Pill Poppin’

This quick post is for those of you out there who struggle with egg quality or are low responders to stimulation meds. Here is the list of supplements I take daily. The list is from Celebrity Miracle Clinic and is especially designed for low responders. The acai supplement is based on a study the clinic is doing to ascertain the impact on egg quality in humans after promising animal studies. I was about to enroll in the study when I switched clinics.

Remember- consult your doctor! I am not a medical expert.

Please feel free to share other supplements or practices that you have found to improve quality and/or response as a reply to this post.

Morning

Myo Inostol 2gm

Co Enzyme q10 400mg

Omega-3 fatty acid 1000mg

Vitamin C 500mg

Vitamin E 200IU

L-arginine 1000mg

Pycnogenol 100mg

Acai Berry Veggie Cap 600mg

Prenatal

Vitamin D 2000 mg (under the advice of my Primary Care Physician)

 

Afternoon

Acai Berry Veggie Cap 600mg

 

Bedtime

Myo Inostol 2gm

Melatonin 3mg (women with thyroid issues should not take melatonin)

Co Enzyme q10 400mg

L-arginine 1000mg

Acai Berry Veggie Cap 600mg

 

Hello, Goodbye- Part 2

Image: John Via Flickr

Image: John Via Flickr

Phew. Glad I got Part One out of my system. Now that its done, that goodbye has been said, let’s talk about the FUTURE.

Well really, let’s talk about NOW because our next step is already well under way.

Hello Future.

We don’t stay down for long in this family. Before the sun set on us Sunday night I had already emailed the new/old clinic to explain our situation and set up a consultation. It often takes time to switch clinics. Time for diagnostic testing, Time to get on the calendar. I was expecting it to take time this time too. Nope… we are in full swing.

Before we left our new/old clinic we already had a consultation with our Reproductive Endocrinologist (RE) to hear his recommendations for what we should try next after our miscarriage. Those of us in the fertility world call this the “WTH” (What The Heck?) appointment. Some more colorful ladies use another letter besides “H.”

I am more comfortable just calling it a consultation myself. If you think about it, with the odds of IVF being less than 50% the WTH appointment should be reserved for when a patient actually gets pregnant. At least that is how it feels for this unlucky girl.

In preparation for this discussion my new/old RE created a plan. All our lab work and other testing is recent enough that there is no need to repeat. So when I opened my email Monday morning and one of my favorite nurses had already responded, I was pleasantly surprised to find we could pass go and go straight to cycling. All we had to do was call the business office and pay a deposit.

By close of business on Monday, the deposit was paid and we were on the calendar for a May retrieval. We set up consultation appointment on April 10th to review the plan and also make necessary adjustments based on what we learned from Celebrity Miracle Clinic. I was told to call with my “pre-month” menses which I took to mean April.  However when my monthly friend arrived Wednesday I called to be sure and they told me it was close enough that we could get going. Yes!

Drugs have been ordered and are scheduled to arrive. I am back on birth control again and we are taking supplements to improve egg and sperm quality. At the consultation we will pick a date in May and count backwards to select a date when I will go off the pill to begin another antagonist cycle (I will explain what that means in a later post). We will retrieve my eggs in May and create our embryos which will all be frozen.

In June we will thaw several of them for transfer. We are doing this because I have never been pregnant on a fresh cycle. Some women just do better with frozen cycles and I appear to be one of those Ice Queens. More importantly, we know that my embryos are slow starters and a frozen cycle will allow us to better match the time when the lining is receptive to the development of the embryo.

Over the last few days I have already talked to three of my favorite nurses. I am excited. I am nervous. But mostly I am just glad to be ready to go and to be working with my old friends.

Now I just need to give new/old clinic, new/old nurses, and new/old RE a more creative and acceptable name. Something as fitting for them as “Celebrity Miracle Clinic” was for the other one.

I’m thinking about it…

Any ideas?

Hello, Goodbye- Part 1

It has been a busy, hectic, and emotional week. In fact we almost haven’t had time to process what happened last Friday.

Almost.

