City Girl Tales

Still boring

2012-01-26T21:05:00.000-05:00

The most exciting thing that happened at my OB appointment today (13w5d) is that the bathroom light, apparently on a timer of some sort, shut off just as I started, uh, providing my urine sample. Trying to catch the stream with one hand while frantically groping for the light switch with my other hand provided a nice little adrenaline jolt for the day.

Otherwise, the appointment was totally unremarkable in every way. The doctor (guess I have to come up with a nickname for her, I'll think about it) went over my NT results in a little more detail, and rattled off the long list of things they'd tested me for at my last appointment that were all clear--no syphilis, whoo! Then she whipped out the doppler and, after some searching, found the heartbeat. And yes, this was another fully clothed appointment. Because absolutely nothing has happened in the past month that would warrant me taking my pants off.

I'm finding all this normality confusing but perfectly delightful.

Quick hits

2012-01-19T18:19:00.001-05:00

• Thanks for the thoughts on FB pregnancy announcements. Not sure yet how I'll do it but since I'll likely wait until I've had a chance to tell a bunch more people in person, I have a month or so to ponder. I realized that I never had to deal with this before because the last time I was pregnant THERE WAS NO FACEBOOK.

• First trimester screening results came back (am a little miffed that I had to finally call my doctor's office 10 days later and bug them to get the results, but that's another story). All normal, risk level calculated at 1/3321. Exhale.

• Maternity sweatpants. Is there a greater invention? I don't think so.

Coming out

2012-01-17T16:36:00.001-05:00

Luckily the past couple of weeks have been pretty busy at work (deadlines) and at home (planning BG's FIFTH birthday party, OMG), so I've had things to take my mind off the fact that it's been a whole week since my NT scan. Not that I'm concerned about the results (which I still haven't gotten called about, BTW)--no, I'm worried about the fact that it's been a whole week since that ultrasound and I've got another week and a half until my next OB appointment. That's TWO AND A HALF WEEKS without a Live Baby Check, people. This may be the longest I've gone without an ultrasound, like, ever.

I was tempted to rent a Doppler--I didn't last time around because I was at the OB's office practically every week, but if I'm going to be all boring and normal this time it might be nice to have some reassurance in these long gaps between appointments before I can actually feel the baby move. But I discovered those things are surprisingly expensive ($40-$50 a month?) and I can't really justify the expense. That's like a month of formula, yo.

So while I bide my time, a question for you all: Is there a way to announce a pregnancy on Facebook that is NOT awful?

I know that ideally, you email or call everyone important personally, and obviously close friends and relatives either will get or have already gotten their own heads-up. But the reality is that there are people in my life who I'd like to share the news with but don't quite merit their own announcement, and Facebook is the logical way to make that happen. Besides, I do generally share photos of BG on FB, and would do so for a new baby too, and to me the only thing that delivers a worse sucker-punch than the unexpected FB pregnancy announcement is the unexpected birth announcement.

So how do you do it without being an asshole? Obviously, NOT like my crunchy home-birthing friend who capped off the announcement of her third pregnancy with the line, "12 weeks and our first midwife appointment tomorrow--can't wait to hear that heartbeat for the first time!" Like, OMG, you announce your pregnancy to everyone you know before you've had a single prenatal appointment? BEFORE YOU HAVE EVEN A SHRED OF CONFIRMATION FROM A MEDICAL PROFESSIONAL THAT YOU'RE ACTUALLY PREGNANT?

I tend to think that something simple, with a minimum of gushing and NO belly pictures, is best. Maybe even with a nod (explicit or implied) to what it took to get there. I'm not sure exactly how this paragon of a post would be worded.

I'm fussing over this because, well, to occupy myself for one, but also because I know I have (non-blog) FB friends who are dealing with or have dealt with IF. I have two very close friends, one of whom went through an IVF cycle (her umpteenth, after having a miscarriage last year and losing her first baby a few days after birth the year before) a month or two before I did, and the other had an FET (again, after many, many cycles) a few weeks after I got my positive. Both ended in chemical pregnancies. I told both of them about my pregnancy right away, so they wouldn't be shocked by the news, but I know it will still hurt for them to see the news out in public. I have another FB friend, a work colleague whom I'm not super close with (not close enough to email her personally with the news), who I'm 99% sure did an IVF cycle last fall--we were talking about some work scheduling and she had two "procedures" five days apart, bed rest after the second one, and has made frequent references to her acupuncturist. And another, a single-mom-by-choice who spent a long, heartbreaking time trying, unsuccessfully, to conceive a second child.

I don't want to hurt these people, and the countless others who may be struggling in silence. But I don't want to deprive myself of some well-deserved joy and celebration, either.

Have you ever seen a FB pregnancy announcement that was handled well? What made it not painful and/or not-assholish?

Boring

2012-01-09T22:06:00.002-05:00

Today was my first-trimester screening. My husband came along, both for support and because he hasn't had a chance to be at any of the ultrasounds I've had so far. The NT scan was uneventful, though I will seriously never get over the sight of that baby bobbing and bouncing on the screen, its little heart pumping away. NT measurement was 0.96 mm, which Dr. Google assures me is excellent for 11w2d. We won't get the full screening results for a week or so, after they get the blood test results back, but I feel pretty good after that ultrasound.

By the way, the blood test? It was a finger prick, and I can confidently say that it was the single most painful bloodletting I've ever experienced. And that's as someone who has had approximately 84,792 vials of blood taken in the last year alone. My fingertip is still throbbing. And they don't just prick the finger (with what feels like a blunt letter opener), they PUMP it five separate times to get five little blotches of blood! Couldn't I just roll up my sleeve instead?

*****

We told Bat Girl about the baby at Christmas. It took her a little while to absorb the news, but she's super excited now. She loves reading the "I'm Going to Be a Big Sister" book we got her, and she's been telling everyone about the new baby, including her whole class, the office staff at her school, and the lady who assessed her for next year's kindergarten gifted & talented program this weekend.

This is going to sound really crass, but my husband and I had really been hoping for another girl. BG, too, wanted a baby sister. But a week or two ago, I started getting a really strong feeling that this baby might be a boy--and feeling that that would be OK. I happened to ask BG last week if she thought the baby was a boy or a girl, and she said immediately, "I think it's a boy." And today after the ultrasound, my husband turned to me and said, "That's a boy. I know it."

We've got another 7 weeks until the big anatomy scan when we (hopefully) find out for sure. BTW, when I was pregnant with BG, I had a very strong feeling very early on that she was a girl. I don't claim to be particularly intuitive, but I was very, very sure, so this should be interesting.

*****

I'm also pretty sure this is a super boring blog post. But I'm enjoying being very boring in this pregnancy so far, especially given that by this point in my pregnancy with Bat Girl, I'd already had half a dozen bleeding episodes, including a bright red scary one resulting in an emergency trip to L&D. Today, I even got to keep my pants on for the ENTIRE APPOINTMENT. I KNOW!!!! I haven't had a doctor's appointment where I got to keep my pants on for over a year!

Right now my biggest worries are trying to find enough food that doesn't nauseate me and trying to find clothing that fits yet doesn't make me look hugely pregnant. I'm waiting until 14 weeks to tell at work, which is when we'll have just passed a major round of deadlines. And that waiting, too, feels like a luxury (though I'm totally eager to spill), since last time around I ended up telling my boss at 11 weeks because I had to go on bedrest for a week.

If I end up being one of those tedious bloggers who logs in once every 4 or 5 weeks to share some dull minutiae of my totally normal pregnancy and has nothing important or meaningful to say about fear, letting go of infertility, or coming to grips with anxiety...well, I'll consider that a blessing.

Delightfully normal

2011-12-28T22:15:00.001-05:00

Everything went smoothly at the OB this morning, other than the fact that I arrived at 8:30 and didn't leave until 11. (And it wasn't even because I had to wait--I was with either a nurse or a doctor the entire time. It was a very thorough appointment.)

First I had an ultrasound scheduled. The nice thing about seeing a high risk OB is that she sees patients right in the maternal-fetal medicine department at the hospital. It's a little...hospital-ish (not too luxurious), but it means all the high-tech ultrasound equipment is right down the hall. I had a 20-minute u/s session with both abdominal imaging and the most extensive wanding I've ever been at the receiving end of--I swear I felt that thing behind my tonsils. Baby looked great, measured exactly perfect for dates (9w4d), and I even got a little choked up when the tech zoomed in on my little sea monkey/hamster/squirmy thingy and I could clearly see the heartbeat flickering away.

Then I met with the doctor, whom I totally LOVED. She had reviewed my history thoroughly but had a few more questions. And the great thing is that, while she said my previous OB was obviously playing it safe, in retrospect I was probably not in imminent danger of preterm delivery and that if the same circumstances happen this time she would NOT put me on bedrest. Yahoo!

I had about seventy bazillion tubes of blood taken (the nurse said, "Have you had blood drawn recently? This vein is really beat up"), then physical exam, then more office chat with the doctor, where she went over the prenatal testing options, talked about the usual pregnancy stuff (don't eat xyz, get more calcium, yadda yadda), and answered my random questions. She asked whether I wanted to try for a VBAC and said that if baby was breech again obviously it wasn't on the table, but otherwise it was totally up to me. (I don't really care, honestly.) If I do have a scheduled cesarean, she doesn't want to do it before 39 weeks, which is exactly what I would prefer too. (Bat Girl was delivered at 38 weeks, and I'd like to go longer this time.)

All in all, a really good appointment. NT screen scheduled in 2 weeks. I'll have my first cervical measurement at 18 weeks, unless there's a reason to have it sooner.

Graduation day

2011-12-21T10:59:00.001-05:00

As of Monday (two days ago), I am officially no longer an infertility patient. My "graduation day" was pretty anticlimactic. I got the usual bloodwork and ultrasound Monday morning. Dr. SF printed out yet another blobby picture for me and let me hear the heartbeat (135 or so, down from 176 last week but I think that's normal), then told me that if my bloodwork looked good I could stop the progesterone and didn't have to come back anymore.

He asked me if I was "done," meaning done with babies, and I said, "I am SO done. And I hope you won't be offended if I say that as much as I appreciate everything, I hope I never see you again." He laughed and said, "It's sort of like sending kids off to college--there's always some sadness but you know it's time for them to move on." He expressed pleasure again at how I managed to get pregnant with a single embryo transfer at my age, and told me I make "great" embryos.

I unloaded all my sharps containers and handed the nurse a massive amount of unused drugs that hopefully some other patient can use. I picked up a copy of my records and paid my $1,400 account balance. And then I walked out.

I guess there are some people who might feel sentimental at a time like this, given all that I've gone through at this clinic over the last five and a half years. Having spent far too many early mornings in that waiting room over the last year of my life, all I feel right now is relief.

Oh, and yesterday was the first totally needle-free day I've had since the end of OCTOBER. That's a huge relief too.

Today I'm 8w4d if you count from retrieval day, or 8w6d if you count from trigger day (which is how my clinic counts it). First OB appointment next week.

*****

My cycle records had a more complete accounting of the embryos than the report I got a few weeks ago. So now I know: From 22 eggs, 15 of which fertilized, we had a whopping 10 blasts on day 5, 9 expanded and 1 cavitating. No wonder the doctor who did my transfer wanted to be certain we didn't want to freeze.

I asked my husband if he wanted to know, and he said no, which was a wise move on his part. I think he would have had a really hard time knowing we discarded 9 potentially viable embryos.

I guess it all worked out for the best in the end. Even if only half of those had made it to freeze, I have no idea what we would have done with 4 or 5 frozen embryos. Maybe two years from now I'll get baby fever again (HAHAHAHAHAHA) and regret not having the option for #3, but we can only work with what's in front of us right now.

Nearly there

2011-12-12T16:52:00.001-05:00

"So this is the point where we start kicking you out," Dr. SF told me this morning. If he thought I'd be sad, he must have been disappointed.

The blobby thing that Dr. SF keeps calling my "baby" keeps looking bigger on u/s, and today he turned on the sound so we could hear the heartbeat--176 bpm. HCG was 67,699 (was somewhere around 30,000 last week, but as I said the numbers are essentially meaningless to me at this point). Since my progesterone levels are looking good, I'm being tapered off the PIO--1/2 cc for the next week, and then if all looks good next Monday (at which point I'll be 8w2d, counting from retrieval day), I'm done with injections and they're cutting me loose.

Annoyingly, I have about 2 cc left in the vial now, which means I have to refill my prescription one last time, paying $60 for 2 more vials, of which I will use less than half of one vial. I suppose I'll donate the last vial to my clinic, along with my leftover Menopur and Ganirelix and two pens of Gonal-F and did I mention that I'm looking forward to NEVER, EVER, EVER doing any form of fertility treatment ever again?

I have my first appointment with my new high-risk OB on the 28th. When I called to make the appointment, the appointment lady told me, "Doctor X is only taking new patients if they're currently pregnant or trying to conceive." And I was like, "I'm, um, I'm pregnant!" Smooth. My limited interactions with the office so far have been good--she had to call me back to confirm the appointment date because she needed to make sure she could book an ultrasound at the same time, and when she did she told me that the doctor had already looked at the limited information I had given when I first called and had a bunch more questions. Then they sent me a detailed medical history form for me to fill out and send back, along with any records I have from my first pregnancy. Imagine that--a doctor who wants to be up to speed on your history BEFORE you walk in the door, so they can actually have an informed discussion with you about your medical needs!

Anyway, this particular doctor is part of the maternal-fetal medicine group at one of the top university hospitals in the city (not the same hospital where I delivered before). I had heard that a drawback of a big group practice is that you may end up seeing a different doctor every time, but I'm actually OK with that. I'm OK with being sort of forgettable. In fact, my goal this pregnancy is to be the most boring patient in the entire practice; to be in the office so infrequently that everyone from the receptionist to the nurses to the doctors have to look at my chart to remember my name. (As opposed to last time around, where everyone knew me so well that I actually had a nurse recognize me and say hello on the street three months after I delivered.)

I've been super tired and experiencing a vague low-level queasiness pretty much all the time, but I finally figured out that I need to eat something every two hours or I get a headache and feel nauseated. I can't get my skinny jeans on but I'm nowhere near as bloated or uncomfortable as I was at this stage with Bat Girl, so I count myself lucky. I want to eat protein all. the. time. Meat, mostly, though I went through a brief stage where I wanted eggs everyday and now I can't even look at an egg. And peanut butter toast. Mmm, peanut butter...

The fatigue, though...I don't know how anyone does this with a toddler, because all I want to do is lie down in a dark room by myself. Bat Girl keeps wanting me to pick her up but I just have to tell her she's such a big girl, Mommy isn't strong enough to lift her anymore. We haven't told her yet, though I have a feeling she suspects something. I'm going to wrap an "I'm going to be a big sister" book and put it under the Christmas tree for her. I figure by the time she goes back to school and starts blabbing to everyone in sight, I'll be 10 weeks and willing for the outside world to know--though I'm waiting until the end of January to tell at work.

I guess I'm feeling pretty optimistic overall. It's a nice feeling.

My own heart stopped

2011-12-05T12:44:00.001-05:00

Ladies and gentlemen, we have a yolk sac, a fetal blob thingy, and...a heartbeat!

Dr. SF says that normally they keep patients through 9 weeks (I'm 6w2d) but that he would consider discharging me early if I got in to see my OB right away. "At this point my job is to get you to a heartbeat and to get you off the progesterone," he said. If levels continue to look good next week, I'll drop to 1/2 cc a day, and then they'll check the level one more time and then boot me.

Uh, now I guess I need to figure out my new OB. And (gulp) call to make an appointment.

