Monday, June 27, 2011

12 weeks - Fetal Matter

Today I went in for a "combination screen" test. They did some monster finger jab (YEOWTCH! WTF was that? A stapler?) and shmeared blood onto a paper. Then an ultrasound where he measured the tissue at the back of the neck to check for stuff like Downs Syndrome. But not just any ultrasound. Oh, no. I went to the same doctor I saw last time around, who works in a high-risk OB clinic. You need a referral just to get in! But they have 3D imaging, and give you a DVD movie of the session, plus a CD of images. And he treats you like a princess! Seriously. Warm belly goo, extra pillows. Heated lap blankets. I shit you not. And he's so thrilled and makes you feel like a million bucks for having a "healthy" baby (since he sees so many sad cases, working at the high risk place.)
Oh man. Last time, I had a 7w (looks like a snot clump) and 9ish w (looks like a gummy bear) ultrasound, and then nothing until 20 weeks, where baby actually looks humanoid. What a treat, to see my tiny, plum-sized little human! That little curled-up profile just took my breath away. And s/he was moving! Arms and legs everywhere. Twisting and turning. Just a magical sight!
Neck tissue was 1.5ish, and he says they're looking for anything under 3, so that was good. Crown-to-rump length (CRL?) shows a due date of 3 days earlier, so that just means baby is growing a little bigger than average for this gestational age, which is another notch in the "non-Downs" category (Downs babies tend to be smaller.) Something about good blood flow in the cord, and good heartbeat (170-something BPM.)

He also found a "twin fragment" which made me sad. He was surprised they hadn't mentioned it at the 7w U/S. I don't remember seeing anything else though, and my husband and I both had our eyes peeled for that extra baby. He showed me the tiny little placenta that had started forming, and the little fetal tissue clump. It's funny. I never really got all misty-eyed over the 2 embryos that didn't take the first time, and only had a little wistful regret at finding only one embryo this time. But seeing my little dead baby that tried to make it, was just a little punch in the psyche. I mean, I obviously wouldn't really want a child who was so genetically challenged that the fetus couldn't survive. But still. I've never had a miscarriage before, and now I kind of have an inkling of what that feels like. Kind of. Obviously, not really, TRULY what it feels like. What a nightmare. At least there's some happiness in this story! I saw my midwife for my 12w appointment after, and asked her what happens to this extra placenta and fetal matter. Does it get delivered with the live birth? Or will I need a D&C after?
Apparently it usually gets reabsorbed. Ewww. But they'll watch for it after the birth and they apparently sift through and test the placenta and stuff to make sure it's all good (double eww.)

In other neutral-to-bad news, he also thinks there's a velamentous insertion of the umbilical cord. Which can theoretically lead to inhibited growth in the fetus (so hizzer slightly larger size is again a good sign,) and also complications during labor. Like, baby can die. And that's just from reading that one link. I'm scared to look at anything else. Plus my sister told me not to look it up at all. I'm not terribly worried (yet,) since he isn't having my OB run extra tests or monitor for anything special, and he'll know more at the 20-week U/S. So apparently nothing too terrible can happen in the next 8 weeks... or maybe just nothing preventable. :(

We brought Little Z to the U/S, since she likes seeing the baby. Many people are surprised that we've already told her, but she's smart, and this can help teach her a little about patience, and having to wait for things to grow (or cook!) Plus she takes her a while to warm up to change, so this makes her feel like she's more a part of the process, rather than suddenly having a baby sibling foisted on her. (When we got her new sheets, she cried and fussed and demanded we put her old sheets back on for at least half an hour, then again whenever she'd remember, despite whatever distractions we were trying.) When I first told her, she spent every night for a week crying and telling me that she wanted the baby out (and not so she could meet the baby sooner, no. Just get it gone!) Now she'll ask roughly once a week if I have a baby in my tummy. So it took 6 weeks (I told her 1 week after we got the BFP) for her to accept this as a not-bad thing.
She did amazingly well. I knew from past experience that this doctor brooks no kiddie interruptions, so I reminded her all day that she wasn't allowed to talk, even with her quiet voice, or else Daddy or Nana would have to take her out of the room. I told her to save all her questions until the end. She did such a great job: when the nurse showed us all into the room (my mom, his mom and sister, my husband and Z all came too,) she started shushing ME when I tried to remind her of the rules! She shushed Nana and Grammelena when they'd quietly ooh and aah too. It was hilarious! And she didn't do anything to warrant getting removed. And after the doctor left, she asked me her saved-up question: "What was that yucky goo he put on your tummy?"

Oops. Still here. Honest.

Sooo.... it's been a while since I posted, yeah? And I left you with a question of how many buns do I have in the oven. [Begin A Chorus Line music here...] One. Singular sensation. Every little breath [he?] takes...
One baby. Apparently the right size, and a 'within normal ranges' heartbeat. That was determined at the ultrasound, what... 5 weeks ago? Sheesh. What a slacker!
Actually, I've been pretty depressed lately. Last time around, all my ailments went away. My clinical depression, allergy to citrus, lactose intolerance, migraines, acid reflux (although it came back the 3rd trimester,) and carpal tunnel all went away during pregnancy; they didn't start coming back until she was around 16-months old. Heaven. My husband called it a "Mary Poppins" pregnancy. No morning sickness, no varicose veins, no stretch marks. My flab did sag a bit, and apparently muscle mass turned into more flab, because while I lost my "baby weight" fairly quickly, my body LOOKS much saggier and flabbier than it did before. But I didn't balloon up like my mom, which was totally what I was expecting. Apparently I got my dad's more "skinny genes." Got my mom's chin and nipple hairs though, so ya' win some, ya' lose some.

This time around: no morning sickness, although I was getting a little nauseous at night. Carpal tunnel still around, although once it started up again, I immediately started wearing the brace, so it never got really bad. Acid reflux still here. V*E*R*Y gassy, same as last time, and boy does it STINK! (Also same as last time.) Still getting migraines, which kind of blows, since I can't really take much for them. More sinus pressure and pain this time around too (which is what causes my migraines.) Maybe that's due to the seasons. Last time I got preggers in September until June, so maybe since the Spring crud didn't all come out until my magical healing-baby powers were well underway, I got off easy. This time I got pregnant during the Spring crud season. Possibly still lactose intolerant, but I take a daily pill for that, and I'm still so gassy and crampy I'm afraid to stop. While I haven't been guzzling the lemonade and OJ (yet,) I'm not getting the sores on my tongue when I have spaghetti or pizza, or the occasional lemonade, so probably my citrus acid issue went away again. Yay! Man. Last time, my sister told me I needed to cut down on the juice, and ratted me out to my midwife, who scolded me too. But man. I looooove OJ and lemonade, and after years of having to endure excruciating pain in my tongue for weeks just to enjoy a glass, you can bet your bottom dollar that I chug-a-lugged it down! And will again! Suck it, bishes!
One weird thing this time is my lack of hungry. I had a cold early on, and had no appetite. One meal a day and I was stuffed. I wasn't hungry at breakfast, then ate a moderate lunch, and was still full by dinner time. And wasn't even feeling hungry in the middle of the night. A few weeks ago I started feeling hunger occasionally, so that's good. Since I kind of forget to eat if I'm not hungry. Lunch is the one meal I do regularly, since I have to feed her. She often eats breakfast while I'm in the shower, so I'm not eating then either. And Unka Seesee makes dinner most nights, so I sometimes forget to serve myself, if we're not all eating together.
Other than the depression, which makes it hard to do anything that I don't HAVE to do (like feed the Oompa-Loompa,) I'm soooooo freaking tired all the time! After a 12-hour night's sleep, I wake up and am ready for a nap. Seriously. And the Princess is starting to phase out her naps, darn her. She now only naps if we're in the car in the afternoon. So unless I want to risk waking the snarling beast, that means if *I* want a nap, I need to sleep in the car too. And I don't like to leave it running, since I could be sucking all the exhaust back in of it's not real windy out. So I leave a door open, to give us a breeze so it's not too hot. And I usually have a leg or two sticking out, to make myself more comfy. I'm sure we look pretty freaky. That's another reason I don't leave the car running. One time we were out napping in the driveway with the car running, and Unka Seesee came out and freaked. He thought I had passed out from the exhaust!

Monday, May 23, 2011

Cheesecake and Chums

Yesterday I went to Blogger's Night Out with some other local IF bloggers. Sunny from Sunny In Seattle, Jen from Despite the Best Laid Plans, plus an anonymous blogger friend. Katie from Taking the Statistical Bullet couldn't make it, for obvious reasons, if you read her posts lately. But we managed to have fun anyway!

Our Anonymous friend is now 17 weeks pregnant through IVF (I switched clinics for this round based on her recommendations when we all last met up in January.) I'm soooo super excited for her. Which is nice. It's so nice to be happy for once that someone is pregnant. It makes me feel less like a heartless, jealous, shrew. I'm happy that I'm happy. If my BFN had turned out to REALLY be a BFN, I can't promise I'd be any happier for her than I was for my sisters, but I was still a good enough sister, while still sad and anguished for myself, to still be happy for them. The bitches.

