No more Daisy

In the last two days, I have already prepared myself for bad news.  I really didn’t think that a grade three three-cell embryo would turn into a blastocyst.  Of course I still hoped for the best.  Miracles do happen.  Just didn’t happen to me this time.  I start to think that maybe we got very lucky the last cycle.  I wonder if this is going to be the norm for future cycles.  Maybe the name Daisy is too weak.  Clay didn’t get its name for nothing.  Bob joked that maybe Daisy should have been Delilah.  I seriously laughed very hard at that joke.  Maybe this is still early.  Maybe I have already cried like crazy on Wednesday.  I didn’t feel a thing in my heart when I saw Dr. E’s email.  I find my mind moving towards the next step.  Do we do one more cycle with Dr. E after this so that we can transfer Clay?  Do we keep Clay frozen and start banking embryos down at L.ife IVF in Irvine?  Do we take care of the fibroids first before even talking about banking embryos again?  Unfortunately, having the diagnosis of DOR means that we are in it for the long haul before we can have our take home baby.  That is, if we use our own eggs.  Things may move faster if we go the donor egg route.  I don’t think I am ready to give up on my own eggs yet.  On top of fertility matters, Bob received a job offer at the startup company I mentioned about before.  I am very proud of him!  At the same time, we have to seriously evaluate the offer and see what kind of health insurance we’ll get.  I am okay with a plan that offers a high deductible.  I just need to know what we’re dealing with.  So there you go friends.  The end of our IVF #2.  We have to sit down and talk about what IVF #3 may look like.  We may not go with Dr. E anymore.  As much as I love her, once insurance money is finished, she’s almost three times as pricey as going to L.ife IVF.  We haven’t decided yet.  I think I will need another thinking break from IVF.  Thanks for all the support you have all given me.  It makes this journey more tolerable.

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Edited to Add:

Ugh.  It doesn’t help that one of my friends shared her pregnancy news with me today.  Well, she didn’t exactly share.  She had been quite cryptic about why she had been taking time off and resting at home for the last week or so.  Since I have been on vacation, she knew that I was available online and kept on sending me messages.  So finally I asked what was wrong with her body.  She told me to call her.  Big mistake on my part, especially today.  Once I called, she began to complain about all day sickness and nausea and what not.  I asked again what was wrong with her body.  She then proceeded to ask me to guess why she had been home.  All I asked was, “How far along are you?”  I didn’t say congratulations.  I wasn’t being a good friend.  But hey, I think I could do that today.  I felt no joy for her.  And I was super annoyed to hear her go on and on about the IV drip, the all day nausea, and not having a chance to go on a babymoon because she’s been so sick.  I mean… she has been trying for a baby for a long time (at least 3.5 to 4 years) so I should be very happy for her that she finally got pregnant on her own.  But… I just feel no joy for her today.  She asked how we were doing.  I said… not good, but I didn’t want to go into it.  And then this comes out of her mouth:

“Just let nature take its course.  It’ll happen when you least expect it.”

Yeah.  Maybe true for you.  I said, “With my diagnosis, I highly doubt it that it’ll happen to us naturally without any medical intervention. We’ve done two IVFs and have gotten some bad news.”

I really didn’t want to hear her whine.  So I found an excuse and hung up.  Sorry.  I am not a good friend today.  But I need to self-preserve.

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Grade three, three-cell, on day three

Okay.  I got my ugly cry out of the system already.  I am doing okay.  

First of all, thanks for all the support from the last post.  I really appreciate all the virtual hugs.

