MicroblogMondays: Trust During Delays

Microblog_Mondays

Last week was a tough week.  Actually, this season has been a very difficult season.  After our last failed transfer, Dr. E suggested adding Lup.ron to the mix for our next transfer.  It may or may not help, but the theory is that it may help change the uterine environment for implantation.  My jaw completely dropped when the pharmacy staff told me that this drug now costs $500, which is $300 more than I last paid for it less than a year ago.  On top of that, Annie would have to have an extra scan prior to starting the injection.  I was super stressed out about the extra cost.  My husband is wonderful.  He told me that this was not worth fretting over.  If there was even a slight chance that Lup.ron may help, then just do it without thinking too much about it.  Annie had a beautiful scan prior to Lup.ron.  Quiet ovaries and uterus.  I thought that we were on track for our next transfer scheduled for December 19th.  A few days after her last scan, Annie stopped her birth control pills and went in for a baseline ultrasound before she started Es.trace to build the lining.  At that ultrasound, it was discovered that she had a cyst.  I just couldn’t believe it.  My mind was all set for the December transfer.  In fact, Bob and I were both going to take the last two weeks of December off and hang out with Annie and Kenneth around transfer time during the first week of our vacation.  So now with the cyst comes delays.  This is the story of our fertility journey.  In the last five years, there has been more delays than we can count.  So instead of transferring our two embryos on December 19th and having our first beta before the end of the year, we’ll have to wait until January 9th.  Annie has gone back to birth control pills for about ten days before she checks on her estrogen level to see if the cyst is gone.  If so, we’ll be on track for the January transfer.  If not, then we will have even more delays.

Maybe this delay doesn’t seem like much to you.  It’s a matter of just weeks.  But somehow it made me super depressed last week.  We started our journey for our baby in January 2012.  December marks the end of the 5th year.  I was so hoping to wrap up the year with the good news that we will finally have our bab(ies) in 2017.  Instead of that, our future will still be unknown on December 31, 2016.

Last Wednesday I woke up feeling down.  You know, I usually pray for peace.  But that morning I didn’t have peace.  I didn’t understand why the sudden blues.  Later on, I realized the potential reason for my emotional state.  Last Wednesday was November 30.  It was supposed to be our heartbeat ultrasound for Mira, our lost embryo, if the implantation was strong and the pregnancy had continued until 7 weeks.  Instead of complaining about the cold weather in Annie’s home state on that day, I was very cozy in my San Francisco office staring at some ultrasound photos on Fac.ebook posted by another lady whose gestational carrier transferred two embryos a few days after our transfer.  This lady is now expecting twins.  Similar stories.  Different outcomes.  No wonder I was down as my subconscious mind remembered the ultrasound we didn’t get to attend.

This delay of our transfer til January has also made it difficult for me to deal with pregnant ladies and pregnancy announcements.  My original pregnant coworker is pregnant again.  Her son is now 16 months old.  Number two is going to arrive in three months.  She continues to be one of those expectant moms that loves to talk about her pregnancy all the time on top of talking about her kiddo.  Her bump has not bothered me much until last Wednesday.   Last week, several friends of mine announced their pregnancies with number two.  They all struggled with conceiving their first.  So of course it is good news that they didn’t struggle with number two.  However, I couldn’t help but feel down about their second pregnancies while we struggle to even have one.

God is good though.  Although I struggled, He spoke to me through my daily devotion.  Bible study for the last two weeks was on John chapters 7 and 8.  Both chapters talk repeatedly about God’s perfect timing.  The Jewish leaders wanted to seize Jesus but couldn’t because it was not yet the time ordained by God.  As I read and studied those chapters, God was telling me gently that my time has not yet come as His timing is perfect.  He is teaching me and Bob to trust Him completely.  We are to continue to wait expectantly and patiently.  It is a difficult lesson to learn and it takes time to digest.  But at the very least, I have processed my disappointment, am surrendering my control, and continue to try to live in God’s presence.

I am super grateful for Annie and Kenneth though.  They are true angels who are selfless and have our best interest at heart.  When I mentioned that we started our journey in January 2012, Annie encouraged me by saying, “Started in January and end in January 🙂 “.  My husband is very encouraging as well.  When I feel apprehensive about the next transfer, Bob told me to view our next transfer as a necessary next step for us to reach our bab(ies) regardless of the outcome.  So let’s not look at it as an end if it doesn’t turn out the way we want.  He said that in God’s timing, we will find a way to become parents.

May we find a way to completely trust in that.

The Other Shoe Actually Dropped

This is going to be an extremely difficult blog post to write.

My husband is often skeptical when things are going well on our fertility journey.  He often feels that he needs to save up every penny to add to our fertility fund because he is always waiting for the other shoe to drop.  I am often the overly optimistic one who thinks that everything is going to be fine.  On Sunday he told me that he was waiting for the other shoe to drop when we sat down to discuss our finances.

The next day, the other shoe actually dropped.

It is still hard to believe that I am writing this post.

Our donor Serena has been doing extremely well in her stimulation phase of this process.  You know how I had that fear that she wasn’t doing her stims right?  Well, that fear isn’t warranted because she’s growing some crazy follicles.  She returned on Monday (two days ago) for her second follicle check.  I was anticipating an email from Dr. E for an update.  Instead, I received a phone call from her.

We all know that a phone call from your doctor is not a good sign.  Sometimes it’s very bad.  This was one of those very bad ones.

She asked where I was, what I was doing, and if I could find a place to sit down and talk.  I panicked hearing her questions.  So I found a private place.  She went on to tell me the following.

This is a donor that she has worked with twice.  Once in January and once in April this year.  She is really familiar with her.  But Dr. E sometimes throws in a drug screen during donor cycles randomly just for the heck of it.  No rhyme or reason.  So on my donor’s baseline appointment on August 22, Dr. E also ordered a drug screen.  The results didn’t come back until Sunday August 28th.  Dr. E usually doesn’t check lab results on the weekend.  However, she was checking on someone else’s so she thought might as well check on Serena’s.  The results shocked her.  Serena’s test came back positive for cocaine.