We talked about nursing, and not bothering to read the pregnancy books (I read Belly Laughs, Pregnancy Sucks, and The Girlfriend's Guide to Pregnancy. I looked up stuff in What to Expect, and read the assigned bits from Pregnancy Childbirth and the Newborn for my prenatal class, but despite my sister nagging me and thrusting 15,634,876 pregnancy books on me, I never read a non-humorous pregnancy book cover-to-cover during pregnancy. Oh. Well. I practically read all of Your Pregnancy Week By Week, since it was just a few pages every week, and it was kind of fun to see what the little zygote looked like as it turned into a fetus.) We talked about going back to work or not, and when did we decide. And she told us her baby names, but I'm sworn to secrecy!
We also had cheesecake! Sadly, I've had a really bad cold this past week, and pretty much no appetite. I've been eating roughly one meal a day, with some snacks (ie: daughter's leftovers/half-eaten cheese sticks.) I had TOTALLY forgotten about our night out, and ate a "large" breakfast at Shari's while waiting for my husband to get done with his visit to the Urgent Care Clinic. (He hadn't been able to hear out of one ear for two days from his version of this cold. Boo-frickin-hoo.) I had a pancake, 2 eggs (over medium. Yes, I know. Avoid "undercooked eggs." Sue me.) and 2 slices of toast. Then I managed to cram in a turtle sundae (turtle brownie with ice cream!) Hours later, at dinner with the ladies, I couldn't even manage my small hummus appetizer. And I was pushing it to eat half my slice of cheesecake. (I had them cut it in half and bring it on two plates so that the other ladies could try it without risk of catching The Plague from me.)

Tomorrow (well, technically today) I go in for my first ultrasound, to find out how many of my Maybies took. (and whether they *shudder* split. Apparently the act of IVF itself slightly increases the chances of monozygotic twinning (identical twins,) from the hormonal and ovarian stimulation. Then ICSI increases the rates again by some fraction of a percent. And Assisted Hatching doubles the microscopic chances. So, there's some (slim) chance I have more than 2 in there. On the plus side, then I could be done, done, DONE, and not want have to ever think about maybe doing IVF again!) So, based on my posting track-record, I'll probably get around to posting about it in a week or so! Cheers!

Thursday, May 12, 2011

Every Silver Lining Has A Cloud

Well. After such a depressing post, you'd expect a little radio silence, yeah? The day after was my blood test at the clinic. I'd spent the day before yelling at myself and stomping on any spark of hope that the pee sticks were wrong. I spent the day I decided to stop peeing on sticks saying goodbye to my Maybies and yelling internally and stomping on any spark of hope. Then I went the next morning for my bloodwork, and again said goodbye to my Maybies as I waited for the walk light as I crossed from the parking lot to the clinic building. Slapping myself internally and putting the smackdown on any little niggle of hope. Every time I felt my breasts tingling it was like a cruel slap in the face. Which was all the time.
After the blood test, they said it would be hours before they got the results, and then would get around to calling me, basically, when they got around to it. "Then they do their rounds, so whenever they get to it..." Thanks. It's not like this is important to me, or anything. So I met my husband and daughter at her kiddie gym class, and we went out for brunch after. Some point before our food arrived (maybe even before we'd ordered. I can't really remember...) I get a call from the clinic. You know in those moves, where they do some camera zoomy trick where suddenly everything in the world is focused on one tiny little thing? That's how I felt.
It was my nurse, which was weird, since I thought she only worked weekdays. And she sounded cheerful. Could this mean...? "Congratulations!" Whaaaaaaaat? Seriously? "You're pregnant! Your number was at 147, and we're looking for anything over a 50." Oh. My. God. I was crying so hard, and I thanked her and hung up and couldn't even function. I knew that my husband was sitting there, and I knew what he must be thinking, but I couldn't even form a thought coherent enough to consider how to let him know the good news.
Until my daughter's voice asked, "Mommy. Are you sad?" I look over and her mouth is downturned in her little sad moue, and her lip is starting to quiver and her eyes are filling with tears. So I say "Oh, no, baby. I am so HAPPY! I am so happy there was just no room for my crying, so it had to all come out." My husband isn't an idiot, so he understood, and was also pleasantly shocked. My daughter was not convinced. So everything else took a back seat to calming her down. I couldn't really blame her, especially after she found me crying periodically the day before. Now whenever I laugh really hard she asks me why I'm crying. Poor thing.

It's weird. I'm totally thrilled and happy, but I'm also still all withdrawn. I don't want to talk about it. I don't mind people knowing. I just don't want the focus to be on me right now. I don't want to talk about it. I made him call his mom (I mean, she's his mom, after all.) If I could have gotten away with having him tell my sister, I totally would have. Luckily my sister was at my mom's house so my mom heard her side of the conversation, so that saved me having to make another call. And his mom told his sister, who had no cell service until she got back from her camping trip on Monday. I didn't call my stepmother-in-law until many days later. Mostly because I only thought about it while driving or too late at night, and I didn't want to text her.

Friday, April 29, 2011

Princess and the Pee Sticks

The home pregnancy tests say you can test 4-6 days (depending on the test) before your missed period. So if ER date is "Day 14" of your cycle, then one should be able to get a result around 10 days later, right? Even though the blood test isn't scheduled until 2 weeks after. I remember that I did a pee stick at the earliest possible moment last time too, and got a BFP! I Googled info on how long it takes for an egg to implant (9 days after fertilization, although my sister swears she "knew" when her first pregnancy implanted, and it was 3 days before her period was due.)

Around a week before the blood test, by nips started getting tingly. My boobies feel tighter and fuller. Ad at one point I absentmindedly glanced in the mirror while brushing my teeth and thought "Whoa! Those are big!" So I had high hopes. Same thing happened last time!
My plan had been to do a home test the Wednesday before my blood test (Saturday,) but I'd be at my sister's house, and she's been chomping at the bit. Screeching that she can't possibly wait that long to get results. Yeah. 'Cuz it's sooo easy for me. So I decided to go ahead and try Tuesday, so I might possibly have an answer for her before I got there.
Photo credit
4/26 - (Tuesday) - BFN. Well. Huh. The boobs were still sensitive, so maybe it's just too early. My sister began grilling me on my behavior. Had I been avoiding "offensive" foods like onions and garlic? Resting enough? Thinking positive? Excellent. So now if I'm not pregnant, it's all my fault, because I stayed up late one night playing Farmville. And offensive foods? Really? E-v-e-r-y-t-h-i-n-g gives me gas. In fact, when I was pregnant the first time, WATER gave me gas. What exactly am I supposed to avoid?

4/27 - (Wednesday) - I went and bought a pair of ultra-sensitive 6-days-early tests. BFN.

4/28 - (Thursday) - Tried peeing in a cup instead of directly onto the stick, in case I'd somehow messed that up. BFN. Said goodbye to my little Maybies and cried in the shower.
Called the fertility clinic and asked when I should schedule a follow-up, on the likely chance that my blood test in 2 days will be negative too. (7 weeks after the start of injectibles.) And left a message for the financial counselor to find out if my insurance will pay again, or if we'll need another prior auth, etc. (Apparently my insurance limits to $25k/year, and she estimates we'll have around $10k left. It's too soon to know for sure, since it often takes 3-4 weeks for the insurance to respond to a claim. She kind of suggested that maybe we could wait until the yearly max resets next year. Yeah. I want to waste another 7 months.)
The nurse of course got my hopes back up again. After I'd finally let them go. She told me that my blood test is scheduled for the earliest possible day they'd expect to get results with a blood test. Um. So why do home pregnancy tests work early then? But now I could still possibly maybe be pregnant. Torture. I don't think I'm pregnant, but I can't let go and move forward until I know for sure. I so want to move on.

Started spotting at bedtime. Like a big red punch in the gut. Could just be normal. Could mean nothing. Could mean everything.

4/29 - More spotting. Still tingly boobies though. Had only bought 2 more home tests, and didn't really want to throw away another $10 just to get my soul crushed again.

Scared Little Z when she found me crying in the morning. "Mommy. I don't want you to be sad. [*tears welling up*] I only want you to be happy!" [*crying*] And all day she's been asking me if I'm happy now. And telling me that she's sorry that I was so sad "yesterday." (She is still struggling with the concept of time. Anything before naptime was "yesterday." If the sun is even remotely out, it's "morning." And if it's bedtime, then it's apparently also "morning.")

So depressed it feels like someone's sitting on my chest. The thought of someone bringing up my IVF at the moms club event I had committed to running today (otherwise I would have just played hooky and sacked out at home all day) makes me cry. Thinking about virtually anything at all makes me cry. Seeing the sun shining makes me cry.

Sunday, April 24, 2011

My Maybies

I've always found it funny that you are already considered to be two weeks pregnant just after conception. Not that you know yet, in most cases. On my Egg Retrieval date, I conceived twins, and I wasn't even in the room! Heck. I wasn't even in the same city! And they were already 2 weeks along!

We gnawed our fingernails for 3 days, waiting for the Embryo Transfer date. Based on our Day 3 transfer last time, and the lack of embryos to try and choose from this time, they were pretty confident in scheduling us for a Day 3 ET. But based on my poor embryo quality last time, and my even poorer egg numbers this time, my hopes weren't very high. I tried calling on Day 2 to get an update on quality, but all they could tell me was that the cells were still dividing. Well. Not bad news, at least.

