I have contemplated for months if I should broadcast our journey to creating new life. Today, a random Wednesday, I decided it was time. Maybe it's a way to release my emotions, my thoughts and a way for those who know us to have a place to go to get an update. I, also, look forward to the day when I get to write my last sentence announcing the birth of our darling child. Plus, secretly, I have always wanted to write a novel. If I capture my moment to moment emotions, tests, results maybe I'll have enough info to recall and write my story. Along the way, in our very loooong journey, we have met incredible people...doctors, nurses, therapists, ultrasound technicians, receptionists, acupuncturists, phlobotomists, anesthesiologists, you name it. I have a condition called Polycystic Ovarian Syndrome (PCOS). It's unexplainable as to how one gets PCOS yet it is the most common infertility diagnosis, 1 in 10 women. PCOS is not the most correct name. I don't have cysts on my ovaries. Women with PCOS don't always ovulate because their follicle never matures to the right size for ovulation. Instead a woman with PCOS has many little follicles lining her ovaries that resemble a pearl necklace. For some, with PCOS, it's as easy as taking a pill called clomid, a four day prescription that you take after your menses which stimulates mature growth for your follicle(s). The dose is based on many other factors such as hormone levels. Since most of my hormone levels are normal I was on a very small dose and my body responded incredibly well. Two follicles. An average woman only releases one follicle (the egg is released out of the follicle during ovulation). Women on fertility meds have a greater chance at conceiving multiples. If you don't conceive a full-term healthy pregnancy in about four months from using clomid, odds are not in your favor and the route would be IVF (in vitro fertilization). On month three I got pregnant but unfortunately lost the pregnancy. Today is Oct. 6th. If my pregnancy lasted our baby would have been born a few weeks ago. It hurts to think about it. We tried for three more months on clomid and, though, my body responded well to clomid I never conceived again. During our clomid months we would naturally try to conceive at home but we would also be doing a procedure called intrauterine insemination (IUI). Rob would do his business, I would pick up the "kids" from the clinic and drive to my doctors to then be inseminated. What would normally be an easy pap-smear type set-up was always much more difficult. A tenaculum had to be used because my cervix would not cooperate, it stayed tightly shut and would not allow any foreign objects through to my uterus. The tenaculum clamps onto the cervix and holds it open while a speculum and catheter make their way in, as well. Hey, what a party! Come early April, when I learned, yet, again, I wasn't pregnant we decided to meet with Dr. Weckstein at Reproductive Science Center in San Ramon. He was recommended by my cousin who has friends who had their miracle babies because of Dr. W. and by my acupuncturist, Judy, at Nurture Acupuncture specializing in infertility. I go weekly and receive acupuncture and reproductive massage. There has been studies proven that acupuncture increases your chances of successful pregnancies by 65%. Nurture Acupuncture suggested I go on a low-glycemic diet and stay away from foods that the Chinese believe are not good for the body while trying to conceive--raw foods vs. cooked, cold foods vs. hot, spices, fruits, shellfish, pork, etc. So, I changed my diet.
After our meeting, April 14th, with Dr. Weckstein, we were convinced the way to go would be IVF. If we continued without IVF my chances of pregnancy would be somewhere between 5-10% a month, an average woman has a 20% chance. The average woman takes about six months to conceive. I was sooooo hoping that by March it was going to be my time. While I was in the middle of a business trip, I learned the news, that yet, again, I wasn't pregnant. Another stab to the heart. A deep breath, a few tears, a conversation and a new thought for another try resurfaces. My parents are incredibly generous. They have taken the financial burden off of Rob's and my shoulders and are paying for our IVF procedures, I mean, everything it entails. We still pay for acupuncture, blood tests and some therapy...that's the least we can do.
Dr. Weckstein made us feel confident about our next steps. He's amazing! Just a wonderful, caring, loving, supportive person who happens to be an incredibly amazing doctor. If anyone reading this is in need of help with their baby journey, I highly urge you to contact RSC and meet with Dr. Weckstein or any of their other great doctors. So, we took the next two months off. Wow, it was a breath of fresh air, no nerves, fear, sadness, drugs...just plain life as we knew it.
