Slowly getting better!

Day 5 after LIT -- still two big, angry, insect bite-looking spots with a bit of a rash and a bit of itching left over.

Hopefully it'll be gone by the weekend. Next round in about 9 days' time! 

First immunology treatment

So I just did the first of hopefully only 2 LIT sessions last Sat. The nurse came over at 6am as agreed and extracted 10 vials of blood from a sleepy, groggy Dennis. I'm a bit nervous at this point because I had forgotten to tell Dennis to abstain from alcohol the night before, and he had gone out with friends Friday night and of course had several rounds of scotch. After researching online, I found out that alcohol is counter-indicated because it tends to lower white blood cell count and tends to water down blood - both not good effects we want on our LIT day. 

Oh well. Guess my husband has tons of blood because when we got to Bloodworks at 10:30am, we found out that they were still able to extract the needed amount of white blood cells. 

So Dr Aleta injected me on the left arm, in 2 injection sites to spread the concentration of the "foreign bodies" for better absorption. It hurt a bit - like being stung by a bee - for about 10 seconds, then it burned.... And burned. 

She had to cover it with bandage to cover it from sunlight. 

So this is how it looks like with bandage -

This is how it looks without it. You'll see two very angry shot marks and the beginnings of a bad, itchy rash --

You also see the bruise on the inside of my elbow -- which I have on BOTH arms. Hideous, I know. But a necessary side effect of all the blood draws I need to get on a very frequent basis. 

So now it's been 2 days after the procedure and I'm happy to report I think I reacted sufficiently to the treatment. Hopefully this means it's working and I reach the required minimum 80% level after the second treatment. 

Wish me continued luck!

Embryologist Consult

So we went to see the embryologist and Dr Mendiola today to find out the status of our embryos. Recall that last June 11, I had my egg retrieval procedure which resulted in the ff:
> 2 mature eggs
> 1 semi-mature (called M1) egg
> and, 2 immature eggs that will be subjected to IVM or in vitro maturation, which hopefully results in their upgrading to mature grade

So after 9 days, here are the results:
> Mature Egg 1 was able to be grown into a Day-2 embryo by June 13 and was frozen as the backup embryo to be transferred if all else fails (scary phrase)
> Mature Egg 2 grew to Day 5 but degenerated by the time Day 6 rolled around
> Semi-mature M1 egg grew but very slowly... only 2 cells by Day 2 and compaction-stage by Day 5, whereas normally, embryos should reach blastocyst stage by this time. It finally reached blastocyst stage by Day 7 (two additional days after the average), and was frozen. This will be our priority contender come transfer time.
> The 2 immature eggs did not make it to maturation.

So we have 2 embryos - a blastocyst and a Day-2-er. Funny, I even gave the 'transfer one or two' thing quite a deep think; yet, it turns out I don't even have that as a choice. We'll transfer the blastocyst first, it being the higher-odds of the two, when I'm ready for the transfer. Day-2-er will be the backup for a future cycle.

Dr Mendiola was very patient with our questions and also assured me that the embryos can stay frozen until my immunologist clears me of the auto-immune issues I have. He has heard of LIT therapy and agreed that it's better to get them done and cleared before going for a transfer.

I'm a bit bummed, to be honest, that we only have 1 of each type. I honestly thought one of the immature eggs would catch up, and then hopefully we have 2 or even 3 blastocysts. I guess I'm just an overachiever by nature and by heart and I guess I expected a lot from my embryos as well. Or maybe a part of me felt that I wanted at least a part of this process to be 'perfect', even if the others aren't. I dunno. Dennis is more optimistic than I'm feeling right now.

Ironically, it's the semi-mature egg that made it to blastocyst stage, and the mature one fizzled out right before it reached it. Funny how nature works. This also gave me an idea of what may have happened during our first IVF round -- maybe that embryo is similar to Mature Egg 2... They're both perfect contenders on Day 2 (IVF round 1 embryo was a Day 2 transfer, if you recall) but didn't result into anything at the end.

Funny.

In an unfunny way.

Oh well.

So tomorrow, we're doing our first LIT treatment. I found this provider based in Katipunan that does home service of the husband blood draw, which saves us the trouble of trekking up to Katips at the crack of dawn (FYI, LIT sessions always involve an early-morning blood draw from the husband because it takes about 4 hours to process the blood to isolate only the lymphocytes, before it is ready to be injected into the wife's... forearm! I don't know why they particularly chose the forearm, as it sounds like a painful transfusion site to me... Anyway...) So they'll arrive at our condo at 6am, get Dennis' blood out into 5-6 vials, and then we're supposed to go to their clinic by around 10:30 or so for me to get the lymphocyte transfusion. Then we'll see how my body reacts to it. From my understanding, the more violent the reaction (i.e rashes, boils-looking angry red inflammations, etc), the better. It is supposed to mean that my body is 'reading' Dennis' genetic material and a 'battle' is being waged, hence starting the assimilation process. The objective is for my immune system to read, recognize and accept Dennis' genetic material as non-threats. Very sci-fi, right?

On my way back to the office earlier from Kato, I couldn't help but cry as I talked to our future child in my thought-voice (of course, I was being chauffeured back, so it was just thoughts running through my idle, in-transit head), telling him or her that, see, this is how much mommy and daddy love you. This is how much we are fighting for you -- that we fight even for your conception to happen, for your implantation to happen, for YOU to happen. It's not meant to be compared to people blessed with natural pregnancies. It was just an expression of the magnitude of sacrifice that we're doing --- a level of sacrifice that sometimes overwhelms me beyond comprehension. We love you, advocate for you and fight for you, even when you are simply an idea, a dream, a hope in the hopefully-not-distant future. We sacrifice so much, to the point that we even 'play' with our health, just to have even the smallest chance of YOU happening. Love. That's all this is all about.

Love.

When you do come around, and I believe in my bones that you will (and you're just choosing when to make your grand entrance), boy, will you be the most loved and cherished child that ever graced this world. If I can bottle up all my hopes and dreams for you, all my fears and doubts, all my pain and endurance, I would, if it can remind you everyday just how WANTED you are.

