Our Son

So much to say. So little sleep. We met N's birth mother in October. She invited us to be present at his birth and it was the most amazing experience of our lives. We drove 3,000 miles to get him home. We are in love. He is brave, beautiful, inquisitive, and gassy. The birth father has until January 2nd to establish paternity and contest the adoption. We are holding our breath. I have big plans to write about all that has happened and to catch up on all of your blogs. 

IVF #2: Officially BFN

RE called with the news this afternoon.
Even though I knew the answer, it hurt just as much as seeing that single line on Monday.
She thinks we should try again.
I think she's crazy.
Out of 19 eggs, we've only had 3 make it to transfer. We've never had a positive pregnancy test and we've never had anything to freeze.
I think the last question is, donor embryos or done TTC?
Sucks.
Makes me so mad that we didn't jump right to IVF back when we started trying (and we were both 35!). I hate that so much other stuff got in the way (surgeries, hospitalizations, insurance). We worked so hard to fix the other problems, only to end up with eggs that are too old.
I feel like we need to take some time to figure out what our goals are as parents. At 40. Or older.
It used to be we wanted two kids, that I really wanted to be pregnant, and that we really wanted to adopt.
Maybe that looks different now? One kid? No bio kid pregnancies? Open to different types of adoptions?
It's so hard to keep getting back up again.

Not today

So S and I spent all day yesterday being sad over our single little line.
This morning I headed off to the RE for an 8 am blood draw, the whole way telling myself I would *not* cry in the office.
At 8:15, the nurse apologized and said she gave me the wrong test date!!
I have to go back on Thursday for my official draw. (and ps, she said, no more peeing on things)
Of course, I stopped by the grocery store on the way home with every intent of peeing on sticks hourly until Thursday morning. But I couldn't find them. So I left empty handed.
Hope is a bigger bitch than progesterone.

9dp3dt - blank

POAS this morning. Blank.
Blood test is tomorrow.
But I'm calling it.
IVF #2 is over.

No Frosties

The last little embryo didn't make it. I expected that. But I didn't realize how upset I would be to get the call. Part of me thought if #4 made it, then that would be a good sign that the 3 they put back would make it as well. I know it just takes one and that there's still hope, but I'm sad.

2dp3dt - symptoms

Progesterone is really a tricky bitch (or is it the estrogen)? Clearly I can't have any pregnancy symptoms this early (if I'm lucky, those bad boys are just floating around in there, dividing on their merry way).

• Transfer day I was sleeepy. But I blamed everything on the Xanax. I napped and napped and napped. That night I was a little sweaty, but not too bad.
• 1dp3dt I could not keep my eyes open. I wasn't hungry until dinner time and took a 3 hour nap. Unheard of for me! I was kind of hot and clammy all day. Also, commence the heavy duty night sweats (so gross).
• 2dp3dt I'm still tired, but not as bad as yesterday. However, I've been nauseous on and off all day. Around 10:30 I had a crazy bout of low blood sugar (I'm not diabetic, but I do get grumpy if you don't feed me!) and I'm still kind of warm and clammy

Estrogen has a history of making me nauseous. I typically throw up the first night or two after starting bcp. And progesterone notoriously makes me burp! I have all the other standard symptoms of IVF meds, huge sore bo.obs, lower back ache. But those were present prior to transfer. 

All of this to say, the meds are giving my body crazy pregnancy symptoms, which I guess is good, but it's playing tricks on my head!

PUPO

Pregnant until proven otherwise...with triplets! Of our 8 fertilized eggs, we had 4 arrest by day 3. Of the 4 remaining fighters, we had 1 8-cell grade 2 (the little guy in the upper left), 2 more fragmented embryos (no grade given), and one slow grower (no further details given). The embryologist and RE recommended we put the 3 "best looking" embies back. #4 is growing in the lab and if he makes it, will be frozen on day 5. We were both so nervous that we don't remember much else that the embryologist said. She's supposed to call on Monday with news on #4 (our little insurance policy). I hope to ask her some questions then. I supposed the details don't technically matter (these embies are goring to grow and stick or not, despite their percent fragmentation or overall grade). But I want to know.

It's weird to get this far. The most pregnant I've ever been. I feel pretty good. My ovaries are a little sore and my ass is killing me from the progesterone, but nothing compared to the yuck of all the pills and stims of the last 3-4 months. I feel almost normal. I haven't felt almost normal since that myomectomy back in November 2012. I feel *happy*. I'm a little obsessed with every twinge and back ache. I know nothing is going on in there yet. But I think about those little embies constantly. Please let one of them grow and stick and be our take home baby.

Eight is Enough

Our awesome RE texted me this morning. 11 of our eggs were mature (vs 4 out of 7 last time) and 8 have fertilized! 8 little embryos doing their thing in the lab across town. Grow embies, grow!

One Dozen

 

Retrieval is complete. My RE, who is so wonderful, found 12 eggs in there! I was so relieved when I woke up and she told us. Last time we had 7 eggs, 4 mature, 3 fertilized, and 0 made it to transfer. I'm hoping there is at least one fighter in the bunch. Fertilization report is tomorrow. My RE said she'd keep an eye on things and text me if she had any news (I told you she is wonderful, right?). She knows we are nervous about a repeat of events. Fingers crossed that time and all of those supplements and meds can keep the fragmentation at bay.

IVF #2: Stim days 9 and 10 (and trigger!)