Dr. E immediately called Serena on Sunday night and confronted her.  Serena denied using any cocaine.  When Dr. E saw her on Monday August 29 for her third follicle check, she told Serena to tell her the truth.  And Serena still said that she didn’t.  After her scan, Dr. E had to leave to do another procedure, but her physician’s assistant sat Serena down and asked her again.  It was then that she kind of made up a story and said that it could have been from a party that she went to and it could have been second-hand smoke from a cocaine pipe.  Afterwards, Dr. E consulted with a toxicologist at Lab.corp who said that it is nearly impossible to have that level of cocaine in one’s system if it was not ingested or snorted.  So basically she was lying and did not own up to her mistake.

When I heard the news, I was immediately devastated.  Everything had been going so well.  Why do bad things always happen to us?  Has our journey not been crazy and difficult enough?  I thought that because of the positive drug test, we couldn’t use her eggs anymore.  The thought of starting all over yet again and possibly losing our gestational carrier due to a longer wait was paralyzing.  But Dr. E actually said that she doubts that the eggs will be affected.  She thinks that our donor will still make beautiful eggs that will turn into beautiful embryos.  But to her, it is more about the character of the person.  She asked me to talk with Bob and think and pray long and hard about whether or not we wanted to proceed knowing that this person breach our trust and the contract.

Honestly, I was relieved to know that the eggs are still going to be good to use.  But what does one do in this situation?  Do we cancel the cycle and start all over again losing A TON OF MONEY that we had already paid out (agency fees, monitoring fees, legal fees, insurance, medication), or do we move forward knowing this piece of information.  I told Dr. E to call Bob and explain to him what she found out and let him ask questions.

I was standing there not believing what I had heard.  Dr. E said that this had never happened before in her years of practice, that a known donor that she has worked with multiple times would fail a random drug test.  What are the odds?  And here we are, encountering this problem that truly dampens the joy and the excitement at this stage of the game.

Bob spoke with Dr. E for 20 minutes.  After understanding about Dr. E’s take on nature vs. nurture and drug use and drug addiction and moral values, he told me to speak with our attorney (the one who did the donor contract for us) and the agency owner.  I so appreciate him that he was calm.  His calmness helped calm me down as well.  That Monday afternoon Dr. E called me at 1:15 or so.  I was scheduled to see clients at 2, 3, and 4pm.  Since this was an urgent matter (as we had to decide if we would move forward or cancel), I saw my 2pm client, but switched the other two to another day.  My mind was going to all sorts of places during my 2pm appointment and it was so difficult to concentrate.  But I pulled through.  Following that, I called the attorney and the agency owner but couldn’t get a hold of either one of them.  The attorney returned my email.  He basically said that if we had professionals (our RE and the toxicologist) to back the claim of cocaine use, it is a breach of contract.  However, it is often difficult to seek damage from donors who don’t have much financially.  Basically, the so-called contract is a guide and you hope that people with good nature would voluntarily follow through with it.  Unfortunately this is not the case.  We could take her to court.  But do we have the time and energy and the money to do so?

Since I couldn’t get a hold of the agency owner, I decided to leave work and go to the one person that I always turn to when we are faced with tough decisions.  My sister-in-law was once again there to be my sounding board.  Luckily I found her and met her at her house.  We discussed about it and both of us felt that we could still move forward with this donor knowing that Dr. E said that the risks of using her eggs are very minimal at this point.  She prayed for us and promised that she’d continue to pray.  She said that if the Holy Spirit speaks to her in a different way, she’ll let me know.

That evening was very difficult emotionally for me.  There were so many questions that we had to ask ourselves and answer.  Didn’t we have peace when we prayed about this donor and decided to book her?  How could a person be so arrogant and selfish to do this after committing to be drug free during this time?  Are the eggs really going to be fine?  Is my future child going to have a predisposition of addiction?  Is she a habitual user or is it recreational and occasional?  If we decide to move forward with her eggs, will they still be affected by her cocaine use?  Has she been using for a long time?  Am I knowingly putting my future child in danger?  If we don’t proceed with her, how much money are we going to lose?  How much more money do we have to shell out for a new donor?  How are we going to locate a new Asian donor and have a cycle soon so we don’t lose our gestational carrier?

So many questions that we struggled to answer.

But God is good.  I prayed and I prayed and I prayed for peace, wisdom, and discernment.  Although our donor’s cocaine use really disappoints me, I have been leaning towards moving forward.  Sometimes I had the urge the just start all over and cancel her and lose that money.  But most of the time I feel that we should move forward.  Bob has been strongly leaning this way from the get-go.  Once he learned from Dr. E that it is highly unlikely that the egg quality is going to be affected, he doesn’t want to wait any longer and just wants to get this over with.  But at the same time, he is okay with the decision to cancel the cycle if I felt really strongly about it.

I just could not believe that we had to make this decision two days before the trigger shot.

But, my gut tells me that we should proceed and everything will be fine.

I had a terrible night of sleep on Monday night.  I truly could not go to work on Tuesday as I needed that time to process this news and think.  I continuously prayed for peace.  Throughout the day, I spoke with many people whom I trust.  It’s very interesting that 90% of the people that I spoke with said that they’d feel comfortable moving forward knowing that the eggs are probably going to be fine if not still excellent.  Some of my believer friends also felt that way.  My dear friend Elisha spoke a word of encouragement to me.  Basically, this is Satan’s way of distracting us from Jesus.  Jesus is here with us in this storm so look to Him and Him alone.  And if God gave us the peace when we chose this donor and we have peace now, then we should go for it.  My therapist is so wonderful.  I sent her an email asking her to speak to me on the phone for this emergency.  She called me the same day.  She basically said that if my gut tells me to go for it, even if it’s not 100% of the time, trust my gut.  I told her that I was worried that this one piece of information would damage the narrative that we’d build around our future child(ren).  She thinks that we have all the right to build this story with positive things rather than negative.  This piece of information about our donor using hard drugs is one piece of the puzzle.  It does not define our child.  We are the ones who would raise our child the way we want to.  She thinks that once we decide to move forward, we have to work towards an acceptance of this piece of information and continue to find the positive of this story.  She thinks that drug use in the egg donor population is probably quite prevalent.  We just usually don’t know that piece of information.  Now we know it in our situation, what we are going to do with it is the most important.

