Next Step?

Yesterday was a tough day.

We had already learned over the weekend that our recent IUI had failed. I was scheduled for another doctor's appointment on Monday morning. I went in, fully expecting the same routine... do an ultrasound and some blood work, talk to the doctor, hear that we should try another IUI. In the back of my mind I considered that maybe the doctor would be leery of another IUI and would suggest we move ahead to IVF. Jacob and I had discussed that possibility and were prepared to make the decision to move forward if it was necessary.

I was not shocked when the doctor said that he didn't feel that an IUI would be wise for us to try again. He had given me as high of a dose of medicine as he would ever give me for as long of time as possible and he didn't feel that the results were good enough to merit spending that kind of time and money again. Even with these high doses and the added Lupron, I just did not respond well to the medicine. (Basically there were still too few "good" follicles.)

However, I was caught completely off guard by what he said next. He said that because he would use the exact same medicine regimen for IVF, he also didn't feel like IVF would be a wise choice for us. For those who haven't been through infertility, basically IVF was what we held up in the back of our minds as our last option....if all else fails, IVF will give us the best shot. Most women have a 50-60% chance of IVF being successful. To my shock, the doctor said that he would give me only about a 20% chance of success with IVF. He said while it would be my "best shot", it would be a lot of money to spend for something that he didn't really feel would be successful.

He suggested that we do one of two things....

1) Decide to try the IVF if we really feel that we want to do everything we can to give it our best shot at success. He reminded me though, that this would be a lot of money for a low chance at success.

2) Go back on to the low dose of Tamoxifen that I had taken before. He said I could try this "month after month and hope that one day we get lucky and it works". He said my chances would be about 5-10% each month.

I was in shock. I had just heard that there was a low chance of me ever becoming pregnant again. Impossible....no, unlikely....yes. I felt very much as though the doctor was "throwing in the towel".

I spent yesterday hurt, sad, depressed even. I felt like I'd just taken the second worse blow in my life. Would I really never be a mother again? I was angry (more to come on this later.) I was confused. I was beaten down. I was questioning. I was lost. I didn't know where we would possibly go from here.

Today I'm still very sad. I'm still confused and I still have no idea what is next for us. I'm also still very scared. As usually happens though, the more rational Erica woke up this morning. Today I'm ready to consider our options and to make decisions. Obviously all the emotions I was feeling yesterday are still there, but I can see through them better today.

In short, Jacob and I desperately need your prayers. We have major life decisions to make. In order to have our own biological children.....we NEED a miracle! We simply won't have another baby without a miracle from God. I also need you to pray that through this process we won't become bitter towards God.

(By the way, sometimes I absolutely do feel angry at God. I know that there are people who don't agree with that, but anger is an emotion that arises. I know that God is good, I know that he is not the author of evil. My rational self knows this, but I am human. I get angry with God and I believe whole-heartedly that He understands how and why I feel that anger more than any person on earth can. I don't, however, want to let that anger turn into bitterness or linger for too long.)

Jacob and I feel certain that God would not have placed this STRONG desire for children into our hearts unless He fully intended for us to have children. We're not certain what that family will look like, when it will come, or how we will get there. We have not give up hope, but we do need direction!

Please pray with us as we consider the following...

-Should we get a second opinion?

-Should we do the IVF knowing that our chances are lower than most couples? There is a large part of us that feels like we have to give it our "best shot"!

-If we do decide to go forward with IVF, where will the funding come from? Are we willing to put ourselves into debt for this?

-Is adoption our best option at this point? If so, where do we start? What do we do? Where will the funding come from?

-Are there other options that we need to consider? (egg or embryo donation?)

Thank you again for taking this journey with us!! I know that so many of you are praying for us!!!!

Taking Another Step

Sorry it's been awhile since I've given an update on my own fertility "journey". I honestly have been struggling with a lot of depression and anxiety about it and I just didn't want to talk about it. For some reason, sometimes the fear of it never working and the hurt of nothing working up to this point just completely consume me. That happens to be much worse during the holidays.

