Let it ride on Righty!

Don't you know it. AF came 3 days ago (in the end it was a 32 day cycle) and so I went in to my RE today. I have a nice 15mm cyst on the right. I wish a person could bet on ovarian cyst development like you can bet on race horses...

"I'll take a daily double on Lefty and let it ride on Righty for the win!"


Imagine the glory and riches! People would come from far and wide to watch me grow a cyst and then predict its exact measurement just before a wanding!

Ok, so I am not even let down about it this time. I am so used to delays. 'Scuse my French, but fuck if I'm going to let this make me feel bad. Here's the plan: going on Yasmin BCP for 10 days, trying to quiet down this cyst. If it works, we go immediately into FET #1 at that time. If the cyst is still there, it's Lupron time.

Note: I have tried Trivora (Triphasil) BCP twice, and it does NOTHING to supress cysts. But that one is a tri-phasic low dose pill and I remember reading somewhere that this type of pill is basically useless for this particular purpose. I wish I could find the study again. I saw my RE consulting with another doc this time (a gyno) and maybe that's why we're going with the Yasmin.

Yasmin is mono-phasic and each pill contains 3mg drospirenone (a progestin) and .03mg ethinyl estradiol (an estrogen). My only hope is that it does not cause any depression in me. Which happened a while ago on Mircette.

BTW, what does a FET cycle with Lupron look like? Can anyone give me a basic idea?

Hang with me, girls. I was hoping to begin the FET cycle officially today, but nope, not yet. In the meantime, I am reading you!

How Long Did it Take You?

Hey gals, I have a question...

How long did it take you to get your period the cycle AFTER IVF? That is to say, assuming you did not get pregnant. I am talking not about the period that you get to END the IVF cycle, but the one following.

I have had a very strange cycle. I think it's anovulatory (no ovulation) because I've had no signs of ovulation, and I usualy have plenty of signs in mid-cycle (abundant CM, temp rise, LH surge, you know the drill). And I don't feel the usual signs of impending period. BBs have remained small like at beginning of cycle, no cramps, no bloat. I am now CD30 (2 days late) and seem to be stuck in limbo. And no, I am not pregnant.

Thoughts? Experiences?

UPDATE:
(warning, gonna speak frankly here...) Ok, so now it's CD32 and I have just experienced 2 days of MAJOR abundant CM. I'm talking globs. Had a little bit of bleeding this morning but not enough to appear on a pad, and now it's totally stopped. I tested LH yesterday (dark but not positive) and today (lighter), so if there was a surge I might have missed it. Yesterday saliva was very clearly ferning (meaning high estrogen), not ferning today. Call me crazy, but did I just ovulate on CD32? Have not been temping, so no info there.

I have read that a little bleeding during ovulation is not abnormal after long follicular phases. Again - anyone? Most certainly this is the first time this has ever happened to me.

(note to Bea, who commented earlier: if I'm right and this luteal phase is normal, I will also have a 46 day cycle on this first "unmanipulated" cycle after IVF! Or maybe my period is on its way and will be here in a day or two. We'll see.)

Taking the Long Way 'Round

AF arrived two days ago and a brand new cycle has begun. We continue down the long road towards Frozen Embryo Transfer #1, with the weird fact of never having tried a fresh transfer from IVF #1. We've got five "excellent-quality" blastocysts frozen in batches of two, two and one. For this I am grateful.

It's been a crazy couple of weeks. I've been to the internal medicine doc, had a Holter monitor attached for 24 hours, did a Pulmonary Function Test, and a 2D Echocardiogram (ultrasound) of my ticker. All these tests have, so far, come back normal.

I have had some intermittant chest pains, however. So the RE wants to make absolutely sure I do not have some clotting issues (which would mean, perhaps, tiny embollisms that could be undetectable on tests that scan the larger vessels). Thing is, we can't do the bloodwork that tests for clotting issues until I wait out a full "natural" menstrual cycle for all the IVF hormones to clear. There's still too much stuff in my system that could easily skew the results.

How long DOES it take for my body to "go back to normal" after a retrieval cycle? I have noticed that my bbs are still big and haven't reduced the way they normally do by CD3. Anyone?

Admittedly, I've had some nasty heartburn (ouch!) since the ER incident - which, ironically, seems like it may have actually been caused by the chalky antiseptic stuff they gave me to drink in the ER to TEST for esophogeal issues. The heartburn seemed to begin just after that! But I could be totally wrong. And I digress. The chest pains that caused me to go to the ER in the first place were different - more to the right and left - sharper, almost itchy in nature. But apparently heartburn can cause some pretty weird chest pains that can even go up into the neck and down arms. And for sure heartburn can be caused by all the hormones. Talk to a pregnant lady to confirm that one.

So, though I am not stoked about WAITING some more... priorities are most certainly in order over here. I don't even care all that much that we didn't do the fresh transfer. Basically, getting pregnant fell WAY down in the priority line when I was scared there was something really wrong with my health. I'm still waiting for the all-clear, but feeling confident that it's nothing too drastic.

Regarding OHSS... My mild case went something like this: discomfort began 3 nights after retrieval. Was pretty uncomfortable for 2-3 days, with the worst couple hours being right after a vag ultrasound to check me out. Then, most of the swelling seemed to go down the couple days following that. Discomfort would flare up sometimes in the evenings - much better if I was lying flat (less pressure on the ovaries?) I kept drinking Smartwater - making sure to have 8oz per hour. (You CAN actually get really sick from over-hydrating, so be careful, girls.) I feel very lucky I didn't get a worse case. I can't believe how brave you women are who get a bad case of OHSS and actually do IVF again. I don't know if I could do that.

Ok, so it might be a little while until I post, since I'll be like a REGULAR PERSON this month, not even on BCPs! That's actually kinda cool.

I am thinking of all of you out there and wishing huge amounts of Summer Solstice luck to those of you cycling now. I'll hopefully be joining you for FET#1 within the next couple months.

I leave you with this. As my therapist so aptly suggested: "See what happens if you concentrate on having hope instead of forming expectations."

Not sure if this speaks to you, but it sure makes sense to me.

The Rocky Road Detour

Today we did not do transfer. Here's the story in a nutshell: as you know, I was dealing with a mild case of OHSS. Well, yesterday at about 7PM, I had a sharp chest pain. It was shocking and really hurt. But then it went away.

Now, I had had pains in my legs all week AND my Hubs had just given me a leg massage... so this worried me. I was concerned about a PE (pulmonary embolism) - that's a blod clot that can move from an extremity up into the lungs and beyond. Can be fatal, so no messing around here. And estrogen therapy is a big risk factor. God knows I have enough estrogen in my system right about now.

I called my RE and he told me to head straight to the ER, that it was a good sign that the pain had passed, I had no shortness of breath, no dizziness. But just to be prudent it was the right thing to do. So I did. Or, rather, we did.

Spent all night in the ER getting evaluated with various tests and scans, thankfully everything came back negative for PE. Then I started having some chest tightness and burning. I still have it now. We are fairly sure it's a nasty case of heartburn or espohogeal spasm. Ouch. Pepcid not helping. Anyone experience this during IVF?? (I am going to my internist tomorrow to be further evaluated.)

The biggest surprise was when my RE walked in to the emergency room at 11:30 at night just to check on me. He does NOT live close by and he gets up at like 5AM. Of course I had spoken to him on the phone, but I was not expecting this. You should have seen Hubs' face. He was really touched.

We talked about whether we should or should not transfer today. We elected not to. I had just had a dose of radiation and was injected with dye (from the CT scan) and I was tired and it just seemed like a poor idea. I love my RE. He is prudent. He wants me to get pregnant, but he has his priorities in order.

So, this morning we found out that all of our embies have survived until day 5 - so far we've frozen 4 fully-developed, excellent quality blastocysts (in 2 batches of 2) and they're giving the remaining three a little more time to develop before freezing them as well (hopefully they will make it). This is really great news, and makes the fact that we're not doing a fresh transfer a lot easier. We still have a chance(s) if they can survive the freeze and thaw.