Today is day three after retrieval.  I was quite nervous this morning.  You know that mental state?  It doesn’t matter what you tell yourself, you’re still nervous.  Dr. E usually updates us early in the morning.  We waited and waited, refreshed my email account on my phone many times, and stared at the computer screen while I was at it.  No email.  I think the not-knowing kills me more than the bad news.  This morning I had to take Bob to his immigration appointment in downtown at 11am.  Still no news when I was waiting in the car for him.  I was hoping that Dr. E wouldn’t call me on the phone.  I somehow equate bad news with phone calls.  I was thinking, “Please please no phone calls”.  When Bob got back to the car, he asked, “Any news?”  I said “No” while refreshing my phone screen.  And there it was.  One new email.  My heart was pounding and my hand was shaking a little.  I was hoping for at least similar progress as last time: grade one four-cell embryo on day three.  Unfortunately, the news wasn’t what we wanted.  This is Dr. E’s email:

“This morning’s report is not as encouraging

but there is always still a chance as you know from experience

our day 3 embryos is a 3 cell grade 3. The likelihood that it’s genetically normal is low but not zero.

the second embryo isn’t dividing.

I will update you on Friday

I’m sorry this cycle isn’t going better

but there’s still a chance we have a blastocyst

I will let you know on Friday”

 

Cue ugly cry.  Well, it took me maybe two minutes before I felt it in my heart.  The oh-so-familiar feeling from last cycle, although this time the feeling was worse.  I don’t know what grade three three-cell translates to when it comes to making a blastocyst.  I don’t want to consult with Dr. Google or ask a friend.  I just know in my heart that this could be a bust.  All the stimulations, monitoring appointments, waiting, driving.  It comes to this low point of ONE embryo not dividing the way we want it to.  All the hopes and dreams riding on this one embryo, again.  Daisy doesn’t seem to have the kind of persistence that Clay did.  I really want Daisy to prove me wrong here.  

I AM grateful for Clay that is still frozen in time, waiting to come home.  And I am ultra-grateful for 1) getting this news when I am on vacation and not at work and 2) Bob being around and hanging out with me all day while I recuperated.  We have given names to embryos up to the letter i.  I hope that we really don’t have to use up all the names before we get our take home baby.  

We don’t know the outcome of this cycle.  I may be pleasantly surprised again.  I may not be.  But I do know that every time with embryos that don’t grow, my heart dies a little.  

I know the Lord will help me get through it though.  I know it.  

Deja Vu

This sounds so familiar.  One embryo is a grade one two-cell.  Just like the last time at this point.  The other one has stopped dividing as of now.  But Dr. E said that we’ll continue to keep an eye on it.  My fear is that this grade one two-cell embryo may decide not to divide and grow.  We really want to make a Daisy this time to join Clay.  Why is this so hard?  I am going to be off for the rest of the week so I have a lot of time to ruminate on the embryos.  Ugh.

I am praying for God to take care of my emotions so that I can keep calm and keep faith and trust in Him that He already has a plan for us.  

Update: Fertilization report

I have been a little nervous this morning.  Bob woke up and asked if Dr. E emailed us.  Nope not yet.  When I was eating breakfast, I saw her email saying that we got two embryos this morning and she was “so so happy” and would call me later to discuss more.  

I have been secretly/not so secretly hoping for at least three embryos to start with.  Needless to say, I was overcome with emotions and started tearing up.  Bob hugged me and let me cry a little.  One minute after I wrote back to Dr. E, she called me and explained the situation to me.  She said that we began with one mature egg and three not-so-mature ones.  The lab was able to turn one of the not-so-mature eggs into an embryo.  I am so glad that she did not tell me about the three not-so-mature eggs yesterday.  Otherwise I would have been very worried.  She is very hopeful that this cycle would be good because she said that with my lower FSH (10.6), the textbook tells you that the quality of the eggs would be better.  She’s secretly/not-so-secretly hoping that we will have some embryos with good quality that will grow faster this time.  I guess my one dominant follicle this time soaked up all of the meds.  It happens.  

