Saturday, July 20, 2013

not again

In twenty-four hours...

a tire on our car exploded,
a broken/leaky sink made a serious mess,
we got bad news from the mortgage company which will likely delay moving for at least six months,
our stroller tipped over with Harriet in it (terrifying, but she's okay),
and my IUI (intrauterine insemination) was canceled.

I've never experienced a canceled cycle until now, and it has me a little worried. Was it my lack of sleep this month? Was it the fact that I didn't take my vitamins every day? Did I eat too much sugar? Was it the extra stress I've felt lately? Or maybe the drug's potency is just wearing off. We've been trying to conceive our second child for seventeen months now with four medicated IUI cycles (including this last failed cycle). Maybe this is just a sign that it's time to move onto something else.

Andrew wants to do one more IUI. It's not very expensive or invasive, so I tend to agree with him. The only problem is that I have literally zero hope that an IUI is going to bring us a baby. We have done over ten medicated cycles total, and none of them have brought us a child besides our IVF cycle. When we started trying to conceive our second baby, I had a ton of hope. I thought that we'd have success with IUI...I knew we would. I never expected that we'd be rerouting our journey through the land of IVF....again. But I'm not going to do IUI with injectibles. I don't feel comfortable with the risk of multiples and I don't like the financial cost to success rate ratio. IVF is much more appealing to me, especially since we've had success with it before.

But there's something about doing IVF a second time that leaves me feeling a bit unsettled. We were incredibly lucky to get a first chance at IVF. We were extra lucky that it worked. It feels a little excessive to do IVF again, and I am keenly aware that we are in the minority here. The fact that we were able to do IVF at all - let alone for a second time - is an immeasurable gift. I was in tears the other day while expressing the magnitude of this blessing to friends.

Beyond the logistical and financial aspects of IVF, I'm starting to worry about the physical toll it might take on my body. With our last IVF, I felt strong and resilient. I was extremely bloated (at the peak, my waistline was growing two inches per day). I found it difficult to breath. I was an emotional wreck. But I went about my life as normal and felt far from miserable. In fact, I got a tongue-lashing from a nurse for taking my dog on daily four-mile walks.

But I worry that IVF might be much harder on my body the second time around. When trying to conceive Harriet, I barely noticed that I was on clomid and metformin. While trying to conceive a second child, both of those drugs knocked me off my feet. For some reason, my body is much more sensitive, and I just can't handle the side effects like I used to. IVF medications are so much more intense than the oral medications I've been taking, and I worry about how they will affect my ability to function, especially since "taking it easy" isn't exactly an option when you have a toddler.

Speaking of Harriet, I'm fearful about how this process will affect her, especially since the appointments are constant. I will be away from her twice as much as I am now, and I already feel guilty about that. I don't want her to pick up on the emotional and physical toll IVF will take on me either, but she will. Of course she will.

Lastly, I wonder whether IVF will work for us this time around. Before Harriet, I responded well to the drugs every single cycle. I even got pregnant twice. This time around, my cycles are extra long, and as I said before, this last cycle was a complete flop. I've had to be on the highest doses of my oral medications in order to see any results. I worry that my doctor won't be aggressive enough and will just rely on our old protocol because it worked before. I plan to try to convince him that my body is different now, so we need to at least consider other protocols. But I have no idea what I'm talking about. It's just a feeling I have in my body. I want to listen to it because I tend to trust my body...a lot. But I also wonder if it's just my dreaded anxiety stopping by for a visit. We have a consult with Dr. C on July 31st. I've already started my list of questions...there are going to be a lot of them.

Thank you, friends, for all of your support. I have no doubt that you will all rally around me in this, generously sharing your wisdom and encouragement with me. You always, always do.


27 comments:

  1. I'm so sorry about your cancelled cycle. I remember when our doctor told us he wanted to convert our IVF to an IUI and how crushing that was. All that work, both emotionally and physically. I hope your consult goes well and you get to change up some things. I know I will be fighting to change my protocol as well. Let's get together, Em. I need to see you. <3

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    1. I want to see both of you beautiful ladies!! Blessings!

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  2. Oh Em, I'm so sorry about the string of unfortunate events, and especially about your cancelled cycle. I can completely understand your concerns about the effects all the meds and stress will have on your body.

    Regarding a second IVF, I just wanted to say that my brother and his wife did IVF twice and were successful both times. In fact, they had twins the second time! Their RE said a woman's body is better equipped to get and stay pregnant the second time around. So although you are feeling more affected by the meds this time, your body will be stronger than you think when it comes to achieving and carrying a pregnancy again I bet. You are such a wonderful person, and I can tell from your blog that you and your husband are such amazing parents. I am praying God will fulfill your dreams for another baby, and that the journey there will be one of strength and growth. Much love.

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  3. I hated having to do IVF again. Just starting it up exhausted my mind. But, it worked and that's the goal, right? I hope you get the answers you seek on the 31st.

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  4. I am so sorry your cycle was cancelled. After just having a cancelled cycle myself, I know how devastating it can be. Take all the time you need to make your decision as to what to do next.

