How many children?

This post came about after a prompt from St Elsewhere a few months ago... The idea has finally taken on enough form that I think I can write it down, even though I'm not sure I have a final answer yet.

In St Elsewhere's prompt there were three questions:

Q. How many children do you want?
Q. what issues/factors drive this 'number'?
Q. Has the number of children you wanted changed through your TTC journey? Would you rather leave this number question open and say as many as we can?

I will try to answer them as a whole.

Before we even started TTC I always dreamt of having four children, and maybe two of those would be twins. We'd have a fun and loving family. Never a dull moment. Then we started TTC and it didn't go as planned. After trying naturally for about two years, and then six failed IUIs, my dream of four children had been changed into the desperate cry to have at least one living and healthy child.

Then IVF #1 was a success. A breezy pregnancy which resulted in a healthy baby, love and happiness and the adrenaline rush of wanting to do this again. Soon. And so many people were saying that probably my body would know what to do now, and we wouldn't need IVF anymore for baby #2, #3 and who knows, #4 (which was still a desire, but I'd lost quite a few years during the TTC and IF battle so I wasn't sure if I wouldn't be too old by that time). But, when usually (or at least according to the books) life with baby becomes easier after the first three months, mine became a sleep-deprivation hell. I lost myself and I couldn't imagine wanting to go through that again. Maybe I wasn't made for this. Maybe I should be content with one child.

But of course it got better, and looking back I thought there might be things I could do differently with a second baby. So we started TTC again. But no luck the natural way, and we didn't want to waste too much time, so after a few months, we were sitting in the RE's office again. IVF#2 was a go. The first attempt was cancelled midway because of my mother's passing. The second attempt went OK, but when lying in the recovery room after ER I told myself "I never want to do this again", so much stress, so much uncertainty. Two beautiful embies were transferred, one was frozen. Since IVF#1 had been a success I thought this time around it would work too. And the dream of four children was suddenly back: twins from IVF#2 and then another child from a subsequent FET... How wonderful would that be?

Well, it didn't happen. I got a BFN from IVF#2 and the dream of four children immediately changed back into the realization that maybe I should be content with one child. 

I didn't have high hopes for the FET a few months later. But this one stuck around, and was pregnant with a second son. Another great pregnancy. Two boys. I couldn't be happier. When I gave birth to him I thought I would have this feeling of "now my family is complete. Our family building is over" like I heard some women say. But I didn't. Not that there was a feeling that I immediately wanted to do this again. No, there was just love, an immense amount of love for this new and tiny human being, nothing more and nothing less.

I let go of the dream of four children. But three children is still a question mark. In two years I'll be 40. I find that quite old to be a new mom again. And that thought I had in the recovery room after ER does come back to me every now and then, I was so adamant about it, "never again".  I wouldn't mind being pregnant again though. I absolutely love being pregnant. The first few weeks after birth? Getting used to the sleepless nights again? I'd gladly skip that. And handling three kids while hubby is away on a week-long business trip, while I already lose my patience too often with two? And thinking that now, maybe, it would work the natural way? And I'm still apprehensive of the months to come with this new baby, who's now three months old - the time when it all started going downhill for me with our firstborn. I know the two boys are quite different, and I'm a lot better prepared, but still...

So, I guess the jury is still out. It's too soon to make a final decision. However, one decision has been made in my mind: no more IVF. If we were to have a third child, then it would have to be a natural miracle.

Lost

How desolate can one feel, at 6:15 am, staring at a pee stick, wishing for that second line to show up. Especially when just a moment ago, I woke from a nice dream in which that second line was definitely there.

I had an appointment at the lab at 9:15 for my first beta. I noticed some super light pink spotting before I left. Had my blood drawn. Went to Ikea to try to distract my mind. Felt crampy, with lower back pain. Typical first day menstrual symptoms.

I went to the bathroom. There was more blood. I cried.

