Wisdom from the Stirrups

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My RE is notoriously good natured, always jovial and joking. He always makes me feel comfortable even if some of his comments are a little off the cuff. I’m always happy to be dealing directly with Dr. M rather than one of his colleagues, or through one of his nurses. So when I found out he was doing my cyst aspiration I knew I was in good hands.

Having been in the procedure room previously for my egg retrieval, it felt familiar yet slightly frightening. It is a sterile room, so I had to be gowned up, booties on my feet and hair under a mesh cap, serious business. The last time I was in that room I was on some pretty heavy drugs so my memory is a little fuzzy. This time I felt very exposed, as it is just a bed in the middle of the room with a light directed on me. Normally when I am in for monitoring I can keep a sheet draped over my knees but more full access was required so I was laid bare and this time without J by my side. I’m sure I was just as exposed for my egg retrieval but at the time my state of mind didn’t allow me to care all that much. At one point the nurse had to press on my abdomen to get my ovary lower so Dr. M had better access. You’d think after everything I’ve been through I would no longer feel embarrassed or self conscious but I felt so vulnerable.

The nurse assisting with the procedure was very nice, and both her and Dr. M chatted with me during the process. He always tells me (and his other patients I’d imagine) that I’m brave whenever he’s inflicting some sort of discomfort on me. I always just tell him I do what has to be done in the circumstances. He told me people probably wouldn’t even believe the places I’ve had needles. I lamented that my friend’s husband is trying to play the pity card because he has to have a vasectomy. Dr. M asked me why he was having a vasectomy so I told him because him and his wife have 3 kids and the last one was an accident. As soon as the word was out of my mouth, Dr. M groaned and said “Accidents happen in cars, we’re all adults and we know how babies happen…it may not have been intended but it certainly wasn’t an accident.” Truer words have never been spoken.

He went back to joking with the nurse, how he’s been married for almost ten years and he said after a certain number of years the fires of passion cool, and nothing does that better than entering kids into the equation. To which I responded “So does this whole situation”, indicating my surroundings and referring to all J and I have been through. He didn’t have a smart remark for that. On that somber tone our discussion turned to successes and failures (with life in general) and I mentioned the failure of a friend’s FET cycle. He seemed genuinely saddened and expressed as much when he told me the clinic staff feels the pain along with their patients when they know they’ve done their best and it still isn’t enough.

Dr. M told me that parents always just tell their kids to do their best. But what happens when their best isn’t enough? When no matter how hard you try at something the effort you put in may never yield the results they deserve. He then went back to making fun of my tattoo and joking about how easy men are to manipulate. Though he may come off as crass, and sometimes flippant; he cares, and he knows the pain. He feels it himself when despite the best efforts of all parties involved, the goal is not reached. I’ve always liked Dr. M with his impish smile, and charming accent but seeing his compassionate side has let me know my embryos and I are in the right hands.

Hopefully the next time I’m in that room will be when one of my embryos is being transferred back to my womb to stay.

A Date with Destiny

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I started bleeding again on Wednesday, for the third time since Oct. 25. I have still been taking Lupron despite the fact that at my last monitoring appointment I had a 5cm (2″) cyst, my lining was approx. 5.5mm and my estrogen was in the thousands. By rights I probably should have been cancelled but my Dr. decided to keep me on Lupron for another 10 days to see if it would help shrink the cyst, and lower my estrogen. I had my doubts and hated that I was told to continue waiting. I’ve felt as though I have been waiting for the inevitable; a cancelled cycle.

I was booked to do bloodwork on Saturday and have another monitoring appt on Sunday but when I started bleeding on Wednesday afternoon I called the clinic and they told me to do my bloodwork and come in today. Technically right now is around the time of my expected period (slightly late but that’s been the norm as of late) so more than likely the bleeding I had a couple weeks ago was just some breakthrough bleeding, and residual from my cancelled Suprefact cycle.

Leading up to last weeks monitoring appt I was having discomfort and pressure localized to my right ovary (where the cyst lives) and I was still having that pain into the beginning of this week. I figured if I could still feel it, it hadn’t gone anywhere and hence would still be pumping estrogen into my body. As of Wednesday the pressure had subsided and I was no longer having any pain.