I love you already.

Another unpleasant surprise!

So I mentioned a few weeks ago that I was going to do an immunology workup after the first ivf failed. Partial results came out today and the second part which tests for 1 other condition will come out in 2 weeks. 

Surprise! Of the 4 conditions that my results tested for, I have 3 of them. Wow! Talk about a curveball. Curveball because my OB previously told me he doesn't think I fit the profile of someone with immune issues and because, as Dennis' logic goes, how much odds can a couple really take?

Well, I guess fate had other plans. 

First, I have an autoimmune condition VS my husband's (or any other unrelated person) genetic material. If the last ivf did implant for a while, the uterus becomes a hostile environment for it soon after, because my system reads his DNA (which is half of the embryo) as foreign and should be attacked. The solution for this is to do a LIT treatment - lymphocyte immunology treatment or paternal lymphocyte treatment. It involves getting blood from the husband and washing it to isolate the white blood cells. Then infuse this into the wife so that her system can be taught to accept his DNA as "friendly" and not hostile. The immunologist I saw today says that she thinks I'll reach normal levels after at least 2 sessions. And once I do reach the minimum of 80% on this test, I can proceed with the IVF. 

The treatment cost is quite significant too but I don't wanna dwell on it, simply because we'll do it anyway. No use pining over the money. 

Second, I have autoimmune against... Myself! The manifestation of this is blood clotting -- no wonder my legs often feel painful especially when I get my period. It means my blood coagulates as an autoimmune reaction. The treatment for this will be aspirin and daily heparin shots which I'll administer on myself. 

Third, I have thyroid issues. This needed some deep-diving which led me back to the lab today to get more blood drawn out. At this rate, I think my hemoglobin count must be so low already with all the blood draws!

Another test which I'll get in 2 weeks' time will count by natural killer cell count. This is the mother-fucker autoimmune condition of all -- I pray I don't have it. It makes one not able to be pregnant at all and the treatment entails massive amounts of money -- and that says a lot because in our 3 years of infertility, I think I've grown a tolerance for this kind of spending. I pray I don't have it. Please please please. 

I'm so tired. Seriously. What else is out there for us to conquer before we have a healthy baby in our midst?! Dennis breaks down every time we face a challenge and I myself don't know how much longer I can put up a brave front. The fighting spirit that we wring out painfully from our hearts gets a bad bad beating throughout every cycle that doesn't work and every condition that gets uncovered. This is bordering on traumatic, to be honest. And I don't know how much stronger we can remain to be for long. 

Then again, it must be even more painful to lose hope. So we live to fight another day. LIT session 1 will be this Saturday. Fight!

ER Attempt #2!

So I had my egg retrieval (ER) yesterday morning. We got to Kato before 8am and the experience was a bit different for me now that it's my second time to do the procedure. Things felt faster, I think... Or maybe because I was less apprehensive and nervous and more "in control" due to the sense of familiarity. 

After being prepped, it was my turn at around 8:30am. I was surprised to see it was Dr Mendiola- Kato's head practitioner- who was going to do my procedure that morning. Just like the last time, the OR was filled with doctors (Dr Ong-Jao and Dr Perillo were both observing) and nurses and embryologists. Kato's super professional way was such that every single action and result obtained was checked and validated. It made me feel at ease. 

So after cleaning and administering local anesthesia, Dr Mendiola started the procedure by popping the more visible follicles. This process was much more painful than the first time, mostly because it involved multiple follicles. The sensation is half a sharp pain when the needle would  permeate the follicle and an acute sucking pain when the fluid and egg were being suctioned out. 

Anyway, to spare you the yucky details, I was able to generate 5 eggs -- 2 mature, 1 semi-mature and 2 immature. We initially thought we could harvest 8, but it turned out that one was a cyst disguising as a follicle, another one was a follicle but didn't carry an egg inside it, and the 8th one didn't show up for the party. So 5 is what we have. I was happy to know that Kato did in-vitro maturation, which essentially means lab-controlled maturation of an immature egg. This means that our semi-mature egg has about 80% chance of maturing whereas our 2 immature ones have about 25%. I'd take those odds over zero, which is the case if they didn't do IMSI. 

So the plan recommended by the embryologist is to culture 1 egg to day-2 just like last time and culture the balance 2 eggs (or more if the immature ones catch up) to day-5 blastocyst. While there is a 50% chance of mortality among fertilized embryos cultured to day-5, they are believed to be stronger than day-2s and have better chances of implanting. The reserve day-2 one will be frozen and kept for future use. This method allows us to hinge on both styles and have some eggs in each basket, so to speak. 

Dennis also had a good production level yesterday. So happy!

So there. We're going back on June 20 to find out how many fertilized embryos survived the culture process and freezing. Hoping for 100% rate of survival! Please pray for our little embies!!!

Oh and since embryo transfer will be done next cycle, I have a month (roughly) to decide if I want to transfer 1 or 2 embryos. This is noting that ivf embryos tend to have a higher chance of splitting after implantation, resulting to identical twins. And noting that embryos do not have any dependencies on each other in terms of ability to implant, said Dr Mendiola. What this means is if we have 2 embryos that are likely to implant, they will likely both implant whether they were put in together to share a pregnancy or put in separately to be carried in 2 separate pregnancies. And noting that I have a heart-shaped bicornuate uterus that won't stretch as much as the average oblong ones of other women. But a part of me stubbornly feels 2 is better than 1. Hehe. No logical back-up for that sentiment though, and I know carrying twins (much more triplets if an embryo splits; and I refuse to entertain the idea of quadruplets!) is extremely difficult and carries significant risks for mommy and babies. 

I guess I already know the answer. The only upside of putting in 2 is it increases the chance of that particular cycle (but not the chance of each individual embryo, as I mentioned). This means that I can spare myself (and Dennis) the horrible emotional strain and pain of a failed cycle because the cycle has double the odds. Does that make sense? So it's just emotional self-preservation. Vs physical safety and health. I guess I know which one takes precedence over the other. We've just been carrying so much pain throughout this process I can't help but try to find a way to shield us somehow. 

