Out of the archives...

It's been a couple months since I posted or even looked at the blog. It seems like the hit counter is a lot higher than last I looked. So if anybody is reading this, I hope it's helping. Or means something to you. It's been really a couple rough months. The miscarriage happened in June. It's now September and my body is just barely recovering. Mentally I'm not sure I'd say I'm as well. Intended D and I have been fighting more than we probably have in the last 8 years of our marriage total. We are at a point where we both feel really helpless. "I feel impotent and out of control. Which I really, really hate."--- to quote Clueless. (would it be funnier if impotence were our problem? I dunno.)

I am not worried about our marriage per say. I'm more just worried about our mental health. We have finally reached that point where it feels like there are no answers. Having a donor cycle fail. Man. We just didn't see that possibility as a strong one. Donors are supposed to be the solution aren't they? That solution that we finally take the plunge and accept. The option we finally embrace as that one gift that comes with a huge compromise --- but a compromise that gives us so much that it's worth it.
And then when that fails, then what?...
Then we move on of course. But it's so painful. How many times do we have to compromise?

We have one more frozen embryo using donor eggs. One more. So now the questions start surfacing... Should we get a second opinion? (or more like a third, because this is our second serious IF clinic and we have had the same outcomes from both of them...)
So a third opinion would have to be from one of the miracle clinics... Cornell or Sher or one of the voodoo doctors who don't follow the protocols established by the mainstream docs but who seem to make occasional miracles happen. But are they really miracles?
And the more important question is: do we have the emotional stamina to actually track down the miracle solution? *sigh*

From the archives of my email I found an email that I consider a third, fourth and fifth opinion. We were the case study that was presented at our clinic's monthly case study. They all discuss the case, figure out as a group what's going wrong. This was from February 2008. Yes, a year and a half ago, when we started up with IVFs at our current clinic and had a failed cycle. It was already our 3rd IVF total. So the following is an email I sent to Intended D. Because we are using this blog as a record of sorts, I thought it would be a good idea to post it here so remember these details which I am prone to forget in the abyss of treatment cycles and protocols, conversations and phone calls that have occurred over the years...
---- Original message ----
Date: Mon, 11 Feb 2008
From: Intended Mommy
Subject: conversation with the doctor
To: intended D


So I spoke with the doctor for about 15 minutes.

The information from the cycle indicates to her that it goes back to my egg quality again. We had 27 mature eggs, and only 14 fertilized normally. There were another 7 that fertilized abnormally. She said that is an indication of egg quality, like what we talked about with (our first previous favorite RE).

Normally this is correlated with diminished eggreserve, but of course in this circumstance, I havelots of eggs, they are just abnormal. She had no explanation for this, the science hasn't come that far (although she didn't say it that way...)

She is going to present our case at their weekly case meeting, to get other feedback from other doctors. So that'll help, and she'll get back to me next Tuesday. The suggestion she made re: protocol is changing it to another protocol where you don't use lupron, but use another drug to maintain suppression of the ovulation. It's called an antagonist protocol if you want to look it up.

There is no data to suggest it is going to work. It's just another thing to try, to see if the embryos look any better.

She suggested if this next cycle doesn't work, she would be ready to recommend donor eggs, although she would be willing to work with us up to maybe 6 cycles if we wanted to. The arbitrary chances she gives us are 25% chance of IVF working. She has seen women in my situation, but it's not common. (The more common situation being diminished egg production...)

She doesn't recommend genetic testing because it requires removing a cell from the eggs at day 3 and then putting in blastocysts. It takes 2 days to assess the chromosomes. She doesn't think the embryos would be worth compromising because our embryos don't survive to day 5 anyway. NONE of the embryos grew AT ALL after day 3 this time around.

One thing she would have us try is a blood test checking OUR chromosomes -- checking the karyotype. If we come back with any mutations in our chromosomes, it might explain the poor quality of the embryos. It's UNLIKELY because we don't have any strange qualities that manifest. But it might indicate something that would at least tell us that we are not likely to create a health embryo at all..., so she is going to send us a lab slip to get it tested. It takes a month she said.

She doesn't think it's immunologic because that is typical for recurrent pregnancy failure more than just poor quality embryos. And she doesn't think it's the endo because again, all signs lead to poor embryo quality. Bottom line is there isn't much that can be done about poor embryo quality. (Unless we see a miracle doctor, of course) So for now we are going to wait until next week to see what comes out of the conference with the other REs.

(aren't you glad I took notes?)

---------------------------------------------

if anybody is wondering, the karyotyping came back normal, the immunologic testing I had after the miscarriage in June indicated an abnormality in the MTHFR but not an abnormality that explains anything. And of course here we are with donor embryos and we've still failed. What do we do now? Plan F was and still is adoption. We will love our child regardless of where the child comes from. I'm just tired.

At the movies...

IM and I went to see Julie & Julia yesterday afternoon...matinee price, baby! It's certainly a good movie and that "phony-balony" Meryl Streep is amazing in everything she touches. So when you add Amy Adams and Stanley Tucci...and, hell, I'll even include Nora Ephrom...then you are guaranteed at least an enjoyable movie.

(one might consider the rest a "spoiler" so if you haven't seen the movie and can not accept any surprises being ruined, however slight, then stop reading)

There really interesting thing to IM and I is that there were a couple scenes pointing out Julia Child's apparent infertility (or to be fair her and her husband Paul's infertility...not like finding who to blame is even a worthwhile enterprise except for diagnosis and treatment). The first scene is really subtle and I wondered who else noticed (other than infertiles) where Julia and Paul are at the park and a woman pushing a stroller strolls by :) and there is just a pause...and Paul squeezes her hand a little bit more and she glances his way. The 2nd is when she reads a telegram announcing that her sister is pregnant. She reads it in Paul's presence and proceeds to break down in tears while assuring him that she is very happy for her. It kind of chokes me up just writing it. It was a very well done scene.

Anyway, another interesting thing is a few movie critics (notably salon.com) and film bloggers noticed the infertility part and mentioned it in their reviews. Of course, any asshole with an opinion can opinionate and the review at salon.com got some interesting ones...such as this one, this one, and this one. The first two are completely asinine and rolling infertility in with feminism...come on! There is a rule: don't talk about shit that you don't understand. It's very simple and yet so many people don't follow it. The third one though is a little more interesting. How do we know Julia Child was infertile...was she? According to her biographies she never had kids and thought it would have been nice to have had them. But, I think it's a stretch to say it was no big deal to her. How do we know what a super positive, private, woman of her generation thinks. We barely talk openly about infertility now and it's 2009 for god's sake.

I guess I'm just curious about Child. There is always that sense of the infertility "club" so to speak and learning of a member you were unaware of is always kind of fun. Is fun the right word? I suppose it's nice to have evidence that you are not alone and that someone as accomplished and famous as Julia Child dealt with the goddamn bitch of an unsatisfactory situation too.

Oh...and evidently Julie Powell has PCOS....so she's in the club too. Too bad for her...but I'm happy she's open about it.