYN a few weeks ago (who won't be our actual OB/GYN, but that is for another post) and had our first visit with our Perinatologist last week. Building up to that visit, both my husband and I researched the heck out of the tests we would need to consider.

The consultation did not go well.  

While I didn't think about it before, our Perinatologist must be a part of the same religious medical group as the OB/GYN practice (not uncommon here in the south). This essentially means he Was. Not. Happy. when we were trying to get information about options if the worst case scenario happened and one of the fetuses has a chromosomal abnormality (CA) that we feel we could not deal with. These can range from things that would result in a stillbirth to death after a few weeks of life to some that we feel the quality of life would be extremely poor. Termination is somber idea for us who have fought so hard for life. 

At the doctor's appointment when discussing the CA tests, I uttered a question about "termination" and the doctor stopped short and very ADAMANTLY told me they DO NOT do that there. (Even our OB/GYN didn't act like he did.) Based on his attitude after that, we all began to have a genuine concern that he was misleading us on several counts. Tests he up-sold recommended to us (instead of amniocentesis) that we later found out may not be recommended for twins or donor eggs (which in this case, my eggs would be considered the donor eggs.) This is especially odd since I'm sure twins takes up a large part of his practice. Additionally, based on information we knew, some of his numbers for risk were off. (Example of that is below.) Finally, he suggested dates for the amniocentesis that would not allow us to get the information back in time (for GA law) should it be one of the items that we would consider termination. 

When I asked him directly about risk percentage of CA for what he was recommending - cell-free fetal DNA that tests for 3 types of CA - versus and the difference of the additional CA items discovered with amniocentesis, he assured me that miscarriage through amniocentesis was greater. (We do not have confidence that he was honest here.) 

My hubby says this is confusing how I say it, so I'll try to clear it up.

---------------------------------------------------------------------------------------------------------

(Chance of any CA (for 1 baby) in my age bracket with twins = 6-8%) - (Chance of one of the 3 types of trisomy that his test is for - variable X) 

Is this > (Risk for miscarriage for doing an amniocentesis (.3-1%)?

or 
is 7%-X > 1%

So theoretically, if the cell-free fetal DNA tests only 4% of the CA's, that still leaves us with 2-4%  untested risk. In my mind, that is a higher risk than the .3-1%  from amnio. This isn't even including the other things amnio tests for that are non-CA. That 4% is probably pretty close estimate. 

---------------------------------------------------------------------------------------------------------

All of this is a major problem, but to get a new specialist would could cause us to run past the time period that were are so precariously balancing in at the moment.  

Don't get me wrong, this is not something either of us takes lightly. I shouldn't even have to justify it as everyone has their own limits - and yet I still feel an overwhelming need to do so. We have gone through so much and if we had to make a decision like this, it would be horrific. But that said, both my husband and I are on the same page on what we would and wouldn't do when faced with certain results for certain tests. And our SIL/surrogate agrees as well.

Not only do we have to consider what we could handle at the birth of a child (death being a major one), but also as we age. Both of us have had a lot of experience with people important in our lives that have some very severe issues - both young and old. Enough that we wonder what will happen when everyone is much older and unable to physically care for them. With our siblings (and us) all in an older age group, the option of family being able to step in probably would not be available to our babies. Unless I left the burden to my son, which I don't think is fair at all. 

A child born with a severe chromosomal abnormality can have devastating effects. More than likely one parent will have to not work, which can be a big blow in income. Add the costs of medical and 1000 other things normal people don't think about, and any savings could be wiped out in a very short time. It only money right? Yes and while that may be true, older parents entering their 70's and 80's may have zero money left over to care for their child when they no longer can (much less themselves). They are then faced with the VERY REAL probability of a mentally and physically disabled child that will be sent to a state run facility. Knowing the child will spend the rest of his/her life potentially living in hell is just not something we are prepared to risk. 

So while I absolutely despise that we have to think about things like this, I guess I feel it's important to share. Because I think it's important we all know these things before we jump in.* That may not change our minds, in fact I can almost guarantee in most cases it won't, but maybe if someone is on the fence about other decisions (such as donor eggs)** then the information will be important to them. We all get so caught up in the idea and worry of having a baby, that we forget some of the other, very real, life changing concerns.

In my mind, there is no right or wrong answer with these tough decisions. I place no judgement on those of us that don't even want to know about things like this. Nor do I judge those who decide things differently than we would. In the end, we are all left with our own decisions and we must choose what we can live with 1, 5, 40 years from now - not what matters to outsiders looking in.

Sigh. I told you this would be a rambling post. We had such a small chance of getting pregnant. Heck, our chance of miscarriage was higher than our chance of getting pregnant. If we can just make it past the amniocentesis, then I will be able to breathe. For a little while at least. 

*In our experience, which is A LOT of different medical professionals, we really did not get enough information about all of the risks for my age. Really the only one that was relayed to us was our lower chance of getting pregnant. I'm not sure if we would have made a different decisions, but I think medical professionals need to do a much better job of informing their patients about these risks. 

**Even this does not guarantee that all will be fine and dandy as many here in IF blog land can attest. 

Testing... 1,2,3

Yesterday we went to the new OB/GYN with SIL.* Excited in our anticipation for another ultrasound, we weren't prepared for the possibility of NOT having one and were a little disappointed when it didn't occur. Not sure if it was because the appointment ran long, if the doctor felt it wasn't necessary, or she was holding off because she knew the perinatologist would want to do one. You know....because of all the testing coming up.

Testing? What testing?

