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.