Work is just kicking my butt lately. Don't they know I'm busy growing follicles? Actually, they don't. I've kept it quite. A few of my co-workers know I'm doing IVF-ish things (I had to tell them due to travel conflicts, etc), but I've been able to keep the details of this cycle off their radar.

Saturday I went in for my stim day 9 scan. Estrogen came in at 1060 and progesterone was 0.7. I don't remember the follicle counts, but they ranged from 10 mm to 16 mm on both sides.

Sunday I was hoping for the news that it was time to trigger. No such luck. Follicles had grown (ranging from 11 mm to 19 mm, I think), with E at 1528 and P at 1.2. Slow and stead. Slow and steady.

Monday was my first encounter with Dr. Asshat. This is the guy that that acted like I was a hysterical hypochondriac when I came into the office after my myomectomy (my doctor was on vacation). He was so condescending and when I asked if the excruciating pain might be a blood clot he told me it was highly unlikely and to just go home. Of course, I then spent 6 days in the hospital for PE and DVT. I have seen my chart since then and he later wrote that he told me to go the ER immediately. So not true! Anyway, lead follicles were up in the 20s and he said it was time to trigger. I never did get an E and P report for that day.

By Monday afternoon I had a headache. It just kept getting worse and worse. I took some Tylenol, but it barely touched it. The sad news was, I had to stay up until 10:30 pm to trigger. The minutes finally passed and I went right to sleep, with my now raging headache. It progressively got worse until I was throwing up in the middle of the night. I have no idea what time it was as it hurt too much to look at the clock. A few more Tylenols and I willed myself to go back to sleep. Luckily my headache was gone this morning, but I've felt off all day. Kind of hot, sweaty, nauseous, and out of it. I don't know if it's the drugs or the anxiety or bad luck (or all of the above).

I am so excited and scared for retrieval (and I am so glad my regular doctor, whom we both love, is on for retrievals tomorrow). I'm guessing that there are about 10 follicles in there (if you don't count the minis that have been hovering at 10 mm). Not sure how many will have eggs, but we'll know tomorrow! I feel like we're scratching off our last IVF lottery ticket. 

IVF #2: Stim day 8

Things are moving along. Follicles are growing about 1 mm per day. Righty came in with one 13, two 12s, and a few 10s. Lefty had one 13, 5ish 12s, and a few 10s. Honestly, I never remember the numbers correctly. The nurse/tech/doctor (I still have no clue who that lady is) gets busy with the wand and calls 'em as she sees 'em while the nurse at the computer logs everything into my chart. I frantically try to keep up in my head and then promptly forget everything a second later. She (nurse/tech/doctor) said she likes the way lefty looks, but we might just get one or two eggs out of righty and, "that one could be your baby,". It was everything I could do not to cry when she said that. 

Last night was my first growth hormone injection. There was a bit of a mix up with the dosing seeing as the vial comes as 8.8 mg, the instructions say to add 2-3 mL of water, and my nurse said to take 8 units. When I asked for clarification, she said, "oh, I think it's 1 mL". Well, I eventually found out that there are 26.4 units in a vial, but then I temporarily forgot how to math and accidentally overdosed myself. But not by very much. Maybe it will give me a baby *and* make me taller (says the girl who lies about her height every time she says she's 5'3 - I am. In heels).

I'm feeling pretty uncomfortable these days. Not as terrible as I remember from IVF #1. More sore, crampy, and bloaty. I have officially switched to my fat pants...and only button them if I'm going out in public.

Nurse just called. My estrogen came back at 602 and my progesterone at 0.7. That seems low to me (the estrogen). Last time, on stim day 7, I was already up to 743/0.5. They want me back in the office tomorrow. I was feeling kind of happy about my follicle results but now I'm going to have to google the heck out of my estrogen results.

IVF #2: Stim day 6 *updated*

Today was my first follicle check since my baseline. I was a nervous wreck this morning. S and I have been fighting, which I notice we do during every IVF (WTF). I am so anxious/nervous/obsessed with this cycle. I'd like to say it's because it's our last one. But it's not (well, it is our last one, it's just not the reason for my general neuroses). It's because it's fucking hard. It's because it's a dream we've been chasing (unsuccessfully) for 4 years. It's because I want this to work so bad. It's because I'm injecting buckets of hormones that may or may not have been extracted from nun urine. It's because it's IVF. The stupid thing is, it doesn't matter how much I worry, the outcome is the outcome.

Deep breath.

So far so good on my follicle counts. I had to look back (IVF #1: stim day 5) as I didn't remember the specifics, but this cycle is shaping up to be pretty similar to last cycle (let's hope the outcome is different). Today, righty had 1 follicle at 11 mm and ~5 at 10 mm. Lefty had the ever present cyst (now a whopping 24 mm), as well as 1 follicle at 11 mm and ~8 at less than 10 mm. I'm a little nervous about those two lead 11's. But hopefully everyone will catch up and grow nicely. Still holding strong at 450 IU Bravelle and 150 IU Menopur. Last time I started at 300/150, jumped to 450/150 on stim day 5 and back down to 300/150 on stim day 9. I'm not sure if I expected more eggs with the higher starting dose, new protocol, and 3ish months of supplements (DHEA, CoQ10, metformin, extra vitamins), but I do have my fingers crossed for better quality.