Pray for us please!

Man's perspective

Rare does a man lend perspective on infertility. Much less a pastor! This is a good read and some parts brought tears to my eyes. A part of me feels that while we will be eternally and deeply grateful once we are blessed with a child, we'll also still carry with us a sense of PTSD over this infertility experience. Yes, as in post-traumatic syndrome. It's indeed so traumatic and the experience so unlike other challenges in life, that I think a part of me will never forget it. 

Anyway, here's the link -

http://natepyle.com/the-disgrace-of-infertility

Update!

My ovaries have cooked the eggs enough -- We have a retrieval schedule! It will be on Wed morning, and we're looking at getting at least 3 eggs up to a maximum of 8! Woohoo!

Praying everything goes well!

Waiting for egg retrieval part 2!

After taking minimal stimulation drugs the past week or so, we're now waiting for the schedule of when we can do egg retrieval. Hopefully we get at least 3 eggs and fertilize them. 

I thought that since we were doing minimal stimulation, there won't be side effects the way that traditional IVF patients report having. Turns out the side effects are definitely still noticeable and still quite substantial, to my surprise. I can't imagine how conventional ivf protocols feel at the stimulation period if I already feel like this under minimal stimulation. I'm so bloated and I feel my ovaries are so heavy. There's a strange heaviness that I carry around all day and the doc says that's because of the multiple eggs growing. I am also more irritable and prone to flaring up -- which if you know me well, you'd know is not my nature. I also feel really warm, which is made worse by not being able to drink cold drinks or eat ice cream, as prescribed by my acupuncturist. 

Oh well. I'm just complaining uselessly. The truth is, all this is acceptable and accepted in our quest for Baby Chan :)

Wish us luck today!

You said it!

This post totally gets my perspective about the lonely world of infertility -

https://medium.com/theli-st-medium/the-saddest-room-on-earth-cb2249250830

Please read it if you have time :)

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

Shrinking fears

I am full of fear, I admit.

Reading this blog post made me realize it's natural, even 'right', to be feeling this way. Feeling fearful that the IVF may not work affirms that this is very important to me, and that the risks are far outweighed by the potential rewards.

Logging this here, so I don't forget --- that fears are natural, but they can be 'put in their place', that perspective is crucial in surviving this with my sanity and marriage intact, that this *is* hard, there's no shame in admitting that.

http://www.catchingrainbowsfertility.co.uk/2012/11/how-to-shrink-your-fears/

For future re-reading and re-reading and re-reading.

Chasing the Stork

So the (scientific) stork chase formally starts today. I will attempt to chronicle this experience, both so that I can look back on it (hopefully with positivity and gratitude) and so that it can help me sort through the mixed bag of emotions that accompany any fertility treatment. 

So we're here today at Kato, for the first step of the process, which is a Day-2 blood draw to see my hormone levels and an ultrasound to get baseline stats of my uterine lining. What makes Kato different from other fertility practices is they use a protocol in the administration and management of IVF, which means that they leave less things to chance than conventional practice. This doesn't mean they guarantee success but I guess the comfort is that you know your procedure is less dependent on the actual practitioner assigned to that particular procedure on a certain day, but more on the accomplishment of each step of a carefully designed protocol that took years in Japan to come up with. So the first of those steps is to come in the day after you get your period.  Hence we're here today. 

I had a fitful sleep last night imagining many scenarios, including both positive and negative outcomes. I guess thinking of the possibility of failing, then thinking of the next steps to take after that, is less about being pessimistic or not being positive enough... And more about self-preservation. Only those going through infertility know what this feels like - that self-defense mechanism inside you that comes from going through more heartbreaks and more "no"s than you thought you would need to. While you want a positive result, more than anything else in the world, you also know you need to be able to move on from failure. Because giving up is not an option. 

So here we are. Pray for us. Pray for a smooth road here in Kato and for a successful outcome. Please. 

Long update

(Warning: Long post)

As they say, we all have our own crosses to bear. I have accepted that this is ours, and I just pray for divine guidance and protection to ensure that everything will be okay in the end.

OK, to recap, my husband and I went to Taiwan last February, mainly for a vacation with his parents, but while we were there, I felt it prudent to visit the IVF clinic there and get some tests done. We were there already, after all, and it will only take one morning to get everything done. One thing I heard is that the clinic there has a 100X better magnification for their semen analysis and hopefully it sheds more light on why we have been unsuccessful in our attempts so far at natural conception.

So off we went to Mackay Memorial Hospital. It's a much smaller place than I imagined, and not exactly looking top-of-the-line, if you get my drift. Makati Med and St Lukes look so much better and much more 'high tech', but this place has the highest success rate in Asia, so maybe looks can be deceiving. We had our consult with the famous Dr Robert Lee, and had our blood tests done. Dennis also had his semen analysis done and then off we went to enjoy the rest of our trip.

Fast forward to two weeks later and I get an email on the results. The Taipei diagnosis for me is that I have fair ovarian reserve, which means I have egg quality and quantity that matches my age. That's good news. However, Dennis has oligoasthenoteratozoospermia. A mouthful to say, I know, but an even bigger mouthful to swallow and accept. Basically, it means sub-par sperm on all 3 counts (or 3 factors by which sperm is judged -- count, motility and morphology or the level of normal-form sperm VS abnormally-shaped).

