Garage Sales, Pumpkin Candles & Football: Fall is Officially Here!

Is it just me, or is there something strangely thrilling about selling your old crap from the comfort of your own garage? Our neighborhood has two community-wide garage sales each year, and every year it's the same thing; My husband laughs at me saying, "No one is going to buy that! Are you kidding me?!" To which I always respond, "Oh, just wait and see! People will buy anything!"

This year, we literally went through every single cabinet, drawer, and corner of our house to pull out anything not being used. Our front hallway was beginning to resemble an episode of TLC's "Hoarding: Buried Alive." BTW, if you are a neat freak like me, I do not recommend watching that show. It's like a bad car accident you can't look away from! Ick

Garage sales in our neighborhood are so insane there are actually traffic jams near the entrances. As usual, there were people bombarding our driveway as the sun was still rising and I was scrambling to set everything up. Then towards noon, the real show began. I sat back in my rocker and watched people drive by with huge truckloads of furniture, toys...you name it, all bungeed together haphazardly. It's just astonishing to see how nuts people get for a good deal. That's about the time I usually make a table that says "FREE" which creates a frenzy I'd liken to the release of Cabbage Patch dolls in the 80's. WOW! Take it! Take it all!

4 hours and many "interesting conversations" later, we walked away with $750! Well, technically my husband was out golfing as I wheeled and dealed, but he donated some electronics, so we'll let him slide. If only I could have a garage sale every weekend my life would surely be more interesting. Oh, who are we kidding? The fact that I even find it thrilling probably means I should get a life in the first place. ha!

Why stop there? We have a small jar about 4 inches high in the kitchen that we throw all of our change into. It reads "Vacation Fund" but I am on the prowl for one that says "IVF Fund."

What, they don't make those you say? Still, that jar isn't fooling anyone. We all know damn well none of that $$ is going towards vacation. It's going straight to our two main cash funnels (a.k.a. fertility treatments & hubby's MBA.)

Needless to say, I was shocked when I emptied this tiny jar full of coins into the local Coinstar and out popped a voucher for $60. Hot damn! I love Coinstar! If you have never used one, please dig through your seat cushions immediately and try it out.  It's nothing short of winning on the slot machines in Vegas. Plus, with this there is no risk of losing. All that was missing was a flashing light and siren. It's like free money I tell you!

Even if we aren't planning a vacation anytime soon, we did not waste any time treating ourselves to a dinner out with friends and enough Moet to kill a small horse. You see, this is what happens when you are on such a strict regimen of no alcohol, no gluten, no dairy, no FUN for God knows how long...it's hard to stop once you finally have it! We had an absolute blast, but being that I'm normally such a rule follower while undergoing fertility treatments, I still felt a wee bit guilty waking up in a bit of a haze the next day. Oh well, I won't pretend to be perfect. We took our butts straight to church that morning, which helped me feel like a little bit less of a sinner, especially since we tithed 10% of the garage sale earnings. :)

We were also blessed with a little cold snap and some gorgeous weather this weekend in Austin! Lows in the 50's-60's at night and sunny 70's-80's during the day. Perfect weather for some Sunday lunch, shopping, and lazy football watching. I figured I'd finally make Fall official with this scrumptous addition...

I will admit that Fall, and more specifically November, have become a bit of a thorn in my side from an emotional standpoint. I've lost pregnancies the past two Novembers in a row, and still no baby or even hope for a pregnancy in the next month or two. My ovaries are basically put to sleep right now while I am on hormone replacement as part of recovery post-surgery.  I'm really going to try extra hard to stay positive during the holidays this year. I've got to keep finding joy in the little things...like pumpkin candles, fuzzy slippers, baking cookies and wine by the fire. I know the holidays (Halloween, Thanksgiving & Christmas) can be hard for many of us trying too long to start families, but I hope you'll be able to find joy in the little things too.

Speaking of Fall...As you may remember, I applied to do substitute teaching at my local school district right before the school year started. Well, I have STILL yet to be hired. I am beyond grateful to be a stay-at-home-wife right now, but I'm getting antsy and would love to be back in the classroom on a part-time basis. I would think I'm overly qualified; A former teacher (although certified in FL), and I graduated summa cum laude with an MS in Education. Either the school district is super unorganized, or they have a serious overabundance of subs here, because it's like pulling teeth trying to get hired as a freaking substitute teacher. It's not rocket science, so what gives? Hopefully I will get an offer for employment with them soon. It would really be nice to make some extra $ and still have the flexibility I feel I need to stay sane right now. Just continuing to pray for patience, guidance and peace here...

