But my body had other plans…

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My mini IVF cycle was really off to a great start. I responded excellent to the meds and at my first ultrasound I had 7 follicles. Even my left ovary, which tends to be sleepy, was producing well. It felt like this might be the protocol to do it. Each ultrasound was good and my follicles grew well and consistently. We got to last Thursday, did an ultrasound and labs to make the final decision of whether we would trigger on Friday or Saturday. My nurse called and based on my estrogen level it was decided that we would go one more day for optimal growth – trigger on Friday and retrieval on Sunday. I was right on schedule with my predicted calendar.

And then I got a second call late in the afternoon. Apparently they measured by LH in addition to my estrogen and to everyone’s surprise my LH was high – like ovulation peak high. Wait, what?! Despite the antagonist I was injecting daily, which blocks your brain from releasing LH, my brain decided to do it’s own thing. I was about to ovulate. Just two days before, my LH was low as they would expect. I was informed that my retrieval would be the next morning. I was stunned.

I spoke with my RE in the morning before the procedure. He said this happens in about 1% of the cases with antagonists. Of course I’m in that 1%. He told me of the one other patient he’s had where this happened. He waited 36 hours after the high LH reading to do the egg retrieval and ended up missing all the eggs because she had already ovulated. So, this time he’s doing it earlier – about 24 hours – in hopes of getting the eggs. Of course, the problem is you really don’t know when the surge began so there is guess work.

After waking from retrieval, I was informed that he got 2 eggs. I was devastated. And angry. Such great potential with this cycle – wasted. The issue wasn’t that I had already ovulated, rather my eggs weren’t fully detached from the fibers that hold them in the follicles. He scrapped, trying to release them, but only got 2. So we ended up being a little early. He told me to have sex since I have potentially 5 eggs that are about to be released, but I know that my chances for a natural conception are low, especially with my shotty fallopian tubes. We decided to not waste any time, since I don’t have much, and go straight into another stim cycle when my period starts in about 2 weeks. Is there a possibility that one of these 2 eggs could be the golden egg? Sure. But with stats like I’ve had, I’m not holding my breath.

This all feels surreal, as does most of the IVF process. How do we go from such a great start to this? Part of me is angry, but part of me just feels numb. And I go through the motions because what else am I going to do? After the epic failure of my last cycle, where none of my 9 eggs made it to blastocysts, this simply feels like par for the course. The fertilization report came the next day. One egg fertilized and is growing. In general, you’d expect a 50% drop off from fertilization to blastocyst. Humm, 50% of 1 isn’t looking too good. And if it did make it, would it be chromosomally normal? It’s a long shot. People have told me to have hope – that it only takes one. I get it, really I do. People want you to feel better. And they want to have hope too. But I’m getting tired. I had so much hope and optimism during these last 2 cycles and all the way up to retrieval on this 3rd. Each time I though that THIS was the one that would get me that baby. I really believed it. And all the hope and belief didn’t make it so.  I know I’m sounding really pessimistic here. But at some point, I feel like I have to protect myself from the pain. I don’t feel hopeless. I don’t feel like I’ve come to the end of my road. And neither does my RE. But right now, I need to feel neutral. I need to feel okay with a negative outcome so I don’t drown in it.

Today, I have no idea if this is going to work. I don’t know if I’ll ever have another baby. If my daughter will ever be the big sister that she so desperately wants to be. But I do know that at the end, whether I’m pregnant or not, I will have given it my best. I will have tried everything. And that’s the best that I can do.

For the next cycle we are going back to my original high dose protocol. It’s the same protocol that brought me my PGS normal embryo, as well as the failed cycle that ended in zero blasts. This will answer the question of whether that failed cycle was simply “a bad batch” or if it truly reflected a fast decline in my egg quality. My RE said that after 3 cycles of no good blasts, that’s when we would say that this isn’t going to work. I’ve had one cycle like that. I’m not counting this cycle that we just had, regardless of the outcome, because we were not able to do the egg retrieval at the right time. So I guess there is an end in sight. I truly hope there is a happy ending to this story. I’m not ready to think about the alternative.

IVF #4 – Trying a Mini!

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I went into my follow-up consult on cycle day five, just hoping for some fresh ideas to improve egg quality, and I didn’t want to hear anything fatalistic. I led off by telling my RE, “I know I’m 40 but I’m not coughing dust yet!” And like always my RE delivered. He’s not giving up on me or my eggs, and he was ready to change things up with my protocol. I have no idea if his new plan will work, but I am so grateful for this doctor who is compassionate, intelligent, humorous, and takes the time to really answer questions and explore options with me.

