Flexibility: The IVF Way

03 Tuesday Oct 2017

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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

19 Tuesday Sep 2017

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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

06 Wednesday Sep 2017

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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. 

Healing After Failed FET

24 Thursday Aug 2017

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moonIt’s been three days since I got the news that our frozen embryo transfer (FET) with our one and only normal PGS tested embryo did not work. It was surreal getting that call. I wasn’t even very anxious that day because I really though it had worked. I thought I was pregnant. Quite the vast contrast with my first IVF 3 years ago when I was absolutely sure it didn’t work, and had just finished writing a list of questions to ask my doctor about why it hadn’t worked, when I got the call from the nurse giving me the shocking positive news. This time it was devastating falling from a place filled with potential and excitement, to a place of confusion, anger, sadness, and loss. I wanted to run away.

 

The day after the news I leashed up my dog and headed out to the trail through the hills behind my house. And I started to run. Now, I’ll admit I haven’t run in years and on that day it was pretty brief and mainly downhill, but that’s not the point. Alone out there under the blue sky with only the sounds of birds and my dog’s foot steps, I found the beginning of a release. I initially wanted t run to escape my emotions, the pain that I was feeling, but through my strained breath and sweat, I felt my emotions without judgment, and I began to let them go. This process is far from over, I know. But another thing I realized during this run is that movement felt good. I used to be a pretty physically healthy and strong person. But after some restrictions during pregnancy, and traumatic birth, and then 2.5 years of getting about 3-4 hours of broken sleep a night due to a baby that didn’t sleep well and nursed every 1.5 hours all night long even as a 2 year old, I was physically exhausted. I felt weak in my body. It was like my whole body atrophied. After my daughter finally started sleeping through the night and not night nursing, about 6 months ago, I had difficulty finding the motivation to exercise and really move my body again. I knew I needed to. My job is sedentary and I felt sluggish. But I just didn’t do it. I made excused for not going to yoga classes – no time, work schedule, my daughter’s schedule. There was always something. But after that first run, I realized something. I can’t keep waiting for the perfect time to take care of me.

 

After the news, I felt betrayed by my body. A perfectly healthy embryo was placed in my womb at the perfect time, and my body failed to do its part. After slipping into research mode yesterday, I realized that my expectations about success with PGS testing were too high. In my defense, my expectations were set by my doctor. He didn’t warn me that PGS testing doesn’t ensure that the embryo is healthy from all conditions or that it has the energy needed to continue dividing and growing. And sometimes it’s just bad luck. Maybe my body didn’t hold up its end of the bargain, maybe there was something about this embryo that wasn’t compatible with life, maybe it was both, maybe it was neither. But over the years, and in the future to come, I’m asking a lot of my body. I want a long and healthy life with my daughter and husband. I hope to be able to make more healthy embryos, and sustain a pregnancy and birth. My body wants to move again and feel strong. I want that.

 

Last night I walked into my old yoga studio for the first time in about three years. Prior to my daughter’s birth I attended multiple classes per week and loved it. It was strange to be back, but also comforting. It felt good to do something for me. For my health. I felt so bloated and sluggish from all the progesterone I’d been injecting and wanted to help move it out. It was a candlelight yin yoga class, so nothing rigorous, but just want I needed at the time. I felt tightening in my throat and tears in the back of my eyes during most of the class as I stretched my body and processed more emotions. At the end of class, after savasana, as we sat there cross-legged, eyes closed, hands in prayer position, the teacher asked us to consider what had to happen to bring us here to the mat that night, in an effort to help us recognize and honor all the little things it took. But for me the answer was concise and simple. It took a failed FET.

 

I thought about that as I drove home in the darkness. I saw the beginnings of the new crescent moon raising in the night sky. It was beautiful. The waxing crescent is a time for new beginnings. I also pondered the synchronicity with the solar eclipse, which occurred on the same day I got my news. Darkness, confusion, disruption – giving birth to light, shifting paradigms, new beginnings. I was expecting good news that day – no darkness, no disruption. But I got just that. And now from the darkness of this pain, some light will emerge. I will continue to honor my body with movement, fuel it with healthy foods, and connect with the Divine and my guides. I have not been abandoned. I know there are still more emotions to process. There are more tears that will be shed, and I do plan on doing a ritual to honor this baby that will never be. My path toward healing and well-being is just begun. We will continue trying for a second child. I have a consultation with my doctor scheduled in two weeks, and barring any devastating news, we will do IVF again. But whatever happens along this journey, this loss has given me the gift of honoring myself and taking better care of my body that does so much for me. And I thank that little soul for what she has given me in the brief time we were together.

