Inconceivable

Despite my outwardly blase appearance toward 'trying' this month - me trying to get pregnant? Not! Watch me as I down my martini while riding a roller coaster, then soak in a hot tub for an inordinate amount of time, follow it up with pure caffeine pills and finally, hang on for dear life on a ride with a thoroughbred race horse - inwardly, I was secretly hoping for the ultimate surprise: a conception that required nothing more than two people, some wine and a bed. Things were really promising too, since last year after my miscarriage, I had the period that would not end and ultimately got a progesterone shot in the ass to re-set the ole system. This time, it was a picture perfect cycle.

So, on Sunday morning when I noticed some spotting, I knew that once again I was thwarted and we would be back on Dr. Uterus's roster of Unfortunate Infertile Couples.

A few days earlier, when I was still holding out a teensy bit of hope, I saw a woman walking in front of my house with her two year old. I had seen her before and the beginnings of a tell-tale bulge, but I had chosen to think that her t-shirt was just bunched in an odd way. This time around, though, it was obvious that she had The Bump, and I decided in my infinite wisdom that she had acquired The Bump in the way that most people do - in the privacy of their homes, without drama or fanfare and most certainly without needles, drugs or other paraphernalia. And that depressed me. Who was I to think that we would be able to do that - even now, more than three years since we started down the road to expand our family? What a silly infertile girl you are, thinking that you could get knocked up like everyone else. Don't you know that you're Special (and not in a good way)?

Such is the internal monologue of an Infertile Girl.

Once again, I am coming to terms with the fact that I will most likely not be able to conceive on my own, for whatever reason, and that assisted reproductive technology is my ticket to the Baby Game. I used to find this incredibly unfair. Now I've progressed to mildly unfair. Progress! Two-plus years of having the same thought over and over again will tend to smooth it out, rought out the edges and leave a smaller (and hopefully less painful) nugget than when you started.

Being that it is CD 1 today, I called Nurse To a T (Dr. Uterus's right-hand lady) and scheduled the mock cycle for the FET in August. I tried not to think about the fact that we also started trying again last year in August after the last miscarriage and it was a bust. I'm trying not to believe that I am only fertile in February since that is the month when I have gotten pregnant two years in a row now. I start the Estrace tomorrow (that's a new one for me) and will do the PIO injections starting in July. I had originally decided to go with the capsules (Endometrin?) but two things mitigated against it - expense and we won't have the results of an endometrial biopsy for almost two weeks, during which time I will be starting up for the real-deal FET. If the Endometrin didn't work, that would be a terrible time to find out. So, it's back to the butt shots for me.

And, just for sh*ts and giggles, I'll pick up an HPT to make certain, before I start pumping my body full of estrogen, that there really is no alien invasion. I'm not expecting a last minute reprieve, but it's a lot easier to pee on the stick when you don't think you're pregnant than when you do - which is probably why I hardly ever indulge.

Never a dull moment, here at the Young and the Infertile. Will she? Won't she? Tune in to find out!

image: jillhudgins

The Misbehaving Ovary and Other Tales of My Lady Parts

I am currently rather foggy due to the 800mg of Ibuprofen I took about two hours ago after I got home from an emergency dildocam appointment with Dr. Uterus. What fun is this, you ask? Get a glass of wine and pull up a chair.

Last night I had the worst pain I think I have ever had. It was terrible because it was like someone was stabbing my left ovary over and over again. I couldn't sleep because no matter what position I was in, the stabbing would continue. The pain even started to radiate down my thigh! It didn't help that I had two glasses of wine last night and I was reading the super weird, but brilliantly written American Gods so by the time I turned the light out, my head was filled with all kinds of disturbing images. When I did manage to sleep I had super weird dreams.

Needless to say, when I got up, I immediately called Dr. Uterus' service and had myself an appointment made by 8:30. Of course, my Inner DQ was running around in a panic muttering things like "ruptured cyst" and "lose an ovary" and "surgery, surgery!". I called Sweetie who is out of town and discussed contingency plans in case I needed emergency surgery. By the time I made it to Dr. Uterus' office, I just wanted someone to knock me out from the pain, preferably with lots and lots of drugs.

After a surprisingly pain-free date with the dildocam, it appears that my naughty left ovary has, for whatever reason, developed a hemorrhagic cyst. The good news is that while pesky and painful (did I mention painful?), my cyst is not particularly worrisome and will resolve on its own. I have the heating pad clutched to my lower abdomen and the bottle of Ibuprofen within my clutches (although I may have to upgrade to the Vicodin). I just hope the pain subsides before we go to Paris. Mrs. X will be a cranky girl if her ovary is acting out while she is trying to admire the Venus de Milo.
____________________________________________________________________

Thanks to everyone who commented on my last post for confirming that a) boys do not think before they speak sometimes and b) I was not crazy to be really pissed off by what Dr. Uterus said to me. I was so discouraged by that meeting and it was so wonderful to hear that I was perfectly justified feeling this way. Additional props to Paranoid for perfectly describing our collective rage as 'apoplexy'.

