Thursday, December 27, 2007

The verdict is in....

And....I'm pregnant! Okay, so I've known for a while. I caved and tested last week since I just suddenly had a feeling something was up, and to my surprise, my test 8dp3dt was clearly positive. Chris and I didn't fully believe it until we got confirmation from the clinic on Monday, Christmas Eve. Betas have been good, doubling nicely and all that good stuff:
9dp3dt/12dpo - 105
12dp3dt/15dpo - 380
Soooo....we're excited and also cautiously optimistic because we have been here before. Our first ultrasound is in a couple weeks.
Thanks, Santa!

Saturday, December 22, 2007

Tick, tock.

Is it odd that this wait isn't really bothering me? It's the worst part for most IVF'ers - although, I'm going out on a limb and saying most IVF'ers don't have intramuscular stims and PIO and the perhaps my take on this is a touch skewed.

See, since my body has been such a colossal failure in terms of even responding to treatment, that part of any cycle is the worst for me. Waiting to see if I respond. The doctors are always so positive, because the fact is the vast majority of women will respond the drugs. My ovaries have an attitude problem, much like their bodily host I suppose, and have a tendency to rebel against any and all drugs. Even this time, I was on high dosages of different injections...the drugs my RE kept calling "the gooooood drugs", and my ovaries still managed to flip everyone off and run the other way.

Getting to the oh so dreaded "two week wait" is a huge accomplishment for me. In an entire year of treatment, I've really only had two, including this one. I always knew before hand that the cycle was fucked. Really, I could wait like this forever, if it wasn't for my self-imposed clean living that I guarantee will go out the window the very moment a negative beta is hurled at me.

But for now, I guess I'm content in this land of not knowing. Because not knowing means not knowing if it failed just as much as not knowing if I'm pregnant. And frankly, I'm ok with not knowing either right now.

Wednesday, December 19, 2007

I'm ready to be done.

I'm ready.

I'm ready to either go back to my pre-IVF life, or start my new pregnancy life. I'm ready for one or the other. I just want this waiting to be over. The not knowing and waiting is simply not healthy for an impatient OCD'er like myself.

I'm currently 7dp3dt. I feel pretty much nothing so I'm not optimistic. I have my weekly acupuncture on Friday, which should be interesting.. She knows too much and no doubt by then she'll have an inkling of which way this is going to go. Last weekend, she teased me by saying how pleased she was with all the activity in my uterus. Well, duh. When isn't it a party my in uterus? But she knows things. She knew my dud ovary was a dud with me not saying a word. She knew righty seemed to be doing her job. All this was confirmed via ultrasound and blood work, but she knew first. So on Friday should be interesting. She knows the progesterone I'm on will mask things but still...the woman knows things. I'm not sure she'll say anything at this point, though. Which will drive me nuts and probably affect her Christmas tip.

Monday, December 17, 2007

I'm a sucker.

I did it.

I ate two entire pineapples over the course of 4 days. Including the core. The icky, hard, sour and bitter core.

Why? Because there is an Old Wive's tale that the core of the pineapple contains some enzyme, I think it's called Bromelain, that aids in implantation. Since if an IVF fails it's because the embryo(s) didn't implant (they had quite a head start), I felt helping implantation was important. Also, I've noticed quite a few successful IVF'ers note they ate pineapple. So I went for it.

I've never, in the nearly two years we've been trying, fallen prey to the Old Wive's tales. I always figured if a crack whore can have 20 kids, that the things like sitting with your hips elevated after sex isn't necessarily going to help matters...and could very well be detrimental...bladder infection, anyone? Not to mention, I'm smart enough to figure out that standing on your head after sex will not increase your chance of pregnancy any more than jumping up and down after sex will decrease your chances.

But I ate the pineapple anyway. I like pineapple (er, I used to like pineapple). But I can't help but feel a little duped. I can't help but think there is some guy at Del Monte, sitting in his office, laughing his ass off as he tells the story that he made up this enzyme and posted it on the Internet saying it helped implantation and now all these crazy infertiles are eating tons of pineapple...they're making so much money off the desperate infertiles...ha ha ha!!!

Saturday, December 15, 2007

Back to the small brown eggs...

Since I'm now 3dp3dt (this is infertility speak for 3 days past a 3 day transfer, or in fertile terms, means about 6 days past ovulation), and analyzing things...I had to google the small brown egg thing. It's just too odd not to. Now I wish I hadn't. What did google come up with when searching "small brown human female egg oocyte" (gotta cover all bases):

1) cockroaches
2) brown recluse spider
3) mutant

I'm clearly not a cockroach (Kafka? Huh?), nor a brown recluse spider, apparently, I am a mutant.

