A Baker’s Dozen

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13, is the number the embryologist gave us. Each one of my follicles produced an egg. Now, this is not to say they were all mature, but there were 13 retrieved. I’m happy it’s this many, and not less than the number of follicles but disappointed there weren’t a few more hiding somewhere.

Overall the retrieval went very well. I was nervous, but actually less so than I have been for some of my monitoring appointments when I thought everything might come crashing down. I have never in my life been admitted to a hospital, no broken bones, nothing serious enough for stitches, or an overnight stay. I have been very lucky, and rather healthy my whole life. So I was nervous about the IV (they gross me out so bad), as well as the drugs. I wasn’t sure how they would make me feel, and if I would be nauseous after. I also wasn’t sure how bad the pain would be during the retrieval (even though I know I would be on pain meds). Lots of unknowns making me nervous.

We arrived at 7:20 for our 7:30 intake time. They called my name, along with another woman, and the two of us plus our partners headed back to get changed, ladies into hospital gowns, men into scrubs. After this, they took us into an area I’ve never been before. There were a few “stalls” for lack of a better word, each stall had a comfy looking sort of recliner chair and another normal chair next to it for the partner, each separated by a curtain. They placed a heating pad and a blanket on me (so glad, I am perpetually cold), and let me sit there while they went over everything that was going to happen to me. They gave me some ativan to take they edge off before they even did the IV. I personally didn’t think it did anything at all.

Once everything had been explained to me, the nurse got me ready to do the IV. I told her I don’t like needles, and that I was seriously uncomfortable with the idea of an IV. She told me she would check it out and if she didn’t think she could do it she would get another nurse. This in itself made me wish she would just let the other nurse do it. So she found a vein, poked and prodded at it with her finger, got other nurse to make sure it looked good, and then gave it a go. It hurt, and she didn’t get it in. Now I have a sore wrist that didn’t even take the IV. The other nurse came over, and ended up having to do it up by the inside of my elbow (which was already pretty bruised from my multiple blood draws). But she did an amazing job, I felt the poke from the needle and then she was messing around over there (I can’t watch). I asked if it was in, and she laughed and said it was in right after the needle poke, she is an IV master. It was still gross to me, but not as bad as I thought.

After the IV was in, I was started on a saline drip, with antibiotics. They made me empty my bladder, so I had to take my buddy, the IV pole with me. I pretty much didn’t want to move my arm with the IV so peeing was a bit tricky. Good thing I wasn’t wearing any underwear! They moved me into another room with a bed with stirrups as well as the ultrasound monitor, and a TV that was hooked up to the microscope in the embryology lab they’d be using to find my eggs. I got settled in the bed, and J sat up by my head. There was a window in the room that led to the embryology lab where they would pass the contents of my follicles to the embryologist.

We waited in that room for a while, as the nurse prepared everything. I turned to J and expressed just how surreal it all felt, the fact that we were actually doing this, the fact that we made it to retrieval, and that this may be our ticket to baby. (Please let that be the case!). He got a bit emotional, from all we’ve been through, and for what I’ve had to endure these past couple of weeks. He too, hoping this was it for us. After I was hooked up with my heart monitors, the nurse told me she was going to push my pain and sedative meds. I felt it pretty quickly after that, sort of tired, and really relaxed. My doctor came in, and put me up in the stirrups. No modesty this time, in the ultrasounds usually I can somewhat tent the sheet up on my knees, this time it was pulled right up. My doctor commented on the sparrow that I have tattooed on my lower right side abdomen, just under my hip area. Most people don’t usually get to see the whole thing as it is in a pretty private area…

I don’t remember a lot of what happened, I was watching my follicles empty, thinking of the sweet relief that would be provided. They showed us the first egg under the microscope, but I don’t really remember. I was trying to watch the ultrasound and the TV at the same time. From what I remember of the TV with the microscope findings, was it looked like there was lots of debris in my follicular fluid. I didn’t even look down to see what they were doing but J was, and he was telling me about the huge needle that went in with the vag cam. I’m glad I didn’t see that. I had some pain and discomfort, I said ouch a couple of times and I think they increased my meds a bit. Overall, it was done really quickly.

After it was finished, they put me in a wheelchair, and took me back to the room I started in. They put me back in my chair, tilted it back, put my feet up, and let me rest. J went to give his sample, and while I sort of dozed off the embryologist came by, he said “knock knock” into the curtain that separated me from the others in the recovery/waiting room. I opened my eyes, and he gave me a smile and told me we got a baker’s dozen. I thanked him, and dozed off a bit again until J came back. When he was back the nurse brought me some juice, cheese and crackers. I had some of that, and didn’t feel any nausea (yay!) so they told me if I could go pee, then I would be good to go. After a bit of a wait, and a little bit of pain I managed to empty what little was in my bladder. The nurse checked on how I was feeling, and when I told her I was doing good they said I could leave.

We went to change back into our clothes, and headed out to the car. The nurse said she would be calling tomorrow to see how I felt, and the embryologist would let us know how many fertilized. I think they said they would call again on day 3 with an update, and then again on day 6 to let us know how many make it to freeze. Our next hurdle, out of our hands, and into those of the embryologist, my eggs, and his sperm. Go team!