The road not taken

2011-11-30T22:22:00.000-05:00

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

2011-11-28T14:33:00.001-05:00

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

2011-11-22T21:08:00.001-05:00

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

2011-11-21T21:03:00.001-05:00

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

2011-11-19T14:11:00.001-05:00

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

2011-11-18T10:54:00.001-05:00

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

2011-11-16T16:31:00.001-05:00

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

2011-11-15T08:45:00.001-05:00

Well. Um.

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

4dp5dt

2011-11-14T17:15:00.001-05:00

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

2011-11-13T16:45:00.001-05:00

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

2011-11-10T17:49:00.001-05:00

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

2011-11-08T11:51:00.001-05:00

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

2011-11-06T14:56:00.000-05:00

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

2011-11-05T17:28:00.003-04:00

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

2011-11-03T21:16:00.000-04:00

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

2011-11-02T12:19:00.001-04:00

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.

Caution: Do Not Mix

2011-10-21T16:33:00.000-04:00

It is, perhaps, not ideal for one's stress/sanity/overall health to be combining:
-1 impending IVF cycle (took the last birth control pill today!)
-1 hellish stretch at work (hopefully to calm down by early next week)
-1 gigantic emotional blow, in the form of news of the death Wednesday of my college mentor
-1 seat on the board of directors of Bat Girl's preschool and its attendant duties
-2 different weekend extracurricular activities for a 4-year-old (violin and swimming)--what was I thinking?
-1 Big City kindergarten admissions season, involving (so far) three separate aptitude tests and at least 5 school tours (AND THIS IS JUST FOR PUBLIC SCHOOL)
-and oh yeah, a husband and a child who happen to need a little attention too

Deep breaths. My friend/acupuncturist has instructed me to try to be in bed by 10 pm every night. I've succeeded once in the last week. I was actually doing pretty well on the stress-management front last week, but this week has exploded in a mess of craziness. I'm hoping things should calm down in the work department next week, so I can chill out a bit. Like I've said before, I don't believe that stress is THE answer to anyone's fertility, but I think it's plausible that the orders-of-magnitude greater levels of life stress I've had during this current round of TTC, compared to when I got pregnant with BG, could be A factor.

I'm due at the clinic bright and early Monday morning, for bloodwork and wanding to make sure I'm ready to start the Letrozole. Going to ask Dr. SF about my new fear--what happens if the Letrozole does nothing at all for me--and ask the nurse to help me puzzle out which of the many needles I got in my big bag o'drugs last night goes with which med. I'm terrified of the PIO injections so I'm also going to ask if I can use EMLA cream or something similar to help me get through them.

And speaking of the meds, here's something I'm feeling grateful for this week: Thanks to my excellent health insurance (no one appreciates really good health insurance like an infertile lady who's been laid off and struggled to find coverage, amirite Yo-yo Mama?), my entire supply of medication for this cycle, including 3 900-IU Gonal-F pens, 1 Ovidrel pre-filled syringe, 4 Ganirelix pre-filled syringes, 5 vials of Menopur, 14 Letrozole pills, 2 vials PIO, and assorted Medrol and doxycycline, cost me...$254.00. Amazing. So lucky.

Quiet

2011-10-06T22:28:00.003-04:00

I've been feeling very quiet about this cycle, and I guess last cycle too. I've spent 371 posts (at last count) and thousands and thousands of words documenting in painful detail everything about my IF, my pregnancy, my breastfeeding struggles, my IF again, every injection of every cycle. And now that things are getting serious, I've withdrawn. Pulled inside myself, not feeling the desire to put it all out there.

I think I just haven't had the desire to examine this--this, what's going on right now, the reality of heading into IVF--all that closely. I'm taking it day by day.

Anyway, here's what's happening. We had our appointment, had many tubes of blood drawn, I had some cultures taken and my husband had another SA. I asked Dr. SF about the possibility of getting our transfer canceled due to OHSS (my big worry) and he said that while of course it's always a possibility, especially with PCOS, the fact that we're doing a low-stim cycle should reduce the risk. He also said that because they monitor so closely at this clinic, it's very very rare that they ever cancel a transfer due to OHSS. But, he said, if we did not want to sign a consent for cryopreservation, we could change our minds if this unlikely scenario came up--we would just have to come back in and re-sign the forms.

Then it was form time. We signed "DO NOT CONSENT" for cryopreservation, assisted hatching, and ICSI. Basically we just consented to the IVF itself. I was kind of annoyed with our nurse--she was a little disorganized (very unusual for our clinic) and was asking me questions and contradicting herself about stuff we had discussed less than a week earlier on the phone. When I finally told her, "We actually already talked about this on Friday," she was all, oh, sorry, I talk to so many people, but I thought, uh, yeah, but why not WRITE THINGS DOWN in that fancy computer system?

Anyway, I started the pill last week. I'll be on it for 3 weeks. I'll be on letrozole the 24th through 30th, then start injections the 31st. Retrieval probably around the first weekend of November.

Dr. SF called me back this week to strongly urge that we sign the AH consents. He warned that if we ended up having to do a day 3 transfer (rather than day 5 as would be ideal), AH would give a much better chance of implantation. But AH and ICSI are both dealbreakers for my husband, so we didn't even consider it. It's true that we are making choices that reduce our chance of success. But we're doing it with open eyes.

Birth announcements, pregnancy announcements (and yes, they were real announcements--that stupid breast cancer meme didn't make it onto my newsfeed at all, thank goodness) keep pouring in. I snickered when we were sitting in our clinic waiting room and saw the flyers for an upcoming support group, with the title in huge colorful letters: EVERYWHERE I LOOK I SEE PREGNANT WOMEN.

Ah, another disjointed post. Sorry. I've got a lot going on at work right now too, but I'm trying to compartmentalize it. Head down. Get it done.

Gearing up

2011-09-26T23:25:00.001-04:00

I spoke to our IVF nurse on Friday. (When you go from IUI to IVF at our clinic you immediately jump to a whole new level of handholding, including having ONE dedicated nurse who coordinates everything about your cycle.) She set up an appointment for us to come in this Wednesday and redo all the bloodwork and paperwork we already did two years ago (when we came thisclose to doing IVF but backed out at the last minute)--infectious disease testing, consent forms, hormone levels and ultrasound for me, SA for my husband. We don't have to take an injection class, since we did it before, but she recommended I go online and watch the videos for mixing up the Menopur and doing the PIO injections just as a refresher. She also went over the cycle in a little bit more detail and we talked about timing. Given that I'd like to have the transfer happen as close to the first week of November as possible, it will look a little something like this:

-Start birth control pill Wed or Thurs (assuming bloodwork and ultrasound show my ovaries are doing nothing on their own). On the pill for 3 weeks, then back in for blood and ultrasound.
-1 week of Letrozole to get things started
-Start Gonal-F injections (starting at 200 IU) to juice up whatever follicles the Letrozole started--target date for this is around 10/27.
-As we near retrieval, add Ganirelix (to suppress ovulation) and Menopur (to keep the Ganirelix from crashing my ovaries). So at this point there will be three injections a day, Gonal-F in the morning, Ganirelix and Menopur in the evening.
-Trigger and retrieval sometime in early November, ideally we have one or two nice embryos that go to day 5. PIO injections through the 2ww, naturally.

My biggest fear is that I'll hyperstimulate (unlikely with this low-stim cycle, but you never know--I had mild hyperstimulation the cycle I got pregnant with Bat Girl) and they'll cancel transfer, and given that we don't want to freeze embryos, we'll be left with NOTHING to show. It's possible my husband might bend on the freezing in that one scenario, though (we've talked about it, it's not just my wishful thinking).

I also talked to my friend, who's a licensed acupuncturist, about supporting the cycle through acupuncture and diet. Remember this? Yeah, not making fun of it so much anymore. Basically I'm going to do acupuncture treatments in the pre-cycle stages, during stim, and the day of and day after transfer, also possibly some moxa. I'm also going to help strengthen my spleen (yeah, I know) by trying to avoid cold and raw foods and drinks. I figure it's fall, I don't like cold stuff that much anyway, and I'm going to throw everything I can at this cycle. My friend will do the acupuncture treatments and I'm very comfortable with her--she'll do them outside normal office hours, in her apartment or mine, so it's super convenient for me.

It's past my bedtime and too late for me to come up with anything profound or clever to wrap this up so I'll just leave it at that. More updates after our Wednesday appointment.

Looking back, looking ahead

2011-09-20T00:24:00.002-04:00

"Why is it taking you so long to get pregnant?" Dr. SF complained as he ushered me into his office. "I wish I knew!" I returned.

After taking two months off from reproductive medicine, I was back again. My husband and I had discussed it extensively, and not only were we ready to get back in the game, but he was ready to try IVF...with the stipulation that we freeze no embryos. Dr. SF was a little perplexed by this ("Usually Catholic patients want to freeze everything") but was game. Normally with a patient like me, he said, he would start with 200 IU Follistim, aiming to get about 25 eggs, maybe 10 of which would fertilize and 5 of which would make it to blastocyst--we'd transfer the best one and freeze the rest. But if we wanted to minimize the number of extra embryos produced, we could try a minimal stim cycle as we'd discussed previously, where we'd start with letrozole, then juice it with Follistim (150 IU, I wrote down in my notes). Ganirelix and Menopur would be involved somehow but I'm not quite clear on how.

Dr. SF warned that doing it this way would greatly reduce the odds of success, particularly since we're only doing single-embryo transfer--ironically, in the waiting room the day of my appointment they had on display stacks of copies of an article co-authored by the clinic director about how minimal stimulation cycles have success rates that are "disappointingly low" (8%!). But since I have insurance coverage for three fresh cycles, he's willing to give it a try with one cycle, and then we could reassess if it doesn't work. (Or if, for example, we discover that despite my generally good response to stim, my eggs are actually crap and don't fertilize or my embryos don't grow fast enough.) It's just a matter of getting the right egg, he thinks, since we have no reason to believe that anything else is malfunctioning.

But first, I wanted to try one more IUI...a Hail Mary cycle, I called it. Just one more, one last shot at the "easy" way, and one more to ease back in before leaping into IVF. This was all going on the last week of August. I didn't blog about any of it at the time because...I don't know, I was embarrassed about keeping on doing the same thing and expecting a different result? (I mean, come on, EIGHT IUIs? Who does that?) And, truthfully, I had a tiny bit of hope that I could just surprise you guys one day and say, hey, guess what news I have?

It was not to be. I got my period last Wednesday. The next day I got on a plane to fly cross-country to be in the wedding of my best friend from high school. Who is 12 weeks pregnant. By accident--she was actually on the pill when she conceived. The phone call when she told me the news was hard, I won't lie, even though I can hardly resent someone who has the good fortune of getting pregnant accidentally at 38. I just wish she hadn't said quite so many times how not-ready she was and how terrible the timing was.

I also wish I had remembered to call my clinic and let them know I had gotten my period before I left, so I wouldn't have gotten multiple phone messages over the weekend wondering if I'd gotten my period or if I'd like to come in for a pregnancy test.

Anyway, I'm going to call this week to set up our final consultation before we begin in earnest. I'm thinking we'll aim for a mid-November transfer, which will align well with my work schedule. I wish it could be easier, but since it seems like that's not meant to be, we'll tough out the hard way.

Ten years ago today

2011-09-11T15:54:00.001-04:00

It's still as vivid as it was then.

Really? REALLY????

2011-09-08T14:15:00.001-04:00

Four pregnancy announcements from friends in the last week. Two second babies, two third babies. Kill me now.

NOW they tell me

2011-07-20T19:17:00.002-04:00

Crawling out from under my rock to share this:

Breast Pump Not Best Way to Succeed at Breast Feeding

Talk amongst yourselves. I'll be back soon.

This is not the post I was hoping to write today

2011-06-21T16:14:00.001-04:00

No. It did not work. I am definitely, absolutely, 100% for sure not pregnant.

This sucks.

Where everybody knows your name, part 2

2011-06-13T11:18:00.004-04:00

One of the drawbacks of living in a lovely little close-knit urban neighborhood where you know 80% of the families with kids and always run into a friend when you're at the farmer's market is that inevitably, you will pop into the drugstore for your monthly HPT stock-up and spot the father of a classmate of your daughter's, waiting in line at the pharmacy counter with his two kids, two feet away from the HPT shelf.

You will consider turning right around and heading out of the store, but you literally have no other time when you can buy the precious tests, unless you risk running into a coworker at a drugstore near your office (way worse). So you will skulk in a neighboring aisle waiting for them to leave, like a guilty teenager trying not to get spotted buying condoms by a busybody neighbor, until you realize that their transaction is taking way too long and the ice cream in your shopping bag is melting. You will take a deep breath and make a mad dash, head down, darting out into the open just long enough to grab the familiar pink box, hoping that the argument the dad is having with the pharmacist will distract him from noticing what you're about, and that the older child will not recognize you without your daughter in tow. You will tuck the box under your arm while you wait in line at the cash register, and wave cheerfully at the little family as you leave the store.

You will realize later that you were being silly and that this dad probably could not have cared less if he did see you buying HPTs, if he even recognized the box at all, and even if he did, he probably would have forgotten about it before he got home. The mom, on the other hand, would definitely have known.

Early morning conversation

2011-06-07T10:55:00.002-04:00

Bat Girl barges in on me in the bathroom where I stand, naked post-shower, putting in my contacts and putting together my face.

BG: Mommy, did you know that P [a classmate of hers] has a mommy and a daddy AND a baby AND a dog in her family?

Me: She also has a big brother. They have three kids in their family.

BG: Wow, that's a really large family! [yes, she really talks like this]

Me: Yes, it is.

BG: M [a family friend] has two kids in their family. That's the right number.

Me: Why is two kids the right number?

BG: It's not too many kids. Three is probably too many.

Me: One kid is a nice number too.

BG: No, I think we should have two kids. You and daddy need to put the egg and the seed together and make a baby.

Me: Okay, I will get right on that.

BG: How do a mommy and daddy put the egg and seed together?

Me: ...Oh look, Daddy's awake! Let's have some breakfast!

Where everybody knows your name

2011-06-06T17:25:00.003-04:00

Saturday morning, the phlebotomist taking my blood peered at me as she led me to the chair. "You look familiar," she said in a heavy Eastern European accent. "You have baby with us already?"

"Um, yes," I said. "Five years ago."

"I knew I see you before!" she said triumphantly. "I never forget!"

"Well, I've also been coming here for a few months trying for number 2," I said, not adding, So maybe I look familiar to you because I've been in this office every other day, two weeks out of every month, for the last six months.

"Second one always go faster," she assured me. I told her, "Actually, the first one went a lot faster for me. This one is taking much longer." Funny enough, she didn't have much more to say to me after that.

They kept me at 75 IU over the weekend; this morning I had a few lead follicles around 18-19 mm and a couple much smaller ones. Dr. SF pondered the numbers, saying, "If this were your first cycle I'd definitely stop you here, but seeing as it's not" (it is SO not, I thought to myself) "I might give it one more day. We'll see how your E2 looks, if it's over 1000 we'll trigger tonight but if it's under 1000 we'll give it another push."

Must have been under 1000 because I was just instructed to take 75 IU again tonight, trigger tomorrow, IUI Thursday. That puts me at 10dpiui, when I always seem to know one way or the other, on...Father's Day! Great timing! Sigh.

The thing is, as bad-attitude as I know I sound, I can't seem to keep Hope, that feisty bitch, from rearing her perky head. Since I had a Memorial Day weekend IUI on the cycle I got pregnant with Bat Girl, I have a pretty good idea when a baby conceived this cycle would be due, without so much as counting on my fingers or consulting a due-date calculator. I can picture what the weather would be like as I walk my theoretical future baby through the park, or bring him/her with me when I pick BG up from school. And, God help me, I can even picture the sappy HPT commercial scene where I show the test to my husband and whisper, "Happy Father's Day!" Gag.

