IVF consult

It was this morning and it was good. I love Dr. Awesome. Love, love, love. Hubs and I had both done a ton of research over the past couple of months, so all of our Qs were asked pretty much for the sake of hearing him answer in his understanding, intelligent, calm, confident way. We are signed up to begin meds on August 29, but that might pushed back if my requisite residual cyst is really large or decides to spew estrogen or invite some friends to hang out with it.

Also, when Dr. A was drawing my blood afterward, we chatted about my job, which he thinks is really cool, and about The Girl With A Dragon Tattoo, which is the book we both read this summer. So now I’m pretty sure we’re BFFs. Muhahaha!

No, in all seriousness, because IVF is NO LAUGHING MATTER, it was a good consult. And I am so pleased we switched clinics last month. (Don’t get me started on the regret that brews when I think about hanging on with clinic #1 as long as I did. Alas!)

My heart’s been racing since I woke up this morning. I think consults just wig me out. And, then, you know, IVF is a very big deal and part of me is absolutely freaking out that we have reached this point. (Well, almost, tomorrow’s Beta result will be the final word.) I am not afraid of the injections, or the retrieval, or any of that stuff. I mean, I know it’s terribly unpleasant and stressful and emotional and uncomfortable and hard on my body, but I believe I can do it.

I am afraid of: What if THIS doesn’t work?

Dr. Awesome is holding our hearts and our future in his hands. Thank goodness I trust him 100%.

It’s the same old song

Every morning, en route to my office, my bus drives right by Grant Park, a beautiful lakefront park in downtown Chicago. Hubs and I will be there baking under the steamy August sun this Sunday, as we are every first weekend in August, listening to our fave bands and discovering new ones at Lollapalooza.

This weekend is also the one-year anniversary of the first home pregnancy test I ever took. (I’ve only taken four since then, all because Clinic #1 required them.) It had been weeks and weeks since I’d been off birth control and while I was 90% sure I hadn’t ovulated and wasn’t pregnant (I’ve never ever ever had a symptom, remember?), I wanted to make absolutely sure before indulging in some beers at the the concert. I remember standing in my bathroom early that Saturday morning, hopping from one foot to the other, waiting to see. UP popped the control line, in a flash. And of course, that was all there was. One lonely line. Hubs gave me a hug, then I took a walk around my neighborhood and thought and thought about my next steps. I knew something was wrong.

I was fine afterwards, it wasn’t a shock or anything. But late that night, after a couple of beers were in my system, tears began rolling down my cheeks while hubs and I watched the Fleet Foxes play an aftershow at a bar. It was this endless well of emotion that I didn’t even know was inside me, and I was tapping it for the very first time.

I wish I could go back in time and give that woman a hug. She had NO idea what was in store for her and how tough her year would be. Provera. TSH test. Referred to RE. Consult with Dr. C. The Clomid bust months. The crazy-thin lining. The HSG. Second consult with Dr. C. The cysts. Consult with Dr. K. The hours and hours and hours of Googling.  The bench months. The early morning monitoring appointments. The blood draws. The canceled cycles. The injectables. The failed IUI. Consult with Dr. A. The second failed IUI. The third IUI. The jealousy. The fear. The anger. The regret. The frustration. The guilt. The shame. The heart-crushing longing to see two lines. So many tears.

And now I can’t help but wonder, as I look forward to my weekend at Lolla….do I need a hug now? The truth is, I STILL have idea what’s in store for me. Will I ever get to move forward, and leave this purgatory?

Darth Vader

I’ve been working really hard on accepting my body and my personal path (cue the New Age chimes). Meditation CDs. Yoga. Deep breathing. Honestly, it’s not that I believe that any of these efforts will help me conceive. It’s to make this all feel less scary and sad. And because I can’t keep melting down into a puddle of despair all the time—it’s simply not fun.

And then, just when I think I’m getting a handle on myself, I totally lose control.