Hubby decided not to return to work after our morning trip to Ikea, but to accompany me home. That was nice.

I called the lab at 4 pm. They confirmed what I already knew. I hugged hubby and cried more. I kept thinking about those two perfect 4-cell embryos that floated into my uterus, and then just died.

We picked up our son from the nanny's, and I thought about those two embryos again, what beautiful possibilities there could have been, what dreams I already made, but that were now gone forever.

Our son had fun playing with his friends, and didn't want to go home. The nanny made one of her typical innocent remarks, that we should just make another baby, so she could keep him. Hubby picked up our son, I turned away and cried behind my sunglasses.

I had a glass of wine with dinner. Maybe I'll have another one.

Cramps

Ugh, been having menstrual-type cramping almost all day. No spotting or bleeding though, and I had this too the day before beta with the first pregnancy, so still hopeful. Would like to POAS, but no First Response or similar pee sticks for sale here, and if my beta tomorrow is as low as it was last time (55), I'm afraid the regular ClearBlue stick will give a negative result, even if I might be pregnant. So will not POAS until tomorrow am, before I go to the lab.

French precision

I had to go to the lab this morning to get my blood drawn for an estradiol level check. If it would be below 500 pg/ml I would have to get a HCG booster shot... With IVF#1 my level was well above that (1982), but this time I wasn't so sure, as my boobs are still not sore (which starts freaking me out - to me this is the early sign of pregnancy, I had it with #1, but so far nothing this time). I first thought that if the level would be below 500, the chance of being pregnant would be about zero, but luckily, when I went through old emails I exchanged with a friend, I found out that she did have the hcg booster shot, and she had a successful pregnancy, so that eased my mind a bit.

It was very busy at the lab and the ladies were there usual charming self... I asked them at what time I could call for the results - important as if the level would indeed be below 500, I would have to go to the pharmacy to get the meds and then try to contact a nurse to give me the shot - they told me 3 pm.

So I called around 3:10 pm. "Are you sure the results would be ready at this time?" Yes, I asked this morning and you told me to call at 3... "Well, but normally we don't have the results before 4 pm". You told me to call at 3 pm, and I need to get this stuff sorted if my level is too low... After a few rounds of stupid music she finally came back to me to say that my level was above 1000. So no booster shot needed.

When I picked up my son at the nanny's around 5:30 pm I went by the lab to get the results (on paper this time). When she told me over the phone "over 1000" I assumed they hadn't completely finished testing or something and that the final number would be on the paper. No... the paper also says "> 1000". WFT? They can't give me a freaking number? I mean, it doesn't really matter, because it's over 500, so I don't need the shot, but come on, with IVF#1 they were able to give me an exact number, why not this time? You might wonder why I didn't ask them - well, she gave me the results in an envelope and I didn't open it until I was in the elevator on my way down again. As this was a tiny elevator, my son was freaking out (is afraid in small elevators since we almost got stuck in one a few weeks ago), so I didn't feel like going up again.

I'm really getting a bit fed up with this lab. This morning they also asked me twice what the date of my last period was. I told them, but I also said that it wasn't relevant, since I had a long IVF protocol... I'd prefer to have these IVF-related tests done at the clinic's lab - at least they don't ask stupid questions (like for the vaginal exam where the lab near my house manages to ask why I need this test done - do I have a yeast infection?) and they have their results a lot quicker than this lab. But the downside is that it's 30-45 minutes away by bus and metro while this other one is a 15-minute walk...

Anyway... I guess I'm happy that I didn't need the booster shot. Things seem to go OK inside me, at least as far as the lining is concerned... Still feeling bloated, slightly crampy sometimes, but not as much as last week, having night sweats and crazy dreams (but why don't my boobs hurt? - I googled a bit, apparently some women do have sore boobs with one pregnancy and not with the next. Hmm, ok, I hope I'm one of them then!). One more week until beta.

Well...

2WW/WUB is not making me a very happy woman...

