Traveling

We are in the process of finalizing a trip to Chicago to see Dr. Kwak-Kim. Her office sent me a pile of paperwork that I turned around within 3 hours. I think they were a little shocked at how quickly I completed it all. I guess that is the benefit(?) of already filling out similar paperwork for Dr. Braverman.

There are many reasons for the travel, however the main one is that we are on the cusp of making some significant decisions and we are not comfortable basing them solely on Dr. Braverman’s expertise. We want a second opinion. And honestly, I think we need the second opinion just to feel like we’ve covered all the possible bases. I could also go into the cons of dealing with Dr. Braverman, but I will just say that he’s a very busy doctor that is often spread too thin. Also, the jury is still out but it looks like Dr. Kwak-Kim takes our insurance.

Things with me are very up and down. Some days I am ok (not happy, but OK) and other days I cry often. There were tears today after I read a facebook status update that said “Children make the holiday season magical.” The truth is, I feel no magic in this holiday season (or the past few) and I’m looking forward to bidding 2012 adieu. Actually, I think my first thought here was “2012 can go fuck itself.” Recently, it occurred to me that I am not just crying for my recent miscarriage but at the very real possibility that our infertility journey has come to an end and we have 0 money and 0 children to show for it.

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Which Way

I’d like to say things are getting better and staying better but it seems that returning to infertility treatments has halted and also reversed any healing I did after my miscarriage.

I hate hate hate where I am right now and I’m angry that I cannot seem to snap out of it. Women have miscarriages all the time, it’s not like I’m special or anything. I wish I knew how to just suck it up and move on. On one hand I remind myself that I only lost the pregnancy a few months ago but on the other hand I feel like I should of made more progress? I should be feeling better? I don’t know. It’s just, we put so much emotional, physical and financial effort into that baby we lost: 3 IVFs, a polyp removal, CCS testing, 1000’s of injections (FU Lovenox), the bulk of our savings, etc and now I just feel empty. I have always been a strong person and I feel so very defeated.

Yesterday I cancelled on my RE literally 1 hour before I was scheduled to have a procedure. Instead, I stayed in bed and cried for a few hours. My husband then called to see how the procedure went and was shocked when he heard I didn’t go. I always go. I finally dragged myself out of bed, worked a few hours and then cut out early for a manicure and pedicure. I am trying, but some days the sadness is just overwhelming.

Perhaps it isn’t just the miscarriage, but that I am so worn down after almost 2 years of failed infertility treatments? Why continue when we always get bad news? There are just so many obstacles against us. I don’t know how we will overcome my husbands sperm DNA fragmentation and I don’t know how to overcome the HLA match issues. Especially as there is now some concern about using Neupogen due to my blood clotting issues. While we are fine using a gestational carrier it is a huge expense for us on top of 2 years of expensive infertility treatments.

I’ll admit it, I bought Powerball tickets yesterday. Unlimited funds would really help us reach the goal of 1 baby. We won $7.

Just a note to those of you who sent me an email, txt, or left a message after my last post. Thank you for checking in. Thank you for taking 1 minute out of your day to say hello, commiserate or just support. It made me feel less alone.

Impossible

I am struggling with our next steps. And to be honest here, struggling is a mild word for how I feel.

We’ve been at this infertility nightmare for almost 2 years now, with many years of trying to conceive naturally prior. It has become part of our everyday lives and unfortunately infertility isn’t a train you can just cleanly hop off of and forget. It just chugs and chugs and chugs and drains you.

People keep saying “it will happen for you” but these are people who are not involved in the HOW. HOW WILL it happen for us?

This is not a question easily answered:

1- IF we can get any chromosomally normal embryos that also happen to not have mitochondrial issues,

2- We can then off label use Neupogen at transfer for the HLA match issue. This drug, mind you, is experimental, and is intended to treat chemo patients. It is not covered by insurance (off label use rarely is) and will cost about $10,000 out of pocket. To me though, the bigger issue is not the cost (although that still makes me vomit), but if Neupogen works for us, how could it affect the baby? Or me? No one can really answer this and therefore, I am very very stressed about using this medication. This leads us to the last option, which is to…

3- Use a gestational carrier, to the tune of $60,000 (plus or minus $20k). It’s a huge amount of money, especially after spending money on 4IVFs with CCS testing and immune testing with Dr. Braverman.