His count was an 11, when the healthy minimum is 40 and the average fertile man has hundreds. Motility is 36% when the average is 40%. What really worried me was the morphology result -- he only got a 2% as per Kruger's criteria (a stringent criteria by which 'normal' sperm is judged. It's a highly strict criteria, so high that a result of 14% is treated as extremely good). I worry because morphology can be linked to chromosomal abnormalities, and I am fearful of what that may mean to our future child. Given his results, the Taipei clinic recommended IVF-ICSI to our case. This is a more aggressive form of IVF (yes, IVF has yet another MORE aggressive version than the test-tube one people are more familiar with, believe it or not) that has to do with injecting one single sperm into the egg. Essentially the clinic is recommending this because they feel the sperm is of a weak composition that it will likely not be able to penetrate the egg at all. So a form of additional 'manual help' is administered, with an embryologist picking out a sperm that to his eye, looks healthy and injects that into the egg. Poof! Off goes natural selection. No more 'may the strongest sperm win'. If we do this, our future child will not be the 'sperm that won' but the 'sperm that the embryologist chose'. There are a lot of risks here and a lot of choices to be made -- some I'm still trying to navigate through. I do not want to make a mistake. This is our baby we're talking about. Few other choices compare to this one in terms of significance.

Like any warm-blooded man, Dennis took the news quite badly. Seeing him so sad and dejected was enough to make me cry, but I resolved to stay strong because he couldn't and that's what marriage is all about. I resolved at the start of this journey that in no way will I allow infertility to hurt our marriage, and this was probably the toughest test yet. I told him, "how would you want me to feel if it was me that had the problem? Would you want me to be ashamed? Would you want me to feel undeserving of you and your love? Would you want me to be afraid that you will leave me because I am the reason we can't have a child? Would you want me to feel less of a person, less of a woman, less of a wife, just because of a physical weakness that I had nothing to do with? Take all your answers to those questions and apply them to yourself, because that's how I want you to feel." Deep inside, my heart was breaking, but I couldn't let him see that. I feel all the 'normal' emotions that someone in my shoes would, but I couldn't allow myself to show weakness, when he already felt the heavy brunt of it. It all feels so unfair, presenting options that I feel are risky in one way or another, and making choices that I know I will forever second-guess. It felt that way when the news hit and it still does, until now. I know that staying positive is key, but the reality is staying positive feels impossible sometimes, especially when you don't know the reason why this unfair thing happened to choose you and not someone else. Why bad things happen to good people. Why children are elusive to people who would make good parents yet are born all the time to people who are unready for them.

After some time, my husband, God bless his heart, came around and told me he is ready to support whatever choice I wanted to make. This is where another tough part lies. There are many options to consider and many research to wade through. People who know me well know how much of a nerd I am and how studious I am at knowing about things I want to know about. Obviously, this ranks at the top, and despite the amount of stuff I have read, most especially about the incremental risks of ICSI, I am still unsure of where to stand. On one hand, I want to choose the procedure that will work, but on the other hand, I know it's not just about the procedure that will get me pregnant, but the procedure that will likely yield us a healthy baby. I am so uneasy about the risks on the child, because my conscience keeps telling me it's unfair to expose a baby to additional risks that his peers are not subjected to, when it is me and his dad that are making the choices, not him. Yet, the price of these choices will be borne by him, not us. Does that make sense? It's one thing to toy around with my body, injecting hormones that may increase my risk for ovarian cancer, or taxing my ovaries to the point that they may explode (which is fatal, by the way). But all that is on me. It's another thing to expose a hapless, innocent child to risks that he may have to bear his whole life, to satisfy a maternal need in my heart.

So essentially these are the questions to be answered:
1. How do I want to ovulate?
Option A: Ovulate naturally. The clinic I'm looking to go to has an option of natural ovulation. They will not give me medicine to induce ovulation and will instead just monitor my normal cycle and aspirate (suck out, in short) the lone egg in my ovary once it has matured.

Option B: Ovulate with stimulation. This is close to the conventional IVF whereby I will be injected with medicine that will stimulate my ovaries to produce more than 1 egg. The conventional IVF done in St Lukes and Taiwan inject an irregularly huge amount of hormones. The clinic in Enterprise I'm considering only do it 'minimally', which means their aim is to yield about 2-3 eggs whereas the conventional method aims to get 10-20 or sometimes even 25 eggs. This is huge given that nature's version is only 1 per cycle.

2. How do I want to fertilize?
Option A: Conventional test-tube fertilization whereby the egg is placed on a dish then a concentrated solution of sperm is poured over it. This has less success rate than Option B below but is closer to nature, because the method still allows the best sperm to enter the egg. However, with Dennis' condition, the indication is that this method will likely fail.

Option B: ICSI or the injection of one lone sperm, which was selected by the human eye of an embryologist (tao lang, pwedeng magkamali) but carries a higher success rate. This is quite expected, because you eliminate issues about weak sperm and/or an egg with a covering layer that is thicker than normal, making it hard for a sperm (much less a weak sperm) to penetrate. While this has a higher rate of pregnancy, it has also shown higher (50% more!) risk of congenital defects, like vascular defect, cleft palate, and even learning disabilities. Scientists suspect that this higher level of risks (which are still considered small in relation to the total universe, like a 2% chance) is due to the fact that the weak sperm that otherwise would not be allowed by nature to fertilize an egg, managed to because of a syringe and manual intervention. Hence, a weaker sperm may carry defective genes that were allowed to perpetuate. Oh and there's also evidence that if the procedure yields a baby boy, that boy also carries the risk of being infertile. Yes, infertility can be genetic.

So there. Two options for two questions. Risks every way I turn. Risk of failure. Risk of something wrong. Risk everywhere.

I wish I can tell you (and myself) that there's a way to avoid risks completely. But unfortunately, in the world of IVF, risk is a necessary evil. There's always risk when you use science to deal with something that, once upon a time, only Mother Nature had jurisdiction over. Risk is part and parcel of the game -- it's the nature of the beast. The only thing I can do is to try to choose the route that gets us the result we want, at the least possible risk for my baby.

So where is that line? Where shall I draw the line on the sand?

You may say, so why even try IVF? Why not try naturally forever and see how that goes? My answer to that is because time is possibly the single, most valuable factor in fertility. Time affects egg quality. Time affects endometrium quality. Time affects many other fertility aspects. I don't want to wait and wait, only to find out there's nothing waiting for me at the end of this line. Also, while there are risks to IVF, especially IVF-ICSI, it's still minimal compared to the odds of having a perfectly normal, perfectly healthy baby. So while the risk is there, the reward is also very much there.