Anyone out there ever get preg from FET? Now would be a good time to encourage me regarding this. ;)

OHSS of the Mild Variety

Well, I wasn't supposed to go in for a check-up today but I did. Because I've been feeling some pain in the abdomen and lower back and quite bloated along with some kind of leg cramps/leg pains.

Got wanded by the RE himself and diagnosed with a mild case of OHSS. Nothing original, as you all know, but a little disconcerting and scary if you are a medical paranoid like me. (Man, I'm gonna be a real treat for whoever is my doc if I do ever get pregnant.) Upon ultrasound: ovaries are a bit swolen, and I have some fluid in the abdomen. Blood pressure was normal, urine normal, pulse a bit racy at 90. (But it's back down to 68 now, so maybe I was just freaking and didn't know it? The heart sometimes has to work extra hard when there is an imbalance with the body fluids.)

So far it's not too bad, though I have to say, when I got back in the car right after the vag ultrasound, I stared to feel quite sick - nauseated and my scalp was kinda tight and tingly - I was dizzy. I wonder if palpating the ovaries with the wand squished out some more fluid to make me feel ugh? But I made it home and after about half an hour on the couch felt much better.

I admit I was a little surprised in that after all my research and blah blah blah, I somehow missed the fact that OHSS often starts 4-5 days AFTER RETRIEVAL even though the last injection was ages ago. I kinda thought that if it hadn't happened already (like during stims) that I was in the clear. Dum dum!

Of course I am:

1) drinking fluids - Smart Water (which you can get at Trader Joe's for cheap!) which is water with added electrolytes

2)trying to keep moving/walking around because if we do transfer tomorrow I will be bed resting. One rare but serious complication can be blod clots if one gets too dehydrated, and it's good not to sit/lay in one position too long.

3) continuing with my 81mg baby aspirin for same reason

4) my awesome acupuncturist suggested lymphatic system massage on my legs. you massage the inside of the legs starting with the big toe all the way up to the groin, then massage back down on the outside of the leg from the hip to the little toe. will it help? I dunno, but feels pretty good!

So, the plan from here is to go in to the clinic tomorrow at 7AM and we will decide then whether or not to transfer or freeze everything. OHSS can be exacerbated by a pregnancy, of course, so that's a little scary. But freezing all the blasts is not the optimal thing to do on the TTC front. So, we'll see.

Ok girls, need your input here. Who has been through this? Anyone have similar experience of feeling bad after an exam and then better later? Any additional tips for feeling better/getting better (aside from getting Aunt Flo, thankyouverymuch)? Anyone have a mild case, then got preg and it DIDN'T get worse? Please, though, go easy on me - no scary stories. I can't take that right now. And I think I already know too much.

Thanks for your support and good wishes and stuff. You do know how much it helps, right?

Quietly Dividing

Unless something changes, it looks like we're heading towards a 5-day transfer. My RE called this morning with the following news:






5 out of 6 of the embies that fertilized right away are Excellent quality (Grade 1) at the 6-8 cell stage. The other 1 out of those 6 is of VeryVery Good quality (Grade 1.5) at the 6-8 cell stage. Our late-bloomer is looking good but is still behind the others at 2-4 cells.

We are scheduled for a transfer of 2 blastocysts on Tuesday morning.

Not all of our embryos are statistically likely to make it to blast stage, so we might lose a few, but at this point (due to the good quality) it looks like we'll have enough to freeze for at least one FET. That would be really nice.

There's a lot of sensitive cell-division action that these embryos have to go through in the next couple days. They don't even check the embryos on Day 4 because they don't want to disturb them at all. Next, they'll be heading towards the compacted morula stage (16-32 cells), which I see as a kind of teenage phase - things can be kinda rough in there until they reach blastocyst.

So I am keeping calm and gentle thoughts while biology does its thing. Just think, we were all compacted morulas once. ;)

The First Phone Call

Egg retrieval was yesterday. Things went well. I got the same super anesthesiologist as I had for my cyst aspiration. Man, that guy is good. No "hangover" or grogginess afterwards, and the pain management (for whatever could be expected) has been perfect.

Hubs did his important part of the deal at home right before we left. "Oh man, I hope I got enough out," was his comment upon handing the cup over to me to keep warm. I want to shout out to the guys in our lives - they have their own pressures within all this. Props to the studs who have to do this on command at 5:30 in the morning while we "wait" on them to go have a surgical procedure. Seriously. All jokes aside, it takes a good amount of mind control and focus. I can tell you that that's the LAST thing I would want to do at that moment.

Anyway, my RE got 10 eggies out, and his comment to us a little later after I woke up a bit more in recovery was that they were excellent quality eggs. He said at that time that we were aiming at a 5-day transfer if everything continues to go well. Interesting. I didn't know they could examine the eggs alone and right away know they look good. But I'll take that. No complaints here.

Yesterday I napped and generally took it easy. My lower abdomen felt a little sore but not too bad, especially if I was lying down and taking the pressure off. Those ovaries went through a lot yesterday. Did you know that the way they aspirate the follicles on the far side of the ovary (the side furthest away from the vaginal canal where the ultasound-guided needle is) is by going RIGHT THROUGH THE OVARY? Dang. Sorry I asked.

Now it's about 25 hours since oocite retrieval. About an hour ago we got a phone call - the first of many we'll receive in the next couple days. It looks like 6 have fertilized for sure and there are 3 more that still look like they may fertilize. It's still pretty early in this part of the process. They say 60 to 80 percent of those eggs that show the first signs of fertilization will actually go on to be viable. So hopefully 1 or 2 of those questionable 3 will pull on through. If not, 6 is good.

Tomorrow we'll get another call, telling us whether we're likely to replace on Sunday (day 3) or Tuesday (day 5). In the meantime, I am so grateful that some eggs fertilized. This is a big stop along this road trip. This means that our "stuff" works together. This means that my eggs are not fried (at least as we can tell thus far). That Hubs' sperm can get in there and make things happen. This means that if this cycle does not wield a pregnancy (or a pregnancy that works) that we can try again. That surrogacy is a possibility. That IVF can potentially eventually work for us.

I will never consider this first IVF a "failed" cycle, even if we don't get pregnant. We've gained so much out of it already. This is important to those of us who are Unexplained. It gives us some answers - or I should say - eliminates some of the worst case scenarios.

Now, back in the metaphorical car (a hybrid, of course ;) ... and onward.

Trigger Mode

I shot the hCG trigger (10,000 USP units) last night at 7:45PM. It was no problem - I was allowed to give it sub-cutaneously in the thigh, not intramuscular, so it was pretty much on par with all the other pokes.

Hubs said from the other room, "Wait! Don't do it without me - I want to witness it." Fine with me - I thought that was cute of him. He was there for the initial injection lesson and first shots and since then, I've been taking care of all my injections without a "witness." The way I look at it, the fewer people in our little family who are wrapped up with the daily details, the better. He is sensitive and concerned and perfectly involved, but he's also really happy and not obsessed with this project. I feel this benefits both of us.

Note to self: In the past few hours I have felt really tired and bbs very sore. Makes sense with the hCG. I just want to remind myself that "symptoms" during an IVF cycle are pretty much a bogus indicator of anything. And hey, does anyone know: is 10,000 USP units a lot of hCG? If I didn't get nauseated at all as a reaction to this injection, can we assume that I would not show any nausea at an early pregnancy amount of less than 10,000 USP?

Retrieval is tomorrow. We have to be there at 6:15AM, and Hubs has to do his business (or as he so politely says it, "play the baloney banjo") right before we take off in the car. I am to keep it warm on the short drive. The nurse suggested placing it in my cleavage, until I pointed out that ... um... I don't actually HAVE a cleavage, what with my tremendous A-cups. We had a good laugh over that. Between the thighs will do. Hubs can drive.

I'll update tomorrow or Friday. Hey SuperWomen, think good retrieval and fertilization thoughts for me, will ya? Yet another important stop down this long road.

Checking the Scenery Along the Way

Still truckin' along. Had my Day 7 examination today. The follicles are still doing their thing:

now 5 worth counting on the right ovary, ranging from 19 to 9 (average is 15)

now 9 worth counting on the left ovary, ranging from 20 to 12 (average is 16)

I forgot to get my E2 number from last time, but they drew blood again today, so I know it's being carfully monitored. Endometrium thickness was 8.9-ish.

