Pslam 86:12
Give me a sign of your goodness, that my enemies may see it and be put to shame, for you, O Lord, have helped me and comforted me.
It is now Saturday, nearly four days after we got the news of cycle #3 not working. It seems like an eternity. Each day has seemed to just drag by. Each evening and each day, when I hit a sad spell and need a pick me up, JB and I talk through things yet again. Yet again, I say the same things. This time, the disappointment is different. This time, I am not asking why. It's as if, subconsciously, somewhere, I know why. I know that the Lord is using this sadness in our lives and in the lives of others. This time, I am not questioning my faith at all. I know that the Lord is present.
But this time, I am, as I have mentioned previously, just plain sad. I cry a few times a day, and it's not an angry cry. It's a "please Lord take away this sadness from me" type of cry. I also miss our families quite a bit right now as well. I want to hug my niece Grace and have her ask me to read her a book until I frantically look to another family member to take my place. I want to play Tetris with my Dad and take walks with my Mom. I want to sit on the couch in JB's family house and wonder what quiet is again! Maybe that's the combination of dissaspointment and the holiday season.
I also know that we have 3-4 more chances with the embryos we currently have. I know that we, at that point, are quite allowed to harvest, yet again if we want. But yet again, my heart feels wounded. Not with anger. Not even with jealousy. Not with frustration. Just with sadness.
Don't worry if I haven't called and chatted with you. I really have no desire to talk about this at all right now. JB and I are working through this sadness together, and he's forcing me to watch episodes of America's Funnies Videos and Scrubs whenever they come on -- two shows that you just can't help but smile at.
I have also talked to the Dr. C, talked to Mary, one of the lead nurses, and we have everything lined up for next cycle. So I thought now was as good a time as any -- a Saturday morning when I can take my time and formulate my thoughts, to let everyone know where we are at and what is next.
Our embryo quality
The quality of our embryos has been the latest "drama" in this chapter of our lives. By JB working in the REI department for one month, he has learned a lot. He has, for instance, learned, what constitutes a great, a good, and a poor embryo. In looking at the "status" of our embryos over the last three cycles, it has become quite obvious that our embryos aren't as "fantastic" as I believed. It's not that the doctors ever said they were fantastic, however, they always said, "Yeah, they look good." We never really asked for details, and I just assumed they were great.
Our embryos are "okay". They are quite honestly, very average. This, to me, is just another reason that our becoming parents must completely come from the Lord. First, it was the fact that I never ovulated. Hmmm ... just a tiny obstacle. Then the fact that I didn't ovulate with drugs. Then the fact that injectibles caused me to ovulate a little bit too much forced us to leave IUI (artificial insemination) behind. On to the world of IVF, where we come to find out that there is some sort of sperm binding issue. There is also the thought that the shell of my egg is a little hard, contributing to the sperm binding issue and, possibly, the failure to implant. And now, the embryos that we have created are "average". It's like God is saying, medicine is nice children, but only I can overcome all these odds. More and more we have come to realize that we have very limited control. We can control our stress level and our state of mind, but only God can control my womb.
Now, let me explain what JB has explained to me, over and over again. He said they have a saying in the office, "Bad embryos make cute babies." In other words, an average embryo, in no way, implies that they won't work. Fantastic embryos result in failed cycles as well. They like to see 8-celled embryos. Our's are mostly 6's and 7's. They like to see a "grade" close to 0 and not over 2.5 Our grade has been somewhere between 1.25-2.25. These are good baby-producing embryos. They just aren't great baby-producing embryos.
Surrogacy
Before we knew this, JB and I talked briefly about the possibility of using a surrogate in one of our last tries. We have had a few people briefly suggest that they could be our surrogate (an unbelievable gift!) Our surrogate would undergo the transfer instead of me and would carry a successful pregnancy instead of me (hopefully!) However, this was when we thought we had "great" embryos. If we had "great" embryos, we were assuming that the repeat negative cycles were possibly a "uterus" issue. However, this new information indicates that most likely, a surrogate would not be the answer for us. That this issue is most likely in the embryo itself, not in the uterus. If that is the case, the surrogate would face the same obstacles that I am facing.
Transferring three
It is for all of these reasons that our doctor has agreed to transfer 3 embryos in January. We all feel that this is the right time to increase our number. Triplets is a legitimate concern amongst Mayo's infertility center. They avoid anything over twins like the plague. My doctor said that if all three embryos are dethawed, and all three are better than "average", we may consider letting one of them go to "blastocyst" stage and only transferring two. (As a quick refresher, letting an embryo mature more before implanting, greatly increases pregnancy rates. So we could let one mature, and then refreeze it for a later attempt.) JB and I want to be wise about this. We realize that anything more than twins means a significant increase in the risk of none of the babies making it or one or more of the babies being very ill as well as a risk to my health. We also would never want to have to make a decision about selective reduction because of our selfishness. So we will be as wise as possible to avoid the risk of multiples. At this point, it's hard to imagine multiples. We have just been praying to be parents one time. Anything more would be unimaginable.
Assisted Hatching
We will use assisted hatching during the next cycle. Some people have asked a good question. Why haven't we done this already? Mayo's policy is to wait until three failed cycles before utilizing this procedure as it is "putting the cart before the horse" to do it any earlier. In my case, the reason to proceed with AH is the three unexplained failed cycles as well as the fact that there is a very probable chance that our embryos have a thick shell or "zona". This procedure has been shown to improve implantation rates. (Click on the link to see a photo of AH. )
Janauary 18th
In order to be "ready" to go again, there are a few things that need to be done. In addition to our scheduled Florida holiday, I have to have my ovaries shut down or "down-regulated" before we can try again. This whole process will take about 4-6 weeks. They also want to do another "cervical dilation" to help ease the "day-of" procedure. Remember, doing a frozen transfer is not nearly as difficult on me as doing a harvest. My schedule is as follows:
12-6-06 Start Oral prometrium
12-12-06 Start Lupron shots every day
12-17-06 Finish orgal prometrium
13-06 Cervical dilation and down-regulation ultrasound
TBA Start estradial pills
That is really all that invovled. Not bad at all. Basically, all they are doing, is getting my lining ready for those sticky babies to find a home.
I hope this explains everything that we are getting ready to do. Please, as always, do not hesitate to ask any questions. I definitely want people to understand (as much as they want to), what we are doing. I also found a pretty cool video on UTUBE: Embryo transfer. If you watch closely, this is what JB and I see when the little sticky babies are dropped into my womb. It's a little harder to see in this video than in person, but it is still pretty cool.
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