Over the weekend, hubs and I were en route to our anniversary dinner. We were talking about some construction work that’s being done in our six-flat apartment building this Fall. And in the course of conversation he dropped this lovely factoid, “Mary downstairs is due with another baby.” [Side note: I had suspected this for several months. However, since this gloriously fertile young woman is still carrying some baby weight from the boy she had a mere year and a half ago, I could divert my eyes in such a way as to fool myself that I was going crazy and just imagining things. Plus, she is a stay-at-home Mom and so our paths tend to cross only in the early hours of the morning, when I am sweaty and returning from a morning run, while she is settling her baby into his stroller and thus mercifully obstructing her stomach from my line of vision at the beginning of their morning walk.]

So, anyway. My response to  hubs was something along the lines of: “What the HEEEEECK, it’s so UNFAIR how easy it is for most people! I bet it’s a girl, too. UGH! Why can’t WE have that?” And then my eyes welled up with tears and I said something like, “Great, just great. I guess that means that STUPID baby stroller that’s been sitting in our lobby isn’t going ANYWHERE.”

[There may have been an embarrassing number of curse words peppered within my reaction. Also, I was pretty uncomfortable from IUI-day bloat and also feeling a tad hormonal. But there’s no excuse.]

Hubs just looked at me with his eyes wide and said, “Where did Yoda go? You’re like Darth Vader right now, you went to the dark side!”

[He later told me it was like that scene from Lord of the Rings, when the usually happy-go-lucky hobbit Bilbo Baggins suddenly growls and snaps for the Ring, while dark, stormy clouds billow behind him. Well then!]

This is one of the things I struggle with constantly: Jealousy. I’m envious when friends email their baby updates. I get a lump in my throat when the baby announcements and shower invitations arrive in my mail box. I feel weepy when a pregnant lady walks by. I don’t ever go on the minefield of Facebook because I can’t take the litany of ultrasound pics, belly shots, hospital images, etc. My chest tightens. I honestly feel a little tug in my heart every morning and evening when I see that baby stroller in our building lobby. And now there will a new infant in the building! And now I will not be able to even pretend to make eye contact with Mary or her pregnant belly when we run into each other.

[Big sigh.]

Lately (ahem, very lately), I’ve been doing better. When something baby/infertility-related upsets me, I take a deep breath and remind myself I am on MY OWN PATH. But Darth Vader is always lurking and threatening to make an appearance. It takes some seriously active positive/healthy/accepting thinking to not go to the dark side.

The good news is that I pulled myself together pretty quickly. Instead of turning into a sob-by mess and ruining our night, I wiped the tears from my eyes and settled into the drivers seat of the car and said: “Let’s talk about something else, okay?”

Zen zen zen zen.

And here we are

We triggered last night (twelfth night of stims, not too bad!) and will IUI tomorrow. We officially have one good follie on the left, with a “maybe” on the right (if it works really hard to catch up). I had a bunch of follies hanging out in the 12-13ish range and there was talk about canceling or converting to IVF. So, we triggered quickly to save the cycle. Phew.

I love Dr. Awesome. I love his knowledgeable, compassionate nurses. I love his online patient portal where hubs and I can access my daily monitoring results. I love his protocol. I love that he is checking my P4 in a week. I love that I have a Beta test scheduled and don’t have to take an HPT. I love his aggression with my treatment. I love his caution. I love everything about clinic #2.

Can we be friends?

That’s what hubs and I say to each other as a way to make up after we’ve argued. Those words are code for, “I don’t want to be in a fight in more, let’s move on!” An olive branch, if you will.

I feel like that’s what I’m doing with blogging. I want to be friends with it again. Lately I’ve been focusing more on commenting and less on writing about myself because it was fueling my tendency to freak out, moan, weep, obsess, complain and feel jealous and angry and sorry for myself. There is a fine line between venting and enabling negativity. I am working hard to find the balance. I want blogging to be a healthy, therapeutic thing for me again.

