MicroblogMondays: Complex Emotions

Microblog_Mondays

Ever since we started this surrogacy journey, I have experienced a whole gamut of emotions.

Of course there are the positive emotions, such as hopefulness, excitement, and gratitude that a person such as my gestational carrier has such compassion for us that she is willing to go through pregnancy for another person.  This is sometimes too profound of a concept for me to fathom and to grasp.

Every single stage of the journey also invokes fear, worry, and anxiety, such as our donor’s egg retrieval, fertilization rate, number of embryos remaining, potential weather issues, thawing of the embryos, the transfer itself, waiting for beta, and waiting for ultrasound.

And then there is this deeper emotion of joy that is much greater than the temporary feeling of happiness.  This joy that comes from witnessing the miracle of life that is growing inside of our gestational carrier and from the hope and the promising future of our children being born into this world and meeting us face-to-face.

What surprised me was the sense of loss that I felt during our epic first ultrasound while experiencing this tremendous joy of seeing the two heartbeats that were flickering on the screen.  I didn’t know that those two complex emotions could exist in the same moment, but they did, because I experienced them.

Seeing those two heartbeats was one of the most exhilarating and monumental moments in my life.  The tears that were shed were definitely tears of joy.  However, seeing Annie’s name on the screen and the ultrasound photos brought me back to the reality of what my body will likely not ever be able to accomplish.  It was supposed to be my name and my date of birth printed on the photos.  If I could have my way, it was also supposed to be my eggs, my uterus, and my pregnancy five years ago.  While being super excited and joyful and amazed, I was at the same time tremendously sad.

But I believe that God’s plan for us is perfect in every way and His ways are higher than our ways (Isaiah 55:8-9).  I believe that this is what needs to happen for us to have our babies.  And I fully embrace that.  But it does not mean that I will not continue to have a sense of loss that I have to grieve.  What I need to do is to continue to process my feelings with the help of my therapist.  And I did exactly that.

My visit to my therapist was highly emotionally charged.  It was just so exciting to be able to finally share good news with her after having to tell her heartbreaking news over and over again in the past two and a half years.  But at the same time, my biggest need was to process my grief and sadness with her.  I even cried when I was telling her that.  I knew that sadness and joy could exist simultaneously but it was reassuring for a professional to confirm it with me.  She told me that it is very common for intended mother to feel a sense of loss while expecting via a surrogate, especially when the surrogate starts to feel the baby or babies.  There is the loss of the sense of control because it is not my own body.  There is nothing wrong with these feelings.  It is just part of my reality.  I told her sometimes I don’t know how to feel.  And she said that it is okay to not know how to feel.  She said that as the pregnancy progresses, I may find myself feeling jealous, annoyed, or frustrated with Annie.  But at the same time, I would continue to feel grateful, joyful, and excited.  The key is to feel all that I need to feel and to tell myself that it is okay to do so.  She has heard enough from intended mothers about these feelings, but she kind of experienced it first hand when one of her best friends was expecting via surrogacy.  The second and third trimesters were kind of difficult for her friend.  And I am sure that it will be similar for me.  I don’t know if this sense of loss and the grief will ever completely go away but maybe it will diminish with the birth of the babies.

In terms of my fear that something bad may happen to the pregnancy, my therapist reminded me that I have lived in the unknown in the past few years.  Treat this the same way.  Embrace the unknown.  Whenever I find myself having these thoughts, ask myself if they are helpful.  If they are not, acknowledge them and then let go.  And if anything bad were to happen, I would be able to deal with it just like how I have been dealing with bad news in the past few years.

One interesting thing is that, ever since the news of us expecting twins, my attitude towards pregnant women has changed for the better.  It has been easier for me to chat with my pregnant coworker.  It has even been easier for me to accept pregnancy announcements.  It is quite eye-opening for myself to see the immediate change in my thoughts and feelings.  I know that the sting of infertility doesn’t totally go away, but it’s surprising for me to be able to feel more positive or at ease with other people’s pregnancy in such a short amount of time.

What I am trying to say is, our pregnancy is not always going to make us feel positive and excited.  There are also fear, worry, jealousy, sadness, and anxiety.  But having these feelings doesn’t mean that we are ungrateful about where we are now.  The reality is, we are human beings and have complicated emotions.  The key to maintain emotional health is to address these feelings rather than brushing them aside so that we are ready to welcome the babies in every way possible when the time comes.

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MicroblogMondays: Dealing With Worries And Sadness

Microblog_Mondays

I have been trying to digest and accept the news we received last Thursday.  Admittedly, I haven’t been doing a good job.

