Perfectly Controlled

Finally, for the first time since we conceived our daughter, I have ovulated. Thank you, PCOS, for making it so difficult. Last month it took 8 days of clomid (normal dose is 5 days) to get those stubborn little follicles to grow. Despite not conceiving and having canceled our trip to Mexico (thank you, Zika Virus – pregnant or not, it wasn’t worth the risk), I was just as happy to have had my body working as it was supposed to. Then it got tough again. This month it took 12 days of clomid, plus 3 days of micro hCG injections, plus the hCG trigger shot. Here’s what happened…

After taking 8 days of clomid, I went in for a routine follicular ultrasound to check growth. Well, their ultrasound machine had crashed, and after an hour or more of waiting they sent me home with a prescription for an extra day of clomid and told me to return the next morning for my ultrasound. I was surprised the following day when the ultrasound revealed “little or no follicle growth”… What?! But 8 days worked last time and now I have been on it for 9! They prescribed another 3 days of clomid and had me schedule another ultrasound. The day after I finished my twelfth dose I went in for the third ultrasound this cycle. They said the growth looked much better. The RE had me switch form clomid to micro hCG injections in order to help encourage continued growth. At that point I was also supposed to start my daily ovulation prediction kit (OPKs) – twice a day. If I didn’t have a positive within a few days, I was to return for a fourth ultrasound. That day rolled around and still no positive, so off I went for yet another ultrasound. This time they told me the follicle growth was where they wanted it. YES! They decided to give me an hCG trigger shot, to force ovulation. Ovulation occurs within 36 hours after the trigger shot is given.

Now, I need to backup in my story… Going into this second successful ovulation, we knew that 12 days of clomid could have a big impact on the uterine environment. To be blunt, clomid dries up the cervical mucus. Semen needs the mucus to swim/live in, and ultimately to make a successful journey to their final destination: the egg. This fact was causing me to seriously question whether all of the medical torment I was putting my body through was for not? Yes, we had conceived our daughter on our second round of clomid several years ago, but that was only the regular dose of clomid (5 days). Some of you may recall that cycle was actually supposed to be an IUI (Intrauterine Insemination) cycle, but due to an error at the clinic, we did not end up going in for an IUI.

After much stewing and debating we made the choice to suck-up the additional cost, and give our “all” to what we were sure would be a successful ovulation. I know I don’t want to be on these drugs for long, and IUI just seemed like our best bet at this point. We were not crazy about turning over yet another piece of this journey to science/medicine. Oh well! All in all, by the time I had left my RE after the trigger shot, I felt good about our decision.

The IUI was scheduled for 24 hours after the trigger shot. We woke up early to get showered and dressed. My in-laws came over to stay with our daughter. After arriving at the RE office, my husband was up first to give his sample. (Yes, I feel a bit bad that he has to do that, but seriously, I go through so much- really, it’s fine.) After he was done we left to grab some breakfast, while the lab washed the sample and prepared it in the IUI catheter. An hour later we returned for my part. It was quick and painless, my husband held my hand. After, I laid there awkwardly for 10 minutes (as instructed), got up, got dressed and left.

A couple hours later I went to see my acupuncturist. Soon after, I began having cramping (this is common after IUI). I rested on the sofa when I could (a little hard to do with a toddler). The cramping lasted for two days. Still, it seemed like a good sign. I felt hopeful. Then on the day the cramps had disappeared, I received a text from a friend. She was informing me she had had a missed miscarriage. She knew I had experienced losses (one being a missed miscarriage). She wanted my advice and support – if I was willing. And yes, are you kidding me? That is why I blog. That is why I talk about our journey and openly share things many couples would opt to keep silent. Most of all, I wanted her to know that she wasn’t alone. I knew I could be there for her-discuss D&C vs. natural loss and my experiences. I told her how much I knew it sucked, and that I was heartbroken for her. I offered to watch her son and cook her dinner. I checked up on her often. I did all of the things I wished I a friend had done for me during the lonely days I had struggled to navigate through my losses.

For me, her loss served as a cloudy reminder of all that still lay ahead. The flood of heartache, tears and emotions returned to me. I knew that pain all too well. Yes, I had finally achieved ovulation, in a closely monitored and medically controlled cycle. Even if we are so lucky as to conceive, I knew we’d still have much to overcome… I was reminded of how fragile I am, and how deeply I fear feeling that pain again. But at the same time I know I am strong. If I couldn’t handle this entire process we wouldn’t do it again. We are doing it again, because we know if it ends with a healthy baby – it was all worth it.

We have a lot of “good” on our side these days. We already have our daughter. Countless friends and family are praying for us. I have a wonderful acupuncturist and chiropractor. I am still under 35. We have been on all of our “trying to conceive” supplements for nearly a year. We have always eaten organic, real food. I know we are doing all we can. The good outweighs the bad. We’ve got this. Armed with luteal hCG injections and plenty of patience, we wait. Eagerly, we wait to see what will come of this perfectly controlled cycle… the rest is basically beyond our control.