While I felt guilty in the moment, looking back I do not regret caving in the 11th hour and taking the home pregnancy test. Testing before the official test allowed us to leave early for our weekend of water sliding and cleared Friday night for much needed time to discuss the sad news and what would come next.

Our discussion that night was one of the most challenging in our marriage. Bill and I process bad news in different ways which often leads to disagreements during times when we should be most supportive of each other, like the night of a failed pregnancy test. Especially this failed pregnancy test.

After eight procedures, twenty embryos, one miscarriage, and putting all our hopes and money into the Celebrity Miracle Clinic for one full cycle, we were both reeling and not at all in a position to give to the other what was needed that night. The weight of a disappointment of that magnitude could crush even the most perfect of couples.

Because so much of the IVF process centers on me, it is easy for me to forget that we are both invested in this. We are both elated when we are at a peak and devastated when we are in a valley. I have often made the mistake of expecting Bill to be there to take care of me, to put me back together when I am falling apart, only to realize that he may not be whole himself. This was the case Friday night.

Adding fuel to the fire, we were not at all aligned with what we wanted to do next. I decided long ago we would go back to Celebrity Miracle Clinic for one more attempt at creating a baby with my own eggs. Who cares that we didn’t like our experience there? I reviewed statistics for the best clinics in the country and determined that Celebrity Miracle Clinic was the place to be for an old lady with egg quality issues who was serious about getting knocked up.

Bill, on the other hand, has a deep seeded dislike of Celebrity Miracle Clinic and suggested in a less than subtle way that we consider alternatives.

Cue massive, explosive argument.

Throwing a wrench into the recovery plans of a hormonal Type A infertile woman is bound to cause a wee bit of a problem. It was a long night. Hurtful things were said. The evening culminated in our holding each other at 2 AM seriously discussing whether or not we could go through IVF again at all.

In the physical world, some explosions are devastatingly destructive. Others are critical steps toward building something new and breathtaking, like an expansive tunnel to the other side of an enormous mountain. I feel that Friday night was creative destruction, the clearing of one set of ideas and mental debris that allowed us to find a new path through this huge obstacle in front of us.

The truth is I don’t care for Celebrity Miracle Clinic either. Take for example what happened Saturday. I went for my blood work at 6AM mountain time. At 12:41 PM a nurse from the clinic called me to see if I had done my blood work. I told her that I had. She was then supposed to call the lab and call me right back to give us the results. Five hours later, there was still no call and no results. I eventually called the after hours answering service and had to demand to speak to the on call nurse because I was told “lab results are only discussed during normal business hours.” After five phone calls I finally received a call back with the results of my long awaited pregnancy test.

This type of thing happens all the time at Celebrity Miracle Clinic, but I explain it away and suppress my feelings about it because they supposedly have the best lab and results in the country.

Bill’s suggestion that we consider going back to our old clinic, the one that gave us Spork, made me angry at first. But the more I thought about it, the more it made sense to me.

We initially went to Celebrity Miracle Clinic because we didn’t know if we were still making chromosomally normal embryos. While our old clinic can do genetic testing, they do it at an early embryonic stage that can damage the embryo to the degree that makes it less likely to survive and implant.

Celebrity Miracle Clinic uses technology that allows the embryo to be biopsied at a later stage and therefore does less damage to the embryo, using only a small number of cells from the part of the embryo that will become the placenta.

I debriefed with my Celebrity Miracle Doctor on Monday. He said that we had three genetically normal embryos that were of good quality and we were just “unlucky” this time.

Hmmm… maybe. Maybe it’s a little more than just bad luck.

In our cycle at Celebrity Miracle Clinic we had 5 embryos make it to the blastocyst stage. Of those five, the initial genetic test results came back with two embryos as genetically normal (euploid), one abnormal (aneuploid). The remaining two embryos had to be retested because the tests were inconclusive.

What? Retested? What does that mean?

That means Celebrity Miracle Clinic achieved a 40% failure rate on their amazing state-of-the-art testing and we had to do it again. After retesting, one embryo came back abnormal and the other embryo was Blob. In order to be retested he had to be warmed and biopsied a second time, removing even more cells from his 100 or so to support the test. 

