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Thursday, October 30, 2008

Putting the IF in life...

So the expected date that our donor goes in for her baseline is November 2nd. I've known that date for a while now, but I just realized that it is this SUNDAY. Could all of this be really happening? I keep waiting for "the other shoe to drop," waiting for something horrible to go wrong. Steeling myself for the worst.

I have this inability to go beyond the moment. I can't think too far in the future. I won't calculate what my due date will be if I get pregnant in November. I won't think of baby names. I won't think about how the place that we rent is probably riddled with lead paint. And I WON'T talk about our children as if they are a forgone certainty.

Infertility has caused me to put so many qualifiers on my phrases: "IF I am fortunate enough to get pregnant. IF we are lucky enough to have a healthy pregnancy. IF we are blessed with more than one child." If, if, if, if. I realize that it is probably not a coincidence that the initials for infertility is IF.

I wish that this part of my life was not a big "what IF." Even though I know it is not a possibility, I wish that having children was something I COULD take for granted. Say, perhaps, like some friends of ours who did not want to have kids. They were on birth control and just found out that SHE IS 13 WEEKS PREGNANT. Really, now. I think I may have to call shenanigans on that one. How does someone not realize they are pregnant until 13 weeks into their pregnancy when they are on the pill? Wouldn't you notice the LACK PERIOD FOR THE LAST 3 MONTHS??? I know that there are always exceptions to the rule, but really? Three months into it? Not much of a clue?

They are the second couple in the last year that I have known to get pregnant on the pill. Being a scientist, I have conducted a research study on this phenomenon and have decided that I am like a black hole of infertility, you only have to know me, be in my vicinity in the past year and my infertility will act as a gigantic force of nature, using all of its mass to pull out any shred of infertility in others, either induced or uninduced. Not that I'm bitter. Not that I am trying to make this about me......right?? um, yeah.

Tuesday, October 28, 2008


So I should be hopeful, right? I went in Thursday for a blood draw and I was fully suppressed. Good news! I then added 4 mgs of estradiol and lowered the dose of lupron to 5 units. I went in on Saturday for a blood draw and my estradiol level was in the good range, so the donor is set to start her meds now. This is great, yes? Then why am I feeling so tired and hopeless. And why is my face breaking out? And I feel like I am barely able to keep any food down. And why does my boss tell me to quit thinking "inside the box" and "fly by the seat of my pants?" If he only knew how many hormones I am on. Or that I have become incomprehensibly gassy. Perhaps he wouldn't be so quick to have me fly by the seat of my pants. I could have just taken off from the seat I was in.........Gah. Bah. Bad Monday. OK, I'll quit whining now.

Sunday, October 19, 2008

The maiden and her lupron

Gentle reader, let me tell you a story. A story that begins with a woman and her lupron. A woman and her missing lupron, and the hilarity that ensued....

This story starts out just like it has for the past 6 days, with the sound of an alarm clock going off a the ungodly hour of 6:45 a.m. Not trying to wake her fair prince, the maiden lumbers out of bed, cursing the alarm clock, as she is NOT a morning maiden.

The fair maiden stumbles out to the castle living room, turns on the torchlight, and ignoring the pleading and whining from the royal pets about the snack that they would like to have, proceeds to locate her needles and lupron, neatly placed in their box in the royal cabinet. Through blurry eyes, she notices that she has her needle in hand, but cannot find the lupron. "What?" she declares sweetly and princess-like. "However did I misplace my lupron? Well, it cannot have gotten far, for surely I have placed it in the cabinet were the rest of the royal baby-making supplies are."

But lo, the maiden looks high and low, low and high. She takes everything out of the lupron box. She takes everything out of the royal cabinet. She searches by her disposed needle box, by the royal pet boxes, in the refrigerator, in the bathroom and in between the couch cushions.

"Oh dear. Oh dear." she cries, without ever letting a swearword or five hundred pass from her lips. And then she wonders, "did I happen to throw the lupron in the trash yesterday morning when I threw out my royal needle cover and royal isopropanol wipe? Surely, no!"

