12/15/2008

I've been nominated...

**disclaimer**
I'm having a bad day.


I've been nominated by Nikki for the Brillante Weblog Award. I didn't prepare a 'thank you' speech, as I wasn't expecting this nomination. Oh gosh. Where do I start?

First of all, I'd like to take this opportunity to thank the driving force behind my blog - INFERTILITY. Without you kicking my ass all these years, I would not be the jealous and bitter person that I am today. Before you came into my life, I was a happy, go lucky kind of gal, skippidy-doo-dahing my way through life. And now, my life is like that of an addict - I can't wait for my next IVF fix. After all I am shooting up hormones, taking all kinds of meds, even getting some of the good stuff while they retrieve my eggs. I think I pay just about the same or even more than what an addict pays for a fix. The only difference is that I still have my house (at least for now). Thank you, Infertility, for making me a gambler. Each cycle, each egg, each embryo - I roll the dice hoping to get genetically normal embryos. But for the most part, we get mostly abnormals. I can't stop gambling. Perhaps, I should try another game like roulette. I might have better luck at spinning the big wheel and hoping it lands on my number. After all it is time that I win something back. I mean, after 3 IVFs, 1 OHSS, 3 FETs, 3 PGD/FISH, and 1 CGH - Isn't it about damn time? But until then, I just keep on bettin'.

Next, I'd like to give a special shout out to both MALE FACTOR and ROBERTSONIAN TRANSLOCATION. Male Factor, you were there from the beginning. You introduced us to the Translocation. Translocation, you are da bomb! Nobody can seem to by-pass around you. You're there whispering to us, after every PGS, to let us know just how screwed we really are. I mean, you can't mess with DNA. That's hardcore stuff there. Both of you have tried your hardest to break me. Sometimes, I even think you have a time or two or three. But that just made me even stronger and more determined.

I'd also like to thank my BIOLOGICAL CLOCK. Without you, I would not feel the pressure of each and every wasted cycle. I appreciate you for reminding me that my eggs are getting older every single day. And I may not be able to produce as many as before. So thank you for keeping count.

Next, I'd like to thank FALSE HOPE. Without you, I wouldn't be able to cry myself to sleep at night. And at my age, I need plenty of beauty sleep. Thank you for making sure I get plenty of that. You, False Hope, never disappoint me. You're always lurking in the corner, starting with my first injection; and you have stayed with me through it all.

I'd like to thank all the ASSVICE out there. Over the years, more and more of you have exploded onto the scene. When one appears two more show up as well. Sometimes, it seems that it is not possible to keep up with all of you who keep popping up. So let's break it down into the most popular categories. Let's start with Prayer. Yeah, that's a good one...Moving on. Next, there's Relax. Why don't you just shut the f-up? Next, there's Just Adopt. Um, yeah. Let's move on to Don't expect it. Oh another good one! Thank you, Assvice, for making me realize that you are all so ignorant!

I'd also like to thank all the FERTILE PEOPLE out there, who have control over when they get pregnant and how many children they want. Without your growing bellies and/or toddlers in tow, I wouldn't be reminded of the fact that your husband or significant other who may or may not be an abuser or an alcoholic or a drug user or even a deadbeat has the ability to knock you up. (Don't get your panties in a bunch. I'm just jealous.) Instead, I have to enlist a team of professionals and spend the equivalent of the FDIC insured amount, without the same guarantee of course, just to have a chance of having what you can get for free. Many of you know what it's like to just go have a drink and/or get drunk, then all of a sudden you are pregnant. Well I have kept my head on straight... no drinking, no smoking, no recreational drugs (not that I'm interested in the latter two). Perhaps I should throw caution to the wind and get drunk, do some drugs. I have enough leftover sterile needles and syringes after all. But the reality is that no matter how much alcohol I consume, it won't correct DNA. However, it may kill enough brain cells that I won't understand the concept of DNA and how hopeless our situation really is.

And last but certainly not least, I'd like to thank the UNIVERSE. I feel all the more special that you would take the time and energy, singling us out of the billions of people on earth. So an extra special thank you goes out to you, Universe, for weeding us out of the gene pool.

I know just where I'm going to put this award...right next to our 'SCREWED' trophy.



OMG, I need a drink. Hell, I need the whole damn bottle!

12/12/2008

Back in the chase...


As most of you know, we've been chasing that stork for our entire married life. We've never used any stork repellent or put out a sign that said "No Storks Allowed." Instead, we tried to attract it. We learned about the conditions that the stork likes and what would attract the stork. We learned about all the fertility signs and the most optimal time to entice the stork. We would even set out traps and hoped that we get lucky. Not once did the stork show up at our doorstep. After a while, it seemed like chasing the stork proved to be much more difficult than we first realized. So we enlisted the help of a local stork hunter. With his first attempt (IVF/ICSI/PGD-FISH), he shot me in the ovaries and I ended up hospitalized for 8 days (severe OHSS and almost lost both my ovaries). We realize that things happen that's not totally in our control but being the professional stork hunter that he claimed to be, he should've known better. However, we gave him the benefit of the doubt and gave him several other chances (3 FETs). After those failed attempts, we realized that the local stork hunter was more talk than results. He would keep stringing us along and taking our money (we're 100% out-of-pocket) until we finally realized that we had to hire another stork hunter...the best stork hunter in the United States. The best stork hunter came with a very steep price, but he has the reputation and stats to back that up. Even though there has been an empty trap (July's BFN) and unforeseen circumstances (the 7 CGH 'no result' blasts), we still have the utmost confidence that he has our best interest in mind and will do his best to catch our stork.

Before we made up our minds on what we're going to do with the 7 'no result' blasts, we spent the whole morning on the phone with a few people from CCRM. First, I spoke with John, our embryologist. Back in July, he did a re-biopsy on our blasts that were shipped to CCRM from the FL fertility clinic. Remember that he thawed the 5 frozen blasts... 3 died upon thaw (ugh, my FL RE used the old method of freezing) and 2 were re-biopsied for FISH analysis for the translocation...1 is normal and 1 is inconclusive. Both of them were vitrified and are still frozen in CCRM's lab. He told me that he personally will be doing a re-biopsy of these 7 'no result' blasts. Because the embryos were vitrified after the first trophectoderm biopsy and will be re-vitrified after the re-biopsy, he reassured me that the risk of damage to the embryos will remain at 1%. Apparently, vitrification makes a lot of difference (in addition to the skill of the embryologist). I asked him if he will re-grade the embryos after the biopsy, and he told me that the grade they were already assigned is pretty much the grade that they are even after another biopsy. He said that if we agree to have them re-biopsied, he will do the re-biopsy sometime next week and will call me afterward to let me know how things went. And we will have the results of the FISH analysis before Christmas.

Next, I spoke with our genetics counselor. She said that she doesn't have a written copy of the CGH report, but that she was told there were indeed abnormalities with 13 & 15, which we expected and there were no trisomy 21 in the 8 abnormals. I was thinking that maybe I should get the aneuploidy screening, but since she said that there were no trisomy 21 I felt more at ease. She reiterated that babies with trisomy 13, 18, and 21 can go on to have a live birth, but babies with trisomy 13 and 18 will die within a couple of weeks after birth. Those with trisomy 14, 15, 16, 17, 22, and 18 will all miscarry. Also those with monosomies (except XO - Turner's Syndrome) of any of the chromosomes will miscarry.

I asked for clarification on what 'no result' means. She reiterated that it has nothing to do with our embryos. She explained that sometimes when they amplify the DNA there is not enough DNA to test. And sometimes there is some signal but that signal is weak so they are not confident one way or the other. Now, I'm starting to get the picture. Apparently, glitches happen. She said that they happen in 10 - 15% of the cases, but that our case was unusual in that it resulted in 45%.

Then I spoke with my nurse. Our nurse Jen has been great throughout all of this. She was really upset at the number of no results. She told me that when she heard about our CGH results, she immediately ran to our genetics counselor's office. Anyway... we talked about the FET cycle and when we could start preparing for that. As we are expecting the results from the FISH analysis before Christmas, we could do the FET as early as January. I asked about the differently FET protocols, so she briefly explained them: (1) BCP & Lupron shots, (2) Lupron shots only, and (3) patches only. I told her that my regular doctor, upon knowing the results of my hypercoag panel, is concerned about my being on BCP, so she said that I will probably want to do the Lupron only protocol. She emailed me a sample FET calendar (Lupron only), and I am supposed to call her with my next AF to discuss which protocol and the date I want to do the ET. We briefly discussed about the FET schedule for February. Before we hung up the phone, she told me that once they get the results, she will schedule a re-group appointment for us to discuss things with Dr. Schoolcraft.

After the phone calls, Jerry and I discussed our options and what they recommend. After much thought and consideration, we're going to take their advice and choose Door # 1...To just do the FISH analysis for the translocation. We signed the consent form and FAXed it to them and put a hard copy in the mail. Sometime next week, John will call us to let us know about the re-biopsies. And hopefully before Christmas, we will get the results of the FISH analysis.

So our chase continues for our ever-elusive stork...

12/11/2008

So confused...


It doesn't seem like I'm ever going to be released from limbo-land. CGH was supposed to be our answer. But it looks like even the most high tech thing out there isn't even able to help us. I feel like I've been holding my breath all this time and thought I could start breathing again once we get the results. At least we would know one way or the other. But I was wrong. I don't even know if I could ever breathe again...

I received a phone call from our genetics counselor around lunchtime today. I so was not expecting a phone call from her at this time. Although my heart was excited for a very brief moment, I sort had a feeling that there's going to be bad news. She asked if we had time to discuss things. It cannot be good news if a genetics counselor is calling about CGH results and asks if you have a moment to discuss things. I asked her if it's bad news, and she said, "Complicated." Immediately, I knew that there was a problem. My first thought was that maybe our cells got lost in transit from Colorado to New Jersey. I was not prepared for what she was about to say.