Reproductive Immunology Consult

In my never ending quest to figure out why we haven't been able to get pregnant easily, nor keep a pregnancy once it happens, I've done some personal research on RI (reproductive immunology) here and there. RI is a somewhat limited scope of practice within reproductive endocrinology, and to say that it's controversial would be an understatement. There are very few physicians who focus on treating the immune system as a cause of infertility. The ones who do believe strongly in it's importance and are quick to defend the protocols they prescribe to their patients, many of them claiming to help the women no one else can help.

Most RE's who DO NOT look at immunology on an in-depth level as part of the infertility patient's treatment plan are likely to point out that "there's not enough large scale double blind peer reviewed research." I get this. Even as a lay person, I am extremely selective with which studies I think are worthwhile, and it's not hard to recognize which studies simply show correlation vs. true causation. The infertility field is FILLED with studies showing causal relationships between various lifestyle factors and IVF success/failure rates. For instance, as you probably know, just because someone drinks less than 3 glasses of red wine per week, it doesn't mean that is THE THING that caused them to become pregnant through IVF. It just so happens people who drink less than 3 glasses of wine might also tend to eat healthier, sleep more, and engage in a host of other healthier lifestyle practices, which could ultimately affect IVF outcomes...You see my point.

Still, I do think there is something to be said about treatment options that might not have the huge body of double blind research backing it up quite yet. It's very commonplace to treat cancer patients with drugs that "show promise" through clinical trials. Some of the most effective cancer treatments available today were once only available through clinical trials and that is HOW they were discovered to be so effective in the first place. That is how I kind of view the field of RI right now.

There may not be a sufficient amount of well-designed RI studies that would garner complete acceptance for many of our RE's at this point in time. However, even my RE admits, "We think there's something to it (autoimmunity as a factor in infertility & pregnancy loss)." He is also quick to follow that up with, "We just don't agree with many of the treatments being used on patients, not until there is more research showing sufficient proof."

So, here I am as a patient who has now transferred 5 seemingly normal blastocysts with no success beyond a chemical pregnancy. Was my lining just not optimal? Were our blasts genetically or chromosomally abnormal is some way? Was it just a bad batch of eggs altogether? OR is there some sort of autoimmune issue causing my body to see each embryo as a "foreign invader" and attack it?

There are quite a few doctors who believe some women have heightened levels of activated natural killer cells in their uterus, which basically attack embryos looking to implant. It's even theorized that because activated natural killer cells only live in the uterus and not the fallopian tubes, ectopic pregnancies occur in some cases. I have personally had 3 early losses now, one of which being a suspected ectopic. So yeah, it does interest me and make me scratch my head a little, wondering if there's any chance this could be part of our issue? I also have a family member with lupus and have tested positive for APA's (blood antibodies) myself. Both factors are autoimmune in nature and could be seen as "smoke" which might lead to fire in my case.

I already blogged about the book Is Your Body Baby Friendly before, but if you haven't read it and want a Cliff's Notes version of the principles I'm talking about, feel free to check out these videos...

Failed IVF, Chemical Pregnancy, or Miscarriage
Implantation Dysfunction
...More Videos on Infertility, IVF & Pregnancy Loss

There are definitely two sides to the story for women who do seek immunological treatment to become pregnant. There are those who experience years of infertility, including multiple pregnancy losses, failed IVF attempts, and even donor eggs before seeking treatment for the "underlying immunological cause" which seemingly was the answer the whole time. They found THE THING that worked for them, and with some very individualized tweaks to basically "turn off" their overactive immune system, went on to have their own biological children.

Then, there are other women who regret opening the giant can of worms that is RI; Expensive tests done by very few labs in the country, somewhat untested treatment plans (by the larger medical field's standards), some traveling to Mexico for non-FDA approved treatments, and thousands upon thousands of dollars spent and more time wasted,  only to end up with no baby. Some of these same women have even gone back to their original RE after no success with RI, and THEN became pregnant without any immune protocol whatsoever. So obviously, even if specific immune testing revealed abnormalities in these women, they didn't have success with immune treatment but ultimately DID without this special treatment? How do the RI's explain these cases then?

My own RE still contends that our losses and failed IVF's have most likely been due to genetic abnormalities in the embryos (and more specifically those coming from the egg). There is a plethora of research out there to back up his viewpoint that this is the most feasible argument. However, what if I am yet again one of the very few % of women who doesn't just have "flawed eggs" and it's something else?

I have been extremely hesitant to even toy with the idea that there could be something autoimmune related going on with us, because of the mixed outcomes I've seen out there. So far, I've been continuing to put my trust into my own RE's extensive expertise of more than 30 years, while also reading about all the other cutting edge stuff going on and bombarding him and any other doctors who will listen to & answer my questions. Ha!