In June we began... estrogen pills, aspirin, antibiotic, three injections in the belly and later in the tush. This hormonal prepping is for producing follicles, the more follicles the better chance at getting good eggs. But the docs have to be so precise because a woman can't be overstimulated, all hormone levels have to be perfect. After a month of medication, it was time for my egg retrieval. It is a surgery, fully under anesthesia. At the time of surgery, I had 27 follicles! An average woman only has about 10 or so. Women with PCOS always produce more but it doesn't mean they are all good eggs. Going into surgery, Rob and I were told that they expect 8-10 eggs out of the 27 follicles. When I woke from surgery, Dr. Weckstein shared with us that we had 25 eggs!! From the 25 only about 12-15 were expected to fertilize. (Btw, Rob's seed has been tested and they are "excellent, just excellent" according to the doc.) The surgery is an outpatient procedure. We would get a call the next morning letting us know the status on our embryos. We got the call...23 fertilized! The ultimate time to transfer an embryo back into the uterus is on day five, the stage of the embryo is called a blastocyst...the stage an embryo attaches naturally in the uterus. Most women, going through IVF, do not get to transfer at day five because most embryos aren't living well and are not producing at the rate in which an excellent embryo would inside of the woman's body. On day three we got a call saying our embryos are excellent and that we'd be able to do a day five transfer. Yippee!
Day four, we're getting excited, feeling good, finally approaching the day to transfer and all of a sudden I began to feel ill. A little queasy. Maybe it's nerves. I call the doctor. We think it's nerves. By 5 a.m., on day five, I wake up with excrutiating pain in my lower abdomen. Rob calls the doc because the pain is intense and I'm scared. I was given some exercise movements to take away the pain, it works. By 8 a.m., I'm throwing up. Doc calls to check in to see how I'm feeling. I let him know that I began vomiting. He suggests I still come in. We arrive, I participate in my pre-transfer acupuncture, right after acupuncture I started to feel queasy again. As Rob, my mom and myself are waiting to be seen by Dr. W, I run outside and find the trash can and hurl my eyes out. The trash can smelled of old food and cigarette ash, it made me even more sick. Five minutes later, I'm running to the bathroom and vomiting more. At this point, my stomach is mildly bloated, a noticeable difference from my usual shape. Rob and I meet with Dr. W. He checks things out, notices I do have fluid in my abdominal area. I am now diagnosed with Ovarian Hyperstimulation Syndrome (OHSS). OHSS is more common in woman with PCOS. We have decided to cancel the transfer. Dr. W tells us that if he transfers and I get pregnant, these symptoms will most likely worsen and stay possibly through my first trimester. The game plan is to freeze our babies, for me to heal and come back in two months to try again. RSC has a very high pregnancy success rate using frozen embryos, just about the same from a fresh cycle. I was concerned about the survival rate with a frozen embryo. Dr. W said with embryos like ours the survival rate is 95%. I felt much better.
My heart aches for Rob because this was supposed to be an exciting day and I can see his sadness. My heart aches for myself because I wanted the same as Rob but I feel so miserable I can't imagine feeling this way for three more months. I was prescribed a neasea pill. It helped for the first 8 hours...then....
Day 6 I am feeling my worst, the worst I have ever felt in my entire life. Vomiting uncontrollably, gaining pounds by the hour (fluid), pains in my abdominal area, constipation, new symptoms keep coming by, what seems, the minute. Just awful. Dr. W calls to check in. I tell him the status. He feels that our decision was the best since my symptoms are worsening. But, he does have really good news. Remember above I was talking about the blastocyst stage of an embryo? I learned that a woman is lucky to maybe get one out of many egg retrieval surgeries. Rob and I have 13 blastocysts!!! This means many things but most importantly we have incredibly strong embryos...so good in fact that Dr. W only wants to transfer one back into my uterus (when the time comes). And, this also means I won't have to go through another egg retrieval again because we have so many excellent embryos. Thank goodness for many reasons!