When Blob was frozen the first time he was a 5BA blastocyst which meant he was still in his shell. During the second biopsy he completely reanimated, expanded, and even shed his outer shell. Then he was flash frozen again.

After that he was never the same. 

Embryos are supposed to fully expand after being warmed. In fact, re-expansion is the most important indicator for a successful implantation. Blob barely had a chance once he was warmed again and only slightly expanded.

What Blob looked like at transfer

What Blob looked like at transfer

What Blob should have looked like at transfer

What Blob should have looked like at transfer

Had the test worked the first time, or had Blob not been tested at all, he could be happily growing inside me. There is no way to know, but the testing could have been too much for him. It could have been too much for the other two normal embryos that didn’t implant in January as well.

My new/old clinic transfers embryos at an earlier stage, generally untested but also undamaged. Now that we know more than 25% of our embryos are likely to be chomosomally normal, we can go back to the new/old clinic and continue with some confidence that it will likely just be a matter of time and patience before one of those embryos sticks and becomes Spork’s sibling.

While we do run an increased risk of miscarrying an abnormal embryo that wouldn’t have been transferred at Celebrity Miracle Clinic, as well as an increased risk for Down’s Syndrome or other chromosomal issues, these risks aren’t higher than any other 38 year old who gets pregnant and are still relatively low. The trade off is that we put the embryos back to their natural environment without damage sooner, which bodes well for delicate embryos.

Armed with this knowledge, today we said goodbye to Celebrity Miracle Clinic. I sent the official form from new/old clinic requesting all my medical records. I called my nurse to tell her voice to voice. It felt a little like an overdue break-up, like severing a slightly dysfunctional but at one time mutually beneficial relationship that is no longer beneficial.

We said goodbye to more than just a clinic with that call today. At our first consultation with them back in July we were so filled with the hope we would wind up on the right side of their jaw-dropping statistics. We were mesmerized by their program and amazing facility. Today we are no longer awe-struck.  We said goodbye to that child like wonder and the certainty that Celebrity Miracle Clinic would swoop in and fix what was wrong.

We also said goodbye to Blob today. Even though I knew at transfer he had a slim chance, I fully believed he would make it. The start of my period today underscored the fact that he did not, something I have known since Friday but becomes so real when this time comes, the time when a cycle officially comes to an end and a new one begins.

While a little saddened, we are also turning a page. I received a call with the plan from the new/old clinic today thus taking our first steps through the tunnel we blasted into our own personal mountain. While the pain of goodbye is still fresh if I dwell on it like the pain of a fresh break up, there is nothing like the promise of a new relationship to help the memory fade.

It’s already time to look forward.

And so it is with infertility as it is with so many things in life.

What about Blob?

IMG_6871

Spork in her lucky Wildcat bathing suit ripping it up on game day at GWL. Thanks Chris!

We are back from Great Wolf Lodge.

We played. We loved. We healed. Not completely healed, but we are on our way.

Unfortunately, Blob didn’t make it. I broke down Friday night and took a pregnancy test. It was stark white. Saturday evening we received the official results. We aren’t pregnant anymore. Blob didn’t stick.

Blob’s embryo transfer was very disappointing for a number of reasons, but one important one is that it is the first time we have been public when we received the tough news it didn’t work. Personally, I far prefer it this way. This way everyone we care about knows what we are experiencing. This way we can accept the love, support, and prayers of a community of amazing friends and family members.

However talking through the public aspect of this cycle Friday night and how it accentuated our pain caused a decision regarding the blog. We are continuing it, but are no longer posting updates to Facebook or Twitter. Anyone who wants to receive regular updates is welcome to follow the blog. You can do so by logging into laughterthroughtearsblog.com through your computer and selecting the blue “Follow Us Via Email” Button on the right hand side of the page (under the photo of the three of us). The option to follow us via email is also available on your mobile device if you scroll nearly all the way to the bottom of your phone or tablet. I will still be posting to Twitter via the Laughter Through Tears account under @laughthrutears.

