All I Need is One Good Egg

IVF #2, Negative

2010-03-19T16:13:00.003-04:00

Just got the call: officially not pregnant. Again. I'm so angry I don't know what to do. I had such hope for this cycle....everything went so well, the embryos were so healthy and strong. I really thought this was going to be our time, after almost 6 years I really thought we would finally be parents. I just do not understand why my body keeps failing at something that is so natural and easy for so many others.

IVF #2, Transfer

2010-03-09T11:44:00.001-05:00

Our transfer was on Sunday, and it went very well. Dr. G called me on Sunday morning to give me the report on the health of our embryos: my clinic uses a grading system where Grade 1 - AA is the highest grade. Dr. G explained that grade 1-AA embryos are very, very rare. He told me that we had one grade 1 - AB blastocyst, and one grade 1 -BB blastocyst that were both looking spectacular, AND 2 more blastocyst stage embryos that were not far behind and looked really, really good, AND 2 more embryos that were ALMOST at the blastocyst stage and still thriving.

We agreed that since I'm 39, and this is probably our last hurrah, we would transfer 3 blasts instead of just 2. Dr. G said he felt in my situation the danger of becoming pregnant with triplets was only about 5%, and the chance of twins is about 30%.

So, we transferred the two grade 1 blasts and one of the other blastocysts. The transfer was much more comfortable this time around because I didn't drink so much water! It was so very painful for me the first time we did IVF, so I decided not to drink as much water as they recommended this time around, and it worked out much better. I've always thought I had a small bladder, and apparently I'm right, as it certainly didn't take 32 oz. to fill mine up. I drank maybe 16 oz of water before the transfer, and the doctor said my bladder was "perfectly full" and really helped to visualize everything via ultrasound.

The other new thing this time around is that the embryologist came back into the room while I was "resting" for the required 5 minutes afterward, and handed us a framed photo of our beautiful embryos. This of course, made me cry even harder than I already was. I have done nothing but stare at the picture since we got home on Sunday. I think it must help to sort of visualize them in there, making a happy home....

I just this minute got a call from my nurse, informing me that as of today, we have TWO frozen embryos!! I'm so surprised, and so excited! The doctor told us on Sunday that they would watch the remaining three of our embryos that we didn't transfer, for the next two days in the lab, to see if they would continue thriving, and that if they were robust enough by day 7, they would freeze them. But, she said it was only a 50/50 chance that they would make it. So, I'm so pleasantly surprised to learn that TWO of them made it!! I'm so proud of them!!

Anyway, I'm only in the very beginning of the two-week-wait, and I already feel like time is just draaaagggginng on. The 2ww always feels like torture to me. Nothing left to do but pray, each and every day.

IVF #2, Day 3 after retrieval

2010-03-05T12:56:00.003-05:00

Working from home today, and just got off of a conference call and received an update from much beloved Dr. G. via voicemail: "K, just wanted to call and see how you're feeling, and to let you know that your embryos are looking WONDERFUL. Of the 11, all are still thriving, and 10 of them are considered grade 1 (1 being the best grade), and the other one is not far behind. I'll call tomorrow to check on you and give you another update. Things are definitely looking good this time!"

In our first IVF, we only had one embryo that was considered grade 1. So, I know that having many high-grade embryos is not by any means a guarantee of success, but any way you look at it, this is good news and a reason to smile all day long today.

Frighteningly, hope is alive and well at this point, although something inside of me, even still, is bracing for the inevitable crash.

2010, and IVF #2

2010-03-04T14:39:00.003-05:00

On January 15, 2010, we found out that our 4th IUI had failed, and after consulting with Dr. G, we decided to do ONE more round of IVF. Financially, it only makes sense that this is our last IVF attempt. It is SO expensive, and we're getting excited about pursuing adoption, but we can't afford to do both at the same time! We decided that if this last round of IVF doesn't work, we will close the door on this phase of our lives. For 5 years we've been chasing the dream of becoming parents through biological means, and it just feels like we've done everything we possibly could have done, to that end. It feels like the right time to bring the physical treatment phase to closure. Although I know I will be devastated if this doesn't work.....there's a part of me that feels good about being able to say - never again - to the appointments, the injections, the rearrangement of work schedules and vacations and holidays to accommodate treatment, to the up and down roller coaster of wondering each time if we'll get lucky, etc. I know that adoption is going to present MANY challenges, but at least we can put the past 5 year's worth of treatment oriented challenges behind us, finally.

I thought it would be interesting to chronicle the last 5 years in a succinct list:

October 2004 - Married! Me -33, R - 35

October 2004 - May 2006 - TTC the old fashioned way. Me - 33 to 35, R - 35 to 36

July 2006 - September 2006 - Clomid/timed intercourse cycles - No response from ovaries. Me - 35, R - 37

January 2007 - April 2007 - IUI#1 - BFN (longest stim cycle on record at Fertility Clinic #1 - 65 consecutive days of FSH injections) Me - 36, R - 37

July 2007 - August 2007 - IVF#1 - BFN (Moved to Fertility Clinic #2 and much beloved Dr. G. Best decision ever!) Me - 36, R - 38

September 2007 - May 2009 - BREAK (Gall bladder surgery, major house repairs - impact on budget, lost almost 100 pounds...) Me - 36 to 38, R - 38 to 39

July 2009 - IUI#2 - BFN. Me - 38, R - 40

August 2009 - IUI#3 - BFP! Me - 38, R - 40

September 2009 - Miscarriage (Non-doubling HGG numbers in early pregnancy, presumed ectopic, given methotrexate injections to induce miscarriage) Me - 38, R - 40

November 2009 - IUI#4 - BFN. Me - 39, R - 40

January 2009 - IUI#5 - BFN. Me - 39, R - 40

March 2010 - IVF#2 - ????????? Me - 39, R - 40

Wow, that all looks very tidy and speedy, laid out like that in a list. But it feels like an absolute LIFETIME since those first Clomid cycles at my OB/GYN's office. Oh, how naive I was back then!! And so very impatient!

So, here we are at the tail end of IVF #2. 14 eggs retrieved on Tuesday. Of the 14, 11 of them were mature and all fertilized. As of today, Day #2 after retrieval, all 11 embryos still thriving. Hurray!

We'll wait now to see how may make it blastocyst stage - Day 5 transfer is scheduled for this weekend on Sunday, and after that, it's all over but the cryin'.

All we can do now is pray!

2009-09-03T22:12:00.004-04:00

I have been thinking for quite a while that I was finished with this blog. So it was surprising to me tonight when I felt an urge to document some things here. But, I have come back here on several occasions when I was reflecting on our infertility history and couldn't remember the exact sequence of events that led up to a particular milestone, or when I couldn't remember the date or time frame of an event. So, I thought that I'd probably regret it if I didn't get some of the details of our latest attempt chronicled here, if only so that I can read back through it at some much later date, and get whatever I need from it....

So - we started treatment again in July, and we decided to start from the beginning again. Since I have lost a considerable amount of weight, our doctor agreed that my body might react differently and with less medication than during our previous attempts, and that it made sense to perhaps start with the lesser expensive IUI treatments before advancing on to IVF again. So, I took 150 mg of Clomid along with a few low doses of injectable FSH medications (which were graciously donated to us by dear friends who are now 7 months pregnant with the fruits of their latest cycle) and we did an IUI procedure (our 2nd ever) on July 10. On July 24 we found out that it was unsuccessful. We started another cycle immediately, and had IUI procedure #3 on Aug 10. Here's what happened after that:

Saturday, Aug 22 - Unlike all previous attempts, this time I was nonchalant, completely sure that the IUI hadn't worked, and I did not pee-on-a-stick each and every morning for the last week of the 2 week window. I had been planning to only pee on ONE stick the morning of the beta, just because I couldn't deal with the suspense of having blood drawn and waiting for 6 hours for someone to call me to tell me my fate. But, on Sat afternoon, I went into the bathroom to pee and my last remaining pregnancy test was sticking out of a basket in my bathroom and it caught my eye, and I thought - well, what the hell, I'll just take this ONE test and then I won't have anymore in the house to tempt me, and I'll buy just one more on Monday night to take on Tuesday morning before the beta. So I peed on it, and immediately two lines came up, and reflexively, I almost threw it in the trash as I have countless other times before, thinking that it was negative, as usual. But at the last second, with the stick poised over the trash can, my heart leaped into my throat, and I thought - WAIT a minute. Two lines? Doesn't that mean something good? But, you know, on some of them you need a plus sign, and I couldn't really remember what brand of test I had taken, so I snatched up the instruction sheet, which I had thankfully saved, and tried to make sense of what I was seeing. My heart was pounding, pounding, pounding and the more I looked at the two lines the more I couldn't believe it. I raced down stairs and threw the test onto R's desk and asked him to read and tell me what it meant. He looked at it, and then he looked at me, and we stared at each other and I cried and we held each other for a few minutes, which was sheer joy, sheer elation, thank you GOD for this moment......And then I grabbed my keys and raced to the grocery store where I bought not one but 8 more tests. Because I couldn't believe it was true. I needed more reassurance. What if the one test I used was faulty? What if it was defective, had been in the humid bathroom too long, or I dropped it and broke it before I used it or what if it just LIED to me? I had to be sure, so I came home and drank 2 bottles of water and paced around until I could pee again. Then I peed on 4 sticks, all different brands, and every one of them came up immediately and strongly positive. No pussy-footing around, right away, clear as a bell. No squinting and holding the test up to the light, If you hold it this way it KIND of looks like a second line, right there? No, none of that. Straightaway positive as they could be.

The rest of Saturday, Sunday, Monday, Tuesday, Wednesday and Thursday morning passed in a joy filled haze. On Tuesday morning I went in for my first beta. I wasn't the slightest bit nervous, because I reasoned that 5 pee sticks couldn't possibly be wrong. I knew there was enough hcg in my system to ensure happy news when I got the phone call that afternoon. And sure enough, my nurse called and congratulated me, and told me my hcg level was 637. Holy shit! It might be twins! We fought the urge to tell everyone we knew. I felt like I wanted to take out an ad on the nearest billboard, After FIVE years, we FINALLY did it! WE ARE GOING TO HAVE A BABY! A BABY! Us! We are pregnant! We told WAY too many people. Family and all the people we really love, but still, I know now, way too many people. We were just so overcome with this news, it was incredible, unbelievable, we felt like we had won the lottery. We talked about things that we have NEVER allowed ourselves to talk about since waaaay back when, 5 years ago, when we first got married and naively thought that all we had to do was stop trying NOT to get pregnant and we'd get pregnant. We talked about what we'd do with all the furniture that is in the spare room in order to turn it into a nursery. We talked about possible names, we talked about child care options, we talked about what the baby might look like, whether each of us wanted a boy or a girl.....I started reading "What to Expect When You're Expecting" again, which I also hadn't allowed myself to read since right after we were married. I can't remember a time when I felt so thankful, so happy, so hopeful and joyful....it was a magical week.

Thursday, Aug 27 - I was ridiculously sure of myself going into my second beta on Thursday morning. I knew that my levels of hcg were supposed to have risen at least by 60% in two days. I had calculated that meant my number needed to come back around 1050 or more, and I was honestly absolutely positive that I would surpass that number with ease. I wasn't even nervous. How are you this morning, the nurse asked me as I rolled up my sleeve. I'm FANTASTIC, I said, grinning like a cheshire cat. Supremely overconfident, and supremely naive and stupid, as it turns out. When my phone rang that afternoon to receive the results of the blood test, I was so excited to hear how my number had come back, and was anticipating going online to see if all the hcg charts still thought I was going to have twins. When Dr. G himself began speaking, instead of one of the nurses, I instantly knew it was bad news. He told me my level had only risen to 679. Not a good sign, he said. I could hardly breathe I was so shocked. I hadn't prepared myself AT ALL to hear bad news, hadn't even thought it could be a possibility. He went on to say that the level on Tuesday had been so high, and he thought it was possible that initially two embryos had implanted, but perhaps one of them had stopped growing, and that the other one was still fine. He said that they had definitely seen cases where that happened, and the remaining embryo went on to become a beautiful full term baby. That I shouldn't worry myself to death over the weekend, and that I should come back in on Monday for another blood test and an ultrasound to see what was going on in there, and hopefully my number would jump up and everything would be fine. I got off the phone, called R, and totally lost it. Was sure for about 3 hours that it was all over. Left work early, raced home to be with R who was also off that day, and laid in bed with him crying for over an hour. R is a steadfast rock of support in situations like these, and as he always does, he pulled me up out of it and helped me to see that there was every reason in the world to believe that it was just as Dr. G had said, our remaining embryo was strong and everything would be fine on Monday.

Monday, Aug 31 - after an eternity of time over the weekend, we went trembling into the fertility clinic for the 3rd beta. I was almost shaking I was so nervous. As I sat down in the chair to offer up my vein for the blood draw, one nurse asked the other, confirmed or suspected? My nurse answered, suspected, and then handed me a sheet of paper detailing the benefits of taking Methotrexate to dissolve ectopic pregnancies. What? Ectopic? huh? I hadn't even thought of that possibility until that very second, but gee thanks so very much for suggesting it. On the way down to the ultrasound room, I tried to explain to R why I was crying again, and why they seemingly suddenly thought our pregnancy could be ectopic, and then we both tried to figure out why they thought it prudent to provide us with the information and a consent form for methotrexate before we even had the effing ultrasound for christ sake. During the ultrasound, R stood there holding my hand while the doctor explained (not my beloved Dr G that morning, unfortunately) that although it was VERY early and they couldn't tell anything absolutely for sure, that she definitely saw what could very well possibly be, and most likely could maybe be, a pregnancy sac. But no, they couldn't rule out an ectopic pregnancy based on the ultrasound, bc it was really much too early, I was only 5 weeks that very day, and it's just so early to really tell anything definitively on ultrasound you see. Aaaaaarrrrrrggggghhhhh. R was steadfastly positive, as he always is, and focused on the fact that the doctor had ended on a positive note, "as far as I can tell, this is a pregnancy sac, and I would say that you definitely should NOT take the methotrexate at this point. We need to see what your hcg numbers look like this afternoon, and then we'll have a better idea of how we should proceed.." So, R and I both went off to work and I waited in horrible suspense for the next 4 hours for the fertility clinic's call. This time it was the nurse who called, but her news wasn't any more positive than Dr G's had been 4 days before: in 4 days, my hcg level had only risen to 713. She didn't offer any color commentary on the predictive nature of this number on our unborn child, but rather stated in a very serious tone that Dr G wanted to see me and perform an ultrasound HIMSELF in three days, and that he had arranged to meet me at the clinic on Thursday at 8:15, as long as that worked for my schedule. As if there were ANYTHING more important to me than this pregnancy! Sorry, getting my nails done at 8am, could Dr. G do 10, 10:30? yeah right.

Thursday, Sep 3 - I went by myself to the clinic this morning, feeling defeated and depleted. Dr G performed the ultrasound, and he was incredibly thorough. It took twice as long as it usually does. He said that he saw several cystic areas that might or might not be pregnancy sacs. He said that normally, at 5 and a half weeks, that he would expect to see white lines differentiating a pregnancy sac, which he didn't see on mine, and that he would also have expected the sac to be larger. The several areas that he saw in my uterus which MIGHT be pregnancy sacs were all quite small. Still, he said, knowing that this pregnancy is very much wanted, I want to give this every possible chance...let's see how the numbers come back this afternoon, and I want to see you on Monday, when you'll be 6 weeks, for another ultrasound. He said that at 6 weeks, on ultrasound he would expect to see a large pregnancy sac with a yolk sac clearly visible in it. If we didn't see that, and my numbers continued to creep upward, he would recommend starting the methotrexate. If there were any chance for this to be a viable pregnancy, he said we would have to see the numbers rise quite dramatically this afternoon, and we'd have to see that pregnancy sac with encompassed yolk sac on Monday. So, I left really feeling like there was very, very little hope. And more than that, feeling so terribly frustrated that this horrific suspense continued to drag on. The typical rollercoaster of infertility, only in a condensed way that I hadn't experienced before now. When the numbers came back this afternoon, 774, Dr G again called me himself, and said that given the lack of conclusive information from this morning's ultrasound, and the modest at best increase in my hcg level today, that he strongly recommended that I go ahead and take the metho injection. He told me that he felt there was almost no possibility that this pregnancy was viable, and that if we let it go on, there was a risk of my tube rupturing, if indeed it turned out that it was an ectopic pregnancy. He didn't feel there was any reason to wait and do another ultrasound on Monday. I cried, and called R, and drove myself bleary eyed back to the clinic. The metho injection is not only intramuscular, it has to be injected in two different injection sites in order to increase the absorption potential. Apparently the protocol for this is for the patient to assume the position, standing with trousers lowered and with palms braced on the examination table, while not one but two nurses armed with extra long needles face off behind you and stab you at exactly the same moment on opposite sides of your posterior. I had gotten intramuscular shots before when we did IVF, but R always gave them to me, and I always iced the injection site beforehand so that I never had to feel anything. Unfortunately ice wasn't part of the protocol this afternoon, and those two shots hurt like hell. I am proud to say that I didn't cry until well after the shots were over, when one of the nurses reached out and patted my arm and told me she was so sorry that she had to do it, and that she knew my heart was hurting worse than my rear end. That small act of kindness was too much for me, and I had to sit in the exam room with a box of tissues for several minutes before I could collect myself enough to walk out to the front desk, where I was told I needed to make a date for another two needles full of metho on Monday. That should make for a delightful Labor Day holiday - a trip around the beltway at 8 am to get two more intramuscular injections. Could this get any better?

So, there's the whole sad story. I feel completely wrung out now, and my eyes are are puffed up to the size of extra large marshmallows. Right now I wish more than anything that I could will my body to go ahead and get the mechanics of the miscarriage out of the way RIGHT AWAY. I'm told it could be two weeks or more before my body will decide it's finally time to expel the embryo, or materials of conception, or whatever I'm supposed to call it. I wish I could make it happen tomorrow, I would gladly stay here locked in my bed or bathroom suffering with cramps or pain or whatever may come, for hours on end, if I could only just get it over with right away. I can't stand the idea of walking around in this strange state. Still technically pregnant, but decidedly not. But like everything else about infertility, I have absolutely no control. My body will do whatever it will do, and I'll just be along for the ride.

Perhaps I will post more when this is all over. We're going to the beach in a week, I can only pray that I won't spend my one week's vacation this year dealing with the mechanics of an inevitable miscarriage.

Edited on 12/2 to add dates and corresponding beta numbers, purely for my own future reference:

8/25 - 637
8/27 - 679
8/31 - 713
9/3 - 776
9/7 - 507
9/10 - 324
9/15 - 91
9/22 - 0

Resurrection

2009-04-29T16:29:00.002-04:00

Strange to be back here again, yet, here I am. Thought I might as well start logging my thoughts on infertility again, as I've finally taken some action today, after a very long hiatus. I went back my beloved RE this morning, for the first time in almost 2 years.

It was a surreal experience, sitting in front of him and listening to him recite my 5 history from notes on his computer screen, "Clomid in 2004 and 2005 with no response....protracted IUI cycle in 2006 resulting in an egg reduction procedure and mild ovarian hyperstimulation....IVF cycle in 2007, 14 eggs retrieved, all mature, all 14 fertilized, half of them abnormally. unsuccessful. recommended another round of IVF with addition of ICSI and assisted hatching..."

I sat across from the good doctor feeling somewhat accomplished. I'm 80 pounds lighter than last I saw him. I told him that for the first time in my life I had been having "regular" (40-ish day long) periods. I told him I had been waiting for a miracle. He smiled and said that response was common, human nature, understandable.

I told him I had said the same thing to my ob-gyn 2 months ago, who promptly responded, "You are 38. You don't have time to wait for miracles. Go back to your RE as soon as possible. Make an appointment today."

It took me two months to work up the nerve to jump back into this. In large part, I'm absolutely dreading it. A smaller part of me is starting to feel hopeful again, after only one consultation. I think that is very, very dangerous. Dangerous, but inevitable.

In the almost 2 years that have elapsed since we were officially "in treatment", my personality has changed. For the better, in my opinion. Granted, I may have been in denial during that time. But, it was a far more pleasant existence, being off of the roller coaster. I was able to set all of the constant plaguing daily heartache aside for a while. As I've said before, infertility is a problem that never goes away and has no good solution, no matter how often you analyze it, no matter how many different ways you look at it and turn it around in your mind. It's exhausting to have it top of mind every day. I don't miss walking around with my emotions and vulnerability so very close to the surface. I don't miss bursting into tears for no reason whatsoever. I don't miss feeling pitiful and pathetic and like a failure every day. I am so very fearful of going back to that place, and being that person again.

For practical reasons, I'm also dreading the logistics of getting back into a treatment cycle. I'm working longer hours and have a much more demanding schedule than I have since we began "trying" all those years ago, and I can't quite imagine how this is going to work this time around. The idea of telling my colleagues that I can't schedule any meetings before 10am is laughable.

But, we had some heart to heart talks, my wonderful hubs and me, and decided that there will never be a good or favorable time for getting back into this - not financially, nor physically, nor mentally. We must make it a priority whether we like it or not, because the statistics are stacked against us. No spring chickens, we two.

So. Here I am again. Preparing for another ride on the roller coaster...

Has it really been 4 months?

2008-06-22T23:52:00.001-04:00

Wow, it's been quite a while since I felt I had anything to say on this blog that would be worth anyone's time to read about.

I guess the bad news is that nothing much has changed. IVF is still our only hope, and we still can't seem to commit to a plan for how to fund another try. I still feel like our time is running out. R turned 39 this month, which means I'm not very far from 38 now. Not the end of the world of course, doesn't mean pregnancy is impossible, but certainly doesn't do anything to improve our odds, either.

I suppose the good news is that I'm not as despondent about infertility on a daily basis as I have been in the past. I think that is because the longer we are stalled, the longer I allow myself to be apathetic about it, the easier it gets to....not do anything. I'd be lying if I said I was looking forward to being embroiled in a treatment cycle again, taking the injections, conforming our daily lives around the cycle, opening my heart up to hope again, bracing for the inevitable crash....I'm really dreading having to go through that all over again, actually. But still, if a big pile of money fell out of the sky tomorrow, I'd haul it straight to the RE's office and plunk it down, sign up for another chance.

We entertained R's family this afternoon and evening....had our usual Sunday afternoon cookout, as we do most Sundays in the summer. Today there were 15 adults, 7 children, and 2 dogs running around in our little house. It was a madhouse, of course, but we loved it. At the end of the evening, R's cousin asked if her 3 kids could take a quick bath before they left. They had to drive at least 45 minutes to get home, and she knew all 3 would be conked out in the car and difficult to harangue into the bathtub once they got home.

The sight of those 3 precious and precocious little ones in my bathtub pulled at me in a way that seeing them run around all day had not. As I helped to dry them off and muscle them into their 3 sets of clean and color coordinated PJ's, my main thought, of course, is that I should have been bathing my own children in our bathtub, not someone else's. I should have been putting PJ's on kids in a room decorated with zoo animals and ABC's, not in the room that serves as our "extra den" instead.

But remarkably, bitterness and self pity did not overtake me tonight, as they so often have in similar situations in the past. I feel a sense of hope about it all....although I can't say I know exactly why. Maybe because after all this time I still believe in miracles. Because I think R and I are good people, and because I still believe that good things do happen to good people. For tonight, that's enough reason to keep hoping.

Still here.....

2008-02-12T23:59:00.002-05:00

I confess that I have been avoiding this blog. And I have also been avoiding all of your blogs. I know, selfish, right? I can't help it. The IF blogosphere has really depressed me since the New Year.