As I said, infertility is such a gray area, there's no use looking for the black and white. There are no guarantees in this.

So far, we've told ourselves we'll start the process in May. I have until then to decide what particular method to choose.

In other news, I informed my boss yesterday about my intention to do IVF and what that may mean for my work schedule. Specifically, I told him this means for sure that I will need to be on leave for two weeks in May. This also raises the possibility that the leave may be extended, depending on our outcome, or shortened, also depending on the outcome. There's really nothing definite I can commit to, because I am not in control of how this plays out. And I hoped with all my heart that he will stand with me as I faced this part of my personal life.

Sadly, I was disappointed. For a man I held in such high regard and for whom I made quite a number of sacrifices, I was left wanting. When I expected kindness, empathy and understanding, what I got was a reluctant okay, a mild threat and an order to 'think deeply about my career aspirations.' I was so surprised, and my innocence lost, because I thought he would come through for me the way I felt I always came through for him. To have the audacity to do otherwise was probably the biggest professional slap in the face (okay, not that dramatic, so maybe just a symbolic 'cold water splashed on my face') I have ever received. And if there was any ideas being entertained in my head before of "maybe I can try to manage this pregnancy quest with helping him push his corporate agenda, maybe I can make it work somehow, with some days I go to the office and some other days I stay home", that's now out the window. If you are not looking out for me, then there's no reason for me to do the same for you. In a way, it was liberating -- I now know there's nothing else I could have done. How dare he try to make me choose between him and my personal life -- and how dare he even think he can win in such a choice. Such arrogance.

So there. So much heartache, I tell you. So much more than I thought I could ever bear in my life. I have more questions than answers, more sources of disappointment than sources of hope, more fears than when I started walking this path. I just pray and hold on to my faith... and to my belief that after all this is done, in the end, good things will happen to good people.

Please pray for us.

Fuji is here!!!

Gratitude

Thank you.

WHAT IF

Watch:




http://vimeo.com/11214833

The Strange Familiar

This was my musical discovery for 2013. Particularly because of two songs. Love them both. I guess you can also guess why :p

Alibi --
http://www.youtube.com/watch?v=bJfy3kEa4hM

Courage Is --
http://www.youtube.com/watch?v=cXrWRM0E6YA

Reading material... :p

http://www.999reasonstolaugh.com/

Some more updates if you'd like to hear them

OK, this is turning into an infertility blog, without any explicit intent for it to turn out like that. I guess it's unavoidable, infertility being the biggest battle of my life and the thing I think about on an almost daily basis. I'm not even sure who follow this blog, but I apologize in advance for the barrage of infertility issues discussed here. If you'd like to read more about my journey with it, then read on. If not, feel free to close this page.

Anyway, we're off to HK this evening to try out this therapy that my new friend (and fellow infertility warrior) D introduced me to. It's called Arvigo therapy and it's a ancient Mayan massage and therapy technique primarily intended to realign the uterus. The main principle of Arvigo is based on the assumption that the uterus is the 'center' of the female body and from it emanates all other conditions and issues, such as infertility, painful periods, endometriosis, etc. A tilted or displaced uterus refers to any position of the uterus other than the vertical one that's ideal. Mine is retroverted, which means it faces my spine. It can also be anteverted, like in the case of my sister-in-law, or even folded in half (if you can picture it). This can be caused by a variety of reasons, like your pelvic muscles were born a bit on the weak side so they are unable to support the uterus and keep it in place. Other reasons can be a pretty hard fall when you were little, or lifting heavy things before or during your period (which from my recollection, I think I am guilty of). Anyway, Western medicine has always told me that a retroverted uterus doesn't cause infertility and besides, even if it did, there's nothing I can do or get done to correct it. This is what prompted me to check out this therapy because it claims the opposite and gives me the power (or at least the chance) to correct my tilted uterus, get some pain alleviation during periods and hopefully (of course, this would be the mother of all benefits) get us little Baby Chan. The idea also is that a tilted uterus does not allow optimal entry of sperm and its access to the fallopian tubes where the egg would be waiting. Hence, logically, it should contribute to why we're having a hard time.

Also, there's a second reason we're checking out this therapy. It can also be used on men to alleviate prostate problems. As I mentioned before, Dennis has prostatitis, which is essentially the infection of the prostate which causes its enlargement. The prostate is the control center for men and from it emanates almost everything that makes a man healthy, strong and happy (hormones-wise). So a healthy prostate is a must. Ever since I found out the diagnosis, I've been worried about this and been on the lookout for anything that can help. So here we are, off to HK.

The therapy is a bit on the expensive side.. heck, who am I kidding, it's VERY expensive, at 1,500hkd per session (yes, that's almost 10 grand pesos), and we both will get 2 sessions each for this trip. So, yes, add the hotel and airfare and you have the priciest HK trip I've ever been on, and that's still counting the time I went with my mom to get my dowry items. Intense!

But I guess, after all is said and calculated, at the end of the day, I don't want any regrets. Wherever this journey takes us, I want to be able to face my own conscience and know that I tried everything there possibly is. I've done the treatments, I've read the research, I've taken the pills, I've done the injections, I've seen the doctors, I've exhausted all possible options. More than anything, yes even more than Baby Chan, what I want is peace -- peace of the mind and of the heart. And the way to achieve this would be to do everything in my power and make all the necessary sacrifices and make all the wise choices. No desperation though. Just a careful analysis of our situation, good research to back up our choices and have the courage and strength to follow through, even at great personal cost. This way, no matter how this ends, I know I did my best and that I did right by our dream.

Speaking of, my new friend D has gone through 2 IVF sessions and both were unsuccessful. While I had only just met her and we've only been talking for a little while about our experiences, I felt saddened for her yesterday morning when she messaged me that the second IVF didn't turn out well. I know how tough it can get, and I can only imagine how it feels to have the most aggressive procedure done and still not come out happily on the other side. Prayers to D.

