Alphabet Blessings-Book Review

Maybe my title is a little misleading. I guess this is only partially a review of this book. Bear with me as I also want to use today's post as a little bit of a "journal" entry for myself. I don't normally write in a journal but when I come across things that I want to remember I like to write them in a place I can come back to again and again.

Awhile back, when I was beginning my first IVF cycle in November 2013, I attended a 31 party with a friend of mine. I casually mentioned to the 31 rep that I was getting ready to start my first cycle and she opened up that she also had been through IVF. We even were going to the same RE (reproductive endocrinologist). She was so nice and we told each other we would pray for the other because it seems like that's the only thing you can do for another person going through this. She did tell me about a book that her and her DH had read when they had gone through this before titled "Alphabet Blessings" by Jenifer A. Cotter, D.O. A week or so after the party, I received a large envelope in the mail. This girl who I had never met until this party had sent me the book on loan. Of course, with Christmas and then the devastating blow of the first cycle not working, I never read the book. Well, I got an email this week asking if I was finished reading it would I mind returning it since they were going to be cycling and wanted to read it again. I felt so bad that I had kept it this long. I decided to start flipping through it before putting it into the mail this week.

What I found was an author who was both a doctor and a fellow IVF'er. She is able to put into words almost exactly what I have felt at various times over the two failed cycles and what I imagine most, if not all, IVF'ers feel as well. I want to share just a few of these excerpts here. I hope that if you read this and are also going through the battles of IVF, it will help in some way. If you are reading just as my friend and supporter, maybe this will better help you to understand the confusing tumult of emotions that I go through on an almost daily basis but feel bad telling anyone about.

"Infertility is a condition of inadequacy. These are often feelings of shame, guilt and anger toward ourselves and those around us."

"For many of us, our sadness is compounded by intense feelings of guilt. In situations where it is purely a female factor  or purely a male factor, the affected person must carry the burden of a childless home. Whether we have spoken the words or only thought them, the idea that our partner  would be better  off with someone else is a common one. 'If you married someone else you could have children,' or 'If it wasn't for me, you could have children.' For all the pain we carry inside for being responsible for our inability to conceive, we also carry the guilt of hurting our partner. Of course, it is not something we do intentionally and, most often, our loved one would never lay full blame at our feet, but we own their pain as much as we own ours. Guilt can be quite the demon. Oftentimes guilt makes us lash out at the ones we love because we are so hard on ourselves. We take every comment as an attack or a judgement. If we constantly point the finger at ourselves, then our partners must be pointing at us as well. How could they possibly see past what is so glaringly obvious: The sound of a child's laugh may never echo through this house because of me. I hate myself for that.
"And with the self-hate comes anger at the world around us. Why is is that so many unwanted babies are born when I desperately want one but am denied? Why will the government spend thousands and thousands of dollars to care for those same unwanted children but won't provide me with the opportunity to become a self-supporting parent? Why does my cash flow, my credit rating, or my insurance company get to decide if I am worthy of parenthood?"

"Do we feel sorry for ourselves? Oh yes, we do. We feel as though we are being punished unjustly. We follow the rules. We pay our taxes. We lead a good life. We expect to have the same opportunity as everyone else when it comes to getting pregnant, but instead we seem to get the short end of the stick, time and time again. But for all our self-pity, the absolute last thing we want from anyone else is pity. Far and above this, we desire understanding. Understanding for the pain we endure, understanding for the way this diagnosis affects every aspect of our lives, and understanding for our inability to give up on our dream, no matter the cost of chasing it.
"All of these emotions lie just beneath the surface. Some days we wage a war against ourselves to not be angry today, to not cry today, to not think about having a child for one lousy day, leaving us exhausted and beaten down. Other days, we see hope and possibility in the pregnant woman next to us, the small child tugging at mommy's hand, and, we think, my time will come. I have faith."

We Don't Know What the Future Holds

I have such a heavy heart today. I can't even focus my attention where it needs to be. We're hurt, confused and sad.