Symptoms so far:

• twinges/cramping in uterus/ovaries area
• lower back pain
• feeling bloated
• crazy dreams
• emotional / grumpy: yesterday I started crying because my 19-month old didn't want to eat his lunch (he even threw it on the floor), this morning I bitched at hubby for asking me all kinds of questions that I didn't know the answer too (they were of an organizational kind, and normally I respond that I'm going to look it up for him/take care of it, but this morning I just told him I didn't know and he had to figure it out himself - he was not happy).

Other than that, nothing, my breasts are still not hurting or anything, so I'm a bit pessimistic (even though I know it's still super early).

Images

Two images keep floating into my head: the first is of the two embryos being brought into my uterus, the second one the photos of the three perfect 4-cell embryos the embryologist showed us before the transfer (no, we didn't get a copy).

These images make me happy. They also fill me with anxiety. I've followed enough blogs where I've seen photos of perfect looking embies, only to read a BFN report a few weeks later.

The anxiety is different than with IVF#1 - then, I was almost sure it would fail (but of course I hoped it wouldn't). Now, I sometimes wonder I'm too sure of it working, because the first one did.

I can hardly concentrate on anything besides reading IF blogs. I'm going back into my own blog archives to see what I wrote during the 2WW/WUB with IVF#1. Scold myself for not being more detailed (when did my breast get sore...?). Today I was sooo tired, but not being tired is more an exception than the rule since my baby was born, so it doesn't mean anything (although I do think I'm extra tired from all the emotions coming with ER and ET etc).

So yes, welcome back 2WW/WUB! Please don't drive me insane...

3 = 2 + 1

Embryo transfer was today. Called the embryologist around 9 am to see if everything was still OK. Yes - she told me three embryos were 'interesting', more info when we would get there around 11:30 am.

So, all of the eight eggs fertilized (initially seven, but apparently there was a late bloomer...), of which three were perfect-looking 4-cell embryos, the others were rather messy and fragmented, so not usable. Two of the three would be transferred, and the third one frozen.

After we'd seen the embryologist we waited a little while before the RE led us into the transfer room. Everything went very smoothly. It was u/s guided this time, so it was kind of cool (and surreal) to see the two embryos floating into my uterus.

Got a prescription for progesterone suppositories (that I already started the evening of the ER), baby aspirin, and the bloodwork for later.

Had a nice lunch with hubby afterward. First beta will be on March 9.

Seven

Just got off the phone with the embryologist. Seven eggs made it to the embryo stage. Yay! So much more than I expected, I dreaded the call because I was afraid they would tell me only two made it or something. Pfew! ET is probably tomorrow around 11:30 am, but I have to call the lab again tomorrow around 9 am to confirm.

And our lucky number is...

...8!

So yes, egg retrieval was today. We got up very early, woke up the little man at 6:10 am, dropped him off at the neighbors at 6:30 am and took the car to the clinic, where we arrived just before 7 am. Had to wait a little before a nurse brought us to my room, that I was sharing with another woman also there for an ER. Got paperwork sorted, changed into the hospital gown, said goodbye to hubby who was off to the lab, and then someone already came to wheel me to the OR.

The nurse told me Dr Speed (reference to IVF #1, see the blog archives) would do the procedure. This time that didn't make me more stressed, but brought a smile on my face - and when he walked in belting an enthusiastic "bonjour messieurs'dames" and "ah, c'est ma fiancée" I was instantly relaxed.

The nurse brought in the IV for the anesthetic. She first tried near my wrist, but that was so painful that she gave up and used the inside of my elbow instead. The anesthesiologist was the same as I'd had for the consult and he was very nice, so everything was good. The anesthetic hurt though! Must be different stuff than time, but it worked immediately, because I didn't even have a sensation that I was drifting away - felt the pain when he put it through the IV and then next thing I know I woke up in the recovery room (or was it still the OR, I don't remember). It took me a few seconds before I knew where I was, I first thought I had overslept and missed the ER!