4/19/11 - So we go in for our ET. Since we were scheduled for the afternoon, we were able to get Nana to come down and babysit, so we wouldn't have to worry about Little Z. Ironically, this time she could have been in the room with us, since it was a different area than the ER and we got to stay in our room the whole time. Ah well.
The ultrasound tech came in and checked my bladder, then had me drink more water and wait 5 more minutes. When she came back, all was well. Then we got to talk to the embryologist.
One of our embryos was 7 cells and the other was either 8 or 6, I can't remember. I think 8 though. And when we asked about fragmentation, she looked a little sad and said that one of them had 30% fragmentation, which was not good, since they don't like to see more than 20-25%. I could have whooped for joy. 30% was our best one last time. The other? 15%. I was so happy I cried.
The top one is the 30% 6 -or-8-cell one, bottom is 15% 7-cells.
Since they aren't babies yet, I called them my Maybies. 
For some reason they recommended transferring both embryos, even though my doctor told us initially that they usually only recommend one, since in her experience multiple embryos doesn't increase the chances of pregnancy, just the chances of multiples! We had discussed leaving the number of embryos to transfer open, based on quality, but that if we had a good one, we might just try one. Otherwise probably 2. And if they were really poor quality, 3 or more, just so they wouldn't get thrown out.
So I was mildly concerned about transferring both, since I got pregnant off a 30-40% fragmented embryo last time. Chances are good that they'd both implant this time. Last time, I was willing to have multiples. It would be hard work, but anything's better than nothing. But multiples on the way with a pipsqueak at home already? Hard. Harder than hard.
But my husband was leaning towards their recommendation, even though they couldn't tell me why they recommended two. Eh. Go for it. I'll go in on the 30th for a blood pregnancy test. It'll be a looooong week-and-a-half!

Bust an Infertility Myth: "It Will Happen If It Was Meant To Be"

In honor of National Infertility Awareness Week® (April 24-April 30, 2011,)  RESOLVE: The National Infertility Association is hosting “Bust an Infertility Myth Blog Challenge.” RESOLVE is the largest nationwide non-profit dedicated to improving the lives of people diagnosed with infertility.  
The goal of this challenge is to bring together bloggers from the infertility community as well as other bloggers interested in the topic to answer the question: 
What is the biggest infertility myth and how has it effected your life or the life of your friends and family members?

"...if it was meant to be..."
It's probably not really a "myth," per se, but it's something that just sticks in my craw whenever I hear somebody say something like it. Right on up there with "As soon as you give up, it'll just happen!" and "Well, you can always adopt!" [Not that I have a problem with adoption at all. But for someone who desperately wants a baby growing inside, it's just not the same. And not as easy as they'd make it out to be! I sure hope someone writes about that myth for this event!]

There are many variations. "God works in mysterious ways." "Don't worry! If it it was meant to be, it'll happen!" "If God wants you to be a mother, then He'll provide!" 
They probably don't mean to be insensitive jerks when they say these things. But what they're really saying is "God must not want you to have a baby right now, so suck it up." Oh, that's not what they think they're saying. But it's essentially what those types of comments mean. "You were clearly not meant to have a baby. Otherwise you'd be pregnant." 

Photo credit
With infertility treatments (and adoption,) you kind of need to be higher up in the financial food chain. So does that mean poorer people with infertility weren't meant to have kids? Because they can't afford the $10-$15k for IVF (or more, for adoption, surrogacy, etc,) if that's what they'd end up needing? People who would be wonderful, loving parents, but for some reason just can't conceive? I have to go deeply into dept and spend all our savings just to try and have the child those savings were supposed to be for?

Does that mean a woman who just doesn't ovulate wasn't meant to have kids? Or an infertile man? What if some accident caused the infertility? Or chemical exposure at work? I mean, it's not like we do something to cause our infertility. "Well, yeah. I know I did that so I wouldn't have kids, but now I changed my mind!" What did we do to deserve this? 

Does something completely beyond our control mean that someOne or something out there doesn't think we'd be good parents? Or is it more likely all the crud in our water and air and food that we've been exposed to in the womb, and by breathing, eating, touching our whole lives? Infertility rates are only increasing. Does that mean only the people who sleep with everyone in their trailer park are the only ones meant to have kids? The ones who don't take responsibility for their offspring? Drug users? Those on welfare who can't afford to care for the kids they have, but want more money, so keep popping them out? The ones who abuse their children? The ones who lock their kids in the car and back the car into a lake? These people are the chosen ones?

Many people have fertility issues simply because they waited a little too long. To meet the person they wanted to spend the rest of their lives with. Or to become financially stable. Or to be mature enough to be a better parent (than they would have been otherwise.) So Fate doesn't want people who can and will actually take care of their children to have them? This is all God's plan? 


The only "bright side" of having had such a hard struggle to have a baby is what kind of mother I am because of it. This isn't to say that I'm better than all other parents because of this. But I'm a better parent than I would have been otherwise. I read loads of parenting books to learn how to work with her, rather than against her.  Because I wanted it so much, I'm more patient with my daughter. She is truly a treasure to me. Again, not that other people don't love their kids. But at least compared to my sisters, I place a higher priority on my daughter's emotional and mental well-being than they do with their kids. They think I spoil her by holding her all the time. I think I'm accepting her more sensitive personality and working with her needs. I don't try and make her fit what I think my child should be, but work with who she is. Even if it's a little more tiresome than I would have liked. 

Another Myth:
"You'd be such a good parent! I'm sure it will happen!"
Sadly, the ability to be a good parent does not dictate one's ability to be a parent. 

Check out these links for a basic understanding about infertility and more about National Infertility Awareness Week®
And read about the other "myths" here!

Monday, April 18, 2011

ET for Two

4/16 - Egg Retrieval: So we get up at the asscrack of dawn in order to get up, get ready, get the kid up and ready, and get to the clinic by 7:45 AM. We opted to bring her with us and switch off watching her, since it was waaaay to early to drive to and from a family member's house to drop her off. My mom, who would be the only one close enough to drop her off with, was out of town this weekend. And my sister, who was willing to spend the night before to watch her at my mom's house, had a big test for school that morning that she couldn't reschedule.

It went okay. DH and Little Z had to stay out in the lobby the whole time, which was kind of a bummer. Last time, at the other clinic, my husband got to stay in my recovery cubby the whole time, so we had kind of planned on being able to do that with her this time. They would have let him in, but they didn't want her in there since there was another woman just coming out of her procedure as well. Ah well.

I'm not a fan of needles. They make me dizzy and nauseous and I get the cold sweats, especially whenever an IV is involved. So I'm even less of a fan of having to be poked more than once for a blood draw or IV, yet somehow over 75% of the time, end up getting multiple pokes! This time was no exception. She did something wrong with the elbow vein, and apparently my arm was swelling up with the liquid leaking out under the skin instead of in the vein. Yay. So I got a shot of Lidocaine in my hand and an IV there instead. Joy. Three shots.

I was actually surprised that they weren't all double checking my allergies and date of birth and whether I'd eaten yet that day. Every other procedure I've ever had, every single different person would double check the same information. Luckily, I'm me, have no allergies, and hadn't eaten. (I almost ate a tiny bit of peanut butter off my thumb when packing a brunch for Z, but realized my error before closing my mouth and was able to spit it out.)

They have me pee, walk me into the OR, lie down, put an oxygen mask on, give me a nice heated blanket and pillow (*sigh* My favorite part!) but no leg massager thingy, and then I don't remember much after that. I don't even remember counting backwards. As I start waking up, I hear someone say something about how "she should just be waking up now" and then people coming in to bother talk to me. I got juice and cookies at least. And the shivers. I think I often get the shivers after anesthesia. My memory is terrible about that kind of stuff though. It could just be chilly rooms and no heated blankies (which they only give before the procedures.)

And then the doctor comes in to tell me the results. Which was nice, sort of. Last time they didn't tell me any numbers until the following day. The "sort of" part was the numbers. 3. 3 eggs. Last time we did this, I had 13 eggs. When she did the follicle count before we started the BCP, she counted 11 follicles. Apparently, after starting the shots, I had only 5 follicles they'd been monitoring (plus the cyst.) And 2 of those also turned out to be cysts. I'd been wondering why she was only measuring a few black blobs each time, but I thought they were just watching the bigger ones. I'd had no idea that those were all we had!
Three. Eggs.
Out of the 13 our first IVF cycle (3.5 years ago,) 10 were mature enough to ICSI. So already 25% attrition rate. Then of those 10, 8 fertilized. Additional 20% failure. Then, of those 8, all had higher than normal fragmentation rates. (Normal is 20-25%, my best 4 were 30-45%. The others went up to 80%.) So 3 out of the original 13 were even worth bothering with transferring. Slightly less than 25%. And of those 3, only 1 implanted.
So with only 3 to start with, my hopes kind of plummeted. The doctor and later the nurse told me that we only needed one to be successful, but I can't imagine these ones being any better than the last ones. It's not like eggs get better with age.

