R.I.F.

Recurrent.
Implantation.
Failure.

That's me... nothing but a big failure...

4 fresh transfers and 1 frozen transfer, of mostly beautiful embryos. We've tried day 5, day 3 and day 2 (age of the embryos)... And all of those transfers have resulting in only 3 chemical pregnancies. (Yes, this last one, was indeed another chemical pregnancy, says my RE)

Over the last 36 hours or so, after receiving the news that my beta was only a 1.0, I have felt very panicky. We're at the end of the line here with our genetics. We've agreed to be done spending 10s of thousands of dollars per year on this basically doing the same thing while still not having any more clear of a path. We still don't have a solid reason.

By that I mean, no one can really agree on why RIF occurs. Or maybe what I mean is that there are too many unproven explanations for RIF. Or MAYBE what I REALLY mean is that the medical community has no "for certain" diagnostic tests and resulting methods of overcoming possible abnormalities in those tests to solve the RIF issue. Come on medical community... GET IT TOGETHER!!!

Aside: This is precisely why infertility needs to be voiced more so that funding can occur to solve these issues, and those of us without insurance coverage can hope to someday have help in paying for this madness.

So where does this leave us? With 3 possible explanations:

1. Poor Egg Quality - My eggs are poor quality, chromosomally abnormal, and therefore our embryos stop developing after a few days in-utero because the pregnancy is not viable. 
• Factors supporting this:
• IVF #3 showed "spongy and grainy eggs" which I guess are a sign of poor quality
• IVF #2 embryos kind of 'pooped' out around day 5
• Premature Lutenization in 3 of my 4 IVF stim cycles is correlated with poorer egg quality
• Treatment: 
• Donor Eggs or Embryo Adoption or Adoption
2. Immune System Malfunction - My eggs are fine but my body won't let the little embryos implant for too long. The process starts, but my immune system is messed up just enough that it attacks the implanting embryo and says, "Stop trying to burrow in!" 
• Factors supporting this: 
• Mild endometriosis found in my laparoscopy last year, which is correlated with implantation failure in some literature
• The immune testing I had done showed that I have some borderline signs of this potential issue. (High NK cells, CD56+, APAs.... I touched on this a bit in this post)
• The feverish feeling I got during my 2ww of the first 3 transfers, before I started taking the prednisone during the 2ww.
• Treatment:
• Use some fairly non proven and potentially unsafe infusions in the blood during our FET that aim to suppress the immune system more so than what I've already been doing with the steroids (I used prednisone with my last two transfers)
• Use a proven gestational surrogate to transfer our embryos to instead of me and hope that at least one sticks in there.
3. Both 1& 2
• Treatment:
• Bang head into wall and hope that when I come to, there's a baby in my lap.

The reason that I lay this out there is that I really need some help in deciding our next steps. I just don't know what to do. We have 3 beautiful grade A day 2 embryos in the freezer and I want to make sure that when I look back on this all, I can say that I left no stone unturned AND we weren't stupid in throwing away this last chance at our genetics. I'm open to everything right now. Really... I just want this to end. I'm tired and weary of this journey and I want to get on with my life. Do we transfer all 3 back to me? Do we find a gestational surrogate? Do we try both? If this doesn't work, is donor eggs the right step? Or am I kidding myself into thinking my body can hold a pregnancy?

Any advice is appreciated.

Releasing it to the Universe

We've had many heavy conversations about our next steps over these past few weeks, debating moving on to donor eggs, or trying one final IVF cycle with my body before moving on to a new option.

There have been moments where I am searching through donor profiles thinking if I could just let go of certain traits, for example, blond hair, or height, maybe this could work. The promise of such high success rates and the hope of feeling a baby grow in my belly is so attractive!

But I was also recently standing in the kitchen one night, during a pause in cooking dinner, with my back to the stove, looking straight at B, holding a towel in one hand and a spatula in the other, sobbing those heaving heavy tears..."I'm NOT ready to give up on my eggs! Not yet. I like me! I want "my" baby. I need closure and I don't have that yet"

Back and forth, around and around, letting it stir in my head, in my dreams, consuming and devouring my thoughts and energy...

