Waiting on CD1

So here we go again... sorta... in a new kind of way I guess. This next cycle I will be taking my first ever Lupron Depot shot. It is an injection that puts your body into a state of menopause basically and is thought to calm the uterine lining and any inflammation that may be present. Sounds promising but of course who knows if it's my winning ticket or not.

Unfortunately we have to wait and try and see when CD1 comes... see it's all about timing because the shot is a 3 month injection and then we set up for a Frozen Embryo Transfer and this all seems to align very close to Christmas... and of course there are clinic closures etc.

So we wait and see. If not this month, possibly next or at worst the one after that. I'm not tied to any of these timelines, I no longer feel this sense of urgency. I'm in no rush to go through all of the ups and downs again, but I AM ready.

I've been questioning a lot lately whether or not I should be getting a lap first (for endo). What I came to the decision of, was that surgery is risky, and if Lupron could work, why not try it first. But then you ask yourself, "but what if a lap is the answer and I'm unneccessarily wasting good embryos?"... but truth be told if I did lap, I might be asking the same thing of if I did Lupron. So let's just say that it's a coin toss. I have to be okay with the idea that BOTH may be part of my future. And that one vs. the other isn't going to make a difference. I have to just trust my gut and go with it.

I met with a beautiful (inside and out) woman off one of my support forums (Hi if you're reading this!) who encouraged me to follow my gut. She like so many others I've chatted with have been around the block just as long or longer than myself. Maybe not always in years passed, but in tests, and procedures and cycles etc. I just wish we could all have our happily ever afters. But it was nice to meet someone face to face and feel like I was understood. When my food came and it had cheese on it she immediately knew that I needed to send it back. See dairy for immune or endo girls is a no no. She didn't even need to know that I was also allergic to know that I shouldn't be having it. That's a refreshing experience, as small as it might seem.

Anyways... as I write this I am filled with hope, fear, anxiety, anxiousness and excitement over the prospect of getting back on the horse so to speak. The countdown is on... well as soon as CD1 appears I guess.

Long Conversations

So yesterday I had my phone consultation with Dr. Dulemba regarding laparoscopic surgery for my endometriosis. He's a funny character, and has a quirky sense of humor, but he is also incredibly knowledgeable and forthcoming with his opinions and what others may think of him. I found that refreshing, and makes me respect and trust him.

We had a long conversation about endo and about hormones and ways to go about "treating" it. I put quotations because really the only true treatment seems to be surgery, but there are certainly options to manage the disease as well. Nothing cures it.

So anyways, it was quite a scientific discussion, and a lot of information was thrown my direction. First thing he said to me was, do you have a way to record this? So I did... though I'm not sure I could go back and listen to it all over again, it was a long thorough talk. He asked me some questions to get a sense of how long I've been living with symptoms, how I've coped, and he discovered I am trying to conceive.

This is where I got a little nervous. He is not, nor does he claim to be, an infertility specialist. He understands that he knows very little about endo and its effect specifically on fertility, and instead referred me back to my doctor. Logically though, we talked through some of my concerns and it was nice to hear from someone who specializes in endo that my gut instincts about having surgery before another attempted cycle weren't out of left field. But my RE put some concerns in my head about doing more damage than good, and discouraged me with the facts that there is no evidence to support that surgery increased fertility rates.

I knew before going into this that a surgeon is going to recommend surgery, and an RE is going to recommend IVF and meds. It's a well known fact in the immunological support community... but that doesn't help in terms of coming to any kind of decision.

I guess where my head is at now, is that I've done 3 rounds of IVF with no success. Sure, an immune protocol COULD be my winning ticket, but what if its not. What if I go through a whole other round to be unsuccessful and have used up 2 excellent embryos. What a waste. Why not give myself the best shot possible. At this point, I really do believe it would do more good than harm. But I'm no expert.

Why does no Endo Fertility doctor exist? Ugh. Way too specialized I suppose. I know that Dr. Braverman and Dr. KK definitely take endo into consideration for their patients, but they're expensive and far. This journey is expensive enough as it is, and with us looking into adoption, I don't want to be completely out of money to explore other options if I need to.

Anyways, so I'm thinking surgery at the end of August. Homme InFertile and I talked about it briefly last night but my head was spinning and I was running around like a chicken with my head cut off (no literally, I burned myself even because I was so all over the place). I think tonight we'll discuss it further and I will call the clinic to get information regarding insurance coverage etc. My plan of action is surgery mid/late August, 3 months of lupron, and then a FET. But a little wishful side of me wonders if maybe, just maybe I could get pregnant naturally after surgery. I don't know if that's a pipe dream though, so more to think about.

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In case anyone is interested, here is my very scattered note-taking from the call. It may require some deciphering haha ;) but feel free to ask me about it.