Since I am having a seemingly normal period, and I can no longer feel my cyst I got really nervous for my monitoring appt. Nervous because I was starting to have a sliver of hope. I felt like I was getting ready for a really big date; I tidied up my lady business and shaved my legs last night. Laid out my clothes for this morning (for the necessity of getting ready faster, I had to be out of the house by 6:15 this morning). My stomach was in knots all this morning (though that’s nothing new for clinic visit days).

I got to the clinic excessively early, despite the slow drive due to the 3ft of snow that has fallen in the last 24 hours. Checked in, and second in line for my ultrasound, my morning was filled with a lot of hurry up and wait (a familiar theme in my life). To my surprise Dr. M walked in to do my ultrasound, even though the whiteboard in the waiting area said Dr. C was doing ultrasounds today. I was pleased to see him as that meant I might be able to get some answers as to what we were going to do now.

He asked if I was in for an FET baseline ultrasound (seriously, why do doctors not read charts before walking into a patients’ room?). I gave him a brief rundown of my situation and mentioned we were checking my cyst, lining and estrogen levels. I mentioned that I hadn’t been having any discomfort from my cyst and perhaps it had shrunk. As he moved to the right, nope, there it was. Big as ever. And another small one had developed on the left. I felt annoyed and disappointed but Dr. M said we can fix it, and that he would have to drain them. He went to check my bloodwork and speak with a nurse about next steps. As I was getting him changed I could hear him telling the nurse my estrogen is still too high (mother lovin’ cyst!).

As I came out of the change room the nurse beckoned me to come with her. She put me in a consult room and told me she just has to see if Dr. M is ready to do the draining. I looked at her, wide eyed “He wants to do it now?!” She told me yes and asked if I was busy today… I told her I was meant to be at work but could adjust. She asked what time I worked at and I told her 9:30 (It was 8am at the time). She gave me a bit of an eyebrow raise to which I asked if I’m going to make it in to work at all? She made a face and said she’d find out when Dr. M wanted to have me in. When she returned she told me I was booked in for 12:30 and that it wouldn’t take too long. As I left I called work to tell them I’m wasn’t coming in at all. No point in going to work when I’d just have to leave again shortly after arriving. Especially with the terrible weather and road conditions. They probably thought I was taking a snow day, but oh well.

I returned for the cyst aspiration and the prep was the same as if I was doing an egg retrieval or a transfer. Gowned up, I returned to the same room where my eggs were retrieved. The procedure was not comfortable. It is essentially the same as an egg retrieval without the good drugs. They only had to poke in twice as opposed to many times as they do when aspirating follicles, but still. They did use a freezing agent on my cervix and to be fair it was very successful. But once the needle penetrated and was going into the cyst, that was another story. Dr. M had a hard time getting the needle through the wall of the cyst and it was up there with HSG pain. But it had to be done.

When the nurse was prepping me to go back she mentioned starting my estrace in the next couple of days. Say what?! I was prepared to have to wait until my estrogen levels came down but apparently once the cysts were emptied and no longer producing estrogen the level didn’t really matter anymore as they will now be artificially manipulating it.

So I have a schedule, and it looks like this one is actually going to happen. Estrace starts tomorrow, continuing on with Lupron as well as five days of antibiotics for hubby and I as a prophylaxis. I have an ultrasound to check my lining on Dec. 8. As of today my lining is 5mm which still seemed a bit thick to me but my period hasn’t finished yet so it could potentially get thinner and Dr. M wasn’t concerned. I’m not so sure my lining will be at 8mm by Dec. 8 but they just want to keep a close eye on me since I have had so many issues. But if it is at the proper thickness, transfer could potentially be Dec. 13 or 14 at the latest it could be a few days before Christmas.

I am hoping for the former so I can at least get a beta (or more, if needed) in before we leave for Hawaii on New Years Day. I called J afterwards to give him the rundown and he says its going to work. After all of the setbacks he thinks this will happen, and it will work for us. I’d like to share his optimist… But I’m a pessimist at heart, and don’t want to get ahead of myself.

But I have googled our potential due date. And I’m hoping we can finish the year off with a bang.