Even before my emergency meeting today, I had requested to talk with Dr. Uterus again regarding the mock cycle. I wanted to understand the theory behind it, particularly since so many of you who have done an FET haven't heard of this being done. I couldn't get the cost-benefit analysis. Cost: much pain, lost month and an endometrial biopsy. Benefit: maybe information about what might happen with the actual FET. As you can tell, the costs were outweighing the benefits.

After discussing my cyst, I brought up my concerns regarding the mock cycle. In his view - and this is strictly his view - not doing the mock cycle ahead of time would be bordering on careless. The purpose is to ensure that the particular protocol that is used works on the particular individual such that the endometrium is the right thickness and ready to receive the totscicles. In fact, the gold standard is two mock cycles in a row! Thankfully, he recognizes that this isn't practical and only recommends one. I was still concerned that even with all of this information, the actual FET cycle may still not have the same endometrium results as the mock cycle. He acknowledged that this was a possibility, but it was the best source of information and far better than not doing one at all.

I had also given some thought over the past few days to a possible compromise on the mock cycle. Rather than doing the PIO injections, I would try the new vaginal inserts. He had told us on Tuesday that he has had some patients who have not responded to them, but since it is during the mock cycle, we'll know then rather than during the FET cycle. And, if I don't respond to the vaginal inserts, I will happily poke myself in the ass till kingdom come. He was happy with this compromise and was fully on board.

So, I will do the mock cycle because I know that I will not be able to live with myself if I don't do it and the FET results in a bust. I will always wonder if it didn't work because the protocol failed and we didn't know it because I didn't do the mock cycle. And, with the vaginal inserts, I don't feel as if it is such a huge burden on me for a cycle that is a mock cycle. We would also really be starting to try again at the time that we had discussed, which was July with the mock cycle being in June. The Queen has also given her approval.

I also asked a simple favor from him: I asked him not to tell me any more stories of his other patients. He agreed immediately. He acknowledged that they usually help other patients who feel like they are alone in their struggle - but I told him, I blog, I'm not alone! I am also one of those people who don't particularly benefit from stories of other people's success. He was very gracious and apologized for telling me stories in the past. I immediately absolved him of any guilt since he didn't know that I didn't want to hear them until now.

So, I am finally at peace with our meeting with him and I am on board with our plan for going forward. It feels good, even if my naughty ovary doesn't.

The Post In Which Mrs. X Is Chatty

image: Lovely Day
First off, thanks to everyone who commented on my last post and helped me see that there really isn't a whole I can do right now to ensure a positive outcome (short of like, sleeping with Kevin Federline - ick, yuck and barf), Instead, I should watch a Golden Girls marathon (fabulous idea Matthew M.F. Miller), do my taxes or play on-line games (I choose on-line games Deathstar), go shoe shopping (mmm, shoes thanks Melanie) and basking in the additional waves of good vibes coming from shinejil, schatzi, tabi, peesticksandstones, kidlicious (welcome!), and lori). If nothing else, I can't say that I was depressed during the 2WW. So thanks and I can only hope to provide similar excellent advice should you ever find yourselves in such need. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
We can also now have our own Disney On Ice special: Embryos on Ice! Yep, our six little blasts that were left after the transfer made it safely into the thaw just like Han Solo. Sweetie was concerned that they, too, would have carbon-freezing sickness upon being thawed. I assured him that this probably won't happen. We also discussed the very real possibility that they are all skating around right now in the liquid nitrogen or maybe having one helluva kegger. One can only hope. They can survive in this state for eternity (assuming of course someone keeps paying the electric bill). We're just glad to have six back up options.

I also got an answer on my question about the Day 3 v. Day 5 transfer. The missing piece of the puzzle that Dr. Google selfishly withheld is that to reach Day 5, the blasts are put in a rather challenging environment in the lab and those that make it to Day 5 are truly the "best". Total survival of the fittest, infertility style. He only uses this for where there are many embryos and you can afford to lose some that don't make it to Day 5. We had 9 embryos and I would have been supremely pissed if we lost some before transfer because of the Day 5 Challenge. Dr. Uterus would much rather see how the Day 3 embryos do where they want to be rather than in a lab. I was very pleased with this explanation. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
image: The Pack
It appears that I've been tagged by Lori in some out-quirk-ing contest. Well, let's see what Mrs. X can come up with, shall we? But first, the rules.


1) Link to the person who tagged you.
2) Post the rules.
3) Share six non-important things / habits / quirks about yourself.
4) Tag at least three people.
5) Make sure the people you tagged KNOW you tagged them by commenting what you did.

Quirk No. 1: I had peanut butter and jelly sandwiches for lunch every single day in high school. Yes, I still eat them sometimes. But maybe once or twice a month.