FET Results

21 Monday Aug 2017

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Today I found out that my IVF didn’t work. We had one embryo that was genetically normal based on pre-implantation genetic screening. A little girl. My uterus was perfect. My embryo was hatching after the thaw and ready to implant. The timing was perfect based on ERA testing. My progesterone and estrogen were perfect. We had a 80% chance for success according to my RE. But it didn’t work. My nurse couldn’t even give me a reason. When she called me I heard it in her voice before she even gave me the news, and I held my breath – I couldn’t believe this was happening. “I’m sorry”, she said , “both tests were negative.” I’m struggling to make sense of this. I’m struggling to not loose faith in the divine, my spirit guides, my angles. Are they really there? Were they listening to my prayers every day? Why did this happen? It was so hard for me to create just this one healthy embryo. Now we are back at square one. And I’m 40. I’m not even sure if I’ll be able to make another healthy embryo. My heart breaks for this little girl that will never be.

Holding Faith & Trust in the 2 Week Wait

15 Tuesday Aug 2017

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The waiting has begun. Well, more waiting I suppose. The hard, second guessing everything and over-analyzing every twinge kind of waiting. We had our embryo transfer last Thursday. Everything went well during the thaw. I mostly knew it would, but there’s always that small chance of something going wrong. I didn’t focus on that. I did acupuncture right before (and after) the transfer and was feeling pretty at ease at that point. After we got called back to the transfer room, it was just a short wait until my RE brought me a picture of my precious little girl. There were two pictures actually. One was right after the thaw and the other was 4 hours later. I was relieved when I saw that in that short time she had already started hatching. To me, that meant that she hadn’t been harmed during the biopsy or thaw and was right back to growing strong again. My RE said, “Let’s give her something to attach to,” and just like that, my perfect baby was placed into my womb.

I’ve been following a post I came across about what happens after a 5-day transfer. It’s interesting to read about if you haven’t, and you can find it here.  Yesterday I was at Day 4 after transfer, and on that day my little embaby is finding her way deeply into my uterus and attaching to the endometrial blood supply. Early in the morning I felt a sharp jab to my uterus that actually woke me up from sleep. It was over in an instant. I can’t help but think maybe this was my baby making that final journey deep into her nest.

Or it could have been unrelated. This is that time during IVF/FET when you really over-analyze absolutely every little thing your body does. The two week wait is a trickster. Every “symptom” could easily be explained away by all that progesterone, a pending period, or anything else really. Feeling so unsure about myself is something I’m not accustomed to, and it’s rather unsettling. More than ever I have to rely on trust and faith. Trust in the science that brought us to this point. Trust that this  little embryo and my body know what to do and can do it. Trust and faith in the Divine that my prayers will be answered. Faith that this will really work. To hold space for that I must find my courage. I can do this.

Yesterday I went for a walk in the local arboretum. It’s a place of beauty, serene nature, and fond memories. It’s also home to a lovely labyrinth. Labyrinths are magical places and I feel lucky to have one so close by (although you could certainly make a simple one in your backyard or home with nothing but a long piece of yarn). Labyrinths are different from mazes. Mazes have multiple pathways, dead ends, and the correct path is hidden for you to deduce. Labyrinths have once path; it goes in then back out. There is no guessing or figuring. Walking the curving path creates a rhythm and lets the mind disconnect from everyday tasks and stressors. It’s a meditative practice. There are many different ways to mindfully walk a labyrinth.