By Day 8, I continue to get worse. I gained 20 lbs in less than 8 days, all water weight. I couldn't wear a bra, I could only wear sweats and was only comfortable wearing Rob's t-shirts. I looked like I was seven months pregnant, too bad I wasn't. I had a very hard time breathing, I had to sleep sitting up. I could not find a comfortable position to sit in, lay in, what have you. The weirdest sensation was being hungry but feeling so incredibly full after four bites because my stomach had no room to expand, all of my organs were in the way because of the swelling in my ovaries and abdominal area. Fortunately, by now, the vomiting stopped but other symptoms worsened.
It wasn't until Day 10 or 11 that I began to feel slightly better. I was told I would start urinating like crazy (btw, my urine turned brown during OHSS). Well, I began peeing a river every so often throughout the day. The more I urinated, the color of my pee was turning back to normal. Phew. I started losing the water weight. My constipation turned to diarrhea. Lovely.
By Day 14, I was back at the office. What a ride. And, still no baby.
About five weeks later we were back to trying and prepping my body for the transfer. More acupuncture, injections in the tush which my darling hubby is so brave to handle. A handful of doctor appointments to check out my lining, etc. Two weeks later I was ready!! BRING IT ON!
August 30th, transfer day. We arrive. I first participate in a pre-transfer acupuncture session and then do a post-transfer session, too. The acupuncture helps to have a healthy blood flow. The staff, always so loving and warm, greeted me and Rob. We are brought back to the surgical area. The transfer is nothing more than what a pap smear involves except for the catheter and embryo. What should take a total of 15 minutes took an hour and 15 minutes on a full bladder. I had to get on and off the table five times, to pee a little bit at a time because my bladder was getting too full. Which means the speculum was re-inserted five times along with the catheter. My cervix, yet again, was being stubborn. You could see on screen there was this tiny piece of tissue that made it close to impossible to get the catheter into my uterus. After an hour of trying, bringing another doctor in to help, the room was tense...me, Rob, Dr. W., Amy, u/s technician and Andrew, the embryologist, were biting tooth and nail hoping this procedure wouldn't be delayed. And, now, the tenaculum is out and now in me (I forgot to mention above that once the tenaculum is removed the cervix has to be coterized (spelling?) for bleeding). Well, I'm happy to report we finally got the catheter in my uterus and our little darling was transferred into my uterus. Supposedly my lining was like a cloud...I told our little darling to find a comfy spot and take a long nine month nap. We finally got to go home.
After a transfer, you have lay down or sit up for two days. Your only movement is to go to the bathroom or take a shower. After those two days you are not allowed to exercise, lift, etc. After a Day 5 transfer (because though we are months out from the retrieval, our embryos are still at Day 5, blastocyst, since they were frozen), the wait for the pregnancy test is nine days. Nine looooong days....
Sept. 8th, the ninth day, and the Jewish new year, D.day...I'm a nervous wreck, I believe I'm not pregnant because why would I be? Rob, my loving, darling husband, stays home with me to keep me company and sane. We go to breakfast, take a walk and let the time go by. Each time the phone rings, I jump. It reminded me of waiting for that boy I liked to call. Dr. W calls...I'm pregnant! WHAT?!!! OMG!!! But, here's the catch my pregnancy hormone level, hcg, is low,however, I'm in the gray area...it can go either way...high enough to be a healthy pregnancy but also low enough to go the other direction. I have to wait two days for another hcg test. Sept. 10th...again, the wait. I get the call. And, yet again, I'm losing the pregnancy. My hcg level did not move. It's supposed to triple within in 72 hours. I'm told to come back in four days to test again. I get my period...getting a period used to be exciting because with PCOS I didn't always bleed. But this past year, it was heartache...I cried just looking at the blood that was supposed to nourish our baby and now it's not. To make the moment of bleeding even worse when you miscarry, you cramp when you are passing the pregnancy tissue. It's rubbery not like your normal clot. It's an awful thing to witness and then flush down the toilet. It feels like you just flushed your baby down the drain. More tears... Yet again, I'll approach May 2011 with the sad thought that our baby would have been born this month.