Yesterday I also spoke with the agency owner who apologized about this situation.  But there aren’t too many options for us.  We either cancel or we move forward.  It’s hard to recover the monetary damage.  If we go to court, the judge would say that the donor has the right to do whatever she wanted to to her body, and she has the right to terminate the contract at anytime.  Agency owner has known this donor and her sister for quite a few years.  She said that it is quite out of the character for the donor to do such a thing.  She also said that she had spoken to the donor prior to our phone call and the donor was still motivated to complete the donation.

Dr. E actually ran a repeat drug screen on Serena on Monday.  She put it down as STAT but was told that she probably wouldn’t get the results back until Friday.  When I spoke with her on the phone yesterday and told her that we were leaning towards continuing, she was very conflicted.  We are like family to her.  And she hates people who lie.  To her, the cocaine is not the problem because she doesn’t believe that the eggs or our future child would be in danger.  Her biggest problem about this is that the donor shows no remorse.  Serena lied about this over and over again.  Dr. E said that her urine sample on Monday came back very low in concentration, which means that Serena probably intoxicated herself with water from the time she got Dr. E’s call on Sunday to her appointment on Monday.  She basically was trying to dilute her urine so that maybe whatever drug in her system would not show.  She wanted to cover up whatever that might be remaining in her system.  Dr. E is sorely disappointed with this person.  She just wanted Serena to admit that she was wrong.  But I told Dr. E, that this journey has been so long and hard for us, and we are so so close to getting embryos, that Bob is willing to gamble and take the risk of having the genes of this person knowing that we will raise our child differently.  Dr. E said that even if the repeat drug screen comes back negative, she does not trust this person anymore.  But her eggs will still be good.  She supports us 100% if we decide to move forward with the cycle.  We had the whole discussion about nature vs. nurture, susceptibility to addiction and what not.  What a heavy duty discussion to have especially when I have never even smoked a cigarette in my life (I know I am an extreme).  It is so hard to fathom doing drugs.  It is also hard to fathom someone who wouldn’t admit their mistake even after being caught.

First our previous donor disappeared. Now this donor breached the contract.  This is why it is very difficult for me to trust young people who are in their 20s.  This is why I’ll never work with a gestational carrier under 30.

My sleep was better last night but still interrupted.  I woke up in the middle of the night with a headache and feeling bugged that this has happened, but at the same time I felt like we were very close to making a firm decision to move forward.  When we woke up at 3, Bob said that we should speak with Annie, our gestational carrier, about this new development and see if she would still be okay with carrying for us.   I had an extremely full day today.  I had to go into work early to see one client, then I had an hour-long presentation in Chinatown to parents of young children.  I had a full afternoon of appointments at work.  I only had time to speak with her at 7:30 when I started driving to work.  I am just so grateful for Annie.  She is such an amazing person.  She picked up the phone, listened to me, and reassured me that she would have no problem carrying for us, and that she’ll provide the best environment possible for our baby to grow in.  We spoke some more and she prayed for us as well as the donor before we hung up.  I am just so full of gratitude that our gestational carrier shares our beliefs and we could speak so openly and honestly about our struggles.

In the morning, Bob and I both felt good to move forward knowing that we’d love our child in the future no matter how the story of his/her creation began.  We love our friend’s adopted son regardless of his birth mother’s alcoholic history.  We know that we will love our child unconditionally.  And since we repeatedly got the confirmation from Dr. E that the egg quality will most likely not be affected (well of course she won’t be able to say 100%), we feel safe to proceed to retrieval.  My presentation went amazingly well.  I sometimes surprise myself that I could turn my personal life off and be very professional without a problem.  Dr. E updated me on the donor.  Her second drug screen came back negative as expected.  I don’t know if she really didn’t have any cocaine in her system on that day or the diluted urine yielded negative results.  But that’s beyond the point now.  Most importantly, we decide to continue with the cycle and her scan today yielded excellent results:

RO: 11.5, 14.5, 10, 20.5, 16, 16, 15.5, 12.5, 11, 17.5, 14.5,  remaining <8

LO: 14.5, 14, 17, 14.5, 18, 15.5, 17, 16.5, 14.5, 23, 13, 10

Of course another fear of mine is that Bob’s sperm won’t perform.  Dr. E reassured me that PICSI is going to help find the best sperm.  We are scheduled to show up at 8am on Friday for the semen collection at the clinic.  We are very close to the finish line of making some embryos.  This afternoon was the first time in a couple of days that I started to feel excited about the prospect of owning embryos again and the hope of having our baby in the very near future.  It IS an exciting time.  I hope that we are still full of hope and joy on Friday when we drive to the clinic.

Isn’t this a crazy twist?  It’s more complicated and surprising than fiction.  I am sure that if I ever wrote a memoir of my journey, nobody is going to believe me.

We don’t know why we are being put in this trial.  And we may never understand why.  But after two agonizing days, I have a new appreciation of us as a couple, how we handle ourselves in an extremely difficult situation, and the loving friends and family that we have.  We are surrounded by love.  I am very sure that no matter who contributed to half of my future child’s genes, our child will be positively influenced by the numerous people that are going to love him/her.  And dependence on God and the guidance of the Holy Spirit is the lesson I have learned here.  This was an extremely difficult decision to make.  One of the most if not THE most difficult decision we ever had to make.  I hope nobody who reads this will have to make this decision in the future.  And I hope that there aren’t any more shoes to be dropped.  However, even if there is more, I am quite sure that we will be able to pull through one way or the other, because we have God and each other.

More Curveballs Thrown Our Way

My slight panic started on Wednesday when I read that the new guideline from FDA for donation of any human tissues is that the donor can’t have traveled to an infected area of Zika virus within the past six months of the donation or can’t have had a sexual partner that traveled to those areas.  I immediately wrote the donor agency owner about our donor to ask if she had traveled to these areas in the last few months.  She confirmed that the donor hadn’t.  I am still thinking that we should include a clause in the agreement in the future for the donor not to travel to those areas.  I am just thinking ahead and don’t want this to be the reason our cycle could be delayed.  This Zika virus epidemic is adding a new layer of worries to egg donation.

