Another step forward

We finally got the results of our second beta. Today we are at 353. Relieved and thrilled are both understatements. We know there is a LONG road ahead but we are happy to be on the journey. They aren't having me come back on Friday, for which I am thankful. In past pregnancies we have never had good news from a third beta. I am not superstitious, but I think I will do better to just relax and trust that things can be different this time instead of fretting over phone calls and numbers. There is nothing I can do about it anyway so in and out I breathe. Our ultrasound will be on Tuesday afternoon. I know there won't be a chance of seeing much, but something, anything in my uterus would be cause for happiness. And a milestone we haven't before reached.

Praise God!

I just received the call from my RE. I am officially pregnant, with a beta hCG of 157. The sound you are probably hearing right now is me exhaling. Try as I might to remain calm today, I have been on pins and needles since the band-aid went on my arm. We repeat the beta on Wednesday, with an ultrasound to follow next week because of my history of ectopics. My estrogen was on the high side so I am to discontinue my patches. My progesterone was also high so I had the choice to cut back on the injection amount or switch to suppositories. I opted to stick with the shots because if it ain't broke, don't fix it. Thanks to everyone for their comments and support. I so appreciate it! Now I'm off to repeat my latest mantra: "just relax, your body can do this."

A new day...

...and a new pee stick. I am amazed to be reporting that this one appears positive. The faint line of yesterday that I whole-heartedly discounted may have been something after all. Today's showed up more quickly and is definitely darker...visible without squinting or turning the test toward the gamma ray producing mega wattage bathroom light fixture bulbs. I am stunned. When I told husband he hit me with the classic Dumb and Dumber line "so you're saying there's a chance." I guess we do have a chance after all. A very long way to go, yes, but a glimmer of hope nonetheless.

When winning equals losing

I prevailed in the HPT argument, which is to say that I talked husband into a compromise. We tramped through the snow and cold to CVS and bought a box of my preferred FRER, with the understanding that I would use one first thing this morning. I awoke at about 3:00AM with the urge to go so the deed was done. Like so many other times, no matter how long I gave it my best "please line show up" stare, nothing happened. It was negative. I am 6dp5dt or 11dpo today. I crawled back into bed and waited for my pulse to return to normal and my breathing to slow. I am a realist, but the tantalizing knowledge of a great quality blastocyst in my uterus had my hope receptors firing. I thought this time might be different/good/real. Husband didn't wake up and I finally reclaimed sleep after a lengthy conversation with my rational self about how we will have more chances, life will go on, and how I am thankful for so many things in our lives. When husband woke up I gave him the news. He dug the stick out of the garbage and declared that he saw a faint line. Faint is being awfully generous - it is definitely an evaporation "line." So I am at work today and though thoroughly disappointed and sad, I also feel at peace. As I said in my last post, I prefer knowing to not knowing. Now we will move forward again into more of the great unknown.

Step away from the ledge

Yesterday husband had to talk me down. I was driving home from work and I casually mentioned that I was planning to make a stop at Target for some essentials...shampoo, deodorant, HPTs. He immediately and strenuously objected, much to my suprise. I am 5dp5dt today, or 10 dpo. If there was something to see, I think I could have seen it this morning. He was having none of it. He wants to wait until Saturday. Now I'm not a pee stick freak. I have had my fair share of run-ins with them, but in all the time that we have been trying and with our multiple losses, it has been inevitable. So here I sit, 3 1/2 days away from my beta (I would say 4 days but it is early on Monday morning ;)and I am itching to know. That is the type of person I am. Be it good news or bad, I like to be let off the hook. Husband admitted that he, on the other hand, prefers the ignorant "bliss" of not knowing for as long as possible. How or why he thinks this is pleasant I don't know. He is so NOT ready to know, in fact, that he volunteered to make my Target run for me. He even bought me the mascara I needed (with cell phone guidance provided by me, of course). I am currently bargaining with him that since I wanted to test today and he wants to test on Saturday, that tomorrow is a perfect compromise. He said we'll talk about it tonight. :) I have acupuncture after work so I will most likely be in a very zen and "come what may" mindset for at least a few hours. Then the battle of wills will likely be on again.