Follistim has been reduced by half to 100 IU for tonight and tomorrow night (extra day added on). Tomorrow will be my last injections of Ganirelix, Lupron, and Repronex - which has also been reduced by half to 75 IU.

Tomorrow night I shoot the hCG trigger at 7:45PM and you know that can only mean one thing... retrieval is scheduled for Thursday morning bright and early. Hopefully more of the follicles will plump up and mature to where they need to be - around 20. My RE seems pleased with progress so far.

Physically I feel pretty much normal. Maybe a bit tired but my gut's feeling good and I am thankful. Also, I think maybe the estrogen patches are having a calming effect, mentally. Or perhaps I am inventing this! But I feel pretty chill. And chill is good. Another reason for feeling relaxed is...

***

A few hours after my RE checkup, I went for an appointment with the acupuncturist who will be supporting me during my embryo replacement - before and after. (My regular acupuncturist will unfortunately be out of town, but it's all working out.) My "substitute" is really good and I had a nice session with her today. She works out of part of the office where my RE is located, so I saw him when I was coming out and he spontaneously gave me a hug. It was cool. He's a great doc and I know he hopes the best for me - for all his patients. Nothing wrong with a human touch in my book.

Anyhow, I asked the "substitute" actupuncturist to use bigger needles on me next time. She used really thin ones this time because it was my first session with her and she likes to go easy on people at first. But I told her that I am used to bigger needles and that she could use bigger ones during the replacement. Holy crap. I think I'm getting addicted to things being stuck in me. Seriously. It feels good. (Maybe I should report this to my therapist.)

A Little Further Down the Road

Today is my 5th day of stims (Repronex 150 IU and Follistim 200 IU) and I added my Ganirelix (250 - not sure of the unit of measurement on this one, looks like a funky "u" - Thalia, set me striaght if you're reading :) and Luveris (75 IU). Also stuck on some estrogen patches (.1 mg one on each butt cheek).

It sounds like a lot of action, but really it's 2 injections in the AM (the Luveris gets mixed in with the Repronex and then the Ganirelix is a pre-filled syringe) and the Follistim pen in the PM. Patches, of course, are cake. LOL!

Here is my follie report as of this morning:

4 worth counting on the right ovary, ranging from 15 to 11 (most are about 13)
8 worth counting on the left ovary, ranging from 17 to 6 (most are about 14)

This is interesting because when I was checked at Day 3 of stims, I only had 3 on the right and 6 on the left. I was under the impression that what was developing at that time would continue to grow but that it was unlikely that anything else would ripen on this cycle. Even the RE seemed pleasantly surprised. Looks like a few extra follies have decided to join the party. We'll see.

Blood was drawn for E2 but I don't know the results yet. Endometrium measuring 8.6 (I think that's right. I caught the number on the ultrasound screen, I forgot to ask for a printout of that one.

Physically, I felt nothing until last night. Now, I have some fullness in the lower abdomen and some twinges in the ovaries. i would definitely not call it pain, just twinges. In fact, since you members of the Royal Court know I am the Empress of Cysts... I must say, the sensations in the ovaries are very similar to what I feel pretty much every month when I have a whopper brewing. Only this time it's in both ovaries and I feel like it's warranted.

Mentally, I have had an easier time as of late. Seeing my therapist weekly. Seeing my acupuncturist weekly. Taking good care of myself. I take no good days for granted and am thus far balanced and measured in my thoughts about this cycle. Already I feel we're gaining and gathering information. We know I respond nicely to stims and that follicles are developing. This is one good, solid step down this long, long road. From here, who knows until we get there?

One more check-up on Day 7 of stims (Monday) and if everything is going as projected, trigger will likely be on Day 8 (Tuesday) and retrieval on Thursday.

My Protocol

First of all, RIP cyst. You have hereby been banished from the Queendom... ie: aspirated. Procedure was 100% painless. Felt a little tired after, which is to be expected, but no nausea or anything. I would say the one nice thing about having gone through this is that it's the exact same procedure for retrieval, so I'll know what to expect. Fingers crossed that I get the same anesthesiologist for my retrieval day. He did a good job.

Guess what guys? I HAVE FINALLY STARTED IVF #1! Can you friggin' believe it? I know there's a long, (bumpy) road ahead but I've finally stepped onto that road and started walking. I did my first injections about 1/2 hour after the procedure this morning with nurse N instructing and Hubs observing so that he could remind me later of any details I might have been too fuzzy to absorb.

I have to say, I had zero hesitation. I was so damn happy to finally be getting started I just stuck the needles right in. It didn't hurt at all. One in the abdomen, one in the outer thigh. Short, thin little subcutaneous needles. It was SO not dramatic. (Okay, I WAS still a little bit on drugs, so I'll give you that, but seriously, for those of you who haven't been initiated yet: it is not nearly as big a deal as you might imagine. Unfounded fear is the biggest problem with the injection stuff. And I count myself in that club! Read this post to see my initial reaction to the box of drugs and syringes when I first received them back in March.)

Here is my basic protocol, of course with the understanding that the stim days could be extended or shortened and that med amounts could change (I don't know the precise IUs yet for anything else - will update).

CD1-CD7: Repronex in AM (150 IU FSH/150 IU LH), Follistim in PM (200 IU follitropin beta)
CD5: Repronex, Ganirilix (antagon), Luveris (lutropin alfa), Estrogen patch
CD6: Ganirilix, Luveris
CD7: Ganirilix, Luveris, change Estrogen patch
CD8: Ganirilix, Luveris, hCG Trigger
CD9: change Estrogen patch
CD10: retrieval

And I'm not aware of my exact antral follicle count, but it's something around 7-ish on each ovary. I hope they like to party... (addendum: as Bea said in the comments, "just hard enough.")

Empress of Cysts!

Do not worry my royal courtesans. I have not forsaken you. It is I, the Queen of Postponement, now officially adding to my title: Empress of Cysts!

Just got back from the RE to find that after 18 days on BCPs the very same cyst that postponed us last month has tripled in size. It's a whopper, as they say in the common language. This is only to be expected for a monarch of my veneration and status.

The weird (good) thing is that it's not bothering me at all - pysically at least. However, it might very well explain some of my increased anxiety/depressive feelings this past month. If this puppy is producing lots of hormones it would be the answer to a great deal of consternation. I have been working weekly with the Imperial Therapist and feel that I definitely have things I need to work out/adjust in my life, etc. And this is helping! But there seems also to be an element of chemical imbalance that is frustrating. Could this be the answer?

WE WILL FIND OUT! Because I am going in tomorrow morning at 6AM to aspirate the fucker (sorry, that's not very regal of me, but it's either I swear at the cyst or the next nurse who wands me loses her head) and begin stims. Now, of course, it will be tough to decipher whether my mental state improves with the aspiration because I will at the same time begin pumping my body full of Follistim and Repronex. God only knows what these new chems will do. Any chance these drugs will make me feel GOOD? (C'mon people, throw me a line here...)

This was not unexpected, so I am not freaked. Even an Empress doesn't enjoy spending a big wad of money for an extra medical procedure, but at this point, I am ready to do anything to just be able to finally start IVF cycle #1. These months of postponement have been a royal drag.

I'll update tomorrow with tales of anesthesia, aspiration and my magesterial protocol.

ALL RISE! Hear ye hear ye: the Empress is now going to the beach. Later.

A Word About Therapy

Hi all! I'm back from the DC/NYC trip and it was super. Tomorrow I will swallow my last BCP and then wait for AF. Then maybe we'll get lucky and I'll have no ovarian cyst, and if I do we'll aspirate it and begin IVF injections next week.

So while I'm waiting to see how all that pans out, I thought I would share what I've been through over the past few weeks.