Since that day, I woke up every morning confused about where I was and when it was.  Once I realized that it was Friday, or Saturday, or Sunday, and that our quest for a baby is once again going to be delayed, sadness overcame me.  This sadness has been intermittent.  Sometimes I feel fine.  Sometimes my heart hurts.

This four-year journey has been so tough for us.  Even before we started to try for a baby, an abdominal myomectomy was necessary to remove over 50 tiny fibroids from my uterine wall.  They were not in the cavity but the sheer number and volume of them pushed on the uterus and altered its shape.  Recovery time for this open surgery was six weeks off work and three menstrual cycles before we were advised to start trying for a baby right away.  My FSH was elevated already.  I knew that we should try quickly before the fibroids grow back.  Well, we all know how that has been going.  Despite how much we want to get pregnant, it just hasn’t happened for us.  We watch people who try with their own eggs and donor eggs get pregnant one by one.  We miss the train every single time.

In the meantime, a new fibroid has been growing in the back of my uterus.  A couple of years back, it was much smaller.  In the last few transfers, nobody had ever said anything about it interfering with implantation or pregnancy.  I felt fortunate that no one had told us that we had to remove it.  Until last Thursday.

I have been trying to avoid another surgery at all cost.  Being cut up and recovering from it is not easy.  Plus I just don’t want to weaken my abdominal wall any further.  I know plenty of people have two or three abdominal surgeries but I didn’t want to be one of them.  I didn’t want another surgery to delay any fresh cycles or transfers.  But, as we have learned time and time again, it is not in our control.

All of a sudden, I am worried about things that may or may not happen.  Of course we want things to go smoothly and according to our timing.  But our history shows that things don’t often go the way we want.  I am worried that the surgery would be scheduled at the time my in-laws are in town.  My surgeon told me that after the surgical consultation (on 4/20) it takes about a month or two to schedule the surgery, and I’ll have to be off work for two weeks.  Can you imagine being home with my in-laws while I am trying to recover?  I so desperately want the surgery to be around the time my own mother is still in town.  I am also worried that somehow my donor has traveled to an area infected by Zika virus and my clinic deems her ineligible to donate until a much later time.  I feel that somehow with our “luck”, bad things that are unlikely to happen will happen.  And, my biggest worry is that after doing the surgery and spending all the money, we still won’t have a child we can call our own.

Sometimes I just want to hide in a hole and quit it all.

Irrational.  I know.  But these are real fears and worries.  I usually try to deal with worries by taking it one day at a time.  But this time I just can’t seem to focus on the positive .  My brain these few days is filled with these worries that I can’t seem to shake.  We skipped Easter breakfast at church because I didn’t want to deal with people.  I avoided meet and greet time.  I didn’t want to have anything to do with babies.  Seeing all the matching outfits of kids and families of two, three, or four kids, I was once again reminded of the void in our life.  Bob was amazing though.  Being a helper at the nursery today, holding all the babies gave him the resolve to become a father of his own child in the future.

I continue to pray for peace.  After having peace on Thursday, I don’t seem to have it these past few days.  I know it’s up to God to answer my prayer.  I desperately want God to take away these worries and give me the peace that surpasses all understanding.  But again, I can ask but this too is out of my control.

Fortunately, although I am a mess this time, Bob is not fazed by any of these potential problems.  He has been my voice of positivity, logic, and rational thoughts.  He consoles me and tells me that it’s okay for me to feel sad, but he doesn’t want me to stay there for too long.  He acknowledges my fears, but is also firm in his beliefs that although our timeline is delayed once again, we will eventually move forward with the next cycle with a uterus that is healed.  He believes that the donor will be fine and will give us the embryos that we need.  He believes that I will get pregnant and we will be parents in 2017.

His unwavering belief is exactly what I need.  I am grateful that one of us is doing well.  Our patience is once again tested.  I hope that soon I will get over this sadness and this state of worries so I can be back to being calm, happy, at peace, and patient again.

And I hope that none of my worries comes true.

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.

Day Three Report

The phone call came at 3:30 when I was seeing one of my clients.  The nurse introduced herself and said that she was calling to give me a transfer time.  It will be Wednesday at 1:45pm.  She gave me the instructions to arrive 15 minutes early, drink water, and take a Val.ium at 12:45pm.  It didn’t seem like she was going to talk about the embryos at all.  So after I told her that I will have an acupuncture session before and after the transfer, I asked her about the embryos.