We don't really have any concrete plans set in place in terms of 'trying' in the near future. My body has refused to cooperate with our desire to start a family for almost 3 and a half years now. Because of the PCOS, I don't ovulate, so there's no chance for us to turn up miraculously pregnant while trying on our own. For what it's worth however, I refuse to remain on birth control pills while in limbo. Instead, every 2 or so months I call my RE's office to get a prescription for progesterone to induce a period. For the privelege of this endometrial-cancer staver-offer I must submit to a pointless pregnancy test administered in the RE's office.

I went for one at the end of January. It was very, very strange. I felt like I didn't belong there, like everyone could see that I wasn't really trying and why was I wasting the time of the staff there. Just months before I had felt like that waiting area was my second home. I knew all the nurses by name. I felt productive and dedicated and hopeful when I was climbing in and out of the stirrups 4 and 5 times a week. When I went in January I felt like a fraud and an outsider. It was weird to feel so far removed from that whole 'sisterhood of cycling' thing.

I guess I was also feeling that way about this blogging community. I can't read the blogs of those who are pregnant. I know I don't have to justify that to anyone, even though it does feel really shitty to admit it right out loud. And for every happy preggy blogger, there seem to be as many heartwrenching losses in our community of late as well. Reading about the horrific pain that so many are in, particularly Mary Ellen and Steve after losing their triplets - it just makes me nauseous and sick. And in this limbo-land, reading all the other blogs of those who are back up in the saddle (and stirrups) and are earnestly, hopefully, dutifully trying again - those just make me feel like a lazy loser.

The fact is that our only, only, onliest hope is IVF. And we simply cannot afford it right now. Who knows when we will be able to do so? There's a potential recession coming. We've had unforeseen expenses over the last 6 months, smaller bonuses and tax returns than we were expecting, and the housing market continues to decline. So, I honestly don't know when the next opportunity might be for R's sperm to meet one of my eggs. Possibly not until next year, by which time R will be 39 and I will be 38. Lately I've allowed myself to think about the fact that it might just be too late for us. I have prayed and railed and asked God - are we not meant to be parents? I still have no answers of course.

I'm just trying to take things day by day. As of tonight, I'm caught up on all of your blogs, and although I probably won't be commenting as much as I have in the past, please know that I'm back and keeping up with all of you again.

For my own sanity, I'm going to try to post my thoughts more often here, and not just when I'm feeling particularly sad. I promise to blog some joyful things every once in a while, as I have SO many things to be thankful for. As melancholy as this post has come out - there is still much joy in my life. I'm trying very hard to concentrate on it!

Angel in Alabama

2007-12-10T13:38:00.000-05:00

Sometime last week, just a few short days after pouring out my heartache on this blog, I arrived home to find a package on my doorstep. It turned out to be an unexpected gift from Kellie, my angel in Alabama.

She sent me a beautiful little figurine, as well as the most inspiring and tear-jerking card you've ever read. Kellie's main message was this: I understand your pain, I'm sorry you're hurting, and there is reason to hope.

This unbelievably kind gesture from a woman 1,000 miles away who I've never even met - it lifted me up indescribably. It also brought on yet another freshet of tears - but not the same desperate kind of the past few weeks. These were tears to acknowledge that Kellie's words might? will? definitely will? come true: "K, you WILL be a mom."

This beautiful little figurine, with its little arms and hands outstretched, and its small face turned up to God - it's the last thing I look at before I go to bed each night. It is a heartwarming and much appreciated reminder to keep Hope alive.

Thank you Kellie, your gift means more to me than you will ever know!

Melodrama

2007-11-28T11:49:00.000-05:00

I wish I could say I've thrown off the pall of sadness that was cloaking me the last time I posted (just before Thanksgiving.) Unfortunately, if anything, it's gotten worse. I feel so.......vulnerable, I guess. Kind of fragile - like any little thing could send me into a crying, pity-partying meltdown.

I feel anxious all the time, and more than that, I've become aware that I seem to be constantly bracing myself for hurtful news of some kind.

I look at our little dog Murphy lately and all I can think is how wrenchingly sad it will be when he eventually dies. He's only 9 years old, and I'm not expecting him to go any time soon. But for some reason I cry every night when I cuddle up with him, and wonder how I will be able to get out of bed and go on with my life when he dies.

Every time we see friends I find I'm bracing to hear that they are pregnant (again.) Or when the phone rings my brain kind of winces, wondering if there will be horrible or sad news, or some other hurtful knowledge on the other end of it.

I feel needy and dependent. The slightest mood change in R has me spiraling into thoughts that he's going to leave me...if not now, someday. I've lost my faith in happy endings. I feel cynical. Empty, except for the tears that seem to be always right behind my eyes.

I hate myself for being this pathetic person. I'm so weak. I have SO much to be thankful for, and I have to really FORCE myself to recognize that on a constant basis. I would much rather sit around feeling ridiculously sorry for myself. All the time.

I'm also an ingrate. R took me out to a fabulous, expensive, special and romantic dinner for my birthday a week and half ago. All his idea. Instead of enjoying spending a special evening with him, and savoring time spent together (which is really the most important thing), and appreciating the substantive price tag of the bottle of wine and filet mignon, I cried in the night like a 5 year old because he didn't give me an actual gift to open. AAACCKK! I'm so not this person.

My God, I just read over this and it's so freaking melodramatic. Blech!!!! But, it's what I'm really feeling. Ugh. I don't know how to snap out of this.

I'm simultaneously looking forward to this Saturday, and dreading it with my entire being. I'm forcing myself to attend an adoption 'convention' in DC, where I'll attend seminars to get educated on the facets of international vs. domestic adoption, open vs. closed, costs, timeframes, etc.

I want to go, and learn, and understand our options. I'm also weighed down by the idea of it - overcome with sadness. I keep picturing myself wandering all over this huge convention surrounded by pictures of babies and children who need someone to love them. It should feel empowering to educate myself about our options. Instead it makes me feel like sobbing until I can't stand up straight.

********************

I just had to dash off the bathroom. R just sent me an email that yet another couple, who got married right around the same time that we did, are now expecting their first child. They think it's a boy.

By this point I think we infertiles understand each other. You know that of course I'm happy for them - thrilled they don't have the same problems that we do. They must be so happy! How perfect to announce their pregnancy right around the holidays. That's what I've always dreamed of! These two are such a wonderful couple and will make fantastic, smart, compassionate, responsible parents. I bet their child will be gorgeous! And, OF COURSE I'm glad they are pregnant. I wouldn't wish infertility on my worst enemy.

But the truth is, when I first read the email I instantly starting crying. My first thoughts were: Poor me! Why not us? That should BE us! Oh God, please help us, our hearts are breaking! I don't know what to do anymore.

Happy Thanksgiving

2007-11-22T00:23:00.000-05:00

Well, I don't feel at all worthy of this, but my dear Jenna has suggested that I belong on her list of Distinguished Blogger Flame of Fortitude honorees. Although I humbly appreciate her tag - I've been feeling so un-thankful and un-thanksgiving-ish this week that it feels counterfeit to even post about this. Ugh.

I've been feeling so sad this week - I can't seem to get into any kind of holiday spirit. Usually by this time I'm feeling warm and fuzzy and spiritual and reflective and all of that. But this year I feel like I'm digging waaaaay down and the warm fuzzies just aren't coming. I'm going to try VERY hard tomorrow to dredge up some thankful-ness and put on a happy face and appreciate time with my family. But it won't be as natural as it normally is. I keep breaking into tears for inappropriate reasons and at inconvenient times. I had to race off to the bathroom several times at work this week before any one saw me having a "moment". I really, really hate feeling this pitiful.

I hope to post something much more cheerful, or at least productive, after we get back from Thanksgiving. Hope all of y'all in the US have a wonderful Thanksgiving holiday tomorrow with your families and friends!

Hello again!

2007-11-14T14:53:00.000-05:00

I can't believe it's been over a month since I posted anything here - I'm sorry I've been such a silent blogger! I have, however, been diligently keeping up with all of you. There's been happy news out there, as well as deeply, deeply sad. I've been rejoicing and grieving right along with all of you.

So firstly, Congratulations to Faith! I've been reading along with her since before her successful IVF cycle. It's hard to believe it's been 9 months, and then some! Go and see her beautiful new boys, here.

And if you haven't already been over to visit Cam or Ann during this soul-crushingly sad time, please do - and if you're behind in your reading, like I was last month, go and give some love to ISOMorning Sickness, too. They all need our support now more than ever.

So, you may have guessed that since I haven't been fervently blogging and posting loads of detailed accounts of treatments lately, that we're taking a break. Oh the consternation that is bound up in that phrase: taking a break. Usually in our case all breaks have been physician-mandated ones - wait for a cyst to go away, wait for my lining to thin out, take another cycle of BCP's, etc. This time however, we mandated the break.

We were supposed to start IVF#2 when we came back from our annual Outer Banks beach vacation the first week of September. The several thousand dollar water-pipe repair emergency the second week of September put the kibosh on that month.

So then we were supposed to start in October.....but in the beginning of the month I suddenly realized the origin of the feelings of dread that I had been unconsciously carrying around for several weeks: I was dreading starting a new cycle. I had fallen into a comfort zone, pretending the problem didn't exist, or I was at least relieved not to be consumed by dates and calendars and shots and worries of impending doom for a while. I just blithely ignored the irony of taking my birth control pills each and every night, having been given license to do so by the perpetually pending cycle that was going to start any-minute-now. More than anything I realized how effing tired I am - bored, I would even say - with the whole being-infertile thing. I'm tired of being sad, I'm tired of agonizing over every cycle, I'm tired of worrying about where the money will come from to pay for treatments, I'm tired of structuring and scheduling every other part of lives around the unknown and un-plan-ahead-able requirements of treatments. I'm tired of saying to myself on every holiday or otherwise momentous occasion: I wonder if I'll be pregnant by this time next year? I'm tired of answering the question "Do you have kids?" with an answer like "Not yet!" I'm so, so, so tired of being the person that everyone feels sorry for. I'm even more sick and tired of feeling sorry for myself. I'm tired of thinking about fertility all the time, every day, every week, every month. I'm tired of feeling a sharp pang to the heart when I hear that someone else I know is pregnant, with their first, second, third child. I'm tired of waiting for my life with children to begin. I'm tired of hanging out with other people's children and wistfully thinking of the ones we don't have yet. I'm tired of thinking "someday." I want someday to be soon, now, today. I'm tired, dare I say it - of even talking about this! None of what we have been through in 3 years has made one iota of a difference to the bottom line - Nothing has changed in 3 years: I'm still not pregnant and we still don't have a child.

R and I had several long discussions in October about what we should do - or, I guess more accurately, when we should do it. We decided that it would be very difficult to face the emotional, financial, and physical stress of doing a cycle so close to Thanksgiving and Christmas. I was picturing myself fighting the throngs of people in the malls with bags of gifts and having to duck into messy public restrooms to stick myself with needles. Or being at Thanksgiving dinner all hopped up on hormones and bursting into tears for no outwardly apparent reason. Or receiving the crushing, blackening news of a failed cycle - malfunctioning body, money down the drain, yet another disappointing setback - just before Christmas.

I just didn't think I - we - could handle it. So we've decided to wait until January to embark upon IVF#2. It wasn't an easily reached decision however. At least, not for me. I'm all wound up about the fact that three days from now I'll turn 37. Only 3 years left until I'm 40. I can vividly remember when my mother turned 40, and I thought she was ancient. I don't feel ancient yet, certainly. But when I let myself contemplate the full weight of being thirty-seven years old.....I feel a sense of panic, like there's a rising tide that is swelling up faster and faster, and my legs are buried in the sand. I feel an overwhelming sense of urgency to do something, anything, just do it quick because time is running out! But yet, there's nothing else I can do. Is there?

Well, that actually brings up an issue for another post - I went to an adoption fair yesterday at work. I'll devote an entire post to that emotional event, next.

In other news, I've decided that during this non-cycling down time I should concentrate on eating healthier and losing some weight - getting more fruits and vegetables into my diet, and cutting out bad fats and bad sugars, etc. I decided to try Weight Watchers, for the first time in my life.

I've struggled with my weight my whole life. I went on my first diet when I was 9. I've had a lifelong love-hate relationship with my bathroom scale, let me tell you.

Anyway, one of the reasons I've always been turned off by Weight Watchers was the thought of those gruesome in-person Weight Watchers meetings where all the middle-aged ladies in their elastic waist pants congregate in the fellowship hall of the local baptist church and celebrate losing 1/8 of a pound every week and swap recipes for lightened up versions of tuna casserole. Blech!!!

So, maybe the fact that I finally decided to try this has something to do with the fact that I'm finally accepting my OWN middle-agedness? Or maybe it's because a co-worker told me she hates the idea of going to meetings too and that you can join 'anonymously' online. Who knows? But for better or worse I joined in October, and I've lost 16 pounds and one pants-size so far. Not bad. It hasn't really been that hard to adhere to - that really surprised me. The thing I really like about Weight Watchers is that you can eat anything - anything at all - and it doesn't cause a collapse of your whole diet/system/plan so as to send you into a tailspin and cause you to immediately throw in the towel and begin planning for when you'll RE-START at some point in the future. That is usually my downfall with diets - especially when I was doing Atkins years ago. One slice of bread and you were completely ruined! Knocked out of fat-burning ketosis by one bite of mashed potatoes! It would be days before you could get your bodily chemicals back into the precise balance required to burn the fat and lose weight! There's simply not enough wiggle room in a diet plan like that - at least not for me. It leads to the pound-packing mentality of - "Oh well, I've already gone off the plan today by eating that Snicker's mini from the Halloween candy bowl. It's all downhill from here. Might as well 86 that salad I was planning to eat for lunch and have a grilled cheese instead." But Weight Watchers is much more forgiving. If you eat the Snickers mini, it is not the end of the world, or even of your day. Just means you must adjust your food intake for the rest of the day to compensate. It makes for faaaar less guilt than I'm used to shouldering when it comes to food. This is sad to admit, but I've become accustomed to feeling guilty every time I eat something - no matter what it is. I think Weight Watchers helps people like me to let go of at least a little of that food-guilt, and for that reason I think it's been good for me so far.

But the season that is by far my biggest downfall during this time of year, the thing that strikes fear in my dieting, salad-munching, saturated-fat-avoiding heart, is well upon us. Thanksgiving, you ask? Christmas? Hanukkah? Kwanzaa? Nay, nay - even worse, and MUCH more insidious and long and draaaaawn out: Football Season. Aaaaaaggggjhhhhhhh!!!!

Every Sunday whilst watching the Redskins (lose) I'm assaulted by chicken wings, beer, chips, cheese dip, brownies, beer, chips, pizza, beer, chips....did I mention beer and chips? I'm a sucker for beer and chips. I think I could subsist on beer and chips alone, if the case arose on a deserted isle.... And the worst part is that all this food is usually at my OWN HOUSE! We tend to entertain very frequently during football season. So, invariably, if I'm tempted to go 'off-plan' as the Weight Watchers say, it's on Sundays.

So instead of serving the good stuff for all of our friends, and then forcing myself to either abstain or cry into my celery and carrot sticks all afternoon, I've endeavored to find some recipes for less fat-laden, but still football worthy things to serve on Sunday afternoons.

To wit, the delicious and road-tested recipes cut-and-pasted below (from the Weight Watcher's website.) Everyone at our house has enjoyed these, hope y'all will too. Enjoy!

(For anyone else who happens to be counting Weight Watchers Flex Points, the chicken wings recipe makes 4 servings at 4 points per serving, and the chili recipe makes 10 servings at only 1 point per serving, not including the baked tortilla chips you'll include for dipping.)

Buffalo Wings with Blue Cheese Dip

Ingredients
1 sprays olive oil cooking spray, or enough to coat sheet
12 oz uncooked skinless chicken wing(s)
1 1/4 oz Old El Paso Taco Seasoning Mix, or similar product
1/2 cup fat-free sour cream
2 Tbsp blue cheese, or gorgonzola, crumbled
2 Tbsp fat-free skim milk
4 medium stalk celery, cut into 2-inch pieces

Instructions
Preheat oven to 400ºF. Coat a large baking sheet with cooking spray.

Place chicken wings in a zip-close plastic bag, add taco seasoning, seal bag and shake to coat. Transfer wings to prepared baking sheet and bake until cooked through, about 18 to 20 minutes.

Meanwhile, to prepare dip, whisk together sour cream, cheese and milk.

Serve wings with dip and celery on the side. Yields about 3 wings, 3 tablespoons of dip and 1 celery stalk per serving.

Chili Party Dip

Ingredients
15 oz canned turkey chili without beans
8 oz fat-free cream cheese
4 oz canned jalapeno peppers
1 small onion(s), finely chopped
1/2 tsp hot pepper sauce

Instructions
Combine all ingredients in a saucepan.
Cook over medium heat, stirring frequently, until cheese melts, about 10 minutes. Yields about 1/4 cup per serving.

Misinformation

2007-10-10T11:13:00.000-04:00

Did y'all see the Oprah show yesterday (Tuesday) about infertility???? I tivo'd it and watched it last night. I was prepared to get riled up, based on what happened when our friend Jenna, bless her heart, was on last time.

But geeeeez, what a train wreck!! I found both segments to be TOTALLY infuriating. What an unbelievable dearth of detailed information!

The first segment was about a couple who went to India to hire a surrogate. The issue the show concentrated on was whether this cottage industry of surrogate Indian women having babies for white American women constitutes exploitation. The facts: cost of hiring a surrogate in the US: upwards of $80K; cost of hiring a surrogate in India: ~$12K (presumably not including travel expenses); amount of money received by Indian surrogate mother (which is purportedly more than most women earn over their lifetime): ~$6-$7K. Oprah stated that in her opinion this was not exploitation but rather women helping other women across the world - the American woman gets what she most desperately desires and otherwise could not afford to pay for in the US, a biological baby. The Indian woman receives what amounts to nothing short of a transformative amount of money - enough to drastically improve her family's living conditions, quality of life, and to ensure a bright future for her children by providing them with higher education. Personally, I agree with Oprah on this one, but can nevertheless understand the controversy.

However, there was absolutely NO background given about the American couple and exactly what their specific infertility diagnosis was. They merely stated that they had been "trying" for 3 years, and had spent a total of ~$30K so far. This is troubling because I believe it's a common misconception (no pun intended) that surrogacy is a widespread solution to general infertility. However, this is the exception rather than the rule.

As I was watching, I longed for the couple to share more about their personal experience - what was their diagnosis? Why did their doctor believe that surrogacy would be a viable option for them? What treatments had they tried and failed previously? There were no details given about this. I was trying to imagine that I was still a smug, ignorant, not-yet-trying-to-get-pregnant-and-so-have-no-clue-of-what-could-go-wrong woman. What might I take away from the segment? That even if I eventually discovered I was having trouble getting pregnant, that there was no need to worry, bc I could always get a cheap surrogate in India. Not to be too crass, but that might very well have been the main take-away from that whole piece for some people!

So, as if that part of the show wasn't bad enough, the next segment was an interview with Alexis Stewart, daughter of Martha. Now, I'm not a fan of Alexis' anyway, just based on listening to her awful radio show on her mother's Sirius channel. At least from her radio persona, she comes across as a spoiled, foul-mouthed, ill-mannered brat of grown woman. Not completely surprising, given who she is, imho.

However, I'll start with the positive: Alexis did make a good point in the top of the segment as to the illusion that celebrities create by having children late in life, and that this creates this false sense of security for women, as in, "Hey, Halle Barry can have a baby in her 40's, so I don't even need to start worrying about my own 'biological clock' until my late 30's at the earliest! If celebrities can do it, anyone can! Great!" I totally agree with Alexis on that point, and also that it is really frustrating that celebrities won't own up to the fact that they are using some type of assisted reproductive technology in order to have these child bearing successes so much later in their lives. No one ever admits to using donor eggs, which perpetuates the myth that one's own fertility can and will remain viable into the 40's and even 50's. This lack of acknowledgement on the part of those in the public eye is only continuing to contribute to the shame and pain of the infertility struggle that affects so many of us today. So, Alexis hit the nail on the head with that, as far as I'm concerned.

BUT, what struck me about the rest of her interview was how very misinformed she herself is - even after having undergone a year of infertility treatment. How is this even possible? I myself feel like I could sign up at the nearest med school and teach a fucking class on reproductive endocrinology. After the first year of this shit, I was intimately familiar with the menstrual cycle - the terms used to describe the process, what they meant, the length of each part of the cycle, all the hormones involved, the possible drugs that could assist and what effect they had on the cycle, not to mention all the terminology used to describe my husband's part of the deal, etc., etc., etc., ad nauseum, ad infinitum.

So when Alexis picked up a Lupron needle and said, "So, you take this for the first 2 or 3 days of the month, and it's very painless, and you take this drug to prevent endometriosis.", I wanted to jump through the TV screen. Are you kidding me???!! But my first issue with her comments are that she also didn't share any details of what particular infertility diagnosis she was struggling with. She didn't even say that she was undergoing IVF. Rather, she said that she spends $28K per month on her infertility treatments. As anyone who has ever undergone any type of ART knows, it's physically impossible to complete one IVF cycle EVERY SINGLE MONTH. So all I can think is that her doctor is robbing her blind because she's the daughter of a very, very rich woman. Whatever.

That doesn't bother me nearly as much as the misinformation she was spouting. How about this one: "Yes, so at my age, you tend not to grow very many eggs, so you have to take these drugs in order to stimulate egg production.", or this one, "Over the course of this year I've had around 5 or 6 eggs implanted in me, but none of them have stuck.", or even this: "Well, at a certain point if all of this doesn't work, I guess I'll have to look into egg surrogacy."

I know that all of these miscues when taken alone might not seem like a big deal, but it REALLY, REALLY bothered me that she didn't seem to even care that she wasn't being accurate. I think that there is such a lack of real information out there in the spotlight on infertility, and I really feel like Alexis Stewart should have felt more of a responsibility to educate the millions of viewers of the Oprah show with real and accurate information on her struggle. I think Oprah (her producers) bear a part of that obligation as well. I feel like everyone involved with that show fell woefully short of their obligation and responsibility.

I for one, would much rather hear (see) an interview with a well-informed, prepared-with-details non-celebrity regular old person struggling with this problem - like you or me - than a celebrity who was either unprepared and ill-informed, or perhaps not even willing to share the critical details that define this experience.

To be candid, the whole show just made me angry. It barely, barely even scratched the surface of this complex and seemingly epidemic struggle that impacts more and more women and couples across the world every day. I'm really disappointed.

But, what did y'all think?

Three Years

2007-10-03T11:59:00.000-04:00

Happy 3rd Anniversary, baby! My dearest darling, my big strong handsome man, my strength and solace. Three whole years we've been married, and I still wake up every morning excited to spend the rest of my life by your side. I love you more than all the stars in the skies and more than all the fishes in the sea. Here's hoping that this will prove to be "our" year, and we'll finally make our dreams come true, together. I love you!

****Our actual anniversary was yesterday, but for some reason I couldn't get this post to go through yesterday.....

Back to Reality

2007-09-20T16:12:00.000-04:00

We're back from our beach escape! One week in the Outer Banks is never, ever enough. Every year I ask myself if there's any humanly possible way that we could manage to stay for 2 weeks the next time we go. I've never taken 2 weeks off in a row - seems impossible but I know that there are some who swear by 2-week vacations.

The week before we left the mean weatherman was predicting rain for 6 of the 7 days we were to be there, and I was freaking out. However, beach weather is always fickle, and wouldn't you know we managed to somehow luck into perfect weather every single day! Never rained so much as a drop until Saturday morning as we were packing up the car to come home. Just how I like it!

