The road not taken

Last weekend, we got the official embryology report from the clinic. The one piece of information NOT on there, of course, was the one piece of information I didn't already know, which is how many of our embryos made it to day 5 besides the one we transferred. In other words, how many potentially viable embryos did we throw away?

I have to assume there was at least one, because the doctor who did our transfer was very particular about confirming beforehand that we didn't want to freeze anything. But nobody has volunteered the information, and we haven't asked.

I'm torn about whether I want to know. Sheer curiosity, if nothing else, makes me want to know. But then, knowing won't really change anything or add anything, beyond putting a hard number on the nagging thought, we just threw them away. (And in case you didn't already know, I'm hugely pro-choice and if it weren't for my husband's reservations about freezing I would have chosen to donate unused embryos to research.)

If I weren't pregnant, it would be different. Knowing would give us some perspective on whether we should reconsider freezing on a second cycle. Knowing would help us understand how good my eggs are, whether this was really the right protocol or if we should go for a more robust stim next time. But assuming all continues well with this pregnancy (crossing all digits and banging on every wood surface within reach, ptui ptui), that's it. We are done with ART. We are done with trying to get pregnant. I don't care if my ovaries never pop another egg out for the rest of my life.

So I sit, and stare at this sheet of paper, and wonder.

All is well

Uneventful blood and scan this morning. Dr. SF raved about my bloodwork results from last week and was delighted that I was pregnant after just one transfer, thrilled that it happened on such a low stim cycle. He pointed out that my ovaries were still pretty swollen so they were dwarfing everything else on the ultrasound, then finally found the little smudgy blur of a sac, implanted right in the middle of my uterus. Yay!

Beta hcg this morning was 4341--the numbers are meaningless to me at this point but apparently my clinic now has a policy (which they didn't have 5 years ago) of just giving you the number whether you ask or not. Back when I was pregnant with Bat Girl I would have to ask before they would give up the hard data, but I guess enough people have asked over time that they decided it was just easier to tell us up front.

Back next Monday for another ultrasound. Might see the heartbeat next week or the week after. Dr. SF recommended that I make an OB appointment sooner rather than later--"within the next 4 weeks"--given my high-risk situation. I'm looking at a high-risk group this time rather than the OB I used for BG and he said the practice I'm considering has an excellent reputation. At this point I'm looking at probably only a couple more RE visits and then I hope to be done with the place FOREVER.

Oh, and one really really nice note from this morning: During my stims phase I would always see this one couple at morning monitoring. Really nice-looking folks, the kind of people I could see befriending (sadly, there are many people I see in the waiting room about whom I do not feel the same). On retrieval day, we passed the husband in the hallway down by the OR. And this morning, I saw them in the waiting room again, which can only mean that she's pregnant too. I smiled at them and said, "We're on exactly the same schedule!" They both smiled back and the husband said, "It's good to see you." And it really was.

Pukey

But not for the right reason. I got some kind of stomach bug and spent the entire night last night violently ill. The phlebotomist this morning, when I explained why I was a little dehydrated and hard to stick, said slyly, "Are you sure it's a stomach bug?" And I had to say yes, yes I'm quite positive, trust me you do not want the details.

I was so sick that I had to call and ask if I could come have my bloodwork done later in the day, because I could not face the physically impossible task of dragging myself to the clinic during regular monitoring hours. I was so sick that when I got home from the clinic (after having spent $60 on cabs to get myself there and back) I crawled into bed and started shaking and couldn't stop, until my husband forced some Gatorade into me. I was so sick that we pushed our departure for the holiday to tomorrow morning instead of tonight, because I knew I couldn't handle three hours in the car today.

But the good news is that today's beta HCG was 669. I didn't even need a beta doubling calculator to know that was a good number (but FYI, it's a doubling time of 40 hours). Progesterone was "over 40," the nurse said. (I was lying in bed half-dazed in a tangle of sweaty sheets so I didn't inquire further. I actually checked my phone log later to make sure I hadn't hallucinated the call.) Bloodwork and FIRST! ULTRASOUND! on Monday morning.

Oh, and PS, as if the projectile vomiting wasn't enough, on my way out to the clinic this morning I slipped and fell down the stairs. Yes. Pregnant woman. Fell downstairs. It was, alas, not a graceful Scarlett O'Hara tumble, but an ungainly slip, landing with a thud on my ass/back/elbow. I felt foolish asking the nurse about it but to her credit she didn't even crack a smile, just reassured me that short of blunt force trauma to the abdomen a little fall wasn't going to dislodge anything.

