Saturday, December 29, 2012

A Little Bit Pregnant

You know how I’ve been saying all along that I couldn’t imagine getting a firm yes or no, I just expected to be in limbo forever?  Well, I was right.

My beta came back at a 9.37.

Anything over a 5 is considered “positive,” but this is really, really low.  It could mean a late implantation, or it could mean that I was briefly pregnant and had an early miscarriage.  The only way to know is to go back on Monday for a repeat blood test and to see which way the numbers are moving.

So, I still don’t know if I’m pregnant.  I mean, I guess I am - the nurse on the phone did say the words, “you’re pregnant,” but there were a lot of conditions attached to it.  I’m trying not to get too hopeful or too discouraged, and to think of myself as still in limbo rather than pregnant with the risk of a miscarriage.  For all I know, the miscarriage has already happened.

The nurse said that with numbers like this, things tend to go 50/50.

If it doesn’t work, I’ll be ok -  I have never had the joy of being “pregnant” and therefore won't feel like I lost a pregnancy, so I actually think it’ll be better than a pure negative.  At least it proves that my embryos can implant, and maybe once my hydro is removed one will be able to stay implanted.

And if my test on Monday comes back and my numbers have jumped way up?  THEN I can celebrate.
 
I keep going back and forth between being really, really mad at how the universe is fucking with me, and not even caring because at this point I’m so numb from the emotional mood swings that it just makes me want to shrug.  There’s nothing to do until Monday, anyway.

%#&4!@)*#!*$&%#!@*&@!*#@!

Whoever said “You can’t be a little bit pregnant” must be the same asshole who said “Just relax and it will happen.”

Friday, December 28, 2012

Last Day of Waiting

So, today is the day!  My doctor’s office has my blood and is supposed to call me this afternoon with the results.  I’m pretty proud of myself that I never took a home pregnancy test (as of this morning, I even know where Henry his them), but to be honest I’m terrified of HPTs.  I think I’ll be able to handle the nurse telling me no better than I’d be able to handle that one single little line staring at me.  If I took a test and it was a no, I’d feel like it was my fault for having been impatient.

I don’t really have a prediction… I am leaning no, but I think that’s just because I’ve never been pregnant before, and I don’t know why today would be any different.  But I’m ready to be surprised!  And honestly it’s not so much that I’m expecting a no as it is that I’m not expecting a yes… I find it easier to believe that this will drag out forever than to believe that there will be any sort of resolution TODAY.

Anyway, symptoms - my boobs are still denser, and are now even a little bigger, but that could easily be the progesterone.  They’re still not very sore.  I did feel a little queasy when I woke up yesterday, but it’s so early for morning sickness that I doubt it’s related.  Today I feel gross, but that’s probably just because there is a cold running rampant around Baltimore.  So in other words, lots of little signs and symptoms, but nothing that can’t easily be explained away.

Want to know one of the strangest things, though?  On Christmas day, my aunt says, “I had a dream you were pregnant!  And there was a whole weird story behind it… but I can’t remember what it was.”  She doesn’t know anything about any of this, so it was out of nowhere for her to say that.  And then my mom made a really awkward comment and I changed the subject.  But as soon as my mom and I were alone, we agreed that it was weird.  My aunt has never shown any psychic tendencies before, but I guess it’s never too late to start?

Christmas was ok, but Christmas eve mass was hard.  Here’s a list of things not to do on Christmas eve when you are having trouble getting pregnant, and are pumped full of hormones:

Do not go to the “family” mass, where everyone is encouraged to bring their kids and there is a nativity pageant instead of a homily

Do not sit behind an adorable little boy in red suspenders and red chuck tailors

Do not also sit behind a weird looking but smiling baby girl, and an adorable little girl in a giant Christmas dress

Do not pick a stupid fight over nothing with your husband before mass so that you’re already in a melancholy mood when you get there

Do not let the Christmas music get to you – not even when the pageant kids sing the first verse of Silent Night.

Ah well, at least we were late so we were stuck in the very back corner of the balcony, where no one could see me.  And at least I was wearing waterproof mascara.

Results tomorrow, I promise!