Last month we decided that we would take the month off and begin to consider the possibility of doing an IVF cycle in the spring. However, when I called the doctor's office and spoke to the nurse she said that the doctor was "reasonably confident" that I would get pregnant with an IUI and would do one at 1/2 price. Being the bargain shopper that I am, I just couldn't pass up half-price! :)

I took Tamoxifen again for the second month in a row. The first month, I did not do well with the medicine...I felt awful, had headaches, felt nauseous, it was just bad! But the second month went much more smoothly. I felt a lot better and it really wasn't too difficult of a month. Because I had spent quite a bit of time in Indiana due to my Grandpa passing away and Jacob working out of the Lafayette plant for a week, I was a little nervous that we wouldn't be back in Tennessee in time for the IUI. Even in the midst of infertility, though, I've always had a very reliable cycle! I ALWAYS have a positive ovulation test on day 14 and ovulate on day 15. Well....wouldn't you know, I ovulated 2 days early! So, we missed the IUI because we were still in Indiana!

For those of you who don't know anything about endometriosis, one of the reasons that some doctors believe that an IUI is helpful in women with infertility caused by endometriosis is that endometriosis can cause an increased amount of "macrophages". Basically, macrophages attack foreign material in your body. The increased macrophages are due to the constant presence of disease in the uterus. Basically, your body is always on attack-mode. Unfortunately, that can mean that the macrophages also attack sperm. Basically, the IUI puts the sperm closer to where it needs to be! (Now I'm not a doctor, so please don't hold me to any of this or quote me as an expert!!!) Basically, the IUI is a good thing for us to have each month, but we missed out this past month!

So, today we saw the doctor again. There were a lot of factors to discuss and I won't bore you with everything, but here were the bullet points from the appointment....

- The doctor does NOT feel like I'm going to need an IVF to get pregnant, at least at this point. He's pretty confident that the surgery went well enough that our chances are looking up. Since the surgery, we've only had one IUI, so it makes sense to still be confident in the possibility of it working.

- My egg reserve test did show a low egg reserve, which is still a concern in the back of our minds. Basically it means that I won't "stimulate" (produce as many eggs) as other women my age, no matter what treatment we do. The bad news is that there is also some evidence that women with a low reserve also have lower quality eggs, which makes our chances of getting pregnant lower. If we need to go to an IVF cycle, we will probably have difficulty getting the number of follicles that most fertility patients get. It's likely that we would not have eggs to freeze and use at another time. So, the $15,000 would really be for ONE try!

- We decided that the best option for us at this point is to move on from the tamoxifen to the injectable medications. This time we'll be starting with a higher dose of medication from the beginning in hopes of getting more follicles (eggs). I'll also be adding another medication in addition to the HMG. I'll take injections of Lupron to prevent me from ovulating on my own. This will allow us to stimulate for longer without the fear of me ovulating before it's time. Using the injectables in this way will also give us a good idea of how I would stimulate for IVF if that becomes necessary.

Originally, we decided to sit out my next cycle and start the injectables toward the end of January. Although the cost of an injectable cycle with an IUI is much cheaper than IVF, it's still a big cost for us! Because of the dose of medicine I need, it can easily cost anywhere from $1,500-2,000. Unfortunately, we don't have that as "extra" in our budget! We knew we'd need the next four weeks to save up some to get ready for the cost. However, we have a wonderful couple in our lives who have said they will serve as our financial backers! They're willing to loan us the money in order for us to be able to go ahead with the injections as soon as possible! Thank you Jesus for our amazing family!!!! It's not fun to borrow money, but we're just very thankful for the opportunity to continue trying to start our family!

So....all that said, I should be ready to start injections by early next week. By Monday or Tuesday, Jacob will be back to injecting medicine in my back-side nightly, this time with an added injection in my belly as well! Yipee! :) Please pray for us over the next several weeks as we take yet another step forward in our "journey"! As our doctor said today "only God knows what will work and when"!

