So many questions.

After the nurse called on Friday to confirm the shitty news of our second failure, she said the RE had requested a consultation. I’ve heard this referred to on the forums as the “WTF Appointment.” As in, what the fuck went wrong?

I have questions. But I’m scared to know the answers. Is it me? I’ve put on like 10-15 pounds this year with all the stress and medications. That’s not good. I have a very stressful job at multiple times during the year (tax deadlines are a bitch)…is that destroying my chances of success? I have minor hypothyroidism – can I even successfully manage that during a pregnancy?

Then there’s the big question. Is there even any sperm left? The super fun part of testicular failure is that you don’t know when the sperm will just go away. Hell, for all we know, he stopped producing sperm last month and all this worrying about another cycle is all for nothing. Before we do another cycle, I want another SA done to make sure. He had sperm (obviously) for our cycle in May, so that leaves some hope. Husband is still wonderfully (and fucking annoyingly) optimistic that this will work. We will have a child. Whereas I use the word “if” when talking about children, he is still firmly in the “when” camp.

Guys, seeing him with tears in his eyes on Friday morning gutted me. We’ve been together 6 years and the only time I’ve seen him cry is when he had to put down the dog he’d had since childhood. And then Friday. When I crawled back into bed after my morning shower and had to tell him that it didn’t work. I had failed us again. We weren’t going to be parents. He said he loved me and that it wasn’t my fault and that we would do this again.

I don’t know how I feel right now. I’m kind of a mess. The idea of another full cycle makes me sick to my stomach. All the injections and the constant blood draws and twat wandings. The retrieval. The embryo hunger games. I swear, I’ve lost 10 years off my life in the last 8 months from the stress and anxiety alone.

Back to the original topic at hand. The WTF appointment. It’s Wednesday. I’m not sure what to ask. I still have some issues with how the first cycle went, mostly stemming from staff communication and expectations, that I want to address. But other than that…what should we be asking?  Every step of this process, I feel SO out of my element. I’m like a deer in the headlights. Have any of you been through this meeting and care to share any fantastic insights?

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14 thoughts on “So many questions.

  1. Hey there… the number one thing I learned was to get Immunology testing done whether the doctor thinks it’s a problem or not…so, ANA and NK (natural killer cells) testing… also have your thyroid retested at the same time since that along with those other two are all about immunology and making sure your body is not rejecting the embryo. We just retested my thyroid and it still is about a point higher than the top of the range so we are increasing my Synthroid even more as I learned that for first trimester it’s got to be in the lower end of the acceptable range.

    My brain is pretty fuzzy right now but did you say you had an endometrial scratch? If you do it again make sure to get one if you haven’t already as that’s also supposed to help the uterus know that the embryo is not some alien object needing to be expelled. My doctor wasn’t exactly in support of Immunology testing but knew it would make me feel better and even allowed me to take prednisone even though he didn’t think I needed it since it didn’t do any harm to my body to add a little more protection. I also changed acupuncturists to one with a different style when it comes to helping increase blood flow to the uterus. And of course the other thing to definitely do is to just have a free consult with another clinic if at all possible (fertilityiq.com has good reviews) and see what kind of questions they ask. Don’t look at their success rates, just see what their thoughts are and what kind of protocol they might suggest. I’m not sure if you found this yet in Blogland but I am amazed at how many different standard protocols are out there. And of course then there’s the whole genetic testing on the fresh embryos that if I could go back in time I would have absolutely done ( I just didn’t know it existed) since at least a quarter to a third of embryos never implant because of chromosomal issues.

    I’m not exactly the poster child of IVF success as you know but I do feel better having done what I did and at least gotten a positive pregnancy test which proves that my uterus can implant something ( not that I have any joy inside me at all post miscarriage) which is why we’re going for another round instead of considering that our last as originally planned.

    It’s so hard and it sucks so bad. I’m sorry you’re dealing with this as well.

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    • You always have such fantastic thoughts. 🙂 Always much appreciated! No endometrial scratch, was never mentioned and I’ve only ever read about it online. My OBGYN was actually the one who discovered my thyroid issue when I went in for the initial “It’s been a year, why am I not knocked up yet?” appointment (ohhh memories when I thought it would be nothing serious). She has me come in every 6 weeks for a retest and adjustment, so I may ask if it needs to be more frequent when we cycle again.

      We’ve talked about PGS, but I just don’t know if I can stomach the additional $5,000 cost. :/ That and they require testing to be done on at least 4 embryos or they won’t do it, so we’ve never had enough make it to day 5 to test, sadly.

      We’re also toying with a second opinion. Kind of depends on how this appointment goes and how she handles all of our questions!

      This whole thing just blows, and I hate that so many fantastic people out there are constantly stuck in this endless loop of hope and disappointment.