Since I am of AMA, there are about a zillion tests that should be done to test for chromosomal abnormalities. Great another reminder that if something goes wrong, it's probably because we used my old-ass eggs. Thursdays doctor was not the first doctor to count me as 41, even though my birthday is not until the end of April. Seriously - I am waaaayyyyyyyyyyy over hearing the tut-tut regarding my age.

We elected not to do the chromosomal testing on our eggs/embryos. Not sure why, but it was one of the things I just didn't focus my laser (some say obsessive) research skills on during the IVF process. A part of me thought that a small biopsy could endanger our chances of implantation and thus we weren't really interested in lowering our chances (no matter how small) or spending extra money unnecessarily. Now, unlike congress, our proverbial bill is due and it is time to pony up (i.e. take all the tests).

Here is the nice handy-dandy chart for us to stress over for the next 6 or 8 weeks. Look a bit overwhelming? Yea, me too. Fortunately some of them overlap, so it's not like we have to do all. But we DO have to weigh the pros and cons of each and decide which we think is best.  Right now we are weighing more towards the amnio vs the CVS. Hubby says CVS is slightly riskier for miscarriage and the doctor mentioned something about loss of limbs(!!!). I haven't had the heart to look.

RISK ASSESSMENT CHART FOR DOWN SYNDROME AND TRISOMY 18 Screening parameters First Screen 11-14 weeks Integrated Screen Combines first screen & Quad Quad Screen 15-18 weeks Amniocentesis After 15 1/2 weeks CVS Chorionic Villi Sampling 10-12 weeks Down syndrome detection rate 83% 92% 81% 99.9% 99% False positive rate 5% 5% 5% 1% 1% Trisomy 18 detection rate 80% 90% 80% 99.9% 99% Biochemical Markers PAPP-A Free Beta hCG PAPP-A AFP hCG uE3 Inhibin-A AFP hCG uE3 Inhibin-A Diagnostic evaluation of hundreds of types of chromosomal anomalies Early Diagnostic evaluation of  chromosomal anomalies Nuchal Translucency NT NT NT *** *** Timing 1st Trimester 1st & 2nd Trimester 2nd Trimester 2nd Trimester 1st Trimester Open Neural tube defects Detection Rate *** 80% 80% 99.9% *** Fetal Nasal Bone presence Preliminary results/ significance *** *** *** ***

All this and we know we are at higher risk because of twins. I should be celebrating and instead I feel like a big bag of worry. At least the appointment went well.

*I never know whether to put SIL or surrogate. Some days it feels more appropriate to put surrogate for a number of reasons, but other days it seems so impersonal for such a great thing my SIL is doing. Bear with me. 

A Ferris Wheel

From: http://www.tumblr.com/tagged/devil%20in%20the%20white%20city?before=17

Recently I read: The Devil in the White City: Murder, Magic, and Madness at the Fair that Changed America, an intriguing, historical novel about the World's Fair in Chicago in 1893. While I will spare you even a brief review (ok fine, for the most part I liked it - there are you happy?), I was fascinated to get the history behind the wonderous Ferris Wheel - a staple to every decent fair I have ever known. In this well researched story, the Ferris Wheel, though only briefly mentioned, so perfectly captures the feelings that I am going through right now. From the build up of delays and potential problems to the exhilarating ride to horrible possibilities of things that can (and do) go wrong to the remorsefulness that comes with loss and success.

Similarly,
I'm nervous.
And excited.
And scared.
And guilt-ridden.

Who knew that after getting our initial hCG values (and good ones at that), that I'd still feel like a bundle of nerves? In the Land of IF*, a positive pregnancy test really is just extending the anxiety from the 2ww. Yay we are pregnant with a good hCG! Oh crap - I hope it doubles in two days. Yay it went over double! Oh crap, I hope it grows as expected by next blood test. Yay! It grew as expected! Congrats - you get a new 2ww till ultrasound, where hopefully, you will see a heartbeat. It feels like every milestone comes with new nerve-shattering waits.

But I'm also excited. For the first time ever, I'm considering shopping. On the surface that seems like a trivial thing, but as fellow IFers** know, it really isn't. There's always the thought "What if I buy something and then something goes wrong?"  In March, we have a HUGE, local community mom consignment event coming up, and if everything is still ok, then I'll feel like I can purchase some things. Not big things, but SOME things. A pleasure I have completely avoided on all of our tries (with the exception of 1 book last year). There are other things I am excited about, but the idea of allowing myself to shop is a pretty big deal.

Being scared is another emotion all together. There are so many things to worry about. Will the pregnancy make it? What if there are twins? What if there are more??? What if the baby(ies) are born early? What if there are medical problems afterwards? As the pot grows bigger, it feels like any loss would be that much more.

Lastly, I feel guilty. Of late, I have not read as many success/pregnancy/baby blogs as I normally do and even ditched a baby shower a few weeks ago that came smack in the middle of my 2ww. I just needed a break from everyone else's "Woo hoo". Quite frankly, I was trying to simultaneously prep my self for a bad outcome, while still holding out some hope. Now we have had a few "woo hoos" of our own and I think of all the other individuals out here in blog land, men and women who have been through so much more than me, still waiting. And that makes me sad. And it makes me feel guilty. Like a weird survivors guilt where circumstances could change and put me right back were I was before. Guilty for my current feelings of success that happened while I was shamefully avoiding other's.

The ride of infertility is much like that first ferris wheel created in 1893. Not only does the ferris wheel go up and down on it's circular ride, but the details before, after, and in-between can't be ignored. The marvel of it all staying together, even when massive numbers of nuts and bolts fly off, is awe-inspiring. On so many levels, each successful turn is to be admired.

*When I refer to the Land of If, I mean it from a metaphorical perspective. I am not quoting the book, but I do like to place a link to it because I feel in this phrase, Melissa Ford so perfectly captured the seclusion often felt by our community: people dealing with infertility. As such, I like to give her credit.