2 1/2 weeks ago I was sitting at dinner at my favorite sushi restaurant with my Hubs and some very close friends (another couple). In the middle of dinner with no warning, I felt a plunge of depression (or it might be described as a surge of anxiety - I am learning). I felt awful, couldn't finish my delicious meal, went to the bathroom with loose bowels and felt just hopeless. It wasn't that we were talking about anything specific (or were we?) or that I was thinking about anything I particular (or was I?) I just plunged. For the next 3 or 4 days after that, I was feeling bad, but never as bad as that initial plunge, but still bad. Depressed, anxious, hopeless. Most of all, fearful that I would continue to feel this way and not sure I could handle that.

So I went and got help. I got a referral to a coulple of therapists and I went to see one as soon as I could get in. It helped immensely. I have another appointment with her and one with another therapist later this week - they say it is good to see a few people and see who is the best fit.

I suspect that hormones played a part - a big cyst can cause some symptoms, I am told. And when I started the BCPs things got noticably better - but this was in concert with my getting professional help, so it's impossible to tell. But I remain vigilant about hormones and mental health. I remain fearful of injecting myself with the IVF drugs and also fearful of pregnancy and post-partum depressions and their hormonal connections. Part of my work will be dealing with these fears.

The first therapist I met with told me that fertility/IVF issues are second only to dealing with a death when it comes to stress levels. Moreso than a divorce, moreso than losing a job, moreso than other big life changes. (Relatively speaking, of course. Stress is different for everyone with every different situation. But it did put it in perspective.) We had a fruitful first session, and I won't go into grand detail except to say that I cried like a fountain the entire time and it felt great. And during my trip east, I also told my nuclear family about our struggles and about IVF. Reaction was tremendous. Understanding and quiet and centered on how they could support us best. This was a big breakthrough for me.

I am curious about your experiences. You, out there. My IVF/fertility issue friends. I know we often speak of loss, of stress of fear. I have read in your blogs about quite a few panic attacks and depressive episodes. I would really like to hear some positive stories about how you came through all this and felt peace again. Pregancy, baby or not.

If anyone is reading this who is feeling really bad mentally (maybe not all the time, but wish you were doing better), I cannot recommend enough the value of a mental-health professional. These folks seriously know what they're doing, and even though we feel very alone in these dark moments and can't imagine anyone else really understanding how we feel, they will tell you that there is enough similarity in how humans experience anxiety and depression that there are MANY things they can help us do to feel better.

I send you hugs and hope. (I know we sometimes hate hope, but I really don't see the point in living without it.)

The Queen of Postponement Has Arrived!

Sound the horns! Raise the standard! Her Majesty is in da house!






This morning I went to my RE, hoping, as you know, to begin IVF #1 but feeling very much abdominally that a cyst would be present and a problem. Well, after a thorough going-over with the Wagina Wand (I'm a Queen, people. It was gold-plated under that latex) it turns out that I was thoroughly and positively correct. Right side, nice and juicy. And THAT is why I reign supreme.

My RE wants to try one more month to get me cyst free. If I show up with a cyst on the next start date (for the 3rd time), he will aspirate it and we will be a go tht same day. And don't think this Monarch of Menses can't grow a cyst on BCP's. I did that last month just for kicks.

I do appreciate my RE's prudence. He offered to aspirate it today and start if we insisted, but he knows this will cost a buch of extra bucks (that we don't have) and it does carry a small risk, as any aspiration/retrieval procedure does. (Don't believe me? Read the last few entries on Beagle's blog to scare yourself shitless regarding punctured bladders.)

So, I am starting birth control pills AGAIN on Sunday and taking them for approximately 18 days. He said we could go as few as 10 days, but I figured this was a sign that I, the Queen, should take advantage of the postponement and go to my Dad's 65th birthday in NYC. So I asked for another week tacked on. I was feeling horribly guilty about skipping the celebration and LYING about the reason to the person I trust the most in the entire world, and this frees me.

Dare I say some things happen for a reason? My guilt mechanism sure as hell feels better. This is almost enough to have me not regret the postponement at all. Weird but true. So seriously, don't waste your comfort and pity on me this time - I may really need it down the road, and god knows some other Queen is needing it much more right now. This time, I would appreciate instead, your wishes of Bon Voyage for my birth-controlled trip to NYC.

So, it's back to hanging about in my royal way and visiting your blogs. I may not post here for a couple weeks, but I am reading you. So many of you have so much going on, I bestow upon you bravery during the storm, and I dispatch my knights to get your backs. (They are female ART Knights, very tough and effective. Do NOT mess.)

Onward, m'ladies.

Eggwhites: Just Another Word for Omelette

Well, my TWW is done but I am still in the nether-region of where the F is AF? I've got the collection of negative pee stix (11DPO, 12DPO, 13DPO, 15DPO), the negative Beta (13DPO), I've got the spotting, now just waiting for the BBT to fall and AF to really get here full-force.

(Before you think I'm a totall kook for peeing on all those sticks, I really did it as a matter of curiosity and information gathering - I would really like to know if I manage to get to some sort of implantation stage even if it doesn't hold on past normal cycle length.)

I have to say it was an interesting TWW. Wasn't really expecting anything (if I were, we probably wouldn't be already scheduled for IVF) but I will admit: I had some very interesting symptoms. I know they can ALL be chalked up to PMS (except for maybe the last weird one) but I was thinking... maybeeeeeee....

C'mon. You know you miss the olden days of Symptoms Without Suppositories (or injections) so what the heck. I'll treat you:

- my small bbs got bigger/denser (always do on 2nd half of cycle) but nipples were puffed out and were stinging a whole lot, especially at night and that was new to me. sometimes itchy-stingy. haven't felt that since I first grew 'em!

- I had light AF type cramping during 6,7,8 DPO. Thought that was nice timing... right?

- I had interesting "twitchy" feelings in the UtRus. Like, you know when you have a muscle twitch in your leg and you can actually see it twitching but you're not consciously moving it? It felt very much like that. happened about 1/2 dozen times per day from 9DPO until 14DPO.

- I was peeing constantly. But I was also really drinking a lot of water, so whatever.

- BBT is currently still high and (spotting notwithstanding) I am 1 day late. Very unusual for me.

- Drumroll please...

- Ok here's the weird one. Started around 8DPO. Oh my god my palms were itching the heck out of me. And the bottoms of my feet. And for about 3 days the nape of my neck/back of my scalp. like UBER itching. Not all at once... a location would just start itching and it would last for about 10 min and fade away. No rashes, no allergies, nothing to be seen. So I figured it was hormonal. Has anyone, ANYONE, had this before - preg or not? Totally weird.

- most of these "symptoms" have abated. funny how they do that after a negative Beta.

And that's it for the fun. Comments and opinions welcome on my retardedness. Amazing what a mindf*ck TTC is in general, no? Take that x 100 for a person going through IVF with all the shots and physical discomforts and money involved... I'm going there next.

Hoping CD1 will be tomorrow so I can get in to the RE by Sat and not have to wait until next week. And hope for no cyst. I always seem to have one present at the end of most cycles (did I tell you I suspect I may have LUF Syndrome? But have never been diagnosed - except for self-diagnosed with my Doctorate from Google University.)

p.s. We ate the remainder of those organic pasteurized eggwhites in a delicious and healthy fritatta! So all was not lost!

UPDATE: It's now April 4 and AF arrived this morning. So we go in for cooter-cam tomorrow AM. I suspect a cyst on the right side (I'm getting pretty good at this cyst thing. I can feel it)... anyone want to wager how big? I am guessing at least 6cm. But this time, unless the RE feels otherwise, I will elect to aspirate instead of wait. if we wait, it's gonna be a crap shoot for me to find a month without a cyst.

6 Things Meme

Sunny Jenny tagged me with this meme so I'll play. I've been sticking only to the theme at hand here on this blog, but why not take a little break.

So here are...

Six Interesting Things about Me

1) I once read in a dumb women's magazine that if you weren't fat by the age of 30, you'd never be fat. I never forgot that dumb "fact." And I always wonder if I should test the theory with some, you know, delicious treats on a very regular basis. But then I can't bring myself to do it. Ahhh! It's true!

2) At parties I often find myself talking to/playing with the kids instead of interacting with the adults. They're often times more real. And more interesting. And I don't feel shy with them.