The RE is strongly recommending growth hormone (saizen). I'm supposed to order it today and start it tomorrow. It's damn expensive. But since this is our last go, I'm going to do it.

I'm not as bloaty as last time. During IVF #1 I felt like I had the worst gas ever and I couldn't even button my pants. This time, I have some lower back cramps (that's my typical spot for period aches and pains) and some very stabby stomach cramps. Not sure what that's about. Feels more like endometriosis pain than stim pain. Last time, around stim day 9, I was so uncomfortable I questioned if I would even make it to retrieval. However, I was recently talking to a friend (now 36 weeks pregnant with her IVF baby) and she had 44 eggs retrieved (!!!!) with no IVF pain at all. Seriously??? (on a side note, she's 39, did PGD, had only 4 genetically  normal embryos, put two back, and will be meeting her daughter in the next few weeks).

I'm pretty excited. Overwhelmed. And scared. I'm glad I go back every 2 days as I need the constant reassurance that things are progressing. Next up, follicle check Friday morning.

*update*
Nurse just called. Estrogen is 295 and progesterone is 0.4. Last time, estrogen was 176 on stim day 5. Tomorrow, I add ganirelix (every night until trigger) and saizen 8 IU (every night until retrieval).

IVF #2: Baseline Ultrasound

I got reacquainted with the dildocam this morning. I forgot how sad it is to sit in the sad waiting room with the sad ladies. I did not forget how uncomfortable it is to take your pants off, throw your legs in the stirrups, and have a stranger jab at your uterus with a stick. Righty, my little underachiever, was silent on the matter of IVF #2. No follicles. No cysts. No nothing. This has been typical since my 2010 surgery to remove the dermoid. Lefty kept the party going with multiple follicles ("several" was the official count) and one big cyst. The cyst landed me in the blood draw room so they could check my hormone levels. I've been anxious about it all afternoon, but the nurse just called and I'm cleared to start stims tomorrow.

I have a little suspicion that the "cyst" is actually a mini dermoid. My surgeon said she suspected lefty had a small dermoid, but she didn't want to cut into my intact ovary, since righty had been hacked to pieces. And that same cyst showed up during IVF #1. It's probably a hairy, toothy, mini-me of the tumor that was removed back in 2010.

For the record, estrogen was 52 (I'm on vivelle patches) and TSH was 1.7 (which is the lowest I've been since I started levothyroxine).

The excitement is starting to creep in. I've been feeling eeyore-ish in general lately. But this bit of good news has me smiling. Stims tomorrow. Follicle check on Wed. Here we go....

Surge! (and more bullets)

• I did finally get an LH surge on CD15. That's a little late for me, but considering all the damn pills I'm on, we'll call it normal
• I started estrogen patches (one every other day) on CD25 and ganirelix (one shot every night for three nights) on CD26
• I freaked out a little after reading up on the estrogen patches and all of the info on blood clots. You Will Get Blood Clots. Do Not Take This Medication If You've Had Clots. Oh, no big deal, me and my clotty clotness will just be in the corner injecting lovenox and hoping for the best
• CD1 was Monday and I go in for my baseline ultrasound tomorrow. In general, that makes me incredibly excited. Except....
• I lost my shit yesterday. I didn't realize how terrifying I would find IVF #2. I thought I was feeling good. I thought I was prepared. I know this is our last try but we have back up plans B, C, and D and I thought I was going to be zen about the whole thing. Not so. I am so scared to do this again. Because it is hard. And it hurts (mostly emotionally, but a little physically). And it has always ended poorly
• It does't help that work has been a nightmare and I've been putting in 12-14 hour days for weeks. And some of the people I'm working with are being beatches. And I'm generally just over it
• And it doesn't help that we had 3 weeks of ups and downs with a birth mother, including multiple calls with her and her mom, and plans to drive to their home town to meet them (at their insistence), which all ended very suddenly when we received a call from the mom (birth grandma) that they had decided to parent
• I owe a bunch of people Liebster responses and blog comments. I've just been overwhelmed with life. But, I'm hoping to get back to my regularly scheduled life soon. And back to things I enjoy, like all of your blogs (and mine too)

It came with a pregnancy test (and other bullets)

• I had to get a new pack of pee ovulation sticks. Target was out of the generic brand and I was too tired to drive to the other target (side note: I recently found out there are 42 targets in my city's "metro area". Seriously?), so I handed over the extra $4 for first response. Apparently, when you buy the fancypants brand, you get a free pregnancy test. I am now obsessed with it. I'm constantly thinking about that little pink pregnancy test in my sea of purple ovulation tests.
• For those of you playing along at home, CD1 was July 22. I thought I would surge today (CD13), but so far nothing. I'm now worried that the pee sticks are broken. But it's probably me. (or, most likely of all, it's just normal and I should calm the f down and I'll probably ovulate tomorrow)
  
• Work has been a total nightmare and that's pretty much all I have been doing since my last post.
• We were contacted by a birth mother last week. She is very young and very early in her pregnancy. She sent us a long sweet email and we played it cool and wrote back something very noncommittal. Now I feel bad about that. After 3 years of this we're so jaded and we let that get in the way of making a connection with her. I hope we get a second chance
• Tomorrow the social worker comes to our house for our home study renewal. I'm supposed to be cleaning the house right now, but instead I'm reminiscing obsessing letting my mind run wild with the last 4 years of the adoption/IVF journey and all the possibility that awaits in the next few months
• Sometimes I spiral down into thoughts of this being never ending. The shots, the pills, the hormones, the emotions, the waiting, the wondering, the disappointment, the hope, the heartache. But I keep trying to remind myself that every day brings us one day closer to the resolution. One day we will step off this roller coaster. I don't know what it will look like, but one day we will be there and we will be thankful for all the years we put in (and of course then we'll step onto a new and different roller coaster [hopefully parenthood] but I am so ready for new and different)

It's always something

Just received this email from RE office:
Unfortunately, you will not be able to start IVF this cycle, due to our lab closure. Because of the protocol that Dr. X has selected for you; which does not utilize any birth control pills we are not able to make any adjustments to your protocol.  You will have to wait for your next period to get started. 