Sunday, December 23, 2012

Boobs

This morning, as I was getting into the shower, I shouted to Henry.

“Henry, come feel my boobs!”

I know this is hard to believe, but he came running.  He cupped my breasts in his hands and immediately said, “Wow. Heavy.”

That’s right, my boobs are heavy.  Not swollen, not sore, just heavy, dense.  I’ve convinced myself that my boobs have been bigger or tinglier in months past, but this time they are really and truly differentHenry even admitted that in the past he’s been lying when he said that he noticed whatever symptom I'd convinced myself of, but this time he felt it.  No, “but if you squeeze them this way, don’t they just seem a little bigger?” from me needed.

I know that it could just be the increased progesterone in my system from the supplements, but it’s not a bad sign.  Not a bad sign at all.

As I climbed into the shower, still feeling myself up, Henry added, “You know, this really isn’t helping the whole no sex thing.”


Thursday, December 20, 2012

In One Basket

My last embryo didn’t make it to freeze – he stopped developing at the six cell stage and never started back up.  All of our eggs are, officially, in my basket.

While I’m a little sad for the baby who will never exist, I’m mostly ok with it.  If one of my embryos wasn’t going to make it, I’d rather it be the one they didn’t transfer than one of the two they did.  And, since they transferred the strongest embryos, I don’t think it really says anything about the maybe-babies currently in my uterus.  Eggbert had already grown beyond the stage where this one stopped developing, so that seems promising.  Frankenstein was at the same stage, so fingers crossed for him (I’m hoping it wasn’t anything to do with the rescue ICSI).

And, as insensitive as this sounds, if that embryo wasn’t strong, I’m glad it stopped developing before it got frozen.  Freezing is the one thing not covered by our insurance (which seems crazy – it saves them money in the long run!), so freezing an embryo would cost us almost as much as a fresh cycle.  Freezing more than one embryos would have cost double!  I’d still be happy to do it for the time and stress it would save if we had good embryos to freeze, but I wouldn’t want to pay for freezing, go through a frozen cycle, and then not have it work because the embryo wasn’t very good.  Now I understand why my clinic only freezes blastocysts.

The news about my embryo is the only contact I’ve had with my clinic since my transfer Monday, and the last contact I’ll have until my pregnancy test just before the end of the year.  As I told my nurse, it’s all starting to feel a little bit like a dream.  Soon the only physical reminder I will have of everything we just went through is the wet-chalk residue from my progesterone suppositories in my underwear: all of my scabs have healed, and even my most stubborn bruise has almost disappeared.  My ovaries feel back to normal.  After a day of bed rest and a couple of days of taking it easy I’m almost back to my usual activity, minus exercise (although I’m careful about lifting things, make Henry walk the dog, and try to limit my walks up and down the stairs).  Sometimes I have to remind myself it happened.

Really and truly, the only thing left to do is hope.  Hope during an IVF cycle is such a strange thing; it’s like constantly trying to balance on a see-saw.  Too much towards pessimism, and you feel the need to remind yourself to “think positive!”  Too much towards optimism, and you have to remind yourself that it might not work.  But soon something WILL happen – that see-saw will come down on one side of the other.  I realized recently that this is the one thing I find the hardest to believe, even though it’s the one thing guaranteed to happen.  I don’t expect it to work or not work; I just expect to be in limbo forever.  That definitive answer – YES or NO – seems so unlikely.

And yet… I feel cautiously optimistic.  I have nothing to base that hope on besides a vague soreness in my uterus that seems to be lasting longer than it should, but it’s there.  I’m trying not to get too carried away – misplaced optimism has never done me any favors before – but for now I’m enjoying it.

Actually, I lie: I do have two signs from the universe to base my hope on.  First, this morning, I came across this gallery of really creepy twin portraits. As soon as I opened it up, I thought, “Yup.  Definitely having twins now.  And they’re going to be terrifying.”