    It is good that you are remembering how lucky we are to even be able to try IVF. I think it is important to not lose sight of that fact. I hope you find peace in wherever your journey takes you. None of this is easy...

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  5. Ugh, it's so hard to make a decision on what path is right for you. FWIW, I have PCOS and am supposed to be a 'super responder' based on my hormone levels, but I barely even responded to oral meds (finally O'd maybe once or twice on 150mg Clomid) and on our injectibles IUI cycle, I was on higher and longer doses of meds (150mg Clomid CD5-9 and 75iu Menopur for 7 days after that) before I finally ovulated ONE follicle. I'm not sure what an injectible IUI cycle would cost you out of pocket, but if you're being monitored, maybe the risk of multiples wouldn't be AS high as you're worried about?

    Good luck figuring out what path is best for you. Hard decisions for sure. :(

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  6. Oh Em. That first paragraph had me almost in tears. That is a lot to deal with.

    And now you have so many decisions to make, all of them painstakingly difficult. I have never had to undergo a medicated cycle of any kind so I am kind of loathe to offer any advice but I will voice the thoughts I was having as I read and I hope you'll take them for what they are, the musings of an ignorant woman who never had to do any of this stuff.

    My thought was definitely the same as yours, that going straight to IVF would be the way to go. If you never had success with IUI when you were responding more readily to the medications, it doesn't seem likely you would have success now that your body seems to be responding differently to medications.

    At the same time I understand your hesitancy. Maybe a way to feel better about all of it would be to pursue some Eastern therapies for three months before IVF so you know that your body would be in the best possible shape to get pregnant with IVF. I know Eastern therapies aren't super popular in this community and I'm not trying to suggest that you will just get pregnant doing acupuncture and changing your diet, but I do think those things might help your feel like you're being more proactive about your second IVF and giving yourself the best shot. I also think it really would help your chances and allow your body to respond to the medications in the best possible way. It also might help ease your guilt about putting Harriet through whatever she may experience.

    Again, this is just my two cents and honestly, it's basically what we planned for our one medicated cycle that was tentatively scheduled for this summer. Please know that I am probably the least experienced person commenting so take my thoughts for what they are, just my thoughts and not very valuable.

    I truly hope you find success a second time. Abiding with you during this uncertain and difficult time.

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  7. Oh sweet girl! So sorry to hear about your rough week and canceled cycle! Praying that you would receive a peace about what next steps look like and that you would be filled with a hope as well! Romans 15:13 May the God of hope fill you with all joy and peace as you trust in him, so that you may overflow with hope by the power of the Holy Spirit.

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  8. Canceled cycles are very difficult. I remember all too well the emotional pit I was in when I learned that my first cycle was canceled because my body wasn't behaving. It's so hard because each time is draining physically and emotionally. Very sorry that you're dealing with this.

    Honestly, I think it's time that you and Andrew to sit down with your RE and having a frank discussion on how to proceed. Weigh out the pros and cons of doing another round of IUI. In addition, when you talk about IVF, I would bring up all the concerns you've brought up here as I do think they are valid. I understand the mindset of doing what worked in the past, but I also think taking into account how you've been responding to the drugs this time around is incredibly important. Pregnancy chances one's body and that's nothing to sneeze at.

    Thinking of you as you navigate all this uncertainty and frustration. I'm also glad that you and Risa have one another during this time.

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  9. I'm sorry to hear about your cancelled cycle :( And then, the IVF thing... Ugh, I know how hard it was to come to terms with having to do IVF in the first place, and it only gets harder the 2nd, 3rd, 4th and in my case 5th and 6th time after that... It's never easy and I just pray that this last IUI cycle is the lucky one of you

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  10. Ugh, so sorry my dear friend. That is a whole lot of stress to deal with when the treatment cycles themselves are already so stress filled. I can't imagine the disappointment and frustration that come with a cancelled cycle.

    IVF is such an emotionally and physically grueling process it's no wonder you're feeling hesitant. My FET cycles have been challenging enough for me, I really don't know that I could go through IVF again. I agree with you in that this time around things have been more difficult for me, possibly because I'm older and also trying to keep up with a toddler and life in general.

    Sending hope and praying you find clarity regarding which route is best moving forward for you.

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  11. I'm so sorry to hear that this round of IUI was cancelled! That's such a huge disappointment. :/ I'll be thinking about and praying for you as you continue on and decide what the next steps are. It's such a shame these decisions are so loaded with financial issues as well. :(

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  12. That is a very hard and personal decision to have to make. I'm so bummed that your IUI was cancelled. :( I can understand him wanting to give it one more shot before moving on to IVF, but I can also understand your thoughts as to why it might be a waste. The not knowing is the worst, isn't it? I hate that about IF, and always second guessing ourselves. You are such a strong woman that I'm sure whichever way you decide to go, you'll be a rock star! I hope the right choice for you as a family becomes a clear and easy decision for you guys.

