Monday, October 24, 2011

Partial DQ Alpha Match

Last Wednesday started as a great day, the grandmas’ and I got to see the little bubble dance all around and even got a very cool video of it to show Blue when he got home.  I also got to stop the PIO shots, progesterone suppositories and start weaning the dex.  It was also the day I was supposed to be released from Dr. Sher until we went back for a sibling.

It all went well until I got the call from Dr. Sher’s nurse.  I was expecting the “congratulations you’re no longer our patient” call, but unfortunately I got the “we received your test results call.” 

As I’m sure you’ve picked up on by now if they test me for it I’ll have it…. So, as expected, they tested Blue and I for alloimmune matching and we are a partial match. 

Instead of hysterically crying, like I did when they told me I have a blood clotting disorder, I laughed.  What else can I do at this point?  I rushed to the hospital for another intralipid infusion and instead of wondering if God was telling me I should never have gotten pregnant, I thanked him because clearly with everything working against me I had some intervention from him!

My quick description of alloimmune implantation disfunction is this:  It is important for us to have differing immune systems and so our bodies have evolutionarily developed ways to create babies with complex immune systems.  One such way is for us to be less attracted to the smell of a person with a similar immune system to our own (for the record I think Blue smells great.)  Implantation of an embryo is a lot like a tissue transplant except that with a tissue transplant you want an almost identical immune system, with embryo implantation you want a completely different immune system.  If the embryo attempting to implant has similar immune components to the mother, the mother’s system will fight back by creating natural killer cells against the embryo and choking off implantation, or eventually causing an early miscarriage. 

What this means for Blue and me?

  1. Since Blue and I have a partial match it means that (statistically) 50% of our embryos will be unable to implant in my uterus. 
  2. Because we’ve made it this far in this pregnancy Dr. Sher feels confident that this embryo didn’t match and will stick around for the long haul.
  3. From now on we will only transfer 1 embryo at a time, if we were to transfer 2 embryos (and one of them matched me) my body would attack the matching embryo and inadvertently the other non-matching embryo at the same time, thus wasting a viable embryo.
  4. For this pregnancy, and in future pregnancies, I will need bi-weekly intralipid infusions until 24 weeks.
  5. Most importantly, we’re really lucky that we were able to get pregnant the first time around, especially with 2 embryos transferred.

Wednesday, October 19, 2011

The Math of IVF

Today I had my last ultrasound to be released from Dr. Sher.

The Bubble at 10 weeks, you can clearly see arms and legs now, we even saw fingers today!

I did a little reminiscing today and this is what I came up with…

2 attempted IVF cycles consisting of:

42 Subcutaneous Shots
+ 99 Pills (not including vitamins or supplements!)
+ 81 Vaginal Suppositories
+ 56 Intramuscular Shots
+ 3 Intravenous Intralipid Infusions
(+ 210 more SubQ shots of Lovenox to come)
+ 3 plane tickets across the country

= 1 Perfect 10 week old fetus

I wish IVF math was as consistent as regular math.  I wish if you just added the right number of things together it always equaled a baby.  Today I’m ecstatic for me but I’m also grieving for all of the other infertile women out there who’s math didn’t work out as well as mine.

Monday, October 17, 2011

Blue put his foot down

I love my Blue.  He is the voice of reason while I am the worrier.  Most of the time he lets me go on my merry way and rarely weighs in on a decision I’m passionate about, but every once in a while he puts his foot down and takes a stand.  When he does, I listen.

Blue put his foot down this weekend. 

Once I fully understood the clotting/lovenox issue I explained it all to him, but truthfully I didn’t expect him to weigh in.  I had already decided to go with my Alaska doctors and not take the Lovenox, just request monitoring of my homocysteine levels. 

After I explained all of this to Blue he replied in a stern voice, “why would we stop trusting Dr. Sher now?”  He went on to explain that we’ve regretted the times we didn’t listen to him and have yet to regret a single thing we did listen to.  He pointed out that we aren’t doctors, our choice is which doctor to trust and he trusts Dr. Sher, so do I.

So the decision is made. 