3) I stopped consuming all artificial sweeteners about 5 years ago because they scare me. It was after I had a very large diet soda and then tasted a sweet "aftertaste" about 7 hours later. I thought, oh my god, these chemicals cannot be innocuous.

4) I made my close friend promise that if ever I was in a coma she would pluck out my chin hairs regularly so that other people wouldn't see them. (No, I don't have PCOS - it's just a few regular ol' genetic whiskers. Attractive. I know.) I promised to do the same for her. Wherepon she told me I should also pluck her nipple hairs for her.

5) Part of me wishes I would have become a doctor like my dad. It's not a major regret, just a recurring thought. More and more often as I get older and find myself hyper-interested in medical issues and wishing I knew more and had more solid scientific background. My cousin thinks I should go to medical school. (I would be a first-year resident at like, age 45. Not impossible but... also not sane.)

6) I sometimes have creative ideas or am able to solve problems I couldn't solve before, right when I'm waking up. Sometimes I try to stay in that "just waking up" state for an extended time for this reason.

Well, I think everyone's been tagged by now, so I'll just say, grab this meme if you feel like it and tell us about yourself... after all, TTC and IF issues are only part of each of our lives.

Reproductive Semantics

I thought I would bring this very insightful thought from Comment Land onto Front Page. The famous and ever-supportive Soralis brings up a very good point regarding the semantics used in the IRS (and apparently Canadian as well) tax forms. Read the previous post for context.

Soralis Wrote:
I just had to say something about the Fertility Enhancement... I think it is really bad that it's called enhancement, makes people believe that we are improving on something that actually works. (I got a letter from our provincial health minister and she reffered to it as fertility enhancement and said it wasn't covered because it wasn't medically necessary.)

Soralis, you raise an excellent point pertaining to the semantics. It absolutely should be thought of as medically necessary and should be covered by insurance. And now that I think of it, "enhancement"... sort of does imply that it's just making something that works even better - like that messed-up assumption that all IVF folks are TRYING to "get twins" or whatever. (And "enhancement" on its own actually makes me think of breast augmentation or something... hmm...)

That being said, I am a steadfast believer in the power of positive thought. I like to think (of myself and of the world around me) in positive terms rather than negative. That's why the term appealed to me. Of course, I do need some professional scientific expertise to (hopefully) make things happen and plan to use all tools available to me to do it.

But you are so right. We all really should become activists to a certain degree. Speak out, write letters and be heard, like you have done. Fertility issues are so private and so painful, we often want to forget about all of it as soon as we can (regardless of outcome). But perhaps we owe it to our sisters (and the men and women who love them) who will follow us to call for change in health care policy. To not be ashamed and step up. Thank you for (inadvertantly) making me realize I have a responsibility to do something. I'm not quite sure yet what or when, but you've got me thinking.

ART is Tax Deductible

You probably already know this but I did not until yesterday. Save all your receipts for IVF - it is all tax deductible. The doctor's bills, the meds, car milage (only .22/mile but every bit counts), travel & lodging, etc. (Actually, it appears that any medical/dental expenses not covered by insurance are deductible, but it's nice to know they don't EXCLUDE fertility stuff.)

Here is the IRS's Publication 502 Medical and Dental Expenses (Including the Health Coverage Tax Credit) 2005

And this is the particular paragraph:

Fertility Enhancement
You can include in medical expenses the cost of the following procedures to overcome an inability to have children.

- Procedures such as in vitro fertilization (including temporary storage of eggs or sperm).

- Surgery, including an operation to reverse prior surgery that prevented the person operated on from having children.

Just thought I'd post in case there was someone else out there as clueless as me. ;) That's why I have an accountant. I don't think I would have thought of disclosing this information to him had I not been aware.

p.s.
i think Fertility Enhancement is a much nicer way of thinking about it. Better than Infertile or Subfertile. And possibly more accurate in many cases.

Update: Ovu-LATE-shun

Well whaddaya know. So the last few mornings I've taken my BBT and there was no rise whatsoever. Then, this morning (CD 17-unheard of for me) I presented with abundant, stretchy CM. So I tested LH again and lo and behold it was a very dark positive. So I guess I hadn't ovulated a few days ago and my body is trying again. I suspected this might happen. Will continue to test BBT to see if there's a rise.

(Note: The Hubs and I did the deed today but didn't use the pasteurized eggwhites this time. Maybe we'll go for it again tomorrow. So... what was already a wholly unscientific experiment with no controls : Can Eggwhites Up Your Cooter Help You Get Knocked Up Even When You Know It's a Friggin' Retarded Idea? is even further tainted. All I know is that I am SO ready for our first IVF cycle approximately 17 or 18 days from now.)

It's Eggie Time!

Yes it's Easter time, and yes, I am into counting my antral follicles and such, but I am not referring to either of those. No, fair readers, this time I am referring to the pasteurized eggwhites I shot up my cooter this afternoon.

As you all know, we were postponed from IVF this cycle because of a cycst that I managed to develop even while on BCPs. Which is supposed to be nearly impossible. So, what the hell, why not try the mythical eggwhite as sperm-friendly lube and great medium for spermular travel this cycle? The Easter Bunny would be proud, no? And as we are labled with Unexplained Infertility, we deserve to do stupid things on long weekends. Sue us.

Now mind you, I normally have very nice, clear signs of ovulation each month on day 13, 14, or 15: abundant CM, LH predictor kit cooperatively giving me the only pink line I ever get to see. This month, though, having just come off BCPs and having a big ol' cyst on Leftie, things seem a bit less predicable. In fact, with no CM to speak of, I figured I wouldn't be ovulating this month at all. Ah well. We're scheduled for IVF next month anyhow, assuming cyst is gone.

My current cycle looks like this: no detectable CM and the LH seemed to rise during the past few cycle days - 12, 13 and 14 - (darkest yesterday afternoon but still not "positive") but then I detected NO LH AT ALL today which is CD 15. So I figured hey, maybe I missed detecting the actual surge sometime yesterday and today is O day. Why not give it a go. Clearly we've got nothing to lose.



So, I took a baby medicine dropper, pictured above, cleaned it thoroughly with very hot soapy water. Then, I opened a brand-new container of the organic, pasteurized egg whites* (also pictured above) and sucked some up. Then, I let it sit in the dropper for about 15 min to warm up. Then, I lay on the bed and squished it in. Ok. A bit weird, but so far so good.

Luckily, the Hubs works from home. So I intercommed into his office (in the garage) and invited him to horizontal mombo. He replied, "Um, uh... hon... you told me earlier that you thought you weren't going to ovulate this month." I was like, "Yeah, I'm probably not ovulating, but there's a small chance I might be, so why not." He was like, "Ummm... I... well, I kinda released a few hours ago." And now, friends, we all know why the Hubs likes working at home! LOL!

But he is a trooper and so said, "Hey, let's give it a go. I don't know how much I've got in there, but it only takes one, right?" You gotta love the guy. And he ain't 19, either. He's 35. So all respect going out to the Hubs and his refractory period today! Props, dude! We did the deed, slipping around in eggwhites, and I lay around basting for a while.

It won't work. It was just for experimental fun. What, you think I was born yesterday? This is an IVF blog, people. I am way over the "normal" way of procreation. I'm probably not ovulating (who knows if I ever actually release eggs, anyway), Hubs made his end of the equation practically ineffective, and I have a big cyst screwing up this cycle in any case. So whatever. But I'll test BBT the next couple mornings to see if there's a rise. if not, maybe I'll keep on with the LH testing for shits & giggles.

Balk balk baaaaaalk. Balk balk balk baaaalk! (That's me turning into a chicken and wishing you all a very happy and eggful (the kind that matters) Easter and Passover holiday.)

* As I am quite sure you've read at some point, there is risk of infection when using regular eggwhites out of an egg. Eggs often contain salmonella. However, I figured I was mitigating most of this risk by using these pasteurized (and organic, to boot) egg whites. Is there still some small risk? Maybe, but I felt comfortable with this decision:

Regular CD3: Postponed

Well, here's a true test of my optimism in the last post. We've been postponed for a month because I have a big ol' cyst on the left ovary.

