Wednesday, October 14, 2009

Going to DC instead

I have been in New Jersey since Sunday night. I had 4 nights of free hotel thanks to hotel reward points (at least I managed to get something back out of all my hotel stays in the past year or so), so I am staying in one of the slightly more upscale hotels this time. And they upgraded me to a suite! It is quite nice to have the extra living space to stretch out a bit. Actually this is even be bigger than some apartments I have lived in!

On Monday I had another consult with my doctor. No big surprises, no major changes. I confirmed that we do not want to do donor eggs, and we talked about the chances at age 44 with high FSH. The chances are very small, but live births through IVF still do occur. The biggest problem I think is that we are limited to IVF because of my tubes. IVF with one's own eggs stops working completely at around 47 (even at 46 it is so unusual that it would likely be a case study), but of course natural conceptions can and do occur until well past this age, so those of you who can try naturally, don't give up! I so wish that natural was an option for us, then it wouldn't feel like it is so hopeless. I guess all the manipulation of the egg oustide the body is just too hard on older eggs.

With the anecdotal stories of successes at 44-45 years old at this clinic (including someone who I know personally), I am still willing to give it a shot with my own eggs whilst understanding the low probabilities. Since we are likely to be ending our TTC journey sometime next year, I feel that this is part of a winding down process.

As it turns out, this week's labs are pointing to a bad month for me. My FSH has jumped to 37, and E2 <10 on cycle day 10! Now if I lived here in New Jersey I would probably push on with some monitoring, because it is entirely possible that I could still grow a follicle eventually, but it would be a super long cycle. Unfortunately it is also possible to be an anovulatory cycle. Since I have a rental car and a hotel room to pay for (the free nights ended on Thursday), and out of town monitoring is iffy at best from 3 time zones away, we will be canceling the cycle.

So DP is flying up today. We'll be back at the clinic on Monday morning to freeze some sperm for a later IVF, and then we're taking the train from Philly to DC on Monday afternoon. The weather here has been miserable with rain and wind and winter temperatures, but this coming week is forecast to be sunny and much warmer. Should be lovely to see the fall colors in DC while out sightseeing!

Saturday, October 10, 2009

Maybe a cycle

I like to take a bit of a mental break after each BFN, so I have been away from the blogging and the boards that talk about TTC. And after a BFN, it doesn't quite end there. There is the post-IVF AF to deal with, usually a particularly intense version that comes several days after "the call". That always has me keeping a low profile for a few days.

Right now I am trying to come to terms with the ending of my journey while at the same time putting in some last attempts. I know that sounds kind of strange, but it is a mindset that I am trying to get used to. I need to become comfortable with the idea of moving on, and that will take time.

Looking back, after all my efforts I have only managed 3 transfers in the last 12 months, my least productive year so far. And only 4 embryos in those 12 months. Since this is a numbers game, I don't think that is good enough... not for someone in their 40s anyway... to overcome the odds.

I am so burnt out I really didn't want to cycle again this month. But I have a consult scheduled from a while back that is coming up this week, and DP has another business trip over on the east coast again. Since we are both scheduled to be traveling over there, logistically it one of our most suitable months to cycle ever, so may as well try and take advantage of it. At the very least I thought I should get some monitoring to see where I am this month.

On CD2, I had:
FSH: 13
E2: 28
LH: 2.4
Prog: 2.3

For me, these numbers usually mean that by CD5 the FSH will spike to between 20-30. Usually, but not always. And I am always pleased when the E2 comes in above 10.

So I went to my local labcorp on CD5 nice and early in the morning, in the hopes that a STAT result will make it to the east coast before they close for the day. Always a bit dicey with the 3 hour time difference, but if it doesn't make it then no big deal, I'll get the results the next day.

Well, today is the next day. And no lab results. The clinic called to confirm that they haven't received anything yesterday or today. The local labcorp offices are all closed on Saturday, so I can't chase up the results. And I couldn't find any customer service number that was open on a weekend!

Oh well, this is a typical scenario when doing out of town monitoring 3 times zones away. Wish I could confirm if my FSH has spiked or not, that would determine whether I should take estinyl or whether I should start stims.