The genetics counselor told me that Dr. Mandy Katz-Jaffe (CCRM's genetics research director) received our CGH report via phone from Reprogenetics, so she does not have a detailed, written report yet. Out of the 15 blasts biopsied, she said that 8 of them were abnormal. Ok, I guess that's to be expected. I was prepared for that. I wasn't prepared to hear what she was about to say next. The rest of the blasts were 'no results,' meaning that they aren't normal nor abnormal. Huh? She then went on to say that it has nothing to do with our embryos but that it's a limitation of the technology. Huh? I was confused. If CGH could determine 8 embryos as being abnormal, why can't they determine the rest one way or the other?

She said that Dr. Schoolcraft and Dr. Katz-Jaffe had a lengthy discussion about our situation, and she informed me that they never do that. They either defer it to one or the other, but I guess they wanted to discuss the best way to proceed given the circumstances. For the seven embryos with no result, Dr. Schoolcraft and Dr. Katz-Jaffe are recommending that Dr. John Stevens (CCRM's director of the embryology department) thaw the 7 embryos, re-biopsy them, and re-vitrify them. Then send the biopsied cells to Reprogenetics next week where they will perform FISH analysis for the translocation only (13 & 15). The genetics counselor emailed me papers that we will have to sign to have the 7 embryos re-biopsied and re-tested. Dr. Stevens would be able to re-biopsy them next week and we could get the results before Christmas.

Our second option is to do the re-biopsy and re-vitrify them. Instead of doing FISH analysis for only 13 & 15, they could also do aneuploidy screening (14, 16, 17, 18, 21, 22, X, and Y chromosomes). Because of my age, she said that I am not at an increased risk to produce eggs that have an abnormal number of chromosomes. Dr. Schoolcraft and Dr. Katz-Jaffe both agree that screening for aneuploidy (14, 16, 17, 18, 21, 22, X, and Y chromosomes) in addition to the translocation may reduce the number of normal embryos that would be available for transfer. As with any PGD (FISH and CGH), it is only 90% accurate and, therefore, it is possible that a normal embryo could erroneously be scored as having aneuploidy. They don’t want to risk that. Their goal is to eliminate the embryos with an unbalanced translocation, thereby preserving the embryos that are normal for the translocation and offering them for transfer.

Our third option is to do nothing and take our chances with the transfers. I asked her the consequences of transferring aneuploid embryos. Embryos with trisomy 13, 18, and 21 all could result in live-births; however, babies born with trisomy 13 and 18 would die within the first couple of weeks of life. Abnormalities with 14, 15, 16, 18, and 22 would always result in a miscarriage.

Before we decide what to do, I want more information on the 8 CGH abnormal blasts. Do all 8 have the translocation? If so, is there a pattern as to what other chromosomes are abnormal with the translocation? I still don't really understand why the 7 blasts had no results. She said that it has nothing to do with the embryos but with technology instead. But she said that CGH could screen for translocations. She said that ours is the first case using CGH to screen for translocations. I guess I'm just confused, just so confused.

12/09/2008

A thing about translocations...

Ok. So today is 3 weeks and 4 days. Gosh, it seems like forever already! I have been trying to keep myself occupied and not think about it, but it's nearly impossible for me to think of something else! People say that the hustle and bustle of the holidays are supposed to be a distraction, but I don't think it's working for me. Sigh.

Since I can't think of anything else but our 18 blasts -- 3 blasts that are PGD normal for 13 & 15 and 15 blasts waiting on CGH results -- I might as well not fight it and just blog about it.

We first heard the term Robertsonian Translocation from our first RE here in FL back in May '06. Because of the severity of the male factor (abnormal everything), the RE had Jerry karyotyped. We weren't opposed to it because every single exam that Jerry had to take (some of which were very painful like the trans-rectal ultrasound), everything came back normal. We just wanted answers. We were expecting his DNA to come back normal as well. I remember thinking, before we were told the results, that anything would be better than abnormal DNA. OMG, I was in shock and disbelief when we got the devastating news. We spoke with a geneticist in Boston, and I asked her how this could be. There really is no answer, as all of his siblings and his parents would have to be tested. All of his siblings and/or spouses are past the child-bearing age or had other issues going on, so the geneticist said that there would be no point in testing them. Only one of his siblings has a biological child. Two of his siblings resorted to adoption to complete their families. And one sibling chose not to have any children, as his spouse already has children from a previous relationship and doesn't desire any more. Upon hearing this, the geneticist told me that most likely the translocation could've been inherited. We spoke with 4 different geneticists, and they all said, after going over Jerry's family history, that it could most likely have been inherited rather than some random event.

If you click on the picture at the top of this post, you can see the translocation and how it affects the embryos. Before, it all seems so abstract. But after actually taking a look at the translocation, it gives me a better grasp on the whole thing. And when I study it further, it just makes me scared, scared at just how severe it really is. Because of the translocation, out of the six possible combinations, only 2 embryos would be viable - one completely normal embryo and one having the balanced translocation. Futhermore, we learned that about 65% of the sperm are affected. Our geneticist says that although it's good to know what we're dealing with, it doesn't mean that every cycle 65% of the embryos would be abnormal. Sometimes, there may be less abnormals and sometimes more abnormals. The 65% came from the sperm that was checked at that particular time (last June).

With our first two IVFs we did PGD, specifically the FISH testing. The FISH testing was used to screen for the affected chromosomes. With our first IVF (at the local FL clinic), we had 8 "normal" out of 17 embryos tested. However, we couldn't rely on the 8 being really normal. You see, the FL RE tested for 13, 18, 21, and the sex chromosomes, totally skipped testing for chromosome 15. While the additional chromosome testing information is useful, our situation didn't require 18, 21, or the sex chromosomes to be tested. Therefore, we couldn't trust if what he deemed "normal" is really normal in our case. So that's why we had the 5 remaining frozen blasts re-tested. (There were only 5 frosties left after the 3 failed FETs.)

With my 1st IVF/ICSI/PGD cycle at CCRM this past July, we had 23 embryos that were tested for chromosomes 13 and 15. And at the same time, Dr. Schoolcraft also tested the 5 frozen blasts from FL. Out of the 23 fresh embryos, only 7 were normal for both 13 and 15. And with the re-tested blasts, only 1 was normal and 1 was inconclusive. One 5AA and one 4AA blasts from the fresh IVF were transferred. BFN. Out of the fresh, only one made it to freeze and the re-tested blasts were also frozen. So at that time, we have 3 blasts on ice. With our November IVF/ICSI/CGH cycle, we have 15 blasts that we're waiting on on the results.

Because I've never even got so much as a BFP after transferring top quality blasts, there may even be a bigger problem with the chromosomes than expected. So that's why we're doing CGH, where it tests for all of the chromosomes. The FISH testing is limited to testing on a few chromosome pairs. Although it is great that chromosomes 13 and 15 could be tested with FISH, it doesn't test for the other chromosomes that might be affected due to the bulkiness of the translocation. Our CCRM geneticist told us that perhaps the translocation affected other chromosomes from pairing up correctly. So by doing CGH, hopefully we'll get some answers.

12/06/2008

While we're waiting...


So it's been 3 weeks and 1 day since the cells from our 15 blasts were sent to Reprogenetics in NJ for CGH testing. Our geneticist, a few days before my ER, informed us that it may take around 8 weeks to get the results back. So it looks like we've got a little while yet to go. I have always been very anxious during my 2 week wait, so this is having me on pins and needles for 4 times longer!

While we're waiting, let me give a quick overview of CGH (from what I understand). CGH stands for Comparative Genomic Hybridization and is used to analyze the full karyotype (23 pairs plus the sex chromosomes). It is used to identify an imbalance in chromosomal material such as Trisomy 21. It is until recently (within the past few months) that CGH can be used to screen for certain translocations (i.e., Robertsonian Translocation 13;15). We've been told that we're one of the first couples to use CGH to screen for Jerry's type of translocation. Before this, we could only do FISH analysis (tests only 9 to 12 pairs plus the sex chromosomes).

The process starts when the embryos are grown until they reach the blast stage (usually around 5 days in culture). Then the embryologist grades the embryos and decides which embryos to biopsy. The embryologist then biopsies the trophectoderm cells (outer cell mass of the embryo). The cells from each embryo are placed in its own test tube and shipped to Reprogenetics for analysis. Because the turnaround time for CGH, all of the biopsied blasts must be cryopreserved.

Once the samples are received by Reprogenetics, the DNA contained in the tubes is amplified. The sample DNA is tagged with a green fluorescent tag and then mixed with a sample of normal DNA, which is fluorescently labeled red. Then the sample DNA (green) and the normal DNA (red) are cohybridized to a slide, which takes approximately 71 hours. Then a microscopic analysis is done. The images images are collected and analyzed by the computer, which compares the intensities between the green and red of each chromosome. Thus, a molecular karyotype is generated. A 1:1 ratio of each chromosome is considered normal. Any other ratios are considered abnormal. A couple of examples of abnormal results include Trisomy 21 with a 3:2 ratio and Monosomy 21 with a 1:2 ratio. CGH has an accuracy rate of around 90%.

The chromosomes of interest to us are chromosomes 13 and 15. Those are the chromosomes affected with Jerry's Robertsonian Translocation. I will discuss the Robertsonian Translocation in further detail in another post. The reason we're doing CGH this time instead of the FISH analysis is because we've never gotten a BFP, even after transferring top quality PGD normal blasts. Remember, the FISH analysis only screens for up to 12 chromosomes. So there is a possibility that even though our previous blasts were considered PGD normal, the other chromosomes that weren't screen may be abnormal and we just didn't know it. Hopefully, CGH testing will be able to give us some much needed answers.

11/28/2008

Another anniversary and another Thanksgiving...