I managed to grow it even on BCPs! This is the 5th or 6th big cyst I've had diagnosed (on either ovary) since TTC a year ago. I don't have POS, it's just a single, big, probably corpus luteum cyst that flares up big and goes away by the next cycle. I know most women have a cyst like this from time to time, it's not unusual. But this could be the missing puzzle piece as to our "unexplained" part.

Anyway, the FE gave us a 3-part choice: 1) proceed with IVF during this cycle with the understanding that there's a small risk that a cyst under stim could result in torsion or other bad complications 2) aspirate the cyst which would cost $$ and a tiny risk 3) wait until next month. Of course he recommended we just wait, saying that everything else looks good, that I have time on my side, plenty of follicles, and my bloodwork is fine. I don't even need to go back on BCPs because that didn't successfully prevent a cyst anyway.

So, I felt let down, OF COURSE! But am already bucking up. The Hubs was pretty relaxed about the whole thing, asking the FE right off if we could "try the regular way" this month. He's so cute.

A months a month, no big deal - and I'm sure there will be other delays, surprises and disappointments along the way. In the meantime, I am going to enjoy this month of beautiful spring. Oh, and perhaps we'll try the pasteurized eggwhites+medicine dropper trick ;) Well I'll be damned... it seems that my optimism is intact!

I may not post for a while (nothing to say on an IVF blog while on hold) but will lurk and be back soon. Hugs and good luck to everyone else out there, I'll be reading you!

Pre-day 22: Happy to See AF (for once)

Yesssss. Bleeding. Hello Monthly Visitor, may I offer you a fresh and delicious tampon? And this ain't no April Fool's joke. I have been off the BCPs for 3 days and here we are. Excellent Smithers, things are going exactly as planned.

We are on the launching pad to begin this first IVF cycle. A FE nurse called to remind me "no more pills" a couple days ago and confirmed me for tomorrow's injection instruction and beginning shots. I will post a thorough protocol after I've been schooled.

Well guys, I feel optimistic, relaxed, and... thoroughly committed to enjoying my life aside from IVF. Because, yes, I have a (really good) life aside from this. I admit that I have become tunnel-visioned at times about TTC, but I remain a happy person, open-minded and ready for what comes my way. We will do whatever it takes (within reason) to become pregnant and have a child to raise, but some things in life you just can't "make happen," you can only open the doors. And you know what, I am actually ok with that. For real. It doesn't mean I want it any less than anyone else, it just means that I know I'll be ok, and still whole, if it doesn't happen. That's just my truth.

The sun is shining, there are flowers all over, life is good!

If you're reading and in a different emotional place right now, I hope you're better soon. I take nothing for granted. I promise. And I send you a big hug with a virtual flower.

Pre-Day 20: IVF Acronyms

As y'all know, I am kinda new to the game here. When I first started researching IVF, actually, to be more precise, when I first started researching TTC issues (that's trying to conceive), I discovered and had to learn (as we all do) a whole new language of acronyms! Pretty amazing, really. Those IM'ing teenagers got nothing on us when it comes to acronyms. They become ingrained pretty quickly.

Here is a comprehensive list of fertility-related acronyms that might come in handy for anyone else out there who is kinda new to the game. Some are medical, others are just funny internet-invented acronyms.

Not everything I've heard of is on there. For example TTCers love to use TMI (too much information) ...like when describing cervical mucous (CM) or various devices shoved up the nether region or whatever. But we all know we can never get TMI!

Pre-Day 16: Jealousy, an Unusual Appearance

I rarely experience jealousy. I remember that I did occasionally as a kid, but not really so much since I've been an adult. When good things happen to others (even those I don't like so much) I don't feel jealous. I don't really see a connection between them and me. For example, even when someone gets a job that I was hoping to get... I don't quite see it as a reflection on me, so I don't resent them for it. I might be a bit disappointed but then I just figure it wasn't meant to be for me and I let it roll off. I don't get jealous when other women hit on my (very) handsome husband. I choose to trust him, and I don't worry about it. If I didn't trust him, I would not be in the relationship. I don't know why all this is the case with me, but it just seems to be.

Well, I recently found out that a "couple friends" of ours is 13 weeks pregnant and when my husband told me I got into the shower and balled my eyes out. It's not that I don't wish them well (I most certainly do!) but I think I was using their TTC as a bit of an emotional crutch. Like a mental, "See, we're not the only ones trying for a long time. It's just not so easy for everyone. We're not the only ones." (They had been very open about TTC so I knew they were trying, whereas we have kept TTC to ourselves.)

I could never have suspected it would be such a blow when he told me. I was jealous and fucking pissed off. It wasn't about her. Or them. It was about my frustration. It was real, true jealousy. I did not like it.

I don't feel it very intensely now, after that initial explosion. Saw her the other day and it was fine to talk about all the details of her pregnancy and she's a cool person. There was only a tiny undercurrent left in me.

Funny, because right around the same time (same week!) ANOTHER friend reported that she was pregnant. But this did not ilicit the same reaction in me. I mean, I think I did say, "Oh man, another one!" or something, but there were no jealous feelings. I really do think the problem lies in the way I had set my first friend up as a crutch for myself.

Last time that'll happen.

Hey, all you new IF web-friends out there ... I hereby promise you that I will never feel jealous when you've become pregnant. So don't forget to celebrate with me when it happens!! I will read your pregnancy and parenting blogs and take it all as proof that good things happen to good people :) You are not my new friends because you're experiencing IF (even though that's how we found one another). You're my new friends because you're fun, funny, articulate, honest, open women who have the guts to lay it all out. That will not change.

May this Spring be fertile for all of you, in mind, body and ... that other place!

Pre-Day 14: Tonight's Movie Starring... Oocites!

Check it out. I found this completely amazing IVF video on OR Live. (I am a giant geek. This website ROCKS.)

The Center for Reproductive Medicine at Wake Forest University Baptist Medical Center, was featured in this really cool webcast showing how they do IVF, including oocite retrieval...



... what the embryologist sees and does in the lab...





... how the eggs and sperm look when they're being cultured and/or manipulated...





... stuff like stages of meiosis, checking for pronuclei, morula stage, blastocyst stage...



... and how the geneticist does preimplantation genetic diagnosis, and everything...



I loved watching it, because I am quite interested in the medical and bio procedures and frankly, I sort of felt uneducated about a lot of this. This video is long overdue in answering a lot of questions for me. It's aimed at a lay audience (no pun intended for all you TTC'ers out there) but they explain assuming you have half a brain. Which is always good. Because most of us do.

It's over an hour, so pop some corn and make some time if you're interested.

(Be sure to disable your browser's pop-ups. Also, I think they might have had a few technical difficulties during their webcast because sometimes they don't cut away effectively to the slides/insert videos.)

Pre-Day 12: I'm a (Lying) Little Teapot

This excellent post entitled "A watched Pot Never Boils" by Flygirl on She Speaks got me thinking. Click over and read it - she's a great writer.

I am generally a really open person. What you see is what you get. I think my friends and family trust me and know that I don't much bother with artifice. That being said...

Trying to conceive feels like a really private thing to me. From the very beginning, I have kept it to myself (except for one VERY close friend who promised to never ask me "how it's going" and another far-away, IF-experienced friend who I called up to ask about IVF issues). I asked the Hubs to do the same. At first he was like, "Why?" And I explained to him that:

1) I don't want people keeping tabs on my fertility. I don't want them "watching" me or wondering about our fertility when they see us. I for SURE do not want anyone's pity if things don't go as easily as we'd like. For god's sake, we put enough internal pressure on ourselves anyway, the last thing I want is to feel any pressure from outside.

2) I don't want anyone else to have to feel the rollercoaster of hope-disappointment-hope-disappointment. Especially potential grandparents. We are SOOOOO lucky that neither set of parents has EVER put any sort of pressure on us about kids. But I know they're hoping and I couldn't bear to drag them along on this thing I can't control.

I was glad I put these parameters around us at the beginning (guess I was intuitive on that one) because things have not been successful yet and I am extremely glad I only have to deal with myself and (very supportive) Hubs.

