Battle scars. When will I settle in? 9w4d pregnant.

I wish I was able to let go and get excited about this pregnancy.  I wish I could experience the resounding JOY of a first time mom.  I wish I could DREAM about nurseries and bonding with my baby and dwell on our sweet future together.  I think about these things, but do I DREAM?

Instead, I feel cautious.  I am SO happy to be pregnant, so blessed to finally be in this place, but it is NOT the bliss I would have always thought it would be.  Leading up to my first ultrasound, I was nervous, my mind fraught with anxiety.  When could I OWN this pregnancy?  When would I settle into it?  When would I just ENJOY being pregnant everyday?  The ultrasound came and went and though I worry so much less now about whether or not it is real, I have to admit that I have yet to settle into it.  Yet, to wake up in the morning, overcome with feelings of joy and elation that we are PREGNANT.  In my heart I am so thankful and praise God each and every day for this little miracle.  I have been researching baby gear and look forward to putting together a nursery, but I still find myself…well, numb.

This numbness of mine has resulted from so many months of battling with infertility.  Unmet expectations, broken dreams, waiting, enduring, hoping, and so much failing.  A relentless cycle that has left my soul forever changed, my heart hardened.  As the months turned into a year + many months, more and more I began to protect myself.  I worked hard to keep the pieces of my life together.  I went into full on self-protection mode and was able to give very little to those in my life and in my community.  Month after month, I continued to reach out, clinging to any hope I could find in God, Google, or some new treatment plan.  Time and time again, failure.  After a while, I grew calloused, I had to find a way to cope with infertility and no longer allow it to own me.  I had to find a way to rid it of the power it had over me and find myself again.

Well, new life has begun in me and with it, I am trying to restore my heart.  As I learn more about myself and how I respond to pregnancy, I realize just how much work there is yet to be done.  This journey is far from over.  I want to feel again, to LIVE in the moment again.  I want to enjoy each and every moment of this pregnancy and this beautiful baby that is growing in side of me.  I don’t want my past to determine my future. I realize that infertility has shaped me in countless ways for the better of my future family.  I want my children to have a mom who feels their pain and disappointments, who laughs at their sweet jokes, and whom can cry when necessary.

I will regain my soft heart…one day I may even wear it on my sleeve again.  In the meantime, I just thank God for this amazing privilege of finally working towards becoming a mom.  A dream I had all but given up just a few short months ago.  I hope I can find myself settling in soon and I hope that this baby in my belly is in our life to stay.

 

***

I had written this post last night and then thought I should sleep on it before posting it.  Part of me feels guilty for the feeling the way I do, for not being OVER the MOON excited.  But then, as I logged in to my Word Press account this morning, one of my dear blogging friends, Chanel, just found out yesterday that her baby had no heartbeat. This was her second U/S.  She had had a fabulous one just a few weeks ago.  Chanel and I received our BFP within days of eachother and so I have felt a special connection towards her and this baby.  I am heartbroken and so very sad for her and it just serves as another reminder of just how hard this journey really is.  There are no guarantees once receiving that long awaited BFP.  Please send her some LOVE!

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What made it work? IVF prep, God’s grace, and a fabulous RE!

For some time I have felt the need to write about some of the different things that I did leading up to my IVF cycle that could have helped it work.  One will never know what exactly did the trick.  Mostly, I just give all the credit to God and figure it just FINALLY was the right time for us.  Nonetheless, the further out I am getting from our cycle, the more I seem to forget.  I never thought I would say that as we lived it for so long – the shots, the oral medications, the vaginal suppositories, but I am.

So, let’s get to it…

One of the first things I did upon discovering that I might have endometriosis earlier this April, was to get on what I am calling a anti-negative immune system regimen.  There are some negative immune things going on in endo, I sought to counter these effects with:

DHEA 20mg.  I took a very low dose.  DHEA had many positive effects apart from increasing the better parts of my immune system and decreasing some of the unwelcome parts.   (I could go into so much more detail about DHEA and get all scientific, but don’t want to lose you, so we’ll stick with my better/unwelcome parts analogy. ) Apparently it also helps with egg quality.  (Somehow, according to our RE, all our embryos turned out “perfect”, so I’m thinking this really helped.)  Was my RE really on board?  Not really, but they let me stay on it. There are a lot of clinics around the country utilizing DHEA as part of their IVF protocols.  In my humble opinion, I think we will begin to see more of it.