And then last Sunday, we had brunch at our favorite Indian buffet with our good friends. I don't think the conversation was very baby focused, and in fact I'm having trouble actually recalling much of what was said. But on our way back home in the car, during a pause in conversation, I looked at B and calmly said, "Can we try one... last... time?"

And he decidedly confirmed, "Yes"

And so, with that, and a quiet release of the heaviness, our decision has been made.

One. Last. Time.....

Did you hear me, universe?

One.

Last.

Time.

My Brain

I'm still wading in my emotions right now and I want to come out. I want to be free of this journey but the only way to be free is to keep going through. But its really thick right now... and heavy. Its like a muddy sloppy trek through a thick dark forest and I can't see the end and I'm carrying a big pack filled with my gear that makes each step a struggle. The gear I carry with me is all the research I've done, all the statistics and protocol variations, all of the what ifs of cycles past and donor eggs of the future, all of the money spent and the knowledge of the money to be spent.

This journey can suck the life out of you  if you let it. Many of us who are multiple IVFers have found ourselves here, with a new set of sadness and struggles. We're past that point of the initial infertility shock and loss and failure. We're the veterans, the ones who's hope fades from time to time, who are past that shining star of the promise of their first or even second IVF.

I'm not saying our pain is any more than the pain of those who are successful on their first IVF cycle, let alone their first IUI, but I'm just saying we're at a different point in this journey.... Considering 4th, 5th IVF cycles, donor eggs, adoptions...

I think its different because we have to face the real possibility that we will never see our own biological child. (And I do know some face this without even attempting IVF... so please don't take this as anything other than one experience/perspective). That was not in view with my first IVF cycle 2 years ago, even our second... But now, its real. Its SO real that it hurts like hell. I've grieved that I can't conceive a baby the natural way, that I've made peace with. But now I'm grieving the possible loss of  my genetic child.

It makes me wonder how many of us are there? What percent of people make it this far? What percent are successful with their first IVF or with their first IUI? Am I the norm or am I the exception?

Anyways, B and  I spent a half hour at our clinic last night looking through donor egg profiles. It was a heavy night. It didn't feel right yet. It felt sad and strange and somewhat wrong. So I think that just confirms I'm not ready to make decisions yet.

We did however, lay out all the options the other night and here's what came out as when I tried to organize the mess in my brain.  Remember those old anti-drug commercials with the scrambled egg in a frying pan saying "This is your brain on drugs", well...

This is your brain on infertility:

For the math geeks in the audience,  I even calculated the probability weighted cost for each option (not pictured)

Ramblings

First, I wanted to say THANK YOU! I have more than 50 followers! Yippee! Thanks for following my story. It really means a lot to me. And so do all of your comments. I love the blogging world for the community it has built for those of us walking this path. It helps me realize that I am not alone and that there are others out there who have walked this path before and have succeeded. And it gives me strength to keep walking and hoping that one day my dream will come true, in some form. So thank you, deeply from my heart. I hope that I have been able to support you as well.

Next goal... 75! or shoot, should I try for 100???

Secondly, thanks so much for helping me decide which blog post to enter into the Creme de la Creme contest. I asked you for your help last week and the clear winner for my entry is "The Hot Pink Paperweight". Wish me luck!

Ok, so where are we with our next steps, you ask? I'm still not sure. All I know is that I need to make a decision because this limbo is eating away at me. I feel anxious, I'm not sleeping well and I feel like I could scream at most everyone who is in my way or does something that irritates me just a little bit.

For the last week or so, we've been heavily weighing our options. They mostly come down to either  trying one last time with my body or moving on to donor eggs. We've considered adoption and its just not a door we want to open at this time. But as I consider these options, I get a little voice in my head that still doesn't believe that I'm here... I still don't believe that we've been at this for almost 4 years, that we've tried multiple IUIs, IVF, diet changes, immune testing, exploratory laparoscopy, yoga, acupuncture, 'not trying', 'relaxing' (and PLEASE, DON'T TELL ME TO RELAX)... And nothing has worked.