The nurse really didn’t prepare to give me a report, because she told me to wait for a second while she pulled it up.  I don’t know if it is not the custom to give a day three report, or if a day three report is not necessary because we are growing to day five.  She first explained to me that the embryos are graded from grade one to grade four, one being the best and four being the worst.  All ten of our embryos are still there.  There are no grade one embryos.  We have three grade two embryos: 10-cell, 9-cell, and 4-cell.  There are four grade three embryos: 7-cell, 9-cell, 10-cell, and 10-cell.  There are also three grade four embryos: 9-cell, 9-cell, and 4-cell.  When I heard all of this, my mind froze a little and all I was focusing on was that we didn’t have any grade one embryos.  The nurse did give an assessment to each embryo, from above average, to average, to below average.  However, I didn’t write fast enough to note them all.  I asked her if the grade four embryos mean that they are not good to become blastocysts, she said that you’d never know.  Some blastocysts come from grade four embryos.  I thanked her and hung up.  My client, who is on the autistic spectrum, was waiting for me to be done with the phone call.  I really had to pull myself together so that I could focus and finish up the session with him.  But my visceral reaction was so real.  I had been so at peace and calm with this.  All day I was not nervous.  Up until the moment when I was told there was no grade one embryos, my shoulders tensed up and I felt full of anxiety.  I don’t know why but my mind just focused on the negative.  I even started to panic and wondered if we should transfer two blastocysts instead of one.

I wonder if it might have been better if I didn’t know the grading because the knowledge of it only added to my fear and didn’t give me information about whether or not we’ll have a blastocyst on Wednesday.  It’s sometimes true that ignorance is bliss.

After the session, I updated Bob who was at that time busy with work.  Fortunately, my last client canceled so I had the time and space to process this news.  I guess my expectation was that these young eggs should give us some grade one embryos.  And I was probably expecting a textbook case.  With higher expectation comes disappointment when the expectation is not met.  My mind automatically went to the worst: we don’t have any normal blastocysts to transfer.  I had to stop myself and again focus on God, on His unchanging nature, and on His power and might.  He already knows the outcome of this cycle.  What I need to do is to focus on Him and Him alone.  And who am I to pretend that I know about grading?  I know nothing about grading or whether these embryos will become blastocysts or not based on their day three performance.  God makes the impossible possible.  Anything could happen between now and Wednesday.  Instead of focusing on the numbers, I should focus on my gratitude that these ten embryos are still growing.  My mind vacillated between my faith in God’s plan and my fear of having a very bad outcome this cycle.

One thing I am really sure is that I will not consult with Dr. Googl.e.  I don’t want to read anyone’s stories about their success or failure with these gradings.  Their stories do not translate into my future success or not.  So I promised myself that I will steer clear from doing any online searches.

Lying there with dimmed lights at my acupuncture session, I closed my eyes and concentrated my energy on the word “gratitude”.  God has taken us this far to this point.  I believe that He will carry us through if this is His will.  I am grateful that some embryos are good quality.  I continue to pray for the perfect number of blastocysts to complete our family.  My tensed shoulders started to relax and my breathing became deeper.  Although now I feel that this is not a sure thing, I know that we will be well taken care of.

My heart is a lot calmer than it was this afternoon.  This journey has not been easy.  Even with donor eggs, it is still not easy.  Worry is not going to help with my situation, so I try to replace my worrying thoughts with positive thoughts.  I continue to pray that God sustains me with peace and calmness that only comes from Him.  And we shall see what His plan is and what the future holds.  Our prayer is that the chromosomally normal embryos will make it to day five.

Transfer Date Has been Scheduled

After meeting with Dr. No Nonsense last Friday, I had an impression that we could schedule a transfer any day in November.  Since I will have a day off on November 11, I was imagining taking November 12 and 13 off, and transferring on Friday the 13th.  Apparently, it doesn’t work that way.  On Monday and Tuesday, my nurse and I were emailing back and forth.  She told me that November 13th is too close.  A more realistic date for the lab schedule and to have enough time to build my lining is November 24 or November 25.  That’s the week of Thanksgiving.  Of course it’s better to transfer earlier, but it just doesn’t sit well with me to take November 24 off for a transfer.  Do we take a day off also on November 25?  If so, then should we just take the whole week of Thanksgiving off?  Plus I have a prior engagement on November 24 that I could possibly get out of if necessary, but it’s not really necessary.  After talking back and forth with Bob, we decided to go for November 25.  My other consideration is that I need to find an acupuncturist that is willing to see me on the day before Thanksgiving.  I can no longer go to my usual acupuncturist since she moved to another city.  Or I can forgo acupuncture all together.