So there were some tears, and a lot of numbness. And the depression I've been fighting ever since I started the BCP came and hit me. Hard. I almost don't even want to try again, if it doesn't work this time. If I didn't have my little girl to take care of, I don't even know if I'd be able to function.

4/17 - The day after the retrieval was my husband's *cough*ty-second birthday. We had a fun time. We all ate brunch at the mall, shopped a little. Played at the kiddie play area for a bit. Hit a Half-Price Books store on the way home. And we got the call with our results so far.
Of the 3 eggs retrieved, 2 were mature enough to ICSI, but both fertilized. So that's good news, I guess. I'm hoping my body put all its energy into making those some really quality eggs.

4/18 - After getting the info for my Day 3 egg transfer, I called back to ask about my little embryos. They couldn't tell me whether they were fragmenting or not, but could tell me that they're still dividing, so that's good. They're both still alive. So that's where I'm at today.

Are they twins if they haven't implanted yet?

Saturday, April 16, 2011

A Day Without Needles

4/14 - To celebrate getting to stop my meds, we went to Ikea to lie about Z's age so she could play in the play area. But we were thwarted by a new policy that no diapers or training pants were allowed. Nuts. So we went to the kids furniture area and played with the toys and jumped played on the beds. We had a great time, until I realized that I had totally forgotten my final antagonist shot (I had planned to do it after my appointment,) and I either hadn't listened or hadn't heard what dose of HCG I was supposed to be doing. And everyone at the office was in a company-wide meeting, and wouldn't be available until 3pm, several hours later. Ughhhhh.
When the nurse finally got back to me, she told me to go ahead and take my antagonist shot, even though it was very late, and to take the full dose of HCG. And they even let us reschedule DH's "appointment" time for the egg-retrieval on Saturday to a half-hour before mine, so that we could tag-team watching Z, since my mom was out of town, my sister who normally could have come out to watch her had a big test that morning, and my other sister and his mom were both over an hour away - not fantastic when you're supposed to be there at 8:15 AM.
That night my husband wanted to go to poker night, since there was a friend visiting from out of town. And I had a meeting with my MOMS Club. And was supposed to do the shot at 8:45pm. He's always done the IM shots, since they're a lot harder to do, both angle-wise and muscle-resistance-wise. But now I'd be on my own. I was going to have to leave my meeting early to meet a nurse in Seattle who would do the shot (for $50,) until I remembered one of the MOMS was an MA. So after checking to see if she'd be there, and be willing to do it for me (in a public restroom at Starbucks!) I cancelled the nurse.
There was a lot of giggling and clock-watching from about 8:30 on, since everyone knew what was going on. Then we trooped in, with my daughter, to the restroom. Luckily, it was a family-style restroom, with just one toilet and a sink and lots of space. She used the Koala diaper-changing station as her table, and had me lean over the sink. The nurse that morning had drawn on a "target" for me, so that part was pretty easy. And it was a lot quicker and less painful then I remember from years ago when my husband did them. But we were doing the progesterone shots back then, which got more and more painful as my muscles got stiffer and hurt more. The police who had arrived for coffee just before we went in gave us a funny look (I mean, really. Two ladies walking out of a single-person bathroom, with a very tiny minor?) but didn't hassle us. I made sure to thank her for being a pain in my heinie. :)

4/15 - Friday morning's pregnancy test was positive (and I fully enjoyed the irony of doing a pregnancy test when we all knew full well that I was not pregnant. They just had me do to to make sure that the HCG had been absorbed properly.) Ahhhh. A day without needles!

A Cyst Assist

It's been a while since my last IVF post, and a lot has happened... or not happened. I was a little over a week away from my suppression check, and the potential start of my meds. Well. Not so much, apparently.
I dutifully take my BCP, go in all excited for my suppression check (3/16)... and see a big black blot. I could tell immediately that something was not right. I've had cysts (from the Clo.mid) and seen follicles and all that jazz before, and this was the largest black blot I've ever seen. 28mmx28mm. A big whopper of a cyst. They tell me that it may be nothing, blah blah blah, but we'll do an estrogen check to see if it's active or whatever. So keep taking the BCP. Next day's lab results: high estrogen. Continue on the BCP and come back next week. Joy.
So I go back in for another U/S and bloodwork (3/23)... still there. Slightly larger (31mmx25mm.) And my estrogen is still high. Come back next week.
3/31 - still there. But slightly smaller this time. 25mmx25mm. I ask more questions this time, since I'm still not sure what this all means. The estrogen interferes with the stimulation meds, so there's no point in starting until the cyst stops interfering. And they aren't concerned about a cyst unless it's there "for too long." 12 weeks, apparently. *sigh*
But this time... the estrogen levels are down. We're a go! They were going to have me start stim meds on Sunday 4/3, but then one of my appointments would conflict when I'd committed to babysit my nieces. So we moved it to Tuesday 4/6. And I moronically remembered to stop taking my BCP Saturday night, as if we'd be starting Sunday, even though I knew we were moving it to Tuesday. Doh! Luckily I remembered for Sunday night.
 4/6 - Meds Day 1: I got to start my shots at my sister's house. Glee. I forgot how hard it was to remember all the little steps they don't tell you at the injection training class. I forgot to pull 1cc of air into the Meno.pur syringe before attaching it to the vial of saline. If you push the air in first, you don't get the suction trying to push the water back out of the syringe once you've drawn it (basically, you negate the pressure you've created by trading 1cc of air for 1cc of water.) If you just draw the water out of the vial, you create pressure where the syringe wants to push the water back out. All while you're trying to pop the lid off the powder vial (because you forgot to open all your stuff before starting.) Then you push the water into the powder vial, but you;re just moving the pressure from the syringe to the vial, and when you draw the medication back out, you have the same issue, with the syringe trying to push the liquid back out. And now you're trying to tear open the needle wrapper and put the tip on without letting the liquid push out.
4/7 - Meds Day 2: I got to do these ones at home. This time I remembered to open all the wrappers, but still hadn't thought to push the air in first.
4/8 - Meds Day 3: We were out to dinner with DH's family, so I got to do my shots in a restroom stall. And just as I unwrap everything, 5 ladies come in. Someone had just stared using the only other stall right before they arrived, and I knew I'd still be several minutes. So I opted to put everything away again and letting them all go first. Like there wasn't already enough pressure in handling needles and not messing up doses, I needed to feel rushed?
4/9 - Meds Day 4: Got to do shots at home. Invited Little Z to come and watch. She was to sit on her stepstool and not move. So naturally, just as I'm about to pull out the needle from my second shot, she stands up, trips and crashes into me. Joy.
4/10 - Meds Day 5: Had my Day 5 bloodwork and U/S. The technician couldn't tell which of two large black blots was the cyst, and which was a follicle. I forget the numbers, but I think they were both around 18mm across. She wasn't measuring too many follicles, but I assumed she was just going for the largest ones, or that they were blocked by the cyst. They also had my start the antagonist shot that morning, rather than the next day, which is what my calendar had said.
4/11 - Meds Day 6: Back at my sister's house, to babysit for the next morning. Only this time she was out of town, and after about 15 fruitless minutes of trying to kick various toddlers and preschoolers out of the bathroom (Really? You have to pee right now? You too? And you? You never use the potty when *I* ask you to! YARGH!) So I retreat to my sister's bedroom, and my poor BIL comes in just as I'm doing my first shot. I was cool, since I'd heard his footsteps and guessed that he was headed there. But he was mortified to be barging in. But I'd had a feeling he was going to come in, so I just folded down my waistband (I have plenty of fat to pooch out without having to take my pants off!) I even made sure my panties weren't peeking out the top.
4/12 - Meds Day 7: After a fun-filled day trying to find an urgent care out in an area where there's only one or two McDonalds per city, then waiting at the pharmacy for my daughter's ear infection meds to be filled, we got to the ferry in time to miss it and instead arrive to meet DH an hour later than planned. Then we all went out to dinner at The Melting Pot, where I got to do my shots in a restroom stall again, only without any pressure or interruptions this time!
4/13 - Meds Day 8: Time for Day 8 labs and U/S. I scheduled it in the Seattle office, so I could drop my husband off at work and leave Z with him for my appointment. But apparently he had an "all-hands"meeting at work for several hours, and it would have been difficult to leave to bring her out for me. So we gave her the choice, and she opted to come with me to my appointment. I felt bad about bringing her, for everyone else's sakes, but there were 3 or 4 other families with kids there too, so it wasn't so bad. And she did fantastic. Other than asking every 10 seconds whether they were going to put the wand in my "ba-dye-nah" yet. She stayed out of the nurse's way for the blood draw, and held my hand to "help me be brave."
She was fascinated by the U/S wand and was sad that she didn't get to see it "going in."
They decided to have me continue meds for another day, and come back the next morning for another U/S to see if the large follicle and cyst changed any.
4/14 - Meds Day 9: My husband had yet another crucial meeting, and had lunch plans with a friend, so drove himself to work, so I took Z with me again. This time we were in a different U/S room and she got to see the whole process from a better angle, in her point of view. But we were a go for the HCG shot that night!