Colonoscopy ***

Endo - Immune System Disease  

Commonly also have Interstitial cystitis

http://www.mayoclinic.org/diseases-conditions/interstitial-cystitis/basics/symptoms/con-20022439

http://endometriosis.org/resources/articles/interstitial-cystitis/

Women’s Health Initiative (WHI) - breast cancer and hormone outcomes (study)

Pelvic Floor Dysfunction - physical therapy (it is real, people do benefit, but it’s overused)

Options:

• Do nothing
• Pain management
• Lupron
• Mirena iud

ROBOT LAPAROSCOPY***

Sometimes they put a barrier in… but this is foreign tissue (which in some cases can create more scar tissue)

they use amniotic tissue to try and avoid this (it’s slippery and ideal) but is very expensive (a very small piece is like 2k) - even then it’s not perfect

Stitch up the ovaries (ovarian suspension) for the primary healing period (about a week and a half)

Second look laparoscopy (surgery a week apart)

Ultrasound

Pre-op visit (day before)

Surgery the next day

Wednesdays and Fridays for Surgery

15th-26th ish

Office manager - insurance - melinda

Amniotic tissue is NOT covered.

Surgery, FET, or Adopt?

I wish I just had a crystal ball sometimes... like I could just see into the future, have confidence knowing all will work out. I guess that's what faith is supposed to be, but I'm running low on that these days.

See every decision I make leaves me with a plethora of what-ifs. What if I had of held off transfer because I was sick last cycle? What if I hadn't of been sick? What if I had of done PGS? What if I had of pushed for immune protocol? What if we had done more testing? What if we had of put back in 3? What if we had only have put in 1? What if, what if, what if.....

It's hard to not look backwards, when you can't look forwards. When there is so much uncertainty in your future. When you have too many options... too many paths to choose from. For me, these days, those options are the big 3.

1. Surgery to treat endometriosis and hopefully increase odds of success following recovery.

2. FET with 2-3 of our remaining frozen embryos with a full immune protocol in place.

3. Adopt a newborn that is biologically not our own.

Within each of those there are more options.
Surgery:
- do we try right away after, or do we allow time to heal?
- do we try naturally following?
- do we follow this with IVF? or IUI?

FET:
- do I do intralipids even though I have a reaction to egg?
- do I do 6 months of lupron before trying? or just a few weeks like RE advised?
- do we put back in 1 to not muddle, 2 which we've done every other time, or risk doing 3?
- do we wait to do FET until I've been super good on my diet for 6 months?
- do we undergo any additional testing to get more answers?

Adoption:
- do we consider open adoption?
- what ethnicities are we open to?
- how does this work for Canadians living in US? Do we go to Canada?
- do we adopt internationally?
- do we accept twins/triplets?
- do we accept disabilities?

There's a lot to consider, and unfortunately I DON'T have a crystal ball, and unfortunately no one can tell us what is best for us at this time. But we don't know for ourselves anymore either.

Update and Adoption Considerations

It's been a while. I've taken a break to heal emotionally as well as physically. I recently went on a girls trip to Europe. Went all over in two weeks including Prague, Vienna, Venice, Rome, Malta, Aberdeen and Frankfurt. Quite the adventure and so so good for my soul and happiness.

Now that I'm back, of course I return to my family planning. I actually went and did a past life regression with Melanie Harrell who was trained by Brian Weiss. If you don't know who that is, he has a fabulous book called Many Lives, Many Masters. Anyway, she took me back to a few past lives, the second of which had an impact on my fertility. *trigger warning* I was supposedly raped by my father in that life which may have been leading to some blockages in my 2nd Sacral Chakra. If you don't know anything about Chakras, a quick google on the Sacral Chakra will explain that it all has to do with sexuality and creative forces.... so reproductive organs beware ;)

Anyways, was all very interesting and therapeutic regardless of whether you believe in it or not. I felt much lighter and got some much needed emotional healing from this.

I'm not sure I'm quite ready to dive into trying to conceive again (naturally or otherwise) but I have been in contact with Dr. Dulemba's office in Denton, Tx and scheduled a phone consultation regarding a laparoscopy etc. Apparently he's one of the best!

On another note, I've been heavily researching our adoption options. We are scheduled to attend an open adoption seminar to learn about the process. I've also put in a preliminary application with an agency to see if they'd be willing to work with us since we're Canadians living in the US but no green cards or citizenship. So we'll see what they have to say. I anticipate there being many a hurdle on that front. Hence "you can always just adopt" being a really annoying invalid statement (as well-intentioned as it often is). It's also absurd how much it all costs. Ugh... maybe we won't be buying a home next year. Boo.

So that's my quick update... where things are at with me right now. I've been enjoying not being so strict on a diet, and just relaxing into living life. It's important to take care of ourselves throughout this journey and that has certainly been my focus these last few months.

I'll keep ya'll posted!

Where to go from here...

Another negative this morning and I know it's really over. I'm technically 13dpo (or 8dp5dt) ... today was our initial test day plan for a reliable result and it's stark white (as expected).

So picking up the broken piece of another failed cycle and trying to move on. Or forward at least. Beta is still scheduled for Monday (though we know what the result will be), and our WTF appointment to follow directly.

I've made the decision to have surgery for my endometriosis before pursuing any further steps. I've found a great doc down in Houston, where we're moving next month or so. I'll have a consult, see what she has to say, do a laparoscopy or hysteroscopy depending on what she suggests and then see what she discovers. We're also considering PGS testing on our frozen embryos but we know that's not ideal/easy/or in some cases even possible since they're already frozen. Hindsight is always 20/20. It just felt so different this time, I guess we were just hopelessly optimistic.

I might be M.I.A for a while as we grieve, move cities (oh goodness), and get settled in our new life. Though doubtful I'll be able to stay away truly since this is such an outlet for me.

I hope to come back and finally finish my story with a happily ever after. One can dream.