Who DOES That?

I missed my beta appointment.

Sort of.

After transfer, I checked out and realized I didn't have any appointments scheduled for my beta.  By my math, it should have been the 31st since it was a 6 day blast.  When I went to check out, she had me schedule on the 4th because of the holiday.  So I figured that they had reduced hours for New Years Eve.  No biggie.  On Thursday I got a call asking what happened.  They were worried because it wasn't like me.  I told them I thought it was Monday.  Apparently I had two betas scheduled.  I was kicking myself because I could have just gotten it over with, but I didn't know about the Thursday visit.

So I promptly started peeing on things.  As of this morning I am absolutely not pregnant.  I'm truly okay.  It wasn't meant to be and my family is the way it is supposed to be.  I'm looking forward to getting all of this crap out of my system.  I want my body back.  I want to like it again and not be so damned mad at it all the time.

A new journey begins.

All Systems Go

We are a go for transfer on the 23rd.  They wanted 7mm.  I was 7.1.  There's still mucus in there, but they're letting me go.  SO GLAD!  

Quick funny story.  My hair has been curly since Chipmunk was born.  I decided to chop all of my hair off and rock it.  I'm having a good time.  I walked into the clinic today (without tripping)  and the receptionist said, "I love your hair!"  Phlebotomist said, "I love your hair!"  I'm in the stirrups.  Doc comes in and says, "Sorry I took me so long to get you.  We have another Lisa HapaHopes and she's a patient of Dr. Awesome's too.  I thought she was coming so I was confused.  They are so cool.  They won this video contest and got a scholarship for their daughter.  It was from Ferring and..."  I said, "Dr. M, that's me.  I just got a hair cut."  He laughed so loudly.  I'm pretty sure I signed all of my HIPAA rights away with that video about a billion times over.  I'm just glad they think we're cool.

Can't I Just Go Back To Bed and Try Again Tomorrow?

I had my first monitoring visit for our FET last week. My lining wasn't great, but it wasn't horrible either.  She thought I'd be fine by this week.

Not so much.

My day started when I literally tripped into the clinic.  Yes, literally in the real sense of the word,  not the way people butcher it now.  I somehow walked right on out of my shoes and landed flat on the concrete, cutting my knee and scraping my chin.  That should've been my first clue that today was destined to suck.

My lining has actually shrunk.  What was a 6.5 is now a 4.7 and I still have a bunch of mucus in my uterus.  They pushed back my transfer to the 23rd and I'm adding Vivelle dots.  Two of them twice a week.

I cried the whole way to my office.  As much as I've tried to remain cool, I don't think I really tuned into how emotionally ramped up I was about this cycle.  I can't stop crying.  I can't get it together.  I'm all E2ed up and I can't. stop. crying.  I guess all of this estrogen is just going to my emotions and my ass.  Both seem out of control lately.  I hate FETs.  I think I've mentioned that before.  I also think my lining did this before.  Swell.

I went to fill my prescription.  Insurance apparently only pays for one box a month, not two.  So I filled the one box, cried again, and will hope that the angel nurses at the clinic can fix this shit sometime in the next 15 days so I don't run out of patches and can get them filled before I have a new deductible to tackle.

I hate this.  I hate the drama.  I hate watching my body fail again.  I hate worrying about insurance and money.  I hate over analyzing everything I do.  I hate being sad when I should just be enjoying the holidays with my healthy, happy two year old.  I hate it all.  This SUCKS.  It all just sucks.

And my chin hurts.

So an FET is happening...

We were planning on telling no one, but a visit to the RE today reminded me that I need my tribe.  I know this means that a few IRL friends are reading this.  Unless you're "Farrah," please understand that I'm in a weird place and don't really want to talk about it in person.

We have one embryo left.  The fresh cycle for this embryo started at "the clinic which shall not be named."  It was a day three embie from a set of 8 (I think), thawed for our FET, and cultured to day 5. We transferred the two best blasts from that cycle and planned to freeze the rest.  This was the only one that survived and it was a slow grower.  It's a day six 3AB expanded blastocyst from a now twice failed cycle.  We don't have the highest of hopes for it, but we feel very connected to our embies and we want to give it a chance.  Since we're about to hit out deductible, now's the time (because when you can't build your family the old fashioned way, you base your childbearing decisions on deductibles).