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  13. Em, I am so sorry that you are going through this again. I am keeping you in my prayers. Let me know when I can take Harriet for you-We would love to do it for you! HUGS!!!!

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  14. I'm so sorry your IUI cycle got cancelled but I'm more sorry that you've had to come to the decision of having to do an IVF cycle to maybe conceive again.

    Good luck with whatever you decide.

    xxxooo

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  15. I'm so sorry you've had so many challenges lately. I think you're concerns about IVF are valid. Follow your heart my friend. And so hoping that everything is downhill from here!

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  16. When it rains it really pours. Sorry to hear of the rough 24 hours and having to visit the decisions you were hoping to avoid in the first place this time around. If you do one more IUI, I pray with all of my heart that it works for you and you don't have to do IVF. I will say, that as daunting as it is to go through IVF, you make some really good points about IUI/injectables and the cost, risks, etc. We also skipped IUI/injectables and went straight from Femara/IUI to IVF. I will def be routing for you!

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  17. I'm so sorry that your cycle was cancelled, that sucks. And to have all those other things happen at the same time just magnifies the emotional toll... Boooo to the week of disappointment and bad news. I can totally understand how going back to IVF is nerve wracking and conflicted--it is so time consuming and so hard on your body. I do think it's a different experience each time, and with a toddler it is definitely going to be different and challenging. However, I am a true believer in the diagnostic power and success rates and control that IVF gives you, despite not having had any real success myself. If you are worried about multiples you can do SET and cut those risks significantly without significantly altering your success rate. I had a friend who was trying for a third after having twins and wasn't interested in having a ton of embryos, so she only fertilized half of the retrieval and froze the other half for donation. She did SETs and got pregnant with her son at the second FET (after a freak chemical pregnancy on her own after the fresh failed). So many options, especially since I know you have very strong thoughts on "excess" embryos. Make that list of questions, and don't feel bad advocating for the protocol you think will work or for additional testing to be sure that you are doing what's best for your body, now, not your body from years ago when this last worked. A good doctor will be open to this conversation and back and forth. Good luck on the 31st -- it sucks having to make the best of a crappy situation but it's all we've got, right? Here's to silver linings in this awful, awful cloud. :)

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  18. How frustrating! I know what a disappointment it can be with our canceled FET in January. It's such a let down, but just trust that the timing is not right. We conceived our daughter with IUI,but went straight to IVF for our second child. The IVF meds ARE much worse on your body as you know, however if the end result is a sibling for Harriet, then it's worth it. I'll be praying for you. Hang in there!

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  19. i am proud of you. and i am so impressed. you are so strong and so brave. and the way you listen to your body is admirable. you are advocating for yourself and i love that. as much as i love you.
    you are selfless for thinking of harriet, but i know that it wont hurt her or be something she resents you for and remembers down the road. if a sibling is what you want for her, than a sibling is what she shall get. it is what your family deserves.
    keep following your heart my sweet friend. i am praying for you.
    and would LOVE to see your last IUI or another round with IVF work for you. you will have to tell me how your appointment with Dr. C goes. ill be thinking of you!!

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  20. Oh wow, I am so sorry you have so much going on right now. That is more than most people can handle. In terms of treatment planning, it seems like you are in the middle of trying to "know what's right," when really there is no way to know what will happen in any of these situations. All you can do is make some decisions and move forward and hope. Trust your body (you seem to know it well), but also trust that maybe the next step (IUI or IVF) will hold something a bit of magic for you.

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  21. Bad news is supposed to come in threes, not fives! I think you're set for a while. All I can say is follow your heart and hold onto your hope!

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  22. Just catching up. That is a LOT to deal with in one hit. I'm so sorry about the cancelled cycle. I sympathize with your fears about having to move to IVF again. It is just so much MORE- more invasive, more expensive, more emotionally challenging, more physical issues, etc. But it did bring you your sweet girl. And you are one strong mama. I know you will be able to get through it.
    xoxo
    T.

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  23. Oh, Em! I hate that this all happened to you! I pray that God wraps His arms around you and Andrew during this tough decision time and guides you in the direction He has chosen for you! You're such a wonderful woman and the world is a better place by having you in it!

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  24. That is a super duper crummy week even without the weight of all the infertility questions! I'm praying that whatever direction you and your husband decide to take, that the Lord will continue to bless you richly and grow your family! But cut yourself some slack Em, you are a GREAT mom! Harriet is blessed to have you! There are going to be so many stories to share of how hard you fought for her and her brother/sister.

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  25. I'm so sorry for your cancelled cycle! I hope that your upcoming appointment provides you the clarity you seek. Best of luck. I'll be thinking of you!

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  26. Oh my. That is a lot to deal with in one week. I'm so sorry about the canceled cycle. I, for I e, do not think a second IVF is excessive. Yes, you are fortunate it worked the first time and got your Harriet. Of course we don't know if it will work a second time. But it might! There are no guarantees. I pray for peace in the ultimate decision you make. Even though I'm very behind on your blog, please know I've been thinking about you!

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