March 2017 - FET #1, Like jumping out of an airplane

Wednesday, March 8, I began the medicines for our Frozen Embryo Transfer (FET).  This was preceded, as usual, with a baseline ultrasound and blood test on March 3 to be sure my body is ready and the customary prescribing and ordering of medications, which arrived in a FedEx box on the porch with a heavy thump.


I was working from home to be sure to be there when it arrived and our office is right next to the front porch.  My heart sank when I heard the thump.  That whole day, I had felt uneasy, and that sinking feeling when the package arrived affirmed that I really wasn't ready for all of this.  I felt guilty and sad.  Since we kicked our infertility battle into high-gear with IVF about a year and a half ago (when we got tested and diagnosed), I always thought this part would be exciting and hopeful.  I'm feeling none of that.  On the contrary, I've been feeling dread and anxiety over the choice.  In fact, since coming back from my business trip in early February and scheduling the official date of transfer (March 29), there have been several moments of doubt and internal renegotiation about what we are about to do.  A psychological fight-or-flight response to my fear of all of what we've done so far failing and my fear of giving up on my ovaries.


The past couple of months and particularly the last few weeks have been as hard for me as the hardest weeks of 2016.  It's been as hard as when we went from 5 to 1 embryos in round 1, as hard as when we had completely failed rounds (rounds 2, 3, and 5), and as hard as starting round 4 after so much bad luck and lack of success.  And I hadn't even started the transfer protocol / medicines yet...literally only the date has been scheduled and I haven't even started the uphill march yet.  I kept thinking, "It could be rescheduled in a heartbeat.  Why am I feeling such panic?  Shouldn't I wait until we get started to freak out?"


The feeling has moved from terror to panic to depression to cautious hope and back again a multitude of times.  Starting the medication has helped a little.  There's some amount of commitment and action in taking my estrogen pills and applying and wearing the estrogen patches.  When I went in for the March 3 baseline check, my scan was done by the other RE in the office (not my usual one, but one I see fairly often).  He asked how I was feeling about getting started, and my reply was, "Terrified."  He chuckled and said, "Well, it's been 3 years...time to jump out of the airplane.  It gets easier once you're through the door, plus you can't ride in the plane forever."  While an odd metaphor for IVF transfer, I get his point, and tentatively agree.


I'm now a week into the estrogen patches and pills.  The patches are stickers the size of a quarter that I stick below my belly button and replace every 3 days. So far, I've found they don't stick too well on their own, and need an additional tegaderm / sticker / dressing on top of them.  Other than that, they've been pretty easy. The pills (Estrace, 2mg) are the same ones I've taken in the past for estrogen priming.  They dissolve under my tongue (as opposed to swallowing them), and they have traditionally caused some pretty heavy nausea for me.  Previously during retrieval rounds, I only took 1x day, but now I'm taking them 3x daily - 6am, 2pm, and 10pm.  It hasn't been terrible so far, but there have been some rough days.


This estrogen course will go for 17 days before I'm instructed to add in progesterone injections (on March 24).  Those will continue (1/day) through the transfer and on until scans and tests either prove that we have failed or through the 10th week of pregnancy (sometime mid-May).  This 50-some-odd shots are to be given intramuscularly ("IM"), usually in the upper-rear / lower-back area.  So far all my shots have been subcutaneous ("Sub-Q"), meaning just in a pinch of fat / skin (usually in the stomach region).  The IM shots have a 1.5-inch needle that goes all the way into the muscle where the medicine, which is an emulsion in oil, is then injected.  This oil is fairly viscous, and has been known to cause lumps, bruises, and soreness at the spot of injection.  Getting my game face on for this part.


Overall, I'm feeling a bit better about the whole process...better than I felt during the "jumping out of the airplane" talk.  I have to admit, it was pretty rough for a few weeks.  The stress / anxiety is there because it's such high stakes for us, but the stakes are high because science is actually giving us this small chance for success.  Without this whole process, we would have next to 0 chance of getting pregnant naturally.  Still, it's hard to face the real possibility that the 3+ years we have spent working on it up to now, particularly all the effort, time and expense of the last 16 months, could realistically end in failure.

January - February 2017 - A pause, the last couple of months

I'll start by saying sorry...I've had an awful time getting started on this blog again, though I've needed quite badly the therapeutic exercise of writing it.  Several friends and family have checked in and asked how things are going, which by the way, is completely ok to do!  Thank you so much for your concern and curiosity as to how things are progressing.