I know I will manage to go on if this doesn't work. I know because I have done it many times before. But I will still be devastated.

CD whatever

2011-06-03T17:32:00.002-04:00

Well hello there! I haven't had time to update because I've had a hectic week of work. But I'm currently on day 4 of stims, which works out to CD-I-have-no-idea because as you may remember, I took an extra week off before I started stimming to help me get myself emotionally prepped. Which doesn't seem to help because I have a terrible attitude right now. I'm convinced this cycle won't work, am annoyed by the necessity of doing my shots, and generally feel hateful toward life. So yeah, I think taking the rest of the summer off will be a good and needed thing. Because, you know, this won't work.

Anyway, I've done 3 days of 112 IU Gonal-F, and tonight I'm doing 75 IU and going back in tomorrow. This morning's bloodwork showed E2 went from 89 on Tuesday to 510 today. Not that that really means anything to me, other than that it's a big jump--I know vaguely what E2 numbers should look like around trigger but the interim is just noise to me. But Nice Nurse volunteered the numbers without my even asking, which I loved.

Meanwhile, Bat Girl has just been diagnosed with vitiligo, of all things. Because we needed another weird condition to deal with over here. I haven't really processed my own feelings about it but of course the important thing is that she's basically healthy and we'll all be OK. More later.

TGIalmostF

2011-05-26T10:49:00.002-04:00

I'm having a rough week. As you might guess. My nagging cough has bloomed into a full-on head cold. Work is a PITA. My Facebook feed is full of belly shots and birth announcements*. At least it finally stopped raining in Big City.

I went in on Tuesday for CD3 bloodwork and ultrasound. Except when I was done with the vampires, the phlebotomist told me, "OK, you're only getting blood today, no ultrasound, so you're done!" I knew it was just a clerical error, that I definitely was supposed to get an ultrasound, but I had to go back up to reception to ask to speak to a nurse to straighten it out. And...it was just too much for me. I burst into tears, and once I started I couldn't stop. All the grief I'd been holding in since Friday just came pouring out, and I sat in the waiting room trying in vain to choke back the sobs. Luckily it wasn't crowded (not that anyone would have cared--I mean, if you can't cry in the waiting room at the RE, where else CAN you cry in public?), and luckily I didn't have to wait long for a nurse--perhaps one of the receptionists hit the panic button, I don't know.

The nurse was super nice and waved off my attempts to apologize for being a runny mess: "This is a really stressful place. I know you would be happy never to see me again." That, of course, just made me cry harder, and she fetched me tissues and a glass of water and whisked me into an ultrasound room ahead of everyone else so I wouldn't have to wait outside.

(They've got a new batch of extra lovely nurses lately; when I called Monday to arrange for my CD3 scans etc., the nurse I spoke to actually said--and believe it or not, this is the first time a medical professional has said this to me--"I'm sorry you got your period. That really sucks.")

I cried through my ultrasound, which was actually fine--I have a large corpus luteum cyst on my right ovary, but bloodwork revealed it's not making any trouble hormonally so we're good to go. But I asked if I could take a week or two before starting up again, just to give myself some time to regroup emotionally, and my doctor was fine with that.

If this cycle (#7 for baby #2, if anyone is counting) doesn't work I think we'll take the rest of the summer off. I'm tired, bone tired. I'm sick of being bloated and watching what I eat and behaving as if I were pregnant without actually being pregnant. I almost cried again yesterday morning when I discovered that I couldn't even button the pants I was planning to wear to a business meeting, because I'm still such a puffy mess. (I ended up wearing some shapeless sack dress.) I'll give up bikinis and margaritas and my favorite shorts gladly, if I'm pregnant, but if I'm not, I want to enjoy this summer, dammit.

*Birth announcement today from someone who has now conceived and given birth to two children in the time since Bat Girl was born. One last week from someone who has conceived and given birth to THREE children since Bat Girl was born--I can't resent her too much, since she has three children under the age of 4, poor thing.

On suffering

2011-05-22T20:10:00.004-04:00

When I was pregnant with Bat Girl, an acquaintance of mine was pregnant with twins, due three months after I was due. I learned early on that she had gone through infertility too, so I tried to bond with her over it, but it wasn't as easy as you might think. She had endured a much longer and harder road than I had--many more years of struggle, multiple rounds of IVF, miscarriages--and never missed an opportunity to remind me of that fact. She was forever reminding me that my one cycle of injectables was "no big deal," which got to me after a while, as you might imagine.

Of course, I couldn't begrudge her any of it, especially after she told me she'd had a miscarriage just days before I'd announced my pregnancy--god, the pain I must have caused her--or after she, too, went on bed rest, but then ended up delivering her twins months early, with the attendant NICU stays et al. (Her babies are fine now.)

Still, it rankled every time she'd dismiss what I'd been through--I mean, it all felt pretty darn difficult to me at the time, and I didn't appreciate being told it was a piece of cake. But I tried to take it to heart and not only remind myself that I was lucky, but that I shouldn't discount the experiences of others. Those "I took Clomid for two months! It was so hard!" folks I used to make fun of? I tried to remember that their experience was painful in its own way, and no less worthy than my own.

Almost exactly a year ago, I saw this acquaintance at a baby shower for a mutual friend. As often happens in such settings, the talk turned to babies, and she and I started talking about whether or not we'd have another. With her history, unsurprisingly, she declared herself done. Still raw from the first round of TTC#2, I confided that we were hoping to have another, but were taking a break from treatment, not only because we didn't have IF insurance coverage anymore but because I needed a break, emotionally. "We did three or four injectable cycles back-to-back last fall and I just couldn't face another," I said. "You know how it is, sometimes it just gets to be too much."

Right on cue, she said, "Oh, I know. And three or four injectable cycles, that's like nothing."

I didn't say anything, but I kind of wanted to punch her. Like, I GET IT. You had it worse. MUCH worse. Fine. Can't you just let me have my pain???

On the day I knew my last cycle failed, when I was lying awake putting off the moment when I'd get up and take the inevitably negative test, I couldn't stop thinking about that encounter. And it pissed me off. Why was I doing that to myself? Couldn't I even let myself wallow without pulling some kind of messed-up Reverse Pain Olympics on myself? Couldn't I just let myself have my pain?

*****

Thanks for your comments and emails. I'm a little numb right now, but I'm sure it'll hit me hard soon.

Although that was the last IUI cycle that insurance will cover, I'm almost positive we're going to go for at least one more. My husband is willing, and without going into it too much, it's looking more and more like IVF is not in the cards for us. (Yes, despite the fact that IVF with single embryo transfer is the best medical solution to our situation, and despite the fact that it would carry a 40% chance of success versus the cruddy 20% chance that IUI has. And yes, it is very much a mutual decision.)

Based on the bloating I had this 2ww, I'm going to guess that I'll be directed to take a couple of weeks off before starting stims again. And if not, I'm going to ask if I can anyway. I need a little time to regroup.

Alas

2011-05-21T19:14:00.003-04:00

Yesterday morning, 10dpiui, the test was as white as [insert your favorite white-based metaphor here]. I was so sure I was not pregnant I had a glass of wine with dinner.

Today, 11dpiui, yet another negative. Started spotting this morning. I'll probably get my period tomorrow.

I plan to spend the rest of the weekend doped up on allergy medication (denied to me this whole pollen-filled 2ww) and chocolate. Not sure what our next steps, if any, will be. I don't think I'm ready to call it quits.

9dpiui

2011-05-19T18:23:00.002-04:00

I dreamed I got up, peed on a stick, and got a positive. Then I woke up. Then I peed on a stick, and got a positive. Then I woke up again. Over and over, layer upon layer of peestick dreaming, like if Inception were made by Serono.

Then I woke up for real. Peed on a stick. Negative.

Still only 9dpiui. At least one more day before I start getting depressed.

What I've learned this week

2011-05-18T08:58:00.004-04:00

There's a reason why those plus/minus hpts are always on sale: They suck. Fuzzy, hard to read, all pixelated. I used my last one yesterday and promptly went out and spent the big bucks on some trusty FRERs.

First blank test today (8dpiui), meaning trigger shot is officially gone. Fingers crossed that I'll see something by the weekend. I feel pretty terrible (bloated etc) but it's hard to separate the hormonal discomfort from the fact that I've had a terrible cough all week and haven't been able to sleep (and haven't been able to dose up on cough medicine on the slight chance I might be pregnant). Despite the bloating, sore breasts, armpit lumps, etc., I also haven't felt that bustle of activity in the pelvic region that typically signals something going on in there (though I did on Sunday, 5dpiui).

Did I mention this is the longest, slowest 2ww ever?

Longest 2ww ever

2011-05-14T09:49:00.002-04:00

I can't believe I'm only 4dpiui. This week has DRAAAAAAAGGED. Part of the problem is that my last several IUIs have happened to be on a Sunday, so my mental calendar keeps wanting to count from Sunday, even though this time my IUI was on Tuesday. So I'll be like, "Oh, Thursday, almost a week gone already!" and then realize, no, it's only been TWO DAYS. Ugh.

Anyway, all proceeding as expected. SymptomWatch: the usual Ridiculous Nipples (TM) and bloating, not too much tenderness. I'm also having two symptoms I had when I got pregnant but haven't had on any cycle since, namely constipation and tender lumps in my armpits, but I'm trying not to read too much into that, considering that we're squarely in trigger shot territory and there hasn't even been enough time for anything to implant.

I've finally figured out that I always get my period 2 weeks after trigger, not 2 weeks after IUI, so a week from Sunday is D-Day--and I'll probably know one way or another as early as Friday. HPTs are on sale this week so I'm just going to go all out and test every single day next week, testing out the trigger and then seeing what happens. It'll give me something to DO instead of just sitting here going crazy.

How honest?

2011-05-09T21:03:00.004-04:00

In order for us to make the IUI happen tomorrow morning without my being hideously late for work, my husband is going in early to make his contribution, and I'll drop Bat Girl off at school a half-hour early before racing to the clinic to do my part (i.e. lie back and think of England). When I got home from work today, my husband told me he'd confirmed that school was OK with us dropping BG off early (they have morning daycare) and that he'd already told BG about the change in schedule.

As I was putting BG to bed, she asked me, "Why am I going to school early tomorrow?" Oops--we hadn't agreed on a story beforehand. "Uh, what did Daddy tell you?" I asked.

"I don't know," was her response. So I figured I could safely tell her whatever excuse I felt was right. "Mommy has to go to work early and Daddy has to go to the doctor," I said, both of those lines having proved sufficient under similar circumstances in the past.

"That's not what Daddy said," she said, frowning. Uh-oh. "What did Daddy say?"

"He said you're going to go try to have a baby," she promptly responded.

My first instinct was to be pissed at my husband. Did our 4-year-old really need to know that? What if she told her teachers? What if she keeps asking tough questions? What if other people start asking tough questions?

Then I thought about it. Would it really be such a bad thing if people did know? With the exception of at work, I'm pretty open with people about our current TTC status (and even at work, a lot of people know about our previous infertility struggles). In contrast to the first time around, when we were pretty secretive about it, many people in our lives know that we're going through treatment right now--our close friends, our parents, our siblings. I had unofficially been keeping BG out of the loop, but after all, she's asked us for a baby brother or sister often enough at this point, and we've told her that we'd like to have a baby brother or sister in the family someday too. I suppose it's only one step further to let her know that yes, we are trying to make that happen.

She had some questions about how exactly we were trying for a baby, of course. She already knows the mommy-has-an-egg-and-daddy-has-a-seed-and-put-them-together-and-a-baby-grows-in-mommy's-tummy rough outline, having loudly asked "How do babies get made?" in the toothpaste aisle at the drugstore a couple of months ago. So I just told her that sometimes mommies and daddies need a little help from a doctor to put the egg and the seed together.

What I'm really concerned about, I guess, is disappointing her if this all doesn't work out. But I guess letting her know that we tried to have a baby, but couldn't, certainly isn't any worse than letting her think we never cared enough to try at all.

As long as she doesn't spill the beans to my boss, we're OK.

Well, that was fast

2011-05-07T17:27:00.004-04:00

Despite my screwup the other night, everything looked just fine this morning. I had I think two 17mm follicles on the right (and a bunch of smaller) and a 12.5 mm and various other smaller ones on the left. My E2 apparently had risen pretty quickly--Dr. SF told me that yesterday, after just two days at 112 IU and then one accidentally skipped dose, it was already 900. "It seems like with you, as you get older, your ovaries get--"

"Weirder?" I supplied helpfully.

"Younger," he continued without missing a beat. (I imagine REs are used to the inappropriate use of humor from patients in stirrups.) "They're responding really fast."

Assuming today's bloodwork confirmed the trend, he said he'd have me coast tonight (no meds), trigger Sunday night, then IUI Tuesday. The exact same as the 2006 cycle that got me pregnant, he pointed out, the one we've been chasing and trying to replicate this whole time. "Let's hope for the same end result!"

Let's hope so.

Can't stop thinking

2011-05-06T22:05:00.003-04:00

about the woman having her blood drawn in the chair around the corner from me this morning. I didn't realize until I got up to leave that she was weeping, silently but uncontrollably. The phlebotomy staff, ordinarily a tough, no-nonsense crew, was huddled around her, one taking vial after vial of blood, another simply crouching next to her, holding her hand while murmuring sensible but gently reassuring things like, "You don't know anything for sure until the tests come back." I hope she got good news today. I hope that's not a totally futile hope.

Um, oops

2011-05-06T18:32:00.002-04:00

This morning, when my alarm went off, despite the fact that it was way earlier than I'd like to have woken up, despite my sleep deprivation, despite the fact that I had to haul my ass into the clinic, I was feeling pretty good. I had taken the day off work, and after my morning RE check-in I was getting my hair cut. It was a gorgeous day. Life was good.

Then I realized: I forgot to take my Gonal-F shot last night.

I've actually come close to forgetting before, so much so that I now program a reminder into my phone as soon as I get the call from the nurse each day, with an alarm set to go off at 10 pm, flashing the night's dosage, just in case. And last night the alarm went off, and I said to my husband, "I have to go take my shot"--but I stayed on the couch and immediately forgot about it. Worse yet, right before I went to bed, I checked my phone, saw the reminder still sitting on the screen...and deleted it without a thought. Duh.

So I headed in to the clinic with my tail between my legs, confessing immediately to the RE on duty, who was very kind to tolerate my babbling explanations ("I guess I've been doing this too long, it's just become too routine, haha..."). And luckily, through some miracle, my E2 actually still rose this morning, even though I went drug-less for a day. So 75 IU tonight (I WILL NOT FORGET) and then back in tomorrow morning.

Rolling right along

2011-05-05T10:59:00.002-04:00

Ovaries looking as expected (lots of stuff growing, nothing over 12mm yet) on today's ultrasound. According to my bloodwork I am responding "crazy good" (to quote the nurse who called with results) to the medication, so I'm dropping to 75 IU tonight and coming back tomorrow for another check. Fingers crossed.

CD-something-or-other

2011-05-02T14:22:00.003-04:00

Hey, so a whole bunch of stuff has been happening in other parts of the world that's super important, but right here right now we're just going to be talking about my ladyparts, OK?