DHA.  Found in Omega 3 Fatty Acids, I took some additional DHA on the side.  Also, to help out my immune system and improve my egg quaility.

Vitamin D – 2000IU.  I increased my Vitamin D intake as it also appears to modulate the immune system.

Melatonin 3mg every night to help improve egg quality.

…I figured if endo was preventing my embryos from implanting or attacking them prior to even reaching my uterus, well, it was time for me to take the offensive position and get it UNDER control. I will never really know how my immune system was really functioning as I did not undergo testing.  Nonetheless, I felt these changes were very important and there was enough literature out there to support them. On a side note, as much as I loved my RE, he isn’t really into the whole immune system side of things and only begins to delve into these things in women with recurrent miscarriages. He kinda laughed at me when I brought it up early in our treatment, but I carried on anyway.

Next, I ordered a book.  IVF Success Program.

This book was GREAT!  Definitely overwhelming and there is NO way you can incorporate everything into your life.  But it provides all the research on everything from diet to exercise to medications to acupuncture to little changes that can make all the difference in having a successful IVF cycle.  A few changes I made as a result of reading it were that I started going to acupuncture again.  I went once a week and then on the day of my transfer, I had acupuncture before and after.   I tried to incorporate more pH basic foods into my diet including cucumbers, red peppers, kale, etc…while decreasing pH acidic foods such as red meat in hopes to encourage more positive changes in my immune system and overall fertility.  She also recommends drinking mint tea everyday…so mint tea I did.  I am not going to get into all the research here.  Too much to talk about, but I really liked the book.  She also goes over the whole process from starts to finish, the different medications you are on and all of the tests you will endure.  There is a yoga book included, as well as a menu planner, and a journal to track your experience.  She also talks about the research behind the eating of pineapple core for 5 days post transfer….

Thus, that is what I did.  Pineapple core post transfer for 5 days!  Just the core.  The bromine helps with implantation.

I had NO caffeine whatsoever, no alcohol, and apart from a few luna bars each week, did not consume any soy products.

I was on bed rest for 2 days post transfer and was not allowed to exercise or have sex until we had our positive beta.  Our RE wanted my body in REST mode.  Walking was okay as long as it wasn’t too strenuous and I kept my heart rate under 140bpm.

These are the main things I did to improve our chances of success.  I really believe they helped as our embryo quality was “perfect” on all of our embryos according to our RE and embryologist. Also, I felt really good throughout our cycle and think the acupuncture and diet changes really helped with that.  Yet more than anything, I prayed…a LOT and left the whole cycle in God’s hands.  I realized pretty early on that worrying would get me NOWHERE.  I had no control except to take my medications and eat as best as possible, the rest was up to my body and God.  I knew that if He willed it to happen that it was going to happen.  I just had to keep the faith, keep the trust!  Of course, I got anxious from time to time and fretted and worried and googled, but as quickly as I would see my mind spiral out of control and count us out for this cycle, I would try to take captive these thoughts and replace them with ones of faith and belief.  Mind over matter.  I was NOT going to let my worries get the best of me.

Of course, I realize that my RE deserves a great deal of credit too!  Oregon Reproductive has an AWESOME protocol and amazing doctors and I feel SO blessed to have received care under them!

Post transfer, I was on Endometrin 3x daily, Estrace 2x daily, and Aspirin.  I am still on the Endometrin and Aspirin and only finally got off the estrogen last week.  I am hoping that starting next week I will get to begin my wean from Endometrin.  I still take my 2000IU of Vitamin D and prenatal with DHA, but stopped all other medications.

Anyway, much credit to Dr. Hesla and his colleagues.

