Monday, June 29, 2009

Still waiting

I just realized that I never blogged about my Saturday scan. Oops. In my defense, my parents were here for the weekend, staying with us in our tiny apartment, so there wasn't exactly a lot of time or space to blog.

At any rate...the general plan had been to have a scan Saturday morning, and then if everything looked good to go they would trigger me right then and there, and we'd have the IUI Sunday. I wasn't so keen on doing this with my parents in town, but at least we'd have free babysitting so we wouldn't have to be the bad patients dragging a kid to the fertility clinic.

So Saturday I left the house at the crack of down, carrying my Ovidrel shot in a little cooler. (Side note: Because I'm sort of repeating a grade here, going back to Clomid after already doing injectables, I find it mildly entertaining that they'll do the trigger shot for you in a Clomid cycle, considering that it's a sub-q shot, which I've already given myself plenty of.)

And...nothing doing. I have plenty of little follicles on both ovaries, but nothing that looks like it's ready to break away from the pack. The doc who did my scan (not my doc, but one of my favorite REs at this clinic) said to come back Wednesday for another u/s, and if nothing has developed by then, it looks like this cycle is a bust.

It's remarkable how different it feels to go through treatment this time around. I'm so much less emotionally invested in the outcome of this cycle. I was mildly disappointed, of course, but not devastated or self-blaming the way I would have been (and was) if a cycle didn't work out four years ago. The very fact that I didn't remember to blog about it until now--back then, I would have rushed to the computer immediately.

I wish I could have had this kind of equilibrium back then, but of course the only reason I'm able to feel this way is because I know that I could walk away at any point and still be happy.


Thursday, June 18, 2009

All systems go

Day 3 bloodwork this morning. Phlebotomist missed the vein and had to go digging for it--ARGH! I don't want to take the bandaid off and see the bruised mess that must be underneath.

Anyway, just got the call from the nurse and everything looks good. FSH=7, which is great (though I had to look it up online to double check--time was I would have known off the top of my head). Start Clomid tonight, back next Saturday (day 12) for u/s and if we have the right number of follicles (1) in the right place (right side) they'll give me the trigger shot right then and there, and IUI next day.

I've been freaking out (A LOT) about this whole second child concept ever since we had the consult with Dr. SF. So much so that I was getting ready to say to my husband that maybe we should just call the whole thing off, that maybe I didn't want another child after all. Then I realized that what's really freaking me out are (a) thought of being pregnant and on bedrest and terrified again, (b) thought of having another newborn and attendant horrors again, and (c) financial worries. When I think about actually having two slightly-more-grown children--teenagers, school-age, even having one toddler and one school-age child--that actually sounds wonderful to me. (Those of you currently in hell because of one toddler and one school-age child, just smile and tell me I'm right.)

So I've been bucking myself up by trying to think of GOOD things about being pregnant and having a newborn (not many, but they do exist--I think) and also by addressing my fears logically. (a) I may not have any problems with a second pregnancy--perhaps my ute has stretched and won't give me grief again. (b) If I have another kid, I'll be more prepared for the psychological fallout of having a newborn, and will cut myself way more slack on the breastfeeding/pumping thing especially (i.e. will not make myself crazy over it). (c) No good solutions here, but people have 2 kids on a lot less money than what we have and survive. It will be fine.

Oh, btw, those of you who know me in real life (or at least on FB or Twitter)--I'm not "out" about trying for #2, so please don't make reference to this or to IF on FB or Twitter or anywhere else my non-blog-reading peeps might see. Not that you would, anyway, but just in case. Kthxbai!

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Tuesday, June 16, 2009

Bad timing

I just got my period. The cycling can begin. Hooray, you say? Perhaps. BUT. Counting forward the days based on how my clinic does Clomid IUI cycles (day 3 monitoring, day 12 monitoring and trigger, day 13 IUI), I will have monitoring next Saturday and IUI Sunday. (If--BIG if--I get a single follicle on the right side, that is.) And it just so happens that my parents are arriving next Friday for a 3-day visit.

On one hand, hey, we won't have to worry about babysitting--my mom can watch Bat Girl while we swan off to the clinic at 6:30 a.m.! On the other hand, any scenario in which one has to discuss being inseminated with one's own mother is just not a good one, you know? Especially since I certainly haven't even mentioned to my parents that we're THINKING of trying for #2, let alone actually trying.

The thing that irritates me the most is that I ACTUALLY HAD SOME CONTROL OVER THIS. If I had waited just two days--heck, even ONE day--to start taking the Provera, if I had thought ahead a little, this wouldn't be a problem. But I assumed it wouldn't work so quickly (I just took the last pill Saturday), and if it did, certainly I wouldn't get my period on Tuesday, THE WORST POSSIBLE DAY TO GET IT for scheduling purposes, would I?

Bleah. It is what it is. I guess we'll just deal.

In other news, I almost entered an online contest to win a new baby carrier. Then I didn't, because I am not insane.

Sunday, June 07, 2009

You know you're a parent when

someone pooping in the middle of your living room is cause for celebration rather than horror.

(In the potty, people, not on the floor. Only way BG will consent to hang out on the potty for any length of time is if it's placed smack dab in the middle of the living room floor. At some point we'll work our way back into the bathroom.)

Friday, June 05, 2009

Back in the saddle

Going back to our fertility clinic after a 3-year absence was kind of like going back to your high school after you've graduated. Everything is familiar, but just a little different (they moved the reception desk! they got rid of the stuffed animals in the phlebotomy room!), and it looks a little smaller and shabbier than you remember. You recognize some of the staff members, but you know they don't recognize you--to them, you're just another face among hundreds that have passed through those doors. You wonder if you look different, more mature or changed somehow, compared to the last time you were here, and compared to those who are here for the first time.

