I have some test results!

Our chromosomal testing is still pending. (The nurse told me today, for the first time, that the results for these particular tests take 4-6 weeks! Would've been nice to know earlier!)

The sperm antibody test was negative (which is good!). And my endometrial biopsy was normal.

Good news so far! It is a bit of a mixed blessing not knowing what has contributed to our miscarriages, but I'd much rather have good results like these than have them find something else wrong as well. Let's just hope everything comes back okay with our chromosomal testing. For me, that test is the scariest, because if either Drew or I have chromosomal abnormalities, there really isn't anything we can do about it. At least with the sperm antibody and abnormalities with my endometrial lining, there are medications I could be put on to help the conditions.

In any event, I feel very grateful for the positive results thus far. Thank you for all of your thoughts and prayers!

-Em

Since my last post two weeks ago, we've prayed and talked, prayed some more, talked some more, and made some decisions. Neither one of us could shake the unsettling feeling of jumping right into the Follistim (FSH shots) regimen without having test results back from my endometrial biopsy and our chromosomal and sperm antibody tests. We are still awaiting the results of those tests, but we feel somewhat at peace right now taking things one step at a time--slowing down and making decisions on our own terms, not according to the pressure of doctors. I'll update you as soon as we receive results from the three different tests and keep you updated on our decision about whether or not we'll be moving forward with FSH shots regimen, but for now, I thought I'd give you a bit of a picture of what our last couple of weeks have been like...

First, I had my biopsy on that same Friday, the 10th, and I wasn't quite prepared for it. When the nurse who performed the procedure entered the examination room, I was a little confused. "The doctor isn't doing the biopsy?" I thought. Drew also was surprised. Next, she asked me if I'd taken Motrin. I looked at her, confused, and said, "No, no one told me I was supposed to..." She said that a lot of cramping can occur, but sort of shrugged off the fact that I hadn't taken any and said she'd get me some after the procedure if I needed it. Now, I knew this procedure wouldn't be pleasant, but I don't think I really had any idea how unpleasant it would be. Think: yearly pap smear type of uncomfortableness times 100. Yeah. Awful. I assumed the all-too-familiar stirrup position and she proceeded to try to clamp my cervix to keep it "out of the way" for the procedure. Oh, but my cervix was being tricky, you see. She called it "frightened" and "uncooperative." "Well, yeah," I thought. "My cervix knows the drill...it wants to run away right now, get as far away from those clamps at possible...do you really blame it?" She continued to struggle, and I felt myself getting more and more tense, which I'm sure, in turn, made the situation worse. She finally got up and went to find another nurse. The other nurse walked in and was terribly nice, asking me how I was doing, and apologizing for the obstacles they were encountering. She directed the first nurse a bit on what to try, but Nurse #1 was still having problems getting cooperation out of my silly cervix. Finally, Nurse #2 walked to the edge of the examination table, and I felt wholly exposed as two strange people peered into my nether regions while pondering the behavior of my cervix. Nurse #2 tried a few things, Nurse #1 kept apologizing profusely, and Drew stood next to me squeezing my hand.  Finally, I could tell Nurse #2 was switching gears. Both nurses were frustrated at not being able to get things to work, and I could feel them switch into "gotta get this done" mode. This mode feels like man-handling, I'll tell you that right now. No more gentle touch or trying to keep me from undue pain. I winced, and winced, then gasped and felt hot tears tumble down my face. Oh my goodness. Nothing prepared for the pain...nothing. I can say without hesitation that it was the second worst pain of my life, second only to the contractions and labor pains I felt during the worst of my miscarriage with LJ. Once they'd obtained their specimen of my endometrial lining, both nurses apologized several more times, then Nurse #1 went to grab some Motrin. Needless to say, I spent the rest of the day pretty much out of commission. I continued to cramp and spent the rest of the day on the couch. Thank goodness I didn't have to work that day.

Earlier that day, Drew and I went to a laboratory in Grand Rapids to get our chromosomal testing done. In the lab, one of the technicians informed us that these particular tests are only performed Monday-Thursdays. Great. Would've been nice to know before. We left, planning to try again the following week. When we asked Nurse #1 at the fertility clinic about that, she said she didn't realize the tests were only performed on those days...well, at least they didn't just forget to tell us that important detail! The following Thursday we went to a different branch of that same laboratory and finally got our blood drawn for the tests. I must say it never ceases to amaze me how charismatic my husband is with strangers we encounter. He had all the ladies in the office laughing and telling me how funny he is by the end of our time there. I like him and think I'll keep him.