Went back in to the RE this morning for a follow-up to see how my "beaten up" ovaries are doing. All quiet on that front, and bloodwork shows I'm in no danger of ovulating on my own any time soon, so I'm starting stims today. As Dr. SF explained to me when I asked if it made a difference to start this long after my period, in someone with a normal 28-day cycle, yes, but "if you don't have a cycle, it doesn't matter. We normally start on day 3 because it's when your estrogen is lowest, but your estrogen isn't doing anything by itself." They'll also be calling this my CD3 on the charts, just so they can keep straight how long I've been stimming.

Anyway, 112 IU of Gonal-F today, tomorrow, and Wednesday, back for check on Thursday. This is the last IUI that insurance will pay for. But I'm trying to pretend that's not the case, or I will start feeling quite desperate.

Do I know how to have a good time or what?

2011-04-18T22:48:00.003-04:00

You know what's totally awesome? Working from 9 am to 9:30 pm for the second day in a row, then getting your period on your way home. Best Friday night EVER. At least I was standing in line waiting to pay for my beer when it happened.

Day 3 blood and scans this morning. Dr. SF recommended waiting a couple weeks before starting stims, because my ovaries are, and I quote, "looking a little beat up." So I'm going back for blood and scans in two weeks and we can go from there, unless of course I ovulate on my own HAHAHAHAHAHA hoo boy that was a good one. I'm a little relieved, honestly--I think the break I had before starting last cycle helped me handle it better. Not that it made it any easier when it went bust, but at least the cycle itself hadn't been torturous to boot.

Still have a lot to say about failure and other delightful topics, but no time to say it. But don't worry, it's coming.

10dpiui

2011-04-13T10:05:00.004-04:00

I woke up before my alarm this morning and lay in bed for a while, feeling completely Not Pregnant and delaying the moment when I got up to take the test that I knew would be negative.

And it was.

I have a lot more to say on the subject but I am just. so. angry at the world and sad and I can't focus enough to say what I want to say and I have to go do some bullshit work at my bullshit job and all I want to do is crawl under the covers and cry.

(Yes, I know things could still change blah blah earlycakes and if I end up being wrong and pregnant after all we will all have a good laugh. But I am pretty sure that this is over.)

Exhale

2011-04-11T10:11:00.002-04:00

Other than Saturday's heart attack, it was actually a good weekend. Lots of good kid fun, and a wonderful dinner out with friends for my husband's 40th birthday. I'm still a little shaken by what-could-have-been, but trying to get past it. The scariest part, as my husband pointed out, is the total randomness of it all--that no matter what you do and how hard you try to protect your kids, bad shit happens. Even if I had been right there, holding her hand, a car still could have come from nowhere and hit both of us. We are so lucky.

And here we are, 8dpiui. Assuming that Renaissance medicine was incorrect and experiencing a great emotional shock does not spell reproductive doom, I'm now in the thick of the 2ww. I decided to test out the trigger, because apparently I'm bored and have money to burn on HPTs. So I tested on Saturday and got a faint positive (trigger), and tested this morning and got a negative, meaning the trigger is no longer registering (though I still have bloating and sore boobs). Will test again on Wednesday and Friday (or until I get my period, whichever comes first).

Heart attack of the day

2011-04-09T19:08:00.003-04:00

As we have all learned from watching Cops, trying to escape the police via high-speed car chase never, ever succeeds. So it is some small comfort to know that the jackhole who, in attempting to avoid being pulled over in his fancy automobile*, DROVE UP ONTO THE SIDEWALK FOUR FEET AWAY FROM MY CHILD**, will surely be rotting in jail tonight.

*Probably stolen. Or full of drugs. Either one.

**That is the last time I ever let her run ahead of me.*** My throat still hurts from screaming.

***At least the squad car in pursuit stopped long enough to let me run up and grab her before itself screeching off down the sidewalk, sirens blaring.

The wait begins

2011-04-04T14:31:00.002-04:00

IUI yesterday morning. We had to do the whole hectic kid-swapping thing again (husband goes off to give his sample, I follow with BG an hour later, hand her over to him at a cafe, go get inseminated, meet up with family afterward), and the rest of the day was hectic too, with music class and a birthday party and lots of subway riding and a cranky overstimulated child at the end of the day. I was very bloated and achy and exhausted by evening--I swear I could feel those eggs popping out one by one over the course of the afternoon.

IUI was performed by Nice Lady Doctor (I hope that doesn't come off as condescending; she's just the only female doc in this practice), who declared my husband's sample "excellent" at 60 million, more than twice what we've had at previous IUIs. Now we cross our fingers and wait. I must say, if I can't get pregnant with at least half a dozen eggs and 60 million swimmers, I will be very put out.

Reckless

2011-04-01T21:50:00.002-04:00

I'm sure you will all be as pleased as I was to know that yesterday, CD8, my ovaries were back in their respective corners, keeping a chaste distance from each other as nature intended. I was directed to take 37.5 IU last night and come back in this morning.

This morning, CD9, I had two 20mm follicles on the right, one 19 or 20mm on the left, and whole mess of 15s and 16s lurking around on both sides. OK, well, sure. This is someplace we've been before.

The very nice female doctor who did my ultrasound this morning spent some time talking to me about it. I expressed some nervousness, then said something about lead follicles and she said quite frankly, "Well, they all ovulate into the fluid and then there's no way to control which ones and how many the fallopian tube picks up." Which is, I have to say, the first truly concise, hand-to-forehead, "ohhhhh now I get it" explanation of the total randomness of IUI (and hell, TTC in general) that I've ever heard. I mean, I guess if I had really thought about it, I would have realized that this is what happens. But there was a part of me that sort of visualized all available eggs pinging one-by-one down the tube like pinballs heading down the chute, biggest ones first, despite all experience and reason to the contrary.

The doctor told me that if I'd had a left tube, she would say that I had a very high chance of multiples. "With only one tube, though, it's really impossible to say. But you have to remember, this is not IVF. Your chances of getting pregnant at all are still only around 20 percent." Which echoes something Dr. SF said to me on my very first (successful) cycle, that the chances of not getting pregnant at all are still a lot greater than the chances of conceiving multiples

At any rate, assuming we were willing to go ahead, she said we'd trigger tonight, IUI Sunday morning. So I went ahead and asked the nurse to call in the Ovidrel script, and scheduled the IUI for Sunday. I can say with certainty that five years ago I would have pulled the plug on the cycle. But time and age and repeated failure can make you a little reckless.

When the nurse called with instructions for tonight, I asked her for my E2 level, and that did give me pause. Last cycle my E2 was 1128 on trigger day. Today it was--well, I left the Post-It I wrote it on at work, but it was just over 2000. If you take the E2 level as a general indicator of how many mature follicles there are, that's...a bit concerning. But I'm putting my head down and going ahead (and dragging my husband along with me). Like I said, a little reckless.

I've gotta say, the further in I get, the less I'm able to judge those families who end up with sextuplets. I can see a lot more clearly how it happens--and how once it does, it's hard to turn back. Because while we would definitely reduce higher-order multiples, I have to say that if I got pregnant with twins, there's a good chance I would continue the pregnancy. Even though twins in me is equivalent to at least triplets if not quadruplets in a normal uterus. And knowing this, I'm still willing to go ahead.

I'm just rambling at this point. I'm going to go do my trigger shot now. Hope this is the last time I ever have to inject myself with anything.

CD7

2011-03-30T22:36:00.004-04:00

Very quickly, since I've been up since the crack of dawn and had an exhausting all-day meeting: Everything basically fine at today's ultrasound. I'm assuming my E2 is up since I got a message today to drop Gonal-F dose down to 37.5 IU and come back tomorrow. My husband has observed that I'm starting to get bloated again (gee, thanks honey!). And, for your Phreaky Photo of the day, I give you this, an ultrasound image of my ovaries actually snuggled up together:
(The doctor doing today's ultrasound said, "Oh, they're kissing!") No, that is not normally what they do, they are normally one on either side like everyone else's. I assume this is just living proof of how everything kind of mushes around in there, which is why I'm told it would theoretically be possible for my one (right) tube to pick up an egg from the opposite (left, tubeless) ovary.

WEIRD SHIT.

CD5

2011-03-28T18:16:00.003-04:00

No matter how many times I've self-injected (probably 50 or so--of course folks who have done IVF have done WAY more), every time I set up all my stuff in the bathroom--pen, needle, alcohol swab, gauze--it feels slightly unreal. I watch myself ice down my abdomen, wash my hands, prep the shot, and there's still a part of me after all these years that can't believe it's happening.

It's been much easier this time, for some reason. I've been visualizing the needle slipping in between my cells (rather than puncturing my skin) and somehow that makes it hurt less. Last night, I left the bathroom door open while I was shooting up and my husband walked by while I was doing it. His OMG expression made me laugh mid-injection--don't laugh while you have a needle in your belly flesh, girls, it doesn't feel good.

*****

Morning bloods and scan uneventful. Uterine lining appropriately thick, ovaries "active" but nothing gigantic. Dropping dose to 75 IU tonight and tomorrow night, back again on Wednesday.

CD2

2011-03-25T21:23:00.002-04:00

Hey! Hi! What's up! So, here I am again. Did a round of Provera, period started yesterday, went in today for the old poke-and-probe. (Let me tell you, the belated discovery that I don't actually have to have CD3 bloods and ultrasound done on CD3 has made a world of difference to the quality of my weekend mornings.) 112.5 IU of Gonal-F tomorrow night and Sunday night, back in on Monday morning. I very closely and specifically questioned the nurse who called me with instructions to make sure that Dr. SF wanted me to do the full 112.5 units, rather than dialing it down to approximate 100 as I did last cycle, and she confirmed yes, 112 (and that's why he wants me to come back after only 2 days of stims rather than the usual 3). Here we go!

Trying so hard

2011-03-15T09:45:00.004-04:00

to have a good attitude, but jeez, it's like primary infertility all over again with the world rubbing other people's fertility in my face.

I saw the director of Bat Girl's school last week and found out one reason why BG may be obsessed with having a baby sister: Four, yes four, of her classmates are actually getting baby siblings this spring. One I had known about already; one I found out about when the mom showed up at BG's birthday party hugely pregnant; the other two I had no idea. (This is what happens when you're a working mom and never see any of the other mothers and drop-off or pick-up.)

Then, not 10 minutes ago, one of my work colleagues announced she's expecting her second. Her first is 2--hey, just about the age BG was when we started trying for number two! My coworker is also nearly exactly (like within a month) the same age as me, which just adds insult to injury--somehow it would be easier to deal with if she were a lot younger or a lot older.

Then there's my friend whose second pregnancy vibes I was hoping would rub off on me. I begged off a lunch date this past weekend, knowing that I wouldn't be able to deal, and spent the day outside with BG instead, watching her run around enjoying the springlike weather. We ran into one of the I-had-no-idea moms and her newborn.

As usual, the babies of fellow infertiles do not rub me the wrong way, at all. In fact, they delight me--I couldn't be happier, truly. And to be fair, for all I know, all of those other babies might have been hard fought for too. But I'm still not particularly happy hearing about them.

Meanwhile, yesterday I had to go in to my clinic for a blood draw--even though I swore up and down to the nurses that I really, truly do not ovulate on my own, they would not call in a Provera prescription unless I had bloodwork first to prove it. The nurse who called me with the results could have been a little more tactful: "So, we took some blood this morning to see where you are in your cycle, and it looks like there's really nothing going on at all," she said cheerily. "We'll definitely want to bring on a bleed!" That's me, a barren tundra inside! Yep!

(Yes, I'm exaggerating. I know I got pregnant once, I should be able to do it again. Just wallowing a bit here.)

Anyway, I'll be on Provera for 7 days and then we'll start the whole party over again. Whee!

Salt in the wound

2011-03-03T20:58:00.003-05:00

Lately Bat Girl has been obsessed with having a sister and a brother. (That's AND, not OR.) Her brother is apparently a grown-up who lives in his own house and has lots of cool toys, which she describes to us at great length. Her sister is closer in age--sometimes she is "a big kid," sometimes she is 3 (did I mention that BG turned 4 last month??? bad mommy), and sometimes she is a baby.

I don't know if BG has picked up on the baby-wanting vibes around here, but in the last month or so she has turned up the volume on the baby sister talk, sometimes even going so far as to tell me that I have a baby sister growing in my belly. Which, as you can imagine, was fun to deal with while going through an ultimately doomed IUI cycle. We've had to (a) keep reminding her that Mommy doesn't have a baby in her belly, and (b) point out that if Mommy had a baby, it could be a sister OR a brother, and boy is she not happy with the idea of a baby brother. But if she asks, we do say that yes, we would like to have a baby sister (OR BROTHER) someday, and maybe we'll be lucky enough to have one.

Well, apparently she's pretty set on this baby business. Because yesterday, one of the moms at BG's preschool stopped my husband to ask about the baby sister that BG has been telling EVERYONE she's going to get soon. And today BG's teacher asked my husband if it was true I was pregnant.

It's a good thing I've had to go in to work early all week and so haven't been able to do school drop-off. Because I really, really, really would not have been able to handle those questions.

Benched

2011-02-27T17:07:00.004-05:00

CD3 ultrasound this morning revealed my ovaries to be absolutely covered with "enormous corpus luteal cysts," in the words of the doctor. So I have to take the month off to let things settle down. I'm going to try to get a better handle on my work stress in the meantime--I'm certainly not of the "just relax!" school but spending the next 8 days after my IUI with my stomach clenched with stress can't be good, right?

I'm also trying to put things into perspective. Looking around the clinic waiting room this morning, I reminded myself that most of the women in there would give just about anything to have what I have--one healthy child.

Nope

2011-02-25T21:36:00.002-05:00

I don't know if it's because of the hormones, or because my unmedicated cycles are really not normal at all, but I always find that the first couple days of a period following a failed cycle are much rougher than usual. Bad cramps, aching back, weepiness--I don't get those symptoms on a non-IUI cycle.

See what I did there? That's what you might call burying the lead. Yeah, I got my period today. I took another hpt yesterday morning, 11dpiui, and naturally it was negative. Some instinct told me to put in a pantyliner before I left the house, and sure enough, as I was walking across town I started feeling that telltale ache in my abdomen, and the spotting started soon after.

Emotionally, I don't mind telling you I've been a wreck. I had an orthodontist appointment yesterday morning, of all things, and I seriously started crying right there in the chair when the doctor was over an hour behind schedule. I had to go pick up BG soon, and all I wanted was to go buy myself a goddamn donut to try to drown my sorrows in empty carbs, and I wasn't even going to have time to do that. Yes. I was crying because I couldn't have a donut. Then I started sobbing in earnest as I was walking back to the subway. I made it through the rest of the day, then after I put BG to bed, I cried again to my husband as we talked about what to do next. Then I baked a cake and ate...well, let's just say a lot of it.

I don't know why it keeps getting harder and harder. You'd think I'd be used to it by now.

We're going to try one more IUI. If that doesn't work, we're going to revisit the discussion about IVF.

10dpiui

2011-02-23T20:45:00.002-05:00

I took a test this morning. It was negative.

I wasn't surprised. It's still too early, honestly. My post-trigger symptoms have all waned in the last few days--less bloating, less cramping, boobs gone from Ridiculous Nipples (TM) down to normal premenstrual soreness--and having been pregnant before, and knowing how my body responds to hormones, I know that if I'd had enough hCG in my system to get a positive hpt, I would likely have SOME kind of symptoms.

Knowing the test would most likely come out negative didn't make it any less disappointing, though. It didn't prevent me from (once I decided, last night, that I'd test in the morning just to have something to think about) having multiple dreams about POAS (with varying results). It didn't prevent me from sitting in the bathroom watching the control line come up, staring at the white space next to it hoping for another line to appear; even doing that crazy thing we do where we hold it up to the light and tilt it at various angles, trying to decide if there's actually the ghost of another line there, even if just an evap line, or if we're just imagining things, willing it into being through sheer force of insanity.

