Saturday, April 28, 2012

Our IVF Plan

After the laparoscopy findings last week (where a large nodule was removed), our friends have been thrilled that we've finally located the source of our infertility.  Now our family and friends tell us "you guys can probably conceive naturally now!  Just relax and have some fun."

These words made me shudder.  It reminds me of the years 2007-2009 when I was convinced we had a fertility problem but Doctors, family and friends tried to tell us "it would happen."  Clearly, it wouldn't happen as we had many infertility issues to overcome. 

I don't want to get my hopes up that we will conceive at all, let alone naturally.  During our first IVF attempt, NONE of our eight eggs fertilized naturally.  We obviously have some sort of problem in the fertilization department (likely DNA fragmentation) that is overcome by PICSI during the IVF process.  But this problem is likely to impede or significantly slow down the chances of a natural conception.  I estimate we may have a 10% chance of natural conception now if we tried for a year.  Not good odds. 

So I want to keep going with IVF.  IVF gives us our best chance.  But it's expensive.  Very expensive. And it's been causing problems in the family.

DH's parents don't want us to continue IVF. They think it won't work and it's a waste of money.  Their attitude upsets me, as I don't think it's any of their business how we spend our money.

My parents are the opposite. They see how much I want a baby, and they're willing to help financially. 

So, now we just have to decide what to do.  IVF?  Try naturally?  Give up?

It feels that we've come too far to give up now.  It feels so CLOSE to a baby.  We can make good embryos. We just need the right embryo.  And now my endometriosis has been resolved, it should help our chances.

So DH and I have agreed to a plan.  It's basically easier for me to have a "plan" for the year that we can follow, rather than trying to make decisions based on raw emotions (particularly following a BFN). 

So, this is our plan.

May - Healing from laparoscopy and internal stitches.
June - Transfer last frozen embryo.  If negative......
July -  One month break to "try naturally." (I can tell this to the in-laws if they ask me...I can say "we're not doing IVF right away.  We're trying naturally" even though it's only for one month).
August - Stimulated IVF cycle.  This would be our 5th IVF cycle, so I can't imagine what will happen if this doesn't work.

God, I hope it works!

Wednesday, April 25, 2012

Momentum

Finally after months of feeling that things were "on hold" in the fertility department it's wonderful to have some momentum.

After the laparoscopy this week, I've been mentally thinking of anything we can do to move forward from here.

I've made appointments with my RE and the surgeon to ask some follow up questions.

I've been researching fertility supplements for DH to improve his sperm fragmentation issues. If there's a small chance the surgeon thinks we can conceive naturally (even if I don't quite believe him) I want to do everything we can to improve our chances of conception or future IVF. 

I've just found some very expensive male supplements that I've ordered online.  DH and I discussed it before buying them.  We agreed that we don't want to have any regrets - no stone left unturned.  Whether we are successful with a pregnancy or not, we want to do everything in our power to make it happen.  So the supplements are en route as I speak (I dread to even look at our credit card balance these days!)

So then next steps:
1.  Meet with the RE in May to discuss findings of laparoscopy.
2.  Meet with surgeon in early June for post-operative review, review of natural killer cells test, and recommendations for further IVF.
3.  June - FET using our last frozen embryo.

I'm not sure what we'll do if the last embryo doesn't work.  I guess we'll do another IVF cycle if the RE thinks it's worthwhile. One step at a time though. 

I"m feeling good mentally - finally I can see some light..

Tuesday, April 24, 2012

Interesting lap findings

I had the laparoscopy this week.  My RE wasn't sure if I needed one, but I felt that something wasn't right so I went ahead with it.  Boy, am I glad I did.

The surgeon was very surprised by the findings. He removed a very large endometrial nodule (the size of small orange) that was impacting on the uterus and some other internal organs.  He was able to remove all of it, and he doesn't think it will grow back again.  Most likely I've had it since a teenager, and it's been a significant part of my infertility.  It was evidently missed by the previous surgeon who diagnosed moderate endometriosis back in 2008 (how he could have missed a nodule the size of an orange was beyond the comprehension of my current surgeon!)