We ate and drank sinfully, luxuriated in the sun, swam in ocean, pool, and hot tub, romped in the surf with our dog, played golf, went kayaking (Ok actually only R played golf or went kayaking, I concentrated on the luxuriating in the sun part), and drank many, many, many cocktails on a daily and nightly basis.

We also went on a lighthouse sightseeing mission one day towards the end of the week: we decided to drive the 130 miles from the northern most part of North Carolina's Outer Banks, where we were staying, all the way down south and across the ferry to Ocracoke Island. It took us all day, but we saw all four lighthouses most often associated with the Outer Banks: Currituck Light, Bodie Island Light, Cape Hatteras Light, and Ocracoke Light. It was quite an adventure!

Anyway, now that we're home, all I can do is pine away and wish we had never left the beach!!! Siiiiigghhh.....

Compounding my lack of enthusiasm for returning to reality, we came home to a leaking water pipe in our front yard. Actually, on the second day of our vacation, our neighbors called R's cell phone to report that they had seen a "small lake forming in our front yard" and they wondered if we'd like them to call the water authority to have our water turned off until we came home? Um, yeaaaah, that seems like a wise course of action! I began to fret over this lovely piece of information until R reminded me that there was absolutely NOTHING we could do about from North Carolina, and as such, we shouldn't ruin our entire week's vacation worrying pointlessly over it. He was right, and I tried to put it out of my mind for the rest of the week. (yeah right)

But, now we're REALLY back to reality, and the repair people are coming tomorrow morning to excavate the old pipe (all the way from the edge of our property at the street, through the yard, through R's perfectly manicured grass, through our borders with impatiens, otto luyken cherry laurels, hosta, etc.) and then install the new one.

Isn't it fun to spend $4,000 the weekend after you get back from your annual vacation? Especially when it's 2 weeks before you were supposed to spend $10,000 on your upcoming IVF cycle??

Given this state of affairs, R and I made the somewhat difficult decision last night to postpone our IVF cycle for at least a month. We'll need at least that long to determine how to scrounge up the necessary sack of money to proceed. It's really the only thing we can do. Having running water in the house is not exactly a luxury.

Sooooo, instead of starting the Lupron injections this Sunday, as I had been planning, I probably won't be starting them until sometime around Halloween. But golly gee, in the grand scheme of things, what's another month? We've already been at this for 35 months. Hell, might as well make it an even 3 years.

Just checking in....

2007-09-04T15:13:00.000-04:00

Well, I have absolutely nothing of interest to report, but was feeling delinquent for not having posted anything lately!

We're just killing time until our vacation to the Outer Banks in NC next week. Woooo-hoooooo! So, hum drum, ho hum, bring on the beach vacation and accompanying cocktails! I'm soooooo ready for a vacation, I can't even tell you.

Did I tell you that my master plan of manipulating the birth control pills to time perfectly with the end of our vacation was foiled? Curses!! Dr. G said that I couldn't stay on the BCPs for 5 consecutive weeks, because the risk of over-suppression was too great - especially for a long-responder like me.

So, I have to take 2 whole months of pills. Boo hiss. Luckily the first pack ended last week, so I'm getting my blasted period out of the way this week. The good news is that I won't have to contend with a period whilst swimming in ocean, pool, or hot tub next week, nor will it cramp our opportunities for vacation er, romance. Thank God!

Bad news though, is that instead of being able to start stims IMMEDIATELY upon returning home from vaca, I'll have to wait an additional 3 weeks. You know that doesn't set well with my immediate gratification driven psyche, but what can I do?

I guess that does give us a stay of execution in terms of writing the enormous check to pay for this next round. So that's good.

Anyway, just wanted to say that I'm still here, and still keeping tabs on each of your blogs. Wishing all the best for each one of you!

Now what?

2007-08-17T12:48:00.000-04:00

R and I have been going around and around the mulberry bush, as they say, on what action to take next in trying to start our family. After many days of soul searching and lots of knock-down, drag-out tearful conversations, I think we have finally have a mutually agreeable plan, at least for the very near future.

The crux of our difference in perspectives is this: R is tired of watching his wife go through endless days and nights of shots and doctor's visits and emotional highs and lows. He is worried about the emotional (and physical) toll that 6 future cycles of IVF (if we sign up for Shared Risk) might have on my emotional well-being, on my very personality. He's ready for us to be parents, now. He is interested in pursuing something that offers certainty and security in terms of an outcome. He is frustrated by the unpredictability of IVF. When considering the prospect of spending over $20 thousand dollars, I think he feels much better about signing up for something that has a 100% chance of putting a baby in our arms at the end of it.

I, on the other hand, am clinging desperately to the idea of having another chance at a biological child, and pursuing that opportunity as quickly as possible. It's the only thought that keeps me from being well and truly 'depressed', as a matter of fact. I'm just not ready to let that dream go. I feel really desperate and out of control; I'm not sure how to change or channel these feelings.

Our endless and frustratingly circular conversations over the last week stemmed from the fact that I'm scared out of my wits that we are heading down a path that will breed resentment in the future. If R feels we should abandon treatment and pursue adoption, and I go along with that, will I wake up 10 years from now resenting that I didn't "try harder" or insist on further opportunities to try for a biological child? If I want to sink a huge amount of our money and our time into 6 further IVF cycles, to the tune of $22K, will R resent me when monthly financial decisions are impacted as a result of this expenditure? Or, if all 6 cycles fail, and the money has been refunded to us, will R resent the fact that we've then "wasted" potentially 18 - 24 months and we're at the starting gate to adoption at ages 39 and 41, respectively?

Bless R, for he is unbelievably supportive and open minded and kept reiterating that in spite of his opinion about being ready to move on to adoption, he respects the fact that it's my body, and will support whatever I want to do next - more treatment or otherwise. Ack! Why didn't I rejoice in this response? Because I want to come up with a plan that makes both of us happy and leaves no room for questioning or second-guessing or resentment at any point in the future. And that is IMPOSSIBLE. There is NO GOOD ANSWER to this dilemma.

From a financial standpoint, we've decided that we simply cannot afford to shell out the full amount required for Shared Risk right now. In the spring when we both receive our annual work bonuses, we could conceivably fund a $20K payment - either for a Shared Risk IVF treatment plan, or for adoption. But not until then.

However, we have almost $4,000 worth of insurance coverage left. If we did one more cycle in the pay-as-you-go format, after adding in all the "extra" treatment options Dr. G recommended (ICSI, Assisted Hatching, etc.) we'd need to come up with about $7K (not including the drugs, of course.)

I almost come out of my skin contemplating the idea of waiting for almost 9 months to try again. 9 months is a lot of time to "waste" when you are trying to get pregnant, especially when you are about to turn 37.

Ultimately we've decided to come up with $7K and try again as soon as we get back from our beach vacation. I'm on BCPs now, so if all goes as planned, I'll likely be starting stims around the middle of September.

I don't know what we'll do if this cycle fails. Wait until spring to try to find $22K (in addition to the $7K we just blew)? Abandon treatment and begin pursuing adoption? I don't know. But I've accepted that I can't make decisions right now based on what may or may not happen in the future. We can only make one decision at a time, based on the current situation and circumstances. At this moment, doing another pay-as-we-go cycle seems like the next right step. Maybe I will second guess this decision. Maybe not.

I'm scared to death that it won't work, again. I'm terrified to think that this could be our last attempt at a biological child. Right now I'm trying very hard to "relax" (yeah right), and am hoping to enjoy our vacation in a few weeks.

Syringes and needles and vials, oh my!

2007-08-12T23:58:00.000-04:00

Late last week I decided that I was tired of paying for the little miniature Sharps containers the pharmacy keeps sending me, so I decided that in order to reuse them, I would empty all the full ones I have (yeah, I'm stockpiling full Sharps containers, and I know I have a problem) and put the contents into a recently emptied extra-giant sized laundry detergent container.

So, I dragged all of my bursting-at-the-seams Sharps containers into my kitchen and dumped everything out onto my kitchen counter. (Yes, I know that seems sort of unsanitary, but I reasoned that I could bleach the kitchen counter afterwards...) Anyway, the more I dumped, the more morbidly fascinated I became. I felt a perverse sense of accomplishment looking at all of those spent vials of medication and used needles. (Yes, I know I'm cracked.)

Soon I found myself carefully sorting through the contents, almost feverishly piling syringes on one side, needles on another....

This, I thought, is what hundreds of needle pokes looks like. This is what ONE IUI and ONE IVF looks like. This is what thousands of dollars worth of drugs looks like.

And above, you can see for yourself what it looked like.

For the as yet uninitiated, clockwise from the top left: Empty vials of Menopur, progesterone in oil, and hCG; empty Follistim Pen cartridges; used Lupron needles; used needles; used Follistim Pen needle caps; and used syringes.

Planning for next time

2007-08-12T22:43:00.000-04:00

So I managed to get in to see Dr. G this past Friday. He called me on Tuesday evening, the day I got the beta results. He said that he was very sorry that this cycle didn't work, and suggested that we get together as soon as possible to talk about what we could do differently the next time. He suggested meeting on Friday at 2pm, and of course I readily accepted. What a saint.

He recommended several changes for next time: he thinks we should try to shorten my stim as much as we can, bearing in mind that I'm prone to hyperstimulation. Apparently the vast majority of patients have stim somewhere between 9 and 14 days long. Mine was 20. He wants to see if we can shorten it down to around 10-12. He believes that the long stim MAY have resulted in some of my eggs being post-mature. He thinks that may have contributed to our poor fertilization rate. The plan for next time will be to start me off right away with the highest dose of Follistim that I was on last time - 225ius. He'll watch my E2 level closely, and if it takes off immediately and looks like we're headed for hyperstimulation, then we'll immediately back down the dose. But if all goes well, we'll hit the old ovaries with the higher doses right away and see if we can get them to perform in a shorter time period. The hope is also to get more eggs this time around. Dr. G said 14 was great, but 20 would be better.

All 14 eggs they retrieved this time were mature. He said that was great, and was a sign of good egg quality. Of those 14, only 11 fertilized, and 6 of them fertilized abnormally. I'm sure I learned this in some long forgotten biology class, but when the sperm fertilizes the egg, the newly formed embryo is supposed to "kick out" the extra set of chromosomes. In 6 of our embryos, that didn't happen, and so they had 3 pairs of pro nuclei present. Dr. G explained that this could EITHER be caused by more than one sperm entering the egg, OR it could be an egg quality issue. He thinks it was the latter, in this cycle, but he thinks the quality issue can be attributed to the post-mature state of some of my eggs due to the long stim - NOT an overall age-related egg quality issue. So, his second suggestion, to eliminate any possibility of having more than one sperm enter each egg next time, is to do ICSI (for anyone not familiar, Intra Cytoplasmic Sperm Injection).

His third suggestion is to perform Assisted Hatching on our embryos next time around. He explained that this COULD be the reason that our gorgeous, 8-celled, compacting embryo didn't implant this time around. Perhaps it had a little trouble hatching in time to implant?Interestingly, Dr. G explained that although studies have shown no measurable benefit of performing Assisted Hatching on embryos of couples undergoing their first IVF cycle, the data does show that it helps in subsequent cycles. So, I guess his theory is that we might as well give them as much help as we can, and apparently with their embryologist's sophisticated and practiced techniques, there is little danger of harming the embryos when they "chip" away part of the "shell" or zona pelucida before the transfer.

I think it is really mind blowing - all of these procedures they can perform (ICSI, Assisted Hatching, etc.) on these tiny few-celled embryos. I can't imagine being the embryologist responsible for inserting a single sperm into a single egg cell?!?!?! It's almost like science fiction.

What's even more remarkable, in my opinion, is that "natural" conception and subsequent birth ever happens at all!! Every star and planet has to be aligned and every cell in your body and your partner's has to do EXACTLY what it is supposed to do at exactly the right time in exactly the right way......when you think of all the things that can go wrong, it makes you wonder how we managed not to go extinct before the advent of medical intervention! The deeper my knowledge of fertility issues, the more I'm convinced that every child is indeed a true miracle.

So, anyhoo, now the big freakin' question is how the frick we're going to pay to continue with this shit. We only have about $3,000 worth of insurance coverage left. If you add in all the costs of the "extras" Dr. G recommends next time around, we'd have to cough up about $10K to pay for a single cycle. (Plus, we'd have to pay $2,500 for a subsequent frozen cycle, should we be so lucky as to end up with embryos to freeze, of course.) By contrast, $22K would buy us 6 further attempts and/or a guarantee of our money back. We've been talking about it, and we're leaning toward Shared Risk as the logical choice. But $22K is a significant amount of money - do we finance it with a personal loan? Should we borrow from our 401K plans? Should we borrow against the equity in our home? Honestly?...We don't really want to do any of those things, but at some point we're going to have to make a decision and move forward.....

As luck would have it, Friday when I met with Dr. G also happened to be the day that my period showed up. So, he told me I could go ahead and start the BCPs if I wanted to. No pressure though - he said we could "manipulate" the pills in order to start the Lupron whenever I wanted to. We're going to the beach the second week of September, and there's no way in hell I want to be dealing with either a period or Lupron shots while I'm on vacation. I intend to be blind drunk the entire time. So, at this point I'm thinking we may be ready to start the Lupron around the 3rd week of September. We'll see. I guess it depends on how long it takes us to figure out the financial part of the equation.

Sooooo, I'm still obviously very disappointed that we're not currently pregnant. But, thanks to the upbringing of my two wonderful parents I'm a fairly resilient person. I think I'm over the bulk of rage and bitterness that swept over me for most of last week. It's not the end of the world, for pete's sake. It's just another failed cycle. It sucks, but we'll try again, that's all. The way I figure - if no one is dying, then it's a pretty good goddamn day. Losing a parent to cancer has a way of helping to put life's trials into perspective. This is hard. Really hard. But R and I are still here, still putting one foot in front of the other, still loving and laughing and enjoying each other and dreaming of the future. I keep trying to focus on my innumerable blessings, and that really seems to help.

Negative

2007-08-07T15:58:00.000-04:00

As expected. Still didn't make the news any easier to hear.

I feel like an empty shell. Metaphorically, emotionally, physically.....My heart feels permanently broken. But I know it isn't.

And in spite of being just SO fucking sick and tired of all of this shit, all I really want to focus on is trying again. I don't want to hear - oh you should just take some time and grieve and think and reflect, blah, blah, blah. No, I'm all out of patience. I'm all done with taking breaks and wasting precious time. I'll be 37 in 3 months. I want to start another cycle now. Today. This very instant! That's the only thing that would make me feel any better. Plowing ahead.

So you can imagine how I wanted to leap through the phone and strangle the receptionist when she told me in a semi-snotty tone that the earliest I could get in to see Dr. G to talk about what went wrong and what we can do next is August 31. There's no WAY I'm waiting an entire month. I emailed my nurse and begged her to cram me into Dr. G's schedule anywhere she could. I would meet him in the parking lot, call him on his cell phone while he's sitting in beltway traffic, meet him at 6am,9pm, the middle of the flippin' night, whatever it takes, just get me an appointment sooner than a month away!

I thought I had prepared myself and all I would feel today is more anger, more bitterness. Interestingly, I mostly feel sad and sorry for myself right now. Not angry, so much. More pitifully disappointed. I bet more of the lovely rage I've been experiencing will be back tomorrow though.

I also don't feel like "talking this out" with any of my best friends like I usually do. The only person I want to talk to is R, and he won't be home from work for another couple of hours.

What is there to say anyway? This sucks. That about sums it up.

Hope's on her way out

2007-08-05T22:23:00.000-04:00

Well, it's 13 days past my 3 day transfer, which translates to 16dpo, and nary a second line has been spotted. I think it's safe to say at this point that it's all over but the cryin'. It's been more than enough time to have seen a positive result from an HPT, but of course I'll go for the official blood pregnancy test on Tuesday.

My rage has sort of ebbed and flowed this week. I have good moments and bad. Today I had a pitiful trip to the grocery store - is it me or are there more pregnant bellies and mother-child parades per square foot at the grocery store than any other place on earth? Except for maybe, Disney World??? I was overcome and swiping tears off of my face in the frozen food aisle. I'm sure the other shoppers thought I was a wackjob.

But, I'm still glad I've handled things the way that I have - testing everyday so that there was a gradual and incremental grieving period happening each day. I still maintain that I couldn't have handled letting hope blossom and grow stronger and stronger for two whole weeks, having more and more fantasies about being pregnant, and then have it all crushed with one phone call. It's too much suspense, too much build-up, too much riding on that one call that I'd surely hyperventilate or pass out or scream or all of the above. As it is, knowing full well that Tuesday's news will be negative - I STILL don't think I can bring myself to answer the phone when the nurse calls. I decided a long time ago that I was going to let it go to voicemail, so I wouldn't have to make any conversation or say anything at all to the nurse.

I'm sure that Tuesday will still be very difficult, but I think, I hope, I've already processed a lot of my anger and sorrow over the loss of this cycle - which, I feel compelled to iterate, is just a nicer way of saying that our two embryos, our two maybe-babies have died. So, maybe I'm fooling myself, but I don't think I'll completely lose it when I get the news. I could be wrong I guess.

One small glimmer of an idea that is helping me to move on already, is that I just figured out that we may not have to make the big Shared Risk $20+ K payment immediately in order to continue treatment after this. I remembered that we should have at least a few thousand left of insurance coverage, since we didn't need to use anything towards freezing any embryos this cycle. So, I'm pretty sure that to do another cycle we would only need to come up with $4K or so, which is much less daunting than coming up with $20K. So that gives me hope that we can IMMEDIATELY start a new cycle and try again.

After 3 years of this, that's the only thing that makes me feel any better, is the idea that we can pick ourselves up, dust ourselves off, and try again immediately. I think part of the dread I was feeling about possibly failing this time around had to do with the knowledge that we'd likely have to wait for 6 months while we tried to scrounge up the money for shared risk.

I have to say though, I'm just really fucking tired of being patient. I've been patient for 3 years now. I'm sooooooooooo tired of this! What an understatement! It makes me want to jump out a window. The fact that we want this with every fiber of our very beings and there is not ONE thing I can do to exert any control over when it will happen. And in the meantime, I just have to roll with every punch, and keep waiting. Patiently. What choice do we have?

Pissed off to pitiful in 6 hours

2007-08-01T11:46:00.000-04:00

9dp3dt

No more spotting since that one little incident on Monday. However, every day when I test, and see that white blank spot staring back at me where a second line should be, it makes me more and more....angry. Good and goddamn well pissed off, is how I felt at 4:30am today when I woke up - having been dreaming as usual of being pregnant - and peed on a stick. Nothing, nada, zilch.

I climbed back into bed, and laid awake until R got up around 6am, feeling progressively more and more full of RAGE. It really scared me, how strongly that emotion washed over me. I was absolutely completely and totally sure that this has all been a giant waste of time, money, and emotions. And why? WHY??!!! Why couldn't this work out for us? IVF works the first time for lots and lots of people. Why not us, goddamn it?

I wanted to throw something against the wall and watch it smash into bits. I wanted to jump out of bed and have a screaming wailing fist-beating tantrum. I wanted hit something, someone, inflict some pain, make something or someone else hurt like I hurt inside all the time. I felt like I was going to fly into bits. I laid there with my heart pounding and pounding and with the blood ringing in my ears and I thought - what will happen to me when I get the final news after Tuesday's beta that this didn't work? And I was terrified.

And now, 6 hours later, I've talked myself down from the ledge, yet again. I've convinced myself that I still have a chance. That 9dp3dt could still be considered a little early for a positive HPT. That some people don't get positive HPTs at ALL, ever, and the blood test still comes back positive. (although the beastly voice in the back of my head says that this is the stuff of false hope and urban infertility legend, and not to believe it, because my blood test is a full 15 days past the 3 day transfer, which equals 18 days past ovulation, and there's only an infinitesimal chance that one wouldn't have HCG showing up in one's urine after all THAT time.) That I should hang onto hope, that there's no reason to think negatively, and that there's every reason to believe it worked, and that we have fallen on the joyous side of the 50% success rate that Dr. G quoted me.

And so, the rage having run it's full course this morning, now I'm feeling plaintive and desperate and pitiful:

Please stay, little embryos, little maybe babies. We love you so much already. You are already here, so just please stay.

We're in awe and spellbound over you already, and we'll be more so with every sonogram, every milestone.

We'll cry in joy and wonder at your birth, your birthdays, your graduations, your accomplishments.

We promise we'll give you our whole hearts, and everything you could ever want or need to the best of our every ability.

We have a room in our house for you already, it's here and waiting for you. We have a giant crazy wonderful extended family who's waiting to love you, too. And a dog who will lick your face and make you laugh. Grandparents who will dote on you and shower you with so much love you won't believe it.

We're all waiting for you, and we have been for so long.

We want you so much. We love you, already. Please, please, please - stay.

Spotting - UPDATED

2007-07-30T14:45:00.000-04:00

I'm spotting, just a tiny, tiny bit.

This is exactly the same thing that happened in my last IUI. I convinced myself for 2 whole days that it was implantation spotting, and then, my period arrived in full glory.

It's far too late for implantation spotting at 7dp3dt, isn't it? Yes, I know, it is. I think this might be it for this cycle. Just like last time, my body won't even do me the courtesy of making it to beta...

I can't believe this.

****************************************************************

OK, first of all, thank you, thank you, thank you to Jeanie and Samantha and others for your reassuring comments. I have managed to talk myself out of the defeatist attitude from earlier today. I'm not CONVINCED that it's all over, but I'm still skeptical.

The spotting only happened that one time, in the bathroom at work this afternoon. It was gone when I went back the next time. It was pink and brown, not red. But still....

7dp3dt

2007-07-30T11:29:00.000-04:00

Found out over the weekend that none of our 'extra' embryos made it to the freezing stage. Dr. G tried to be reassuring about it - he told us before the transfer that we shouldn't be surprised if we didn't end up with frozen embryos, as less than half of the patients in our clinic don't either.

And then over the weekend he told us that there is absolutely no correlation between the success of the current cycle and whether or not there are embryos available to freeze. He encouraged us again about the quality of the 'compacting' embryo we transferred. And on the day of the transfer, the embryologist reassured us that they regularly see pregnancies from embryos like the "slower" one we also transferred.

In spite of all that, I still feel discouraged.

And I know I'm doing myself such a disservice by POAS every day. (I started on Friday morning, and am now unable to stop.) I'm doing better than last time though - last time I POAS twice, even three times a day! But that only lasted a week, as my period showed up early and put me out of my misery, as far as the suspense goes.

Ask me how many times I've googled these phrases: "earliest BFP after IVF", "earliest accurate HPT after embryo transfer" or "BFP at 4dp3dt, 5dp3dt, 6dp3dt, etc., etc.,) Anyway, I'm powerless against the siren call of the pee sticks in my bathroom.

I think I'm also depressed because for the past 3 nights I've had EXTREMELY vivid dreams of getting a positive pee stick result. I dream that I jump back into bed to tell R, that I grab the dog and dance around the room with him, that I call my mother crying with joy, etc. Then, when I wake up, it takes me a minute to figure out that it was just a dream, which creates the obvious crash back down to reality. GAWD it's awful.

And on top of it all, there's this undercurrent of feeling like I'm fooling myself into thinking this even has a snowball's chance in hell of working. I keep thinking of how idiotic I'll feel when I find out it didn't work, how stupid it was to waste my time imagining symptoms (do my boobs hurt? is it just the progesterone?). I kind of get this vision of myself looking like a total dope with a big stupid grin on my face, going thru all of these machinations for no reason: being all excited, R patting my stomach and referring to 'Frick and Frack' (his names for the 2 embryos), taking pains to avoid caffeine and alcohol, not lifting heavy items, asking R to bring the laundry basket up and down the stairs when I'm doing laundry, carefully timing every one of our evenings so that R gives me the progesterone shot precisely at 10pm every night. Ack! What a rube! What a moron! What a dumb ass!!!