OK, I have to go pass out now. I just didn't want to disappear for the holiday without updating. Will be out of town for the rest of the week but will definitely update on Monday after the u/s. Happy Thanksgiving, y'all.

Tempting fate

And I don't care. Because I am so damn bloated and my old maternity jeans are so damn comfortable.

(For those keeping score, at no point in this cycle have I been as bloated as I was on my successful IUI in 2006, despite popping out 22 eggs this time versus 5 or 6 that time. I wonder why--maybe the antagonist, or the fact that in a retrieval they also suck out fluid where in an IUI it's all just floating out there? Whatever the reason, I haven't had the horrible internal jostling, or the distended bellybutton, or the belly stretched so far that my abdominal muscles hurt. However, I am still bloated in a distinctly pregnant-looking way. And you know what? Besides being more comfortable, maternity jeans hold in and smooth out a belly a lot better than regular jeans held together with a rubber band. For those of us trying to keep things under wraps for a while.)

Exhale

Beta HCG = 183. A "beautiful" number, according to the nurse.

Repeat beta on Tuesday (would have been Monday but I have a meeting that would make getting to the clinic difficult).

8dp5dt

Confession: I'm starting to get a little bored with POAS.

After five straight days, seeing that second line appear no longer provides enough of a buzz for me. No, I'm jonesing for the hard stuff. The needle sliding into my arm first thing in the morning. The jittery rush every time the phone rings. The voice on the other end of the line bringing either euphoria or despair.

Beta day tomorrow.

6dp5dt

I know you will all be shocked, SHOCKED, to hear that I'm a little distracted right now. Thank goodness I had a productive day at work on Monday because the last day and a half has been a complete wash.

Second line reliably appeared this morning. I bought a couple more cheapy HPTs to get me through until Saturday--once I reach beta day, it seems silly to keep POAS.

Yes, I am saving all the tests and comparing the lines. Hell, I probably shouldn't admit this, but I still have shoved under my bathroom sink, way in the back, the HPTs I went through with my pregnancy with Bat Girl. Yes. I have in my home a collection of plastic sticks soaked in five-year-old pee. Don't judge me.

File under "chickens, counted before hatched":
• Yesterday morning my husband, after being shaken awake and having a pee-soaked stick waved in his befuddled face with the urgent whisper (Bat Girl was in the next room) "IT'S POSITIVE!", wandered into the kitchen and bleated, "I'm going to be FORTY-SIX YEARS OLD when this kid goes to kindergarten."
• Later, also from my husband: "[BG] is going to need her own room. She's not going to want to share a room with a 2-year-old when she's 7." Me: "Why don't we get through the blood tests first before we worry about that?"

Like I should talk. I expended a lot of energy yesterday thinking about when was the appropriate time to tell BG about a pregnancy. I also calculated my potential due date (July 28, in case you're wondering). It's all totally, ridiculously premature, considering I haven't even gotten my first beta yet. But I feel like I spent my entire first pregnancy, and especially the first few weeks of that pregnancy, tiptoeing around waiting for everything to go south, being afraid of what might happen. Being scared and negative isn't going to make it hurt any less if this whole thing goes to hell, so I might as well allow myself to dream.

5dp5dt

Well. Um.

PS It is surprisingly hard to take a decent photo of a faintly positive home pregnancy test.

4dp5dt

What I am proud of today:

• Last night I did the PIO shot WITHOUT THE EMLA CREAM. I wanted to see if I could do it; my husband thought I was crazy. But I did it, and it wasn't actually that bad. I'm going to keep doing it without now, just because it's kind of a pain to put it on and then wait 60-90 minutes with the dressing on before I can do the actual shot. But I'm really glad I used it for the first week; it made what was a terrifying thing into something actually manageable.


What I am not proud of today:

• I tested this morning. It was WAY TOO EARLY but I kept feeling symptom-y, and I knew that the trigger shot would be out of my system by now (I always test clean 8dpo, like clockwork), so even though I had resolved to wait until Thursday or at least Wednesday, I busted open the box of FRERs.

The control line came up right away, with a big ol' blank space next to it. Since I know the second line, if it's going to show up, almost always comes up right away too, I didn't bother waiting the full five minutes and playing the squinting and angling game. I stuck the test in the wrapper and shoved it in the trash; then I went into the kitchen, fed the cat, and made breakfast for Bat Girl.

Ten minutes later, I headed back into the bathroom for my shower. And I (looks around, whispers) dug the test out of the trash and looked at it, even though I KNOW you're not supposed to do that. Sure enough, there was now the shadow of a second line, and I stood there torturing myself--real line? evap line? hallucination???

