Onto the next round

So, after 3 days from stopping all my medication, I got my period yesterday. This means today, I come back to KATO for another round. Yes, so soon. Yes, I know. 

A part of me was initially overwhelmed by the thought of doing it all again. But with courage shared by my husband, I realized that to stop would be an even scarier proposition.

So today will be the baseline blood work and ultrasound again, to measure readiness of my system for a fresh cycle. Wish us luck!

From what I understood during our initial briefing, if I go for a medicated cycle, we'll do egg retrieval and fertilization on month 1 and do embryo transfer on month 2. This timeline should work out vis-a-vis the immunological workup I'm doing on the side. The results should be out by then, before the embryo transfer. 

I know some people might find all this a bit too much to handle. Believe me, I feel that way sometimes too. But walking through this journey inevitably involves handling multiple considerations all at once, on top of the usual concerns in life and career. It's just the way it is. I read in an article by a reproductive endocrinologist that one thing he can say about infertility patients is that no doctor will ever find a more determined set of patients than those undergoing treatment to have a baby -- there is no patient more motivated, more willing and with more fight in them than people who want a child. This, according to him, is what makes them different from cancer patients. While some emotions may be the same (body is failing me, why me of all people, feels like I'm running out of time, money issues, etc), the reason to keep fighting among infertility patients is what makes them fight harder, longer. 

So here's to fighting again, giving it another shot. May this be it for us. Please!

Next Step: Immunological Workup

So, while waiting for my next cycle, I figured I might as well go for the immunological workup that I've been putting off (and also because Dennis doesn't want me to get it done because it's expensive and because his gut says it'll be negative anyway. Don't ask me why his gut has inputs on medical test results hehe :p )

There are 5 main possible immune problems in pregnancy, which you can get one or several of--
1. The couple's tissues are too compatible; the woman's body considers her placenta as foreign with her immune system activating against the baby
2. Blood clotting problems like APAS
3. An immune reaction to the baby (ANA antibody)
4. The couple produces antibodies to sperm which immobilize and destroy them upon contact
5. Certain white blood cells are overactive like NK (natural killer) cells

So to get tested for all these scenarios, I need to take 2 blood tests -- the first is a set of 5 types of tests, and costs about P12,000 cash. I did this this morning. The second blood test can only be done every Monday, and will cost a whopping 50,000+ pesos, because it's about $1,050 plus a P5,000 shipping fee, as the test can only be processed in the US. I almost fell off my chair when I got quoted the price. OMG.

A part of me shares Dennis' gut feel that I'll be negative for this test. But then, a part of me (a more logical part) says just do it, as knowledge is power. And I've always decided on these things based on what I can live with and what I can not. In this case, our bank account may take a bit of a blow but at least I'll have answers. No regrets.

So, I guess I'll do that the next Monday I can steal some time off work.

:-S

Speaking of work, yes, I'm back at work. Figured the sooner the rest of my life gets back to normal, the faster my heart will feel normal as well. It's still devastating to remember what happened, but we sincerely are recovering, I can feel it.

Please continue keeping us in your prayers.

'Til the next update!

The end of cycle #1

So, the first cycle didn't work.

We were up so early this morning, as we both barely slept a wink, and off to KATO we went for the blood test. After getting blood drawn, we waited almost an hour for our turn to be called. Once we entered the consultation room, Dennis told me (after) that he had already seen from the doctor's face that it didn't work. Me on the other hand, I was so hopeful for good news I had no inkling. I was also a ball of nerves so maybe that made me less conscious of other people in the room.

Almost as soon as we sat down, Dr Jao showed me the blood test results and explained that the figures meant the embryo didn't implant and we had an unsuccessful cycle concluding before us. She also patiently answered all our questions, with the utmost care and really good bedside manners. Despite our shock, we were able to ask some questions on what may have gone wrong and what the next steps can be. After some time, we told the doctor we'll think about it, all the while holding back tears, and waited to be called by the cashier to settle the bill. To be honest, it was quite a surprise for us that it didn't take. I think some part of us felt like this *was* it. That this was the cycle we were waiting for. We were wrong.