And on top of THAT - I'm in the middle of the first fight I've had with my best friend in many, many years and consequently I feel like the universe has run right off of its goddamn tracks, AND, our beloved Westie - Murphy - nipped at R this morning for absolutely no reason when R was trying to kiss him goodbye.

When R was saying goodbye to us this morning, I was still in bed, and Murphy was laying at the foot of our bed. R's theory is that Murphy can somehow, through his extra doggie perceptiveness, sense that I'm preggo, and his reaction when R came into the room and got down into his face came from some instinct to protect the pregnant lady. I don't buy this for one minute, but I have to admit that I LOVED that R came up with this theory. I found it very touching...

Soooooo, one week down...... one week and one day until beta.....

4dp3dt

2007-07-27T14:10:00.000-04:00

Ugggghhhhh. How I hate this goddamn two week wait. I feel like every day lasts for at least 3. Every day the pendulum of my emotions swings in a giant arc: if I wake up feeling hopeful and certain that I'm pregnant, I go to bed terrified and in a cold sweat that I'm not.

I've started rationing the last Harry Potter book to myself. I'm a really fast reader, and could blaze through it in one sitting if I let myself. But I decided that a regular distraction each night would be good for me. Would keep me from obsessively reading back through all of you pregnant ladies' blog entries and taking mental note of your descriptions of your retrievals, transfers, embryo quality, early pregnancy symptoms, etc. Which I'm already doing every goddamn day and so anything that keeps me from doing it at night is a good thing.

So I'm allowing myself 30 minutes of Harry per night. It's working, so far. Although, I may cave in this weekend and just read the whole damn thing. I reason that if I chose, I COULD go back and re-read ALL SEVEN Potter books during this 2ww from hell! That would keep me busy!

Oh, I HATE suspense! I just can't take this! I really can't. I think it's inhumane. It's entirely too much build-up! It's a wonder we don't all work ourselves into such a frenzy that we just combust upon receiving the beta results from our clinics.

By my calculations, a week from now, at 11dp3dt, I should be able to get a fairly reliable result from an HPT. So, a week. Or, a more distant goal - 11 more days until beta. It might as well be a thousand.

I have no symptoms. I feel completely normal. Implantation should have happened already, I think, but I've had no spotting of any kind. Which might mean something. Or it might mean nothing. Bugger!

I have to say though, I'm so, so, so encouraged by the outbreak of knocked-up-edness around here!! If you haven't heard already, go read Baby Blues, Ann, and Les' fabulous news.....I hope the good results are contagious!!!!!!!!

Day 3 Transfer

2007-07-23T13:06:00.000-04:00

We're home from the transfer! I have to say that the embryo transfer was by far the worst part of this whole IVF cycle, from a physical standpoint. I was in sheer agony bc of having a full bladder! I kept telling R that I wasn't sure I could hold it any longer. When the doctor finally came in and was threading the catheter through my cervix, I told her that I was half convinced that I was going to pee on her at any moment. She clearly thought I was kidding. I wasn't.

I cried through the whole thing. Partly emotions, I'm sure, but also because the nurse was pressing down on my bladder AND my swollen ovaries the entire time. Aaaaaaarrrrgggghhhhhh!!! Man, that really hurt. Obviously, worth it in every way, but still - that was worse than sub Q shots, IM shots, and egg retrieval all rolled into one!!

So the good news is that we had one embryo that was "super-fantastic fabulous looking", but the bad news is that the rest of our embryos are slackers. The dr. said that they like to see embryos between 6 and 10 cells by Day 3. Only one of ours hit that mark this morning, at 8 cells, and the dr. said that it was already showing signs of compacting and dividing again, so it's definitely an overachiever. We transferred the super fantastic one, as well as the next best one, which was at 5 cells this morning. The doc said that they certainly see pregnancies all the time from "so-so" embryos that are still growing a little too slowly on Day 3. She didn't see any reason we should risk transferring more than 2, even with the slower progress of the second one. She then said, in reality, if we do get pregnant, we'll never know whether it was from the superstar embryo, or the C student embryo. Interesting to think about that...

Our other 3 embryos had only made it to 4 cells by the this morning, so they said they would continue watching them to see if they make it to blast and are able to be frozen. But, I'm not holding out too much hope for that.

Anyway, now I'm on bed rest, and R is waiting on me hand and foot, which I have to admit is very nice! I don't know how the hell I'm supposed to be able to stand waiting until AUGUST 7 for our beta test!! Lord knows I will have peed on many a stick by then, but I'll have to hide it from R. He thinks it is a ridiculous waste of money, and he doesn't like the fact that I get all worked up over it every single morning. I think he'd prefer to save all the tears and drama until the end. I'm just not built that way though.....there's no way I could last for 2 weeks without getting some preliminary results from a pee stick.

As soon as I'm up and about again on Wednesday, I'm going to lay in a supply of First Response tests.

And so the wait begins........

Day 2 Fertilization Report

2007-07-22T11:12:00.000-04:00

All 5 embryos are still thriving and dividing normally! Transfer will be Day 3, tomorrow, at 10:45am.

Hurray!

2 week wait begins tomorrow.....well, technically I guess it will be the 12 day wait. No matter, I will still be going out of my gourd the whole time. And against all sense of decorum and sanity, I'm planning to POAS at every opportunity, daily towards the end. I am not one for any sort of suspense, and I can't stand the thought of going in for a beta and getting a subsequent phone call without being able to prepare myself in advance for bad news.

More tomorrow!

Day 1 Fertilization Report

2007-07-21T11:43:00.000-04:00

Well, I'm trying really hard not to feel completely deflated. We have 5 good embyros as of this morning.

Yesterday they told me that that they'd call btw 12 and 3 with the fertilization report, so when Dr. G called me at 9am, my heart leapt into my throat, and I just knew that he was calling to say that none of them fertilized, or that none of them made it thru the night.

Instead he said that all 14 of the eggs they retrieved were mature. He said that was great, since only mature eggs are able to be fertilized. But, he went on to say that although 9 of the 14 fertilized, only 5 began dividing normally. The other 4 either divided abnormally, or were fertilized with more than one sperm.

So, on Day 1, we only have 5. Dr. G. said that he could tell by the tone of my voice that I was crestfallen, but that this was actually good news. He reminded me that he has had many, many patients with similar fert reports who went on to get pregnant. I'm sure that's true.

I guess I just had this fantasy that R and I were going to turn out to be the superheros of the IVF world. That we'd have maybe 10 or 12 fabulous embryos on Day 1, that we'd end up with 5 or 6 superb looking blastocyts on Day 5, and that we'd have lots of embryos to freeze as an insurance policy or for future family building attempts. Doesn't look like that will be the case. I'm now just praying that we end up with at least two to transfer.

I asked Dr. G if today's report meant that we'd most likely have a Day 3 transfer, since we have so few already. He said that it's still too early to know the answer to that, but that 80% of the patients at this clinic have Day 3 transfers, so that was always a safe bet.

He'll call tomorrow to let us know how they fare overnight, and what we're left with.

I have to say, I'm very surprised at the depth of emotion I feel for the embryos - all 9 of them. I didn't expect for this to feel so real - for it to really hit home so quickly that these tiny little multi-celled living things have the potential to be children with R's beautiful brown skin and my eyes running around our house. I didn't expect to have any sort of grief feelings yet, for the embryos that didn't make it, but I do.

We are praying, praying, praying hard for our 5 little precious embryos up there in the lab. Please, please be strong! Just a few more days and you can be nestled snugly in your new home...

Retrieval

2007-07-20T12:32:00.000-04:00

I'm home from the retrieval, very loopy and sleepy.....it went very well. I'm relieved to report that this time, I was completely out and felt nothing during the procedure! Thank God!

They got 14 eggs, which I'm told is good!

More tomorrow when the fertilization report comes in!

Is it in yet??

2007-07-18T22:44:00.001-04:00

OMG, we just did the trigger shot, and here's an excerpt from the conversation btw me and R:

R: "OK sweetie, are you ready?"

K: "Um, yeah, I guess so." (voice shaking, palms sweating, on the verge of tears)

R: "Are you sure? Are you ready?"

K: "Yeah, yeah, I'm ready. I'M READY!" (at this point, I had the bathroom counter top in a death grip, and was panting in anticipation of the jolt of pain)

R: "OK baby, here we go..."

K: "Ok, ok, okokokokokokokokokokok..."

R: ......

K: (pant, pant, pant, grind fingernails into counter)

R: ........

K: "Is it in yet? IS IT IN THERE YET?????!!!!!!!!!!"

R: "OK, I'm going to press the plunger in now, ready?"

K: "You mean it's in already? You put it all the way in? Are you sure it's all the way in there???"

R: "Yeah, it's all the way in."

K: "Are you sure? Did you pull back on the plunger? Was there any blood? Did you check for blood? Are you SURE???!!!"

R: "Yes, yes, no blood. It's all over. I pushed the medicine all the way in, it's over."

K: "WHAT?? Are you SURE? I didn't feel it?? I didn't feel a thing - I mean, I didn't even feel at all! I can't believe it! I can't believe I didn't feel it AT ALL!!!"

R: "Oh shit."

K: "WHAT??!!!"

R: "I just pulled it out and you're bleeding everywhere - hand me something, quick!"

R & K: (after pasting a bandaid on my frozen ass) "We did it! We actually did it!"

K: (ever the voice of doom and gloom) "I didn't feel that AT ALL. I can't believe it!.....But, the progesterone in oil will be much harder, because it's so much thicker. I'm sure THAT will hurt...."

Immediately after R left the bathroom, I started crying. From relief. I had worked myself up into such a frenzy while mixing up the diluent with the hcg powder because those fucking needles are SO. FUCKING. HUGE. I was shaking when I handed the goddamn thing back to R. I just couldn't believe I was going to have to take that gigantic needle in my ass every night for God knows how long. It looked like it was about the size of steak knife for fuck's sake.

Oooooooooooooooh thank you thank you thank you thank you Lord for ice packs. Thank GOD I couldn't feel it! I am heaving such a huge sigh of relief right now, you have no idea. Well actually, most of you do have a very good idea. Wheeeeeeeeeeeeewwwwwwwwww.

I can totally take it if the PIO hurts when the medicine goes into my muscle, I am fine and dandy with bruises and muscle pain and not being able to sit down the next day. But I don't know if I could take it if I had to feel that 6 foot long needle going in every time, I really don't. Thank you Lord!

Next hurdle, Friday morning's retrieval.

:)

"Ding!" They're done!

2007-07-18T11:23:00.000-04:00

Largest follicle at 23mm as of this morning, as well as several more at 20 thru 17mm.

So......trigger tonight! Retrieval on Friday!! Transfer on Monday or Wednesday, depending on how the embryos are doing!!!

I can't believe it.

I'm delighted, and thrilled, and grinning, and my heart hasn't stopped pounding since I left the RE's office this morning.

But, I'm very apprehensive about 2 things:

First, and most imminent, I'm reeeeealllly anxious about the intra-muscular injections. Since I'm not taking Ovidrel, and taking the generic 5,000iu hcg shot instead, it has to be taken IM instead of subQ. So, it all starts tonight! Ack! I also thought I needn't worry about the progesterone-in-oil injections until after the Transfer - but I found out today that I have to start those on Friday after the Retrieval! Waaaaaahh!!!

The nurse at my RE's office drew two big black circles on either side of my ass, so that R would have perfect targets. She recommended icing the area before hand, so that you don't feel the needle going in (which prevents flinching). She said I should put something warm on it immediately afterwards (a heating pad, a wet washcloth in a baggie microwaved for a minute, etc.) and massage it for awhile, and further, that I shouldn't do the shot just before going to bed. The idea is that I should be moving around enough afterwards for the oil to get worked into the muscle, instead of just sitting there in a lump all night.

I KNOW that I can and will do whatever it takes. I know that I can do this. But since I've never had an IM injection, I'm letting myself get all worked up over it. I'm really, really dreading it. Maybe it is the psychological aspects of giving up control to R, (which has nothing to do with trust - I trust him completely), as well as the shock of looking at such a huuuuuge needle. It elicits a visceral reaction. Ugh.

And the other thing that I'm anxious about is the retrieval process. So, if you remember, the faux retrieval I had last time, which we called a "Follicle Reduction", was incredibly painful. Under no circumstances do I want to feel all those needle punctures in my ovaries again! This morning I told the nurse about my experience, and she was totally horrified. She PROMISED that I would be TOTALLY out for the retrieval this time around, and that I wouldn't feel anything during the procedure. She said that she would put a note in my chart that I wanted to speak to the anesthesiologist beforehand in order to relate my past experience. I guess that makes me feel slightly reassured?? I'm still a ball of nerves over it though.

I'll post again after my first IM shot tonight, if I survive.....

Day 18 of Stims - Report

2007-07-16T11:24:00.000-04:00

So, the follicles are growing, ever so slowly but surely! The largest one was up to 18mm this morning! Several others btw 17 and 14, and the rest are still under 12.

I was so impressed this weekend with Dr. G, I can't stop thinking/talking about it! So, on Sunday morning when I went in for monitoring, I only saw the nurse, not Dr. G. And for the first time I had at least one follicle at 17mm. Progress at last! As usual, later in the afternoon the nurse called me on my cell phone to give my my dosage instructions. She told me to stay on the same doses (225 of Follistim, 75 of Menopur, and 5 of Lupron in the morning.)

But then, around 6pm on Sunday evening, Dr. G. called me. He said that he was excited to hear that the wanding had shown some progress and growth, but that he had been thinking about it all afternoon, and that he had decided that he wanted to take my dose of Follistim down a little for that night, to 150ius. He said that he wanted to continue seeing me every single day so that he could watch things very, very carefully. He said he wanted to get in at least 2 or 3 more days of stimulation, because he thought we could get a good number of mature ones if we proceed in a very controlled manner. Since my E2 had jumped from 192 to 436 over the weekend, he was concerned that we not let it skyrocket until we have more than just one or two mature follicles. Slow and steady wins the race, in this case.

So - I'm just soooo impressed with this guy. Obviously he's going to look like a prince compared to what I was dealing with before. But even bearing in mind my point of reference, I think he has an incredibly sensitive and caring bedside manner. I mean, the man probably got 50 charts dumped on his "desk" (perhaps he gets info virtually, i don't know?) after monitoring hours were over, and then he calls me at home to say that he's been thinking about my status all afternoon????? Come on, in this day and age, that is a little surprising, and very impressive, in my opinion.

I feel very blessed to have moved on to this practice, and to this doctor, in particular. I have much hope in my heart for this cycle. So much so that I drug out one of my pregnancy books last night, "Pregnancy Over 30, Everything You Need to Know". Ugh, what a guilty pleasure it was, reading through some of those chapters. I confined myself to the most innocuous parts - the How to Conceive chapters mainly....then I indulged myself in the first chapter after the "Congratulations, You're Pregnant" header, which was all about how to eat right. That seemed safe enough.

Of course I'm not going to jinx myself by pulling out "What to Expect When You Are Expecting". I'm not that stupid. I haven't read that one since November 2004, the month after R and I returned from our honeymoon, and I decided to "get serious" about trying to conceive. A small part of me was actually indignant that we didn't get pregnant on our honeymoon, 2 weeks after I went off the pill. (insert bitter, jaded laughter here)

So, in November '04, I went to the bookstore one Saturday and bought a ton of pregnancy books. I couldn't WAIT to read "What to Expect". I had seen that book given as a shower gift several times, and to me, it represented entrance into the world of expectant mothers, parenting, the 'Mommy Club', being a 'real' family, etc. I pored over the photos of the developing child in utero, I loved the play-by-play accounts of what the mother should be feeling and seeing and experiencing. I think I read the whole book in two nights, I was that entranced and excited.

I remember thinking that if we got pregnant in November, that despite the 'rule' about not announcing it to the world until the end of the first trimester (when all the danger miraculously disappears, right?), that I wanted to tell our families when we were all together at Christmas. I got all choked up thinking about it. I could hardly wait! Oh Lord, it seems like a totally different woman, who had all of those naive thoughts. It's like remembering how you felt about something when you were a teenager, and looking back on your teen aged self and thinking "oh, girl, if you only KNEW!"

These are the things that make me so sad about infertility. I feel like I'll never get back that pure and hopeful perspective on things. I hate that I feel so jaded and bitter. I hate that I've become so good at being pessimistic as a means of protecting myself. If you expect the worst, you'll always be pleasantly surprised, right?

A year ago I just accepted that with all we were going through, it was normal to feel depressed, normal to feel frustrated, normal to feel bitter and angry, etc. I assumed that once I was holding a baby in my arms, all of the negativity would recede, and I'd go back to being my normally happy and optimistic self.

Lately I've begun to worry that this struggle, once behind us, won't ever really fully recede. That this experience has permanently changed my personality. That even after I'm rocking my child to sleep at night, I'll still be snarky, angry, jealous, quick to judge, and more self-centered than I've ever been....

I'm already worried about this. But if this first IVF cycle, the only one that is somewhat subsidized by my insurance, fails? Oh boy. Look out world. An even MORE unpleasant version of me will be unleashed. I'm absolutely terrified that we'll end this summer just as not-pregnant as when we started, and I just don't know what that's going to do to me.

Quick report: 13th day of stims

2007-07-11T16:15:00.000-04:00

This morning's ultrasound revealed very "plump" looking follicles which are starting to grow!! On Monday they were all under 10mm; today there were some at 11mm and some at 12mm!

I know that sounds like a paltry increase in size - but this represents real progress for me, people!! Last stim there were absolutely no signs of activity in there for 55 days!!

The office just called to tell me to up my dose of Follistim from 150ius to 225ius tonight (the highest dose I've ever taken), and to come back tomorrow morning. Dr. G isn't playing around!

I'm just happy to be making some progress, any progress. It helps me to maintain those ever elusive hopeful feelings......

Progress Report - Day 11 of stims - Updated!!!!

2007-07-09T10:22:00.000-04:00

Actually, I'm really not sure whether this is a 'progress' report or a 'status quo' report??

So, according to the latest wanding session I have 14 follicles on my right ovary that are all under 10mm, and 16 follicles on my left ovary under 10mm. At my last two appointments Dr. G said that although they were all still small, they were showing signs of growing, and better still, that they were all growing at the same rate. Last week he said that although it was slow going with me, that so far this is exactly the response he would have hoped for.

My E2 (estrogen) levels had been rising pretty steadily, from 30-something, to 60-something, to 110-something on Thursday morning last week. But then, when I went in on Saturday over this past weekend, for some bizarre reason my E2 had dropped all the way back down to 30-something! Who knows why my broken body reacts the way it does, but it is just so frustrating.

So, over the weekend he upped my dose of Follistim from 112ius to 150ius. We kept the Menopur dose the same, at 37.5ius. I was hoping this would cause a commotion in there - because remember, on my last cycle, 200 was the dose at which things really got going.

But, ho-hum, this morning's wanding revealed that all my little follicles are still just that - little. All are still under 10mm. I saw Dr. B this morning instead of Dr. G, and Dr. B said not to get too discouraged, and that the blood work would be more revealing and more of a diagnostic tool than the wanding at this stage of the game. If my E2 comes back low again, she said they'd likely up the dose again. If not, I'll probably stick to the 150ius dose until the next wanding on Wednesday morning.

I'm so anxious to see some real activity! I'm soooooooo preoccupied with getting to the retrieval-transfer stage. In spite of my best efforts to remain numb, Hope has taken up residence in earnest. I have almost nightly dreams about babies - not that we're pregnant, but that we already have a baby that I'm feeding and carrying and rocking and kissing. Last night I even dreamed that we had twins! (In the dream, Pamela Andersen Lee was our nanny, and our neighbors called the police bc Tommy Lee kept showing up and shouting in our front yard, but I digress......)

Anyway, the point is that the possibility of success seems all too real to me - easily visualized. Even as horrifically dangerous as I know this is, this outlook is making me all the more anxious and full of nervous energy and ready for action!!!!

However, part of my bubble was definitely burst this morning in the RE's office. A woman came in as I was signing in at the receptionist's desk, and announced that she had come bearing gifts for the office. She brought forth a giant shopping bag, and as she hauled out sharp's containers, needles, syringes, leftover medication, etc., she told the nurses that she wanted to donate all of her unused items because she and her husband were "DONE."

She said, "...we've been at this for more than 3 years now, and as of today, we're either pregnant, or we're done. And I pee'ed on a stick last night and came up with squat, so I believe we're officially done." She went on to ask for a form to officially withdraw from shared risk.

When she sat down, I broke the cardinal rule of etiquette in RE waiting rooms across the nation(which dictates strict silence and lack of eye contact)and I said as empathetically as I could, "I hope the Goddamn stick was wrong!" She smiled and said, "Thanks, but after 3 years, seven thousand dollars worth of drugs for each cycle that our HMO won't cover, and the last 2 months of walking around looking like I'm already 2 months pregnant, I've just had it with this shit. I hope someone else can use my leftover drugs, and that they'll have a better outcome than we did."

What amazed me was how upbeat and straightforward she seemed to be about this resolute decision. I was thinking that were I in that position, I'd likely be overcome with the poor-me's, and would be swollen-faced and bleary-eyed, asking for tissues along with the shared risk withdrawal form.

For the rest of my wait, I had to battle the monster negative thoughts that came at me full force - "you seeee? there are no guarantees even with IVF! if it didn't work for her, why in blue blazes would you think it could possibly work for you? this first cycle is never going to work, never ever. and after that, even if you scrounge up the money to buy 6 chances in shared risk, none of THOSE are going to work either! that's going to be you 1 or 2 years from now, throwing up your hands, crying uncle, asking for your money back bc you'll be broke after paying for all of those drugs!!"

I think I've gotten those crappy thoughts back under control now, but caged as they are, they are still there, niggling at the back of my mind and threatening to overcome Hope's voice at any moment.

This afternoon's phone call with my E2 results could really help to banish those thoughts even further back, if my levels are indeed heading in the right direction......

*******************************************************************************
UPDATE: E2 level is back up to 112! All doses to remain the same until I go back on Wednesday morning.....

God Bless Dr. G!

2007-07-02T10:02:00.000-04:00

My estrogen came back low, so I started the stims on Friday. Yee-haaa!! Kind of like riding a bike, that nightly injection routine. I fell right back into my old rhythm and ritual like I hadn't ever stopped.

However, the other thing that started this weekend, in earnest, was the Lupron-induced headaches. Great googly moogly, the goddamn headaches! Speaking from the perspective of one who has suffered through probably 5 big migraine headaches in her life - truth be told, these little Lupron headaches are but a mere trifle by comparison. I mean, it's not like I must take to my bed or anything, BUT it is a miserable thing to have a persistent headache that just won't seem to go away. I was popping Advil like Pez candies all through the weekend, and in so doing, bought myself maybe an hour's worth of relief each time. And then, the blasted headache would come right back! Aaarrgh.

So, this morning I had my first wanding/monitoring session, and when Dr. G asked me how I was feeling, I was truthful. I told him that these Lupron headaches were cramping my style! The first thing he said was that I must stay away from Advil, Motrin, etc. Apparently ibuprofen could cause a "blood issue" when it comes time for retrieval. Not really sure what that means, but OK, he's the doctor, so I'll buy it.

Then he said that I really should be taking Tylenol instead. The nurse in the room sort of snorted when he said that, at which point Dr. G started laughing too, and admitted that Tylenol is really worthless for headache pain. He acknowledged that Tylenol did absolutely nothing for his own headache pain, and that he might as well swallow an M&M, as far as analgesic prowess was concerned.

