Happily Ever After

The more I think about switching clinics the more stressed I get. I think I’m just going to stay with Boston IVF for now. I will still meet with the other clinics though. That way I can find out what they would do different and maybe talk to my current RE about it.

I’m at work today and finding it hard to get anything done. I’m still very depressed. I just don’t know what to do. Part of me wants to give up for a while. I’m sick of TTC. However I’m not sure how much longer I’ll be blessed with my insurance so I decided to keep trying. It depresses me though. I Just don’t know what to think. Our chances of conceiving on our own is slim now that my RE suspects egg quality.

I hate feeling this depressed. Part of me wonders if I should just go to my OB and request antidepressants. However I hate them. I was on them YEARS ago and managed to learn to deal with my depression/anxiety on my own. This TTC/IVF roller coaster is to much for me to handle now. I can’t seem to find any enjoyment out of life right now. Not even with my husband. 99% of the time I just want to be alone…which is not like me. I can’t sleep at night any more. All I can do is lay there depressed until I get so tired I can’t keep my eyes open any more.
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I seem to go in and out of this “mood”. I hate that I’m so up and down. Just goes to show I don’ t need anti-depressants. However when I’m down it makes it hard to get anything done. I know I will get through this “funk.” It’s just a matter of how long it will take me.

I took the day off today so I can have some time to myself. I really needed it. I have been very depressed the past few days and need to get myself out of the funk. I’m confused and frustrated. I’m confused by all the blessings I’ve been given and some of the stuff that was said…I don’t know what to make of my patriarchal blessing any more. It all seems like it was meant for someone else.

I booked a BUNCH of consults:
I had one with my RE (Boston IVF-Dr. Bayer) last night but I need to talk to him further

I spoke to my current RE. He thinks I have egg quality issues. He said my embryos were “iffy” quality. Technically they were grade 2 and the worst grade is 1, however they would have been better quality had they been more then 5 cells. He said I can do the blood tests I want (like karyotyping) although since he suspects egg quality I don’t think he sees a point but he will let me do it.

He wants to ad LH to my protocol and said he will up my dosage to 300 gonal f if I want him to but he doesn’t want to risk going any higher because he is afraid I’ll stim to fast (which I probably would because my body is stupid).

I am meeting with the RE at the other clinic next week. I don’t have the mental energy to search out other clinics since my insurance could change at any moment. As of right now I have it till April 1 2008 but that could change any time.

I’m hesitant to go to a new clinic because they have to get used to how my body works all over again.

anyhow, I don’t know what to do. I should switch clinics and I might go with the local clinic if I like the doctor. However I feel guilty switching. This local clinic is MUCH smaller and their success rates are not any better. Boston IVF does over 3k a year and the local one does around 1k.

guess it’s all dependent on what this new RE says.

I’m so angry right now. I suspected egg quality after my first IVF fails. Just goes to show that having a PhD doesn’t always mean everything. I’m so angry and annoyed. I feel that if I was in charge of my cycle I would have been pregnant a long time ago!

Egg quality only gets worse as you get older and that scares me. I’m angry right now. Very very angry and sad.

Today is worse then yesterday. I still can’t believe this is happening again. I sit here and ask myself what I’m doing in life that makes me happy. I own my home, I have a new car, a husband that loves me, a good income. Everything (with the exception of my husband) is materialistic.

My dreams: (not goals dreams, I have plenty of goals)

My number one dream has always been to be a good wife and an even better mother. To be able to bare my own children and be a stay at home mom.

Oddly enough I really can’t think of anything else. I must have other dreams right? I seem to be so focused on this one dream that I seemed to have pushed aside or forgotten any other dreams I may have had. Maybe I have no other dreams? That just doesn’t sound realistic.

