Wednesday, February 10, 2010

Failed Follicles

It's appropriate that it's snowing hard outside our windows. Like a comforting blanket engulfing us in a fresh start. And that comfort is exactly what both Craig and I need. I've never been more happy to have my schoolteacher husband home for a snow day.

This morning we went into the fertility center for an ultrasound and more bloodwork. I came in with such confidence and high hopes after receiving a call yesterday that my bloodwork from the day before showed that my hormone levels were exactly where they should be and that I was responding well to the IVF drugs.

When the doctor inserted his ultrasound probe to check out what was happening with my ovaries, he put pressure on my right side and remarked: "There's one large follicle there; that's unfortunate."

"Wait, fortunate or unfortunate?" I asked like a naiive four year old. He is from Ghana, schooled in England, and has a difficult, muddled accent to comprehend at times, especially when the words he is speaking may as well be Greek.

"Unfortunate," he explained. In short, my follicles are nowhere near the size that they are supposed to be at this point in the process.

I got dressed and we went into another exam room where the doctor poured over the numbers and ultrasound picture with Craig and me as his nurse stood over my shoulder. It was bright - too bright and white - in there and I felt as if I was going to vomit right there on the floor as I took in the news. All the extra estrogen pumping through my body doesn't help matters either.

He explained in a very matter-of-fact style that the hope is for there to be 10 follicles at maturity (16mm). I have one - one - follicle that is 17mm and only two others even emerging, both less than 10 mm. This is the case even though he is giving me four times the normal amount of hormone injections that someone of my age would be given. We were given the hard news that although things looked promising in the beginning, it's pretty obvious now that the 6 months of chemo has aged my ovaries and they are not functioning as they should be.

Now it's just a matter of weighing chance and percentages and our chances of getting any embryos to freeze are looking very, very dismal. As mentioned, normally they like the woman to have at least 10 follicles that they can enter and retrieve from. Of those follicles, only 50% may actually hold an egg. Then of that 50%, only 60-70% of them will likely fertilize and turn into an embryo. We only have 1 to possibly 3 follicles to work with. Do the math. It's not pretty and is overwhelmingly disappointing. They would cancel the process immediately in this situation for any other IVF patient but because of my unique case and the fact that this could be our only shot at a future pregnancy, they would make an exception if we decided that we wanted to take the risk and continue on.

The color drained from both of us as it all sunk in. Craig asked a lot of questions. I took notes. The room got very hot and everything just kind of blurred to me.

We have two more days of hormone drugs to play with. We can't let the one 17mm follicle get any larger as we run the risk of the egg dropping (if there is one in there) so we can only do two more days of meds to give the other two potential follicles the chance to grow to maturity. We'll then go back on Friday morning to see what the progress has been and make the decision as to whether or not go ahead with the retrieval knowing the risk that I could go through the surgery and come out with nothing - not even an egg, nevermind a fertilized embryo.

That would take a huge emotional toll on us, and also a financial one. IVF is not a cheap process - even with donated meds and financial assistance from an organization that helps cancer patients in situations such as ours called Fertile Hope, the process costs over $10K and is not covered by insurance. So, if we go through with the retrieval, which is where the bulk of the cost is incurred, we could drop all that money into something that has very, very, very small odds of being successful. We have a big decision to make.

After explaining all of this, the doctor looked at me straight in the eyes and said: "I'm sorry." He grabbed my shoulder and said "you're going to be okay." and walked out. I couldn't speak and the lump in my throat got too overwhelming. I looked at Craig whose eyes were blurred and had red flush marks arising on his face. The nurse looked at me and just kept remarking how we've been through so much hell. She started crying. I started crying and she brought me a box of tissues. This is the first time I've ever broken done in a doctor's office during all of this. It was just too much. This was the one hopeful thing we had going.

After more shots, more bloodwork for both of us, urine samples from Craig. Up to the check-in area, down to the first floor lab, back up to the third floor, we had to leave to kill an hour because Craig preemptively emptied his bladder before the two-hour cut-off time. We just wanted it all to be over but that wouldn't happen until after Craig had the worst lab tech who stabbed him over and over in the arm until she brashly called out to her colleague for help in finding a vein. He came around the corner ashen and weak at the knees. Like we hadn't already gone through enough.

On our "break" from the tests and shots we went to Quaker Diner for a bacon, egg and cheese and talked things out. While we were weighing the options, two adorably cute little girls were twirling around our booth. One was wearing sweats and mini Ugg boots with a blue, fluffy, tulle princess dress zipped up over her other layers. She was dancing and laughing with her sister saying: "I'm mini Cinderella!" as they galavanted around the diner.

Craig and I laughed and cried at the pain and irony of it all. Now we're home on the couch, exhausted and deflated, trying to figure out what the hell is happening.


  1. Karin:
    What a horrible day it has been for you and Craig. I am so sorry! It sounds as if the snow has really been for you both, like you said, blanketing you during this terrible time. I began following your blog a few weeks ago and must tell you that what you are doing is amazing, humbling, significant and truly stunning. I very much enjoy your writing, your candor, your hope...I couldn't find any way to email you directly, but wanted you to know that you are impacting people everywhere who are thinking about you and sending you thoughts, prayers, hope, and support.
    Best, Shelly

  2. no, actually the one hopeful thing you have going is that you are going to beat this Hodgkins disease and go on to have a wonderful, fulfilling life with maybe some children of your own or maybe some children that would be so lucky to have you both as parents! don't let this get in your way! from someone who cares!

  3. i agree with 'anonymous'. you will beat this and whether you have children biologically or not, you will have children that will be so lucky to call you mom and dad. you are both so incredible. i know first head what one round of hodgkins does and your strength and love for one another will definitely beat the final round. i cannot imagine what you are going through. we think of you all the time.