Approaching it this way will give accessibility to what is happening in the process to only those who are interested in following us versus our social network at large having daily updates shoved in their face. We will also continue to reach other infertile couples who may need our support and experience for their journey. These are two primary motivators for starting the blog, to keep people in the loop and to help others.

Our next step is to take a couple of months off to eat healthy, take supplements to prepare my eggs for another retrieval, and just grab some needed time off from treatment. We have decided to return to our old clinic in Michigan for our next cycle. By going out west we learned that over 25% of our embryos are chromosomaly normal. This gives us the confidence we need to continue with a clinic we always loved. A clinic that boasts the added benefits of being closer to home and substantially less expensive. In fact its about a third of the cost.

My posting frequency will likely die down for awhile. I plan to post two to three times a week during our waiting period versus five to six times a week.

In some ways, this new chapter we are entering is already exciting for me despite the fact we are still processing the disappointing news that our last embryo didn’t make it. We love the clinic that gave us Spork and connected with them in a way we couldn’t with the new clinic. I feel like we are coming home.

I will add more detail on what happened and what comes next later, but this will be the last post we put on social media. Please feel free to follow us if you are interested and never hesitate to talk to either of us about how things are going or how we are feeling. We want to share with those that care about us and want to know.

Thank you all for your support. Keep the prayers and positive intentions coming. We aren’t done fighting.

Alisa, Bill, and Spork

What to Expect When I Might Be Expecting

I am taking tomorrow off from posting so this is my last post prior to our blood test. One more day!

Someday I will write the post I have been formulating in my mind which will answer a lot of questions about why we came out of the infertility closet. There are many reasons to keep this struggle private. There are just as many reasons to go public. Having tried it both ways I am content with our choice.

It’s a darn good thing because there is no putting this particular cat back in the bag.

Image by dizzy-miss-lizzy via Flickr

Image by dizzy-miss-lizzy via Flickr

There are dozens of reasons we decided to share openly, but there was one big one. Over time it simply became too difficult to hide.

I have the kind of job where you don’t call in sick. Every day is filled with commitments that usually necessitate not only my participation, but my leadership. I was able to get away with only telling my boss and support team members about infertility when we were seeing an in-state clinic, but once we decided to travel halfway across the country for treatment I needed to spill the beans with my team and key coworkers.

It was amazingly liberating and the support was awe-inspiring, so after a time we decided to be expand the list of those who are in the know to the whole wide world. After several years and a multitude of semi-secret procedures and tests, we became hardened to the initial feelings of shame and guilt. We lost nearly all our modesty.

We were ready.  Only one concern remained and we are facing that fear head on tomorrow. We were worried about you.

The hardest part of being public is the guilt we feel for putting people we care about on the roller-coaster with us. Once you tell your friends, family, and Facebook, everyone is involuntarily forced into a car, locked in, and unable to escape until the ride is over. When things go badly, which they sometimes do, we often feel worse for how it makes other people feel than for how it makes us feel.

Image via houndiggity via Flickr

Image via hounddiggity via Flickr

Naturally I have been thinking about how we are going to break the news this weekend. Will it be right away? If the news is bad, will I let my true feelings show or will I couch my reaction for the benefit of others?

Someone I am very close to asked me yesterday if I would let her know the results over the weekend. “Of course I will,” I replied, “but aren’t we still friends on Facebook?” She acknowledge that we were but she wanted to know how I was really feeling, not just what I would put into cyberspace.

My middle sister also recently told me that while she loves reading the blog, she misses having a more personal connection on the topic of my battle against being barren.

Huh. Interesting.

Both my friend and my sister were in-the-know long before anyone else. I acknowledge the way I communicate with our closest friends and family members changed since our infertility proclamation. While I totally get that they miss the intimacy, it was not something I anticipated when we made the shift. Truly, I am moved and flattered by their reaction.

As a result, we will definitely let a small group of people know the results of our pregnancy test before Facebook, Twitter, and my friends on WordPress. But when we do share the big moment with the blogosphere, I promise I won’t pull any punches.