I’m still trucking along with injections and monitoring for IUI 3.0 at Clinic #2. Dr. Awesome is using a similar protocol to Clinic #1’s, except instead of Luveris to help out my super-duper low LH, he asked me to begin inject low-dose HCG on my fifth night of stims and also to start Ganirelix (to prevent premature ovulation) on my seventh night of stims. I’ve “checked out” (well, more than usual) and I’ve been letting hubs do the Googling and cycle comparing when I get monitoring results. He has also been taking the pressure/stress off of me with injections. He preps them each night (mixing up the low dose HCG, dealing with the Ganirelix, setting up the Gonal-F pen), and then injects me while I look away. It’s amazing what a difference it makes to take all of my injections in the evening and to have someone else worry about them for me!

I’ve also been focusing on being more gentle with my body. I’ve been doing lots of yoga, and no running. I bought a meditation CD aimed at infertility and have actually been leaving my desk for a half hour every day at “lunch time” (we all eat at our desks) and listening to it on a park bench. I’ve been practicing the deep breathing I learned on that spa trip with my Mom in April. I have not managed to chillax into a blissful Yogi state by any means, but I am really trying to be more “okay” with everything. The good and the bad. The happy and the sad. Even Steven.

Honestly, I know that all of the hard work I’m doing on myself hangs in a fine balance….the moment my cycle goes off the rails, or a friend emails with baby news, or whatever, I could potentially melt down. It’s easy to be Zen when everything’s going okay. Still, it’s more pleasant than the alternative—being a crumpled mess of despair no matter HOW things are going.

I’m trying really hard to take this cycle day by day dear bloggies. I’m trying to find my sweet spot.

Injects 3.0

CD2 monitoring at clinic #2 this morning. (Allllll the way out in the ‘burbs.) Blood work, super-intense ultrasound measuring everything and looking for abnormalities, an injections class, paperwork signing. Of course, during the u/s, a residual cysie was discovered on rightie.

Giorno otto del ciclo

That post title? Cycle day 8, in Italian. Gotta keep everyone on their toes. Also, I already named a post CD8 and can’t bear to repeat last cycle’s meltdowns, especially the one on CD8. New cycle, new attitude.

Soooo, monitoring. Nothing to see here, folks! I have zero follies over 10mm, none big enough to measure. But it’s okay. I think some little guys will probably wake up and begin growing in a few days. My lining was 1.8mm at baseline and it’s up to 5mm. Which is, you know, AWESOME for a lining-challenged–girl like me. I think my lining is digging the Luveris.

We also got some great news yesterday. Hubs’s SA #2 with Dr. A’s preferred Kruger Test for morphology came back all good. He has some great looking swimmers. So if we can get to IUI land again this cycle, we know we have a shot.

My blood work with clinic #2/Dr. A is also rolling in and everything looks okay so far. TSH (the reason I was referred to an RE last August), is normal. AMH is normal. Dr. A noted some perhaps alarmingly high kidney- and liver-related hormone levels in previous rounds of blood work. So, even though he said it wouldn’t be related to my ferility troubles, he was a bit concerned and ran extra tests on secondary hormones that give a better picture of the health of those organs. Everything is normal. PHEW! Seriously, part of me was awaiting a call from Dr. A to the effect of, “You’re going into premature kidney failure, get to the ER immediately.” (I know, I’m nuts.)

Which begs the question, what the frack is wrong with me and why don’t I ovulate? I know the answer doesn’t matter….it simply is what it is. (Yeah, Yoda Egg is currently in the house.)

Ciao!