Another anniversary and another Thanksgiving came and went. We have much to be thankful for, despite our struggles with infertility. Many people spend their lives searching for their soulmate, their one true love. Some people are lucky to find the person they can truly call the better half of themselves, while others spend the rest of their lives searching and never finding. I am happy to count myself among the lucky ones. Last week, Jerry and I celebrated our 15th anniversary.

Deep down as each progressive anniversary approached I was convinced we'd somehow beat the odds. When we did our first IVF, we thought that that was it. All we had to do was IVF and then bammo! I'd get pregnant. Oh to be so naive again... And then the 3 FETs...those cycles were supposed to be "it." And even changing clinics and going to the best one, there are no guarantees.

It wasn't supposed to be this way. This was not supposed to be part of the plan.

11/18/2008

Blood test results


While we were there in Denver, knowing that the cycle was going to be a freeze-all (due to the CGH testing), I wanted to make sure that all the i's are dotted and t's are crossed. I want to go into the FET (Frozen Embryo Transfer) knowing that we have done everything possible. I asked my nurse if there were any more tests that could be done on me and she mentioned that the only other thing that she could think of is the APA and Hypercoagular Panel. She said that the tests are costly, and they only recommend testing if a woman has had several miscarriages. I didn't want to take any chances, as it would be more costly doing another whole IVF/ICSI/CGH cycle than to have these tests done; so I asked her if I could go ahead and have those tests done. She said that she would talk with Dr. Schoolcraft about it, and he said that it'd be up to us. The APA is about $500 and the Hyper-Coag Panel is about $3000. What's another $3500 in the whole scheme of things, right? So two days before my ER, I had 10 vials of blood drawn (9 of them were for the tests and 1 vial was for my stim check hormone levels).

APA -
There may be a link between APA (Antiphospholipid antibodies) and implantation failures. APA have been postulated to bind to phospholipids on trophoblast tissue, impairing trophoblast development and preventing normal placentation. In other words, the presence of APA may prevent the embryo from implanting in the uterus. My APA test result came back as normal.

Hypercoagular Panel -
Most of my hypercoag panel came back as normal except for the Protein-S (free) and Plasminogen. My Protein-S level is low - mine is 54 and normal is 56 - 124. This means that I form clots easily (increased risk of thromboembolism). However, I have elevated Plasminogen levels, meaning that my body breaks up clots easily. It seems like one makes up for the other.

I was also tested for the MTHFR gene (hyperhomocysteinemia). I am heterozygous for the gene, meaning that I have one single copy of the gene (a1298c). The problem lies if there are two copies of the gene - causing the fetus to not get enough folate, leading to neural tube defect. But just as a precaution, I will be put on prescription Folic Acid (Folgard 2.2 mg).

My nurse said that she will call me after she talks with Dr. Schoolcraft about these results and see what he recommends. She said that my Protein-S is just two points away from normal, so he might just put me on baby aspirin or some other blood thinner.

While I had her on the phone, I asked her about how many days I would have to stay in Denver for the FET. She said that I could fly in the night before the embryo transfer and then leave two days later. And that my beta would be 9 days after the transfer. I told her that I probably would just stay in Denver until after the beta, so that I would know before coming back home. I would feel more at ease if I was not on the road during my wait.

I just want this to work. PLEASE PLEASE PLEASE!!

11/17/2008

We're home


Finally, after two days of driving, we're home! It's not an excited 'we're home!' kind of thing. It's the 'Whew, that was a loooooong drive' kind of deal.

My BFF in the entire world (besides Jerry of course)...I love you, Rachel!!... was so gracious to offer to take care of our 4 persian cats. We didn't want to ask her (we knew how much work it'd involve, and she's quite busy herself), but we had no one else to turn to.

I guess the other people in our lives must suffer from "infertility fatigue." We kind of knew it was coming, but we never expected to be this abrupt. We figured that people would fall away slowly one by one, but ever since our last BFN in July, people who said that they will be there for us weren't. It's ok. Ever since we got married, Jerry and I have been each other's support. It would make things nicer if we had family backing us up. We were naive for believing them when they told us that they'd be there for us now, when they didn't want us to get married in the first place. But I digress...

I've still got a lot to unpack and laundry to do (3 weeks worth!), so I'll post more later.

11/14/2008

Fert Report - Day 6


Today, we learned that 5 more blasts were biopsied and vitrified. So out of the 22 embryos, a total of 15 made it to the blast stage to be biopsied. The embryologist could sense my disappointment over the phone, so she kept telling me that having 15 embryos out of 22 go to blast is "great." She reminded me again that the percentage of embryos making it to the blast stage is 40 0 50%, and we had 68% make it to blast. I know that's great... if you're not factoring in any genetics. Unfortunately, I know the severity that the genetic factor plays in all of this. So my mind starts doing the math. Cells from the 15 blasts will be analyzed. Due to DH's Robertsonian Translocation of the 13th and 15th chromosomes, roughly 65% of his sperm are affected. So right off the bat, 65% of the 15 blasts will be abnormal. In other words, at most, we should have 5 - 6 normals. Then we have to take into account the extra percentage that the other chromosomes might be affected due to the bulkiness of the translocation, making the embryos aneuploid. So again, the numbers will be decreased... By how much, we don't know. But there have been studies that show more chromosomal abnormalities - other than the affected chromosomes - when one parent has a translocation. Ugh. I hate this. It's so frustrating. Anyway...

While I had the embryologist on the phone today, I took advantage of that by asking tons of questions, including the grades of all 15 blasts. There were 2 blasts with a grade of 5AA. Two blasts with 4BB. One blast with 3AA. Four blasts with 3AB. Three blasts with 3BB. And 3 blasts that are 2/3.

Then I asked the embryologist at what point do they grade the embryos - before or after the biopsy. She said that the embryos were graded before the biopsy. That way, they would know which embryos were good enough to biopsy.

After getting all the information that I can about the embryos, I asked about the sperm. Basically, these questions were out of curiosity more than anything else. The total sperm count is 13.6 million, but the total motility was 2.7 million. She assured me that they do a morphological assessment on the sperm and pick only the best ones (as far as they could tell under the microscope) to fertilize the eggs.

After getting the info about the sperm, I had even more questions. I asked her how my eggs were (again, out of curiosity), and she said that they were "excellent." They did do ICSI (ICSI in lamens terms: physically inject one sperm directly into the egg), but they didn't have to do the laser ICSI , which she said was good. She explained that they don't routinely do laser ICSI, as the less things they have to do to the egg the better. She said that my eggs fertilized "beautifully."

The embryologist was so patient with me. She stayed on the phone with me for a good 15 minutes or so.

I guess I'm just trying to process all the information. I don't want to get my hopes up just to have them shattered. Been there, done that... not once, not twice, not even three times. Let's try years and years worth of disappointments. Not to mention that I don't even count the temp and fertility signs charting nor the medicated IUI's. Heck, that's "child's play," for a lack of a better phrase.

What happens next? We wait. The genetic counselor told us to expect to wait about 8 weeks, as the holidays are coming up. So now, we rolll the dice and the countdown begins...

11/13/2008

Fert Report - Day 5


I wasn't expecting to hear from embryology today, but imagine my surprise when I got a call from the embryologist this afternoon with the day 5 report. Before I tell you how many embryos made it to the blast stage, let me explain the blastocyst grading (from what I understand). There are three components that go into the grading of the embryo: (1) blastocyst development status, (2) inner cell mass score, and (3) trophectoderm score.

The blast development status (expansion - hatching stage) is indicated by the number in the front. The number ranges from 1 to 6, with 1 being the lowest and 6 being the highest quality.

1 = Blastocoel cavity less than half the volume of the embryo.
2 = Blastocoel cavity greater than than half the volume of the embryo.
3 = Full blast, cavity completely filling the embryo.
4 = Expanded blast, cavity larger than the embryo with thinning of the shell.
5 = Hatching out of the shell.
6 = Hatched out of the shell.

The first letter is the grade of the inner cell mass (the cells that will become the fetus). The letters range from A to C, with A being the highest and C being the lowest quality.

A = Many cells, tightly packed.
B = Several cells, loosely grouped.
C = Very few cells.

The second letter is the grade of the trophectoderm (future placenta cells). Again, the letters range from A to C, highest to lowest quality.

A = Many cells, forming a cohesive layer.
B = Few cells, forming a loose epithelium.
C = Very few large cells.

Today, out of the 22 embryos, there were 10 embryos that have grown to the blastocyst stage, quality ranging from 2/3 to 3BB to 3AB to 3AA to 5AA. The 2/3 grade is the earliest blast stage, almost a grade 3 but not quite. She said that she went ahead and biopsied them because if they wait until tomorrow, the embryo might already be hatched. And doing a biopsy on hatched embryos isn't preferred. I wished that I had asked her how many blasts at each grade, but I was just so excited to get the day 5 report. Anyway...The embryologist biopsied the 10 blasts and then vitrified them about an hour later.

Tomorrow, she will check on the 12 remaining embryos, and hopefully they all will be good enough for biopsy. But then again, she did tell me that roughly 40 - 50% of the embryos only make it to blast. So I'm anxiously waiting for tomorrow's call.

11/11/2008

Fert Report - Day 3



The embryologist called with an update on our 22 embryos. She said that all 22 embryos have divided and are excellent quality for the most part. She said that at this stage (Day 3), they'd like to see the cell number be between 6 - 10 cells. Seventeen embryos are within the 6 - 10 cells, with 11 embryos being at the perfect 8cells stage. Three embryos are at 4 cells. One embryo is at 3 cells, and one embryo is at 2 cells. She said that, on average, 40 - 50% of the embryos will go on and develop to the blast stage. We will get another update on Day 6 (Friday), after the biopsy and vitrification. I don't want to get my hopes up, but I'm somewhate relieved that the majority of the embryos are progressing nicely.

