Remembering

Today we are also remembering, one year ago today, the loss of our sixth pregnancy.

Can't believe it was a year ago.

Can't believe we are still in this mess.

Can't believe we are still nowhere in terms of taking a next step.

Taking some time to grieve this loss, and the hits to each of us emotionally as individuals, the impact on us as a couple.

Here's hoping with everything we've got that by this time next year, we are out the other side.

Mo

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Which way do we go? Meeting with the RE

The holidays are thankfully over and I am still in the process of recovering from a severe flu that I came down with Christmas day. Fever long gone but cough seemingly here to stay for a while.

But now that the holidays are over, it's time to begin to sort out options with this baby-making business. To get that rolling, Will and I met with our NYC RE to discuss the fact that this latest miscarriage was a chromosomally normal boy and what that means in terms of next steps.

He is so kind and met with us for nearly an hour, but unfortunately, we didn't leave his office having a sense of what the next step should be.

He said we are "getting closer" to a gestational carrier as a direction to take. But then again at other points in the conversation, he didn't seem to think we were necessarily there yet and said that many people lose a chromosomally normal pregnancy, so it's not really an indication that I can't carry a baby to term. If we had a second chromosomally normal loss (God help me), he said then we would be looking at surrogacy as the next right step. He also said that he felt that having a chromosomally normal embryo or two is great, but does not necessarily make a baby. He reminded me that my embryos were biopsied and frozen and thawed. He reminded me that my embryos didn't all develop on time (the late fertilizers, the day 7 blasts), which he thinks is a harbinger of doom for viability.

And I've started to look into gestational surrogacy, even though I am not happy about the idea. And Oh. My. God. It is so expensive. Breathtakingly expensive. And really expensive before you even know if the baby will really take or not. Like $25,000ish before she'd even be nine weeks pregnant (and I've lost babies past that point. Twice). Ugh!

My doctor also said that many women with histories like mine go on to use an egg donor (in their own body) successfully and that we are getting closer to that path as well. But probably not there yet either, since we have the five chromosomally normal blasts and one no result still waiting for us in Denver. On hearing that, I promptly went and picked two egg donors from two different egg donor agencies. They are both really smart. They both have light skin and very dark hair. Just like me. They are both in their early twenties, which I like. I see them as my ladies in waiting. But of course, the question is, can a pregnancy survive in my body? We don't know. Sigh.

Honestly, at this point, I just want to get out of this reproductive business and take whichever path is fastest to have a child. Still don't know what path that is, unfortunately. I wish it were clearer, so I could choose it.

One commenter after the miscarriage - anonymous, of course - stated that "Isn't it time you see the writing on the wall?" and that since I'd had the best clinic in the country transfer chromosomally normal embryos I should...actually she didn't say what I should do, because the solution is apparently so obvious to everyone but me, it doesn't need to be spelled out. Dear anonymous, I've tried and tried to read the writing on the wall, but I can't make it out. Do I conclude my body can't support a pregnancy? Do I conclude that despite the fact that I can make chromosomally normal embryos there is STILL something wrong with my eggs so that they can't make a baby? I don't know. And my doctors don't know either. And that is what sucks so much.

Both Schoolcraft and our local NYC RE think it is most reasonable for us to try another transfer with my embryos in my body. And while having my own genetic baby in my own body would be my dream come true, my only reaction is Ugh.

Will turned to me in bed recently one night and asked if I would be willing to do another fresh IVF with microarray so we'd have more normals to try with. That would be fresh IVF #8. Nine, if you count the frozen transfer. And I said no. At least for now. Which is a first. I have always felt I could go one more round. Ugh.

Ugh. Ugh. Ugh. Because I can't imagine succeeding. All I can see is more grief. More delays. More pain. With no end in sight.

So what do *I* want? I just want out of this bloody mess. I want to move on to having a baby.

Problem is, I still don't know how to get there.

Mo

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Speak of the devil...and genetics news back

Speak of the devil, my period came - almost immediately after the last post went up. Day one, here we are.

Also, genetics on miscarriage #6 are back.

Normal male.

I don't even know what to think.

Mo

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Do you think it's possible?

Do you think it's possible that my RE turned the vacuum aspirator up too high during my D&C and accidentally sucked out my uterus?

D&C was November 11th. It is now December 14th...and no period in sight.

