Transitions

It's safe to say my family has gone through a huge transition with the birth of Stella. L & C had only ever spent 3 nights total away from us when they went to stay with my in laws while we were in the hospital. Bringing Stella home is one of the biggest changes we've all gone through. 

Our first few days home as a family of five were challenging to say the least. I think having a c section and being unprepared didn't help. I went from doing almost everything for the girls to being unable to do a lot of simple things. I couldn't lift them, change diapers very easily, help bathe them, or carry them. It was tough for everyone. Top that with post-partum hormones and feeling guilty for turning their lives upside down and it's safe to say there were a lot of tears from everyone. Clara in particular had a really tough first few days. There were a lot of tantrums, time outs, and tears.

W and I are trying to be as consistent as possible with the girls. Now that I'm feeling better and more able to help, they are doing much better. They really do love their baby sister and I often find them bringing her blankets, pacifiers, toys, and giving her kisses and fist bumps. They talk about her all the time and ask about her if they don't immediately see her. They also seem to have a lot more patience for her crying (especially in the car) than I do. When I put her in the car seat they'll come over and say "baby happy" in hopes that she doesn't scream her head off like usual.  

It seems at this point a lot of the issues we're seeing with the girls are just typical two year old things. They fight over things like good sisters and don't have enough language to fully communicate their wants and needs, especially when they get emotional. Sometimes I think life would be easier if we waited a little longer to have another baby, but I'm also excited for my girls to grow up together. I know before long the girls won't even remember a time without Stella in our family. The thing about infertility is you don't really get to plan your family and time things "perfectly". 

Tomorrow W goes back to work and I take back over. I have help lined up a few days a week (my FiL is taking the girls to gymnastics every wednesday and my MiL has agreed to help Tuesdays). My mom has also said she'd help but it really depends so much on her mood how much she's able to do. I'm super nervous about having to care for all three girls mostly alone, but I'm also somewhat looking forward it. Having him home has been amazing and great, but in some ways it makes life more difficult. Getting out the door always seems to take longer with him and I don't feel like he's as firm with the girls. I've noticed a lot more negotiating and whining/crying since he's been home. 

Wish me luck (and a TON of patience) tomorrow as I take over with my three amazing little girls. I can do this!

Aunt Flo is a no-show

I popped my last prometrium pill on Monday. So here I am, waiting very impatiently for her to make her grand appearance. I know sometimes it takes a few days, but I am anxious to get started. I guess I thought the positive OPK would mean my period would come 2 weeks later. Well, 2 weeks and 4 days later I'm still waiting. 

I don't feel totally like I'm going to get my period. My boobs aren't sore at all which usually happens. My skin is breaking out on my chin which is generally an AF sign. I took a HPT yesterday and it was definitely negative. 

The main reason I am anxious is because we don't even have a tentative date for transfer at this point. At my last RE appointment he left it up in the air which protocol we would be following, perhaps one involving Lupron which means MORE TIME. I don't want to take the Lupron and I want to be able to avoid Thanksgiving and do the transfer this month.

I left it with Dr.S that I would give him a call with AF shows. Hopefully she will soon and I can convince him that we should do the FET this month. 

Becoming a more patient person

My doc called today while I was in the middle of a therapy session. As soon as my phone rang I excused myself. I felt bad just getting up and leaving for 15 minutes, but there was no way I was missing another call from him. He apologized for not calling back sooner as he was out sick Monday and Tuesday. 

Dr. S talked about the results of the biopsy. He first talked about the proliferative endometrium and said that although it was concerning, but there was nothing we were going to do about it at this time. When I told him I had only been on the progesterone one day he said that it may not have been enough time. I asked about how my progesterone levels got so high during the IVF cycle and he said that is in the blood and that my endometrium may be different. Without doing a biopsy the only thing you can do is measure the blood levels of progesterone and go by what you see on ultrasound. 

