Oh, there you are hope.... I've been looking for you

Two weeks ago we had our phone consult with Dr. Ahlering (the IVF doctor). It was a lengthy conversation in which he answered many of our questions. He also gave us a lot to think about. Basically he gave us two options. Option #1: We could do a traditional fresh IVF cycle and transfer. This option would mean we would do the prep for IVF (injections, ultrasounds, and blood work). Then the week of the egg retrieval we would go to St. Louis (where Dr. Ahlering's clinic is) for daily monitoring until my ovaries are ready for retrieval. At this point they would fertilize whatever eggs were retrieved and watch them as they hopefully develop into viable embryos. Once viability is achieved (usually 3-5 days) two embryos would be transferred back into my uterus- where hopefully one would implant. At this point if we have any embryos left they would be frozen for future use (more on this later). At this point I would continue some injections to encourage implantation and growth. 

Option#2: Everything is the same until after the retrieval. Once retrieval has happened we would go home. They would continue to watch our embryos grow. Once the embryos reach viability all of them would be frozen. Then when we were ready- typically a month or two- we would return for the transfer of two viable embryos that survive the thawing process. There are two advantages to a frozen transfer. The first advantage is it would mean a shorter stay in St. Louis leading up to the egg retrieval day. This is because if we choose this option we would have ALL monitoring done in Tulsa until the day of retrieval.  Then we would go back a different time for the transfer and stay just one night. So it would mean instead of possibly two weeks in St. Louis we would only be staying a few nights total. The second advantage and the reason we ultimately chose this route is because of something Dr. Ahlering called endometrial advancement. He said that he has seen an increase in success rates because of the frozen transfer method. He attributes this to the absence of endometrial advancement. This is basically a side effect of the stimulation medication given to make your ovaries respond appropriately prior to egg retrieval. What happens is because of the hormones the endometrium lining advances faster than normal. So as a result when a day five embryo is transferred the endometrium lining may already be on day 7 or 8 which may impede implantation. Dr. Ahlering has been monitoring this by biopsying all patients on the day of egg retrieval. He says he has seen this condition in about 70% of patients. He said some still get pregnant and some don't. So because of this risk and because of the easier travel we have chosen to do a frozen transfer. We feel like based on the information we have this will be our best option at this time. To address embryos frozen but not transferred: it is possible that we could have more than two viable embryos. If this happens the remainder will stay frozen. If the first transfer doesn't take then we will thaw two more to use for another transfer. If the first transfer does work (and we are praying it does) then we will have he remainder of the embryos to try in the future for more children. There is also the real possibility that only one or two embryos will make it to transfer. There is also the possibility that none will. Although this possibility exists-we are choosing not to dwell on it. We are very aware of the statistics and he chances for failure. Right now we both feel so hopeful and until proven otherwise we will remain so! 

I want to touch a little bit on some of the thought process that brought us to where we are. For sure a lot of thought and prayer has brought us to our decision. First of all- if this has taught me anything it is- you can never ever know what decision you will make in a particular situation until you have been faced with it. Fertility like many things causes most people to have an opinion one way or another. To be perfectly honest even pretty far into this journey I was one of those people. I would think about IVF and say no way could I do that. I look back at those statements and feel shame- not because I have went back on what I said but because I was judging a situation I knew nothing about. Every couple must make the decision they feel is best. Literally not one other person can tell you what you should do. If I could talk to my old self I would say- YOU HAVE NO IDEA WHAT YOU ARE TALKING ABOUT! I truly believe the decision is up to the couple. Now don't get me wrong- I have asked people, read books, and searched for countless hours on the internet looking for the right answer. By the way it can't be found because there is not a right answer. There is only a right for you answer. For me the issue I took with IVF was an ethical one. I wasn't sure if this was something God really wanted us to do. There is A LOT of science involved. So I began to pray along time ago. I felt like I was leaning toward adoption while I knew my husband wasn't. I prayed honestly that God would change Tim's heart and open it to adoption. The more I prayed the craziest thing happened- He changed my heart instead. I felt more like God was leading me away from adoption and toward IVF. I have come to the point where I feel like 100% this is where God has led us. Now that is not to say that adoption is not a miracle and exactly what some people should do. I am also not saying that God is not going to lead us back to adoption someday. I am just saying right at this moment God has closed that door in my heart. I also will not say that IVF is right for every Christian couple. Again, this is something everyone must decide on their own. I will say this one thing- I believe that regardless of what happens scientifically in a dish outside my body- if I am lucky enough to see that living, breathing baby on the screen- it is nothing short of a miracle created by God. The scientist can do whatever they want but only God can give life. 