#Microblog Mondays: Infertility Leave

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Not sure what #MicroblogMondays is? Read the inaugural post which explains the idea and how you can participate too.

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A friend sent me an article a couple of weeks ago discussing “Infertility Leave” as the new maternity leave. It was an interesting read, it touches on how much of a toll infertility takes on a woman’s career and the juggling act that is required. It touches on the egg freezing option that both Google and Facebook are now offering, which shows that family planning is starting to be considered by some companies (though the whole egg freezing is probably a step in a different direction altogether).

At first, I thought infertility leave sounded like a great thing but after having it roll around in my mind for a bit, I’m not so sure. For one, it would mean opening up to your employer about infertility, which I know a lot of people (myself included) are not comfortable with. Secondly, even if employers offered it, I think there would still be a stigma attached to using it, and other employees would judge from lack of understanding. Overall, I think it would still be a hindrance to ones career, whereby using an “infertility leave” would leave you open to judgement, and being passed over for opportunities for growth. I know of quite a few ladies who have given up careers to focus on trying to conceive, or carry a healthy pregnancy. But is it fair that they have to choose? Or what about those of us who have to work? If your company offered it, would you take advantage?

Old Friends, New Again

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The universe seems to work in a way that just when I think I’ve caught my balance, it throws me a curveball. I received an email from a long lost friend the other day. Long lost I thought, because shortly after I told her our last IUI failed and we would be looking at IVF, she disappeared into oblivion. She lives in a different city than me, but we used to email back and forth quite often, keep eachother up-to-date and occasionally meet up when one of us was in the others’ city (we don’t live a plane ride away from eachother, just a long car ride). To be fair, after she didn’t respond to my last email, I didn’t call her out on it, or try harder to get in contact. My thought was, ball was in her court, and the timing of her lack of response led me to believe that she maybe didn’t believe in the choices I was making.

Her and I live on different planets in most regards, her religion and upbringing make us very different people that believe very different things, but I was pleased that we could always be respectful of eachother’s views, and remain friends. She was one of the few people I confided in early on about our infertility, and she was very understanding and didn’t try to offer “helpful” suggestions. When she failed to respond to my last email (back in February-ish) when I told her we were going to pursue IVF, I was hurt. I thought it was a pretty important email but I know some people of her religion may not be ok with ART, and IVF so I thought maybe I had hit that line in the sand. I let it go, and received radio silence until this Sunday, when I was surprised to see an email from her in my inbox.

She apologized for not being in touch, that life had gotten in the way (for 10 months…ok whatever). She filled me in with what was going on with her, and asked what was new with me. Apparently her and her husband finally got a new family doctor, after not having one for several years. Her husband had testicular cancer not terribly long after they got married (back in 2010), but they caught it early, and treated it agressively. He ended up losing one testicle, that I do know, but otherwise my friend doesn’t really like to talk about it. She told me she had a full check up, and her doctor did a whole reproductive work up as well because she has debilitating pain when she gets her period (red flag!).

After all of her testing, her uterus was found to be in perfect condition, but her right ovary is almost three times the normal size due to cysts. She is still having that looked into, but obviously it’s not good. She then proceeded to tell me that a couple of months back her period was late. She tested and got a faint positive. She then got one of those tests that dates your pregnancy so she could see how far along she was and it was negative. She went to her doctor and their test was negative as well, and two weeks later she got her period. Now, as soon as I read this I knew she had a chemical pregnancy. She went on to explain this to me in her email, that apparently it is pretty common for first time pregnancies, but most women don’t even know it has happened and she just happened to find out because she’s been undergoing all of this other testing on her reproductive systems she’d been watching her cycles more carefully. She then went on to tell me that her spirits were dampened for a while, but they are back in the saddle and trying again (ok, didn’t know they were trying in the first place).

I do feel awful about her chemical pregnancy, and wish she didn’t even have to know what that is. But her wording, that it “dampened her spirits”, rubbed me the wrong way. Like it wasn’t any big deal to her. I almost felt like she is back in touch because she has some possible fertility troubles of her own. I may totally be mistaking her tone (it is an email afterall) and projecting my own shit onto the whole situation.