He seems to think that now the nodule has been removed, we have a good change of conceiving naturally.  As thrilling as it was to hear that (and it was very exciting to be told that after years and years of infertility treatments), I haven't taken it to heart.  The surgeon doesn't know my DH's sperm issues and high fragmentation rate meaning that it's unlikely we'll fall pregnant naturally.  But anyway - it was a lovely thing to hear after waking up from surgery "we've found something significant that's likely been the cause of your infertility - we've removed it and you've got a good chance of conceiving naturally now." 

The surgeon also took a biopsy to test for natural killer cells, to see if immune issues may be a problem.  It will be good to get these results back too.

The findings from the laparoscopy are significant step forward for us, and explain why the last three IVF cycles haven't felt right (and have been negative).  It also gives us hope for moving forward from here. 

The next step?  I'll go and see my RE in a few weeks after I'm feeling better physically.  We'll discuss the surprising results of the laparscopy, and re-evaluate future treatment with this new knowledge (maybe now we're just dealing with male factor issues, rather than my issues too). 

Then I'll go back to the surgeon and get the results of the natural killer cell test.  He also wants to show me some photos of the surgery.  Apparently it was quite something.

I also want to get the surgeon's opinion about moving forward from here.  I want to discuss DH's sperm issues with him and get his perspective. Does he REALLY think we can conceive naturally even with DH's issues taken into account?  It just doesn't seem possible to me, after dealing with infertility for so many years.

I'm feeling a bit sore now, but very very thankful.  I feel I've been lucky.  That our unexplained infertility issues are finally coming to light and being resolved.  Surely this makes us one step closer to having a baby?

Wednesday, April 18, 2012

Things aren't quite right

Our infertility journey has been "unfolding" (or rather, dominating) our lives since we came off birth control in 2005.

Back then, we had no idea what lay ahead of us. Being two 26 year old fit, young things, we assumed back then that we'd be able to have as many kids as we wanted when we wanted them.

But things haven't turned out that way for us. Fast forward to 2012, and here we are with one beautiful miracle two-year old, and an unfolding infertility story.

Over the course of the years we haven't known what was "wrong" with us. At first it was unexplained infertility. Then after the first laparoscopy I was diagnosed with endometriosis causing poor quality eggs. Then they thought the problem was overstimulation from the drugs and that I was fine. Then came DH's sperm DNA test which revealed high levels of sperm DNA issues (meaning we'd be unlikely to fall pregnant naturally).

We thought we'd overcome all of those issues when we had our beautiful DD two years ago. We assumed along with our RE that we'd be able to have another child. But here we are almost one year after starting out on our IVF journey to have another child, and sometimes I wonder if it will ever happen.

I've been getting some strange menstrual symptoms. Things just don't seem right in my body. I've been getting loads of spotting for two weeks before my period, and also lots of symptoms in my pelvis. I think it's the endometriosis back again. I'm so thankful to be having this laparoscopy next week to hopefully get rid of it.

Things in our personal lives have also been difficult. DH has been getting tension headaches morning and night. So I've been trying to do everything around the house to lighten the load. It's exhausting. But I'm learning to just do what I can, and let the rest go. The floors are horrible and need a good clean, so I'm going to pay for the cleaners to come in today. We dont' care about the cost today - we're just too tired from everything.

Hopefully things will be better next time I write and the laparoscopy will be over with. Then we can get on with our fourth cycle of IVF trying for another baby. At least we now know what is wrong and it can be fixed. It's just been such a long and expensive road which seems to reveal more problems and no pregnancy.

It seems like we've been enduring infertility for years. Well, it has been years (since 2005). I just want this part of my life over with. No more IVF, surgeries, financial strain caused by ongoing treatments and difficulty coping with my friend's pregnancy announcements. I just want to get on with life and leave this all behind me. It's all been a bit of a nightmare.