I am so frustrated. And sad. And angry. Something always comes up. Insurance, fibroids, dermoids, polyps, MTHFR, crappy embryos, and now lab closures. Why didn't they tell me when I called in my CD1 that it wasn't going to work out? They should have at least warned me on CD1. And not let me buy those dumb pee sticks. And not make me have to tell people at work because I had to get out of a trip and then train another person on the info so they could go on the trip in my place. And not let me mark up my calendar with potential retrieval/transfer days. And not get all hopeful. Fuck.

Vacation, chacne, and a miracle (or two)

Just got back from here:

Sedona, AZ. It was amazing and perfect. We hiked until we about passed out. We ate, well and frequently. We watched part of the honey boo boo marathon on TLC. I couldn't ask for more in a vacation. Oh, and I ovulated. Woo hoo. Bring it IVF #2.

Which brings me to my next topic. Chest acne (chacne). The area between my neck and my tatas suddenly resembles a 14 year old boy. I think it's the DHEA. I hope it goes away soon. Or more specifically, I hope it goes away when I start IVF #2, stop taking the DHEA, and get knocked up.

I was thinking a lot about IVF and kids and our journey on this trip. It takes a miracle for any baby to get here, but it's going to take a miracle for us to get to that miracle. I'm ready for all those miracles.

Here we go again

I took a blogging leave of absence. It was too much. The RE said to take an IVF break to let my body heal, but I also needed a blogging break to let my mind heal. It's been a good break. S and I have reconnected in new and better ways. We've found some hope around this next round of IVF. We celebrated S's grandma's 92nd birthday with lots of laughter and lots of food. And we're heading out for a little vacation in the desert next week. I am so looking forward to that.

Today is CD3 for  me. The IVF #2 protocol (E2 suppression) is about 2 months long. Next step is waiting for an LH surge. Then I'll start with the estrogen patches and ganirelix. My period was wonky this month (4 days late, which is unheard of for me). Not sure what that means. I'm trying to stay positive, but the doubts creep in so easily.

This is our last try for a bio kid. Insurance covers two IVFs and here we are at IVF #2. It doesn't feel super important to me that we have a bio kid (although that does sound nice...and we happen to *love* our new donor pick). It just feels super important that we have kids. And if this door shuts, it means one less option for getting there. But we do have a plan B. And a plan C. So we will keep moving forward. For now, I just need to get to Tar.get to get some ovulation test strips.

IVF, the gift that keeps on giving

"While it may occasionally occur that one's character shows in one's face, this is nothing to count on, for one's face will show in one's character long before that possibility has had a chance to arise."
--Fran Lebowitz
(I love Fran Lebowitz. She makes me laugh every damn time.)

Apparently, IVF has decided to show *its* character in *my* face. There's a good and a bad side to this unexpected outcome.

The good: my average brown eyelashes now go on for days. It's true. For the last few weeks, I would look in the mirror and think, "I look different. My eyes look nicer or something." And then I finally realized it was my eyelashes. When I asked S about it, she said "Yes! But, I just thought your eyes were looking so beautiful because I was falling more in love with you." (I got a good one right? I've totally trained her on what-to-say-when-your-wife-asks-you-anything-about-her-body).

The bad: my already strangely flat eyebrows (see below) have become bushy overachievers. Much like my eyelashes, they too now go on for days. Case in point:
S: You have an eyelash in your eye. Let me get it for you.
S: Wait a minute, it's attached.
S: To your eyebrow!



That's right, my eyebrows are now so long that they fall into my eyes like little eyebrow bangs (see below). I think it's the supplements. Maybe the DHEA? Or all the vitamins? Interestingly (luckily?) I haven't noticed the effects anywhere else!

Like Clockwork

My period arrived last night. 28 days exactly. My ovaries, my eggs, my tubes, and my ute may all be for shit. But damn if my period isn't the best, most perfect, overachieving, right-on-time period ever. It kind of made me feel good (something works!). Also, it's nice to shed the last remnants of this first IVF. IVF is hard. Harder than I ever imagined. I thought IVF was the ANSWER. The miracle cure that brings the baby. But it was so hard. Physically,  logistically, emotionally, financially. It knocked the wind out of me. I had no idea. I thought it was just this lucky thing that people with insurance or money get to do. For fun! For a baby! But it rips you apart.