I stayed for about 20 minutes in the recovery room, which looked more like a hallway and was also used for impromptu meetings by the nursing staff. A bit too much chatter for my foggy head I must say...

Then I was wheeled back to my room (it was 8:15 am by then), where I drifted in and out of sleep for about an hour, then I felt a bit better, and after an initial glass of water they also brought me some breakfast, which was appreciated. In the meantime my roommate had been brought back into the room as well and now we were both waiting for the embryologist to come tell us what the harvest score would be, and after that for the nurse to take out the IV needle and the anesthesiologist to sign the discharge papers.

The embryologist came by between noon and 1 pm. Result: 8 eggs retrieved. A bit disappointed, but no big surprise as the RE had said on Friday that there were 7 (this in contrast to my roommate, who was told on Saturday there were six follicles, only to hear today that 22 were retrieved! So she was quite shocked - have the feeling someone did not pay attention along the way, somehow I was glad when I found out she's with a different RE team than I am). I have to call the lab tomorrow to ask how many were fertilized and at what time I have to come in for the transfer on Thursday (so 2-day transfer this time instead of 3-day). So now we have everything crossed that out of the eight eggs we'll get at least one or two decent embryos that can be transferred back and grow into a healthy baby. Here's hoping...

Anesthesiologist came at 2:15 pm. By that time both my roommate and I were bored out of our heads. We were finally home about an hour later. Felt very tired and slightly crampy. Will make it an early night tonight.

CD32 -Triggered

Got myself the trigger shot tonight at 8:30 pm. I'm as ready as I can be and hoping for the best on Tuesday.

CD30 - getting pessimistic

Well, everything is basically still as OK as the last few days, but today I asked the RE how many (usable) follicles we can count on, and the answer is seven (...).

Last time (yes, 2.5 years ago) they retrieved 14 (of which eight were fertilized, of which only two were good enough to be transferred). So I'm a bit scared that it won't work this time. I know you only need one great one, and some smaller ones could still mature over the coming two days, but hmm, I'm a bit blue. Oh, and for the records, estradiol level is 2621 pg/ml today.

But the good news is that we do have a date set for ER and it will be Tuesday, so exactly the same cycle length as last time, even though I'm reacting differently to the stimulation and the dose for the last few days is also much higher than for IVF #1. I guess that's due to being 2.5 years older than last time? So tonight and tomorrow night again 225 IU Puregon injections, then triggering Sunday night.

Update: the RE's secretary called to say I should change back to 150 IU Puregon for tonight and tomorrow night (based on my pretty high estrogen level).

CD29 - second u/s

We all had to get up very early this morning so I could make the 7:30 am appointment at the clinic for u/s and blood draw and hubby could catch his 8 am TGV. This meant waking up our son at 6:30 am, which he did not appreciate at all - try to change his diaper and get him dressed while he was throwing a 'I don't want to wake up yet' tantrum, give him a bottle, deliver him to the neighbors (which hubby did, by that time I'd already left) who took him to the nanny... I was about 10 minutes early at the clinic, the female RE was there again and early as well, again just one person in front of me, so my turn was exactly at 7:30.

Lining was great at 8 mm. Then she looked at the follicles and first said ER would either be Saturday or Monday, but after closer inspection decided it would rather be Monday or Tuesday. I didn't ask the exact numbers but apart from a few that are already too big, there seem to be about five on each side which are now around 14 - 16 mm. I'll try to get more details tomorrow.

Got my blood work done right after that and just got the results: estrogen level is now at 1597 pg/ml.

I have to up my dose of Puregon from 150 IU to 225 IU tonight and then come back in for another u/s and blood draw tomorrow. When I asked the RE what time she said she didn't know yet. Told her about this morning with our little one. She told me I should just have asked to come in later, they could have taken me between patients... Secretary just called to confirm the dose for tonight and told me that the RE had mentioned I could come in at 11 am tomorrow (when she's starting her regular schedule)! Yeah, that relieves me of quite some organizational stress as hubby won't be back from his business trip until tomorrow evening. Have to get my blood work done earlier though, so they will have the results the same afternoon.