After the call from the embryologist, my nurse called to see how I'm doing. Yesterday, I wasn't feeling too well - very bloated and nauseous. We went in so that we could update our communicables, and I asked to see a nurse. After talking with the nurse, she wanted me to have an ultrasound and blood work done to check my CBC and electrolytes. The ultrasound showed a little bit of fluid in my ovaries and behind the uterus. I also was running a little bit of a fever (101 F). The nurse also weighed me, and I had gained 3 pounds since my physical. She said that wasn't bad, but for me to keep an eye on it. Yesterday after we got back to the hotel room, I weighed myself to get a baseline with the hotel scale. This morning, I weighed myself again and I had lost 5 pounds. But my stomach still feels bloated and distended. I will go in tomorrow for another ultrasound to see if there is more fluid build-up. Hopefully, I'm on my way to feeling better.

What I'm feeling now is no where nearly as bad as my 1st IVF in FL. OMG, it's like night and day. So the plan today is to rest and still drink lots of Gatorade.

11/09/2008

Fert Report - Day 1

Kristy, our embryologist this cycle, called me this morning to give me the fertization report. Out of the 34 eggs retrieved, 25 were mature, 22 fertilized via ICSI. She said that I will get another fert report on Day 3 - Tuesday. I am anxious to hear about the embryos' grades. I hope all of them make it to blast, so that they can be biopsied for CGH. I will be on pins and needles until I hear from her again.

In comparing this cycle with my last CCRM cycle back in July:

July cycle
E2 at trigger (Lupron) = 4577
E2 post trigger = 5742
Eggs retrieved = 30
Mature = 26
Fertilized via ICSI = 23
Day 3 biopsy
PGD/FISH for chromosomes 13 & 15 = 7 normal for 13:15
Transferred 2 embies (grades 5AA & 4AA) = BFN
One embie made it to freeze on Day 6

November cycle
E2 at trigger (hCG) = 3534
E2 post trigger = 3944
Egg retrieved = 34
Mature = 25
Fertilized via ICSI = 22
Blast biopsy
CGH = Results in about 8 weeks but may be sooner

Now compare it to my first IVF back in FL:
E2 at trigger (hCG) = 3808
E2 post trigger = Didn't measure
Eggs retrieved = 23
Mature = 20
Fertilized via ICSI = 18, but one died before biopsy
Day 3 biopsy
PGD/FISH for chromosome 13 only (should've tested 15 as well) = 8 normal for 13 only
Freeze all cycle due to severe OHSS

Saturday's Egg Retrieval

Yesterday morning was my scheduled egg retrieval (ER) day. So we arrived at CCRM around 7:15 am. We were way early for once. So we took a walk around the building and started taking pictures. It was cold, but it felt nice with the sun beaming down on us.

We finally pulled up to CCRM's parking garage located on the west side of the building. Jerry pressed the intercom button and spoke with a receptionist, who then buzzed us in. So we pulled into the parking garage and parked right outside the double doors. We took the elevator to the 2nd floor and waited in the surgery waiting area. A nurse came to get me back for the pre-op. It took about 15 minutes to get me ready. During this time Jerry had to wait in the surgery waiting area. Once I was done (IV put in, heart monitor, blood pressure cuff put on, oxygen meter, etc.), the nurse went and brought Jerry back to where I was. We had a few minutes before the anesthesiologist came in to speak with us. He was extremely nice. We discussed how nauseated I get every time I go under, and he told me that he would try to pre-empt the nausea by giving me Zofran and Decadron in my IV.

Next, Dr. Minjarez came in. She was the on-call doctor, as everyone else had gone to the conference. She did my July ER, and I was hoping that she would be able to do my ER this time around. And I'm glad that she did! She even remembered that she did my ER last time. She said last time, I had 30 eggs. And she didn't know how many I'd have this time, but she told me that she would aspirate all of the follicles that she could see.

Then the anesthesiologist came back in and injected a relaxing drug in my IV. I don't remember anything after that. Jerry said that about 15 minutes later, Dr. Minjarez went to the waiting area and talked with him. She told him that the embryologist was still counting my eggs, but she said that I had 20+ so far.

The next thing I remember is waking up in the recovery room with a nurse hovering over me. She took the tube out of my mouth but kept the oxygen tubes in my nose. She also changed my IV bag - I think it's a bag of electrolytes/Heparin to prevent hyperstim. I drifted in and out of sleep. Then the next thing I remember was Jerry standing by my bed.

He had a worried look on his face. But I knew why. With my 1st IVF back in Pensacola, FL everything went wrong. But we attributed that to the incompetence of the FL doctor. And since I triggered with hCG back in Pensacola and now this cycle here at CCRM, we didn't know what to expect. Last cycle at CCRM, I triggered with Lupron, and I was just fine. So we didn't know if my bad reaction in FL was because of the incompetence of the doctor or my body doesn't react well to the hCG. After yesterday's ER, my bad reaction to the hCG in FL was due to the complete incompetence of the FL doctor. I triggered with hCG here at CCRM this time, and I was just fine! In FL, I triggered with hCG, the FL doctor retrieved 23 eggs and I developed severe OHSS and was hospitalized for 8 days. Here at CCRM, I also triggered with hCG and Dr. Minjarez retrieved 34 eggs. No adverse reactions. Hmmm. Makes you wonder huh? CCRM doesn't get the honor of being dubbed the #1 fertility clinic in the United States for nothin'. They really know what they're doing. I just wished that we had come here first instead of going to the incompetent FL doctor.

Let me tell you what a genius Dr. Schoolcraft is. He wanted me to do the hCG trigger this cycle, and he knew what a bad reaction I had in FL. So he kept me on the Antagon protocol so that I would have the Lupron trigger to fall back on. That way he kept his options open, if my E2 levels started to get extremely high. If my E2goes high, he could trigger me with Lupron. However, this time, my E2 level was almost the same as my E2 level with my 1st IVF back in FL. Dr. Schoolcraft triggered me using the hCG trigger and I didn't have the same adverse reactions as when I was in FL. Plus, this time, I had more eggs!

34 eggs!!! When I told my sister, she called me an Easter basket. Gotta love her sense of humor!

I'm waiting for a call from the embryologist today to see how many eggs were mature and how many fertilized via ICSI. I hope that the numbers are working toward our favor. So right now, we're just anxiously awaiting the fert report.

11/06/2008

Trigger time!



So finally, after 15 days of stims I finally get to trigger!! This time, I'm not using Lupron as my trigger shot. Instead, I'm using hCG. My E2 is 3534.

I took my last Cetrotide injection this evening, and I get to skip the Follistim shot. Yay! The phlebotomist who usually draws my blood in the mornings (one of the nicest people ever) will be coming to the hotel to give me the hCG injection. The hCG has to be given at exactly 10 pm. This injection is intramuscular, and Jerry has never given me the intramuscular shot before. And tonight is not the time for him to practice.

Tomorrow morning, I go in for blood work only.

My egg retrieval is Saturday morning at 9 am. We have to be at CCRM at 8 am.

I am so excited to finally get to egg retrieval. I am anxious as to how many eggs they get from me, but I have to have faith that whatever number of eggs they get, that'll be enough. I'm already looking forward to the fertilization report on Sunday.

11/05/2008

8th Stim Check

My E2 is slowly creeping up. Today it's at 2920. Dr. Schoolcraft decreased my Follistim from 300 to 225. I take it that he's thinking it's almost time for egg retrieval. When the nurse called me, she asked me if I was getting antsy. I told her yes, but I want what's best and it doesn't matter how many more shots I have to take.

After receiving the call from my nurse, we went to Todd's Pharmacy to get more meds - 2 more amps of Menopur. The people at Todd's know me by name by now and they know what I need. We are taking it one day at a time, as far as meds go. I don't want to buy more than I need. Jerry has been keeping all the receipts. Let's just say with 2 IVF cycles this year plus the meds, hopefully we'll get a hefty income tax refund.

While we were in a different section of town, we decided to just eat dinner over that way. Luckily, we had packed my evening meds (Cetrotide & Follistim) and took them with us. After dinner, we had to drive around the mall parking lot and find a secluded spot under a light. We had to keep the car running with the heater on because it's frigid cold tonight. Jerry liked it, but I couldn't stop shivering. So I got in the back seat of our Yukon and got the Cetrotide ready. It's basically just injecting a saline solution into the powder vial, waiting for the powder to dissolve, draw the solution into the syringe, and change needles. Once that's ready, I took my usual position when getting shots. I held the syringe up high, so as to not to bump it. Jerry made a comment about mall security and having to explain why we're both in the back seat with a syringe. We both had a chuckle at that. Anyway, he gave me the shot and drew blood this time, which is the first time this cycle that's drawn blood. I have bruises in my abdomen, but never a drop of blood. Oh well. It was bound to happen.

Tomorrow morning, I am instructed to take 2 amps Menopur and then go in for my ultrasound/blood work appointment at 9:45 am. It's getting close. I don't know if it's in my mind or what, but I think I can feel my ovaries getting bigger.

11/04/2008

7th Stim check

Ultrasound shows that my follies are around 14 mm to 21 mm, with about 11 being mature and about 10 more little ones trying to catch up. The nurse said that I may not get as many eggs as last time, which was 30. My E2 level is only 2192, whereas last time it was 4086 after 12 days of stims. I'm still on the same dosage of meds that I've been on for the past few days. Tomorrow morning, I go back in for another ultrasound and blood work.

I can't help but think what the genetic counselor told us... That there is a possibility that we may not have any normals after CGH testing. Do you know how scary that is? Dr. Schoolcraft hasn't given us the donor sperm speech...yet. But our genetic counselor brought it up at our last meeting. And this evening I finally broke down and cried uncontrollably, shaking and bawling like someone who's lost all her hopes and dreams. This may sound ridiculous, but I feel like I'm mourning the deaths of the children that I will never have. I mean, they don't even exist; and yet, I feel like I've already lost them. How can I feel this way about someone that hasn't even been born? It doesn't make sense. I've had all these hopes and dreams for our future children, and suddenly I feel like someone had taken them all away. I feel robbed.