Some people have told me to try not to focus so much on TTC. Try not to obsess over it. How do you not live, sleep, and breath something that you have wanted your entire life? I have dreamed of being a wife and a mother. I have dreamed my entire life of having babies. when I was little I’d put clothes under my shirt and pretend to be pregnant. As silly as it may sound to others it’s my life long dream. It’s all I’ve ever wanted. Picture your biggest dream (something realistic not unrealistic) something you have wanted your entire life… (and I’m not talking about a trip to the bahamas…something big) The one thing you want out of life…if you could have one wish what would it be? now picture never ever being able to attain that dream. Picture having to go through physical and mental turmoil month after month. Trying desperately to attain your dream. Doing everything in your power to get what you want. Only to find that after all the physical and mental pain that you failed once again.

Right now my life is taking care of my husband. Working full time so he can go to school. He works too but not because he has to. We can very easily live and save off of just my income. Granted his income lets us save even more money and that is why he choses to work. Not to mention he likes to work.

I love my husband but it has been a HUGE sacrifice for me to put him through school. I wouldn’t change a thing even if I could but I’m tired. Tired of working my tail off. Tired of having a high stress job. Tired of working in sales…but where else will I make the money I make here? If I get any other job I’d make 10-20k (a year) less then I do at my current job.

I tell myself that when Jon graduates my options are open. However how do I justify leaving my job when our jobs combined will have us making around 100k? How do I justify leaving when we will be pocketing an entire income? I can’t. I can’t justify that. Not even for my own health. Am I crazy? Does anyone else do this?

What would be wise, would be to drop to part time when Jon graduates so I can take some time for myself. I’ve spent the past 4 years supporting him through school. It’s time for a break. It’s time for me to take time for myself. Don’t get me wrong. I chose to support him and put him through school. It was a decision we made together. I wouldn’t go back and change it even if I could. I’m very lucky to have the job I do. It gives me the insurance coverage I need for IVF.

Another stress is the fact that our company is being sold. As of right now I have my ins coverage through April of 2008 but that could change at any time. Our co pay also went up from $20 to $75 for “expensive” procedures. Not sure if that will effect me but it’s a drop in the bucket compared to what others pay for IVF. I got an email today saying we could be sold and we are having a meeting. A VERY last minute meeting. I’m scared to death of losing my infertility coverage.

I had a blessing a while back (and I realize that those not of my faith will have no clue what I’m talking about here but M will) and it said I will get pregnant “sooner then I think.” Well this IVF didn’t work. Am I really supposed to believe it will happen on it’s own? Um…yeah right. I have no idea what that statement means but it keeps ringing in my ears. This will sound terrible but as happy as I’d be I’d also be TICKED if I got pregnant on my own after everything I have put myself through. Can you imagine? After 3 failed IVF’s? It would be like a slap in the face but a blessing all at the same time. Again I’d be so happy if it happened on our own…but to realize I went through all those treatments for nothing would be hard to swollow.

My beta was negative. I’m in shock. I mean I knew this would happen. I honestly can’t believe we will be doing IVF a 4th time. I feel defeated; like my infertility has won. I can’t seem to get my body to make babies. I have a feeling my embryos die before they make it to the blast stage. Not to mention my most recent issue “sticky eggs”. I’m angry. Angry this is happening to me. I thought for sure my 1st IVF would work….my second was a complete let down.

I feel like giving up. To be honest if it wasn’t for my PB I would have given up long ago. Not to mention my desire to know what it feels like to become pregnant. Part of me wonders if Jon and I should fill out adoption papers while we pursue our 4th IVF but I’m scared and not ready to do that yet. I know that it can take years to get a baby through adoption so part of me sees no point in even trying.

I’m tired, angry, exhausted. I can’t take this any more. I had a vacation set up for this week but Jon messed up the dates and we can’t go. I’m so angry and sad that we can’t go.

I just want to go home and sleep. AF is kicking me in the butt too so that doesn’t help matters at all. I need a vacation but have to wait till mid December. I need a few days off from work but I only have 11.5 more hours to take and I’m using that for my vacation in December. I planned our vacation for tomorrow thru Saturday on purpose.

I feel defeated today. I feel like my infertility has won. YOU won are you happy now??? Can I have my life back please? I just want to be myself again but I can’t. I’m a different person now. My infertility has changed me. I’m trying to make the best of it but it has hard. Trials change people. I’m trying to take this trial and make good of it but it’s hard. Today I give up. Today I am defeated.