The whole thing smacks of the Sex and the City episode where Miranda finds out she is accidentally pregnant with Steve’s baby (who ironically also, only has one testicle) and Charlotte is doing fertility treatments to try and get pregnant to no avail. It’s nothing my friend has done to me, but the woman whose husband has one testicle, and her an ovary full of cysts can manage to get pregnant!? It’s hard to swallow.

My friend is a very sweet person, so considerate (though sometimes a bit oblivious), and very sensitive to others, so I am going to push past my discomfort and write her back. I felt comfortable telling her about our infertility issues because there was no judgement (until I thought there was), perhaps I could use another ally in my corner…

I appreciate all of the support for my FET and, the love from all of you wonderfull bloggy friends when things seemed to be crashing down on this attempt as well. I’d ask to have those good vibes sent to someone else who needs them more than me right now. One of my fellow friends in IF had her FET this past Saturday. Her IVF journey has not been smooth either but she managed to transfer 2, day 3 frost babies this past Saturday. Please send you well wishes into the universe for her!

As for our own treatment, my cycle has not been cancelled (yet…ever the pessimist). My doctor advised that I stay on Lupron until tomorrow when he is having me come in for a scan, and possibly some bloodwork. I haven’t had any more significant bleeding since last Friday, but some spotting over the weekend, and some remnants of blood still being expelled up until yesterday. If the bleeding I had last week wasn’t technically a period then tomorrow is CD28, otherwise I’m not really sure how to count things. We’ll see what tomorrow brings.

#Microblog Mondays: Tears

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Infertility has given me a lot of reasons to cry, yet I don’t. Why that is, I do not know.

They threaten to appear, sometimes with the tightness in my chest, sometimes with the chokehold on my throat. Other times they make it all the way to the rims of my eyelids but they do not fall. I don’t blink them away, or swallow them down, sometimes they would be a welcome release. A much needed outlet of emotion.

They come in unexpected waves, rising up at an unexpected turn, but never do they fall from my eyes and roll down my cheeks. Perhaps they’re waiting for the day when they can be happy tears instead.

The Heaviness of Infertility

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I started my Lupron injections Friday morning, and all went well. The needle is very small (and sharp), as is the dosage. I feel like injections are old hat as they became routine throughout the course of my IVF cycle, and personally I find the injection preferable to the 5 times daily nasal spray that was tried for my first cancelled FET. So after retrieving my meds from the fridge, and administering the dosage, I got ready for work and headed out. Around 11am that day I felt sort of weird, like I was having a lot of discharge (sorry, I hate that word) or something. So off to the bathroom I headed, and I was shocked to find blood. Apparently my period had started, on CD21. I was stunned, and horrified. I had to buy a tampon from the little vending machine on the wall (you’d really think I’d be a little more prepared and have some hanging out in my purse). I guess the pain and spotting I was having the week before last was the writing on the wall.

I called the clinic and left a message for them, advising that I had an unexpected arrival and I wasn’t sure what to do from that point. They usually return same day calls in the afternoon, so I was a zombie all day, trying to be productive but not succeeding. Nurse M finally called me back around 3:30, and her response to my situation was “You are one messed up lady!” (with a giggle). Yeah, thanks, I know. She told me that Dr. M wasn’t back in until Sunday (today) and that I should stay on my Lupron until then, and she would call me after they had discussed the situation, and what to do. She didn’t sound hopeful for the cycle continuing, as she agreed with me that this was not good.

The following hours were like living in a waking nightmare. I had to go to dinner with my mom and aunt, for my mom’s birthday and it was difficult to act normal, when my head was spinning. (I know, the fact that I don’t discuss IF with my mom is an issue for another post). My mother has problems of her own, anxiety and depression which leads to insomnia, which leads to more depression and anxiety. She is currently off work, and not in the best state. She has had these issues since I was very young, so growing up I haven’t always felt as I could lean on my mom, as she has her own demons to battle. I think this has a good lot to do with why I haven’t discussed our IF with her. But again, there is another whole post in there about her and my relationship.