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      • Yeah it’s amazing what some doctors share and other doctors don’t even bring up! It was our fertility doctors nurse who told me to make sure and ask for the scratch as it helps the uterus prepare for an embryo, and is often done for those who’ve had multiple failed transfers. It only takes like 2 or 3 minutes so I would recommend asking to have it done … all guns blazing! 🙂

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  2. I’m sorry you are going through this. I don’t have a lot of advice for what to ask during the appointment, but I can say it sounds like you are where I was a month ago or so and what helped me was taking a break from everything fertility related for a bit and then going on an adult vacation with just my husband. I swear it melted away all our troubles! It brought us to a level of happiness we’ve never actually had before. And we are taking on huge debt right now for fertility crap, but the vacation was so needed I don’t even care about the money. Once we got back we started talking about our next steps and moving forward…it was so much easier to make some big decisions after we had some time to clear our heads. Take the time to do what’s best for you. I hope your appointment goes well…good luck! Xo

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    • It really sucks doesn’t it? So much build up and anticipation and then…NOPE! We’re definitely planning on a little getaway, but it’ll have to wait until tax season is over in mid-October. 😦

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      • It sucks so much! It’s hard to explain how awful it is until you’ve gone through it. I’m so glad you are planning a get Away! I love anticipating and planning a trip!

        I also wanted to say if you are wondering about how to improve egg quality, read the book “It starts with the egg” by Rebecca fett. All research based on how to improve egg quality…

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  3. I hate this aspect of fertility treatment (ok, I hate a lot of them). It’s so frustrating that you have such a responsibility to be an advocate for yourself. If you don’t do it, no one will. But, there is a huge learning curve to know the lingo, the research, what questions to ask, etc. And docs love to tell you to “try again”… but at $15k (at least) per cycle, that isn’t an easy decision for all of us.

    I’m not an expert by any stretch (just finished IVF cycle #2, both terrible), but I would ask about the medication protocol you’re on in addition to the suggestions above. I don’t think you shared what protocol you used, how many days you stimmed, etc. but you could always explore other options. I found out (belatedly) that our clinic typically starts everyone with the same protocol (long Lupron) and only tailors for subsequent cycles (once they see how you’ve responded, etc.). I did have marginally more success with an antagonist protocol.

    We have male factor issues as well (although now we’re starting to think maybe my egg quality is a bigger issue), but we’ve talked about maybe doing more testing on sperm quality as well and maybe using PICSI.

    Just some thoughts!

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    • Asking about protocol is #1 on my list! I was on the antagonist protocol, I think 9 days of stims? I used Follistim, Menopur, and Ganarelix. I am definitely interested in how she plans on changing it up, if at all. 12 eggs retrieved, 11 fertilized but only 2 made it to day 5. Not ok in my books!

      We’re purely MFI as far as we know. The most my husband ever produced for a sample was 300,000 and then 2 months later it was only 40,000…so who knows. We may be out of time and not know it yet. ICSI was our only option!

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  4. I’m so sorry for what you’re going through. Like all of us, I have also endured these WTF appointments. One thing that really helped us last time was to take a break before the appointment. Although I still thought about it all the time during the ‘break,’ scheduling it for about a month after the devastating news really helped us to gather our thoughts and be more prepared to hear what the doctor had to say.

    I think during these appointments my main question is always “what are the possible reasons this happened/didn’t work?” Then “What are your recommendations for next steps?” “What should we change?”

    We are preparing for a 2nd opinion appointment at a different clinic, just to get a different perspective. Good luck with your appointment!

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    • Thank you. 🙂 I probably should have scheduled it much later, but we’re so worried that he’s got no sperm left that we feel some pressure to move on! I think if we do another SA and he still has a respectable (hell I’d be happy with 5,000!) amount, I definitely want to take a break. Reclaim my body and my life for a little bit.

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  5. Firstly, I’m so sorry as you are going through a truly shattering experience. Also, your husband sounds wonderful and you guys a great couple. xx I second the suggestion to do all the autoimmune tests. They are super-expensive but it’s really valuable to know what is or isn’t going on in that regard. Although I have had 2 positive implantations, 2 missed miscarriages have got me wondering WTF in a different way to you so I just went and had them done and laughed maniacally at the cost. 🙂 Also, my BFF did 21 transfers that all failed. Yes, 21! She ended up with a whole cocktail of autoimmune things going on and finally she was put on some steroids which allowed her to get pregnant the old-fashioned way (twice – she has 2 under 3 years old currently). She also recommends this book in case you want to know more about autoimmune stuff. She said it helped her to understand it all. I’ve not read it yet, but food for thought. xxx
    http://www.babyfriendlybook.com

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