My nurse sent me a calendar so I have a better idea of what to do when.  The following will happen barring anything unexpected:

October 26 Start Lup.ron

October 31 Take last birth control pill

November 1 to November 5 Expect period to start

November 5 Call nurse if period does not start

November 6 Begin one estrogen patch

November 9 Remove old patch and apply one new one

November 12 Remove old patch and apply two new patches

November 15 Continue two new patches every three days

November 18 Remove old patches and apply four new patches

November 19 Lining check, Bob to sign consent

November 20 Projected date of thawing the eggs and fertilization, Bob to give sample

November 25 Estimated date of embryo transfer

 

I have Kais.er insurance, so whatever my clinic prescribes is not going to be covered my insurance.  I tried to get my new OB/GYN (my previous one left the practice) to prescribe some of these meds, especially the non-fertility ones.  She refused because she is not part of my care for this, but she said that she could write the script for progesterone once I get pregnant.  Well, it never hurts to ask, right?  Although the answer was No this time.

I was comparing prices of meds last week calling around different online pharmacies and the local Wal.greens specialty pharmacy.  I am surprised to find that Fre.edom is not the least expensive one.  The local Wal.greens specialty pharmacy is the most expensive.  For the one Lu.pron two-week kit, two vials of progesterone in oil (I need three but I have one in my posession), and the four boxes (8 patches each) of generic estrogen patches that I need, I save maybe $100 ordering from Av.ella Pharmacy.

I often check on goodrx.com to find discounts on drugs since I have to pay out of pocket.  I have successfully used the discount codes for many different drugs in the past, such as Medr.ol or Val.ium.  I have never done that for fertility drugs.  This time I found a discount coupon for the Lup.ron at the local Wal.greens specialty pharmacy.   Last week I physically went to check with the pharmacy staff if I could use the code for Lup.ron.  I explained to one of them that I had used these codes for other drugs, so I just wanted to know if this would work also for Lup.ron before I place an order.  All I got was a blank stare at first.  Then she went and asked another staff member.  Without even checking anything, this other lady told me that they would only take manufacturer’s coupon and nothing else, even for non-fertility drugs.  I know that what she said is not true because I have used the discount coupons from this website numerous times and it has worked every single time.  But there is no point of arguing.  I walked away knowing that it is not worth my time, effort, and money to try to get the discount to work.  I would be better off just ordering painlessly from an online pharmacy and having the meds delivered to me without me having to wait in line and argue about anything.

That’s what I did.  I placed an order for the medications yesterday.  They will be delivered to me tomorrow.  I will be ready to do an injection on Monday.  My first one in the last seven months.

What am I currently thinking and how am I feeling?

I am happy that we have an opportunity to have an embryo transfer before the end of the year.  I know that my chances are a lot higher now than when I was cycling with my own eggs.  The aspect of donor eggs is not a source of stress or anxiety at all.  I am not bothered by the fact that I need to use donor eggs.  I feel grateful that it is a choice for us.

But I have mixed emotions.  I feel that I should be more excited than I am right now.  I am hopeful.  But at the same time, I have these thoughts that things could go wrong at any step in this process.  I can tell you what goes through my mind.  Given my history of bleeding through birth control pills, I wonder if my menses would start before I take my last pill.  If that happens, does that throw things off?  What if my lining does not grow?  What if I don’t respond well to the estrogen patches?  What if the eggs don’t thaw well?  What if the eggs don’t fertilize well?  What if there is only one blastocyst?  What if there are no blastocysts?  What if we transfer one and it doesn’t work and we have nothing to freeze? What if, what if, what if.

Sometimes, I am scared to death that this won’t work.

The fear is definitely there and it is very real.  It’s not something that I can just brush aside.  Those of you who have been on your own fertility journey for a few years probably have similar feelings about this.  When things go smoothly, you can’t help but wait for the other shoe to drop.  So what have I been doing to counter these fears, what-ifs, and negative feelings?  I pray.  Every single morning on my drive to work, I barely listen to the radio.  I often turn it off when I turn onto a road where I can see Pacific Ocean.  And I pray.  I pray for the ladies in my bible study group.  Each one of them. I pray for Bob, for his leadership in his own bible study group, for his work, for our unity and harmony at home, and for my work.  I pray for those pregnant ladies in my blog world for their pregnancy to go well.  I pray for those that are still waiting to get pregnant.  Then I pray for myself.  I pray that the Lord will replace my fear with calmness, peace, and strength.  I pray that I will depend on Him every single step of the way.  I pray that whenever I am scared, He will remind me of His sovereignty and His perfect plan for us.  I pray that the Lord will give us the miracle that we have been waiting for.  And I pray for the perfect timing and the perfect number of embryos that are in His plan.  I need this daily.  And I do this daily.  As the time approaches the transfer, I am very sure that I need to submit myself to the Lord more than ever.  Even with these prayers, there are a few moments during the day that I am fearful of a failed cycle.  But I am always reminded by the Lord of His goodness.  No one knows what is going to happen except God.  And God is the only one who can give life.  Fretting over it is not going to help me.  So I need to focus on the present, and I am trying really hard to do that.  I sometimes recite this: “I am doing everything I can to get pregnant”.  The rest is really not up to me since I am not the one who has the control.

