All Tricks and No Treats

Halloween is probably my favorite holiday.  Not for mountains of candy like it is for most kids and many adults, but for the chance to dress up and play a part for the evening.  Many of us have big parties to go to where we tend to drink a little too much and revel with our friends.  It is a break from the boredom, stress, and responsibilities that generally come with being an adult.  I tend to spend months planning and often making parts of my costume for the year.

The fun has definitely been sucked out of Halloween the past couple of years.  Last year we had our post IVF recap meeting with our RE the day before our party.  I did not take the news well that our eggs were poor quality and that they suggested going through yet another IVF cycle to try to get better eggs.  I wasn't able to stop crying long enough to get my makeup and costume on so that kind of ruined going to the party.  I also made Mark hand out the Halloween candy.

This year we just didn't have a Halloween party, so the costume will go unworn for yet another year.  If we really wanted to, we could have planned one, but since it was too close to getting back from India we passed.

The trick or treating was another matter.

After finding out that I just had yet another pregnancy loss, I felt that Halloween was a little too soon and a little too much to handle.  Just the thought of seeing a bunch of children running around in their adorable costumes felt like a knife through my heart - seeing it in person would probably ensure a teary breakdown. We decided that we would leave a bowl of candy on the porch and go to dinner and a movie to make sure that we weren't home during trick or treating.

Unfortunately, not being home for trick or treating did not protect me from all of the sadness that Halloween brings.  Oh no.  The onslaught also spills into work.  Halloween is a big deal where I work - there are treats, a costume contest and trick or treating in the afternoon.  Because the possibility of children could extend to the entire day and not just during trick or treating (based on prior experience), I decided that it was just safer to work from home and avoid the entire day to begin with.

I know that other infertiles have the same feelings about Halloween, Holidays, Family Gatherings, etc. etc.  An infertile friend told me that they had a year that they also weren't home on Halloween.  Depending on where we are at, we may be able to get past our own sadness and truly be happy for all of the children that everyone else seems to have no trouble having.

So while trick or treating, when you pass the home with no lights on don't judge them so harshly.  Yes, they may be cheap assholes who just don't want to spend the money on candy, or they may be a childless couple who sees every costumed child as a reminder of the child they may never be able to dress up for Halloween.

Sorry, Try Again.....

I woke up this morning and Mark said that we got an email from India - the beta is now negative.  He gave me a hug and said he was sorry.  I got up and read the email myself and started to process.  In my mind I was thinking - I knew it - and was sorry that I had been right all along.

What this means to all of you not versed in infertility speak is that we were pregnant, and now we are not pregnant - we had an early miscarriage. 

A few people know about everything and they have been being wonderfully supportive.  A couple keep telling me that I need to be more positive.  Well, it is easier to take bad news when you weren't overly positive about it in the first place.  When you get good news you are then pleasantly surprised.  Unfortunately, I tend not to be pleasantly surprised that often - especially in the fertility department.

Despite my self-protective nature, I am taking this news harder than I thought that I would.  I thought that since it is not happening to me, and that I kept telling myself the pregnancy is only theoretical at this point, that somehow this news would be easier to take.  Somehow my protective shell would keep me from being incredibly sad, feeling disappointed, and breaking down into tears.  Turns out my shell is not as strong as I thought it was.

We can try again in 10-15 days if everything resets for our surrogate.  We also should start looking into what we need to do to ship our frozen embryos (if needed), since I have read that can be a process in and of itself.

For now I will try to keep my chin up and be as positive as I can.

But, deep down I fear that the remaining six embryos will suffer the same fate.....

 

Positive?

We received our initial beta test results today - 28.6.  While this is not an absolute negative, it is not overwhelmingly positive either.  At a gestational age of 5 weeks and a fetal age of 3 weeks (I will discuss this in a later post - I didn't get it either and kept calculating the due date wrong), a normal HCG level is anything from 18 - 7,340.  Once an embryo has implanted the HCG level should double (or nearly double) every 48-72 hours.  They will be repeating the beta in two days to see if the HCG level is rising appropriately.

Right now we cannot be certain of anything - positive or negative.  We get to ride the beta roller-coaster for a while.....

The 2WW becomes the 3WW

We have not yet heard from India.  We were supposed to get the first BETA results on Tuesday.  We sent an email yesterday.  The reply we received today was that we will receive the test results on Monday.  Monday!?  WTF!? 

I guess people weren't kidding when they said that the only thing that runs on time in India is the trains.  I admit that we felt our fair share of "India Time" while we were there.  We quickly learned that "five minutes" could actually mean anything from 1/2 hour to 2 hours.  We learned to not be in a hurry to get anywhere and to never expect appointments to start on time.  However, we are back in the states now and are no longer on India Time - things are supposed to happen WHEN they are supposed to happen.

We are trying not to read into this.  I fear that the first BETA wasn't conclusive and that they are waiting for a more conclusive result.  Mark thinks that they just haven't done the test yet.  Mark is probably right.  We need to try to be patient and wait to see what Monday brings.

"Part of the healing process is sharing with other people who care." Jerry Cantrell

Up until recently, I have been pretty quiet about my infertility.  For a number of years I simply wasn't working towards a baby - either by trying to get pregnant myself or trying to get someone else pregnant.  So, why focus on an issue that isn't an issue at that moment?

While getting ready for my first IVF cycle I found out about Resolve - The National Infertility Association and all of the wonderful services that they provide - their website, publications, online community and even local support groups.  I stalked a while on the online boards - gleaning helpful information here and there.  I finally posted a couple of times and even found a small group of women who were also pursuing surrogacy in India.