It just keeps getting better, doesn't it!?

The Grass is Always Greener

In terms of progesterone supplementation post IVF transfer (pretty much no matter what your protocol is, you'll be on progesterone), the grass seems to always be greener on the other side.

Those that endure the daily PIO shots - progesterone in oil shots which are intramuscular, a big needle and a thick substance that injects oh so very slowly - often would rather they had the suppositories.

Those that endure the suppositories - which are large, vaginal suppositories that have a tendency to leak quite a bit so you're prisoner to the panty liner for the entire time you're on them - often would rather have the shot and just get it over with.

What's my preference. Well. How about just one freaking progesterone supplementation method? I'll take either shots or suppositories. Because at this point, I get both. BOTH.

Thursday, December 13, 2007

This year's Christmas Card

I have always wanted to do the photo-Christmas card. But I feel it's reserved for children. Sure, there's the occasional "Us and Our Pets!" card, but since we have one very camera shy cat, not to mention the very resistant husband, that's not going to happen.

Is this card inappropriate? I think it tells the story of our year and how we've spent the holidays so far.

Then there are the holiday letters. You know the ones, the one full typed page of crap people send? If you send them, I mean no offense, but I do think you're lying. No one's life is that great. No one's kid is that smart and just freaking fantastic. No one's jobs are that grand, and no one is getting a raise every month. And seriously, no one cares what new car you bought. If indeed your life is all sunshine and roses, it's really best to not advertise like that. People don't like braggers. Where are the truthful letters? Where people talk about how Bob lost his job and it nearly caused a divorce, or Jimmy got caught (again!) smoking pot at school and got expelled.

If we did a letter, it would be truthful. Who wouldn't want to receive this?

"Happy Holidays, Friends and Family!
We may not have spoken with many of you this year because we have been so gosh-darned busy with our fertility treatments. January started with us in the middle of our first treatment cycle, our first cycle on Clomid! Those hot flashes sure helped with the winter chill. We were so excited and hopeful, but alas, Katie ended up not responding at all to that silly drug! No worries, in February, we tried it again! This time the moodiness, hot flashes and night sweats were especially bad, but we persevered. But once again, Katie's defective body still didn't respond! In March we increased the dosage which guessed it, twice the side effects! Hey and guess what!? She ovulated for the first time ever! But poo, no pregnancy. Not all was lost though, Katie developed a nice big cyst from the cycle and had to take a break from meds in March. In April she was back on that Clomid horse, suffered through another month of debilitating side effects to find she once again didn't respond. Well, drats. How about a different drug!? OK! In May she tried Femara, and hey...the side effects weren't so bad. Her response was less than thrilling, but shock of June we found out Katie was pregnant! June and July marked big milestones for us as we saw our baby's heartbeat twice, once early at 5.5 weeks (such an over-achiever! must take after her mom! ha!) and again at 7.5 weeks. Then August rolled around and WHOOPS! Looks like we spoke too soon! Katie miscarried at 12 weeks. September and October were spent recovering from the D&C with no anesthetic - both Chris and Katie needed recovery time since Chris was in the room the whole time and saw the whole procedure! Talk about a memory he'd like to erase! Katie also needed to seek therapy during this time because the miscarriage made her a little wackier than normal! But in October, we tried Femara one last time...and wouldn't you know it? Katie didn't respond AGAIN! By the end of October, we were meeting with our new clinic and RE and decided it was time for IVF/ICSI - and we were starting in November! November and December were a blur of shots, pills, appointments and well, no surprise to us, quite a few disappointments! By the end of December we were anxiously awaiting the final outcome of our IVF cycle, be continued.

Wednesday, December 12, 2007

Transfer Complete

Introducing...our two embies: The one on the left is the 8-cell, grade 2 which had started to compact so that's very good news for us. The one on the right, well...not so pretty for a reason. This one only made it to 6 cells, grade 2 or 3 (thanks Valium, now I don't remember the important details) but the embryologist felt it was worth a shot to transfer it anyway. We have about a 30% chance with the 8-cell and less than a 5% chance with the 6-cell. Poopy.

It went ok. After the retrieval, which was so disappointing, we were prepared to not have a transfer. What many people don't realize, is IVF is not only not a guarantee of pregnancy or a live birth, but there is certainly no guarantee you'll even make it to a retrieval, or a transfer or anything. The cycle truly can stop at any point in the process. While science has come a long way in infertility and it's amazing what they can do, they don't know everything, have no way to diagnose everything in advance, and not everyone is successful.

Which is where I come in.