The other thing I have to think about is the US trip in May. My family had initially planned to go attend a cousin's wedding in NYC in May, and afterwards take a short trip around NYC and trek up to DC on a family vacation, also to celebrate my dad's 60th birthday. The wallet damage for me and Dennis to join this trip would roughly be around 400k-500k, inclusive of our plane tickets, our share in the accommodations and some pocket money. Given that this Hk trip would already be costing us somewhere in the US$2,000+ level, and the therapist did mention needing at least 3 months (meaning 3 trips) to be able to see results (which means we'll need budget to fund 3 HK trips), we have a BIG challenge facing us. I want to be able to join the trip, but also need to be responsible and set aside budget to fund this more important quest. What to do, what to do.... :-/

So there. Wish us luck, in all forms possible! :P

Gong Xi Fa Cai!

Out with the old, in with the new! Last day of the Year of the Snake tomorrow. Be our lucky year, Year of the Horse!! 

Motherhoodwinked

It may be really early in the year to proclaim this but this book is perhaps the most remarkable book for me this year. 

I've never finished a book in under 2 hours before, and that's still with some parts reread for emphasis at that. This autobiography gripped me like nothing I've ever read before -- I saw myself in Anne's story, felt everything she felt and cried when she cried. She's right-- infertility is such a rarely-discussed topic and because of that, women suffering from it can feel so devastatingly alone and isolated. It's bad enough to have to cope with such overpowering emotions all the time -- anxiety, doubt, anger, disappointment, envy and fear -- it is even worse to have to bottle them up for fear of being misunderstood. 

I could relate to so many things she mentioned and went through. There were times I found myself nodding along or laughing out loud or just stopping -- because she had pointed out something I also felt or did but didn't quite notice. For instance, she talked about infertile women putting their lives on hold, not planning long-haul trips or making commitments months down the line, in consideration of the possibility of being pregnant. Life can tend to revolve around a future state, rather than being enjoyed at its current (though childless) glory. I can also relate to not shopping for clothes, or more often in my case not buying anything too formfitting or unstretchy like slacks, assuming it will be a waste because I'll eventually get pregnant and cannot wear them anymore. These adjustments, no matter how small, are peculiar to women dealing with infertility, and it's high time they see the light of day, because keeping them under wraps just make a hard situation unnecessarily tougher. 

I cried with her too as she went through the many let-downs and the journey through two rounds of IVF. I cried too, this time with joy as if I knew her personally as she discovered she was pregnant after the second try. I sobbed as well as she discovered the baby stopped developing at 6 weeks and had to be taken out through D&C. It's such a scary journey -- this one I'm (and lots of other women are) on -- and it's one filled with more questions than answers, more doubts than guarantees and riddled with physical, emotional and mental strain-- both on you and your marriage. Science is only one part of it. That's the part people who are spared from this usually know about. All the other tests -- tests of love, tests of faith, tests of priorities, among others -- comprise the other unspoken and unseen ones. They can be much, much harder to navigate; sometimes it's hard not to think maybe this quest is starting to take on a cost you are not be willing to bear. 

Great book by a great writer, who bravely shed light on such a difficult topic. Reminds me of this woman I met a few weeks ago during a session on fertility fitness. She suggested us starting a support group about infertility, as she shares my feelings about how isolating this journey tends to be. Maybe I should give her a call....

52-week challenge, put to better use

OK, so I started the year embarking on this 52-week challenge where you save a certain bit of money every month and hopefully, you keep at it so that by the end of the year, you discover you have successfully put away a significant amount of cash.

I initially wanted to do this to get myself into the habit of setting money aside, especially money that would otherwise go into something not-as-practical like shopping, and maybe be able to cushion the expenses that spike up in December.

This morning, our househelp was talking about her decision to ask her son to stop schooling (he is on 1st year college in a small school in Paranaque) because she will be unable to support his studies. The thing with the vicious cycle of poverty in this country is that one illness or one accident or just any one random big thing will set the entire household's budget off-track and cripples everything. This time, her father-in-law is in a serious medical condition, which spiraled out of control after having a substandard surgical procedure done. Anyway, that's a really long story, but the ending of it all is that now he needs even more medical attention and thus will be the beneficiary of the entire household's disposable income, not that there was much to begin with.

So, I spent the ride to work dwelling on this and thinking about how sad the story was. The boy has a good head on his shoulders, seems to learn fast and seems to have the academic aptitude to actually finish college, despite obstacles like not having much resources like a computer or sometimes even shoes to go to school with. So, I'm thinking what if that's where my 52-week challenge money goes? Wouldn't that be a better use of the money? More than just sustaining his tuition and maybe a little bit of his weekly allowance, we'll be giving him opportunity to build a better life for himself - better than the one his mom was given.

It's so sad, really. I wonder if our nation's leaders even understand the plight of the "everyday Filipino." This is the usual kind of situation the Filipino masa encounters. If middle-class people like me sometimes feel like I'm just a hamster on a wheel, sometimes feeling that I work just to earn more money for a big corporation or for people who are already rich to begin with, how much more people like them?

Oh well. This is going philosophical. Just putting down this morning's thoughts.

Happy weekend!

:)

"I might have to wait. I'll never give up.  I guess it's half timing,and the other half's luck. Wherever you are, whenever it's right, you'll come out of nowhere and into my life."  ~ Michael Buble

Reminder! :)

Letting Go

That's the best way I can describe this 2013. This has been a year of letting go, letting God, and letting be.

Whether it's with my career (taking a huge leap into a different industry -- one I would not have otherwise gotten into on my own), with my health (especially with getting pregnant) and with my mindset (less of trying to control things and planning every single detail). 2013 may not have been an exciting year for me in the sense that it was really quite steady, it also taught me to be patient and to be more trusting. Trust that good things happen to good people, trust that life will always be a bit uncertain and trust that, in the end, things will happen in the manner and timing that they are supposed to. No use wringing around in frustration or rattling cages (exag but you get the point)...