So, some basic injection tips they generally don't tell you:
Open all the wrappers for each step before starting that shot. It's much harder when your hands are full of syringe.
If you'll be drawing water out of one vial to mix with the medication powder, pull that much air into the syringe first, then push the air into the water vial before drawing out the liquid. You don't need to do this when adding the liquid to the powder, since you aren't starting with a pressure imbalance. The unpressurized water going into the powder vial does what the air did for the water vial.

Thursday, April 7, 2011

Letting Go of Guilt

The ladies at SITS are hosting a "Letting Go" Link-up, to inspire us to let go of our hang-ups and redefine "our best."
Now, this isn't my normal blog, which is far more fun. I come back and dust this one off once in a while, when something comes up, or when I need to vent. But I'm too chicken to strip my soul naked on the one that our friends read and families subscribe by email to.

This is hard for me. Not just the thought process, but the sharing process. I don't really advertise my infertility issues (except here, obviously,) but I don't keep it a secret either. And I never share the emotions: fear, guilt, shame. Not even with my husband, really. When I first read this challenge, I thought... "Huh. What can I let go?"  My first thought was maybe some vague parenting hang-up, but nothing came to mind. Then I thought, "My guilt?" and my gut reaction was "No! It's mine! 

Because I don't share it, because I don't let it go, it's almost like a friend. Not a good friend, mind you. But one that's all mine, and no one else's. Someone I can go and play with whenever I want, even if I don't have a good time. Someone who will come to all my birthday parties, even if a part of me wishes they wouldn't. But this isn't someone I met through work, or my husband. Not a friend of a friend. Mine, and mine alone.

I have no reason to feel guilt. I didn't do anything to cause my infertility. And no reason to feel shame. Lots of men and women experience this. More than anyone could imagine.
But it's hard to let go. Sometimes you just feel like sitting there poking at your emotional wounds. "Does it hurt now? How 'bout now? Oh, and remember this?" [poke, poke, poke] "Now how do you feel?"
I've let go of so many things. Issues from childhood. Issues from my parents. Issues from my siblings. Even issues from my husband. But I just can't seem to part with the issues I created for myself. A teacher in High School once said something about how we shouldn't regret anything we do. If you did something bad, learn from it so you never do it again. But don't spend your life regretting what could have been, or what you did wrong. I took that advice to heart. I've always been a firm believer that everything that has happened to you makes you who you are today. And you need to love who you are in order to be happy, and in order for others to love you as well. So everything that has happened, and everything that I have done made me the person I am today. Made me the person who met my husband. Made me the person that he loves. Made me the person who created our daughter with him. And made me the person that she loves. How could I possibly regret being that person?

And yet... we tried for years to get pregnant. I've heard stories more heartbreaking than mine. But they aren't my story. I know some of what they felt, and they know some of what I feel. But no one can know exactly how another person feels. Not exactly.
I've wanted kids, like, forever. At eighteen I was planning what I'd do to become a single mother. Yes. You read that right. There wasn't anyone I wanted to be tied to for the rest of my life, but I wanted a baby. I was willing to move back in with my parents, if that's what it took, to be able to take care of one. But I didn't want to trick anyone into it. No "Yeah, I'm taking the pill." kinds of deceit. Plus I wanted to find good breeding stock, if you get my drift. So I dated a few guys, got into a few emotionally unhealthy relationships. One of those was without protection, as I recall, but nothing happened. He later had several kids. Then I had a long-term relationship with someone, and my recollection is that we'd kind of been "trying," or at least not not trying (he doesn't recall this, and shudders and takes a deep sigh of relief any time he thinks about it,) for several years. Nothing. Then I met the perfect guy... only one hitch: He didn't know if he'd ever want kids, but if he did, he wanted to be married first. But he didn't know if he'd ever want to get married. I'm not one of those people who deludes themselves into thinking "Maybe he'll change." So sometime in the first year of our relationship, I sat down with myself and forced myself to make a choice: Him without kids, or someone else with kids. I chose him, and no regrets. And no blame or resentment for not having kids. Because he didn't lie to me about what he wanted, or give me false hope. I chose him, and all that that entailed.
But over the years, his friends all started getting married. And having kids. And on our 5th anniversary, he proposed, with the caveat that he wasn't actually ready for a wedding yet. Just ready to commit to me. Well, I hadn't ever expected him to marry me, so, bonus! Then four years after that, on our 9th anniversary, we got married. And he said he was ready to start having kids with me.
So 2 weeks before when my husband and I got married, we immediately started trying. I had had a feeling there might be issues, so had started seeing someone at my OB/Gyn's office for fertility issues before we got married. Nothing. Got bumped up to an actual doctor, who started prescribing stuff and ordering expensive tests and doing ultrasounds to check for things. Nothing. Then to an infertility clinic, who said they were sure I'd get pregnant without anything fancy. Nothing. Then fancy procedures. Nothing. Then my Grandma let me cash in on my inheritance early, so we were able to afford IVF without going deeply into debt. Noth... oh wait. What? Pregnant? Really? 

But that was still two years of feeling like a failure. Two years of having my soul crumpled into a ball and stomped on every 28 days (26 for me, actually, the first year. Until they found a problem unrelated to fertility, but fixing it regulated my cycle. Let me tell you what a treat it was to get that extra 14th period every year.) Two years of watching my sisters and everyone else I knew with a uterus popping out babies like Pez dispensers. Two years of hating my body for not being able to do the one thing I wanted most. Ten years of cramps, moodiness, long periods, periods even though the pill I was taking was supposed to prevent them. Yeah. Ten years since I first went crying to my mom as she welcomed me to womanhood. All that, for nothing.

Until the miracle of science (and a hefty dip into our savings account.) And still, then only one egg out of the three we transferred "took."
I decided that when she was 18 months old, I wanted to start working on the next one. Since then we'd have a little time for delays to space them at least two years apart. So my body failed me again. At around 16 months, my cycle started being 14-17 days, irregular, and mostly bleeding. One month I didn't bleed 3 whole days. Yay. After wasting a few months being jerked around by the first doctor I saw, who didn't want to try and discover the cause of the problem, I had to wait another month to get in to see someone else, then it took months to wait to get tests and procedures done, before we were back on track trying to make babies. Then our vacuum, steam cleaner, washer, dryer and water heater all broke within 3 months of each other, so we ran out of funding for infertility treatments. So now she's almost 3. And now we get to start paying to try trying again! 

I can't make any promises. But I will try to let go of my shame. And my guilt. But just in writing this today, I felt a weight lift off my shoulders. The smattering of rain didn't keep us from playing outside. The sunshine was sunshine-ier. I wasn't as quick to race out the door the minute my sister got back from work to take over watching her kids. And I was a lot nicer to them today.
And as I gave myself the IVF shots today (Day 2 of probably 10,) that little part of me didn't hate myself for needing them. 

Thursday, March 3, 2011

Busy Day!

Today we crammed in all the fiddly appointments before the actual IVF protocol appointments. We did the "consent visit" where we sign things saying we consent to IVF, ICSI, etc, and what we want done with any extra embryos. Plus get new questions answered. Like, since I'm still nursing my first child, will that interfere? (No.) Can I go to my niece's birthday party the day after (projected) egg-transfer? (Yes.)
We also got his semen analysis results. Everything but shape was at or above "normal." Shape was around 10% below, so they still recommend ICSI. Then we sat around for an hour until my OH/Sounding appointment. It was kind of exciting. OH stands for Office Hysteroscopy, which they didn't do my first time around. They just did a "practice run" or SHG. My doctor did that too, this time, but I wasn't even aware she had done it. I thought she was still swabbing me with iodine. Then the hysteroscopy! I got to see my cervix opening (looks like a sphincter!) and inside my uterus. It looks like some strange peachy-fleshed sea creature. With the occasional red floaty bit. And lots of bubbles, but she said she caused that with whatever she was doing. I got to see the little dots that were where my fallopian tubes let out into the uterus as well. OoOoOoh!
It was very uncomfortable. VERY. Not as bad as the HSG or the uteran biopsy, which hurt so bad I couldn't even speak. This was like... really REALLY bad cramps, in a spot you don't normally feel. But I made sure to talk throughout, so I wouldn't have a vaso-vagal reaction again and get dizzy/sweaty/nauseous. So I just said whatever came into my head, and then explained why I was jabbering, so the doctor and the nurse went along with it. :)
Then my husband, who had been watching our daughter (my mom watched her for our consent visit, but then she had other plans during our other stuff,) took us to a nearby mall for lunch and play area time. And cupcakes! Then back to the clinic for the injection training course, which I wanted to do again, since it's been over 3 years since I last did this. Princess fell asleep in the car, and napped the whole time. So my husband didn't get to review the shot that he gets to do, but that's probably for the best. Apparently he can see a video tutorial online, plus the other couples wouldn't have appreciated having her there. And toddlers plus needles aren't exactly a recipe for success!
It was a tough call, whether to let the other couples know that I had done this before. On the one hand, it might be heartening to meet someone that this procedure had worked with. On the other hand, I loathed anyone fortunate enough to have kids when I was going through this, and knowing that OTHER people could have kids had no bearing on MY ability to have them!
In the end, they figured it out, since the nurse and I exchanged some questions and answers that kind of gave it away. Last time, I did AM and PM injections for 3-4 weeks. This time it's only PM injections for less than 10 days, which kind of came as a shock to me. Plus I was familiar with the needles and bottles and what to do, and was often doing them before the nurse showed us. One lady asked for my email, so she could ask questions, which I was happy to do. Some people want someone to talk to and bounce questions/worries/fears off of, and some don't. I know that's what a lot of IF bloggers are really doing. Using this forum as a way to talk this out with other people going through the same things. I didn't really want/need that the first time. I'm more of a loner. I'm happy talking my problems through with my husband, or occasionally the pharmacist I worked with at the time, if I had medical-related questions. But this time I'm being much more open about the fact that we're even doing this (it's hard to hide things on Facebook!) and past pregnancy success makes a potential future failure much easier to face. It would still be heart-wrenching. But at the end, I still have this wonderful little person who makes my life complete. I just have room for more completeness! So if I can be someone this woman can share her fears with, and maybe reassure a little, I'm happy to. Her husband seemed either uncomfortable and covering it with humor, or just kind of insensitive, or non-supportive or something. I could tell that she was very invested emotionally in this process and wanting a child, but I felt he was just kind of going along for the ride. The other couple at the training session seemed very well educated, and grasped things fairly quickly.
I was mostly feeling ill at the thought of handling all those needles!