In the end, I decided to take 150 IU of Bravelle and skip the estinyl. If the FSH has spiked up on Monday I'll just start the estinyl then. Or skip the cycle this month altogether if it looks really bad. I must be a veteran since none of this has really bothered me very much, even down to guessing what my meds should be. Gosh I remember when I first started doing IVF how I thought everything had to be exact, and the protocol couldn't be altered in the slightest. I have since learned that my ovaries tend to be resistant to pretty much everything: high stim, low stim, no stim, it really doesn't make much difference... 1 or 2 follies is always the result.

So I am flying up to NJ tomorrow, and will be at the clinic on Monday. I haven't committed to a cycle, I want to see what my numbers are first. I am pretty relaxed about it because if it doesn't look good this month, I will join DP on his business trip when he travels down to Washington DC and do the tourist thing while he goes off to work. And to be honest, I am quite looking forward to another little mini-break. But I can only go down to DC if I cancel my cycle, the timing is such that I can't do both.

And DP will be coming to the clinic no matter how the cycle goes. If I end up doing a retrieval then he will be there to do his part, otherwise he will leave a sample to freeze for a later cycle. So no pressure for him about a wasted trip to the clinic.

It is kind of a strange start to the cycle. I am flying to New Jersey tomorrow, have a meeting with the doctor on Monday but after that I don't know what will happen... if I will be doing low stim IVF at Cooper or going to DC for some sightseeing.

Saturday, October 3, 2009

Some thoughts at the end of another cycle

I like the comment from theappetiser about a series of little BFNs being better than one big BFN, that is exactly how it works for me. There is no way I could handle getting my hopes up and then getting that phone call, it would send me over the edge. I am also the type of person that goes into the ocean or pool slowly rather than jumping in, I'd rather endure the slower torture than the one big shock!

That said, of course I did get another confirmed BFN, and as expected the phone call was absolutely no big deal at all by then. I'd had several days to deal with the BFN already and I think the nurse had a harder time delivering the news than I did hearing it.

It is not so much this BFN on its own that is bugging me, but the thought of a marathon TTC journey ending unsuccessfully. At 44 years old, with IVF as my only option due to tubal issues from prior surgeries, it is just plain grim.

If it was possible to try naturally, I would at least have a non-zero chance if we quit doing IVF. After all, natural pregnancies certainly do occur into the late 40s. But a successful IVF in the late 40s with one's own eggs would be a world first, it simply doesn't work as well as natural.

I wish I were younger and could just put things on hold for a year or so and come back and start fresh after a long break. But you just can't do that at 44.

I don't regret all those IVFs that we tried. I don't even know how many we are at now, 15 IVF transfers? Something like that, possibly more. More than what most people would be willing to endure. Some of those have been natural/low stim IVF cycles, so it isn't quite as brutal as it sounds. It is the acceptance of being childless that is still the hardest thing for me. It is difficult to even get my mind to contemplate that thought for more than a few seconds. Well, I am going to have to get used to the thought. I am going to have to figure out what I want to do with the rest of my life if I'm not going to be a mother. It is still very daunting right now.

In many things in life, if you work really hard, you can achieve your goal. I am finding out the hard way that trying to conceive through IVF with high FSH isn't one of those things. Protocols can only go so far. It is a crap shoot. Pure luck plays a huge part. Or lack of it.

Many do get lucky, but there are those that do not. Usually you don't hear of the ones that do not succeed, they stop updating their blogs, they stop participating in TTC message boards. They move on. Their voice isn't heard on the internet any more, so you don't really hear of the people who give up and choose to be childless. And this can give the false impression that there aren't many of them. And that the odds of success can't be all that bad. But the truth is, for some of us, it simply isn't going to work in the timeframe that we have left.

I'm not completely done right now, but some time in 2010 will see me calling it a day.

Please, no comments on donor egg, adoption, or other family building options. After many years of IF, it is not like we have never given any thought to these options. We appreciate that we live in a time when many things are now possible, and are genuinely happy for friends that are going down these other paths, but for reasons that we do not want to go into here, we have decided that these options are not for us.