In the spirit of connecting with my trust and faith, I began my path at the labyrinth opening by calling to the Divine and all of my spiritual and angelic helpers. As I walked the curving path toward the center I focused on my prayer – that my embryo transfer succeeds in blessing me with a healthy pregnancy and baby. I focused on this as I slowly walked with intention all the way to the center. Once there, I gave thanks. I am truly grateful for all the help and blessings I have received along this journey. I know that the Divine and my helpers have been watching over me all along, and have had a hand in all the amazing things that have miraculously gone right. As I wound in the reverse direction out of the labyrinth, I filled my heart with gratitude – including gratitude for the blessing that is growing inside my womb. Labirynth

Approaching Transfer in Sync with the Full Moon

08 Tuesday Aug 2017

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Two days until transfer day, or maybe that’s one day if you don’t count the actual transfer day. It’s finally (almost) here. The wait has been long and I’m ready to get my little embaby in my womb. It’s obvious, isn’t it? I’ve managed to find myself in a calm and hopeful place, which was my goal for this process. I attribute this state to a number of things including, but probably not limited to, emotional exploration through reflective blogging, Circle and Bloom FET meditation practice, prayer and ritual, honest conversations with my few supportive people, mindfulness practices, acupuncture, craniosacral therapy, nature walks, date night with my husband, some fun outings, and getting accurate information from my RE. These things have been invaluable. I didn’t have all of this the first time around, and it’s made a huge difference.

 

Yesterday was the full moon, and as I approach my transfer on Thursday, I wanted to harness the energy of the moon. I’m entranced by the moon. The August full moon is often called the Corn Moon, and calls us to focus on harvesting that which we have already planted. The synchronicity with this and my embryo in waiting and  (hopefully) pending pregnancy is magical. It was suggested to me by another magical woman that I set out a special stone to charge with the fertile energy of the full moon and keep it on my person until I get a positive pregnancy result. I liked the idea and thought the best way for me to do this is to use a piece of stone jewelry. After considering my options, I decided on two pieces that are made with stones that aid in fertility, and have a special meaning for me. These particular pieces include rainbow moonstone, rose quartz, carnelian, rhodochrosite, amber, and quartz. I also decided to set out a rose quartz heart palm stone that I plan to have handy after the transfer as a reminder of love, acceptance, and welcoming.

 

I set these items out on my wood stump on my balcony, which gets a great show of moonlight, and spent some time in prayer. This morning I mindfully put on my bracelet and necklace, and offered thanks. Thursday can’t come soon enough.

charge

Jewelry by MacRae Naturals, Goddess statues and spiral baby by Brigid’s Grove, candle by me.

Understanding the ERA: A Field of Flowers

03 Thursday Aug 2017

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StockSnap_P52TO8UCYSI find that it’s so easy to over-analyze in this process, inevitable leading to anxiety. I’m also tempted to consult Dr. Google and we all know how that turns out. So I’ve been trying to not over think it, but the one aspect of my upcoming FET that has really got me in knots is the timing of the transfer and my Endometrial Receptivity Assay (ERA) results. Learning just enough about the ERA test and implantation to make me dangerous, I’m struck by just how small the window is for implantation. Since I only have one embryo, I know we have to get the timing right for success. When the timing is off, that’s when perfectly normal, healthy embryos don’t make it. Sure there are other reasons FETs can fail, but this is a big one. And so, I’ve been worried.

Let’s talk ERA testing and implantation. Here are the basics. Estrogen help us grow a nice plush lining. Some women do a natural cycle for this and others do a medically controlled one. If you’re going the medical route, there are many different protocols to help you get there. Mine included 2 shots of estradiol weekly for about 6 shots total prior to transfer. My nurse explained that while estrogen helps build the lining, progesterone helps the lining stay put, so days before the transfer I’ll start progesterone in oil (PIO) shots. But it’s a lot more than that, really. Progesterone actually changes the make up of the lining and helps the receptors there activate.  Now here’s where it gets scary. Those receptors are only active for a short amount of time and then they close off. An embryo can only implant during that small receptive window. So the timing of the transfer is key, and that’s really based on how long progesterone has been in your system.

The ERA test is a relatively new one to hit the infertility treatment scene. To do the ERA, you do a mock cycle – including medications and all – but instead of doing the embryo transfer, they biopsy your lining. My RE did 2 biopsies in one mock cycle – a biopsy on day 5 and another on day 7 – to ensure that we covered the most likely receptive time frame. If the first biopsy comes back receptive then they don’t bother testing the second. But if the first is non-receptive then they can test the second sample to see what’s going on. I was glad they did 2 biopsies in the same mock cycle because it saves time  (and money) from having to do another whole mock cycle for a second biopsy if the first one fails to find the right day.