But alas, it appears that after all this searching, this is the only place left it could be. So at 7:15 a.m. the now grumpy maiden proceeds to get a new trashbag out and place the pieces of trash from the old bag into the new piece by piece. She notices a timeline for the layers of trash, a strata if you will, with tacos for dinner at night covering the needle package and isopropanol wipe from the night before. No lupron yet, but the maiden keeps digging. Ah yes, dirty napkins, scrapings from dinner two days before. Still no lupron. But, it is small, and perhaps it has worked its way to the bottom of the bag. Un-merrily, the maiden digs on until she reaches the coffee grounds at the bottom of the trash bag. No royal lupron. "Shitsy. Oh, I mean deary me! Whatever will I do. I don't want to ring the physician-on-call at the royal fertility clinic. Perhaps I can solve this problem on my own."

So the now less than fair, slightly panicy maiden thinks really, really hard, using the few brain cells that work at what is now 7:30 a.m.

"Aha!" she cries. I have a royal bag of unused medicine in my royal closet. I remember that I had some lupron in there!" So digging into that bag she goes, trying not to think about the amount of royal money that was spent on the usused medications or the failed cycles that they represent.

"Lupron--yes, lupron, there you are, just in the bottom of the bag where I placed you. I shall call the happy little bluebirds to bring me my needle. I shall inject myself with you and then lay myself to slumber.......Oh, sonofabitch the lupron expired in April."

By now the fair maiden was too weary and too irritated to care. She grabbed the expired bottle of lupron, plopped herself down in her loyal chair and injected herself with the expired lupron, figuring that it still had some potency left. Drug companies usually hedge their bets on when their drugs expire. So inject herself she does.

After taking her royal needle and depositing it in the royal needle disposal box and throwing the isopropanol wipe in the *new* garbage bag, she feels a pull. A pull to the royal baby-making medicine cabinet, the one she systematically took apart piece by piece, the one which housed her box with needles and lupron which she searched 5 (yes, five) times. For some reason she opens the box again. Instead of grabbing all the needles in one hand while searching the box, she mearly peers into the box.

And there, nestled in amongst the needles, is HER MISSING BOTTLE OF LUPRON.

"Oh motherf*cking holy hell." Ahem, I mean "Oh fiddlesticks!"

A New Journey

So today is the day. Well, rather, tonight is the night.

I have spent so much time writing about where I've been, that I've neglected to say where I'm going.

Tonight I take my last birth control pill (or Irony Pills, as I have been calling them) and hope to soon get what will be my last period for nine months.

Wow. I can't believe I wrote that. Not the pill part, but the 9 months part. Of course, besting Aunt Flo is still something that will take a lot of science and prayers. Seemingly a dichotomy, but somehow fused in a complicated pattern of life and hope in my mind.

We are "starting" our journey to parenthood using donor eggs.

I say starting in quotes , because we have been on this journey for the last year now. Yes, exactly one year last November. I should, and will, post about that later. Now I am just a little overwhelmed.

We've been given a tentative schedule: take last b.c. pill on the 19th, wait for period. If I get my period (which I always do, I'm a champ in that department), I'll go in for bloodwork on the 22nd. If all looks good, I reduce the lupron injections in half compared to what I'm taking now, and start loading me up with estrogen. If THAT goes well, then the donor will start stimulating......she's estimated to go in for a check on the 1st of November, with a possible retrieval on Nov 13 or 14th. Of course these dates are not set in stone, and nothing here has ever worked according to MY timetable, so I'm trying to stay flexible in my mind (that sounds weird---like mind gymnastics or something).

I feel a small ray of hope that this journey brings....and a lot of fear. Fear that it wont work. Fear that if it does work I'll miscarry. Fear that I'll never be able to relax about this.

Show and tell

Since it is getting colder out (at least for those of us here in the northeastern United States, I thought that I would post some pictures from last Spring (May, I believe) when Ryan and I visited the Boston Public Gardens. Tulips are my favorite flowers...

A bed of beautiful white and red tulips

The front of the Boston Public Garden

Weeping willows overhanging the pond

A swan on the pond

Now that the leaves are turning I should go out and take some photographs of all the lovely trees out there.

I grew up in Florida, so the idea of "seasons" still fascinates me...I even still enjoy the snow. Of course we have only had to deal with it for the last 3 years, so maybe the novelty will wear off on me. I love when it snows after dark, when the ground is sparkling, white and smooth and you look up to see all the small flakes falling from the skies....