Thursday.  My lining check day for the Endometrial Receptivity Array (ERA) biopsies that had been scheduled for next Tuesday and Thursday.  I had just gone to the bathroom and emptied out my bladder.  My trusted nurse practitioner came in and got right to business.  She knows me and she knows my uterus.  So it should have been like the usual scans that usually take about 5 minutes to finish.  This time was totally different.  The NP probably spent about 25 minutes, first vaginally, then abdominally, and finally vaginally again.  The fibroid that is in the back wall of my uterus (and not in the cavity) just really blocked the view this time for her to even visualize my lining clearly.  The fibroid measured over 7cm.  My immediate thought was that it had grown much bigger than I remembered.  The abdominal ultrasound is usually a better method to check my lining but I had emptied out my bladder so the contrast wasn’t great.  I think she did find the lining but it wasn’t very clear.  She just wanted to make sure that she measured it correctly so she used the vaginal method again.  It was just a bit disconcerting to see such an experienced sonographer having such a hard time finding a lining on a uterus that she has seen several dozen of times.  She looked at every angle and every depth.  Every time she measured, it was at least 7mm vaginally and 9mm abdominally.  But she just wanted to make sure.  I lay there quietly and patiently.  The scan took so long that she had to ask someone else to perform an IUI that she was scheduled for.

The NP reviewed my images on the computer and told me that she’d recommend checking my estrogen with a blood test to confirm that I did indeed absorb the estrogen.  I told her that this time it did feel differently as I hadn’t experienced a lot of cervical fluid so I was thinking that my lining might not have grown much.  Anyhow, I was told to meet with a nurse later to go over progesterone instruction in order to get ready for the biopsies next week.  She checked my previous measurement for the fibroid.  It was about 5mm back in 2014.

In the phlebotomy room when a medical assistant was about to do the blood draw, the NP and Dr. No Nonsense showed up.  Dr. NN explained to me that the fibroid has grown to a point where it is now interfering the ultrasound scan.  He said that whenever a fibroid grows over to 7cm, it’s hard to know its effect on getting pregnant and implantation.  Since we already failed two DE transfers, it might be good for us to consider removing it.  Since our donor is not going to be ready to cycle until end of May, beginning of June, and retrieval probably won’t be until July or August, it might be good to take care of this right now.  In terms of the biopsies next week, he said that we could still do it.  I asked if the results would be valid if my uterus is going to be different because of the fibroid removal.  He said that if the surgery doesn’t penetrate to the lining, then it shouldn’t make a difference.  But if it does, then we may have to do the ERA again in the future.  I made a quick calculation in my head.  If I cancel the biopsies, I’d only lose the medication money (which was a few hundred dollars).  If I keep the biopsies and the results turned out to not be valid because of the surgery, then I’d have wasted a lot more money.  So I told him that I’d rather cancel the biopsies.  The discovery time for fibroid surgery is 3 months.  We discussed a freeze-all vs. fresh DE cycle.  He said that the results don’t make a huge difference, but we could sync up the donor for a fresh cycle, we would do it.

The first thing I did when I walked out of the clinic was to contact Bob.  I stood next to my car and chatted with him on the phone for 15 minutes.  I was surprised that both of us could keep our calm.  However, we were both very discouraged.  It just seems to be never ending.  When we move forward one step, we seem to be pushed back a couple of steps.  How many curveballs does it take for us to make a baby?  Is this God’s way of telling us that we should not even try to have a baby this way?

I know we shouldn’t jump to conclusion.  God has His plans.  But truthfully, as much as I try to keep my faith, these circumstances throw me down time and time again.

But we are doers.  We process our feelings and we move on.  I let Bob vent as much as he wanted to.  He needed it.  I know as a provider of the family, his mind already went to how much more money we’d have to save up to realize our dream.  On the phone, we discussed a few possibilities and the next steps.  Definitely contact the Kai.ser surgeon who did my hysteroscopy and saline sonogram.  She is the expert at Kai.ser who does all the abdominal myomectomy.  Bob suggested getting a second opinion from another RE to see if a surgery is absolutely necessary before we could try for a baby again.  So he possibly wanted me to contact Dr. E.  He even suggested transferring the donated embryos and see if we would get pregnant.  Basically we were just throwing ideas out there trying to gain some control of the situation.

That afternoon, I wrote my Kai.ser surgeon asking about the surgery.  I had my open surgery end of 2011 to remove many tiny fibroids and don’t want to go through with such a big surgery again.  I had to stay in the hospital for one night and took 6 weeks off from work.  My Kai.ser surgeon wrote me back.  She said that the myomectomy can be done laparoscopically.  It is an outpatient surgery with much faster recovery times and disability compared to open surgery.  She set up a surgical consultation with me for April 20th.  She said that I should consider this: it takes one to two months to book a surgery, and three months of recovery time to heal before a pregnancy.  She was so nice. She told me to email her again if I had any other questions or concerns I wanted to discuss prior to the consultation appointment.

This is her title:

Director of Minimally Invasive Gynecologic Surgery
Advanced Laparoscopy and Robotic Surgery

So I am not worried about her skills.  I have 100% confidence in this doctor.  I am more thinking about that this will be my second surgery and the implication it has on my ability to get pregnant.  I don’t want to weaken my uterine wall and I don’t want a uterine rupture when I eventually get pregnant.

Bob called me at work again.  After walking around and calming himself down, he was feeling good and hopeful again.  He called to cheer me up and to let me know that we would get this done.  We always do.  I really appreciated the phone call.  I was feeling a bit sorry for myself and had a hard time making myself emotionally available for the clients that I would see that afternoon.  He told me to go ahead and contact Dr. E’s staff to schedule a consultation for a second opinion.

I confirmed with Dr. E’s finance person that the consultation and ultrasound with her don’t cost too much.  I am still trying to schedule an appointment with her next week since I had already blocked my schedule for the biopsies that will no longer take place.

After work, I stopped by my Dear Colleague’s house and told her the whole thing in person.  I just needed to talk it all out.  I thought I was going to cry, but I didn’t.  After that, I updated my various friends online on what happened.  One silver lining of this whole ordeal is that my support system is phenomenal.  My friends are available any time I want.  I feel tremendously blessed in this department.