In my case, the first biopsy came back pre-receptive – meaning my lining wasn’t quite ready yet – and the second biopsy came back post-receptive. The laboratory that did the testing recommended a certain number of hours of progesterone that would get me right into the middle, which should be my peak receptive time. Based on this, I’m supposed to start my PIO shots at a very specific time and have my transfer at a specific time on day 6. Those results have literally been haunting me.

There were 2 things that worried me:

  1. I’m worried about doing a transfer on day 6 since for my first IVF we did a fresh 5-day transfer, which obviously worked because I have a daughter. So is changing the day really a good idea?
  2. I was really hoping one of the biopsies would come back “receptive” rather than pre- and post-receptive because,  to me, that seems like guess work. Having a biopsy be clearly receptive would seem like more of a sure thing. Maybe my thinking was wrong here, but I was worried.

Now I haven’t seen my RE since my biopsy, and won’t see him until the big day, and the nurse gave me my ERA results. She assured me they were accurate and I tried to accept that. But here we are one week before my FET, and I couldn’t stop thinking about it. Today I went in for my last blood draw before the transfer, so this was really my last chance to ask questions in person before the big day. I went in to get my blood drawn, and to my surprise there was my RE standing there looking at some files. He’s rarely ever out of his office or the exam rooms, so this was a rare opportunity. I asked him if he had time for a quick question even though he was clearly busy. He said yes and not only took the time to fully answer my questions, but he even drew me a graph. I love this guy. And I feel so relieved having my questions answered and getting a better understanding of this complex process. So I wanted to share.

ERAHe drew a normal bell curve and explained that it represents how many receptors are active in the lining. The more receptors that are active (represented by the highest peak of the bell curve), the better chance an embryo has of implanting. The ERA results focus specifically on finding the peak window of receptivity – the optimal receptivity. This could be day 5 for some women, or other days like day 4, 6, or 7. My results gave a peak window on day 6, but there are still receptors active on day 5 (which for me would be on the right side of the bell curve where the line is lower), which is why my last IVF transfer worked. ERA doesn’t test for the whole bell curve – it’s aiming for the peak window. So he said, that this time I’ll have even more receptors active than last time so we will be giving my embryo an even better chance of implanting than we did the first time.  That cleared up question #1 for me and made a lot of sense. Then he explained that the test is able to accurately calculate my receptive window even with the pre- and post-receptive findings, so they purposely space out the biopsies by 2 days (rather than doing days 5 and 6) to capture the best window. He said he is very confident in the results and that made me feel good too because he is great at what he does and I trust him. I’ve also read about the high accuracy of the ERA in research studies. That gave me peace of mind on question #2 also.

My RE also gave me a nice analogy. He said that the receptors in the lining are like a field of flowers. The more flowers you have open, the more likely your baby is to implant. At first, only a few early flowers begin to open. Implantation can occur but it’s less likely. Shortly thereafter, the whole field bursts with life and all the flowers are in bloom. This is when there is the greatest chance for implantation. Then most of the flowers begin to fade, while a few hold on for a bit longer, and implantation success dwindles. The ERA test tells you when your whole field is in bloom. A pretty thought, isn’t it? I think I’ll use that visualization on transfer day, and the days after as my embryo continues to nuzzle in, Goddess willing. I can’t help but think that someone was looking out for me today and helped time things perfectly so that I could ask my RE these questions. Now I’m going into the last stretch with a renewed sense of calm and confidence. I finally feel excited!

Meditation for FET

02 Wednesday Aug 2017

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sunflower.jpgEight days until our frozen embryo transfer (FET). We’re almost there. I wrote in my last post about my unexpected influx in anxiety and worry about this FET. I’ve been able to significantly reduce that, thankfully, and one of the major contributors to that reduction has been a meditation and visualization program that I’ve been doing daily. This program is specifically designed for the FET process by a company called Circle and Bloom. You can find it here. I’m not affiliated with the company in any way, and I’m not getting anything for this review, but it has been so helpful for me that I wanted to share. What I like best about this program is that it’s designed specifically for FETs so there are different meditations in the series for the various stages of the process. So it really “fits” with what my body is doing at the time. The guided instructions for focusing my attention, progressively relaxing my body, and fertility related visualizations help keep my wandering mind on target and allow me to fully melt into the experience. It’s really been a life saver. They also have a series specifically for IVF, which I did 3 years ago when I did my first IVF. I found both programs to be well worth the money, and I like that they have digital versions so I can listen to them on my phone or other device, wherever I am.