I had not posted anything about beginning our second cycle of IVF simply because the hurt from the first failed attempt was so hard for me to deal with. I was angry at God for letting it happen and angry at myself for even thinking those thoughts. I thought was a bad Christian and even a bad person which just sunk me lower. I can't even imagine why he has given me this longing to be a mother when there doesn't seem to be a way to fulfill it.

I managed to get right with myself and refocus on the blessings the Lord has given Jamie and I.

And I had HOPE must of all for this next cycle. Dr. Fritz had a plan to address the endometriomas on my ovaries to help the cycle perform better hopefully. Things worked like they were supposed to and I went on my stim meds with positive results. In this cycle they were able to retrieve 12 eggs as compared to 6-7 in the last cycle. When they fertilized, we had 7 embryos. That's a huge step up from the only 3 we had in the first cycle. When I got the call on day 3 (the first possible day for the embryo transfer), they said they wanted to go ahead and transfer 2 because they were the best quality-one was near perfect. We got to the RE office and ended up waiting for quite awhile because the doctor that was supposed to perform the transfer had gotten hung up in the OR in Chapel Hill. It turned out to be the best thing because Dr. Fritz stopped by the office just to check in and said he would do it since he was there. And after looking at the remaining embryos, he decided to transfer 3. There were 3 that were quality enough to put back in my uterus while the others like wouldn't make it to blastocyst stage because they were poorer quality (which meant, again, we probably wouldn't have any to freeze). Everything seemed to be setting up so well I think we thought how could this possibly fail?

I had several scares (because everything freaked me out of course) where I had some blood or some cramping. But from others who had gone through successful IVF cycles, it sounded like everything was happening the way it should.

Until Sunday, March 16. I had not been sleeping the greatest and had been feeling bad the day before thanks to another colitis flare up. Yes, I had stressed myself out enough during this cycle to cause this flare even after a colonoscopy 3-4 weeks prior had shown that my UC was in remission and no signs of ulcers. I got up to use the bathroom in the middle of the night and saw it. Blood. Bright red not the pink like I had seen before. I knew immediately what that meant. My beta HCG test (pregnancy blood test) wasn't scheduled until Wednesday, March 19 (which would be today). I knew I couldn't wait that long. I emailed the nurse who has been so wonderful to answer all my questions patiently and not make me feel like an idiot. She was out of the office on Sunday but responded Monday morning that Dr. Fritz said I could go ahead and come in for the test on Monday or Tuesday. Since I was already off work Monday from the flare, I drove in and had them take the blood.

I got the official call yesterday around lunch time. It was, in fact, negative.

While I knew this was the outcome and Jamie and I had already had our time to be sad, I still couldn't help feeling that wave of emotion all over again. Even today, I'm crying while I type this. There is truly a period of grief that you go through.

We have no idea what the future holds at this time. We had purchased a package that included 2 fresh cycles and 2 frozen cycles. Because we never had embryos to freeze, we forfeited the frozen cycles. At this point, we have exhausted our package. Dr. Fritz was cautiously optimistic in this last cycle and I'm not sure if that means that he won't want to perform another cycle on us or not. We have an appointment scheduled on April 9 to meet with him but I've also asked for him to call me before then just to find out if the door is still open to that idea. I don't want to get there on the 9th and be blindsided.

I would like to ask for prayers for Jamie and I. Prayers for peace and comfort as we go through this sad time. Prayers for wisdom from the medical staff and from us that the right decisions are made for the future. And most of for prayers that we will somehow understand this grand plan that God has for us.

We are beyond blessed to have our friends' and families' support through this and we could never say thank you enough.

Club Med

Well...I finally got all my medications squared away today after pouring over price lists from various specialty pharmacies for days and weeks. It's amazing how much once pharmacy can vary from another on the same drug-and I'm paying cash!