Kind soul that he is, he offered to write me a prescription for Tylenol 3, should I so desire? I can't drive while taking that, or operate at full mental capacity for that matter - but at least, he reasoned, I could take a Tylenol 3 if a headache were to prevent me from sleeping. However, he continued on to say that actually, Tylenol 3 is hard on some folks stomach's, and in fact, why didn't he just go on and prescribe me some Vicodin? The fireworks on Wednesday would seem all the more effervescent after one of those babies! I, not being a complete FOOL, gladly accepted the scrip on my way out the door!

So, my presiding sentiment for today is one of thankfulness for the amazing bedside manner of my Dr. G. - a more caring and attentive doctor I haven't ever had the pleasure of meeting. It's interesting...the further I get into this experience at the new clinic, the more I notice the stark contrast between RE's. I would have had to grovel and beg at the previous clinic for any sort of sympathetic perspective, or even acknowledgment of discomfort - let alone a prescription! Please! The prevailing attitude at the previous clinic was kind of like - hey, you CHOSE to go through this treatment, and this is the reality of that treatment, so try not to be such a baby about it and suck it up.

Trying, trying not to think too far into the future as to the potential for success for this cycle. To allow myself to do so would invite emotional calamity, somehow. BUT, I have to say that Dr. G's manner is really causing me to have overall "good vibes" about our chances this time around. Plus, every time I talk to my Mom, she says she feels in her heart that this time will be 'it' for us. Oooohhhhh how I want to jump on that bandwagon with her!!

I report back on Thursday am for another wanding session. Until then, same dosage continues.....

Let the wandings begin!!

2007-06-29T11:02:00.000-04:00

So, my BCP-withdrawal induced period began on Wednesday, miraculously right on time. I'm choosing to take that as a sign of good things ahead for this cycle. Wouldn't it be just fabulous to have a body that reacts predictably to external stimuli? (Read that: drugs, drugs, and more drugs.)

I've been taking the Lupron injections every morning now for over a week. The needles are so tiny, I almost can't even feel them! I've only had one bruise, from yesterday morning - I was half asleep and on auto-pilot, and just kind of jabbed myself willy-nilly. Every other deliberate stick has been painless and bruise-less.

This morning I went in for the Day 3 baseline sonogram and blood draw. All things considered, it was as pleasant an experience as one can have, getting one's arm stuck and one's hoo-ha probed.

Everything looks quiet, except for the usual suspects - the ever-present cysts on my my poly-freakin'-cystic ovaries. But Dr. G said as long as my estrogen comes back low, I'm good to go to start the stims tonight. Woo-hoo! I'll be filling up another few Sharp's containers soon enough!

(Btw, I'm morbidly fascinated by the 4 CHOCK FULL Sharp's containers residing under my bathroom sink which are left over from my last marathon injection cycle. No manner of self-counseling has spurred me to haul them back to the RE's office for disposal. I get some perverse sense of accomplishment from hefting their weight and imagining exactly how many needles and syringes are stuffed into each container. How many needle sticks in the belly does that container represent? How many dollars worth of drugs were injected through those used syringes? I really can't bring myself to get rid if them. I don't know why. I think I might have a problem.)

My protocol for the weekend is as follows (assuming my estrogen comes back low): 112.5 ius of Follistim and 37.5 ius of Menopur each night, 5 units of Lupron every morning, plus my pre-natal vitamin and baby aspirin (which, for anyone who doesn't know, is supposed to help with implantation).

I go back on Monday morning for another wanding session. Meantime, I'll be resuming my nightly pep talks to the ovaries. Get off your duffs in there, girls! Time to make the eggs!!

Guess now I'm in a 'Mock 2WW'. Should I practice going insane?

2007-06-19T15:50:00.000-04:00

So, I've been hanging out here in BCP land, with nothing much to report and no deep thoughts to share for a quite a while now. Thought I'd post a quick update on my fledgling (yet still exciting, to me!) IVF cycle.

So, today marks 2 and 1/2 weeks that I've been on the blasted bcp's, which meant it was a good week to get my Mock Embryo Transfer procedure out of the way. One more pre-requisite that I can cross off of my countdown-to-IVF checklist!!

For anyone who is unfamiliar with this procedure, it is basically a dress rehearsal of the transfer procedure that will be performed for the gorgeous embryos that R and I are going to make later this summer. Because a transcervical embryo transfer is essentially a 'blind' procedure, most doctors like to do a test run in advance of egg/embryo development, while there is still plenty of time to react to any unexpected difficulties or complications with catheterization or uterine position.

During the procedure, they thread a special catheter through your cervix into your uterus, and they measure the angle and shape of your cervical canal, as well as the depth of your uterus, to make sure they know what size instruments to use, etc. There was no pain involved - in fact the the only thing I could really feel at all was the speculum going in, and then I could feel when they filled my uterus with saline, in order to observe via ultrasound the shape, depth, etc. It was quite interesting to watch, on the ultrasound screen, actually.

Since this morning, I've had some bleeding and cramping on and off, but nothing worth complaining about, really.

I start the daily Lupron injections this Friday! Never having taken this particular drug, I'm not sure what to expect? I've never really had any side effects from anything I've taken so far, not even Clomid, so I'm not really worried. I remember reading on someone's blog that she thought the Lupron shots stung worse than the stimulating drugs. That would be a bummer.

I also found out today what my starting drug protocol will be for stims. I was a little dissapointed at the low dosage he wants to start me on, but I'm trying to just relax and trust him.

Last time, Dr. D started me at 75ius of Follistim. Then I went up from there over the course of 2 months to 200 ius of Follistim - my highest dose, and the dose at which I finally began responding (and over-responding.) Dr. D didn't add in any Menopur until I was already at 150ius of Follistim. My dose of Menopur remained constant for the 2 weeks that I took it - 75ius.

So, Dr. G is recommending that I start out at 100 ius of Follistim, and 50 ius of Menopur. I think he believes that my response at the end of the last cycle may have had more to do with the addition of the Menopur than with the higer dose of Follistim. Let's hope he is right!

At any rate, I do feel good about the fact that Dr. G reiterated to me today that he will not let me go on and on with the stims for weeks and weeks....he said that the longest he would consider going would be about 16 or 18 days. If nothing is happening, we'll stop, and regroup - possibly try another drug protocol.

So, that's my story for now, y'all! I'm trying to allow a healthy amount of hope to start to develop, without letting myself get too carried away....isn't that always the trick?

Day One!

2007-06-04T23:14:00.000-04:00

Well, Miss Priss arrived over the weekend, on Saturday. Hallelujah! Talked to my nurse at the clinic today, and she said to start the BCPs tonight!! Woop-woop!! And we're off to the races my friends!

I know I'm a broken record, but I s-t-i-l-l can't really believe we're doing IVF. I keep waiting for the other shoe to drop. Every time the clinic calls, I expect them to say, "Yes, K, well there was this mix-up, see? And you can't really do IVF. NO, no, heavens no - what were you thinking? Certainly not..."

So, I'm to stay on the BCPs for 3 weeks, and on 6/19 I go for the Mock Embryo Transfer. I know that's like, a really necessary thing, and all? But, I swear - something about the name of that procedure just totally cracks me up every time. I imagine all these high school kids dressed up like doctors with fake mustaches and glasses that are too big for them standing in their drama club room reading from scripts with fake grown up accents or something. "Ahem, ahem....yes Nurse, um Jones? Could you hand me the um, speculatum? Ahem, ahem, I mean the uh, um speck-you-lum?..." Sheeew - see, I've gone and cracked myself up again!!

The nurse said she had to check with Dr. G as to what doses of all the various drugs I'll be on for this cycle. That's one of the (many) things that I'm worried about actually. When I had my consult, I asked him how high a dose of Follistim/Menopur he would be willing to start me on? After 60 endless days of shots last time around, I only began to respond when I had reached about 200ius of Follistim and 75ius of Menopur. He responded that he wouldn't make me start out anywhere near as low as I did previously, but neither would he recommend starting me right off the bat at those highest doses. He said that he wanted to confer with the other doctors in the practice and get their opinions on it, before stating the actual doses he recommends. So, I'm worried they'll all convince him to be as conservative as Dr. D, and I'll be right back to the drip-drip-drip torture I had before.

It's really not so much that I mind taking subQ shots for a long period of time - I'm not even really bothered by that. As I've said before, there's something comforting, in a deeply twisted way, about the habit-forming nature of those solitary shoot-up sessions in the bathroom every night. And frankly, at this point, I wouldn't bat an eyelash if they told me I'd have to take a thousand shots in this cycle. Whatever it takes, however many shots, however many days - bring it on.

What makes me more anxious than the thought of shooting the drugs....is the thought of having to pay for all the drugs. Especially if this drags out again. I think in my last IUI cycle, I had to reorder boxes of medication about 7 times. The thought of forking over all that money chills my heart.

And speaking of ordering drugs, my clinic steers patients with no drug coverage to order from Schraft's Pharmacy, citing that they are easiest to deal with, have free FedEx shipping, and have the most reasonable prices. I've ordered from them in the past, back when I still had drug coverage, and was always very pleased with them. But - you used to be able to go to their website and see all of their prices listed - this was extremely helpful if you wanted to shop around and make SURE that they had the best price for a certain drug. I went to their site yesterday, and discovered that they've apparently been swallowed whole by the mega-pharmacy Walgreen's. I hate to be cynical, but I'd be willing to bet any amount of money (the cost of this cycle, heh heh) that all the things I loved about little Schraft's, your friendly neighborhood infertility drug source, are about to get sucked down the tubes. Goodbye excellent customer service, goodbye reasonable and competitive prices, goodbye focusing on the actual person using the drugs, goodbye free shipping, goodbye convenience of having all the info you really need at your fingertips on their website....

I sincerely hope that I'm pleasantly surprised in this regard. However, what I experienced when I tried to go to their website is a very bad sign. The old Schraft's website has disappeared. The only info you can glean from the site now is several vague pages about Walgreen's and how they really care about their customers and that's why they have this specialty pharmacy for infertility drugs. No pricing, no logistics about shipping, no names of any of the doctors or pharmacists on staff there, no detailed information on the drugs themselves - just an endless loop of pages that all lead back to one nameless, faceless, generic Walgreens 1-800 number. Ugh.

Yes, I do realize it's ridiculous to get worked up over such a seemingly small detail in the grand scheme of all things infertility. But, you know, I already feel like I'm constantly frittering away hour after hour on the phone every day with nurses, administrators, insurance reps, drug coverage insurance reps, labs, former doctors, blah, blah, BLAH trying to cut through endless swaths of red tape. This is just one more thing to have to DEAL with, if you know what I mean. Oh, the bureaucracy! It makes me feel defeated, just thinking about it.

Sigh. I've really GOT to learn how to handle stress more efficiently. Watson graciously recommended anjionline.com for fertility-oriented meditation techniques. I took her advice to heart, and signed up for some sample fertility meditation downloads. And, I TRIED, people. Honest to GOD, I really, really tried to pay attention, and focus, and quiet my thoughts and feel calm and collected and send healing energy towards my girly bits......But, I felt like an idiot! I had fifty FRILLION thoughts buzzing through my head the whole time: about work that day, about whether the sound I just heard was the dog licking his paw again, which I've TOLD him not to do anymore, about what I was going to wear for my meeting with Ms. Senior VP at work the next day, about how many minutes earlier I was going to have to get up the next day in order to make it to the gas station because I forgot to do so on the way home........I just simply could NOT make them stop. For every healing thought I had, 25 more came whizz-banging through my head at the speed of light. I just don't think I'm cut out for meditation?? Maybe if I took a valium first? But, then I wouldn't need to meditate to relax...

Waiting on Miss Priss

2007-05-31T22:52:00.000-04:00

So, while I'm here in limbo-land, waiting on my prissy period to deign to grace me with her presence, I thought I'd post about something inspiring I heard today.

I attended a funeral today, for my best friend's father-in-law. He was interred with military honors at Quantico Cemetery at the Marine Corps base in Quantico, VA. It was a beautiful service, and the presiding chaplain delivered rather unique remarks, in my opinion. They were the most upbeat and joyful remarks I've ever heard at a funeral or interment service, and I've been to far too many.

In addition to the typical, "he was 81 years old, he lived a long, full life" type of stuff, the chaplain also admonished the rest of us to take joy in our own lives and loved ones - to wring the most out of every life experience we have, each and every day. While smiling a big infectious smile, he said (and I'm paraphrasing here), "We don't have much time here, any of us - so love your family and friends with your whole heart. Forgive everyone! For everything! Life is too short to harbor resentment. Let the love pour out of your heart at every opportunity! If you love someone, tell them! Try to be conscious of the joy in every life experience!"

I was particularly uplifted by this, and have been thinking about it all day. It helped to reset my perspective a little, which is always a good thing. His sentiments remind me of a passage that is very dear to my Mom. She has it framed by her bedside. (I believe we first heard this in a benediction delivered by our most beloved Dr. P, the former minister of our church, and the man who married R and me two and a half years ago):

Life is short.
We do not have much time to gladden the hearts of those who travel with us.
So be swift to love,
and make haste to be kind.

I think that says it all, folks.

8 random things about me...

2007-05-23T16:06:00.001-04:00

I apologize for yet another post that falls under the category of ME, ME, ME! Tagged again by Jen at The Mama Wannabe to come up with eight random things about myself:

I have an ear for foreign languages. I whizzed through French in high school with straight A's, and always received compliments on my accent. The summer between my junior and senior years of high school, I spent a month in Germany, and learned a shitload of German. My senior year, I enrolled in First Year German (which was directly across the hall from my Fourth Year French class). During the second month of school, my German teacher came down with laryngitis. I ended up teaching the next month's worth of classes for her, in German. For several years after that, I thought I wanted to be a foreign language teacher when I grew up. I majored in German in college because all my German classes were easy and required the least amount of effort on my part. If I had it to do all over again, I would have gotten a business degree. I've never once spoken anything other than English in any job I've ever held.

I made a lot of extra money in college by translating German "business writing samples" for a guy who worked for a major stockbroker in downtown Richmond, VA. I now suspect the "writing samples" I translated were the work product of either colleagues or competitors that he somehow stole. He always paid me in cash.

I'm the girliest girly-girl you'll ever want to meet - I won't go to the mailbox without makeup on. I wash/blowdry/curl my hair every morning. I feel absolutely naked and uncomfortable and anxious if I leave the house and forget to put on perfume, jewelry, or lipstick. It takes me a minimum of 1 hour to get ready to leave the house in the morning. (much to R's dismay, since we usually carpool most of the way into work together.)

*I grew up in a family of hunting men. I am the only daughter and only female grandchild on my Dad's side of the family, which is a farm-living, horse-raising, salt-of-the-earth, southern Virginia hospitality-having, God-fearing family. The men of this family, including my Dad, his uncles, his brother, his many male cousins, etc. grew up hunting quail and dove in the marshy ever-encroached upon fields and farmland of southeastern VA. When I was born, my father took one look at me and told my mother to prepare herself, for her daughter was going to take to the woods with her Daddy, if he had anything to say about it. On the much heralded occasion of my 12th birthday, my paternal grandfather presented me with a 12-gauge shotgun. I've never been more honored by any birthday gift, before or since. The times I recall out walking in the woods with my father, my grandfather and our bird dogs (you haven't seen anything until you've seen an English Springer Spaniel or a Brittany Spaniel standing stock still, tail rigid as a board, pointing a covey of quail - it gives me goosebumps thinking about it) are some of my most precious and treasured memories of my father, who passed away when I was only 17 years old. I wouldn't trade those times for anything in this world.

My maternal grandfather was an identical twin. When I was younger (and oooooh so naive) I always fantasized that this would ensure side by side bassinets, dual strollers, and double trouble for me when it came time to have children. Now I worry that my chances of doing double midnight feedings are great, but for entirely different reasons.

I have an incredible ear for recognizing famous voices. I'm constantly harrassing R with this question, every time we happen to see a TV commercial (which is not that often, since we have DVR now, which - hearken, friends and neighbors - Changes.Your.Life!): "Who's voice is that, honey? Huh, huh? Do you know? Do you want me to tell you??" My favorite are those cartoon movies with laundry lists of famous people for me to discern - like, Over the Hedge, or Happy Feet, or Monsters, Inc. (that's my favorite!!) I try not to listen to any of the previews so that I won't have any unfair information before the movie comes on. If I hear a voice that I recognize, but can't place, it feels like a puzzle I'm solving. If I can't get it at first, usually I'll think of the voice in my head, and I'll "hear" another phrase that has been spoken by that voice which has somehow stuck in my brain. From the context of that recalled phrase, I can almost always figure out who belongs to the voice. If I could somehow make a living using this skill, I would quit my project management job in a heartbeat.

Ever since I was little, I've always been able to remember lots of song lyrics, and I can remember them for a loooong time. I got satellite radio in my car (my Christmas gift from R, two years ago) and sometimes I'll catch a song from the 80's that I haven't heard in 10 years, and I can still sing every word. My best friend Monica still makes fun of me because of this dorky ability.

If I could come back in another life as someone else, I'd want to be a female vocalist. And I don't mean a pop star. I mean like a traffic-stopping, a capella-capable, Barbra Streisand kind of vocalist who can hold a high C for 5 minutes and bring tears to your eyes. I LOVE, love, love to sing, and can't think of anything better than doing it for a living. (On alternate days I think I'd like to come back as the female lead singer of a rock band who can actually sing. I'd have to come back in a previous decade though, a la Heart, or even Pat Benatar. That would be a lot of fun too. But in a different way.)

Similar to my invitation at the end of the "I Am" post - this has been all around the world and back again, so rather than naming anyone in particular, I will just say, if you haven't been tagged yet - consider this your formal invitation to participate!

*I realize I will alienate some readers with this tidbit about hunting. All I can tell you is that my Dad's family has never hunted for pure sport; I grew up eating Sunday "bird dinners" prepared by my grandmother, which were great feasts of dove and quail, breaded and fried and delectable, served with collard greens, butter beans, and fried cornbread. I believe God made those birds delicious for a reason. But, I'm conflicted, because I'm also a huge animal lover, and could NEVER, EVER kill anything that I thought was cute - not deer, not rabbits, not even squirrels. Birds and fish I have no problems with, probably because I don't have even the slightest desire to cuddle them. And, bc they taste so good.

IVF. Huh, I guess we're really doing this?

2007-05-22T15:44:00.000-04:00

So, I got this big package of information in the mail over the weekend from the new clinic: A Guide to IVF. A booklet to track the timing and details of your treatment. A giant checklist of all the things we have to accomplish BEFORE we can start the cycle: Blood work for me, blood work for R. Genetic screening bloodwork for me. Fax results of annual gyn exam and pap smear. Fax results of R's semen analysis from previous clinic. Fill prescription for Provera, BCPs, and prescription pre-natals. Schedule mock embryo transfer, schedule injection class (injection class? puulease, I feel like I could TEACH the damn class.) Etc., etc., etc.

As I'm going through all this rigamarole, every now and then I catch myself thinking: Holy shit. We're doing IVF?

For some reason it still hasn't really sunk in yet! Everytime I think of it, I think - My God, this could actually work. The first IVF cycle actually DOES work for some people. It really, really does. I could actually be pregnant by the end of the summer. (Shout outs to Faith and Watson!)

This is very quickly followed by harrowing thoughts of how devastating it will be if it doesn't work. There's so much pressure riding on this, because we're paying fee-for-service for this cycle. At the end of it, we'll have used up all of our remaining insurance benefits, and burned through all of our "extra" money for all the drugs. If it doesn't work, we'll be faced with some big financial decisions - how to come up with $20K for the shared risk fee, plus drug money for each and every cycle. Take out a loan? Borrow against the house? Stage a bank heist? Ugh.

I've never been much of a new age-y sort of gal, but I'm thinking I'll need to take up some sort of relaxation activity to ease this stress. I can practically hyperventilate right now if I let myself think about how important it is for this cycle to work. And I haven't even started blasting hormones into my system yet! Can you imagine what a wreck I'll be in a month or so???

If I had the money, I'd definitely do acupuncture. If I were more flexible, I'd take up yoga. If I were Watson's mother, I'd inhabit a pod...ahem, excuse me, Life Vessel. If I had more control over my brain, it would be enough just to get on the treadmill. (Unlike most people who zone out while exercising, I tend to sharpen my focus on all the things about my body that I hate, including my reproductive inadequacies.)

Too bad I can't just resolve to drink more alcohol. That would be a lot more fun than acupuncture needles.

I am...

2007-05-18T11:49:00.000-04:00

OK, Samantha and Jen both tagged me for this, so here goes:

I Am

I am happy, kind, empathetic, and generous to a fault.

I am the kind of person who cries and laughs easily and often.

I am a child of God, and a big believer in His mercy.

I am the wife of a man with whom I wanted to be my whole life, even before I had ever met him.

I am acutely aware of how lucky I am to have such limitless and complete love for my husband, and to have a husband who loves me as deeply and unconditionally as he does.

I am the only-child daughter of a widowed only-child mother who has been my closest friend and confidante since I was teenager.

I am a senior project manager for a financial services company....and I dream of being 'independently wealthy.'

I am blessed with several especially close friends who are my family in every respect except blood lines.

I am a lifelong dog lover, and the daily recipient of doggy kisses that make my heart swell from our Westie, Murphy. I am certain I would not be able to get out of bed for a month if something bad happened to him.

I am a worry-wart, and have a constant movie scene of worst-case scenarios playing unrelentingly in my mind.

I am a 'soon'-to-be Mother, even though I have no idea if or when our next fertility treatment will work.

I am delighted when cooking and entertaining and surrounded by family and friends in my home.

I am striving to be more grateful for all of the joy and wonder in my life.

Now, this seems to have run around the blogosphere several times over. So, if you haven't yet been singled out to perform this little exercise - consider yourself tagged!!

K to IUI: So long, sucka. Oh, and thanks for the OHSS.

2007-05-15T23:29:00.000-04:00

So, my much anticipated consult with the new RE was today. It went really, really well. I really liked Dr.G - he seemed very kind. Unlike Dr. D, he looked me in the eye the whole time we talked. Also unlike Dr. D, Dr. G made me feel as if he had all the time in the world to talk to me. I hadn't realized until today how important that quality is.

He seemed very positive about our plight, and could see no reason why we shouldn't have hope that IVF might work for us. He said he thought it would be unwise to continue with IUIs, as I've proven that I'm prone to OHSS. He was very surprised that no one at my previous clinic had mentioned the idea of converting our long-ass hyperstimulated cycle to an IVF cycle. He said that they do not, as a rule, perform "follicle reduction" procedures at the new clinic. In fact, he has never performed one. Ever. They don't 'believe' in them. Rather, when someone over-responds the way I did, and produces a shitload of mature follicles in an IUI, they either convert the cycle to an IVF cycle.....or they cancel it.

He told me that in their practice, I never would have been allowed to stim for 65 days. He said he would have called a halt to things at 17, 18, or perhaps 19 days, if nothing was happening, and induced a period. Then we would have started all over again with a different dose, different drug combo, or something else.

He basically said that he thought further IUIs would be a waste of time for us, because it would be highly likely that I'd end up over-responding, and end up converting the cycle to an IVF cycle anyway. Why not just do an IVF cycle in the first place, is the logic, I guess.

His opinion was that it would be better to do IVF, and then if I end up with severe OHSS, we'd do the retrieval, cryopreserve the embryos (assuming there were some of high enough quality) and do a frozen cycle once the OHSS had resolved on it's own. (Much like the experiences of our good friend Samantha) According to the good Dr. G, I can anticipate success rates of around 20% for an IUI cycle, 50% for a fresh IVF cycle, and btw 35 and 40% for a frozen cycle. So, a frozen cycle still holds more promise than IUI, any way you slice it.