Going back to the clinic was unexpectedly strange.  I had a sick feeling in my tummy all morning that J didn't really understand until the visit was over and his feelings mirrored mine.   Since winning the video contest, we have an odd little celebrity there, so it's strange to walk in, be immediately recognized, and everyone from the front desk to the embryologists wants to know what your kid is doing for her birthday in a few weeks.  Unsettling too in a way.  I just kind of wanted to keep my head down and get this over with if that makes any sense. Instead, everyone just assumes the cycle will work and they are "dying to see what 'Chipmunk's' sibling will look like."  Maybe it was bothersome because we walked in being okay with not having much hope.  We both walked away feeling bad that we were okay with not feeling hopeful.  Like we should be more hopeful, excited even.  Perhaps we're just still scarred and reeling.

It is different, though.  If this doesn't work, we're okay with it.  We'll be sad, disappointed, but three years ago, the thought of a failed cycle meant looking at our future completely differently.  Now it doesn't.  It means the future we envisioned will stay the same, because another child would be a bonus.  I know so many women are reading this and thinking I'm nuts.  I didn't envision a one child family, but as conception became more difficult, and we started to see a family of two adults as our reality, Chipmunk became the bonus.  I no longer feel a hole in my heart for a second child to fill. I would welcome one, of course, but there will be no more fresh cycles.  If this FET doesn't stick, the door is closed.

I don't know, maybe I'm still sorting out how I feel.  I just know that I stood at that desk scheduling FET class and words like saline ultrasound, E2, FSH, and PIO were pouring out of my mouth like second nature again and I hated it.  We're heading down the gauntlet one more time and I fucking hate the gauntlet.

Knowing Enough To Be Dangerous

My dreams of late have calmed down some.  In the first trimester there was an epic tale every night.  Of course none of my dreams were the "super cool fun sex dreams" my girlfriends told me to expect in pregnancy.  No, mine were more of the miscarriage, infant death variety.  It was 10 weeks of nightmare-ville.

They've slowed down, but when I do get them, they are not at all joyous or fun.  Last night was a prime example.  With our ultrasound coming up, I'm getting anxious.  My anxiety is higher for two reasons.  The first being that I know too much.  I know just enough to be dangerous.  I have over 900 deaf children on my caseload and deafness often comes with a lot of other things.  Things that could be seen on an ultrasound at this point.  You name it, I've seen a kid with it.  When I see a kid with some syndrome or anomaly,  I learn about it. This is backfiring on me.  The second reason for my anxiety is that my mother is flying in and coming with us.  This is great in theory!  Except for the part where she is SO excited about finding out the gender that she can't think of anything else.  I have to keep reminding her that the main point of this ultrasound is to check out ALL of Chipmunk's parts.  Not just the plumbing.  I have to tell her that asking the tech to do something silly to share the gender with us is really not a good plan since she's going to be measuring kidneys and such and I'd rather she concentrate on that.  I feel like a B crushing her little plans for fun, but I have to remind her that this is a Level II ultrasound.  There is this pessimism about me.  So many eggs wouldn't even fertilize.  Only one of nine embryos transferred stuck around.  How can this one possibly be really and truly chromosomally hunky dory?

So last night I had a dream that my baby had holoprosencephaly.

Don't look that up.

Where are those fun sex dreams again?

We Have Doublage!

342!!!!

Thanks and Recap

The Chipmunks

Thank you, thank you, thank you for all of the prayers and well wishes. I honestly believe that we would not have gotten this far without all of your good vibes out there in the universe. Keep ‘em comin! This beta crap makes me a hot mess.

So since I’ve been MIA, I thought I should update you on how retrieval and transfer went, especially since it was not as expected!

Just to recap, I was doing a three month treatment of Lupron Depot that started in November. Midway through January, I started stimming. So I didn’t use any antagon or additional Lupron, we just let the Depot shot do it’s long acting thing to keep me suppressed. I have not had a period since early November (that’s gunna be fun to explain to an OB… if we get that far).

Things were going great as usual for the stim portion of the IVF entertainment. In fact, I thought things were going better than usual. My estradiol was rising smoothly and we didn’t even have to make changes to my meds. My follies were growing nicely and at a similar rate. I’m not sure how many I had on trigger day, but I know it was enough that they only measured the larger ones. All was well. I was very hopeful.