But let me tell you, despite being fearful at times and scared to death, I also did some other things that some may feel could jinx things for myself.  Once we picked a transfer date, I looked up our potential due date.  You didn’t read it wrong.  Yes I did.  I didn’t do it for the first transfer but my friend did for me.  I myself looked up the due date for my second transfer.  Now for this third transfer, I feel hopeful and know that looking up the due date is not going to jinx anything, if it is in God’s plan for us to get pregnant this time.  Another thing that I have been doing is to search for one piece of maternity clothes that I can buy and keep in my closet.  It’s something tangible to look forward to.  Something to remind me that it is very possible that I will be able to put that piece of clothing item on in the near future.  You know, maternity clothes I have seen so far in brick and mortar stores are hideous.  Last weekend I went to four places and did not see one piece of clothes that I like.  So I may have to go online and buy myself something.

So here we are.  A bit over a month from now I could have an embryo inside of me trying to implant.  I will continue to take it one day at a time and hopefully won’t go too crazy as the time gets closer!

MicroblogMondays: Frozen Donor Eggs (a post not so micro)

Microblog_Mondays

This is going to be my third attempt in writing about what has been going on since our donor Iris bailed.  I have been so short on time lately that I just can’t seem to finish a post about it.  I hope you are ready for a not so micro post.

It’s been three weeks since we got the news that Iris had disappeared.  I don’t quite think much about her anymore.  Emotionally I am not affected much by her.  Did she ever return any emails or phone calls to the agency?  The answer is no.  She returned the $200 that the agency sent her for transportation to and from the clinic, without attaching a single note.  Just like that, she disappeared into thin air without a single word or explanation.  On some level, I feel disappointed at myself for choosing a person who would be so irresponsible.  But my therapist told me that I should not take any responsibility because her decision and disappearance had nothing to do with me and Bob personally.

So what has happened in the last three weeks since we found out that we had to start all over again?  It took a few days for my emotions to return to normal.  Then I began to think about the next steps.  Naturally, we started searching for a donor again.  Both the agency database and the in-house clinic database did not have any donors that we could work with immediately.  A proven, repeat donor who is part-Chinese would be our first pick.  Nobody matches that description.  I expanded my search to agencies outside of the Bay Area.  Still, the choices are very limited.  I was discouraged for a few days and was defeated that the chance to have a transfer before Christmas would be very slim.  Why do I want a transfer before Christmas?  I think it has to do with us approaching the end of the 4th year trying for a baby.  Christmas is a season that focuses so much on family and children.  I just want to share the joy with others who have children or who are pregnant.

We have discussed in the past about doing a fresh donor cycle vs. doing a frozen donor egg cycle.  I didn’t really go into details with you guys about the differences.  Basically, the chances of a pregnancy/live birth are higher with a fresh donor cycle because the recipient couple would receive all the eggs in that cycle, hence the chances of making multiple embryos would be quite high.  Many donors would retrieve from 15 to 35 eggs during one cycle (although some may make fewer than 10 eggs).  Many of these eggs would be fertilized and at least a few embryos would/should make it to the day five or day six blastocyst stage.  Often times, a recipient couple transfers one to two blastocysts and has a few other blastocysts to freeze for future use, may it be for a frozen embryo transfer if the first fresh transfer didn’t work, or for a chance at a second child in the future if the first transfer results in a live birth.  The cost of a fresh donor cycle is high.  Compared to that, a frozen donor egg cycle is a lot cheaper.  At my clinic, the difference could be over $10,000.   The eggs are already there, frozen for a recipient couple’s use at any time they are ready.  The advantage is that you don’t have to sync up the donor’s cycle with the recipient, and there is not a risk of the donor not stimming well or actually backing out from the cycle.  The disadvantage is that the clinic guarantees at least six mature eggs.  Compared to a fresh cycle with 15 to 35 eggs, six eggs seems to be a small number.  With fewer eggs, the chances of having multiple embryos are smaller.  Plus, there is a risk of the eggs not thawing well.  So realistically, there could be one or two embryos to work with.  Once the embryos have been transferred, if the cycle doesn’t result in a pregnancy, there may not be any frozen embryos to use for a frozen embryo transfer.  So there is always that risk of exhausting all the embryos quickly and having to do another cycle all over again.