When my period comes, Dr. E wants to see me at the tail-end of my period to perform a saline infusion sonogram.  She will check the fibroid in the cavity and also the other fibroid.  If there is only the small fibroid in the cavity, she will remove it right then and there.  Then we can do a transfer the following month.  If she also sees the bigger fibroid creeping into the cavity, then we’ll have to do a laparoscopic surgery to remove both fibroids.  We’ll look into transfer in three months.  Fibroids can cause miscarriages and pre-term labors.  It’s better to remove them before proceeding.

Needless to say, there is more waiting.  If the transfer works, the earliest I could give birth to a child is after my 40th birthday.  Who else is counting?

Egg retrieval number two and Classmate

Today is retrieval day.  Everything felt eerily familiar.  This cycle has been kind of weird.  I have been a lot more relaxed in terms of the process.  Bob arriving home 15 minutes late for the injections?  No problem.  I even almost forgot that I needed to refrain from eating and drinking at midnight.  Good thing my husband was on top of things.  Otherwise, I would have gulped down the glass of water that was by my bedside.  Since retrieval was on a Sunday morning, there wasn’t any traffic even when the bridge on our usual route is currently closed.  It took a total of 52 minutes to get there versus the one hour 25 minutes that took me on Friday.  The clinic was busy; many women walked in and out with their husbands and children to get ultrasound and blood work done.  Bob was taken to the lab early for his part of the deal while I was still waiting in the lobby.  At 8:30 sharp, the nurse who prepped me at the last retrieval came out to greet me.  We did almost all the same things; changed, answered questions, signed consents, bathroom visit, IV insertion, and visit from the anesthesiologist.  I was glad that Bob made it back before I had to go to the operating room so he could hang out with me and give me one more kiss.  Lying on the table, I lost another twenty minutes of my life without having any memory of it.  The last thought I had before I felt asleep was a prayer to God, “Please let there be eggs.”  I guess I have been a little ambivalent about this cycle.  At the last follicle check, five follicles remained in the running.  One big follicle and four smaller follicles were visible.  I had in my head that maybe the one big follicle had sucked up all the meds and the other ones might be empty.  Again, this is my fear and my defense mechanism speaking, but I was just hoping that there would be more than two to three eggs.  Bob was still holding out hope for five eggs.  

Twenty minutes later, I slowly woke up.  Bob was by my side.  Dr. E came in and cheerfully reported that we have four eggs.  Just like last time.  I was pleased but at the same time I was secretly wishing for five.  And then in my very groggy and sleepy state, I was thankful that I got four again.  Not one, not two, not three, but four.  That was worth celebrating.  We did it with significantly less drugs than the first IVF.  Now we’ll just see if the egg quality will be better this time.  I can’t wait for the fertilization report tomorrow, but at the same time I’m terrified.  I am hoping for one more embryo than the first time.  That will be awesome.

Our little Clay has to wait a little before he/she comes home to my uterus.  Dr. E announced that there is a small fibroid in the uterus.  There is also the big fibroid in the uterine wall.  There is definitely no transfer this time.  I will have to return to Dr. E’s office in about two weeks for a procedure to remove the fibroid in the cavity.  At that time, we’ll discuss about the bigger fibroid.  I hope that we will get to do a transfer some time before November.  I may be setting myself up for disappointment since there may be recovery time before we can prepare for a transfer.  This is again time to exercise more patience.

The three-hour nap post retrieval was awesome and much needed.  We had sushi for dinner.  It was a good way to finish our retrieval day.

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We had a wonderful day hanging out with my elementary classmate whom I had not seen for 21 years.  We played tourist in the city and took the cable car all the way from downtown to Fisherman’s Wharf and back.  We walked around and had the best fish and chips.  The fish and chips place was decorated with happy birthday banners because it was the owner’s birthday.  It also happened to be Classmate’s birthday.  When I told the owner, she came out and gave Classmate a free soda.  Since we had already ordered a fried Snickers bar, she gave us an order of fried Oreos on the house!  I have to say both the fried Snickers bar and fried Oreos were out of this world tasty and amazing.  I didn’t forget the fact that it was extra fattening.  But it was so good!  I think it was worth the calories.