Now, of course, this means there is NO WAY I can wait until Wednesday to test again. I am going to have to buy another 3-pack of HPTs so I can test every day between now and Saturday. Don't worry, I will most assuredly keep you all posted.

3dp5dt

Yesterday my husband took Bat Girl to a birthday party so I could stay home and rest. I probably should have taken a nice long nap, since I had to get up early to hit morning monitoring to get my progesterone level checked (all good), but instead I curled up on the couch to catch up on Friday Night Lights. I've been slowly making my way through the first season, 5 years late, and loving it.

So yesterday was the season 1 finale, the big state championship. And wouldn't you know it (SPOILER ALERT for the 5 people out there who haven't yet watched this show like me), before the opening credits even roll, Tami Taylor finds out she's pregnant. The nurse (Smash's mom) asks her, "Was this planned?" And Tami, the mother of a 16-year-old, smiles through her tears and says something like, "We planned it 13 years ago. And then we planned it 12 years ago. And 11 years ago, and 10 years ago. And then we figured, we have our beautiful little girl, maybe this just isn't God's plan for us."

And I lost it. I sat there on my couch, sobbing at a fictional television character's happy ending, and hoping for that joy for myself.

*****

SymptomWatch: I had a little cramping the day of transfer and the day after. Yesterday and today I've been feeling a heaviness in the general uterine vicinity. Woke up this morning with sore, sensitive nipples. I'm trying not to read too much into it and just take it one day at a time. I've decided to POAS on Thursday. Maybe Wednesday if I can't take it anymore.

Here goes

This afternoon, we transferred one grade 4AB blastocyst. My clinic grades blasts as follows: The number grades the size of the blast from 1-6 (6 being the biggest). The letters go from A-D, with the first one referring to the part of the blast that will become the fetus, and the second letter referring to the part that will become the placenta.

So, translation: Today a nice young doctor put a pretty good-looking clump of cells into my uterus. We hope it'll decide to stay there.

It was pretty cool seeing the embryo on the monitor (we got a picture to take home too). Then the embryologist zoomed out so I could see the label on the dish with my name and my husband's name on it, and then so I could see the pipette drawing the speck of an embryo up into the catheter.

I've heard of other people wearing their lucky socks and such to their ET, but at my clinic they make you strip off even your socks (they give you hospital-issue socks that, mysteriously, have treads on both sides) before you go into the operating room. So I just wore whatever was comfy and could easily be stripped off and stuffed into a locker.

The hardest part, of course, was calibrating the "full bladder" required. I overestimated at first and was in agony before I got called back, so the nurse said I should just "let out a little" and then drink some more. Have you ever tried to pee "just a little"? Yeah, it's pretty much impossible. But then I chugged some more water and it all worked out, without my having to resort to a bedpan or being in agony.

The good thing about a day 5 transfer is that the 2ww is a lot shorter. Beta scheduled for next Saturday. Gulp.

Two days more

Got the call this morning that I'm being pushed to a 5dt. Hooray! The nurse didn't have any specific information about embryo quantity or quality but she said if the doctor and embryologist make the decision to go to day 5, that means everything looks good.

Progesterone shots have been going fine. I won't lie, I totally cried Sunday night before the first one. It didn't help that my husband uncapped the syringe, stared at the needle, and said, "THIS needle? THIS is what I have to stick in you?" and then had to take a moment to come to grips with the notion while I was lying there pants askew in horrible anticipation. (We'd watched the video several times and took a class ages ago, but I guess he forgot.) The anticipation was the worst, but once he finally did it it wasn't so bad. The EMLA cream really, really helped--the needle just felt like the tiniest prick going in, and I barely felt the injection. My husband was freaked out by the sensation of pushing that needle into human flesh, but then he's an injection newbie. (I had my own moment a long time ago.) I'm sure by the end of the 2ww it'll be old hat.

I followed all the tips I've gotten online--lie on your stomach so the muscle is totally relaxed, massage for several minutes afterward then apply heat--and while I'm a little sore, it's not too bad. So far. Last night's injection was tougher--the needle hurt more (I didn't leave the EMLA cream on long enough, I think) and then I really felt the oil going in. I'll prep better tonight. If anyone got here by googling "scared of PIO" or "progesterone injections pain" or any combination thereof, let me wholeheartedly recommend the EMLA cream, even if you have to beg your doctor/nurse for it. Get some Tegaderm or similar membrane dressing to hold a blob of cream on your skin for the hour-plus it takes to numb. We also had the recovery room nurse draw circles on my rear post-retrieval to help give us a target to aim for--and a good thing too, as the area she marked was considerably higher and more to the outside than I thought it would be.

