Immunology testing and other stuff

So I did the tests recommended by Dr. C. His clinic is huge, fancy, and totally faceless. I did not like it one bit, despite chocolates with his logo and fancy teas. The girl who was taking my blood samples had shaking hands, and looked decidedly uncomfortable and completely inefficient. Anyway, the results are in, and - surprise - my immunology results are totally normal. No elevated Natural Killer cells, nothing. The accompanying note said that based on these results, Dr. C recommends IVF. No surprise here: that's what they were pushing from the very beginning.
Now, yesterday we received a thick envelope with the financial information from this clinic. I went through it with a growing sense of dread and helplessness. There is NO WAY we could afford this. Just no way. Even if we felt comfortable enough with the idea of pumping me with drugs and risking another cyst or the same darling endometrioma growing... I don't know what to do now, I just don't.
I also started this "no gluten no dairy" regimen on Monday, and by today's evening, I felt thoroughly miserable. And hungry. What do these people on Paleo diet even eat? I cannot eat that much rice, I despise quinoa, I am not a huge meat-eater, I looove cheese and bread with everything basically. I don't feel full without it. So I caved in and ate some leftover pasta, with Parmesan to boot. I know you are not supposed to use food for comfort and solace, but what have I left? The atmosphere in our house is not a happy one currently.

Phone consultation

Our free phone consultation with the new doctor, let's call him Dr C, was rescheduled and took place today. He asked few questions, some of which I have already answered in their clinic questionnaire. He seems to think that the best way to go would be an aggressive stimulation IVF with immunology prep beforehand. He does not do natural IVF since he doesn't think the efforts required are justifiable with too low success rate.
He suggested that I cut out dairy (yogurt is thankfully okay), gluten (and I'd just had pasta for lunch), and alcohol completely (and he calls it a life). He also recommends to up the daily dose of CoQ10, Vitamin D, and to add Omega-3 and prenatals (I can't even describe how much I hate taking prenatals while not being pregnant). He also wants me to do blood tests for NK cells, cytokines and antiphosphilipid panel. He does not believe that my husband needs to do a Sperm Chromatine Structure Assay for his low (2%) morphology, as it was recommended by my second Dr (let's call him Dr J). He was quite adamant on this issue (but again, so was Dr J).
So, we're off for the tests on Monday. Depending on the results, we'll see whether we need IVF or we could treat immune issues and try naturally. Frankly, cards are stacked against us on all counts. We're dealing with female issues, male issues, immune issues, and we would probably have no money for IVF. And even if we had, having this endometrioma as an after-effect of Femara, I don't know if I want to risk anything like this happening again.

No good news

So yes, the endometrioma is back, possibly gotten a push from Letrozole, and is just slightly smaller than it was before the surgery in February. Not only that, but my CA-125 is higher than it was before the surgery. I am not back to square one, I am back to ground zero. I just cannot win. Such a neat double whammy: no pregnancy, but a bunch of potentially dangerous cysts, that threaten the whole possibility of me ever getting pregnant again.

I realize that all this time, I've been waiting for a miracle. Like you know, deus ex machina, light saving the darkest hour, this kind of thing. But apparently the miracles do not apply to us anymore. We had our miracle 6 years ago, only we did not understand just how great and singular it was.

And of course I am angry. At the surgeon - did she do her job well? At Dr who prescribed Letrozole - how could he not take into account my history, being told about it repeatedly? He said "you're in a good place right now", and then proceeded to put me in a much shittier place. At myself - if I wasn't so impatient, I would not have taken Letrozole, and maybe I'd have had another shot at miracle. At my body, which is failing me again and again.

Surprise surprise

Morning: pregnancy test negative. Evening: I've got my period. Two days earlier. This is ridiculous. I am upset and furious. This never happened before: my luteal phase used to be pretty consistent. Damn the Letrozole cycle, damn the doctors, damn my stupid old body.

Approaching a new clinic, and something about hope

Yesterday I emailed one of the local fertility centers which was mentioned somewhere as a good one to go for reproductive immunology issues. They have their first consultation free, which sounds just about right: we are in a tight money spot right now, and I would rather learn in advance what they can offer me, if anything. So I spent two days preparing my medical records and filling their extensive questionnaire, and getting more and more depressed by the minute.

What, realistically, anyone could probably offer me at this point? I honestly have no idea. I tried the anti-inflammatory protocol and failed. I tried Lethrozole and failed. Maybe some new twist on the first one could work. Maybe we could talk about the natural cycle IVF. Maybe it's just a matter of persistence and trying naturally, again and again. And hoping, hoping all the time.

Today, looking at the joyous faces and rainbow flags in the news, I remembered the famous Harvey Milk speech about hope. "You got to give them hope". At least someone didn't hope for nothing.

But me. Honestly, how do I even dare to hope. Me, with my 40th birthday just around the corner, with my shitty tests and 5 miscarriages, with first betas testing lower and lower every time? I know I need to stop obsessing about it, but when my Facebook feed brings new pregnancy announcements almost every day, I just can't. All those people getting their seconds, thirds, and fourths, but why not me? And my compilation of infertility blogs, which I made just few months ago, is full of happy reports, pregnancy complains, and ultrasound pictures. I am happy for everyone at these blogs, and I wish them all the best, I just want to be there myself as well. Hope is such a heavy burden.