Habit No. 2: If I can't find something, I automatically think someone stole it. It doesn't matter that there might have not been anyone in the house. I am not above accusing my cats ("Kitty, what did you do with mommy's keys?")

Important Thing No. 3: I have been to Mardi Gras and flashed balconies with hundreds of people. One time (yes, there were multiple times) I was a little drunk and forgot to lift my bra in addition to my shirt so the crowd got a lovely view of my lace bra. I was roundly booed.

Quirk No. 4: I love even numbers and hate odd numbers passionately. Luckily, I was born on an even day, in an even month in an even year. Sweetie was born in an odd month, on an odd day in an odd year. I married him anyway (on an even day in an even month but in an odd year).

Habit No. 5: Everytime I walk into my kitchen I mentally curse my ugly, ugly countertops. Die Corian Die!

Important Thing No. 6: I have been in Newsweek and Time.

Well, Lori, Ms. Lord of the L? Quirky enough for you?

For my three tags I throw down the gauntlet to shinejil, melanie, and jellybelly. Who among you can out-quirk me? Hmmm?

Uh, Houston? We, Uh, Have a Transfer

Around 1:30pm this afternoon, I was strapped into the gurney of death, legs firmly velcroed into the cushy stirrups (so much better than the ones at Dr. Uterus' office!) and our three little A grade embryos made the final journey through the catheter back to the mothership. They are now pinging around my uterus where hopefully at least one (but not three, please!) will implant for the next nine months.

The mock transfer was a lot easier than this one was, though. I had some cramping as he was inserting the catheter, which I told him about. Once the catheter was in, he gave me the time to wait for the cramping to subside before he inserted the embryos. I did some deep breathing and held onto Sweetie's hand (he was in the Bunny Suit and he looked like a giant Smurf with a blue cap rather than a white one) waiting for everything to subside. It did and he went ahead with the transfer. He removed the catheter and Dr. Freak Out looked at the entire thing under the microscope to make sure none were still in there. She gave the all clear and he released me from the jaws of the speculum. All in all not horrible, but not the most pleasant experience either.

I had to remain lying down for another 30 minutes during which time we talked with Dr. Uterus about the procedure and what to expect from now on. I had to ask the obvious question of whether the minute I went to the bathroom I would expel the little guys which Dr. Uterus informed me was "outlandish" bordering on "impossible" (there's that hyperbole kick again). I'm not on bed rest, but I am on restricted duty - so no raking (no chance of that anyway), but most sedentery activity is ok. I'm not the super high impact kind of gal anyway, so I am perfectly content to read, blog, sew, snorgle animals, and just plain be boring which is exactly what the doctor ordered.

I also start the progesterone shots this evening. I'll be on my own this time since I can't call my neighbor every night to come down and help. Sweetie has promised to be just outside in case I find that I need reinforcements. I'm going to try not to dread them as that will make them that much more painful.

Ah, what I won't do for a child.

Image: Saffanna

Did I Mention I Don't Want Triplets?!

The latest blast report continues to have good news. They are growing just like they are supposed to and all 9 are dividing and multiplying. 7 are rated Grade A and 2 are rated Grade B+. The breakdown also reminds me of my report cards from school. Weird.

Knowing the genes that make them up, I am certain the two "B+" blasts are getting teased mercilessly by the 7 "A" blasts. We are very pleased so far, but we are still cautious about getting too excited.

Dr. Uterus and Dr. Freak Out are apparently in agreement that our best shot at a pregnancy is to transfer three blasts, rather than the two that Sweetie and I have discussed. I hadn't talked with Dr. Uterus yet about how many blasts I wanted to transfer, but I had mentioned to his nurse that we were looking for two since WE DON'T FREAKIN' WANT TRIPLETS. She mentioned this to him and he is still of the opinion that our best shot is with 3. This is consistent with the average number of blasts that he has transferred before in my age group according to the CDC reports.

Sweetie and I discussed it and are very hesitant not to follow their advice. The assumption has always been that if you transfer three, all three will implant and poof, we have triplets. The reality is that statistically, it's not a sure bet that even one will implant let alone three. So, we are willing to accept the risk of triplets in order to get a viable pregnancy.

I also need to stop turning to Dr. Google. Curiousity killed the cat and it sure as hell makes IVF a lot harder when you read all kinds of random studies about what does and does not make for a successful cycle.

For now, I'm going to focus on being really relaxed tomorrow since I read in an actual book (Dr. Silber's boringly-titled tome How to Get Pregnant) that women who were über-relaxed during the transfer had a much higher rate of pregnancy. Dr. Uterus also mentioned this, so it must be fact! Right?