Tuesday, October 14, 2008

Recent History--part three or IVF 1, 2 & 3: a whirlwind of activity

By the time April rolled around, when the doctors said we could start IVF again, I was nervous, excited, and scared. After attending an orientation class at our IVF clinic, shown how to give myself injections (I left sweaty hand prints on everything I touched when I was holding the needle), we were ready to go.

After an excruciating time getting the medicines (a topic for another blog post), we were on the road. Now, I would never say I was a morning person, so dragging my fat butt out of bed at 6:30am to give oneself multiple injections left a lot to be desired. Then again, so did not having a child. So out of the bed I came, bleary-eyed, to the vials and needles that I had set out the night before and began mixing, flicking and poking my way to what I hoped were super follicles.

I was really unclear as to what was supposed to be happening. Actually, I knew what was supposed to happen, I just was unable to see danger signs.

The first danger sign was that after a week of stims on the doctor's "second-most aggressive protocol" my estradiol levels (a measure of developing follicles) were in the 200's. So the nurse in charge (NIC) of my chart, bumped me up to the "most aggressive" protocol. Fine.

I went in for an estradiol check a few days later. "We're moving up, slowly, but it looks better." I was up to 350.

The next day I had more bloodwork. I was up to around 450, I think. "Here we go," said NIC. "Come in on Saturday for another estradiol check and an ultrasound."

Since it was on a Saturday, my husband came with me, and I "forced" him to come in the back room with me for the ultrasound. I had given him the rundown about my new-found relationship with "Mr. Wand," but I thought that formal introductions were necessary, given the intimacy of the relationship. After modest introductions, Mr. Wand disappeared into the recesses of my body cavity and the probing began.

Ultrasound techs cannot give info about what they see, at least at my facility, so we waited for the phone call later that afternoon.

I remember that I rushed to the phone with a pad and pencil to write down any further instructions. The Saturday nurse read me my estradiol number: 451. One follicle detected. "Great," I thought, "I have a visible follicle." Unfortunately, after 10 days of stims, 1 follicle and a non-doubling estradiol level does not a protocol continuation make.

I have to admit I was taken completely by surprise when the nurse said that we were going to have to scrap the cycle.

Really? Scrap the cycle? Just like that?

Unfortunately, this news came the day before the most coveted of holidays for infertiles: Mother's Day.

I spend most of Saturday crying. Trying to pull myself out of the funk, I suggested that Sunday my husband and I go out to eat.

Haahahahahahahahahahaa! Wrapped up in my own grief, it had completely escaped me that on Mother's Day, hundreds of mothers would descend upon eateries around the area, smartly dressed children in tow. We ate dinner quickly and returned home.

For IVF attempt #2 I was a little more knowledgeable. We started that protocol in June. It was slight variation on the original theme of pump-her-with-as-much-hormones-as possible.

This time, however, we had better results. My estradiol levels were climbing. They were finding follicles. Good reports were coming back. We were actually given a day to have the trigger shot and a retrieval day!

Times were scheduled. Appointments were made. We were ecstatic!

The retrieval went well: out of the 8 follicles seen, 6 eggs were recovered. The next day we were told 4 fertilized. A transfer day was set. Things were moving so fast now!

Two days later we went in for the transfer. Of the 4 fertilized eggs, 1 had quit dividing after the 1st day, so it was not a candidate for transfer. Of the other three, one had only progressed to three cells, so its future was not in my uterus either. The other two showed more promise: they were still dividing, although one embryo was only at 4 cells while the second one was at 6 cells. I wasn't sure how many cells there were supposed to be at this stage (I had instituted an internet "blackout" for myself to try to limit my stress level), but six cells seemed about right from what I remembered from my readings.

While six cells may be close, eight is actually the number one is going for. Well, perhaps my little guys were just slow-pokes. Surely bathing them in the temple that was my newly reconstructed uterus would give them just the chance they needed.

I NERVOUSLY set about for my two-week-wait. I fidgeted, I daydreamed, I did relaxation exercises, I spoke to my therapist, I spoke to my husband, I tried to concentrate at work. I did, however, realize that the day I went in for the blood test, that I would not be at work that day. I was holding it together, but barely. Bloodwork at my clinic is always drawn between 7 and 8:30 am, so I had half a day to kill before the blood test came back.