So I'll continue parsing my symptoms, checking my boobs (is that some soreness in my armpit?), gauging the tightness of my waistband. And I guess I'll keep testing until the hope runs out.

Catching my breath

2011-02-18T22:01:00.002-05:00

Brutal week at work this week. Trying not to think too hard about whether the insane amount of stress will affect implantation.

IUI Sunday was fairly routine. The biggest wrinkle was that we couldn't get a sitter for a Sunday morning and due to a long, boring complication of who had to be where when, we had to drag BG 40 minutes downtown on the subway. My husband headed out first, gave his "sample," then BG and I met him near the clinic, I handed her off, and he entertained her for another hour while I went in for the IUI. Doctor doing the IUI was the same one who did the IUI in 2006 when I got pregnant (and also the one in 2009 when I thought I would get pregnant), so while not definitively a good omen, not a bad one either. Good sample, 26 million.

Since then, I've had plenty of symptoms, every single one of them attributable to the trigger shot, the ovary-plumping drugs, or the progesterone spike. Ridiculous Nipples, of course, are my trademark trigger shot side effect. Bloating, stretching, pulling, jostling in the pelvic area, all normal at this point in the process. But it's hard not to hope, all the same.

Eek [UPDATED]

2011-02-11T12:13:00.004-05:00

"How do you feel?" asked the doctor on monitoring duty this morning (CD 12).

"Like I'm about to ovulate!" I chirped.

As the dildocam slid home, the doctor said, "Well, you've got a lot of eggs here, so I can definitely see that you'd feel bloated." (Bloated, yes, but there have also been more...um...personal symptoms suggesting imminent ovulation. Fellow veterans of the TTC wars, I trust you know what I mean.)

I watched, squinting at the screen as he clicked and measured...18...15...15...right...left...then it was over and I wasn't sure what had happened, but I had a pretty strong suspicion that there was a LOT going on. I'm used to seeing perhaps two large follicles on an ovary, and there were definitely more than two.

He told me that most likely I would trigger tonight for a Sunday IUI, bloodwork pending. Nurse called a few hours later to confirm that yes, I should take Ovidrel tonight and schedule my Sunday morning IUI. I asked her what my follicle count and E2 were. She told me:

Right side (where I have a tube): 5 @ 15 mm, 3 @ 17 mm, 1 @ 19 mm (and a bunch of littler ones)
Left side (no tube so not so much of a factor): 2 @ 17 mm, 1 @ 19 mm (and a bunch of littler ones)
E2: 1128

Yikes. Even if we assume the left ovary is not really in play (which isn't totally guaranteed), that is DEFINITELY more follicles than I have ever triggered with in the past. (Cycle I got pregnant I had one lead follicle and two close behind; last year I had three cycles and never had more than two over 16 mm a day before trigger.) Granted, I never had this level of detail about the follicle counts before, and I usually had my final ultrasound the day before trigger, not day of, so it's likely that I had some 15 mm guys hanging out at trigger in the past too.

But still. 1 19mm and 3 17mm follicles seems like a lot for someone who really, really does not want to have multiples. And we all know those 15mm follicles could decide to join the party at any minute.

Here's the thing: My doctor isn't actually in the office today. So the call to go ahead was made by one of his partners, who doesn't know me and my history. The nurse said she would email Dr. SF and he would call me back this afternoon so I could talk it over with him. If I was 32 and on my first cycle, I would almost certainly pull the plug and cancel the IUI. Too scary. But I'm 37, which while not ancient is old in fertility terms, and I had 3 unsuccessful IUIs last year with average 2 mature follicles on the right side each. And I once again reread this, which, while 10 years old, had this to say (emphasis mine):

For patients age 35 and older, pregnancy rates in HMG and clomiphene + HMG cycles were doubled when six or more follicles were > or = 12mm without a significant increase in twin or higher order implantations.

and

Conclusions:
Withholding HCG or IUI in clomiphene, HMG, and clomiphene + HMG cycles when six or more follicles are 12 mm or more in diameter may reduce triplet and higher-order implantations by 67% without significantly reducing pregnancy rates for patients under 35 years of age.

For patients age 35 and older, withholding HCG under the same circumstances may decrease pregnancy rates by half without significantly reducing multiple implantations.

Clearly more follicles does improve the chance of pregnancy; considering that I'm 37, and thus far have not been successful with fewer follicles, do we go for it and consider that the risk of multiples is probably less than for someone 10 years younger with the exact same numbers?

On one hand: I'm tired. I hate this shit, the needles and the slog. I don't want to do IVF, and I barely want to do another IUI. I want to just go for it and take home a baby.

On the other hand: THIS IS HOW PEOPLE END UP WITH SEXTUPLETS.

Nurse promised that Dr. SF would call me back later this afternoon. I will of course update then.

UPDATE: Dr. SF called right as I hit "publish" on this post. He talked me down. While of course, he said, we cannot avoid the risk of multiples with IUI, this cycle is actually pretty equivalent to the cycle I got pregnant on, maybe actually safer from an avoiding-multiples standpoitn. Apparently that cycle I had 3 follicles hovering around 17 mm the day before trigger with an E2 of 1074, so I most likely had a much higher E2 the day of trigger, and probably a bunch of 15mm follicles too. He thinks that we're not going to get a cycle much better than this, and recommended going forward.

So we're going forward. And you can all laugh at me when I end up pregnant with sextuplets.

Not a repeat

2011-02-09T17:43:00.002-05:00

If we were truly recapturing the magic of the one mythical cycle that worked, I would now be coasting after 5 days of stims, preparing for trigger with a couple of nice fat follicles. Alas, my ovaries did not get the memo about repeating their five-years-ago performance. This morning, CD10, after a rather painful Pap smear (I was overdue for one so they threw it in; it is clear, however, that this is not a fertility clinic's area of expertise), I was wanded by the doctor on duty (not mine), who said that I had "lots of eggs" growing, but nothing in the lead. He measured a couple of them but didn't share the numbers with me. Based on my E2 level (again, no idea...), I'm to do 112 IU tonight, then drop down to 75 IU tomorrow, and come back in for monitoring on Friday.

So. It is what it is. I'm disappointed, but it's hardly surprising that (a) my finicky ovaries would respond totally differently to the same protocol on any given month; and (b) my finicky 37-year-old ovaries would not be as responsive as my 32-year-old ovaries were. I'm hoping we can still pull out maybe a Friday trigger and Sunday IUI, because I have such a hairy week at work next week that the logistics of an IUI next week are reeeeeeeaaaaaally going to stress me out.

Meanwhile, my ovaries are definitely feeling tender, and my boobs are actually kind of sore too, which I don't remember happening on previous cycles (at least not until after trigger). The injections have been hard. The mechanics of them, fine, I remember to do everything properly, I'm psychologically up to them, all that. But actually pushing the needle into my flesh, for some reason, is really difficult this cycle. It hurts, even though I try to numb up with ice. My skin seems to push back on the needle, so I have to push hard to get it in, and when I pull the needle out my flesh resists giving it up, so I feel a pinch and a pull on my skin as I drag the needle out. Oof. Am I just getting old? Too sensitive?

Speaking of sensitive...way back when I was trying for #1, I got sucker-punched by a pregnancy announcement from my friend R. It was one of many, many pregnancy announcements I was dealing with back then, but for some reason this one hit me particularly hard. (I had to excuse myself from dinner and go cry in the bathroom.) This afternoon, what should I get in my inbox but...a pregnancy announcement from R! She's due in July with #2! Isn't that awesome?!?!?!?

Yeah. I was glad it was over email so I could be cranky about it in the privacy of my office. Perhaps, though, some good mojo will come of it. Because 3.5 months after she gave birth to her baby #1, I had my baby #1 too. Maybe I'll get lucky and have a repeat performance after all.

CD8

2011-02-07T22:40:00.002-05:00

After three days of 112IU (really more like 100IU, since I've kept the dial a little under the 112.5 mark as directed), my ovaries are "definitely swollen," said Dr. SF (and I'm starting to feel it), but nothing notable yet on ultrasound. Lining good at 8.5 mm. Dr. SF said he'd base the next couple days' dosage on my E2 levels, since that's a better indicator at this point than follicle size. Finally got the call late this afternoon to continue 112IU, come back Wednesday. Onward!

CD5

2011-02-04T23:53:00.003-05:00

First injection of the new cycle done. (Almost forgot about it, too, despite programming a reminder into my phone.) I was worried it would be weird or I would forget how or something, but turns out it's just like riding a bike. Or falling off a log. Or something. Anyway, I did it.

CD3

2011-02-02T11:24:00.003-05:00

Not fun: making my way to the clinic at 7 am in a horrible ice storm. Sidewalks slick with an inch of sheer ice, pelting frigid rain, really testing one's commitment to getting pregnant. Sort of symbolic of my wintry state of mind as we start off our second round of trying for #2.

Also not fun: bleeding right through the paper onto the exam table. Ick.

However, all systems are go for this cycle. Dr. SF had put a cheat sheet in my chart to remind himself of the details of my one successful cycle (3 days at 100 units Follistim, then drop down to 75 for 2 days). Friday I'll start with 112 units Gonal-F (he advised me to actually dial it between the 75 and 112.5 lines to get a little bit less), back in for monitoring Monday. Normally I would have started tonight, but I didn't want to come in on Saturday (it's BG's birthday! and I have to prepare to have a horde of small children dismantle my apartment!) and since Dr. SF isn't in this weekend he said he'd just as soon have me come in on Monday when he could see me himself.

Wintry metaphors aside, I am trying to have a really positive attitude about this cycle. Being cranky and whiny about it is only going to make it harder to drag myself out of bed before dawn or give myself the injections. Being upbeat isn't necessarily going to make it any easier, but it will help me stay a little saner, perhaps. (I hope--this positivity thing is kind of new for me.)

Aaaand here we go again

2011-01-17T21:59:00.003-05:00

Thoughts on returning to the RE's office after a 14 month absence:

• This place reeks of desperation and despair.
• Why do I see more Hasidim at the fertility clinic than anywhere else in the city?
• (Well, where else would I run into them? It's not like they're hanging out at the clubs on Friday night.)
• (Not like I've hung out at any kind of club myself in the last 10 years or so.)
• Boy, all these comfy upholstered chairs would be a perfect breeding ground for bedbugs.
• Must be Bring Your Husband to the Clinic Day. Lots of sheepish-looking dudes getting called back solo.
• I can't believe I'm back here.

Dr. SF was really pushing for IVF this time. He said that while we can keep doing what we've been doing (low-dose gonadotropins plus IUI), it's pretty inefficient especially given our desire to avoid multiples. He said that with IUI I'm just as likely to get pregnant with twins as with a singleton, and reminded me (as if I needed reminding) that I could easily have ended up with twins when I got pregnant with BG. But he also said that really, we still haven't done all that much with project baby 2.0--those 3 (or 4?) back-to-back cycles in 2009 notwithstanding, the sum total of eggs I've produced so far is actually not that high. So he didn't have any objections when I said that we really wanted to try a couple of IUI cycles first and see how it goes. (My husband and I had discussed this beforehand and settled on trying 2 cycles IUI before we reconsider IVF.)

So we settled that we'll start a new cycle this month, pending today's bloodwork, and try to duplicate as closely as possible the 2006 cycle where I actually got pregnant. That is, rather than starting at 75 units and ratcheting up, we'll start with a few days of 100 units and dial down, since that cycle I did 3 days of 100 units, 2 days of 75 units, and a day of coasting before triggering on day 9. The Gonal-F pens in my fridge are still good, just barely, so I can use those.

Looking ahead, I asked if there was an option to do a low-dose IVF with the intention of ending up with as few leftover embryos as possible (since freezing is one of the aspects of IVF my husband is squeamish about). Dr. SF said yes, they do a letrozole plus follistim protocol for women who have had breast cancer or for whom high estrogen levels are otherwise inadvisable, with the aim of getting 4 or 5 eggs--with a day 5 transfer, that would mean probably few survivors. Since my insurance will cover 3 full cycles of IVF (meaning we don't have to try to pump out as many embryos as possible in one round that's our only shot), he thinks it would be fine to try that first, if it comes to that. And the other interventions my husband isn't comfortable with--assisted hatching, ICSI--would most likely not be needed in our case anyway.

Dr. SF ordered up bloodwork--progesterone, hCG (ha!), estrogen, TSH, the usual--and I'll get a call tomorrow letting me know whether I need Provera or can just wait for my period to come on its own. (I'm on CD 30-something and spotting, but that doesn't mean anything in PCOS world.) And--I can't even remember the last time this happened--I GOT TO LEAVE WITHOUT TAKING MY PANTS OFF. I know, right???

So there you have it. It seems this is an infertility blog once again. Yay?

Everything old is new again

2011-01-03T20:13:00.003-05:00

Funny how I still have my clinic's phone number memorized, even though it's been over a year since my last failed cycle.

Yep, we're officially diving back in. What it amounts to is this: I just turned 37. Bat Girl is about to turn 4. My husband will be 40 this spring. We want another baby. My eggs ain't getting any younger. And incidentally, those Gonal-F pens I stockpiled in 2009 are going to start expiring next month. (Though at this point I might not even use them, since my new insurance will cover meds and I do feel a little weird about using meds that are about to expire and that have been sitting next to some aging kimchi for the last 13 months.)

I do have insurance coverage for IF treatment now...but my current plan has a lifetime limit of 3 IUIs and 3 IVFs. Since IVF is still off the table, that means we basically have 3 more chances. That's...a lot of pressure. At the same time, though, I'm not sure I have more than 3 cycles in me, given that I'm still shuddering a little at the thought of another injection.

So perhaps this is our last chance. I have a weird superstition that I might get pregnant in March, because the last time I got pregnant I had been at a new job for 9 months, which meant I told my boss I was pregnant right before my 1-year anniversary. And in March, I will have been at my current job for 9 months. I know it's stupid, but we have to hold on to our stupid little fancies so we can get through the day, right?

Appointment with Dr. SF in two weeks to talk details. Yikes.

Heartbreak

2010-12-11T20:35:00.001-05:00

My friend's son died on Friday.

I want to scream.

Hmm

2010-12-09T17:39:00.002-05:00

I'm having one of those click-to-the-end-of-the-Internet days (read: totally unmotivated) and stumbled on this. My skin has been absolutely terrible lately. Take a good long look at that picture and guess what parts of my face are the worst!

At a loss

2010-12-08T21:13:00.002-05:00

One of my dearest friends, who happens to live literally on the other side of the planet, got pregnant after multiple rounds of IVF and one miscarriage. The pregnancy has been plagued by complications--hematoma, vanishing twin, placenta previa, preterm contractions, culminating in (as of about a week and a half ago, at just past 29 weeks) total hospital bedrest. I talked to her last week and she was bored silly but optimistic and happy, making jokes about bedpans, enjoying feeling the baby kick, and looking forward to hopefully keeping the baby in until 35 weeks.

You can see where this is going, can't you?

Today I got an email from her husband, saying simply that she had delivered a boy, 10 weeks early, and that their son had multiple fatal birth defects, most likely due to a trisomy. (They hadn't had an amnio, but a level 2 ultrasound at 25 weeks had shown no major abnormalities.) He is expected to live perhaps a few months at most, but more likely a matter of days.

I just...I don't know what to say.

Almost missed it

2010-11-30T00:14:00.002-05:00

Thanksgiving was my five year bloggiversary! I was traveling for the holiday so I nearly forgot about it. I have come so, so far since those first sad, bitter, frustrated posts. If I had been able to see that exactly five years later I would be updating my blog surrounded by the debris of a sticker- and tiny-animal-obsessed 3.5 year old...it would have been more than I could ever have hoped for.