This is our 3rd and don't know if it will be our final IVF. We've sunk a fortune into trying to conceive. Where do we draw the line? When we're in debt up to our eye balls? I'm afraid we're already there. After 2 IVF/ICSI/PGD cycles and 3 FETs, and this will be our 3rd IVF cycle...when will my body finally say enough is enough? It seems like it's on its way there, as my ovaries aren't cooperating much this time. My mental state is shot all to hell. My happiness seems to depend on the results of the ultrasounds and blood work. I feel like my life isn't my own anymore. IVF has taken over. And if we can't do IVF anymore, what do I have left? Ugh. I hate this!

11/03/2008

Today's hormone levels & a brief freak-out moment

I finally got the call from a nurse about my hormone levels. My E2 is 1798, LH is 5.3, and P4 is 0.5.

To sum up everything this cycle:

10/23... 1 amp Menopur & 75 iu Follistim
10/24... 1 amp Menopur & 75 iu Follistim
10/25... 1 amp Menopur & 75 iu Follistim
10/26... 1 amp Menopur & 75 iu Follistim (E2 = 73)
10/27... 1 amp Menopur & 75 iu Follistim
10/28... 1 amp Menopur & 150 iu Follistim (E2 = 103)
10/29... 1 amp Menopur & 300 iu Follistim & Cetrotide (E2 = 147)
10/30... 2 amps Menopur & 300 iu Follistim & Cetrotide
10/31... 2 amps Menopur & 300 iu Follistim & Cetrotide (E2 = 464)
11/1 ... 2 amps Menopur & 300 iu Follistim & Cetrotide
11/2 ... 2 amps Menopur & 300 iu Follistim & Cetrotide (E2 = 1052)
11/3 ... 2 amps Menopur & 300 iu Follistim & Cetrotide (E2 = 1798)

Tomorrow, I am instructed to take 2 amps Menopur and then go in for ultrasound/ blood work. It's getting close. The tech measures only the bigger follicles, so I really don't know how many eggs I'm cookin'. I've been comparing this cycle with my last cycle, and things seem to be similar but not quite. The only difference this time is that I started the Cetrotide one day earlier and am on more Follistim. I'm also doing the Cetrotide injections at the same time as the Follistim injections this time whereas last time, there was about 4 hours in between. But I've been told by my nurse to take both shots at the same time, so I've got to trust that.

I am freaking out. I NEED to have at least 30 eggs. With 65% of Jerry's sperm affected by the translocation, the percentage of chromosomal abnormalities in total is increased. In other words, there is a high probability that the percentage of abnormal sperm is even higher than 65%. There is no way to tell if the translocation has affected the other chromosomes; however, the genetic counselor said that there is a high likelihood that the percentage of abnormals is higher than the 65% originally thought.

Let me explain. Last cycle, I had 30 eggs retrieved. 23 eggs were fertilized via ICSI. After PGD, only 7 were normal for chromosomes 13 & 15. We transferred 2 grade AA blasts, which left 5 more embryos. Only 1 out of the 5 made it to freeze. By looking at that, it makes sense that the percentage of abnormal sperm is way higher than 65%.

One second, I'm all peachy. The next, I'm so sad. I don't know if I will produce as many eggs as last time. I'm trying not to stress out about it, but that's all I can think about. I have to make more eggs to compensate for the abnormal sperm. If I don't, then we might not even have any normal embryos after the CGH and then all of this would be for nothing. I know I'm jumping ahead of myself, but I'm the type of person who thinks two or three steps ahead. This sucks. It's so not fair.

6th Stim Check

This morning, I had my 6th stim check (day 12 of stims). The tech only measured the bigger follies, but I still have quite a few smaller ones trekkin' along. Today, my follicle sizes are between 12 mm and 20 mm. The nurse told me that 15 mm is considered "ready" for trigger. So it looks like I have a couple of days to go. After the appointment, we had to go to Todd's Pharmacy to purchase more meds. I got 2 more amps of Menopur and 2 more syringes of Cetrotide. Right now, we're going day by day, just like the last cycle. So far, everything with this cycle is very similar to my last cycle. While I'm waiting for the nurse to call with my blood work results, I thought I'd take this opportunity to post some pics.

Below is a panorama of the lake in Evergreen, Co. We had a great time walking around the lake. I've been told that when the lake freezes, it's opened for ice skating. How fun would that be!



Here are a couple of pics taken on top of Buffalo Bill's lookout mountain in Golden, Co. Of all the places that we've been to so far, this has the best view of the mountains. Below is a pic that we're going to get enlarged and framed when we get home.





Below is a pic from the Garden of the Gods in Colorado Springs, Co. The rock that we're standing in front of is the famous Balanced Rock. Jerry and I had so much fun exploring the park and we even climbed on a few, even though the signs say don't climb on the rocks. Whoops.

11/02/2008

5th Stim check

So the time change had me all flustered this morning. We had to make adjustments as to when to do the Menopur shot. We had the hardest time last night trying to figure out when I should get the shot this morning. You wouldn't think that it'd be this difficult, but it was. Jerry and I had to literally count out loud the number of hours between the shots. Anyway...This morning, we woke up at o'dark thirty so that I would have enough time to get the Menopur shot and make it to our 7:15am ultrasound/blood work appointment in time. Even though the traffic from downtown to CCRM wasn't that bad, we were about 5 minutes late. The ultrasound showed my follies just trekking along, taking their own sweet time. My E2 is 1052, LH is 1.6, and P4 is 0.4. I am still on the same meds that I've been on for the past 3 days through tomorrow. We told the nurse that we have enough Menopur for tomorrow morning, but I only have 150 iu Follistim left. So she went and got me a 600 iu cartridge of Follistim to tide me over for the next couple of days. It will show up on our bill later (at least that's what happened last cycle). I will probably need to go to Todd's Pharmacy and get more Menopur and Cetrotide tomorrow.

After the appointment, we went to brunch at Ellyngton's Dom Perignon Sunday brunch at the Broadmoor Hotel in Colorado Springs. Let me just say this: The food was divine! My sister told me about that place, saying that they were featured on the Travel Channel. They spend all week planning for the brunch, which I didn't understand why it would take a whole week to plan. But after having eaten there, I totally get it. The eggs and omelets were prepared anyway you like it - fresh at the buffet station. Waffles, pancakes, wide selection of breakfast breads/pastries/croissants/muffins and meats. They also saute fresh made-to-order meats, poultry, and fish. There was a salad station and a cheese and crackers station. There was also jumbo shrimp, oysters, mussels, salmon. And the best part was the sweets station - chocolate fondue (strawberries, marshmellows, bananas, etc.), cakes, tarts, petite fours, mousse, cookies, creme brulee, cheese cakes, tiramisu, key lime pie, etc. Totally yummy. Jerry and I only had that one meal today, and I am still full.

We were going to go back to the Garden of the Gods but I was so tired. Cookin' these eggies makes me tire easily.

Tomorrow, my appointment is at 9:30am. I'm hoping and praying that my little follies catch up to the bigger ones. I compared this cycle with my last cycle at CCRM, and I'm a little "ahead" as far as the E2 level goes. Last cycle's E2 at this stage was 986, and this cycle it's 1052. I'm curious to find out what tomorrow's E2 level will be. Last cycle, my E2 jumped from 986 to 4086 at the next stim check. I wonder if it'll do the same this cycle.

11/01/2008

4th Stim check on Halloween

I had my 4th stim check on Halloween, on my 9th day of stims. I have about 20+ follicles, 6 - 15 mm. My E2 was 464, LH was 0.97, P4 was 0.2. My nurse told me to continue on the 2 amps Menour, 300 iu Follistim, and Cetrotide until Sunday morning, when I go in for my 5th stim check at 7:15am. Yikes! For those of you who know me, I am so not a morning person.

I'm getting really nervous now. I don't feel like I'm producing enough eggs. Maybe it's the pressure I'm under to produce a lot of eggs. I looked at my July '08 cycle, and it seems like I'm having a similar response. Last time, they retrieved 30eggs. I'm hoping with all my might that I produce as many, if not more this time. The pressure that I'm feeling is immense. But I'm trying not to think about it, but the more I try not to think about it, the more I think about it. It's a vicious cycle.

On another note, our puppy (we still call her a puppy even though she's 7 years old), was the hit of the hotel last night. She is just too much for one costume, she had to have two!! The first costume is Buttercup as Snow White, and her second costume is Buttercup as a princess. Let's just say she got a lot of attention from the valet to the front desk check-in to the Club Lounge, even Elways here at the hotel. She was like a celebrity; everyone (the hotel guests and the people who work here) was whipping out their cameras and taking pictures of her. The LA Lakers are staying here at the hotel (they have a game against the Denver Nuggets tonight) and Buttercup got all the attention! How funny is that!



10/29/2008

3rd Stim check & Genetics appointment


This morning, Jerry gave me the 1 amp Menopur shot and then we headed to CCRM for my 3rd stim appointment. I am on day 7 of stims. There are still around 20 follicles, around 8 - 12mm in size, but she said that some may be hidden so I may have more. She predicts that I may have a similar response as last time... about 30 eggs. Today, the ultrasound showed that my follicles have grown a little bit from the day before. My E2 is 147, LH is 1.35, and P4 is 0.2. My E2 level is a bit low, so Dr. Schoolcraft is increasing my meds significantly tonight, so that the other little follicles can catch up. So tonight, I am to take 300 iu Follistim. I'm also to start Cetrotide as well, to keep me from ovulating. The nurse also told me that Cetrotide will counteract some of the high dosage of Follistim. The nurse also said that I can take the Follistim and Cetrotide at the same time, so I get pricked three times a day from now on. And for those who know me well, I absolutely hate needles!! But ya gotta do what ya gotta do, right? Yes, I'm desperate here. Anyway...