2dp5dt

OHSS symptoms thankfully did not make an appearance and we were able to transfer on Saturday morning. One blastocyst was transferred and according to the RE who did the procedure, all went as planned. Having never done this before, we were in awe of the whole process. I am fairly convinced that my valium was a placebo as I swear I felt no different on it than I normally do. I may have been a TAD more relaxed but nothing notable. I admit I was sort of looking forward to a nice hazy calm settling over me during the procedure and for several hours after. No dice. We drove home in the first stage of a pretty big snowstorm. It was a good thing we got out of there when we did. As it was, we saw some cars in the ditch. I took up residence on the couch and let husband bring me food and beverages. My 48 hours of "bed rest" is officially up so I am catching up on a few things. I feel like I've been out of commission forever because I have been laying low since the retrieval. It feels nice to be up and around and at least visualizing being productive. As for frozen embryos, at the time of tranfer there were four other blastocysts that they were planning to freeze. They were going to look again on Sunday and freeze any additional blasts. We haven't heard the final number yet. I've been kind of crampy both yesterday and today which is most likely a side effect of the progesterone. The shots are going amazingly well for how unfamiliar with and nervous about the whole process husband was. So we wait. I still need to schedule my beta, which will be on 12/10. If I know me, I will probably sneak a HPT on Friday or Saturday. Until then, just feeling fortunate that we have made it this far.

Fertilization report

Husband got the call today. The lab called my work number first but moved on to his cell phone when I wasn't there to answer. So things look like this: out of 23 eggs retrieved (one more than we thought) 16 were mature. Out of the mature eggs, 13 fertilized. We should get another update on Friday, along with a transfer time for Saturday provided that I have been able to fend off OHSS until then. They also mentioned transferring on Sunday depending on how things look. Husband and I don't know what to think. Part of that whole "hoping for quality not quantity" was about not having so many embryos...not more than we could ultimately use. Granted, with no idea as to what their quality would be or currently is, it is hard to say how things will look in another few days. Six previous losses means something is wrong but is it the embryos, my body, both? We realize that putting back a good embryo is no guarantee of a healthy pregnancy. So we will wait and see and I will continue to rest and not worry about what I can't control. Thanks to everyone for their well wishes and encouragement. They are greatly appreciated!

What a difference a day makes

When I last checked in, things were looking the way we wanted them to look. My body wasn't going crazy, we had follicles but a modest number, we were almost there and I was happy. Saturday brought another monitoring appointment. Follicles had increased to about 12 - 13 mature. I returned home and eagerly awaited the phone call that would give me my trigger shot and retrieval instructions. The phone rang, but instead it was my RE calling to explain that my E2 level had unexpectedly jumped from the day before and was now in an uncomfortable 4000+ range. Our options, he expained, were as follows.

1) To cancel the cycle completely - no trigger shot - and let my body simmer down. However, as we had been conservative and hadn't pushed too hard with stimulation he couldn't guarantee that the same thing wouldn't happen on a subsequent cycle.

2) Trigger as planned and retrieve the eggs, watch me closely for symptoms of OHSS and if they are mild or if none develop, transfer one embryo.

3) Same as option 2 but if symptoms are moderate or severe, freeze all embryos and do a frozen embryo transfer at a later date when I am back to normal.

After some careful thought we decided to go ahead and trigger, with the understanding that we would take all preventative measures possible to mitigate OHSS: rest, fluids, protein, and something in my IV during retrieval to start the protein/fluids situation moving in the right direction. Retrieval was yesterday at 8:30AM. Everything went well. I was, however, shocked to learned that they got 22 eggs. We don't yet know how many of them were mature...I'm guessing that several probably weren't but I also know that my guesses really mean nothing when it comes to this process. We will hear tomorrow from the emryology lab to see how things are going. I have been a good little patient and have camped out on the couch drinking protein shakes and "resting my pelvis." I was told the less friction the better. I'm not sure exactly what causes friction but I am limiting any and all movement just in case. It wasn't in my plan to take several days off of work after retrieval, but I am more than determined to stay feeling good if at all possible. Our RE has recommended a day 5 transfer from the beginning due to our recurrent losses and this is still the plan if we end up transferring at all. By Friday we will guage how I'm doing and make a decision. I guess we could call this a detour on our route but still with the hope that we will eventually reach our final destination.