Our community has come so far in the last five years too. Though I no longer consider myself an active participant in the larger IF blog community, those of you (you know who you are) who were there with me nearly from the beginning, who cheered me on as I did the same for you, who made me feel less alone in that horrible place...you will always be more important to me than I can ever express. I love you guys.

Countdown

2010-10-06T10:50:00.003-04:00

5: Months until the two Gonal-F pens in my fridge expire
4: Years since I was pregnant with Bat Girl
3: Months until I turn 37, taking another step into Advanced Maternal Age
2: Number of children I always wanted to have
1: Number of unassisted periods I've had since last November
0: Degree of certainty about whether we want to dive back into treatment

Sunrise, sunset

2010-09-08T10:46:00.003-04:00

Today was Bat Girl's first day of preschool (sob). We were taking an official first-day-of-school picture in front of our building when the lactation consultant we saw when BG came home from the hospital happened to walk by with a friend. They admired the photo, asked where BG was going to school, and told us they had both gone to that very same school 50-odd years ago. The LC didn't recognize us, but laughed in delight when I reminded her that she had come to see us when BG was a newborn.

It felt like a nice way to come full circle.

Take this survey

2010-06-29T11:56:00.002-04:00

Thomas Hale (yes, that Thomas Hale) is conducting a survey of women who used (or are using) domperidone or Reglan to build milk supply while breastfeeding. Take it now! (PS I'm so glad I blogged my breastfeeding struggles, because I would never have remembered all the details about when and how much and how long without this record.)

Relief

2010-05-17T23:00:00.002-04:00

Lest you think I've been spending all my time since that last post weeping, I should share with you that on Tuesday Bat Girl learned how to play Duck Duck Goose at daycare. As soon as I got home from work she demanded that we all play. I don't know if you remember how RIDICULOUSLY EXCITING it was to play Duck Duck Goose when you were a kid, but the look of glee on her face, as she practically vibrated with anticipation waiting for one of us to say "GOOSE!"--well, I can't remember the last time I laughed that hard.

*****

And in other good news, I got a job! It is, in fact, very nearly the same job I turned down almost exactly two years ago. You know, the job I turned down because I loved my then-current job and thought it was a better path to what I wanted to do with my life? (And then I got laid off six months later and cursed myself for sticking with the old job.) It is also the exact same salary I turned down two years ago as being not enough of a bump up from my then-salary.

But a lot has changed in two years. I got laid off, for one thing. I spent a year and a half freelancing/consulting and incrementally moving myself in the direction of my ultimate ideal, the penguin zoo. But then work dried up over the winter, and we started running a major deficit in our budget, and I started coming to terms with the fact that while I might do OK as a roving penguin handler, the market for penguin zoos has really dried up, and there really aren't many, if any, full-time penguin zoo managers anymore. (In fact, that Dream Job I didn't get last year ended up majorly reducing their penguin division, so it wouldn't have been a dream job after all.) And we need money, and our health insurance now costs $1250/month, and we have preschool bills to pay come fall.

So I took the job. It's not perfect, but it's a good job--a better (as in more enjoyable for me) job than what they were offering me two years ago, even though the salary is the same. I like the people, and they have excellent benefits (including IF coverage). And I buy myself some time to figure out if I want to totally reevaluate my future. I'm relieved. And happy (even if I don't sound totally enthused on paper). There's still some i's to dot and t's to cross on the paperwork (so if we're friends on Facebook, please don't mention this on there--I have a lot of industry friends on FB and it's still under wraps) but by the end of the month, I should be gainfully employed again. Yay!

Sadness

2010-05-07T23:12:00.003-04:00

This morning, I opened my email inbox to find a message with the subject line, "Baby!" Yes, a birth announcement, from the husband of a friend I hadn't even known was pregnant.

The email brought up all sorts of complicated sadness for me. First, the difficult feelings I have toward this friend, M. I met M when Bat Girl was just a month or so old. Her daughter was six days younger, born in the same hospital as BG even, and we met walking the paths of our neighborhood park with our newborns bundled into baby carriers. We were each other's mainstays through those foggy newborn months, bonding over breastfeeding difficulties and sleep issues, putting together a little moms group for other neighborhood women with newborns, sharing a babysitter, meeting up in the park on summer weekends (once we both went back to work) to marvel at our girls' chubby legs and attempts at crawling. We got to know each other's husbands. We celebrated our daughters' birthdays. I really thought we were good friends. We were good friends.

Then, when our girls were about a year and a half old, M got a job on the other side of the country, and she and her husband and daughter packed up and moved. They had a goodbye party, which of course we went to, and M and I said heartfelt farewells and promised to keep in touch.

And I never heard from her again. Not one email or phone call or text. I sent her a few emails asking how she was doing, but never got a response. At first I thought maybe she was too busy to keep in touch, but then a few other neighborhood moms mentioned hearing from her. Then I thought maybe she didn't have my email address and my emails were going into her spam folder, or something like that. But then I started getting occasional mass emails from her husband--notes that they were looking for a new subletter for their Big City apartment, announcements about a new project he was working on--and I had certainly never given him my email address. So I knew that she had given him my email for his "New York Friends" mass email list, yet somehow never found the time to write me a single word personally, after all that we had been through together. And that hurt.

So of course, seeing M's husband's name in my inbox brought up that hurt all over again. She was pregnant--and I hadn't even known it. I had to find out through that impersonal mass email to everyone they know, after the baby was born.

Then there's the fact that she just had her second baby, and her first is exactly the same age as BG. See, my bitterness about other people's pregnancies/babies is very specific now. I feel no resentment toward people having their first, even if they had no problems getting pregnant. (We've had a LOT of first babies in our lives lately--one born last month, one due this month, two more due this summer. Two of those are to friends who had miscarriages last year, so for those I am especially happy.) Maybe I still resent people who have super easy, robustly healthy first pregnancies--but only a little. I also feel little or no resentment toward people who have two kids under two--I was not ready for another baby when BG was that young, and would not have wanted one at that point.

But people with children roughly the same age as Bat Girl, who are pregnant with or have just given birth to their second? People whose second babies were conceived during the period last year when we were going through treatment? Those people, I resent the hell out of.

Last weekend I ran into the mother of a friend of BG's from daycare, whom I happened not to have seen for several months, and who was obviously, gigantically pregnant. I'd had no idea--and yes, her daughter is just a few months older than BG. I felt like I'd been socked in the stomach. And I ran into this woman and her belly again at daycare drop-off this morning.

AND this morning I got my period. I'd been spotting or bleeding basically every day for about 5 or 6 weeks, and I finally called my clinic last week and got a prescription for Provera. Took the damn prescription, and you'd think that after bleeding for 6 weeks straight there wouldn't be anything left in there, but as it happens, there sure is.

So there I am this morning, feeling terrible because of my period, which had to be artificially induced thanks to my eternally fucked-up ovaries, unemployed with no way to pay for IF treatment and no insurance that covers it, feeling sad and resentful about not being pregnant and not knowing if I'll ever be pregnant or have another child, feeling bitter about someone I know with a kid the same age as mine who's having another baby, and oh yeah, dealing with some more relationship crap that I don't really feel like getting into right now. And then I get a birth announcement from the husband of a friend who basically dumped me.

So yeah, not the best morning.

But dumping it all out on the Internet helps. So thanks.

PS I did write a very nice short email back to M and her husband (he sent the email but she was cc'ed) congratulating them and telling them how adorable the new baby was and how beautiful and grownup their daughter looked and how they both looked great too (they sent a lot of pictures). Because, you know, everyone deserves congratulations when they have a baby, and I'm not an asshole. At least not in public.

Infertiles! FRERs! A match made in heaven!

2010-05-03T21:47:00.003-04:00

So apparently TLC.com has a new web-only reality series, A Conception Story. The idea was suggested to TLC by the makers of First Response, who will be supplying the participants with free ovulation and pregnancy tests.

I don't have a beef with the concept (it's actually quite brilliant, from a media/branding POV) and I haven't watched any of the episodes or even looked at the site. But I just had to share this quote from the NYTimes article on the series, which should elicit a snort from anyone who's had to allocate a special area of the medicine cabinet for HPTs:

Ms. Feldman [vp for marketing at First Response] said that while their customers are evenly split among those wanting a positive and negative result, “hopeful positives buy more boxes and use more sticks.”

You THINK???

(I also thought of the Serono ads Julie wrote about, where the husband is showing us his wife's gigantic stash of HPTs stacked and squirreled away in every spare inch of their home...)

Party people

2010-04-14T10:48:00.002-04:00

Okay BlogHer ladies, I finally got around to buying my party pass and RSVPing for a bunch of parties: People's Party, SparkleCorn, and the Green Affair, and waitlisted for CheeseburgHer. I have no idea if I'm actually going to go to any of these but I figured I'd get in while the getting is good.

HOWEVER I would much rather sit down and have dinner/drinks with my favorite bloggers than go to a big crowded party. So if you haven't already, let me know if you'll be in town that weekend and I'm going to try to organize something. At the very least we can meet up for coffee or SOMETHING.

Grr.

2010-03-27T20:39:00.006-04:00

I think I've mentioned before that I live in a fairly diverse area of Big City. There's a wide mix of socioeconomic and racial groups, and many of the families we encounter and hang out with are mixed-race, in every possible permutation. There are also lots of gay and lesbian parents, lots of families built through adoption--lots of different-looking families, in other words. Parents here tend to be of a progressive stripe--people who are really sincere about social justice, who try really hard to teach their kids about equality and getting along and all that jazz.

All of that to say that I don't encounter blatant racism all that often around here. Once some middle-school-age boys made ching-chong noises at me while I was walking down the street (and boy was I PISSED) but that's rare enough that it really sticks out in my memory. So my "responding to racism" muscles are weak, I guess.

Today we were at a birthday party for a little friend of Bat Girl's. It was a small gathering--I knew all the kids at least by sight from the playground, and most of the parents by name. I was the only non-white person there. It happens sometimes.

Someone had an older kid who had recently broken his foot, and we were talking about it, so the only parent there whom I did not know started talking about how he broke his foot once. He is a professional dancer, and he broke his foot while on tour in Seoul, South Korea. The doctors there wanted to put a pin in his foot, but he wanted to wait until he got back to Big City, so he endured an 18-hour trip home in total agony so that he could be seen and operated on by the orthopedic surgeon to the Big City Ballet.

Sounds reasonable, right? Except this is how he told the story: "So the doctors at the hospital in Seoul were like, [squints eyes and talks in singsongy ching-chong voice] 'We fix! We put pin in foot!' [normal voice] And I was like [speaks loudly and slowly in that "You don't speak English so you must be mentally challenged" voice] 'No way! I am going to the U-NI-TED STATES OF A-ME-RI-CA!'"

I was so stunned that I just kind of smiled and nodded. No one else reacted to it either, of course. And I didn't want to make waves at a social gathering. So I let it go by, even though I was seething inside.

And now I am furious with myself. I wish that I had said something. Ideally something that specifically called him out, like, "Dude, is the ching-chong voice really necessary?" But even something milder like, "Actually, the doctors in Seoul are quite excellent. My uncle is one of them." (Again, I think that it's perfectly reasonable for a professional dancer to want to have a foot injury treated by an American physician who specializes in treating dancer's injuries, instead of by doctors he doesn't know in another country. It's the WAY he told the story that was so offensive.)

If it were just me, I could forget about it. But Bat Girl was within earshot. Chances are, she didn't hear it and wasn't paying attention if she did. But it was an opportunity for me to model a response to racism for her, and to let her (and the other kids) know that that kind of behavior is unacceptable, right when she's at the age where she's absorbing everything I do. And I missed it. I don't want to bring it up now, because if she didn't hear or notice, I don't want to make a big deal about it. But I worry that she did hear and will take away the wrong lesson (that it's okay for someone to act like that, that it's okay not to say something).

On the other hand, maybe it was a good reminder that I've gotten too soft. I wasn't prepared for that moment because I've started assuming that something like that would never happen. But now I'll be prepared. And next time, I won't let it go by.

All clear

2010-03-11T20:42:00.003-05:00

Quick update: Had the HSG this morning. Tube is clear. So we're basically in the same place--no reason IUI shouldn't work, if and when we get the desire and/or money and/or insurance to try again.

The procedure itself was a little...pinchier than I remembered from when I had it in 2006. But it was a lot faster, because I had given the radiologist a heads-up about my unicornuate uterus ahead of time (and since it was the same facility where I had my previous HSG as well as the MRI confirming the UU diagnosis, he was able to call up the records), so he didn't have to waste time trying to get dye to flow through a tube that isn't there. I also haven't had really any cramping, again I think because I didn't have all that extra fluid pumped into my abdomen.

Also, my uterus looks exactly like a tiny banana. That is all.

Are you coming to BlogHer?

2010-02-17T11:53:00.003-05:00

I say "coming" rather than "going," because, as it happens, BlogHer '10 is happening in my city. I know it's not until August, which is months and months away, but surely some of you are already making plans. I'm probably not going to the conference itself (though I may get a parties-only ticket), but would love to see any of you who are coming to town. So who's going to be here? And who hasn't planned to come yet, but might be tempted by the chance to hang out with ME? ;)

Technically still an IF blog

2010-02-11T14:14:00.003-05:00

Bat Girl turned 3 last week, and I know I owe the 10 of you some sort of birthday post, which I will try to get to, I promise. (Though a lot of my mommyblog-type energy gets diverted to Facebook, where it's easier to throw up a sentence or two about some cute/hilarious/crazy-making thing my kid just did.)

But I just got off the phone with Dr. SF, and I wanted to get this down before I forgot. I called him earlier today and left a message asking whether there was any value to my having an HSG, just to make sure my tube is clear, since we're taking a break from treatment right now anyway. He called back and we ended up having a long discussion about options and next steps. Everyone involved is clear that, medically speaking, IVF would be the most efficient and responsible way to achieve a pregnancy. But since that's officially out of the question for us due to my husband's beliefs/discomfort/whatever you want to call it, Dr. SF said there's no reason why we can't continue to do injectible IUI cycles--we just have to be patient. Looking at the numbers, the last cycle I did in November was almost identical to the cycle where I got pregnant, and it's just luck (or rather lack thereof) that it didn't work. My FSH is good, husband's sperm looks good, so I should be able to get pregnant, it'll just take more time and finesse.

I explained to him that because we no longer have insurance coverage for IF treatment, we'll be waiting a few more months before diving back in, so we can either save up for another cycle (though I do have that Gonal F chilling in my fridge, thank goodness) or maybe acquire some insurance with IF coverage. Dr. SF said that if we do change our minds about IVF, there are a few grant programs available through the state and through the clinic that can help pay for it, so that's good to know (though I don't think we will change our minds).

Since my last period in November, I'm 99% sure I haven't ovulated. I spotted on and off through most of January, and last weekend finally started a heavier bleed, but it doesn't look or feel like a real period. Dr. SF said that if this "period" lasts more than 7-10 days, or if at any point I go more than 60 days without a period, I'm probably not ovulating and I should go into the office to get bloodwork and probably a Provera prescription, to clear things out.

And he had no objections to my getting an HSG (which my insurance will cover), and said he'd have a nurse call me to make the arrangements. Couldn't hurt, might help. I'm not sure what I'm hoping for--if it turns out my one tube has been clogged this whole time and all those cycles last year were a waste of time and energy and $$$, I will be pissed. On the other hand, it will be a weird sort of relief to have something concrete to blame it on, rather than this feeling of frustration that it SHOULD have worked but didn't for no discernable reason.