 

One thing that I really like about using meditation is that it helps to reset my mind so that I can leave the panic and “what if’s” behind and find a place of calm. And that is no easy task when you’re going through infertility treatments. In those moments of calm I’m better able to focus on what I’m grateful for and connect with the Divine. I can also more easily take solstice in my mantra: trust, faith, courage. Every day I’ve been reminding myself that worry and lamenting over the worst possible outcome will not change anything. It won’t prevent anything. Meditation has helped my calm my fears just enough so that I can say, “What if this does work…” rather than “what if it doesn’t”.

 

But meditation doesn’t have to be something formal. I think that anytime you find yourself completely immersed in the moment, that is a form of mediation too. I feel the same sense of calm when I’m talking a walk in nature, sitting in the sun, or engulfed in an art project. My husband took me to one of those painting and wine places, where you get a blank canvas and are instructed by a teacher on creating some picture. And there’s wine (which I drank, moderately, without guilt or worry). Aside from when we had to stop and sneak into the bathroom together so that my husband could give me a shot, gotta love this process, I literally didn’t think about anything other than the painting I was creating. It was a great break and so wonderful to connect with my husband for a fun date night. We laughed and teased each other. IVF is so all consuming that we often loose that joy, or at least misplace it for a while. So I’m going to continue my meditations, both the structured FET meditation series and the more fluid “in the moment” pleasures. I think this will help me come to my FET on the 10th holding a sacred space of readiness and welcome for my baby.

FET: Unexpected Apprehensions

19 Wednesday Jul 2017

Posted by in IVF#2 with FET

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I have an apprehensive feeling setting in. I have my baseline ultrasound and initial blood work for my frozen embryo transfer (FET) scheduled for Friday. This is the real deal. We have one embryo. One shot. And that’s making me nervous.

It’s so different from the first time we did IVF three years ago. Then we did a fresh 5-day transfer. When I showed up that day, 5 days after my egg retrieval, I didn’t even know how many embryos had made it. I knew that at least some did because the transfer wasn’t canceled. But I didn’t know anything about the embryos. That day I found out that 3 of 7 made it to early blasts, and 1 was lagging even more behind so they were going to watch it to see if it continued to grow. The RE recommended transferring 3 due to my age, 35 years, and quality of the embryos. We didn’t do PGS testing back then so it was based on visual grading. I was shocked when he suggested transferring all 3, but it gave us the best chance of success per his statistics and the risk of triplets was so small. I had been through so much by that point that I was willing to do anything to get pregnant, so we transferred all 3 and I was thrilled. That fourth one arrested so we didn’t have any left to freeze.

When I look back on that I realize there are some similarities between then and now. In both situations no embryos will be left over after the transfer. So really they are both one shot deals. If either failed, we would have to start IVF all over again. But I didn’t feel apprehensive that first time. I felt excited. I felt like for the first time EVER I had a real chance of becoming a mother. Why did I feel that way then, but feel so sacred now?

Well, I think there may be a few things going on now that are impacting my emotions.

First, let’s face it – my biological clock is screaming. We’re past ticking. I’ll be turning 40 in the middle of this FET. Happy birthday to me. The thing that scares me most about that is how poor my egg quality was despite supplements. At age 35 I still had some time for multiple retrievals if I needed them. We didn’t do banking, though I now wish we had. At that time we were paying out of pocket and doing multiple rounds for banking would have been a challenge. Plus my RE didn’t even mention it, and I was so focused on just trying to get pregnant that banking never even occurred to me. Truthfully, I thought one child would be enough if I was ever lucky enough to have one. And I am so blessed to have my daughter, but that doesn’t mean that I can’t still feel a deep desire to grow our family like so many other people do.  If this FET doesn’t work and I am faced with doing another egg retrieval, my egg quality could be even worse than it was this round. It might not work at all. So time isn’t my friend and that makes me nervous.