For instance, while I was busy looking at the calendar and pressuring myself before on getting pregnant, I realized I almost forgot that I was also hitting way ahead of schedule other milestones that I thought would take more time. I did get promoted and went up the career ladder much earlier and faster than I expected. All this exposure to senior management is something I thought I would have to work another decade for, in order to get.

We also paid off our loan with the condo and bought our 2nd unit much sooner than I would have thought had you asked me when we were about to get hitched in 2010. Life is funny, I guess. And sometimes, all you really need is a healthy dose of perspective. Don't get too caught up looking for what you do not have. There is really no point to it. Let things be.

So there. That's what 2013 has meant for me.

That said, I'm ready for you, 2014. Please be kinder. :)

Viral exanthem and an unexpected long holiday

Atty contracted a nasty viral fever and rash combo last week (Dec 12) and it resulted to an unexpectedly long holiday for us. While I wouldn't want him to get sick anytime of year, I'm grateful it happened during this time when work really winds down anyway and he can rest at home without compromising his work commitments and requirements. And since I was already on leave, liquidating my unused 2013 days off, I was able to care for him without feeling guilty about missing work or leaving my boss hanging. So I guess there's not much to complain about. Being stuck at home for days and days also felt like a mini holiday, plus with the horrendous traffic outside, it wasn't so bad at all to be cooped up inside. 

And the good thing is, according to the doctor yesterday, his rashes should fully clear up by the 22nd or 23rd, just in time for Christmas! Woohoo!

So, the end of 2013 looms nearer and nearer. Time for my annual reflection post. Will put it together in the next few days, along with our yearly FILC survey :)

Ok, attention: me

So apparently....

1. We have an infection again. This time, the doctor assured us these are "post-party" organisms and can be expected to show up after the bigwigs are deado. So in a way, it's an improvement. Sort of. 

Dennis is really so much steadier and more level-headed than me. I was initially feeling dejected by the news but he assured me it was okay and we're just not meant to finish by 2013. Okay...... Fine.....

2. My progesterone and estradiol levels post-ovulation may be within normal range but are sub-optimal. This means that to satisfy our objectives, I need to be hitting the upper portion of the range. And my results, sadly, fall more on the lower side. Another big sigh. 

Not much can be done on this end though, apart from acupuncture. I am too scared to be tampering with hormones. 

So there. A little update on our baby-wishing quest. 

Haha! Listen to me. I better switch on the positive mood before the weekend kicks in!

This describes how I feel about work!!! :/

PARASOL

The business is up! Moving slower than I would have wanted, but my business partners and I are all fulltime professionals, so it's also expected. But finally, it's up, and hopefully it works out! Please support! :)

We've got beautiful laces and fabric, perfect for made-to-order gowns! Visit us at
https://www.facebook.com/#!/pages/Parasol/167639230110967

:)

Heart

So, I took a hysterosalpingogram last Saturday in Makati Med. A bit of a backgrounder, back in Feb 2012, when I first went to see a fertility specialist, I was told that one of the first steps in determining what I'll need to do in fertility work-ups is to get my fallopian tubes tested, to see if they are patent (meaning they are open and there are no obstructions for egg meeting the sperm). There are 2 ways to go about this: doing it via sono (meaning an ultrasound probe goes inside along with a catheter through which water will pass) or via hystero (meaning an x-ray procedure where a dye is pushed up via catheter). The good thing with the latter is it gives the OB an aerial shot of your uterus and tubes, and be able to see much more than a sono does. The bad thing with it is it's much more costly than the sono and if your doctor doesn't suspect any uterine abnormality like fibroids or endometriosis, then the sono can do. Back then, we decided on the sono, since we were still very optimistic that it will only take a few months before we successfully get pregnant and because our doctor then said it should be good enough.

Fast forward to July 2013 when I go see a different OB - this time someone who is both an infertility and a high-risk pregnancy specialist. He recommends that I do the hystero procedure to be absolutely sure. The thing with the sono, which wasn't explained to me before, is that any positive outcome there will only indicate that at least 1 tube is open. It doesn't necessarily mean that both tubes are viable. Since I'm having trouble conceiving, if one of the tubes are not patent, it means I'm only eligible to even fight the good fight only half the time (or 6 cycles per year -- a small chance, if you ask me).

So I put myself in his good hands, and had it scheduled last Saturday. I prayed to Buddha and asked for His divine grace and protection to make sure things go smoothly and I don't end up doing more harm than good in having the procedure done.

So off I went last Saturday, having fasted since midnight the night before. My amazing husband lovingly joined me as I fasted, out of solidarity and love. So I got to doc's clinic at 12noon, and was assisted by the nurse to the operating room area. Another nurse got me hooked up to an IV - which kind of unnerved me as the last time I was on one, I wasn't even old enough to remember the experience - then she had me strip and prepped on the OR table. My mom came by and had all these questions to make sure I was prepped correctly. Then the anesthesiologist arrived, asked me a few questions, then honestly, that's the last thing I remembered before dozing off.

After what seemed to me to be a few seconds, I woke up being wheeled off into the recovery room with Dennis' and my mom's faces smiling in front of me. Essentially, the doctor had good news and not-so-good news. The good side is that my tubes are both patent and are in order. The bad news is that I have a heart-shaped uterus, or more scientifically known as a bicornuate uterus, which would pose some difficulty in conceiving (well, well, well....) and even more difficulty in carrying a pregnancy to term and healthily.

To be honest, I was so shocked to get the news. I was prepared for there to be tubal problems, which seem to me to be more "overcome-able" due to the many advances in IVF. I was not at all prepared to hear that my uterus had abnormalities -- and abnormalities that have serious consequences to a pregnancy. I feel that it's 'worse' than any tubal defect, because it kind of takes IVF off the table, hence it takes out a lot of what I felt science could help us with. It made me feel more hopeless, to be honest, and my heart broke a whole lot more. I knew Buddha told me that there was something I needed to know, so I needed to take the test. (Honestly, it was also why I delayed actually doing the procedure. Dr Manahan recommended it to me way back in July and it took me almost 5 cycles to get it done) But I felt He was overestimating my strength of resolve in throwing me this curveball. I had always assumed my challenge was in conceiving. I didn't know even carrying will most likely be difficult as well.