For now I am just resting and recuperating. I am pretty sore and crampy, with a bit of spotting, my heating pad is my best friend right now. Luckily I didn’t have any nausea or ill effects from the sedatives (besides being tired, and sleeping a lot today). I will await the next bit of information, and hope we have success with our eggs, and get some good quality embies for our frozen transfer! Thank you to everyone for their well wishes, I’ve taken comfort in the kind words and knowing the experiences of those that have gone before me.

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Light at the End of the Tunnel

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Today I think I finally turned a corner. I can see the finish line on the horizon and it has vastly improved my mood, and physical well-being. Yesterday at my monitoring appointment the doctor mentioned that she thought I was almost ready for retrieval, that she was thinking Thursday as a matter of fact (two days earlier than my tentative schedule). They booked me to come in this morning, just to check again, make sure everything looked on track, and schedule my retrieval.

I still have some rather massive follicles hanging out, a 31mm on the right, and a 26mm on the left. There are also several “normal” sized ones around 20mm or so, as well as 3 smaller ones at 15mm, 13mm, and 12mm. In total she counted lucky number 13 today, though I suppose there could be more that are hidden under the giants. All in all, majority of them are large enough for me to trigger. I am slightly disappointed in the number, as I had excpected to be a bit higher, especially since some of these follicles may hold over matured eggs. In my mind, I am figuring there may be 10 “good” ones, so say half of those fertilize properly (we are doing ICSI, so maybe that will up our chances), and then half of the fertilized ones make it to freeze. That’s only 2 or 3 embryos. And then how many will survive the thaw for an FET? What do we do if we use them up and no pregnancy occurs? That’s only my conservative speculations, and pessimistic views, but it makes me nervous.

I am still feeling pretty gross, a lot of fullness and discomfort in my abdomen, but I don’t feel nauseous which is a big win. I think a lot of physiological symptoms I’ve had lately related directly back to the anxiety I’ve been feeling over the course of my cycle. Each step it seemed like another hurdle appeared, and I began having anticipatory anxiety. Each day before my monitoring appointment I would have nausea and stomach upset (I was worried about being constipated from the meds, but it ended up being the opposite problem). Pepto-bismol , and ginger tabs became my breakfast. Eating became difficult (also due to the fullness I’m feeling, my stomach doesn’t have as much room).

Now that I know we will make it to retrieval (which was looking murky at times) I am feeling much more confident in this cycle. My retrieval was confirmed for Thursday, so I will be triggering tonight. Unfortunately, I was informed that it will be a freeze-all cycle, as my estrogen is through the roof. I was intending to ask the doctor about my estrogen levels today, as I was concerned about it being high and cause for concern of OHSS. From what I had read anything over 4000IU – 5000IU was symptomatic of OHSS. The first thing the doctor said to me when she came in the room was, “Did they tell you your estrogen levels?!”. Mine was at 20,000IU. When the doctor first told me this, I thought she had misspoke, and I repeated the number, dumbfounded. It’s a miracle I don’t feel absolutely awful from those kind of levels. Other than my anxiety induced symptoms, plus the distended belly, I have been pretty symptom free. Now that I am out of the throes of despair about the mishaps in my cycle, I can appreciate that my side effects have been pretty minimal.

Disappointing to know we will have to freeze-all and wait to transfer, but the clinic staff and doctors kept speaking to me as though this was the likelihood, over being able to do a fresh transfer, so I was mentally prepared. Some clinics have even quit doing fresh transfers all together, and my clinic is considering this approach as well. I think it will be good to have time to recuperate, physically and mentally, before embarking on the actual reason for all of this madness. I don’t know all of the details of how a frozen transfer works, but the IVF nurse told me that it is a two-cycle process. Obviously my next period that comes after the retrieval is going to be a bit wonky, so that doesn’t count to start my FET cycle. The nurse advised me that I should get my period 5 – 12 days after retrieval, and I am hoping for the shorter side of things. After that, my next cycle should start early to mid September, and at that point I am to call and advise them on CD1. Since it is to take two cycles, my second cycle for the FET cycle would start early to mid October. I am going away on a work trip for a week mid September, and then out-of-town again for a friends’ wedding at the end of October. Each trip could possibly pose a problem, again, all depending on how long it takes for AF to show up after the retrieval. There goes my mind, spinning months ahead again.

The trigger I am using tonight is not hCG, as when dealing with elevated estrogen level, an hCG trigger can exacerbate someone already at risk for OHSS. They are having me use decapeptyl as a trigger, so not to worsen my already elevated chance at OHSS. My doctor has recently started using it in place of lupron, as he finds lupron to be expensive, and he likes the results of the decapeptyl. It needs to be refrigerated, so it is currently hanging out amongst the lunches in my work lunch room fridge. I will be triggering with two syringes of decapeptyl, at 8:30pm tonight. I get a much wanted reprieve from any needles to the gut tomorrow and the Thursday is the big day! I am more excited than nervous right now, but ask me again tomorrow night. I’m sure I will be stressing. But for now, I can see the light at the end of the tunnel.

 

Head Case

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I had been freaking out since Thursday when I was supposed to take my orgalutran in the afternoon because my LH had started surging already and they wanted me to suppress it ASAP. Well I was at work, didn’t get the message until later, and didn’t have the orgalutran with me anyways. I took it as soon as I got home, hoping that was enough to prevent me from ovulating early. I had literally been worrying myself sick, my stomach had been churning and upset for the better part of two days (although part of that could be from the meds).