Doin' the Old Lady Shuffle

Image: smileygeekgirl
I am doing the Old Lady Shuffle today. That is the hunched over, put one foot in front of the other shuffle due to extremely sensitive body parts and still (unfortunately) lingering 'airs'. I'm counting down the minutes for the work day to end so that I can pop a Vicodin and curl up on the couch. I have been putting the heating pad to good use, though, having it firmly strapped to my mid-section to dull the ache during the day. Thankfully my job does not require me to move around a lot, so I've been able to sit around and play on the computer (isn't that what I do every day?)

In better news, we got the Fert Report: 9 eggs out of 12 fertilized! 8 out of 9 fertilized using ICSI and 1 out of 3 fertilized au naturale (well as natural as you can get in a petri dish). I am really happy since it means 75% of the eggs fertilized. We'll get more info tomorrow on which ones are growing and we should have a tentative discussion on how many will get transferred. We're looking at a transfer on Friday. Hopefully I will be feeling much better by then.

I've also told everyone and their mother from Dr. Uterus to his nurse to the nurses at the IVF lab that I do not want the blastshots. Dr. Uterus declared that I was his first patient to make this request (that's me, always the trailblazer) but he will respect my wishes. I have no problem with them keeping them in the file but as I explained earlier, I would be too tempted to lob onto them as our future children and suffer the consequences should the cycle fail.

Otherwise, it is embarrassingly quiet on the Mrs. X front. Till tomorrow!

Things That Come in a Dozen

Here is a random listing of things that come in denominations or measurements of 12: one cycle in Chinese astrology, golf balls, roses, the Dirty Dozen, the rumored length of John Holmes' "member", hot dogs, and, the number of Mrs. X's eggs retrieved today!!

That's right, ladies, 12 beautiful eggs. I am very happy with the number and apparantly Dr. Freak Out could find nothing initially wrong with them. According to Dr. Uterus' nurse, if the eggs initially appear immature or otherwise 'oeuf', she makes "noises". There were no noises. That of course, doesn't mean that we are going to have 12 beautifully fertilized eggs, but it is a good start.

The retrieval itself was pretty uneventful for me. Although, tell me, Schatzi, how do you do this without pain medication!? Unfortunately, my recovery has been a little ... bumpier than I would have liked. Bumpy how? I have terrible, awful, horrible, excruciating ... gas. The kind of gas that doesn't come out unless you walk around. As Sweetie so eloquently put it, "You're just going to have to fart and belch your way out of this one." It's so bad that I have a hard time taking a deep breath. It totally sucks.

Tomorrow we get the fertilization report. Sweetie spoke with Dr. Freak Out while I was in la la land and she told him that they had decided to do 75% ICSI and 25% natural. So, 9 eggs will be fertilized with ICSI and 3 will be left to their own devices. I wonder if they will pipe in some Barry White, lower the lights, leave some wine to move things along?

It's going to be hard not to focus and fret about how many will fertilize, but I know that it won't help matters at all. It it is literally out of my hands, my body and my ovaries at this point.

Thanks also to Shinejil, Lori, Peesticks, Jellybelly, jill_986, and Schatzi for your wonderful words of encouragement!

(Lori- I reformated the post and managed to lose your comment. Sorry!)

In Black and White

(image: FSSE-INFO) Today's event was that Sweetie and I met up at the IVF lab to sign le paperwork for the retrieval tomorrow. I had copies of all of the forms ahead of time, but didn't bother to read them until last night. I was pretty familiar with the doom and gloom in them (if your children turn out to be freaks, you can't sue us) since it was similar to the papers that we had to sign at Dr. Uterus' office, but it was still sobering to read it all.

Last night, Sweetie and I went through the multiple choice maze of options for any embryos that we manage to get to freeze in the event of an unpleasant contingency. What do we do with the embryos if I die? If he dies? If we both die? If we get divorced? If I have a hysterectomy? We had choices like disposal in an ethical manner (I don't even want to contemplate what that actually entails), continue to store, or donate to an infertile couple. It was a no-brainer if either one of us died (the other would get them). If we both died, we directed that they be donated to an infertile couple. But, if we got divorced, we elected to have them disposed of - I would have a very hard time knowing that my child could be out there without me (or their siblings) knowing it. The hysterectomy scenario would result in continue to freeze the embryos, on the assumption that we would want to use a gestational surrogate, assuming we didn't have the brood that we wanted.

I was just struck by how weird it is to be discussing the fate of your potential future embryos while you're making dinner. Most people will never even have to think of that scenario much less fill out of page of multiple choices as to what to do in various depressing situations. Another uniquely infertility experience.

Sweetie, apparently, was very freaked out by the consent forms for the egg retrieval and IVF because of all of the terrible things that could happen which were enumerated in exacting detail. He is apparently quite worried about genetic abnormalities and was still slightly convinced that Dr. Freak Out had it right that our prior miscarriage was his fault. I disabused him of that notion by explaining that Turner's is caused during the meiosis stage, or when the cells start to divide, not at the moment of conception and not in the wonky sperm.