Don't be so shocked by my reaction though. I've always been more a realist than an optimist.

My husband, on the other, God bless his heart, is so much more of a positive-looking, glass-half-full kind of dude. He reassured me that we will face this together, whatever and wherever it may mean for us down the road. It may mean I'll be on bedrest for the entire pregnancy, it may mean that our baby/ babies will be smaller than ideal and will spend more hospital time -- Whatever it may be, we can overcome it.

As I said, I'm so full of love, even my uterus is heart-shaped.

So there. While we did consider IVF and were even making plans of going to Taiwan next month to do initial tests and consultations, it's now off the table and off our plans. Since my uterus has less space than normal women and will be unable to stretch as far out as a normal uterus would in a pregnancy, then obviously, carrying multiples (twins) which is what IVF usually targets to produce will be dangerous for me.

Next step now is to go back to Dr Manahan this week and see what our game plan will be. I read online that some women have to undergo surgery to try to make their bicornuate more workable. But there are risks associated with that too, and not everyone will be cleared for the surgery. So, we'll see what the next step for me will be.

Whatever the requirements may be, I solemnly swear to go through all that is required of me, even including quitting my job or letting go of anything I may need to, to be able to conceive, carry and deliver a healthy child. I am bargaining, I know, with the universe and with the heavens. But if you've gone through what we have and are still fighting, you use every last card you have and every ounce of courage left, to be able to realise your dream.

I'm ranting.

OK, back to work.

Bittersweet dream

I had a dream the other day. Dennis and I were together in the bathroom (I know, weird right? But continue reading, this won't be a TMI post), and I was about to take a pregnancy test. We both watched as the liquid slowly went up to the testing window of the small plastic panel, and revealed two dark lines. Positive, in other words. I remember the feeling of bliss, joy, elation, happiness and all other words synonymous to pure happiness so vividly, I had tears in my eyes when I woke up. The feeling still felt so so so so real hours and days after that morning. I hadn't experienced anything like that before -- that kind of unadulterated, almost out-of-body sense of pure happiness, and it was unlike any pain I've also ever felt in my entire life.

OK, I'm probably bringing you way way down on this Friday afternoon with this kind of sharing... but anyway, I wanted to document it so I can hold on to that bittersweet feeling of having a dream come true, in a dream. Hopefully it carries me through all these next months until that dream can finally become true in reality as well.

As an aside, we are now studying our IVF options. More on that in a later post.

Busy-bored

Realized something yesterday. While this line of work is very busy (busier in some ways than my previous job, because it covers 3 separate companies and involves shadowing a very busy man), I am also tremendously bored by it. As in I-can-fall-asleep-as-I-talk-or-think-about-it bored.

This may be why I've been reading more books lately. Haha! Trying to fill my brain, at least in part, with ideas that interest me, to counteract the fact that most of my working hours are not as intellectually stimulating as I would want them to be. Don't get me wrong, the work is challenging, and the targets at hand are more than enough to keep me busy. But I am learning that just because your hands are full doesn't mean your mind and your heart are as well. And I yearn to be working on something that gets my blood pumping in my veins and my brain cells overwhelmed with excitement. This is obviously not it. This industry may be a lot of things, but it's not rocket science and it's not for me.

You may say, why not change things? Walk away? Look for something else?

Alas, reality bites. It's not like I can afford to walk away from this and pursue my heart's true passion by tomorrow. There is this big-ass bonus we're waiting for in 2015, and I've worked 2/3rds of the way into it already and can honestly say I deserve that payout. Also, I know enough about what's going on on the other side of the fence for me to conclude that I don't want to go back there anyway. That leaves no other option. So stay put I will.

Busy-bored. Who would've thought I'll ever find myself in this position? Strange territory.

Thoughts

Okay, so everyone knows I'm about as corporate as they come, and while there have been some low points in my career so far, I need to remind myself that, for the most part, I have been extremely blessed. Probably 90% of my 10 years of working have been good- and the 10% that haven't been tiptop good were, at the very least, bearable. I've had only good bosses in my working life so far -- mentors that have made me learn & grow, not just slave away and work at their mercy. I have been financially and intellectually rewarded, and have handled some really good people as subordinates.

However, lately, I must confess I've been thinking about alternative paths -- paths that do not necessarily involve a corporate contract, a set 9-5 (or 6 or 7) time-in-and-time-out and a steady 15-30 paycheck. I don't know exactly what led to this, but I cannot deny the temptation to veer away from the path I've been on and check out what other options there are, in the name of having more flexible hours, applying my MBA degree to real life and being able to dedicate more time to other personal pursuits. I've been toying with the idea of delving into entrepreneurship - 3 business ideas so far, actually - and maybe going into consulting. My parents are also asking if I am interested in helping out my dad. To be honest, the idea is both attractive to me (because I would love to help out my dad and possibly lower his stress level) and stressful at the same time (because after all, he is STILL my dad and I long to keep our conversations work-free the way they are now). Options, options.

It doesn't help constrain my wandering mind to have a husband also contemplating the same train of thought. He is virtually on the same boat as me - meaning, we have nothing really bad to complain about in our professional lives, but we are both thinking of where else we can be of value and how else we can feel more maximized. He has considered many options so far - going back to school for a Public Management/Administration degree (but to what end - does that mean he wants to go into public service?), considering going into independent practice (in which case the overhead expenses become his sole responsibility), etc.

I guess another side effect of waiting to get pregnant is to keep planning around it -- specifically, planning to earn more free time for a baby that is yet to come.

So there are these thoughts. They're just thoughts, really, but I figured why not jot them down for future reference :p

Thanks for reading!

Positivity

Amen!

Happy weekend!