So we got 5 eggs at retrieval. The expected around 10 or more. Of the 5 they retrieved, one was immature (useless, can't be fertilized). The fact that we only got 5 eggs pissed off Dr.R, and the fact that one of those 5 was immature really seemed to anger her. She's quite the perfectionist and is determined to get everyone pregnant. Now I'm a problem child.

Of the 4 viable eggs, let's just say, they were, uh...weird. "Small and brown" according to the embryologist. I have this vision of the embryologist looking at my eggs through the microscope and crinkling her nose in disgust. Then maybe calling her assistant over and saying, "Eeew, look at these. Aren't they weird?" while my poor eggs cringe in embarrassment.

In one way, this is a sort of vindication. I've been saying for a long time my eggs had "issues", but there's really no way to prove it. Even seeing them in their unattractive state isn't proof of issues. Proof that something ain't right, sure...but what?

Dr. R thinks, and myself and my google MD nodded vigorously in agreement as she said this since it is something I have self diagnosed in the past, and I was on Valium (totally missed my calling as a doctor. I was just the shits in science in school and that seemed to be an important part of the occupation) that I have a follicular problem. As in my follicles grow big quickly and the eggs don't really catch up. That, and my eggs may have problems releasing from the follicles as well. If this cycle doesn't work, there are some other protocols and drugs she can try and see if it makes a difference. It's a research project for her now. If I have the same response, well then...we know a biological child is likely an impossibility. In all honestly, I've been on this roller coaster for nearly two years and we didn't really expect IVF #1 to work. Hope, yes, but expectations, no. IVF is a process. Most people will be successful within 3. I'm assuming they don't have "small brown eggs" though. I'm a touch more optimistic that we may have another chance before throwing in the towel. Dr. R said she's tough and will get us through this if we're tough. I said "We're tough, we're just not rich." To which she said we could make arrangements, she could get us donated meds...basically we may not have to pay for everything again. So next visit we'll probably dress in really ratty clothes and ask for food just to drive that point home.

The transfer itself was nothing, I tend to have a very cooperative cervix and it seriously took a couple minutes. Dr. R explained in detail the security measures they were taking to make sure it was our embryos they were going to transfer - my response was, "Actually, we'd be happy to take someone elses if they're better." Oohh, am I a terrible mom already?

And again, we wait and hope for implantation within the next few days.

Monday, December 10, 2007

Disappointing Egg Retrieval

Things really were going too well for us.

At the retrieval, they only got 5 eggs. I don't know how many of those were mature, and we don't get fertilization reports so we won't know how many fertilized, how many grew to be embryos...nothing, until the transfer on Wednesday. That is, IF there is a transfer. With a shitty number like 5, there's a good chance there won't be. Out of 10-12 follicles, only 5 eggs were there. That's a terrible prognosis. Really terrible. People can say "it only takes one" until the cows come home...statistically, we're fucked. And not just for this cycle. This affects the possibility of any future cycles, whether or not there could possibly be a future cycle. This is one huge step closer to "You cannot have children." FUCK ME.

The retrieval itself was painless and easy. With the exception of the anesthesiologist digging for a vein for about a half hour, until she finally listened when I told her she'd have much better luck with my left hand and was able to find a vein easily. I know my veins. I've had enough blood taken in the past few years that I know the drill well. If I offer both arms to a phlebotomist, they look at my right arm and scream "NO!". It doesn't appear I have any veins in that arm. But I do, clearly, or I wouldn't have any arm function.

Apparently it only took about 15-20 minutes and I woke up gabbing away. I think the anesthesiologist asked me about the pain or how I felt and I said I was just dandy. Then I went on to say how I had a D&C with no anesthetic whatsoever and if I could survive that, I could survive anything...shortly after she called my husband in and said I was still loopy. I hope she didn't think that I was making up the D&C story. Because that's all true and I wear that fucker like a badge of honor. Anyhow, Chris came in, our medical assistant whom we adore came in and we were all chatting and joking as I slowly became more coherent. Apparently I'm pretty entertaining coming off of anesthesia.

Then Dr. R came in an interrupted my performance.

"We only got 5 eggs."

Utter silence in the room.

Me: "Well, that's poopy."

Poopy?? Where the hell do I get these sayings? Why do I turn into a pollyana/blubbering idiot at our clinic? True to my character would have been, "Well that's fucked up." I would have felt better about that, even if it's not always considered appropriate to curse in settings like this. Better than my goodie-goodie response. Why didn't I just say, "Drats. We surely were hoping for a few more! That's crummy, but we'll make do with what we have!" Then Chris would respond with "Darn tootin'!" and a fist pump.