Thursday, February 17, 2011

Drug Dealer

My medications arrived this morning. Several thousand dollars of medications. Last time, neither of us were able to be home for delivery, and I fretted all day at work that they wouldn't be on my porch when I got home. But they were. Since I didn't want to risk losing or misplacing anything, we left the box sealed until just before I was to start using them.
No one had told me that some of the medications should be refrigerated. Yet another thing that slipped through the cracks at that place. Yet another "FUCK! Does this ruin EVERYTHING?!" moment. Luckily, Folli.stim can be left out for up to 4 weeks. But still. I thoroughly resented not being given the information, so that I could have chosen to keep them refrigerated or not. I would have chosen to refrigerate them, since absolutely any effort I could make to ensure everything would be in ideal conditions, I would do. And I put them in the fridge this time, even though we have way less room in there now.
I still have butterflies in my stomach from seeing that box on my doorstep this morning, after hearing the doorbell ring. Just another sign that this is really happening. Who knew one could be so excited over prescription medications? Squeeee!
And, for more delight and glee - they were covered on my insurance. So what probably would have been around $5,000 worth of medications were only $242.49. A lot easier to stomach if something got ruined, or we stopped mid-cycle and I had to try again another time with medications.

Sadly, since I started my birth control last night for suppression, I wasn't able to fully enjoy my glee at my meds arriving. Apparently the BCP make me nauseous. They prescribed the generic Ortho.Cyclen for me this time, which I've never had. But when I was (much) younger, I had tried OrthoTri.Cyclen, and threw up every Sunday for a month before I figured it out. So I called to leave a message for my nurse, since it was 7am when I had woken with the feeling I wanted to vomit. I know that BCP and other hormones can cause nausea, but other than the Ortho product I'd had before, I've never had a problem. Since I was concerned that perhaps they both use one of the same hormone variations, maybe my issue was with the specific ingredient.
I got a call-back from the on-call nurse, telling me to take it with food. I told her that I took it with all my other medications the night before, and that I've never ever had a problem with "take with food" medications when I take them all together at night. (I take a prenatal vitamin, a biotin supplement for hair and nails, acid reflux medication, an anti-depressant (BCPs trigger depression in me,) and a allergy pill. Quite the handful.) She just said to slowly take the birth control earlier and earlier in the day, until it's with a meal. But she said she'd have my nurse call me back. Excellent. Done with you.
Then my nurse called (actually, it was the one I hadn't met yet. Two nurses job-share, but they are "my" nurses, and try to be the ones to call me back.) She said they don't normally like to switch pills this early, in case the nausea is related to something else, but she listened and took me seriously and looked up and verified that the BCP that had made me sick in the past was the same ingredient as this one, so it was likely that this was the issue, but she'd consult the doctor. I love being taken seriously. Plus she listened when I explained about my compliance issues. I have learned from past experience with pills taken multiple times per day, that I forget the daytime meds half the time. So it's just easier to take them all at bedtime, even if the acid reflux one is best taken 30 minutes before the largest meal of the day, for example. And it's not like Mommy Brain is going to help matters any!
She said they recommend taking the pill at bedtime anyway. Take THAT, on-call nurse!
Obviously, if they wanted me to stay on this one, I would, but at the seminar last night, the doctor said that the BCP wasn't really essential, if you didn't want to or couldn't take them for some reason. So it shouldn't matter which one! I told my nurse which ones I had used for suppression at the first IVF cycle, and to control my period for the polypectomy. The doctor ended up switching it to the same one I used last IVF cycle. So hopefully that goes well!

Talkin' Shop

So last night we went to an IVF seminar, put on monthly by the clinic. I kind of wanted to go, since it's been over 3 years since we last did IVF, and I remembered looking up a lot of the terms online in the middle of the night, so hoped that maybe they'd explain more.
I didn't view it as a waste of time, but my husband kind of did. He said he's glad he went, in case there had been anything new, but he didn't feel he heard anything new. I was glad I went, since they did go a little more in-depth, plus showed pictures of some of the procedures, like ICSI. They showed a picture of embryos at Day 1, Day 3 and Day 5. I hadn't realized how crappy our embryos were until I saw that beautiful Day 3 picture. Eight clear little cells, happy as could be. Mine were jumbled messes, with all the fragmentation. I was kind of surprised at some of the stuff they left out. Like one of the reasons to recommend ICSI is if enough of the sperm don't have the enzyme on their heads for getting into the egg, or if the caps don't come off to expose the enzyme (I forget which they're looking for.) That was one of the reasons they wanted to do ICSI with us the first time.
And it was kind of neat (and scary terrifying at the same time) to see the needle depositing a sperm into the egg too.
And the embryologist at the seminar mentioned fragmentation a few times, but never explained what it was, so I asked, even though my husband and I were probably the only ones in the room, other than the medical experts, who actually knew.
There were a lot of stupid questions. A LOT. And I didn't like how the doctors answered several of them, but I kept my trap shut. My husband doesn't like me butting in at stuff like this, plus I didn't want to wave it in everyone's faces that we'd done this before and had a child.
Stupid questions, like, should they do ICSI if it's not deemed necessary. Is there an advantage to using assisted hatching if they aren't over age 38 or have thick egg walls?
But I knew where those questions were coming from. From the fear that this wouldn't work. I remember being there. I remember being supremely pissed off and terrified that it had all been for nothing every time I realized they had let some detail slip through the cracks. I remember wanting every. single. advantage we could get. Will this procedure make it more likely? Less likely? If we do this, do our chances increase...?

Plus questions that were financially based. Do I have to do ICSI with frozen sperm? Can we 'collect the sample' at home and bring it in that day? This 'flat fee' for IVF, what if we've paid and you decide to stop that cycle, or do fewer checks along the way? Or more checks? What if we do ICSI and there are tons of eggs? Will it cost more?
Since we had the benefit of partial insurance help the last time around, and 80% coverage this time, it was hard to be patient with these questions, since really, 'saving' on these types of things are just nickel-and-diming it. The IVF retrieval, fertilization, and transfer are the big costs. Around $10,000. ICSI is only a few grand, varying by around $500 whether they are fertilizing more or less than 10 eggs. All the other stuff is peanuts. But it is daunting. Seeing this $15k price tag, plus $3-5k in medications. Each peanut becomes a bigger deal.

Money, Money, Money

Now that we got the ball rolling, it's rolling pretty fast. My insurance company finally called back and said that IVF is covered if IUI hadn't work. So we should be good, as long as the prior-auth process doesn't take too long. Luckily, the lady I talked to on the phone in the finance department understands the urgency and has seemed very understanding and supportive. She was off the day we went in for our initial consult, and I wasn't wowed by the financial counselor subbing for her. And I was almost feeling hatred for the person I was initially transfered to when I called to tell my financial counselor what the insurance company had said about the PA requirements. She was all "looks like she's working on it." "Next time you can just punch in her extension." Look lady. They transferred me to you. No need to get all snippy! And I don't exactly have confidence in their financial counseling team, who first told me that my insurance didn't cover IVF, then, when I said it did, she actually read the info in their computer and told me we wouldn't need a prior auth. I had urged them when I first made the consult appointment to be getting on my insurance. And again at the consult visit. But when I finally got to speak to the regular person at this office, on the phone, she told me she would start the PA process as soon as we did my Day 3 labs. She took me seriously, and seemed empathetic and supportive. Phew.
One of my issues with the previous clinic was the financial stuff. They were so used to IF not being covered, I had to nag them for each. visit. to bill my insurance before billing me. At the time, the IUIs were covered, as were the ultrasounds and bloodwork. When we finally went with IVF, the IVF procedures themselves weren't covered, but the ultrasounds during the ER and ET were covered, as was all the bloodwork and U/S during the medication cycle, and the anesthesia was covered for the ER. But it was like pulling teeth to get them to bill my insurance. And they wouldn't even bill for the labwork. They made me pay them and submit for reimbursement. And then, at some point, they were able to bill my insurance, so there was a bit where they were getting paid by me and the insurance, which they credited later. Supposedly. I'm still not 100% sure I didn't get screwed on the bloodwork somewhere. And then there was an issue at the end, where months later I get a notice from a collection agency that I owe the clinic money. Whuuuuck? They made us pay in full before they did the IVF procedure, and then I went in and paid more for the extra bloodwork and U/S that they added as we were nearing the retrieval date. But they said I was paid in full. Turns out they had double billed my insurance, since my insurance was slow to pay. So they had sent some claims twice, gotten PAID eventually for the first set they sent, then the second requests got declined for obvious reasons, so they then pooped all over my credit rating by sending those to collections. ARRRRRRGH!