**IFers: people dealing with infertility. 

Sunny with a Chance of Rain

Amazing photography by zznzz
http://zznzz.deviantart.com/art/sunny-rain-259517795

130!!!

That's the hCG test results at day 12. Our GC's progesterone is 20 and estrogen is 830. That's a good solid number for 1 baby with a possibility of twins. (Could we even dare to hope?) Everything is looking great.

Well, almost everything. Shortly after the blood test this morning, our GC started spotting. I know that it's not uncommon, and it may mean nothing, but it's still scary. Add to the fact that my age group has something like a 35% miscarriage rate. Doctor's recommendation is for GC to drink plenty of fluids and rest.

I'm not going to dwell on any of that today. Today I am going to be happy. Cautiously happy - but happy happy happy.

Hoping for an uneventful 2 days followed by correct growth rate in 2 days. Stay tuned and wish us lots of baby dust. You know - the good stuff; not the cheap, crappy stuff. We need all the help we can get.

6 Embies

We have 6 embryos. We will see how many continue. (4 of the eggs were immature). The embryologist said if they do well, then they might consider doing a 5 day transfer instead. We told her that we are not sure if we want to take that risk and to have the doctor call us tomorrow when we know more on how they are doing. 

Pros of going to 5 day: out of the embryos that survive, you can choose the very best ones to implant, resulting in a higher rate of pregnancy.

Cons of going to 5 day: embryos that could result in a pregnancy may not make it to 5 day outside of the womb. We could lose them all and have nothing to transfer. 

Trying to get less excited. It's hard. 

Third Party Coordination Goes Awry - Meds Edition

A few weeks ago I had to figure out where to order my and my surrogate's meds from. ACRM recommended 3 pharmacies and called the Rx in to all 3, allowing me to compare prices and such. One of these pharmacies, Village Fertility Pharmacy, actually had the forethought to test my insurance coverage even though I told them it wouldn't be covered. Thankfully I was wrong, so we went with them (a huge bulk of mine were covered!) I ordered both mine and my surrogates meds, shipping to our respective homes. Mine took 1-2 days. 

Since we paying ACRM extra money (~$3100) to do "third party coordination", I naturally thought that if I ordered the meds, that they would do more of the "coordination" and stuff. Honestly, they have not done a good job with this. Repeatedly I feel like I'm running around like a crazy person doing the bulk of the coordinating. With my ADD and new job, this is terrifically difficult for me. 

When my GC came in for her appointment on Monday, they gave her a written Rx for her meds and told her to fill it. No one thought "hey, we've already placed an order with the IP a few weeks ago, maybe we should check on that." The reason I found out? The nurse copied me on an email to the GC that said "You don't need to pick up the Lupron in your original order." All of a sudden I was like "Is this a double order???" The nurse emailed me at first and said that maybe the fertility pharmacy sent the Rx to Kroger. I asked my GC, and she said no - no one told her  about the previous med order and ACRM just gave her the Rx when she went for her baseline ultrasound. She was suppose to start meds that day and not one red flag was thrown up. A few back and forth emails, and it was apparent that no one on their end was really keeping tabs on this. 

Truthfully I should have checked that her med order went through smoothly weeks ago when I got mine. I had informed my nurse that I had received mine, but then got violently ill and forgot to double check if our GC got hers. I had no reason to believe she didn't and I guess with all the balls I am juggling, that was another one I dropped. I'm terrible at organizing these types of things, which is why I didn't mind paying the extra money to the clinic to do so. And I really don't consider $3100 a small fee to do this. As I am sure you have already guessed, our GC did not receive her meds from Village Fertility and it upsets me that I feel like I'm having to do the bulk of "third party coordinating" while paying them a chunk of extra cash. (Yes, I know some of this goes towards the medical aspect, but we were also told it goes towards things like this.)

All of this resulted in frantic phone calls, in the middle of a workday, with my very public cube, to multiple people. This is sucktastic for me to have to do at a new job. Village Fertility Pharmacy said they did not ship the GC order because they had left 2 messages to set-up a profile for the GC and she did not call back. My GC said she never received the messages and I 100% believe her. I asked Village why they didn't call me when they couldn't reach her, and they admitted they should have. (As a side note: I am very forgiving when people admit mistakes and then do whatever they need to do to correct it - Village did this.) Village apologize and after I altered the order (minus the no longer needed Lupron and minus the already procured Estrace), they were able to ship out overnight. 

In the long run, I think the mess-ups of everyone (me, the clinic, and the pharmacy) saved me money, but that still doesn't give me a warm and fuzzy. Especially mid-cycle. I'll write more later on my HUGE upset about a screw-up in charges. It's a freaking shame because we adore our doctor over there. 

Cycle Limbo Part 2: Return of the Cycle

UPDATE

Nurse called. As long as my SIL can come in tomorrow and get an ultrasound - then we are proceeding as planned. Whoooooooooooooooooshhhhhhhhhh.

When the nurse initially called, she kind of presented it as my option with the knowledge that if my SIL's lining isn't thick enough upon transfer day, than the transfer won't take. Normally they want 11-14 days of the estrace to insure a thick lining, but they don't want to start the estrace until a untrasound and blood work on her confirms everything is a go (eg, no cysts, hormone levels good, etc..) My last cycle gave me only 12 days before transfer. She asked me if I wanted to go forth.

At first I asked questions about how would we avoid this next time if we waited. She said that normal protocol was to control the GC's cycle with BCP/Lupron overlap. Then I asked the follow up question that surprisingly, I think was a bit unexpected: why did we not do it this time? This was a little harder to answer, but the short of it was - they/she didn't want to start medications (including BCP) until all the initial testing had been completed. Of course my logical reply was: Does BCP effect the testing. Answer: No.