The online community has been invaluable to me.  In a world where infertiles are the minority it is so nice to talk with other women who are having fertility issues, some even your own same issue!  And, there are rules - you need to be nice and supportive or your posts will be deleted and you could get kicked out of the community.  And, there is the concept of "MENTS".  You use MENTS in a post when you have good news or bad news that could be sensitive to some readers - births or miscarriages.  It is a great system.  It allows you to pick and choose what you want to read or are able to read - some days are better than others.

Lots of us there wish that many other things had MENTS.  Take Facebook for example.  It is full of pictures of babies and children and happy families with babies and children.  While I am, and most other infertiles are REALLY happy for our friends, many times while we are forcing the happy smile we are also sad for ourselves.  Facebook is also tough in that you never know what is going to pop up.  The day after we found out that our friend couldn't be our surrogate I happened to look at Facebook before work.  A big ultrasound picture popped up.  Too late, I saw it.....my heart sank.  At that moment all I could feel is how I may never have one of those of my own.  I had to redo my makeup that morning.

A few people in the Resolve online support community talked about going to local support groups.  Some of them had good things to say, some bad.  I guess like all things it just depends on who is in your group.  I thought about going to a support group, especially last fall.  That was a dark time for me.  We had gone through a cancelled cycle and a less than stellar IVF cycle which resulted in the doctor suggesting that we try AGAIN for better egg quality.  The last thing I wanted to do was try again.  I just wanted to cry and feel sorry for myself and feel like a big fertility failure.  Yes, a support group probably would have been helpful.

I recently saw a post again about support groups.  I looked on Resolve and found two local groups.  I reached out to the contacts and found out that one was meeting today.  I RSVP'd....

I was a little nervous about the whole thing.  Outside of this blog which was also a recent endeavor I haven't shared a lot about my infertility adventure.  You worry that your story isn't that bad or that you haven't suffered enough, or you could be on the opposite extreme and "win".  In the end though that is not what it is about.  It is about being supportive of other women and men who are also going through fertility issues.  And they in turn are supportive of you.  They understand what you are going through.  They understand how hard it is to be optimistic about something where you have suffered failures.  They GET IT.

I plan on going often.  I wish I had gone a long time ago....

October is Pregnancy and Infant Loss Awareness Month

I admit that I have been pretty focused on my own stuff at the moment and and slowly starting to peek my head out of my shell and get caught up on what is going on in the world around me.  One of the things that came to my attention was that October is Pregnancy and Infant Loss Awareness Month.  It began in the United States on October 25, 1988 when President Ronald Reagan designated through a Presidential Proclamation that the month should be recognized as National Pregnancy and Infant Loss Awareness month.


October 15th is Pregnancy and Infant Loss Remembrance Day, which is a day of remembrance for pregnancy loss and infant death, which includes but is not limited to miscarriage, stillbirth, SIDS, or the death of a newborn.  The day is observed with remembrance ceremonies and candle-lighting vigils, concluding with the International Wave of Light, a worldwide lighting of candles at 7:00 p.m.

I missed my opportunity to light my candles, as such I am lighting them now.

I haven't thought much about my losses for a long time.  They so long ago (13 & 14 years ago).  They were also babies that were never meant to be in the first place.  My doctor told me that I would never have children, so when in 2000 when I found out I was pregnant, the miscarriage that soon followed was expected.  I admit that it still hurt.  For a few short weeks I thought that maybe it had a chance.

The second loss is more difficult.  That loss was induced.  In 2001, shortly after coming moving to the twin cities, I found out that I was pregnant.  I was shocked.  The first pregnancy occurred because I stopped taking the pill - I was told I was never going to get pregnant.  This time I was taking the pill - although admittedly not as regularly as I should.

Almost right after I found out I was pregnant I started having problems.  I started feeling faint a lot.  I almost passed out while driving one day.  I was also having a lot of pain on my right side - my uterus is right-sided.  One day the pain was so bad we went to the emergency room.  I was sent back right away for an ultrasound.  They were concerned that I had an ectopic due to my symptoms.

The good news was that it was not an ectopic.  I could tell from the ultrasound technicians face that was the only good news.  For a few moments I saw my baby on the monitor, it was clearly in distress, it was also clearly malformed.  We were told that I was not in immediate danger and that they would send the results to my doctor for a full diagnosis.

Luckily I had found a doctor right after moving who specialized in high risk pregnancies.  She had a patient with a bicornuate uterus who had recently achieved a live birth.  It was, however, not a severe bicornuate case and that type of uterine abnormality has better pregnancy stats than a unicornuate, but she was nevertheless hopeful that someday we would achieve a live birth of our own.

This was not going to be that time.  There were several things that were not in our favor this time.  First, the baby was malformed, it had so far developed arms but not legs.  This could have been due to my uterus shape, this could have been due to exposure to nicotine and alcohol (I had no idea that I was pregnant and had some bad habits at age 26).  Babies with congenital limb deformities often have difficulty with normal development and struggle with developing motor skills, need assistance with daily activities, cannot independently care for themselves once they are older, are limited in movement, and can even develop emotional or psychological issues related to physical appearance.