So after we left KATO, we both stopped by the Starbucks inside Enterprise to collect ourselves. We were both teary-eyed, and Dennis' initial reaction was that he can't do this again. The heartbreak was just too much. Upon hearing that, I started to cry too (and tried to hold the tears in as much as possible! Oh I wished KATO had empty rooms that disappointed couples could stay in for a bit!). We then decided to take the rest of the day off to be together and grieve together.

We then decided to head off to Raffles (I don't know why there, specifically, but that's where we ended up) and we got a private table near the windows and talked. We also decided to call our respective moms there, and I think there's something about hearing your mom's voice telling you it's all right and that there's always a next time and that it'll happen, don't worry, that makes you believe it. That makes you believe that mommy will always know what to do and what will happen, so if she says it, that's how it will be. Hearing my mom made my tears flow and flow, and I know it brought Dennis much comfort to hear his mom say the same, because after that, he was visibly better and more positive.  I guess no matter what age we grow to, we'll always be our Mommys' children.

Anyhow, we dusted ourselves off and took stock of what our next steps could be. We also went to see my OB and asked him for his opinion. We combined this with what the KATO doctor said and we agreed it was the right next-step for us. We'll try again this coming cycle, as soon as I get my period, that is. We'll try a more aggressive protocol, but still not as aggressive as full-blown conventional IVF. We'll also think about maybe transferring more than 1 embryo this time. Hopefully, we get better results.

I will not lie, disappointment is a bitch. Lest you think it was easy to get over this, it wasn't. Sure, there was a great deal of comfort to be drawn from the fact that we did all we can and I, especially, did my part in making sure we got the best possible outcome. I avoided what had to be avoided, I skipped work, I took all my meds, and I ticked all the boxes. I did everything. I can look myself in the mirror and say I did my part. The rest was up to God. And I guess it wasn't our time yet. Because I did my part, I deserve to be at peace with the outcome... to be able to come to terms with it without any regret or blame. I did what I should have done, no more and no less. I did right by our little embryo; it's just that, perhaps, it wasn't our baby.

I prayed a lot this month too, possibly more than I've ever prayed in my life over such a duration. It was a test of faith for sure, and I'm relieved to realize I come out of it with my faith still intact. I continue to pray, for myself and for everyone else out there suffering from infertility. There's no greater heartache, I think, than to crave for a child and to continue to be denied of it, and no greater love that the love that lies waiting for the child that has yet to live to receive it. When I cried today, I cry also for all these moms-in-waiting, anticipating that day they get promoted to 'mother'. I cry for all the dashed hopes, for the loss of innocence in the happy accidents of conception, for the little deaths died, by every hopeful heart, at every failed cycle. It's almost like a cruel joke, I told my sister-in-law, who is also suffering from infertility. To want something that other people seem to get just at the mere intent of it, and seeming to keep being rejected no matter how long you stay on your knees, begging for it. To want something and sacrifice so much in its name, only to be told that it's still not enough. To want something to the point of trading everything else in your life for it, yet find out that it's going to take more than that.

I pray that my marriage continues to stay strong -- that our love will continue to tide us over in this quest to be parents. I pray for my husband to stay strong, despite the moments of weakness and of temptation to relent to defeat. I pray that we continue to have fight inside us and to keep getting back up, equal times that we are made to fall. Let not this one failure mark us and make us jaded. Let this just be another obstacle for us to go through to get to our baby.

So now I lay IVF Cycle #1 to rest while I gather my strength again to face the upcoming cycle.

May this next try be the lucky charm.

It's tomorrow!!!

Aaaaak! Nerves nerves nerves!!!

Pray for us!!!

Stork Chase Status: A weekend away from the first beta (first of many, I pray!)