Hopefully, I didn’t leave too much else out. If so, I will add it in later.  I have really enjoyed other bloggers post of things they have done to improve their success so thought it important to contribute my own!  All the best to all of you!  I am praying for so many of you and am so thankful for this community!

Ultrasound # 1 at 6 weeks 6 days!!!!!

Our ultrasound couldn’t have gone any better.  Our baby…yep, just one…is growing beautifully and perfectly measuring right on schedule!  It was a HUGE relief.  We are so excited and it made it all so much more real!!!  We have been curious leading up to this ultrasound if we would be having 1 or 2.  When I initially received my first beta result a few weeks ago and it was 98, our RE told us at that time it would probably be just 1, but then when my beta quadrupled in 2 days, we thought maybe they had both made it.  I was really rooting for both of them…but having found out the news today, honestly, I felt a HUGE sense of relief wash over me.  Twins would have been fun, but there also would have been a lot more risk involved to both them and me.  A single pregnancy is the best for baby and mom and I really am so thankful that though we put in 2 what was meant for us was one.  There is a small part of me that wonders about that other embryo…was it a chromosomal thing, did it just not find a good spot on my uterus, did my body just only allow one…who will ever know and I won’t dwell on it, but I am just so thankful to have 1 healthy, strong growing baby!  Thank you, God!!!  This is the greatest gift I could ever possibly dream of!

And…I get to officially graduate to my regular OB!  Yeah!  We are SOOO excited to have appointments closer to home and no more paying out of pocket for everything!  It’s the small things, right? : ) But, of course, we would do it all over again in a heartbeat!

Thanks for all your support!  It means the world to me!

To and Fro, Stop and Go….

Apparently that is how our world goes round.

We had a rough day.  Our RE finally sent us the research study on the benefits of doing a 3 month Lupron suppression in women with Endo and boy was it persuasive.  I spent most of the morning convincing myself that I could retake my place on the bench and sit out a few more months before pursuing IVF.  I listed the pros and cons, prayed a ton, asked God to give me wisdom, did oodles of self talk, and asked our doctor lots of questions via email.  By the end of the day, my anxiety level was approaching the *ALERT*  level.  It was just too much. I’m just not sure I can handle the 3-4 month wait.

So…I went back to the article and reexamined it.  Upon looking over the proposed mechanisms to explain why the women who underwent a 3 month Lupron suppression had higher pregnancy rates – once again, I found that we were back to the whole underlying immune issues.  A 3 month Lupron suppression suppresses the activity of the inflammatory cytokines in your body so that they are no longer “toxic” to an embryo.

Thinking about it more, and doing a little research, we are going to stick with plan A.  (Huge sigh of relief). We will definitely do our first IVF cycle this June.  We are going to bump up our Omega 3 DHA supplements, increase our vitamin D intake, as well as add a few other supplements that supposedly help reduce these dreadful cytokines.  Why not?  What do we have to lose?  Furthermore, we came across another study published in Reproductive Endocrinology and Biology last year that documented that Endometriosis does not reduce IVF success rates. Overall, I think we have a great shot.  I’m going to try to cling to hope.  At this point in the game it is so easy to side with failure and believe it is your only endpoint…but not this time.  This time we will have success!

 

Endometriosis. Immunity gone array.

Immunity.

We all love it.  We are all thankful for it.  When we don’t have it, bad things happen.  Seemingly insignificant bacteria and viruses equate with certain demise.  But what do we do when our immune system is overly active?

Such is the case with Endometriosis (Once again, I will refer to it as the big “E”).

I’m am learning so much about this new diagnosis of mine.  Thankful for answers, but nervous as to how it will play out over the years.

 

4 things I have learned.

1.  It is painful – This would explain my intensely painful periods over the years.  5 times between 2003-2005 (I think this is when the big E began to run its course, see more below),  I ended up in either the ER or urgent care with pain so severe, I was doubled over, ready to die.  The nausea came with the pain and quickly lead to vomiting and when there was nothing left to bring up, hours of dry heaving would ensue that left me exhausted and dehydrated…still in PAIN.  Ahh, such pleasant times.  Double O-C more like it. (Out of control).