I called the nurses line Thursday evening to leave a message regarding the fact that I was not able to take my meds when they called and told me to do it sooner, hoping that it would be ok. The nurse called me back Friday morning and basically gave me shit for not being more on top of my phone when they called. It was sitting on my desk the entire time, but I didn’t notice the missed calls or the voicemail until the phone lines had closed…at 3:30 pm. I told her as much, and she said well I need to make sure I get their calls as things can change once they get my bloodwork, and it is very important. No shit, I’m not purposely trying to mess things up, life happens, even when IVF is my first priority. I also did not have my meds with me, I was at work, and they were at home, so I don’t know what could have been done even if I had gotten their message. Everything they gave me indicated I was to take the orgalutran in the evening with the menopur and after the fact I was told that it is extremely rare that they see an LH surge before the orgalutran is started, so they didn’t see it coming either. I would have appreciated not being treated like a child, and rather a patient who is complying to the best of my ability, and paying a lot of g-d damn money for this B.S. (I’m starting to get bitter about this whole IVF process, can you tell?…)

So in any case, I had been stressing, googling, and hand wringing waiting for my follow up appointment. I was feeling pretty intense pressure in the right side of my lower abdomen Friday, so I was pretty sure big righty (my 18mm follicle, as of Thursday) was still there, and hadn’t ruptured. This gave me some comfort, but not enough to slake my worries. It seems after each appointment so far there has been some catastrophe that has threatened to derail this cycle, and I’m getting really tired of it. I didn’t expect quite this much stress between appointments, I thought it would be at it’s worst leading up to retrieval and then waiting for the fertilization report. Apparently things can’t be that easy.

Saturday morning I had to go back for another monitoring appointment, and J came with me this time, to see the ultrasound, and for moral support as I was somewhat expecting bad news. Normally my blood work, and my ultrasound are both done at the clinic, but it seems on Saturdays they do not have a phlebotomist on staff. Therefore I had to go to the main hospital building for my blood draw, before my ultrasound. The blood collection lab in the hospital does not open until 9am, but I was advised that people will get there early, so they can get in first. Duly noted, and lesson learned from the ultrasound numbers game, I decided I should show up at 8am. This was a good call as there were already a few people waiting, and some that had submitted their requisition and gone to wait elsewhere (as I found out when there were more people ahead of me than I had even anticipated). I am normally supposed to start work at 9am, but I told them I had a doctors appointment, and no one asked any questions this time.

After my blood work was completed, we had to wind our way back through the hospital to the seperate wing where the clinic is located. Once at the clinic, we checked in (no numbers or waiting for them to open this time). There was one couple who arrived before us for blood work, that was now sitting in the lobby of the clinic. There were a few other couples, presumably for IUI’s or their related monitoring. As we waited, the lobby began to fill with the other couples that had been at the lab and had now made there way over to the clinic. I was extremely glad we got to the hospital as early as we did. Overall we waited maybe 20 minutes before going back for the ultra sound.

While we were waiting for the doctor in the ultra sound room I was telling J what we would see on the ultrasound, and he was getting confused in the terminology, follicle, egg, embryo; he’s still trying to wrap his head around it all. I get it, it’s not his body or his process and it is hard for him to follow, or understand. Yet another case and point as to why I don’t tell people what I am doing. I was telling him that I can feel the follicles in my abdomen, like the pressue of leaning against the counter while doing the dishes…with a full bladder. I managed to give myself a massive bruise, and lump on my right side Friday night as I managed to nick a blood vessel whilst injecting my ganirelix. I am beginning to hate that stuff, the needle is dull so I have to jam it in, then it leaves a red welt (or in this case an ugly painful bruise). J was feeling pretty sorry for me as I have been feeling pretty disgusting. He said he wishes I didn’t have to go through it all, or that they could at least give me oral tablets or something. Sweet notions, but just not the way it works.

It wasn’t my normal doctor that did my ultrasound, which made me a bit leery, as I had never met this doctor before, but she was fantastic. I told her I was worried because of my LH surge, and not taking my meds right away to prevent ovulation. She said it should be fine, as spontaneous ovulation during IVF was exceedingly rare. I asked her what level my LH was the day the clinic called in a panic to have my start my ganirelix, and she told me I was only at 11 IU/L when they did my bloodwork Thursday morning (around 30 IU/L would be peak). I was thankful that she gave me a number, as that helped ease my mind somewhat, although I wasn’t able to take the ganirelix until 12 hours after that level was recorded so who knows what it was by that time.

She inserted the dildo came, and checked my lining (7.6 mm triple strip, woot woot!) and then moved to the right to start measuring. And there they were, my follicles still all hanging about. Now, I suppose this doesn’t absolutely ensure that I hadn’t ovulated…? I think it is possible that a/some follicles could have ruptured, releasing an egg, but because I am still on a FSH it could be artificially keeping the remaining follicles intact and growing. When the doctor gave me my requisition for Monday’s blood work she selected to check my progesterone as well because if that has risen, then it means I did ovulate. Although, since there are follicles still it may not mean a cancelled cycle, per se. But back to my follicles, that fat follie on my right side has grown from 18mm on Thursday to 25mm as of Saturday morning! Holy hell, no wonder I am so uncomfortable on that side, that is literally the size of a small grape. And that’s not the only one hanging around over there. There’s another bigger one at 19mm, two at 15mm, a 14mm, 13mm and 12mm. On the left side things are a little quieter. There is one leading the pack at 17mm, a 13mm, 12mm, 10mm,  two 9mm and one 8mm. It was so nice of the doctor to write them down for me, she was very informative which was really great.