So it's the last workday I'm taking off for our Stork Chase. After today, it'll be the weekend, then it'll be Monday morning, aka the first beta blood test. First of many, I pray fervently, because if it's negative, I think that's the end of the road. But if it's positive, it'll be followed up by a few other blood draws over the next few days to make sure that the levels are rising / doubling as they should.

The days seem to have flown by a bit faster than I thought they would and I credit a lot of that to : (1) the Alabang staycation that Dennis took me on ; (2) the many friends I've met up with for various lunches and coffee dates, who made me feel like my days were a bit more exciting. Hehe. Thank you, you know who you are :) ; (3) discovering Fertility Friends (an app) that helped me feel like part of a community and enabled some questions to be answered ; (4) TV series that my husband lovingly downloaded for me, most notably Junior Masterchef which both entertained and gave me really happy vibes. 

Some friends have asked me about symptoms, mostly because they are just as excited as me to find out if we succeeded in this cycle. To date, I've mostly felt bloating (which I read can be progesterone-induced), some soreness on my boobs which comes and goes and really high body temperature, which can also be because we're in the middle of what seems to be the hottest summer that ever graced the Philippines. Apart from that, nothing else. And I've read enough to know that these are mostly due to hormones that I'm taking and less about actual pregnancy symptoms. It's too early for anything to be exhibited. So while it's hard especially when you get excited, I do try to keep my expectations in check.

Speaking of what my friends have been asking me, I found out by accident that a high school friend is also going through IVF, but in Taipei. My parents went there about 2 weeks ago for a business trip and they bumped into my friend's mom (my mom and her were both "uno moms" so they know each other). My mom asked what she was doing in Taipei, and she didn't understand why my friend's mom looked uncomfortable and was spewing out vague answers like, "well, my daughter is undergoing... umm.. she's.... well, she has to.." so my mom, out of compassion, just said "ah she's doing IVF."

So I messaged my friend just to give some support and offer an ear in case she wants to talk. No pressure. I kept the message close-looped, so that if she didn't feel like sharing, she didn't have to. Then, I was surprised when she replied, apart from sharing how she is, with a desperate plea to keep it all under wraps and not tell a single soul, as we have a lot of common friends. Turns out she and her husband are not telling anybody at all apart from their families, because they did not want to be pressured to explain in case things didn't go smoothly.

I respect her wishes and am by no means judging her. I totally understand the rigors of IVF and the emotional roller-coaster you go on when you decide to have it. It just made me more conscious of how 'open' I seem to be about this entire journey. True, I am not broadcasting this on Facebook and have no plans to blab to every single person I meet, but a good number of my friends do know what I'm going through--- about 10 or so, and not counting my officemates who of course need to know what's going on and why I'm going to be on leave. To these chosen people, I have no problems sharing this story, and appreciate so much the support that I get from them, not to mention the prayers that I know get said in my name. But I guess what makes me 'open' is not so much opening up to the people I love, but having no issues with sharing my story to anyone who would like to ask (as long as it's not prying!) and to know more about infertility. I share what I can, including my own situation and challenges. I even toyed with the idea before of having a documentary done on my IVF, if only because I want to raise awareness about infertility -- I do not agree that it should be treated with shame at all. It's a condition that needs to be respected, supported and treated. It's an emotional pain that deserves to be aired and to be comforted. It's a dream that deserved to be dreamed. I can understand the fear of being judged or being pitied if the procedure doesn't work, but I feel that (a) there's nothing wrong with sympathy and empathy; (2) if you judge someone who has infertility, then you are the problem, not the person with the condition, and you ought to be the one shamed.

Anyway, for now, I'm just enjoying the rest of my time off and keeping the good vibes up. I'll also be honest and say that I've started to also try to manage my expectations and at least logically plan up a Plan B -- i.e. when can we try again, how much would I need to set aside, etc. It's the delicate dance that every person going through infertility inevitably has to dance -- the precarious balance between hoping for the best and preparing for the worst. On one hand, you pray for your dream to finally come true and believe that you've done all that you can do to make this cycle succeed. But on the other, you also have self-preservation instincts that sort of 'devil's-advocates' and brings up the 'what if it's not good news' part into the discussion you have with yourself. Lots of push and pull happening here, that's for sure.