Second, for the first time ever, Henry and I agreed that we liked the same girl’s name. (No, I’m not going to share it).  Sure, I came across it while looking at baby names so you could argue that it’s not so much a sign as a product of my diligent searching, but really – in our three years of dating and nearly three years of marriage, we have never agreed on a girl name.  We, on paper, like the same things - names that are names; names that are spelled correctly; names with some sort of connection to us; names that aren’t on any “most popular” lists – and we each have a few names we like individually. But until last night we have never come together and said “Yes, this is a name that I would be happy for my daughter to have.” If we can beat the odds to find a name that we can agree on, that positive pregnancy test should be no problem.

Tuesday, December 18, 2012

Waiting: Day One

Well, I am officially in my two week wait!  We transferred two embryos yesterday – the four-day old embryo that fertilized naturally (Eggbert) and the three-day old embryo that was rescue ICSIed (Frankenstein).  One more embryo (Tracey Jr.) is still growing in the lab, and will be frozen in a couple days if it makes it to blastocyst.

Yesterday morning was crazy.  I was still expecting to do the transfer on Tuesday but my nurse was supposed to call me between 7:30-8 to give me the final word.  So I got in the shower at 7 on the assumption that I was getting ready for work.  I got out at 7:24, and there was a message on my phone – a nurse I’d never talked to before, telling me that my transfer was scheduled for that day!  Of course, this strange nurse didn’t leave any additional information on my voicemail, and it was early enough that when I tried to call back the answering machine still listed the clinic as “closed.”  So I started getting ready for my transfer, wondering why it had been rescheduled.  The only thing I could think of was that one of my embryos had stopped growing.

A part of me wondered if there was some sort of mix-up, and I was actually still on for Tuesday.  So I called MY nurse, and luckily she answered.  She confirmed that the lab’s recommendation was now to transfer that day, but couldn’t tell me why.  She did give me a little more info about the embryos that were scheduled to transfer… Eggbert had grown into a morula, and Frankenstein was a six-cell embryo with slight fragmentation.  No word on Tracey Jr., but he was looking good enough that they were going to keep watching him in the hopes of freezing him.

So that made me feel a little bit better.  I’m assuming that they moved the transfer up because Frankenstein and Tracey Jr. weren’t looking quite as perfect as they had the day before, but Frankenstein was still listed as being a “good” quality embryo (on a scale of good-fair-poor).  I also wonder if I got rescheduled for convenience sake; during my transfer I learned that I was the very last transfer the doctor was doing this year.  Maybe he’s on a flight to somewhere tropical right now….

Anyway, I’ll write more about the actual experience of the transfer (and the trigger, and the retrieval… I’m behind!) soon – after all, I’ve got some time to kill over the next couple of weeks.  For now, though, send some positive thoughts to those little embryos floating around in my uterus.  If my tubes really have been blocked this whole time, then this is my uterus’s first chance to show me what it’s got.  Don’t disappoint me, uterus!

Sunday, December 16, 2012

Maybe Babies

I'll be honest: I used up most of my positive thinking on that last post.  Pretty much as soon as I hit "publish," I started getting more and more depressed.  I mean, ONE embryo?  One little lonely maybe-baby?  What were the chances that it would keep growing, be healthy, implant, hang on?  I know that it only takes one, but I'd rather that one be the best of several, not my only hope.

And the rescue ICSI?  Despite my promise to stay off the internet, I kept Googling it, and what I found wasn't good.  The internet's opinion on rescue ICSI could be summed up in three words "it rarely works."  My doctor had recommended ICSI at the beginning - Henry's semen is on the low side of normal - but I had pushed to try conventional fertilization to give those sperm a chance.  Why had I done that?  Was that arbitrary decision, based on my gut rather than any real evidence, going to cost us a baby?

So I waited for my nurse's Saturday morning phone call with a sick feeling in my stomach.  I was convinced, CONVINCED, that she was going to call to tell me that out one sad embryo had stopped growing.  I decided I would be happy if she called and my one embryo was still around; I'd be thrilled if one of the rescue ICSI eggs had fertilized, and if two or more had fertilized... that was too good to contemplate.

Saturday morning I woke up early because Henry was running a 5-miler, and I was his ride.  So I drove him to the race and stood by cheering while he ran past.  Usually I would be running with him (Henry and I recently discovered we love running together... within the last year, we have done two half marathons, two 10ks, and a 5 miler), but of course I was sitting this one out.  I felt like holding up a sign that said "I have a good excuse!" as everyone ran past me.