I told her everything with this cycle has been a bit of a schmozzle. She told me it’s usually the cycles that appear to go perfectly that don’t always end in success. She seemed to think I don’t have anything to worry about, lots of follicles, everything is coming along as it should. I am past believing that everything will go smoothly from this point, but it did give me some relief. I am still a bit nervous to hear my progesterone level on Monday, but I have a bit more faith that all will be well. I thought I had my head wrapped around this process but it is such a steep learning curve, one that I hope I don’t have to repeat.

Looking at how this cycle started I’m not entirely surprised at where it has ended up. My estrogen was high because of the birth control, I started stimming late because of the high estrogen. I’m assuming big righty started developing naturally since I didn’t start stims until CD6 instead of CD3. My first monitoring ultra sound and blood work wasn’t until CD10, so of course I was close to an LH surge with an already large follicle and no ovulation supression meds yet. Looking back I can see it, and it makes sense but I can never predict what’s around the next corner and I hate it. All of this has turned me into even more of a head case than I already am.

Do Not Go Gentle into that Good Night

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I had my first monitoring appointment today, exactly a week after my cycle almost fell apart. Monitoring is normally more frequent by now but because of the confusion with the birth control and my estrogen level, my schedule got bumped by 3 days. To be honest, this is sort of ok with me, as it would put my retrieval over the August long weekend, so I don’t have to miss work, and I have more time to recover (if needed).

I was really nervous going into todays appointment, just because of the almost cancellation of the cycle, and then starting my meds 3 days later. Nothing really got off onto the right foot. I was scared that the cycle might possibly get cancelled because of the problems and delays. Yet again, I had a very early morning, and I wasn’t even first in line this time. Luckily I had to work late tonight so I was able to go into work around noon, well after my appointment finished and I had time to go to the pharmacy, and then home for a bit. I had J come with me because there was a bunch of consent forms that needed to be witnessed, so it was just easier to get the nurses to do it and keep our privacy.

I hate getting there early because then I just have to sit and wait, and stew in my nervousness. It was almost better that J was there, I at least had him to chat with. We went back fairly quickly, even though I was third instead of first this time. I had to wait a bit for my ultrasound as my doctor tends to get backed up on Thursdays as he has “learners” with him in the morning. I could hear him in the next ultrasound room once he finally got going, and he whips in and out of those ultrasounds pretty quick.

I do love my doctor though, he has very good bedside manner, and even though he is in a rush he takes time to be chatty and he loves to joke around about giving me stretch marks. He’s always very lighthearted and I know he tries to make his patients feel comfortable, which I appreciate. He checked my lining and said it looked very good, at 7mm. Then he started listing the follicle sizes out to the nurse to be recorded. The first one on the right side was 18mm! I was surprised there was one that was that big already, but not entirely shocked as I’ve been having some pretty strong, uncomfortable pressure on that side. He counted off the rest of them, on the right I think there were another 4 or 5 that were in the 11mm – 13mm range. The left side only had about 4 I think, again around the same size. I was sort of disappointed that there weren’t more of them, and I expressed this to Dr. M. He told me not to worry, that there would be more soon. He said he doesn’t like the look of the 18mm, it’s too big already so that one might be a bust.

So after that I was feeling pretty good, relieved that everything was on track (besides the 18mm keener). I was told to start my orgalutran (ovulation inhibitor) tonight, and to come back on Saturday for my next monitoring. The nurse who told me to start orgalutran, said come back in two days and that was it. I double checked with the other nurse as I was leaving if there was anything else I needed to do today. She said no, but she did helpfully inform me that apparently the clinic doesn’t do blood work on Saturdays so I have to go to a different part of the hospital, and then back over to the clinic. And the lab for my blood work doesn’t open until 9am. Normally this would be a nice reprieve from the early mornings, but I am supposed to be at work for 9am on Saturday…so I am definitely going to miss a few hours. I am not sure how long the waits are on Saturdays and what the protocol at the clinic is, so that’s another fun unknown.

So, slightly stressed about that, and had to tell my boss that I was going to be at another appointment on Saturday, plus I mentioned to her that I may have others in the coming week. She doesn’t ask me why, which I appreciate and think she knows I don’t want to talk about it. Besides protecting my privacy, and not putting any of my career aspirations in jeopardy, I realized I just don’t want anyone knowing about IVF because I don’t want to have other people waiting with bated breath to hear the results.