And my husband is phenomenal as well.  He came home smiling and wanting to cheer me up.  We had a decent evening despite having discouraging news.  As we both took today off, we have this weekend to talk about what makes sense as our next steps.  We have some important questions to ask ourselves.  What do all these roadblocks mean in our whole journey?  What is our timeline now?  Do we even look at our timeline?  Are we going to continue pursuing egg donation or will embryo donation be our path?  Do we have to save up more money?  If we decide to go with embryo donation, are we okay with losing the thousands of dollars in agency fee?  I am sure we’ll have a lot to discuss this weekend.

If we get a surgery booked in May or June, we would need three months to recover.  So I hope that the donor is okay with postponing the retrieval to September so we can have a fresh transfer.  I know I can plan all I want, but it’s really not up to us for the timing of things.  There are so many variables.   I probably won’t be a mom until I am close to 43, and I am not even 42 yet.  But you know what?  We’ll push on.  It is disappointing to be delayed but it doesn’t mean it’s impossible.  I just hope that the surgery will help us clarify what is the best for our next steps.

I don’t know how many curveballs are coming our way still.  But we’ll do what we need to do to achieve our dreams.  Other than pushing forward, I don’t think there is another way to handle the situation.

God is good.  I have been praying for peace and strength and I have been experiencing both.  I hope I don’t lose sight on my source of peace and strength during difficult times.

Another Disappointment

My OB wrote me and told me the news that beta came back at 10.  I think it’s a chemical.  My OB still thinks that I should repeat beta on Wednesday.  I wrote my nurse at U.CSF and am waiting for her to write me back.

I am doing okay.  Probably just numb.  I am sure I am going to cry some time tonight.

Although I sort of expected it not to work, it’s still heartbreaking that this is not our time.

My mind has already moved onto the next transfer.

I don’t know what else to say now.  Thanks for all the love.

Lucy Joins the Family

I hope everyone had a great Thanksgiving yesterday.

Waiting for phone calls from your fertility clinic is very hard.  Unfortunately, so many of us know how that feels.

Before our phone call yesterday, I was mostly calm.  In my mind, I was thinking for sure that we’d have one or two, or even three day six blastocysts to freeze given the number of early blastocysts the day before.  Well, that was my human way of thinking.  We waited all morning.  We continued our Thanksgiving tradition of going to a South American breakfast place for Bob’s chilaquiles and for my beef soup.  I kept my phone in sight throughout that time including during our wait at a very noisy coffee place for my hot chocolate and Bob’s coffee.  With my hands full, I still tucked my phone in the purse where it was easily accessible.  The phone call came when we just pulled into the driveway.

A very nice nurse told us that we had one embryo that had grown to day six and had become a blastocyst with a grade of 4BB.  Four means it was almost hatching.  She said the other two Bs are good grades.  So this is it.  Our expectation/wishful thinking/hope that we would have two, or three, or even four more embryos was crushed.  I didn’t ask more questions. I didn’t ask which embryo on day three this blastocyst came from.  It didn’t matter anymore.  I felt that the less I know the better.  The nurse asked if I had made an appointment with my RE to go over the next steps.  I told her that we had transferred an early blastocyst the day before.  She said, “Oh that’s excellent!  Early blastocysts are great!”  I appreciated her enthusiasm.

You know me.  I always try to be honest when I am here writing about my thoughts and feelings.  I was disappointed.  With ten eggs, the statistics from our donor’s past cycles told me that we would have about three to four, if not five embryos at the end of this process, especially with 100% fertilization.  I really did not expect to have a total of two embryos in the end.  But I did not fight my disappointment.  My friend L told me that the more I fight it, the more the disappointment will grow.  So I was acknowledging my disappointment and had to process my feelings for the rest of the afternoon.

About 30 minutes after we got the news, I became grateful.  I was very grateful that little Lucy (our 4BB blastocyst) decided to join us.  I know that I could end up with nothing to freeze.  The fact that we have Lucy is a great reason to be thankful for.  We did end up with two blastocysts.  In my human being eyes, this might not have been the most ideal outcome.  In God’s eyes, this is the right number.  I have all along been praying for a perfect number of embryos.  I didn’t know what that would be.  I secretly had been hoping for a number four.  But I know that God doesn’t work that way.  In my human mind, the more blastocysts we have, the more insurance we have.  But God has His own mysterious way of working.  I was reading Psalm 139 and particularly verse 13.  It says, “For you created my inmost being; you knit me together in my mother’s womb.”  God knitted us a long time ago.  He had planned and knitted my baby a long time ago.  Verse 16: “Your eyes saw my unformed body; all the days ordained for me were written in your book before one of them came to be.”

Who is to say that Kevin, the little embryo inside of me now, is not the one baby that God has planned for us a long time ago?  And who is to say that Lucy, the little frozen blastocyst, is not going to be the sibling for Kevin?  He saw my child’s unformed body and ordained all the days for him/her.  Like I said, God works in mysterious way that we don’t always understand.  Kevin could be that child.  Lucy could be that child.  I myself am trying really hard to wrap my mind around it.  Maybe this is God’s way of telling us that those two embryos are enough for you.  You don’t need more, and you don’t have to look further.  And if this works out, we don’t have to worry about donating our unused embryos.

I really don’t know which way it will go.  But I am trying really hard to trust.

I also have my weak moments.  Later in the afternoon, Bob was showing me a funny video of one of my favorite kiddos taking a flu shot.  She was so brave.  I had watched that video quite a few times already.  However, yesterday afternoon, something triggered in me.  Watching her being brave and smiling after the flu shot, I suddenly started crying.  All I was thinking that was I want one of those myself.  I want to document my child’s happy, sad, triumphant, and naughty moments.  I want to share in the joy of parenting, figuring things out ourselves, fail and be successful together as parents.  I don’t know why, but the fact that 1) Kevin was an early blastocyst who was probably only a little bit more advanced than the other early blastocysts in the bunch, and 2) the other early blastocysts except for Lucy did not make it make me deduce that maybe Kevin is not strong enough in my uterus either.  Maybe if Kevin was left there to be grown to day six, he wouldn’t grow either.  Maybe Kevin was not chromosomally normal.  Maybe maybe maybe.  See how my human mind works?  I try to embrace Kevin, but I sometimes feel that this may not work.  And then I worry that if Lucy doesn’t work either, then we’ll have to go back to choosing a donor again.  My mind is messed up.