But wait, there's more.  The position of the baby in my uterus was less than ideal.  Instead of being centered or in the main body of my uterus it was "up in the horn".  Placement of the developing embryo is especially important with uterine abnormalities.  This also was pointing to the fact that my uterus didn't seem to be stretching properly, one of the unfortunate side effects of uterine abnormalities.  My symptoms were pointing to a very painful pregnancy, a pregnancy that most likely was going to lead to either a uterine rupture (which is life-threatening to both me and the baby), a second trimester pregnancy loss, or a very preterm baby with severe abnormalities

For my health, and for the fact that this baby just really didn't stand a chance, we decided to terminate the pregnancy.  When I say "we", I should really say "I".  My ex-husband was against termination.  It didn't matter to him the facts that were clearly in front of him.  He was willing to put my life on the line for the possibility of a child.  I was not.  Some days I feel like a horrible selfish person for this decision, but other days I realize that it would have been even more selfish to leave a child with disabilities without a mother.

I admit that I have spent years stuffing this memory deep down in the core of my being.  I have told myself over and over again that this was the right decision.  Not only would this child, if somehow the pregnancy lasted long enough for the child to be born alive and viable, have severe disabilities, it would have been born into a very volatile and broken marriage.  Even so, I still feel very sad, and I still feel very guilty.  When I stop to think about it, I start to cry.  I am crying now.

“When a child loses a parent they are called an orphan. When a spouse loses his or her partner they are called a widow/widower. When a parent loses their child there isn’t a word to describe them.”

It Could Always Be Worse.....

So it has been a little rough getting back into the swing of things after being gone for two weeks.  First, jet lag is no joke.  Last night is the first night that I finally slept all night and didn't wake up randomly at weird times.  It also takes a while to get the house back to normal - laundry, getting the fridge restocked, going through mail, paying bills, etc. etc.  And then there's work.....ahhh work.

I have the less than ideal situation where I am the only person in my department.  It was not always this way, but that is another long story.  As the only person in my department, there is no one there to cover for me as no one else does what I do.  So, in order to keep the wheels from coming off the bus, I was answering emails and working as much as I could at the hotel at night while we were gone.  Unfortunately there is only so much that you can do remotely and somehow new #$% decides to go wrong once you've got something else under control.

This also holds true for the female body apparently.  Guys you may want to stop reading now.

I was working late as I am still digging our from under a big pile of doo doo at work.  I was actually glad of this as at least there was no one else around when IT happened.  I am sitting there and all of a sudden I feel something rush out of me.  I try to calmly, but quickly make it to the rest room to figure out what the heck is going on.  There I discover blood, lots of blood, lots of bright red blood.

Needless to say, it was a bit unsettling.  While unsettling, I didn't think it seemed life threatening.  I remember something about you not needing to go to the doctor unless you are bleeding through a pad an hour, so I figure that I'd best go home and monitor for a while before I decide to freak out and go to the doctor.  I also decide that these underwear are probably beyond saving and hope that my jeans make it through this ordeal.  Oh yeah, right through the jeans too.

Now I realize that some women have to deal with this sort of thing month after month.  I have fortunately been spared this until now.  I have enjoyed very light, very regular periods since they started.  My periods only last 3-4 days, I don't need more than slender regular tampons, and I have pretty mild cramping and just a little headaches.  The week before I get bloaty - but not like 10 pounds or anything.  So 1) getting my period an entire week early and 2) having a bloody disaster are not the norm.

I know that some of you are thinking that I won the lottery of periods.  Yes and No.  Yes from a general life standpoint in that it is really nice to know when your period is coming and that it really isn't that bad.  While the regular period is also great from a fertility standpoint, the light periods ARE NOT.  The light periods are because I tend to have a very thin lining each month.  Thin linings are bad from a fertility stand point.  VERY BAD.  Inadequate uterine lining results in lower pregnancy rates and miscarriages.  It could have contributed to my earlier losses.

While I was waiting to see if I was meeting the criteria for a doctor visit I did a little research to see if I could figure out what was going on.  It seems that the IVF hormones really do a number on your body.  I read several accounts of crazy heavy periods at strange times post IVF.  Most clinics recommend taking off at least one cycle in between IVF attemps - mostly because it takes a while for your body to get back on track after the hormones.

Turns out that despite the heavy flow I am not in the danger zone.  I'll just need to make sure I don't wear anything nice the next few days.....

IVF By The Numbers

There seems to be a misconception about how this "surrogacy thing" works and how IVF works in general.  People generally seem to think that since we went through an embryo transfer that we will have a baby in approximately 40 weeks.  Sadly, this is not the case.  This whole "surrogacy thing" was a gamble, just like IVF is a gamble.  And, it usually doesn't work the first time, or the second time or even the third time for many.

I have included the 2012 ART national success rates.  Please pay attention to the line that lists the number of live births per transfer.  You will see that for women under 35, this is 47.1%.  Meaning that for each transfer, less than half will result in a baby (also note that this is higher than the success rate for IVF cycle - some cycles are cancelled or result in no embryos making it to transfer).  This percentage goes down to 37.9% at 35-37 and 28.5% for 38-40.  We only have 3 transfers worth, that only adds up to 85.5% - leaving a 14.5% chance of nothing......