On the morning of retrieval, I was pretty anxious. I remember portions of my other retrievals. I remember the pain, I remember begging for more meds, I remember being really cold. I was not looking forward to going through that again. Man, this nurse anesthetist was my best friggin’ friend. It was an entirely different cocktail (Yay Propofol!) and I don’t remember a damn thing. I was quite entertaining afterwards too. I’d like to think that I helped calm the nerves of the poor girl set to go after me, but I’m not entirely sure I’m right in that assumption. J I kept loudly proclaiming that the nurse anesthetist was my hero. He was though, seriously.

It took forever for them to come back with an egg count. One of the other docs in the practice even came down to wait for it because he was sure it was going to “at least be in the teens.” He looked disappointed when the lab finally came back with 12. I was totally cool with 12. It’s not like 26 got me anywhere! Quality over quantity! Yay for 12!

I was honestly not that worried about the fertilization report. Since we’ve added ICSI to the mix, things have been better. Not the upwards of 70% it should be, but way better than the 19% we got without it. Most of my eggs are always mature… I was figuring we’d end up with 6 embies and that sounded like a great number. So when she said we only had 3, I was taken aback. Only 6 were mature and only 3 fertilized… with ICSI. As usual, there was no reason why. It just was. We were scheduled for a 3 day transfer and I was petrified that we wouldn’ t have anything to transfer. I was having flashbacks to our first cycle.

But we did have something to transfer! In fact, all three stuck around. We went ahead and transferred all three. A 6 cell, a 7 cell, and an 8 cell. They looked pretty darned good. J dubbed them Alvin, Simon, and Theodore. Transfer went smoothly and my RE was hopeful that one or two of our chipmunks would decide to stick around.

The bloat came back with force on Saturday. Even J said, “I’m afraid you’re going to take this the wrong way, but you look much bigger than you ever have.” Sweet, honey. Thanks. I started having some sharp pains when sneezing or rolling over in bed. I let the little thought creep in that maybe, just maybe, our last round finally worked.

I caved and POAS on Monday. It was positive. It wasn’t dark, but it wasn’t a squinter either. I dragged J out of bed (I swear he thought there was a fire or something) and we proceeded to fall into complete hysterics. I tested again the morning of my beta to make sure it was darker and it was. Beta #1 was 162 and beta #2 is tomorrow.

I’m feeling so many crazy things right now that I can’t even put them into words. Happiness, shock, anxiety, fear, gratefulness, guilt… That about covers it.

Again, I can’t thank y’all enough for your awesomeness. I hate being in this club, but thank God for the wonderful women in it.

And Aly – I hope your screen recovered.

Speechless

162.  My Beta is 162.

I don't even know what to say.

Beta

Sorry for the lack of posting.  We were out of town and I was trying to avoid my crazies.  What a bunch of crap.

Beta this morning was a big fat 0.  I was really hoping, y'all.  Really hoping.  We are very, very sad and aren't quite sure what to do next.  Another fresh cycle is tempting, but if we have more frosties... then what?  We drag this out some more with more FETs we have no hope for?  We still have the one frostie, but we're reluctant to base a whole cycle on that one little guy, unless we're ready for our Hail Mary FET, which we aren't sure about.  As ridiculous as it sounds, at this point I feel like I'm sending perfectly good embies off to their deaths.  Unfortunately I have to submit my FSA contribution info by the 26th and my WTF isn't until the 30th.

I don't know what to do.  I really don't.  We are so broken-hearted.  My poor husband cried his eyes out.  Nothing hurts more than the feeling that I've robbed him of a biological child.

%^$!

My lining has not grown.  It was 5.9 at my first ultrasound and it was 5.6 today (day 13).  Waiting for a call from the doc with my E2 results and what to do next.  I'm so over this I can't even stand it.

No Big Suprise

Negative.

I'll write more later, but right now I'm going to go either throw things or clean things.  I can't decide.

All Clear!

My baseline ultrasound was cyst free and meds start on Saturday!  My insurance decided to ovary-block two of my Ganirelex (Get it?  Ovary-block?  I'm so funny.), so we'll see how that all pans out.