He reviewed the lab’s report for exactly how my eggs fertilized and what my embryo growth patterns were like. It was clear that we are dealing with egg quality, not sperm issues. He said he was really surprised that none made it to blast and they weren’t expecting that. The cycle before I got 1 PGS normal. Could it have gotten that bad in 4 months or was this a bad batch – he said it’s hard to tell now. But he created a new plan to move forward that focuses on quality over quantity.

We are doing a mini IVF. The idea here, which I’ve heard rumor is great for women over 40, is that less stim meds are used to create fewer eggs, and that hopefully allows those eggs to soak up all the resources and energy needed to improve their quality. I’m ready to try this and I was getting worried about the high doses of meds I had been on. Injecting all that stuff can’t be good long term, right?

While there are many different mini stim protocols, mine involves clomid and menopur, then later adding ganirelix to prevent early ovulation. Although I know clomid isn’t always great for women over 35, I’ve responded to it quite well at that age. Plus we are not solely relying on that. We’ll also be doing HGH a bit longer this time  – starting on day 3 of stims, simply because I wouldn’t be able to have it in time for day 1, and continuing until trigger shot. And the reason for not having it in time for stim day 1 is because I began my mini stim the night of my consultation! My RE didn’t want to waste any time so he had me start clomid that night and use some leftover menopur from last cycle. He whisked me in  for a baseline ultrasound which looked all good to go.

And so we are jumping right back in. I’m ready. The rush at the beginning to get my meds lined up was a bit nerve racking, but everything is ordered. I also had to use gonal f instead of menopur for the second day until my new meds arrived this morning because I didn’t have as much left over from last cycle as I thought. I was assured it was fine this early in the cycle since we are focusing on FSH at this stage, and both are FSH. My clinic would have given me the needed menopur but they were all out too, so gonal f it was.  I took my clomid at night for the first 2 nights and then switched to morning administration on the third day because my nurse said it’s better to take them in the AM before the ultrasounds. Changing the timing of the meds that much makes me nervous because I’m so used to them being very specific about sticking to certain times so the body has what it needs on time. But my nurse assured me that we have a lot of flexibility during the first 5 days of stims and that sticking to specific times is more important later. There’s nothing I can do about any of this now and worrying won’t change anything. So I’m letting it go and trusting that they know what their talking about.

My RE told me that there is a special medium filled with antioxidants and other goodies to “supercharge” my embryos as they grow. The idea is that this enhanced medium can better support “older” eggs in doing what they need to do. We didn’t use that last cycle because he didn’t anticipate that the quality would be as compromised.

We also discussed PGS testing and ICSI. I was concerned that maybe ICSI wasn’t working well for me and maybe we should go back to natural fertilization. My RE explained that it’s actually better on older eggs to do ICSI because the egg doesn’t have to expend a significant amount of energy pulling in the sperm. Who knew. I was pleased with our open discussion about PGS. He readily admitted that some embryos can self correct, although it is rare. He told me about a research study he did where they PGS tested embryos but put back some before the results were in to compare outcomes. He said they put an embryo back in a women and later found out it was abnormal (I forget which chromosome abnormality it had). They were all worried and expected her to miscarry, but instead she delivered a healthy baby. He explained that there are a few chromosome abnormalities that we know are incompatible with life and/or lead to significant healthy problems (I can’t remember the ones he said). Those won’t self correct. But the others, well, they just might. He said that when PGS results come back with multiple chromosome deletions or additions, then you can be confident in those results. But if the abnormal finding is do to just one chromosome issue and it’s not one of those dreaded few, then there is a possibility that the embryo could self correct or the result could be inaccurate.

I also asked about the studies showing significant variance in PGS results across labs, indicating that results just aren’t very reliable. He acknowledged those and said that you have to be careful in interpreting the results. He said that you aren’t going to find that anymore among top labs. And that’s when I put back on my psychologist “hat” and remembered what I already knew about research. People readily tout research studies published in peer reviewed, scientific journals as facts. But that simply isn’t true. A motto that was ground into my head during graduate school was, “the devil is in the interpretation.” There are issues with what the labs do, how the research is designed, and what statistics are used – even in published studies. Sadly way more often that you think, the conclusions that authors make to explain their research outcomes are simply not supported by the data. And yes, these are even published in top journals. There are often flaws in research methodology and statistics that do not support the reported conclusions. In every single graduate course I took, we had to tear apart published studies to find the flaws. They were everywhere. Now you might say, “yes but  that was psychology and this is a different topic,” however, the statistical analyses and research designs are all exactly the same. It’s math. The sad reality is that most health professionals do not have the statistical expertise to see study flaws in published work. My Ph.D. is from a research-focused program. It’s what we do.