He then talked about the traces of the polyp that were found. He was surprised since he had done a sonohysterogram (SHG) in Dec and didn't see anything then. He said that they don't often pop up in a short amount of time and that there is no real reason why this would happen. He said if I had been on estrogen the entire time without exposure to progesterone, that could cause a polyp, but it isn't the case with me. The only thing that could explain why we didn't see anything with the first SHG was because it wasn't done on the high resolution ultrasound machine at their office. He wants to do another SHG on the high resolution machine and see whether we see something. He said it is rare to miss polyps on a SHG because they light right up. If we do find a polyp we will likely do a hysteroscopy. He didn't want to go there immediately because it means surgery and he doesn't want to subject me to unnecessary surgery.  

Doing another SHG means having to schedule with the ultrasound technician and my RE. He said he would try to do it before going out of town next week, but he wasn't sure about scheduling. 

The receptionist called me a few hours later to tell me they won't be able to get me in before Dr. S goes out of town next week. They will have the nurse call me next week to schedule. I was disappointed at first, but at least now we have a plan in place. I am hoping we will be able to schedule it for the Monday when he is back. Until then, I guess I just continue taking BCP's and crossing off the days on the calendar. 

We are looking at the week of the 12th for the HSG. If they find something, who knows when they would do the hysteroscopy. Looks like September is likely out for the FET. The hardest part about that is that my EDD for the miscarriage is September 30th. I really thought I was going to be pregnant again by the time that rolled around. 

Things haven't been easy the past couple of months. W said the other night that he wants a list of all the potential problems we could encounter and once we cross them all off then we know we will get pregnant. It really seems like one roadblock after another and that is something can go wrong it will. I'm starting to become more patient and understanding with this. There is really nothing I can do about it, and feeling badly about it all the time doesn't help. I'm tying to distract myself and focus on other things, but it is hard. 

I made a realization about friends lately as well. If we find a nice couple to hang out with (usually they are married), they are either pregnant or they already have a baby. As much as I like them, it is hard to spend tons of time gushing about their babies. There is no "safe" couple to spend time with these days. That means I am hanging out with younger people who are more at the partying stage of their lives. This isn't a great influence on being healthy and making good decisions. I feel like I just can't relate to any friends right now. 

A few months ago I made an appointment with the other RE in the area. I am happy with the care I receive with Dr. S. I am happy he knows who I am and takes the time to call me personally and talk for 45 minutes if needed. I am happy with the treatment as well as decisions made to this point, but at times I do feel like Dr. S is overly conservative about things. I'm not really displeased in any major way, but the price is a huge consideration. The other RE (Dr.K) has package deals, and they have one package deal I am considering. I have an appointment scheduled with him coming up in September. I never thought it would get here so quickly and I had previously hoped I wouldn't need it when I made it in June. Now I am faced with canceling the appointment and sticking with Dr. S for now until we at least complete an IVF cycle, or seeing the other doc and finding out what he has to say. I feel like my case has been so complicated it will be hard for the new doc to follow it all. Also, I have to get my file to the new doc and that means notifying my current office and making them think I'm not happy with the care I receive. Is there really any point in seeing another doc if we can't even get out of the starting blocks with my current doc?

Any advice? 

Roadblock

I'm glad I went for another ultrasound before doing the transfer. Yesterday afternoon I had another ultrasound followed by an appointment with Dr. S. The ultrasound revealed the same amount of fluid plus traces of additional fluid next to it. 

I then met with Dr. S. He pointed out the trace fluid and gave me three options. 1) Go ahead with the transfer despite there being more fluid 2) Cancel the transfer and do an endometrial biopsy, 3) Cancel the transfer and do nothing. 