When I was in the waiting room at the clinic this morning, there was a child there.  It always irks me a bit when there's a kid there, but I get over it.  Today was a little different, though.  This was a boy of about 10 or 11.  Seriously.  A fertility clinic is no place for a boy that age.  Ew.

The Anxiety Game

Welcome to the Infertility Anxiety Game!  Here's your host, Random Information!

My RE happened to call today to talk about my biopsy results and said I don't have to come in for the post op since I'm doing fine.  I'm back to exercising - it just still freakin hurts when I pee!  Anyway, the biopsy showed some plasma cells.  Not a lot, just a few.  So it could be that I have chronic endometritis or it could be that I don't.  He wants to treat it anyway because it's not going to hurt anything.  So a month of Doxy it is.  Whoopie!  That's the only thing he had a definitive opinion on.  Seriously, I just wish a doctor would tell me what to do!

So he said we can do whatever we want at this point.  We can try on our own for a bit, we can do an ovulation induction cycle, we can do an FET with our lonely embryo, or we can so a fresh cycle.  I was dumbfounded.  I asked why we would want to try on our own and he said that some people want to do that after a lap just in case it worked well enough to allow for a natural pregnancy and that was fine.  It made me a little nauseous to think about being back at the beginning.  I feel like we had to fail and fail and fail before we had an option to do something that had a chance at actually working.  My FSH is 11.6, I'm 34 years old, we had shitty fertilization, I know the lap gives us a certain time window... why would I want to start at square one?  He said that we shouldn't count out IUIs or natural pregnancy based on the fert rate.  I didn't really understand his rationale.  Something about there being lots of reasons why that could have happened?  Children were screaming in the hallway and I was overwhelmed at the moment so I didn't really wrap my head around it.

I said, "We were prepared to do another fresh cycle, and we have insurance coverage for it."  He said, "Well, your best chance is always going to be IVF and it's hard to argue against it when you have coverage."  So that's what we're doing.  But he wants to sit down with us next week to talk about possibly doing a few months with Depot Lupron.  Oh, and since I haven't had a prolonged temp rise and I gave up on OPKs, if my period doesn't start by Wed I'm supposed to call for Provera.  So here's the anxiety list as it stands.

• My poop chute after a month on Doxy.
• Will insurance still cover ART since I've had a lap?
• Why haven't they finished processing the claim for the lap and hysteroscopy anyway?  That's way more money than I have.
• Will insurance cover ICSI since I'm not going to not do that this time?
• Would Lupron really help or is it just wasting time, sanity, and clean armpits in my clothes?
• Why does peeing still hurt if the culture was clear?
• Will this weight ever come off?
• How soon until the endo comes back?
• What if my period starts before my appointment?  Do I call and see if I'm supposed to start BCPs?
• What if I need Provera?  How long until my period starts?
• How bad is this period going to suck?
• Am I being melodramatic?  Should I just wait and see right now?  Am I pushing things by going straight back into IVF?
• Will I ever have a freakin' baby?

Oh darlings. Some input from my bloggy sisters would be awesome!

Owie

I am very good at getting UTIs.  So when I tried to go before bed last night and it burned and not much came out, I was a tad bit worried.  When it happened again this morning, I called the clinic.  They had me come in for a urinalysis.  Thankfully, it was negative.  Just a little blood in there.  They're sending it for culture, just in case, but it's just part of healing, it seems.  I kind of felt like a hypochondriac, but better safe than sorry, right?  And since I was near J's office, we got to have lunch.  I'm now totally wiped.  I'm still going to try to go to work tomorrow because I am bored out of my gourd.

Aside from being tired, things aren't so bad.   I'm a little sore, it hurts when I first get up, still bleeding some, I'm still bloaty and... round, but overall the belly area is on the mend.  The bad part... I've got a canker sore the size of Texas right next to my uvula.  It hurts to swallow, it hurts to talk, sometimes breathing hurts.  This thing is a bitch.  I'm good at getting canker sores too, so I'm assuming that the anesthesiologist nicked me when he was intubating me, I got an owie and now it' s a canker sore.  Ugh!  I hate mouth owies.

"Tomorrow, Tomorrow..." I'm not sure how I feel about you...

