Patience, Grasshopper

Cycle day 39!  I went in for bloodwork and an ultrasound last week and this week and discovered (last week) that I was about to ovulate (cycle day 34... apparently I am taking my time these days) and that I finally did ovulate (found out yesterday).  Thank God.  I delivered L naturally in early January and ever since then my hormones have been so out of whack.  I was hoping that I wouldn't have to use hormones to withdraw myself from this cycle and now I don't.  As a result, we are now approximately 4 weeks from starting IVF #1.  All of this waiting and my overall lack of patience reminded me of this quote.  We'll get there, just not on OUR time frame.

Image from Kushandwisdom

On Not Having Children

Leave it to Cup of Jo to again tackle a tough subject - infertility and choosing to live without children.  Mara Kofoed wrote the post for Cup of Jo and blogs at A Blog About Love, which I just discovered today and love.  I'm still making my way through past posts (a girls gotta work!), but I have already found a few that are just fantastic if you are going through IVF (12 Tips for IVF, Friends & Infertility,  The Work I did to be Happy).

In the midst of struggling with loss and infertility, I benefit from occasionally stepping back from where we are now and reminding myself how awesome my life is and how I used to love the every day things that now seem mundane and get lost in the shuffle of waiting for my next cycle, waiting to start meds, thinking about how much I miss L, etc.  There are so many activities that I love and that my husband and I like doing together... many of which will be much harder to do when we finally have a baby.  Those activities... and each of us an individuals.... gets lost at times.

One of my favorite hobbies is photography. I haven't picked up my camera since L died but I'm going to push myself to get back into it.  It's spring, there are gorgeous flowers and trees blooming all over the place, we are doing more outdoor activities, and I can't just forget about the activities I used to enjoy.  I took the photo above on my iPhone during a weekend trip to Austin, Texas a few weeks ago.  Here's to capturing more of the beauty that surrounds us!

IVF #1 Protocol

I'm waiting (endlessly waiting...) for my cycle to end so I can start the BCP and get ready for our first round of IVF.  We met with the RE last week to discuss my protocol and I am doing the Antagonist / Saizen Protocol with Menopur, Saizen and Follistim.  We'll lead into the cycle with down regulation on the BCP for approximately 2 weeks. Does anyone have experience with this protocol?  Particularly anyone with DOR?

Given my history of clotting, I'll also have my Lovenox dosing closely monitored.  My last two cycles since we lost L have been totally out of whack (really long - 43 days).  I'm thinking that in addition to stress, the Lovenox might be messing with my cycles?  Has anyone had trouble with longer cycles while on Lovenox?  Prior to L, I had regular 28-29 day cycles naturally.

Also, can I again just express my frustration at how long this process takes.  When my cycle finally comes, I then have my period for 3 days and then start the BCP for at least another two weeks and THEN we can start the stimulation meds.  I need to find a few new hobbies to really tackle in the next 6 weeks or I might lose my mind.  Or maybe just another new show (I'm currently speeding my way through Scandal).

Tracking Tools

I've always been obsessed with tracking data.  Back before we were TTC, I was an avid marathoner and triathlete (and I'll get back to both of those things someday).  In those days, I loved my Garmin Forerunner (and still do - I'm just moving more slowly and less often these days).  Instead, I'm tracking all sorts of things using a few favorite online tools and apps.  Does anyone have any tools that they particularly like and find helpful?

 Fitbit - A few friends using these convinced me how great they are.  After almost a month of use, I couldn't agree more.  I'm obsessed!  I got the Fitbit One Wireless Activity + Sleep Tracker (I didn't want to announce to the world that I was tracking my steps by wearing a bracelet) and I love tracking my steps and activity.  I'm not using it for sleep tracking, but it certainly motivates me to keep moving and to get outside for some exercise.  You can challenge your friends who have one and see how many steps they've taken -- I'm easily motivated by competition!  This article offers good reviews of other personal fitness trackers.

Ovia Fertility Tracker - Since we are back to TTC and are currently waiting to start IVF (I need to have 2 natural cycles before we can start), I've been using Ovuline.  You record your BBT, cervical mucus, mood, exercise, symptoms, fertility monitor and pregnancy test results and the app aggregates it for you to tell you when your most fertile days are.  You can also track your food consumption (I find this to be a great motivator for healthy eating) and intercourse.  Ovuline has an easy to use app that allows you to record this data in a discrete way - and if you use a Fitbit or a number of other devices, they automatically sync with Ovia.  I know other versions of this (Fertility Friend, Glow) -- has anyone used another one that they love?