Given all of this, I asked my RE what he would recommend to me. He said, “there are worse things than not getting pregnant,” referring to still birth, late miscarriages, and severe health disabilities.  That is true, at least to me. He advised doing PGS and agreed that we would review the results together to determine if any abnormal findings fall into the category of only one chromosome issue and that being outside of the “dreaded few”. If we have any like that – that could possibly self correct and/or be an inaccurate result – then he would do the embryo transfer if I wished. I’m comfortable with this plan as I believe it gives me the peace of mind in hopefully finding  a chromosomally normal embryo while reducing the chance of discarding one the could have made it.

So that’s the new plan for IVF #4. My first ultrasound is in 3 days!

The 6-Day Report

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And so IVF#3 comes to an abrupt end. The news didn’t go as I thought it would – I found out today that all 3 of our embryos arrested. How did this happen? All the egg quality supplements, the addition of HGH, and this cycle’s outcome was worse than before! Did my eggs get that much worse in the 4 months since my last retrieval? Or was it just a bad crop this cycle and the next will be better? I’m holding out hope that the answer is the latter. I just know there are good eggs in there – my RE just needs to find them! Initially I was feeling very sad and discouraged. I cried. But I’m not ready to give up. This isn’t the end of my journey.

 

I’ll be meeting with my RE on Nov. 27th and I hope he had some answers and ideas. Until then I’m going to take care of myself, try to focus on the simple pleasures in life, and hold onto my hope.

The Numbers So Far: Stims & Egg Retrieval

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I held off on writing about my follicle count during stims because I know how quickly it can change. But unlike last cycle, this one held pretty consistent. At each ultrasound I had 4 to 5 good size follicles and a few smaller ones. I kept hoping that the smaller ones would catch up. At my last ultrasound before egg retrieval, I had a solid 5 with 1 or 2 that might catch up in time, but I was told to not bank on those. I was actually okay with that going in and thought that perhaps my body was just putting in all the effort to grow these few high quality eggs, especially since we added in human growth hormone (HGH) for 6 days during stims to help with egg quality. Plus I’ve been on my egg quality cocktail of supplements – oh how I wish it was an actual cocktail – for so much longer at the time of retrieval. So I was ready for retrieval.

The anesthesiologist, however, was not. I sat there in the retrieval room, draped in paper gowns, and waited for this person to show up to my very important, and time sensitive, event. And then I waited some more. The RE assured me that I wouldn’t ovulate before retrieval because they calculate an extra couple of hours into scheduling specifically for uncontrollable events like this. Apparently there was a mix up with the anesthesiologists, or mine overslept – I’m not exactly sure. In an effort to get everything ready and save time while waiting on this person, a nurse came in to start my IV. She joked and said, “It’s okay, I’ve watch YouTube videos.” But then reassured me that she used to be a paramedic and I’m in good hands. Well I think dinosaurs must have roamed the earth back when she was a paramedic because the first attempt she hit a wall  and the second and third attempts were blow outs. My husband intervened and told her not to try again and that we’d like to wait for the anesthesiologist.

I got a little break, then my RE came in and told me that he had a “plan B” – if the anesthesiologist is much later, they will give me “lots of pain meds and a little something to forget”. Now, I know he meant well, and honestly I’d do anything to get the eggs, but I couldn’t help but have a few tears start to fall. I was scared. I know some women do egg retrievals awake, but I’ve never heard a good story about it. It would hurt and I’m getting a little tired of all the pain involved in this process. This was not going how I expected! The RE also said that either way, we need to get the IV started. In came a different nurse who was able to get the IV going on the first try, though not without some struggle. And let me just mention that I have great veins. I’ve never experienced anything like this. To my relief, the anesthesiologist finally arrived in the nick of time and we didn’t need to revert to the dreaded plan B.

I was shocked to find that they retrieved 10 eggs! Some of my follicles contained 2 eggs (bonus!) and I guess some of the smaller follicles caught up. It was great news. My RE said he was hoping to get 5 or 6 embryos growing from these. Ahh, if only. As last cycle, my excitement only lasted a day until I got the fertilization report. The good news was that 9 of my eggs were mature, but the bad news was that only 3 fertilized with ICSI. And I was crushed. Again. I just don’t get it. How can my fertilization rate be so poor? I’ve been taking so many supplements, as recommended by my RE and consistent with the book, “It Starts with the Egg,” and we used HGH. What went wrong? This fertilization rate seems lower than would be expected for my age, and a drastic reduction from the 100% fertilization rate (natural – not ICSI) that I had at age 36. I know I’m 40 now, but that really does seem a bit much. I want to know why, but I’m trying to not focus on that right now, and hopefully I won’t ever have to.

