My WTF Appointment

0920 hrs I was seen at my REI clinic at Madigan with my spouse.  We sat down with Dr. C. to discuss what went wrong with the last IVF cycle.  J was really tired from his CQ duty last night so I wonder just how much he comprehended from the meeting.

Dr. C. explained everything to us but I still don't know the reason why it failed.

On day 3 we had a 8 cell, 0 fragment, Good quality egg, Perfect embryo.  The abbreviations and number were explained to us from the chart.  So if it was a perfect embryo why did it chose to not stick around?  I know I was pregnant because of the two home pregnancy tests.  I told Dr.C. at this appointment that I took them.  I guess it changed the picture a bit.

Now the focus is on the fact that my eggs are my age and not so much what could possibly be wrong with me but with the eggs themselves.  If we used donor eggs he said we'd have a 65% success rate.  I have only 40% with my own eggs.  But it was perfect I'm yelling in my head.  I must have done something wrong.

I asked about the hypertension issue since I'm always on medications.  Its not that.  I asked about being put on restricted weight limit for lifting  he said even if I moved furniture it wouldn't be the problem.

So why?

He said it could look perfect at day 3 but there are sometimes issues with implantation, yes even with the Assisted Hatching we had done on the embryo.

I then asked if it was the endometriosis. He said that could be a factor but that most likely it was still with the age of my egg.  Dr. C. said one of the larger follicles he drained in his egg quest was filled with blood so he knows that I have issues with endometriosis.

To be quite franks he was genuinely surprised to get the 8 cell with zero fragmentation and a perfect embryo considering I'm 42.  He said its rare.  So we still don't know the exact reason why it didn't chose to stick around.

Looks like I'll be doing a late January embryo transfer if all goes well.  If I don't have enough follicles we'll commute to an IUI and hope for the best.

J's morphology issue is no longer an issue and that is good to know.  Now if only his sperm will stay that good for the next round.  We are still going with the ICSI for the January IVF.  We have to.  Dr.C. says it will again increase our odds of a better embryo.

This time I hope we get four follicles for retrieval day, we had four the first day but Dr.C. wanted to wait leaving it at only 2 follicles left by retrieval day.  Dr.C. just didn't want us to do too early of an egg retrieval.  But now that he knows my ovary reserve is declining we might end up doing an early retrieval in January.

I'm also hoping for two perfect embryos to transfer this time around.  I can hope right?

I can also hope that I'm pregnant now, right?  I mean I am in the two week wait right now after ovulating on my own.  But yes, I know that at my age its rare.  My maternal grandmother had my mom at 42 so there is always a chance. 

Checking The Costs

Just for the heck of it today I decided to start researching the cost of donor eggs.  Donor eggs would give me a bit more time to try for a child.  It wouldn't be of my genetic material but it would be still of my husband's so its not all that bad to consider.

However, after just checking out the cost for a donor egg set of 6 eggs, the cost is going to be way out of my budget.  $15,000 for 6 eggs.  Yes, it would give me that chance to become a mother and its still quite a bit cheaper than trying to adopt.  But I can't afford the cost right now. 

I could do a loan but really is that a smart thing to do?  In this economy taking out a loan to get pregnant?

I guess the only reason why I'm even looking into this Donor Egg route is because I've yet to ovulate on my own after testing now for three days.  I have all the pains but it could just be the endometriosis.  I'm afraid that my eggs are really failing me.

I read quite a few blogs today and on one in particular the gal mentioned a similar problem to what I had with my last IVF cycle.  Her follicles weren't waking up like they should.  Her doctor decided to tweak her meds and she ended up with plenty of good eggs.  She is just two years younger than me.  I wonder is it because the Army doctors are limited on the types of drugs they can use for our protocols that I'm to never have that baby or is it because my doctor isn't all that great as to live up to the expectations I had hoped he would or quite possibly my eggs are just expired.

My odds given the two eggs they retrieved out of 8 follicles, most not even close to being ripe mind you, were as expected.  I had a 50-50 chance of getting an embryo.  I got one.  Just one.  It temporarily implanted but then something went wrong. 

Now I wonder if its the clinic or my body.  Did the embryologist not chose the best sperm when he did the ICSI?  Or did my body just decide to reject the embryo because I had a sinus infection.

I want a do over.  I want a happy healthy pregnancy.  Maybe I'll get that chance come January.  Now I just need to get another 15 pounds off to make it to my next goal.  I could handle going into the next pregnancy with only being 20 pounds overweight since I know my blood pressure will be more under control with the more weight I get off.  But I can't prevent sinus infections, colds, and flues even if I get the flu shot next week.

Too many variables stay subjective.  I'd like to change all that and make it more of a controlled environment.  An ideal environment.  For now the thought of donor eggs will have to shelved.

Waiting on What Ifs

I had my day 5 Estradiol draw this morning at 0700hrs.  Now I have to wait for those results to see if my medicine routine will be changed up.  I'm thinking that its going to change a bit and I've got good reason to think along those lines.

I had my ultrasound at 0800 hrs.  Nurse M asked if I've had any pain.  I said some.  Scale of 1 to 10 its been a 4 or a 5.  I'm pretty good at tolerating pain with having Fibromyalgia.

