Tuesday, May 7, 2013

A Journey to Parenthood...

Ok people, seriously, these are not pregnancy hormones talking-grab a tissue!  Make that tissues...
Today's Journey to Parenthood is about a good friend of mine, Leora and her husband David.  I met Leora, who is a few years older than me, when I was in elementary school when our synagogue hosted a retreat and her family came along with her mother while she catered the event.  That started our family's friendship.  We reconnected in college one afternoon when I wandered into the English tutoring center where Leora worked. 

Fast forward a few years and Leora and I reconnected yet again via the great inter-webs when she posted a link to her blog (which she no longer operates) where she went on to talk about their lack of conception and IVF plans.  I immediately wrote her an e-mail letting her know that due to male factor infertility as well, we had multiple failed cycles, and had been successful with our first IVF attempt!  I was so happy to share some inspiration.  

Fast forward four years later-I am almost 25 weeks pregnant with #3, and Leora and David still have an empty house.  When I found out about my past two pregnancies, she is one of the first people that pop into my head with the question, why?

Why me?
Why not her?
Why me not once, not twice, but almost three times! And her not even once...
Why have my three been so simple, and hers filled with heartbreak and empty arms?

I'll never know and I don't understand.  But through all of this, Leora has been an amazing friend and supporter, even when my dreams are coming true and hers are slipping through her fingers.  

Leora, I hope with all my heart, that some day soon I get to celebrate your rainbow baby with you.

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We got married really young - I had just turned 19 and David was 20. We spent the first 3 years of our marriage doing everything we could to prevent pregnancy.

By the summer of 2008, we had settled down and decided to start trying to have a baby. I had just had my 22nd birthday. We never thought anything could possibly be wrong.

I stopped taking my birth control pills. In August, I went to London with my mother and my sister. I noticed on the calendar that a month or more had gone by with no period. I told my mom and she excitedly ran down to the store to get me a pregnancy test. But it was negative. When I got back home, I went to my gynecologist. He said that a lot of women have anovulatory cycles when they come off the pill. He gave me a round of Provera to jump start my next cycle.

But my next cycle was anovulatory. And the next one. A few monitored cycles later and my gynecologist diagnosed me with anovulatory PCOS. I was told I would need Clomid to conceive. I was so upset. I spent more than a week crying over that diagnosis.

The Clomid was awful, but it worked. I ovulated like a charm on the lowest dose. But I still wasn't pregnant. After 3 rounds of Clomid, my gynecologist suggested a semen analysis. 

When we got the results back, my gynecologist thought it was a fluke, and sent David for another test. But the results were the same. Severe ogliospermia. David's sperm count was so low it was nearly non-existant. IVF with ICSI would be our only option.

Luckily, IVF is covered by the national health care system here in Israel -but they make you jump through a TON of hoops to get approved. We got our male factor infertility diagnosis in January 2009 and we didn't start our first IVF cycle until July 2009 - six months of testing.

We got really lucky with our first IVF cycle though -- boy/girl twins. The perfect instant-family. I was diagnosed with hyperemesis gravidarum when I lost more than 30lbs in the first trimester. But other than that, it was a normal pregnancy.

December 25, 2009. We had gone out for ice cream with a bunch of friends. We got home around 11pm and I promptly threw up my ice cream. And my water broke. We went to the hospital, but we were told that at 22 weeks, it was too early to do anything to save the babies. The risk of infection was too high, so we were given no choice but to terminate the pregnancy. I remember sitting in the hospital bed, feeling the babies kick, and discussing burial options. 

I was induced and delivered our tiny son and daughter. We asked to see them and hold them and were told that it's better if we don't. That's what I regret most - not getting to see them and hold them. 

But we were still so desperate to have a baby. The first phone call I made when I got home from the hospital was to the IVF clinic to schedule an appointment. We took three months to do a variety of testing (blood tests, hyseteroscopy, etc) to make sure there wasn't anything wrong with me that caused my water to break so early. We were given a clean bill of health and told that next time everything would be fine.

We had 4 frozen embryos. Over the next six months, we transfered them in a series of Frozen Embryo Transfers (FETs). Big Fat Negative (BFN).

One year after starting our first IVF cycle, we started our second fresh cycle. I got pregnant again. At 6 weeks, we saw a beautiful heartbeat. At 8 weeks, the heartbeat was gone. I waited and waited to miscarry, but gave up at 10 weeks and had a D&C.  Once again, we were told it was a fluke.

Another six months, another FET, another BFN.

In February 2011, we started our third fresh IVF cycle. Although we had been transferring 1 embryo at a time to prevent twinning again, the embryos from this cycle were such poor quality that we transferred two. Surprise! Twins again!

With my second twin pregnancy  I was monitored very carefully. My OB didn't believe that cervical incompetence played a part in my first loss, so he recommended against a cerclage. I had bi-weekly ultrasounds to check that my cervix wasn't changing.

On July 19, 2011 I hit a major milestone - 24 weeks - viability. The only reason we never got to meet our first set of twins. What a big relief. With lots of plans to celebrate later that evening, I woke up feeling "off". I went to the doctor just to get checked out. I had an ultrasound just 4 days earlier that showed everything was fine. The nurses and doctors thought I was crazy, but sent me for an ultrasound just for peace of mind. And our world came falling down again... my cervix had thinned and started to open.