What I really wanted to communicate instead was that I'm pissed. I'm pissed, I'm confused, and this is not at all helping the bitterness I've embraced over the past year from hell. I want Chris to have jumped over the surgical bed and pinned Dr.R down until she gave us a rational and logical reason for why we only had 5 eggs.

I know this isn't necessarily her fault. If this is a result of Empty Follicle Syndrome, she couldn't have known in advance. IVF is sometimes partly a diagnostic tool, and that's definitely the situation in my case. A $12,000 diagnostic tool. But I do want someone to blame and she's the closest. Because if I don't blame her, I have to blame myself, my body and I'm not sure mentally, I can handle that right now. At least I know I did everything I could to make the cycle successful. No caffeine, no alcohol, no smoking, no running, I ate healthy, did acupuncture and mentally stayed as optimistic and relaxed as possible. I don't feel like I could have done anything different so at least I don't have that regret. Then again, what's worse? Regretting actions you have control over, or realized you have no control and you're just broken? More broken than they thought before?

Now we wait.

Friday, December 7, 2007

It's Official - - - Retrieval is Sunday!

At 8:30am precisely...Chris won't even have to miss a bit of the football games!

I'm already pondering my post-retrieval meal. Since I've had to cut out all my enjoyable vices for this cycle, I have developed a rather odd obsession with eating. But, since I'm so bloated I can only eat a little bit. It's odd. I day dream about the food and then get a couple bites in before I can't eat any more.

This morning's appointment went well, uterine lining looks great, which is such a nice change. I'm used to the "eh.....well...." response to "how does my lining look?". In fact, Dr. R even commented that my uterus looks great. I blushed. So rare for my reproductive organs to get so many compliments! I've responded well to the meds, and she's thinking she'll get 10-12 eggs on Sunday. Now it's just step by step. Transfer will likely be Wednesday.

Tonight is the trigger at exactly 8:30pm, which will be no big deal for us since all of our other meds have been IM shots. Good news, my ass gets a break for tomorrow - no shots! It's my only day off for the whole month. I should take my ass somewhere nice to celebrate.

Thursday, December 6, 2007

He shouldn't know that.

This struck me a while back when Chris and I were at yet another appointment.

I noticed after I got "undressed from the waist down, please" that my husband tucked my underwear in my pants so that they were out of sight. For whatever reason, and I know I'm not alone in this, having my underwear in full view of the doctor is too intimate and they need to be hidden. Considering what is at the doctor's eye level, I do realize how absurd that sounds, but it's a ritual I've taken part in since my first ob/gyn visit many, many moons ago. I also must wear socks. But that's another story.

Back to the fact that Chris knows to hide my underwear. He shouldn't know this. That should be part of the mystery of gyn appointments men know nothing about. He shouldn't be so familiar with a gynecological exam room. He's seen the stirrups more than most women will in their lifetime. Most men have no idea the stirrups are normally clothed in pot holders. Chris does. Dealing with infertility you quickly learn to accept the absurd and abnormal as your new normal, and more often than not you're going through the motions and not really reflecting on how different your life is than others in terms of getting pregnant. But sometimes, like today, it hits you.

After Chris hid my underwear, we got started with the ultrasound and things are progressing really nicely. I don't have exact numbers, but there were a lot of active follies, good sized, smiling for the camera. Even the dud ovary is producing follicles, which is amazing. So far my response is great and it looks like the retrieval will be Sunday. Which, if my math is correct, means we may find out before Christmas what the results are. I don't want to sound bratty, but Santa really does owe us.

Wednesday, December 5, 2007

My new best friends:

Lidocaine Gel

The combination of these two have made the shots tolerable. I feel a little weenie-esq having to resort to numbing action before my shots, but dammit, my ass can only take so much. I am now very jealous of the IVF'ers that do all subcutaneous shots. They were really hurting, my poor husband was developing a complex, something had to be done. I was getting extremely bitchy right before the shot (I attribute some of this to the migraine I have had since Saturday...the feeling of a vice on your head plus shooting pain behind the eye is bound to make the sweetest person cranky, and I'm not the sweetest person to begin with), and as he started the injection, I was beginning to make a scene. A scene that started with me taking a noticeable deep breath in anticipation, then kind of yelling "Fucccckkk" as the injection started, then snapping at him that he needs to put pressure on it right after the shot. I'm laying face down when I get my shots, so I can't see his face but I'm sure it has been a combination of wincing for fear of hurting his wife, and grimacing that his wife hasn't learned to shut up and take it while he's giving a shot. Not like it's fun for him. Well, maybe if I'm uber cranky he gets a touch of satisfaction, but I doubt it.