We desire your prayers as we move forward. We have chosen not share any exact timelines at this point. We want to process all of this privately. As we go if we feel the time is right we will share what we can. 

We are very excited and hopeful for the future and pray God will continue to guide us. 

Another day.....lots of dollars

It's been awhile since I posted an update. We took the month of May off from fertility treatment to think about what our next step should be. We met with Dr. N this week to discuss our options. He talked to us a lot about odds and percentages of success. He was very willing to do whatever we wanted. We have had three unsuccessful medicated cycles at this point. Dr. N said that we could try a couple more cycles this way if we liked but our odds would still only be 6% per cycle. The other option he presented was in vintro. This is something we have really been praying about because we knew at some point we may be faced with this decision. We both feel we are ready to move to this step. Although it is much more involved and pricey (hence the lots of dollars in the title), it also offers the best chance at success. The success rate for a single cycle of in vitro for someone my age is around 60%. Ten times the rate of success for IVF versus our current method of treatment. I like those odds. Though we are proceeding cautiously optimistic, I do feel very hopeful. I will not go into the specifics of IVF for the non fertility friendly readers in this post. I will get into that more later. On Thursday we have a phone consultation with the IVF doctor who is in St. Louis. After this I feel like we will know for sure what the next few months will hold. I will post an update after this meeting. In the meantime we would appreciate your prayers that we make the right decision. 

A quick update

I have been putting off writing this post mainly because I just didn't know what I wanted to share and what I didn't. I will just start off by saying if you are one of the three people reading this and I talk to you on a regular basis if you have questions feel free to ask. If it isn't something we want to share I will tell you. Sometimes I really feel like talking about it and sometimes I don't. Regardless of whichever mood I am in being asked always makes me feel good because I know other people care. We are currently seeing Dr. N on a very regular basis. I will not bore you with all the gory details but will give you some info. What we have been doing for the last three months is what the fertility world calls "combo" cycles. I see Dr. N at the beginning of each cycle and he does an ultrasound to verify that my ovaries are "quiet". This means that the polycystic crazy is calm for the moment. Then I start an oral medication called Femara. This medications job is to help my ovaries sort out a few dominant follicles. When you have PCOS like I do your ovaries tend to have several follicles (potential eggs) that never become dominant and therefore never maturing. This goes back to the reason Dr. N does a baseline ultrasound. He wants to make sure that after being stimulated and going through a cycle my ovaries quiet themselves back down like normal people do at the end of every month. So far my ovaries have cooperated in this. So the Femara helps my ovaries isolate a few dominate follicles to be prepared for stimulation. After taking the Femara for 5 days I start the stimulation medication called Follistim. This is an injection I give myself in the stomach once a day. This medications main job is to get those dominate follicles good and plump so they will be ready for ovulation. After three to four days of "stimming" (giving myself the Follistim injection) I go back and see Dr.N for yet another ultrasound. This is to check the size of the follicles. Dr. N will then give us instructions based on the size and number of follicles. Typically he has me do a bolus injection (double regular dose). Then I give myself yet another injection called Ovidrel. This medications job is to cause the follicles to release an egg for fertilization resulting in ovulation. Without medicated assistance my body does not ovulate on it's own. So in case you are counting in a one month cycle I give myself at least five and sometimes six injections in the stomach. Fertility treatments are not for the faint of heart and what we are doing is mild compared to what I would have to do for IVF! After I give myself the Ovidrel...which is also called a trigger shot, Dr. N then has me start Progesterone. The Progesterone aids in implantation of the fertilized egg and also helps prevent miscarriage in some cases. I supplement with this until I start again or until I get a negative pregnancy test. Once becoming pregnant I will likely supplement through my first trimester. We have completed three cycles this way. We are not sharing exact timelines for two reasons. One is when we do get pregnant we would like to be able to share it with everyone in our family at once. Two is because on the day that I test if it is negative that is something we have felt better about handling privately. These days tend to be rough for us and it is hard to talk about right away. Our doctor is very encouraging and constantly reminds us that it could take several tries before it works and to not be discouraged. So this wasn't as short as I was planning but I felt I needed to update. Please just continue to pray for us that God will guide us in our decisions. 