When I started my Master’s in 2006, I could no longer deal with the unpredictability of my painful periods.  Would this month be SO bad that I will end up in urgent care again, needing an IV, Morphine, and anti-nausea medicine? The unpredictability was anxiety provoking. I could not afford to miss class/clinicals for my period – thus began my 5 year stint on CONTINUOUS birth control.  It kept the painful periods away. Yep, that’s right…not a single period for 5 years.  In retrospect, I am SO thankful for this now, given my diagnosis…given point # 2.

2.  There is cell growth where there shouldn’t be.  Endometrial cells (the cells that line your uterus) somehow find their way OUT of your uterus where they belong and can become attached to your abdominal wall, ovaries, bowel, vagina…you name it.  They grow a lining and shed it right along with your regular menstrual cycle.  This bleeding in areas not meant to have to deal with such atrocities become angry and inflamed.  This leads to the formation of adhesions that cause parts of your body to stick/twist to areas and/or organs they shouldn’t.  Adhesions = SEVERE PAIN.  The fact that I was on BCP meant that my body was given a 5 year stent of reprieve from such growth and inflammation.  THANK YOU, Doctor, even though you didn’t know you would help me so much in the long run, what a GIFT!

3.  My IMMUNE SYSTEM is WHACKED.  I have discovered that the immune system of someone with the big E is a little, shall we say, off the mark.  Without getting too scientific and lose you all in medical ease, I will give you the quick and the dirty.  The body doesn’t like foreign material.  Sperm is foreign material, embryos are invaders – kill them…kill them all!  ATTACK!  Yep, that is pretty much what can happen.

4.  IVF works.  It takes the abnormal conditions within your body and normalizes them within a controlled, ideal environment (like that of our fertile counterparts).  The beautiful 5 day old blastocyst (embryo) is able to attach, unharmed, unattacked to the rich uterine lining of a now medically suppressed immune environment within a woman’s body.  This is KEY to a pregnancy in an otherwise hostile uterine environment.

 

Next question for the RE.  So, if IVF works for us and we achieve implantation, what next?  Will we have overcome all obstacles in our BATTLE against the big E?  Will we need to continue to suppress my immune system?  Or will my other hormones take over and bring the pregnancy to fruition?

Tomorrow is our last BIG RE appointment before we leave for France.  While in France, we will start our treatment regimen….come home mid-June…and then it will be time to start the heavy hitters of IVF.  So much to learn.  A long ways to go, I really hope we can get my immune system in check.

BREAKTHROUGH. Thoughts following our first appointment with the RE.

Going into yesterday, we didn’t quite know what to expect.  Had we made the wrong decision to see the Reproductive Endocrinologist (RE)?  Was it too soon?  Should we have waited to get a referral from our OB/GYN?  As of yet, she was unwilling to give us one.  She wanted to do a few more months of IUIs prior to giving us our golden ticket to see a specialist.  Also, our ultrasound tech on Monday had seen the same RE when she went through a season of infertility and she told us quite frankly that, “She was not impressed.”  Though we have many other friends who have seen him and “LOVED” him, her experience really toyed with our emotions.  Would WE like him?  Would we gain any new insight in to our dilemma?  Would we walk out feeling more hopeless and confused?  One thing was certain, the appointment was going to be expensive – were we up for it?  We decided to press on and go to our appointment.  It had taken so long to get an appointment with him anyway, so why not?  Maybe we’ll receive a little peace of mind.  We can check it off our list.  We are, after all, the checklist types.

But that wasn’t until the afternoon….first, we had to do our 3rd IUI.  That proved to be an adventure, a rather traumatic and painful one at that.

