Looking Back and Looking Forward

Where to start? First of all, thanks to everyone for your kind comments, emails, voicemails, and text messages. I cried hearing/reading every single one of them. This process really is gut wrenching and B and I are lucky to have so much support both from our family and friends and from this online community.

Sunday was devastating. I took Monday to grieve and stayed home from work by myself. B had to go to work and he took the dogs to daycare, so I had the house to myself which is rare. I sat in the front living room (which I never do) on the couch in the sun for most of the day reading, crying, staring out the window. I went back to work on Tuesday and actually had a decent day. I was able to distract myself with work for minutes at a time which was nice.

And then Jen got some truly horrible news and it was all I could think about. At least it kept my thoughts off myself for awhile. If you have a minute, please stop over and grieve with her.

Today was a different story for me. I had trouble focusing. I got frustrated easily, angry easily and teared up at the drop of a hat. One thing that is making this week more difficult than it need be is that a project has come up that is requiring me to work much more closely with one of the pregnant ladies in our department. In the 2+ years we've worked in the same department, we've never really worked together. All of the sudden, I have to delegate to her, review her work, rely on her to get tasks done. I have to check in with her frequently, answer her questions. This is no reflection whatsoever on her personally or professionally, but she is possibly the last person I want constant interaction with this week. Such is life I guess. And I'm starting to realize that the grieving process for this will take awhile. Even if I feel great one day, I might feel completely horrible and down again the next.

Off and on over the past two years I've thought about going to therapy to talk to someone about what we are going through. I kept putting it off thinking the next cycle would be it and all our problems would go away. This time I'm biting the bullet and moving forward with it. At the very least I need someone to convince me that I'm not crazy and obsessive (even though I am). Our clinic has a counselor on staff and we have an appointment set for next Tuesday. I don't know if we'll go just the one time, or if it will become more of a regular thing, but I'm ready to give it a try and luckily, so is B. I know he's not looking forward to it (not that I am either), but he is willing to do this for me and that means the world and makes it so much easier. I likely won't write too much here about our session Tuesday or going forward if we stick with it simply because it just feels too private. But I will let everyone know if I think it is beneficial.

Okay, now to the looking forward. We're getting back in the game-immediately if we can. AF showed up today, so I'm officially on cycle day 1 and I'm waiting to hear back from Dr. S to see if he's okay with us moving forward this cycle or if we need to wait a month or so. Dr. S did call me on Monday to check in and see how we were doing. He apologized and was pretty sympathetic. He said he isn't sure whether my lining was the problem or if there was something wrong with the embryos.

One way to get a better idea of the quality of the embryos next time is to let them grow out longer to the blast stage (5-6 day embryos instead of 2-3 day). The standard FET protocol at our clinic for embryos frozen at the 2pn stage (the day after retrieval), is to transfer them the day after thaw. I'm not sure, but I think that would make them day 2 embryos. At that stage, you can't tell too much about quality which has a huge effect on whether or not they will result in a viable pregnancy. In a fresh cycle at our clinic, the transfer would either happen three days after retrieval, or five days after retrieval at the blast stage. The standard protocol is to try to get them to blast for a 5 day transfer and 3 day transfers only happen if the embryos maybe aren't doing so well or if the embryologist thinks the embryos would do better in their natural environment (in the uterus). Whether to transfer sooner or later is still somewhat controversial, but our clinic generally believes in trying for day 5 transfers instead of day 3 transfers.

The scary thing about trying to grow embryos to blast after a thaw is that they would want to start with as many as possible and, therefore, would thaw all 14 of our totsicles at one time. Assuming most of them survive the thaw, I would expect many of them to not make it to the blast stage and would hope that at least 2 did make it. But they could all stop growing prior to that and the transfer would be cancelled. Then we would be back to square one having to start over with another fresh cycle (stim and retrieval included along with risk of another bout with OHSS-hopefully avoiding the emergency room). However, if this gives them the best shot at picking the two best embryos, maybe it's worth it to risk all of them. If we ended up with more blasts than we were willing to transfer, they could refreeze the rest. So this is a decision we will have to make in the near future.

Dr. S was receptive to trying a natural FET this go round. He agreed that it is possible that my body just doesn't like the extra hormones and it is possible my lining might do better on its own, although we don't know until we try. There are risks to doing a natural cycle-mainly that I could ovulate through and would have to cancel the transfer. What is sounding really attractive about going this route though is that I wouldn't have to take the Lu.pron shots or the estrogen patches/suppositories AT ALL. And rather than doing the PIO shots, if we made it to transfer, we would just supplement my natural progesterone production with progesterone suppositories. That's right ladies and gents, a shot-free cycle!

I have to go into this natural FET knowing full well that there is a chance it could get cancelled either because I've ovulated unexpectedly or because my lining didn't cooperate. And regardless of how prepared I am for that possibility, I'm sure I will be just as upset if it doesn't work out. But since this whole process is one huge scientific experiment anyway, I figure it can't hurt to try something new if Dr. S supports it. Yes, I'm feeling rational today.

So now we just wait for word on whether we can try a natural FET this cycle, or if we need to wait. We then have to decide if we want to go the standard thaw/transfer route, or if we want them to thaw all 14 embryos and grow them to blast before transfer. I also still need to decide whether I want to continue with regular acupuncture or with the electro-acupuncture. Dr. S was pretty indifferent about this. A lot of decisions to make in the next couple of weeks. Feel free to spew advice (or assvice) in the comment section here if you have any thoughts on any of these alternatives.

I'm a little behind on my blog reading, so I don't want you all to think I've forgotten about you. I'll catch up this weekend if I don't get a chance during the week. And for the ColoBloggers, I'll see most of you on Saturday. This meet up is coming at a great time-I could use some advice and company.