In our case, we were of course glaringly different, because we had Bat Girl with us. I felt bad, especially when I saw the multiple discreet signs on the front desk (new since the last time I was there) saying "Due to the special nature of our services, we ask that you make child care arrangements before coming here." But we did the best we could. We stayed out near the elevators instead of in the main waiting room--not ideal, since people coming in saw us as soon as they stepped off the elevator, but at least we weren't rubbing it in the face of everyone else. Unfortunately, it was a horrible rainy cold day, otherwise I'd have had my husband stay outside and run BG around a bit while I filled out paperwork.

Dr. SF brought us around to his office through the back corridor instead of the main waiting room, which I think was also a gesture toward those waiting. I was reminded again why I like him so much--he had reviewed my files beforehand, and had all our cycle stats up on his computer screen, which he referred to repeatedly through our consultation. He wasn't all about the chitchat and personal talk (though he complimented BG's cuteness and behavior) but he remembered things like where we live (unlike most addresses in Big City, ours doesn't immediately signal our neighborhood to those not in the know).

He asked for all the details of how my pregnancy went, what my OB found regarding my uterus when she did the c-section, and how my cycles were now. He wasn't that surprised that I'd only had two periods since December--he said that while some people do get "reset" after a pregnancy, it's just as likely to continue with the same problems. He confessed, "We really got lucky with you getting only one--it could just as easily have been multiples," since I'd had two or three mature follicles on the right side (my good side). Because of this, and because I had such a fast response to Follistim, and because of the problems I had in pregnancy, he's wary of doing another injectables cycle right off the bat, since, he said, "If you got pregnant with multiples, you would definitely have to reduce."

We told him that we were really not comfortable reducing and would prefer to minimize the possibility of multiples. So since I did respond to Clomid at a higher dose, he feels that it's a good idea to start with Clomid, to get a slower response and see how my ovaries do now. I typically got only one egg at a time on Clomid (on the left side as it happens, but it could just as easily have been on the right side) but that's actually a good thing--normally, he said, on average in PCOSers it takes four eggs to get one baby, but that's on average, and in my case it's better to go slow. Once a follicle starts to develop, we might juice it with Follistim, depending on how the cycle is going.

We all agreed that if a few cycles of Clomid don't work, then the best move would be to go straight to IVF. I told him we'd probably want to do single-embryo transfer, and he said that while I'm not an ideal candidate for SET, since I'm 35 (ideal apparently means under 30), as long as we understand that SET carries a lower chance of pregnancy on any one cycle, since they can't know for sure if they're choosing the best embryo, and we're willing to have it possibly take more cycles in exchange for eliminating the risk of multiples, then he's on board with that. Usually he likes to transfer two in patients my age. At any rate, he said, we're a long way from having to decide that right now.

I asked if it would do any good for me to go back on metformin, and Dr. SF said that while they used to think everyone with PCOS was helped by metformin, no matter what size they are, at the latest ASRM conference, the talk was that metformin is not turning out to be terribly useful in thin women. So since I don't have signs of insulin resistance, and didn't develop gestational diabetes, he thinks it's not worth putting me through the side effects. I brought up the whole breastfeeding/metformin connection, and he didn't know anything about it, so I think that's something that I'll have to bring up with my OB. (Dr. SF recommended a high-risk OB who I think I'll try, since we told him we want to deliver at a different hospital this time, should we get that far.)

I rode the dildocam once again, to confirm that my ovaries are not doing anything productive on their own--yep, classic string-of-pearls polycystic appearance. And Dr. SF switched to 3D to get a good look at my uterus and confirm the shape. He also looked to see if there was any sign of scarring or anything that would warrant a saline sonogram to get a better look, but all looked fine. So they took some blood to check where I am in my non-cycle, which will determine if I should take Provera to bring on my period or just wait for it come on its own. Once I get my period, I'll go in for day 3 bloodwork to check thyroid and prolactin levels.

And then...we begin! Clomid, 150 mg, with a dash of Follistim if warranted. A few cycles of that, and then on to IVF.

My head was spinning a little--I made the appointment thinking we'd just talk about the possibilities and then decide to start cycling sometime later. My husband was like, "Well of course we're starting, why else did we make the appointment?" I think we're both not quite 100% there yet, but Clomid is so low-key in the grand scheme of things, that it feels like a good way to dip our toes back in the water. And given the insurance situation, it makes sense to just get going now, so that if we do have to do IVF, we'll start by the early fall.

And I feel like we're going into this with such a different, probably healthier, attitude, than last time. If any given cycle doesn't work, I won't be devastated. If we can't get pregnant again at all, I will be okay with that. I would like to have another child, but I can be happy with just one.

So I guess I'm an infertility blogger again, for a while at least. Yay?


Thursday, June 04, 2009

I never wanted this to happen

The friend who was supposed to watch Bat Girl tomorrow while we're at the clinic now cannot, because her son has swine flu. (Well, not confirmed swine flu, but he has the flu, and according to folks we know in the health care field, there's no other flu going around right now, so if you get flu, it's definitely H1N1. Which means my husband probably had swine flu a few weeks ago.)

At any rate, since there is no one else who can babysit on such short notice, we are going to be THOSE PEOPLE. The ones who bring a child to the fertility clinic. Sorry.