Friendships and Betas

Monday was really hard for me. I am in the early stages of trying to rebuild a friendship that got caught in the awkward emotion-filled mess of: They got pregnant, we lost a baby; they had a baby, we lost another baby. Neither of us was able to be there for the other during some of the biggest moments of our lives. How do you repair that? Their baby is their life; they are now a unit. I totally get it. At the same time, their baby (like all babies) is a reminder of our pain and our losses.

On Monday morning I also got a call from my RE. My Luteal HCG progesterone blood results were back. And they were good. Really good. Scary good. I could hear it in the nurse practitioner’s voice. With numbers that good, she was pretty sure that not only was the Luteal HCG working, but that I am likely pregnant. I hung up the phone and sobbed in terror. Then I told myself it still might not be true.

Those of you who haven’t experienced recurrent losses, or my dear friends who have tirelessly been striving to get pregnant without avail, are probably thinking: What the hell? What is wrong with you? Can’t you even get excited at the possibility of that desired outcome?  The thing is it’s terrifying. Just because I might be pregnant again, does not mean I will have a baby. Based on our previous experiences, for us, pregnancy = joy, excitement, mindfucking fear, loss, heartache, and pain.

I had been instructed to wait until Wednesday to test, since the HCG from the injections would still be lingering in my system and could cause a false positive. I didn’t even know if I was pregnant, and yet I was already willing myself not to get attached, and preparing to say goodbye.  I was praying that I would miscarry early.

When Monday evening came, I had discovered our final set of friends had announced their pregnancy. That’s it. There aren’t anymore. We have watched pretty much every single set of friends get pregnant and go on to have healthy babies in the time we’ve been trying. We are now alone on the island. I wasn’t surprised. I had prepared myself in anticipation of this day. Of course we are happy for them. They are an amazing couple and I had been praying they’d conceive easily. I can genuinely say I do not want to see other couples suffer in the ways we have. I want my friends to have seamless conceptions and naively blissful pregnancies. But since we are human, we are also jealous of the fact they all get to have what we don’t.

As I stared at their Facebook announcement, for a split second I let a tiny thought escape my mind. Maybe this possible pregnancy of ours will happen, maybe we will have kids together. I abruptly popped that little thought bubble. No! It doesn’t work that way for us. We don’t get to have kids at the same time as our friends. I know better, it never works out that way. And then another thought occurred, a terrifying thought: What will come of this friendship? Are we going to lose yet another friendship because they will be pregnant and have a baby during a time when we could possibly be struggling to cope with continual miscarriages?

I couldn’t help but cry in fear of not only losing this potential pregnancy, but what would come of this friendship? They currently live out of state, but they will be moving back to our state this fall. We have been looking forward to having them closer.  On Monday night I lay awake in concern. Would this friendship be like so many and wither under the strain of our losses and their gain? Would I feel the need to avoid them because of the pain it causes me to see others so easily achieve what we can’t? Will we drift apart, because they will get to move on with life and be parents, while we might be caught in the webs of still trying to conceive? I don’t know.

I had already been struggling with: How do we rebuild a friendship after it has been torn down by the hardships between fertile friends vs. infertile friends? How one prevents this breakdown from occurring at all, is beyond me.

The lapse in time that occurred between Monday and Wednesday morning was gradual. I felt I was moving in slow motion. My husband was on a work trip in Chicago, and while he called to see if I needed consoling once our friends had broke their news, he didn’t ask about my progesterone blood results. And I couldn’t bring myself to divulge. (Honestly, the fact he didn’t ask was fine. Blood tests are so frequent in this journey. And I could tell he was tired and had a lot of work to do.)

On Tuesday night I set out my home pregnancy test (hpt) in preparation for Wednesday morning. If the test was positive I would need to go in straight away to see my RE.  I tossed and turned much of the night. When my alarm went off I headed to the bathroom. The test was positive. I am pregnant for the 3^rd time. I immediately let my husband know via text, because honestly you don’t make a big deal of it when the previous two failed.  He was of course surprised considering we weren’t confident in this cycle, due to the whole IUI timing fiasco.

Once at the RE, they drew my blood and promised to call in the late afternoon with the results. We would be looking at two things. One: betas. The beta is a sequence of two blood draws measuring HCG, which should roughly double over a two day period in early pregnancy. I will say my beta with our last loss doubled just fine. So, it isn’t necessarily an indicator of a successful pregnancy, but it can reveal a failing pregnancy early on. Two: my pesky nemesis, progesterone.

