Here we go, FET#3!

A word of caution: there may be TMI up ahead...read at your own risk :)

Started a new cycle today, so it looks like our miracle is not going to come this month. It really did not come as a surprise, though, so we're doing fine. One of the added bonuses of infertility is you REALLY get to know your body. I told Paul last night, as we were laying in bed talking, that I knew tomorrow was going to be "the day". It was dark in our room, so I'm not sure, but I think he was probably vigorously nodding his head "yup." I had reached my threshold emotionally/hormonally (sorry, honey) and knew it could only be hours before "Flo" would come for her LAST, unwanted visit. Yeah, I said it: her LAST visit. The goal is to become pregnant, so I've told her we're moving and she's not allowed to come visit for a very long time :)

I called the nurse today and got my next several appointments scheduled. My doctor has requested a "trial embryo transfer" or "mock transfer" to ensure there won't be any problems on the actual transfer day. I also have some blood work and ultrasound appointments to monitor my estradiol and uterine lining. Our next appointment will be the mock transfer on Monday, April 5th at 1:30 p.m. I don't anticipate any problems with my doctor threading the catheter up through my cervix and into my uterus, as I have had this done 8 times before. However, it will be good for Dr. Matteri to do it at least once before the catheter is loaded with our sweet little embryos.

Dates, dates, and more dates!

Here's what the next several weeks will look like. I start the birth control pill (BCP) on day 3 of my cycle, which is this Saturday, March 27th. I will continue taking these for 3 weeks. The BCP will keep me from growing an egg, as the goal is to suppress my reproductive system, since I already have frozen embryos. I will add a subcutaneous shot called Lupron, beginning on April 12th that will suppress my pituitary gland so that I do not release any hormones naturally. I want my body to respond only to the hormones I am injecting into it, so that it can be controlled and monitored to perfectly reflect a uterus that is ready to receive an embryo and become pregnant.

The first blood draw to measure my estradiol (should be low) will be on April 22nd at 9:00a.m. The first hormone I will add into the mix is called, Delestrogen, beginning April 26th. This injection will increase estradiol in my body and thicken my uterine lining. I will have an ultrasound to measure the thickness of my lining and my estradiol drawn on May 7th (estradiol should be higher).

The next hormone I will add in is an intramuscular shot called, Progesterone in oil (PIO), beginning May 15th. PIO will maintain the thickness of my uterine lining until my pregnancy test. If I become pregnant, I will continue the PIO shots throughout the first trimester, until the placenta takes over. Out of all of the shots, I hear these are the worst as far as pain is concerned :( It will be worth it, if we are blessed with a baby though!

Last blood test before the transfer will be on May 17th. Our transfer is still scheduled for Friday, May 21st in the afternoon. Whew, I'm sure you really were dying to know all those dates! Since this is our on-line journal, I like to have these kinds of things documented so we can reference them in the future, if needed.

Life is good. It may not always feel good, but life is good. Feelings come and go, and let's face it, ladies, our hormones can really mess with our heads ;/ Paul and I stand firmly on the belief that God is good, all the time, no matter what happens. Whether or not, He chooses to bless us with a baby, does not determine whether He is a good and loving God. We know He loves us. He loves us more than we can even comprehend. Take a listen to this: How He loves

Praying that if you read this, you know that you are loved deeply by God. BOOM!

~G & P

So far, so good

My blood test results are back, and what do you know? I'M NORMAL! :-) Thank you, LORD!

Here are the results:

My TSH (thyroid stimulating hormone): 1.628 Anything below 4 is said to be normal, but for fertility purposes, they would like it below 2.5

My AMH (anti-mullerian hormone): 1.7 This is the test that looks at ovarian reserve--how many eggs I have left. They like to see this above 1, which mine is.

My blood type: A+ (Ah, the perfectionist in me is revealed)

After Dr. Matteri's nurse, Roxanne, shared my blood test results with me, we were able to talk about my frozen embryo transfer (FET) schedule. Prior to our conversation, I had forecasted when I thought my transfer might take place, based on when I thought my cycle would start and then 8 weeks of prepping and so on. I know, I'm a little strange this way. I thrive on having dates to look forward to and checking things off my list. I guessed that if everything goes according to plan, we would likely transfer some of our embryos on Friday, May 21st. Roxanne pretty much made my day when she told me that my transfer is scheduled for that exact date! Then, it's as if she was speaking my love language by telling me she was going to e-mail me a calendar that has all my meds, and upcoming ultrasounds and blood work appointments! I really appreciate how organized ORM is.