Here's the thing, though. When people ask me directly if we're going to have kids (why the hell do people feel compelled DO that?!), I now have to lie. I basically say the same thing I was saying before we pulled the goalie. Which is, "Well... we're thinking about it. We're talking about it, but not entirely sure yet." I guess this is a boring enough answer that they kind of smile conspiratorily and then usually leave it alone (after maybe a "Well, it's the best thing I've ever experienced, so I recommend it" or a "Well... don't wait tooooo long. I know a lot of people who have had trouble").

Is it ok to lie about this? I feel ok about it with acquaintances and friends who are not really close... I don't believe they care deeply about my answer anyway. They just want to know in a curious sense, or want to know if you'll be joining them in the Parenthood Club. But I am beginning to feel guilty about it in a few situations. And if IVF is successfull, and I choose to disclose that we used ART... if they are paying attention, they will know that I was giving them this bullshit line for years while we failed enough to get to this point.

I would say, now that we're doing IVF it's even weirder. This is a big procedure, you know? I would love to discuss it with my dad (happens to be an MD and we're really close) but even the thought of exposing him to the hope and then the statistically-likely failure makes me feel ill. I'll be stoked to talk to him about all of it after the fact, when it's all over - regardless of outcome. Part of me feels like I'm lying by not disclosing in this particular case.

Anyone?

Pre-Day 10: The IF Posse

This post is just to state for the record how stoked and overwhelmed I am by the Superwomen who have come out of the blogosphere to support me on this first IVF cycle. I am so green and so new... this blog has only been up for 11 days, and y'all know how new I am to even the idea of IVF.

Every time someone writes "good luck" it's like ... like a circle of women is forming around me. Should this first cycle fail, I now know I will be strong enough to do another. Because I've read about so many of you doing it. Again. And again. And even during all this you STILL have hearts open enough to take another sister into the fold and be encouraging. That is the kind of person I want to be regardless of whether or not I become a mother.

Damn.

On that note, I had no idea that if someone made me cry by sending me an insensitive and perfectly timed to twist the knife quadruplet baby video there was an actual, as Tigglebitties mentioned, "IF posse" who would kick some ass on my behalf. Or at least jump to my defense in the comments section.

Who knew. You guys rock.

p.s.
Someone should tell people that it's best not to mess with the IF Posse - fertility hormones cause more rage (and acne, goddammit) than anabolic steroids!

Pre-Day 8: Why Aren't I Laughing?

So, this morning, I open my email and a friend (who has absolutely NO idea we're doing IVF, much less TTC) sends me this link.



Check it out. It's a video of a mom with her QUADRUPLETS lying in bed and the dad is making them laugh. They are incredibly cute and delicious. However, I also got the creepy feeling that all those little in-unison giggles could come straight out of a horror film. A horror film in which I could play the starring role.

I woke up this morning thinking How many embryos should we replace? Will any make it to day 5? If they do, should we just replace one blast? But what are the statistics? Is one enough? Will the cells divide anyway and make maternals? Would we ever be able to selectively reduce? What are the risks to the surviving pregnancy if we did reduce? What are the risks of having multiples to all involved? Is it fair to the prospective multiple babies to put them at risk for all the stuff that can go wrong... low birth weight, prematurity, and all the complications?

So, you see why this video, which should have made me laugh, actually made me burst into tears. Could my friend's timing have been any more hilariously torturous?

I really want ONE baby (at a time).

Pre-Day 6: I Heart Acupuncture

Today I went to Dr L for acupuncture. It was my first appointment for specific support of IVF. (I've been a few times before.) She is so cool - we went over my IVF schedule and booked a bunch of appointments to best support the cycle. Right now she's working on hormonal balance and stimulating blood-flow to the uterus to prepare it for action and ovaries to get abundant and healthy eggs.

During this BC period, I'm going once per week. Then, I'll go three times during my 9-day stim (including right before retrieval). Then, I'll go just before and just after replacement. Then we'll make a sched to continue on from there - probably 1 or 2 times per week.

Even though our insurance won't pay any part of IVF (which is bloody wrong, but I won't go there right now), I do get some reimbursement for acupuncture, so that's a tidbit of relief.

I believe acupuncture provides some real benefits. I can feel major things happening while I am in treatment and an enormous sense of well-being for hours (sometimes days) afterwards. And you have NEVER slept like you do the night of the day you get treatment. It is how sleep should be. (And I sleep pretty well as it is. This is just uber-delicious sleep.) Dr L has supported many women through pregnancies and IVF so I am excited to be working with her.

BTW, I am not a new-agey type person. I have a real skeptic streak and favor "can it be proven through good science" processes. I find very interesting studies like this.

Pre-Day 4: In-tim-i-day-shun!

First of all, I am really happy to report that it's middle of day 2 on the new BCPs and all is well on Trivora. Lesson learned: when it comes to endocrinology, do not underestimate the power of hormones on the brain. I always knew my occasional crabbiness or weepiness from PMS (ie: changing hormones) was real and that chemical imbalance have mental results, but this really brought into focus for me.

The effect that chemistry can have on our brains is really fascinating. It's so hard to measure quantitatively how someone "feels." I am the only one who can measure that for me. I hereby vow to always take care of myself and stick up for my needs when it comes to any depression issues that could even possibly be hormone or chemical-related.

And suddenly... an intimidating knock at the door. Well, the knock wasn't indimidating... but then I saw the box...



Hmm. Kinda big. Wonder what-all's in there?



Oh sweet jesus. That sharp disposal can mean only one thing... that's a bag of syringes.



And a pen-injection delivery system (there's only one sharp disposal container, somehow made it into 2 photos)



And here's the stuff I will be injecting. Gulp. Follistim (FSH) - for stimulating follicles (duh) - that's the stuff that goes in the pen-injectors. This came with a cold pack and must be kept refrigerated...



This is Repronex, combo of FSH and LH, promotes growth and stimulation of those follies...



This is Ganerilix (Antagon), a gonadatrophin-releasing hormone which supresses the LH surge and prevents ovulation...



This is Luveris which is LH - the hormone that triggers ovulation (used in combo with the Ganerilix above)...



These are Vivelle "Dot" - estrogen patches...



There was also a dose of Novarel (HCG) in there, that you use just before retrieval. But I forgot to take a photo of it.

And this is a bunch of extra non-intimidating stuff, like pre-natal vitamins, folic acid, baby aspirin, fatty-acid blend, progesterone inserts and some antibiotics for retrieval day....



I hope that by showing all this stuff, some woman out there who is newly going through this process will be just slightly less blown away by the amount of medication that's involved. It's pretty intense, even for a (lay) person who's interested in the details. (I'm sure all you super-women out there who have gone through multiple IUIs and IVFs are knowingly chuckling right now.)

This might be a good time to note that I could be wrong about anything I write in this blog, so never use anything I publish as advice or instruction or anything other than lightly-researched entertainment, communal support, and one person's experience. Your FE might do IVF with somewhat different drugs in different combos, this is just how it's been prescribed for me.

AARRRRHHHHHHHHHGGGGG! Ok. Whew. I'm ok. Just a bit scared. Trying to act totally brave but this is fucking nuts. I'm not really nervous about the injection process (maybe a little)... I'm more scared about all these medications and what they'll do. The lists of side-effects are not small. Focus on end result.

Pre-Day 3: A New Pill

Discussed the nasty depression episode with my FE. I am now going to try Trivora, a different BCP. (This is the generic version of TriPhasil) This is the pill I was on 10 years ago without incident so hopefully it will not cause any severe/sudden depression this time, either. I took the first Trivora pill 4 hours ago, so within 8 hours I should be able to ascertain whether there will be issues. Fingers crossed. I happen to be feeling great today - completely normal thus far.

By the way, in case anyone's interested...

Mircette tablets each contain 0.15 mg desogestrel and 0.02 mg ethinyl estradiol. This BCP is monophasic - all of the pills contain the same amount of hormones.