So, last 3 days of PUPO and off we go on Monday! Wish us luck please! And pray for us! :)

Post-it!

Found this to be an interesting read. Parking it here for reference --

http://m.huffpost.com/us/entry/4466210

Decision on teaching

Lest you think all I think about now is my little bub, well, you're only 20% wrong! Hahaha! While I do try my best to not think about it all the time, it's still sitting somewhere else in my brain whenever I do think of something else. Aaaahwell, who can blame me? Anyway, the other 20% of the time, I do get to dwell on different topics, such as.... Teaching!

I've been asked again to teach this year. I do miss it, and I do want to go back to it. But at the same time, my Saturday afternoons have been occupied by acupuncture sessions and the only way for me to accomodate it in my sched is to do it on Sat morning. 

Dennis says to decline them again this year because he doesn't want me to get tired or stressed or both on Saturdays when I should enjoy it as a respite from the stressball that is TV5. I guess he has a point. 

So sorry again, alma mater! Maybe next year! :)

Stork Chase: the waiting game

So we're now officially in the 12-day wait to know the verdict of the IVF cycle. I decided to take the time off from work because I didn't want any what-ifs and regrets. I want to know and be able to tell myself that I gave this the best possible shot. I'm just not used to not doing anything, haha! So I'm getting restless already and it's only the second day. Haha!

Boredom aside, I was struck by a thought a while ago while strolling around the mall after my friends had gone back to work. No matter what the outcome, I already love this little speck of white inside my uterus. I may still feel a bit funny referring to myself as pregnant, but I do feel that this is *my baby* inside me already. It feels so real this early, and I feel as much love and protectiveness over this little white speck, even if implantation hasn't started yet and I'm still 10 days away from confirmation, as I would when day 12 comes. I don't know if that makes sense but at this point, I feel lucky to have this advance knowledge that this little bub is already around. If this was a natural conception, I would not be aware of the little white speck until I miss my period in about 2 weeks. But because we did IVF, I have been fully aware of its existence and been able to love it *this* early. May sound odd to those who've never gone through infertility. But that's how I feel now and I doubt that will change. I had that thought because I caught myself *talking* to it, encouraging bubby to keep growing and to please latch on strongly later. I love it already. I don't know what else to use to describe this feeling. 

So while waiting may not be something I welcome, I would gladly go through it. Waiting, praying, waiting, praying. All for you, little speck of love. 

PUPO

Pregnant Until Proven Otherwise. 

That's the lingo used among infertility circles that describe the stage after embryo transfer but before the beta hCg blood test that confirms a successful implantation. I'm sure it's by no means a medical term but infertile chatrooms use it to pertain to this precarious state. You're partially successful yet you are one critical step away from really calling it a cycle that worked. It's quite funny, how infertiles have created such grey areas where there are none among those who can naturally conceive. Oh well. Such is how this condition goes. And really, I'm very thankful to have gotten this far and remain very optimistic that we'll ride the rest of the way smoothly and cross fingers, successfully. 

So that's where I am now -- PUPO. We were up at 8am this morning, after an anxious sleep because we didn't know what we'll hear at the other end when we called to check on our embryo's progress. 

So at 8:08am, we called Kato and after verifying my identity (as I mentioned, this clinic is very strict with this), the embryologist informed us that yes, we have a 6-cell Grade 1 embryo and I can come in at 10am this morning to have the transfer. 

You cannot imagine our happiness upon hearing this news. Our embryo is developing well! Dennis cried tears of joy, which I didn't expect because he would so often be the stronger one in our pair. Upon seeing his tears, I cried as well. So much relief and so much joy in hearing the first confirmation that, no matter how this turns out, our little bub was growing well. 

