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.