For those of you who have read about our previous IUI experience, you know that we are a bit apprehensive about it.  We’re really not sure how we feel about the whole thing.  Sometimes it’s just easier to view them as a series of hoops to jump through on your way to the RE or IVF or simply because they just don’t know what else to do with you.  Well, I will get straight to the point.  The nurse could not get the catheter into my uterus.  I laid there for 10 minutes…feet held high in stirrups…as she adjusted and readjusted the speculum, changed out the speculum, went through 3 different catheters, poked, prodded, sharp pains feeling like something must have been perforated surged through my lower abdomen.  She aggressively sought what we had came for that day…Intra UTERINE Insemination.  She was not going to give up…no matter how much pain ensued.  I was just praying that God would get me through it.  The disappointment would have been hard to face had I stopped because it was painful…so much effort this month: pills, shots, ultrasounds…this. But, we endured. I felt my mind drift into song “Jesus you bore all my pain.  Savior you bore all my shame.  All because of your love.  All because of your love.  Because of your cross my debt is paid….” and so it went.  Why that song, I’m not sure…but it came to mind and it was appropriate.  I felt my body melt into the procedure table in relaxation…within 30 seconds…it was done.

Good times. How I love IUI.  During those wondrous 10 minutes of sheer torture…she looked up at me and said, “You will have some spotting tonight.”  Thank you.  Thank you for letting me know, I hadn’t guessed.  : )

We drove straight to our favorite bakery and I indulged myself.  I deserved it.  A gooey, delicious, buttercream frosting ladened cinnamon roll.  It went down easy.

Soon, it was off to the RE…

Let’s just get to the bottom line.  He gave us a possible reason we could be infertile.  First though, I must tell you our numbers are perfect, our labs are great, our ultrasounds have been promising.  He couldn’t believe were not pregnant yet.  He said that we have as good of chance as the most fertile couple to get pregnant.  But…there was just this one thing.  Maybe, just maybe it could be a factor.

My sweet husband was diagnosed with essential hypertension as a young boy.  It has hounded his life for the last 15 years.  If you met my husband you would be shocked.  He is so healthy and strong.  He has worked out at least 4-5 days/week CONSISTENTLY for the past decade of his life.  (If only I had some of that motivation).  Appointments with cardiologist, nephrologists, internists and many others have been a constant in his life.  He has endured countless procedures and tests to identify the causative pathology.  Yet, no one has been able to figure out why a boy so young would have such high blood pressure.  It has taken just as much time to get it under control.  His numbers are very good now, but he worries about it alot…worries about the effects his blood pressure had on his kidneys during those years when they were trying to stabilize it.  It is always on our prayer list.

He is on four different blood pressure medications to keep it under control.  One is classified as a calcium channel blocker.  Herein lies our revelation.  In fertility journals, literature is coming out that calcium channel blockers act as a male contraceptive.

Did I really just hear that?  YES, A MALE CONTRACEPTIVE.

You have got to be kidding me.  It is not well documented and hasn’t been formally studied.  My husband is a pharmacist…he knows these drugs more intimately than most.  He was blindsided.  In vitro studies are demonstrating that sperm of men who take these medications are unable to bind with receptor sites on a woman’s egg because they are missing a very important molecule, essential to that process.  WHAT?

Here is a link to an article that explains it in pretty easy terms to follow:

http://malecontraceptives.org/methods/nifedipine.php

Basically, there is not a ton of research about it because:

  1. Nifedipine is generic so there is really no money in it for the drug companies.
  2. The drug companies are so afraid that research will affirm these findings.  As a result, they could be sued by all the men who were unable to have children as a result of this unknown problem.
  3. The majority of patients on these drugs are not in their prime child bearing years.  It is very uncommon for someone to be on this drug in their 20s.

The good news.  It’s REVERSIBLE.  The sperm are otherwise completely healthy and able to fertilize the egg.  They just can’t bind to the egg.

So there it is.  Basically we must wait.  It takes 3 months for new sperm to develop…so, we will wait.  Wait, wait, wait.  Remember, that is the game we play.  We are hoping to meet with our OB/GYN soon and develop a plan for the next 3 months.  We are thinking about skipping a month of meds and IUIs…give our bodies a break and give this possibility time to pan out.  In our minds, what’s the point…if the sperm can’t do their job right now…then let’s wait and see what they can do given a new chance.

My husband calls it a lead…I’m calling it a breakthrough.  I’m really hoping this is it.