I took my first Lovenox shot last night and it wasn’t too bad.  Thanks to all the ladies out there who gave advice on how to avoid bruising/stinging.

Thursday, October 13, 2011

Updated: 30 mg Lovenox Daily

I’m not doing so well right now.  As if endometriosis, diminished ovarian reserve, autoimmune implantation disfunction and a thin uterine lining weren’t enough, I just found out yesterday that I have a blood clotting disorder.

The worst part is that I don’t even know what type of blood clotting disorder it is yet so I can’t calm myself through research.  For the first time I am very unhappy with Dr. Sher’s office.  His nurse informed me via email that I had an abnormal result on my thrombophilia panel, meaning I have a high chance of blood clotting during pregnancy and that they want me on Lovenox shots daily for the rest of the pregnancy.  Who sends information like that via email, at the end of the day??!!

I couldn’t talk to anyone at their office until this morning and still know as little as I did yesterday because I’m waiting on a phone consult with Dr. Sher.  Luckily my sister is a genetic counselor and understands this stuff and is also close with my OB, so the two of them calmed me down enough to make it through the night.

At first the prospect of daily shots for the next 31 weeks sounded daunting, but I’ve accepted that I’m not going to have the sunshine-lollypops pregnancy I imagined during all my IF day dreaming, and that’s OK.  But now I have to sit here for an entire week wondering if I’m already too late.  Most people start Lovenox before their IVF cycle, not at 9 weeks pregnant.  What if I already formed a clot and lost the baby since last week?

I honestly just want to cry.  I just want to curl up in a ball and cry, feel sorry for myself, and yell “why me!?” to God.  Instead I’m sitting here at work because I know there is nothing I can do but start the shots and pray really hard that the damage isn’t already done.

If any of you have any tips on Lovenox please share because I could sure use some.

Update:  I have two copies of the MTHFR gene but normal homocystine levels...  So my REs office sent the results of the test to my OB, who shared them with my genetic councelor sister, who shared them with the local pre-natal gentetic councelor, who shared them with the local high risk perinatologist.  Everyone but Dr. Sher thinks the risks of lovenox are higher than the risk of clotting because the gene polymorphism has not caused my homocystine levels to elevate.  Dr. Sher is adamant that I need to be on Lovenox, everyone else is adamant that I NOT be on Lovenox.  Now I don't know what the F to do.  I've always trusted my OB and my sister sent me to the best perinatologist in the state who concurs, but then again I've always trusted Dr. Sher and he's never let me down...

As for worring about the baby all doctors agree that I shouldn't since the MTHFR mutation doesn't cause early losses.  The issue will come in the 3rd trimester when my risk of pre-eclampsia and placental abruption increase.

Wednesday, October 12, 2011

Fertiles Just Don't Get It...

My sister is married to a close college friend of Blue.  We introduced them the summer we met and the rest is history.  The four of us were close until IF struck.

My sister and I had intended to be pregnant together.  Blue and I started trying about 8 months before they did…  They got pregnant the first month they tried and had a relatively uneventful pregnancy which resulted in my fabulous nephew who will turn one year old in two weeks.

Both my sister and brother in law (BIL) have had troubling being sensitive about our infertility.  At first it didn’t seem to bother Blue but eventually it came between him and my BIL too.  My sister and I have worked hard on fixing our relationship and are in a much better place now than we have been in a while, but both Blue and I are still struggling with BIL because he doesn’t get it or even try to get it.  I think BIL thought the problems would magically disappear once we got pregnant.

After our first ultrasound two weeks ago I got congratulations call from BIL.  He proceeded to ask me how exciting it was to see the heart beat, and then to say he knew EXACTLY how I felt and that he remembered how incredible that first ultrasound was!  I politely agreed because I appreciated the call and enthusiasm but in my head I adamantly disagreed.

BIL had no idea how it felt to see our baby.  He had no idea how it felt to see our baby’s heart beat and feel extreme relief.

After talking to him I realized that pregnant fertiles go in for their first ultrasound full of excitement not fear.  They aren’t just seeing their baby for the first time; they are getting an ultrasound for the first time.  They are starry-eyed first time parents that don’t even know they should be nervous.  They are holding hands because they are so excited.