Fortunately, my mind is not messed up all the time.  I talk to Kevin all the time.  I imagine the embryo finding a cozy spot in my uterus to land.  I imagine Kevin attaching to my uterus.  I imagine Kevin growing and growing and growing.  I imagine it to be strong.  I imagine it to become a little baby that would grow inside me.  I am really trying my best to trust that this embryo is going to become my baby.  I ask God to protect it, nourish it, and keep it nice and safe inside of me.

Bob is like me as well.  He also vacillates between being hopeful and feeling doomed.  Last night right before we went to my brother’s house for our thanksgiving dinner, Bob became utterly frustrated and angry with God that we didn’t have more embryos and that we had already spent so much money and ended up with less than stellar performance with frozen donor eggs.  It hurt him to see me be sad and cry in the afternoon.  And it took him four hours to process that and become angry.  But then, we also should not dismiss what Kevin can do here.  Kevin can still be alive and well and thriving.  Bob went to bed last night telling Kevin to stay put and grow.  This morning he woke up telling Kevin to be cozy and snuggle up inside mommy.

The two week wait is very tough.  I don’t feel anything physically.  I know that I am not supposed to feel anything physically.  Today is two days past.  We still have ten more days to go.  I know regardless of how I feel, these days will pass.  So I will continue to pray for God to sustain this life that is inside me, for it to attach, to grow, to be well nourished.

And welcome Lucy!  We love you and Kevin already.

Processing My Feelings After Our Donor Disappeared

So yeah.  This is what happened.  Our donor is nowhere to be found, still.

I just can’t believe that this is happening to us.  I mean, I know that there is a possibility of donors bailing.  But I never thought that it would happen to us.  Not somebody who had donated twice before and followed through with everything that she needed to do.  One moment things were going well and we were on our way to our donor egg cycle.  The next moment, we are back at square one.  This journey is so unpredictable with so many twists and turns.

At 8am this morning, the phone rang literally when I was turning the door knob to walk out of the house for work.  It was our donor agency director.  Her voice was almost shaking.  She said that she had some bad news to tell me.  I came back into the house and sat down.  She told me that Iris, our donor, called to cancel the appointment with our clinic last Thursday saying that she had to go to work.  To our donor agency director, it was not a good sign, because it takes a long time to schedule an appointment with the clinic so once it is scheduled, a responsible donor should stick with it.  Anyhow, I guess it would have been fine for Iris to cancel the appointment if she had rescheduled it for another day.  But she didn’t.  Donor agency director tried to contact her, leaving her email, phone call, a longer email, and another phone call.  Thursday, Friday, Saturday, Sunday, and today.  No response.  Donor agency director said that she was totally surprised by this turn of events because she thought that the meeting with Iris went really well.  Iris, who met with the director prior to our meeting, never expressed any doubts about egg donation.  She in fact indicated that she would like to donate again even before the last donation was completed.  The director said that donor backing out is not unheard of, but doing so after meeting with the recipient couple (us) is more rare.  And usually the donors who back out would contact the director and give an explanation or a reason.  It’s quite rare for someone to disappear without returning any phone calls or emails.

Donor agency director was feeling horrible that we are in this situation.  I took it as well as I could on the phone.  I told her that it was okay as I’d rather have the donor bail right now than later in the process, which would definitely cause more heartaches and cost more money.  The agency director was praising me for my mature response.  But really, what could one do?  Screaming and yelling would not change the outcome.  I just didn’t understand what had happened there.  Agency director told me NOT to think it was because of us that the donor bailed.  We just won’t know what happened and what went through Iris’ mind.  We are now out $450 for the genetic counseling.  If she had completed the medical screening then bailed, then we would be out another $800.  We talked about other donors on her database.  We saw a fully Chinese donor last week and asked about that one.  Of course she has already been matched.   Bob was there so I updated him, and I went on my way as calmly as possible to work.  Poor Bob.  Today was his first day at his new job, and he sat there being stunned for ten minutes before he could get himself up to get ready for work.

However, on my way to work, I grew angrier and angrier, and utterly disappointed.  Why can’t we catch a break?  There has been so many road blocks from the first day we started trying for a baby.  Now that we have decided on egg donation, the road still has not been smooth at all.  I teared up in the car but didn’t cry.  I just felt awful that this was happening.  I prayed and asked God to sustain me for the day so I could still fulfill my duties at work.

I walked into my office and saw my Dear Colleague.  I couldn’t hold my tears anymore.  I started crying while my Dear Colleague gave me a hug.  I was feeling a little better after crying a little.  Unfortunately, I had to get myself together for my 9am client.  And unfortunately, his very pregnant mom was also there this morning (usually grandma brings him in).  It was extra tough to have her in the session while I was trying so hard to pull myself back to a reasonable state.  I struggled through the whole session and did the best that I could.  I was supposed to work on a project the rest of the morning.  I could not focus and was just staring into space.  I just felt very upset, angry, and disappointed.

I realize that I am not mourning the loss of this particular donor per se.  I have always told myself not to fall in love with any particular donor.  I know we can always find another donor.  But it is about the loss of time, the sense of loss of control, the timeline being pushed back, the huge sense of uncertainty, and the seeming impossibility to get pregnant by the end of the year.  It was also a sense of unfairness that this is so easy for some people and so tough for many of us who struggle with this.  I am angry.

I try not to second guess ourselves and wonder if it was something that we said, or the fact that we made a decision to meet with her that drove her away.  If I had to make a choice again, I would still choose to meet with our donor if at all possible.  Bob had great intuition about this one.  After Iris talked about the future and how she was uncertain about how she would feel about egg donation, Bob asked me several times last week what Iris meant by that.  He wondered if she meant that she wouldn’t donate to us.  I dismissed his observation and told him not to be silly because I really didn’t feel that she was moving towards that direction.  But I guess I sometimes have to trust my husband’s intuition.  The only odd moment that I remember was how Iris rushed out of the house forgetting her purse and had to rush back to retrieve it.  In the back of my mind, I wonder what the rush was.  But that one moment didn’t clue me in on her decision to bail.  I just didn’t see it.  But when we choose our future donor, we will still like to meet with her.  I don’t think there is anything wrong with it and we will proceed with it if the new donor is willing.