So getting past all that, I realized she expected an answer from me about whether I wanted to start or not. Here is where I lost it. Crying the cry only someone that is mildly dehydrated and still slightly sick can manage. My guess is that over the phone it sounded somewhat like a choking horse.

Normally when I get really upset, my sensibilities leave me, but they did not this time. I put the question back to her: "What you are telling me is that I have to choose between my chances lowering further from waiting a month, or take a chance that the lining won't be thick enough." She said she would speak to the doctor and call me back.

I laid the options out like that for a couple of reasons, but the main one was that I really didn't know which is riskier. One would think that a month wouldn't make a world of difference, but women in my age bracket know differently. My AMH dropped drastically in a very short period this year. Conversely, I don't recall our surrogates getting estrate (or similar) that long in India prior to the transfer, so I'm not sure if it is a booster/fail-safe thing or what.* From a medical perspective, since my GC and I started menses within 24 hours of each other, one would think at 29 years of age, her lining would be reasonably thick for ovulation at the proper time anyway.

After speaking with the doctor and both reviewing my records, the nurse called back. She stated that as long as my GC could come in for ultrasound tomorrow (she can), then we would continue the cycle as planned. We nailed down a few of the other details (like when I would start my big gun meds) and now I feel a crapload better than I was feeling. Earlier I was trying not to let panic surge, but I was having a hard time. I would have waited another month if I had to, but honestly, I am ready for this to be over and done with. The emotional and physical, even things you don't let anyone else see, is astronomically draining.

*Originally I thought the Indian surrogates did take meds from the beginning (from my own research of surrogacy), but I had my husband ask the Indian lady directly and she said that she only been told to start medication a few days prior to the transfer. My husband and I now debate if this was a protocol thing, problem with the surrogate, or other. 

Cycle Limbo

Picture from: http://www.examiner.com/review/limbo-a-post-mortem

Wednesday, when I was sick with a nasty cold (and had to work), I posted that I had questions for our nurse. I updated that post with her answers from her call to me. One thing she told me, was that if our GC's period did not started by Friday, to have our GC call her. I promptly wrote it in my notes (where the questions were), sent a copy of those notes to my husband, and started to put a reminder on my calendar to be sure to call our GC on Friday.

"Started" being the operative word. I was distracted by actual work stuff (people come by my desk all the time) and when I got back to a blank calendar entry - I had no recollection what it was for. Between being sick and mission critical work stuff, I hoped that I would remember. Thursday turned into me only leaving my bed to RUN for bathroom necessities due to an added bonus of stomach flu.

Friday rolled around and I was able to work from home. I also had the outstanding attorney papers (almost 60 pages) that I had to start going through ASAP. By Friday night, something tugged on my memory and I realized I hadn't received the insurance information from our GC yet.

<insert important announcement here> I'll go ahead here and announce that our GC is my sister-in-law. She is my little brother's wife who graciously wondrously volunteered to assist us. <end insert>

In my juggling of balls, I guess I thought that getting the insurance information from my SIL was what I needed to do on Friday that was so important. My period hadn't started, but our nurse had told us that my SIL wouldn't be starting injections for 2 more weeks. I was confused and misunderstood this as her "medications". As in ALL medications.

Friday night my period started and I promptly emailed and called our clinic as instructed. Equally prompt was the automated reply (and answering message) informing me that my nurse was out of the office till Jan 2nd. Great. That meant I was going to have to deal with other people trying to get in for my Day 2/3 ultrasound/blood work. Was able to get a hold of someone at the clinic the next morning and they scheduled me to come in for Sunday morning 8:45 AM to get an ultrasound.

You can probably guess what happened at that appointment. First I got my ultrasound and then I was asked, as almost a side note, if our GC had started her period. When I said I didn't know, the nurse on call asked if we were doing fresh or frozen cycle. As I began to explain that we have to do fresh, it sinks in what I forgot. A wave of panic passes over me, except I'm not even sure why because no one has ever told me what it means if the GC hasn't started her period yet. Then I ask the dreaded question. The very pregnant nurse answers - since she hasn't started her meds to insure her lining will be right, we may not be able to start this cycle.

WHAM.

I guess after seeing my face, she decides to call my nurse who I guess is on vacation. We desperately try to get my SIL and brother on the phone. We finally do. Her period started on Saturday. I have no idea if she was supposed to start some medication then. Preggo nurse (can you tell I'm irritated that I have to deal with a pregnant nurse at a fertility clinic in the midst of all this?) tells me that our personal nurse will call us in a few hours. I go home and listen to an recorded meeting we had with our nurse a month ago. Sounds like my SIL should have come in for an ultrasound and blood work as well today. And it sounded like from the other nurse, some estrogen medication as well. Great - just great.

Now I sit and wait. And try to hold myself together. And try not to beat myself up (which is utterly impossible). And know my husband is upset with my forgetfulness, but trying to hold it together and not say anything.

11 follicles were seen this morning and no cysts. 

Money, Get Away

"Money, get away
Get a good job with more pay
And you're OK."

Clearly The Pink never went for infertility treatment. Which is weirdly funny given their nickname.

We are entering our third and final cycle with my eggs and with a person close to us doing the surrogacy (without charge). Approximate cost: 35-40K. That's not a typo. That's how much it will cost us out of pocket. Paid in full by months end. In addition to all we have already spent.

And now, all of a sudden, a little voice inside me is very scared. To spend this much money and use my long shot eggs. Actually I'm quite terrified.