I had my cell phone on my desk at work today (like most days), I can’t generally answer it, but I can at least see if I get a message, or a missed call and then go attend to it away from my desk. Today, I did not notice the two missed phone calls until a bit before 5 pm. I checked my messages, both from one of the nurses at the clinic, urging me to take my orgalutran at 1pm as per my doctors orders (the first message from 12:40pm) and the second message reiterating for me to take it as soon as possible if I hadn’t already (this message from around 2pm) and my menopur was fine to take at the same time I normally do in the evening. The phone lines are only open until 3:30pm. I took my meds home after my appointment and had to stay late at work, until around 8pm when I normally take my menopur. So cue freak out (internally, as I was still at work). I am thinking Dr. M wanted to make sure that fat fucker, 18, didn’t rupture early and screw everything up. Something with my blood work must have come back high, to have them call me twice, and with such urgency.

There was nothing I could do. As soon as I got home, around 8:45pm, I did the orgalutran shot. The pharmacist said it might sting a bit, or cause some nausea, as well as redness and swelling around the injection site. Oh great, I thought, because the menopur wasn’t enough. Firstly the syringe is pre-filled, which is handy, secondly, the needles are dull as fuck. They are about the same size and diameter of the menopur needle but with menopur it slides into my skin with ease, like a knife through butter. I pushed the orgalutran needle to my belly, and nothing, it barely dented the skin. So going at it the second time I had to give it a bit more force. Thankfully it went in, and the injection did not sting whatsoever. I then iced my belly for a bit to prep for menopur. Now, backing up a bit the pharmacist did tell me to do menopur, and then orgalutran, but because the clinic seemed to adamant about the orgalutran earlier in the day (and therefore first) I reversed the order and did them about 20 minutes apart.

My belly did get red around the orgalutran shot, and when I went to do the menopur shot, I tried doing it on the same side as the orgalutran. I picked a spot a fair distance away from the orgalutran site, and away from the redness. I barely pierced the skin, and immediately pulled it back out. Oh the pain! Apparently orgalutran and menopur do not play nice together. Take two, I did the menopur on the opposite side, with no major issue (besides the normal burning).

I have been cycling paranoid nightmares through my head that I’ve ovulated or will, that it’s too late. I’ll have to wait until Saturday to find out if I’m safe or not. I called the clinic and left them a message telling them the situation, so I’ll hear back tomorrow morning as to what, if anything, I should do, beside continuing on with my meds. It may just be my imagination, but I feel like I am having less pressure on my right side, where the biggin’ is/was. I may just be projecting my delusions onto my ovaries, but so far I have been very in tune with my body and able to feel what’s been happening. So now I have a really bad feeling.

In my naiveté I thought our IVF cycle would go smoothly. Then after our first hiccup, I was nervous. But everything looked good today, I though we were back on track, and I let myself get hopeful again. I didn’t think I had any naiveté left, after everything that infertility has taken from me. Fool me once, shame on you, fool me twice, shame on me. Please hold on little (big) follicle. I need you to hang on.

Rumblings

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Well, I am officially stimming. I am on day 3 of my meds, and so far the only one I am on is Menopur. I go back to the clinic on Thursday for my next blood work and ultrasound check and I am really hoping everything looks good. I keep obsessing over the fact that when my cycle almost got cancelled, the nurse called me and told me to stop birth control (the birth control that she initially didn’t even know I was on, yet was prescribed to me by the clinic at my request) and told me I could start stims on Jul. 20. I just stammered some sort of confirmation and hung up the phone, not mentioning the fact that I had already stopped birth control 4 days prior…because birth control ends on a Sunday, and I was speaking to her on Thursday. So I am really hoping that doesn’t bugger things up, but I am thinking (hoping) that it should be fine because they had my estrogen level, and saw my ovaries and lining, and apparently it all looked good (after they found out I was on birth control). Based on that, I hope all will be well.

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My meds for 4 days. Yup, just 4 days, $1350…

So, my first injection actually went very smoothly. It was a bit of a slow process because I am on 375 IU of menopur (does that seem high to anyone?), so it take 5 vials of powder and lots of mixing. I have a little cardboard mat that came with my menopur that has a spot for each thing I will need so I can lay it out, and not forget anything. I try to be very methodical about it because I really don’t want to fuck it up. I thought the needle would be awful, and that I would have a hard time sticking myself, but it has really been a very surreal out of body experience. I didn’t hesitate for very long at all before doing the first one. The needle is quite small, so that helps. It really doesn’t hurt going in, it’s the menopur that sucks. It stings quite a bit going in. I do it slowly because I am scared it might hurt more if I do it too quickly. It grosses me out that I can feel it going in.

Meds for dummies mat. Actually quite helpful.

Meds for dummies mat. Actually quite helpful.

My bio hazard waste bag, and the little not-so-scary needle.

My bio hazard waste bag, and the little not-so-scary needle.

Now that I am three days in, I am feeling…something. Today at work I had some sort of pressure, and rumblings in my lower abdomen. It’s a weird feeling that I haven’t had before, and can’t really describe. I did my third shot tonight and I was feeling pretty uncomfortable afterwards. Nothing awful, or intolerable but not particularly nice. I was laying on my side and I had to roll onto my back because it was causing awkward pressure. I am sort of surprised to feel something already, but I know it’s not just in my head because I already have an abundance of EWCM, which I have heard comes from the extra estrogen in your body.