CD26 - First ultrasound

I had to be at the clinic this morning at 9:30 for the first ultrasound and blood draw to see how the stimming is going. I was early, only one woman in front of me and the RE (a woman whom I hadn't met before) was early too, so everything went pretty fast. I didn't get exact numbers, but the RE murmered something of about five follicles on each side. I don't know if that means 10 in total or 10 usuable in total, because there were some that were already measuring 17 or 18 mm and she told me those would be 'discarded' and the focus would be on the ones now measuring around 13 mm. In any case, I seem to respond quicker to the drugs than two years ago - when after six days of stimming follicles were only measuring around 10 mm. My estradiol level seems to be telling the same story: 545 pg/ml (while two years ago it was 310 on the same cycle day). Don't know if this is a good or bad thing or that it really doesn't matter...

I have to continue with the daily 150 IU Puregon and come back for the next u/s on Thursday morning. This time at 7:30 am - which will be a bit of a logistical nightmare as this is a day our toddler normally doesn't go to the nanny and on top of that hubby will be away on business. So hopefully with the help of my neighbor, who's kids go to the same nanny, and some flexibility on the nanny's part, I will be able to get it all sorted out.

I also had a consult with the anesthesiologist and went by the admission's office for my pre-admission. Everything was fine, but I have to get some additional blood work (coagulation) done, but will do that on Thursday, didn't feel like getting stabbed with the needle twice within a one-hour period.

We're on again!

Yes! AF showed her face again yesterday after a 2+ month absence. I don't think I've ever been so excited about it (we IF'ers live weird lives). So IVF #2(bis) is on!

Went to the nurse yesterday with toddler in tow to get my decapeptyl shot. It was obvious to him the nurse was going to do something to his mommy and he didn't like it. Could not be distracted by the big empty syringe the nurse offered him to play with. Just held my leg and wanted a hug when it was over.

Stimming starts in 19 days (during our ski vacation, but hey, at least u/s won't be until a week later so I don't have to drive back and forth from the Alps, or worse, cancel the vacation, or even worse, postpone the cycle - which I was all nervous about when I booked the trip a few weeks ago)...

Cycle canceled

We drove to Holland yesterday. My dad called Sunday afternoon to tell me my mom had been asking for us. While we were driving up north, I called pharmacies in cities along the way to check if there might be one that would have some more Puregon for us (I only had enough for two or three more days of injections). Did find one in the end, which made us feel good, for just a short while. Arrived at my parents' place in the evening - even though my dad had told me she was doing much worse, I was still a bit shocked at how much sicker she was than when I last saw her, three weeks ago. I called my RE and we talked with my mom's physician this morning. She's entering the final stage - of course it might still take two or three weeks before she dies, but this is no time to leave her side. So... no injection tonight. We'll see when we can do another cycle.

CD21 - stimming has started!

Started stimming yesterday - 150 IU of Puregon - same protocol as two years ago. First u/s will be next Wednesday. No jitters at all this time while taking the injections. Apparently I've become a pro.

I do however have a weird feeling for another reason this cycle - I don't know if we'll be able to finish it properly (i.e. with ER and ET) because my mom's situation is deteriorating fast, so the chance that we have to go to Holland to be at her side is growing by the day. She has already said that she wants it to be over, no more pain, no more suffering. I can understand that and I respect it, even though I don't want to lose my mom, but oh, please, I don't want to have to break off this cycle.

I thought about not starting the Puregon and postponing everything - called the RE's office, my GP, and talked to a good friend, plus of course hubby. The logical thing to do seemed to discontinue, start again in a few months time, but on the other hand, we shouldn't put our life on hold for something that we can't control. So we decided to continue after all. It felt good giving myself the shot yesterday and today. We're keeping our fingers crossed.