Anyway, the point is that by the time the phone rang at 10:30, I had been up for four hours, watched a race, and had a really productive trip to Target (where I got $83 worth of stuff for free by using promotional gift cards I had gotten by buying things I was planning on buying anyway). (Sorry, I have to brag about a good deal).  The anticipation was killing me; I was pretty tightly wound.

Finally, the phone rang.  "Hi Chelsea, how are you?" the nurse asked.  "Well, why don't you tell me?" I answered.

The rescue ICSI had worked on two of my eggs - I had gone from one maybe baby to three!  My previously-fertilized egg was a two-cell embryo with no fragmentation; the ICSIs were fertilized and lookin' good.  My transfer was officially scheduled for the next day (today) at 10:30 a.m., although the nurse promised to call me the next morning between 7-8 to give me the final word.

Even though I was feeling better, I was still nervous.  I spent my day prepping for a couple of days of bed rest... I made a pile funny books and movies (because of this study) and made myself a little nest on my couch with everything I could imagine I'd need close at hand.  And then I had a really terrible night's sleep filled with nightmares about embryos that stopped growing with no explanation.

My bedrest nest... quilt, pillow, cheez-its, tangerines, books, computer, DVDs.

So this morning I got up at about 6:30, put the finishing touches on the nest, and waited for the phone call.  And waited... and waited.... Finally, at 8, I got in the shower since we'd have to leave at 9 to arrive at the hospital an hour before the transfer.  At 8:30, I started getting really nervous, so called the clinic's 24 hour help line.  Of course, as soon as I had a nurse on the phone, I had a call come in the other line so had to do an awkward little, "Oh, she's calling me now..."

The good news was that none of my embryos had stopped growing.  My two-cell had grown into a six-cell embryo, and my ICSIed embryos were all at four cells.  Still no fragmentation.

The unexpected news was that the clinic had called off my transfer.  My embryos are good enough that even though there are only three of them, the embryologists thought they had a good chance of growing into blastocysts, so they were going to wait and see.

So... I'm on hold for the next day or two.  Every time I think there isn't another thing that IVF can do to make me crazy, something else comes along.

Friday, December 14, 2012

Brightsiding

You guys are so nice to comment and wish me luck!

Yesterday they retrieved six eggs.  This morning, I found out that four were mature and one had fertilized naturally (well, as naturally as things can fertilize in IVF) and was dividing “beautifully.”  The other three are being ICSIed this morning (this was the plan – to try conventional insemination first and then ICSI them if that failed).  The nurse assured me that the second-day ICSI often works, it just means that those eggs are a day behind, so I’m not too freaked out (at least that’s what I’m telling myself).  I’m also trying to stay off of the interwebs because people do not like this “rescue” ICSI too much.

So, yes, I’m a little disappointed… I would have loved more eggs, more fertilization, more confidence that things will move forward smoothly.  But if IVF isn’t one long process of staring into the abyss and learning to, as my best friend put it, “accept ambiguity,” then I don’t know what is.  So, onward!  After all, we have one awesome embryo, and three more eggs that could be awesome embryos by this time tomorrow.

I’m a huge fan of trying to find the bright side to anything, or figuring out why something that might seem bad is actually meant to be.  Under the influence of that impulse, I think I’ve found a way to rationalize away these disappointments:

First, why is it actually good that fewer eggs were retrieved?

With my hydrosalpinx, extra fluid in my tubes is bad.  Fluid could make the hydro even bigger and maybe increase its negative effects.  What causes extra fluid?  Ovulation and follicle growth.  Some folks on the internet have even said that they were misdiagnosed as having a hydro when all they really had was a little extra fluid build-up from ovulation.  So while no one wants to get overstimulated, it was especially important for me not to get overstimulated.  A lot of eggs would have meant a lot of fluid which would have meant an angry, swollen hydro.  Thanks to the fact that I didn’t have too many eggs, my fluid build-up is minimal - I’m already less bloated than I was yesterday.  Maybe I was meant to have just a few eggs in order to not wake that sleeping beast in my tube.