Finally, this past Tuesday morning, we had to do the sperm antibody test. That involved Drew providing a "specimen" before he left for work, and me driving like a bat out of hell to Grand Rapids to drop off his specimen and get my own blood drawn again. Now, anyone who has had to do any sort of semen analysis testing before knows that, if you don't provide the sample on-site, you need to get it to the lab quick, and it needs to remain as warm as possible during its transport. I was wondering where the best place would be to "store" the specimen vial during my drive to the lab, and the most convenient and comfortable place ended up being under my shirt, right in the middle of my bra! (I apologize for TMI.) Seriously, there was a perfect little opening there, and it sat quite comfortably. When I arrived at the lab, I also realized how crazy-warm that "compartment" kept the specimen...score! Good work, "girls."

-Em

I received an e-mail from a friend yesterday that made me realize I didn't do a very good job of expressing my feelings in my last post. Sure, I mentioned being overwhelmed a few times and delved a bit into my unending feelings of failure as a woman for not being able to conceive (easily) or carry a child to term, but I don't think I adequately described the real feeling behind this new direction we've been thrust into: fear.

Yes, I'm absolutely scared shitless about these next steps. And it's not just because of the extra 45 minute drive, in addition to our commutes. It's not just because it will cost us our savings. It's not just that this doctor wasn't overly welcoming or explanatory, setting us at ease with the whole process. Rather, it's because the decisions we're making now are absolutely, without a doubt, the most difficult and heart-wrending decisions we've ever had to make.

I guess I should start by explaining that this ovulation induction method--using the Follistim I described in my last post--involves a whole lot more than giving myself daily shots and being monitored by ultrasound/blood tests. Before we are even allowed to embark on our first cycle of "FSH madness," we have to sign a whole bunch of release forms. I've read through the forms several times now, each time walking away and almost hoping I'll have a different reaction the next time I come back to read them. I have to tell you...the first time I read them? I bawled uncontrollably. In them, they reiterate all of the risks of undergoing FSH treatment (the ovarian hyperstimulation and higher risk of multiple gestations I mentioned before), but they also delve into the risks to the child for being conceived in this "unnatural" way (congential abnormalities that they don't yet understand), and, worst of all, they discuss selective reduction. The first time I read through this particular section, I lost it. I know that I'm getting the cart before the horse here, but I am not okay with selective reduction. To me, it is just another way of saying, "you will pick which of your conceived children will live and which will die." And I'm not okay with that.

It feels crazy to write those words here so frankly. On purpose, I've mostly stayed away from discussions on abortion or, say, the Octo-Mom here. I don't really crave being all political and controversial on my blog, but I guess there comes a time when I just have to lay it all out there, unapologetically, if I'm ever going to truly convey my trepidation and feelings of unease.

I'd call myself a moderately liberal person, so I don't characterize myself as a fanatical right-to-life person, though in general, if you care to know, I do believe that "life" begins with the formation of an embryo. I know that my beliefs are biased by my own experiences. With each of our children (our angel babies), we bonded so completely with each of them the moment we knew they existed. Some people have minimized (not with malice, but without tact or true empathy) our losses as "just" miscarriages, because they did indeed occur within the first trimesters. However, for us, the fact that our babies died at that time vs. 20 weeks or 32 weeks or being stillborn full-term, doesn't make any difference. They were little lives who meant everything to us. Seeing my two babies being ripped from my body has given me an appreciation for the miracle and fragility of life more than I ever thought possible.

So, to read those words about choosing which fetuses to "reduce" (if it comes to that) brought me immediately to inconsolable tears. There's no other way to describe this: we are just entering extremely scary territory. I do realize that, from the outside, this is probably hard to relate to, or even an easy statement to disagree with. "Wow, way to get worked up over something that may or may not happen," I can almost hear people thinking. But, you see, that's just it. These difficult decisions need to be discussed and decided NOW, before we find ourselves in a place where the decision is right there in front of us, and we have choose what we'll do. I don't want to get to that place not knowing, not having considered the ramifications of our decision to just barrel forward with the next steps.

I know many of you have expressed hope and optimism for us embarking on this next leg of the infertility journey...that perhaps this is just what we need. I understand those feelings and do admit that I waver back and forth between my feelings of fear described above, and the feelings of "OK, let's just do it; this is it."

