December 2016 - RE Regroup, Hysteroscopy & Holiday Hermits

About a week after the failure of round 5, we scheduled a consultation with my RE and chatted for a while about the disappointing outcome.  "Oftentimes with embryos, the genetic flaws that cause failure don't show themselves until a certain point in the repetition of cell division," he said, "and as you know, this is usually around Day 4-5 of growth.  Unfortunately that means we get situations like this where we lose a larger number of embryos right at the end."

My heart felt hollow.  This isn't at all what I had expected to happen, I was realizing.  Despite treating this round outwardly as "nice to have", somewhere along the line I allowed myself to expect it was going to work out.  We had figured out a good formula...we had a great number of follicles!  The "odds" were in our favor.  RIGHT?!

My eyes were puffy.  I had been crying off and on since the results came in.  I could easily recognize the stages of grief.  My first reaction had been denial mixed with anger and bargaining...lol.  As we chatted with the RE, I asked more questions about other options, other protocols, any other levers we might be able to pull.

Me:

"So we are fairly certain the embryos are aneuploidy.  

Are we sure we think the sperm is ok?  

We only checked it way back over a year ago...

and I heard about this other couple in our support group who had an issue with white blood cells eating away at the DNA of the sperm, 

so maybe it's not all my eggs' fault?  Maybe?  Is this something we should check?"

RE:

"I'm sorry, but this is highly unlikely, 

and how we would address it is by doing ICSI, which we are already doing.  

There's nothing more we would do, even if this was the case."

Me:

Sigh...  "Ok, how about this protocol I came across online?  

It focuses on suppression of testosterone to encourage highest egg quality.

Remember when we did round 2 with the testosterone cream and it was a terrible round?

I also stopped taking the DHEA after round 2 and 3 were so bad and our results were better.

Could this mean I have counterproductive levels of testosterone

which are negatively impacting both quantity and quality of eggs?"

RE:

"Not likely.  I don't think this will help you.  Everyone is different.  

We have no way of knowing if this would be better or worse for you unless we try it, 

and we have already tried 5 rounds of different combinations of protocols.  

You have given it an exceptional effort.  No one can say that you haven't tried your best.

This protocol isn't likely to help you any more than the ones we already did.  

Remember, Diminished Ovarian Reserve (DOR) is often correlated with low egg quality, 

less so in younger women, like you, but still can be an issue.  

I'm afraid that's what we are up against."

Michael:

"I think we just want to be sure we aren't leaving anything on the table here.

Is there anything you'd recommend that we try that we haven't tried yet?

Or should we really start focusing on transfer for the two we have?"

RE:

"I could get on board with trying another round with a fresh transfer at day 3 or 5.
There is a small chance that your embryos don't like to sit in the dish, but I think that's fairly unlikely.
I would rather us try to transfer one of the two that we have and see how it goes.
These two might be all you need, if we're lucky.
If they fail, we can come back to the drawing board, or examine Donor Eggs."

We talked a bit longer, but Michael and I both knew that if he shot down both the sperm and alternative protocol idea that we probably should move toward transfer.  My head was spinning a bit.  I wasn't ready for this, but more waiting, more indecision would just be worse.  If  we were on board with trying a transfer, or even a fresh round, our RE wanted to do a new hysteroscopy, since our last one was a year ago, just to be sure everything is gold-plated and ready to go.  

We got on the calendar for Dec 21 hysteroscopy.  It kept us from travelling for Christmas, but that was a bit of a blessing.  Being around people, especially celebrating people, felt inauthentic for us this year.  The last two years we have been mourning miscarriages around the holidays...it's really hard not to relive them as all the decorations go up.  For the last three years we have kicked off the holidays with the hope that this would be "the last Christmas just the two of us!"  Ugh.  Looking back at that sentiment makes my stomach turn.

We agreed to just lay low, no decorations at the house, and minimize the commitments on gifts / social engagement.  It was restful.  The hysteroscopy including endo scratch went very well.  All the plumbing is in good shape for 2017!  

It was hard telling family we just needed to stay home.  They really want to pull you out and help you feel better.  It's very difficult to explain how drained, weary, and fragile this process leaves you.  There's little joy in getting out and go- go- going...so much energy just to collect yourself and put on a happy face...to add to the long list of things to do, obligations to manage.  Don't get me wrong, I would have loved to spend that time with my family, but it was just too much.  The packing, the airports, the people with kids, the pregnant women EVERYWHERE, the spending of more money on airplane tickets, the round trip flying...veto.  I'm sorry.  We love you all, but veto.

This is how I knew what we did was the right thing for us.  A good example of what it all feels like right now.  

On Christmas Eve, I woke up early.  My heart was thumping hard in my chest.  Not full out panic, but tension and adrenaline that I couldn't calm.  Michael was sleeping soundly, and I didn't want to wake him.  I practiced breathing deeply.  Breathe in and think "Relax", breathe out and think "Calm".  I did this for half an hour.  No help.

I got up and made cinnamon pull-apart bread from some biscuits in the fridge.  Not Gluten Free...screw Gluten Free, it's Christmas Eve!  I put it in the oven, made a tasty vanilla bean icing, and it was already smelling good.  "Maybe I'm just hungry," I tried to convince myself.

I made an eggnog latte.  Yum.  Still not relaxing.  Cinnamon bread done.  Wake up Michael.  Eat the bread.  Merry Christmas Eve!  Hugs.  

The anxiety / panic is still there in my chest.  I just can't shake it.  I had told M about it when we were eating, and he asked what he could do.  I told him I didn't know.  Just wanted him to know what I was feeling.  He was concerned, but not annoyed, and thankfully didn't take it personally.  It wasn't anything he was doing or not doing at all.

A short while later, he's sitting on the couch watching football.  I walk into the room to join him and stop dead in my tracks.  It dawned on me.  "I think I just need to cry,"  I said.  He jumped up and held me as I broke into a full body shaking cry.  As I sobbed, the adrenaline started to release...my pounding heart slowed...and a rush of endorphins started to loosen my muscles.  This is exactly what I needed.  I looked up at Michael as I pulled out of it.  I just yanked him away from the game and soaked his shirt in tears and snot and he just looked at me with love and understanding.  He held me a bit longer and stroked my hair.  I felt so much relief just getting that out.  We sat down and kept watching the game.  I fell asleep after a short while, finally relaxed enough to rest.

I did this about half a dozen times over the last two weeks of holiday time.  I just needed to so I could feel better.  Many people wouldn't understand that.  Being out and around others would be hard...there's part of me that would feel like I had to contain or hide what happened.  Thanks to our rest, I'm needing this less and less.  It's still not easy to explain to family...how you just aren't up for it all and need to just...be.

Hermit Holiday FTW!