We also talked about the statistics that show that IVF births have no substantial increase in genetic defects than the normal population. I reminded him that we could have a genetic problem even if we got pregnant without ART. And, we had already discussed with Dr. Uterus the issue of whether ICSI caused greater numbers of birth defects. Personally, I suspect that the higher numbers of genetic problems resulting from ICSI can be correlated to the fact that the procedure is used for men who have severe morphology problems and incredibly wonky sperm to begin with. Sweetie is not one of those men.

I did ask him if he didn't want to continue and he immediately responded "Nooooo! I want to continue!" I was glad that we talked about his concerns since it seems that a lot of time we discuss my concerns rather than his.

I also took my four antibiotics this evening and promptly felt like I was going to barf, hurl. ralph, and whatever other adjective you want to use for vomit (which I always thought was an ugly word). I think Zithromax should now have this label because it is exactly how I felt:

Mr. Yuck indeed. I am feeling much better now. Especially after I stopped watching Celebrity Rehab with B-, C- and D-listers barfing everywhere and generally moaning as they detox.

I don't know how coherent I will be tomorrow so all of you lovely ladies who still continue to read this saga may have to wait until Wednesday for an update. Till then, so long, farewell.

"The Cake is Baked"

So sayeth Dr. Uterus. He was still on his hyperbole kick, this time declaring that my ovaries were quite possibly the most beautiful of all of 2007 and 2008. For a man who sees a lot of eggs, that was very nice to hear.

We are scheduled for a retrieval on Tuesday. Now the only thing standing between me and mature eggs is the HCG injection:


I wasn't that worried about it until I saw the needle that I'm supposed to use (me: "is that the mixing needle?" Nurse: "no, that's the mixing needle. This is the needle you inject. All 1.5 inches") and when they told me the cautionary tale of the Woman Who Didn't Follow Instructions. This woman had 10 follicles, but 0 eggs retrieved. Why? Because she decided that the intramuscular needle was "too big" and used the subcutaneous needle instead. Since the HCG didn't get absorbed, it could not trigger the eggs to mature. Since the eggs didn't mature, none could be retrieved. Ouch.

I always follow their instructions (yay OCD), but I didn't realize until I heard this tale just how critical the HCG trigger is. I got so paranoid about it and where to inject that they ended up drawing a giant target on my ass for me to use when the time comes. I've also called my neighbor who is in the medical profession and has done multiple IVF cycles to see if she is willing to help since Sweetie just about passed out at the notion of sticking me with a needle (so I guess that would be a no on helping me with the progesterone injections, huh?).

I have resigned myself to the fact that my ass is a giant pincushion and this shot is going to H-U-R-T.

Update: the shot did indeed H-U-R-T and we had some trouble getting all of the medicine into the syringe, but I managed to take it only 5 minutes late. Hopefully that 5 minutes won't make much of a difference.

The State of My Ovaries and Other News

In keeping with the January plethora of State of the State, Union, City, etc addresses, it is only appropriate that I give an update on all things having to do with Mrs.X.

Concerned Citizens of the Blogosphere, you have asked (well, actually not) how my formerly sleepy ovaries are doing on the nuke 'em method of egg production. Good news from Dr. Uterus: he has declared my ovaries to be 'beautiful', 'gorgeous' and humming along on their journey of egg production. My estrogen is apparently doing quite well and was also called 'gorgeous'.

I would not be exaggerating to say that he has a thing for hyperbole.

For my part, I feel as if I have swallowed a balloon that has lodged itself in my midsection and moves everytime I try to sit comfortably. Instead of the pinging and twinging earlier this week, we have moved into dull ache territory. And, I learned the obvious lesson the other night that intercourse (as Dr. Uterus put it) is not advisable. Ouch and ouch. But, Sweetie is now on conservation measures in anticipation of providing a specimen early next week, so I don't feel too bad completely turning him away.

I go back in for another scan tomorrow, Sunday.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
I finished Wuthering Heights and I have to say, I wasn't that impressed. Sorry, Emily dear, but I think Charlotte was the better writer. I haven't read Agnes Grey yet to see if Anne trumps either of you.

Sweetie now wants to get the Laurence Olivier version of the movie on DVD. I'm having trouble picturing him as a brooding Heathcliff.

Next on the reading list is Villette and The Boleyn Inheritance (I love trashy fiction!) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
I found the quilt pattern that I want to use for my friend's baby quilt. I sent a picture to her and she is thrilled. I'm going to use some wonderful vintage children's fabrics. Hopefully, it will turn out as beautifully as I am picturing seeing as how it is my first quilt and all.