Ok then, why the low fertilization?

Assuming that at least one of the ICSIed eggs grows into an embryo, there are two options:

The first, and more exciting, is so that I can have twins!  A while ago we made the decision to transfer two eggs if it was a three day transfer, and one if it was a five day.  If I’m meant to have (fraternal) twins, that means I have to have a three day transfer.  Of course, in order to have a three day transfer, I have to have fewer eggs available. I’ve always wanted twins, so, thanks, universe!

The other idea I’ve had is that maybe the “best” embryo isn’t the one destined to implant; maybe it’s the slightly weaker one, the one that wouldn’t make it to day 5 or survive freezing, that is our intended child.  Maybe I need to do that three-day transfer of two embryos so that this underdog gets a shot at implanting.  Maybe the embryologist ICSIed the next Dali Lama this morning.

Of course, “meant to be” is a dangerous game to play when you’re dealing with infertility; if I get a phone call tomorrow that our one embryo stopped growing, I won’t be able to rationalize it.  But, for now, it’s making me feel better. So, onward!

Tuesday, December 11, 2012

HO.LY. CRAP.

Holy crap, guys.  Just, holy crap.

Remember how a couple of days ago, I was all disappointed because things were moving frustratingly slow?  Well, apparently someone up there was paying attention because my little follicles had QUITE the growth spurt over the last couple of days.

Let me back up.

I started the day sort of annoyed.  See, last night, I went through all my meds and figured out how many doses I had left.  I saw that if I stayed on the same dosage, I was good until Wednesday.  If I was going to have increased doses or go any later, I’d have to get some refills.

All good, until we went to mix the Menopur.  My dose is a vial and a half of Menopur.  The way you make this is to mix 2 mL of water with one vial of Menopur powder, take out 1 mL of the liquid, mix that 1 mL with a second vial, and voila! You have one mL of water with a vial and a half of Menopur dissolved in it.  Then, the next night, you take the vial that still has a mL of liquid, take out that mL, mix it with a new vial, and you’ve done it again.  That way, you are using three vials to get two doses. Easy!

So last night, we take the half vial of Menopur leftover from the night before out of the fridge and mix the liquid with a new vial of powder.  We withdraw it to get ready to inject it, but then realize that there is well under a mL of water in there.  At some point, we lost some liquid, and we have no idea if what is in our syringe is the right dose or not.  We stared at it for a few minutes, but then reached the only logical conclusion: we’d have to toss this dose and use our last two virgin vials of Menopur to mix a vial and a half.

In other words, we started with three and a half vials, and ended with a half vial.  I unexpectedly needed a refill, and was going to have to go out of my way to get to the fertility pharmacy to pick it up before tonight’s dose.  And should I call in refills for everything else while I was there?  If I stimmed past Wednesday it would save me another trip, but if I finished stimming Wednesday or sooner it would be a waste of money. Not the end of the world, but an unexpected hassle of the kind that I was starting to expect as stimming dragged out longer and longer.  I figured I’d ask my nurse’s advice on whether to refill everything, or just the Menopur.

So this morning I show up at my doctor’s office, and everyone is really nice as usual.  I got my blood taken (it only took one try!  Whopee!) and then was sent back for my ultrasound.  I strip, get on the table, and in walks my nurse, my doctor, and a medical student.  They start the exam.  My doctor, once again, can’t find my left ovary (even with the abdominal ultrasound), and eventually gives up and starts measuring the follicles on my right.

He measures one, and the nurse goes, “Well that’s interesting.”  Exactly what you want to hear from someone with an unobstructed view of your vagina!

Me: “Interesting good or interesting bad?”

Nurse: “You grew a LOT! He’s only measured one, and it was over 19!”

Ok, this is cool and all, but whatever – I’m not triggering for a few days yet.  So I decide to address the thing that’s really on my mind. “I’m going to the pharmacy today because of a Menopur incident last night.  Should I call anything else in while I’m stopping by?”

This whole time the doctor is click-click-clicking measurements on the ultrasound screen.

Nurse: “Wait a minute… you might not need to….”