The lack of insurance/$ provides a handy excuse for not diving back in right now. It's true, we do need to wait from a financial standpoint, but I'm still burned out from all those back-to-back cycles last summer and fall. I still can't contemplate sinking a needle into my belly again without a wave of revulsion passing over me.

But I do have baby fever. It's weird--as you all know, the newborn/baby phase was NOT my favorite. Yet I do feel a yearning wistfulness when I see a baby, and sadness that Bat Girl's baby days are long past. I snuggle my great big long-legged potty-using girl and have a tinge of wishing for a baby to cuddle. Clearly this is part of nature's plan to perpetuate the species, by making the baby urge stronger than the "oh God never again." But I also wish for a sibling for BG, for her not to be alone in the world. Sigh.

I know there are more thoughts here but if I wait until I have the time to sort them out and get them down I will never finish this post. So just fill in the blank here with everything ambivalent that anyone has ever said or thought about having another child, and I'll go ahead and hit "publish."

Breathing room

2010-01-12T22:23:00.003-05:00

The last 2.5 months have been a whirlwind. We've taken four trips out of town--one to my husband's family, one to my family, one part-work-part-vacation trip, and then this past weekend a sad, unexpected trip to attend my husband's grandmother's funeral. (This was his mother's mother. It has been a terrible year for that side of the family.) We just got back today, and I'm looking forward to sleeping in my own bed for more than two weeks straight at a time.

I've been working here and there--freelance is slow around the holidays. Spending a lot more time with Bat Girl, enjoying her nearly-3-ness, and also rolling my eyes in frustration at her nearly-3-ness. Latest personality development: flinging herself to the ground in despair when denied something she wants or when she can't manage something she's trying to do. Last week she lay on the living room carpet and wept for a full 20 minutes over something I can't even remember now--probably I wouldn't let her have another cup of soy milk, or she didn't want to pick up a stray Cheerio from the floor, or something equally devastating.

But she also continues to surprise and delight on a daily basis. Last night, I was saying goodnight and she gave me a big hug and said, "Thank you, Mama." "Thank you for what?" I asked. "Thank you for hugging me and loving me," she replied, and my heart just burst into a million little pieces. And I thought, maybe I'll only have one child, but if this is the one child I get, it's pretty good.

OH! And! After more than 6 messy months of potty training, including a massive regression in November and December (probably due to all the traveling plus BG starting daycare 2 days a week) where we went from 90% trained to 100% accidents (we are talking 4 or 5 truly gruesome weeks), BG finally seems to be trained. After all that time, it all suddenly clicked last week. I thought it was a fluke, but she was accident-free the whole weekend when we were running around to relatives and funeral home and church and cemetery etc. She even insisted on wearing underpants on the 5 hour car ride home (we'd put her in a Pull-up on the way there). I guess this was a case of it truly being darkest before the dawn--I seriously thought just a week before that we would never make it. Still in a diaper at night, of course, but I couldn't possibly care less. Now I just have to figure out how to wean her off all the stickers and chocolates and "poop presents" that were required to close the deal.

In case you haven't noticed, I'm avoiding the subject of IF and to-try-or-not-to-try. I'm still not ready to try again, nor is my husband. Nor are we even ready to talk about when and if to try. Not to mention how I've been spotting for the last 2 weeks without a proper period. Or how I can't even think about how much it will cost to try another IUI without insurance without feeling a little nauseated. So I'm just not thinking about it.

Dry eyed

2009-11-22T23:01:00.003-05:00

Thanks for the comments and the love.

I haven't cried. I've been walking around in a sad fog, going through the motions with all the family and social obligations we've had the past few days. It is surely a sign of how much I have grown as a person that on the day of my negative HPT, we spent time with not one, but two different friends, each of whom has a gorgeous new(ish) second child in that adorable 6-12 month age range, and I did not at any point want to scream, vomit, or poke my own eyes out with a sharp stick. (But it did hurt when my husband admitted to me later how much he loved holding those babies.)

I've been eating a lot of junk food (because really, why not?) and skipping my prenatal vitamins (because really, why fucking bother?) and staying up late watching TV because I don't want to be alone with my thoughts when I lie down. It's hard knowing that there's a good chance this may be our last assisted cycle. But one thing I do know--I don't regret that we decided to change our insurance next month, even though that means we can't get in one more cycle. Diving into another cycle right now is just unthinkable--I couldn't possibly handle it.

As a feeling-crappy-about-myself bonus, I have had very little patience lately for Bat Girl's totally normal almost-3-ish-ness--the whining, the slow-as-molasses shoe-putting-on, the milk spilling. You'd think that, being denied a second child, I would appreciate the one I have a little more, instead of losing my shit when she deliberately throws rice on the floor. But when my back is aching and the cramps are coming on and all I want to do is be by myself in a dark room for a day or two, and instead we're seeing endless relatives and I've got my kid attached to me 24/7...it's hard.

And when I do take a moment to hug her extra tight, or when she spontaneously breaks into song ("Monster Boogie") when I'm putting her to bed, there's the sudden knowledge that she's not a baby anymore, and that it's possible--not guaranteed, but possible--that I will never experience the baby days again.

*****

We just got back home yesterday, and tomorrow we're turning around and getting on a plane for another week out of town--I didn't even bother unpacking our suitcase, just shoved in a couple extra sweaters and rezipped the whole thing, dirty laundry and all. We'll be at my parents' house, which means no blogging for me, but I'll catch up with you all next weekend. Have happy Thanksgivings, everyone. I'll be working on remembering just how much I do have to be thankful for.

Nope

2009-11-19T07:24:00.004-05:00

Yesterday morning (10dpiui) I woke up feeling distinctly Not Pregnant. A little boob tenderness, but all the other symptoms I've had were basically gone.

Yesterday evening I started spotting, just a little bit.

This morning, even though I knew what the result would be, I took a pregnancy test. The control line came up right away, but I waited the full 3 minutes and did all the things we do, holding the test up to the light, scrutinizing it from every angle, wondering if I saw a shadow of second line.

But the light in my sister-in-law's bathroom is much better than in my own. There was no doubt. Negative.

I expect I'll get my period sometime today or tomorrow.

Wow, this really sucks.

Always prepared

2009-11-16T19:05:00.004-05:00

As of this morning, the trigger shot hCG is officially no longer registering on a pee stick. Anything that shows up from here on out is definitely homegrown.

We're going away for the week. I'm packing mostly yoga pants because I'm bloated and uncomfortable. My uterus aches and I'm zitty and cranky and ridiculously exhausted. And have caught a cold from Bat Girl (thanks, daycare!) but can't take any good drugs while in the 2ww. If I turn out not to be pregnant, I will be PISSED.

Since we will be away through Saturday (13dpiui), I'm packing a box of pregnancy tests...and a travel pouch of tampons. You never know.

My body is messing with me

2009-11-14T16:44:00.003-05:00

SymptomWatch: After the requisite day or two of minor bloating, things have mostly settled down. My nipples/boobs still hurt, but that's been subsiding as the trigger shot hCG leaves my system. (I peed on a stick today just to check that it's almost gone--and also just for the fun of seeing the second line, let's be honest. I wouldn't ordinarily waste hpts that way but I've got a bunch of coupons and rebates so I figured I'd splurge.)

My uterus (and I know it's my uterus, thanks to the off-center location) is super sore and achy and I've been having all sorts of rumblings and pullings and achiness in my lower abdomen today, but that might just be because of the, er, digestive difficulties I've had lately. And how's this for weird: An hour ago I stood up from the kitchen table and got a shot of searing pubis symphysis pain that won't go away. I know that's not a real symptom, since most women who have it get it late in pregnancy, but I thought that was funny. Also funny (but totally not): I got a mailing from Pampers with info on prenatal nutrition and a sample of newborn diapers. I guess they do this to people whose kids are Bat Girl's age because they figure you're probably working on #2 by now--this actually isn't the first such mailing I've gotten. But I find it kind of presumptuous--and talk about a kick in the ovaries for those of us dealing with secondary IF.

Nothing else to say on this front. Dealing with all kinds of insurance/work/life stress, and I actually had a big stress meltdown on Tuesday. So if I do get pregnant, that's a big in your face to all the "just relax" folks. I'm going to test on Friday, which will be 2 weeks from trigger. We'll be traveling and staying with friends and relatives all week, so I won't be tempted to test sooner.

We are definitely switching insurance as of December 1, which means no more IF coverage. Which means this will be our last try for a while, and possibly forever. I'm too worn out from the last 6 months to feel bad about that right now--and no matter what, we would have lost our IF coverage at the end of the year, so at most we would have gained one more cycle. And we don't want to do another cycle right away just for the insurance, not when I'm so burned out and having more and more trouble with the injections every day as it is. But ask me how I feel in 6 months.

Fingers crossed

2009-11-08T17:22:00.004-05:00

If I were superstitious, I would consider it a good sign that today was another gorgeous, warm, sunny, perfect Sunday, just like the day of the IUI that resulted in Bat Girl 3.5 years ago (albeit in November instead of May). I would also consider it a good sign that today's IUI was performed by the same doctor who did that successful 2006 IUI. If I were superstitious, that is. Not that I am.

IUI itself was uneventful. Doctor declared it a "good sample," 26 million or so, and was in and out in a flash.

I can definitely feel my ovaries, though most of the tenderness is on the left, which concerns me a bit considering both of the leading follicles were on the right. But I feel pretty good otherwise, besides the requisite ridiculous nipples that the hcG shot always seems to produce in me. We'll see what happens.

If this doesn't work, I think we may take a break after this one. The prospect of diving into another injectibles cycle fills me with dread, and I just feel worn down by the whole process. My husband is also in favor of taking a break for a few months. There are some other boring insurance complications factoring into all of this, which I won't take up your time with, other than to say we may be switching plans 12/1/09 instead of 1/1/10 which will save us a lot of money but will also end our IF coverage. Either way, I will probably stock up on a couple of Gonal-F pens before our insurance coverage for IF runs out. They only cost me $25 each (I know!!!), so if we do end up cycling again next year I can save a few thousand bucks that way, and if not I can give them away.

But hopefully this cycle will work. Please, please, please let it work.

Three...two...one...

2009-11-06T12:41:00.005-05:00

So here we are again, in a familiar place.

This morning the two follicles on my right ovary were at around 17.5 and 16-ish mm, while the two on the left were around 15 mm. At first Dr. SF said that we'd drop down my dose tonight (exact dose to be determined based on today's bloodwork), trigger tomorrow, IUI Monday. Then he amended that to say that if my E2 was much over 1000 we might trigger tonight and do IUI Sunday, to bring down the chance of multiples. I reminded him that I have no tube on the left, so those follicles on the left are much less likely to come to the party, but he's also concerned about excessive fluid and bloating if those follicles get too huge.

Then he stopped and said, "Wait, let's really talk about this." He put down the stack of printouts and u/s pictures and looked at me. Ordinarily, he said, he would push it one more day, to get that lead follicle over 18 mm before trigger and maximize the chances of pregnancy. However, doing so will also increase the chance of multiples. Generally speaking, he does this knowing that selective reduction is there as a "safety valve," in his words. "But if a triplet pregnancy would be a complete disaster for you and you don't want to consider reduction, then it might be better to take the conservative route and do the Ovidrel tonight," he told me.

Well, yes, a triplet pregnancy would be a disaster for me. A twin pregnancy would be a disaster for me, frankly. But I also want this to work. And what it comes down to is the choice that all of us undergoing IF treatment make in some form or another: Minimize the chance of multiples, or maximize the chance of pregnancy?

I told Dr. SF I was leaning toward being more conservative, but I would have to talk to my husband. He agreed and added, "This [gesturing toward the ultrasound screen] is about as good as we're going to get," in terms of having a good chance at pregnancy without scary chance of multiples, though he also pointed out that what doctors see on the u/s screen isn't a perfect predictor of what's going to happen once you trigger, as I know Jody can attest to. He finished by saying that if this cycle doesn't work, he will probably push us to reconsider IVF.

I went ahead and scheduled the IUI for Sunday, then the whole way home I thought and thought. I thought about how upset I would be if I didn't get pregnant, and how sick and tired I am of the shots and the early morning appointments and the endless disappointment. And I thought about how devastated I would be if I saw three or even two sacs on the ultrasound screen a few weeks from now, and how even though a twin pregnancy in me is probably roughly equivalent to a triplet pregnancy in a woman with a normal uterus, and a triplet pregnancy is probably equivalent to quads or quints, I don't know if I would have it in me to reduce. And I talked it over with my husband, and the answer was pretty clear: Trigger tonight. Reduce the chances of multiples, even if that means reducing the chance of pregnancy.

I feel pretty confident in the decision. I was even getting nervous thinking about how even with two less-than-optimal-size follicles on my good side, there is a very real chance of multiples, but I reread this (an old study, but I don't feel like digging to find something more recent, though this one also looks interesting) and it looks like the chance of HOM starts to drop off after age 35, which is good news for me and my aging ovaries. (I know that we are still playing with fire here, but I need to tell myself whatever it takes to be able to sleep at night, OK?)

Nurse called to confirm my Sunday IUI and apparently my E2 this morning was 1009. Not scary high (it is, in fact, about what I had the cycle I got pregnant, so I'll probably have a good bit of bloating next week), but enough that I feel even more confident that we're doing the right thing. As much as any of us can have confidence in any of this, anyway. I swear, sometimes I feel like reproductive medicine is equal parts science and voodoo.

The long slog continues

2009-11-05T13:35:00.004-05:00

After two more days of more juice (112.5 IU), I now have 2 leading follicles on the right (14-15 mm range) and two on the left (about the same, but we care less about those). Dr. SF was debating this morning whether to continue to push or to drop down the dose; in his words, "Stimulating ovaries like yours is like walking a gangplank." Based on my E2 results (I forgot to ask the nurse for the number when she called), he decided to keep the dose at 112.5 for tonight but wants to see me back for monitoring again tomorrow, to make sure we're not overdoing it. Right now we're probably looking at Saturday night trigger, Monday morning IUI, if all continues well.

I'm nervous about all those follicles but am willing to wait and see. The ones on the left (no tube) wouldn't concern me if it weren't for the fact that there are also two on the right. I'm hoping one of the follicles on the right takes the lead--two equal follicles on my good side feels a little risky from an avoiding-multiples standpoint, even though it's close to what I had when I got pregnant last time.

Most of all, I am SO OVER this cycle and ready to be done. Over the last week or so, the shots have gotten more and more painful and difficult to do--I've had more bleeding and bruising, it's harder to push the needle in, and it just plain HURTS more, even though I faithfully ice my belly before every shot. I don't know if there's a psychological component to it, or if after 40-odd injections over the last 3 months, my belly skin and fat is starting to put up some resistance. Have any of you experienced this?

So assuming a Monday IUI, the 2ww will be over just as we're leaving to visit my parents for a week for Thanksgiving. I was worried about the logistics of starting another cycle, but I explained to Dr. SF that we would be out of town, but I wanted to squeeze in another cycle before the end of the year when I lose my IF insurance coverage, and he said it was no problem, that I could start stimming at any point after I get my period, whether day 3 or day 10 or whatever. "That's the one good thing about not ovulating on your own," he said.

Assuming this doesn't work, that is. Which I really really hope it does, not least because I'm not sure how much more I can take.

Oh, one good thing I forgot to mention--at Sunday morning monitoring I ran into an old coworker of mine, to whom I'd recommended my clinic earlier this year but hadn't heard from since. She was getting ready to start her second round of IVF. Since we are definitely not going to do IVF, I was able to give her my unused Lupron, Medrol, and antibiotics, and was so happy to see them going to someone I knew. Unfortunately, I didn't realize until I looked that the PIO I have is only good until the end of the month, so she couldn't use it, but I donated it to my clinic, to go to another patient in need.

