Oh, and by the way...

We got two birth announcements over the holiday weekend--one via e-mail, and one last night by phone. That makes twelve--yes, TWELVE--babies born to friends, family, or coworkers since the beginning of August. (And that's not counting my neighbor, who I don't know very well and who had twins eight weeks ago.) Four more are due in the next three months. Now, I don't begrudge anyone their happiness--god knows some of those pregnancies were a long time coming--but I hope that once this last round of babies is born, my friends all settle down and stop procreating for at least a few months. Please?

Thanksgiving weekend suckiness, part 2

(Part 1 here.)

At 9:15, I’m seen by Dr. S.’s partner, Other Doctor, with a young doc-in-training in tow. It’s the first time I’ve seen Other Doctor, and he’s confused by various things in my chart. Why am I cycling for the first time now, when I saw Dr. S. for the first time in March 2004? (Long story, I tell him—maybe I’ll explain it here someday.) Why did US Doc think that was a cyst and not a follicle on my right side? I try to explain, but I’m getting agitated and my voice is starting to quaver. I’m normally pretty cool and collected, but there’s something about doctor’s office situations that makes me lose my shit. Especially when I’m being challenged or made to feel stupid—insurance squabbles, for example, reduce me to tears instantly. Even though I’m intellectually not afraid of doctors, or intimidated by them—I have lots of friends and relatives who are doctors, and my dad’s a doctor. Anyway, so I’m getting all worked up, and Other Doctor asks about my HSG. The anxiety I've felt during the past two days from not hearing from Dr. S. starts leaking out of me. “They had trouble seeing the left tube,” I quaver, “and Dr. S. was supposed to call me, b-b-but he d-d-didn’t.” Sniff. Other Doctor takes pity on me and says, “OK, let’s just take a look here.” I lean back, tears squeezing out of my eyes. I try to rub them away without anyone noticing, but I’m not fooling anyone—the nurse hands me a tissue.

I won’t bore you with all the back and forth, since this is already getting very long for my first-ever blog entry…but it is determined that the 19 mm whatever on my right ovary was indeed a developing follicle, and it appears to have already released the egg. I’ll have a progesterone test to make sure, but on day 14, I’ve already ovulated. I’m in full-blown tears by now—how could this have happened? Wasn’t it supposed to be a cyst? What a total waste!

Ah, but it gets better. Other Doctor has the nurse locate the report from my HSG. “Well, it looks like you have a unicornuate uterus,” he says. What? I thought my uterus “looked perfect”? He flips back through my file to the images taken at my saline sonogram. “Ah yes,” he explains, partly to me but mostly to the young doc-in-training at his side, “it looks like he got a cross-section here, but if had gone farther along, he might have seen that it thinned out again, which would have shown the blah blah blah…” I can barely hear what he’s saying through my sobbing, but basically Dr. S. fucked up. I keep apologizing for being such a mess, as Other Doctor says, “It’s OK,” and Young Doc hands me tissues.

“Now, having a unicornuate uterus doesn’t cause infertility. Your PCOS and insulin resistance is what’s causing the infertility,” he says. I think that’s supposed to be reassuring. He goes on to say that a UU comes with a higher risk of pre-term labor (quite high, as I’ve since learned from my Googling; I supposed he downplayed it so as not to induce further hysterics from me), but that he’s fully confident I’ll be able to get pregnant, and we should keep going with the Letrozole protocol, since I obviously responded nicely. Even if I have only one tube, I ask? Yes—if necessary, we can go to injectibles to make sure I ovulate on both sides, or do IVF. He says that so casually—I guess IVF is no big deal to him, but it’s huge to me. Then he points out that I actually ovulated on the right (correct) side: “Did you have sex?” he says brightly. Um, no.

The plan is that I’ll get an MRI to confirm the UU diagnosis. (“So you can bring in the MRI results and show Dr. S.,” Other Doctor says.) I’m crying, angry, a mess. After I get dressed, I press my cold fingers to my eyelids to try to take down the blotching—not looking forward to having everyone in the waiting room see me like this. My contact falls out of my eye onto the floor, and I have to go begging for saline solution. (Eventually a nurse grabs a vial of the saline solution they use to mix meds, draws it up in a syringe, and dribbles the stuff into my palm so I can rinse my lens.) I get blood drawn, then am in such a hurry to get out of there that I forget to pick up my MRI referral.

The whole trip home, I’m willing myself not to cry. Reading is no good, so I play a game on my Palm—and suck at it, because of the tears and the snot and the I’m such an idiot and How could Dr. S. have screwed up like this? and What a waste of a cycle and I’m such an idiot. I’m holding on to Other Doctor’s last words to me, “You’ll get pregnant, I promise.” But I know all too well from reading other women’s stories that sometimes it really doesn’t happen. I know that what I’m going through is miniscule compared to the struggles other women have gone through to get pregnant, but at this particular moment, when I'm full of self-pity and anger and frustration, this seems pretty bad. It’s not bad enough that I have PCOS, but I have to have a fucked-up uterus too?

I stumble through my front door, sobbing, and pour out the whole sad tale to my husband. Who then redeems himself from his idiot comment on Tuesday by saying, “Think how much more we’ll love this kid after working so hard to get it.”

Luckily, my cousin calls to say my aunt isn’t feeling well, so they won’t be able to have lunch. I spend the rest of the day on the couch, wallowing in self-pity. Late in the afternoon, a nurse calls to give me the results of my bloodwork: I have officially ovulated. She’ll fax me the MRI referral over the weekend.