I went home. I watched crappy TV; I waited for the phone call from NIC. When the phone rang, my heart stopped beating. I held my breath. "I'm sorry, I have bad news. You're not pregnant." I thanked NIC for calling, I hung up the phone and called my husband. I don't think that he could understand a word I said, but he got the gist. He was kind and sent flowers at home for me. But I was inconsolable. See, we had broken a cardinal rule of IVF, don't tell your family unless you are ready for them to ask questions. They knew what day I should have the answer. They called. My husband called them back when he got home from work. That was the day before my mother's birthday, July 16.

IVF # 3 I was ready for. We had taken a month off, to rest and recuperate. By now I had dealt with my pharmacy long enough to know the protocol; I had the drill down pat. I knew who to call and where in order to get all the meds that were prescribed for me.

I also knew what my estradiol numbers should look like. I knew what to expect if the ultrasound techs found follicles (a lot less poking around and a lot more typing on the screen).

So it came as no surprise to me when my third IVF cycle was canceled before retrieval. I called my husband and told him as much when I got back from that morning's ultrasound and bloodwork. "You see," said the ultrasound tech to the tech-in-training, "when the patient has been on fertility medicine for a number of days, it will be easier to see the ovaries. They'll have a number of follicles on them." I guess he didn't know I had been stimulating for a week and a half.

That was where we left off in September of 2007. By this time I had been combing the internet for solace. A little preganant had just had similar results with her latest attempt at stimulation. Her doctor had recommended using donor eggs. I wasn't sure if we were on the same journey...

Sunday, October 12, 2008

Show and Tell

This is my first show and tell, but I thought that I would share some pictures from a "gathering" that my husband and I went to over this summer: a guinea pig pignic!

The last two pictures are of our guinea pigs. And before you ask, yes it is a little odd, but it is also a lot of fun. Basically, some kind and dedicated organizers decide a place and a date for the pignic. They bring fencing to keep the piggies corralled and signs to mark the girls and boys cages. People come, bring their piggies and snacks for the pigs and humans. Everyone just hangs out, talks and laughs watching the guinea pigs run around in the enclosed areas. Then there is a contest for such silly things as "porkiest pig," or pig with the longest fur termed the "Fabio" prize for the boy and "Repunzel" prize for the girl. Everyone laughs, has fun and gets to meet a lot of other people from around the area!

Monday, October 6, 2008

Recent History--part two

After consultation with a laparoscopic specialist at the practice, I geared up for surgery. I went in to this surgery scared, not as scared as previously, but still scared. The surgery was quite a success, however! I woke up, and except for the nearly constant vomiting, I was intact! Only a few poke-holes. The doctor took out about 450 grams of tissue from the fibroids on my uterus. Nearly a pound of flesh! I instantly dropped a dress size (but not exactly the road I would have taken....)

We were in for another surprise, however. While my uterus was now "beautiful" (Doctor's words, not mine), the surgery revealed that I had many, many endometrial adhesions. The doctor removed the ones that he could, but I had some that were encasing my ovaries. Indeed, they had glued my ovaries to the back of my uterus. In addition, I had one falopian tube that was M.I.A. It just sort of trailed up into my intestinal area.... My other fallopian tube, on the other hand, was GREAT! Just not not anywhere near my misplaced ovaries. So we were told that we were going to have to move straight on to IVF.

That was a bigger blow to me than I would have expected.

I know IVF is one of the "last steps" in reproductive technology. I felt like I had suddenly been fast-forwarded past all the other options. Didn't I have a chance at dosing me with clomid? How 'bout an IUI? Really? Straight onto IVF?

I recuperated at home for about 4 days after the surgery. After that, I became too restless. I went into the lab, more for companionship, than to do any real work. I had just made it to the lab and was heartily greeted by a few members. It was nice to get my mind off of everything. I was probably there for 10 minutes before someone wanted to tell me the latest news: our coworker was pregnant!

I don't even know what my reaction was, at least what it looked like on the outside. I know I'm not the first infertile woman to experience the sadness, anger and loneliness of seeing/hearing about other people's pregnancies. I think I feigned happiness and went to look for someplace to sit down.