There is no easy path here. There are no clear options forward. Having a child naturally or even easily via IVF has been taken from us and I’m angry, so very angry that we have to go to such extreme measures while we rack up insurmountable financial debt.

I feel so lost and defeated. And tired. So tired.

Prep

We are oh so slowly prepping for our next IVF. We are throwing so many new things at this next cycle I honestly have no idea what to expect. In reality, my confidence is so shattered that I am not anticipating much success.

I think the most significant adjustment is that I have severely limited gluten and dairy. As I had no concrete knowledge on how to go about such a change, this was quite a learning process. It involved vast interwebs research, interviews with crunchy time friends, discussions with a doctor and a nutritionist, and recon at Whole Foods and Trader Joe’s. The conclusion was I needed to identify the diary and gluten items I could not live without and find alternatives. If you are curious how it’s going, all I can say is this insanity is still in its infancy, so I have no major conclusions as of yet.

Next, I am now taking micro green pills, mitochondrial supplements, and vitamin E. These have been added to my current regimen of baby aspirin, vitamin D, and acupuncture. CO-Q10 has been wiped from my list, and DHEA is still up in the air.

My husband is taking an antioxidant supplement and Clomid. He has severely limited his alcohol consumption and is eating very cleanly. After a few months on this plan he will repeat the sperm DNA fragmentation test.

Dr. Braverman and I discussed the decisions made throughout my prior IVF protocols. It was scary to hear his thoughts, as many of them mimic my own conclusions. My ovaries should of been gently surpressed (I have a repeated history of lead follicles) and estrogen priming should of been implemented. Every single IVF cycle was too short, in fact, I should of stimmed for longer than 8 days. For my last cycle, 3 days of human growth hormone was concluded to be not enough. Also, my Gonal-F dosage should have been stepped down throughout the stim process. Dr. Braverman does suggest very high initial stim dosages (like 750IU) and eventually stepping down. This level of stim medication sets off a warning bell for me. Has anyone stimmed with these types of dosages (after suppression) and been successful? I am very curious for any feedback. Particularly from those working with Dr. Braverman, however all experience with high stim dosages and success are welcome.

We are not focusing on the embryo transfer process at this time, so I suspect I won’t post about it for a few months. I believe we will start IVF #4 in January. It will (hopefully) be a freeze all and embryo banking cycle.

This may all seem like progress, but emotionally, I am not doing well. I am avoiding most people. I cry a few times a week. I tear up everyday. I am in a funk. I am tired all the time. It is a challenge to take care of myself like I used to, so I started making lists. I saw the dermatologist. I scheduled the orthopedist. I visited the acupuncturist. I got a pedicure. It is only 7 weeks out from my miscarriage, and I am still waiting for it to get easier, to feel more like myself. However, I just feel like I’m just going through the motions.

Results

The results are in from our testing with Dr. Braverman.

My husband has significant sperm DNA fragmentation.   Significant.   I feel very cheated by my RE, who told us ICSI would bypass his sperm issues.   Based on our 3 crappy IVF cycles and oh so much heartbreak, it hasn’t.   This is main reason that we’ve made so few blasts, despite a decent number of eggs.

We also have 6HLA matches. S-I-X.  To over simplify (and quite poorly at that), we are too genetically similar. This is the top reason my body rejected a perfectly normal embryo. That and the clotting factors.

There is a lot of information about HLA genetics, but the brief version is this: if a man and woman have similar genetics (something that occurs by chance in nature), the mother’s body may not receive the proper message about protecting her baby. Instead, her immune system will mistake the embryo for a foreign invader and attack it as though it is a cancer or virus. An amazing thing normally happens when a woman’s body carries a baby — her immune system recognizes that baby as something to protect, and produces blocking antibodies to keep it safe from her own natural killer cells. But if, on the cellular level, she and her mate have similar tissue proteins, her body cannot make the distinction between her child and a germ.

More tomorrow.  Today was a very difficult day that I just chased down with a full bottle of wine.