May 21st is a little less than 11 weeks away. We hope this FET will result in the much anticipated blessing of a pregnancy! Our good friends recently found out that their FET was successful and our hearts are overjoyed for them :) Paul and I often wonder what that day will feel like for us. When you have been waiting for years to hear those precious words "you are pregnant," it's got to feel like you won the lottery! Will we stare in disbelief and shock, or will we burst into tears of joy? Stay tuned...we hope we get to share our experience with you in 12 weeks or so.

Prayer Requests:

We've been told we have a less than 3% chance of conceiving on our own, but we know that all things are possible with God :) We still pray and hope for a miracle.

That God would continue to teach us how to live joyfully and truly thrive on our journey. This prayer request is probably the one most dear to our heart. Please, allow me to elaborate. It's easy to resort to bitterness and self-pity when friends, family, and co-workers seem to conceive so effortlessly. Paul is notoriously asked by his patients at work the innocent question, "so, do you and your wife have kids?" It may sound trivial, but even simple questions like that can cause pain and sadness, when you are repeatedly forced to say "no, not yet". Both Paul and I enjoy Facebook as a means of staying in touch with family and friends, but it's not without it's challenges. When the pregnancy announcements come, the ultrasound pictures are shared, and the disgruntled person openly complains about this, that, and the other thing revolving around pregnancy and parenting, it takes strength and perseverance to choose joy instead of jealousy, anger, and resentment. Please hear me on this. I don't share these things so that people won't share about the joys and challenges of pregnancy and parenting. That's part of life. I share because we truly desire to thrive on our journey. Neither one of us want to take the easy way out by drowning in our own sea of self-pity. Because let me tell you, it's a whole lot easier to get angry and feel sorry for yourself when you are continually denied the blessing that so many seem to take for granted. We're not immune to these feelings, which is why we need prayer.

I think that's it for now. We will update as things progress, as always.

Much love,

G & P

The Scoop On Our Totsicles

I received a phone call today from, Alison, the embryology director at ORM! She's originally from London, so her accent was a wonderful addition to our conversation :)

She started out by letting me know that it's a bit difficult to interpret someone else's account of our embryos. However, they decided as a team that it's definitely worth pursuing a frozen embryo transfer. Their plan is to thaw all 8 embryos on the day of transfer (probably end of May), so that they can observe their quality and choose the best 2-3 to transfer. She warned us that we may not have any to transfer if none of them look good or survive the thaw, but there will be no way to tell until they have them thawed and in front of them. She said that 4 of our embryos haven't developed as fully as they would have liked them to, so they are already "red flagged." By day 5 or 6 at the latest, an embryo should be an "expanded" blastocyst and 4 of ours are only "early" blastocyst on day 6, with no growth from day 5 to 6. So, she was just preparing us that we may not have many to work with, but she wants to give them all a try! If there happens to be more than 3 good embryos once they are thawed, they will re-freeze any extra.

This plan is music to our ears. We have been praying for God to give them wisdom. We truly did not want to give up on our frosties, but we also did not want to push for transferring embryos that were not good quality. We are glad they are willing to thaw them and assess their quality first hand. Our prayer is that there is at least one good quality embryo in the bunch that will become our baby!

In a few weeks, my next cycle will come, and then I will begin suppressing my body. First with birth control pills, then with a daily injection of Lupron. Once fully suppressed, I will add an estrogen injection into the mix to thicken my lining, along with some other things, I'm sure. The whole process will be around 8 weeks, once I begin taking the birth control pill.

That's all I know as of right now. I haven't heard the results for my other blood tests, but I will post them when I do.

Oh, happy day!

I LOVE MY NEW CLINIC!!

I started a new cycle this morning, so I called ORM to set up an appointment for a baseline ultrasound and blood work. Dr. Matteri wasn't in today, but they were able to get me in with another one of their doctors. Everything went SO smoothly. The communication between all of their staff is remarkable! Dr. Barbieri knew all about my appt. with Matteri on Tuesday, so she didn't need to ask any questions. She performed my ultrasound and told me my uterus and lining looked very normal for day 1 and my ovaries looked good, too. She counted 9 resting follicles in my right ovary and 12 in my left with my lining thin at 5mm. Then I had several viles of blood drawn for my estradiol, FSH (follicle stimulating hormone), TSH (thyroid stimulating hormone), and a bunch of other things.

