IVF #4 / FET #2 ... how did I get HERE?

I can’t even recall how I got here: IVF #4, FET #2. It’s like having Infertility-Alzheimer’s.

After a weekend of deep-thought and very little discussion between me and R, I decided to go with option number 3: injections. I figured it was time to call out the big guns and quit the screwing around with indecision. I’ve done injections before and since we’d treat an out-of-phase lining with injections anyway, I figured let’s go for the gold. So, on Monday morning I called the RE’s office to tell him that I had started my period on Sunday afternoon and waited for the return call. The nurse called a few hours later to let me know that the biopsy results hadn’t come in yet, so they would call back on Tuesday morning. On Tuesday, the RE calls me himself to say that he has good news and bad news. The good news? My instincts were right on. The bad news? My lining won’t sustain a pregnancy. Just fantastic, really. Just knowing that it was probably my body and not a genetic abnormality that made me lose the baby in February was enough to make me want to die. After all of this, my lining is probably the problem. Let’s see, how long have I been griping about my thin lining problem? (A quick scan of past posts reveals that the first time I mentioned a thin lining was on Monday, June 25 after my one cancelled and two completed IUI cycles.) I’m furious at myself for not requesting the biopsy a year ago. I’m frustrated that it took this long to get to where we are, only to have to worry about the same problem that I’ve been worrying about since the beginning. I’m upset because my body probably caused that baby to be miscarried, not ‘nature’.

So, after a brief discussion with the RE, we agreed that the injections are the best course of action. I asked the RE what he would prefer to do and he answered “the natural cycle”, but I’m just not up for that. We did too many unsuccessful natural cycles to be able to say it’s worth it right now. I need some results. I need some hope again. Trying a new treatment is the only way I’ll get that hope back. I need to see my body respond to SOMETHING.

And, right on time, while I’m spinning deeper and deeper into my own personal despair, R calls to tell me that his sister had her baby. Healthy and everything. It takes all my strength to not burst into tears right now. There are so many reasons why that news is just painful, but I think above all it’s because I feel as though he doesn’t even care to tell his family how hurt I am right now. He doesn’t bother to take the time to explain what life if like for us right now and so they end up thinking I’m the cold, distant, terrible daughter-in-law. They make a million and one excuses as to why I should have felt bad for R’s sister when she was trying but because I already have a child, I shouldn’t feel anything now that I’m infertile. God, life is a terrible, slow, evil torture lately.

I’m feeling so angry and annoyed these days. I’m so tired of people not realizing what they have, how freaking LUCKY they are to have the life that they do. I’m tired of people complaining about their good luck, about how awful it is to be pregnant. I’m tired of seeing people get what they want at the drop of a hat, or making a big deal of their little tiny two or three month struggle, and not even care how life goes on for people like me, suffering and struggling just to create another life. It's has been 25 months for me. I’m tired of the utter un-fairness of all of this. I deserve to be a mother again. I deserve it. And I may never have it.

Infertility testing as medieval torture.

Have you ever looked at a picture of medieval torture devices? If so, you may have recognized some of those instruments as appearing in your local REs office. I swear, the tools they use could only have been developed by a man. There’s no way a woman ever would have wanted to develop a ‘cervical skin grabber’ and unleash it onto her fellow women. I just refuse to believe it.

So my biopsy went as well as an internal, still-awake-for-the-entire-thing procedure could go. My cervix was being particularly petulant and had decided that it didn’t want to come out to play like a good little cervix. So the RE had to use this terrible ‘pin-it-down’ device which then led to having to use the ‘cervical skin grabber’ (and I swear these are his terms, not mine) to force my cervix open. Yes, force was used. And yes, it hurt as much as you might imagine. Probably more. I nearly jumped off the table, but the nurse came and grabbed my hand and the RE told me to count down from ten, which at least got my mind off it. A few little suctions with a catheter lately and I was a few endometrial cells lighter.