In Today's Surrogate News...

image from: here

The long awaited surrogate news is here! 

Our surrogate and her husband are still gung-ho - YAY!!!! Ms L went for her hysteroscopy and HSG testing Thursday and Friday. We haven't heard the official news from the clinic yet, but she is under the impression that everything came back great. Double yay! I'll let myself have that little bit for now.

On the flip side, my surrogate and her husband, both whom are very close to us, are having trouble quitting smoking. If she doesn't quit soon, then it will be a no-go. Quitting smoking is super-tough and she feels awful that she hasn't been able to quit yet. Was there myself once-upon-a-time and it sucks.

We went ahead and asked them if they wanted to try Chantix (we'd pay for it) and made sure with our clinic that it would be ok for them to take. They both wanted to give it a shot and we were happy when our RE said it was ok. We were about to go meet them on Saturday when our water heater expansion tank sprang a leak. Fortunately showered just minutes before the leak was discovered... 

Anytime you find a large puddle of water on your floor you should probably be concerned, but honestly I was more concerned about meeting with Ms.+ Mr. L. We called a friend and my dad to ask some questions, turned a faucet valve that was connected, let hot water run out in the sink, placed a bucket under the leak, and left to go meet them. 

Meeting went great - picked up Chantix Rx and then grabbed dinner with both of them and their little one. Afterwards we had a get-together at a friend's house where it was pretty paramount that we show our face. It's a close friend (he introduced us!!!) and we think we weren't invited to his wedding a month ago because we have been soooooo MIA - we hadn't even met his now-wife until last night. They had been dating for a little over a year. When we returned home much later we found the leak still going strong. A little digging around outside and in the garage led to the discovery of another valve to turn off ALL water. The first one turned out to be just for hot water. 

I hope the Chantix works. It helped me quit smoking years ago, but I know some people report serious side effects and can't take the medication. Chantix is not covered under their insurance either, but Mr. L's doctor gave him a $75 coupon. Oddly enough, Ms L's only have her a $40 one. Weird huh? We were able to use the $75 one. 

Now we go full speed for the other things. On the schedule of phone calls tomorrow is lawyer (required by our clinic), blood work for all, and psych tests for all. Wait what was that last part??? Yea, our third party coordinator said that we would have to ALL have a psych eval. Having a psych eval doesn't bother me (it probably should!), but after 2 failed surro cycles in India I really don't understand why it is necessary. I sent an email to our third party coordinator asking about the necessity (ie. requirement), of this for my husband and I. If it isn't required then I really don't see the need to spend additional monies on it. We didn't have it in India and I don't feel like we need it now. (The surrogate did have one in India and I understand why it is required here.) 

And I'm not sure how we haven't really talked with the financial coordinator at our clinic thus far, but I guess we need to schedule that as well. Sigh. At least then we will know better what to expect. Our original information from the clinic did not include costs for surrogacy. That becomes an entire new list of line items. 

I don't know how I'm going to take off all this time from work. All day psych evals? Appointments at an attorney office? More medical stuff? I don't know how our surrogate is going to be able to take the time off either - though of course we will give her money for any missed work. She starts a new job next week and while we are both super-duper tight with her boss, I think it's still awkward to take time off when you first start at a company. Even if the boss is totally ok with it. 

Sigh. So that's the update. Prior, I steeled myself to expect the worst with her hysteroscopy/HSG tests and now I feel unexpectedly elated. Even after feeling all doom-and-gloom about the cigarette stuff for the last week and a half. I'm still going to be cautious about getting too excited with regards to that, but I've let myself be hopeful for the weekend.

Course not having water it beginning to suck. Guess I should put "plumber" on my list of phone calls for tomorrow. Wouldn't that be funny if that was the phone call I forgot to make tomorrow? (I refused to pay Sunday plumber rates.) My BFF called earlier and said we could take a shower at her house if necessary. Since she could smell me all the way from there... She's a keeper. :-) 

On Feeling Alone

I know that there are TONS of folks that face infertility, but damn it, sometimes this path feels so lonely.

• The hormones.
• The feeling less of a woman.
• The weight gain and the realization none of your clothes fit. 
• The money. (You can't even think of buying new clothes).
• The daily meds or supplements.
• The feeling of failure.
• The limitations of what you can eat/drink/do to make sure you have "the best chances".
• The no baby. 
• The doctor visits
• The pretending everything is fine.
• The pretending like you really want to hear and be invited to every baby event.
• People asking "so when are you guys going to have kids?"
• The CONSTANT reminder that you are old (or at least your eggs are). 
• The roller coaster that just won't seem to stop no matter how long you've been on the ride. 
• The worry that wanting to use your own eggs raises the chance of health issues in your child. 
• The worry that I'm becoming obsessive or annoying.
• Worrying about my in-laws
• The invasive procedures
• The worrying over every little unknown pain will cause a problem
• The money (yes, this is big enough to write twice).
• etc...

My BFF is a guy and I don't think he can completely relate. Actually, I take that back. His situation is worse.
Me: "This sucks. I can't carry a baby. My eggs are getting old. And we pay a fortune just to be on this stupid roller coaster ride."
BFF: "I think my MS, being single, no chance of kids, and the eventually that my walker requirement will turn into a wheelchair requirement triumphs. My insurance alone is over $900 a month and I can't work."
Me: "touche. Let's go grab lunch. It's on me."

My second BFF just had a baby, so it's not like I want to rain on her parade or have her feel like she's walking on eggshells. She's so totally awesome and her baby is as cute as cute can be.

My husband, though tremendously patient with me, doesn't alway understand how this physically and emotionally this affects me. And as many of you know, it's a doozy  Nor do I, having been a parent before and not from a culture who puts the highest importance on having children, understand all of his internal turmoil. On dealing with the emotional side of IF, we probably both stuff it down in order to appear brave for the other.