Doctor: “Yup, you’ll trigger today!”

Of the six follicles my doctor measured, five were over 18!  I was ready to go!  I was so shocked I could have fallen off the table. I said, “But I thought it wans’t going to be until Thursday!” And the doctor replied, “It’s still Thursday – just the retrieval instead of the trigger.”

So, I get my trigger tonight at 10 p.m., and my retrieval will be Thursday at 9 a.m.  I’m so excited!!

P.S.  My estrogen was at, I think, 1120, which indicates about 5-6 mature eggs.  I’m hoping that a couple extra will catch up by Thursday (the doctor on Sunday did see nine…), but I’d be happy with five good ones!

P.P.S.  The location for the trigger shot is rather precise, so the nurse did Henry a favor and drew a little target on my butt.  There are a lot of weird things about IVF, but pulling down my pants and leaning over a table so that the nurse could draw on my ass with a Sharpie is pretty high up there.

Monday, December 10, 2012

This Cycle Is Trying to Ruin My Life

Yesterday morning’s appointment (stim day 9, for those of you keeping track) was a mixed bag:

The good
  • The doctor (not my normal doctor) measured nine follicles on my right ovary – three more than we saw last time.  She also said that they’re all growing at about the same rate, which is great.
  • She also told me that I do not have to worry about my lining at all, because it’s already at a 10.5. 
The bad
  • My left ovary was hiding (again), so I have no clue what’s going on over there.  She reassured me that they’ll find it on retrieval day when I’m passed out and they can get a little more rapey with the ultrasound wand.
  • My follicles aren’t growing very fast – last time the biggest ones were somewhere around a 12, and this time they were approaching 14s.
  • My estrogen is still only at a 646.  It was 377 two days ago, so it didn’t quite double.  (My nurse has reassured me that this is all fine – that they’d rather my estrogen rise on the slow side than too fast, they would have raised my dose if it was a concern, and that it just looks like I’m going to be stimming for the long end of a normal amount of time.  Still… I was hoping for more. I’ve decided that my body put all of its energy into growing those few new follicles, which aren’t big enough to produce much estrogen yet, and maybe I’ll see big jumps tomorrow.)
The ugly
  • My arms are getting tapped out - it took two nurses four tries to get blood, and they had to use a new vein.  The crooks of my elbows are now a lovely collage of bruises.

The longer the stimming/this cycle goes on, the more it is slowly, subtly wearing away all the pleasant parts of my life. For example, this weekend we were at Henry’s uncle’s house. It's near the beach, a few hours away, so we had packed that day’s shots with an ice pack and brought them with us. While we were there, we were left alone in the house for about an hour. Henry’s aunt left behind a key, and told us we should take a walk down to the beach while everyone was gone.  This sounded wonderful; I love the beach, I especially love the beach in winter, and on our drive in we had caught glimpses of beach houses with Christmas decorations, which I was dying to see more of.  So of course we walked to the beach, right?  Nope.  Instead, while we had some privacy, we put the meds into the fridge and the melted ice pack in the freezer and listened carefully for the car to pull into the driveway so that we could get it all put away before anyone noticed.

Then that night we stayed over with my parents to break up the drive.  This was really convenient – except my monitoring appointment was the next morning at 8:15, two hours away, and we had to drop the dog off at our house on the way.  I realize that some people live two hours from their doctor, and I really feel for all of you.  No one should ever have to wake up at 5 a.m. to drive two hours and then get poked.  I enjoyed my midday nap, but I would have preferred to sleep in on a rainy Sunday morning.

Then, this morning… so sad.  See, last week, I ordered a few new dresses for work from Target.  In a shocking turn of events, I actually liked all of them!  I was so excited to wear my favorite one today; I even had a meeting I wanted to look good for.  But then as I was gathering my work clothes last night, I realized that my favorite dress had elbow length sleeves, which would reveal my drug-addict arms.  The sleeves on my second favorite dress were even shorter.  I refused to ruin the effect with a cardigan, so I had to wear my least favorite of my three new dresses.  Those wonderful new dresses will be stuck in the closet until my arms heal!  Oh, the humanity!

Being dramatic helps.