I have to mention that our cat has now taken an interest in the shots and I personally feel he is concerned about his mom's well being as he watches dad inject a big needle into mom's ass. Chris says he's fascinated by the alcohol pad. I like my theory better.

Monday, December 3, 2007

A weekend full of needles.

How was my weekend? Pretty prickly.

Friday - morning shots, evening shots
Saturday am - morning shot
Saturday later am - acupuncture
Saturday pm - evening shots
Sunday am - morning shot
Sunday later am - blood draw at the clinic
Sunday pm - evening shots

There are people that do IVF that have a phobia of needles. A real phobia of needles. I don't have a needle phobia (although I might be developing one), but I do have a rather severe bird phobia and I'm not sure if IVF involved the use of birds in any way that I could do it. I think if someone said, "Ok, so in the morning a bird will peck you in a head a couple times, then you're going to sit in a room full of birds flying around for about an hour and a half, then in the evening we'll have the bird peck you a few more times, the following day we'll have you come to our office where we will have the bird peck at you some more, then you'll head home and set up for your evening pecks. You'll repeat this cycle daily for about a month. Sound good?" No.

On a clinical note, my E2 (estradiol) level was checked on Sunday and my level is "great, doing exactly what we want it to" (have I mentioned my clinic doesn't give specifics? Which on one hand I don't like being in the dark, but on the other hand I know this is for the best. Had they given me the actual E2 number I would have logged a few hours on google analyzing that number from every possible angle, then spent another several hours reviewing that data over and over in my head and essentially making myself a stress case over it. Even though they tell me it's good.) so all seems to be going well so far. My acupuncturist said my right ovary has a lot of activity, left ovary, eh - not so much. My left ovary I have for a long time not-so-fondly referred to it as "The Dud." I'm hoping it eventually wakes up since I really could use those follicles. Like really, really need those follicles. Righty can only do so much by herself.

Friday, November 30, 2007

He Shot Me.

Our very first stim shot was last night, and I’m happy to report, it was successful.

There is good news and bad news.

The good news is the scary looking, dart-like needle that I received about a million of, is NOT used to inject the meds into me. It is a mixing needle. While the injection needle is nothing to laugh at, it’s much thinner and less dart like. This was very good news. As you can see, it’s rather intimidating. The bad news is…they hurt like hell! I have a pretty high pain tolerance (ask anyone that knows me that and they’ll say the opposite, but just because I complain a lot doesn’t mean I don’t have a tolerance. I’m just whiny, that’s all) and I winced through the whole thing. Chris did his job just fine, it’s the actual meds that hurt. Sting, to be exact. Sting like a motherfucker to be completely honest.

It appeared to be any other Thursday night. But we knew the injection was looming. You could see it in our eyes, hear it in our nervous laughter. We had a job to do. My window of injections is 6-9pm (since my morning injection window is 7:30-10:30am, I thought I’d mix it up a little. I’m wacky like that) so I decided to just get it over with. Right after Rachel Ray finished her 30 Minute Meal, I was at the kitchen table with my science experiment, the instructions from our clinic and of course, the paper work that came with all the drugs. It’s quite involved. I have felt I deserve my own white lab coat with my name monogrammed on the front for so long, and now I really, truly feel I’ve earned it. We received great instructions from our clinic and it seemed pretty easy. Well, if you consider mixing powder vials with sodium chloride and then adding the FSH medication into that vial, withdrawing all of that out into the mixing syringe (make sure you get it all! There is about $300 of meds in there, it ALL needs to get in your ass!) and changing needles easy, then it was easy. We went step by step, slowly, making sure we didn’t make any mistakes. Did I mention our clinic said, “The first 3 days of stims are the most important, so don’t mess up! No pressure!”? We read each step out loud in that slow, drawn out way you do when you’re concentrating, doing, and reading at the same time. “Noooowww, inject the soodiummmm chloride into the powder viallllll….mmmmkkkkkkkk”. Finally, it was all mixed and ready to go. Chris took the dart needle off the syringe and replaced it with the one that looks like, well, a needle. I took my position, and braced for the shot. He then walked me through each step, “OK, I’m going to start” and did a great job starting the injection, pulling it out a little to make sure there was no blood (“No blood!” “Ok, good!”) and then proceeding with injecting all the meds. Then the stinging began.

Since they are intramuscular, the injection site is sore for a couple days. I clearly remember this from all my trigger shots in the last year. It’s sore. It hurts. And I get to have these shots every day for about 10 days, THEN we move on to the even more atrocious progesterone in oil shots for another two weeks. Basically my ass is getting brutalised for a month.