Thursday, I will take 2 amps Menopur in the morning. I will not need to go in for ultrasound/blood work, so we have a "free" day. I think we'll probably just hang around the hotel. I've been feeling kind of tired, and Jerry has work to do anyway. In the evening, I will still take 300 iu Follistim and Cetrotide.

Friday morning, I will continue the 2 amps Menopur and then go in for my physical and ultrasound/blood work appointments.

After today's ultrasound appointment, we had an appointment with our genetics counselor. She is absolutely one of the nicest person ever. We talked about Jerry's Robertsonian Translocation again (chromosomes 13 & 15). She explained that there might be more chromosomes that are affected due to the translocation. As the sperm cells are maturing, the translocated chromosomes may disrupt the pairing up and dividing due to the bulkiness of the translocation. Because of this, there is a higher percentage of abnormal sperm than what was thought before. So instead of 64% of the sperm being abnormal, she thinks there is a higher percentage but couldn't tell us exactly how much higher. There haven't been any studies on that just yet. All this time I thought that when the egg gets fertilized, the resulting embryo's chromosomes might get messed up. But she said that the chromosomes would have already been messed up in the sperm...BEFORE it ever fertilizes the eggs. So that just puts a damper on things. She said that with the FISH testing last time, we had roughly 30% normals. But with CGH, she said for us to not be disappointed with a lower percentage of normals simply because they would be testing all 46 chromosomes. It is even more important now that I produce a lot of eggs. I'm hoping for 40 eggs now. I don't know if that's realistic or not, but I'm feeling a lot of pressure to produce lots and lots of eggs.

She also explained how CGH worked. The embryologist will biopsy blast embryos (day 5) and send the clump of cells (placental cells) to a lab in NJ (Reprogenetics). The lab would then compare our embryos' DNA to the standard 23 pairs of chromosomes. Any deviation in the ratio of chromosomes would be deemed as abnormal. The test is about 90% accurate. Because the holidays are coming up, Mary said that it may take 8 weeks to get the results. And depending on my natural menstrual cycle, it may take up to 6 weeks to prepare my uterus for the embryo transfer. So we're looking at maybe a February transfer. She also said that the success rate after CGH is around 80%. That's amazing.

10/28/2008

Hello from Denver!

I know it's been a while since I've blogged. We've just been so busy and tired that I haven't had a chance to blog. So bear with me.

We arrived in Denver Saturday evening. It was the longest drive ever! I hadn't noticed before that Kansas is so big. As we got closer to Colorado, we what we though was white sand on the side of the highway. We thought it was a bit unusual to have splotches of white sand, but as we looked closer we saw that it wasn't white sand at all - it was snow!

Sunday morning, I had my first stim check. I had 20 follicles, sizes 6 - 8. My E2 was 73, LH was 1.09, and P4 was 0.2. The nurse said that I'm right where I'm supposed to be at this point. I'm to continue with the 1 amp Menopur, 75 iu Follistim, and the Dexamethasone until my next stim check.

I didn't have an appointment on Monday, so we decided to explore the Denver area. We went to the Mother Cabrini Shrine and Red Rocks. It was nice to get out. My mom and sister flew to Denver to be with us for a week. So it was nice sharing the sites with them. (I'll post some pics later.)

Today (Tuesday), I had my second stim check. I still have about 20 follicles, but they're not much bigger... sizes 6 - 9. I'm a slow egg grower, what can I say. My E2is 103, LH is 1.1, and P4 is 0.2. The nurse told me that I'm having a similar response as the IVF cycle before, which she said isn't a problem. I expressed my concern about the sizes of the follicles. She said that it's better for me to stim slow and steady; otherwise, my E2 level may spike and have the possibility of developing OHSS (like with the Pensacola RE). Tonight, I'm to double the Follistim to 150iu. I guess the RE wants to see if increasing the Follistim will make my follicles grow faster. I trust him completely, so I wasn't worried. Tomorrow morning, I will still do 1 amp Menopur and then to my appointment.

So tomorrow, I have my third stim check and an appointment with a genetics counselor to discuss CGH. I am very worried about GCH, not of the test itself but of the possibility of not getting any normals. However, I've been told that their CGH stats are around 80%, so I'm hoping and praying that this may be it.

So right now, I'm thinking follicle-growing thoughts. Grow follies grow!

10/23/2008

First day of stims


This morning, I had my first stim shot (1amp Menopur)..Tonight, Follistim. We went through our regular ritual of getting ready for the shot. I didn't feel the prick of the needle, but I did feel the sting of the medicine half-way through. Afterward, I gave my ovaries a pep talk. Grow follies grow! I know it's silly, but I've been trying to will my ovaries to produce between 30 - 35 quality eggs. I need that much, especially with the translocation issue.

At my suppression check yesterday (after taking 25 days of BCPs), the ultrasound tech counted a few small follicles. On my right ovary, there were 9 measureable follicles ranging in sizes from 2.6mm to 5.8mm. And on my left ovary, there were 8 measureable follicles ranging in sizes from 3.6mm to 9.1mm. That's 17 follicles total. I didn't think that I would have any measureable follicles, as I just came off of BCPs. So, I asked my IVF nurse about my ultrasound and all the follicles, and she said that seems about right, as my antral follicle count (AFC) is around 35. And she said that my hormone levels were right where I'm supposed to be at this stage.

After taking my first stim shot, I swear I could feel something cookin' in my ovaries. I don't know if it's all in my mind or not. I'm just hoping and praying that I develop a lot of good, quality eggs. I guess I'll be worried about it until my first stim check this Sunday in Denver.

We're leaving tomorrow morning, right after my morning shot. Next update will probably be Sunday. Keep us in your prayers!

10/22/2008

Suppression check

I hardly slept last night, as I was worried about my suppression check appointments. I have been known to ovulate through BCP and Lupron, so I was worried that I may do the same this cycle, especially right after a failed IVF cycle.

We had the blood work appointment first. We left early enough to get to Gulf Breeze by 9am. When we got there, we searched for the office. The lady on the phone gave horrible directions. She just said that the office is right in front of the Gulf Breeze hospital. Well, the building in front of the hospital is Andrews Institute. So we went there, only to find out that the suite 204 is an orthopedic office. We asked the receptionist if she knew where Dr. K's office is. She said that it's actually in the main hospital in the women's wing. We went in the main entrance of the hospital and asked a receptionist to see if she could point us in the right direction. By now, it was 8:55am. After what seems like forever, she told us that the office that we're looking for is upstairs. We get to the women's wing and walked down the hallway, looking for suite 204. Guess what. The offices only go to 203. So we flag someone down and asked her. She told us that it's in the next building over to the side. So we went out the side exit doors on the first floor and went inside an adjacent building. We finally found the office and signed-in at 9:10am.

The nurse took one vial of blood, and as I was checking out, we chatted a bit. I told her that we're doing IVF in Denver and that I needed the results FAXed to CCRM today. She said that would be no problem. Then she asked me if we lived there. I answered no. After I explained how we needed to do CGH and everything, she asked me what CGH was. I thought to myself, I'm sure glad we're not using this fertility clinic. Anyway, she wished us luck and we left.

It didn't take us long driving from Gulf Breeze to Pace for my ultrasound appointment. In fact, we were about 30 minutes early. I signed-in and we sat in the waiting area. Finally, we were called back. The lady that did my ultrasound was very nice and knew exactly what it was for. She was gave me a play-by-play on everything that she was measuring. She said that everything looks normal, all the follicles were still small.

After the ultrasound appointment, we went home and we waited and waited and waited to get the results of the blood test. Finally, the results came in. Everything is a go for stims tomorrow morning! So yay!

10/21/2008

The meds have arrived...



Yesterday, I finally gave Schraft's Pharmacy the go-ahead to ship my meds. This go around, my meds cost is the highest it's ever been... $2,900. And we didn't even get any post-retrieval meds (Estrace, Vivelle, Prometrium, Medrol), as we're not doing embryo transfer this cycle.

After I got off the phone with Schraft's, I began to feel really anxious and nervous and started freaking out. Oh the ups and downs of this infertility roller coaster ride from hell... One minute, everything's fine; the next minute, I'm freaking out. I felt my life spiraling out-of-control, and I couldn't do anything about it. My mind was racing a mile a minute, feeling overwhelmed at all the meds I have to take...again, worried about the number of eggs I will produce, thinking about the egg retrieval and how I react to anesthesia afterward, scared that we may not have any normals after the CGH testing, freaking out over the amount of money we've already spent on infertility treatments.

I woke up at around 4am this morning and went to the living room, so as not to wake up Jerry, and had a good cry. I sobbed and sobbed and sobbed until I had no more tears. After I calmed down a bit, I went back to bed. It took me a little while to fall back asleep.

This morning, the FedEx truck delivered my meds:

* Menopur 75u vials (14 vials)
* 3cc 22G 1 1/2 inch syringes (20 syringes)
* 27G 1/2 inch needles (14 needles)
* Follistim Pen
* Follistim AQ 900iu cartridges (2 cartridges) w/ needles
* Dexamethasone 0.5mg tablet (25 tablets)
* Cetrotide 0.25mg kit w/ needles
* Novarel 10,000u
* 27G 1 1/4 inch needle (2 needles)
* Tetracycline 250mg capsule (16 capsules)
* Sharps container

I am doing much better today. Maybe it was the cry in the middle of the night. Or maybe it's because we received the meds. I always seem to get "excited" when I receive my meds, maybe like the way a drug addict feels. I don't know.

Tomorrow morning, I will go for my suppression check. If all goes well I start my stim meds this Thursday, starting with my 1st Menopur injection in the morning. Wish me luck tomorrow!