My RE Dr. No Nonsense has always told us to do a fresh donor cycle if we want two of more children because a fresh cycle gives you a lot more eggs.  I do want more than one child.  However, Bob’s position in the last year has been that he only wants one child.  If we get a bonus one (such as having twins), he would be overjoyed.  But he just wants to have one child and be done with this process.  I know that he is very tired of this journey and just wants to move on.  This is coming from a man who had always wanted four children.  It breaks my heart to see him so disappointed and exhausted and just wanting to move on with life.  So in theory, since Bob only wants one child at this point, he shouldn’t care much about fresh donor cycle or frozen DE cycle.  But in reality, he cares a lot because he really wants me to have the best chance at having a live birth and it seems like a fresh cycle will allow us the best chance for that.

You may not remember, but back in May, I wrote about the various choices we had to face when it came to egg donation.  In that post, I mentioned about donor 1.  She is half Chinese half other Asian.  So she is fully Asian.  Back then, I learned that all four of the recipients of her cycles had gotten pregnant.  She had committed to donating for the 5th time for all of her eggs to be frozen.  We did not go with her because only frozen eggs were available.  You can see the above for the reason why we didn’t want to go with frozen eggs.

There is another donor that we also liked.  I mentioned about her in the previous post about egg donation as well.  I described her as donor 3 who only has a bit of Chinese.  I checked with the donor coordinator.  She has just been matched with another couple and will do a cycle in November.  Technically, Bob and I are next in line if she chooses to donate again.  The thing is, I am not so sure if she’d donate again as this is her 3rd donation in a row.  She may or may not want to do it again.  Plus I would still like my future child to have at least a quarter Chinese.  So I am a bit hesitant about waiting for her to be available.

So, out of all the donors on both the agency and in-house clinic databases, the half Chinese/half other Asian donor is still the only donor that we are really interested in.  However, I knew my husband’s position.  I didn’t want to force the issue if he did not want to pursue having a cycle with frozen eggs.  We just had to wait a little bit for a donor to show up that we both like and want to work with.  So realistically, it could be some time in 2016 before we can do a transfer.

And then, Bob had a change of heart.  We were lying in bed one day having our pillow talk.  We were chatting about various things.  Out of the blue, Bob asked if I wanted to consider the frozen eggs from this Chinese/other Asian donor.  I was very surprised at his inquiry.  His reasoning was that 1) this is a young, proven donor with good records, 2) the eggs are all there for us to use, 3) so a donor will never back out from a cycle again (I think he’s a bit traumatized by the incident with Iris and has lost confidence in a future fresh donor), and 4) the cycle is cheaper so if it’s not successful, we still have the money to try another fresh or frozen egg cycle.  We agreed to inquire about the status of the Chinese/other Asian donor.

This is what I learned.  At the time when I wrote the donor coordinator, this donor was about to do a retrieval for her 6th donation.  So we didn’t know how many eggs would be given for each batch.  While we were dealing with our previous donor Iris in the past months, this Chinese/other Asian donor had already completed her 5th donation (and second frozen donation).  That cycle yielded 23 mature eggs which were divided into three batches of 8, 8, and 7 eggs.  All three batches have been matched with various couples but these couples have not done a cycle with these eggs yet.  We would be next in line for the new batch of eggs that results from her 6th donation (and 3rd frozen egg donation).  A transfer had been done with the eggs that came from her very first frozen egg donation but the clinic was still waiting for the pregnancy result.

When I was waiting for the retrieval to see how many eggs would go into each batch, I had asked myself what the most ideal number of eggs would be.  I knew that her first frozen egg donation resulted in 9 mature eggs and 8 mature eggs.  If she has 20 mature eggs, then the cycle would be split into two batches of ten eggs.  If she has 21 eggs, then they would be divided into three batches of 7 eggs.  I was praying that she’d get 20 eggs.

Guess what?  My prayer was answered.  The donor coordinator said that her cycle resulted in two batches of ten eggs each.  They were all deemed mature and were stripped for ICSI (whatever that means).  This would be the best case scenario for someone who is interested in using frozen eggs.  Again, the clinic guarantees at least six mature eggs.  A batch of ten eggs is amazing.

After knowing the answer, I was thrilled at first.  We have ten chances to make a couple of embryos, if not more.  This is a proven donor.  What else is there to think about right?  After praying over the weekend, both Bob and I were saying to each other that we should go for it.  I posted to an online group of DE moms who had experience in frozen egg cycles and many had shared their success stories with me.  Many of them had only 6 eggs and still had a pregnancy and live birth.  I was feeling better and better.  And then, I had a thought.  What if we purchased both batches of eggs?  That’d cost a lot more money but that’d mean that we’d have a chance to have a few more embryos.  Bob still thought that we would only need one batch because he would still want one child.  But he told me to go ahead and ask.