And so we are still here, still trying. But the tables have turned on us. No longer do we fit into the group that has a high likelihood of IVF working. We are now in that group of, "Yeah, you could give it another try, but a better bet with your money is adoption or donor eggs"... I'm sure like others of you who have been give the same talk, there's a part of you that is in shock, hurt, deflated, and then there's another part of you that just turns to stone, and doesn't believe, and doesn't understand really what this means.

And when you finally do get a small glimpse in your head of what this means, that this could mean that we aren't going to end up with a full genetically linked child, that we are going to have to grieve that loss and figure out how too and who to tell... well, I guess I can't just expect myself to make a decision and be happy with it. Either way, it sucks.

On one hand, we can try one last time with my body, but statistically we'd be throwing away a lot of $$ that we could be using towards the donor eggs or adoption. On the other hand, I don't want to regret not giving it one last shot, with a protocol that would be tailored to MY body and not a clinical trial protocol (like my last study), and with other methods that might help the potential immune issues as well... one... last.... try...

Anyways, I'm rambling, but it is a true picture of what is going on in my head. I only hope that I can sort it out soon and find my way back to peace.

One Good Egg

The first month or so after a failed IVF cycle are filled with so many emotions and thoughts racing through my head that they really clog up my ability to find peace. I'm constantly battling in my head between next steps. Should we try one last time with my eggs? Should we look more into donor eggs? Or should we adopt?

These I guess are my new options. After my WTF appointment with the study doctor (RE #5), I had all of my records sent to my doctor here in town (RE #2 - IVF #1&2.. and who we'd go back to if we tried more). She's fantastic. I really like the way she communicates and thinks about these things. She's smart, knows the research well, lets me give her my thoughts on the research and she's honest. I had a follow up with her last Friday. We sat and talked for about a half hour about her thoughts. She said that while it is likely the protocol wasn't good for my body, and potentially it could have just been an off month for me, when the embryologist in the study mentioned that my eggs were 'spongy and grainy', it confirmed her thoughts as to why my first 2  IVF cycles failed. Once again... sucky eggs. Everything else looks just about perfect for my age, except my egg quality.

She would agree to try one last time with my eggs, but the chances of success, from her opinion are only 5%.  FIVE.... PERCENT!

Shit.

I've now entered into a whole new world. A whole new thing to have to grieve and figure out how to process and come to terms with.

On the brighter side, she said, donor eggs would yield about a 70% chance of success, which is very attractive, but we're not there yet. I've spent a few hours here and there over the past few weeks researching donor eggs, as it's never been on my radar before. Now that it is, I need to understand it before we can make a decision if this or adoption is the next best step for us.

So far, I've found the donor egg world is just SO overwhelming (granted so is adoption, but we've looked into that already somewhat and so are comfortable with that... to the extent we can be). I've found myself this past week looking at all sorts of people I pass at work, or in the grocery store, or at the gas station... worrying about, what if we pick a donor, and our baby looks like THAT!  Or what if our baby is ugly and I don't love it. I know these might seem like irrational fears to some of you, they also might seem very bitchy, but I assure you if you were in this situation, the first time you even let this idea of donor eggs enter your head, you'd go through the same thoughts. I know there are a lot of positives to this choice too, but I'm not there right now.

Currently, today, I'm really attached to my hair and my legs (figuratively AND literally ;-) )  They are two of my favorite traits and I really wanted to be able to pass those along to my child. Again, while this is not important in the whole scheme of things its something little that I'll have to let go of. Is this selfish? I don't even know. I'm so confused internally right now with the feelings I'm having. Is it important enough for me to possibly experience pregnancy and carry my child to do this? What about the donor, what responsibilities do I have to her? And then all the fears of, should this be the option we choose, and should it work, how do you tell your child and when and what will they think and ....?

My brain is spinning and I'm still trying to figure out a way in my head to do one last cycle with my body, even though logically, financially this doesn't make sense. But I'm an addict in some way. I think many of us who go through multiple IVF cycle are. We're addicted to the hope of maybe... just maybe... we'll find that one good egg. And our dreams will come true.