While I’m open about IVF in my personal life, I’m not in my professional life with the exception of my boss. So while I limp around the office because my ass hurts, I have to lie and say it’s a pulled muscle instead of the truth. They can’t handle the truth. “Oh, it’s nothing, my husband shot nun pee into my ass last night and it’s a little sore now.”

You know, I have to giggle at the moms that only have “I was in labor for 24 hours with you!” to their children. We have so much more to make them feel guilty about. “Your father had to shoot me in the ass for weeks!” is a good start. I’m not sure how or if we’ll even approach the money aspect. Telling them we spent $12,000 (if this one works, otherwise that amount goes disgustingly higher) to even conceive him/her would probably result in some ungrateful, whiny response about that must be why they don’t have the coolest clothes or best toys.

I can’t wait.

Tuesday, November 27, 2007

"OH! Hiiiiiiiii"

Isn't it awkward to run into someone you know at the RE's office?

This morning hubby and I were on the couch in the waiting room when the door opened. Following standard infertility clinic waiting room protocol, I did not look up. For whatever reason, this seems to be how you are supposed to behave, so that's what I do. Well, the person walking in did not follow the rule.

Her: "Katie?"
Me: [frozen] silence. A little too long goes by and I realize I wasn't hearing things. I look up. "OH! Hiiiiiiiiii" - a really awkward, drawn out hi.

It was my old boss, one I had a very volatile personal and professional relationship with and haven't seen or spoken to in over 5 years. Back then she wasn't exactly lucky in love, so I was surprised to see her in an infertility clinic...and automatically thought she was doing IUI's with donor sperm (I'm so bad) until I saw the blinding flash of light from her hand and realized she's now married. She went on to tell me her brother and his wife conceived twins at this clinic via IUI, at which point our names were called and it was time for us to head in to our appointment. She said something else about twins and in my awkwardness I think I crossed my fingers and wagged them in front of my face as I walked through the door. I have no idea what possessed me to do that. I'm hoping for one, not twins! Of course we'd be thrilled, blah blah, but I have no idea why I made that gesture. The last gesture she saw from me.

So on to our regularly scheduled programming. Our baseline ultrasound was good, we're set to start stims on Thursday. Hubby got his lesson on the shots since these are all going to be intramuscular, which was news to me. I assumed they'd be subcutaneous like my easy peasy Lupron, but it's not. Hubs will be fine, I'm sure. I have a pretty big tattoo of a carousel horse on my uh, hip area, that will serve as a great guide for hubs to use for injections. The medical assistant said "Perfect! Just inject it into the horse's head!" Which, when you think about it, it better than her telling him to inject it into the horse's ass. 'Cause that could be taken a couple different ways. Har har har....

Sunday, November 25, 2007

Hit me with your best shot

(I guess I'd be talking to myself by saying "Hit me with your best shot" since I have to give myself these injections).
November 18th marked my very first shot of Lupron. Easy, easy, easy. The Lupron shots are with little insulin syringes, they're like the starter syringe for the whole process. Nothing like the what seem like hundreds of the other syringes I have for the other meds that really do resemble a dart. I shit you not, a dart. Like the ones you throw at a dart board, dart. Anyhow, these little Lupron shots are nothing. I'm quite used to them now. Although I did have a panic moment a few days after I started...things like "Why am I not getting any headaches? Why don't I feel any side effects? Oh my gawd, I'll bet I'm not even getting any liquid in the needle! I'm just injecting air! I've ruined this cycle, I've ruined our lives, I've ruined everything!" IVF can make you a little crazy. So now each time after I give myself a shot, I make sure I squeeze out the tiny little droplet that's left after the injection so that I feel better knowing there definitely was liquid in there. This prevents me from trying to get the old syringes out of my bio-hazard storage container like I did a few days ago. FYI, that top doesn't come off. Easily, anyway.

Why is my RE so big on urine??

I'm just curious. Why does my RE seem so incredibly partial to meds derived from urine? I know there are laboratory created versions of these drugs so I don't understand her preference for the ones she prescribed me.

Are you a confused fertile? There, there, I'll fill you in. There are several different drugs prescribed for an IVF protocol. Some are older, some are newer...and the newer ones are mainly created in laboratories. They are the man-made version of the older drugs. The older drugs, a couple of them, are made from urine. Yes, I'm serious. Urine. Oh, it gets better.
Repronex, one of my drugs, is made from the urine of post menopausal nuns. You heard me. Post-menopausal nuns! The post menopausal part has a good explanation - post menopausal women secrete higher quantities of the particular hormone needed for this drug. I don't understand the nun part, though, as in why their urine is specially used for this drug. Maybe because it's a place where a large group of post menopausal women hang out together - easier to get 'em all at once. Then again, they could go to any Curves gym in the country and end up with the same demographic.