...It's The Destination

“Serenity is not freedom from the storm, but peace amid the storm” -Unknown

Still moving forward and taking things one day at a time. My wish for this cycle was to be conservative and aim for quality over quantity. Since at least part of our problem has been ectopic pregnancies, we have no idea what to expect if we actually get a healthy embryo in the place where it belongs. That, coupled with my tendency to respond with gusto, has made my RE treat me with kid gloves. Thankfully it looks like we are getting results that we are both happy with. As of this morning's ultrasound it looks like I will do my evening meds tonight, my morning meds tomorrow, and trigger sometime tomorrow. Retrieval will be on Monday. This is pending today's E2 results, but as long as it hasn't taken a drastic jump we should stick to this schedule. I have another ultrasound appointment tomorrow morning, too. I feel like we can see the station up ahead...just a few more stops now. I keep reminding myself that ultimately this isn't in my control. I read Randine Lewis' "Letting Go" meditation last night before bed and it helped reaffirm my understanding that I have done all I can do by following my doctor's instructions and doing my injections faithfully. Beyond that what will be will be.

Chugging Along...(updated)

Live in the present. Do the things that need to be done. Do all the good you can each day. The future will unfold. -Peace Pilgrim

I thought the above quote was fitting for today. It is day 5 of stims and so far I think we are on track (trying to see just how far I can take this train metaphor. :) I had my first ultrasound to check follicles this morning. Don't remember the exact counts and sizes but I know I had six measurable ones on the right, with about 10 small ones. One of the measurables was pretty large and it will probably end up being the odd one out as we wait for the others to catch up. I think there were about three measurables on the left with about 15 small ones. My lining was at 7.3. I haven't been asking my E2 numbers because I think less knowledge is sometimes better with me. The less I know the less I can drive myself crazy analyzing. I do know that My E2 on Sunday was in the 300 range. My RE dropped my follistim dose to less than half of what it had been, which seems to have been his plan all along. I am waiting to hear from my clinic to find out the plan for my next u/s. As it stands now I would go in on Thursday/Thanksgiving. There was some hemming and hawing about this between the nurse and front desk staff so I will get the final word later today. It's possible they will have me come tomorrow and Friday instead, but ultimately it is my RE's call. So I'm chugging along...feeling pretty good and managing not to obsess about the details so far. Due to the aforementioned appointment schedule we will be spending a quiet holiday at home, just me, husband, and stepson. Much easier than traveling to any of our families' homes and trying to juggle schedules, injections, and excuses as nobody is aware of our current situation. We're keeping it simple. Wishing all of you and yours a happy Thanksgiving!

Today's estradiol is 853. Not really sure what that means but I guess they are happy with it.

Peace Train

So at work I recently discovered Pandora, which is my new favorite way to add some enjoyment to my day. I have created a mellow work "radio" station for my listening enjoyment and lately it has been playing Peace Train by Cat Stevens about once a day. I love this song. The words and the rhythm make me smile. With tomorrow being my baseline ultrasound day for IVF #1, I've decided to adopt the concept of a Peace Train for this cycle. Heretofore the best theme I could come up with was the traditional "roller coaster." In the interest of a positive attitude I thought that Peace Train might have a better connotation. If all looks good tomorrow, then I will officially climb aboard and ask the conductor (mental image of my RE in a train conductor's cap) to punch my ticket. So far the lupron isn't making me too crazy. My moods have surprisingly remained mostly stable and no one in my immediate presence has suffered any undeserved bodily harm thus far. Of course this is subject to change. I have been fretting somewhat about my initial follistime dosage. My previous injectable/IUI cycles showed me to be a good bordering on ridiculous responder and from what I've read on other blogs my dosage seems on the high side. I talked to one of the nurses about this and she seemed surprised that I would question the dose. My closest-thing-to-a-lupron moment might have have been when I emphatically told her I DO NOT WANT TO HYPERSTIMULATE AND I DON'T FEEL THE NEED TO PRODUCE 30 EGGS! She assured me that the dose can be reduced if my levels rise too quickly. The bitchy, pessimistic side of me is already rehearsing my "I told you so" speech and in my weaker moments I have already envisioned my cycle being canceled because my ovaries are in danger of exploding. Clearly I have some pre-stim anxiety going on here. I realize I need to trust my doctor and the process, however, given that it is my body I am inclined to think that I know better. Time will tell. Must remember: "now I've been happy lately, thinking about the good things to come and I believe it could be, something good has begun." Off to pack for my journey and planning to leave mental baggage behind.