Anyhow, for those of you that are interested, here is a listing of the drug regimen that I will have to follow. I should be starting this sometime around Thanksgiving. So say some prayers for me that I can handle giving myself the injections (I HATE needles) and also for my family that they can deal with all these hormonal changes that are going to happen. Very interesting that the whole family is going to be exposed to our ordeal since we'll be seeing them all over the holidays. Best of luck to them. ;)

• Bravelle 75iu injections + Menopur 75iu injections - these are the FSH drugs that stimulate the ovary to make mature eggs as well as inducing the development of multiple eggs
• Ganirelix Acetate - this is a GnRH antagonist which controls ovulation and prevents premature ovulation until triggered by a HCG injection
• HCG - human chorionic gonadotropin - induces ovulation
• Crinone 8% gel - a vaginal progesteron it prepares the lining of the uterus for implantation of a fertilized egg. Since women going through IVF likely will not produce enough progesterone on their own because of the drug to control ovulation this is needed to provide that necessary hormone to thicken the uterus for our little embryo.

And So It Begins...

In the words of the old saying, "No news is good news."

My apologies for not updating anything here in such a long time. I was waiting on my next cycle to begin so that I could get dates for the procedures/stimulation meds.

So-after this last weekend, I am officially on schedule for a fresh cycle of IVF.

My protocol is as follows:

- birth control pills from now until Nov 20 in order to control the length of my cycle
- begin my follicle stimulating hormone (FSH) daily injections along with daily Menopur injections. These will stimulate my ovaries to make mature eggs and induce the development of multiple eggs. I will do these injections every day for about 1 1/2 - 2 weeks.
- the week that Dr. Fritz does my egg retrieval I will take injections of a gonadotropin-releasing hormone antagonist (GnRH antagonist) called Ganirelix Acetate. This controls ovulation and prevents premature ovulation until the trigger shot is given.
- the night before my egg retrieval I will take a shot of human chorionic gonadotropin (HCG) to induce ovulation
-somewhere from 3-5 days after the egg retrieval, I will have the embryo transfer.

It's all very surreal that it's actually happening after all this time. I'm excited and nervous at the same time. I'm definitely NOT looking forward to giving myself shots but maybe after the first 2 or 3 it'll get easier.

I have sort-of a No Fail attitude about everything. This can either be very good (because I believe that your mindset controls a lot of the outcome of things) or bad (when I'm devastated if it doesn't work). However, for now, I choose to remain positive that God has his hand on my life and is working through me to fulfill his will.

Prayers are much appreciated over the next month or so. I look forward to (hopefully) sharing good news in the near future.

Bringing You Up to Date

I wanted to take a quick moment to update everyone on where we are as of today.

Earlier this afternoon, I sent the signed forms and payment information off to Attain IVF program.  This came after lots of prayer and asking for God to take care of us emotionally and even financially.

We do not have any further appointments at this moment but I will share what I can when things start moving forward again.

Thank you to all those that have been praying for us along this journey. JGIII and I are both excited about what the future holds and know that as long as we trust in the Lord's plan we will see His spirit shining down on us.

Mock Transfer & Saline Ultrasound

Things have been moving along "normally" over the past month since my last visit which has been fantastic news. I was able to have a somewhat normal cycle (for me) this month although it was while I was out of town which made it slightly more difficult to manage. The pain was definitely increased from last month but still nowhere near as bad as before the surgery.

I had an appointment scheduled for yesterday, the 17th, for the saline ultrasound and mock transfer. It needed to be done as early in my cycle as possible so that the lining of my uterus was the thinnest.

When I got to the office yesterday...it was the most crowded I've ever seen it. Apparently, this meant that Dr. Fritz was also extremely backed up. We ended up waiting over an hour for the appointment. SO FRUSTRATING! I couldn't even reschedule because I needed it done this month and I can't do it any other day this week.

The actual meeting with Dr. Fritz went fine and we all concurred that we are on track to move forward with IVF. When it was time to do the actual procedures, Dr. Fritz asked if it was ok for the other doctor at the practice to perform them because he was so backed up. While it wouldn't have been my first choice, I said yes because they were supposed to be easy and quick. I should have known better. Nothing I do is ever easy and quick when it comes to this.