The stinging from the menopur subsides fairly quickly, but then the site of the shot is tender the following day. It could also be my technique that’s causing the tenderness, who knows. I’m doing the best that I can. I decided to ice my belly before and after the shot tonight, see if that makes any difference. I think I am also going to buy a heating pad for when I start to get even more pressure, and bloating. I’m nervous that if things are already rumbling that it’s going to be really not fun by the end, but only time will tell. I suppose if things are moving along too quickly they will change my dosages.

My day one injection site, so far the one that is still the most obvious. Practice makes perfect?

My day one injection site, so far the one that is still the most obvious. Practice makes perfect?

In other news my sister in law is in town for the next few days. Apparently she had plans to be here all along, yet just message myself and J tonight to see if we could watch her younger daughter tomorrow evening. Terrible timing. She is just under 1 year old, and I’m sure I would have no problem watching her but I don’t want to. As terrible as that sounds, I don’t need to deal with someone else’s child while shooting myself up to try and have one of my own. Plus the timing would have been such that J wouldn’t be home so I would have to manage our two dogs (one of which doesn’t like children, I know something to address at a later time), a baby in a non baby friendly house, and at some point in there also giving myself my shot.

Not only is her timing terrible (not that she’s aware of that) but she asked us last minute, when we both work, and have lives that don’t revolve around children. I don’t have to work tomorrow, which would have been fortunate for her, otherwise it would have been a definite no. I told her I would try and make it work, if her other possibility fell through. I felt bad saying (almost) no, but seriously, even if we weren’t in the middle of IVF this would have been inconsiderate. She lamented to us that all of her friends who had previously offered to babysit declined because “when push comes to shove, a baby cramps their style”. Direct quote. She can be a lovely person, but sometimes, just…headsmack.

So all in all, I am surviving injections. Conveniently, I have to work late on Thursday so I have the morning off, and can go to my next monitoring appointment without rousing too much suspicion at work. Here’s hoping everything goes off with out a hitch. We are still trying to buy a new condo, the offer has been presented, just waiting to hear back. Also waiting to hear back from a tropical paradise to see if they would like to sponsor my hubby to come join their island workforce (which would cause us to back out on the condo offer). Still a lot going on, but overall I am feeling pretty zen. I have moments of anxiety when I think ahead to the “what ifs”. So I try not to do that. I have enough things pulling me in different directions that they all distract from each other, but IVF is numero uno, so if everything else falls through, I have some perspective. Things could be worse (and they may be). But we’ll save that all for another day.

 

Universally Speaking

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Lately I’ve been thinking a lot about the perceived importance that society places on having children. I know it’s a topic I want to delve into, but I don’t even know where to begin, it’s such a divisive and complicated subject. Plus other people have already put their two cents on it out there, and, quite frankly, they’ve probably said it better than I ever could (The Fertility Privilege). But yet again, the universe bumped me on my ass, and I find myself reeling from the value that is placed on those who can, and do procreate, seemingly with ease.

I was helping a client yesterday, and he was being rather chatty, but in an annoying way. Now, I’m going to be judgey mc-judgerson for a minute here and tell you about this guy. The best way I can describe him is, a doofus. He was rather self absorbed, and kept calling me “dear”, even though he was very close in age to me. He was one of those types that is very loud and boisterous, has his opinions, and doesn’t stop to consider any one else’s.

He was already irritating to me right from the get go, but then he started in about his son, he was telling me what an advanced, amazing four year old he is. It was at this point that he asked me if I had any kids. I gave whatever rote, mechanical answer I usually give, “no not yet”, or something to that effect. I think he asked me if I was planning on having kids, and I told him “eventually”, which he seemed relieved by, as if my not wanting kids would have been some cardinal sin (which we all know some people truly think it would be). He told me what a wonder his child was, how it was the best thing that ever happened to him, that having a child is the most important thing, and on and on. Basically saying that life is nothing without a child. I don’t know why he felt the need to prattle on about it. It was like he was trying to convince me on why I should have a child.

Then the same day one of my old corkers came in, and I was booking something for her, and she was chatting a bit with me. I haven’t seen her in probably over a year, and she worked in a different department than me so I never really got to know her very well. At some point in the conversation she said to me, “so any good news lately?”. I just told her, “oh you know it’s been same old same old”, as I realized what she was really asking me. She then outright asked if I had any kids. I said, “no”, to which she asked, “oh you never really wanted kids did you?”. I almost want to just start telling people that no, I don’t want kids. I corrected her and told her, we do, just not yet. Usually my standard response is “eventually”. Seems to buy me some time, but even that may run out soon.

I was off work Thursday, due to the fiasco that was my IVF baseline day. I was initially supposed to only be gone for the morning, but with the cancellation/uncancellation of my cycle I called in and told them I wouldn’t be in the rest of the day. I was only able to give my boss two days notice of this appointment, as I had to wait for CD1, so I told her I had a doctors appointment that I had been waiting for, and was told I shouldn’t expect to be back at work until after lunch. I also mentioned to her that I may have more appointments coming up in the next couple of weeks but would try and keep them before work (which is true). Then when I called at noon and told our receptionist I wouldn’t be back in the rest of the day apparently I raised some concern, as well as curiosity. My boss text me later that evening to tell me she hoped I was ok, and that she was worried about me. I told her I was having some medical issues, but nothing life threatening. That seemed to be enough of an explanation for her, but some of my other coworkers did as me if I was ok, or if everything was ok.