Two more days until transfer! I'm calling in sick to work and then sitting by the phone waiting for the call--they call in the morning to give you the exact transfer time.

Two out of three ain't bad

Out of 22 eggs retrieved, 15 fertilized. I would have been thrilled if we'd had 10, so 15 is amazing.

They'll call me Tuesday morning to either give me a time for transfer that afternoon or to tell me that we're pushing to day 5 (Thursday). Since we're doing single embryo transfer, my doctor wants to do a blastocyst transfer if possible, so fingers crossed that there's still plenty growing and looking good on Tuesday morning.

Twenty-two

They retrieved 22 eggs today. That, may I remind you, was on a low-dose protocol. Am an egg-producing superstar. A very sore superstar. Now if you'll excuse me, I have to go lie back down.

All systems go

It's official: I'm to trigger at (exactly) 10:30 pm tonight; retrieval 10:30 am on Saturday. Unlike with my IUIs, I'm supposed to go in for blood and u/s tomorrow morning, apparently to make sure the trigger shot absorbed properly and to do a follicle count. Also to review final instructions with a nurse, which I assume will include when to take the antibiotics and medrol.

I'm relieved that at least one of the big days (retrieval and transfer) is falling on a weekend, so I don't have to take more than one day off work (or, more accurately, call in sick). Unfortunately for our friend and neighbor who agreed to babysit, we have to dump BG at her place by 8:30 in the morning. But hey, that's what they make cartoons for, right?

*****

I ended up with the friendly phlebotomist today. She smiled when I winced as the needle went in and said, "That wasn't so bad!" (It was.) "It always easier after you have baby. You have baby, right?" Yes, I muttered.

"How old is your baby?"

"Almost five."

"Five! How can it be so long! I remember you very well! It seem like just yesterday!"

Maybe because I WAS HERE YESTERDAY, I thought but did not say.

*****

Some of the nurses, as they're prepping the u/s room, now leave a few prepackaged "feminine wipes" on the counter and murmur as they leave, "These are for you in case you need them after the ultrasound." This is new to me. I guess it's a nice touch, but is it really necessary? Doesn't everyone just crumple up the paper drape and swab themselves with that as they hop off the table? Or is that just me?

Still here

I'm in the thick of the IVF cycle right now. Last week I took 7.5mg of Letrozole Monday-Friday, then went in Saturday for blood and ultrasound. 187.5 IU of Gonal-F Saturday and Sunday, back in Monday. Added one powder of Menopur and one syringe of Ganirelix to the nightly routine (that's three shots per night) Monday and Tuesday, back in today. As of this morning I had something like 5-7 follicles on each side, the largest around 20mm. Dr. SF estimated that I'd have one more day of stims, then assuming blood and ultrasound tomorrow looks good, trigger tomorrow night, retrieval Saturday.

I'm finding the shots somewhat challenging--there is a big difference between doing one little 29g shot with a pen, and doing three shots, two of which are now 27g needles and one of which needs to be mixed. My skin is unusually sensitive, too--normally I have problems getting the needle in but then everything is fine; once I added the Ganirelix and Menopur I've started getting little welts at the injection sites and big red patches all around. But I'm powering through.

I'm still terrified of the PIO shots. I got the nurses to write me a prescription for EMLA cream to help. The nurse I spoke to on Monday said, "You know it'll just numb the surface, right? You'll still feel the injection going into the muscle." But it's exactly the sensation of that thick needle punching through the skin that I'm freaked out about.

The nurse had to run and check with my doctor to make sure it was OK for me to get the Rx, and when she came back she said, "OK, we can write you the prescription, but just so you know, Dr. SF thinks you can TOTALLY handle it." A nice vote of confidence, except that I very clearly heard him say in the hallway, "That's just stupid." Meaning, I guess, my desire to numb the pain, assuming he was talking about me and not, say, a malfunctioning pen or his shoelace coming untied. Thanks a lot, doc. I was pissed, and upset, obviously, but didn't really know how to handle it. (Clearly I should have said to the nurse, "Did he SERIOUSLY just say 'That's stupid'???") I told my husband later and he said, "Well, we always knew that niceness was on the surface for him."

Whatever. Honestly, it doesn't really change anything. I got my numbing cream, my doctor is still excellent at the medical stuff regardless of how arrogant he is (and I've always known he is). I don't care if he thinks I'm being silly as long as he treats me with respect and gets the job done. But I am still pissed.