Classmate has a son who was conceived nine years after he had gotten married.  I always thought that it was due to fertility issues.  After catching up with him, I found out that the pregnancy was planned as they had no problems conceiving.  However, when they tried for number two, his wife developed a thyroid condition and had to be on radioactive medication.  Her doctor advised them NOT to try for a pregnancy for 1 1/2 years.  Since they don’t want their children to be too far apart in age, they opt for not trying for number two since his son is already five years old.  

Bob and I hung out with Classmate for about six hours.  About four hours into our outing, Classmate made an observation and said, “Bob really likes children, doesn’t he?”  I was thinking, wow is it that obvious?  I guess Bob was really drooling over all the cute kids that he encountered on the tourist-filled streets and destinations.  About twenty minutes later, Classmate opened his mouth and asked, “Since Bob likes kids so much, are you guys going to try for a baby?”  Duh, Classmate, of course.  I didn’t say much.  Bob responded with something vague like, “We would hope so one day.”  I just smiled.  Classmate continued with his opinion, “Don’t wait too long.  It’s going to get harder when you get older.”  Duh again, Classmate.  I just smiled again.  What else can you say, right?

Woes

This is going to be a difficult topic to write about.  But it’s been on my mind a lot that I really want to get it all out.  

My husband switched jobs a little over a year ago.  His previous company provided excellent health insurance that covered for almost everything 100%, except for fertility.  Anything fertility related was not covered.  When he switched to his current job at a large corporation, we were very pleasantly surprised that there is a $10,000 lifetime maximum for fertility treatments.  I was secretly hoping that we wouldn’t need to utilize this benefit.  It was a good-to-know kind of thing and I tucked it in the back of my mind.

Fast forward to March this year.  We started seeing reproductive endocrinologists and discovered that all the visits with these specialists so far including ultrasounds and the lab work that is ordered have been paid for under our general insurance.  Our fertility lifetime maximum had not been deducted until we actually started our first IVF.  I started to realize how blessed we are with the amount of coverage that we have so that we haven’t had to dip too much into our designated funds for IVF.  

Most recently my husband has been miserable at his job.  There has been a lot of changes in his group.  His manager suddenly assigned him the task of overseeing the whole project and for him to put the whole system together.  This wasn’t his job before so he has a lot to learn.  Not only does he have to learn fast, he also has to battle getting results from his group mates who are less than cooperative.  On top of that, he has to commute about an hour each way to work.  He used to take the train but because of potential transit strikes the past two months, he opted for driving instead of purchasing a monthly train pass.  Since his work has been so frustrating, he has been thinking about switching jobs.  He began to speak with recruiters and has found leads for job openings that interest him.

Last weekend was a testing time between us.  We started talking about the possibility of a job change.  He wants to work for a startup company with fewer people that would provide more room for growth.  If he can find a company doing what he enjoys doing, then he won’t mind working extra time on his job.  There is a lead for a small company that is located a bit closer to home than his current job.  The founder is really interested in him.  They met up twice already.  

When Bob shared this with me, my fear crept in.  We are in the middle of an IVF cycle that has been paid for by his insurance.  I know that this fertility coverage won’t last forever as we are definitely going to use up the whole lifetime maximum if we indeed do a transfer.  But it’s not only the fertility coverage that I like.  I also like the fact that even after the fertility coverage is over, visits to an RE including blood work and ultrasounds will still be covered under our general health insurance.  We also have the fringe benefits of chiropractic care, acupuncture, and counseling.  They are all covered.  If/When I get pregnant, all the prenatal ultrasounds, visits with the OB/GYN, and the hospital visit are largely covered.  We only have to pay a small copayment.  And currently our complication is the potential laparoscopic surgery to remove the uterine fibroid.  I am 99% sure that this will be covered under the general insurance. My fear is that the new health insurance that is provided through a new job at a startup company will not even begin to compare to what we have right now.