First, we were doing the mock transfer. It involved placing the speculum to insert a catheter into the uterus to measure the length and depth. As it's similar to a normal pelvic exam, I'm already not a fan of this. I thought well at least it won't take long. Problem was my cervix apparently had an odd angle to it that was preventing the catheter from going in the way it should have. She had to add an additional clamp onto my uterus itself which she referred to as a "mean clamp". That device truly lived up to it's name. I'm pretty sure it was some sort of medieval torture device that was dug up in a closet. After 2 failed attempts, the doctor said she would give it one more try and then get Dr. Fritz if it didn't work. The good news was that it went straight in on the last attempt and we were done with that portion. By the end though, I was in tears because it had me so stressed out from the pain & cramping. Not to mention the thoughts that kept running through my head about having to go through this again on the day of the actual transfer.

Next up was the saline ultrasound to determine if my uterus is healthy enough for a pregnancy. The doctor said this should be the easy part. By now, I should have been able to predict that there would be nothing easy about this either. Again, the speculum was in place in order to insert a catheter into the uterus. About 10cc's of saline were to be injected through the catheter into the uterus after removing the speculum. The problem was that every time the speculum was removed and they started to inject the saline, the catheter would pop. This was repeated 5 times. Unreal. On the last attempt, the doctor was able to get 2 quick pictures of my uterus. Not optimal but enough to get an idea of what everything looked like.

Apparently, my cervix has an "S" shape to it or curve which was the problem with the mock transfer. Good news is that she confirmed that my uterus still looks great which I'm hoping is a wonderful sign for pregnancy. She went and got Dr. Fritz to come in and talk to me about everything and look at the images she had captured. He was super positive about everything and just told me to think of it as being "special". I think I could handle not being special right now. He gave me a big hug and told me to try not to worry. The reason for doing all these tests is so that on the day of the actual transfer, we have NONE of these issues arise. He said that I won't feel any cramping like I did during this because they have little "tricks" they can do to prevent that.

So, I still don't know when we are to actually start the meds. I'm emailing the practice today to tell them which payment option we decided upon and find out what we need to do about that. I guess we'll get more information after that.

At least, I'm another step closer to having our dream become a reality...

Short Term Plan in Place

Great news....we've made another step forward and now have a plan in place!

JGIII and I met with Dr. Fritz yesterday for a post-op appointment as well as to develop a plan to move forward. He remains so upbeat about the results from the surgery. The pathology came back showing that he did in fact get the left fallopian tube disconnected from the uterus, however, the right side was inconclusive. Doesn't mean that it's not disconnected but the pathology cannot prove that it was. Dr. Fritz actually joked that my insides were like "Where's Waldo". I love that he shares my sense of humor.

The next step is coming on June 17...the day I get back from Girls State. He needs to do a mock transfer as a way to completely map the shape of my uterus and a saline sonogram which uses ultrasound to look at the walls of the uterus.

We also have to decide by that date how we're going to pay for this process. The interesting thing about the cost options we were given is how different it was from Carolina Conceptions. The price for 1 IVF ("Fresh") cycle and 1 frozen cycle together at UNC Fertility is the same as the cost of 1 fresh cycle at CC. Amazing how 2 offices that offer the same services can be so different. UNC Fert also participates in a program called Attain IVF which offers packages for reduced costs. I don't qualify for their refund program (if you are unsuccessful you get a refund up to 70%) because I'm not "normal". Go figure. LOL The program that I do qualify for gives a discount of 32% for 2 fresh and 2 frozen cycles. We now have to weight out whether we think we might need 4 rounds of IVF. It would definitely be cheaper if I get preggo the first time and don't have to pay anymore. At this point, I think we'd pay whatever to be able to have our own little baby.

Finally, in July I will start with injectable shots of Lupron. I actually had been reading about this drug yesterday because it is used by a lot of doctors to treat endometriosis as it brings on menopausal symptoms which should lesson the development of the endo. I will only be on this for a short time to prevent an early surge of LH which would cause my ovaries to release eggs before they are ready to be retrieved.

I'm so excited to have things start falling into place! I can't wait to see what God has in store for us next. Wish me luck!