Anyhow, there is another drug that works just like Repronex, called Menopur, except Menopur is not made from urine. And I want to know why I got the urine prescription.

So this was bothering me. Then I realized my trigger shot (Pregnyl) is also the older urine method. Except this time it's the urine of pregnant women. So obviously, not nuns. But the same thing - urine. And again, there is an alternative, newer drug that is not made from urine that would serve the same purpose. But I got the pee.

As if I don't have enough to think about.

Here Come the Drugs

The arrival of the meds is such a weird moment in the first IVF process. There's so much anticipation...this is really starting. It's exciting, it's nerve-wracking, it's a small fortune of liquids, needles and pills...and it's our best chance yet. If you've been on this journey for a while, you've no doubt seen the requisite picture of meds laid out on a table for all to see (see left). It's not a big surprise to us going through this, but it is entertaining to show the pictures to friends and family that have never dealt with infertility and have no clue what we're going through. There's an odd sense of satisfaction in seeing their shocked responses. "WOW! That's a lot of needles! Do you have to inject yourself???" To which we get to nod smugly and say yes, it is a lot of needles and yes, we have to do them ourselves. All the while we continue to nod and smirk as if it's nothing. Just another day.

I could not wait to get to my box of drugs. I tracked the shipment on the web, watching step by step as they arrived safely at my parent's house (no need to leave several thousand dollars of drugs on my unattended door step, and certainly no need for my nosy warehouse person at work to "accidentally" open my box before delivering it to my desk), and finally getting that email from my mom, "They're here, honey." Ooooh, I couldn't wait to see them. "Is it a biiiigggg box??" I asked. "Um, yeah, it's kind of big" (very nonchalant in her reply, I might add).

Now I'm worried. Oddly worried that my box of drugs isn't going to be as big as I thought, thus leaving less of an impact on all involved, including myself. For as much money as I just spent, I really needed that box to be impressive. What if my supply of drugs is unimpressive? Just a handful of vials and some syringes? It would be such a let down.

Annnd, it kind of was. It wasn't a huge box. The pharmacy was quite efficient in their use of space. It wasn't a small box, and obviously to the regular people out there it was a massive box for drugs, but for me, it was a little disappointing. Then I got it home and we took everything out, laid it all out on the table, and I felt a little better. There were more than enough needles there to make an impact on even the most jaded fertile.

Saturday, November 10, 2007

How about a discount?