Bob was angry and hurt that the first thing I thought of was the health insurance that we may lose.  He thought that I cared more about our insurance coverage than his happiness and wellbeing as an individual.  This led to “robust discussions” throughout the weekend about the best decision to make.  I admit that I allowed myself to be fearful of the unknown and the future, a future that may not provide us with the comfortable cushion that we currently have with his work health insurance.  This fear is so crippling.  At the same time, it pains me to see Bob suffer so much.  We prayed and prayed for a clear direction.  I have been praying for God to allow me to have faith in Him that He will provide.  I want to have peace with whatever decision that we will make.  I would love to be the one that supports my husband’s decision no matter what he does.  And it hurts me for him to think that I didn’t care about his feelings and his unhappiness.

I woke up in the middle of the night last night pondering about all of the above.  How does one strike a balance between being a supportive spouse and providing another perspective of the situation without making the other person feel judged?  How does one speak with love and openness without hurting the other person’s feelings?  Marriage is hard work.  It’s even harder when the relationship is complicated by the inadequate feelings of infertility, dissatisfaction at jobs, the need to provide for your loved ones, and finances.  All of these make the road tougher.  Sooner or later we will find a solution to all this.  The worst financially will be that we’ll have to pay out of pocket for many things that are covered right now.  The amount of money that we have saved is finite.  If we spend the money on something, then we’ll have less money to do more cycles.  Again, I am letting my fear speak.  I just hope and pray that I will not let this crippling fear take over me and that we will have the faith that God will guide us to the right path.  

“Always something!”

Yup.  There is always something.  That was what my friend said to me today.

At my follicle check today, Dr. E found six follicles of various sizes on my right ovary.  I could personally only see four of them.  But she saw six.  She didn’t tell me the size.  I didn’t ask.  The left ovary is not doing its job.  The two follicles are still tiny.  They grew a little but not enough.  Dr. E said we’d still give them time to grow.  No one knows what will happen in a few days.

We’re continuing with four vials of Menopur, 25 IU of Omnitrope, and one vial of Cetrotide to prevent ovulation.  She wants to see me either tomorrow or Friday.  I have been dreading her asking to see me because of the Bay Bridge closure and I would have to go on another bridge to go see her.  I could always go to another clinic on this side of the bay.  After thinking long and hard about it, I’d rather drive the distance to go see her.  I’d feel better that way.  

Oh by the way, my CD2 FSH this cycle was 10.6!  It was over 18 last two times.  My estradiol was normal at 31.  My DHEA is creeping up and is high.  I guess it’s normal since I’ve been taking 75mg of DHEA a day.  Dr. E still wants me to continue taking it.  

I asked Dr. E if she was sure that we would do a day five transfer instead of a day three transfer.  I meant it as a question to see how she decides on a day three versus day five transfer.  She understood my question in another way.  She said she wasn’t sure if we were going to do a day five transfer because the fibroid that she thought was only making the uterus cosmetically unpleasant looking is now actually growing bigger.  It may creep into the uterine cavity.  She wouldn’t want to transfer any embryos if the fibroid might affect implantation or pregnancy.  She wants to assess the fibroid on the day of retrieval and will make a decision then.  If she decides NOT to do a transfer, she would refer me to “the best” surgeon for the removal of the fibroid.  I have had enough of a full-blown abdominal myomectomy that took six weeks to recover.  I really don’t want another big surgery.  She reassured me that it would not be a full one but one that would be done laparoscopically.  

So we may not get to transfer, again.  We may need a surgery.  Yup.  There is always something.  Bob is very positive about it.  He likes that we still have a bunch of follicles in the running.  If we need a surgery, then we’ll take care of it first.  To him, this is all good news.  I am still taking it one day at a time and am asking God to give me the strength, patience, peace, and calmness to deal with anything unexpected.  Anything can happen in an IVF cycle, right?