I don't mean to be vulgar, but I'm starting to wonder a little bit...

Mo

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Placental pathology results

(pic brought to you by whywouldyouknitthat.blogspot.com)

Not sure if I mentioned it, but after our most recent miscarriage, my RE here in NYC recommended we send slides from the chorionic villi to a placental pathologist at Yale for review (the same guy who performed my endometrial function test).

So we did.

Once I looked into it, I found out that this placental pathology analysis would be covered by insurance, and so I decided to send slides from not only this miscarriage but also from the other four we've had tested.

Results just came back. All of the reports are similar in saying that there were various findings that provided evidence of chromosomal abnormality (including this latest one with the CCS normal blastocyst, which demonstrated trophoblast hyperplasia - it will be so interesting to see what the genetics come back as). All of the losses also demonstrated that maternal uteroplacental blood flow was normal.

All of the miscarriage reports also report what was NOT found:

• no evidence of immunologic rejection
• no evidence of bacterial ascending infection
• no evidence of thrombotic pathology

Not sure if I want this latest loss to be a chromosomal abnormality that somehow slipped through the cracks or rather have it unexplained. Pretty much would rather not be in this situation at all! I guess the best I can come up with is that it will be good to get the information back and then try to make sense of it.

On the placental pathology report from the latest loss, there was one section that has me a bit confused.

Any medical types are most welcome to weigh in...

On this last report only, the pathologist said "this patient and/or her spouse may also have an occult genetic abnormality. A genetic consultation, including high resolution karyotyping and array analysis of the parents, may therefore be beneficial."

Now what in the world is an occult genetic abnormality? I'm assuming here that word occult means "hidden," rather than "supernatural." Aren't one's genetics always hidden?

Is this different from a "regular" genetic abnormality?

And what is high resolution karyotyping and array analysis? is this different somehow from the type of karyotyping we've had done already? We both came up as genetically normal...

Anybody have any thoughts or knowledge?

Feel like I'm starting to emerge from my cave of sorrows, pick myself up again, and try to figure out next directions. Geesh, this loss and all else going on have been hard.

Mo

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Don't indict my uterus! Regroup with Dr. Schl.

Talked to Dr. Schl. today for a regroup appointment post-miscarriage. He said that it will be interesting to see if the baby was chromosomally normal or not once the cytogenetics come back from the D&C...um, yeah. I'd say it'll be interesting... he also reminded me that our microarray tests had a quoted 90% accuracy rate. He says that if the genetics come back normal, that would "change (my) history and complicate the picture but wouldn't necessarily indict (my) uterus." He says many women have one unexplained miscarriage. Most of my other losses were confirmed chromosomally abnormal (in fact, every one that we have had tested).

As for next steps, he said he would stick with the FET protocol and give it another go. He also said that it would be ok by him if we wanted to use a gestational carrier. And that he would even allow us to simultaneously transfer to me and to a carrier at the same time so that we could have a greater chance of success and also get through our embryos faster in case there is some other subtle abnormality that keeps them from making live babies.

One major plus, he said no more evil depot lupron needed until 6 months pass from the D&C. Phew. That stuff was terrible for me. The only other thing we need is a hysteroscopy to check that my uterus is scar-free and baby-free post D&C, and he said we could have our local RE here do that.

So lots to think about. Wish we weren't in this position at all. Not sure what we'll do next but good to get as much information as possible before we go forward.

Still hanging in there with the family emergency. Still completely terrible. Still hanging on to knowing that this can't last forever.

Mo

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7w3d ultrasound: it's over

Went to the RE, who didn't like what he saw and sent us on to a radiologist who specializes in OB at the hospital.

Just to confirm.

Both saw debris in the gestational sac. No yolk sac. Small subchorionic hemorrhage. No fetal pole, let alone heartbeat. Not sure what to think of Monday's reassurance ultrasound.

But it's clear now.

Pregnancy #6 is over.

They are adding me to the OR schedule for today.

Will and I can't believe it. We thought this one might be the one that made it.

Walking between the two doctors' office buildings, I thought, Maybe I haven't woken up yet. Maybe this is a bad dream.

But it's not. It's happening again.

Mo

*****

Update: Surgery rescheduled for tomorrow. I forgot completely that I'm on lovenox and aspirin. My RE wants to wait 24 hours for the lovenox to get out of my system and will fit me in tomorrow afternoon for the procedure.

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