She also absolved me of any guilt about not being able to handle details about her pregnancy. I am so grateful and happy that she is willing to forgive me this one thing. She is a truly wonderful friend.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
I got a new iPod but I'm still trying to figure out how to switch the library from my work computer to my home computer. I am searching for the elusive "iPod control" folder and so far have been disappointed. Damn you search dog!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Sweetie and I are meeting friends for a movie date tonight. On the marquee: Rambo. I'm in it just to see if Sylvester Stallone is using a walker yet.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Well, as you can plainly see, Concerned Citizens of the Blogosphere, Mrs. X is doing pretty well. She has shown much economy in her prudence, wisdom in her interactions and bloating in her ovaries (not to mention snark in her general direction). Go about your business knowing that Mrs. X, for one, has things well in hand.

Good night and Dog Bless.

Bigmouth Strikes Again

I was reminded yesterday of the lyrics to that seminal Smith's song, "Bigmouth Strikes Again" off of their album, The Queen is Dead. They came to me as I was having a phone call with the embryologist going over Sweetie's SA results.

Bigmouth oh ho ho ho ah la/ Big mouth, oh ho la la/ Bigmouth strikes again/ And I've got no right to take my place/With the human race

What, you ask could she have said that would earn these lyrics in particular? This woman put me through the wringer.

We have lots of information about Sweetie's counts from our six IUIs with Dr. Uterus, but the embryologist, Dr. Freak Out, had to have her own to review. So, Sweetie went to her office and "produced" the specimen. (He also reported that her "collection room" wasn't as nice as that of Dr. Uterus, which I call the Spooge Closet, but he was happy to have some new, er, literature.)

She called me with the results and prefaced them with a question as to whether Sweetie has been sick recently. Apparently, his motility was down from his prior IUI counts and it was in her "poor" range. As we were talking, she became convinced that something must be up since his motility was down (although the volume and viability were both in the normal range) from his prior counts. She warmed to her topic of poor motility and began to talk about the troubles of low motility while throwing ICSI around (which we were going to do at 50% of the fertilizations with anyway) and then prefacing that it also depended upon how many eggs I produced. Essentially, she spouted gloom and doom.

She also asked about our previous history and I told her of the one pregnancy and subsequent miscarriage. We had a karyotype performed and determined that there was a chromosomal abnormality, specifically a monosomy or Turner's Syndrome. Dr. Uterus assured us that this was a random occurrence and it was just a luck of the draw. There was nothing that either Sweetie or I contributed that caused it. Dr. Freak Out, on the other hand, started musing as to how strange it was that the one sperm that managed to fertilize the egg was able to produce a monosomy.

As if that wasn't enough, then she starts going on about how she has seen a correlation in her experience between low motility and abnormalities in resulting babies. Finally, she reminded me that since I had tubal surgery (mind you over a year ago), my chance of an ectopic increased. Thanks. So, to recap: according to Dr. Freak Out, my husband has abnormal sperm, we are doomed if he gets me pregnant again and we might as well just turn to donor sperm. That's essentially what we got out of the conversation.

And now I know how Joan of Arc felt/Now I know how Joan of Arc felt/As the flames rose to her roman nose/And her walkman started to melt

Not surprisingly, I called Sweetie as soon as I hung up with Dr. Freak Out and he freaked out. We had a tense conversation about what it means and how to go forward. He even asked if I wanted to cancel the cycle, to which I said no. The second call I made was to Dr. Uterus' office to see if he knew what this crackpot was talking about. I didn't end up talking with Dr. Uterus until today and I learned some very important facts.

1) Dr. Freak Out is not a medical doctor. She has a PhD, hence the doctor but she is certainly not a doctor who can dispense advice and genetic counseling. She was way out of line.

2) Sweetie's sperm are very likely just fine and Turner's is not caused by a pre-existing chromosomal abnormality in the sperm. It happens when the cells start to divide.

3) His motility is also not something to worry about, even if it was lower than his prior numbers.

Dr. Uterus is going to have a chat with Dr. Freak Out and remind her that this is not the kind of thing that you discuss with IVF patients. But, the freak out did give Sweetie and I a chance to discuss what we are comfortable with in terms of donor gametes. At this point, I told him, I am still very invested in having my own pregnancy, so I would go for donor sperm before adoption. He was ok with that.

Luckily, it looks as if we don't have to have that conversation again. And, hopefully, Dr. Freak Out has learned a valuable lesson on filtering.

Babymaking 101

I absolutely lurve these kind of posters that seek to condense incredibly complex biological procedures into four easy steps:

It's like the people at the top are saying, "why yes, I do think I will try IVF! Aren't those needles just darling?!"

There is a large version of this in the exam rooms at Dr. Uterus' office and it cracks me up everytime I see it. There is no way you can make such an invasive, expensive and time-consuming process seem more benign and easy than this poster.

At the same time, it serves to remind me that IVF is in effect babymaking dumbed down. I don't mean that the people who turn to IVF are dumb - no, I mean that all guess work is taken out of the process of conception. The eggs are perfectly matured and harvested. The sperm is introduced at the exact right moment - and some are even inserted into the egg. The resulting blastocysts are incubated at the exact temperature and implanted at the perfect time. The beauty of IVF is that it does make something that is so mysterious and left up to chance as controlled as possible. If only the process were a little less ... everything.