The donor coordinator said this, “We unfortunately do not allow the option to purchase multiple batches of cryo banked eggs because the cornerstone of the program is to offer more recipients an opportunity to match with our more sought after donors.”  

I was at peace with this.  I was actually relieved that a decision was made for us, that we didn’t have to fret about the decision to purchase two batches of eggs.

I was feeling good for a couple of days.  Then I got the latest news.  The donor coordinator told me that the result of the latest transfer with this donor’s frozen eggs was a negative pregnancy and the recipient had one more embryo to try.

Cue panic.  I went from having peace to having fears and doubts.  I was projecting the results of that failed cycle onto my future, wondering if that would happen to me as well.  I seemed to have overlooked the still stellar record of this donor, having a 80% pregnancy rate with her eggs.  I wondered if bad statistics would follow me.  I was fearful that I would be unfortunate enough to have a batch of the worse eggs from the 20 eggs.  I entered into this land of what-ifs.  I could not distinguish my fear from God’s will.  My mind was very noisy and chaotic.

In the back of my mind, I still thought and felt that this was a wonderful opportunity to pursue with a proven donor.  Since we only have to prepare my lining for a transfer, we can possibly transfer before Thanksgiving.  And if this does not work, we still have the money to pursue other opportunities.

But I was scared to death.  I was scared that the first transfer wouldn’t work, and it would be a huge blow to the both of us.  It would mean tens of thousands of dollars down the drain.  It could possibly mean having no frozen embryos to try again and needing to find a new donor.  I have just been so traumatized by this experience that I was so afraid of failure.

My therapist came to the rescue.  A few days ago, a session with her cleared up some of my chaotic thoughts.  Every pregnancy is different.  We don’t know what the failed cycle was like.  We don’t know the sperm quality or the uterine environment.  We do know that the recipient has one more embryo to try.  We also know that other people who used this donor’s eggs have all gotten pregnant.  She told me that things are out of my control.  So I should let go of the what-ifs because no one except for God knows what will happen in the future.  I should focus on my perfect uterus and visualize how welcoming this place will be for my future child.  Instead of putting my energy in thinking that this will never happen to me, I should put some positive energy into believing that this will happen with a perfect uterine environment and a beautiful embryo.  My therapist told me not to rush into a cycle if the reason is that I want to have a transfer before the end of the year.  Go for it if it feels right.  Don’t go for it and wait if it doesn’t feel right.

I was able to get a hold of Dr. NN and asked him a few questions.  He said that this being the donor’s 6th donation does not affect the egg quality.  I also asked him about immune protocol.  He said that I will be on steroids.  He does not recommend any blood thinner like Hepa.rin for me, and he thinks that hCG infusion is not necessary for me.  He thinks that it’s wonderful that we get 10 eggs from this donor.

After talking with him and having Bob’s support, I wrote the donor coordinator and let her know that we’d like to take a batch of ten eggs.  Then came her email.  She told me that there is a change in the guarantee program.  What???

I immediately gave her a call and learned about the details.  Basically, the clinic was evaluating the frozen egg program and wanted to boost the success rate.  According to the coordinator, there was 16 transfers with frozen eggs and 9 resulted in a clinical pregnancy.  So instead of guaranteeing that there would be two viable embryos (could be anywhere from day three to day five) to transfer, the clinic will change its policy to one blastocyst.

I think it is a good change, but I was a bit uneasy with the rate of pregnancy because it is lower than the 70% of transfer with fresh eggs.  I prayed to God for peace and strength as this is such a difficult decision to make.  Bob and I talked and talked.  I let the news sit for a little longer.  I woke up the next morning with peace.

So this is where we are at right now.  We have chosen to proceed with ten frozen eggs from this Chinese/other Asian donor who has had a great record.  I went off birth control pills a few weeks ago because I was bleeding from them.  In order to get ready for the cycle, I will go back on birth control pills when my period comes.  My nurse said the transfer time will be six weeks from the time I go back on birth control pills.  I am expecting my period to come in two to three weeks (I have EWCM lately but I don’t know if I have ovulated yet) so I think transfer time should be somewhere in November.

I can’t help but think that, maybe this is meant to be?  If we had chosen this donor’s frozen eggs in the first place, the eggs that we would get would be very different from the eggs that we are going to get now.  The sperm used for that would be different.  The resulting embryos and child/ren would be different.  Maybe there was a reason why our original donor didn’t work out.  Maybe we are meant to get the ten eggs that we will get?  I don’ t know.  I think we’ll never find out the reason for all these twists and turns until we have a baby in our arms.