I want my sister, my friend, and everyone to know I have been my genuine self on this blog. And for the most part I have been unfiltered. I definitely clean up the language and don’t rant, but I don’t really swear or rant much to anyone but Bill these days anyway. If I do I almost always wish I hadn’t. Blogging has helped me with that.

This is the heart of the reason I love the blog, I work through my emotions in the most positive way possible and by the time I am done laying them all out, I honestly feel the way I have portrayed it. It’s sort of like “fake it until you make it” except I’m not. I’m simply processing it all on paper and getting to a better place as I go.

When the time comes and the results are in, I will divulge how I am feeling without censoring it for the masses.  I just can’t promise it will be before Monday because whatever happens I am going to be a busy Mama this weekend. Busy making the most of whatever fate has in store for us.

Here is our plan:

Pregnant? The Winslow’s are going bowling. I will watch and take photos because I will still need to take it easy. We will play our tails off as a family all weekend and enjoy a a couple of days of freedom from all things fertility related.

Not Pregnant? We embark on an overnight trip to Great Wolf Lodge for Spork’s first ever water slide adventure. I will be able to slide with reckless abandon and soak in my little mermaid’s joy in a way that a pregnant lady can’t. Sure we will be sad, but I refuse to sulk. We will still definitely enjoy a couple of days off from all things fertility related.

When we have time and I am ready to put my feelings of joy or sadness into words, there will be a post. At least that’s the plan for now.

Until then, thank you for your support and prayers. We are so blessed to have each and every one of you on Team Baby Winslow and have only one more request:

If you don’t mind saying one more prayer or sending one more positive intention, please tell God and the Universe that the Winslow family could really use a night out at the local bowling alley.

See you on the other side…

Three Theme Songs for The Two Week Wait

Image via Goff/INFphoto.com

Image via Goff/INFphoto.com

Two Week Wait Theme Song #1

Amy Winehouse- Rehab

Last night on my way home from work Bill called me and told me he was stopping at a pharmacy to pick up some cold medicine for my sister. Apparently she didn’t call me because she was worried I was too busy. Busy, yes? But I was only 200 yards from Walgreens and it would have consumed all of about 10 minutes of my time, a small contribution to help my sick niece get well. Especially since it was my sweet little petri dish of a daughter who passed along this nasty cold.

Still, I declined. My workload had nothing to do with it. I didn’t take it off my husband’s plate because I am a wimp on the verge of completely caving at any moment. I fear know if I walk into any institution that sells or contains pregnancy tests I will walk out with at least one, if not more.

I need an intervention.

 

Image via nydailynews.com

Image via nydailynews.com

Two Week Wait Theme Song #2

Ozzy Osborne- Crazy Train

I awoke yesterday morning feeling total normal. The tell-tale exhaustion from the day before was gone, my “girl”s were a little sore but not tingly anymore, and the tightness in my lower abdomen disappeared. After being convinced for several days that the symptoms I experienced meant a Big Fat Positive (BFP) was just around the corner, I felt sad and dejected. The feelings of sadness and dejection made me think maybe I had PMS. I was spiraling out of control and I needed company. I immediately texted a friend, my sisters, and my Mom to share the insanity.

Keep in mind, I am only 3 weeks and 4 days pregnant. Even in the best case scenario any HCG in my system would  be minimal. Any symptoms I have are much more likely to be caused by hormones I am taking than a pregnancy at this early stage.

By the end of the work day I was yawning mid-sentence when talking to one of my employees about a client. I almost hurled when I walked by the Keurig we have in our lobby. Coffee was my only aversion when I was pregnant with Spork. It was so bad Bill had to brew his morning cup of joe in our garage.

So now I am sane and hopeful again, even though I know it means nothing. All aboard!

Image via wikipedia

Image via wikipedia

Two Week Wait Theme Song #3

Carly Simon- Anticipation

I love Carly and this is one of my all time faves. The ballad begins:

We can never know about the days to come
But we think about them anyway
And I wonder if I’m really with you now
Or just chasing after some finer day.