Hubby and I have been discussing seeking a 2nd opinion for a while now. I guess a forced break following surgery and knowing we only have two embryos left in the freezer lit the fire under my ass. We had a Skype consult with Dr. Geoffrey Sher (in the videos above...one of the more well-known RE's who practices RI) on Monday morning. I read his book IVF: The ART of Making Babies before we ever did IVF, and I am familiar with how he practices from watching his videos. There are other popular physicians like Braverman (NYC), Kwak-Kim (Chicago) and Beer's Clinic (CA) who delve pretty deeply into the autoimmune stuff. To be clear, I'm not jumping ship on my current RE at this point in time. I've asked Dr. V first how he felt about us seeking outside opinions out of respect, and he is all for it. Dr. Sher gives FREE consults to anyone who wants one so why not, right?

Just as I suspected, Dr. Sher would like me to do a blood test for activated natural killer cells; Specifically the K562 Target Cell Test. I have been curious this whole time if I have activated natural killer cells, so I am fine with doing it. I appreciate Dr. Sher ordering the test for me pro bono. I have not paid him a dime. The test is done through Reprosource in Boston, as they are one of the few labs in the country who run this test. They will refer me somewhere to have my blood drawn here, and I will just Fed Ex my sample to them. If it's found to be negative, nothing further will be needed as far as immune testing. If it is positive, then further testing can be performed.

I am doing this K562 test with extremely OPEN eyes; Knowing that while Dr. Sher might truly believe in the importance of it and I'm more than curious to find out the result myself, a good deal of his business is built upon finding a "reason" the patient would need to seek help from him...because most RE's out there do not specifically treat for these underlying immune issues. He has gone so far as to give me his cell phone number, send a follow-up email, the works. I am ultra sensitive to feeling like I'm being sold something, and I really have zero buy-in to that approach.  I kind of feel like a guy just sent me a drink from across the bar, and now I'm half obligated to talk to him or something. I would like to think he really cares that much to help someone for nothing, but I know better.

Plus, I was already annoyed that he was 15 minutes late to our Skype call, even if he was doing it pro bono (It was so early, I had to be his first patient of the day, so no excuse really). He also got a couple of the facts wrong concerning our previous timeline of treatment in his follow-up summary email. Most troubling is that he does not report his success rates through SART because he's a staunch opponent to the entire reporting system. He's created a reputation for himself by being somewhat "rogue" or what he'd probably call a "pioneer", but personally I feel like the non-reporting of success rates through SART is a total cop-out. I see no evidence of his own success reports in a format of his own choosing either on his own website.

I don't care how much you don't agree with the establishment. If your success rates are that great (80% as dictated by his nurse), you will find a way to shout them from the rooftops to every other doctor, government agency, and prospective patient out there! This is a major red flag to me. I have extremely high expectations with the medical care I choose, and so far he's falling short in the "this feels like a fit" department.  So, I will let him do this test because I'm curious and it's supposedly covered by my insurance anyways,  but my bullshit detector is on standby, and it will go off loudly at a moment's notice!

I know there are quite a few women out there who have looked into RI, or those who've at least done research on it and are curious. What did you learn? What are your hesitations? Any feedback on Dr. Sher or other RI's specifically? Would love to hear your thoughts!

Post-Op Follow-Up with RE

We had our post-op appointment a week early and a little unexpectedly yesterday. Apparently, if you have a uterine septum removed, your uterus then becomes the proud recipient of a strange triangle shaped balloon filled with blue dye, that is supposed to remain in place for 2 weeks. This balloon is basically a "place holder" while the uterus is healing.

The plastic tubing you see exiting the cervix is stitched by the physician so that the tubing doesn't fall out of your body completely. However, if you are lucky like me, you will somehow manage to bust the stitch in half....thus resulting in this long ass plastic medical cord hanging completely out of your hoo-ha a good 4 inches. Sexy right?

My nurse told me to come in and get it checked out, and I'm SO HAPPY I did. Dr. V said we could go ahead and remove it altogether...that there is no real evidence leaving it in there for the full 2 weeks as opposed to 1 will make a difference. I am healing fast, and I honestly feel like this thing has been causing more bleeding and agitation just by being in there, so I definitely agreed!

I will say, that out of all the procedures I've had done, the removal of that sucker was definitely the most uncomfortable. It lasted for only about 2 seconds tops, but the feeling was quite indescribable. Imagine someone plucking a hard plastic triangle shaped object through a hole that is smaller than a pencil eraser. Do not be fooled by the word "balloon," because it is anything but soft. Ick! Oh well, at least I am a cyborg no more!

We also talked about everything done during surgery.  Here is a basic diagram showing what was done during the laparoscopy...

-Cyst that was all twisted up around left fallopian tube removed
-Scar tissue on left ovary leading to surrounding tissue removed
-Scar tissue on bottom of uterus & crossing bowel removed
-Scar tissue on liver removed
*Uterine septum also removed, but done through the hysteroscopy & not included in this diagram.