My “period” had already stopped Friday evening and there was nothing all day Saturday. This morning when I went to the bathroom there was more blood, so I used a tampon but when I removed it later on there wasn’t much there. Certainly not a full flow. I waited on tenterhooks all morning for Nurse M to call, as they often call first thing in the morning if returning a call from a previous day. I had plans to go to the movies this afternoon so I was really hoping she didn’t call when I was in the movie, and have to be that person answering the phone. Thankfully she called about 30 minutes before I was about to head out.

The first thing she asked was if my period had continued to be full flow, and I told her, “actually, no”. I explained to her what had been happening and then she wasn’t sure what to tell me. Apparently Dr. M had just left, so she couldn’t speak to him about it. She asked me if I had stopped my Lupron, and I told her no, that she had told me to stay on the Lupron until she could talk to Dr. M to decide what to do. I had her at a loss, initially Dr. M had wanted me to come in to the clinic tomorrow, but now things had changed. She told me since I was still on Lupron, there was no big hurry for me to come in. So she is having me to wait until she can talk to Dr. M and she will call me tomorrow with the next steps. I’m thinking I am still going to have to go in eventually, and I would have preferred to just get it over with tomorrow, because now I have to wait one more day, and delay the inevitable.

At this rate, I can’t see this cycle continuing without some sort of miracle. I may hold the record for the fastest start and end to an FET cycle. At this rate, if this cycle gets cancelled, we will not be starting again until the New Year. We are away in Hawaii for 12 days for the first part of January, so depending on how my next cycles go, we may not be able to do anything until after we return. I’ve been very up and down emotionally this weekend. Sometimes I can put the pain, sadness and frustration down and walk away. But mostly it’s been the cloak on my shoulders, weighing me down.

One Bitten, Twice Shy

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“Hello, Lupron”…[said in the tone of Jerry Seinfeld to “Newman”].

Today is the first day of our second attempt at an FET. I begin my Lupron shots this morning, and will await the start of my next cycle when I will be adding estrogen, and the progesterone to the mix. I’ve been somewhat worried that this day was going to be delayed again, as I was having some concerning spotting last week around CD11 – 13, and then some unusual pelvic/uterine/ovarian pain Friday and Saturday. I told myself I would call the clinic this past Monday if any of the prior symptoms continued, but fortunately everything calmed down. My best guess is that I was ovulating from the same side as my cyst and perhaps the rupturing of a follicle in the vicinity aggravated the cyst. That is a totally uneducated guess, but allows me to somewhat rationalize…

I am trying not to get too far ahead of myself in case there is some roadblock that I have not yet anticipated. My goals right now are to take my Lupron at approximately the same time every morning (7am). It’s not specifically in my instructions, but probably best for the sake of continuity, and routine. I also want to get to bed between 10:00 pm – 10:30 pm (which I failed at last night, not turning in until well after midnight). Limit my intake of caffeine (I’m going to be realistic here and not cut it out entirely), as well as attempt to get to the gym more (meaning more than never). I pretty much stopped going to yoga entirely after my retrieval…which yes, was back in July (the end of July to be fair). Take it one day at a time, try not to make myself do things I don’t want to (beyond reasonable tasks). I am trying to limit my stress, and by not doing obligatory or unenjoyable tasks I hope I can be more peaceful (or at least less stressed).

Life is still pretty hectic after the move, though we’re pretty well settled in our new place, but we’ve not had a lot of downtime since. Our new tenants are moving in this weekend, as well our new appliances are being delivered. We have quite a few social engagements coming up, Christmas shopping, holiday activities, parties, ect. It’s a bit of a tricky time to try and reduce stress. Although the holidays are an enjoyable time, they are busy. In a sort of divine intervention I found out I am over my allowable limit for vacation time to be carried over into the next year, therefore I have 6 days off in the middle of December. If we make it through the whole process, my time off will coincide with the transfer. I don’t plan on becoming couch bound after the transfer but at least the time will allow me to get organized for Christmas (since we will be spending it in the mountains with J’s parents), and then our holiday to Hawaii on New Year’s day (so looking forward to that).

I am going at this with cautious optimism, as nothing with infertility is a sure thing, not even the chance to make it to transfer. So here’s hoping for FET 2.0 to be uneventful, besides getting that embryo home, and keeping it there for 9 months.