In my head, our sweet little embryos are tiny little alka seltzer tablets. I know that sounds weird. But they just fizzled up and died. The official diagnosis is severe fragmentation. On day 1, they were 3 little fertilized eggs. On day 2, they were already fragmenting. On day 3, they were all highly fragmented grade 3 embryos (grade 4 is the worst at our clinic). One was already 7 cells (not good. there was clearly something wrong with that little guy. Always a sucker for the underdog, my heart goes out to that one the most. doomed from the beginning). The other two were 2-4 cells (perfect, as far as cells go). On day 4, they were grade 4 and the fragmenting was just getting worse. On day 5, they arrested. On day 6, they were discarded. I wish I hadn't seen the paperwork. Seeing them coded as arrested and discarded about broke my heart.

My RE was so sweet and she called to check up on us. She feels bad. She got me in on day 6 for a WTF appointment. I wasn't sure if that was a good idea or not. I couldn't talk about it without crying (I hate crying in public). I hadn't processed it all. But it was good. She was so nice and so hopeful. Maybe that's what I needed to hear. I still feel unsure if we should do this again. I think we will. How could we not? My insurance gives us one more chance. My RE thinks that my body is still in shock from the PE in December. She didn't expect these results. I was textbook perfect for someone my age (she says). All my numbers were good, up until the eggs left my body. She didn't expected the fragmentation. She thinks my body is inflamed and we should take a break, take some supplements, and come back and try again with a different protocol. She wants me on DHEA and CoQ10 now. Then metformin in June (I don't have PCOS, nor am I diabetic, she just thinks we should try it). If we do this, I'll start estrogen after I ovulate in June (estrogen priming protocol). Then IVF with my July period, this time with extra ganarelix and human growth hormone. She says, "let's throw the kitchen sink at it."

I don't know. That is so much crap to put in my body. I'm swallowing hand fulls of pills (levothyroxine, CoQ10, DHEA, prenatal vitamins, vit D, special folate for folks with MTHFR, fish oil) and wondering, what the fuck am I putting into my body? I'm reading articles and there are mixed opinions on if some of this stuff will help or harm. But, I started the extra supplements yesterday. Just in case we want to do this come June. I think we will. How could we not?

IVF #1: Cancelled

None of the embryos made it. Devastated. There are a few more details, but I can't write them today. For now, I'm just glad for the xanex I took before I got the call.

IVF #1: Fertilization Report

4 of the 7 eggs were mature. Clearly, my eggs are underachievers.
However, 3 of the 4 eggs fertilized. Apparently we picked some badass sperm.

Here's how it all went down....
By Wednesday night (night before retrieval), I was *so* uncomfortable. I don't even know how people with 10, 20, 30, 40 eggs get through this. The doxycyline made me sick and it turned into a long queasy night.

I felt a bit better Thursday morning and woke up to two epiphanies: 1) damn, I'm a hormonal mess and 2) no way am I wishing for a Sunday transfer, it's PGD and May FET all the way.

All the staff involved with the retrieval were awesome. So nice and comforting and knowledgeable. They definitely put us at ease. On a side note, the anesthesiologist totally grabbed my boob. It was an accident. IVF has given me crazy pregnancy symptoms (huge boobs, nausea [don't even mention chicken to me], the inability to button my pants). So, I was laid out on the OR gurney, large and in charge tatas sneakily hiding under the gown and blankets, when Dr. anesthesiologist, trying to be nice, went to move my blankets and grabbed a fist full of boob instead. It was awkward. We both pretended like it didn't happen.

And then I woke up.

I actually felt better when I woke up than I did before they put me under. My abdomen was noticeably less distended. The RE came in and excitedly told us about our 7 eggs. Lucky 7, she said. Of course, I cried. Just a little. But I had decided that what we really wanted was 10-15 eggs so we could stick with plan A (PGD + FET). 7 meant no PGD.

I went home, ate some soup, and took a nap. Best nap ever. I was tired and crampy, but functional the rest of the day. And chicken sounded good again :)

Today, I had some major cramps in the morning, worse than with a normal period. A few tylenols later, I'm feeling pretty good. Still uncomfortable to button my pants, but not as bad as before retrieval. They called with the fertilization report and I was a little bummed that we're down to 3 embryos. But it only takes one, right? And, Oh. My. Gosh., we have 3 embryos. THREE!! The plan is:

• They call us Sunday morning. If things aren't growing well, we'll do a day 3 transfer at 9:30am. If things are growing well, we'll hold out until Tuesday
• If we make it until Tuesday and things are growing *really* well, we'll consider PGD and freezing. If things are looking more average, we'll go for a day 5 transfer

I feel pretty good about all that. I can't believe how fast all of this goes once you're here. Years and years of waiting and wondering and trying and then it feels like in the blink of an eye you might be getting knocked up next Sunday. Fast but slow. Slow but fast.

7 eggs

Glad it's more than zero. Sad it looks like not enough for PGD and FET. We might be doing this on Sunday. More after I have a little nap....

IVF #1: CD16: stim day 10 - retrieval scheduled (and a day 3 transfer?)

Appointment went well this morning and they've decided I'm ready to trigger. No more stims for me (which is kind of funny, because that means me and my slow growing old lady eggs actually only had 9 days of injections) They didn't provide any estrogen/progesterone stats this time, but I guess it was all good enough. Every time I'm up in the stirrups I try to remember the follie counts and as soon as my feet touch the ground, I forget. Based on my unreliable memory, there are a few too small 10s and 12s on both sides, 4 large-ish follicles on the right ranging from 15mm to 18mm, and 4 to 5 large-ish follicles on the left ranging from about 16 mm to 21 mm.