I am excited but at the same time scared.  I am grateful for this opportunity but at the same time fearful of the future.  I have been reminded again and again this past week during Bible Study that God has the perfect plan for me.  I believe that this is the right decision.  My hope is that I continue to trust in the Lord and in this process without being doubtful or living in fear.  If you are the praying kind, could you join me in praying that I live daily with trust and faith in the Lord?

Thank you for your support.

Wise Words

Last week, I had another session with my therapist to address my issues of having fears about the upcoming donor cycle, which I described in this post.  Prior to last week’s session, I naively thought that since I had accepted our path of using donor eggs as our means to hopefully have a baby, I wouldn’t need to talk to my therapist anymore.  Boy was I wrong.  I think that I will probably need to talk to her on a regular basis for a while.

What I described to her was what I wrote in the post.  I am scared.  I am scared that even egg donation won’t bring us our baby.  I am scared that I will fall into the other side of the stellar donor egg IVF statistics.  I have been basically operating on a mode of failure because that’s what I know and am familiar with.  I haven’t been able to get myself out of that mode.  I am still stuck at the phase of Isabelle’s-eggs-suck.  I know how to do infertility.  I don’t know how to anticipate success and pregnancy.

Well, I told my dear friend A. a few weeks ago how I felt.  What she told me is so so true, that I have to remind myself over and over again.  These are her wise words: “You’re conditioned for heartbreak.  It’s hard to think differently.  Just remember that you’re not playing the same game anymore.  New stadium, new sport entirely.  Look at it with fresh eyes.”  

Yes.  I am so used to bad news, heartbreak, being on the wrong side of stats.  It seems to be an impossible thing to imagine the outcome to be different this time.  But she’s right.  We are talking about eggs from a 24-year-old donor.  My eggs play no part in it anymore.  I really need a paradigm shift.

My therapist agrees with A.  She reminds me that this is a totally different ball game.  I have to consider the fact that we have chosen somebody who is young, so statistically, the chances of her eggs are normal are much higher.  Look at her donation history: pregnancy was achieved at both of her prior donations.  The chances of it working for me are so much higher than when I was using my own eggs.  She thinks that my fear may also stem from the lack of control.  When I was doing my own egg cycles, I had total control over the timing of injections, taking medications, being on time for monitoring appointments, and other aspects of the process.  I currently have no control over what our donor will or will not do.  I can only exercise my faith that she will have the integrity to follow through with everything.  I have no control over when the clinic can schedule her for what appointment.  My therapist told me to keep in mind that my clinic may not update me on the progress as much as I would like.  That will continue to play into my sense of lack of control.

Since those are the things I really can’t control, my therapist told me to focus on what I can control.  We all know from the operative hysteroscopy that my uterus looks good.  In fact, my surgeon said that there is no reason why I can’t get pregnant with such nice looking uterus and lining.  My very wise friend A. once compared the ovaries to uteruses.  She thinks that woman is fickle and complex, hard to read, hard to please, like ovaries.  To her, uterus is like a man, easy to treat and manipulate, resilient, reliable, and simple.  Both A. and my therapist reminded me that I should look at my situation like it’s brand new because my baggages and bad experiences have been brought on by my own eggs, which have been completely removed from the  current equation.  My own eggs do not play a role in the upcoming donor egg cycle.  All I can do is to make sure that I am taking good care of myself and my health and do everything in my power to make sure I follow my RE’s instructions to grow the best lining that I can.  

My therapist once again reminded me to do this: when I have these negative thoughts, ask myself if they are helpful to my situation.  If they are not helpful, acknowledge the thoughts and feelings then file them away.  Don’t think about them until my scheduled “worry time” at night.  So I have been asking myself that same question whenever I fear that the upcoming cycle won’t work: Is this thought helpful to my situation?  No?  Okay, then I won’t worry about it until 10pm tonight.  It has been helping.  Rather than constantly worrying about the what-ifs and things that may not ever happen, my mind has been mostly freed up during the day from these fears.

At the end of the session, my therapist reminded that I have something positive and beautiful happening in my life.  A new possibility that was not available to me in the past.  For such a positive thing, I should surround myself with positivity rather than negativity.

Very wise words.  Something to think about.  I feel very fortunate to have wise friends like A. and a wise therapist who truly understands this process of ups and downs during infertility.  I have been feeling much better ever since the last therapy session.  I am sure I will feel the struggles and have fear again.  The good thing is, wise friends and my therapist are going to be there when I need them. This thought is very assuring.