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%.

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.

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.

Clinic #2

I called clinic #2 yesterday to discuss “what’s next.” Do we need to do a second consult with Dr. Awesome before beginning treatment? Should we go right to IVF? What happens if I have a cyst? Should we try a third and final IUI?

The nurse was lovely and went through my file with me and answered all of my questions. She said Dr. A is satisfied with hubs’s SA results and my hormone levels from the fasting blood tests I did a few weeks ago. He feels an IUI is not a waste of time, but he would support our decision to do IVF, too. It’s 100% up to us what we do next. She went through the IVF start dates for the fall and asked me to call back as soon as we’ve made a decision—either way—so we can get the necessary meds ordered and paperwork signed. I also gave her all of the relevant details from this current cycle and let out a sigh of relief when she didn’t seem fazed by my number of big follies vs. low E2 number. (I’m sorry about this, but you should know that I am QUITE obsessed with my estrogen and will probably be talking about it for a while. 🙂 )

On Friday, when I got my E2 results, the only thing that prevented me from melting down at work was the thought that we could go directly to IVF and be done with this #@$^#* IUI crap. But the more I think I about it, the more I feel like we should probably do an IUI with Dr. A and let him get a firsthand feel for my body’s weirdness and response. Besides, he will have a different protocol (potenitally stepping up my Gonal-F dosing mid-cycle, not using Luveris, adding Ganirelix to absolutely prevent premature leutinization) and that could be helpful as a diagnostic when creating my IVF plan.

Plus, there is a chance this low E2 thing would happen again during an IVF cycle. IVF is not a guarantee that I’ll have good hormone levels, a fluffy lining and some good eggies. Everything is a freaking crapshoot, even IVF.

So I am thinking that we will do an injects/IUI cycle with Dr. A in August. (Hopefully my cysties only keep me on the bench for a week or so this next cycle?) And if that IUI doesn’t work, we’ll either jump into the September 12 or the October 3 IVF cycle. I have a fair amount of unused vacation left and want to take a REAL trip with hubs (not a wedding weekend trip where we eat all of our meals with place cards in front of us). So maybe we’d take September off treatment, take a trip just the two of us, and come back ready to IVF in October. (Side note: It’s painful to think about taking a voluntary month off, given all of my bench time.)

Behind all of this planning, excel sheet calculating, etc—I am almost ashamed to admit it—but, the teenie tiniest bit of hope is maybe-sorta-kinda blossoming. I don’t know why. Maybe it’s treating myself like a pregnant woman…no glasses of red vino after a long day at work, no runs along the lake, no lifting weights in front of the Today Show, no hot yoga classes. Maybe it’s the emails/blog updates I’ve been reading with “It worked!” updates. Maybe it’s the hope that we are about to begin working with a new doctor and a new clinic. But the moment I  start to feel hope, my face blushes red and hot with the ridiculousness of it all. I feel like a complete fool. I have visions of the Baby Gods Up Above shaking their heads and whispering to one another, “Poor thing, she actually thinks there might be a chance.”

I want this to be over. Over. Over. Over. I have never been so ready to have the luxury of thinking about something else, my friends!!!

PS Anyone seen Season 5 of Weeds? We have been watching the DVDs all summer and began the final disc last night. Darnit if the plot development isn’t a complete buzz kill. I mean…a show about drugs and pot where the lead character perpetually carries around either 1) a venti iced Starbucks, or 2) a bottle of white wine? I thought I was safe getting hooked on it!

Googled out

Hi bloggies. I hope everyone had a great July 4th weekend! I spent Saturday working on some big freelance deadlines and also fit in some extensive Googling and message-boarding on my low-estrogen situation. Hubs Googled and found some cool studies that suggest the link between E2 and number of mature follies is not as important as I thought. Of course, I also found some studies that suggested otherwise. You can drive yourself NUTSO with Google Scholar, my friends! And don’t even get me started on message boards…oof, lots of scary/wrong/stupid information floating around out there.

I wish

I wish I didn’t know my estrogen number.

I wish I didn’t believe this cycle was doomed before I even IUIed.

I wish that on top of IF, my body didn’t respond like a freak of nature to the meds.

I wish I had a few good eggs after my month on the bench, my two weeks of injections and my six monitoring appointments.

I wish I wasn’t scared to death that I don’t even have one in the bunch.