This time I was given the option of doing another egg retrieval after the first for banking, but I decided to move forward with the FET. It’s a gamble really. At this point we are only trying for one more child. We decided to go for it with our PGS normal embryo because my RE gave us a high chance for success. So we are betting on this little one.

Another thing that makes this time different from the first is the expectations. Mine, my husbands, my family and friends, even our daughter’s expectations.  I was so fortunate that our first IVF worked for us. But I knew what a miracle that was. I read all the statistics about how most couples need multiple rounds of IVF to bring home that baby. I even participated in the Attain Financial program where you pay up front for three IVF cycles at a discounted rate and they reimburse you a large percentage of the cost if they all fail, so you don’t go completely in debt for nothing and can afford additional treatments or other options if necessary. There’s no reimbursement if it works on the first try, so really I ended up paying more than I would have if I had only paid for one round of IVF. But I don’t regret that decision because having that safety net was so reassuring during the process. I made that choice initially because I knew it would most likely take multiple attempts. But my loved ones hadn’t read the research I had. They pretty much expected IVF to work. And it did. So now my family and friends are already planning for my second baby. And, truth be told, so am I. PGS testing seems to make that expectation even higher. A normal embryo should stick, right? I know it’s no guarantee, but it raises the bar.

All in all, I suppose it’s kind of like expecting the worst and getting the worst. It’s harsh, no doubt. But when you expect it to work and it doesn’t – well that’s even more devastating. I want to be optimistic, and up until now I have been – but as I start this FET I feel more shaken than I had in the past. My expectations are so high. I don’t want to fall that far.

We’ve also been very open with our daughter about this whole process. It’s something I have mixed feeling about. I can completely understand why many parents would keep this a secret from their child until the pregnancy is well established. But I can’t even poop without my 2.5 year old all up in my business. Do you think I could administer 4 shots daily without her noticing? No, I couldn’t. So we decided to be honest with her. We told her that we are trying to make a baby and this is how mommy makes a baby. Of course she wanted to participate in the process. So I gave her a job that she proudly did every morning and evening. She was in charge of the alcohol wipes and wiped my belly before each shot. She talked about wanting to take the shots herself because she wanted a sister in her belly. We explained to her that if we are lucky to get a baby it could be a boy or a girl and we’d be grateful for either, but either way it will be in mommy’s belly. It was sweet. I have no idea where she got the idea of having a sister from but she was adamant. When we found out that we actually had one normal embryo – and it was a girl – we caved in our excitement and told her. She was so excited. I know telling her may not have been the smartest decision, but we couldn’t hide our elation. It’s done. And I’m terrified of letting her down. I want to give her that sister.

And the last thing that I think is weighing on me this time around is that I’m already picturing our lives with this second little girl. Somehow, knowing up front the gender of this little embryo that isn’t even in my womb yet has made her all the more real to me. I’m not sure if that even makes sense. With my first IVF baby, we didn’t even find out the gender until she was born. It was one of the best moments of her birth, at least in part because it was a pretty traumatic birth and seeing the look on my husband’s face as he told me our baby’s gender was a precious bright spot. I loved not knowing the gender during pregnancy, but honestly it did make me feel a tiny bit disconnected. It’s not that gender is so important, in fact I think it’s a bit overemphasized. But there is something more personal, to me, about naming the baby and connecting in that concrete way. Knowing that this little embryo is a girl has made her seem more concrete – more real. We’ve even started calling her by name. I can envision my two daughters growing up together.

Going though the lengthier mock transfer process has allowed me so much more time to create this attachment to this little embryo than I had when I did my fresh transfer 5 short days after my first egg retrieval. How can I be attached to an embryo that isn’t even in my womb yet? I’m not even pregnant yet. Still I sit here having these real feelings. And that make me more afraid of loosing her before we ever even had a chance.

As I write all of this out, it makes more sense to me why I’m feeling all these scary feeling as I begin my FET, rather than the excitement I expected to feel. While I really don’t want to go through this whole FET fearful, I do want to acknowledge these feelings and give them the respect they deserve. I do have good reasons for feeling the way I do, and I feel less confused having explored them. So now that I’ve acknowledged these feeling and have a better understanding of them, I’m going to look for ways to move past them. Ultimately, I want to go through this FET with hope, joy, and cautious optimism. With the help of the Divine and a small circle of support people, I think I’ll get there.