Anticipation, Anticipation
Is making me late
Is keeping me waiting

This beautiful little ditty goes on to describe the longing for a lover, but this first verse and chorus makes me think of Blob. Are you still with me now, Blob? Are you still living and growing?

Or is this cycle just a step toward a finer day when we will have another baby in our arms?

Whatever the case, I am more than eagerly anticipating the days to come. Specifically Saturday when this part of the wait will finally be done. With any luck we will be done waiting for pregnancy test results forever.

If you had a theme song for how you are feeling today, what would it be?

Pitch Drop Experiment Vs. The Two Week Wait

My post yesterday about the mysteries of IVF reminded me of another great Radiolab episode that helps put the torturous wait for our pregnancy test results in perspective.

It could be a lot worse.

It could be like the Pitch Drop Experiment.

Nine days of waiting feels like a really long time, especially when a healthy chunk of retirement savings rides on the outcome. The wait is painful and and requires great patience. However it doesn’t  begin to compare to the patience practiced by the late professor John Mainstone.

Sadly, the revered researcher went to his grave without ever seeing the results of his test. Those results are due at any time now, and were estimated to arrive last July.

But still, we wait.

John Mainstone Waiting

John Mainstone Watches and Waits

The experiment began under the supervision of another scientist in 1927. Eighty-seven years later researchers are still longing to see the results, making my 9 days pale in comparison. However just like my pregnancy test, the wait will end in a fraction of a second creating a mesmerizing moment where time that has lagged dramatically slingshots into high gear, moving at the speed of light toward what comes next.

The contrast is fascinating.

What is this intriguing and insanely lackadaisical experiment?

Pitch is a substance that is technically viscous, however if you hit it with a hammer it will shatter. The experiment is all about attempting to observe the substance’s liquid like properties and take note of what happens in the moment in which pitch drips out of a glass like a viscous substance should.

pitch_bits

To accomplish this, a sample of pitch was heated and poured into a funnel shaped glass. Once the pitch settled, a process that took three years, the bottom was cut from the funnel.

Then the wait for the pitch to release a drop commenced.

Slowly but surely, the pitch began to stretch and prepare to drip. Over the last 87 years it has lazily dripped 8 times, an average of once every 10.87 years. However, the drops have never been observed. The experiment began before it was feasible to use cameras to monitor the pitch and the researchers consistently missed the fraction of a second they  patiently anticipated.

Capturing that moment is exceedingly difficult. How do you observe something that happens anywhere from every 8 to 13 years but in a blink of an eye?

At one point, professor Mainstone was monitoring the pitch at a time when it was crazily close to dropping. He went to get coffee and when he returned, the pitch had dropped. Imagine his frustration! I am sure it was far worse than a two week wait, especially considering the experiment had to have grown to feel like “his baby.”

The last time the pitch dropped, there were was a camera on it but it malfunctioned.

Seriously, this poor dude was doomed.

Today the pitch has three cameras trained on it and there is a live video feed on a special website set up by the School of Mathematics and Physics at The University of Queensland where the experiment began.

Click to go to the live feed of The Pitch Drop Experiment

Click to go to the live feed of The Pitch Drop Experiment

There are people hopelessly addicted to watching the live feed, wanting desperately to see with the naked eye what no other human has ever seen live. I too was sucked into the obsession when I first learned of the Pitch Drop Experiment, but soon realized that you could waste your life away by devoting it to following the imminent drop.

This is another way the experiment is like a two week wait. You can obsess about it non-stop, but it won’t make the moment arrive sooner. Wasting your time and energy thinking about it is pointless, but its amazingly difficult to avoid.

Thankfully there is no chance I will wait for nearly a century for my results.

So Dr. Mainstone, I tip my hat to you for your patience, fortitude, and resolve. I am so sorry you will miss it, again.

 

 

 

Personal Update: Feeling more pregnant than ever. With Spork I didn’t have much morning sickness but I was so exhausted every day I came home from work and would fall asleep on the couch before dinner. Its way too early for real pregnancy symptoms, but I did feel that tired yesterday. I am hopeful Blob has stuck and is already putting his Mama to the test!