Fertility Friend - This tool is similar to Ovia, but it provides additional options that Ovia does not (e.g., fertility monitor, IUI, IVF, ART meds).  I think the BBT chart is much easier to read on this app than it is in Ovia, too.  And I signed up for the VIP membership, which provides access to a number of advanced features that I really like.

Goodreads - This one has nothing to do with fertility or health, but instead reading.  I love being able to look back and see what I've read in the past few years and to see what friends are reading.  It's the first place I go when someone recommends a book so I can see what others have thought and to add the book to my "to read" list.  My only complaint is that you can't have a "secret" bookshelf - I don't like to advertise to all of my Goodreads friends that I have read so many fertility books, so I don't end up tracking those.

The Fault in Our Stars

Image from Amazon

Over the weekend, I finished the book The Fault in Our Stars by John Green.  I knew the story line of the book (the protagonist is dying of cancer in her teens) so I wasn't surprised by the sadness I felt when reading.  I was struck by a particular line in the book, though (I'm paraphrasing) - Grief doesn't change us... it reveals us.

Since we lost L, people have repeatedly said that we won't return to normal, but that there will be a "new" normal.  I do feel fundamentally different.  I am not sure, though, whether that different feeling is because I am actually different or I am just exploring and dealing with an entirely new side of myself?  I've never before suffered such pain or sadness or grief - and perhaps this is just who I am when I am in the heart of things that are inconceivably horrible?

It saddens me to no end to think that I might never feel like "myself" again.  As much as I love to think about L, to imagine what my life would have been like with her, to envision how we would have just celebrated our first Easter, I hope there is a time in the future when I can think of her fondly rather than with feelings of despair and loss.  It just seems like that wouldn't be the way to go through life and that at some point there must be a shift.

What I don't want to be is someone who is so defeated by what has happened that I don't ever find the joy in living.  I know L wouldn't have wanted that and I owe it to myself, to my husband, to our family, to be a better and stronger person than that...

Has anyone read the book?  If so, did you enjoy it?  Did it resonate with you at all?

Stillbirth Reading

Something I have found incredibly helpful since we lost little L in December is reading about other people's experiences with stillbirth.  I can't decide whether its a terrible thing for my mental state to be reading about other's grief or really cathartic?  I think it is the latter - I don't feel as alone when I know that I am not the only person this has happened to.  Nothing else I've experienced in life has been so isolating.  I'll write more about this in the future, but today I just wanted to share the books/articles I have found most helpful.

• I can't tell you how many times I've read this beautiful piece by Kate Suddes for Cup of Jo.  Ironically, I first read this when it was published in November of 2013 when I was 5 months pregnant.  I got about 1/3 of the way through the post and stopped because I had not even considered that something so unspeakably awful could happen.  I re-read it just days after losing L and everything Kate wrote resonated with me and still does.  One thing particularly hit home - people pretending nothing had happened. We would run into friends who would just not say anything about our loss (nevermind that I was also hospitalized for 10 days including 3 in the ICU).  It was as if they didn't ask, we wouldn't think about it.  I think of L every minute of every day.  Read this piece!
• The first book I read was An Exact Replica of a Figment of My Imagination.  Again, it just helped me put into words how I was feeling.  My husband also read this and it really helped him to understand some of the emotions I was feeling that he couldn't relate to.  NPR reviewed it in a way that summarizes the book well and there is an excerpt.
• The Art of Presence by David Brooks in the NY Times is an amazing article on being present for people going through a tragedy in life.  This isn't specific to infant loss, but we'd all be better off reading the article and taking it to heart.
• Knocked Up, Knocked Down - A funny and honest memoir of sorts from a woman with first-hand experience with stillbirth and miscarriage.
• Pregnant Chicken on Stillbirth -This is a good read for some basics on stillbirth.  For example, most people don't know that if you lose a  baby after 20 weeks you have to deliver the baby.  In my case, it was a natural birth without an epidural (not my choice - I couldn't have one because of other medications).  This will help explain some of the details and offers some advice about what you can do for others to help.

I've checked out a bunch of other books from the library on the subject, but these are my favorites.  Has anyone else read anything they found particularly helpful/meaningful?  If so, I'd love to know what it is.

Book Review - It Starts with the Egg

I don't know about you all, but I obsessed with reading the latest books and research about infertility.  I particularly enjoy those that offer some practical tips for things that we can do without drugs to improve our chances of conception.  It helps me to think I am doing everything I can to facilitate getting pregnant - it is nice to have control over something through this process.