If I tried to discuss things with my mother, then she would be incredibly sad worrying about me. That would only add to my stress. No thanks.

In blog land I sometimes worry that I am offending others. In my posts and sometimes my comments; both farthest from what I am actually trying to do. Just trying to convey my thoughts at a particular moment in time. Or trying to avoid feeling sad. Or trying to be helpful. Or funny.

In work and with friends, I'm limited to what I can say. Sometimes because I'm trying to protect myself (lest I am fired for going through IF like I alluded to here) and sometimes I just don't want everyone knowing my business. Nor do I have the desire to be the discussion of gossip as can happen when you have a large group of friends. Nor do I want to be the person that constantly complains and whines as that drives me crazy. Little bits are fine, but when you run into that person who has had problems for soooooo long, it becomes exhausting to talk to them. I certainly don't want to be "that" person.

Yet life goes on. Everyone is busy discussing their kids, sharing fun photos, and doing fun family projects. I'm sure it's a grass-is-greener type thing (after all, we've had some AMAZING travel adventures over the last 4 years), but if I see one more Luvs commercial on Hulu, I'm going to scream.

Weekly Update: A Job, Land of IF, Being a Proud Parent

So many things, so many things. I've forgotten half of them already. Let's just hit the highlights and see what else I can remember.

Hi Ho, Hi Ho, It's off to Work I Go.
Had to go back to work. Money is just too tight right now. Me not working for 8 months has finally taken a toll on our finances and if we want to continue in this Land of IF, then we can't do without my paycheck.

My first week of job hunting was really me just talking to recruiters. I figured I had put enough off during my travels to India, that now was the time to dig deep. That's always an adventure, but by week 2 I had a job - fortunately my area of expertise has an extremely low unemployment rate. It's a contract to perm position in IT, doing what I have over a decades experience experience in. I will be making over 10% more than what I did at my last job and for a company that has a big name all over the world.

What about my dreams to do some sort of humanitarian thing in the non-profit industry? Selfishly, our dreams of a family rates higher on the scale, thus I had to give up on a career choice that would pay just over 1/3 -1/2 of my current salary. All is not completely lost as the project I am working on helps people from 9/11. At least I can believe in the project. Some of the companies that wanted me to interview were BLECH. (Have had enough of soul sucking from my last job thank you very much!)

Speaking of Land of IF...
1.) Just starting reading the book Navigating the Land of IF: Understanding Infertility and Exploring Your Options by Melissa Ford of Stirrup Queens fame. Only on chapter 3 (have had to study for work - <sad face>), but it is pretty awesome. Have my own mini-collection of IF books, but this is the one that most interests me right now. Probably because it's not all doom and gloom fact based. Melissa does an excellent job of making the reader far more relaxed over a very NON-RELAXING subject and everyone is included. It's a hard road and the recurring theme is that we are not alone. And that it's ok to be all emotional. I'll write a full review when I'm finished.


2.) Our friend and her husband who offered to do surrogacy for us are "both feet in". YAY!!! That's the first hurdle. We've consulted with our local clinic and there are a couple of things we have to address, almost all of which we expected. Then there is the insurance issue. We don't know yet if her insurance has a surrogacy clause. Trying to find that out without sending up red flags. They aren't known nationally to cover these things...One step forward, two steps back.

The item I had not thought about was that my doctor wants to retest my FSH. It was high last january (12.4) and with the decrease in my AMH, she wants to make sure that it hasn't shot up to the high teens. I know, I know, it's a Big If. Wish me luck. If it comes back too high, then we could be in holding pattern for years for the DE as I've previously mentioned here and in other places.

Proud Parent
Some of you might remember that I have a 20 year old son. What I don't think I have ever mentioned is that he is in seminary school. Which is perfectly natural since his father is Jewish, my husband is an ex-Hindu, and I have had a lifetime of "trying to figure it all out". (Try not to laugh.) Anyhow, my son has a religious podcast now and I am very happy to see him do something he enjoys so much! Of course as the proud mama I had to listen to it right away and I was tickled in doing so. He was great! Very few people in life get to have the career that they absolutely love and I think he will be one of the lucky few. We have the best discussions and I'm thrilled that not only am I his mother, but also his friend. He dives into projects where he can bring help to those who need it and I am so incredibly proud of him.

-------------------------------------------------
Well, that's all I can remember right now. Still recovering from the flu, which is interesting with starting a new job. I'm exhausted.

The Plague and Me (or is it "in Me"?)

Grouchy, achey, and sick - that's me. (If I've offended anyone about anything, I apologize. My mind has been fraught with sickness, worry, and anger.)

I've had the flu for 3 days now AND my OB/GYN appointment last Friday revealed free-flowing fluid on my ultrasound. Not good. My doctor is suppose to call me with the results (radiology/ultrasounds are done in a different place then his office), but so far he has not. 

Having had an indeterminate* PID type infection many years ago, I know what a problem having free-flowing fluid can be. Last time it included antibiotics for about 6-8 weeks,  trouble walking for weeks, tons of abdominal pain, and admittance to the hospital for almost a week. Not exactly prime for IVF treatment. I'm willing to bet that's what caused one of my fallopian tubes to be blocked. 

If I don't hear from my OB/GYN by tomorrow morning, I'm going to have to call and explain that I need to get on antibiotics STAT. I should have gotten an extra dose of antibiotics after my last IVF treatment. The first cycle I asked for it because of my past issues, but I forgot this last time. Just went with the normal 1 treatment after IVF. Did I mention I don't react well to some antibiotics? Particularly the ones that are usually Rx'd for this sort of thing. Sigh.