Some good news and a little perspective

I meant to write this post yesterday but just didn't do it. This week we got a little good news. One of the nurses for my new doctor (I will be calling him Dr. N from now on) left me a voicemail on Monday. She asked me to call her back but said it wasn't an emergency. Even though her tone did not hint at all that something was wrong I instantly broke out in a cold sweat. I knew they had sent off some blood work when I was there last week so my fear was that something had come back abnormal. I immediately called her back and was told she was in a room and that she would return my call. I then sat and waited for what felt like hours but was really only like 10-15 minutes. Did I mention how much I love this clinic!!! When she called me back she began to tell me that in the 3 vials of blood they drew, they ran a test called AMH. As I have quite an extensive knowledge of all things fertility I knew of this test but I didn't know exactly what it was for. She said it gives them a picture of my ovarian reserve. She said my number was "excellent"! It was at this point in the now two minute conversation I allowed myself to exhale. She went on to say that this test lets them know that we do not have to be in a hurry. Basically I am a ways from menopause.... Even though I just experienced menopause for six long months! This is good because if my level had been low the doctor might suggest we move right on to IVF as to not waste any of the ovarian reserve. The nurse said that they usually get concerned if the number is 1 or below. Mine was 4.05. I thanked her for being the bearer of good news. She said the doctor asked her to call because he wanted me to know. Again I love this place!!!! It has been my experience in the past with fertility stuff, doctors don't usually call unless the news is bad. I am so appreciative that they called me for good news. After I got off the phone, I of course googled all about AMH. Apparently there are 4-5 levels depending on which study you read. The good news is my number is in the best category either way. I think this is the first time I have gotten a good grade on a fertility "test"! 

After getting this news I have felt so hopeful this week. Yesterday I also gained a little perspective . My devotion that I read every morning was entitled "Great Expectations". The author of the devotion gives the scripture of Philippians 1:12-21 as a reference. The author talks about Paul being in captivity and how being in that situation did not alter his hope or happiness. I am going to quote directly from the devotional:

"I once asked a counselor what the major issues were that brought people to him. Without hesitation he said, 'The root of many problems is broken expectations; if not dealt with, they mature into anger and bitterness.' In our best moments it is easy to expect that we will find ourselves in a good place surrounded by good people who like and affirm us. But life has a way of breaking those expectations. What then? Stuck in jail and beset by fellow believers in Rome who didn't like him, Paul remained surprisingly upbeat. As he saw it, God had given him a new mission field...... Paul never expected to be in a great place or be well liked. His only expectation was that 'Christ will be magnified through him'(v. 20). He wasn't disappointed." 

I will tell you this spoke directly to me. I have been disappointed so many times by MY expectations. I am not saying we shouldn't be hopeful or believe that things are going to work out. But I think there is a difference. Expectations are the limits that we place on situations.... on God even. Imagine what I could see Him do through me if I would stop expecting Him to do what I think He should! And this definitely applies to our journey to have a family. 

Food for thought. 

New day.....New doctor

As some of you know we saw a new doctor today. This visit was night and day compared to our first visit with Dr. B. this doctor talked really fast and gave us lots of information! He discussed with us our options going forward. He talked to me a little bit about our treatment up to this point. Honestly he is not a fan of the treatment we have undergone. We didn't dwell on it a lot but he implied that I could've gone without the 6 months of injections for endo. I am refusing to let this depress me or dwell on the fact that we could've possibly wasted the last 8 months. I know that we are right where we are because this is where we are supposed to be. Don't get me wrong when he talked about it with us I felt sick, but Dr. N said it is in the past and all you can do is move forward from this point. So that is what I choose to do. Dr.N did tell us that our best chance of pregnancy is IVF. He said although this is the best chance (60% vs less than 10%) it is not the only choice and definitely not the first line of action. Today he did an ultrasound to "see what was going on". He said that I have a lot going on but not in a good way. So the plan for now is to induce a new cycle to clear out all the old and hopefully give me a clean slate. I will be doing a combination of oral medication called Femara and injections called Follistim. This medication cycle will be monitored by ultrasound. The goal is to get my body to ovulate. We are so hopeful after this visit and really praying that the future will hold great things for us! I may or may not update this through the cycle depending on how it goes. 