Ugh

Not feeling so great this weekend: headache, hot flashes, some nausea and a stuffy nose. First three symptoms seem to be the lovely side effects of the decapeptyl, the other one is a cold, with thanks to my son (who is in a far worse state than I am at the moment).

CD01

AF showed up this morning which means we're on for IVF#2! Exciting and scary at the same time (I'm already worrying on what to do for babysitting the day of the ER when I have to be at the clinic at 7 am...).

We went to the RE again on Wednesday. This time he was busier than a month ago and we had to wait for an hour to see him for only five minutes. Oh well... Got all the forms signed and took prescriptions home for all the meds for the entire cycle. The sperm test showed hubby apparently has an infection somewhere, so he has been started on antibiotics and has to redo the test in about three weeks, but luckily that doesn't mean we had to hold off cycling for another month.

I thought my recent pap meant I didn't have to go to the lab to get a vaginal test like last time, but unfortunately I was wrong. So I scheduled that in yesterday because I didn't want to run the risk of having my period and then maybe getting the test results in too late for my REs liking. It was OK, sort of. I hate it that they always assume there's something wrong (yeast infection etc), and then you have to explain 'no no, it's just a preventive measure before the start of our IVF cycle'. I still don't understand why the RE can't do it himself.

I went to see a nurse this morning to give me the IM shot of Decapeptyl 3 mg (replacing the Enantone that I had to use two years ago). Stimming starts on CD20. So nothing much going on other than stupid cramps (thank you AF) and hubby a bit afraid of me being very grumpy for the coming three weeks.

Past experience comes in handy

Before we meet again with our RE on October 20th, we have to get some tests done. I had my blood drawn last week, hubby still has to do his, which can be done at basically every medical lab in the city (of which there is one on almost every street corner here in France). But he also has to have his sperm tested again. Which of course he doesn't want do at a random lab, but at the one belonging to the fertility clinic. So he called... and they told him they didn't have space before October 28th, which of course isn't possible for us, as the RE needs to have the results on the 20th.

Luckily, we've done this before. And we know our RE. I remember several occasions where I would be in the waiting room, or in one of the transfer rooms, and he would come in, complaining to the biologists that nothing worked, etc. etc. So, I sent the RE an email, explaining the situation, asking if he could recommend another lab, or maybe find a spot at their own lab for us after all...?

Within an hour I got a call from the RE's secretary, who told me he had gone over to talk to the biologists (haha, I know exactly how that conversation went) and that we should call the lab again, ask for the biologist, tell him we spoke with the RE, say that it's urgent, and get our appointment fixed. If we still would have problems, we shouldn't hesitate to call or email the RE again. So I called. Appointment's set for next week Tuesday.

First appointment for IVF #2

So yesterday we had our first appointment for IVF #2. The clinic had moved since we'd last been there in 2008, so it was all a bit new to us. We had expected a waiting time of at least 30 minutes, but it seemed like our RE is going through some meager times (or it was just a slow day yesterday), because we were seen almost immediately and his cell phone didn't ring either during the consult (which was always the case last time around, very annoying).

There are some tests to be redone (blood work for both of us, sperm for hubby, and pap for me, but luckily I have one scheduled two weeks from now with my OBGYN, so I don't have to do that at the lab like last time) and then we have another appointment in about a month (mandatory reflection time + time to get all the tests done and fill in the paperwork) and then we should be good to go at the end of October.

Of course we hope this time around will be as successful as last time, but to me it seems there is some extra pressure. My mom's cancer turned out much worse than initially thought: it has spread to her brain, so the prognosis is quite bleak (survival rate somewhere between two months and two years - for the moment she's doing ok and in fighting spirit). I hope she'll be able to hold another grandchild - our second child. Maybe I'm asking for too much, but it would be such a wonderful gift, to all of us.