10/14/2008

First appointment arranged

I finally have my first appointment finalized. It has taken me about a week of back and forth phone calls to get things set, so I'm relieved about that. It's my suppression check appointment - to make sure that I don't have any cysts and that my E2 (estrogen) and P4 (progesterone) levels are within the correct range before I start my stim shots. Dr. Tucker's office will be doing the vaginal ultrasound, and Dr. Kouliano's (fertility clinic based out of Mobile, and has an office in Gulf Breeze) office will be doing the blood work. On October 22nd, I will go to Dr. K's office at 9am for the blood work and he will FAX the results to CCRM that day. Then later that day, after CCRM gets the FAX, my nurse will call me and tell me what to do next. Hopefully, my hormone levels will be within the range so I can start my shots the next day. If not, then I will probably have to wait another cycle. Let's hope that doesn't happen. I want to get it over with already. I'm already having second, third, fourth, etc. thoughts about doing this again, so any delay wouldn't be good. Anyway... after Dr. K's office, I will have to book it to Pace to Dr. T's office, where I will have my ultrasound. Hopefully traffic will not be too bad, as I have to get from Gulf Breeze to Pace by 10:30am.

So right now, I wait...again.

10/13/2008

CCRM in the news...again!

Just another reason why I feel like we made the right decision about going to CCRM...

http://www.reuters.com/article/pressRelease/idUS212174+30-Jul-2008+BW20080730

10/05/2008

Waiting...

So right now, I am waiting to finish my BCP. You'd think that I'd be used to doing all this waiting, but it never gets easier. Waiting for my cycle to begin. Waiting for the right days to take the tests. Waiting for the results. Waiting for the IVF calendar. Waiting to order the meds. Waiting for the meds to arrive. (And it's like Christmas every time I get my meds package from UPS.) Waiting to start the meds. Waiting for more tests. Waiting to take the last shot - the trigger shot. Waiting for egg retrieval. Waiting for the fertilization report. Waiting for the results of the genetic tests. This time, we're going to be doing CGH and that will take at least 6 long, agonizing weeks for the results. Waiting for my next cycle. Waiting to start the meds. Waiting for more tests. Waiting for the embryo transfer. Waiting for the pregnancy test. And if it's a BFN, then waiting for my cycle to start so I can do this all over again. It seems like the waiting never stops for me, and maybe that's why it's so hard.

Our lives are on hold...every day, every month, every year. Not fully living nor fully dead. For over a decade now, we have been waiting, only to end up right at the beginning every single month. While other people are going on with their lives, enjoying their lives to the fullest...with their children, planning for the future, we are stuck in this holding pattern. Waiting. Always in limbo. We cannot move forward without children, yet we are not ready to give up. So we have no choice but to wait. Waiting to get out of infertility hell and to the land of the living.

10/01/2008

Last test down

So I had the last test that the doctors could do on me as far as fertility issues are concerned. I was all nervous and freaked out about the HSG test this morning. I was so scared of having that test done because I had read horror stories out there about it, how it was the most painful experience and all that. But I guess everyone is different. I talked with a few woman on the fertility boards, and they said that it wasn't as bad as they thought.

We were told to be at the Diagnostics Center at Sacred Heart by 8:30am this morning. We parked in the Brent Lane parking garage - let me tell you, it was nerve-wrecking driving the huge Yukon in the low ceiling parking garage. We had to circle around several times to find parking. We finally found parking on the second deck.

We had the first check-in at the Diagnostic counter. Basically, it was just me telling the receptionist who I am and what test I'm having done. Then we were told to wait in the first waiting area located in the main hallway. It took us about 30 minutes to be called for the second check in. We had to fill out insurance stuff and pay. I was just thinking, the price we pay depends on if we have infertility coverage. We don't have infertility coverage, but it's just a diagnostic test. Oh well. What's another few hundred bucks right? Just comes out of our savings, which is dwindling rather quickly now.

After the second check-in, we waited for like 5 minutes to be called back. Jerry had to wait outside in the hallway. Lord knows he doesn't need any radiation to damage what miniscule good sperm he has already. The nurse was really nice and explained how the test works. And then she said that I looked very familiar to her. I told her that she may have seen me with my MIL, when I took her to get her x-rays done. We talked for a little while, as the PA doing the test was running a bit late. I told her all the tests that I had already went through, and she made a comment that it's a man's world. If it was a woman's world, after finding out about the male factor fertility issue, a woman wouldn't order all these tests that I had to go through. Yep, it's a man's world alright.

Anyway, the PA came in and he was very nice. He explained what he was doing step by step. For the record, I hate pap smears. It was almost like a pap, except that a catheter was inserted through my cervix. At the end of the catheter was a balloon that was inflated so that the dye wouldn't drain back out the cervix. The dye is then injected and I could see the dye fill up my uterus and then my fallopian tubes and then spill out at the end of my tubes. After it was all over, the nurse called Jerry in so that he could see. The PA described the parts of the x-ray. He pointed to a triangular shaped object as being my uterus. He said that it looked normal. Then he pointed to a sphaghetti like thing, and those are the fallopian tubes. And then he showed us the dye that spilled out at the end of the tubes. And then said that everything is normal. The shape of the uterus is normal. The fallopian tubes are normal, there were no blockages as evidenced by the dye spilling out at the end of the tubes. Jerry went back out in the hallway to wait for me as I got dressed. On my way out, the nurse jokingly said that she'd give Jerry an enema, only because I had to go through yet another invasive test only for it to turn out normal. We both laughed, and she said it's the least he could do. I like her.

So yay, at least now it's totally official. And boo, there is nothing wrong on my end that would prevent us from conceiving. However, I do wish that there was something wrong with me because anything would be better than genetic issues.

The doctors waited so long for me to have this test done because they didn't think it'd be an issue since we already know the cause of the infertility. When the doctor ordered it, he told me that he didn't think I had any blockages but that he needed it so that all the bases are covered. I was hoping that they would find a blockage that could possibly cause backflow of toxic fluid. That would explain why the embryos didn't implant this last time and that could be fixed. But nope. No such luck. They couldn't find anything wrong (physically, hormonally, or genetically) with me, so that means that there are more genetic issues wrong with the embryos, most likely due to the pairing up of the translocated chromosomes with normal chromosomes.

Even though the embryos were tested for the known genetic issues (translocation of 13 and 15), because of the specific type of genetic issue that Jerry is a carrier, it may cause other chromosomal abnormalities in the embryos. So even though they checked for chromosomes 13 and 15 to be normal in the embryos, just because of the translocation, the bulkiness of the fused 13 and 15 could knock other chromosomes out of whack.

Because of this new research on translocation carriers, there is a very little chance that the other chromosomes will be normal. We are guardedly cautious now, so that's why we are opting to do the CGH where it tests for all 23 pairs of chromosomes. We can no longer rely on just testing 13 and 15, as there is research suggesting that other chromosomes might be aneuploid. Because of this, we expect even fewer embryos to test normal for the number of chromosomes.

For more info on the research on translocations:
http://ohsufertility.com/Papers/pgd%20balanced%20translocation.pdf

After reading the article, I got even more discouraged. And I thought about the conversation we had with Jerry's brother and his wife the other day. We had dinner with them last Friday, and my SIL told us that they knew a couple who met after Hurricane Ivan, got married, and and now they have a 1 year old. Oh I was so jealous! We've been married almost 15 years now, spent over $100K on fertility treatments, and still no baby. I'm trying to focus on the positive though. And the positive thought now is that it's a good thing that Jerry has a really well-paying job and is able to work from home; otherwise, we might not even can afford fertility treatments or travel to the clinic. Everything happens for a reason, people always say. I'm not sure if I believe that.

9/24/2008

We're going for it again!!!!!!!!

I got my IVF #3 schedule!!!! I'm so excited! I want to be a mom so bad that I'm throwing caution to the wind and going for it again!!

Here's my tentative schedule, as the date may change for the egg retrieval.

I started my period on Monday, so that's cycle day one (CD 1). I start the BCP today (CD 3), and I will be taking it for 25 days. I don't like taking BCPs, as they make me nauseous. But I don't mind because it's just one of the hurdles I have to go through to have a baby. The reward definitely far outweighs what I have to go through.

Next Wednesday (October 1), I will have to do the HSG test here at the radiology department in Sacred Heart. You would think that with all I've been through, I wouldn't be anxious about this test. But, I'm very nervous about it. I'm nervous partly due to the horror stories I've heard and mostly because I have little confidence in the health professionals here (other than my GYN and regular doctor and opthamologist and allergist and...Gosh, I see a lot of doctors) in Pensacola. Maybe I'm just tainted by my experience with the local fertility doctor. I don't know.

I take my last BCP on October 18. Then October 22, I have my suppression check. The suppression check is to make sure that my ovaries are "quiet." In other words, no follicles/eggs are growing. It is checked via vaginal ultrasound and hormone blood tests. I'm always anxious with the suppression because I have been known to ovulate while on BCP AND Lupron shots (Lupron is supposed to further suppress the ovaries) at the same time. But then again, I was a patient here at the local fertility clinic when that happened. Again, I should've been monitored more closely but I digress...

I start my stimulation shots on October 23. I should be on the same meds as before - Follistim in the morning and Menopur in the evening.

October 26, I will have to have my first ultrasound/blood work at CCRM. Because I have to be there by then, we have to leave Pensacola on October 24. We will be driving the Yukon again, as we are taking Buttercup with us. We will stay overnight in Dallas. It just happened to work out for us that Dallas is the half-way point.

I will have to go in for ultrasound/blood work every day until egg retrieval. Dr. Schoolcraft is very cautious, as I developed severe, and I mean severe OHSS (ovarian hyperstimulation) with IVF #1 here in Pensacola under the care of the local fertility doctor.