So have you ever considered adoption?

For people struggling with fertility this question is often a two-edged sword. On one hand adoption is ordained by God. In the Bible He commands us to care for the widows and orphans. On the other hand, to a couple who yearns to be like everyone else and raise a child that is a perfect mix of their traits and appearance, this question can often bring pain. For years when people would ask me that question I would instantly feel guilt. Guilt because I know that adoption is something God calls us to do. Guilt because I am spending countless amounts of money, time, and prayers on trying to have a biological child when there are lots of children who don't have homes. Guilt because we have yet to make grandparents out of our parents who so desperately want to be. Guilt because I have heard stories of families who were complete through the miracle of adoption. I actually would have so much anxiety that as soon as the question was asked I would try to come up with something that would satisfy my social obligation to make this person who was suggesting adoption feel like I was in fact considering it. Truth is at this time in our journey adoption is not a consideration for us. I am not saying we have never discussed it. Of course we have discussed it and if the time comes that we feel God is telling us that is what we should do we will definitely be open to His leading. We have some precious friends who have opened their home to the miracle of adoption twice. Once domestically and are now in the process of adopting after fostering. This relationship has so made me appreciate that God does lead some to take the step toward adoption. I am currently reading a book called Hannah's Hope. If you have not read it you should! It is excellent and has already been such a blessing to me even though I haven't finished it yet. In the book she quotes another author about the subject of adoption. 

This is the passage : "God had the desire to create new life; and he wanted to create it in His own image. If He, being perfect and complete had this desire to create, how could it be selfish or wrong? And because He created us in His image, with many of His attributes, it should come as no surprise that we have His desire to create. If we yearn to take part in the miracle of creating new life " in our image" with our attributes, and want the intimacy of nurturing our child to maturity, that is only natural. This yearning is God-given and how we are created. It's no wonder we feel jarred and confused when we are unable to fulfill it."

I love this passage. I have read it and re-read it. It speaks to my heart. There should be no shame or guilt in my desire to have a biological child even if it is difficult. And to take it a step farther when I get asked that question now I feel no guilt. I feel like at this time, considering adoption when we feel so strongly that it is not what we are supposed to do right now, is giving up on something God has instilled in us. Now don't get me wrong I am not saying adoption is not something we are NEVER going to consider. But what I am saying is that just because we have far surpassed what society considers a "normal" amount of time to try for a biological child it does not mean that we are selfish for not considering adoption. I honestly believe that God is going to bless us with a biological child. But if He doesn't then we trust that He will tell us when it is time to think about other options. 

A

Hurry up and wait...Story of my life

I can say hands down the most frustrating part of this journey is the waiting!! Waiting for test results, waiting for the doctor/nurse to return my call, waiting for my cycle to start....wait wait wait! Seems like some days my life is on hold just waiting. If you know me you know that I am a planner. I like things to be planned and I hate when plans change. I am pretty sure this whole journey is partly God's way of teaching me that I am (and never was) not in control. I am working on this. I am trying to change the way I respond to the changing of plans and time tables. I have come a long way from the days when a nurse not calling me right back would send me in a tailspin. Right now I am fighting the urge to be totally frustrated. I refuse to let things I cannot control determine my attitude. A little update on our progress: Over the new year I had thought I might actually be pregnant. I even for a little bit let myself get my hopes up. It was not so. So now I am awaiting my endometrial biopsy. This will tell the doctor if I am ovulating. If I am not then we will start injections. The biopsy should be late this month but I just learned from the receptionist that Dr. Bundren might be out of town. What will happen then I asked her? Oh you just wait until next cycle! No big deal just wait another month. Grrrrrrr!!!!! So after an entire year just wait one more month. So if that happens it could be another three months before I can do injections if I have to do birth control in between the biopsy and injections. I am trying not to think about this and instead just take it one day at a time. That is all I can do right now. 

A