Now I have 3 embryos growing. One of them has to be my golden egg. It only takes one. I focus on that, but it is so easy to get pulled back into the numbers game of probabilities and percentages. That’s a scary game. So I’m putting all my energy, prayers, and intention out to these little 3. Coincidentally, or not, I happened to have 3 egg shaped bees wax candles left from the bunch I bought when I started this journey. Bedazzled with green glitter, rose essential oil, symbols for protection and blessing, and sprinkled with the herbal mix I created when I set my intentions for this cycle, which you can find here, I mindfully light these three candles nightly to send this love and energy to my embryos. Tomorrow I will find out how they fared.

3 embryos

Taking a Moment to Remember

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*Trigger Warning* – I just want to give an upfront warning to those struggling with infertility who might not be in a place where they want to read about another person’s experience with birth. This is that kind of post.

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It was 3 years ago today that I went into labor. Well by this time I had already been in labor since 2AM. My daughter’s birthday is tomorrow. So, yes, it was a long labor. About 32 hours. Each year since her birth, these two days have given me pause. They bring up such a mix of intense emotions – many of which are hard to name. This is the first time that I’m actively trying to conceive again during her birthday, and it seems like that is adding another twist to the emotions.

Like every good student, I studied up on all my birthing options and put together what I considered to be the best plan for supporting the beautiful, natural birth I had envisioned. I found an excellent team of nurse midwives who could deliver at my chosen hospital. The nurses who generally worked with the midwives were on board with natural, flexible birthing options. They were backed up by OB’s who respected their judgment. My doula was caring and experienced, and was studying to become a midwife herself. I wrote both a birth plan and a baby plan. I had practiced hypnobabies diligently in preparation. My bag was packed. My mind was filled with images of strong women crouched down, birthing their babies into their own arms. I knew to be flexible despite my planning, because things don’t always go as planned. I wasn’t that naive.

But I truly did not expect what happened. I spent thoughtful time after her birth processing what had happened. Long story short, although I was completely dilated, pushed for 4 hours, and could see the top of the baby’s head for quite some time, she simply would not come out. Due to the lengthy session of strong pushing, she was so tightly lodged in my pelvis that they actually had difficulty getting her out during the emergency C-Section. We later found out, informed by the OB who performed the C-Section, that the bone opening the baby had to pass through was 1.5 inches to small in diameter. It wasn’t that my child’s head was too large, it was simply my structure. He said I would never be able to birth a full term baby. My midwife actually agreed that there was nothing we could have done differently to have a different outcome. And we had tried every natural option and strategy they could think of. I felt okay at the time, knowing that the C-Section really was medically necessary and not a result of a cascade of medical interventions. While I was at peace with that knowledge, and felt grateful for the advances in medicine that helped me both conceive and birth my child – neither of which would have been possible years ago – that didn’t take away the birth trauma. I talked to both my midwife and doula at later appointments about what happened. I processed the trauma successfully.

Now, at this time of year, I light a tealight in a goddess candle holder that I only use for this purpose. For these two days I honor that birth. The birth of a daughter. The birth of a mother. I acknowledge the unbearable pain that I found the strength to bear. I remember feeling let down by the team I built around me who were supposed to give me support. I remember feeling alone, scared, and confused. I remember speaking up for myself even when I only had a few words. I honor my voice.  I honor my body for all that it did despite the parts that it could not do. I hold space for both the sadness and the joy.

Many people are quick to say, “as long as she was born healthy – that’s all that matters.” I am grateful beyond words that my daughter, who had to be revived three times after this traumatic birth,  came through it healthy and safe. I would have endured anything for that. But it’s inaccurate to say that that is all that matters. Birth matters. A woman’s experience matters.

I feel blessed to have gone through that transition into motherhood. And I honor it in all the chaos that it was. I hope beyond words that I get to experience birth again in all it’s raw beauty, power, and pain. I know many women on this path never get to give birth to a baby, and I am grateful that I have. And yet, still my heart yearns for one more child.

IVF, New Beginnings, and the New Moon

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The time is finally approaching to start my third IVF cycle. I’m currently still taking provera to bring on my period and control my ovaries until it’s time to begin IVF. I have three more days on it, and I seriously can’t wait to be done. It seems, for me, progesterone is the most crazy making of the cocktail of hormones I take during this process. I get irritable, short-tempered, and really want to retreat within myself. The latter likely compounded by the turning of the season, as fall brings cool weather, shorter days, and longer nights. I’ve been countering the effects of progesterone the best that I can by enjoying the fall festivities and creating a lunar inspired bullet journal. I’ve set this journal up so that it follows each lunation – the lunar month beginning with the new moon, waxing until the full moon, and then waning to the dark moon. The journal has been a fun, creative endeavor and has been helping me become even more intimately connected to the moon and her cycles. And I do love the moon and her mysterious energy, which tug on my emotions as well as by body rhythms.