Getting warmed up

Quickie update. I went into clinic #1 for an ultrasound to check out my cyst this morning. It’s gooooooone. Which means I’ve stopped taking BCPs and I hope to  begin injections on Thursday. For those of you counting, yeah, that leaves a few BCPs in the packet. In other words, I’ve fast-tracked myself. Suck it, remaining pills. 🙂

What’s the rush? (Besides the fact that my as$ has completely fallen asleep from warming the bench for so long?) We’re heading to the Chesapeake Bay for another wedding on Friday morning. The hardest part is that we’re staying at a tiny B&B with three college girlfriends, two of them are bringing their babies. It would be nice to have a little hope in my heart, don’tcha think?…So thank the LORD I will be injecting this weekend.

I told hubs last night that I was dreading this morning’s ultrasound. Not because I was afraid the cyst would still be there (which I was worried about). I’m afraid because I know how brutal each monitoring appointment can be…how freaking emotional I become as I anaylze my response to the medicine. Hubs looked at me calmly (he is omni-calm!) and said, “But you’re always emotional, so what’s the difference?” Haha. So true. And I’d rather be emotional with hope as an undercurrent, instead of emotional on the bench.

So, I’m waiting for my period, then waiting for baseline monitoring. Then, hopefully, injects 2.0. And meanwhile, blood tests and hubs’s SA at clinic #2. Heck yeah!

The compromise

This post is too long and all over the place (aren’t you dying to read it now? haha), but so are my thoughts so here goes….

We had a great consult with Dr. Awesome at the new clinic yesterday morning. The only downer: I went into the appointment with the mentality that Dr. A was/is our new RE. Apparently hubs missed the memo….for him, it was an exploratory meeting.  Dr. A is smart and mellow and aggressive and honest and chillaxed and positive. I’m hyper and type-A and a little gloom & doom and prone to freakouts and Dr. A’s qualities are an antidote to my crazy. I am ready for a fresh start and some more urgency with my treatment.

Hubs really likes Dr. A, too, but he (hubs) is being all academic and reasonable about the decision to switch doctors. He feels like my reasons for wanting to switch are “emotional and reactionary.” Is that possible? Ummm, yes. But geeeeez. I have been with clinic #1 for 9 months and spent 6 of them sidelined. I took Clomid three times even though it wreaked such havoc on my lining that I couldn’t have supported a pregnancy even if we’d gotten an eggie to meet up with a swimmer. The word surrogacy was uttered at a very premature stage! So. Yeah. I’m over them. And I have been for a long time.

Here’s what I like about Dr. A, aside from his demeanor that exudes confidence/mellowness.

• He does not automatically bench patients with cysts. He considers each one (size, number, whether or not they’re secreting E2) and then either 1) lets you cycle through it, 2) watches it with monitoring every 7 days so you can jump back in if it goes down, or 3) tries to get it to burst (and maybe even release an eggie if it’s a viable follie) with an HCG shot. For someone like me who is SO PRONE to cysts, this is a pretty huge deal. It would theoretically eliminate a lot of my bench time. (And my friendly cyst would NOT have benched me this month. Sigh. Another lost month.)

• He does not cancel injection cycles for too many follies. He lets the patient decide when the multiples risk is too high. He might strongly recommend canceling, but ultimately it’s up to the patient.

• He gives patients the option of converting to IVF if they produce too many follies during injects.

• While he does not employ it often, he thinks I’m a good candidate for a “step up” protocol…which basically means he’s open to tweaking the injects dose to a higher level if the response isn’t great at a lower level. (Clinic #1, as a rule, only lowers the dose. To me that suggests cycles could be a bust, like when I was on too low a dose of Clomid?)

• He is the only doctor at the clinic, which means that he is ALWAYS the one making the decisions about treatment. (It bothers me that Dr. K is “my” RE at clinic #1, but two other docs are often making the decisions when she’s teaching or not on call.)

• He has the best IVF success rates in town.