Image via Amazon

Author Rebecca Fett just published It Starts with the Egg.  After being diagnosed with DOR prior to turning 30, the author, who has a degree in molecular biotechnology and biochemistry and is a practicing lawyer, wanted to do everything she could to improve her egg quality.  I thought I had read everything on this subject, but Ms. Fett opened my eyes to additional (easy) lifestyle changes to improve egg quality.  The following are the key takeaways:

• BPA - Recycle your plastic Tupperware and buy glass.  This article from The Kitchn offers reviews of various options. Drink from glass containers (Life Factory makes my favorites) instead of plastic water bottles.  Eliminate other plastic items from your kitchen.  Think mixing bowls, measuring cups, coffeemakers (switch to a French press).  This is particularly important if these items are ever heated as the heat releases more BPA.  Only purchase canned food if the can is specifically labeled BPA-free.  The only current product line that is completely BPA free is Eden Organics.
• Phthalates - Phthalates are known endocrine disruptors and you should do your best to eliminate these from your life.  You'll find most of them in your bathroom in nail polish, cosmetics, lotion, hair products, etc.  The Honest Company makes a number of products that are phthalate-free and this article offers helpful tips on how to eliminate them from your life.  Start with scrutinizing the labels on your perfume, deodorant, shampoo, conditioner, lotion, laundry detergent, etc.  You are looking for the terms phthalate (can be buried in a longer word), DEP, DBP or fragrance.
• Food - Generally eat organic fruits, vegetables, and meat and avoid processed food.  Depending on your specific issue, going gluten-free may be helpful.  Regardless, you want to stick to low glycemic index foods (particularly grains), which predominantly means whole grains such as quinoa, couscous, kidney beans, lentils, and chick peas. Avoid white flour, pasta, bread - anything that is a "simple carb" containing white flour.  Sugar should also be avoided.  Basically you should be eating the things you know you should eat and that are good for you.
• Caffeine & Alcohol - Studies vary and everyone has an opinion on this one, but best to avoid both, particularly if you are preparing for an IVF cycle.   
• DHEA -75 mg day from a reputable source (like a compounding pharmacy).  Mine is prescribed by my RE.
• COQ10 - 300 mg/day taken in the morning with protein.  
• Thyroid & Vitamin D - Get both of these checked and get them into normal ranges.

Even if you have read all sorts of books and blogs on this subject, I think there is new information to be gained by reading this book.  Do any of you have recommended reading?  

Hello, I'm _____ and I'm Infertile

Is there a word worse than infertile?  Wait, don't answer that - I know there are worse diagnoses, but in the midst of TTC, "infertile" might be the worst thing you can hear.  My husband and I started our infertility journey unexpectedly just over a year ago when I was diagnosed with premature ovarian failure (again with the terminology - failure? Couldn't they have at least come up with a kinder term?).

I thought the diagnosis was the worst thing that could happen to us, but I had no idea.  But I'll get to that.

I know from trolling fertility blogs that sharing stats can be helpful for offering context to others, my AMH level was (is) so low that it is undetectable (<0.15) at age 32.  My initial day 3 FSH in April 2013 came back at 17.3.  I saw 3 REs (including a doctor at CCRM) before settling at a different clinic.  After a failed IUI round in June 2013, I received the best news of my entire life on Friday, August 2nd when I had a positive pregnancy test.  We had spontaneously conceived!

The first 20 weeks of the pregnancy we were worried that something would be wrong given my poor egg quality from the DOR.  Everything was going swimmingly until 25 weeks when I developed what I thought was horrible sciatica.  After an emergency visit to my doctor and several after hours calls because my back and leg pain was so bad, I finally went to the ER on 12/28/13 only to discover that I had an extensive blood clot (from my toe to my inferior vena cava) in the form of a DVT.  At first our baby, L, was just fine... but the next morning after a harrowing fifteen minutes of rushing to the OR for an emergency c-section (while on heavy doses of blood thinners making the procedure very dangerous), we lost our little girl.  I'll spare you the details about the next ten days in the hospital other than to say that I lived (obviously) and that now a future pregnancy is much riskier giving my history of clotting.

The last four months have been a total blur.  I couldn't really tell you what we've been up to.  I get up and get dressed and go to work and try to act like a normal human being but I couldn't feel less like myself or be more sad.  Not only did we lose our daughter, but I fear that we have lost our dream of having a biological child.  But mostly I just think (constantly) about my little girl, L.

That said, we are moving forward.  We are back to RE visits and are prepping for IVF in late May.  I feel like I've exhausted my family and friends in their ability to hear about doctor's visits, hormone injections, etc. and so I need another outlet for my feelings, ramblings, and research.

So here I am.