Another interesting tidbit he offered is that for those prone to hyperstimulation, he likes to use a generic form of hCG, rather than the Ovidrel variety. Ovidrel apparently only comes in a pre-measured, pre-filled syringe in pre-determined amounts - 10,000 somethings? ius, maybe? I dunno, but since hCG is often the catalyst that propels someone into hyperstim mode, he likes to use less than the traditional dose - not as much as comes in the Ovidrel one-size-fits-all shot, but juuuuust enough to get the follicles to do their thing and release the eggs. The generic form can apparently be ordered up in whatever size dose he chooses. Probly cheaper too? A girl can hope.

The other good news, financially, is that at the new clinic, one is not precluded from participating in shared risk if one has previously gone through an IVF cycle. This is not the case at my previous clinic. I thought that seemed unfair, and apparently the new clinic shares that perspective.

Dr. G said he thought it made perfect sense to use the rest of our insurance money towards the purchase of a single IVF cycle - why in the world would we leave that money sitting on the table if we didn't have to? If the first cycle works, great. If it doesn't, we will essentially have used the first cycle as a diagnostic tool to better understand if IVF is a good choice for us. We'll have more information, based on my response, and the outcome, to decide if it will be advantageous to proceed with shared risk.

I told him my only worry about proceeding at this point is that we were trying to plan a vacation the second week of September. He first said that he thought we could definitely get in a cycle before then. Then I think he realized that I'm coming from a place of having stimmed for SIXTY FIVE DAYS, and he said that of course, the safest course of action - in terms of not interfering with our vacation - would be to wait and start the BCPs and Lupron in August. Then, I suspect he saw the look on my face, and he hastily added that of course, waiting and treading water for the rest of the summer might be, emotionally and mentally - not the wisest choice. Ha! I told him I wanted to start right away, and that we would take our chances with the vacation situation!

He said worst, worst case would be that I could end up with severe OHSS and end up in the hospital, which would of course preempt our vacation, if the timing lined up with that week. But of course, there's really no way to pinpoint the timing, bc we don't yet know exactly when we'll start the cycle, we don't know exactly how long it'll take to stim, we don't know how bad the OHSS will be, we don't know the exact timing btw retrieval and transfer, etc., etc.

I'm really inclined to book the damn vacation, and pray for the best. But, does that create even more pressure when that's the last thing we need? I don't know. I just feel like I'm so sick and goddamn tired of putting every fucking thing in our lives on hold in order to accommodate infertility.

At any rate, I now have in my hot little hand a doctor's order for some pre-conception genetic screening bloodwork (apparently the new clinic does a more thorough genetic screen than my previous clinic), a scrip for Provera to induce a period once they get the results of the genetic screen back, and the business card of the nurse who has been assigned to my case. I'm to call her as soon as I've completed the blood work. She said it takes at least 2 weeks to talk to the financial coordinator and get all the insurance details squared away (that seems a little ridiculous to me - 2 weeks, for cripes sake? but, I'll deal with it, I guess.) Then, I assume that after my period arrives, I'll have a baseline sonogram and bloodwork, and then be cleared to start the BCPs (there's something so totally demented and twisted about taking birth control as a part of this process, don't you think?)

The ONLY thing I'm apprehensive about, as far as treatment goes, is those damn intramuscular shots. I've only had to contend with the subcutaneous variety thus far. I could be remembering this wrong, but I think Dr. G said today that the Lupron was IM? I hadn't realized that, until now. I knew that the infamous progesterone-in-oil shots were IM. Dr. G said I'd be looking at around 3 weeks of PIO shots??? Good God. I can't imagine how sore my ass will be after all of that.

So, anyway, it feels good to be almost out of limbo, and be working towards a specific goal again. I'm thinking I'll probably go to the lab sometime this week and get the blood work out of the way. The sooner we get this show on the road, the better. I'm dreading the lab though - is it me or is going to one of those places somewhat akin to spending your afternoon at the DMV? If I didn't know better, I'd swear that LabC0rp and Quest Diagn0stics were both government agencies.

Thanks for your kind comments...

2007-05-08T14:46:00.000-04:00

Just wanted to say how enormously I have appreciated all of your kind words of support since last week! I was incapable of posting anything for several days after the last cycle ended, mainly because I was just so damn angry. I knew no matter what I set out to write, it would come out as venomous, bitter, nasty....

I have more perspective now. We're concentrating on what the right next move is. It is largely a question of finances, as it is for so many others dealing with infertility. I'm lucky enough to have some insurance coverage, but when it comes to the cost of IVF, it's a mere drop in the bucket.

I have not gone back for any kind of follow up with Dr. D. I know, logically, that the failure of the IUI was not his fault. But for some reason.....I just feel like I'm done with him. I called the Nurse's line at Dr. D's office on Thursday morning to tell them that there was no need for a beta on Sunday, as I was most definitively not pregnant. The nurse said something about not seeing anything written on my chart indicating what Dr. D would want me to do next - did I want to make an appointment for a consultation the following week? And I said, you know what - don't call me. I'll call you. Maybe.

I'm much more energized about meeting with the new doctor next week. I want to lay my whole history in front of him and find out what his perspective is. Does he think IVF is the right next option? Does he think there's any point in doing another IUI? Will he agree to start stimming me at the 150-200iu range? Or will I have to start back at those little drippy doses again, and stim for another 2 months? God forbid.

Even knowing how painful the OHSS is, and knowing that it is highly likely I'll end up right back there again.....I'm still eager to begin treatment again. Every day that goes by I feel like I'm losing precious time. I feel anxious not having a plan. As ridiculous as it was to take 65 consecutive days of shots, mostly without seeing the slightest hint of progress - at least I felt I was DOING something, taking action, following a plan every night at 10pm. There's something darkly comforting about the ritual of shooting up every night in the bathroom. I still catch myself watching the clock at night, counting down until it's time to 'do my shot.'

Ugh.

I guess right now we're concentrating on how the hell to come up with the money we'll need to continue. Weighing our financial options. If we go whole hog, and sign on for the Shared Risk plan, we'll get 6 tries - 6 fresh cycles plus any frozen cycles that come out of those, if we're lucky enough. But, we'll have to plunk down somewhere around $20K - $25K before we can begin.

If we opt to pay for one cycle at a time, we can use our remaining $7K of insurance money, and just pay the balance out of pocket - which would be somewhere around $5K, I think.

OR, we could continue with another IUI, which could be completely covered by our remaining insurance money.

In any and all events - we're all out of pocket for drugs. At my highest doses of Follistim and Menopur there at the end of the last cycle, I was at about a $1500 per week habit. That's going to add up awfully quickly.

So, if we're going to pay the same for drugs no matter which option we choose - I kind of feel like it would be smarter to do an IVF cycle. I would really hate to do 2 more unsuccessful IUI cycles, and then realize we spent $10K or more on drugs that we could have spent towards IVF.

The trick though, is that if we opt for the Shared Risk plan - which is appealing for many reasons, not the least of which is that it relieves some of the intense pressure for that first cycle to be successful - we'll have to leave $7K of insurance money sitting on the table. It's hard to walk away from that. (The rationale is that if you are doing "Shared" risk - you have to personally bear all of the risk on your end without any help from insurance money.)

And then of course, there's the gamble factor to consider: What if we pay as we go, pay $5K to supplement the rest of our insurance allotment, and we're successful. That's a bargain! What if we opt for Shared Risk, borrow against our house or something for the $25K, and then end up having a successful first cycle? That's NOT a bargain, and wouldn't we be so regretful that we didn't just pay out of pocket for one cycle to see if it would work? But what if we get to the end of the 6 tries (and frozen cycles) and we're still unsuccessful? How amazing is it that we could actually get that money back in order to use it for adoption fees?

Oh God, I don't know what the right answer is. I keep going over and over and over this in my mind, and R and I have had at least 4 conversations about it since Thursday. I just don't know what the right answer is? I'm trying to open myself up to feel what the right path is for us, but I'm still struggling to know just what it is that God means for us to do.

I still wonder if we should give up? Are we meant to adopt? Is that what this is all about? People always talk about "letting go, and letting God." I have never figured out how to do that, exactly. Being a control freak, it's a foreign concept. I'm trying to just get - quiet. Calm down and see what thoughts creep in when I open myself up. We'll see.....

It's a bust.

2007-05-03T08:25:00.000-04:00

I started my period in the wee hours of last night, and have had ridiculous cramps ever since.

Isn't it just hilarious that my body, who, heretofore always acted oblivious of the appropriate time to begin bleeding, suddenly THIS time decided to do it right on time?

I've been up since about 3am. Had a long hiccup-y cry with R when he woke up at 5:15.

Mostly I just feel so foolish for being so hopeful and fantasizing for these (almost) two weeks about how wonderful it was going to be, telling R we had finally done it, it was finally our time, calling my mom to tell her, celebrating Mother's Day this year, how and when we'd tell the rest of our family and friends when the time was right, etc., etc.

65 consecutive days of shots for nothing. God only knows how many monitoring appointments and blood draws and fighting traffic to get the RE's office and being late to work for nothing. A week's worth of laying in bed with OHSS pain for nothing.

My body has made a fool of me once again.

Not sure what we're going to do next.

I'm human again! Oh shit, is that bad??

2007-04-29T21:54:00.000-04:00

So I woke up today feeling much better than I have in a week. And I was so thankful and happy to not be in pain! Until about halfway through the day when I remembered that they said IF I were to get pregnant I would probably feel worse before I got better. AAAhhhhhh! Of course a part of me is telling myself this means I probably didn't manage to get knocked up, on this, our one and only legitimate try. But, I'm trying REALLY hard to think positive and will my way into a positive result at the end of this 2WW from hell. I'm banishing all negative thoughts each time they creep into my brain. Which happens about 46 times an hour.

But anyway, let me tell you about my visit to the Scary Radiology Lab with Dr. Doom-n-Gloom on Friday. Dear Lord in Heaven, did this guy scare the crap outta me - cripes!! The ultra high tech ultrasound was actually pretty cool - it not only showed the normal black and white Rorschach images as the ultrasound at the RE's office, but it also could show, via different colors, blood flow, fluid movement, etc. Also the quality of the black and white Rorschach blobs was like the difference between regular and HD TV broadcasts. You could like, see the PORES on my ovaries faces! Har har.

Anyway, so here's the list of observations Dr. Doom rattled off to me after prodding me with the wand for what seemed like HOURS: "Your ovaries are three times their normal size, the lining of your uterus is twice as thick as it should be, you had at least 3 or 4 ovarian cysts which have ruptured within the last 48 hours and are now leaking fluid into your abdominal cavity - likely the reason for most of your acute pain, there is decreased blood flow to both of your ovaries, and many different hemorrhagic cysts remain on your ovaries which contain blood and other debris and they may or may not rupture in the near future. Also, there is no absolute certain way to diagnose ovarian torsion, it's extremely difficult, even with high-res ultrasound. Your ovaries are both symmetrical, so that might indicate that neither have twisted, as it would be highly unlikely for both to have twisted in the exact same way. However, having said that, since they are so enlarged, I would have to say that you are at very high risk for ovarian torsion. I'm going to go call your doctor and he'll have to decide whether or not you need surgery...."

He did call Dr. D, and then patched him thru to me once I was back out in the waiting room, and as soon as I answered the phone Dr. D said, "Well hi there kid, sounds like everything is looking really good!" Um....wha??? I told him the other doctor had scared the shit out of me. He said he figured as much, and that's why he wanted to talk to me directly. He said he thought it was great that I had blood flow to both ovaries, and that DUH, of COURSE it will be decreased if they are that enlarged, which we already knew. As for the rest, he said, well, yeah, we knew you were hyper stimulated, and those are all things we expect to come along with that. He basically said what he's been saying all along, which is that he knows it sucks, but there's nothing really to be done but to grin and bear it and suck down a Percoset every now and again when the going gets really rough.

So, I went home and crawled back into bed. Then on Saturday, I had another pity party when I woke up feeling even more pain that I had on Friday. Then, miraculously, I woke up today feeling almost human again. Back to the way I felt just after the IUI actually, where I felt full and uncomfortable - but only in pain when I walked too quickly or laughed too hard or sneezed or something. Oh LORD, oh Lord, I hope this isn't a bad sign, because, remember they said that IF I got pregnant that I would.......... Oh! Right! I'm not supposed to be thinking that! Nope, no negativity! Only happy shiny sugary sweet thoughts! Happy thoughts! Happy thoughts!! I AM going to be pregnant, I AM going to be pregnant, I think I can (get knocked up), I think I can (get knocked up)...Chooo chooo!!

By the way, this 2WW thing really bites!! 1 week down, 1 to go......

OHS Sucks.

2007-04-26T19:09:00.000-04:00

Well, prepare yourselves, for this will be another in a long line of 'poor me' posts. I feel like dogshit. The OHS has gotten progressively worse and worse since Sunday. Sunday after the IUI and Monday, I pretty much just felt my ovaries - felt how big they were, felt them everytime I walked, felt them when I stood up or sat down, and as aforementioned, when I had to urinate. Tuesday this progressed into feeling like my whole midsection was one big cramp, which I could feel all the way across my belly and through my lower back. It was unrelenting, but bearable. On Wednesday morning I woke up and noticed that after I peed.....I didn't feel any sense of relief. I walked into my kitchen to let the dog out onto the deck, and by the time I got back to the bedroom I was in really bad pain. I discovered that the only thing that made the pain relent, at all, was if I laid on my right side. I was huffing and moaning to beat the band on Wednesday morning, and finally R convinced me to call the RE's office. Dr. D told me to get dressed and come to the office - he'd work me in, between other patients.

It was all I could do to stand up in the shower long enough to get the shampoo out of my hair - I had to take several breaks while getting dressed to come lay down again to let the pain recede a little bit. I rode to the doctor's office with R driving as fast as he could, and me stretched out across the backseat trying to get some relief.

Dr. D showed us my ovaries on ultrasound (from the outside, thankfully, no wanding on this visit) and confirmed that they indeed were both the size of grapefruits. His basic attitude was that he was not at all surprised that I was in pain. He said that he was not concerned about ovarian torsion (where your enlarged ovary can twist on itself, cutting off it's own blood supply), because he said that if that were happening, I wouldn't be able to speak, or sit up, or stand, or do much of anything other than scream in agony. If torsion happened, he said that the only thing to do would be to call an ambulance and meet him at the hospital.

He asked me if I'd been eating and drinking. I said no, I haven't felt like doing either of those things at all. He said I didn't HAVE to eat, but I did have to drink. He said to go get Gatorade on the way home. He also gave me a prescription for Percoset. I honestly don't know how I would have made it this far without it. I've been going through periods every now and then - once around 4am last night, once around 12pm today, where the pain just absolutely would not go away, would not subside no matter what position I contorted myself into. I shudder to think how bad it would have been if the Percoset wasn't at least taking the edge off of it.

So, Dr. D made me promise I'd call him this morning and let him know how I was doing. I left a message basically saying that I wasn't any worse, but neither did I feel any better. I'm nauseous, everytime I stand up and/or drink Gatorade the nausea gets worse. I told him I was scared to death of running out of Percoset, bc I didn't know how I would bear the pain without them. (He didn't give me any refills on the measly 24 pills he prescribed yesterday.)

His nurse called back this afternoon and said that Dr. D had gotten my message, and was OK with my progress report (?) and that he thought maybe I'd feel better if he sent me to get some kind of special, high falutin' ultrasound scan that could rule out ovarian torsion for certain. The nurse proceeded to tell me that she had gotten the radiology lab to 'work me in' even though they had no appointment openings. I should be there by 3:15pm, she said, but be prepared to wait, since they'll be squeezing me in whenever they can. Oh, and I should drink 32 ounces of water 1 hour before the "appointment" time. Are you freakin' kidding me???

The way I feel right now, this sounds like a sentence of torture!! First of all, I've got to get someone to drive me to the damn appointment - someone in front of whom I won't feel like an idiot when I'm moaning and panting in the back seat. (R took off on Wednesday to take care of me, and I really don't want him taking any more time off because of this shit.) Then they expect me to just hang out in the waiting room for God knows how long....with a full bladder?? Not only is it excruciating at this point to have even a moderately full bladder, did I also mention that I can't sit or stand for more than about 2 minutes without feeling acute pain radiating across my right lower abdomen?? There is simply no physical way I can do this. My plan is to march (hobble) in there, tell the receptionist that I'm in major pain, and I simply cannot sit in their waiting room. I'll give her my cell phone number, tell her that I'll be laying in the back seat of the car, and to call me when they are ready to take me. The time it takes to get to the car from the office will be bad enough.

I'm so exhausted from this pain, and so tired of laying, squirming, tossing, turning, in bed. If nothing else, this kind of thing really makes you appreciate having a normal pain-free life. I should count my blessings every single day! I'm so aware right now of things I usually take totally for granted.

I think the worst thought though, that keeps creeping into my mind, is that after all of this, if this doesn't work?....Ugh, what a nightmare it will be to know that we have all of this to look forward to with IUI#2...

Is it time to pee on a stick yet??

2007-04-24T15:08:00.000-04:00

So, I had my first IUI on Sunday morning! It was quite exciting! Actually, the IUI part was rather anti-climactic, if you ask me. Especially given how much of a pain and a production the follicle reduction was. Apparently, a follicle reduction in an IUI cycle is the exact same thing as an egg retrieval in an IVF cycle - except, in an IVF cycle, they keep the eggs, in a follicle reduction, they don't. Who knew? Not me. I thought the nurse was going a bit overboard when she called in a prescription for me for valium, and told me to take it 15 minutes before my appointment time.

Before I go any further I should probably warn you: if you are a first time IVFer, or are like my good friend Kellie who hates the idea of surgery/procedures, etc., or if you just don't want to hear about painful stuff, (then why are you reading an infertility blog, hardy har har) then you should probably just skip the next paragraph...

Yeah, so I was totally, TOTALLY unprepared for the pain involved in the follicle reduction procedure. When they told me that I would be sedated for the procedure, I thought that meant I'd be out. As in, OUT. Asleep. NOT awake or aware. Um, yeaaaah...not so much. When the nurse had me all prepped in the "procedure room"(not quite an OR, but neither as casual as an exam room), IV inserted, good drugs dripping into my arm making me feel like I'd had 6 vodka tonics on an empty stomach, oxygen mask over my nose, legs akimbo resting on weird bent-knee-holders instead of stirrups, (and I should have been really nervous when she TAPED my legs to the leg holder thingys) and the cast of doctors and nurses gowned and masked and gloved and ready to go.....all of sudden I thought - hey, I'm not asleep! I'm still aware! I feel like I'm completely bombed out of my gourd, but I'm still, you know, present and in control of most of my faculties! So I said to the nurse, "Hey, I think I need more drugs!" And she said, "Why?" And I said, "Because I'm still talking to you!" And she said, "Don't worry, you won't remember a thing!" And I distinctly remember thinking, "Oh SHIT. They have no intention of putting me to sleep!!" So, yeah, the doctor took out (sucked out? aspirated??) 10 follicles. And although I was really, really out of it, I felt the needle each and every time. I think I had my eyes closed the whole time, but I kept crying out, and the nurse kept telling me to shush and try to relax. Yeah right! It just seemed in my drug addled brain that it went on and on forever. Round about number 6, I asked if we could take a break, because I didn't think I could stand it. I'm telling you it hurt like a motherfucker. I heard Dr. G say, "Just hold on K, we're almost there, we're almost there..." Dear GOD.

So, ANYWAY, after all that, I was helped into a wheelchair, and then they took me back to an exam room. They had me lie there for about 40 minutes while the drugs wore off, and I think I slept most of that time. They made me drink some juice, I think, too. Then, when the nurse finally came in to do the actual insemination it took all of about 45 seconds, and I said, "That's IT?" I kept waiting for it to hurt! She was in and out before I even knew what was happening!

Dr. G came in a little while later, and the first thing he asked me was if I remembered anything from the procedure? I looked at him a little incredulously and said, "Um, yes. I remember that it was painful!!!" He sort of laughed conspiratorially and then told me that he had taken out 10 follicles, and left 3. He said that he could tell I was probably going to experience some mild hyperstimulation symptoms. He said my ovaries were very enlarged, but not to the point that he was overly concerned. However, he said that they might get larger over the next two weeks. He also said that if I do end up getting pregnant this cycle, the OHS symptoms will worsen for several weeks before they get better! Conversely, if I don't get pregnant, the symptoms should dissipate pretty quickly. Bummer, huh? Whatever, I'll endure any amount of pain if it brings me closer to bringing home a baby!

So, indeed, the OHS symptoms have worsened since Sunday. This morning I could literally barely walk when I got out of bed. It hurts if I let my bladder get full, and it hurts worse when I sit down to pee (it also hurts me to write that word: pee. My mother taught me that was a vulgar word, and we've always used the euphemism 'tinkle'. However, that seemed a trifle silly, having dropped the F bomb just a couple paragraphs up...) After I empty my bladder there is much relief, but actually emptying it is a Herculean feat. I'm the world's WORST baby when it comes to pain, so I've taken to moaning as I hobble around. I thought I was alone in the bathroom at work yesterday, and indulged myself in some oohs and aahs of pain before settling down and peeing, already. Too late, I realized there was another occupant in the far stall. I can scarcely imagine what she thought I was doing in there. But, I drew up my feet under me lest I should be identified by my shoes, and waited until she left before exiting. HA!

So, I've decided my strategy for enduring the 2WW will be to pee on a stick early and often, so that I will know when the HCG trigger shot is out of my system, and hence I will not be led into false exhilaration at a fake-me-out positive HPT. I tested on Sunday after I got home from the IUI, and of course, got a line. Not a dark one though, which surprised me. I tested again today and didn't get a line. So, I wonder if that means that detectable levels of HCG are out of my system?? It seems rather early - don't they usually say that the trigger stays in your system for 6-10 days? I took it on Friday, so it's only been 4 days? No matter. No amount of self-talk will prevent me from peeing on sticks at every imaginable opportunity. So, I'll do it again tomorrow and see what I get - maybe today was a fluke, and the trigger will turn tomorrow's test positive, you never know. And yes, now that you ask - HPTs DO grow on trees! Why, I have a lovely First Response tree just outside my kitchen window....

Ovaries in overdrive

2007-04-19T14:09:00.000-04:00

I still can't believe this is happening! Went in for monitoring again this morning, and suddenly my wizened old ovaries fancy themselves overachievers of the highest order. Yesterday morning I had one follicle at 21mm. This morning I have NINE over 20 - some up to 23mm. And don't forget the 16 or so hovering in the 17-19mm range. YIKES!

Dr. D called a few minutes ago to confirm that although octuplets might make the record books, we won't be taking the chance. Instead, he'll perform a follicle reduction before insemination, limiting me to only 3 eggs. Even that makes me nervous. I'm definitely NOT one of those people who says, "Oh gee, wouldn't it be nice to have twins and just get all of this pregnancy stuff out of the way with one fell swoop?!" Nuh-uh, not me. I've SEEN people pregnant with twins, I've TRIED to talk to mothers of twin babies when both kids were squalling and demanding attention simultaneously, I've WITNESSED the chaos, and I say, gimme a singleton pregnancy any day of the week and twice on Sunday...that is to say... well, you know what I mean.

Anyway the plan is to trigger at 11:30pm tomorrow night. Then bright and early on Sunday morning R will make his deposit, and they'll put me under for the follicle reduction. The nurse said that they'll go ahead and do the insemination while I'm still out of it. She said this like it was a good thing. Am I to surmise that the insemination procedure is not pleasant? I had the cervical culture and mock-insemination done, way back in the Mesozoic era, before I started this cycle. I didn't find it particularly uncomfortable? But maybe there's something about the real thing that is worse than the run-through??