I could take some time off (again) but my insurance might change next year so we can’t afford to take time off. Not to mention it takes about 3 months to complete an IVF anyway. That in and of itself is a break.

I feel like all the prayers in the world won’t change a thing. Fact of the matter is my body doesn’t know how to make babies.

I hope other people read this and realize what a miracle having a child truly is. It makes me sad that some people take it for granted.

Well I’ve been spotting since 10dper. It has been brown up until today and only internal. Today it’s pink and there when I whip. Cramps are really bad so I’m sure AF is on her way. I know that there is a small chance all this is pregnancy but I doubt it. I never spot that early but it could be the Crinone. DH has forbid me to test. Says I have to wait for my beta. I’m sure I’ll have AF by then. 😦 My cramps are very bad though.

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spotting is now heavy and bright red. I’m going to go tomorrow morning for my beta. I could care less what my RE thinks at this point. I’m also switching clinics. I have no idea where. I’m assuming the clinic close to home since DH says he’s sick of driving me down to Boston IVF. It makes for a very long day. Problem is I need to find a doctor who will do the testing I want done. If they won’t do it I won’t be their patient. I’m sick of being told what to do. It’s my body, my insurance. I’m paying them. They WILL do what I want to do. (with in reason). I want CD 3’s. Another SA, Blood testing for clotting disorder, kareotyping, immunity testing and an antral follicle count. I want to make sure I don’t have DOF (diminished ovarian reserve). I want my next RE to put me on a higher dosage of gonal f. I’d rather over stim and have to put off transfer for a month if it means getting more eggs. with me it’s not “it only takes one”. that is complete crap. If it only took 1 egg I would have been pregnant a long time ago. YES it’s quality not quantity but I don’t even think my embryos are making it to the blast stage so I need enough to be able to do a 5dt so we can see what they are doing. I need someone that will be very aggressive with me. not someone who will label me “unexplained”.

Well I’ve officially ruined my weekend. BFN again today. I know I could still get a BFP but I’m not holding out hope. I will be 12DPER tomorrow and will use my last test. If no positive tomorrow then I’m going to officially give up. YES some woman get late +’s but it doesn’t happen to often. Usually by 11 DPO they have gotten their BFP. Some as late as 12 DPO.

I knew I was right. I knew my embryos were dead when they transfered them.
I’m so sick of this. I don’t understand why I can’t get pregnant.

I had a blessing in which it said “it will happen sooner then you think.” I’m starting to have doubts again. “yeah right” is all I can say. “what ever”. Just as I started to have faith again…it’s going to be completely crushed. Well if God isn’t going to work with my time frame then I’m going to start looking into adoption. Regardless of whether my PB says by natural means. I control my life and I make my own decisions and I want a baby now not later. (how’s that for a temper tantrum) Oddly enough DH and I talked about adoption and at this point that is the route he’d almost rather go. Unfortunately we just spent our savings on two heating systems (we own an apartment building) and a down payment on our new car. I’m sure by the time we got a baby we’d have the money though.

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I took a very long nap…well I actually went back to bed and got up at 3:30 and I feel better now. I still think I’m out of the running but we’ll see. I don’t know if I’ll test tomorrow I think I might leave it for Monday morning. But then again I don’t know if I want to do that to myself on Monday. AF should be here Monday or Tuesday. I always start regardless of progesterone. we shall see.

BFN again this morning. Still early is what I keep telling myself. I just can’t picture doing this a 4th time!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

So I tested this morning but I knew it would be negative. I’m a little down in the dumps only because I know the next few days will be hard. I don’ t know if I can really handle another disappointment’s. I’m not looking forward to switching clinics. I’d like to go to the SHER institute in NY but it’s a 4 hour drive. I could fly there the week of ER and ET but I’m so sick of being away from home for ER and ET. I think I’ll look into their clinic and the clinic that is local. I may even cave and give my Re another shot but it really depends on what he says. I need someone that is going to be willing to do testing to see if I have DOR (diminished ovarian reserve) I have some signs…”sticky eggs” being one of them. I’ve only had my CD 3 bloods done once and my E2 was around 50. Not to bad but not as good as it could be.

well I will probably break down and test tomorrow, then Saturday and Sunday. I know tomorrow is early too but oh well.

actually there was a line on my HPT but it was an evap.