After our little biopsy party, the RE had me meet him in his office to discuss the options for next cycle. He really wants to do an unmedicated, natural cycle so he can see what my body does after being on fertility drugs for almost a year. I’m not so keen on that option, but he seems sold on it. I’m still gunning for trying to replicate our September cycle where the lining got to 7.5mm, but even with that, he wants to try it with no estrogen. Once again, we differ. My body just doesn’t process estrogen the way it used to, so I’m thinking giving it that little extra boost with the Femara might be all that it needs to get that lining fat and then we can concentrate on getting it trilaminar. Decision, decisions. You know, it just should not have to take this much thought to get pregnant. It just shouldn’t. So, the options are as follows:

1. Do a natural, unmedicated cycle using only an OPK to time the blood work and ultrasounds. When I get my first peak reading, get blood work done to measure progesterone and other hormones (possibly estrogen and LH) and then once the progesterone gets to a certain level, schedule the transfer. Get pregnant.

2. Assist ovulation with letrizole (Femara, taken for five days) to force my body to make more follicles thereby making all those follicles make extra estrogen with the hope that it makes a nice thick lining early in my cycle; add extra estrogen for five days after ending the Femara to keep the estrogen-train going and hopefully getting that lining nice and thick. Induce ovulation, monitor with a few blood tests to make sure progesterone is high enough and schedule the transfer. Get pregnant.

3. Use injectable medications to perform the same task as the Femara, but at a higher, more potent doseage (not as high as an IVF cycle, but higher and more reliable than Femara). Do this with the hopes that all the extra follicles will make natural estrogen and a thicker lining. Induce ovulation, monitor with a few blood tests to make sure progesterone is high enough and schedule the transfer. Get pregnant.

4. Give up all hopes of ever having another child and get on with my life.

Right now, I’m leaning towards number 2, with number 4 as a strong back-up.

The RE wants me to take the weekend to think about it. In the meantime, he’s going to wait for the biopsy results. Which, of course, could change everything. Good results would throw me into choosing between number 1 and number 2. Bad results would force me to consider option 3 or 4.

Decisions, decisions.

Cancelled and holding.

After giving it the ‘old college try’ (as one nurse put it), my RE cancelled this FET cycle. Talk about a blow to my psyche. It’s awful to be on the receiving end of a cancelled cycle. Actually, awful isn’t even a strong enough word. Ugh. I’m just SO tired of all of this IVF stuff. I’m trying every day to just hang in there a little longer. As though it will get better. I wish with all my heart that I just KNEW it was going to work and we’d end up with a baby. It would make all of this torture worth it, if I just knew the outcome would be worth it. Why does everyone else seem so damned sure that it’s going to work for us? What do they see that I DON’T?

The RE was so puzzled as to what was happening that he wanted to see me face-to-face rather than breaking the news about cancelling the cycle to me over the phone. It’s admirable, but I’m sick of going to that office just to get more bad news. We’ve decided to try an endometrial biopsy to see if we can figure out what my lining looks like up close, but I have a sneaking suspicion that it’s not going to be good news. I’ve looked and looked (online) about how to treat a lining that ‘fails’ an endometrial biopsy but there’s very little information out there. I asked the RE what he would do to treat it if it’s out-of-phase (which is a failed test result) and he said something about injectibles and FSH. That confuses me because they usually use FSH to stimulate your ovaries. I’ve taken it in the past for my two (FAILED) IVF cycles, and it didn’t do jack for my lining. Sure, it makes me produce more eggs than a chicken, but it doesn’t fix my lining issues.

In the meantime, R and I have decided to go forward with one more attempt with this RE. We have an appointment with another RE for a second opinion on April 28; I got the intake forms last night from the new office and I was completely intimidated by the packet. There’s so much information that they ask for; it’s hard because my doctor already knows all of this information. Is it really going to benefit me to go over all this again with a new doctor? It’s such a hard decision.

My current RE and I discussed what we should do with the next cycle. I remembered that my lining got to 7.4mm in September when I was using the Femara, but looking back over my chart, the RE discovered that was also the only time my lining didn’t achieve the triple stripe appearance it needs to be viable for a transfer. So it appears as if I’m damned if I do and damned if I don’t. Still, he agreed that we could try to mimic that cycle and see if I respond the same way. We just have to make sure that I don’t ovulate prematurely.

Just another day in IVF paradise.