And this stupid flu. I have so much to do before I start work on Monday and I'm too exhausted to do any of it. Was suppose to get a cavity filled tomorrow (that I've put off for MONTHS because of IVF) and now that's not going to happen. I certainly won't be able to take care of it when I first start work. Double sigh. 

Found out today that if I had gone to the doctor within 48 hours of flu symptons then I could have gotten an anti-viral that reduced the symptoms and reduce the length of time I was sick. Thought there was nothing you could do for the flu. Now it's been more than 48 hours. Should have gotten the stupid flu shot, but was worried about it with IVF. 

At least I have my wonderful husband. Not only makes the best homemade soup ever, but laughs at my grumpy faces. 

*the doctors never found the cause of the infection though I was later told it probably resulted from a polyp removal I had a month earlier. STDs, the most common culprit, was ruled out. When I asked why my doctor gave a diagnosis of PID, I was told "because that is what we label any infection of the pelvic area regardless if we know the cause or not".

A job, a surrogate, and possibly the flu

http://liannetaimenlore.blogspot.com/2012/08/edbp-movie-review-lion-witch-and.html

“All shall be done, but it may be harder than you think.” 
― C.S. Lewis, The Lion, the Witch, and the Wardrobe

Two weeks ago my husband and I decided that I needed to go back to work. Our funds are greatly depleted and the time had come. This made me more than a little nervous on several counts.

1. I'm rusty in my job field. Not only because I took off 7 months for IVF treatments, but also because my last position had me doing a different area in my expertise. While that's all great and fine, the problem becomes two-fold in that I could either continue in that subcategory (with only 2 years experience) or go back to my old subcategory with well over a decade experience. Going back to the old actually means I have 2 years worth of catch-up to do as you have to constantly stay updated. 
2. Interviewing terrifies me. I don't know why, very few positions have I ever interviewed for did I not get a job offer, but they still terrify me. Like make me want to vomit type of terrify. Like my voice shakes and my mind can go blank type of terrify. Now that I think about it, maybe I have such a good success rate at job offers because I usually go with the one of the first couple. That gets me out of other interviews. Add on #1, and I simply did not feel ready to interview. 
3. Wasn't sure how this would fall inline with our IVF treatments. What if our surrogate here doesn't work out? Then we are back to looking at India. Can't exactly take time off to go there for 3 weeks when I'm brand new at a company. We don't save any money by doing IVF in India, only surrogacy, but I don't have confidence that my embryos will make it to freeze. Need to look at things to increase our chances, not decrease.

As my grandfather used to famously say "Oh well, what the hell" and thus I dived into job search mode. Went on a interview last week, felt like puking (before and after!), thought I bombed part of it, and lo-and-behold, they loved me. Took an online technical test and scored high. Job was offered immediately (like within 5 minutes of me completing the test!)  So here I am getting ready to start my contract-to-perm position next Monday. Have a shit load of studying to do before then. 

In other news, we met with our friends (husband and wife) that are considering surrogacy for us. We have to meet with our clinic here in Atlanta to find out some more answers, but I felt really good talking with them. Made me realize that they had thought it through (at least with the information they had) and wanted to think it through some more after we laid all the heavy duty stuff on them. That's actually a really good sign to me. 

The next day my friend emailed me and said she went through the forms and wanted me to check with the doctor about a medical issue she had years ago. We have an appointment with my clinic on the 30th, so I will have my list of compiled questions then. Meanwhile, I also have a phone consultation this week with another clinic via Skype. 

The only big concern my friends really had was insurance. They've had problems with theirs in the past. If we have to buy insurance, pay for a ton of new medical tests for all 4 of us, plus attorney fees, then that may be too cost prohibitive. Won't really know until we speak with some clinics. Don't even know if they will still take me. 

And if this all seems a bit lacking in the segue arena - it's because I fairly certain I have the flu. Sigh. 

Another option

http://www.robinurton.com/blog/2008/05/belly-cast-painting/

The other day I received a shocking offer. One that could solve a lot of problems for us. Maybe. If we are lucky - and that's what it usually boils down to in the end. In a Tim Burton kinda twisted way.

Someone close to us has offered to be a surrogate here in the States. 

Interestingly enough, my husband and I had 2 different reactions. He was ecstatic and slowly realized that I... well... wasn't. Don't get me wrong - it will be FABULOUS if it works out, but just a mere offer doesn't turn into a done deal and I guess that's what has me a little nervous.

This person is very close and dear to us. I love her completely and I nearly cried when I read her email. BUT, I'm afraid to get my hopes up.

Today my Atlanta Clinic called and they had my AMH results back: .86. Not good. Not good at all. Not horrible (like in India), but definitely not good. It has dropped over half from January. So I'm fairly certain this will be our last try with my eggs. And that's IF ACRM will even take me now. I'm hoping that the fact I had 3 good embryos last month will help convince them.

The idea of using someone close to us make me nervous for so many reasons. What if we plan everything, go through IVF, and then she decides she can't do it? I would understand why, but that would kill me. What if she isn't approved medically? She smokes, how do I know she will be able to quit? That's a HUGE thing. (I'm guessing she quit 5 years ago when she was pregnant, but I didn't ask.) And how much time to we have to wait for all of these things to align?

Also, how will she feel giving the baby to us and seeing the baby all the time? One commenter on my carrier's perspective story made me feel better about that, but is that the norm? So many questions. We are meeting with her and her husband this weekend to discuss everything.