I posted on http://www.haveababy.com (SIRMs forums where a doctor will respond to your posts for free) and here is what Dr. Sher said about empty follicles.

btw SIRM is a very reputable clinic and one of the top clinics in the US (from what I’ve been told)

It’s nice to actually get an answer for once and not the crap my RE feeds me. I’ll be interested to see what my RE has to say about it when I call him next week.

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Underdeveloped and mal-developed (dysmorphic) eggs often have an exceptionally dense surrounding cumulus cell cluster that tends to attach them tightly to the inner wall of the follicle. The hCG shot, which is intended to mature the egg and disperse(loosen) the cumulus cells so that the eggs will comes free upon suction and can thus be readily retrieved upon needle aspiration, often fails to cause sufficient dispersion of cumulus cells when the eggs are underdeveloped or dysmorphic. Consequently, such eggs are often so more tightly adherent to the inner follicle wall that they fail to release easily. In such cases the eggs may not be readily captured with the first attempt at follicle aspiration, requiring that such follicles be repeatedly irrigated( flushed) and or scraped to try and dislodge them. In severe cases, these fail to come free. When this happens there is a tendency to describe such follicles as being “empty” . Since this implies that such follicles did not house eggs, it is a complete misnomer. There is no such thing as “empty follicles”.

Since most RE’s can easily perform the technical aspects of ER and since better quality eggs tend to readily release with the initial attempt at aspirating the follicle it follows that failure to successfully aspirate an egg is often due to the egg being immature or dysmature. The latter is usually indicative of the egg having an abnormal numerical chromosomal make-up (aneuploid).“Poor embryo quality is virtually synonymous with embryo aneuploidy and in >90% of such cases this is due to egg ( rather than sperm) aneuploidy.

Imperfection is part of the human condition. Thus a percentage of human eggs (regardless of age) will always develop abnormally (dysmorphism). Once exposed to an LH-surge or the “hCG-trigger” such eggs will have an abnormal number of chromosomes.

Egg dysmorphism and thus egg/embryo aneuploidy increases with age. In younger women ( <35yrs) 45%-50% of all eggs are aneuploidic, at 40yrs the incidence is about 60% at 43, approximately 80% and about 90% at age 45yrs. Fortunately, aneuploidic eggs/embryos fail to implant or miscarry early on in pregnancy. Sadly, depending upon which chromosome(s) is/are involved, developmental defects such as Down's syndrome (Trisomy 21) sometimes occurs.

The unavoidable threshold risk of age-related egg dysmorphism and aneuploidy can however be seriously compounded through over-exposure of developing eggs to male hormones (predominantly-testosterone). These hormones are normally produced by the connective tissue (stroma) that surrounds the egg-bearing follicle(s). Overgrowth of the stroma occurs with advancing age (beyond 35years) and/or at any stage when ovarian reserve declines below a certain threshold (evidenced by poor response to fertility drugs, rising day 3 FSH level, falling Inhibin B levels, etc.). The eggs of such women are thus inordinately vulnerable to an over-exposure to LH-induced ovarian testosterone. In such cases, over-administration of LH-like products(hCG) or LH-containing fertility drugs (Repronex or the use of ovarian stimulation protocols such as “Flare-agonist protocols” that establish very high LH levels early on in the stimulation cycle) can be especially harmful.

There is little one can do to reduce the age-related risk of egg/embryo aneuploidy. However since the risk of compounding egg dysmorphism and thus egg/embryo aneuploidy can be avoided by individualized stimulation protocol selection and precise timing of the hCG “trigger shot”… both very important considerations when attempting to improve egg/embryo quality and IVF outcome, especially in older women and those with diminished ovarian reserve.

Dr. Sher