We talked for a while and I asked for his best recommendation. He said none of those situations are ideal, but since we know a FET is less successful than a fresh transfer, it would be best to eliminate any other variables that may reduce the chances of implantation. He also said he would hate for it to not work and look back and say we should have waited. He looked at the ultrasound and my trial transfer and tried to determine if he could avoid the fluid. It was possible, but not the ideal placement for them. He was planning to place the embryos where the new fluid appeared. He doesn't know why the fluid keeps reappearing since I don't have a hydrosalpinx and there is no possible reason at this time. He recently rechecked my testosterone levels and they were normal (thanks Metformin!)  He's not sure we will be able to avoid this happening in the future, but it is probably best to wait and see what happens in subsequent cycles. It's not a problem I had doing IUI's or on anything ultrasound until last month. 

I opted for choice number 2. He did the biopsy right then and it was not fun. I wasn't able to take anything prior so there was a lot of cramping, but nothing horrible. It felt similar to an IUI but with much more cramping. I saw the tissue he removed and it was a decent amount. 

After the biopsy I went back into his office to get my prescription and paperwork to bring to the receptionist. At first he wrote me a prescription for oral progesterone and told me to take it for a week and then would start the protocol for the FET once I get my period. He then informed me that he is going to be out of town from Sep 1-11. We looked at a calendar and determined that if I took the progesterone and we started another cycle, the next time we would do the transfer would fall during that time he was away. He offered that the other RE in the office could do it, but I've never even met the guy. So, after some discussing with the nurse he decided to put me on birth control pills and keep me on them until he is back. That way he will be there to make any decisions and not have to communicate over the phone with the office during my cycle. 

In a sense I feel relief. I know this is the best decision and gives me the best chances for the future. I'm not sure why this fluid started appearing and has now become a chronic problem. I'm hoping giving my body a break for a month will help and the fluid won't reoccur in the future. 

I had the cyst and surgery and wasn't able to start trying until January. Once January hit we did the IVF that got cancelled because I got pregnant, a miscarriage in Feb followed by a D&C and laparopscopy #2. March was spent waiting for my cycle to start again after the miscarriage, I tried Clomid + IUI in April, injectables + IUI in May, Lupron started for IVF in June, IVF cycle in July was cancelled at the time of the transfer due to fluid, and a cancelled FET cycle in August. I need to step away and take a month off, forced or not. 

At the same time I am disappointed. Disappointed that this has been so difficult, disappointed that my body won't cooperate, and disappointed that I will be in limbo for another month. I need to step back from infertility and distract myself. I need to live life outside of trying to get pregnant and just be. This is going to be hard, but it is something I know I have to do. At this point I don't know how to not focus on TTC. We shall see how the next month pans out. As I left the office my RE apologized that we had to cancel the transfer again. My response, "I'm learning how to be patient." 

I take it back

Ok, I guess I kinda overreacted yesterday to the bad news of having a dominant follicle on the wrong side. I was super disappointed and apologize that you had to listen to me complain. 

I talked with the nurse this afternoon and she said we are going to go ahead and trigger tonight and go in for the IUI tomorrow. Rather than doing 2 IUI's as planned this cycle, we will do one tomorrow and then it is up to us to have "relations" the following day. 

My RE is hoping for the phenomenon of transmigration in which my other fallopian tube will hopefully pick up the egg. I am not counting on this, but who knows. 

I am starting to think we should just move on to IVF. The hard part is that we were there 4 months ago. On Jan 5th I started Lupron for our first IVF cycle. I ended up pregnant naturally that cycle so we never continued. It is hard to want to try something less successful, even if it is less invasive and cheaper. I am starting to think IUI's are a waste of time and energy and that I would rather focus on something that is more likely to work. The more blogs I read, the fewer positives I see as a result of IUI's. 

I work so hard all day at being patient (patient while children give me a run for my money, patient when I ask them to do something and they take their sweet time, patient with children who are not as competent as others, etc.), but I am finding I am not feeling as patient in other facets of my life. 

On the plus side I realized after giving the trigger shot that 2 weeks after my first shot in January we got the results that I was pregnant. let's hope we are that lucky again in two weeks!