A (Brave)rman New World

per·sist·ence/pərˈsistəns/
Noun:
1. Firm or obstinate continuance in a course of action in spite of difficulty or opposition.
2. The continued or prolonged existence of something.

If my wife is nothing else, she is persistent. I think this journey is proof of that. Despite the burdens she has faced - emotionally, financially, and physically, she has remained persistent in her journey to attain this goal. And despite the heartbreak of the last failed attempt, her persistence continued to reign supreme. Give a persistent girl all of the resources of the world wide web and she will find something, anything, to answer her questions. That persistence has led to a discovery...something potentially big. Maybe an answer. An answer to an all-consuming question...why isn't this working?

Let me back up a little and take you back to the most recent saddest day. We hadn't decided yet what our next step would be but we were at a crossroads, to say the least. Do we keep trying? There isn't a manual on when to say when. For all intents and purposes, Heidi is perfectly fertile, perfectly reproductive. Every procedure has been met with accolades at how perfect things were...her follicles, her embryos, her lining, everything. Despite this, we continue to be met with disappointment. So, was this the point where we say "I give" and stop? What about adoption? We could try that avenue. What about becoming foster parents? Another option, for sure. What do we do? Where was the "Fertility for Dummies" guide when you needed it? What? What? What do we do?

We threw out those questions...stop, continue, adopt, foster, stop, try...Despite the pros and cons of each, there was something that wouldn't let us throw in the towel just yet. Heidi wants more than anything to have a baby. She also wants to be pregnant. Not just to have a baby, but to be pregnant, to have a baby. She said to me that most little girls dream of their wedding day when they grow up. Not her; she dreamed of being a mom (a little punch to my self-esteem since I thought I was all that she dreamed about, but apparently, no...there was this too). So, we managed to decide on that much, but we still had to figure out how we would try to accomplish that. There was IUI but we hadn't ever even gotten pregnant on the four we had tried. We could try IVF again, but the medicines were so hard on her little body and so expensive. If we decided on IVF, we wouldn't be able to try again right away; we'd have to take some time to save more money (we did briefly consider a "knock up my wife" fundraiser...feel free to send your payment now!).

While we hadn't yet decided on what to do, Heidi took to the internet to see what she could find. Remember when I said she just "knew" things? Her intuition is good, I mean, really good. She can't always pinpoint why she feels something, but she's usually pretty spot on when she feels it. So, this voice known as Little Heidi (my new nickname for her intuition) kept nagging at her, bringing her back to her positive ANA blood test. That's the ONLY thing that wasn't perfect. We started prednisone after the second IUI to stop the pain, but maybe that was just masking something. Maybe there was something else that a positive ANA might affect.

Sitting in my office one day, Heidi walks in and puts a piece of paper on my desk and said "Read this.". I read it (she's very authoritarian, if she says read something, I'm reading it). Yep...I'm pretty familiar with this...it was all that Heidi had gone through from IUI, to IVF, to miscarriage, to positive ANA. I said "Yea? This is about you. So?" Her response "It's not about me. It's about someone else. And she got pregnant." What the what??? My persistent wife had searched the internet and found a testimonial about a woman just like her, who had the same history as her, who had the same auto-immune issue as her, who got pregnant. Heidi told me that she had found a website for a specialist in New York...a reproductive immunologist. He had a lot of information on his website about the affects of ANA on failed pregnancy. Again, I say what the what??? I think that night we looked through every page on his website. We watched every video he had posted. We thought...maybe this could be our answer. What if? So, Heidi filled out the sixteen page questionnaire and sent it in to the specialists office. And we waited. While we were waiting, Heidi happened to shut off her phone because it was acting possessed. During that 2.67 minutes that her phone was off, the doctor called and left a message. Really? That was the window you called in? Really, really? Anyhow, he left an encouraging message, saying to call the office to schedule an appointment and "do not despair". Our new mantra...

We decided to talk to our fertility doctor to see what he thought. We scheduled an appointment for April 10th (or somewhere around there). We also scheduled an appointment with the reproductive immunologist for April 20th. Since our private jet is in the shop, we scheduled a Skype appointment (God love technology!).

Our visit with our fertility doctor goes...well...oddly. We presumed he would immediately be on-board with our discovery and excitement about meeting with a specialist. We were a little shocked to find out that he knew about various reproductive immunologists in other states and had never mentioned any of that to us. We were a little disappointed that he seemed to be resistant to our discussing this with this new doctor. He kept saying that we hadn't tried that many times, not enough times to count as multiple failures (I disagree. I would say six tries sufficiently demonstrated multiple failures). He cited statistics that eventually, with enough tries, Heidi would get pregnant...there was nothing wrong with her. It was...odd. Heidi cried and began to put the information she found on the specialist away. To her, the conversation was over. I pulled the information from Heidi's hand and gave it to Dr. Welden. We talked a little more, about how if everything was perfect, why wasn't she pregnant? What about the pain of the first two IUI's? What about the fact that the only thing not perfect was the ANA? Dr. Welden started to warm up a little to the idea of a specialist. He admitted that he wasn't the expert in ANA and that he would, in fact, be willing to work with the specialist as long as everything he recommended was ethical and wouldn't put Heidi in danger. Incidentally, these are also my criteria so I think it's safe to say we were finally on the same page.

On April 21st, we meet, face-to-face, well, via Skype, Dr. Jeffrey Braverman, reproductive immunologist. We had prepared a list of questions to ask, everything we could think of. Before we could ask our questions, he asked his. There were many. One of those questions to Heidi was "Why are you trying IVF?" Her response: "Because I'm married to a woman and want to have a baby." His response: "That's great, but why IVF?" LOL Outage from the closet unnecessary...it wasn't the intent of the question. LOL...my wife. Then he began talking about what he thought about our situation. It became pretty technical...talk of natural killer cells. Talk of Interleukin 10 from endometriosis. Tumor necrosis factor created by a reactive oxygen species. Activation of her compliment system and the resulting attack on the embryo. It was a little like speaking to someone who spoke a different language. Here's what we did understand...there's hope. It would seem that it is likely that the ANA is creating a sci-fi like attack on anything we stick into Heidi...sperm, embryo's, you name it. Her over-achieving immune system attacks it like it's a flu virus, leaving it incapable of surviving. If this is in fact what is happening, there is a protocol that she can be on that will prevent this reaction. The down side is that they are daily injections and would likely need to be continued throughout her entire pregnancy. Well, speaking for Heidi's backside, it's a small price to pay.

What now? We have to do some blood tests and it'll take about three weeks to get the results. We received the "kits" in the mail today to take to a lab. Heidi will generously donate about six vials of blood, or pretty much all of her supply. In three weeks, we have another appointment with the doctor and find out what our protocol is. That's that. Fingers crossed. Optimism is back. Positivity is back. I'll leave you with Dr. Braverman's words to us during our consultation..."You will have a baby at the end of this."

That's all we ever wanted.