Fresh Embryos From Non-Donor Oocytes

	<35 nbsp="" p="">	35-37	38-40	41-42	42
Number of cycles	38662	19599	18410	10167	6224
Percentage of cycles resulting in pregnancies	46.7	37.8	29.7	19.8	8.6
Percentage of cycles resulting in live births	40.7	31.3	22.2	11.8	3.9
Reliability Range	(40.2 - 41.1)	(30.7 - 32.0)	(21.6 - 22.8)	(11.2 - 12.4)	(3.5 - 4.4)
Percentage of retrievals resulting in live births	43.4	34.5	25.4	14.0	5.0
Percentage of transfers resulting in live births	47.1	37.9	28.5	16.3	6.1
Percentage of cycles with elective single embryo transfer	14.8	8.9	3.0	1.2	0.6
Percentage of cancellations	6.3	9.2	12.7	15.8	21.5
Implantation Rate	37.5	27.6	18.4	9.8	3.8
Average number of embryos transferred	1.9	2.0	2.4	2.9	2.9
Percentage of live births with twins	29.5	25.0	20.3	13.4	9.0
Percentage of live births with triplets or more	1.1	0.7	0.7	0.7	0.4

51.4

48.6

44.4

37.5

28.2

19.4

We Really Need a Win

Today we are still super jet-lagged and tired and still having some digestive issues from India.  We tried to get at least a couple of things done today - mainly laundry and getting some groceries - but other than that not doing very much.

We did get out and meet our friends at the dog park today.  I admit that it was nice to get outside and walk around, and it is always good to tire the dogs out.  Our friends asked us it we thought about day care yet (they have already had a bad experience and had to find a new place which took seemingly forever).  On one hand I thought it was silly as our children are still theoretical at this point, but on the other hand their point about some day care facilities having a one year waiting period is true.  We said that we would need to wait until our children are real and no longer theoretical.

When we got home we talked about when that would be.  For Mark, real vs. theoretical happens a lot sooner than for me.  When are they real?  Is it at a confirmed pregnancy test?  Is it after the first trimester?  Is it after 29 weeks, when a baby has a chance at surviving outside of the womb?  Is it the due date?  Is it not until you are holding them in your hands?  Or, is it not until they are free of the danger of SIDS or fatal genetic diseases?  I simply do not know when they will be real to me.

I am currently very scared that we have invested a lot of time, money and emotions into something that may not come to fruition.  The doctor asking us if we have talked about donor eggs was not reassuring us of success.  Yes, we have 10 embryos to implant, and I am desperately trying to be hopeful that out of 10, one will make it.  But I am having a hard time being hopeful.

The harsh reality is that as women age the number of potential eggs that we produce each month starts to get smaller and smaller.  The quality of the eggs also is impacted, with the potential for disorders and genetic issues or the eggs simply not even able to implant and become fully viable pregnancies increasing, and increasing sharply as we reach our late 30s and early 40s.

At 39 my fertility outlook is not as it used to be.  My number of antral follicles is going down, my FSH is going up, my egg quality is becoming more and more questionable.  Simply put, the number of chances that we have to produce a healthy child with my DNA is becoming more and more slim.  I can try to fool mother nature by taking supplements, hormones, doing acupuncture, and being more healthy, but in the end it is simple biology and mother nature is not often fooled.  This is not me being a pessimist, this is reality.

I could try to be more hopeful, I could try to be "sunshine and rainbows", but I can't.  I know this is hard for many to understand (Mark included).  My self-protective policy has been that if I don't get my hopes up in the first place, then I am less disappointed when things do not work out.  I don't do this for everything - there are a lot of examples where I have given things a try and when they didn't work out I have shrugged it off and kept going.  This is too big for that.  This is too hard.  I fear that at some point I am not going to be able to simply dust myself off and get back up, at some point this could break me.

This has been hard for Mark too, although he is better at dealing with this than I am.  Sometimes I wonder if it is because he hasn't had to endure all of the shots, doctor appointments, hormones, blood draws, invasive ultrasounds, bloating, weight gain, melasma from the hormones, emotional roller coaster from the hormones, etc, etc.  Maybe it is because in the end, he's not the problem.  I am the one with both a bum uterus and (potentially) bum eggs.  I admit that he is generally more optimistic and I am generally more pessimistic, but this is a whole new level in pessimism - even for me.

I will try to draw from Mark's optimism but I know that it is starting to waver.

We really need a win.  For both of us.

Home Sweet Home

Our journey started 24 hours ago.  We left the hotel at 11 pm as we did not know how long it would take to get through the airport for our 3:12 am flight.  We figured that if in the US they say to be there 3 hours before your international flight, then in India we better be there closer to 4 hours before our flight.

I was glad that we got there early at first, the airport was packed despite it being 11:30 pm at night.  We had to go through 4 passport checks before we boarded the airplane.  We both got manhandled at security.  At least the women got to get manhandled in a little privacy box, the men had to suffer their humiliation right out in the open. There were men with machine guns all over the airport.  Mark commented on this but I reminded him that there were also in Mexico.  We have said several times that India reminded us of Mexico, a much poorer, less corrupt, less dangerous Mexico (without the all-inclusive resorts).

Our first flight was rather uneventful and the pilot and crew were very conscious of the fact that it was on overnight flight and most of the passengers were trying to sleep.  Not so much on the second flight.  I admit that it was a day flight, but still Delta, keep in mind that there are several people trying the get their body clocks adjusted and are trying to sleep.  Stop making the plane beep randomly and for seemingly no reason whatsoever.

We were so glad to finally be home.  Our dogs were so glad that we were finally home.  Despite feeling like the walking dead due to lack of sleep and too much travel, we made ourselves unpack and start some of the seemingly never ending pile of laundry.  That's success for the first day back.