My tentative egg retrieval date is November 3. But I tend to take a little longer to "cook" my eggs, so the surgery may be later. We will not be doing any embryo transfers this cycle, as we are doing CGH to test all 23 pairs of chromosomes. That genetic test will take approximately 6 weeks, so after the embryologist biopsies the embryos on day 5, he will immediately vitrify them. Vitrify is the new way of freezing the embryos, with a 99% change of not damaging the embryos versus the old method (that the local fertility doctor did) which has a 50-50 chance of damaging the embryos. So after we get the results, I would start preparing my body to accept the CGH normal embryo(s). That would be a Frozen Embryo Cycle (FET). I've been through 3 FETs before, and they're not as hard on the body as going through regular IVF (which this will be my 3rd IVF). It takes about another 6 weeks to get ready for the FET, so we're looking at early next year before I actually can get the embryos. That means another drive to Denver, possibly in the snow!

We were thinking of just staying in Denver from October on to the FET cycle, but that wouldn't be feasible. We looked at renting a house, but I don't want to live in another house other than my own. It goes back to my OCD.

I can't wait!!!!!!!!!

9/07/2008

Peace, if not only for a moment

We woke up at 9am so that we could go to the 10:30am Mass. We usually like to get to church at around 10am, as we like to "prepare" for Mass. I usually start by kneeling and doing the Sign of the Cross and a prayer asking for forgiveness. Then I reflect on His Passion.

Jesus suffered both physically and mentally. He was rejected. Judas betrayed Him, Peter denied Him three times and the rest of the Apostles abandoned Him. Those who tortured Him not only wanted Him dead, but they also wanted Him to suffer. He endured horrendous scourging. At the praetorium He was publicly derided and sentenced to death by crucifixion. As a further humiliation, He was forced to carry the instrument of His execution. He was so weak, He could hardly walk and yet He dragged the heavy cross on His shoulder and fell with the cross on top of Him. He got up each time. After reaching the crest of Calvary, He received the nails into His hands and feet. When they raised the cross up, the nails in His hands held His body up. But His up-stretched arms began to squeeze His lungs and He couldn't breathe. So He had to push down on His crucified feet to raise His body to fill His lungs with air. He managed to do this for three hours. Finally, He had no strength left and He suffocated, and died, giving us His life.

Whenever I think of what Jesus suffered and died for us so that we may live, I no longer thought of myself - only Him. This brought me peace at the moment.

I will close this blog with a quote from St. Gemma Galgani.

“I wish that my heart could beat, that I could live and breathe only for Jesus, I wish that my tongue could utter no other name than that of Jesus; that my eye could see only Jesus; that my pen could write only about Jesus, and that my thoughts could soar to nothing but Jesus. I have often wondered where on earth there might be something on which I could center my love. But neither on earth nor in heaven do I find any such thing but only my beloved Jesus… I am the fruit of Your passion, Jesus, born of Your wounds. O Jesus, seek me in love; I no longer possess anything; you have stolen my heart…” - St. Gemma Galgani

9/02/2008

8/28/2008

I am a Mom Wannabe

A Mom Wannabe

By Alison Kathleen Whitney

I want to be a Mom. But I can't. Instead, I am a Mom Wannabe.

I want to procreate. I want to conceive a child, naturally, with my husband, in the privacy of our home, in the spirit of love and passion, in the way God intended. But I can't.

I want to discover that my period is several days late. I want to buy a pregnancy test and pee on a stick. I want to see a + sign. I want to cry tears of joy for the news we'd discovered. But I can't. Instead, I cry tears of pain at random, for no reason and with no warning.

I want to experience morning sickness. I want my hormones to go haywire. I want the "pregnant glow". I want to have my husband talk to my belly. But I can't. Instead, I try not to look pregnant. I don't buy clearance clothes for next year, "just in case". I try to keep my emotions from going haywire. I dream that my husband talks to my belly.

I want to take prenatal vitamins. I want to eat for two. I want to schedule my first doctor's visit. I want to sit in the waiting room with other pregnant women and know that I am one of them. But I can't. Instead, I wonder if those pregnant women ever had problems conceiving. I think how cute they look as they waddle with their big bellies. I smile at babies that are not mine. I ache from loving someone I've never met.

I want to hear the doctor say "You're Pregnant. Your progress is right on schedule." But I can't. I want to surprise my parents with a new grandchild. I want to tell my friends and family our good news. I want my life to change overnight. I want to read "What to Expect When You're Expecting". But I can't. Instead, I have no news to tell. I realize my life hasn't changed in years. I read "When Empty Arms become a Heavy Burden".

I want to monitor the progress. I want to see ultrasounds. I want to hear the heartbeat. I want to watch our baby grow. I want to feel the kicks, but I can't. I want to decorate the nursery. I want to childproof our home. I want to shop for adorable, soft, tiny outfits. I want to shop at Gymboree. I want to save money for the baby's future. Instead, I imagine a crib in an empty room down the hall. I avoid baby stores in the mall. We spend our money on doctor's appointments, tests and
high-tech procedures. We spend our money on a dream. We are left with an empty bank account. We are left with empty arms.

I want to share the experience with my pregnant friends. I want to compare symptoms. I want to be the guest of honor at a baby shower. But I can't. Instead, I watch my friends get pregnant quickly. I watch their bellies grow, attend their showers, see their pictures and try to be a good friend. I watch their lives change and our friendships change in front of my eyes.

I want my belly to drop. I want my water to break. I want contractions. I want an epidural. I want my husband by my side and my family in the waiting room. I want the pushing. I want the pain. I want to hear the cry. But I can't. Instead, I feel a different pain. I hear my own cry. Yes, I even hear the cry of my husband which hurts more than I had ever imagined.

I want to hold our baby in my arms, with tears of joy streaming down our faces. I want to experience the miracle of birth, thinking "We did it", but knowing that God did it. But I can't. Instead, I hold my husband in my arms with tears of sorrow streaming down our faces and wondering what God's plan is for us and why we have to go through this.

I want to pray that one extra special blessing be added to my life. And I do. I pray my 1000th unanswered prayer to God and hope this time He answers. I pray for the miracle of life that only God can give. I pray that someday soon He will give it to us.

I want to be a mom, but I can't.

8/27/2008

The sting of infertility

I've received many heartfelt messages, and have been told many times that they wish there was something they could do for me. Most even told me that they just don't really understand what I'm going through, so they don't know what to say. And that's ok. But how can I describe the feeling of isolation and being "different" to people who cannot possibly know what that feels like? Infertility is one of the biggest challenges that life has thrown our way. It is hard to see beyond the immediate pain of infertility. Everywhere I turn, I'm faced with that fact. I would say about 99% of my friends and family have at least one child and/or are currently pregnant. How can I find a way to be happy for others without always focusing back on myself?

They are members of a club that I may not ever be able to join. They would talk for hours about their pregnancies, sharing morning sickness stories and talking about which obstetrician was best. This would launch them into stories of their first pregnancies and deliveries. I spent long blocks of time saying nothing because I had nothing to contribute to these conversations. Each time one of the babies kicked or moved for the first time, I was reminded that I may never get to experience that. Life had denied me a basic experience shared by almost every other woman on the planet.

I feel like I don't fit in anywhere. I'm in my mid-30's, and most of the people we know became parents in their mid-20's. My husband's childhood friends have children ranging in ages from 11 to 21. My friends are either single and not even thinking about children or married and have young children or are currently pregnant. This means that I am in a different stage of life than most of the people I knew, which made me feel like the "odd man out." Jerry and I were talking about this a few days ago, and it's hard to imaging that we could've had a 13 or 14 year old had infertility not been a word in our vocabulary.

Some of our friends are childless by choice. It must be nice to have a choice in childbearing. I've heard people refer to these couples as DINKs (Dual Income, No Kids). I did not want to be a DINK (although we're just single income now, so would that make us a SINK?). I've read about how DINKs were choosing not to have children; instead they lead very lavish lifestyles involving travel and acquiring nice things. That did not describe us at all.

So we felt like we did not fit in anywhere. One set of friends talked about their children all the time, and the other set talked about their travels. We knew nobody who was in our situation, and this makes us feel very lonely. We eventually stopped attending functions such as baby showers and the like. I do admit that I attended a baby shower earlier this year; however, I debated back and forth on whether or not I was going to attend - not because I have anything against her (on the contrary, I think the world of her) but because I was afraid that I might lose my composure and bawl my eyes out. Jerry and I were sad but really enjoyed shopping for my friend's baby shower. We were sad because the stuff we were getting were not for our baby but for another family's. And the joy came from looking at all the baby items and thinking that maybe one day people will be attending OUR baby shower.

The last few weeks, I've been having trouble sleeping and trouble with controlling my grief. After years and years of BFN after BFN after BFN, it doesn't get any easier. This last BFN was extremely hard - I felt more hurt and sadness than I ever thought possible. I am at wit's end on how I am going to get through this. With each new grief, we relive the past grief as well. I remember the fear I had when we were first diagnosed as infertile. I just assumed that we were a fertile couple, so I had no reason to fear infertility. But when the doctor diagnosed us as male factor infertility, I was in denial. I mean, I was only 25 and Jerry was 29. This had to be a mistake, I thought. But reality set in right after our first official BFN back in 1999. What a rude awakening that was. No one ever warned us that we'd ever feel the paralyzing sting of infertility. After 9 years I still feel the sting as if it was just yesterday. It wasn't until July 2006 that we started letting family and a select group of friends know.

Sometimes, all I need to feel "normal" again is to hear someone else say they're going through the same thing. It's not that I wish infertility on anyone. On the contrary, it's just that I need someone, particularly someone who really understands, to tell me that it's normal to feel this way...That it's normal to feel anger, to feel sad, to feel extremely bitter...all at the same time. I hardly recognize myself anymore. Infertility has forever changed me. Infertility took my identity and gave me a new one.

Anyway...I've joined a couple of infertility boards and tried to be active there. It's comforting to talk with women who've been there and done that and are still battling infertility. Yes, it's a battle, and what an uphill battle it is. Even though I've never met these women, I feel a strong connection with them. And that helps with the loneliness I feel.