That big bulging thing at the top is the uterus. Anywhere you see orange is scar tissue, and anything orange was removed. You can see scar tissue stretching from the lower part of my uterus here. Apparently, some of the scar tissue was also transecting my bowel, which could have caused complete blockage in the future. Glad that's gone!

The white tube on the left is my left fallopian tube. That nasty blue looking thing is a cyst the size of a lima bean. Notice the tissue attaching the cyst to the fallopian tube. Turbie Twist has nothing on this thing! How on earth it got so twisted up I do not know, but it looks like it's got a death grip on my tube...

Same structures, different angle. Is it just me, or does the tube look like it's being strangled? I also find it awfully ironic that this is the side where I had the "suspected ectopic."  While Dr. V says he doesn't think this would necessarily cause an ectopic pregnancy he can't rule it out either. There is no way to tell for 100% certain, but there's a small chance the cyst could have been causing issues with "uptake of the egg" any month I ovulated from the left side.

Hmmmm. Let's think about this; My left ovary is my dominant ovary. Most months (when ovulating naturally or on just pills...ie. Clomid/Femara) I ovulate from the left. I know this from many many months of ultrasound monitoring and also ovulation pain periodically. So, if most months I am ovulating from my left ovary, and there has been a possible issue with uptake and/or passage of the eggs on this side ALL ALONG, could it be more than coincidence we've had so many issues getting pregnant on our own? Well, it's plausible if you ask me. My RE says it's unlikely yet "possible."

Maybe the eggs just weren't getting taken up by the tube like they are supposed to.  I realize in the world of infertility, NOTHING is cut and dry, but dare I say that having this little clue has given me a tiny bit of hope that wasn't there before? It may be false hope, but at least there is nothing strangling my tube anymore. Hallelujah!

BTW...the cyst was biopsied and it was benign. Additionally, Dr. V said if there were any cancer  inside on my lady parts, he would have seen it. So, I also got confirmation that there are no signs of anything like ovarian cancer (a.k.a. the silent killer which stole my mom) brewing anywhere inside of me.

Stringy thing above: I think (?) this is the scar tissue that was attached to my left ovary and stretching across to surrounding tissue.

Slimy gray organ above: Not many people get to see their liver up close and personal, but here it is!  Scar tissue removed.

Lastly, all of that white stuff in the middle is the uterine septum. This is what dipped down into the top of my uterus (birth defect).  I'm guessing it's white because of very little, if any blood flow to this area. I can see why uterine septums can cause miscarriage. If the embryo implants here, it's certainly not optimal. Dr. V said my septum was slightly more pronounced in reality compared to what my HSG's showed. I've heard many people receive the same "It was more than we thought" news once doing the hysteroscopy. Glad the top of my uterus is no longer comprised of tissue with no blood flow! Geesh!

As you can probably gather, we are happy we had the procedures done. It has completely erased doubts we had about polyps or endo existing. We are thankful those things are NOT issues. It also brought other very interesting things to light, which could have been playing a role in our infertility.

And so the recovery continues. No more antibiotics, just estrogen and progesterone to mimic a cycle. We are instructed to wait one additional cycle after this one before proceeding with our final FET. This puts us at late November/early December to begin our FET cycle. In the meantime, I will just do what I always do...take care of my mind, body, and spirit the best way I know how to. The "break" will be nice. I had a few glasses of red wine last night at a wedding rehearsal dinner, and it really never tasted so good! ha!

The icing on the cake yesterday was coming home to a surprise hubby had ordered. How cute is this magnetic chalkboard? It's on the side of our fridge now, so we can write love notes to each other any time we want. I really hit the lottery marrying my hubby. He's been there with me every step of the way. The road to parenthood has tested us in ways we'd never imagined, but in the end, we are stronger because of it. :)

Wonderfully Made

Sometime in life I receive an unexpected message that I need to hear, in the most unlikely of ways. I must admit that 4 days ago as they wheeled me back to the OR for my surgeries, I felt so vulnerable and broken. I wiped my tears as my RE walked up to greet me, because I didn't want to seem like a wuss.

We had literally only made the decision to move forward with BOTH hysteroscopy and laparoscopy less than 24 hours before; Maybe my mind just didn't have enough time to process they would actually be CUTTING into me in 3 places now instead of just inserting a camera through my cervix with no incisions? Quite a big difference! I realized that even though the lack of time to mentally prepare was causing me anxiety to the point of tears, it was probably better I didn't have so much time to think about it first. Quick and painful is more my style....always has been.