Onward and Upward

We are moving forward. The trial transfer is done and all went fine. Apparently my ovaries look like my doctor (for whom I’m trying to think of a clever blog nickname) wants them to look. We had our RN consult and learned about our protocol and all this cycle will entail. They agreed to the meds I was hoping for so I will be able to use what I was given, which makes me happy and relieved. The balance of the meds has been ordered and will arrive on Friday. Lupron starts a week from today. Can we really be doing this? It has been a hypothetical for so long and I have lived vicariously through others who took the plunge before we did that it’s hard to believe it is finally our turn. At times I am excited, at others nervous, and still others in disbelief. It has been so long since we’ve cycled…hopefully we’ll find that groove again without too much trouble. I suppose what IVF newbie hasn’t envisioned screwing up the medication amounts or injection times and accidentally ruining her cycle? When they go through the protocol it seems so overwhelming and daunting. One shot at a time, I keep telling myself. For those of you who have been through this, any advice?

Experience (mine and others’) tells me not to assume that this cycle will be the magic bullet. As with anything that is being tried for the first time there is that rose colored glasses feeling of “this will certainly do the trick.” I can’t go there. I am not betting against success but I am also not counting any chickens…or eggs, as suits the metaphor in my case. When I do let my mind wander to “what if this works” territory, I can’t help but feel a little frightened. Seven years have passed since we first felt the desire to become parents. During that time the wounds we have suffered have scarred over and self-protection mode has kicked in. I have never been that infertile woman who still coos at babies. In fact I have been known on more than one occasion to decline an invitation to hold a friend’s baby. At my house the Pottery Barn Kids catalog is thrown in the recycling bin without a glance. I haven’t attended a baby shower since one of my nephews was in-utero. He turned four last August. On a daily basis I have made it my practice to deny any motherly longing or instinct to save myself any extra pain. My biological clock became the enemy so I ripped out its moving parts and made them into jewelry. If by some miracle IVF worked for us, would I be able to find my mommy chip again? I have to believe I can. As deeply as it is buried, it must still be there somewhere.

Random Thoughts

It has been a while since my last post. I have been in a state of self-induced stress over all the elements falling into place for this IVF cycle. There is the money element, which found us plaing beat-the-clock waiting for a check to arrive. There is the physical element which found me in an agonizing wait for my period to arrive. Last month I got it on the 14th. Now no one can set their watch by my cycles, but roughly I was expecting it to come by the 18th at the latest. My trial transfer is scheduled for the 23rd (tomorrow). I got my period yesterday. I have been told there is no need to reschedule and that we couldn't even if we wanted to because of timing issues and my RE's schedule. So the red witch and I have a date with the stirrups...how fun. At this point I shouldn't even let it bother me anymore but I'm still human - all infertility humiliation evidence to the contrary. Clearing those hurdles will bring us to Friday when we have our RN consult. I guess that will give us some insight into our protocol and which medications I will be on. I am praying that the leftover meds I received from a friend of a friend will fit my protocol. If not I may twist my RE's arm pretty hard to make them fit. I think I will feel better when the plan is in place and the meds are lined up on the counter. At least that's what I keep telling myself. Amazing how much there is to think about before a single injection has been taken. Must remember to breathe in and out and remain (more) calm than I have been so far.

I received discouraging news today from my friend who was to be cycling at the same time as us. Things did not work out for her to begin this cycle and it is up in the air as to whether she will be able to try IVF in the future. It is yet another case of scary inferility road blocks happening to good people. I got an update from another friend who recently had a failed, most likely final, IVF. They are taking a break to regroup and see what makes sense for them in the future. It is so not fair how this ugly beast can chew people up and spit them out over and over again. These are good, deserving, strong people and yet their dreams are still in limbo. I was once told that babies are not passed out according to merit. So very true.

Here is a link to a series of articles that is running in my local newspaper:

http://www.startribune.com/infertility/

Today's piece is on whether or not insurance companies should pay for IVF. I just hate the misuse of the word "implant" in articles dealing with IVF. I actually emailed the authors of this one to correct them. It also pains me to see or hear people who know nothing of infertility on a personal level weigh in on things like insurance coverage. Unless you have walked in these shoes, you have no idea how you would feel or what kind of decisions you would make to build your family. I appreciate it when infertility issues are written about and given some time out of the closet, but I dislike how it provides a forum for others to judge situations they can't understand. I guess we can't be lucky enough to have one without the other.

Those are my random thoughts for today.