Um, I don't have a good ending for this, so I'll just sign off. But I'm sure you'll hear from me again very soon.

An open letter to my ovaries

2009-11-03T15:05:00.003-05:00

Listen up, ladies. I know that historically speaking, we have not always been on the best of terms, you and I. But seriously--flaunting two 14-15 mm follicles on Sunday, only to have nothing bigger than 12 mm to show today? Are you kidding me with this?

I guess I shouldn't have been surprised--apparently you went on an estrogen-producing strike over the weekend, making my E2 plunge from 250-something on Friday to 80 on Sunday (according to the doctor this morning). But that's why we upped my dosage, so you would get more delicious gonadotropins to snack on. I just never realized that follicles would actually shrink this late in a cycle.

I'm interpreting your renewed interest in producing estrogen (E2=279 this morning) as a peace offering. In return, I promise to continue delivering sweet gonadotropins for at least two more days, but I expect a little more motivation on your part.

In closing: WTF? And also: Get your act together. Thank you.

Your friend,
electriclady

Slackers

2009-11-02T14:18:00.004-05:00

Yesterday, as I headed across town to my clinic in the early morning light, I walked along one of the final legs of the marathon. As I dodged gaggles of cops and watched volunteers setting up the barriers and viewing stands for the crowds that would be arriving in a few hours, I thought about the long slow slog that is infertility, and wondered if I would ever make it to the finish line this time around.

I've been feeling pretty discouraged lately, and I know part of that is because of how long this is taking compared to how (relatively) easy it was the first time around--we messed around in treatment for a long time, but once we finally sorted out what my ovaries actually needed, I got pregnant on my first injectible cycle, which was the first cycle where we actually made it to IUI without getting canceled. I've started second-guessing myself and wondering if I should be doing things differently. Should I be eating better? Taking different supplements? Drinking more milk or eating less meat? Doing more yoga? And I keep thinking back to when I got pregnant with Bat Girl, and trying to figure out what was the X factor. Unfortunately, a lot of that is difficult to replicate now that I have a kid--I was in the best shape of my life, ate incredibly well, practiced yoga 3 to 6 hours a week and ran once a week, slept tons, etc.

And then I remind myself that the real differences between then and now are that (a) I stimmed too quickly last time and had 3 follicles going, with a side of mild OHSS, neither of which I want to repeat, and (b) I'm 3 years older now, and so are my ovaries, and I can't do anything about that.

As much as I don't want to duplicate that 2006 cycle (besides the positive results), it's hard not to feel anxious at how relatively slowly this current cycle is going. Back then, I triggered on day 9. Yesterday, on day 12, I had two follicles on the left (ARGH!) side in the 14-15 mm range, and one or two in the 11-12 mm range on the right, which means they probably won't go anywhere. I was instructed to up my dosage from 75 IU to 112.5 IU last night and tonight, which probably means that my E2 is lagging despite the decent-sized follicles.

I'm hoping everything will look better on Tuesday and I'll get to trigger that night--a Thursday IUI is manageable, but the logistics of a Friday or Saturday IUI are trickier. I'm also hoping for a little more action on the right ovary. I'm willing to trigger with two follicles on the left and even with two on the left and one on the right, since the chances of the right tube picking up an egg on the left are so small. This might be our last shot--if this cycle doesn't work, we won't be able to cycle again right away because we'll be traveling over Thanksgiving, and I'm not sure we'll be able to squeeze in one more cycle before Christmas. And then we lose our good insurance and have to start making some tough decisions.

In summary: Wake up, ovaries!

Ho hum

2009-10-29T15:22:00.002-04:00

After 14+ years in the post-collegiate working world, I've finally figured out my natural work rhythms:

9-10 am Diddle around on the Internet, no matter what time I sit down to work.
10 am-1 pm Massive burst of productivity.
1 pm-5 pm Lunch, followed by massive collapse in productivity.
5 pm-10 pm Second burst of productivity.

Unfortunately, this schedule is not really compatible with regular office life. Even now that I work from home at least half the time, I can't really take advantage of that evening productivity burst thanks to the whole need to feed/bathe/sedate the child. You know the only time it worked well? When I was pregnant, on bedrest, working from home, with my husband working nights. Can't go out at night, can only watch so much TV, why not work until 11 pm and sleep all afternoon?

All that is to say that I decided not to feel guilty about blogging in the middle of the day, even though I'm in an office, because it's certainly no worse than any of the other time-wasters I'd be occupying myself with right now, like reading Gossip Girl recaps or hanging out on Facebook.

Today is CD9. I haven't written about the progress of this cycle because there hasn't been much to say. I've been on 75 IU Gonal-F since Friday, and went in for monitoring Monday and yesterday. As of yesterday morning, there was still nothing over 10 mm on either ovary, though what little action there was appeared to be on the left ovary (fuck). Dr. SF wasn't concerned about the lack of follicle growth, though, because my E2 has been rising appropriately, so he says he's going by that rather than the ultrasound for now. I'm going back in tomorrow and I expect (I hope) we'll see something then.

My mom is visiting this weekend, and it's unfortunate that no matter what, it looks like this cycle's IUI won't be happening while she's here (and therefore available for free babysitting). Ah well. Bat Girl is excited for her Halmoni's (grandma in Korean) visit, though mostly because my mom promised to bring her a toy farm with animals. She's an acquisitive one, that daughter of mine. Did I ever mention my theory that children under 3 are basically sociopaths? Little to no empathy, total selfishness, poor impulse control, disregard for the destruction they wreak.

Speaking of my little sociopath, her latest catchphrases are "Because it's true" and "No worries." "Because it's true" is her answer to almost any question--it's how she tries to shut us down:
"Why did you hit the cat with the stick?" "Because it's true!"
"Why do you want candy?" "Because it's true!"

I have no idea where she picked up "No worries." In action, it looks like this: The other night, we were at a friend's house, and BG started pulling out some toys in their 9-year-old's bedroom. I said, "I don't think [daughter's name] wants you to play with those, honey." She said, with perfect talking-down-the-crazy-person intonation, "No worries, mom," complete with talk-to-the-hand gesture. Hilarious.

Lest I overemphasize her sociopathic tendencies, I should tell you that she also says "please" and "thank you," (mostly) without prompting; hugs strangers; loves to play princess (no idea how--I never believed people who claimed that princessmania was just in the air and little girls absorbed it naturally, but it seems to be true). She is 99% potty trained at home--wears underpants, goes to the potty all by herself (all we do is wipe her and pull up her pants)--but has never once used the bathroom away from home and so is still in pull-ups outside the house. I finally figured out that the issue is her independence--she is SO all about doing it by herself at home that she doesn't want to tell us when she has to go, which is of course the only way you can possibly make it to a public toilet in time. She's clearly physically capable of real bladder control--she can go 4-5 hours without peeing if she's really into playing--so I think it's just a matter of waiting for her to decide she's ready to wear underpants all the time. Daycare (starting next week, we hope) will probably help too.

Wow, that was totally boring except for the 5 percent of you currently potty training a toddler. Sorry.

That's all that's happening with me. What's new with you?

Awake

2009-10-22T23:35:00.003-04:00

I should really be sleeping right now. We have a preschool tour in the morning (gulp) and I should be getting some rest and I'm exhausted from getting up before dawn for u/s and bloodwork. But lately I've been having a lot of trouble falling asleep--last night I went to bed at 11:30 and lay in bed awake for an hour and a half. And trust me, for the last 2.5 years I have had NO trouble falling asleep whatsoever, so this is really unusual for me.

Oh yeah, about that u/s and bloodwork--I got my period yesterday. I guess I wasn't really surprised, since the chances of me getting pregnant this cycle were pretty small. But I won't lie, I was still having these fantasies that somehow it would work, and wouldn't we all be so surprised! Whee! But no. I guess this explains why I was UNBELIEVABLY CRANKY on Monday.

I went in for monitoring today, CD2, because I didn't think I'd be able to make it all the way down to the clinic and back before the aforementioned preschool tour tomorrow. So I'm back on 75 IU Gonal-F starting tomorrow, in for bloods and u/s Monday. Dr. SF specifically wanted me to start stimming tomorrow instead of today, so that my first check-in would be on Monday (when he's in the office) instead of Sunday, because he didn't want one of the other docs to drop my dosage without checking with him, since, as he said, "Your ovaries tend to shut down when we drop your dosage." I will say, my clinic is definitely a huge machine (you should see the number of women in the waiting room during monitoring hours), but it's little things like that that always make me feel like I'm well taken care of.

We'll be able to do one more cycle now, and then since we'll be traveling the week of Thanksgiving and the week before, we'll have to take a break. If this one doesn't work, I will probably request an HSG during my off-cycle, just to make sure that my tube is still clear. (I had an HSG in 2005, which is of course how my UU was initially diagnosed, but it's been four years and I assume it's possible things could have gotten gummed up a bit, what with getting pregnant and having a c-section and just generally getting older.) I actually asked the nurse about doing it this cycle (forgot to ask Dr. SF when I saw him) and she said they prefer to do it during an off-cycle anyway.

After Thanksgiving, if I can time it just right with Provera, we might be able to squeeze in one more try before we go away for Christmas. Then we lose our IF coverage and I don't know what we'll do next. I'll have enough time to stock up on meds while I still have the insurance, so a good chunk of the cost of a cycle would be taken care of. But obviously I'd much rather I just got pregnant now. Hear that, universe?

Meanwhile--preschool! Ack! This is one of two schools we're looking at for BG for next year. It'll amount to a little over $10K for full days, 5 days a week ("full day" for 3-year-olds meaning 9 am-3:30 pm). That's pretty affordable for Big City--typical preschool tuition is more like $13-15K for half days. Not sure where we're going to come up with this money, but we'll worry about getting in first. As soon as the preschool applications are done, of course, I have to start the apparently multi-year process of negotiating the city bureaucracy to get her into a decent public kindergarten--which we're going to have to do, because private school tuition past preschool ain't gonna happen. Or we could move to the suburbs...and pay the $14K/year in property taxes instead of private school tuition. Remind me again why I live here?

Hm, I guess it's not so surprising that I can't sleep, after all.

Vax links

2009-10-21T14:51:00.002-04:00

As it happens, right after I wrote my last post, a whole bunch of flu/vaccine/flu vax-related articles have popped up. So I thought I'd collect 'em all--they make for interesting reading.

On swine flu:

From Newsweek and factcheck.org: Inoculation Misinformation. An excellent article dispelling myths about the H1N1 vaccine. I guess I don't have the right kind of crazy email-forwarding friends, because I had NO IDEA the misinformation was this ridiculous.

From the NYTimes: Flu Story: A Pregnant Woman's Ordeal. Aubrey Opdyke was pregnant when she contracted H1N1. She spent four months in the hospital, five weeks of that in a coma, and had six collapsed lungs and a near-fatal seizure. Her baby had to be delivered at 27 weeks by emergency C-section and lived only seven minutes.

On vaccines in general:

From Wired: An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All. This was really interesting--it's the first article I've seen that states really clearly that by weakening herd immunity, parents who don't vaccinate don't just make their own children vulnerable, they endanger children and adults who have been vaccinated, because vaccines don't always "take":

The frightening implications of this kind of anecdote were illustrated by a 2002 study published in The Journal of Infectious Diseases. Looking at 3,292 cases of measles in the Netherlands, the study found that the risk of contracting the disease was lower if you were completely unvaccinated and living in a highly vaccinated community than if you were completely vaccinated and living in a relatively unvaccinated community. Why? Because vaccines don’t always take. What does that mean? You can’t minimize your individual risk unless your herd, your friends and neighbors, also buy in.

From Slate: My Son Has Cancer. He Can't Go Into Daycare Because of Unvaccinated Children. Less subtle, this one, but effective.

Oink

2009-10-18T18:03:00.002-04:00

So I was moved to post about flu vaccines after reading this post. Except I just wrote the post in my head and didn't, you know, actually compose and post it. The post I wrote in my head was of course beautifully eloquent and masterfully argued. But here's what I'd like to say:

All three of us (me, husband, Bat Girl) have gotten the seasonal flu shot. We will be getting the H1N1 vaccine as soon as we are able. We got the seasonal shots at the beginning of October from BG's pediatrician (she only gets the thimerosal-free versions), and since she recommends spacing out all flu vaccines one month apart, BG will be getting the first dose of H1N1 in the beginning of November, and the second dose at the beginning of December. (Kids under 9 have to get 2 doses of H1N1 for it to be effective. Since she has had the seasonal flu shot before, she only needed one dose of that one.) Since she freaked out getting the seasonal shot and tried to rip the needle out of her leg, I decided to get her the nasal spray for H1N1.

I am a very big believer in flu shots. I have gotten one every year for as long as I can remember. Longtime readers may recall that I fretted a bit about whether to get a thimerosal-containing flu shot when pregnant with BG--but I went ahead and did it anyway. So there was never any question that we were getting the seasonal shot. I debated the H1N1 shot a bit, but considering that (a) I am hoping to get pregnant this flu season, (b) pregnant women and small children have had the highest fatality rates from H1N1 so far, (c) we are planning to put BG in day care, i.e. viral stewpot, 2 days a week this winter, and (d) given the demographics of our neighborhood (hippies, bobos, and non-English-speaking recent immigrants) the local vax rate will likely be quite low, I am not taking the risk of going unvaccinated. If I don't get pregnant this cycle, I will get the nasal spray when BG gets hers. If I do get pregnant (ha!) I will get the shot as soon as I possibly can.

If you are someone who has issues with vaccines in general, I totally respect that. What I have a hard time with is people who fear the H1N1 vaccine based on totally unfounded information that they picked up through rumor or on MDC. To wit:
-If you don't have a problem with seasonal flu vaccine, you shouldn't have a major problem with the H1N1 vaccine. They are made in exactly the same way--the only difference is the virus part.
-There are NO ADJUVANTS in any flu vaccines in the US. (If you're not in the US, your mileage may vary.)
-If you fear mercury in vaccines, you can get a thimerosal-free flu vaccine, either via a single-dose shot or the nasal spray (which is always mercury-free).

Here's a piece by Paul Offit (whom I know a lot of people have a problem with) explaining all of this in more detail. So if you decide not to get vaccinated--which you are totally within your rights to do--you will at least have the science straight. That is all.

Thumb twiddling

2009-10-13T22:52:00.003-04:00

I'm trying very hard not to pin too much (any) hope on this cycle, because the chances are so low that it worked, what with the ovulating on the side with no tube and all. Still, I can't help paying attention to every twinge and ache, wondering if it's a sign, and if so, of what. I've had some aches and pulling and tenderness in the abdominal region, but nothing that I can pin down as a definitive sign of success or failure. It'll be another week at least before I know. I'm just trying to assume that it didn't work and plan ahead for the next cycle, so I won't be too disappointed--but we all know how well THAT works.

So to distract myself, and because I have neglected my mommyblogging while in the throes of treatment, I give you a brief scene from this morning, just after Bat Girl and I rose for the day:

Me: Let's take off your diaper before you start playing with your toys.

BG: NO! GO AWAY FROM ME! DON'T TOUCH ME!* I'M VERY VERY BUSY!

Me: Honey, that's not a very nice way to talk to Mommy.

BG: [sweetly] Could you pleeeease go away from me now?

*This is her latest thing--screaming "Get away from me!" or "Don't touch me!" whenever we try to do something incredibly offensive like, say, remove her sodden overnight diaper or tuck in her blankets when she wakes in the middle of the night or get a closer look at a boo-boo. Charming, no?