I think it's true what doesn't kill us makes us stronger. I used to hate that saying, but the longer I live life, the more I realize it's true. I went through thyroid surgery 4 years ago; They removed a golf ball sized cyst from my thyroid for goodness sakes! Surely, if I survived that I would survive this too. So, I sucked it up, took a deep breathe and said, "Just knock me out fast please!"

The day following surgery was not easy by any stretch of the imagination. My body was so out of whack from the anesthesia wearing off, and the pain medication didn't seem to be helping during the first 24 hours. I felt a weakened and defeated "poor me" mentality starting to take over my psyche. I have really been working on re-training my brain to work through negative thought patterns though (with help from my therapist and more prayer).

One thing I've found especially helpful is not ignoring those thoughts, because if you just ignore them, they'll keep coming back at inconvenient times in a cyclical fashion. Instead, I acknowledged the hamster wheel of negative "whoas me" that had begun turning in my brain and just said to myself, "I hear what you are saying, but let it go. Let it go. You are stronger than this. You have been through worse, and you are wonderfully made. This surgery will be no match for you."

I then closed my eyes and lay there, imagining my mom standing near my bed. She has been gone for 8 years now, but I could literally feel her presence; One of her hands was holding my palm and the other was brushing the top of my hand, like she always did when I'd get sick as a kid. She had the softest hands on the planet, and I still know exactly how they felt. It was like a blanket of comfort was placed over my entire body, and I knew everything would be ok. I'm telling you, it was a moment of divine presence like never before.

From that moment forward, I have begun feeling exponentially better in what seems like record time. I have always believed in God's ability to heal of course, but I also strongly believe in the power of our own minds to direct our bodies towards healing. Sure, there have been aches and pains, like the huge amount of CO2 that was trapped under my rib cage, causing pain and inability to fully breathe. I've just been making fun of the side effects and finding humor in them. I told my friend I felt like a Macy's Thanksgiving Day balloon, because that is exactly what it felt like! ha!

Really, I'm just choosing to focus on what's going right. Each morning when I wake up, I tell my husband about all the improvements that are being made OUT LOUD. I'm just so excited to wake up each day to small improvements, and I feel like in doing that I'm continuing to speak victory over my recovery. All I know is something is working. I've been regaining about 10-15% of myself each day. Yesterday, I drove my car and was back in the gym. Even if I'm only walking on the treadmill at 2 mph, I'm absolutely amazed at how quickly I'm recovering! I've been off pain meds for two days now, except for the occasional extra strength Tylenol. Yesterday and today have been the biggest turning points. I honestly feel about 60% back to normal already.

This is where I realize I've just received an unexpected message I needed to hear...I mean really NEEDED to hear. I AM WONDERFULLY MADE. I went into this surgery feeling so incredibly vulnerable and powerless. Now, despite looking down at incisions and still having some soreness, I feel twice as strong emotionally and spiritually than I did going in. Seeing how fast my body is bouncing back has been a much needed reminder of how truly AMAZING the human body is....all of our bodies are! I know it's so easy to forget, especially if you are going through infertility, but I just want to remind you all that YOU ARE wonderfully made! This song says it all...

                                                "Wonderfully Made" by Matthew West

Love it! BTW, if you haven't listened to his entire record, I highly recommend it. Very uplifting stuff!

Now, I do think that healthy nutrition, drinking oodles of water, taking my meds on schedule, and pushing myself physically each day are playing a role. However, a larger part of me is being boldly reminded how powerful our minds are in guiding our healing and how powerful prayer can be. Not only that, but also how powerful we are on a basic biological level as human beings. Is it just because I'm a total science nerd? I am seriously just blown away by the phenomenal things our bodies can accomplish in such a short time.

Every day, I'm asking for healing. I'm speaking victory over each small hurdle I overcome. I'm taking time out to be still and visualize my body healing from the inside out; Each area inside where something was removed by the surgeon is being bathed in a healthy environment. Each resection of unhealthy tissue has been removed to pave the way for new and improved blood flow and proliferation of new cells. Each and every fiber of skin being held together by sutures is re-attaching and healing with lightning speed. It's like there is a 9th grade biology video playing in my head! I am seeing it unfold, and I can literally feel my body healing from the inside out. It's quite a miraculous thing I must say.

Please stop and take the time to give yourself some credit today. Remind yourself that you are wonderfully made too!

Doctors, Insurance, and Surgery Oh My: Hysteroscopy & Laparoscopy Done!

The past 5 days have been a whirlwind of doctors, nurses, surgery coordinators, and insurance companies. In my last post, I talked about how excited we were to FINALLY obtain insurance coverage for a hysteroscopy. This procedure would enable our RE to look for uterine polyps (possibly causing implantation issues) as well as to correct the uterine septum I was born with (possibly causing miscarriage/infertility issues). The hysteroscopy box has been left unchecked this whole time, but we've felt increasing urgency to do it lately, especially since we have now had 3 failed IVF transfers and have only two remaining embryos left on ice.