Part of me wants to just jump right in, screw the feelings of unease that seem to have settled so heavily in my heart. Part of me DOES think that making these difficult decisions and taking these risks is what needs to be done (and, of course, will be well worth it if we achieve the desired outcome of a healthy child).

But part of me, like I mentioned, is heavy-hearted. Why am I hesitating so much on this? Is it Someone trying to speak to me and tell me that this is not his will for our lives, or the life of our child? Is it just the fear of the unknown overtaking me and making me irrational? Why can't I shake these feeling of unease with the whole situation?

I suppose I should also explain where I'm at spirtitually right now, which might give you some insight into the situation. Most of you know that I grew up in a religious household, and although I don't know if I can call it "falling away" from God or religion in college or the years directly follwing college, I can say that I, rather unknowingly, put a personal relationship with God on the shelf during most of those years. I was expanding my mind, studying other religions, and trying to understand where the beliefs I was raised with fit into the overall picture. Though I wouldn't call myself religious these days, because I keep finding so much that makes me uneasy and, frankly, rather ill within the structured ideologies that people cling to moreso than truly having a personal relationship with God, I would say that my relationship with God has been restored, and I feel that my faith has been renewed.

Even a couple of years ago, I didn't really believe that this was possible. My faith was really tested during those horribly dark and difficult days of the demise of my first marriage and subsequent divorce. And I'm ashamed to say I could not find the comfort and strength in God during those days to help get me through. Instead, I felt bitter towards him for allowing me to go through what I did. I was astonished by how hatefully I was treated during a time when all that I already felt inside was shame and utter sadness for not being able to save a marriage that was horribly broken and probably never right in the first place. Then, during our first years of infertility and losing our first child, LJ, I also became very angry with God. I still felt so relatively young to be tackling such HUGE life disappoints in such a short period of time. I kept asking God, "Haven't I been through enough?" I'd look at friends or family around me who'd had perfect marriages the first time around, supportive families, and only limited (if any) difficulties in having children of their own, and I'll admit it: I became very bitter. When going through crises, many people will utter the words "Why me?" and I was the worst offender during those dark days.

I spent a lot of time wondering why I was considered, by God, to be a much worse person than everyone I knew. "Am I really that horrible, God? Because you must be punishing me." I must admit, I still have days when I think "Why me?" or, I sincerely wonder why the hell it isn't God's will for us to be parents yet. I don't know that we're necessarily supposed to make any sense out of it. People often say, "When it happens, you'll realize the timing is perfect." Eh, sorry. I don't really buy it, and I honestly don't believe I'll feel that way. We've been ready for years, and anytime now would be "perfect." But, I do know that there are things about our life and our relationship that God understands better than us, and that if it's supposed to happen, it will happen in his time. I understand that and do accept that better now.

Since our first pregnancy loss, slowly but surely, I've felt myself turning to God again. I'm still trying to discern if I needed to hit rock bottom, emotionally, before I surrendered to him and let him take control of my life. I do think that that's probably what happened. I was at such a low place in my life, where I literally felt like what I held most dear had been stripped away from me, and I gave in. "Fine, then, God," I said. "YOU tell ME how this is supposed to go." And that is where I continue to be right now. Every day, I ask God to tell me where this is supposed to go. I don't need the ultimate answer, crystal-ball-style, from him, but I'm mostly just asking for wisdom and guidance as we go about our days. I talk to God a lot more than I ever used to. Prayer, for me, used to be something I thought needed to be done "just so" to be worth doing at all, but now my prayers are often as simple (or possibly as irrevent) as "Help me!" or "Seriously, God?" or "Please just be with me today; I need someone by my side, otherwise I know I won't have the strength to make it through." It has been so comforting coming to this sort of relationship with God. I feel comforted and at peace with my spirituality.

So, I guess what I'm wondering is...is this current discomfort and fear that won't go away happening for a reason? Should I follow my heart, and hold off making any hasty decisions until I find some clarity? Or should I follow the logicality of my head, and delve into the medical intervention to help us conceive a child?

I guess I keep coming back to the "magical" month when I got pregnant with LJ. We were taking a break from all the testing and drugs, and we became pregnant for the first time. I want to believe that, if we got pregnant once without all the medical intervention, it can happen again. So then the question just is...do we sit tight and wait around for that to happen, or do we jump into hyper-space mode with Dr. Soup-Nazi?

Thanks for letting me get my feelings down. I think I'm going to try to get back to bed now.

-Em

Habitual aborter without current pregnancy.