Triphora ramps you up slower: 6 tabs of 0.05 mg levonorgestrel and 0.03 mg ethinyl estradiol, then 5 tabs of 0.075 mg levonorgestrel and 0.04 mg ethinyl estradiol, then the rest are 0.125 mg levonorgestrel and 0.03 mg ethinyl estradiol.

(Desogestrel and levonorgestrel are both progestins but are slightly chemically different. Considering I didn't even take AP chemistry, I'll get off the "deconstructing BCPs" bus right here.)

The good news is that the Doc told me this morning that it is totally possible to do IVF without BCP's, it's just a bit more challenging with scheduling and any cyst issues, etc. I feel relieved knowing that. Pressure's off.

Pre-Day 2: A Bad Start

So, last night, about 12 hours after taking my first BCP (Mircette - desogestrel/ethinyl estradiol and ethinyl estradiol) I had a really crappy anxiety/depression episode. I had felt a few pangs in the afternoon, but didn't think it too abnormal. Then, at 10:30PM, I really plunged. Ugh. Felt awful. Loose bowels and all. Even though I consciously KNEW it was the BCPs, it still felt really bad.

Then the bad dip passed and I went to bed. But it was a bad night. Every 15 minutes I would come awake with a wave of depression feeling. At about 4AM it subsided and I was able to sleep - relief! This morning I felt completely steady and normal when I woke up. Needless to day, I did NOT take another pill. Had a few waves of yucky feeling mid-day, but milder and shorter in duration. The afternoon was ok and the evening had a few more mild waves as the hormones left my body.

Last night before I went to bed I searched around the internet trying to find some information. I mean, almost every BCP has "depression" listed as a possible side effect, but I didn't think it could slam down after one pill like that. Then I saw a link on another person's IVF blog that led me to Brown University's Health pages:

Mood changes
Some women may notice changes in their emotional status: depressed mood or emotional instability. If you have a history of depression, it is important to monitor your progress carefully when starting BCPs. If you notice changes in your mood after beginning BCPs, call your provider.

It was the part about starting BCPs that I found interesting here. Do I have a "history of depression"? Well, I wouldn't call it a history, but I did have a 6month "early life crisis" 11 years ago at age 25 - a functional but painful depression. So I do know what it feels like for real. And I had a short "depressed time" when I left a long relationship about 7 years ago. But those were situational, manageable down times, I did not need drugs, just some good behavioral therapy the second time 'round. Other than that, I am a pretty damn stable and happy person. Is this a "history"?

I was on the pill for 10 years (Triphasil) from age 19-29. Aside from what I mentioned above, I don't remember any depression side-effects. I DO remember feeling "better" when I finally went off the pill. Hard to explain what I mean by that but just felt more normal. Never went back on.

Anyway, all I know is I am NOT going back on Mircette and I hope there is another hormonal combo out there that works for me. Because that feeling completely sucks. I would be willing to put up with almost any other (non-dangerous) side-effect. But the plunging depression I cannot do.

I sometimes get nervous about post-partum depression and sure hope I would not have to go through that. I feel so bad for the women who have to deal with it. At least I would be aware and watching for it. Ah well, that's getting a bit ahead of myself, no?

Pre-Day 1: We've Begun

The weirdest thing is that the beginning of the process involves going on the pill! That's right. I am on BCPs to "quiet down" my reproductive system and also so we can schedule nicely with our FE - fair enough. I am to be on the pill for 19 days (I am told you can go on them anywhere from 10-28 days), taking prenatal vitamins, folic acid, baby aspirin and fatty acids according to FE's script.

Today I had my first intra-vaginal ultrasound for IVF purposes. The count was 6 follies on one side and 7 on the other. Not too bad of an antral follicle count for a 36 year old. I hope they all (and then some) mature as prompted and contain good eggs.

This week, Hubs will get his STD panel done - I've had mine - as is necessary under law in this state.

Things I am thinking about:

Doing extra acupuncture around IVF. I was already doing some and enjoying it. There is some evidence out there that patients who received acupuncture just before and just after embie replacement achieved better pregnancy rates than those that didn't do acupuncture.

I found this Reuter's Health story on a University of Washington study regarding how many embies to replace. I am really wondering what to do regarding this issue. I would really like to have one baby at a time. But I also don't want to go through 5 IVF cycles trying to do it. Hmmm...

*** Why We're Doing IVF ***

Here we are at the very beginning of our IVF process. My name is UtRus and I will be your guide because it's my 36-year-old uterus that will hopefully soon be occupied by a growing bunch of cells that will, with much luck, turn into a viable foetus and then a baby for us. I'm really just writing this to keep my own head in order and also because I know how much I've gained from reading other people's fertility-related stories out there on the internet.

Of course I never thought I would be writing this. I figured, like every other woman out there, that after years of trying NOT to get pregnant, that we'd one day pull the goalie and get knocked up right away. And I learned, like many other women who have thought these thoughts, that things don't always happen as you picture they will.

I am 36, my Hubs is 35. We tried for 9 months out of one year (not consecutive, took a 3 month break in there) to get pregnant the traditional way but no dice. There were good indications that I was ovulating on day 13 or 14 of a 28-30 day cycle - temps charted nicely, CM was nice and juicy at the right times, OPKs lit up with 2 lines when they were supposed to. We did all the preliminary tests:

his SA - normal. The second time, that is. The first sample, about 3 months earlier, was still considered normal but was much lower in count and not as healthy morphology-wise. He has a vericocele, this we know. The urologist wanted to correct it, the FE said that urologists always want to correct vericoceles and that it rarely makes a difference, especially when his SA (both of them, actually) was in the normal range.

FSH, E2, Inhibin B - normal.

HSG - inconclusive. Fertility Expert thought one side was great, the other side had one ovary & tube in a strange position with very little spill, said laparoscopy might be an option since I might have some endo on that side. Consult with Gyno thought ovary position was fairly normal and that since the tube had a nice thin line and then a little bit of spill (though preferential to the other side) that things were not abnormal, laparoscopy not indicated for me.

PCT - inconclusive. this was done by my Gyno, not our FE (it's not really protocol anymore because it's thought to be an unreliable test) which showed NO LIVING SPERM 2 hours after the deed. But we stupidly used Astroglide which might have snuffed 'em.* Either that or my CM hates Hubs' swimmers. In which case we need to bypass my CM!

and also... mystery cysts - 4 months out of this past year, I have been diagnosed with one very large cyst (corpus luteum, probably) on one ovary or the other at the very end of my cycle. Of course, what prompts diagnosis is pain which I fear is an ectopic pregnancy. Ultrasound then shows a giant cyst. They always resolve on their own. But... am I REALLY even ovulating? And these giant cysts tend to disrupt the following cycle, and I had at least 4 in the last year, so...

Hubs and I both suspect that we would eventually get pregnant if we kept trying. However, we'd like to have two children (in a perfect world, may we be so lucky) so we've decided to get aggressive before it gets less and less likely that this will happen. Why make the same mistake again - we already waited until I was 35 to start trying! I feel it's hubris to carry on "just trying" at this age. It would be so great if during IVF this time we can get enough 36-year-old embies to freeze for a stab at child #2 when we are a few more years down the line.

I realize we could be WAAAAY too hopeful here, but what the hell. If there's ever a time for "hopeful" to be healthy, this would be it. I know quite realistically that we'll be lucky if we can conceive, period. And luckier still if we eventually have a baby to raise. I know that for many beautiful people in this world it never happens. And I would like to state for the record that I will still have a good rest-of-my-life if it never does. I like the idea of adoption, always have (might do it in any case), and I can also picture being quite happy without kids. So with these things being said, I hope IVF works for us.

*Note, a fairly recent study came out that says most lubricants kill sperm pretty damn effectively (so does saliva, mind you). They tested many of the usuals: Astroglide, FemGlide, Replens. Only one, Pre-Seed, was not AS bad for sperm. We've basically used Astroglide every damn time we've ever had sex, except for 1 month when we tried Pre-Seed on a whim at the very beginning (before we saw the study). Didn't prefer it - too thick, not slippery enough. If we'd only known. I would have chucked the stuff out the window. I also would have at least tried the pasteurized eggwhites+medicine dropper thing!