****Added Correction.....because of the timing and with Christmas and New Year's, it's going to work best for me to take a birth control pill for a week or so and begin the injections after the first of the year. Basically, we're hitting "pause" for about a week!

Ultrasound and IUI

Just to update everyone on where we are with our fertility "journey"...

I had an ultrasound on Wednesday that showed that this new medication had fixed the problem with my uterine lining. The lining was very good. However, I just have one good follicle, and it was a VERY good size. There aren't really any other smaller follicles on either side. Although most "normal" people get pregnant with one follicle, and it's completely possible, I still am just not responding well to ovulation induction. We will, however, still have an IUI this month (probably tomorrow morning).

In the bigger picture, the fact that I'm only having one follicle at a time is alarming to me because of the test on my egg supply a few months ago. I sort of went into panic-mode! I had hoped that the scar tissue had been most of the problem and that I would respond better to medication after the surgery, but that doesn't seem to be the case.

Jacob and I are considering our options for going forward with treatment and trying to decide how to balance the financial burden of IVF with the scary thought that our time to conceive may be limited. Please pray with us over the next several weeks that God would give us a clear direction as to what we should do next.

By the way, I know that I'm kind of jumping the gun with this since we are still doing an IUI this month, and it's completely possible that I could get pregnant. We just have to plan ahead and decide where to go if it doesn't work so that we can begin the process of saving, getting a loan, finding $15,000 on the roadside, winning the lottery (which we don't play), getting on a game show, you know....that sort of thing!

Thank you all for your support and prayers through this entire process! We can't say enough how much we appreciate it...by the way, we're open to suggestions, advice, and opinions!!! Feel free to comment here or send me an email (ericabcrum@gmail.com) or facebook message!

Oh and....if you're not yet "following" my blog, please become a "follower" so that I know you're reading!! Just go down the screen and click on "Follow" on the right-hand side. :)

Specific Prayer Request

Alright blogging friends, I know so many of you are praying for Jacob and I, and we are so very appreciative of that!! I just wanted to give you a little more information so that you would know how to pray for us more specifically. Until this point, we have really kept the process to ourselves, but I felt like it was time to call on some more of God's prayer warriors to help lift up our specific needs.

Just a little bit of background info in case you don't know our story:

Oct. 2008 - I realized my cycle wasn't "normal" and saw the doctor to discuss some treatment

Dec. 08 - I started Clomid

March 2009 - I miraculously became pregnant

Sept 09 - At 29 weeks gestation, Kinley was stillborn

Dec 09 - I started Clomid AGAIN!

March 2010 - After taking the Clomid for a few months, I knew it wasn't working. I was scheduled for a laparoscopy. The doctor discovered Stage III endometriosis. He was surprised by how bad it was and said it was a "fluke" that I ever got pregnant with the endometriosis.

April and May 10 - I received Lupron injections

June 10 - I had my first appointment with the fertility specialist in Knoxville. He was very proactive and I began injectable medications and had my first IUI, it failed.

July 10 - Did another month of injectables and IUI and it again failed.

That brings us to today... I have not really responded well to the injectable meds, so there is some concern that I may have a low egg reserve. I had a blood test done that should give us more information about that in about a week. In addition, the doctor is concerned that there is some scar tissue from the endometriosis and the surgery.

Basically, Jacob and I are to the point that we need to make some decisions about what to do from here. We currently have the option of one more IUI with a higher initial dose of injectables or taking a break from trying to get pregnant until we can save the money (about $12,000) for IVF. There are positives and negatives to both options and we really don't have a clear direction yet on what to do from here.

We're seeking God's direction and want to be sure that we're within His will with our next few steps. Please pray with us for clear direction in our decision making and our finances as well as for peace mind and a renewed hope in God's promises for us. It's very easy for me to get frustrated with the fact that I became pregnant with Kinley relatively easily only to lose her so soon. As well as to begin questioning why God would allow me to go through that and now have such difficulty getting pregnant again. I know God's still in control and I know He has a plan for us, but it sure wouldn't hurt to have a few extra prayers!! Thanks to you all!!