Hello, my name is Ember, and according to my Reproductive Endocrinologist (RE), I have a habit of aborting my children--the knife twist in the gut to it being that I am also currently "without child." Nice to meet you, too, Doc.

This tear-inducing diagnosis was received last week at our first consultation with a fertility center that specializes in in vitro-fertilization (IVF). I guess I should be happy that I am not technically considered "infertile." I just like to kill my babies is all. That's not so bad, right?

If only for the sake of being more than just a little bit overwhelmed and confused, I've put off writing about this appointment, and--even before that--the events led us in this particular direction. I guess I have some catching up to do, and I might as well spew it all out now, while the wounds (and tears) are still fresh. You might as well grab a snack or cup of tea, folks. This is a long one...

First, remember when I told you our last cycle was unsuccessful? I also mentioned then that we would probably continue the same course for a couple more cycles...that is, until my body would require a break from the fertility drug Clomid. Well, I was wrong. Shortly after we learned of the failed cycle, I received a call from the nurse of the doctor we'd been working with saying that she would no longer be prescribing  me the fertility drug and that she wanted to refer me to a different doctor, a fertility specialist (reproductive endocrinologist) that she had worked with closely in the past.

"OK...," you say. "So what?" Well, for us, you see, this turn of events was all completely abrupt and without warning. Just two weeks before, we'd both been sitting in the examining room with her during my mid-cycle ultrasound. We laughed and joked as usual. We really liked our doctor and had formed a great relationship with her. A month before that, we'd sat in the office with her discussing how we planned to move forward after my second miscarriage in December, and she seemed touched that we wanted to stay the course with her to keep trying. We completed a whole new round of blood tests (an infertility panel) and added some additional drug regimens to our repertoire--experimental drugs that we hoped might work toward preventing future miscarriages. We were all set to try again. But then, one failed cycle and we were done. We were left reeling, wondering what had changed on her end...why she no longer wanted to work with us.

Basically, we felt dissed.

Even though Drew, I'd say, was the one who was even more attached to the doctor than I was, I have to admit that I took this news very hard. As with everything that has happened during these three years and three months of trying to conceive, I feel responsible for everything happens. I am the one who has bounced from doctor to doctor, trying to find one who can help us. I'm the one whose body is broken. I am the one who couldn't keep her children alive. I'm the one who keeps the best man ALIVE from being the best FATHER alive. It is my fault. (You might notice that I'm a teensy-weensy bit ATTACHED to this whole process.) So, anyway, as soon as we got the news, as you might imagine, I felt like I was a failure. She was willing to work with us, she said, but (in hindsight), she was only willing to work with us if we turned around and succeeded in getting pregnant again right away. But I couldn't make it work. My body failed me again. It's MY fault that my doctor "dumped" us.

After spending some time feeling that way, my feelings of failure morphed into feelings of anger. "What a DAMN MINUTE," I thought. "She promised to help us. Then, she dumps us, in essence, through her nurse, without WARNING? She doesn't even call us in to tell us she's DONE with us in PERSON?"

Ugh, conflicting emotions. And this is just the beginning of the conflicting feelings we've experienced over the past few weeks, folks. After we were dissed by my doctor, we took a few days to talk, research the fertility clinics in Grand Rapids, and decide whether or not we felt ready to set up consultations. We decided, in the end, that we needed to at least go and see what they had to say about our particular situation. If we didn't try, we'd never know, right? And I, for one, couldn't live without knowing if there was something more that could be done for us. I'm not ready to give up. Yet.

Through friends, friends-of-friends, and colleagues of our own, we had heard, on the whole, good things about the fertility clinic we'd decided to go to. Good enough, we thought. <Deep breath.> Let's do this.

On Thursday, we both took most of the afternoon off to drive the 45 minutes to Grand Rapids for our consultation. The office itself looked welcoming and comforting when we entered. An older couple and younger couple were both sitting in the waiting room when we walked in--nice to see the couples there together, and definitely a far cry from my shameful waits among protruding bellies and babies at by OB/GYN clinic. We filled out many forms, answered even more questions from the nurse, then proceeded to wait in the tiny, hot examining room for 45 minutes. The doctor finally burst in and told us to follow him as he seemingly jetted to his office down the hall. Once in his office, we exchanged a few (very few) pleasantries before he jumped into the slew of questions. Prior to the visit, I had filled out no less than five pages worth of my medical history including family history, menstrual history, cyst history/emergency room visits, prior pregnancies, prior diagnoses, prior surgeries/procedures, all of my infertility/hormone blood panels, and all of the current medications I'm on, including all dosages and length of time I've taken each. During his line of questioning, I was asked to recall the past 3+ years of my history of trying to conceive, much more specifically than I was prepared to do from memory. I kept thinking, "Dude, you're the one holding the five pages it took me hours to complete prior to the visit, YOU tell ME the answers!" My OB/GYN clinic hadn't sent over my medical records in time for the consultation, either, so I remembered as best I could, but felt a bit miffed that all that work and calling my old clinic several times to remind them seemed to have been for naught.