Last Day in India

Us and Mr. Joy at the hotel
 

At this very moment we are sitting in the hotel, counting down the hours until we leave for the airport.  Don't get me wrong, it has been a wonderful and (hopefully) productive trip.  But, it will be a little over two weeks when it is all said and done, and that is a long time to be away from home.

Today we visited Humayun's Tomb.  It was built in 1570 and is the first garden tomb built in India.  The Taj Mahal is actually a near copy of this tomb's architecture nearly a century later.  While only two people were buried at the Taj Mahal, 155 people were buried within the Humayun Tomb complex.  The complex includes several smaller monument - some even older than the main tomb.

In 1993, the tomb was declared a UNESCO world heritage site and since has undergone extensive restoration.  I would love to come back and see what the other monuments in the complex look like post restoration.

 

We had lunch today with Mr. Joy.  He let us know that our surrogate is very healthy.  She is originally from Nepal.  Mr. Joy says that Nepalese women have “strong wombs”.  He let us know that he will be looking in on her throughout the (crossing fingers) pregnancy. 

We will be able to meet her via skype later in the pregnancy but unfortunately not in person.  We did not realize that we would have needed to meet her before the egg retrieval as post retrieval I was recovering and after the transfer she is resting until the beta test.  After the birth we are allowed no contact with her, as they have had problems with surrogates making demands from intended parents.  (I had read about this on other blogs so this is unfortunately true).

Mr. Joy also told us about what to expect for the trip back (if everything works out).  We would need to return and stay for 25-30 days after the birth to complete the exit process.  The clinic would be able to arrange an apartment for us for that month that includes our own SERVANT.  He would cook, clean, do our laundry, go shopping, and even make us 2 am coffee or tea if we wanted.  We were able to see one of the apartments today and meet the servants.  It is nice by India standards but really reminds me of the first apartment that I had in college.  The price would be the same (if not better) than a hotel for a month so we’ll make it work).

Thank you India for the memories, hopefully we'll be seeing you again in about 9 1/2 months.

The Dreaded Two Week Wait Begins.....

The two week wait (TWW).  The longest two weeks of your life (or so I assume from reading the fertility blogs and support group posts on the subject).  For those of you who don't know, the two-week wait refers to the time interval that starts once you ovulate and lasts until you either experience your period, experience a "missed period", or find out you have conceived through a positive pregnancy test.  In the case of IVF this is the time between the embryo transfer and the first beta test.

I have read about the two week wait on my fertility blogs and now, finally, it is happening to me.  I don't know if it is better or worse that it isn't ACTUALLY happening to me, but rather happening to me through our surrogate.  It is such a strange concept for me.  My two pregnancies were years ago and were not planned, so there was no TWW, rather a surprise positive pregnancy test.  Since then I have spent years trying NOT to get pregnant since the likelihood of a successful pregnancy in my "tiny" uterus was small if not impossible.  My pregnancy losses were proof enough of that.

In all of my 39 years, this is the first time that I am desperately hoping for a BFP (Big Fat Positive).

Today we visited the doctor who gave us an update on the embryos and the transfer.  Of the 8 eggs retrieved, 6 made it to day 3.  4 were transferred and 2 were frozen.  FROZEN!  I actually had embryos leftover that were FROZEN!  From everything that I have read it is not common to have embryos leftover to freeze, especially for older ladies like me.

This cycle was much more successful than my last 2.  The first was cancelled, the second resulted in only 4 out of 10 eggs making it to fair quality embryos on day 3, the third (and most likely final) resulting in 6 out of 8 eggs making it to good quality embryos on day 3.  And, I did not get OHSS this time like I did the last time.  Maybe the seemingly endless pills, acupuncture needles, and fertile-green shakes, in addition to limiting caffeine and alcohol paid off.  We hope that the 3rd time is the charm.

The doctor said that the embryos were "good quality".  We did not receive a full report on grading so I don't know exactly what "good quality" means.  I just hope that it is better than the grade 3 embryos that we froze our last IVF cycle. 

I sincerely hope that out of the 10 embryos total that we have, one should make it all the way......

 

If It Weren't For the Constant Harrassment.....

The plan for today was to visit Old Delhi.  On the way there we passed through some of the posh areas of South Delhi that we thought were only a myth.  The streets were remarkably clean, the avenues were lined with trees and flowering bushes.  The residences all had tall, ornate fences and gates between them and the street.  So, THIS is how the other half lives in India.

We started the day at the Red Fort.  It is located in the center of Delhi and was built in 1648 as the fortified palace of the Mughal Emperer.  It has an area of over 250 acres that is enclosed by 1 1/2 miles of defensive walls.  We were struck by how ornate many of the buildings were with inlaid marble and carvings similar to the Taj Mahal.  Inside the complex were a large network of fountains and water channels.  Sadly the water channels and fountains are not operational at the moment and some of the original art and grandeur of the complex has been lost to looters over the years.

We were again asked to pose for several photographs.  While cute and first, it is starting to wear on us.  We joked that we should turn the tables a little bit and start telling people there's a charge to pose with us.

I kept saying Mughal like Muggle which made Mark laugh and make Harry Potter jokes.

 

 

 

After the Red Fort I was hoping that we would explore Chandi Chowk and the temples there and maybe even the spice market since they were literally right across the street from the Red Fort.  Unfortunately, once we stepped outside of the Red Fort grounds we were mobbed.  People shoving fans, and other merchandise in our faces.  Helicopter (aka cycle taxis) drivers all had "great rates" and were happy to show us the best spots for shopping.  It was overwhelming to say the least.  Mark was adamant that we abort the mission and move on to the next place.  I was sad about this but he was probably right that this was the best move.  It's really a shame.  The constant harassment is stopping us from seeing many of the sights of Delhi.