While sitting in our clinic's office, we came upon a flier for Infertility Counseling. Which, is actually great because counselors and therapists that specialize in infertility are rather rare, and it is something that not many people understand. Like, oh, my grief counselor I saw after our miscarriage. I remember saying, "Well, we've been in treatment for a year" and her immediately saying (this from a woman that did a whole lotta nodding and nothing else, so for her to suddenly pipe up at this moment, with something totally inappropriate, let's just say...pissed me off) "I've heard that's quite normal. That it takes a couple up to a year to conceive." Yes, lady, that can be quite normal. But we've been in treatment for a year, trying for much longer than that. Which I made clear. Then I cried about something else and all my toughness was shot to shit.
Anyhow, hubby and I looked at this pamphlet and the list of things someone dealing with infertility might experience. Shock of all shocks, it was as if it was describing me personally. Hubby even asked "Huh. If you have all of them, do you think you get a discount?" I wish it worked that way. Then it would be free!
But even looking at the "symptoms" now, I still wonder how valid it is. I mean, there are some damn good reasons we feel these things. Like...
Jealousy of people who are pregnant or have children Ok, people, let's be honest. How is that weird or uncommon, or even unexpected? How often do we see people buy things just because someone else has them? Even cars (typically big SUV's, I'm just sayin'...), houses, definitely clothes...we're a society full of gloriously green monsters. So how would infertility be any different? When you're the childless couple at an age when everyone else has children, you're excluded. No one wants the weird childless couple that can sit and drink while everyone else takes (god, hopefully) care of their own kids. Sure, the pregnancy thing is an example of the bitterness the infertiles tend to go through. Until our miscarriage, I didn't have that jealousy towards pregnant women. Thankfully, my instinct to hiss like a cobra as one passes seems to have subsided, and I'm working on my instinct to slap a woman's hand from resting on her pregnant belly. Give me time, people.
Guilt at time and anger at other times Well, how is this different than life in general? I feel guilty that my body is why my hubby and I are spending a small fortune on a chance to have a baby. I also feel guilty when I take that parking spot that I knew someone else was trying to take, but damn, it's raining and I don't want to walk further in the rain! Sure, I'm pissed that we can have what everyone else has or jeez, that no one else we know has to pay to try and have a baby...but I'm also angry in general and that was far, far before I even met hubby, let alone jumped into fertility treatments.
Feelings of intense preoccupation with infertility - Um, yeah. Let's think about this. Let's look at an infertilies calendar. Even without doing IVF, you're spending so much time at the doctor's getting ultrasounds (yay! good follicles! or boo! sorry, not responding, see you next cycle), or blood work (Hi, I'm George, and I'm an intern. Can I take your blood today?), or even taking your temperature every morning, or peeing on an ovulation predictor test, or once you get past that point, analyzing every.single.damn.symptom in hopes that it's not PMS and it is indeed pregnancy symptoms. Or when you do IVF and you're shooting yourself up every morning and every evening, and you can't go to social function that go past 8 o'clock because you have to do your in the fuck does any sane person not have an intense preoccuptation with it?? It would be insane to not be preoccupied by it.
Difficulty Concentrating and Completing Tasks - I attribute most of this to the drugs. The fertility drugs, that is. Sure, the pot in college might be a contributing factor, but I....wait, where was I?
Feelings of resentment towards family because they don't "get it" - In all seriousness, I've struggled with this. Most infertiles have. No one gets it. Nor can we expect them to. We can just hope we have people that support us during this really difficult time.
Feelings out of control. Frustrated at the unanswered questions. Duh. Infertilty/fertility is hardly a perfect science. There is only so much they know, and so much more that really is left to chance. That's frustrating.
Anxiousness and fear of becoming pregnant, especially after a loss. Oh, yes. Oh so very anxious. I mean, who wouldn't be? Losing a baby after trying for so long, taking so many drugs, getting almost through the 1st (and oh so scary) 1st trimester is going to screw up even the most rational and solid person you know. I know, because it happened to me. (Yes, I once was very rational and put together.)
Mood shifts over the slightest things - yes, this is quite possible as well. Infertiles are often on many different drugs that will possibly induce PMS like symptoms with no warning. Hey, YOU take drugs that give you hot flashes during a meeting or night sweats all night or moods that change on a dime and tell me how you feel.
Crying at unexpected times - Again, drugs. Again, depression. Again, anxiety. Again, [sobbing]....

We go through a lot and counseling can help if you find someone that specializes in infertility. But, damn - there really are a lot of reasons why we feel this way. And they really are justified.

Aaaannnd, We're Off!

After 21 months, a year of fertility treatments and a miscarriage, we're finally embarking on our first IVF cycle. Considering we have no insurance coverage, this is a big step. A big, atrociously expensive, step. But unfortunately, necessary. So we're off to our first "interview" with the clinic closest to us.

We've had more than a few disappointments with appointments and our (ok, my) expectations, and since we're now paying completely out of pocket and we're basically paying $200 to interview our RE and clinic, I'm coming out with guns a-blazing. No fucking around. $200 for one hour? Oh, we're gonna talk about what I want to talk about, what I want to know, and nothing else. No need for a biology lesson, here. We've been through the ringer, we know what we need to do to try and have a successful pregnancy, and we don't need the formalities. Period.

Here's hubby's and my conversation driving to the clinic:
Me: We're paying $200 bucks for this appointment and we will discuss what I want to talk about.
Hubby: Uh-huh.
Me: No biology lesson, no detailed explanation of IVF - I know what it's all about.
Hubby: MmmmmmK.
Me: Yeah - I have no problem telling her that we aren't going to sit there and listen to her whole shpeel. We're not her average patient. We're not new. Right?
Hubby: Right...

This is the gist of what happened:

Dr. R: - OK, so here is a diagram of the female reproductive system, and here are your ovaries...
Me: [silence and some head nods]

Yeah, I talk a pretty good game. But this woman was intimidating, even for me! I went in with my guard up - big time - and even crossed my arms across my chest and smirked a few times, until I realized, uh...I think she really knows what she's talking about. Aside from her comment that I should lose weight (I am ONE good stomach flu away from an ideal weight - I'm not a skinny minny, but c'mon - a couple days of intense diarrhea and vomiting and I would so be at an ideal weight) to which I again smirked and thought "You are so fired before you were even hired", but eventually, she did get my attention in a good way. I also started to relent that maybe, just maybe, my Google MD might be no competition for her actual MD, or PhD, or certification in Reproductive Endocrinology. That maybe, just maybe, her competence and great statistics and overall computer mind when it comes to infertility, might finally be our answer. So after a little over an hour (score! we totally got free minutes), we both decided this would be our home for our very first IVF cycle. And so the journey begins.