The plan is, 10pm trigger shot tonight, 9:30am pre-op tomorrow, and 9am retrieval on Thursday. I can't believe it! (but thank goodness as my ovaries hardly fit in my pants anymore)

Then what happens? I have no idea.

• The original plan: retrieval, fertilize, grow to day 5, biopsy, send  for PGD, transfer up to 2 healthy (frozen) embies with my May cycle
• The backup plan: If there are too few embies to biopsy for PGD (I'm not sure what this magic number is), then we just grow to day 3 or day 5 and freeze. Then proceed with FET in May
• The backup to the backup plan: Of course I want to be pregnant yesterday. Well, three years ago, if we're being honest and making wishes. So, I am sort of putting the idea out there that if there are too few embies to warrant PGD, we just do a fresh transfer next week. The major hiccup being that all of my doctors have suggested I wait 6 months from PE diagnosis (Dec 21, 2012), before I get pregnant. But I'm thinking that I'd rather risk the PE (I had a CT the first week in March that showed no clots) versus risking the freeze/thaw on the embryos, especially if there are just a few (or a couple, or one. please let there be more than zero) (*updated: nurse has me tentatively scheduled for a day 3 transfer on Sunday - fertilization report and doctor's orders will have the final say)

This leaves me feeling:

• Incredibly excited and thankful
• Scared an anxious
• Desperate, when I think about what's going to happen
• Calm, when I think that our little peanut(s) are growing big and strong in my bloaty ovaries right now
• Sad, when I think about my grandparents and how much I wanted them to be here for this (it was recently my grandpa's first yhartzeit. I remember my grandparents lighting yhartzeit candles for their parents and/or siblings, whom I never met. It felt so significant, their love for their families that passed, the ritual, the stories they told me about the people they loved and missed. In the same way that only a child can believe the sun rises and sets with herself, it felt strange, how huge their love and their grief was for people that had died before I had even been born. And now I'm going to repeat that. Lighting the candles, telling my children stories, sharing how much I love and miss my grandparents. I know they might be "here" in their own way, but boy do I wish they were *here*.)

IVF #1: CD15: stim day 9 - the ups

Let me tell you part of the best news of all, I am *so* uncomfortable. And I love every second of it. My ovaries are seriously large and in charge in there. I've been walking around with my pants undone all day (thank goodness I work from home). The RE office just called with my afternoon update. Here are the stats for today:
Estrogen - 1,374
Progesterone - 1.0 (thanks to Amanda Raye for pointing out that this is indeed normal)
Lowering my meds back to my regular dose (4 vials bravelle, 2 vials menopur, everything else stays the same).

A few random thoughts for today:

• Even though today is stim day 9, my results are really based on 8 days of meds, since I take my stim shots in the evenings, but have my blood work and ultrasounds in the mornings
• I ran out of bravelle and menopur and had to order more of both. Somehow, my brain keeps thinking "need to order more" = "wasteful". I'm not sure what that's about, but I am very, very, very thankful I even have the option to order more
• It's looking like we'll trigger Tues or Wed and have our retrieval Thur or Fri. I am so nervous and excited
• We're doing PGD (hello, old lady eggs) and have always planned to freeze everything with FET in May (fingers crossed). But now that I actually feel like this IVF is really happening, I'm daydreaming that if there are only a few eggs (one of my fears) then we'll just put them back right away instead of risking the freeze/thaw (but really, I hope there are lots of eggs and, health wise, it would make SO MUCH MORE SENSE to wait until May)
• I am wondering what the calendar/meds look like for an FET. I need to look that up next. For someone who can't take birth control, do they just shoot me up with progestrone and wait until I ovulate?
• And these bullets are the reasons why I've developed IVF-insomnia. (I woke up at 4 this morning and  never did fall back asleep - finally gave up and rolled out of bed at 5:30 to get some work done)

Back to the RE tomorrow morning at 8:30.

IVF #1: CD13: stim day 7 - ups and downs

Let's start with the downs. I had an appointment Saturday morning. Things were not looking so good. I cried. Follies had grown an average of 1mm in 2 days. I can't remember the exact measurements because I was so nervous/upset. Mostly 10s and 12s, I think. There may have been a 13mm. They kept my meds the same and told me to come back in two days. Later that afternoon, they called with my blood results, estrogen: 743 and progesterone: 0.5. The estrogen made me feel a little better...quite a jump from the high 100s at my last visit. I have no idea where my progesterone falls on the "normal" range. If work would stop bugging me with deadlines and conference calls, I'd have time to look it up ;) More later this afternoon with results from this morning's scan.... 

IVF #1: CD11: stim day 5 - it's working! (*updated)

First U/S and blood draw since I started stims on Sunday night. I've been feeling bloaty/crampy but was trying to pass it off on my nightly ice cream indulgence. I was a little afraid I was going to be sent home with no follicles and a diagnosis of gas pains. But things turned out way better than just some mild GI disturbance. Righty, my little under achiever who never quite recovered from the 2010 dermoid surgery, is holding steady with ~5 follicles, all under 10mm. Lefty, my little workhorse, has ~5 follicles, all under 10mm, along with a few at 11mm and a few at 12mm. You go lefty! Lining is at 8mm and estrogen results should come in this afternoon. The only potential issue is what appears to be a functional cyst. A small cyst was noted at my baseline appointment, but since my estrogen was low, I was cleared to cycle. However, the cyst is now bigger and appears cloudy on U/S. I'm hoping this doesn't impact my other little eggs. Next appointment is on Saturday and I can hardly wait!