For us it was so different.  I’d been in that same room 10 times before, for 10 other ultrasounds that never showed me anything positive.  I was in that same room the day they told me I had 40 year old ovaries.  The ultrasound experience wasn’t new for us, it was repeat of the past with a lot more on the line.  I already loved our baby with all my heart but I knew better than to get attached.  I held Blue’s hand because I needed him incase the news was bad, just like I held his had the day they told me I hadn’t responded to the stims during our first IVF.

Before I ever got to feel excitement I had to feel the full weight of relief lifted off, so no BIL, you have no idea how it felt.

Friday, October 7, 2011

The Silent Struggle

I wrote this post 9 months ago, when I first started blogging, when I was at a very low point and thought I couldn't go much lower.  Blogging has saved my sanity, its gotten me through the times I really thought I wouldn't make it through.  It's nice to read this now as I sit here pregnant and think that I can finally let the vulnerability go and maybe help some people in real life.  Now that i'm pregnant I want to shout it from the roof tops "This baby wasn't a surprise!  We busted our ass and our pocketbook just to get pregnant!"

My infertility has been kept a secret from all but my closest friends and family, this seems to be a common thread with most other infertiles.  Why do we keep it a secret?  I’m not even sure I can answer this for myself but I’ve been trying really hard lately.  I’ve realized that the reasons change with time but beneath the rest lays the heart of the problem: vulnerability.

Surrounding the root of the secrecy is a thick skin.  A gradually expanding defense you develop after months of failed baby making, a protection that eventually leads to isolation.  At first you tell a friend you’re trying as a fun shared secret, there’s a sly smile on your face.  After a few months you start to notice that person looking at you funny and you know they’re wondering where your baby bump is.  You start to worry about what you’ll tell them if they ask, dreading the inevitable day they finally do.  You don’t know what the problem is but can’t help but feel like a failure, and now this person knows that you failed…  It’s one thing to fall on your face but to do so in public is so much worse.  So then the secrecy begins.

As the secrecy creeps in the fear sinks roots and begins to grow.  Subconsciously you start forming thoughts that start with if we get pregnant, instead of when we get pregnant.  The fear and tears are bottled up, balancing on a narrow precipice just waiting for that gust of wind to tip them.  When the receptionist at the OB/GYN office asks the reason for your appointment, you break down, because speaking your fears aloud somehow makes them real.  Silence is the preferred option, the retreat into isolation begins.

You thank God daily for the internet; you spend hours researching crazy things like ideal basal body temperatures and how long a sperm can live.  You’ve memorized every early pregnancy sign and hold out secret hopes that the heart burn last night was caused by pregnancy hormones.  You search endlessly for a magic fertility pill/book/diet that will make all the hurt go away and give you a baby before anyone else notices that you failed.  You do all of this alone.

The people who do know start to offer suggestions, they mean well and you take it well.  At first, but at some point you stop smiling and nodding when you hear the same suggestions over and over.  You want to yell when they sweetly suggest it will happen in God’s time.  Does the God they know think the 16 year old on TV deserves a baby more than you do?  Does he think that the crack addict down the street would be a better mother?  You fluctuate between an angry cynical version of your former self and a hysterical weepy one.  But to the world you just look blank; you slip away slowly and silently and most never notice that you’re no longer the person they once knew.

Your marriage is at a critical fork in the road, either they’re the rock you completely rely on, or a crack forms in your foundation and grows with time.  Then you start in on the vitamins and fertility drugs, you feel like something between an 80 year old and a drug addict.  The hormones rage and then suddenly you’re not just depressed you, you’re demonic you!   Somehow the raging hormones are controlled by the secrecy too, you reserve all that crazy for the one that you’re either standing on or driving away.  At some point you reach a breaking point and hopefully someone is there to catch you. 

As you hide in your silence you start to notice that you’re not the only one out there, there is an internet full of other secret infertiles like you.  They have your story, they understand you, and suddenly you’re not so alone.  The community of infertiles helps become part of the rock you balance on and maybe even starts to repair some of that crack that has formed between you and your closest friends/family. 