 

The India Gate was on the way back to the hotel so we decided that would be a nice stop.  It really was.  The Gate is surrounded by large water features with fountains and Fountains.  There were some children swimming in one of the water features.  I was truly jealous as it was 97 degrees today and we were pretty hot and disgusting by this point.

 

The Gate used to be called the All India War Memorial as it is a monument to the over 80,000 Indian soldiers who were killed in World War I.  The soldiers names are carved into the stone.  Inside of the arch is a structure that holds the four eternal flames which is India's Tomb of the Unknown Soldier.  Truly a beautiful and meaningful monument.

 

 

 

 

 

Outside of the India Gate we ran into a gentleman who had a king cobra in a basket.  I could not believe that we actually ran into a man with a king cobra in a basket in India.  No, he did not have a turban and a play a recorder to make the snake dance (that would have been awesome by the way).  I of course had to get a picture (against Mark's warning of course).  He motioned that we could get a picture WITH the snake.  I am sure it was defanged but still - there was no way either of us was getting near that thing.

He (of course) wanted some money from us for the "show".  Mark gave him some, mainly to get him to stop following us.  Thankfully the taxi was pretty close.  I hope the snake got some dinner out of this.
 
Monkey Watch - only one monkey spotted today.

Baby Watch - no news on the eggs/embryos or transfer.  Supposedly we will hear something tomorrow.  The suspense is KILLING me!!!!!!!!

Today We Were Celebrities

Since I was a good girl (aka Mark keeping me in the hotel against my wishes even though it was for my own good) and rested in the hotel the past few days I was given the OK to get out and do some sightseeing today.  Since it was 99 degrees today (I wish I was embellishing) and I am still a little tired and bloated.  As if sticking yourself in the belly 15-40 times, enduring multiple ultrasounds and blood draws, and having your emotions all over the place due to your hormones going crazy - you also get bloated, very bloated from IVF, and the bloat can last up to 10 days post-retrieval.  At least this time it is looking more like Thanksgiving dinner and less like I'm 4 months pregnant so I am hoping that I will not get OHSS this time.

The restaurant in our hotel is on the second floor.  Since the buildings are so close together, for appearances the building next door to the hotel has a decorative screen.  While eating breakfast this morning I saw something moving on the top of the screen.  For a second I thought it was a cat, but then I realized it was much larger.  It was a MONKEY.  I knew there were temple monkeys and that in the bazaars you may see them with street performers, but I was not expecting to see them just roaming around on their own.  In addition to random cows, packs of stray dogs, feral cats, and snakes , Delhi also has a monkey problem.  There is an estimated 30,000 monkeys (mostly rhesus monkeys) roaming the streets of Delhi. http://www.globalpost.com/dispatch/news/regions/asia-pacific/india/140704/delhi-unruly-monkeys-steal-stuff-terrorize-kill

While we were out today I kept an extra watchful eye out for monkeys but saw none.

We first visited the Qutab Minar complex.  The Qutab Minar is a 73 m-high tower of victory, built in 1193 by Qutab-ud-din Aibak (the first sultan of Delhi) immediately after the defeat of Delhi's last Hindu kingdom.  It is quite beautiful.  The minar is made of red and buff sandstone and marble and  covered with intricate carvings and verses from the Qur'an.  It is surrounded by several other tombs and monuments that were added by subsequent rules.  While there we were asked to join a few photographs - a couple of school groups and a nice gentleman.  We felt like celebrities.

 

 

 

We had some time to kill before lunch so were headed to Deer Park.  I wanted to go there since it was noted in the guide book as having a deer enclosure there (hence the name).  This was definitely more of a local spot vs. tourist spot as the signs were all in Hindi only vs. Hindi and English as we've seen most everywhere else.  We still managed to find the spotted deer, peacocks, yet another monument and the rabbit/guinea pig enclosure.  I thought that was an odd combo - rabbits and guinea pigs - but they seemed to get along fine.

 

 

 



 

We then headed off to The Garden of Five Senses and Magique restaurant for lunch.  Our taxi driver could NOT find this place.  We drove around and around.  Which, since we were hot and the taxi had air conditioning we weren't that worried about.  We finally found The Garden of Five Senses (Yay!).  We found out why we couldn't find Magique - apparently it's closed.  After walking around the gardens for about an hour we ate at FIO which was EXCELLENT.  Great food and cocktails :)

 

There was a random camel at the Garden.  We don't think this was for camel rides - it looked like one of the gentleman at the snack bar's ride.

 

No news on the eggs/embryos.  The transfer should be tomorrow.

 



 

It's For My Own Good

 

Well, then I am a boring person because I am BORED.  Yet another day of hanging out in the hotel room.  The internet is spotty, so it is hard to do much work beyond answering emails.  We cannot do large downloads so streaming movies via Netflix or Apple TV is out of the question.  So, we are pretty much stuck watching TV.

 

Indian TV is very interesting.  Luckily we have found a couple of movie channels that show primarily American movies with subtitles.  Unluckily all of the channels seem to have commercials - even HBO.  We keep seeing commercials that show people living in large houses/apartments with lawns and high dollar appliances.  We wonder who these people are and where these people live since we haven't seen very much of that so far on the trip.