I get my hcg tested again...my levels have gone down. Well, at least we are on the right path. We can begin to move forth. Three days later, I get tested again... my levels quadrupled. WHAT? I get tested again and it still goes up. Why? I had my period. I saw "it" come out of me. How could this be? I'm not pregnant but my body is acting like I am. I still have some tissue that did not leave my body. I need to have an injection of Methotrexate which is a small dose of chemo. Also used for early abortions. I received two injections, one on either side of my hips. I bleed like I did when I had my period for the second time...just soaked. I get tested, my level is going down. Get tested again, went down, slightly. Tomorrow, tested again...fingers crossed the trend continues downward.
In the meantime, I wanted to be tested for autoimmune deficiencies. Fortunately, all came back negative. I do have a DNA mutation stating that I am B vitamin deficient which is crucial for a healthy pregnancy. I was given a prescription strength of a vitamin called Folgard which contains B6, B12 and Folate. Hopefully, this is the answer to a healthy pregnancy.
Dr. W is continues to be very confident that Rob and I will be celebrating with a healthy full-term pregnancy. I asked Dr. W why he was so confident that I am going to have a healthy pregnancy. He said because our embryos are incredibly strong, I have a normal shaped uterus, my tests come back normal and because of my young age. He said he couldn't promise me I'd get pregnant the next transfer but that he is confident we will be celebrating! I can't wait for that day. I truly can't. Rob and I had a wonderful meeting with Dr. W. We got to ask all the questions we needed and Dr. W made us feel good about next steps and what's currently happening.
Next, is a surgery called a hysteroscopy which was originally scheduled for Sept. 29th but had to be postponed because of my hcg levels. They have to be at zero. We have a ways to go. As soon as my levels are down to zero, we can reschedule. The reason for the hysteroscopy is to fix the little tissue issue with my cervix. Dr. W said my cervix is a bear and once we fix that, hopefully, we'll be on to better days. During the same procedure, since there are cameras inside of me, he can look around at all of my reproductive organs and give it the thumbs up. So far, all of my tests be it blood, hsg or saline sonongram come back normal so I expect my hysteroscopy to be normal as well.
After the hysteroscopy, a month later we can start to try again...another transfer. Now is the time to consider one embryo or two. I fear carrying twins but raising twins would be a joy. A baby is a privilege, I want to be given that privilege...waking up every hour, calming our child, feeding our child. As we approach transfer number 2, we'll talk with Dr. W on his thoughts. Transfer number 2 will probably take place in Dec or Jan. So, from March thru Jan, we will have only tried twice to have our bambino. What a ride...
In the meantime, I started going to therapy. I haven't even broached the emotional roller coaster this has been for me and Rob. I continuously have a lump in my throat, I could cry at any minute. I have a hard time walking into a department store and bumping into the childrens/baby section, or at a grocery store where they sell baby goods, or at a restaurant watching a family, a mom with a newborn or a woman who is pregnant or those families that have five kids...why can't I have one? I often ask, why me? I'll never know. But what I do know, is this journey has already made me a better parent. I will have more patience and I will view all moments, whether tiresome or happy, as a privilege. Therapy has been wonderful, a source to release. My therapist is wonderful. I just realized, as I have been writing this entry, that there are people in our life now we would have never known had it not been for our baby journey. So, I'm grateful for that, too.
Let me just say that Rob is amazing. I love him so much. He has been a rock, been my angel, been my everything. He's cared for me when I was ill, when I was sad, when I was mad. I hope that I'm there for him the way he's for me because this takes a major toll on him, too. I proudly admit that this journey, though very hard, has brought us even closer. Thank goodness, I am so grateful for that.
I've brought you up to date...minus sad days, scared moments and obsessive Googling. So, Rob and I wait...I guess that's the operative word, we wait. And, ultimately, we wait for the moment our baby is in our arms. I know it will happen, I can feel it but I just wish I knew when.