After the hysteroscopy in December, the stress of the holidays, the death of my grandfather, and a 3-week long business trip, I had pretty much checked out on this process until I had to get back to it.  So much was going on that stepping away from writing the blog and thinking too deeply about the process was easier than I thought.  Almost like putting a book on the shelf.

It wasn't completely set aside and haunted me a few times, and more recently as we've started to move toward the next steps.  It was very present in mind during my grandfather's funeral.  He was 94 and the day he passed, there was record snow fall at Crested Butte, CO, arguably his favorite place in the world.  I thought back to all the time spent with him there, from the ski lessons to the fly fishing philosophy and "big" fish stories, and how my children would never get to meet him.  He was larger than life in so many ways, and his funeral reflected that with standing room only attendance spilling out into the foyer at the First Presbyterian Church in Roswell, NM.

My mother gave a touching and humorous eulogy fondly reflective the man he was.  As the oldest grandchild I stood to add to that and the tears started rolling as I faced the full church.  So many people who knew, loved, and/or respected my grandfather enough to show up that day.  I forgot my funny stories and just went with the one I could remember.  More of a theme, really.  I choked on the words a bit, but in the end, my grandfather was all about "winning".  Yet, it wasn't in the traditional binary way.  In order to win, there didn't have to be a loser.  He would always encourage everyone to do their best and to go "full-tilt", as my mother put it, into a problem or challenge.  If you gave it your all, you were a winner.  Going through life, everyone could be a winner in their own way and on their own path, and he took it upon himself to be sure everyone around him was giving it their all at all times.  They were hard words to say, given the struggle we have had these last few years.  My brother then spoke and told a perfect story about how Grandpa would always be asking, "So, what's next for you?"...always looking forward, looking ahead to what can be acted on vs. what was behind you.  So very relevant, and a habit I should practice far more often.

I departed for my business trip the same day that Michael and I arrived back in Houston from Roswell.  3 weeks away to Wales, Belgium, and Czech Republic.  It is likely my only international business trip this year and to 2 new places, so I didn't want to waste the opportunity feeling down on myself.  As Michael dropped me off at the airport, I cried.  I was already missing him.  He's my rock and I have been feeling so fragile that there was a part of me that wanted to call off the whole damn trip right then and there.  In the end, I'm glad I went.  I accomplished all my business objectives and felt in control of SOMETHING by doing so.  I met lots of people face-to-face and built relationships I had only had on the phone up to that point, which was fulfilling.  I also made it a point to get out all day during my free weekends to sight see and take on some culinary adventures.  Retail therapy is also a wonderful thing.  I believe this is the earliest I've ever been ready with my Christmas shopping list, EVER.

It was a good trip, and similar to our August vacation to California, a very helpful break from the process.  At the end, I was thrilled to be going home to see Michael, yet I felt the anxiety creeping back into my chest about finally having to make an official decision about our next steps in our fertility journey.

One of my favorite stops on the trip was an old church in Bruges with a sculpture by Michelangelo called "Madonna and Child".  It is one of only a few of his works (perhaps the only?) that can be found outside of Italy.  I read that it was sold to the Flemish way back when due to the fact that both the Madonna and Child are posed in a way with their heads tilted downward, rather than up toward God, making them less desirable.  I'm not Catholic, but I paid to light two candles, one for each embryo on ice.  I figured it shouldn't hurt to do so...no one was standing there checking for Catholic IDs (is that a thing?) and the Holy powers-that-be surely have more important things to worry about than my specific religious education as it pertains to candles.  I sat in the cold church (no heating) studying the sculpture until I couldn't feel my hands or toes.  It was January in Belgium, after all, and only just above freezing outside (and in the big stone church) that day.  It may just be me, in the baby-related circumstance in life where I find myself, but I loved that sculpture and felt sad it was "rejected" back in it's time.  I guess it's easy to be picky about your Michelangelo statues when they come so easy?  When you have so many?  I wonder if the Flemish, who purchased it at the time, saw it as wonderfully rare, prized, and special.  The downcast stares of both figures are peaceful, and their postures are relaxed.  A pair who went through the ringer to be just where they were in that imagined and rendered moment.  They were wonderfully at peace just "being" together.  My two little candles flickered in the cold, representing my two frustratingly rare, prized, and special embryos that might come so easy and mean much less to someone else.  I longed and prayed to be at peace like that, to find some form of peace in our upcoming decision.  To be ok with these two possibly being all we can get from me.  Lots of emotions, some tears, as my moment of alone time in the cold pew passed.  My cold fingers and toes led me out to find a cafe and a warm mug of hot chocolate.

Side note: I will always be able to find (momentary) spiritual peace in a warm mug of hot chocolate.