 

Another interesting thing is the jewelry commercials - particularly those hawking wedding/ engagement rings.  One in particular talks about how they found their day of love despite being having an arranged marriage.  Another talks about a promise that grows and should not be broken.  Mark is insistent that this is another commercial about arranged marriages.  I guest that this would be the norm.  Mr. Joy thought that arranged marriages were as common as higher than 70% of marriages and was surprised to hear that so many of us in the US had "love marriages".  The divorce rate in India is just over 1% vs. almost 50% in the US - maybe they are on to something.

 

While I find the nuances of Indian commercials interesting, I am longing to get out of the hotel soon.  I am doing OK after the retrieval - but still a little sore and a little tired yet.  Mark is right.  I need my rest to make sure that I make a full recovery.  I am also keeping a watchful eye out for any symptoms of OHSS since I had a mild case after my last cycle.  I hope that is not case with a couple less eggs this time - but I also don't know what my E2 levels were so there is always a chance again.

 

 

 

 

 



The Pick Up

Today was my egg retrieval, or "pick up" as they call it here.  We weren't scheduled to go to the clinic until noon, and I was allowed nothing to eat and little to drink before so I tried to sleep in as late as possible.  I was trying not to be nervous, but I was nervous.  I was about to undergo a medical procedure in a 3rd world country.  I think that I had every right to be nervous.

The walk to the clinic was very slow.  I am feeling pretty uncomfortable by this point and every step makes my swollen ovaries bounce.  Bouncing ovaries don't feel very good.

The clinic is not very busy when I get there.  Myself and two other woman got called back for our procedures.  On the day of my last retrieval there may have been several procedures that day - I will never know as I was in my own room pre and post procedure.  Here, however, space is much more limited, so there was only one pre and post procedure room so I was painfully aware that there were several procedures going on at the clinic today.

We were all given gowns and asked to step into the adjoining restroom one by one to change.  We all got to sit on one of the two recovery beds and await our procedure.  As we sat there in uncomfortable silence I was observing the other two women.

The one I think may have been a surrogate.  She had on a plain salwar kameez and seemed very shy.  She was there for her transfer.  The other woman was there for her pick up and I think that she was a fellow patient.  She obviously had some money - she had on western clothing, painted and manicured nails and a lot of jewelry.  She was looking at me with such contempt and distaste it was hard not to notice.  I get it I guess - me being a horrible American and all.

It was my turn for my procedure and I went back to the procedure room.  It thankfully looked pretty close to the one back home - just smaller.  The lab was in the next room which also thankfully resembled the one back home.  This made me feel a little better, if only for a short while.  Unfortunately the clinic has a small staff and had a lot of clients to take care of today, so I had to wait in the procedure room for a while before things got started.  The nurse spoke very little English.  She could tell I was very nervous and was trying to tell me to relax.  But, I wasn't relaxing.  Oh no, I was getting more and more nervous the longer I waited.

At long last, people began to start filing into the procedure room to prep me for the retrieval.  The anesthesiologist was a middle-aged man and was very nice.  Unfortunately I have very small veins and they only had the normal adult-sized needles which was making the whole IV process very difficult.  They finally got a vein to pop and thankfully didn't hesitate.  It hurt.  It kept hurting.  The liquid coming in the IV was burning my arm.  I couldn't help myself - I started crying.  Thankfully the anesthesia was started soon after that and I drifted off to sleep.

I was awoken by the anesthesiologist who kindly told me that the procedure was over and asked how I was doing.  I was OK.  I little groggy, but OK.  Thankfully my hand wasn't hurting as much from the IV.  I was waking up fine and wishing that I would brought something to read back with me.  Unfortunately with only two beds I had to start making my way over to the other bed soon.  I wasn't feeling too bad and was anxious to see Mark and get back to the hotel to rest so I was happy to comply.  I was sitting up fine and wasn't nauseous at all so I was allowed to change into my clothes and go up front to meet Mark.

The doctor saw us and went over the results.  She seemed very happy.  There were 8 eggs retrieved - all mature.  She said that the quality looked fine.  This was better than expected.  We were given discharge instructions and a few medicines to take over the next couple of days - antibiotics and mild painkillers.  The transfer will be on Tuesday.  We will be kept up to date on how things progress over the next few days.  For now the focus is for me to rest and recover from the procedure.

Wow.  8 eggs.  Decent Quality.  This all may work out after all.............

 

We Found All of the Other Tourists

 

I begged Mark to get out of the hotel for a little bit today.  He agreed only to lunch.  We decided on Lodi, The Garden Restaurant based on Mr. Joy's recommendation.  He has gone on and on about how his last assignment, an Australian couple, took him to this restaurant for lunch.  The bill was $70 USD (for three people including drinks).  Not wanting to be bested by Australians, we offered for him to join us.  He declined since today is Dussehra, a Hindi religious holiday, and he has the day off.  I fell less bad about him coming with us to the Taj Mahal on Sunday since he got two extra days off this week.

 



The restaurant was very nice.  It had a cute outdoor seating area complete with hanging lanterns, seating cabanas, misters and fans.  Definitely A LOT different from the little spots that we see on the way to the clinic.

One of the first things we noticed was the clientele - they were ALL tourists.  I guess this from their dress (shorts, tank tops), accessories (cameras, cell phones, flashy jewelry), and (I hate saying this) race.  Nearly all of the clientele in the restaurant appeared to be non-Indian.  The prices really weren't that bad - higher than we have paid at our hotel, but not by much.  Our bill was a little over 2,000 INR for two vs. 1,000 INR at our hotel (I did get a virgin juice cocktail and we expected the prices to be a bit higher).  The food was pretty good, but honestly, not twice as good as the hotel.