Shhhh! Sleeping Ovaries!

I went in for my baseline scan today as Big Red showed up right on time on Tuesday. Normally the baseline scan I have done is for an IUI to see if the roiding from the last cycle had sufficiently quieted down. This time it was to see if my ovaries were in nice Lupron-induced hibernation.

And you know what? They were.

They are happy sleeping ovaries that are about to woken up to the banging on the door with the fiercest round of Menopur they have ever seen. I can only imagine what kind of noise they are going to make. They make enough racket on two vials, Lord only knows what four starting out of the gate is going to do. I have a feeling that there will be enough twinging that I will feel like there is a pinball pinging around my mid-section. Oh, the joys of screwing with the reproductive cycle.

On a sad note, I also had my last glass of wine and bath this evening since I start on the Menopur tomorrow. I can live without the booze, but in the winter, there is nothing better than sinking into a tub of hot water with bubbles and good book. Like all things we give up for IF treatments, however, I will certainly live.

Lupron Symptom Watch: Day 7

Newest random symptom: acne in strange places.

Weird and unpleasant.

The Werewolf Drug

I started my Lupron injections last night and it was totally anticlimactic (except for the yowling cat outside of the bathroom wanting to get in to see what was so interesting that I had to close the door). Sweetie and I had discussed that Lupron was part of my protocol and he promptly decided that it should be called the Werewolf Drug in part because of the lup(us) (Latin for wolf) in the name and because of the horror stories of its effects.

So far, I haven't felt any different, but I'm practicing my howling just in case.

Update: I think I've had my first Lupron-fueled meltdown (how many more to go?) this afternoon. Dr. Uterus uses a different lab to do the actual IVF and they called this afternoon to get my insurance information. The lab has this way too perky woman working there who cheerfully informed me that I will probably have drop $1000 for her (including a $600 deductible - never heard of that before) which is in addition to the $1135 that I dropped at Dr. Uterus' office yesterday. We are using insurance, but it sure as hell doesn't seem like it right now. I called Sweetie to complain about this latest "oops" fee and once again bemoan the fact that we are paying for that which most people get to do for free. Unfortunately for him, he wasn't very helpful.

He kind of got on my case about letting this stuff bother me. I explained to him that each bill just ratchets up my anxiety and investment and my concern that I will fall really hard should the IVF not work (which seems perfectly reasonable to me). He opined that this was self-defeating (he's right) and that if I'm going to have that kind of attitude, we might as well just not do it and spend the money on travel or something. Not what I wanted to hear (but probably what I needed to hear). I just wanted to whine. Plain and simple. Instead, I get chastized.

Well, I'll just whine here: whine, whine, whine, whineeeeeeee, whine, whine, whhhhinnnnnne, whine, whine, whine! And, yes, I would like some cheese with that whine.

It's Like Christmas All Over Again

As I was brushing my teeth this morning, the door bell gonged and I scampered hurridly toward the front door, toothbrush still in my mouth. On the doorstep, shivering in the cold was the Magic Fed Ex Man holding a large package with my name on it. I knew exactly what it was: DRUGS! My mind immediately began singing, "Drugs, glorious drugs!/Lots of syringes and Lupron!"

And oh, what drugs there were. Boxes upon boxes of Menopur, the box of Lupron, the box with the HCG trigger (not my usual pre-filled Ovidrel), the icky progesterone shots, and antibiotics. And then there were the needles. There were so many that any professional baseball player would have swooned in envy. Bless the pharmacy, they were even tucked in the empty sharps container.

Why am I getting excited about drugs? Because otherwise I will cry like a baby at what I am about to put myself through to be able to produce a child.

Disapproving Cervix

I think my cervix has decided that it has had enough prodding for the year. It was very disapproving and disgruntled during my sonohysterogram today and is still making its displeasure known with spotting and some cramping. This year it saw lots of action - four IUIs, one HSG, one pap smear (which I swear didn't happen because I didn't feel a damn thing), and today's scream fest of an SHG. I'm sure if it could talk, it would say, really, enough, can I just have a break for a while to remember what it was like when I was a happy, unmolested cervix? It seems like a very long time since my cervix was seen once a year and then went on its merry way.

It's amazing how much agony one little body part can produce. I can't wait for childbirth.

Clear SHG But Still Seeing Red

I had my SHG today to confirm that my uterus is hospitable for growing human life - basically to confirm that I have no polyps, fibroids, etc. After all, what's the point in going down the IVF road if your uterus is already full with other stuff? It took Dr. Uterus two (!) attempts to get things just 'so' which meant two pokes of the catheter - I swear I almost fell off the table I was in such agony. It was by far the most painful procedure I've had so far in the infertility journey. It was 10 times worse than my first HSG when my tubes were blocked and the pressure from the dye on the blockage was quite painful. Even post-op of my D & C when I had to take the Satan drug Methergine was easier compared to this.