All morning I was on the verge of tears.  But being at work prevented me from really crying.  I just didn’t feel well at all.  I inclined to cancel my afternoon clients and just go home.  However, I also felt bad for canceling them.  I struggled for another hour, and decided to take care of myself first.  I sent my sister-in-law a text when I left at lunch time.  I thought that it would be better for me to process my feeling crying in front of a person with sympathetic ears than all by myself.  Fortunately, she was available and urged me to go cry at her house.

I walked in her door.  Once I opened my mouth, I could not control my tears.  I just cried and cried and cried.  My wonderful sister-in-law, bless her heart, situated me on the couch and surrounded me with tissue, water, chips, nuts, and Toblerone! In her presence, I just cried my eyes out, wondering aloud about our journey, all the road blocks, the uncertainty about the next steps, and feeling unloved by God.  After crying for about an hour, my breathing was more smooth, my heart rate slowed down, and my emotions had calmed considerably.  Then I stared to feel hungry.  My wonderful SIL fed me lunch before I went back home.  She is amazing.  I am so glad that every time I needed someone to support me, she is there.

The rest of the afternoon I just sat on the couch and chatted with my wonderful friends online.  I just needed to sit and be by myself.  I also began to think about options.  Maybe we’ll start thinking about the frozen eggs that are available from the Chinese/Korean donor at our clinic?  Maybe it’s worth exploring?  There aren’t too many choices on the agency’s database as of now.  So as for fresh donors, we don’t have choices until someone else pops up on the database.  We have to continue to wait.  Unless we pursue egg donation with frozen eggs, I don’t think we will have a transfer by Thanksgiving, our original timeline.

Every time crisis strikes, I am thankful for Bob as my husband.  He came home after his first day of work at his new job and we chatted about things.  He was calm and reassuring.  I know that maybe this hasn’t sunk it yet for him, and he may feel angry later.  He did feel angry this morning, but like he said, life goes on.  We chatted a little about frozen eggs and agree that it’s worth exploring.  But no doubt we have lost a bit of confidence in this process and may be taunted in the future by the fear that this may happen again if we choose a donor for a fresh cycle.

What if Iris shows up again with a good explanation?  I really don’t know if I can put my trust in someone who could be flaky and disappear again without contacting anyone.  The confidence is gone.  We will see how this is going to unfold.

I am so fortunate that my work is flexible, so I was allowed to process my feeling at my own pace.  I am ready for work tomorrow, and whatever that we will have to face.  I am sure that I will still need more time to wrap my mind around this, but I still believe that everything will work out in the end, not according to my own timeline, but according to God’s.  I just hope that we continue to have the strength and perseverance to keep up our faith.

More Roadblocks – Unsuccessful Hysteroscopy

There has been so many roadblocks in our quest to pursue egg donation.  It has almost become comical.

Yesterday was actually a sunny day.  Since I had to fast four hours prior to surgery time, Bob took me out to breakfast early so I could be full before the time limit.  Usually there are plenty of metered parking spots in front of the clinic’s building.  However, on a baseball game day (since the new clinic is very close to AT&T Park), these metered parking spaces are easily all taken.  We fortunately pulled into the last available spot before a bunch of drivers drove by asking if we were leaving.  Once we arrived at the clinic, we paid up and I was taken to the back for a physical exam.  The nurse took my blood pressure, which was slightly high.  And she also checked my weight in a convoluted way: after seating me on the exam table, the nurse raised the table and pointed a hand-held device at me.  The weight was registered on the device.  That was a weird experience.  Why they couldn’t just have the old-fashioned scale is beyond me.  Anyhow, a doctor came in and explained the procedure to me.  Since I was still bleeding even after being on the birth control pill for two weeks, I was worried that the blood would obstruct the view of the uterus.  The doctor thought that a little bit of bleeding would be okay.  As she explained it, I knew that it was going to be a simple procedure with minimal invasion.  Basically, Dr. No Nonsense was going to put a scope in my uterus, check on the scar tissue, and use scissors to remove it.  Okay.  I got that.

After the physical exam, Bob and I were taken to the other wing of the clinic.  This new clinic is like a maze.  The procedure side of the clinic had this open view of the bay with a few barges parked there in the water.  That was Bob’s work place for the next 1.5 hours.  I was led to a recovery room to get ready.  This is actually where the clinic currently does all the retrievals and transfers.  It looks really nice, clean, and modern.  All the recovery rooms are separated and all with a view of the bay.  I changed into my gown.  Both nurses were super nice.  They administered two pills of Ativan and one Norco to me.  The petite nurse told me that she only works here one day a week.  While she was doing that, she commented on my nice juicy veins.  Well, I think because she was not used to the IV catheter provided by this clinic, she kept on maneuvering the catheter needle and could not get it to go through my vein.  I usually tolerate pain really well.  Her maneuver was making it very uncomfortable for me.  She apologized, took out the needle from my wrist area, and tried my arm.  Same thing.  No luck.  She mumbled something like it rarely happens to her.  I reassured her that it was okay.  The tall nurse, a regular nurse at this clinic, came to the rescue.  She tried my right wrist and got it in on the first try.  Thank goodness.  I think the Ativan and the Norco were really calming me down because I was just sitting there smiling.  The tall nurse suggested to bring Bob back to say good bye before I went in.  He came in smiling, saying that he bumped into Dr. NN in the waiting room and showed him the electronic medical device that he was working on for work.  Dr. NN was super interested in it because his wife is a physician with a discipline related to the body part for which the device is intended.  Bob and I chatted for a little and kissed before I was wheeled into the operating room.

In the OR, I was positioned on the table before Dr. NN showed up later.  As usual, I asked for extra blankets.  The nurses were so nice.  They kept telling me that the most important thing was my comfort level.  They would give me the minimum amount of Fentanyl to keep me comfortable.  I could ask for it any time my pain level would go higher than five.  They really took very good care of me.  When Dr. NN came in, the first thing he said was how enamored he was of Bob’s new toy out there.  So I said, Yes, Bob said that since Dr. NN was going to cut up his wife, it was only fair for Dr. NN’s wife to purchase a device from Bob.  Too funny.  🙂  For the next 20 minutes, Dr. NN was trying to get the computer to log off from someone else’s account so he could log onto his own account.  I lay there with my legs wide open waiting for him to do so.  Sometimes technology is very frustrating.