I was immediately sent to the nearest hospital with a level III NICU. When I arrived, the doctor checked and I was fully dilated, with baby A's feet already sticking out. We were given two options: deliver vaginally and not try to rescue the babies, or a C-section and taking the babies to the NICU. We knew we couldn't give up on our babies so I was taken for a C-section.

The first few days after the boys were born were terrifying. We were told the first 3 days were the most critical and Micha & Asaf passed those with flying colors. Of course, they had the usual micro-preemie problems (on and off of a ventilator, jaundice, etc), but they seemed to be strong and doing well.

Sunday morning, day 5, we came to visit. After saying good morning to our babies, we went upstairs so I could have my staples taken out. When we got back to the NICU an hour later, we were locked out. They were working on Micha. After 2 hours of sitting and waiting, the doctors came out with bad news. Micha had a heart attack, which is really rare in preemies, but since he was so small, they weren't able to restart his heart. We went in and held him as they turned off the vent and the monitors. We kissed our little boy good bye.

The next day, we got more bad news. Asaf had stopped urinating, which signaled a problem with his kidneys. There was no blockage, so the problem would either resolve itself or wouldn't. After 4 days of praying for our little boy to pee, his little heart couldn't handle the kidney failure any more  Once again, we held our little boy as the doctors turned of the machines and the monitors. We said good bye to our second little boy.

After a C-section, doctors usually recommend waiting a year or more to get pregnant again, but I knew we couldn't do that. Just 3 months after our boys' births and deaths, we did a FET with the single poor quality embryo we had left from their cycle. We never thought in a million years that it would work, but it did. Unfortunately, my fourth pregnancy turned into one of our biggest nightmares. My beta HCG levels went up and then fell - indicating a miscarriage, But then, the numbers went up again - which is a bad, bad sign. After failing to locate an ectopic pregnancy, my numbers fell and we sighed in relief. But then they went up again. After 4 months of beta hell and panics about ectopic pregnancies, we finally found a tiny piece of residual tissue on the ultrasound. I had a surgical hysteroscopy in February 2012 and finally ended the pregnancy.

All of this was, understandably, incredibly hard on our marriage. We got into huge fights because I wanted to try again immediately and David didn't. We took a few months break and went on a vacation. In May 2012, we decided to try again. 

That cycle was the biggest disappointment. So far, our problem hadn't been the IVF -- in fact, the IVF was working great and I kept getting pregnant. But this cycle, my 4th fresh cycle, only one egg fertilized. We transferred our single embryo but it didn't work. Our doctor was puzzled.

We tried again in June 2012. I got pregnant and we took every precaution we could. At 14 weeks, my cervix was stitched closed with a cerclage to prevent any pre-term dilation. I was taking progesterone injections weekly to prevent pre-term contractions. We were doing everything we could possibly do. But at 18 weeks, I once again got the feeling that something wasn't right. I went to the doctor and asked for an ultrasound. The on-call doctor thought I was being ridiculous, but agreed to send me for a scan. I worried that my cervix was changed despite the stitch. I worried that I would go into preterm labor again. I was never prepared for what we actually found on that ultrasound.

Our perfect little boy had no heartbeat.

We were stunned. 

We went to the hospital and I was admitted for an induction. I had to have my stitch removed and I was induced. 24 hours later, I delivered a tiny little stillborn baby boy. We asked for genetic testing to be done, to hopefully give us answer why we lost him. But the only results we got were that he was a perfect baby boy. We'll never know why his little heart stopped beating.

December 2012 brought another failed fresh IVF cycle.

February 2013 we started yet another cycle (11th for those still counting - 7 fresh and 4 FET). Once again I got pregnant. This time we had yet a different kind of loss - a blighted ovum, a type of first trimester miscarriage where the baby stops developing but my body keeps developing a placenta and a pregnancy sac. 

So here we are. May 2013. Five years of trying, four years of IVF, seven fresh IVF/ICSI cycles, 4 frozen embryo transfers, 6 pregnancies.... still desperate, with empty arms, and hoping to one day bring a baby home.

We started to pursue adoption in November 2010 - after our second loss. Here in Israel, all adoptions go through the government. The wait list for a healthy baby is 7-10 years. We've been "on the list" for 2.5 years.

We've also applied to become foster parents, with the hope of taking in a baby for foster care and eventually being able to adopt. After jumping through all the hoops to be approved as foster parents, we finally were in January 2013. We are now waiting for a match. It could be tomorrow, it could be in 10 years, and we have no way to know. Foster care has many risks, but we are willing to take them to have a chance at raising a child.

I don't know what the future holds for us. I don't know if we'll ever bring a baby home. I don't know if our marriage survives more heartache and disappointment. I wish I had a crystal ball, but I don't. For now, we aren't ready to accept living child-free, so we try again... 

Maybe next time....

4 comments:

  1. Wow, just wow! there are no words! I am so impressed by the strength to have gone through so much and still be positive. I am praying that one day they can hold and raise their own child.

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  2. There are no words--I will keep you in my prayers.

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  3. My heart is just broken for your friend and her precious angels. I admire the strength to go on and to pursue other ways to grow their family. My sincerest prayers are with your friend.

    Other women I know who've had losses like this found out later they had blood-clotting disorders or were RH-negative. Of course I'm sure those were probably ruled out for your friend but the problem-solver in me can't help but want to reach out. We'll be praying for them, that they get matched for foster or adoption quicker than they imagined.

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  4. i know someone who had miscarriages and then took blood thiners and it worked.
    our thoughts and prayers are with you.

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