I appreciate the concern, but some of it is just innate curiosity, and my office likes to gossip. I really wanted to keep all of this completely separate from work, but obviously that would be next to impossible. I’m a private person, I don’t want to share my personal business, especially since I work with gossipy middle aged woman who already have children and will never understand what I’m going through anyways.

No matter where you are, it seems priority is given to those with children, having a family is seen as growth and maturity (although this couldn’t be further from the truth in some cases). People proudly display their families with stickers on the back of their vehicles (my brother and sister in law, and half the rest of the world). I don’t care that Timmy likes soccer, and Janie likes dancing, or that you have a dog, a cat, a fish and a horse. I’m a part of society too, I have skills to offer, and I matter. I am hoping that I’m close to adding to my family and I don’t want that to  change my perspective. I try not to think of having a baby as completing our family, because just the two of us and our dogs, we are complete. We would just be getting a much wanted addition. And I promise I won’t think I am a better person because of it.

Tripping at the Starting Line

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What a day. I have run the gambit of every emotion today. I had this lovely post all planned in my head as I was headed home from my morning of IVF training, starting to feel excited, ready to get going. And then all hell broke loose.

I had to get up really early this morning (5:30 am, that is early to me, ok?!) because my clinic operates a first come first serve system for monitoring ultrasounds and blood work. They start at 7:45 am, but you get there early, take a number and they go in that order. Generally people start showing up around 7 am. So because I knew I had a lot to get through and still had to go back to work after I wanted to be there early. 7 am, and I was first, success, feeling good!

Once I took my number, I had a seat in the lobby as others coming in for monitoring started to trickle in. There were all different women, of different ages, ethnicities, some with husbands, some without. There was one woman I noticed who came in looking very polished and well dressed. I assumed, like me, that she had to return to work later. She was working on her laptop in the lobby, with her metal thermos mug by her side. I’m always curious about other people’s’ experiences, and how they got to this point, as I often wonder about myself.

Killing time waiting, I checked my Facebook. One of my Facebook “friends” (acquaintance is a better word) posted a 16 week baby bump photo with an avocado (because that’s the size of the baby right now). She’s not in a relationship, hasn’t been for some time. In fact she just got back from galavanting across Asia, and then Brazil (but so far by counting back she got pregnant before she left). There has been no mention of a pregnancy up until today, a few people who commented seemed to know about it already (including her best friend and mother), but everyone else was stunned. She legitimately looks like she has a bit of a bump, and it doesn’t seem to be a joke. Which is infuriating to me. I guess because it is so out of the blue, clearly an accident, and no mention of who the father even is just burns me. So that was not the best way to start my morning.

The clinic officially opened at 7:45 am, I was promptly called in, first for blood work. The nurse put the tourniquet around my arm and started feeling for a vein. She remarked how small and spidery my veins were, which was news to me. I have never heard that before, and no one has ever had an issue taking my blood. She tried the other arm, and same problem. I told her I don’t usually have issues, and she asked me if I’d had any liquids yet this morning; ah, no, no I had not. She told me that being dehydrated makes veins harder to find. Duly noted, I will be chugging a gallon of water before my next blood draw.

So after my blood draw, she walked me around the corner to get changed for my ultrasound. I went from the change room to the ultrasound room in my make shift toga sheet skirt and sat on the bed to wait for my Dr. He’s not the most prompt person, but then again what Dr. is. He is also the only IVF Dr. in the clinic so he has a lot going on. He came into the clinic while I was still waiting to be called back, and he had a troupe of residents with him. I secretly hoped that none of them would be witness to my visit with the dildo cam. I do not require an audience for that, thank you very much.

After he checked my lining and ovaries (all looked well) I went over to speak with the IVF nurse. She gave me my schedule, for my meds, as well as next ultrasound and blood work. She went through some legal paperwork, asked me a bunch of medical history questions. She told me that if I didn’t hear from her by 2 pm today then that meant that everything was a go, and I could start my meds tonight. I asked her what would cause it not to move forward, and she told me hormone levels that were either too high, or too low, neither of which I have had a problem with.

Next came the meeting with the embryologist, who went through the process from the time the eggs are collected, to ICSI, embryo growth and then transferring back. He gave me my success rates based on last years numbers in my age category (60%), and talked a bit about fresh vs. frozen, where the success rates are nearly identical. He mentioned that in younger patients more often than not, they are overstimulated (in the sense that their estradiol levels are above what they like to see to do a fresh transfer, not necessarily serious OHSS). He also told me I can transfer up to two embryos, but I could tell he was suggesting only one. That is my preference too, as I really do not want twins, nor all the complications that can come along with multiples. I don’t even know that we want more than one child, so two in one shot, no thank you. Anyways, I digress.

After the embryologist, I had to go back to reception to drop some major money. I had already paid a $200 deposit up to this point, and now I owed the additional $7500 that is the cost for the whole IVF process including ICSI and frozen storage (if there is nothing to freeze they refund that portion). And I’m sure that’s not even that bad compared to what some of you ladies have forked out, but it still stung. All I can say, is at least my credit card earns me points. The IVF coordinator went through the charges, and advised what portions would be refunded in case of cycle cancellation, depending on what stage of the cycle the cancellation occurred, and I signed off on it all. Done with the clinic for now, I headed out for the pharmacy about 10 minutes away, that fills all the fertility meds, and does the injection teachings.