So off we went at 9:45, and after vital signs were taken, I was led to the operating room for the procedure. It was explained to me there that by then, the Grade 1 embryo had changed classification into Grade 3, most likely because the 6-cells have begun another round of division. You see, in IVF, embryos are graded from 1-4 with 1 being the highest. 1 means that the cells are dividing into equal parts and there is no fragmentation (breaking up of cells). At this point, I worried a bit but then decided to lift it all up. We'vereached this   point and this group of dividing cells is *my baby*, no matter what the medical field may call it. 

So after some cleaning, they showed me the embryo being fed into the catether by the embryologist. Then it was handed to the doctor to be inserted through my cervix and into my uterus. I got to watch the monitor and witness the whole thing, live. It was very surreal and high-techy. The wonders of science. If phones were allowed, I would've taken a video :p

After the catether released the embryo, they took a screen shot and gave me a printout. Here it is -

That little white dot on the left is it! The little ball of cells that hold all my love. Hi there, little bub. Please stick and hold on! We will have a good ride together, I promise :) 

After, I was told to rest for 15 minutes then I was released and given post-op instructions. Our next visit will be on May 26 where I'll do the blood test. In the meantime, I am to take all this 3x a day -

No problem! I can do all that and more, to help make my little bub stick and hold on. 

I've also taken the time off from work, to avoid mental stress and unnecessary exersion. In fact, bedrest is not necessary and may not be very good for blood flow. But stress is never a good factor, so I'm lying low for a while. 

We may go off for a short out-of-town break next week though. To help pass the time and to help me relax more. 

So there. Wish me good health these next 12 days and for our little love to stick to mommy! Prayers please! :)

This *is* it!

Yes, the egg retrieval happened today! What an experience! 

So off we went to Kato at 8am this morning, after following the care instructions they gave me for last weekend which involved 3 rounds of nasal sprays containing some ovulation-a activating agent plus taking ibuprofen to sort of make the egg follicle stay in place and not burst. It's a delicate dance between immature follicle that won't fertilize and a mature follicle that's fertilization-feasible but needs to be extracted at the right time, I was told. And that's why some natural-ivf cycles get cancelled -- when the egg isn't caught in time or punctured / extracted prematurely. 

So all weekend long, that's what I prayed for and thought about. Channeling positive vibes, I would often "talk" to my egg and tell it to stay in place until Monday. On Sunday night, I had a fitful sleep because I was so excited for the procedure the following morning. 

So off we went at 7:45am to head over to Enterprise. As advised, I did not apply anything to my body that might carry chemicals, like deodorant (I know...), makeup, perfume, etc. Apparently, eggs are susceptible to chemicals. I even had to take off my nail polish the day before. I didn't mind though. At this point, that's a non-issue and doesn't even count as a sacrifice. 

When we got there, the nurses were expecting me already and guided me to my assigned bed in the recovery room. I was instructed to change into the lab gown and unload my bladder, put my hair in a net and wait to be collected. The nurse came by after a few minutes to get my vital signs, then she led me to the operating room. 

I was so impressed with their SOP particularly with the repeated verification of my identity (which if you're familiar with mistaken identities when it comes to assisted reproductive techniques, you will find great comfort in their insistence in making sure you are who you say you are and that your samples are labelled correctly and checked and read carefully every time it's touched) and the full disclosure of what to expect before something is done to you. The operating chair was also pretty high-tech, very Japanese. The stirrups were leather and hence not metallic and cold, complete with velcro straps that can hold your legs in place and minimize involuntary movements that may jeopardize the procedure. There was also a screen to my left and my right, which gave me full view of whatever is being done. 

The doctor then asked me, after inserting the speculum, cleaning me and inserting the ultrasound wand, if I felt cramping the night before. I did feel some twinges but was hoping they were just usual pre-ovulatory signs. I suddenly felt nervous it may mean the follicle had burst. 