So, here I was....all scheduled for Friday's hysteroscopy. No big deal really. Then, I get a call from my RE asking how I would feel about adding a laparoscopy to my surgery. As many of you might know, the laparoscopy is another box many people like to check BEFORE they jump into more invasive fertility treatments. This procedure is more invasive and requires much more recovery than the hysteroscopy, but it allows the RE to get a complete view of the abdominal and pelvic organs and is used to diagnose and treat endometriosis, fibroids, cysts, and scar tissue. In fact, this is the ONLY procedure that allows for the diagnosis and treatment of endometriosis. Research has shown that even small amounts of endometriosis can result in infertility, and even IVF failure. Many times, hysteroscopy and laparoscopy will be performed simultaneously since they address different things related to infertility. 

Now, keep in mind we were presented with the option of doing laparoscopy way back when, after we hadn't had success with Clomid & Femara alone and were considering moving onto IUI or IVF. At that time however, we were told we were NOT covered for laparoscopy and that it would be a $12,000 surgery. We were given the choice of doing this very expensive surgery that might not find or solve anything, OR we could roll the dice with IUI or IVF. It was up to us. We made the decision to skip the surgery, mostly because we had zero insurance coverage for it. If it were FREE, you bet I would have chosen to do it a long time ago.

My RE is not the type of doctor that goes cutting into anyone unnecessarily either, and so he agreed with our decision to pursue IUI and IVF without ever having the laparoscopy done. He is also somewhat conservative and tries to get his patients pregnant with the least invasive means possible first.  A lot of his patients end up getting pregnant with pills, IUI, or IVF and never have to go through any surgical procedures whatsoever. Those people are very fortunate! Not to say that going through IVF is easy at all, but being able to skip any additional diagnostic surgeries and become pregnant is a bonus.

However, when you are like me...someone who has had fertility treatments for 26 months, 3 pregnancy losses, and 3 IVF transfers, still with no viable pregnancy, you find yourself going back to square one and asking yourself what's being missed....if you should bite the bullet and just have the surgeries to check things out for real, once and for all. I have never had anyone go in with a camera and actually look to see what's going on in there...nothing past two HSG's. As the IVF failures add up, it's begun to feel like we're throwing embryos into the vast unknown. 

Really, the only thing that's ever held us back from doing the lap was the cost of this darn surgery. Well, low and behold, all of a sudden for reasons unbenownst to me, I'm told we are now MAGICALLY covered for both the hysteroscopy and laparoscopy procedures under certain "medical coding" for my uterine septum?!?! I am trying not to get my panties in a giant wad over the lackluster timeliness of this miraculous occurrence and just focus on the fact that we have people working extra hard on our behalf to get something, ANYTHING covered with zero fertility or diagnostic coverage NOW....even if they didn't seem to work quite as creatively on our behalf before. I can't change the past, so I'm just trying to be grateful we are obtaining the coverage now.

We double and triple checked this week that both of these procedures would be covered under the medical coding being used. We even had our RE's surgery coordinator conference us into her phone call as she obtained benefits approval from our insurance company and recorded the entire conversation on mp3. Insurance companies rule the world, and you can never be too careful! I will believe it when I see the claim go through ultimately, but it looks like we were able to obtain coverage for $15,000 worth of surgeries for a mere $20 copay. So, my response to my RE was "Let's do this!"

Both laparoscopy and hysteroscopy were performed yesterday. Here are the findings (from what I remember/understand):

-uterine septum was excised...GONE!
-cyst found "all twisted up" into my left fallopian tube was removed
-scar tissue found on supporting ligament/entry into uterus (?) removed
-scar tissue found on liver removed
-NO endometriosis
-NO polyps

I'm told that if I wasn't already experiencing pain from the cyst on my fallopian tube, that it would have caused issues in the future, and it's good that it was removed. I have complained before of stabbing pains in the left fallopian tube/ovary area before, and very pronounced with both of my last pregnancies during the time when implantation would have been occurring. That is also the side where my suspected ectopic pregnancy occurred. Very interesting indeed.

Not sure where exactly the scar tissue was on this uterine ligament/structure/thingy, or what it could have affected...will have to gain a better understanding of this at my follow-up apt. I am beyond thrilled that there was no endometriosis or polyps. In a way I'm sure my RE could easily say, "See I told you so...didn't think you had either of these things present." On the other hand, at least now I know. I mean, how do you know until you check!? Most of all, I'm glad the uterine septum is gone, because that definitely could have been causing issue and also present issue with any future pregnancies.