Tuesday, February 15, 2011

Counting Chickens

Normally I'm good at keeping my expectations low, so I'm rarely disappointed. Normally I'm good at assuming something good WON'T happen, so that I don't tempt fate into ruining my plans.
But for some reason, I just can't right now. Part of me wants to start buying "Big Sister" shirts for Z. I mean, I'm just ASKING to be sucker-punched in the gut by the Powers-That-Be for that! My husband keeps trying to gently remind me that it may not work. And I know this. I mean I KNOW that IVF may not work. Especially since we don't really know what the issues are, other than a slightly lower % of ideal "swimmers" and a high fragmentation rate of the embryos (probably due to sub-par eggs, but since there's no way to test the eggs, who knows?)
We decided to sign the waiver and get started on IVF right away. Now, this wasn't a decision taken lightly. I spoke with my family practice doctor, who told me that since I had antibodies from contracting chicken pox as a child, rather than from a vaccine, that I should be fine. He also said that my chances of getting chicken pox again were so slim, and then the chances of damage to the fetus is so small (2%) after that, that he didn't see any reason not to start IVF right away. Plus Z has been vaccinated, and if I were to catch it, I'd be more likely to get it from her versus getting it from one of her friends at school or wherever. And then, the same day as my doctor's appointment, I get an email from my nurse at the IF clinic saying that the doctor herself recommended signing the waiver, giving the same reasons as my doc. Well. Great!
My period started yesterday, and now we start the ball rolling. Today or tomorrow I need to go in for labwork, then start BCP tomorrow for suppression. I'm scared. I'm terrified that this won't work. Or that I'll mess it up somehow. Last time, I had nothing to distract me from doing this. Just work and the snooze button to delay my daily shots until I remembered and got them done just a little later. But now, I can totally see myself leaving my meds at home when gallivanting off to my sister's house (I frequently forget my REGULAR daily meds when visiting my sister.) And how can I wake myself up at 7am to do shots without also waking up my little co-sleeper? I plan on using the calendar app in my iPhone to help, but the alarm is sooo hard to hear from in my pocket.
But despite my fears, I'm blissfully hopeful and borderline certain that it will all turn out okay. I'm tempting fate to come and destroy my bliss.

But I can't help myself. I'm totally counting my chickens before they're hatched.

Thursday, February 10, 2011

A Pox On Both Your Houses!

Well. Maybe bad news. Some of my labs came back. My STD testing all came back normal (not really a shocker there,) but my Varicella (chicken pox) screening came back equivocal (meaning I do not demonstrate full immunity.) "Non-Immune" status is a test result less than 0.91. Between 0.91 and 1.09 is considered equivocal, and a result greater than 1.09 is considered immune. My level was 1.07. In 2007, the last time we did IVF, my result was 1.96, but apparently immunity can wear off over time (hence Shingles later in life.)
So I can get immunized again, but that would be 2 shots, spaced a month apart, with another 30 days before they'd want to start the IVF process, since the chicken pox vaccine is a live virus.
So we can either wait another 2 months, and risk having to pay out-of-pocket because we no longer have the IVF insurance, or sign a waiver and plow ahead.
Another fucking blueberry!
The chances of me contracting chicken pox while pregnant are slim, but not non-existent, as we go to preschool and gym class and whatnot. And the chances of a fetus in the first 28 weeks getting damaged by the virus is only around 2%. But the risks include death, malformation, mental abnormalities, and lots of other fun stuff. After 28 weeks, they appear to be safe, unless they are born within 7 days of the mother contracting the chicken pox. Before then, they have enough antibodies provided in the womb.
But my results are so close to immune status. Sooooo close. What are my chances of contracting the pox while pregnant, when I might be immune? (Equivocal just means you're not necessarily immune, but you might be.) If you asked me whether I would let my child be deformed to save $15 grand, I'd say "Hells no!" But this is just a teeny tiny miniscule chance that something could happen if I don't get vaccinated versus risking having to pay around $15,000 out of pocket to get pregnant.
Now, if we choose to do the IVF now, and something does happen, I'll never ever forgive myself. Ever. But I also don't want to spend our entire savings on this either. I want a baby so bad. Sooooo bad. But bad enough to risk deformity or health issues? Because of our ages (35 and 41) we're already at higher risk for a whole host of fun things to inflict upon our child. Do we dare add another risk factor?

Friday, February 4, 2011

New Beginnings

Our first appointment at the new IF clinic was at 9am, with an 8:45am check-in, and bringing children is somewhat frowned-upon, (understandably!) So rather than waking up before the sun and then waking up the sprout to drop her off at Grandma's, we opted to spend the night at my mom's house and just wake her up before leaving. So naturally, Little Z refused to fall asleep before midnight. Argh. And woke me up. A lot. All. Night. So we opted to leave without waking her and hope for the best, since chances were good that she'd sleep until 10 or 10:30, and we should be back by then.
We met with the doctor, who I liked, and she kept asking if we have any questions. Like what? We've done this before. And I'm normally just waking up around now, so I need a little help jump-starting my brain here, lady. She suggests that we can do an ultrasound today, and some genetic testing and the FDA-required bloodwork for IVF (Hepatitis tests and such.) Wow! Moving things right along! Love it already!
She checked out my uterine lining, since I have been a little concerned due to my relatively light periods since my polypectomy a year ago. Looks good. She checks out my ovaries to see if I have been ovulating (looks like I have) and how many eggies are in the works (3-4 on the left, 4-5 on the right.) She says they wouldn't recommend IVF if the numbers had been lower than 5 total, so we're good. Whoop! And since we aren't going to fart around with Clomid or Femara and timed intercourse, or IUIs and other stuff, she says we can start with my next cycle! Holy crap, that's fast! They bang out a preliminary calendar, based on a projected cycle start of Feb 15, in a little over a week.
Start BCP on Day 4, 4 weeks of BCP before suppression check, 2 days after that, start injectibles! We could be doing an egg retrieval as soon as 7-8 weeks from now! FROM NOW! Part of me is super excited to finally be proactive again. And part of me is resistant, because it's all happening so fast! And yet a third part of me is frantic that we get this done, and that it's successful, since we don't know how long we'll have this IVF-coverage insurance plan, since they've been laying off a bunch of my husband's department.
After talking to the doctor and being whisked in to get an ultrasound, we wait for our blood draws before talking to our personal nurse (we get 2 actually, since they job-share. But they are the ones who will be contacting me and answering any questions. Which is a large part of why I chose to switch to this clinic. Already more personal service!)
My one concern is that this clinic only has a 2-week protocol with the medications, and my previous clinic had done a 4-week protocol. And I hadn't been developing as expected, so my dose stayed high. Hopefully this clinic will stay open-minded about trying it, if things aren't looking good.
Since the U/S and bloodwork has made us stay later than expected, and my mom has an appointment of her own at 11, we have them take my husband's blood sample first, then he goes to pick up Z, so my mom can leave. Then he comes back for me. So I get my blood draw, talk to the nurse and get a preliminary calendar, and such, then I'm told that they need another blood draw, since they didn't take enough for all the tests. Urk.
Then off to the financial counselor, who tells me that infertility isn;t covered on my insurance, and that my projected out-of-pocket will be around $15,000. Whoa, hold up, lady! I would have bee panicking here, except that I personally called my insurance, even though my husband already had, just to be clear on my coverage. So I told the financial counselor that my insurance does cover infertility, but that ours is the only plan they have that does. Ah. She looks at my actual file and sees that they, to, called and verified my coverage, and rattles off the same information I got, about it being covered at 80% after my $200 deductible. Whew! So then I ask her about the IVF coverage, since all the insurance could tell me was it's covered if I "can't get pregnant by other means." So I ask her if they'll be calling to get a prior authorization or whatever, since I don't want to be scheduling IVF appointments if the insurance is going to want me trying something else I haven't done yet first.
Apparently, they can't be bothered to call for me to find out. She says that since IVF is covered, it doesn't need a prior authorization. I don't know about you, but if something is only covered under certain conditions, that's usually what a prior auth is for. To determine that those conditions have been met. Argh.

So I call my insurance after I get home, to talk to the PA department, and they say they have to call my husband's employer to find out what they mean by "can't get pregnant by other means." Well. Finally. At least someone is willing to find out what I need to do to get this done! I wonder if that means that his employer pays the 80%...