 

I was happy with Marks' restaurant choice because I had a secret plan.  The Lodi restaurant is right by the Lodi Gardens which is very close to two other monuments that I would like to visit.  I thought that I could easily weedle Mark into a little sight seeing today.  Well, that didn't happen.  Midway through lunch I started not feeling very well.  I assumed that something that I ate for breakfast was not agreeing with me.  So, I agreed to just go back to the hotel where I started feeling much better after lying down for a little bit.  Mark was right, I shouldn't be pushing myself right now.  I hate it when Mark's right.
 

Gandhi Jayanti

Today is Gandhi Jayanti, which is a national holiday celebrated in India to mark the occasion of the birthday of Mohandas Karamchand Gandhi, the "Father of the Nation".   This is only one of three national holidays in India that is celebrated in every state and that most things are closed on.  So, not much going on in India today for a non-Indian.

The clinic was open for a short time today and only for a few of us that required visits for shots.  I was the lucky recipient of a shot in the belly and one in the butt.  The butt shot is still pretty sore by the way.  At 2 am this morning I get to shuffle out of bed and take my trigger shot.  Should be a good time.

It was fine that there wasn't much to do today since I am not really supposed to be doing much anyway per the clinic.  Despite only having six follicles my ovaries feel noticeably swollen and I am feeling tired and uncomfortable.  I knew that this was coming.  Luckily it is only for a few days.  I haven't been getting updates on my E2 levels, but I suspect that they are lower than my last cycle.  I don't feel nearly as emotional as I did the last cycle.

I was glad that Mark suggested a visit to the spa today since most things would be closed.  I had a facial and Mark had a massage.  I was complaining a bit about being cooped up, but honestly it's probably for the best.

In two days the retrieval will be over.........

Things Are Moving Along

This is what I took home from the clinic today.  Two boxes of Ovitrelle on top of an ice pack wrapped in newspaper.  Really.  I have watched similar packages going home with other ladies over the past few days, but somehow it wasn't real until it happened to me.  I do give them credit for the ice pack and trying the keep the medicines cold to remain effective.

Today was for the most part pretty boring and slow.  For some reason or another, Mark and I both woke up I the middle of the night and both had a lot of trouble getting back to sleep, making us both lacking some sleep today.  We tried to sleep in a bit and get down the restaurant with just enough time to get our breakfast.

Our appointment today wasn't until 1:30 so we had some time to kill before heading off to the clinic.  I was catching up on US and local news - the hotel only has HindustanTimes and Yahoo is Yahoo India - so I have been a little out of touch on news back home.  We decided that it is probably easier to just walk the few blocks to the clinic rather than trying to negotiate with one of the tuk-tuk drivers, so we headed out a little after 1:00 to make sure we had enough time to get there.  Mark and I feel a lot more comfortable with the walk at this point and the streets seemed a little less busy.

We arrived and the clinic did not look that busy today.  Looks can be deceiving.

The doctor called us back and let us know that the ultrasound machine was down at the moment and that we would have a 5 minute wait.  5 minutes in India = an hour and a half.  As we were waiting a LOT of people were shuffling in and out.  I figured out that there were two ladies having their retrievals today - one of the husbands was worried sick, the other was asking about the nearest place to get a beer.  Also, a VERY pregnant woman waddled in.  I think she was scheduled to give birth today.

We were called back and the doctor was chatting with Mark as I was getting ready for my ultrasound.  During my ultrasound, the doctor and the nurse once again commented on my "tiny" uterus.  My first ultrasound the nurse looked VERY concerned.  The doctor then seemed to be explaining something to her and I heard "unicornuate".  I am pretty sure that this was the first time the nurse has seen a unicornuate uterus "in person"  I guess that since only less than 1% of woman have this particular uterine abnormality it is to be expected.  It also makes me feel a little better about the whole GC situation since my uterus is "tiny".

The doctors consulted and started throwing around a lot of drug names and doses.  This was new.  Things must be happening.

The doctor told Mark that my eggs were "ready" and I was going to start some additional medications.  In addition to my Gonal F, I was given Ovurelix to prevent me from ovulating.   Tomorrow I come in for Gonal F, Ovurelix and they will also add Menopur - the Menopur will hopefully boost my egg quality.  Then, at 2 am on Friday morning I get to give myself the two shot of Ovitrelle to trigger my eggs to mature and be ready for my retrieval on Saturday.

Saturday?  That is a day faster than my last two cycles and a good three days faster than the average woman.  I am a fast-stimmer.  I worry a bit as this may be part of the poor egg quality issue, but I guess it is what it is.

A Saturday retrieval does give us more free days with which to do some sight-seeing so I guess that will be good.  Hopefully with less eggs I won't develop OHSS like I did the last time.  I also made sure to bring plenty of protein powder and Pedialyte powder to help ward off OHSS.  The bad thing is that now I am officially cooped up in my hotel room for the most part until after the retrieval on Saturday.  This sucks.  I admit that I am starting to feel a bit uncomfortable and may not be up for much anyway, but I still hate being cooped up.  Mark keeps reminding me that this is the whole reason while we are here and that the most important thing is my health and safety.

He has also agreed to massages and/or facials tomorrow and lunch at a nice restaurant (outside of the hotel) on Friday in order to placate me.  I am trying also for the zoo.......