So far, recovery has not been fun. The procedures took two hours. I had a few things cut out of there, and I'm definitely feeling sore and heavy and uncomfortable. There were three incisions made in my pelvic area, and there is still a balloon inside of me that won't be removed until two weeks from now at my follow-up appointment. It feels kind of similar to the day following an IVF retrieval...like you're walking around with a huge bag of marbles inside your abdomen, except more painful. I can't sit in a chair, but I can stand up and lie flat. I'm basically just rolling in and out of bed like I'm half paralyzed to pee and then go right back to watching tv and sleeping. We may not be able to try our last FET until November due to recovery time. However, I haven't had any nausea, and for that I'm thankful. So far so good in the whole scheme of things and no regrets; I have been through worse before (thyroid surgery) and I will get through this too.

With any surgery there are risks. There are people who have had horrible recovery experiences with laparoscopy and wish they'd never done it. Then there are others who've had easy recovery or found things that impacted their fertility, so it was worth it. There are also plenty of stories of those who became pregnant following this procedure as well. Everyone is different, but we are really happy we found a way to take a closer look inside finally. Things were found and taken care of during the procedures, and now I know once and for all if polyps or endo are playing a role.

If our final FET doesn't take, we feel we have a better picture of what we're actually dealing with and which forms of treatment are still feasible. We may not have $$ to keep doing IVF an endless amount of times, so we are thankful to have this broader picture of what's truly going on and what we have to work with going forward.

hCG is Outta Here; Onto Hysteroscopy & FET #3

Lots of good news today. First and foremost, my hCG is already back down to zero.  I was obviously just paranoid about this being anything other than a very early miscarriage. Notice, I don't use the term "chemical pregnancy" which is actually the medical term for a miscarriage less than 6 weeks along. I can't stand that term or "spontaneous abortion" for that matter. I know that's what appears in my medical chart, but it's just a personal pet peeve I guess. I feel those terms take away from the significance of even the earliest loss of life or make it sound as though it was the patient's choice. Is it just me?

Very happy indeed that this short lived pregnancy is already over and a new cycle has begun, because we are ready to move on from it. I think my past experience going through methotrexate shots and zigzagging levels of hCG for 10.5 weeks during our last loss scarred me mentally big time, so I panicked a little fearing this could result similarly. However, there is nothing funky here to worry about, no ectopic or anything remotely abnormal...other than extremely painful cramping and lots of bleeding.

The cramping was so intense yesterday that nothing could touch the pain...not even a double dose of 500 mg hydrocodone. I'm actually not even going to complain about the pain and bleeding too loudly though. I was SO freaking happy to see progress arrive quickly and in full force yesterday.  With every painful gush, I've been so thankful and am rejoicing that things are happening so swiftly!

Today we had our "WTF appointment".  Gotta love my RE. He deserves the "Patience with Patients" award. I walked in with a laundry list of questions and a stack of SART rates for the last five years; My questions did not poo poo around any uncomfortable topics, and I did directly ask him to defend different aspects of things I am questioning....such as inconsistent SART rates in certain categories, what I consider "less testing" requirements as compared with other clinics, and various protocol choices and differences. I am not rude by any means,  just well prepared and documented....total nightmare of a patient I'm sure. ;)

I guess for us, we are beginning to feel like we're throwing embryos into the vast unknown. 5 down and only 2 left...yikes! For me, part of this feeling is because we've never had a laparoscopy or hysteroscopy to evaluate my insides more invasively with a camera. I've always wondered if there's something being missed. I've had two HSG's which have both been crystal clear and a mock transfer prior to IVF, but that's about it. Ultimately, we all agreed that although there has been no real push for me to get a hysteroscopy previously (my clinic does not require it pre-IVF), it is certainly an option still on the table.

We did ask about hysteroscopy a couple times before IVF but were told that we didn't really need it and that it might end up being $3000 spent for nothing. Well, once you've spent $30,000 on treatments and still haven't had success that sticks, that $3000 doesn't seem so "unnecessary" anymore if there is even a teeny tiny chance of finding something that could prevent implantation. We wanted to do this surgery no matter what, but low and behold after hours on the phone to my insurance company and the surgery center, the surgery coordinator at my clinic thinks that outside of a small co-pay to the surgery center this will end up being covered 100%! They will use my uterine septum as evidenced on my HSG's to warrant an actual medical coding and turn what is normally a "diagnostic procedure" into a "medical procedure" so it's covered. WhAt the WhAt?!?!

