puppies at 5 weeks

On our way home from a wedding at Sugarloaf in Maine this weekend we stopped at my parent's house to see the puppies. They are just about 5 weeks and ADORABLE!! I am holding Sami (or Thelma as Rob decided to name her this weekend). We'll pick her up in three weeks:)

puppies!

yup, we're getting a puppy. My parents bred their chocolate labs and had 10 puppies, 6 chocolate (3 males and 3 females) and 4 yellows (2 males and 2 females). They are about 4 weeks old now. My parents (being extremely loving and generous) have given us first pick of the litter. We think we're taking the golden color female. I want to name her Samuel Adams (Sami for short) becuase, well I am a big fan of the beer. Rob is leaning towards Patsy (becuase of his love for the Patriots). We'll see what fits her best when we bring her home.

Here is the mama and some photos of the pupps when they were about 3 weeks old:

strike 3

My period started today (yesterday afternoon really).
Will call Dr today, bloodwork is scheduled for tomorrow anyway. Nothing to to at this point but wait for the confirmed (-) result.
My plan needs a major overhaul.

NEWS

WE HAVE FROZEN EMBIES!!!!! WAHOOOOOOOOOO!!!
we've never had embryos that were able to be frozen with our past two cycles. We got the letter yesterday (after yet another frustrating day for me). I was so happy when I read the letter I burst into tears. (Maybe the progesterone had something to do with that, but I was beyond happy).
We haven't told anyone...(well except anyone reading this). We are hopeful that the babies inside of me are growing, BUT are being very cautious not to get too excited and not to say too much.
So there it is, my slight glimmer of hope while remaining cautiously optimistic.

moving on!

Today is another day! I am feeling much better yesterday and today. I felt crappy all weekend, but much more normal today. I'm in the "two week waiting" period of this cycle, but much like the last two I feel FINE!! Oh well. We're hanging in there.

I was so bloated this morning I couldn't button any shirt I own, and I only fit into TWO pairs of pants, that means I hope I don't spill anything on myself this week because I literally do not fit into anything else now. Ugh. The progesterone is doing a number on me.

ethical decisions

Many people have ethical issues with IVF in general. I consider myself a more liberal person (I married a quadriplegic who would highly benefit from at the very least stem cell research). I consider myself a caring person who is looking to make the world a little better than it was yesterday.

So where does that leave me as I face the technological advances that might allow my husband and I to have our own children? I accept IVF and the process. I accept that our embryo, created in a lab will not grow into a human being unless it is implanted in my womb.

But where do we stop? Many woman finally get pregnant after multiple attempts and complications. But the babies can be born almost too early. They may need feeding tubes in their noses, can have brain issues or require surgery. They require constant monitoring by neonatal neurologists and other specialists. Their underdeveloped immune systems require anyone holding them to wear gowns and gloves. Its all too much to think about now. I am in no way demeaning the medical system or what these parents have to go through with these babies, they are true miracles. But I am not sure I can handle that.

So how far do we push the envelope? How many times to we keep trying before we accept that it won't happen? I don't have those answers. I think they are very hard to find. And one of the main reasons infertility (or fertility as I prefer to say) treatments are so emotionally and physically exhausting.

I also have read what a blessing infertility is. As I sit here with tears in my eyes, I have to agree. I have seen so many women conceive without difficulty only to take their children for granted. Those precious babies that are a gift from god.

We have tried so hard, we have prayed so much. If we are finally blessed with children there will not be one day that passes when I am not eternally grateful for the blessing of life.

Our long and often frustrating journey with infertility

Three years ago I married the most wonderful man I have ever met. He had been a quadriplegic for 10 years at the time, we knew starting a family may bring us some difficulty. But with youth on our side, we started.
I stopped taking birth control pills after we were married, not with the hope of getting pregnancy right away, but to see what would happen. My husband had been through multiple bladder surgeries prior to our wedding, so conceiving naturally would be a miracle at best. But, with the thought "It only takes one", we thought maybe we had a chance.