Catch and Release

I just found out that my old IF clinic has merged with the new one I'm seeing. But their computer files aren't linked yet. And I will still need to sign a records release form. Whuuuuck? How stupid is that. The new clinic can't just call and ask for files to be faxed. And since I dicked around too long lost track of time, I had to drive out to the old clinic to get a hard copy of my file to bring in for my first appointment. But could they print it up and have it waiting for me and my release form? No. Which is bullshit, since I shouldn't even need a release form to release my records TO MYSELF!
My husband had faxed over his release form, so they could fax his motility and morphology report, and since we had our appointment the next day, I just told them so that they could fax it that day, rather than waiting until after our crack-of-dawn-o'clock appointment the next morning. So the guy at the office prints it out and lets me have it. Which I'm totally fine with, since as I'm flipping through it, I notice that his motility and morphology test results aren't even there. I mean, yeah, it's nice to know that he didn't have Hepatitis 3+ years ago, when these tests were done, but really, I think the fancy semen analysis which prompted the first clinic to recommend ICSI is somewhat more crucial information. So the receptionist prints that out for me. Thanks, bub.
But... my husband hadn't signed a release to allow ME access to his information. I wasn't going to bitch about it, but really. This new clinic had us each sign a form releasing our information, test results, and permission to leave messages with the other partner.

Sunday, January 30, 2011

Hey, Jealousy!

I have my first appointment with the new IF specialists this coming Friday. I'm so excited! I have all my forms printed out, but they're so overwhelming! I have no idea what all my hormone levels are at various times of my cycle! I can't remember what year my wisdom teeth were extracted! I can't even remember exactly what therapies were all tried, or how many times. Much less, when. (Femara w/ IUI? Femara w/o IUI? Clomid w/IUI? Clomid w/o IUI? etc etc. I don't remember!)
The down side is that we need to be there at 8:45 AM. Kind of a hardship for someone who has a hard time eve getting up before 9. [Me.] Plus we get to wake up the squirt and drop her off at my mom's house first. Joy. My husband's original plan had been to bring her along, when I was asking him if I should take an afternoon appointment a week later so we could get someone to watch her, or what. But after reading their guidelines, they request that we not bring kids, and if we do, to have a caregiver there just for them. Which makes sense. It's hard to listen to the doctor with someone pulling on your pants legs, whining to use your iPhone (she loves her apps!) Plus it's potentially emotionally disturbing for other patients to see you waltzing in with your kid(s.) I know it would have been for me, my first time 'round. I hated seeing people with babies anywhere, but it would have been a harder blow at the clinic, more and more as each treatment cycle kept failing.

I refused to even meet the next-door neighbors because she was pregnant when they moved in. And. I. Wasn't. My husband would talk about them, if he'd run into them outside or something. I'd see her swollen belly as she went inside from her car. I hated her. After the baby was born, they'd come trick-or-treating. My husband would tell me they had come, and I wouldn't know who he was talking about, since I never remembered their names. We'd see them occasionally, if we all happened to be outside at the same time. I rarely spoke to them. Only if DH wasn't around to do all the talking.
We had gotten married in June of '05, and immediately started "trying." By the time they'd moved in at a few months pregnant (late '05) I was getting frustrated. Then she started "showing," just to depress me even more. Then in May '06, when she had a wonderful new little baby, I'd been trying for a whole year. It was over a whole 'nother year before I got pregnant. A year of hearing baby cries through the open windows all Summer. Seeing them going places as a family. Knowing that they had this treasure, one that I might never find.

I got so used to ignoring them that it wasn't until my daughter was old enough to be interested in their daughter that I even learned their names. My husband would be outside with her and the neighbor girl, about 2 years older, would invite her over. They had a slide. And swings. And a sandbox. Our back yard has... weeds. Always dark with shade. Low-hanging branches. I call it "the Jungle."
When their daughter got a trampoline for her 4th birthday last year, I gave in and got to know them. I had no choice. All summer long we could hear them out there jumping and laughing, and my daughter would start yelling (from inside the house) to try and let Appie know that she could hear her and wanted to come out and play. Every day: "I wannto dump on Ap-pee's tramp-a-neen!" Every time we'd go outside, she'd race into our backyard, since our always-open gate is right next to their closed gate, and she only vaguely knew how to get there. She was only barely 2, after all!

Friday, January 28, 2011

No News Is Not Always Good News

The Rest of 2010
After my (second) polypectomy, my doc wanted to wait a cycle or so, then see me again. Let me have a chance to get a good lining in my uterus. And then she refers me to their in-house fertility specialist (another nurse.) They don't do anything beyond prescriptions and IUIs, but more of my visits might be covered, since they aren't an infertility specialty practice.
I consult with the nurse, and don't really like her. I don't hate her. But we just don't gel. And she's all "so, when you think you might be ovulating, give me a call and we'll do an ultrasound. I charge extra for Saturdays." Um. Okay. But... can we make sure I'm even ovulating first? If a blood test can show that I'm not ovulating that cycle, can't we do one of those before hopping in for an ultrasound? Since the U/S may not even be covered by my insurance? How frustrating. And I have no clue when I'm ovulating. My basal temp hardly ever formed a pattern, the 6+ months that I wasted on that. And the pee sticks never gave anything but inconclusive results. Yet ultrasounds showed big huge egg-making follicles. So, disheartened, I went home.
My husband was not in love with the cost, especially since he was still under the probably mistaken impression that now I would magically get pregnant, with those pesky polyps out of the way.
Plus, over the next summer, we had to buy a new washer, dryer, vacuum, steam cleaner and water heater. Which kind of depleted our savings.
So. Another year wasted. I mean "trying." With no way, other than my iPhone period tracker app, to determine when I was probably ovulating, it was tough to know when to try. Plus my gooey-egg-whites were happening at a different time than the period tracker had down. So who knows?

Magically, despite everyone telling me stories of how women who were told they couldn't have babies got pregnant weeks to months after adopting or having their first child through the magic of science, babies didn't spontaneously appear in my uterus. Nuts.

25 January 2010
I just found out that my health insurance not only covers infertility treatments (at around 80%, I think) but also they cover IVF! Well, they only cover it if more traditional methods don't work, but we may have covered all that with the first go-round. So I made my first appointment, with a different specialists office that our first go-round. Since the first place was so professional and impressive and all. Gag.

Same Song, Second Verse...

Early 2010
So my husband takes the day off work for my polypectomy. We pack up Little Z, with her entourage of toys and snacks and diapers, and go to the special surgery center at the hospital. I'm starving, since I'm not supposed to have eaten for 12 hours or whatever, and since this is a lunch-time operation, the last opportunity I had to eat was the middle of the night. I had woken up for my last opportunity to drink water though.

So we're sitting in the lobby, filling out forms. My daughter is eating blueberries. Omnomnom. She pulls out a half-masticated berry and feeds it to me. I absentmindedly eat it, and continue talking to my husband and signing forms.
Then we're called back to the desk to turn in our forms and answer more questions and cough up insurance cards, etc. The lady is coming back from Xeroxing our insurance card when she catches my daughter popping another half-chewed blueberry into my mouth.
"Oops! No food, remember! Close call!" Ummm.... Shit. I spit that one out... but I had still eaten the first one!
We debate whether or not to come clean with the docs... and we finally do, when our special waiting room nurse asks me if I've eaten anything in the last umpety-ump hours. Yeah. Just one blueberry though. 
So my doctor comes in and tells us the risks involved. Any food could come up and get inhaled and kill me, worst-case scenario. Plus I suffer from acid reflux, which I don't even tell her. Which increases my risk of something like this happening. She gives us a few minutes to decide. 
I'm mortified, and don't want to have wasted everyone's time. DH doesn't want to risk anything happening to me over something so stupid. We kind of decide to go ahead, when the doc comes in and says "You decided not to risk it right?" Weeeeeeell. "I talked to the anesthesiologist, and we both feel like the risks aren't worth it. We still have time for lunch, so our time wasn't wasted, and I'd never forgive myself if something happened." Fine. Twist my arm.
A frickin' blueberry.

So I go back on my BCP and we reschedule for the next available opening. This time, my husband doesn't feed Little Z if I'm even in the room. And no blueberries!
My daughter (around 20 months-old) is thrilled that the nurse uses the pulse machine thing on her finger after checking mine. ("White finger pinch" she calls it. Now she asks for it at every doctor visit.) She is sad that they don't have a BP cuff small enough to fit her, but the nurse humors her and pretends.
No hitches. I go into the OR, get hooked up with an IV... by the anesthesiologist's assistant. Ugh. He has to try a few times, which is not cool when you suffer from needle phobia, like I do, but I got lots of practice coping during all my tummy jabs with the IVF meds. But still. Jeez. I also tend to get chilled easily. If you're feeling quite comfortable, I'm a bit cold. If I'm feeling just right, it's a little warm for you. That kind of thing. But they had nice, warm, toasty blankets all over me. Mmmmmmm! And air pump leg massagers. Ahhh. This is the life... except for the needles, and scary medical procedures and such!
"Okay. Count down from ten for me..." 10.. 9... 8.... "Hi there! How are you feeling? We'll just wait a few minutes until the doctor is done talking to your husband, then we'll bring your family in to see you. Would you like some juice or some crackers?" 
Oh, hells yeah! And keep 'em coming!

So it all went well. She got all the polyps, etc etc etc.
And this time, we got before and after pictures! Ewww.