Ultrasound results

So the results are in, and they don't make much sense - except for the confirmation that yes, I do have cysts, and I also have some "free fluid with debris" flowing around down there. Ain't it just peachy - I know I am full of awesomeness. Moreover, somehow the radiologist decided to compare the results with the ones I had in December, before the surgery. So his/her sorry exercise looked like: um, yes, the lesions got smaller etc. What. The. Fuck. S/he didn't even measure their sizes, how about that? And then my hurried surgeon emailed me "good news, your cysts are smaller and we don't have to do a follow up". Excuse me? Haven't you, you know, cut the whole shit out?! My OB/GYN said that "um, the endometriosis always comes back, so the cysts just had rearranged themselves". My uneducated take was that it's a few leftover cysts from Letrozole which could still go away, but no one seems to really think about it. They think that yes, this is the same old endometriosis back so soon. Which is very weird. Does it really, as the radiologist implied, has roughly the same configuration as before? How could this be?! Did they just forget to cut it out, having better things to do while I was sleeping? I don't know what to think, I am just pissed off and depressed even more.

The longest day of the year

I spent it checking my email every few minutes, awaiting the results of the ultrasound I had on Sunday to check the state of my ovaries after the botched attempt at Femara/Lethrozole. I haven't received any calls or emails, and I am exhausted from the whole imagination overdrive this is causing me.
Also, these past 3 days I have been: 1) drinking, 2) eating medium-cooked meat, 3) eating sushi. All during the two week wait. I think what this fifth miscarriage did to me was taking away hope - and thus maybe freeing us to go along with our lives. First small things, like drinking alcohol and planning vacations. Maybe bigger things will follow.
We are not completely done yet, though. We still plan on having a few phone consultations and seeing what we could do with our limited budget and travel opportunities. However, I have to get myself out of this limbo, which swallowed two years of our lives already. I have to. I don't know how, but I have to.

Random

Today I called to pay my bill for a Mother's Day ultrasound, and had a nice lady on the phone tell me that they do a 15% discount for infertility cervices. Her voice seemed so kind, so for some reason I started crying, and I am crying still. Meanwhile, my husband is dealing with all kinds of relatives/family friends at his mom's funeral, and fielding their questions about why haven't we got a 2nd/3d kid, why haven't we got a house, and all other shit older relatives normally ask. And yes, they also share their kids' stories around the lines of "oh and then they just miraculously discovered they're expecting their third, and they weren't even trying". WTF.

Feeling so down

I've been feeling incredibly down for the last few days. I've been testing every morning over the weekend, and the test line was getting paler and paler - until, on Monday, it wasn't visible anymore. I went for betas and spent an hour in a crowded lab waiting for my turn, thinking that I really didn't need to be there, since I already knew the answer. I haven't had breakfast, and might have been looking so miserable, that the technician offered me juice. This never ever happened before. Then she took a needle out too early and had to reinsert it, and I couldn't contain my tears.
The result was 2. My bitch RE didn't even say "I am sorry" (my OB/GYN, on the other hand, emailed me specifically to offer her sympathy). The other Dr. was uncharacteristically grim when I emailed him the news, and suggested we come and see him "sometime". His stupid office scheduled this "sometime" for August, and marked it as a "new infertility appointment". I am going to call to yell at them one of these days.
So, here's what I am dealing with now:
- I am feeling hopeless and helpless and desperate, because, once again, my chance to have a second child has evaporated. The bleeding came on Wednesday, and brought a new wave of grief and frustration.
- I am feeling sad re: death of my MIL, and having thoughts about the inevitability of this horrible end for people I love... everyone of us was someone's beloved baby, kissed and caressed and carried in arms, being read to and cooked for, and then fast forward - and there's no one to do this anymore; and then, this horror, and pain, and suffering, and then a cremation and a void.
- I am feeling alternately the immense comfort of my parents being here with me during this difficult time, and the poignancy of them getting older, frailer, and sadder. I am feeling guilty for not being able to cheer them up, and my heart breaks when I think that they would be leaving soon, and I don't know when I am going to see them again.
- My husband would be out of town for another week, and I miss him. Part of this time we would be alone with a kid, and this is going to be the hardest time - with all my grief and all bottled up tears.
- I am feeling like time just seeps through; my kid is having a graduation party this week, and this wonderfully safe cocoon her preschool provided would not be available anymore. With everything we've been going through the last two years she attended this place, it slowly became, in my mind, the embodiment of safety, the only constant place in her life. More constant than even her home, and safe from its pervasive sadness.
- I am feeling a horrible anxiety due to some health concerns; in the next couple of weeks I will have to face them and schedule some appointments. I am just so scared. I think somewhere in my heart of hearts I have this crazy idea that being pregnant is a miracle shield that keeps all the health issues at bay. I know it's not the case, of course, I am not stupid. It's just that I don't want to be thinking about tests and doctors if they are not related to be being pregnant - but I have to, and this makes me cry.
...And then I was folding the small girl clothes, new with tags, that someone in our household didn't get around to wearing. I was folding them to send to her younger cousin, and my heart was breaking again. It wasn't supposed to happen this way.

* * *

This is truly a horrible time for another chemical pregnancy to happen, especially with the implications that go with it - i.e. we are hitting the wall and not getting anywhere, and we are too freaking old to have another baby. I mean, 2 chemicals in a row is one thing; 3 chemicals in a row - bringing the total to five miscarriages - sound like a final sentence. And the thing is, my MIL died last night. My husband is beside himself with grief, and he is dealing with it and with all the rituals and bureaucracy surrounding death - and he is dealing with it alone, across the state. I am at home with a kid, and I am powerless. I did not tell him about the test, because I did not want to put extra pressure on him, and I did not want to put him through another round of beta hell. But the thing is, he remembers. He even remembered to ask me today, if I'd checked already - and I did not tell him the truth. I wanted my news to be a ray of light in an all-around bleak time, but now I fear it might as well be the breaking point.

This is truly hell. I couldn't help but Google happy endings for low HSG, but there were not much. Also, from my experience, if something doesn't look right and requires some elaborate mental scheming, calculations, and explanations like "sometimes it could still be normal", it probably is not right at all.

And yes, I've already thought about the name. Stupid old me.