*Updated
Nurse just called. Estrogen is 176. Doc says to increase my meds (add 150 IU Bravelle) to help some of those smaller follies catch up. New Rx is for 450 IU Bravelle and 150 IU Menopur.

Crap. Does that mean it isn't working? I was all happy this morning (yay! there's eggs!), but now I'm worried they are growing too slow. At least they have a few days to catch up.

IVF #1: CD8: stim day 2

Mixed my first syringe of stims last night. I'm on 300 IU bravelle and 150 IU menopur (for now). S sat at the table biting her nails. My hands were shaking. We were nervous! All went well though (I think). So far no side effects, except maybe with the lupron (10 units twice a day). I always feel a little dizzy after, my injection site burns, and I get a bit of heart burn. That's the easiest injection to give though (compared to stims or enoxaparin).

I feel like I've been waiting years to add a pic of my IVF meds to this blog (pic below includes ganarelix, bravelle, menopur, dexamethasone, doxycycline, and femara - only things missing are levothyroxin, lupron, enoxaparin, and vitamins). I can't believe we're finally here. I am so nervous about Thursday's scan and blood work. I hope my ovaries are getting to work in there. Every time I feel my anxiety getting out of control I try to remind myself that it's not my job to predict the future, it's just my job to try and have a good today.

IVF #1: CD5 - so far, so good

This might be the only time I'm really happy for low numbers. E2 is 29.2 and lining is 3mm. All is as it should be for someone who hasn't started stims yet. The ultrasound tech (I don't even know who she is...a doctor? a nurse? a tech?) noted that she saw an empty follicle (presumably from my last ovulation) and some basal follicles. Fertility med holiday tonight, lupron tomorrow. This is getting exciting!

IVF #1: CD4...this time with extra welts!

First injection last night went well. Except for that angry red welt that took over half my abdomen. As I sat around scratching my belly I googled "ganarelix + reaction" and found that it's a pretty common occurence. 30 minutes later I was as good as new. Same drill tonight. Baseline appointment tomorrow morning at 8:30!

IVF #1: CD3

Today is the first day IVF meds. 1 SQ injection of ganarelix (along with all my regular meds: prenatal, vit D, CoQ10, enoxaparin, levothyroxin). I'm excited :)

And amused....

IVF #1: CD2 (*updated)

I've never been so happy to be a crampy, bloated, hormonal mess. There have already been a number of crises and I haven't even had my first date with the dildocam.

Despite asking several times last week, no one at the RE office would tell me when I would start my meds. All the microdose lupron flare protocols I could find online come with weeks of birth control first, which I can't take. So, when CD1 rolled around (yesterday) and no one answered my OMG-WHAT-DO-I-DO emails, and my meds arrived but were missing the microdose lupron, I started to panic. At 8pm, a new nurse called and said my nurse had been out of the office, I didn't have to worry because the RE lab is closed until next week (WTF?) so no new IVF cycles can start this week anyway (WTF!!!!), and I should get on birth control pills until my stims start next week (F.T.W.). Clearly, she missed the part in my chart where I ALMOST DIED FROM BIRTH CONTROL last December.

I wrote an email to my nurse this morning explaining that whomever called me last night was a HAZARD TO MY HEALTH and that this whole IVF timing, birth control, and missing meds thing needed to be worked out. My nurse called me back and treated me like a lunatic, which I somewhat deserved, but mostly did not. She tried to chastise me in her own special way ("I guess I shouldn't have taken yesterday off") and I fell for it, stupidly beating myself up for having a minor email confrontation over something important.

We straightened out the missing medication. Apparently you need a compounding pharmacy for microdose lupron. Then she told me to come in on Friday (CD5) for a baseline ultrasound and to start meds on CD6. I tried multiple times to get her to explain why we were waiting to start meds until CD6 and she just kept placating me with "it will be fine", "it's just how we do it", "you don't have to worry". I'm not a real doctor, but I do play one at my job, and understanding my protocol is important to me. Not explaining makes me think either she doesn't know (which is fine, but I'd rather she just say that) or she is messing with my protocol for the benefit of their lab schedule (would they do that?).

All of this prompted much googling on my part and I found that 1) not doing anything until CD6 is not "standard" and 2) it's all the rage to "hate" the microdose flare protocol (seriously, more than one RE publicly admitted to "hating" microdose flare).

So, as of today I am:
...excited to be starting IVF
...aggravated at how things have started
...scared that my protocol is f'ed up
...wondering if I should bring up my protocol concerns with my doctor or just trust that 1) I don't know everything and 2) she has a degree in egg making
...holding out hope

*updated: they just emailed to say they are adding ganarelix on CD3 and CD4. Here we go....

