One of the harder things to come to terms with when it comes to infertility is the realization of how very little control you have over your own life. When I worked as community health nurse, a big topic for my patients was family planning. I’ve gone to lots of trainings on the topic and I’ve provided lots of education on the matter to clients as well. Who would have guessed that after all those teaching sessions I would see my own plans blown to bits over and over again?
Despite the fact that my plans haven’t exactly gone as I hoped (to put it mildly), having a plan of some kind still brings me some comfort. At the end of a failed cycle, that’s the first thing Andrew and I ask ourselves, “what do we do now?” and “what’s our plan?”
Fortunately, we are working with a really great doctor (Dr. Geoffrey Sher) who came up with a very solid, sensible plan for us- here are the details of what’s been going on since our last IVF and what the next few months look like for us:
First was more testing. I was checked for any kind of reproductive immunology issue- all my tests came back normal so we don’t have to worry about that. Andrew had a hormone panel done that showed his levels of FSH and LH are a little on the low side. Dr. Sher started him on Clomid to get those sperm in shape. Andrew also had an ultrasound to look for a varicocele, which came back positive. (Side note- this is our fourth reproductive endocrinologist! FOURTH! How are we just now finding out about this varicocele!?)
Dr. Sher said that his semen analysis shows a “stress pattern” – meaning the sperm count is great, but the sperm quality isn’t. We have lots and lots and lots of really abnormal sperm, which is typical of a varicocele and has great potential to improve.
The way he recommends remedying this situation is through a varicocele embolization procedure. It’s supposed to be a pretty simple procedure, performed on an outpatient basis by an Interventional Radiologist. So far the hardest part of this has been actually scheduling the procedure- it’s been a nightmare quite honestly just due to unresponsive physician offices, but we’ve switched radiology clinics and are making some headway. The goal is to have the procedure completely done within the next 2-3 weeks max.
So between saying goodbye to this varicocele and poppin’ some clomid, our sperm should be kicking it into high gear in the next few months. Now for the other half of the equation- those little eggs and my low AMH levels.
This is an area that Dr. Sher is not approaching as casually as some of my other doctors have done in the past. Based on the fact that my AMH is low, which indicates low ovarian reserve and the fact that I haven’t had the response we hoped for in my past cycles, it’s time to get aggressive about our family planning.
His recommendation is that we do embryo banking. What this looks like is two back-to-back fresh egg retrieval cycles, without any embryo transfer. So we stimulate my ovaries using a new protocol I have never tried before (agonist/antagonist conversion protocol), then retrieve the eggs, fertilize them, and let them develop for five days. At day five the embryos will be biopsied for PGS (genetic) testing and then immediately frozen. I’ll then have one month off from injections, and then we start over- retrieve more eggs, fertilize them, biopsy them, freeze them, etc. (All of this happens in Las Vegas, by the way. We live in Los Angeles so we’ll be traveling to Nevada for about 7 days each cycle.)
At the point we’ll re-evaluate. How many embryos do we have? How many of them are genetically normal? How many children do we ultimately want? How many embryos do we want to keep for later cycles?
When we first started IVF we weren’t really thinking long term family planning. We were mostly thinking, “let’s get the first pregnancy figured out and then we’ll cross the sibling bridge when we get there.” Dr. Sher is recommending we start thinking about the long-term now. I already haven’t had a great response to IVF based on the number of eggs retrieved and a year from now (let alone 2 or 3 years from now) it could very likely be even less successful.
So we are planning to do the two retrieval cycles. After we’ve determined we are happy with the number and quality of embryos we have on ice we can begin a Frozen Embryo Transfer (FET) cycle.
The FET cycle is the one that actually gives me a chance to get pregnant. In fact, if things go well with our embryos, it actually gives us a really, really great chance of getting pregnant. Sadly, that day is still a long way out.
The varicocele ablation should happen in November of this year. We then need three months for the sperm to develop normally to give us a good chance of getting high quality embryos. That means our first embryo banking cycle will be in February 2017. Our second will be in April. And our first FET will be in June. Count forward 9 months and that means we are looking at March 2018 due date at the earliest.
The comfort of having a plan tends to disappear when you realize how much you don’t actually like the plan.
Not that I disagree with the doctor’s recommendations at all. I see the wisdom and the value of them. We’ve prayed about it and we feel peaceful moving forward. If at any point we no longer feel that this is how God is leading us, then we’ll make a change. I just don’t like it because it means more waiting- a LOT more waiting.
This current plan means that not only will we not have a baby this Christmas like I had hoped, it means we won’t even have one by next Christmas. It means I am 100% going to miss my “deadline” I set of being a mom before I turn 30. It means that my friends who are announcing their pregnancies now will be delivering their babies before I even have a chance to get pregnant. (You guys, I bawled my eyes out- multiple times- when I realized all this.)
For the first time in this process, the fact that I have a solid plan from a qualified doctor is not bringing me the comfort I thought it would. Looking at this plan leaves me feeling frustrated and like I kinda want to kick something.
Our doctor’s plan may not have brought me the reassurance I was looking for, but I know there is someone else out there whose plan actually does bring Hope and Peace.
Jeremiah 29:11 is telling me that God knows all about the plans He has for me and that those plans are GOOD, not bad, they are plans to give me a great future and hope!
Proverbs 16:9 is telling me that even though I may have a lot of my own plans and ideas, but HE is the one who directs my steps.
Psalm 37:23 is telling me my steps are ordered by God and that God is taking delight in my path.
Philippians 1:6 is telling me I don’t have to worry about being left in my current condition, because it’s God who started the good work in my life and it’s God who is going to finish it.
Romans 8: 28 is telling me that all these things are going to work together for my good.
Ephesians 2:10 is telling me that I am God’s workmanship, that I have been created for great works and that I will walk in and live out those things He planned for me.
1 Corinthians 2:9 is telling me that things God has planned for me are beyond my wildest imaginations.
Isaiah 43:19 is telling me He is doing a new thing in my life and making a way there seems to be no way.
Psalm 37:4 is telling me that as I delight myself in Him, He gives me the desires of my heart.
Habakuk 2:3 is telling me that even if things feel slow, keep waiting! God’s promises to me will be fulfilled- and not one day late, either!
Psalm 138:8 is telling me He will fulfill His purpose for me. His love for me is ever steady and endures forever.
Matthew 28:20 is telling me that He is with me always. ALWAYS. Even to the very end of time.
Better than a man with a plan, my God has a plan for me. He loves me and He isn’t abandoning me. He isn’t surprised by the timing of these cycles and His plan for my life hasn’t been foiled. Spending my time thinking about our upcoming IVF cycles might not bring me hope, but meditating on His words for me does. So that’s what I’m going to do- from this point on, that’s my plan.
Many are the plans in the mind of a man, but it’s the Lord’s purpose for him that will stand.