When I was finished, I met Roxanne (Dr. Matteri's nurse) and she sat down and chatted with me about what the next step will be. She told me that on Tuesday, next week, she and all 4 of the doctors are meeting with the embryologists to discuss my case--specifically the quality of our embryos. During our meeting on Tuesday, Dr. Matteri told us that several of our embryos were likely to be abnormal based on how slow or quickly they developed. So, depending on their recommendation, we will either proceed with a frozen embryo transfer after our vacation or keep our embryos frozen for the time being and pursue a fresh IVF cycle late spring/early summer. We should receive a call next week regarding what they discussed and their recommendation. Let's pray that God gives them wisdom!

We also decided that since Paul and I have a 10 day vacation planned for the end of April and they haven't reviewed our case yet, it makes sense to hold off on starting the birth control pill until at least next cycle. For once, I actually don't mind waiting!

While I was driving home, I got a phone call from them with 2 of my blood test results! They said my estradiol was 34--very normal for this stage in my cycle and my FSH level was 6.85--also very normal, Praise God! They should get the other results back in the next couple days and the AMH some time next week. The fact that my FSH is low, is a good indicator that my eggs are good, but the AMH will be the deciding factor.

Overall, we are feeling great and are SO pleased with our care so far!! Thanks for praying for us. We will keep you posted as we know more :)

Our consult appointment/2nd opinion

Rewind, one week ago, I went with a friend of mine to one of her appointments at Oregon Reproductive Medicine (the clinic we are interested in). I got the chance to meet her doctor (Dr. Matteri) and ask a few questions. That same evening, Paul and I went to the free seminar, put on by ORM. We both felt comfortable with the clinic and liked Dr. Matteri's approach toward infertility treatment. We both felt we should meet with him one on one, so we made a consultation appointment, which took place this afternoon. My current clinic took longer than expected to fax over my records, so Dr. Matteri was not able to thoroughly look through them prior to our appointment. It worked out just fine, but when you only have an hour to discuss your case and future options, it makes a big difference if they are able to review your records beforehand.

Initially, without really knowing the nitty gritty about our embryo quality and the way things are done at NW Fertility Center, Dr. Matteri suspected that we may have a genetics problem resulting in genetically abnormal embryos. He said at ORM, if a couple transfers a total of 4 fresh (not frozen) good quality blastocyst embryos and they do not get pregnant, there is more than likely a genetic issue going on. But, the closer he looked at our embryo reports and the more info we provided him about the lab and the protocol for transfers, he said it sounds like a lab/protocol issue. That doesn't mean we are out of the dark concerning the genetics issue, but he is leaning toward the issue residing with the method/lab that NW Fertility Center uses for IVF. I appreciated that Dr. Matteri spoke very respectfully regarding our current clinic. He did not bash them or insult their practice, he just pointed out the ways that they are different and how ORM's differences are beneficial.

One of the major differences is the lab that ORM uses. They are one of the first clinics in the U.S. to put in a "clean room" lab where the embryos grow. Basically, it's a filtration system that removes any impurities from the air (dust, mold, etc.) to keep it sterile. Very important when growing embryos! Their lab is also operating 24/7, so they aren't continuously setting up and closing up shop every other month, another big advantage. Their team of embryologists are some of the best in the world, to boot.

Earlier, I mentioned that their protocol is different as well. In case you aren't familiar with this terminology, "protocol", in a nutshell is this: a clinic's medical guideline for how they make decisions regarding a patient's diagnosis, management of care, and treatment. Every clinic has their own way of doing things, you just need to find a clinic that fits your needs. I believe we have found just that--a clinic that fits our needs--and we are some needy people, so it seems!! ORM will monitor my hormone levels more frequently to ensure they are where they need to be, they suppress all their frozen embryo transfer patients with birth control pills and Lupron (just like I did for my fresh IVF cycles), they use del-estrogen and progesterone as shots intramuscularly to thicken the uterine lining so that the hormone goes directly into the bloodstream, and they advocate doing acupuncture before and after the transfer to increase blood flow to the uterus and minimize potential cramping. They also operate as a team of doctors, so they will collectively review your case if needed.

Dr. Matteri gave us some ideas of where to go from here, before transferring any of our frozen embryos. He suggested I have my blood drawn for the Anti-Mullerian Hormone (AMH) test, which is one of the very best predictors of egg quality to make sure I don't have bad eggs. The results take a couple weeks, so we will update when we know more. Once my next cycle begins, I will go in for a baseline ultrasound to make sure my ovaries and uterus look normal and they will draw blood to get my estradiol and FSH (follicle stimulating hormone) levels. If all looks good, I may start the birth control pill in preparation for my frozen embryo transfer. Their frozen transfer protocol is about 6-8 weeks long, which may interfere with our vacation planned for the end of April, so we may wait to transfer until after our vacation. Their embryologists are also going to review our embryo records next week and let us know what they think about the quality of them.