We also had a super close friend (2 actually) offer to be an egg donor for us. (Yes - we are surrounded by truly phenomenal people.) Not sure if those offers are genuine either, and more importantly, thought out. Am I being too pessimistic? Am I letting MY personality traits (agree to things before really thinking about them) bleed into how I think others would react? I don't know. I just know I can't take much more of the roller coaster. Sadly, it's a roller coaster no matter which way we choose. Isn't it?

Failed again

The Beta hcg levels went down to 15: chemical pregnancy, ie. failed cycle.

I knew before I even read the email. I knew when my phone went off at 2:55am to let me know that my BFF's baby made its debut. I knew yesterday when I made my limbo post yesterday, I just didn't want to believe it.

This is the part where I feel like a failure.

My husband and I hugged each other for a long time this morning, but then barely spoke after he got out of bed. As hard as this is for me, I think it's harder for him. I have a son - he does not. He has wanted children from the very beginning and I had to disclose the problems we would encounter (my cryoablation) when we had only been dating 3 weeks. His only question then was if I still produced eggs...

He can't console me and I'm not sure how to console him. A selfish part inside wants me to yell out "you can still have a biological kid - it's ME that's the problem". I wonder if his family, or even he, thinks that marrying me was a bad idea. An illogical part of me whispers that he will leave. What do I bring to the table?

I feel broken.

I can't even do the basic function of a woman.

I haven't cried and just walk around pretending everything is fine. My mom says she is devastated and wondered if this is just what clinics do to get more money out of you. I have to be the strong one and explain the plain fact that clinics in India get more money on successes than failures. Not to mention attract more clients.

Last week I signed up for a seminar tonight at my clinic here in Atlanta. It's a seminar to discuss infertility options, get a free AMH blood test, and get free one-on-one with one off the doctors. I'm curious about my AMH since the one test in India came back so low, thus I will go. Talking with a doctor will help too. I'll probably avoid sitting next to the peppy people. Shouldn't be hard. I've noticed that everyone avoids people with recent failed cycles. I guess it's like the pregnant girl in high school - they don't want to "catch" it. 

Still in Limbo

We were suppose to get the update today. We didn't. Which is not surprising, because sometimes that's just how it is. 72 hours will give a better picture of where we are at anyway.

Woke up a 4:38am and started checking email. Realized around 11am it wasn't going to come. Hopefully I will wake at a normal time tomorrow morning.

Rather than write out a long post (and rather than reread what I wrote yesterday), I will just recap what I sent to my mom this morning.

yea, I know she is looking for the hcg value to double every 48-72 hours, so she may have not been able to do the test today, knowing that tomorrow is just as good (if not better.)

Just as an FYI,

At 14 days

any value over 25 is considered pregnant. 

any value under 5 is not preg

5-25 is indeterminate

Ours was 27.44

The average for 14 days is around 100. The value doubles every 48-72 hours (for many many weeks.) If you do not see the value doubling, then it is cause for concern that the growth may have stopped. This can be from ectopic pregnancy or that the embryo has just stopped growing and the body will usually miscarry it naturally. Happens all the time and of course at my age the chances of miscarriage is higher.

So I guess we are waiting to see if it is still growing properly. From what I understand, a low value could have been caused by the embryo implanting itself a little late, or it could be the embryo that fertilized late (1 out of the 3 did.) .  Healthy babies have been born with initial low hcg values, but it significantly lowers our chances. A statistic I saw said that <35% will be successful when the value is between 25-50 at the 16 day mark. Low hcg has no bearing on the baby's health after it is born.  If it is growing slowly, then there could still be chance and they will just monitor every 2-3 days until the 5-6 week mark when an ultrasound would show if there is a gestational sack and if it is empty. At least this is how it is done in the US. I haven't asked her yet. 

Literally in limbo and I guess it could go either way.

Here we are again - 2ww

Formula for moment of inertia
from: http://www.wikipremed.com/image.php?img=010105_68zzzz111100_12002_68.jpg&image_id=111100

I have about 100 things to write about, but right now I'm stuck with inertia over our pending results for our 2ww. My husband is out of town until Saturday night, and as much as I would like to say if the email comes tomorrow than we will wait to read it together, it's not gonna happen. If the email comes, I'll read it. This last week I've felt like a pressure cooker with every emotion beginning to boil up.

For some reason I thought it was coming on the 6th, but my husband thought it was the 7th or 8th. He remembered that the clinic is normally closed on Sundays, so if we don't get an email tomorrow then it will probably be Monday. In fact, if it isn't in by the morning, then we probably won't get it till Monday morning because of the 9 hour difference: surrogate tests should be done by my late morning time.

Truthfully, if it's bad news, it's probably best that my husband and I don't read it together. Like many men, he doesn't do well with tears and I know that this entire process is probably harder on him then it is me. At least mentally. Never-the-less, if it is bad news then I will surely cry and the last thing I need to add to his woes is my tears. Last time we went through a cycle it was super hard for him with every up and down and when we got the bad news, we could barely speak. I had prepared myself better for the bad news, but not enough that I could console him.

Last time I didn't even tell my siblings and close friends when we got the bad news. I just didn't want to talk about it. My husband called his family and I emailed my mom. She was pretty sad, so I stayed strong. A month or two later everyone else eventually came around and said "I guess it wasn't good news." By then I was already in  mode for my new cycle and had completely forgotten I didn't update anyone. This time we've told more people and gave promises of an update when we find out.

The update is hard enough, but it's the feedback that will really get me. I just don't want to have to have one-on-one conversations with each person on how they are sorry it didn't work out. Look at me. I'm already thinking the worse. I can't help it. Need to think positive thoughts. I left India on a super-positive note and I need to keep it going.

Sigh. Easier said than done. I have so many things I need to work on, but can't seem to do any of them. 2 ww. Bring it.