Finally, Dr. NN was ready to get started.  He exclaimed and said, You are not just spotting, you are really bleeding.  When he started to put in the speculum, I felt the pulling and the tugging.  The nurse was right next to me explaining what Dr. NN was doing.  She was gentle and reassuring.  I was lying there watching the screen while he was doing his thing.  I was watching and watching, and my heart sank a little.  I had seen a hysteroscopy done before at my OB/GYN’s office.  I knew what it should look like. Although no one was telling me what was going on, I could tell that things weren’t going well.  I saw on the screen what looked like the inside of me.  But I didn’t know what part of my body it was.  Was it still in the cervical area?  Was it already in my uterus?  It was hard to tell.  I could see narrow passages and some blood attached to the wall of some sort.  I could see what looked like torn cotton balls blown by wind.  After struggling for a while, Dr. NN mumbled something under his breath and took the scope out.  He told me that my cervix’s opening was too wide, so the water that was pumped inside me that was intended to be used to expand the uterus kept on leaking out from the cervix.  He had a plastic bag underneath the table that was filled with the water that was supposed to remain inside me.  Because the uterus could not be expanded, he could not get a good look at the cavity in order to find the scar tissue.  He said he wished that he could do this in the real operating room when I am put under, so that he could use a bigger scope and maneuver things around inside me without making it painful for me.

With me lying on the table with my legs wide open, I listened to him and was thinking, This can’t be happening.   I told him that I cannot get the other surgery done with general anesthesia at UCSF because of the cost ($18,000 out of pocket, which I can’t afford).  I paid for this current procedure out of pocket hoping that the scar tissue would be cleared.  In order to get the other surgery done, I would have to go back to Kaiser, using my own insurance.  Kaiser insurance does not cover for a procedure done at UCSF.  Dr. NN told me that he wanted to write an email and refer me to another reproductive endocrinologist at Kaiser.  I mentioned that I actually did have an appointment scheduled with the surgical team doctor at Kaiser for June 9th.  I intended to cancel the appointment but was too lazy to do so.  So I currently still have the appointment scheduled for next Tuesday.  He said that whoever is going to do my surgery at Kaiser could contact him via email so they could touch base and talk about what to do next.  Dr. NN looked at my face, and said, you are disappointed.  I said, of course I am.  I just want to get it done and be done with it.  So he said, Okay, let’s try to do this one more time.

Dr. NN pushed the scope through one more time.  Same scene on the screen.  Some blood spots, fleshy looking walls, and some torn cotton ball like material being blown by the wind.  And liquid that kept on leaking back out of my body.  He couldn’t expand the uterus.  He pulled everything out, and showed me the big plastic pouch full of bloody water that came out of my body.  I lay there, looking at him.  I was speechless.  What can I say?  We tried.  So I asked a few things.  I asked about the fees that we had already paid for.  Dr. NN said he would see what he could do about it.  Also, I was wondering what code would be used for the procedure at Kaiser.  If a fertility code rather than a medical code is used, then the procedure will not be covered.  He really didn’t know the answer to that.  It is left for me to figure it out with Kaiser.  Dr. NN finished up with me, then exited the OR to go talk to my husband.  Before he left, he said, “I know the procedure in the future will be simple so we will get you ready to have your babies.”  The nurses remained inside the OR with me and explained the whole thing all over again to me about what happened just now.  I really appreciate their kindness and thoroughness with me.  When I was ready, I got up and was wheeled back to the recovery room.

Bob came in with a big smile on his face.  I really appreciate him being calm.  Dr. NN had explained to him what happened.  Bob looked at me and asked if I was worried about the money.  He told me that it was just money, so don’t worry about it.  The good thing is, we can get it done, and we will.  It is just a minor setback.  Because of his calmness, I was calm as well.  I sat there sipping my ginger ale and eating my crackers.  After the nurses made sure that I was fine, they removed the IV catheter from my wrist so I could change and go home.

It was still sunny when we walked out of the clinic.  Sitting in the car, I started feeling a little nauseous.  It could have been from the meds that were given to me.  When we arrived home, I had to lie down because the discomfort in my stomach was becoming a bit too much to tolerate.  I fell asleep.  My mom, who came home later, applied herbal ointment on my chest to make me feel better.  She and my dad also bought us dinner so we didn’t have to worry about food.  It is very nice to be taken care of while my physical being was recovering from the experience during the day.

How about my emotional wellbeing?  Like I said, it has been one roadblock after another.  I never anticipated a problem with the saline sonogram.  And I never expected a failed hysteroscopy because it is really actually a very simple procedure.  I shouldn’t be surprised that things are not going the way we want because… really, things haven’t gone the way we want for quite a few years now.  There is always a surprise when we turn a corner.  What is important is our attitude towards these roadblocks.  Frankly, it still bugs me a little at this moment that the simple procedure could not be done successfully.  But I can’t help but think that there is a reason why this road is so bumpy.  We are doing everything we can.  But we are not in control.  I think we have really learned that nothing is in our control, or our doctors’ control.  I prayed and cried out to God to just take me down the path He wants and help me to have the strength and peace to go through with it.  And I feel fortunate that my laziness paid off as I still have an appointment with Kaiser really soon.

Some days are harder than others.  When times are tough, I am learning to be extra nice to myself.  Today I still took a day off as planned although the procedure was canceled.  I felt that some down time is good for my wellbeing.  I got up early and spent some cuddle time with Bob.  I went for a walk with my father.  Breathing in the fresh air in the park, bathing myself in the sunshine, and chatting about whatever with my own father, those two hours were well spent and good for my soul.  I need to learn to embrace the good moments, and this morning’s moments with my father were the perfect example of something simple and extraordinary.

Friends, I am trying.  I feel that I am going to stay in the pit for a little longer.  But it’s okay.  I am figuring out a way, with God’s help, to climb out of it.  Hopefully I will find the way out very soon.