The nurse practitioner called around 4:30 p.m. She said, “Yep, you are pregnant.” Really? They always say that. Yes, I know, I had a positive hpt. Still, I guess it feels good to hear those words. My progesterone had already dropped significantly, so I would need to begin progesterone injections again. My first beta came back at 2,358. With my previous pregnancy the first beta was 174. Like I said, the number itself doesn’t mean a whole lot and there is a wide range of what is considered ‘good’, but knowing this number was higher, somehow made me feel a little better.

After I heard that first beta I started to relax and ordered myself to stop thinking about miscarriage (easier said than done).  The number was good. Today I am pregnant. All I can do is take it one day at a time.  I keep telling myself: even if #3 ends in loss, we will still, somehow, be yet another step closer to that someday end goal.

On Friday I went in for my second beta. The nurse practitioner took way too long to call me with the results that evening. By 6 p.m. I still hadn’t received a call. I was concerned it was a bad sign, and I was also worried I would have to go the entire weekend without knowing. She finally called and apologized for the delay. Beta #2: 5,349. Awesome. I couldn’t help but allow a small flutter of excitement to escape. With my previous pregnancy my second beta was 517 (with a three day gap between, rather than two days). My progesterone had dropped a little more, but I had already had my first injection, and it was still within range.

There are a handful of reasons miscarriages occur. Sometimes, like with my first loss, we don’t know why.  Here are the major causes:

1. chromosomal (our second loss, and not preventable)
2. anatomy (the structure of the uterus, I should be OK there)
3. infection (I will be on an antibiotic for 8-10 weeks as a preventable measure)
4. blood/clotting issue (I am on baby aspirin as a preventable measure)
5.  hormonal (I am on twice weekly progesterone injections)
6.  immune issues (it’s a complicated cause, we aren’t concerned with that at this time)

My RE has me on a combination of pills and injections in an effort to prevent what we can. I have particularly struggled with being put on Erythromycin (the antibiotic). I understand my doctor feels the benefit outweighs any possible risk. However, I detest the idea of being on any medication, and especially while pregnant. After much stewing and debating with the nurse practitioner and RE, I gave in. I told myself I have to trust my RE 100%. The goal is to keep this pregnancy, and we are going to do everything we can to bring home a healthy baby.

The Stay Pregnant Protocol (SPP)

I would like to thank each one of you for your support, thoughts, and prayers. Knowing we have so many incredible wishes and prayers spinning around in the universe is the best reassurance we can get at this point! Once again, our journey dangles somewhere between the sweetest thing and potential loss. This is nowhere near over. We ask that each of you continue to send out those happy thoughts and prayers!

Love’s the Sweetest Thing

It is one of our songs and a theme we used in our wedding. Reception tables were dotted with large brightly colored pyramid cones, each cone displaying a cascade of succulent lollipops. A flag atop each cone read: love’s the sweetest thing. If you aren’t familiar, the song is by U2. We played it during our cake cutting, because the flighty tune didn’t seem fit for any other part of the occasion.

Love’s the Sweetest Thing is also engraved inside my husband’s wedding band. It was a song that played on the radio ten years ago, during one of our first dates. We had both remarked how much we loved it.

Today we are celebrating four years of marriage and ten years together. We never do gifts, but this year we also decided no cards or flowers. Every penny we have has been dedicated to our trying to conceive (TTC) journey. So this year, in lieu of a four-dollar greeting card, my love, I’ve decided to dedicate this post to you, my amazing husband.

It wasn’t too long ago that you cheered me on as I ran across the finish line. You’d proudly hug my sweat-drenched, tired frame. Or we’d exchange high-fives as we finished a race together. Nowadays it isn’t so much cheering and celebrating, but supporting, encouraging and loving. Not that the latter three displays of affection were absent from our relationship prior to TTC – they did exist – but now their role is so much more prominent. Those lighthearted emotions and displays of affection have taken a backseat to the heavy-duty, serious ones.

On our last anniversary we were struggling to understand why we seemed to be infertile. In the time between that last anniversary and this one, we have lost two babies.  And, perhaps, in the past year we have also stumbled upon some explanation as to why it has been so difficult for us to conceive. Often there aren’t answers. Still, we continue to search for and grasp at bits of reason. I know at times it is hard for both of us to wrap our heads around what has unfolded over the past year.

When I walked down the aisle four years ago, I certainly didn’t realize one of the biggest hurdles in our marriage would be the simple (ha-ha) act of trying to conceive a child.  We had no idea what obstacles lay in wait. But, eh, I guess that’s marriage, right?!…

A month after our previous anniversary, I broke down – a year of TTC had passed. You promised me we would do whatever it took. You desperately wanted to give me what I so passionately wanted. To this day, your dedication to me, and our journey remains.