Dr. Uterus was very apologetic and also stated that I apparently was the first patient of his to have more pain with the SHG than with the HSG. I have always strived to be different but this was not what I was hoping for. I did do some googling and found several other ladies who had unbelievably painful SHGs, so I know that I'm not alone. The good news was that the scan was quite clear and there do not appear to be any problems uterus-wise.

The whole experience, though, threw me into a bit of a depression partly because it was so damn painful and partly because the whole process just took so freaking long. I waited for almost an hour before we got started and then it took another 20 minutes after the procedure to check-out. I was fairly despondent by the time I got home and had a good cry. I felt so alone, as if I was the only person having this terrible time today. Then I made lunch and felt better. Funny how that works.

Next Stop: Hyperventilation Land

So I got my tentative IVF protocol in the mail today and I actually almost started hyperventilating. Here it is:
I thought I was pretty experienced at the infertility thing after 6 IUIs, but I apparently don't know squat. I feel like I haven't gotten much information from Dr. Uterus' office about everything that is entailed, and as usual I will have to turn to Dr. Google to fill in the blanks. I do know that I have my BCPs and I'll start popping those tomorrow as Big Red showed up yesterday.

Apparently, I need to have a sonohysterogram (SHG) to make sure my uterus is polyp, fibroid and scar free. It makes perfect sense, but that wasn't exactly mentioned before. I have to schedule it for next week as Dr. Uterus is skipping town the first week in January (can you blame him? All of these rabid infertile women constantly hounding him to knock them up? The man must be exhausted). Since the SHG is best performed when the uterine lining is very low (all the better to see your uterus with my pretty), that will put it at the beginning of next week which as we all know is Christmas. And since the mail was delivered after Dr. Uterus' office closed today (they close at 12pm on Fridays) I have to wait to make the appointment until the 26th for the 27th or 28th. Grr and double grr. Why didn't the nurse mention this the freakin' two other times we've talked about the BCPs? I can already feel my OCD flaring up.

An abnormal SHG can temporarily put the kabosh on IVF so that will be the next hurdle. The good news is that they are going to continue using the medicine I use already (Menopur) which means the five or so vials I have left over will still be put to good use. There's nothing like shooting up with post-menopausal women's urine to make you feel good about yourself.

At the same time, though, I have to admit that a tiny part of me is beginning to get excited. This is a new adventure now matter how you look at it and we are starting to climb for the summit.

I Want the 29 Million That I Paid For!

Unlike all of our previous IUI attempts, Sweetie was not in town and thus could not provide a fresh specimen for use. I knew this ahead of time and so I had him make two deposits of troops in the Sperm Bank so that we wouldn't miss an entire cycle because of his work schedule. All told, he banked about 60 million sperm (Super Sweetie!). Only half usually survive the unfreezing, so the projected total for the insemination was 29 million. It was such a relief not to have to worry about how many he might produce on a given day, too, so it was worth the cost of freezing right there.

I arrived yesterday at Dr. Uterus' office at the appointed hour for The Procedure, but not after seeing Dr. Uterus drive into the garage while I was walking to his office - glad to know I wouldn't be keeping him waiting since I was running a little late myself. While I was being ushered into the ubiquitous exam room, his nurse told me that they had 11 million motile sperm unfrozen. I knew this meant that they had only unfrozen the one batch, not both. Rather than panic, though, I simply asked if it was possible to have the other one and told her that the plan all along was to use both. I refrained from demanding the 29 million sperm that I had paid for. There was no need to be rude, after all.

This turned out not to be a problem as it only takes 10 minutes to unthaw them (I'm still kind of fuzzy on how that actually happens - Sweetie swears they put it in the microwave). I was very glad to have that extra time to relax and do my version of meditation while listening to my favorite album by Matt Pond PA on my iPod. I was nicely relaxed and in a good place mentally when it was finally time.

I was nice and comfortable (well as comfortable as you can be on a table with a sheet while lying on paper) when Dr. Uterus came in as his usual bright self. I decided ahead of time that I wanted to have some time after he inserted the speculum to relax again since that particular part of the procedure is always uncomfortable and made me more tense. He had no problem with this and I was glad to have that extra time to get used to it. There was a little discomfort with the actual insemination, but that was similar to my prior ones.

In the end, we had 25.5 million motile after the unthawing which was pretty close to the anticipated number. I was perfectly happy with this outcome. And I was really proud of myself for being able to relax and be positive about the insemination, particularly in light of all of the hand-wringing-drama that it took to get there. Rather than assume that it was doomed because I was so worried, I recognized that I had a good chance and that chance was no where near being over.