Ever since yesterday, I have felt like there was a warm ray of light shining down on the top of my head. I cannot express how thankful and grateful I feel right now for this opportunity. This will be, literally, the first and only chance that R and I have had to create a child since we married 2 years and 6 months ago. Isn't that a kick in the pants?

Updated: Follicles a go-go

2007-04-18T10:07:00.000-04:00

To say that I'm pleasantly surprised is a gross understatement. This morning was my last hurrah with Dr. D. I'm down to the last of my drug supply. If this morning's scan had shown the same old status quo with my unresponsive ovaries, the plan was to cease and desist, rather than continue throwing good money after bad. The next step of the plan wasn't to occur until mid-May, when I have a consultation appointment scheduled for a second opinion with another doctor at a different clinic.

To my utter amazement, this morning's ultrasound revealed that the drugs have finally worked. My follicles have been in the 6-10 mm range for over 60 days, but they've now moved on up to the big time, several clocking in at the 16 through 19 mm range, and even one at 20!!!!!!!!!!!!!!!!

I. Can't. Believe it!

Today, for the first time the wanding was reeeaaallly uncomfortable, and for the first time, my left ovary was hiding behind my uterus. The RE had to really be aggressive to find it, and it was so uncomfortable that I was making little "ooh, ohh" noises from the uncomfortable-ness of it. It was worth it though, because that is where the 20mm chief follicle was hiding. RE said that was the threshold they looked for to indicate readiness to trigger. He also said that we'll have to monitor closely to see if the others try to catch up to Mr. Big. If there's a sudden burst of competition, I'll need to have the follicle reduction procedure to reduce the risk of high order multiples.

Bottom line is that trigger is imminent, and IUI is likely to happen sometime this weekend.

I know that several things could still go wrong from here. What if the trigger shot doesn't work? What if I don't ovulate in a timely fashion? What if my body can't seem to release the egg at all? What if, what if, what if?

You know what? I'm absolutely not worrying about any of that. Won't even let myself go down that path. La, la, la, la.....Right now, I'm giving my full concentration to being joyful and thankful that my ovaries are in fact, NOT completely unresponsive. This means that there is hope to try again after this. This means that this is not the end of the road. This means that my body cooperated and performed properly, and for that I wholeheartedly commend it.

I have been effusively thanking and congratulating my ovaries all morning, lest they should feel unappreciated and go on hiatus again.

The office will call me this afternoon to tell me whether I need to take my last 3 remaining doses of Follistim, and/or when to take the trigger shot. Be assured I shall update you as soon as I hear something!

:)
***********************************************************************************
Update: I have officially set my clinic's record of longest stim, at 65 consecutive days. R thinks I should get some kind of recognition for that, like my name on a plaque in the waiting room or something. The streak ends today, thank the good Lord above. Dr. D has decreed that no needles shall pierce my skin tonight. Drugless for tonight, then back tomorrow morning for one last wanding, to ensure there are still only one or two biggies. If all goes well, I'm back on the needle tomorrow night--- for the trigger! Woo hoo!!!

Black market drugs

2007-04-13T15:08:00.000-04:00

Quick question: Has anyone heard of buying fertility meds from strangers via ads on the internet? Is it against the law? Is it a very common practice? I was searching for the best price for Follistim to buy my last fix, and I came across a "craigslist"-ish type website where individuals have posted ads describing all the meds they have leftover from cycles (both for positive and negative reasons, I assume) with prices far lower than you could get from any pharmacy. Although this seems inherently frightening and creepy to me, I must admit that part of me is intrigued- the price for the Follistim I need would be about a third of what I'd pay from the pharmacy. Have any of you heard of this? What are your thoughts?

Getting a grip

2007-04-12T10:09:00.000-04:00

Well, I'm happy to report that I'm slightly less unhinged than I was when I wrote my previous post on Tuesday night. I'm still very sad about the current state of affairs, but I've dragged myself sufficiently far - but not all the way - out of that deep dark hole to be able to string coherent thoughts together again.

My thoughts on adoption over the last few days run along very similar lines to Julie's most recent posts on "A Little Pregnant." (And I've also followed the ensuing flame-fest on Chicagomama's blog incited by Julie's posts...)

I have the same reservations about adoption, at least right now, that were expressed on ALP - to me, right now, it feels like a crappy second choice. It feels like settling for decidedly less than. (I understand that once you actually have an adopted child, you love that child no less, and possibly more, than anyone else loves their biological child. So please don't flame me to a crisp, I'm merely expressing my own personal fucked up FEELINGS here.)

The way I feel at this moment, I can't imagine how to get from here.....to there. Because here is bitterness, and anger, poor-me syndrome, and grief. I can't fathom how I will get through these feelings of loss - grieving the inability to have a house full of children with my hair and my husband's eyes and my grandmother's nose, grieving the missed experiences of carrying a child inside of me and feeling it kick for the first time, etc., grieving the missed experiences of saying yes, I'm due in 3 months! and giving birth, and breast feeding, and listening to friends and family argue over whether the baby looks more like me, or R, or Aunt Polly? How do I get from feeling like this shriveled up, bitter, jaded person......to a place where I'm approaching adoption with a positive, excited, this-is-definitely-the-path-for-us attitude?

R is absolutely amazing, that's at least one thing I know for sure. I've endeavored over the last few days to try to concentrate on how colossally blessed I am to spend the rest of my life with this astounding man. When I called him, hiccupping and sobbing after my appointment on Tuesday, the first thing he said, after, "I'm so sorry baby", was something quite positive. He said maybe this is for the best - maybe now we can put the infertility treatment behind us, put all these little accumulating disapointments to rest, and focus on something that has a 100% chance of having a positive outcome. He said that he has prayed over and over again about a positive outcome for our infertility struggle - BUT, that he has never prayed specifically for me to be pregnant. Rather, he said, he's prayed for us to find the path and the way to our family that is meant for us. So, he said, maybe this is finally a nudge onto OUR path?

He seems much less conflicted than I. He said something yesterday that summed up his feelings, very simply: He wants a family, he wants to be a father. We can't get pregnant. Therefore, we will adopt. Simple as that. He's looking forward to the joys of being parents, of having children running around in our house. Having children in our lives is more important to him than the process by which they will come to us.

I feel like I have to get to that same point, to feel that same way, before I can really commit to the adoption process. Right now I have so many fears and doubts. Now - I have absolutely NO doubt that I, we, posess the capacity to love an adopted child as fiercely and passionately as I , we would love a biological child. But, I worry that adopted children would eventually resent that our desire to adopt them was, in itself, borne from a place of grief and loss?

An anonymous poster on ALP wrote,

"Please. Don't. It made my heart sink to read this post. Let someone else adopt the baby you are feeling so ambivilent about. Only children do not die from onlieness. I just can't imagine how gut wrenchingly awful it would be for you to adopt a child and have this child later in life discover these archives. Please. Don't. Step away from the application now." (italics mine)

I get that - even as I write this post I think - we'll never tell our future adopted children the details of this struggle, and I must destroy all evidence of this blog lest they should find it someday and feel they were our second choice! I guess I just don't know how to reconcile that.

Other than emotional ambivalence and lack of moral fortitude where the theory of adoption is concerned....my other concerns for the immediate time being are that I feel completely emotionally drained and physically exhausted. I've come to the conclusion in the last couple of days that I have to move forward with little shuffling baby steps.

Yesterday I decided that I had to make an appointment for a second opinion with another fertility clinic in this area. If I didn't, I might always look back and wonder, what if? However, I simply couldn't face the visualization of starting over at a new clinic - staring down the months ahead filled with more tests, then more ultrasounds, more shots, more hoping, hoping, hoping, and most of all, more disapointments mounting up and and up and up. So I told myself, all I have to do today is pick up this phone and call to make an appointment. That's all. I don't even have to think about what comes after that point. Just make the appointment, and don't think any further. So, I accomplished that. I have an appointment on May 15 with a well respected doctor at the largest fertility clinic in the metro DC area.

As far as adoption goes, I made phone calls and sent emails yesterday to several former co-workers who have made the journey from failed infertility treatments to the adoption process. I asked them for a quick overview on all things adoption, as well as advice on the emotional component. I asked them if they felt these reservations, and doubts, and like Julie on ALP also asked on her blog - I asked them if those doubts fell away the further they went into the process. I was trying to find out if it's OK to at least start the process feeling this way?

Both of the women I was able to get in touch with yesterday said that they felt exactly the same way. One woman, in particular, said it took a whole year for her to gain the excitement she now feels about her impending adoption of a son from Russia. She now wishes that she hadn't waited so long to begin the copious and time consuming research necessary to even begin the adoption process. She wishes that she hadn't wallowed in self pity and jealously for as long as she allowed herself to do. Like everything else related to infertility, time is never on your side. She warned that if we decide to consider international adoption, many countries have age limits over which they will not allow you to adopt infants. If we want to consider domestic adoption, she cautioned that most agencies will tell you that if you are an older couple, you'll have a lesser chance of having a birth mother pick you, regardless of your financial stability or effervescent personalities.

So, baby steps. I've decided to begin researching the idea. The theory of adopting a child. What information does one need? How does one prepare? What is necessary? In this way, I hope to be able to collect all the information that we'll eventually need in order to consider and commit, but in a sidelong, oblique sort of way that doesn't require commitment up front.

Maybe, as I go along, some of my doubts and reservations will begin to fall away. Maybe one day I'll wake up and feel in my heart that this IS our path.

I'm certainly not naiive enough to believe that I'll be able to work through all the pain of infertility, all the grief, all the loss, all the anger, in some proscribed period of time, and just be a clean, blank slate ready to begin the adoption process. I think like anything else on this protracted journey to parenthood, it will necessarily be a progressive progress. So I think the only way to begin is just to....start. Start learning about it, and see what happens as we go. This approach is very much against my nature, but I think it's the only way I can get through this.

In the meantime, as aforementioned, we've decided to continue the meds at least until the drugs I've already paid for are depleted. At that point, we'll have to decide whether to shell out for more drugs. This worries me, for two reasons: inasmuch as I've told myself over and over again that this is a futile effort, and I should under NO circumstances allow a positive thought to enter my mind.....somewhere deep down I still have a vision in my mind's eye of the impending wanding session on Saturday morning - that Dr. D will break out into a wide grin and say, "Well waddya know about that - some progress at long last!" And I'll call R, crying from the parking lot, but this time crying with relief. I try to banish these thoughts, because it will be soooo much easier on Saturday to hear the familiar refrain of resistant and inactive ovaries, if I've already convinced myself that bad news is the only news I'll get. But, to no avail. Hope continues to creep in, unbidden.

And finally, what about the crack factor? No, no, I'm far too practiced a stirrup jockey to be concerned about the ubiquitous paper sheet and it's inherent coverage-related shortcomings. I'm talking about the impulse that I KNOW I'll have, even after Dr. D looks at me morosely from between the stirrups on Saturday and shakes his head in resignation, to say....OK, how about just one more shipment of drugs? Just one more week? One more week of doses, and then I promise I'll quit these fucking hormone shots. One more hit? Please, Dr. D, can't we go up to 225 IUS a night? That's just a little more than 200ius, but what if that will make the difference? What if my ovaries are holding out for the extra large, super value meal sized dose? Let's just give them one more chance, waddya say? Uuuggghhh... it makes me feel PATHETIC already!!!!!

Down in a hole...

2007-04-10T20:43:00.000-04:00

I've heard some of you describe it that way, when you've received bad news about another failed cycle, or a canceled course of treatment, or some other setback on this journey. That is a perfect description of how I feel today. Let me endeavor to bring you up to speed:

Last week I ordered another batch of drugs, and when it arrived on my doorstep the invoice indicated my credit card had been charged for more than $700, instead of the $50 co-pay I had expected. Further investigation revealed that I had exceeded the calendar year limit imposed on infertility prescription drug coverage by my insurance provider. I quickly calculated that regular out-of-pocket costs for my current consumption of Follistim and Menopur would cost me almost $1300 per week. That's expensive even for someone with normal functioning ovaries, who might be on the drugs for a week or maybe two. For someone who's now been taking daily injections for 60+ days, it's a bloody fortune, and a luxury I knew I couldn't afford to keep up.

So, I despaired and cried and screamed and generally felt, by turns, immensely sorry for myself, royally pissed off at my insurance company for hiding this calendar year limit in the fine print, outraged with my ovaries for their stupefying laziness, and then sorry for myself again, around and around we go, etc.

I made an appointment for this morning to meet with my RE. I wanted to impress upon him that if my husband and I were going to have to borrow money to finance our treatment, that I wanted to be sure it was the most aggressive form of treatment, the wisest use of our precious funds. I wanted, in my innocence, to announce that I was ready to move on to IVF, please, and don't spare the horses.

In the comfortable leather chair of my RE's office, after delivering the above rehearsed speech, I took a breath, and braced myself for what I thought would be a lecture on the fickle nature of polycystic ovaries. I was expecting admonishments from Dr. D that just as he could not predict how quickly I'd respond to IUI doses of gonadotropins, neither could be predict my response in an IVF protocol, and that I could expect to spend just as much money on drugs in this next, and final, level of treatment. That we could convert this long and laborious IUI cycle to an IVF cycle, but that even with larger doses of drugs, we couldn't expect my ovaries to respond overnight, and that I'd have to continue to be patient.

What I got instead left me breathless, and savagely biting the inside of my bottom lip to keep from breaking down in front of my RE: "K, I'm sorry to have to tell you this, but I really think it might be time for you and R to start considering adoption."

Basically, he thinks that I have unresponsive ovaries. He said he had seen a handful of cases of ovaries as resistant as mine in his 27 years in reproductive endocrinology, but they have been few and far between. Based on past experience, he would be willing to continue attempting ovulation induction with gonadotropin therapy, but he doesn't really have a lot of hope that it will work. It should have worked already, and the longer it doesn't work, the more bleak the probability of eventual success.

Dr. D said that for what it was worth, before I made this appointment, he hadn't been ready to quit just yet. If money weren't an issue, he'd have recommended continuing for at least another 2 or 3 weeks before throwing in the towel - but, it's now up to me and R to decide. We agreed that I'd continue at least until the drugs I've already purchased are depleted. That gives me about another week. At that point, R and I will have to decide whether to spend another $1400 for one more week....or quit.

Needless to say, I have been a complete wreck today. I came home after my appointment this morning, opting to work from home rather than drag my swollen and bloodshot self into my office. There's not a tear left in me right now. Neither is there the energy required to go into all of the labyrinthine thought trails I've been down today in my head - and with my husband - about adoption, mourning the loss of a biological child, the wisdom (and fortitude) to seek a second opinion, etc. etc. etc.

I'll be back tomorrow to get all of that out, and perhaps more. Right now, I feel like I've been run over by a truck. I'm sadder and more devoid of hope than I can ever recall feeling since my father died when I was 17 years old. So, I'm going to bed.

I'll have a decaf Follistim latte please...the regular kind might make me HYPER.

2007-04-05T09:44:00.000-04:00

Good morning girls -

Thanks for the well wishes from Monday's post. Monitoring this morning went as usual: nothing much happening, still.

After the initial wanding confirmed my suspicion of continued inactivity, I asked Dr. G (who was doing the scans this AM instead of Dr. D, my usual doctor), a question: If they can perform a fabulous follicle reduction in the event I produce too many follicles, then why in the name of all that is holy can't we get this show on the road already?? Why can't we just blast my frick frackin' ovaries with hideous amounts of drugs to spur them into some kind of action?????? (OK, no, you're right, I didn't ask the question exactly like that, I was far more controlled and respectful, I assure you.)

Dr. G said that the reasons we can't do that are twofold: with higher doses of FSH, my ovaries are likely to become quite enlarged. The poor fallopian tubes then, end up stretching waaaay out to reach the monster-sized ovaries in order to perform their job as catchers and get ready to grab whatever's going to come out of them. Sometimes this creates a crappy situation for the F-tubes where they basically miss. Obviously, that would make it pretty difficult for the sperm, exquisitely deposited through well placed catheter though it may be, to reach the egg.

The other reason, he said, is that lucky ladies like me who have PCOS, and are receiving higher doses of drugs, are highly prone to ovarian hyperstimulation. Imagine, he said, that I were to produce 18 big ripe follicles. My body would be cranking out estrogen like crazy, and even if they went in and sucked out 15 of those follicles before trigger, it's unlikely my body would be tricked into immediately reducing the full court press of estrogen. Hence, I'd be suffering from ovarian hyperstimulation with no relief in sight, save canceling and popping BCPs till the cows came home.

He also added that in the above described scenario, even if it wasn't a dangerous enough level of hyperstimulation to warrant canceling the whole shabang (which - chances are it would be), that if I somehow, against the odds, became pregnant in that state - that I'd be (gesturing to indicate general humongous-ness) "...out to HERE and absolutely MISERABLE."

Siiiigggghhhhhhh....

SO, they'll call me this afternoon to tell me what to do as far as drugs are concerned. I suspect it will be another four days of Follistim and Menopur. I can't help wondering how long they'll continue this endless low-level stimulation, until they'll throw up their hands in defeat and declare me a non-responder? This can't go on indefinitely, of that I'm certain. It just doesn't seem healthy?

Reduction in Force?

2007-04-02T12:45:00.000-04:00

Hey y'all -

It's been a few days...but because my ovaries were up to their usual level of staggering inactivity, I had no progress to post.

Sunday's appointment was slightly more noteworthy, unfortunately not in an overly positive way. Sunday was day 50 of daily stim injections for me, and suffice to say that the RE was none too pleased with my lazy-ass ovaries.

Here, yet another excerpt from our over-the-stirrups conversation:

RE: "K, there's still nothing happening in here, and I'm worried. Your ovaries are just completely loaded with follicles, but none of them are responding to these meds. They are all still around 6-8mm, and that is not a good sign."

Me: "I know. I've been giving them pep talks every night, but they clearly have a problem with authority."

RE: "You have what I call SCARY ovaries. IF you do eventually respond to the meds, and IF ALL of those follicles develop, we'd have a nightmare on our hands. We couldn't risk triggering with that many mature follicles, it would be very irresponsible."

Me: "I understand. So what now?"

RE: "Well, understand K - I'm not saying that you should give up.........yet."

Me: "Ahem! Ffflugh, hughhh! Ahem!" (Yet???!?!?!?!)

RE: "I can give you more drugs, of course, but the risk is that all those follicles will mature simultaneously. If they do, there is a procedure that I can perform before triggering you, which is called a follicle reduction. You'd be sedated for the procedure, and we'd insert a needle into your ovaries and remove all the "extra" follicles, leaving you with a nice, safe, 2 or 3."

Me: slightly less pale now, "OK."

RE: "So, do you have any thoughts about this? What are you thinking you want to do at this point?"

Me: (stifling the urge to scream like a banshee), "Ummm, well, I'd like to PROCEED." What's the alternative doc? Go sit in a corner and RELAX until my ovaries decide to get off their sorry asses and work for a change, all on their own????

RE: "OK then, I'm going to leave you on 150ius of Follistim for the next 4 days, but we're also going to add Menopur to your daily routine. You'll take 75ius of Menopur, in addition to the Follistim, for the next four days."

Me: "OK, so ummm, because I have all these tons of follicles - does this mean that I'm a better IVF candidate than IUI candidate?"

RE: (literally stepping back in his haste to rein in my over zealousness, and holding up a hand palm out, traffic cop style), "Well now, I've never said I thought you were a good candidate for IVF. We're not even ready to talk about that yet. I mean, no eggs, no baby. No eggs, no IVF, you know? We don't even know if you can successfully produce eggs yet, there's no way we can even start talking IVF until we know the answer to that question."

Me: (doubled over with wind knocked out of me), "Oh. OK."

I've been ruminating on this exchange ever since. I feel like Dr. D stole my trump card. I guess I've always felt like IVF was in my back pocket as our Plan B, fall-back, pull out the big guns, save the baddest for last, last resort option - my IF safety blanket, if you will.

I lost a whole lot of optimism at that appointment on Sunday. I had never allowed myself to consider the possibility that maybe my ovaries COULDN'T make eggs. I had just always supposed that it was a matter of the right drugs - albeit possibly the right combination of drugs, and the right timing. Walking out to my car I suddenly had the urge to smack my forehead, V-8 style - How foolish, this foregone supposition of ovarian ability!! Jesus, K, really, you should be so fucking lucky!

Now I'm scared to death that on Thursday at my next monitoring appointment, Dr. D will take one swipe with the wand and declare me a lost cause. "Nope, nothing happening in there, this is a case only St. Jude can help with!"

We're hosting Easter at our house on Sunday, so I'm trying to concentrate on preparing for that this week instead of dwelling on these fears, but, well, y'all know how it is.....

On a lighter note, speaking of Easter, I went bananas this weekend and bought 6 dozen colorful, fillable, plastic eggs....you know, the kind you use for hiding? I'm planning an Easter Egg Hunt for my nieces and nephews when the family comes over on Sunday. After filling 6 dozen eggs with all manner of miniature chocolate bunnies, jellybeans, marshmallow eggs, and pastel foil covered Hershey Kisses.....I found out that only THREE kids are going to be in attendance on Sunday. Ack! My sisters-in-law are all going to kill me when their kids go home with 24 eggs full of candy, each! Oh well! I also saw on the news this morning that they're expecting it will be around 40 degrees on Easter Sunday, so we'll all be wearing our winter coats to church! Bah!And who wants to hunt for eggs when it's that cold outside? Actually, KIDS, that's who. I suspect it could probably be blizzard-ing, and they'd still be clawing each other and scrambling through the front door to get out there and find that candy!!! I LOVE Easter, and I can't wait for Sunday!

Drama, RE clinic waiting room style

2007-03-21T22:37:00.000-04:00

So I think I've finally gotten my insurance issues straightened out, and I am extremely thankful that I did not have to sell the car, the dog, or my body in order to pay out-of-pocket for my cycle when I went to the RE's on Saturday morning. The financial coordinator took pity on me and gave me a free pass on Saturday, with the understanding that I'd straighten everything out on Monday, when my insurance company would finally have all of my info in their systems. Which they did, and I did, and now all's quiet on the insurance front, as far as I know.

But this morning was full o' drama at the RE's office, let me tell you! First of all, let it be known that I'm the grumpiest asshole in the morning you've ever seen. R can attest, I'm just not nice to deal with, at all. I hate, despise, detest, and abhor getting up early in the morning. Especially on mornings when I have to get up extra friggin' early to fight the MONSTROUS metro DC-area traffic to get to the RE's office by 7am (ish). So here I am, swinging into the ridiculously miniscule parking lot of the RE's office this morning, which is a ONE WAY deal - all the parking spaces are angled for people coming from the southerly direction - and suddenly I'm nose to nose with a hugantic bright red F-150 type pick-up truck. The truck jams on the brakes, I jam on my brakes - most indignantly, might I add, because I AM IN THE RIGHT, and red-truck is waaaay in the wrong, as he is GOING THE WRONG DIRECTION IN A ONE WAY PARKING LOT, for Chrissakes. Instantly my blood pressure sky rockets, my face turns bright red, and as we're stopped there, front end to front end, I mouth (scream) the words, "What the FUCK are you doing you IDIOT??!!" Now mind you, red-truck driver can see me plain as day, but I can't see who is behind the wheel of this monster truck because of the illegally dark tint on the windows. Which makes me even more angry. Finally red-truck backs up and pulls around me, and as I'm pulling into a parking space I realize the truck is turning around in order to park too. Uh-oh. It dawns on me, too late, that the only other establishments in this office space/retail area - the Sally Beauty Supply store, Acupuncture Clinic, and Quick-Cash-A-Check joint are all still closed at this hour of the morning. (I just realized how funny it is that all of those particular establishments are in a building anchored by an infertility clinic!) Hence, the red-truck driver is more than likely about to make her or his way to the same waiting room to which I'm headed. At this point I'm starting to feel a little embarrassed at my outburst, and I decide to fiddle with my purse, keys, cell phone for a minute so as to avoid an unseemly confrontation in the parking lot. Yeah, prolong the awkwardness until we're actually IN the waiting room together! Great idea! I scrunch down squirming in my seat as red-truck driver, who turns out to be of the gentlemanly persuasion, walks past. Curiously, he seems totally unfazed, doesn't even glance my way, to get a look at the woman who just cursed him out. Hhhhmmmm...