I set some new moon intentions to carry me through this lunar cycle, especially since my egg retrieval will take place during this lunation. Since every full moon has an associated meaning, I decided to link my new moon intentions with the theme of the full moon that will accompany this lunation. That will be the November full moon, known by many different names such as the Mourning Moon, Beaver Moon, and Snow Moon, among others. Since this is the first full moon to follow Samhain, some see it as the beginning of a new year. A time to leave behind that which no longer serves you to make room for a fresh start. A time to wash away the past and focus on the joys of the future.

As I thought about this idea, it truly seemed perfect for what I’m about to embark on. I’m setting aside my last IVF/FET failure, and with an open heart, I’m opening up to a new beginning. And quite literally, my body is going to be growing the seed for that new beginning. So with candles lit I focused on my new moon intention:

I let go of past failure and fearful, anxious thoughts. I focus on a new beginning – a new life. I’m creating healthy eggs. My focus is on a healthy embryo, who will become our second child. Expanding our family fills my heart with joy and gratitude. 

Then I decided to draw a couple cards form my favorite decks to see what messages I would receive to go with my new moon intention. From the Womanrunes I pulled The Cauldron of Dancing Women. The rune of honor, loyalty, and commitment. From the Spirit de la Lune I drew the waning gibbous “Surrender“. To me, the message in these two cards is saying that it’s time to show up with steady purpose. Something I will certainly need to get me through the grueling IVF process. It’s about trying again so that I can create a partnership. Hopefully that will be a partnership with a new child that I will carry in my body. I’m committing my energy and love to this. The path is not easy, and I cannot control it. Not every current will always run smooth. I will need to relax and be carried by the current. I surrender to what I cannot see, and with an open heart and trust, I will do this.

new moonBy the time this lunar month comes to a close with the dark moon, I will have injected a full protocol of stimulation medications into my body, underwent another egg retrieval, learned how many eggs were retrieved, waited for and received the news of how many fertilized, found out how many embryos made it to biopsy for PGS testing and what quality they were, undergone two uterine biopsies for more ERA testing, and will be anxiously awaiting PGS results.  Waiting on the fertilization report, embryo biopsy report, and PGS results will be some of the hardest parts to endure – far worse that what I will physically go though, which is by no means easy either.

All of this will happen during this lunar cycle. It’s almost overwhelming to think about. But I will show up – committed to making this child, ready to love her before she is even conceived. And I will flow with the current, surrendering to the process during it’s inevitable ups and downs. I can do this.

Finding the Way Back

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It’s kind of amazing how women going though infertility treatment can find hope again after so many disappointments and failures. I can’t tell you how many women I’ve seen in support groups hit what appears to be the lowest point of sorrow and despair, only to turn it around, try again, and hold hope. I’m truly amazed and inspired by these women.

I’ve read so many posts after losses and failures where women have asked the question, “How do you go on? How do you find the strength to try again?” Inevitably someone responds with the declaration that you just will. I wish there were instructions on how to climb out of the pain. And certainly, different people find strength in different places. For some it’s spirituality/religion. For others it’s support and love, whether from family, friends, or the infertility community. For many it’s that drive to have a child that is so strong it seems to have a life force all of it’s own. For some it’s habit. And for yet others it’s the passage of time that heals. Maybe it’s a combination of many or all of these things, or something completely different. But for all of us it includes an internal strength that we might not have even known that we had. 

After my failed FET I questioned my spiritual beliefs. I felt abandoned by the Divine and lost in a vast universe. I felt alone and confused. I think it’s normal to feel all of these things after loss. And for a moment, I wasn’t sure if or how I would gain back my sense of faith and connection that my spiritual beliefs have brought me. It felt like an identity crisis. Because after all, my beliefs are a central part to my being. I didn’t share my reaction with my IVF support community because I often feel like a spiritual outsider in IVF groups that are often composed of many vocal people with Christian beliefs. I typically don’t mind the difference because I appreciate religious diversity and understand how much support and strength women get from their personal religious beliefs, just as I get strength from mine. But I didn’t feel like that was the right forum for sharing my crisis of faith because I knew that the responses I would receive wouldn’t be inline with my particular belief set. I’ve yet to find a pagan post in my IVF support groups. Of course, I’m sure they are quietly in there, just like me, but that’s another topic.