Laparoscopy and hysteroscopy at 8:45 tomorrow morning.  I'm anxious.  Not about the surgery, not even so much about the recovery, but about what's in there.  Do I want them to find something so we have answers?  Do I want them to find nothing so I can go back into my denial bubble and think we don't have a problem?  But we do have a problem, so wouldn't it be nice to know what it is?  And if they don't find anything, have I just been a big baby about pain for the last... 15 years or so? 

There has to be something in there, right?  We failed that IVF in a fantastic manner.

Lap Date

Nothing at all like a lap dance.

Finally heard from my RE!  Lap will be happening on June 1st.  J and I decided that the long term risks of using Lupron were more likely to happen than any long term risks from the lap.  I didn't want to take it unless I knew I had to.  So, they will do the lap and the biopsy at the same time. 

I don't know if I want them to find something or not.  Scratch that.  I want them to find nothing, we do ICSI on the next cycle, we get an awesome fert rate, gorgeous embies that decide to stick around, a healthy take home baby, and a solution to all of life's problems. 

The End.

Jiminy Christmas

My RE called last night for an impromptu WTF.  I certainly don't mind the phone call vs office visit scenario.  He's kind of socially awkward and seems to do better on the phone.  Also, I'm down with the lack of copay for these phone calls.

He was so kind.  He genuinely seemed very surprised by our poor fertilization and negative beta.  He said we would definitely do ICSI, but that there was no guarantee that it would fix things for us.  He wants to do an endometrial biopsy, which seems to be pretty standard after a failed IVF, so while I'm certainly  not psyched about it, I will sign up for more cervical suction cups and catheters.

Then he started talking about the endo issue.  About 10 years ago, I had symptoms that led my then Gyno to suspect endometriosis. She put me on the pill and there I sat.  Truth be told, I had symptoms long before that, but I also had an asshat for an Gyno when I was young and naive who said "Yup, periods hurt."  He was a dude.  Surprised?  Anyway, they have never seen any evidence of endo on my ovaries, so they assumed that if it were endo, it couldn't be severe.  He said that there is a chance that I could have severe endo that just isn't on my ovaries, and while it would be rare, it could affect egg quality and fertilization rates.  He didn't come out and say it, but I think the fact that we had a few fertilize, ended up with a couple of embryos, and I didn't get pregnant leads him to think this is an egg issue and not some subtle sperm issue.

So he wants to do one of two things.  Either assume I have endo and put me on Lupron for 2 1/2 months or do a lap.  I was down for the lap right then and there.  For one thing, I need to know.  For another, I ain't takin' something as evil as Lupron without knowing if I really need it or not.  For a third, I have a big history of early onset osteoporosis in my family that includes my mother.  I do NOT need to encourage that shit and I certainly don't need to shrink for the love of all that is good and holy.  No Sally Field meds to be added to my cocktail, thank you very much.

He didn't want me to make any decisions yet.  He wanted us to sit on it for a bit and then come in and talk to him about all the pros and cons.  He's never seemed very psyched about the thought of a lap and hasn't come out and said why.  Before it was just that he thought IVF would circumvent the issue, but he doesn't have that to fall back on anymore.  He said any surgery was a big deal and the Lupron is a big deal too.  I send babies off to surgery on a daily basis so maybe that's why I'm a little desensitized to the whole surgery thing, I don't know.  He kept talking about how emotional this all is and that we just had a big blow.  While I appreciate the sentiment, all I kept thinking was that it was one of a million other nasty blows and we just want to keep chugging along.  He recommended seeing their therapist and I thought that was a good idea.  Lord knows I'm as anxious as all get out these days. 

The RE kept repeating, "The biggest predictor of outcome is age and you have that on your side."  I wanted to yell, "FOR HOW LONG!?"  I turned 34 a month ago.  The magic number will be here before I know it.  Every time we make a decision, another cycle goes by before we can act on it and another month is lost.

I just hate wasting time.  I feel like there will be an end to all of this at some point and I want to get there.  Whether that's end comes with a baby or not... I just want to know what's on the other side.  I want to stop hurting.  I want to see my husband enjoy 24 whole hours of happiness.  I want my life to revolve around something else.

If you've gotten this far, I appreciate it and apologize for your eye strain.  Got any advice?  To Lap or to Lup?

Peacin' Out This Week

I'm back from the conference... and gave a concert yesterday.