Warning, metaphors ahead

So I sort of feel like a diver who is beginning the climb up that really long ladder that leads to the high-dive platform. Did anyone else feel like this when they were on the brink of starting their first IVF cycle? I am being slammed by so many thoughts and emotions racing through my head. I thought it might help to get some of them (whatever the blog equivalent is) down on paper. We have been leading up to this for a long time. Our eighth wedding anniversary is in a few weeks, which makes almost exactly seven years since the goalie was pulled. Yes, we did that “we’ll have a year to ourselves before we get pg” thing, which seems so very quaint now. As the calendar pages have flipped and flipped and no baby has joined our family, the thought of IVF began peppering our conversations. Mostly it was in terms of how nice it would be if a giant bird dropped a pile of money on our front lawn (possible bastardization of the whole stork metaphor but more fitting for our situation) and we could then afford to roll the in-vitro dice. Still no bird, still no large sum of money…instead the realization that I’m not getting any younger and we will just have to take a deep breath, close our eyes, and dive in. It is a very strange feeling to be at once so excited that we are finally taking this step, and so scared that we are playing the last card in our hand. As long as we hadn’t tried, it was always still a possibility. Now the tests are done, the calls are made, the paperwork has been sent, and our names are on a calendar somewhere in our RE’s office. With the recent rush of IVF cycles at our clinic, the first available time was late November. We took it. If the frantic notes I took while speaking to the nurse can be trusted, it seems this date is roughly when the transfer will happen…if everything goes according to plan. That’s where that long ladder comes in I guess. At least we’ve taken the first steps.

One hurdle down, many more to go

We heard back from our doctor's office and we have, after further consideration, been accepted for the shared risk IVF program. This came as a big relief to us but as with any hurdle in the IF world, once you clear it your mind is already on to the next one. We are extremely grateful that we have the opportunity for a monetary safety net. With no insurance coverage and still some debate as to exactly how we will shoulder this debt, any financial reassurance is a boost. We are now looking toward the next steps, which are complicated by the fact that an infection showed up on Husband's SPA test. This is the second time an analysis has revealed infection for him and the doctors don't know why it is happening. His side of the equation suffers from the presence of the infection so we need to wait until it is out of his system before we get down to the business of IVF (now with ICSI). This being said, timing becomes a bit of a puzzle with a few possible solutions. Do we start the BCPs and hope that we get the all clear from the urologist or do we wait 100% until we know he's good to go? We can't seem to reach an agreement on that. Of course I'm the one who is anxious to begin. For now we are cooling our heels and letting Cipro do its job (we hope).

Denied But Still Fighting

As I write this, someone somewhere in an office probably far away is deciding my reproductive fate. Husband and I having recently completed the requisite tests for a shared risk IVF program, our clinic faxed in the paperwork and the waiting began. I got a call from our clinic coordinator this morning with what turned out to be an update. We were denied. They were scared off by our six early losses and wanted to shut the door. Our RE, however, has gone to bat for us and appealed to some higher authority within the shared risk company (which we are hoping involves a physician). Our losses have all been very early and two were ectopic. This means that we have never had a confirmed intrauterine pregnancy. Our RE feels this is a horse of different color (picturing the painted horse scene in The Wizard of Oz) and has told them as much. In recurrent pregnancy loss, as in real estate, location is everything. If given the chance to take up residence in the legal dwelling rather than in the air shafts of my proverbial home, it is possible that our microscopic offspring could thrive. That’s the idea anyway. Whether that would happen is anyone’s guess but we were/are hoping to be given the opportunity to try. We know that we can still attempt IVF on a pay per shot basis but none of this is covered by insurance (unless by some miracle husband’s new job has a spectacular benefits package) so we really wanted to have that financial net under us before descending into more debt. Perhaps it’s not too late to pull up stakes and move to Europe or at least one of the few states in this country where coverage is assured. I keep repeating my catch phrase/mantra/sanity saving sentence in my head: “control what you can and let the rest go.” We have done what we could do, our RE and our clinic are doing what they can do, and the rest is totally and completely outside of our control. All that is left to lament are the conditions which exist that have brought us to this point. Should we have somehow known to rein ourselves in after say, three losses and take a stab at IVF? Really not financially feasible at that time. Should we have been on birth control to prevent the spontaneous pregnancies that started occurring in the last two years? The way we saw it, each one was a very real chance at having a child. The only silver lining in the way they turned out was that they provided another clue to our situation – ectopic is now in our vocabulary. I know, I know, lamenting the past (or pointing out its irony or injustices) isn’t letting go. I guess I had to get a little of it off my chest before I can exhale and attempt to truly relinquish my inadequately human hold on this whole situation. Exercises in futility have always been my cardio of choice. I’m trying to be better about that.