So I took my struggle to two of the pagan online communities that I’m a part of, even though they are not infertility groups. The responses I received were overflowing with love, kindness, validation, and support. Not one person told me how to “fix” my crisis of faith though. And I really wanted someone to tell me what I should do to feel better. So there I sat, re-reading all of the supportive comments from mostly women who had never dealt with infertility (and a few that had), and somehow after a while I began to slowly feel better. As it turned out, these wise women gave me exactly what I needed. They didn’t try to fix it or convince me that “everything happens for a reason”. They just held space for me in my struggle and offered me kindness. I suppose they knew I would find my way back to Goddess, and I did.

Earlier in the month, as the dark moon transitioned into the waxing crescent, I found myself ready to begin again. Renewed from the darkness. I revisited my candle magic that I did here during my first egg retrieval, to modify it for what I felt was the new focus for this upcoming IVF stimulation. For this cycle I’m focusing on energy and power – that fiery spark that my eggs will need to grow strong and healthy. Egg quality was a problem for me during my last round, and at my age that basically means that my ovaries and eggs didn’t have the energy stores needed to really thrive. So here’s what I did for my egg ritual this time around:

IVF 3Supplies

  • Beeswax egg candle
  • White dish (white is for  activation, beginnings, blessings)
  • Green glitter (fertility and rebirth)
  • Rose (for love) and Frankincense (for energy and attraction) essential oils
  • Herbal blend of Apple wood shavings, rosemary, basil, sage, and lavender (this combination brings in action, beginings, fertility, blessings, energy, love, protection, and a dash of luck)
  • Crystals: bloodstone (strength & reproductive health), amazonite (calm, clarity, & peace), moss agate (fertility & birth), rose quartz (love), and septarian egg (healing, nourishing, & calming)

I started out my ritual by invoking Gaia, my spirit guides and angels, and all those allies in my fertility journey to hear me and grant me their assistance in making this IVF stimulation cycle successful by helping my ovaries grow strong, healthy eggs that contain all the energy and life force needed to form healthy, normal embryos – one of which will grow into  our second healthy child. This was my intention for this working.

Then I did some candle magic! First, I anointed the egg candle with rose and frankincense essential oils. Second I carved some symbols. I combined 3 runes that I intentionally selected from the Womanrunes deck into one symbol: The Dancing Woman (rune of power), The Yoni (rune of making), and The Flame (rune of fire/energy). On the other side of the candle I carved the Reiki Power symbol to boost my intention. The Reiki power symbol (“Choku Rei”) is often translated to “place the power of the universe here” and I love to work with this symbol when using Reiki. Then I sprinkled on the green glitter because who doesn’t like glitter? Next, I placed the candle in the white dish and surrounded it with the herbal mixture and crystals. Finally I lit the candle and as the wax pooled near the wick, I sprinkled some of the herbs into the melting wax.

As the candle burned  I held my hands over my ovaries and let the energy flow. I focused on healthy eggs growing, visualizing my ovaries glowing with light as I said these words:

I send energy and love to my ovaries. I carry the seeds of life within my ovaries. I send energy, vitality, and love to my eggs. My eggs that are being stimulated during this cycle are healthy and have all the energy needed for development. From these eggs, my healthy baby will grow. So mote it be.

I repeated those words until I felt done. Then in closing I gave thanks. It felt good to re-connect with the Divine and the magic within me, especially after I had thought I was lost.

Flexibility: The IVF Way

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Just when you think you have a plan and feel comfortable with what’s coming, at least in terms of IVF, something changes. IVF is truly a lesson in flexibility and patience. As I type this, I’m on cycle day 37 just waiting around for my period to start so that I can begin my stimulation medications for IVF #3. I never thought I’d see a cycle day 37. In fact, through the years of dealing with infertility the longest cycle I’ve had was 29 days. So I didn’t see this one coming. Because I’ve never had the experience of a lengthy cycle or missing periods, I didn’t even know that there was something my doctor could do to jump start my period. It just wasn’t on my radar. Finally, after sending my nurse email after email saying that I’m still waiting, she mentioned that I could come in for an ultrasound and get some help to start my period. And my first thought was, “Seriously??!! Why didn’t you tell me that a week ago?”