After our last anniversary, the year wore on and seemed to pick at our tired relationship. A relationship no longer comprised of carefree wine tasting weekends, beer brewing fun, running excursions, and socializing. But, now, a much more complicated existence built upon the pressures of timely intercourse, the sadness and guilt of realizing there was perhaps something wrong with each of us and trying to fix it, the awe-struck moments of wonder and joy when we finally became pregnant, and later, the sorrow, heartache and bitterness that came with losing those pregnancies. Even though we are still baby-less, our lives and our relationship have changed.

After each lost pregnancy you respected the time I needed to heal, but you also encouraged me to pick up the pieces and continue moving forward. You motivated me to get out of my shell and become social again. (I might still be working on that last one.)

There are so many nights you have held me while I sobbed. You comforted me as I wailed,  “When will it be our turn?” “Why can’t I get pregnant?” “Why do I keep losing babies?” “I don’t understand, my body is supposed to get it.” “This is so unfair.”

With each miscarriage, you have rode beside me on that terribly hormonal and emotional rollercoaster – a ride we never bought tickets for, but somehow ended up on. Your body wasn’t the one going through a miscarriage (thank God, that would be weird), but it was your baby and your wife, so you tried to empathize. While I willed you to shed tears, you repeatedly stated that it was your job to be the strong one. And although perhaps inappropriate at times, you often find bits humor in this otherwise sullen journey. Not always, but on some occasions you’ve turned my tears into laughter.

You supported me and understood when I abruptly left my job, due to being harshly mistreated by heartless coworkers the week following our second miscarriage. You told me you were proud of me for standing up for myself and promised me we would be OK… regardless of the fact we now had the D&C and other imminent fertility bills to pay.

You painstakingly rebuilt our front shed, after I very purposefully crashed my car into it during my wildest fit of “When will it be our turn? This is so unfair!” (You know that hit summer song by Icona Pop? “I crashed my car into the bridge. I don’t care. I love it…” Sub shed for bridge and, yep, that’s my jam!)  Anyhow, at that point a couple of months had drifted by since our second loss. As we continued to witness other couples announcing pregnancies and excitedly decorating their nursery, we repaired the destruction my rage had produced. And we mourned the fact that if things had turned out – as they should have with our first pregnancy – we too would be doing the final prep on a nursery, rather than repairing a destructed shed. Instead we felt a gaping distance lay between where we stood, and the ambiguous dream of a someday nursery.

I don’t know about you, but I feel like the past two years of trying to conceive have been a separate lifetime, wrapped up tightly in a cocoon all its own. I suppose in part, that’s what marriage is: a chain of separate small journeys, all linked together by the love and passion of two people.

I wouldn’t want to endure this messy, emotionally draining, passion filled journey with anyone but you. I know if (heaven forbid) we continue to lose babies, I will be able to cope because of you. And eventually, we are going to be alright. If there is anything these recent two years have proven – beyond the need to practice patience and strength – we were meant to be partners in not just this journey, but life.

I hope you find the same love, strength and support within me that I repeatedly turn to in you.

We both know that someday – when that desired outcome does occur – that already sweet end-result is going to be one hundred times sweeter for us than it is for most… It truly will be the sweetest thing.

Preserving a Nest of Hope

Today I would have been cradling a newborn in my arms. My husband and I would be stumbling through our first weeks of parenthood.  Bursts of euphoric energy would carry us forward during week after week of sleep deprivation.  Our schedule would be filled with endless feedings and diaper changes.  Oh, what I wouldn’t give… If only it would have been.

July 13, 2013 – Due Date for Baby #1. A day that once held so much promise: A new life, a new family, and a dream come true. Quite frankly, the day simply came and went with little mention of what would have been. I suppose the only person who gave it much thought (and admittedly shed a few tears) was me. I suspect Due Date #2 will be the same when it hits in November.

My heart will never let go of the bittersweet memories tied to that first pregnancy. We had been trying for a year. I truly believe it was because of weekly acupuncture sessions that we were finally able to conceive naturally.  I wanted to be certain I was pregnant, so I had a general blood test done with my primary doctor. In hindsight, it was a waste of money and silly, but it was all I could think to do at the time.

Surprising my husband with the incredible news, after we had been trying for a year, was no easy feat.  I snuck over to a local craft store and bought a natural colored box. Inside, I shaped a small nest out of a twig-like material.  On the inside of the box lid I carefully placed colorful scrapbooking letter stickers, to spell out: We Are Having A Baby!  In the little nest I placed the positive home pregnancy test, alongside a note that read: “Time to start building the nest. You are going to be a Daddy!”

That little faux-twig nest became a symbol for our first pregnancy. It was filled to the brim with all of the wonder and excitement a first pregnancy deserves. The magic of what should have come was woven among those delicate twigs. It held so many things we will never get back. When I gave that small box to my husband, we had thought the hard part of trying to conceive was finally behind us. In the moment I presented that little nest to him, we were both blissfully and naively unaware of what was to come.