About one year later I walked in the Avon Walk for Breast Cancer in Boston. It is a marathon and a half walk over two days to raise money for breast cancer research and treatment. I had never been so moved in one weekend as when I participated in this event. I knew at that time we needed to get serious in our attempt to start a family. Our parents were young and healthy, we were healthy and if we could have children I wanted them to be able to remember their grandparents like we know them.

We made an appointment that summer to see a reproductive specialist. She directed us back to the doctor my husband had seen in Boston for a "sperm" consult. We knew he had a complete stricture due to prior surgeries, and getting sperm out may be an issue.
We met with the doctor that fall. We tried injections. No sperm. In December 2006 my husband underwent a "scope", and the doctor determined surgery is our only option. We were also trying to sell our condo to then buy and renovate a house. The other issue is we had also almost lost my husband due to unexplained complications following a bladder surgery in 2004. With the painful memories of the prior surgery that almost ended his life, and the stress of renovating a house, he was very reluctant to go under the knife again. I felt my dreams of bearing children slipping away. Despite the heartache, I could never ask him to risk his life to try to make another.

We talked about everything, we fought about everything. We both wanted children. The hospital that this surgery would be at is bigger, the doctor has more experience working with people with spinal cord injuries, it looked like the outcome had a much better chance of success as compared to the complications of the last surgery. In March 2007 he finally scheduled surgery for July, more than a year after our initial appointment with the reproductive specialist.
The surgery was successful, we had enough viable sperm for 10 IVF/ICSI trials. ICSI is performed when there is not enough sperm for in-vitro fertilization. The embryologist fertilizes each egg with one sperm. The fertilization rates are usually lower. Success rates are usually less.
Our first cycle was in September 2007. We wanted to have a baby the following summer when my mom and my mother-in-law would be able to come and help us after the baby was born. The timing seemed perfect.
I started 4 weeks of birth control pills in September 2007. Then I started one injection to prevent early ovulation, then another to stimulate my ovaries to make as many eggs as possible. Five days after starting the stimulation meds I went daily for internal ultrasounds to count and measure follicles and blood work to measure my estrogen. As the follicles on the ovaries develop, my belly became more bloated. It feels like "having two billiard balls in your pockets." Everything (walking, sitting, sleeping) becomes uncomfortable.
In October, nine days after starting the stim meds, when I had 20+ follicles I did a "trigger shot" to induce ovulation. 36 hours later we went to Lexington, where I was put under general anesthesia and underwent an egg retrieval. I didn't feel any pain. They retrieved 18 eggs and sent me home to rest for the day. All that medication had added five pounds to me, and I was instructed not to exercise or I would risk ovary hyperstimulation and/or rupture. Oh, and drink 1-2 liters of Gatorade/day. We would get a call in a few days to update us on the fertilization. I also needed to start progesterone injections in the buttocks daily. The medication is in oil and it is injected into the upper-outer buttocks muscle. The needle is about three inches long. Because my husband does not have the manual dexterity to give me the shots, we enlisted the help of my boss. Every morning between 7 and 9am I went to her house, laid on my side, she gave me a shot in the butt and then I iced it. It hurt, but in order to maintain a pregnancy I needed it. If I got pregnant I would continue the shot for 6-10 more weeks.
Following the egg retrieval all of the eggs would attempt to be fertilized and monitored for at least three days. Many will die due to various causes. Our embryo transfer was a scheduled for a day 3-5 "flex schedule". If we had at least 5 embryos make it to day 3, then the embryologists keep the embryos in vitro for two more days to get a better assessment of which embryos will be likely to implant.
At day three we had nine embryos. We excitedly went back on day 5. I took Valium to help me relax and drank water for an hour to ensure I had a full bladder. We had only one embryo make it to the "blastocyst" stage. Our initial plan was to transfer one embryo to avoid a multiple pregnancy. We transferred the one available blastocyst, and the ultrasound tech gave us a picture of it. I rested on the table for 15 minutes, and then went home to rest for the day. The embryologists would watch the other embryos and send us a letter letting us know how many could be frozen. In two weeks I would return for a pregnancy test.