 

There’s something cruel about waiting for your period when what you really want is a baby. For someone like me who isn’t used to this, unlike my infertile sisters with PCOS, a late period is what we’re all hoping for – the more days that pass with no bleeding, the more hope you have that you are pregnant. So despite my best efforts to not get overly hopeful for a miracle natural pregnancy before starting my IVF cycle (don’t we all hope to be that unicorn!), I did get just a teeny bit sucked into that excitement. My husband was completely sucked in and thought for sure I was pregnant. Poor guy. But after a few fantasy days of hopeful thinking, I read a few things online that suggested that DHEA can alter your cycle length. After that, I quickly began thinking DHEA might have lengthened my cycle and my hope for a natural pregnancy faded. I did, however, pee on a stick to confirm that I wasn’t pregnant before talking to my nurse. And, just like every pregnancy test I’ve ever taken, it was stark white. You know, glowing so white you need sun glasses. My nurse actually had me stop taking DHEA to try to bring on my period.

 

Unfortunately, a week after stopping DHEA, still no period had presented itself. So today I went into the RE office for an ultrasound to see what could be causing this delay. Ultrasound results showed a thick lining and no ovarian cysts, which is good news. My RE said that I just didn’t ovulate, so my body wasn’t signaled to begin a period. Apparently this happens to about 6 -10% of women every month. He thought it might be related to the fact that my hormones have been on a roller coaster ride due to the resent IVF and FET cycles, but didn’t specifically blame it on DHEA. So lucky me. I was prescribed Provera, which is a oral progesterone, to start my cycle. Instead of the typical 5 or 10 days of Provera, I’m going to be on it for a whopping 20 days in order to keep my ovaries “quiet” until it is time for me to start my stimulation medications based on when my RE’s lab is ready for my egg retrieval. I’m a little nervous about being on Provera for this long, but I’m going to have to trust my RE on this one. Also, I was instructed to begin DHEA again for egg quality. I hope that week off wasn’t too detrimental. But I’m not going to worry about it because I can’t go back in time and change it. I think my ability to worry less about things outside of my control is improving with time and practice (something we get a lot of during this process). Well, at least improving a little bit.

 

So instead of having my egg retrieval next week when I had expected based on the plan that was developed during my last consultation, I’m delayed about a month. Now I’m anticipating egg retrieval early in November, and if we have a healthy embryo, a transfer in early December. And that’s if there are no more surprises. I think to most people a month delay would seem like no big deal. But we infertility warriors get it. Well, I guess we’ll be canceling our trip to visit my family in December. Life really revolves around IVF, doesn’t it?

Thoughts leading into IVF#3

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ORI recently got back from a week long vacation. That never happens for us. Typically our only “vacations” consist of driving back to my hometown to visit my family. But we had an opportunity to join a couple family members at a cabin on Crescent Lake, Oregon.  And for me, it was just what I needed after our failed FET. Time to get away from the stress of this process, spend quality time with my husband and daughter, and just simply relax in nature. Being in nature nourishes my soul. But there was one part of the trip that stood out among the rest in a very personal way – and surprisingly, it was when I was all alone.

I had the opportunity to ride a seadoo by myself for a good while. And when I say “by myself” I literally mean that I was the only person on the lake. It was magical and freeing. I love riding seadoos, but I haven’t done so in about 8 years. It was something I missed so it felt good to do it again. The wind whipping through my hair, the crip water hitting my body, the fun. It was beautiful out on this crystal blue lake surrounded by pine trees. I found myself laughing out loud as I sped and jumped waves. The elements of earth, air, and water swirled around me as I felt the spark of fire within. And it was in that moment that I realized that I can be perfectly happy just as I am.

At one point during the ride I found myself yelling out my wishes to the universe. Calling out my prayers at the top of my lungs, yet still, only the Divine and I could hear them. Then I noticed how calm and sure I felt that we would have success with IVF and be blessed with a second child. And that’s why I’m really writing this. I want to remember how calm I felt, how confident. Because I know that once the meds start, once the series of ultrasounds start, once the Facebook chatter ensues, once the agonizing waiting begins, it will be so easy to forget this feeling. It will be so easy for the feeling to get buried under mounds of anxiety, worry, second guessing, sadness, doubt, anticipation, and fear. Is it possible to hold on to this feeling while going through the ups and down of IVF? Probably not – I’m human after all and this journey is hard. But maybe I can call it back.

I hope I can read this post during those tough times when I’m deep in worry and fear, and remember that when all the hormones and stress were stripped away, I felt completely confident that it will work out. I tend to question what messages are truly intuition versus what is the insidious voice of fear. I questioned that quite frequently during my last IVF. I think the fear creeps in though, during the process. During the stress. But this feeling I had that day on the lake – that was coming from just me and the Divine. I want to remember that.

I want to remember the feeling of knowing that it will work out, while simultaneously knowing that I am okay no matter what happens. That even in loss, even if we don’t have a another child, I can be happy.  It may seem contradictory to say that after just expressing my confidence, but I believe both views are important and valuable. So these are my thoughts going into my 3rd IVF. I hope that this will guide me through the difficult times.