After the questions seemed to lessen, he said, "OK, so it seems our main task at this point is figuring out how to keep you pregnant."

Agreed.

He went on to mention that both Drew and I needed to be tested for the lupus anticoagulant (sperm antibody) as well as any chromosomal defects, either (or both) of which can contribute to my "habitual tendency to abort."  In addition, he wanted to schedule me for an endometrial biopsy to see if my endometrial lining is capable of supporting a pregnancy. I told him I was almost positive my doctor had performed this procedure along with my laparoscopy, hysterosalpingogram, and hysteroscopy last February (so, yes, we'd established my lining was A-OK), but he said that he'd like to repeat the procedure to see if "conditions have changed" at all.

After he discussed the tests we need to undergo, he delved right into "the plan" for our next cycle. He recommended Follistim, which are daily, self-injectable Follicle Stimulating Hormone (FSH) shots that he said are a "more natural," yet potentially riskier (risks = ovary hyperstimulation and higher risk of conceiving multiples) and more potent way of inducing ovulation (basically, a substitute for the fertility drug Clomid I'm so intimately familiar with). My doctor and I had discussed Follistim several times before, but had decided against it, in the long run, because of the tremendous cost difference per cycle (think: less than $100 for Clomid vs. more than $1000 for Follistim...and that's just for ONE MONTH).

At that point, he led us into yet another private waiting room, shook our hands, and said that if we have any questions, the nurses are very knowledgeable and should be able to answer them. Then, he was gone in a flash...just as quickly as he came. In the "holding cell," Drew turned to me, eyes wide. "I am NOT happy right now," he said. And I immediately knew that would be true for him. The doctor himself was rather cold, clinical, and (obviously) rushed. From seeing other specialists for different reasons, we both know that the lack of bed-side manner is a common trait in specialists, but we were taken aback by how much the consultation was...well...not really a consultation. Besides answering his direct questions, we didn't really have much of a chance to get a word in edge-wise. We hadn't necessarily given him any indication that we wanted to leave the office that day with a plan of attack, but we got one, like it or not. We felt (still do feel) completely overwhelmed by what was discussed, the price list we were given showing the costs for all of these tests/procedures/medications (which, have I mentioned?, aren't covered by insurance), and the time commitment involved in driving back and forth to Grand Rapids several times per week during a cycle (for blood tests, ultrasound monitoring, etc.)

The good part is that the clinic had some "extra" Follistim injectibles sitting around (left-overs from a cycle in which another patient conceived and no longer needed it), which means that for our first cycle on injectibles, we only have to pay a portion of the cost. And...I have a feeling this place gets results. It's what they do, after all. I have read through the success rates for IVF on the clinic's web site, and although the doctor agreed that we're not in the category that needs to consider IVF (yet, at least), it was somewhat comforting to see that they pride themselves on getting the job done. Before he walked us to our "holding cell," he did say to me, quite definitively, "We're going to get you there, young lady." I'm not sure if that's something he says to all the girls (hehe) or not, but I wanted to believe him. I wanted to believe that this rather aloof, yet uber-intelligent fertility specialist MEANT it when he said it to me. Not based on trying to inflate my hopes or optimism, but because, from looking at the data before him, he logically thinks it's possible.

This week, I will have my endometrial biopsy done on Friday, and Drew and I will complete our chromosomal tests that day as well. Next week, we plan to do the lupus anticoagulant testing. I'll try to keep you posted on test results, when this next cycle is set to begin, and any hilarity that ensues as I try to learn how to give myself a shot in the stomach every day (just kill me now!). Though we are still feeling a bit overwhelmed from being dumped by my old doctor, bombarded by the new doctor, and having a mountain (literally, you should see our kitchen counter) of information thrown at us in such a short period of time, I still want to believe that this Soup-Nazi-of-an-RE is going to get us there.

Please, God, help get us one step closer to kicking this disgusting habit of mine.

-Em