Once I actually get into the waiting room I realize why - he's got bigger fish to fry. He's the guy in the corner of the waiting room trying to comfort an hysterical, sobbing, inconsolable wife. I felt like the world's biggest schmuck, let me tell you. I have no idea what was actually upsetting this couple, but I can vividly imagine a number of failed infertility treatments, or deliveries of bad news, that would make ME cry like that. Oh, it was awful to sit in that waiting room with them, oh LORD, I have seen the error of my ways and I will endeavor not to fly off the handle for petty reasons because you never know the heavy burdens being carried around by the strangers you encounter. Amen.

THEN, just after red-truck driver and red-eyed sobbing wife finally get shuffled off to the back to meet with Dr. D.............. a Woman-To-Be-Reckoned-With comes striding out of the back, presumably having just met with Dr. G, or maybe one of the nurses, God help her. I mean, the look on this woman's face, I can't even do it justice. Every person in the waiting room paused mid-magazine, riveted to the spot, and this woman, long black hair flying out behind her, eyes blazing, nostrils flaring, goes flying up to the 'check out' counter at approximately 98 miles per hour. Without so much as a sidelong glance, not even so much as a flicker of a look at her wide-eyed husband - WHAPPAP - she whips a sheaf of papers with laser accuracy into her husband's lap - WHAP - slaps her 'check out' sheet onto the counter - WHIRR - spins on her heel and is out the door in a flash - WHABAM. Not a word to the receptionist, nary a credit card produced, not a syllable for the astonished husband or even a gesture to follow-me - nada. The poor bastard husband is sputtering and spinning and snatching up papers and finally goes stumbling out the door behind her. Good Lord, the entertainment factor. Never have I wanted to be a fly on the wall so badly - to be privy to the conversation that went on in that elevator ride from hell back down to the parking lot! Alas, I supposed I shall never know, but I'd sure hate to be the Dr. that had to deliver bad news to that bitch on wheels. I was agog at the whole scene - I understand that everyone reacts to the hell of infertility in different ways, but I would no more treat my husband like that, or even my dog, for the love of God.....it was really unbelievable, you shoulda seen it.

Anyhoo, so, rather anti-climactically, here's what's going on with me: the same old shit! Can you believe it? I know - shocking, right? The old ovaries are still scoffing at the puny amounts of Follistim I'm shooting up every night. No cause for activity on their part, heavens no! Much more fun to float around in there like bumps on a log, flouting authority and FSH at every turn. Sigh....so, we're upping the dose to a whole 150 IUs of Follistim, and the next chance for the ovaries to prove themselves fucntioning members of society is Saturday morning. Of course, Saturday morning! Because did I mention how I LOVE, LOVE getting up early in the morning?

Yeah. Well, that's all for now soul sisters - peace out.

K

On top of everything else...insurance issues!

2007-03-13T16:41:00.000-04:00

Lordy, lordy ladies, have I got a complicated earful for you. (I'm sure you're all on the edges of your seats out there, huh???)

So, the basic udpate is this: we did not, as I suspected, come to any conclusions over the weekend as to whether or not to continue down the IUI road, or put a halt to this looooong-ass cycle and just kick it into high gear by jumping into IVF. R and I discussed, but just went around in circles, never coming to a conclusion with any real conviction either way.

So, I went back for a monitoring appointment this morning, and wondered if I'd receive any information that would sway our decision either way?

The basic outcome was as I suspected: no change. Still loaded up with immature follicles, still no growth. They just called with the RE's reccommended protocol, which shockingly includes the direction to increase my dose! By a whole 25 IUs! I know you IVFers are cackling hysterically at this puny and wimpy dose, but every IU counts when you're a PCOSer doing IUI, I tell you!!! So, I go back on Saturday morning to see if the extra 25 IUs will make a difference.

BUT, here's the new problem: Wait - allow me to digress for a moment (what's that you say? you have no choice but to allow me to digress, as usual? yeah, yeah, tough cookies..) to say that I can't remember whose blog I read this on - maybe you, Watson? Or maybe Kellie?? but I remember reading someone's post that said that she can't EVER seem to leave the effing RE's office without being saddled with yet ANOTHER obstacle, problem, hurdle - be it physical, emotional, administrative in nature. I SOOOOO agree. Two steps forward, one step back....This is what drives me to drink at 8am on a Tuesday morning. Well, not really, because you know, the drinking and driving is bad, bad - BUT, I was having explicit THOUGHTS of Johnnie Walker Black while sitting in traffic on rt. 66 this morning.

OK, SO, back to the new(est) problem: as you know (i think) I left my job at Major Cell Phone Company three weeks ago. I started working at Major Financial Institution two weeks ago. My health insurance provider will be EXACTLY the same - my IF coverage will be EXACTLY the same. So, former insurance expired at the end of Feb. New insurance coverage begins on March 1, AFTER I enroll. So, I just enrolled today, and as soon as the insurance company receives my enrollment info, coverage will be retroactive to 3/1.

OK, are you still with me? Or have your eyes rolled back in your head and drool started coming from the corner of your mouth? I'm getting to the root of the problem now, trust me....

So, my insurance provider, both past and current, require you to call a certain phone number to get advanced authorization numbers for all IF treatments before they begin. I called them today to explain what was happening with the old job, new job, same insurance company situation. The woman I talked to told me in no uncertain terms that I'll really be causing them a lot of administrative headaches by having the nerve to change employment in the middle of this cycle, and in fact, had I told them when I started this cycle on 2/11 that I was going to be taking a new job before the cycle was over, they never would have agreed to cover it in the first place. I calmly and sweetly told her that I AM INFERTILE, and I HAVE PCOS, and therefore I HAD NO WAY OF KNOWING THIS CYCLE WOULD LAST SO EFFING LONG. For the love of God, people, I could have smacked her. THEN she told me that my insurance through my old job is now terminated, so as far as they are concerned they aren't paying for anything right now. IF and WHEN they receive my information on enrollment through my new employer, they certainly are not going to agree to pay for a cycle of treatment that began on a date in the past when I wasn't covered. She suggested that I prepare to pay for the rest of this cycle out of pocket.

AAAAAAAAAAAAAAAAAAAAAAAAAAAHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH!!!

So, this being the case, unless I can convince my RE's office to let me continue this cycle, but report it to my "new" insurance as a new cycle that began on 3/1 or later - I have 3 choices:

1) Cancel this IUI cycle, take progesterone to induce a period, and Start. All. OVER. AGAIN,
2) Continue with this IUI cycle, and prepare to pay out of pocket for wandings, bloodwork, and God willing, the actual insemination,
or 3) Cancel this IUI cycle, and begin an IVF cycle.

I've left a message for the financial coordinator at my RE's office, but of course haven't heard back from her yet today. I will continue hounding her tomorrow, and depending on what she says the policy is about LYING to my insurance company, I'll guess we'll have to make a decision.

I tell you, if it's not one thing it's the other. Madness!!!

K

Never ending IUI....or move on??

2007-03-09T08:58:00.000-05:00

So I neglected to post after my monitoring appointment this past Monday, because, well, there just wasn't anything to report. Same story, different monitoring appointment: plenty of follicles, but no growth happening yet. I went for another appointment this morning, and got the same exact news.

But then, my RE said something that at first really sent my spirits plummeting, but over the last hour has really caused me to rethink the course we're on right now. Here's an exerpt from our delightful mid-wanding, over-the-stirrups conversation:

RE: "Well K, have you been talking to your ovaries, asking them to get on board with what we're trying to do here?"

Me: "Yes, I've been giving them nightly pep talks, but they are so stubborn!"

RE: "Yeah, well, as you can see there's still not a whole lot going on in here {wand, wand, wand}..."

Me: "Yeah, as usual."

RE: "You know K, you would be a perfect patient for a new IVF-type procedure that we're working on introducing later this year. It's called IV*M - in vitro ma*turation. Basically we extract immature eggs and then mature them in vitro, then fertilize them, then transfer them back to your uterus. I mean, here you are, absolutely loaded up with follicles, but obviously it's proving difficult to get them to grow. We could extract plenty of immature eggs from you, no problem.....I don't want anyone in this practice to be a "guinea pig" though, so we're waiting until later in the year when there will be more data available - if the data shows above average success rates, we'll start offering IVM here. You'd be a perfect candidate."

Me: {slightly bug-eyed} "Soooo, are you saying that IUI is not going to work for me? Are you canceling this cycle?"

RE: "No, no, we're going to keep trying here for a while longer. But if we cant get you to ovulate, I just wanted you to know that IVM would be a possible option for you."

Me: "Uh? OK? Um...thanks?"

RE: "Haveaniceweekendwe'llcallyouthisafternoon......." on his way out the door....

So, at first I was crestfallen. All the hope I had been holding that it was only a matter of time, that at some magic future wanding session the RE and I would be high fiving over a sonogram screen showing 2 or 3 huge mature follies....all of those feelings departed suddenly like air out of a popped balloon. All of a sudden that nasty dark voice in the back of my head reappeared with it's familiar refrain: "did you REALLY think this was going to work? you idiot! you're not going to have any children! why do you persist with this pathetic hope of yours? it's futile!! futile!! you aren't good enough! you don't deserve this! give up now!"

I walked out of the office in a fog, trying in vain to shut down the nasty voice. I had a good cry in the car before getting on the road to head to work, repaired my makeup, then called R to tell him the latest development. And as I was relaying the RE's words to R....I suddenly thought - well, this really only applies to the protocol for trying to make my ovaries produce one or two eggs at a time - for IUI, right? If we were to move on to IVF, they could blast my fucking stubborn-ass ovaries with obscene amounts of FSH, and they'd be overcome - they'd HAVE to fucking do their jobs and produce eggs, right? And that would be a good thing, bc with IVF the more the merrier.

So, I said to R that I wondered if we should abandon this IUI cycle and make the decision to--da-da-dunh - move on to the mother of all infertility treatments - IVF? It is one hundred percent a financial question for us, you see. Looooong ago when my OB/GYN diagnosed me with PCOS, he told us that our best bet, most sure fire, quickest way to pregnancy was going to be IVF. He said, if you can afford it, you should do it right away. Money definitely BEING an object, we decided we'd try everything and anything before moving to IVF....

Well, my current insurance covers $10K of IF treatment - specifically for IUI and/or IVF. We haven't used any of that $ yet, bc we've yet to make it to the actual insemination part of any medicated cycle.

The question I think I will have to ponder this weekend is this: Should we move straight to IVF? Cancel this IUI before we have to waste any money on it? And if we say yes to that question, then the next question that follows is whether we should sign up for one cycle of IVF, which would probably run around $6K, right? OR, go whole hog and shell out for shared risk - which I think at my clinic is $24K, making our out-of-pocket around $14K?

Lay it on me y'all, what do you think????

************************************************************************************
Update: The RE's office just called with my instructions, and well, golly, what a surprise! They want me to stay on the SAME dose, for yet another 4 days. And then come back in for another blasted wanding session on Tuesday morning. So that they can tell me the EXACT same thing. And then call me on Tuesday afternoon, and tell me yet again to stay on the SAME dose, and come back again on Saturday morning. Whereupon they'll say the SAME thing and tell me to stay on the SAME dose and come back again on Wednesday, etc. etc. ad infinitum, ad nauseum.....Groundhog Day, anyone? I feel like screaming BLOODY MURDER, people, I'm losing all of my positive thoughts, and all I can see is this never ending, perpetual headache-causing, pain-in-the-ass cycle stretching out for weeks and weeks on end in front of me. AAAAAHHHHHH! Stupid, stupid, stupid fucking lazy-ass ovaries!

K

MWAH-HA-HAAAAA!!!! (in manner of The Count, from Sesame Street)

2007-03-02T00:01:00.000-05:00

Went for a wanding session this morning, and my RE took one look at the sonogram screen and said, "K, your ovaries are laughing at us." While I was trying to figure out how to take that little gem, on his way out the door he said, with his hands over his ears, "They're saying, we can't hear you! We can't hear you! Let's try another four days of meds, and hope that they don't decide we're shouting at them....See you on Monday!"

Well, at least the man has a sense of humor. And if I wasn't able to laugh at this point, I'd be homicidal.

So, I'm going to try to have a heart to heart with the old ovaries tonight. Give them a little pep talk, you know, if I can manage to get their attention. This attitude of theirs, this aloofness, has really got to go. They can't continue in this fashion, it simply isn't becoming.

The RE has also decreed that I shall switch from Bravelle to Follistim as of Monday (if there's still no cooperation from the ovaries.) Since I'm taking a dose and a half of Bravelle each time, and since I have to mix up the meds from the vials, I'm basically having to throw away a half dose of the stuff every night. And these drugs ain't cheap, am I right ladies? So, I'm all for the Follistim, as the RE described that I can just dial up whatever dose I need from the pen-thingy, no muss, no fuss, and no dinero down the drain each time.

Oy vey -

K

Surpise! More shots...

2007-02-26T23:07:00.000-05:00

Hey y'all, since I know you've been up nights, wondering what happened at my last monitoring appointment, I thought I should finally get around to posting something...

But first, I wanted to respond to some of your MUCH appreciated comments. (I'm such a DORK, I get all tingly when I see a new comment has been posted, a la Sally Field's "You like me, you really, really like me...")

Anyway, let's see: Yes, Faith, unfortunately I am on the Metformin. Well, I suppose I shouldn't say unfortunately because I wasn't even having periods on my own before getting on the dang stuff. But my complaint is that after being on it for almost a year, I still get infrequent bouts of Montezuma's revenge in the stomach department (oh who am I kidding, in the BOWEL department). It's so strange because it doesn't seem to correlate to anything in particular in terms of what I've eaten. It's like every once in a while the Met wants to just ever-so-subtlely (not) remind me that it's still in my system, doin' it's thang. It pisses me off though, bc I can never tell when it's going to hit me like a ton of bricks. Or prunes, as it were.

And, yes, Baby Blues, my husband is indeed Filipino, and was indeed wearing a Barong in our wedding ceremony, as were all our groomsmen! And I'm an idiot, bc when I read your post I wondered, "how'd she know what a barong is?"...and then I bothered to pay attention to your blog where I could have clearly seen "Philippines" listed in your location!! DUH. R's family is from Quezon City (mother's side) and Bataan (father's side). R was born in Manila, but came to the US when he was 9 mos old. He still has lots and lots of family who still live in the PI, and of his (enormous) family who live here in the DC area, it seems one or more of them are always traveling back there. R hasn't been back since 2002 when his Lolo passed away. I'd really like for us to visit there together soon, but of course, it's difficult to plan it, what with all the uncertainty of IF, and, well you know...

And finally, Ms. C, as to my meds for this cycle: For exactly 13 days I was on one injection of 75 IU's of Bravelle nightly. Now, I'm on 4 more days of a dose and a half of Bravelle, which I guess would be 112.5 IUs each night.

Which brings me to the very anti-climactic update I owe you on this, the longest IUI cycle on earth: I went in at the freakin' crack of dawn this past Sunday for another monitoring appointment. And by the way, don't you love weekend mornings at the RE's office, when aaaaalll the husbands come out to play? From the looks on their faces, I know most of those men get coaxed there the same way R does, with the promise of weekend breakfast with all the cholesterol and nitrate ridden breakfast meats he can eat, afterwards. Woo hoo! Me? I'll have an egg white omelette and wheat toast, and a side of baconsausagecornedbeefhashandscrapple, please. And coffee with Splenda.

Anyway, so, no big surprise. I still have "lots of eggs", but my ovaries still look "very quiet." Argh. Dr. D commented that us PCOS'ers must "walk the knife edge" when it comes to meds. One false move with just a little too much FSH, and it could be disaster. And really, I think I would just step out into traffic if, after all this, I produced a dozen eggs and then had to just sit by and let them go to waste. For someone who hasn't ovulated in over 2 years, this would just be torture.

So, my updated protocol, as I mentioned above, is to take a dose and a half of the Bravelle for 4 more nights, and then it's back for another wanding session on Thursday morning. Which will be my 18th day of shots, not that I'm counting or anything.

Peace out, homies. Happy end of February, and shit.

- K

No news is good news?

2007-02-21T23:59:00.000-05:00

Weeeeell peeps, nothing earth shattering to report from this morning's monitoring appointment. Basically, the old ovaries are taking their sweet-ass time, blast them. The nurse said I had "tons of eggs", but that things were still looking "pretty quiet." Harumph. That means 4 more days of shots at the same miniscule dose, lest all those eggs ripen at once and give us the potential for having a litter.

I go back on Sunday morning for the next monitoring appointment. Until then, it's pincushion city.

Did I mention that at the beginning of this cycle Dr. D warned me that some lucky ladies with PCOS must endure 2 to 3 months of daily shots before they are ready to trigger? Yes, that's right, I said 2 to 3 MONTHS, not weeks. Good God! He explained that PCOS sufferers tend to not respond, not respond, not respond to the drugs, and then suddenly...OVER respond with little warning. Therefore, we must go veeeery, veeeeery slowly. Fabulous. Just what I wanted to hear! Newman.

No big deal

2007-02-19T22:05:00.000-05:00

It's funny how I went through all this build up and hype when I was waiting to start injections, and the first few nights I felt like it was this HUGE production. I'd go into the bathroom a full 15 minutes before the time I was supposed to take the shot, compulsively scrub my hands with anti-bacterial soap, swab the entire surface of the vanity with copious amounts of rubbing alchohol, lay out the syringe, needle, Q*cap contraption, vials of meds, etc. in very orderly fashion, consult the printed instructions (with pictures!) 86 times before beginning the process, etc., etc. It all seemed so intimidating and laborious.

Fast forward one week....my DH and I go out to eat quite frequently (TOO frequently), and for the past two nights I've tossed my meds and needles in an insulated lunch bag, and shot-up in the ladies room of various restaurants! I decided that I couldn't be prisoner to the have-to-be-home-at-10pm-to-take-my-shot situation, and that the shots were just going to have to fit into our social calendar!

Now my little painless shot seems like such a non-event! Especially after talking to a fellow infertile friend at dinner last night, who described her last IVF protocol which had her taking shots at 5 different times during the day, including those painful intra-muscular ones. UGH! My measly little Bravelle shot pales in comparison to that.

Funny, how your perspective can change so quickly.

Cheers!

K

Finally, an outlet!

2007-02-18T23:15:00.000-05:00

Finally an outlet for this insatiable need that I have to talk, think, eat, breathe, sleep, and dream about our never-ending quest to have a baby! I'm so glad I started this blog tonight, and you know what? I think this will be soooo helpful and therapeutic for me even if not one single soul reads it but me!

So, here's a somewhat short version of our TTC history: we've been trying for a total of 2 years and 5 months now. I have PCOS, and to my knowledge, have not ovulated in over 2 years. My husband is a total stud and has super sperm. We've done 4 rounds of Clomid in total, 3 with my OB/GYN, and the last one with my RE. In all cases, the Clomid had absolutely zippo effect on my stubborn ovaries. The last round of Clomid we did with my RE back in September of last year ('06) was supposed to be our first IUI cycle, but it was canceled due to my lack of response to the Clomid. Then, in November, I had gall bladder surgery, and spent most of December recovering from that. So, we started afresh in January, and I begged my RE to let us 'graduate' to injectible medication. Please, for the love of God, NO MORE CLOMID! He readily consented, and so here I am, on CD 8, having just taken my 7th injection of Bravelle.

Hurray for injections! Who on earth would ever have thought that I'd be so delighted to receive a box of needles and medicine in the mail last week? You would have thought it was Christmas morning, the way I danced around. Hurray! I get to inject myself on a daily basis! Alriiiight, let the party begin!!

I'm THRILLED to be taking action, I guess that's the main thing. I feel like we've been treading water for so long, always having setback and postponement after postponement. In 2 and a half years I've only been through 5 medicated cycles in all - because all along the way, I'd have to stop because the lining of my uterus was too thick, or because my polycystic ovaries needed a break, or for myriad other reasons. The worst is being put on BCPs for a couple of months to rest my ovaries.....there is just something about taking BCPs when you've been desperately trying to conceive for what feels like centuries, that makes you want to fling yourself into traffic at the next opportunity. Ugh!!

I always explain to my DH that for me, instant-gratification-girl that I am, the hurry-up-and-wait factor of infertility treatment is truly torture. You know, if you were being treated for any other sort of condition or ailment, your doctor would prescribe a drug or a treatment, you'd zip over to the pharmacy on your way home from her office, you'd take said drug, and immediately you'd know whether that drug had the desired effect. If it worked, fabulous - whichever ailing body part in question would be back in business. If not, back to the doctor the next day, or the day after, and she'd prescribe something else. Zip to the pharmacy again, give it a whirl, back to the doctor soon after if the condition persists. By the end of two weeks, you'd have gone through 10 drugs, if necessary, but you'd likely have come out of it with a winner. You'd at least know what the course of treatment would be, and you'd likely be all patched up within a month at the latest. But, in the lovely world of infertility, it seems everything happens in monthly increments. Try a treatment in January...if it doesn't work, well, you've got to sit and marinate in those discouraging thoughts until February (if you're lucky), which is your next available opportunity to go back to the good old drawing board to try something else. It's slow torture, I tell you! Meanwhile, and I know my fellow infertile myrtle sistahs can relate to this, every single stinking friend I've ever had since kindergarten is either pregnant or has just given birth. Everywhere I look, babies and pregnant bellies abound. Aaaahhh!! Calgon, take me away!

Anyway, on this, my first IUI cycle, I took 5 injections of Bravelle and went for monitoring yesterday (Saturday, 2/17) morning at the crack of dawn. Never have I been so eager to jump out of bed on a Saturday morning. During the oh-so-popular wanding session, my RE says, "Weeeelll, look at all of those eggs in there!" Me, "REALLY????" Mind you, in 2 years I've never produced so much as ONE egg, so this is miraculous, as far as I'm concerned. My RE, "Yes, but we can't possibly let all of these mature....you'd end up with...." Me, chiming in, "A litter?" My RE, "Yes, exactly. That's EXACTLY what we don't want. So, we'll need to continue to be extremely careful with you, and keep you on a really low dose of Bravelle for the next few days..." Meanwhile, I can't stop smiling because he said there were EGGS in there! For the first time! Ever! The only thing I've ever seen on those confounded sonogram pictures are the damned cysts that grow on my uncooperative ovaries each month. So, EGGS! Hurray! Go ovaries, go! 2-4-6-8, who do I appreciate? My ovaries, my ovaries, GO OVARIES!

4 more nightly injections of Bravelle, and then another date with the ultra sound wand early on Wednesday morning. I'm crossing all fingers and toes that things have progressed and we'll be able to schedule the IUI at that point. The suspense is killing me here, people. Although, I suspect the 2WW will be loads worse. I've never actually been in the 2WW before, (thank you damned un-functioning ovaries), so it will be a new kind of torture for me, I'm sure. Stay tuned, if you dare!!!!! (and thanks, dear reader, if you have made it through this ridiculously loooooong post...)

K