Moving on to IVF #3

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Today I had my follow-up consultation. The one I never wanted to have. The “what went wrong?” consultation. Or, as it’s otherwise know, the WTF consultation. Like any good researcher, I came prepared with a typed list of questions and ideas. I wasn’t really nervous going there, but once I found myself sitting in the familiar lobby of my reproductive endocrinologist (RE), I felt that rush of anxiety flood back into my body. My palms started to sweat, my throat tightened, my heart beat just a little faster. I sat silently observing the physiological change triggered by entering this place. I reflected on how many emotions are triggered by simply being there. Anxiety, fear, excited anticipation, hope. This place represents both pain and dreams come true. Quite a paradox. I focused on taking deep breaths and observing my reactions without judgment. My reactions began to calm, and then the door opened and I was called back.

My RE was genuinely bothered by having to have this appointment with me. He expected my FET to work. He had gone over my chart repeatedly searching for an explanation. As a self proclaimed “control freak” he wanted an answer so that he could fix it. He wants this to work for me. But we had everything right: the timing based on ERA, lining thickness, PGS normal embryo, and no other conditions negatively affecting us as we have had a successful IVF in the past. As much as he hated to say it, it boiled down to bad luck. And that killed us both. He did explain that even though an embryo is PGS normal, it may still have other issues that keep it from continuing to develop. Unfortunately my embryo failed to implant at all. My RE described the embryo as a fuzzy tennis ball and explained that the uterus has receptors dispersed all over it that are like velcro strips. If you bounce the ball in there it may hit a velcro strip and stick, or it might roll around and unfortunately miss all of the velcro strips. The ball only has so much time in there to roll around and hit some velcro before it starts to disintegrate. Apparently my ball missed the velcro and that just happens sometimes. He sure loves his metaphors, but I do like that about him.

We are lucky though, because we have insurance coverage. Part of me keeps thinking that they will revoke this coverage – like they would only pay for one try – but the appeal they granted said “all treatments related to infertility”. They didn’t put any qualifiers or limitations on the approval. Given that, we are able to try again. I feel blessed for that. My RE seemed relieved because he knows what a financial burden this is and he believes we can have success if we try again. And so we will.

We are going to do a few things differently this time. First, I won’t be suppressing with birth control pills (BCP). This was a shock to me because my clinic usually uses BCPs to batch cycles. I’ve read that BCPs can be over-suppressing for women with diminished ovarian reserve (like me) and negatively impact egg quality in older women (um, me again). He said that we will just start the stimulation meds with my next period due at the end of the month. I’m not sure if this is because my period just happens to coincide with the upcoming batch of patients he has cycling or if his decision is due to the aforementioned factors. I didn’t ask. I’m interested to see how this impacts, if at all, the quantity and quality of eggs I produce. Second, we are adding human growth hormone (HGH) to my stimulation meds to try to improve egg quality. I’ve heard good things about this so I’m hopeful that this can help us get at least one normal embryo, and hopefully more.

Third, we are going to re-do the ERA test. He said we can do it during the stimulation cycle after the egg retrieval so that we don’t have to waste a month with a mock cycle. Last time we did 2 biopsies for ERA testing. The first sample came back pre-receptive and the second, done two days later, came back post-receptive. It was logical to split the difference to determine the optimal transfer day. But he said that he would like to see the test find a definitively receptive result. So we are going to do the biopsy on the day that my last ERA assumed I was receptive just to make sure, and do a second biopsy the day after just for good measure. Hopefully this will help us nail down without a doubt the ideal time for a transfer. I’m thankful we can do this during the same cycle as egg retrieval so that I don’t have to drag this out quite as long as the last IVF/FET. Fingers crossed it all works out like that. Lastly, my RE told me about a medication that can make that velcro (yes we’re back to that metaphor) bigger and longer, so that it has more “grab reach” to catch and hold on to my embryo. It’s something that I will insert (my poor overworked vagina) 5 days prior to the FET. Of course, in all the information overload, I forgot the name of this velcro aid, but I’m happy to try it.

So that’s everything. Hopefully these changes improve my egg quality, nail down the perfect transfer time, and improve my implantation odds. I’m a little nervous because I won’t have been on supplements for very long before we start stimulation medications, but I suppose time is not on my side anyway due to age. Also, my RE seemed to not be very worried about that and brushed it off saying, “you were one them not long ago,” so there’s that. And with that…here we go again: IVF #3, FET #2. May luck be on my side and the Divine bless me with fertility.