Whenever I'm presenting at a big conference like this one was, I get a bit of an emotional let down when it's over.  After a concert, I get an even bigger let down.  A conference and concert smack in the middle of a TWW from an IVF cycle is askin' for it.

I'm so happy for all the gazillion BFPs there have been this week.  Truly.  I really am so happy to see them.  On the flip side, my gut and my head both remind me that statistically, we can all have successful cycles.  I had a hormone check today and while my P4 is good, my E2 is low so I have to add in Estrace.  Swell.  What the hell is up with my body and estrogen?  Seriously?  And how many hormones can I jack in there at one time? 

I'm officially up 10 pounds since BCPs started.  I know they told us to expect that, but it messes with my head.  I bawled my eyes out today after I got off the scale.  I know that if this cycle is not successful I will need to wait until I get this weight off before having another go or else I will need a new wardrobe.  I've never written about this on my blog, but I lost around 50 pounds about 10 years ago.  As a short girl, I was solidly into the obese category and managed to squeak myself into the normal range.  10 pounds means back into the overweight side of things for me.

Anyway, I'm not in the happiest of places right now and need to just take a step back.  I'll update after my beta on the 14th (that seems so very far away).

A New Kind of "Unexplained"

When I have bad news to relay to a patient's family, I sit on it.  All day long it languishes on my "to-call" list until the last minute.  Apparently, REs do the same thing.

We wanted to avoid ICSI unless we really had to and there was no reason to believe we needed it.  I didn't like the increase in abnormalities (albeit very small) and if we could do one thing naturally in this process I wanted to do it.  So we had a semen profile where they went over J's sample with a fine toothed comb for any known issues that would result in a need for ICSI.  He passed with flying colors and we opted not to do ICSI.

All 26 eggs were mature, but only 5 fertilized.  He said there was no reason for it and just something that happens for some couples.  My eggs looked great and the sperm was perfect.  They were all still alive and kicking this morning, but for whatever reason, they just didn't fertilize.  The 5 embryos we do have looked good today, so we're still hopeful, but there probably won't be anything to freeze.  We're going to do a three day transfer on Sunday.

I asked if this was the reason for our infertility and he said that it most likely was.  He said that for that reason alone, having the answers, he thinks we made the right decision to not to ICSI.  I agree wholeheartedly.  And I know, we should be so happy to have 5.  Some people don't get that far, but I'm still in tears.

I spent years of heartbreak and soul searching to find my J.  I hate the feeling that no matter how much we love each other, our gametes don't really like each other much at all.

Trigger!

It was an eventful morning, to say the least!  They counted 40 follies.  Yes, I said 40.  22 of them are over 14, so he's estimating that's how many mature eggs we'll get.  Thank God for the Lupron trigger.  Surprisingly, I'm hardly uncomfortable at all.  I'm a bit bloated and my pants are tight.  Seat belts are less than fun, but that's about it!  Oh, it hurts to poop.  Forgot that.  I know you were dying to know.  Anwho, triggering tonight, along with my trigger sister MGG, and retrieval is scheduled for Thursday.  I had to divvy up my patients between my colleagues today.  They're psyched for us, but not so psyched to take on my caseload on top of their own.  C'est la vie!  They all have shiny happy babies!

My thoughts can best be summed up by recapping a conversation with my mom...

Mom: So how are you feeling about everything?
Me: A lot of things.
Mom: I'll bet.
Me:  I mean, they still haven't given me a diagnosis, so what if nothing fertilizes?  What if nothing divides?  What if I just have a bunch of empty follicles?  What if I do get pregnant and I hyperstimulate while I'm out of town next week? What if I have 40 embryos and a Catholic nightmare?  What if they accidentally transfer the embryo of the black couple who were getting their trigger instructions when I walked in?
Mom:  Yeah.  That's a lot of things that could happen, I guess.  Hey, did you see Smash last night?

My thoughts exactly.  It's too much crap to think about and I can't do a damned thing about any of it.  So let's just watch obnoxious TV and move on!

Actually, my cousin was on Smash last night, which is kind of awesome.  I didn't get to see it because I was at rehearsal.  Apparently, he's in the ballet scene and it totally cheesing it behind the main character.  I'm almost as excited to go home and watch it as I am to trigger!