Bullets

• I think of posts I want to write and then I don't write them. Maybe this will help get me started
• Blood thinners: they make you bleed. Or, more accurately, they make you not clot. I awoke to a shirt soaked in blood the other night. It scared the crap out of me. I was bleeding from one of my old injection sites. Enoxaparin stigmata.
• Over the last few days I've seen my pulmonologist, perinatologist, and reproductive endocrinologist. Guess who cleared me for IVF? All 3 of them!
• Speaking of multiple doctors appointments each week, my job must think I'm dying. Or just a big slacker. I spend more time in waiting rooms than I do at my desk. 
• My period. I have never been so excited to get my period. She should be here in the next day or two. I expected her today. But, things don't go as planned. 
• Retrieval. This is it! The start of our first retrieval cycle. I'll be on a microdose flare protocol (is that code for old-lady-regimen?). No bpc for this clotastic girl. Just straight up microdose lupron, bravelle and menopur. I haven't gotten a clear answer as to when I'll actually start my meds. In fact, they haven't even arrived yet. But hopefully I'll know all the nitty gritty details next week.
• We picked a donor. That was a hard decision. It was between two people, who are both kind of perfect in their own way. I don't think there is a "right" or a "wrong" choice, but I still find myself hoping we made the right one.
• Transfer. If all goes well, transfer will be with my May or June cycle. We're freezing everything and will do a FET. All the docs insist I not get pregnant until 6-months post-PE diagnosis.    

Sorrow floats. But so does hope.

I've been busy getting my act together. And licking my wounds. And going to doctor's appointments. And calling billing offices about doctor's bills (seriously, why can no one submit to my insurance the right way the first time. oh, and btw, having insurance = the.best.thing.ever.)

At first, I was all panic-y about my MTHFR mutations (see previous post). As someone with a degree in mutations, you'd think I wouldn't dive off the deep end and read everything on the internet. And then believe it. But I did. But then I started being sane. And I saw my hematologist. 15 vials of blood later, she released me from her care. No other clotting disorders noted, just the perfect storm of bcp, surgery, and MTHFR. She did suggest that I not get pregnant, but I suggested that she come up with a better plan. So I'm on 80 mg lovenox twice a day for the long haul (until 8 weeks after any successful pregnancy).

I started taking supplements (B vitamins! 3 kinds!), but I still felt off. My TSH came back at 2.9, which isn't even high, but I asked for for some levothyroxin and oh.my.g-d.i'm.cured. That stuff is speed for middle aged people. I love it. Combine it with a cup of coffee in the morning and ICANCONQUERTHEWORLD. That little pill is seriously the highlight of my day. I secretly want to overdose.

So what's the plan? Next week I have a repeat CT, courtesy of my pulmonologist. If my lungs are clear, he will give me the OK for retrieval (March or April) and then transfer (May or June). Hopefully. We'll see. A lot of stuff has to go right. Two days after the CT, we go on vacation (YAY! we are going here and here and a bunch of other places). When we get back I have a pre-conception appointment with maternal fetal medicine. I'm not really sure what that's about, but my RE is requiring it now that I'm super-duper high risk. What's one more person looking at my hooha, right? That same day I have injection training and a trial transfer with my RE (you can imagine how thrilled my job is that I spend more time a the doctor's office than I do at my desk). And the following week, if everything goes well (and that's saying a lot), I'll start my period and we'll start our IVF cycle (What?? Yep, start our very first IVF).

Then, everything goes on ice. My pulmonologist wants me on 6 months of treatment before transfer. My clots were diagnosed on 12/21/12, so that puts us at my June cycle. You know I'm going to be pushing for May though. We're doing PGD (I still don't know if that's the right decision) and that means any resulting embryos have to be frozen anyway (that's just how my RE does it...I know not all labs follow that path). So it all kind of works out. We can do our retrieval cycle, send away for our PGD decoder ring, and then (fingers crossed) put something back late spring/early summer. I love this plan.  

Clouds in My Coffee: Vanity and Compound Heterozygous MTHFR

I found out yesterday I'm compound heterzygous for MTHFR (C677T, A1298C). That could very well be the cause of my 2012 clotting extravaganza. And it's one more obstacle in trying to get pregnant. Ever since I found out, I've spent my time crying, obsessively googling, and wondering what it all means. Does it mean we're not supposed to try for bio kids? Does it mean we're supposed to try harder? And where do I get off thinking this is some sign from the universe directed at me?

I just don't know what to do. In early 2010, when they said I'd have to have surgery before even an IUI, we wondered if that was too much to do for a pregnancy. But they said I had to have the surgery no matter what, so we did it. Later that year, when they said we'd have to do IVF, we wondered if that was too much. Then they said I'd need a second surgery and we drew the line there and moved on. And then regretted it. Now I'm at risk for blood clots (due to my previous clots alone) and my MTHFR mutations put me and any potential pregnancy at risk for a myriad of health problems. Do we keep pushing forward?

I feel like my identity is not my identity anymore. Thanks to mandatory mail order pharmacy, I have 10 boxes of generic lovenox sitting in my house. I inject myself twice a day and have a body full of bruises. With this new MTHFR diagnosis, I'm about to add to my growing number of bottles of supplements. I'm at risk for heart disease, stroke, cancer, and Alzheimer's (and a million other things if you read some of the scarier websites). Any potential pregnancy is at risk for birth defects and still birth (not to mention inheriting my mutation). I don't want to be this "sick" person. And I don't want to follow my grandma's path through years of dementia. (I am really scared of that) I've always felt healthy and capable and now I feel like neither of those things.

Maybe I'm over-reacting. Or just need to wallow for a minute (2013 was supposed to be better, damn it!). I'm working on figuring out what I need to do/take to keep my homocysteine levels low and get the folate I need. I have follow ups with pulmonology, hematology, perinatology, and reproductive endocrinology. One step at a time. But I don't know what the next step is supposed to be. I wish the universe would give me a sign.