Today, Saturday, I went out and ate raw fish, bought raw-milk soft cheese. And a chocolate cake. Monday, I’ll make an appointment for that MRI. And I’ll call Dr. S. and try not to cry on the phone when I ask him what the hell went wrong here.

So how was your Thanksgiving?

Mine sucked, frankly.

Monday morning I had an HSG. Piece of cake, I thought. I’d had a saline sonogram the week before (“Your uterus looks perfect,” Dr. S., my RE, proclaimed), and basically sailed through it. I mean, it was no treat having a catheter threaded through my cervix, but the filling of the uterus with saline solution? The vaginal ultrasound? The oh-so-mild cramping as the salt water leaked out of me for the rest of the work day? Nothing to it. I’d been told the HSG would be similar, so I wasn’t too worried. While the radiologist messed around between my legs, the nurse stood at my side and patted my arm, asking every few minutes if I was doing OK. “No problem!” I chirped, the Good Patient to the end.

I could see the screen as the radiologist worked, but I honestly couldn’t really tell what was going on—I’d googled HSG images beforehand, of course, so I’d know what to look for, but everything was hazy and blurry, ghostly ribbons of dye weaving across the screen. When he was done, the radiologist said, “The right tube looks fine, but I’m having trouble seeing the left. I’ll talk to Dr. S—maybe there’s a fibroid or something blocking the way.” “Oh no,” I said, “There couldn’t be. Dr. S. said everything looked fine.”

I admit I felt a little worried—I called my husband and told him there was a possibility I might not have a left tube, but he was reassuring. “We don’t know anything yet,” he said.

Late in the day, at my desk, I developed unbelievable cramps. Like the worst period you’ve ever had crossed with the soreness you felt the day after being forced to do 50 situps in gym class. It was so bad that I thought I might have developed an infection. I staggered home and took my temperature to make sure I didn’t have a fever. 98.0. Um, guess not. I spent the rest of the evening downing Advil with a heating pad pressed to my belly. I’d heard that the cramping from an HSG is generally worse if you have some kind of tubal blockage or uterine abnormality…hmmm… (/dramatic foreshadowing).

Tuesday morning I had an ultrasound—day 11 of this, my first Letrozole cycle. I arrived at 8:15 (at my doctor’s office, if you’re cycling, you drop in for monitoring any time between 7:30 and 8:30), was ushered into an exam room at 9:20, and was left to cool my (bare-assed) jets until 9:40. (Luckily my office is a 3 minute walk from the clinic and I don’t have to be there until 10.) I ran into Dr. S. in the hall—he wasn’t doing my ultrasound, since the doctors there rotate early morning duty—and he said, “Oh, I was going to call you last night—I’m still trying to get in touch with [the radiologist] to discuss your HSG results, but once I do I’ll call you today or tomorrow.” “Great!” says the Good Patient.

US Doc saw two 12-13 mm follicles on the left and one 19 mm on the right. Lining 6 mm. “But Dr. S. saw a cyst on the right side at my day 3 ultrasound,” I piped up. “Hmm…now that you mention it, it does look kind of ragged around the edges. It probably is a cyst,” said US Doc. I felt very proud of myself for pointing this out—otherwise she would have thought that cyst was a developing follicle! (/more dramatic foreshadowing).

“Are you doing a natural cycle or insemination?” she asks. Um, I don’t know? I had assumed natural, since this is our very first cycle on ovulation inducing meds. Insemination, it is determined after consultation with Dr. S. I will come back for one final US on Friday morning, trigger Friday night, then get inseminated (I assume IUI?) Saturday and again on Sunday.

I call my husband to tell him we’re going the IUI route rather than sex (I refuse to say “baby dance,” that loathsome message board moniker), as we’d thought. He grumbles, “OK, but can we have at least one of our kids naturally?” I flip out. “Well, considering we tried ‘naturally’ for a year and a half and nothing happened, and I’m almost 32 and have PCOS, no, we probably can’t.” Jerk. But I tell him we can have lots of sex before and after the IUI, and if I get pregnant we can pretend it was from the sex.

Dr. S. doesn’t call that day. We still haven’t heard about my husband’s semen analysis either (done the previous week). But I’m not worried...not that worried, anyway.

Wednesday I got my Ovidrel scrip filled. Still no call from Dr. S.

Thursday was Thanksgiving, of course. We had decided not to drive from Big City (where we live) to Small Town 5 Hours Away (where his parents live) or to fly to Far-Off Smaller City (where my parents live) for the holiday—or rather I had decided, since I knew we’d be cycling and that there was a chance trigger day would fall smack dab in the middle of the holiday weekend. Looks like that was a good choice. Yay me! We have plans to have lunch with my aunt and uncle Friday, but Thursday is all ours. My husband made a beautiful gourmet dinner for two and we opened a bottle of Montrachet. I speculated that this might be my last bottle of wine for a long time (foolish girl).

Friday morning. Up at 6:30 to make it to the clinic by 8:15 again—it’s a 40-minute trip via public transportation to the doctor’s office, and I had to put on a full face of makeup just in case I was so delayed at the doctor that I would have to go straight to lunch with my aunt and uncle instead of going home first. I’ve packed my Ovidrel, as directed, so the nurse can show me how to inject myself at the end of my appointment. Aren’t I optimistic?

to be continued…