Next thing I knew, the extraction was being done quickly and being explained to me as I was led to look at the left screen. The doctor explained to me afterwards that when we started, the follicle had already begun to burst. That's why she jumped to quick action and asked for the extraction needle right away. Thank God, and I know Buddha was watching over me, she managed to catch the egg that still lay inside the follicle, and hurray, it's a mature egg! Fully ripened! You can't imagine how happy I was! The embryologist again repeated my name, Kato patient number and birthday, then showed me through thescreen  the egg that was collected. Then it was over and I was led back to the recovery room. 

While alone in the recovery room, I couldn't help but cry with relief and joy. We had a mature egg, caught just in time! One step down, 2 to go!

After resting for about half an hour, I came out to wait for Dennis and then together, we waited for the embryologist to discuss our status. We waited about an hour which they warned us about beforehand, as this was the window needed to analyze the sperm sample. When we were called in, I was surprised to receive another set of good news -- our sperm sample was higher than the previous tests we've done. Count has gone up to 44m, from the usual 12-20M level that we're used to seeing. Motility was okay too and morphology, while still low, was workable. She recommended we do ICSI, given our results and we only had 1 egg to work with. After asking some questions on how they perform ICSI, we decided to go for it, trust the process and cross our fingers. After all, we've already gotten this far. 

After that, I was given some meds and instructions on what to do and not to do. We'll know by Wednesday morning if the fertilization went well and the embryo responded well, given the 2-day embryo criteria that they observe. Assuming our little bub is viable, they'll do the transfer to me on that day as well. That's the 2nd step to hurdle. I'm concentrating my prayers on that leg now. Bit by bit, with prayer and some good luck, hopefully, we'll get to the point we've worked so far to get to. 

Good vibes only! Til the next update, hopefully a good one! ;)

Isdizit?

I'm back at KATO, after being here just yesterday, because the doctor felt it may be *the* time to harvest my egg. Dennis and I are both excited and eager to get the process going. If today's ultrasound looks good, we may be looking at egg collection this weekend, then fertilization shortly after that, then fingers crossed that the embryo comes out strong, enough to be deemed worthwhile to transfer unto my uterus. That's all in just a short span of 2-3 days, then it will be about 10-12 days of waiting to see if the embryo implanted well. Please please please! We're both very optimistic and excited to start the process. Hopefully thisisit!!

Stork chase update and other stuff that's going on

So, I went to Kato again yesterday and did an ultrasound to monitor my ovulation. As mentioned before, we're doing a natural-cycle IVF so the first part is figuring out when my follicle for the month will mature and try to time the egg retrieval at the optimum time. Of course, part and parcel of that is making sure I'm healthy, eating well and doing things like acupuncture to make sure the egg is at its healthiest.

So off I went and the doctor tells me that my follicles look a bit on the small side still, this being Day 11 of my cycle. Since I usually have 30-day cycles, it looks like this will be another one of those and hence, we should see better 'egg action' by tomorrow, Thursday. Then she said it looks like, from her estimation, egg collection will be Saturday. This will also be the time when a sperm sample will be required and in-vitro fertilization will soon take place.

So far so good, in short. Not much activity yet.

Oh and I got my hormone test results back and while some values are on the low side, they're all normal. Whew.

Work, on the other hand, is getting really hectic. A big part of this is because of the bad shape that the company is in. It's been so draining being part of this and, while I want to help out my boss in every way I can, I also know I have my personal objectives and I don't want to overly stress myself out. Hayayay. So here I am considering maybe only taking 5-7 working days off, instead of the original 2 weeks I planned. Just because it seems like such a bad time to be out (then again, because the company is in such deep sh*t, is there ever going to be a good time to be out?!).

What to do, what to do...

Oh, and UA&P is knocking on my door again to teach this upcoming semester. On one hand, I really want to do it. I've missed teaching and it's such a good way for me to keep a balanced perspective about work.It allows me to do something I'm good at and I enjoy, and has no complications in the way that work always has. But on the other hand, I am also worried because it's still a big commitment and it's still pretty time-consuming.

What to do, what to do...

:-S