One week later we got a letter in the mail that none of our embryos could be frozen. We were upset, but still had hope that the one perfect blastocyst we transferred would result in a pregnancy.

The day of my pregnancy test, early November, I went to the hospital in the morning and planned to leave work early so we could both be home together to get the news.
We got the news; sorry but you are not pregnant. We were deflated. I was convinced I was pregnant. We were going to tell everyone the good news that weekend at my mother-in-laws 50th birthday party. But it didn't happen. My heart ached for the failure we suffered.

The doctor called me that week. She really could give us no reason for the failure, maybe a bad batch of eggs. The plan was to try again. Same meds, same plan.
I had started my period, so I started the birth control pills again. Four weeks of birth control pills, two weeks of shots, egg retrieval: 18 more eggs, transfer at day 5: one embryo made it again. We briefly discussed transferring two, but opted not to to decrease our chance of twins. I knew that day the chance of success of that cycle was not good. It was exactly the same as the first. I cried following the transfer, but we held out hope. The only change in medication this time was not taking shots in the butt. Instead of shots, I opted for a vaginal suppository which I took three times/day (lying flat for 30 min each time)...much easier than driving to someones home daily for an injection.
The embryo transfer was mid-late December. My pregnancy test was scheduled for Dec 30th. I got my period on Christmas Eve when my family was at our house for Christmas dinner. I tried to fight it, lay flat as much as I could, but it had really started. I forced my way through family gatherings on Christmas without saying anything. I cried each night, my husband cried. We prayed for help in understanding. I called the doctor on the 26th and they brought me in for blood work on the 27. No pregnancy.

We had a conference call with the doctor. Still no real reason why the cycles failed. Maybe it is the immature sperm, she told us again, ICSI pregnancy rates are statistically lower. All she could tell us for sure is the genetic change that needs to happen in embryos from day 3 to day 5 was apparently not happening with our embroys. Genetic testing shouldn't be an issue, transferring earlier shouldn't make a difference, I had a great response to the meds, it shouldn't be an egg issue; we just need to get the right sperm and egg together. But for the heck of it she changed one medication. And I planned to call the doctor who performed my husband's surgery.

We decided to take January off. I had gained 10 pounds now and I was tired. I couldn't exercise like I had before. I decided to start acupuncture, one time/week.
In January I went to CA to visit one of my best friends, sipped wine and enjoyed the freedom of not taking any medication! I turned 30 with only a slight heartache that I had not become pregnant by then. We met with the "sperm" doctor who insists the sperm is fine, but questioned my cycles. They progressed quickly and he questioned the egg quality.

My next cycle started in February 2008: 4 weeks of birth control, followed by two weeks of three different injections. I made it one day further in this cycle for the egg retrieval (this week). 17 eggs were harvested. As of last night there were 7 embryos left. We were brought in for transfer today, transferring two fair quality embryos and the waiting period begins again.

In 7 months I have gained 10 pounds, I have injected myself with five different medications too many times to count, I have undergone multiple internal ultrasounds and blood draws, I have had 53 eggs retrieved, I have been under anesthesia three times, I have taken three rounds antibiotics and three rounds of steroids, I have given myself vaginal suppositories three times/day for two weeks. I have had 4 embryos transferred. I have undergone 10 acupuncture sessions. I have had highs and lows, I have cried too many tears and laughed a little less than I used to. I have used 14 vacation days for fertility procedures. To my knowledge, I have not become pregnant.
I have met some truly amazing and supportive people on this journey, for that I would not change a thing.
I still hope that someday I will bear a child or in some way be a parent.
I will continue the battle, one day at a time.