I stayed around for another half an hour or so. Left the lab and went home and sobbed. I was overcome with sadness.....devoid of hope......bereft.

I stayed that way for the next three months or so while I healed. For the first time I was scared, really scared that we wouldn't be able to have children. I couldn't look at pregnant women. I couldn't go to church, usually my place of solace, without dissolving into tears halfway through the service. My husband tried to help, tried to soothe me, but I was inconsolable. Even though I knew that IVF was still an option, an option that many, many infertile people would love to have, I was in mourning. No longer was I going to have my fantasy of calling up my husband at work and saying "Surprise! We're pregnant!" Or calling up my family and saying, "Well, we were just ready to start a family and then we found out I was pregnant!"

I felt like a part of my privacy had been taken away. What should have been discussed in the bedroom between my husband and I was now in the hands of doctors upon doctors. Our most personal decision was now shared with nurses in scrubs and embryologists.

To be continued...

Sunday, October 5, 2008

Recent History--part one

I had that surgery in 2002. My husband and I were living at his Mother's house while we were both in "back-to-school" mode. We knew we wanted kids, but with all the debt we had (not to mention the fact that we were living in his MOTHER'S house), it made trying for kids a no-go. At least then.

It took me another 2 1/2 years to finish graduate school. I found a post-doc position (sort of like an independent scientist-in-training), and we moved to our new city.

We spent the first 3 months trying to get to know the city better--it was larger than any city I had ever lived in before---trying to feel competent in my new position at work, formulating plans to pay down all of our school debt, and generally enjoying living on our own. Although we had been married for 7 years, 4 of them were spent at his Mother's house.

We started trying "seriously" to get pregnant in December of 2005. For pregnancy "protection" we had been practicing Natural Family Planning (NFP) since the surgery in 2002. We were not always as careful as we could have been, but I thought that we were doing a STUNNING job. I mean really: no pregnancies here!

Since I had been charting my cycles with NFP, I had a pretty good indication that I ovulated. My cycles were a little short, but other than that, pretty normal. So we took the charting from "no pregnancy mode" to "bring it on" mode. I wasn't really surprised the first few months that we didn't get pregnant. I had fibroids after all, and I had read that it is normal for it to take 6 month to a year to pregnant. Yet, I had a lingering suspicion, a familiar words kept bubbling up in my brain....fibroids.....endometriosis....

So, after 6 months of trying with no success, I asked my Gyn for a referral to a specialist. She had already had me get another ultrasound for my fibroids, and quickly wrote me a referral for a local fertility practice at a local hospital.

It didn't take as long as I would have thought to get an appointment. Then again, I said that I would just take the first doctor who had an opening. My husband and I went together. I was pretty shell-shocked after the meeting. It wasn't that my doctor wasn't nice, it was that I was just unprepared for the number of tests: clomid citrate challenge test (CCCT), hysterosalpinogram, hysteroscopy, sperm analysis, ultrasound. Once we had taken all of these tests--well, I guess I wasn't the one taking the sperm analysis test--we were to have another meeting with the doctor. I remember asking our assigned nurse at the practice to re-explain the importance of the CCCT. "It's a test to measure the quality of your eggs." and that we wanted a number below 10. "What happens if you get a number above 10?" I asked. "Well, then you have to use donor eggs if you want to become pregnant. But let's not worry about that now, you have a lot of tests that you need to take, and then the doctor and the two of you can decide how best to proceed."

I took all the tests except for the hysterosalpingogram. My husband took his. The doctor wanted to schedule a meeting, and the we didn't need to worry about that test yet.

Now, I'm not entirely foolish. I knew another surgery was coming. One does not walk around with fibroids larger than one's own uterus, have trouble getting pregnant and realize that somethings gotta give.

We met with the doctor. As we suspected, nothing further was going to be done until I had the fibroids out. There were too many, they were too big, and it was too risky. But there was also another thing to talk about. My CCCT results were "a little high." 18 to be exact. I remembered the number 10. 10 or you will be using donor eggs. 18 was not just a little off. It was not 11...13..nowhere close to 10. But the doctor was hopeful, "we've had a lot of luck with women with high numbers." Besides, I had a surgery to get ready for anyway.

To be continued...