Shortly after I entered the pharmacy, and gave them all of my info, the same polished woman from the clinic waiting room came in to collect her next 5 days worth of dosages. I’m not sure if she was doing IUI with injectables or IVF. She was on different meds than me, but who knows. I desperately wanted to make contact with her, and give her the sisterly solidarity look but she was pretty closed off, and focused on getting in, and getting out. They put through the first 4 days of my Menopur, and also gave me a prescription prenatal. The prenatal has 5mg of folic acid instead of 1mg, and is split into two pills for better absorption, plus is a prescription, so it’s coverage under my drug plan. Free prenatals, yes please! I’ve been paying for those suckers for over 2 years now! I gave her my drug coverage card, and J’s as well pleading in my head for the coverage to work. I don’t have any fertility related coverage, but I have up to a $5000 lifetime maximum through J’s employer. She brought the receipt up to the front, $10.30 was all I owed for over $1300 worth of medication. I almost cried out of happiness. That $5000 is going to disappear really quickly but I am so grateful to at least have that coverage. If we didn’t we would make it work, but it helps.

The pharmacist went through the protocol of how to inject my menopur, it seems pretty simple, and the needle is really small. I am lucky, I thought I would be on more meds, but it’s only menopur for the first 5 or so days, and then I add Orgalutran, and then the hCG trigger, and off we go. Then the progesterone, if we do the fresh transfer. Not so bad, less scary than I thought. But we’ll see how it goes after the first injection.

I headed home to drop off my meds. It was only about 10:30 and I told work I’d be in after lunch so I figured I’d go home, relax for a bit and then head in later. I had a quick nap, ate some lunch and just as I was getting ready to go into work I noticed my phone had lit up. I just missed a call from the clinic, and it went to voicemail. I looked at the time, it was only ten past twelve. My mind immediately starting whirring, this couldn’t be good, she said they wouldn’t call if it was all a go. I waited for the voicemail light to pop up, and hit listen as soon as it did. The nurse left me a message letting me know that unfortunately my estrogen level was too high, and they had to cancel my cycle, call back on my next CD1.

I couldn’t believe it, didn’t understand, this had never been an issue on any of my other CD3 blood work. I wandered around my house with my palm to my forehead in disbelief. I tried to calculate my next move…work, I was supposed to go to work. I didn’t think that was the best idea, so I called and told them I wasn’t going to make it in at all. After that, I tried to get a hold of J, but couldn’t reach him at work or on his cell. At that point, I was lost, overwhelmed. I threw my phone to the ground, and just wailed. I cannot tell you the last time I cried so hard, it’s literally been years. The tears of this whole process, all of it, from the first month we tried, until now came flooding forward. I scared my dog, and he went and hid, poor guy.

I calmed myself down somewhat, and J called. You know when you talk to “your person” and as soon as you do, you can’t keep it together anymore? Yeah, that happened. So I am on the phone with him, sobbing, and he doesn’t know what to do or say, he doesn’t really understand all the different hormones and what they do or how they work. He was asking me why my estrogen was so high, and why didn’t they know from previous blood work. Valid points. I called the clinic, and she didn’t have a good answer for me. She told me that they like to see it under 200 (mg?) and mine was 415. She said on my last CD3 it was 245, which would have been acceptable. I told her I was on BCP, and asked if that would have made any difference. She said she wasn’t sure and asked me if I needed to take it to regulate my cycles. I told her no, I just was taking a “break” from trying to conceive for a while (I’m well aware I didn’t need to be on BCP for that, but it’s what I wanted). So in any case, she tells me not to take them anymore, and we can check my levels again next cycle.

So that’s it, my mind starts reeling, when can we cycle next, will I be away on my work trip, how much fucking further is this going to push our timeline? It might not be until the end of the year if we have to do a frozen transfer. In the middle of losing my mind, my phone rings. It’s the clinic again. The nurse says that yes, it was because of the BCP that my estrogen was high. She said to me that “I went behind their backs and took birth control…ha ha, I’m only kidding!”. I then informed her that it was in fact my IVF Dr. that prescribed them to me back in April, and he told me it would make my cycle easier to manipulate. “Oh”, was the only response I got. “Well you can start your meds on Jul. 20.” I’m sorry what? She said that my Dr. told her the clinic used to use BCP with the cycles, so it was fine for me to start stimming on Jul. 20, and we would carry on from there.

At this point my head was about ready to explode, from nervous excitement, to crushing disappointment to cautious hope. So apparently we are a go. I am starting my stimming meds 3 days later than initially planned, but whatever. I just hope this doesn’t cause problems with the rest of my cycle because the asshats at the clinic can’t keep track of what meds they’ve given me.

So since I had the rest of the day off, I’ve spent it watching Sex and the City reruns, and wouldn’t you know the first episode that was on was the one where Miranda finds out she’s accidentally pregnant and Charlotte finds out she only has a 15% chance of having a baby. Well played universe, salt in the wound.

If you’ve held on to the end, gold star to you, stay tuned for updates.

*Oh, also, thank you for the concern for my hubby, his lump evidently is a blood bruise. He got hit playing lacrosse and apparently the blood just hasn’t reabsorbed. At least that’s one potential crisis averted.