I realized after writing this that I wrote it in a hypothetical tense and never used the words me or I.  So I guess hiding my vulnerability continues.  The thing that struck me the most in all of this was identifying how important the community of infertiles online has been to my sanity.  I wonder what the implications of our silence are in real life?   Are there lonely, depressed women out there who need to hear they’re not alone?  Could we make all the difference in someone’s life by just being open about what we’re going through?

Thursday, October 6, 2011

Belly Shot...

I have a really cute baby belly right now.  I look like I’m about 5 months pregnant.  The problem is that I’m only 2 months pregnant...

It turns out I’m pregnant with Blue’s baby and dexamethasone's baby.

I can't believe I'm posting a picture of my fat belly on the internet...

I hate taking dex.  It was OK when I took it with Lupron but as soon as I cut the Lupron the side effects have gotten worse.  I wake up hungry every day.  I eat a meal, take my last bite and find that I’m still hungry.  I’m hungry when I’m sleeping.  I’m hungry when I’m nauseous.  I’m hungry ALL THE TIME!

Before, the nausea kicked in I could control the hunger but since I started feeling sick all the time I can’t.  The only thing that makes me feel better is to eat, so I just keep eating.

They say steroids make you really bloated too, so maybe I'll hold out some hope that my belly will magically disapear when I stop the dex in just 13 more days!

I really hope this is a dex problem and not just a pregnancy thing.  If it’s a pregnancy thing I’ll be the size of a whale by the time the baby gets here…

Wednesday, October 5, 2011

Today I Embrace My Pregnancy

When I talked to Dr. Sher’s nurse after our ultrasound last week I told her how worried I was about not seeing the baby for 3 weeks.  She asked if I wanted another ultrasound.  Who doesn’t want to look at their baby another time?  So, of course, I said “Really? Yes, please!” 

So here we are, 8 weeks pregnant and with more beautiful, fuzzy, black and white pictures of our little bubble.  It is measuring at exactly 1 week ahead of last week, 8 weeks 3 days.  The heart was clip clopping away at 167, which, from what I’ve read, is a perfect increase from last week also. 

Little 8 week old Hunter bubble, you can even see one arm and leg poking out!

I promised myself yesterday (after closing my 500th go.og.le search of miscarriage after seeing a heartbeat) that if everything looked good on today’s ultrasound that I would embrace this pregnancy.  Now here I am, with a perfect little one growing away and committed to my promise.

Here it goes:
  • I will not go.og.le miscarriage anymore
  • I will not stalk blogs about missed miscarriage
  • I will tell people I’m pregnant (except for work, I’m waiting until 10 or 12 weeks)
  • I will remember that there are no guarantees in life and that I am the luckiest girl alive to be pregnant at all!

Monday, October 3, 2011

Fraud Alert

Since our ultrasound I’ve been doing my best to quit worrying!  Everything looked just like it should and so, along the same lines as my PUPO philosophy, I’ve decided to just enjoy it while I can.

We went to a work BBQ for Blue on Friday, and since Blue had already told almost everyone at his work about the pregnancy, (which I think is funny because he is the one who wanted to keep it quiet) I figured it would be nice to be “out of the closet” for a night!  

I’ve always struggled with hanging out with the wives of Blue’s co-workers because they all have babies, lots and lots of babies, and I always feel jealous and out of place.  A lot of the wives knew we were struggling and several even knew about IVF, they are all really nice women and I’ve always looked forward to getting pregnant and finally having something more in common with them.

So I was looking forward to this BBQ, getting to act and feel pregnant unabashedly!  So I talked to other women about maternity clothes, daycare, parenting, etc.  I never once prefaced the announcement of our pregnancy with “but it’s still early….” 

By the time we left I was beaming, it was so nice to act like a normal pregnant girl!  Everything was fine until I got in bed that night and let the weight of IF lay back on my chest. 

What was I thinking?? 

I’m a fraud!  I’m not a normal pregnant girl!  I’m a PIF!  I don’t get to run around acting like everything’s all right!

So I slept fitfully and then woke up the next day symptom spotting, praying for nausea, being a general crazy person, because I honestly thought I might have jinxed myself right out of this pregnancy.