I wish I didn’t feel like I’ve utterly let hubs down. Again.

I wish I were the patient who didn’t have an “unusual” response.

I wish my big follies held healthy eggs like they’re supposed to.

I wish I hadn’t gone from feeling 80% filled with hope to 99% not filled with hope.

I wish this chapter of my life would be over.

I wish I could embrace any of the, “you never know/stranger things have happened/it only takes one/maybe there IS an egg in there” mantras floating all around me.

I wish I could think about something else.

I wish I could forgive my body for fracking up another cycle.

I wish a good night of sleep had made me feel stronger, instead of weaker.

I wish I could stop being so sad, scared, jealous, resentful, selfish, envious, angry, and afraid.

I wish I didn’t know my estrogen number.

HIGHS and l..o..w..s

Monitoring was fantastic. 8.1mm lining. (The tech had to measure it a few different times to give me that great number, but hey, I’ll take it.) Rightie got up to 18! Leftie is going nutso with a 20, 18.5, 18, 17.5. I swear on the walk into work the entire world was so super duper sparkly I needed sunglasses. I kept thinking to myself, THIS IS AS GOOD AS IT GETS! I even thought about how if THIS didn’t work (my thickest lining yet and four follies, amazing for me), we should just go directly to IVF because no IUI cycle would ever work.

I had a cartoon-size smile on my face all day.

Before you tell me I could become octo-mom, let me tell you about my blood work. My E2 is 292. If you’re thinking that number sucks, you’d be correct. The rule of thumb is 200 E2 per mature follie. Which leaves me with….maybe one follie? And my LH is officially so low that it’s not even measurable.

Ugh.

So. I’m triggering tonight. And they want me to come in TOMORROW a.m. for the IUI. It’s odd that they’re not doing the standard 36 hours post-trigger IUI. Especially since I’m most definitely NOT surging on my own (low LH, see above). I can’t help but suspect they’re rushing me so no one has to come in and deal with a patient on July 4th. I’ve got calls into the nurse and Dr. K. I’m sure they won’t change the protocol but maybe they can give me a tiny piece of hope back.

The ups and downs absolutely kill me.

***Update***

What do you know, Dr. K agrees with me and we’re doig the IUI on Sunday instead of tomorrow. The on-call RE’s reasoning for doing the IUI tomorrow morning was that my E2 seems to have plateaued (sad). He wants to catch any viable egg before it goes bad, so to speak. Dr. K sees his point, but would rather IUI 36 hours after trigger. They are hoping that out of all those big guys, one holds a good egg. So after 15 days of stims and 4 follies measuring 18mm or bigger, I have maybe one good egg. Please. Please. Please. Please. Please let it be the one.

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.

My first 2ww

Oh, my lord. I am so freaking bloated! My ovary area feels exceptionally stabby and crampy. It hurts to sit, it hurts to walk. I’d use a sick day, but I know I’d just go home and Google the crap out of my numbers (Lining! One mature follie! Sample for today’s IUI!) and I don’t think that would be healthy (or fun)!

But mentally and emotionally, I am feeling happy, strong and more like myself than I have since TTC. Yip! 🙂 I will not attribute this to “hope,” because, quite honestly, I’m pretty lukewarm about everything. And I felt like Dr. K and nurse G were equally lukewarm about my chances this morning; hubs assures me I am nutso and he didn’t get that vibe at all. (I’d probably be happier with a cheerleader overseeing my treatment instead of an RE.) I’m relieved to have made it to IUI land and am very happy to be in my first legit 2ww (I don’t really count December—the one ovulatory cycle I’ve had—with 3.2mm lining).

I know a lot of you are BIG BELIEVERS that “what the mind believes, the body achieves” and I agree that it’s gooooood to be positive and I appreciate the comments I’ve been getting to that effect. HOWEVER, I hope you will understand me feeling happy without simultaneously feeling like, “Ohhh yeah, this is IT!”

I was talking to hubs the night we triggered and I said, “Do you think there is ANY chance this could even work?” (Because in my heart I struggle to have even 1% of faith that my body can get pregnant. I want it so badly, but it just seems so foreign to me. PUPO? Not me, that would be totally ridic!) And hubs looked at me like I was crazy and said, “Of course it can work! Why would we go through all of this if it couldn’t?”

Hmmm. A good point.

Sometimes you have to let other people believe and hope for you.