Um, kind of wish we had the hysteroscopy done a long time ago. DUH PEOPLE! What happened was...My doctor saw in my file that I have no fertility coverage and not even any diagnostic coverage, so he is the one who told me it wouldn't be covered when we asked him about the procedure before. He obviously hadn't considered a different way of coding, which is what the surgery/insurance gal specializes in...creativity if you will. She is the one who said she could get it covered on my behalf all of a sudden. Gah! This is why "checks and balances" are so important when you're getting fertility treatments and have no insurance coverage for them. Oh well, no sense being too pissed about this "slip through the cracks" at this point...We're just grateful we found a way and it IS getting done now and should be covered. I will only believe it when I see that bill for $0 of course.

So, we've scheduled the hysteroscopy for this Friday 9/20. Dr. V will look for any polyps, and will remove anything which could be hindering implantation. We have no reason to believe I have any polyps, because I have never had anything show on ultrasound or HSG. However, there is still a chance, albeit small, he could find something in there. Here is a basic rundown of what the procedure entails...

Additionally, I have always had a slight uterine septum. This is a uterine abnormality (a slight dip in the top of the uterus) that I was born with. It's so slight and shallow that it would probably never cause issues with infertility, but it's POSSIBLE it could cause issue further into a pregnancy....if an embryo implants on the actual septum. Again, it's probably not a huge issue, but I'm not really willing to take my chances with "probably not" anymore at this point. During the hysteroscopy, the uterine septum can also be repaired, so we're kind of killing two birds with this one procedure. This is kind of gross, but this is what it looks like when they fix a septum with hysteroscopy...

It feels like we're basically flying into this procedure in only 4 days, but I am content with the decision. We both feel like it's the right thing to do before transferring our last two embryos, whether they find anything or not....at least we'll know for sure the coast is clear up in there. Should be interesting to see if they find anything!

I know many of you have had hysteroscopies. Would love to hear your experiences, tips, anything you'd like to share!

Pregnancy Loss #3 :(

Today we received word that I am "barely pregnant", and not for long. Blood test revealed:

hCG= 6
progesterone= 8
estrogen= 64

Looks like we can assume this will be our third pregnancy loss. I guess when we entered into this cycle I was thinking that the third time (our 3rd IVF transfer) would be the charm! Well, this third time is definitely NOT the charm.

The past week has felt a bit strange. Friday evening (3dpt) I felt some extremely sharp pains followed by some strange fluttering in my far left lower abdomen (identical to what I felt last time with my ectopic pregnancy). As I lay in bed, I even thought quietly to myself "Um, that felt uncomfortably familiar. I really hope that was either a normal implantation or just gas." I know people rarely actually feel implantation, but I definitely felt it during my last ectopic pregnancy.

Then, I had fleeting and re-appearing signs of what were "maybe pregnancy-like." I tried to ignore them and attributed the super sore nipples coming and going, along with fluctuations in breast size to just being the fertility meds. However, what wasn't typical was how they would come and go day in and day out. The only other time this happened was during my ectopic pregnancy. Like one day I'd wake up with sore boobs, and twelve hours later it's completely gone, and then low and behold it comes back....very inconsistent.

I'm not saying this is ectopic. It shouldn't be, right? I mean, isn't that WHY we moved to IVF in the first place...to avoid the ectopic nightmare we experienced when we did IUI? That is the whole reason for taking the fallopian tubes out of the picture....only 1-2% of people will experience ectopic pregnancy during IVF. I'm sure I'm just reading into everything too much and speculating unnecessarily. Praying with everything I've got that this is a normal early miscarriage and not an ectopic repeat. Yes, I actually just said I hope this is a "normal miscarriage." Sometimes I can't believe this is my life, but I guess it is.

Either way...early miscarriage or ectopic, it's another loss of life and my heart is broken. I had become so attached to the picture of those two seemingly perfect little embryos that were taped to my kitchen backsplash next to our prayer for them, especially the little hatching one. It just seems more real when you can see that process taking place for some reason.

I feel like my body is so broken right now. Sperm and egg seem to be perfectly happy together until they enter my body. It is just the most deflating feeling in the whole entire world to feel you can't do the one thing women are put on earth to do. Animals of every living species don't seem to have a problem with the one thing I can't do. I feel broken, and flawed, and like I may not ever be fixable.

I've tried my best not to ask this question in a pathetic, begging way to God, but I can't help it right now....

Why God, WHY? Will I ever understand why this has to be so hard? I feel like I have almost wrapped my brain around infertility and the lessons we are supposed to learn, but why give someone something if you're just going to take it right back away?

I'll do a repeat hCG test on Monday to make sure the number is decreasing to zero. Praying that my instincts from Friday night were wrong (that this isn't ectopic) and that my zero comes right away with the next test. Then, we have yet another "WTF appointment" set with our RE Monday afternoon. I already have 3 pages worth of questions to ask. In the meantime, I'll be here trying to set the world record for chocolate chip cookie eating. Ugh, I hate these feelings of defeat, heartache, and having to start all over again.