Tuesday, April 10, 2012

The surgeon says...

I went to see the surgeon, to get an opinion on whether endometriosis is a problem. I was previously diagnosed with endo a few years ago and after a laparoscopy I fell pregnant with DD. I've been getting some symtpoms of endo returning, and I think it may be part of the reason (or the full reason) why our seemingly "beautiful" embryos (as described by the RE) aren't implanting.

The surgeon was a little strange in his manner, but a kind man. He listened to my history and symptoms, and he agreed that he thinks endometriois is a likely reason why IVF hasn't worked.

We discussed immune therapy. I've researched it online but my RE is reluctant to put me on any immune protocols yet (due to the side effects). He agreed that it may be an issue - and he's going to test for natural killer cells when he does the laparoscopy.

He is going on a vacation next month and has only one day of surgery left before he goes. His surgical list was full...but much to his assistant's horror he insisted on squeezing me onto the surgical list before he leaves. Thank you!

So now I'm scheduled for laparoscopy surgery to remove any endometriosis and test for natural killer cells that may be preventing the embryo implanting. The surgery is the week after next.

Oh - and the BEST part about the meeting (apart from finding a Doctor who has the same thoughts as I do), is that he said without a doubt that he expects we'll fall pregnant again. And then he repeated that he has no doubt we'll fall pregnant again (after the endo has been treated). So that was a wonderful thing to hear. NB. I have heard my RE say this and it hasn't worked out so far, so i'm not counting on it. But both my RE and the surgeon have independently given us a good prognosis now which is very encouraging.

So now it's full steam ahead for surgery in a fortnight! I'm feeling positive again for the first time in a long time.

Monday, April 2, 2012

Where I'm at

Sorry it's been a while since I last wrote. Things have been pretty crazy in my life lately.

On the trying to conceive front.....I went to see the RE and she suspects that I may have endometriosis. She doesn't necessarily think it would stop an embryo from implanting, but it may. She gave me the option of having another FET to see if it works, or going to see a specialist endometriosis surgeon. I decided to book in and see the surgeon and i'm seeing him next week. I don't want to go ahead with an FET and waste our last embryo if endometriosis is a problem. I'd prefer to have a laparoscopy, have it removed and then proceed with more IVF.

So, we've been on a bit of a "forced break" from IVF while waiting for the appointment with the surgeon. It's been a good thing to have a break. It's difficult to fit in socially as many of my friends have now had second or third babies, and I feel different. But i'm determined that I won't let infertility ruin my friendships. So on "good days" I'll invite my friends and their newborns over and we'll have a great time. On "bad days" I avoid them and hang out with my other friends without newborns or pregnancies (so I don't have to think about it). I'm lucky to have a wide range of friends which helps a LOT.

On a personal note my Grandfather just passed away. He's been sick for a long time. It's been emotionally draining to spend so much time at the hospital with him while he was sick. DH and I were fighting from the stress of failed IVF combined with wanting to be at the hospital all the time. As soon as he passed away we felt a sense of great sadness but relief that he's no longer suffering. So the past few weeks have been about mourning his life, sorting his possessions and coming to terms with the fact that he's no longer around.

My friends have been wonderful - I think they feel a bit sorry for me with the failed IVF attempts and my Grandfather dying. I've received gifts and cards from friends, and I really appreciate it. I don't feel like I deserve them but I appreciate them.

I try not to think about the future at the moment. It's too depressing to think we may not have another child. I just try to enjoy the day, and enjoy being with DD and my husband and family. It helps a lot to not worry about the future.

So next step - meet with the surgeon next week. Book in laparoscopy for sometime hopefully soon. Have endometriosis dealt with. Proceed with further IVF. If it doesn't work, I'm going to ask the RE to put me on immune therapy (she has been reluctant to do so). If that doesn't work, then we're out of answers and it's the end of the road. I'm trying not to think like that - just taking each day as it comes.

I'll update again after seeing the surgeon next week.

Thanks for reading this little blog!