We're happy with how our appointment went. Hopefully in the next week or so, my cycle will start, and we will be one step closer in the process of becoming parents. Our journey is much like a popular roller coaster at a theme park. The journey consists of ups and downs, twists and turns, excitement and anticipation and long lines of waiting. Currently, we are moving forward in the line, but are not quite close enough to step into the seat. If you are reading this, we appreciate you taking this ride with us. Whether you strap yourselves in and ride the journey with us or simply cheer us on from the sidelines, we are grateful.

Waiting in line for our next ride...

Gold star for Dr. Stoelk

I thought I would add something that I really appreciate about my current doctor. After spending 45 minutes with us yesterday, trying to figure out why I have abnormal bleeding and why I'm not getting pregnant, he called me and left a message. On the message, he said he had another thought that he wanted to share with me and wanted me to call him back with some information. I didn't return his phone call because I didn't have the exact information that he needed. Well, he called me today and we were able to talk for about 10 minutes. I just appreciate that although he is busy, he has taken the time to call me each and every time my IVF's have been negative and now, when we are searching for answers. He encouraged us, once again, not to give up. He also extended compassion and empathy to us, when he didn't have to. Of course, this all makes our decision that much harder. I will truly miss his bedside manner if we decide to move on.

Cancelled...again :(

Here we are, at 3 years of infertility this month, and another door has been slammed shut regarding our frozen embryo transfer. In December, we had to cancel due to an ovarian cyst I developed. Now, we need to cancel because my lining did not thicken appropriately (only a 5-6, should be at least an 8), I started spotting (AGAIN), and I had already ovulated (which I already suspected). The main reason we will not be able to transfer our frozen tots is because of the inadequate endometrial lining and the unusual spotting that has accompanied it.

It truly does not make sense to us. What's also frustrating is that my clinic only does IVF related procedures every OTHER month and on top of that, the embryologist is only there 2 weeks out of that month. No big deal for the average woman that is a patient at my clinic because their body responds appropriately to the hormones and they are able to fit nicely in their schedule. My body, however, is "unique," as my doctor put it. It tends to bleed for NO apparent rhyme or reason at very inopportune times resulting in the cancellation of multiple cycles. So, the only option we have is to try again next month and hope that we are able to conceive on our own. If that is not successful, we see if my body will cooperate by fitting into the 2 week window in April for a frozen transfer.

But, there is another option. We just need prayer on whether this is the path that God wants us to take. There is another clinic in Portland that is much larger than the one I am currently at. They have 4 physicians that work with IVF patients and they do IVF every month. The downsides are it is more expensive and we would have to leave our doctor, whom we happen to like and have gotten to know these past 2 years. Did I mention that this place is more expensive?? Ugh, infertility treatments are expensive everywhere, but this place is a bit more :( We don't want to put a price tag on our child, but we also want to be wise stewards of our money. It's just plain sickening...

Since our last negative IVF in October, I have often thought about getting a 2nd opinion elsewhere. I had anticipated it being further down the road, but that was before the last 2 frozen transfers got cancelled. Each month that we are not able to transfer our embryos is another month of allowing my endometriosis to grow back, which also decreases our chances of conceiving. Unfortunately, time is not our friend. The urgency is not just about not wanting to wait any longer. It's about increasing our chances of getting pregnant.

This clinic has a "free" seminar this Tuesday, February 16th from 7-8:30 p.m. (this will be the only thing that will ever be free from then on out). We will get to meet one of their doctors in a group setting with other people and hopefully be able to ask a few questions. From there, we will pray and decide about whether we should pursue them for a consultation/2nd opinion. If we do decide to do that, we will need to let my current clinic know and retrieve my records from them. I really don't want to leave, but my gut is telling me it may be time to move on. Sometimes, you just need a different set of eyes to look at a situation. This clinic will have 4 sets of eyes reviewing my case and deciding what is best for me. Who knows, they may have a different approach that works well for my body, but we won't know, unless we give them a try. That's my feeling, at least. Oh, and their pregnancy success rates are about 10-15% higher.

Like I said, Paul and I plan to pray about this and we hope you will, too. This is a very big deal to us, and we want to make sure we are truly listening to God's plan for us. We welcome your thoughts, advice, and wisdom with open arms. If God brings us to your mind, please pray as we make these tough decisions in the coming weeks.

With love,

Gretchen & Paul