Aside from those differences, his thoughts about my protocol are pretty similar to clinic #1. He’d stick with the Gonal-F, starting with a lower dose and potentially building over the course of stims. He’s not a big fan of the Luveris, and doesn’t think it’s a big deal that I have trace amounts of LH. So he’d probably nix that part of the stimming. He also wants to repeat hubs’s sperm analysis, because he didn’t love the morphology number from the one back in October. He has a test methodology he likes better than the one clinic #1 used, which will shed more light on that subject. (I really believe it will be fine.) If it turns out morphology is an issue, he’d recommend we move onto IVF sooner rather than later.

Whew! Right?

So, over dinner last night, we hashed out our course of action. We will move forward with all of the testing Dr. A has suggested. (A new SA for hubs, bloodwork for me, including a metabolic panel, androgens, AMH and re-testing my TSH.) While all of those tests are being run and the results come back and Dr. A tweaks our protocol, we will do one more IUI with Dr. K. Hubs feels like she has learned a lot about my body and we should give it one more shot. He reminds me that both of us were sick on IUI-day last time, and maybe this one will go better. Even Dr. A concedes that my last injects cycle “looked great,” so it’s not like we’re wasting a chance by sticking with clinic #1. Plus, hubs feels like it’ll be easier on me to go to them this month…because I know the monitoring drill, I know the nurses, etc etc. And if it doesn’t work, I can jump over to Dr. A on CD3 and potentially not have to be benched as long next cycle since he will manage my cyst differently.

As you all know, I’m ready to pull the plug with clinic #1 rightthisverysecond, but I have been convinced that hubs does have valid points. Plus, it could take a little while for hubs’s SA results to come back and I’d like to move into the next cycle ASAP. It might take a couple more weeks to get the ball rolling at clinic #2. When you’ve been on the bench as much as I have, waiting a couple more weeks is just….ouch.

What do you think? Would you be frustrated that we’re not doing IUI #2 with Dr. A? Or do you see the benefits of sticking with Dr. K for one more go-round? And, isn’t it fun how my TTC life is finally heating up a little? 🙂

It didn’t work

There will be no cinematic, beginners-luck, image-of-a-positive-HPT, how-I-told-hubs finale to this cycle, dear bloggies. I guess I knew it in my heart of hearts when NOTHING felt even slightly different in me as the days ticked by during the 2ww. Still, one little line is a sad sight.

I think we’ll have a forced break in June, because of yet another wedding trip. (Gah!) Now that I’m stopping the prog supps, my period would have to show up by the weekend (and I’d have to be cyst-free, what are the chances with my history?!) for us to squeeze in another cycle before we leave town on June 18 (fyi, I didn’t IUI until CD17 of this cycle, and Dr. K wants to lower my dosage next time).

So, we will try again as soon as we can. And keep our fingers crossed that I just fell on the wrong side of the coin toss this month. That someday I WILL see two lines. In the meantime, I’m booking a consult with APlusB’s Dr. Awesome in June. My clinic has subpar IVF rates and his are the best in our area; we want to meet with him to begin exploring our options if we need to go that route. Maybe we’ll even do our next injects cycle with him. It might be time for a fresh start with a new clinic.

Positives of this cycle

1. My lining kicked ass! We have come so far from the dark Clomid days when Dr. C was talking about a surrogate.

2. I totally responded to the Gonal-F. More slowly than some folks, sure, but I did get a mature follie.

3. As always, hubs has great swimmers and for that we are very, very grateful.

4. We didn’t get canceled!

5. We made it to IUI-land for the first time!

Room for improvement

1. I would love to see my lining get past 8mm.

2. We had one mature follie this month. Next time it would be awesome to have two or three or four legitimately mature follies before triggering.

3. Hubs and I were both sick with colds on IUI day (him especially, poor guy). I sniffled and sneezed my way through the first week of the 2ww. Feeling 100% healthy would be great next time.

4. We traveled 9DPO and 11DPO; hopefully next cycle falls during a more chill, stay-at-home time in our lives.

5. I probably won’t go running during my next 2ww. I doubt it messed up anything, but the fact that I’m even writing this means I’m not 110% convinced it was okay.