I got on the scale.  I've lost according to their scale but according to mine I've gained back 1.2 of the 2.8 I lost this week.  So I was bummed out.  Nurse M said weight gain is to be expected with the ovaries swelling up.  Sure, sure, tell that to me all you want but I know that I failed myself.

Nurse M asked if I've been experiencing any of the side effects from the medicines.  Yup.  Headaches, nausea, bitchiness, lack of sleep but I've got it under the best of control I can with counseling, avoiding the television which increases the headaches, and venting when needed.

J held my hand during the scan.  He was nervous.  He has been really stressed for the past few weeks about this IVF cycle and other things like deployment issues.  Now for the results of the scan.  Um, well its not all that good.  Last week I had 8 antrals, potential follicles/eggs, now I have three on the left of which are ready to go now.  What do you mean you could do a retrieval now? 

Dr. C. said he could have an egg retrieval on Sunday for the 3 ripe follicles measuring over 20 mm in size.  But....yes there is always a but.  He then said that I have 4 potentials on the right that he'd rather wait for.  Another BUT....But he said the 3 on the left would be no good by then.  SO...we are most likely going to do an egg retrieval of the four, I hope like hell that the four are ready and good, on Wednesday.  I'm two days ahead of my IVF schedule.

I did tell them at the start of this IVF cycle that I ovulate early.  They said it wouldn't happen that way because I'm on regulated hormones.  I so wanted to shout, "I TOLD YOU SO!".  But of course I didn't say it.

Another BUT....things might still not go as planned for Wednesday.  I still have another scan on Monday and another blood draw.  If the follicle aren't ready or if I'm now down to say two, then my IVF will get cancelled.  I have to be prepared.

I have to also be a realist here.  Even with four follicles on the right and three on the left I might not get a quality egg.  I might find out there is nothing of sufficient quality to do the ICSI on.

I was chatting with my husband about all the "what ifs" on the ride home this morning.  I wonder if I'll get a refund if there are no embryos to transfer.  Do I get a refund if there are no quality eggs?  If so how much?  How long before we could do another IVF cycle?

Then there are the big hopes and what ifs.  What if this actually works but I miscarry?  I've miscarried twins before.  What if my eggs seem of good quality but then I produce a baby with an arm sprouting out of its scull?  Hey's its always a possibility, a scary one but still possible.

I need to relax and not think about all these possibilities.  I need to keep my blood pressure down.  It was good today at 135/82.  I have to keep it low enough or else the retrieval will get cancelled.

IVF And Army Complications

Well it seems as though that when it rains it pours.  Creating life is now a bit more difficult for J and I.

Here I thought I was the only one with the fertility issues, but now it seems that the morphology of his sperm is now borderline.  When did that happen?

So we are now adding into our procedure ICSI, Intracytoplasmic Sperm Injection, and the AH, Assisted Hatching.  This is going to up our cost of the IVF another $1400-1800.

Now for the biggest problem.  Getting the chance to keep my spouse home for the IVF and pregnancy, God I hope there is a pregnancy.

My doctors aren't being that cooperative.  I've now asked two of the folks at my REI to write a letter stating that in the event of pregnancy that they would recommend that my husband be allowed to stay on rear-D until the risk of loss is removed.  They won't do it.  Its not like we are asking him to stay home for the entire deployment.  Nor are we asking his brigade to go understaffed either.  We've explained to my doctors that they are currently overstaffed for my husband's slot and he would like to be considered for one of the rear-D slots that are open.

But no, REI can't help.  Now I have a referral to MFM, maternity fetal medicine.  I need to be evaluated for my high risk any way and maybe they could write a letter with a recommendation.  I hope.

I have to go over to see a mental health doctor too.  No I'm not crazy but I'm just getting myself prepared to deal with this deployment, a possible pregnancy, possible miscarriage, possible realizing that my fertile years are totally gone.  I need someone to talk to about the hormone roller coaster that will understand what I'm going through.  Maybe she will be able to write some sort of recommendation.

Next I have to see my cardiologist.  I'm far behind on those appointments.  I've missed two this year.  Maybe Dr.K. will be able to write something about my risk factor.

I still have to go see my PCM, primary care medicine, for a prescription renewal of my high blood pressure and asthma medicines.  Maybe Dr.G. will be able to write a recommendation.

I have my doubts.  I'm certainly not going to ask my optometrist to write a note.  I'm not blind yet even though my optic nerves are calcifying.  Yes, eventually I will go blind.

I just want one of my doctors to write a blasted note that the commander needs before he makes out the list of who he is planning on sending out for this deployment.  I'd like my husband to be left here.  We've made so many sacrifices already.  For three years we've had to put off trying to conceive because of training, hardship tour, deployment.  Now I'm just asking for this IVF cycle and pregnancy time if there is a pregnancy.  I'm not greedy.  I'd rather not bleed to death on the floor due to a miscarriage because no one is there to help me.

I'm all set otherwise.  I'll cope just like I always do.  I have my two grocery bags of hormone injections all stored away like they should be.  I have my huge plastic bag of needles and syringes next to the shelf stable medicines.  I'm good to go.  I know when and how to inject the medicines.  But yesterday we were told in the seminar that I'm not to give myself the daily progesterone injection but that my spouse has to give it to me.  So how the bloody hell am I to get that particular injection if he is deployed?

Who is going to write that letter?