Sunday, November 30, 2014

oh! there was ONE symptom.

I was wiping down the cook top on the stove and the glass cleaner spray smelled so intense I took a step backward. And this is WITH a stuffy nose from my cold.

It made me remember that last night, at the grocery store, I could smell the bananas from like 20 feet away. They smelled completely overripe, like black bananas, but didn't look like that. I could smell the citrus when I was shopping for lemons (which I didn't buy, by the way, because the store was selling them at four for three dollars - major rip).

Now, I started the estradiol yesterday so that COULD be why I have a heightened sense of smell, but I didn't really have that when I was taking the same stuff for priming. So, this might actually be a legit symptom.

I'll be interested to see what my hormone levels are on Wednesday.

symptom spotting.

I'm 2dp5dt (two days past five-day transfer) and so far, nothing.

No real symptoms whatsoever.

I know that it's early and that not every women gets symptoms regardless. But still. I've got nothing. And I've been on the progesterone now for a week now, so shouldn't I be feeling something? When I'm not in a cycle, and have ovulated naturally, I get heartburn and gas and tenderness in my boobs.

Okay, so my temp is elevated (as it should be), and I've had a couple of hot flashes. And yesterday I pooped five times and then again this morning; I never thought this was a possible sign of pregnancy by if you Google it quite a large number of people have reported it. (Me, I thought it was because I was taking Miralax preemptively, as progesterone tends to constipate the hell out of me even when I'm not on supplements.)

Let's see...I was a bit queasy yesterday, in the AM and the PM, but I also started the estradiol and that can sometimes make me feel nauseated. Oh, and I'm definitely getting a cold, but I felt like I was fending one off during a lot of my stims so I can't see how that's tied to having a bean or two on board.

Basically, there's a rational explanation for everything, and not a single "symptom" that feels like an actually symptom.

Theoretically I could start POAS Tuesday (the equivalent of 9 DPO), but I'm fairly certain that it would be negative even if I was pregnant. I'd told myself I'd hold out until Wednesday AM, the day of my first hormone-level check (10 DPO). But I could totally see myself caving out of curiosity. Isn't this what cheapie Internet test strips were invented for?

Even though I have this cold, I am so looking forward to going back to work tomorrow. Anything to keep me busy and make the time go faster, right? Less time to obsess.

I read on another blog that someone said she had infertility bipolar during the 2WW - that she vacillated between certain her IVF worked and convinced that she'd never be pregnant. I'm guessing this is fairly common among us infertiles. It's definitely where I am, just two days in.

Here's a confession: I'm terrified my cycle won't have worked in part because every time I'm in one, someone close to me gets pregnant a few weeks before I do and I don't. First attempted IVF that was converted to IUI: Gumbo. First true IVF: Glam Coworker.

Kindred got her BFP a couple of weeks ago, and I honestly couldn't be happier. But some crazy part of me wonders if this is going to be the Pregnancy Touch all over again, where my friend is successful and I am not. Maybe I really SHOULD start charging to rub people's bellies.

Or maybe I should just chill the eff out.

Saturday, November 29, 2014

and so it begins...

The dreaded 2ww. Which, to be fair, isn't even a full two weeks. More like 11 days, with my first hormone-level check just five days after transfer.

And yet.

I feel it's going to be a long eleven days.

Last night, I felt a few uterine twinges and some low back soreness, like I get around ovulation and AF. My guess is that it was a little cramping from the procedure itself and/or progesterone, since I did a shot last night. We were at a family dinner and didn't get home until after midnight, but I couldn't sleep right away. I didn't tuck in until after 1:30 a.m. and then was up at 6:40 to pee. I haven't been able to fall asleep since.

As I type this, I'm feeling slightly nauseated. Is it psychosomatic or am I just hungry? Thirsty? I pounded water and other beverages all day yesterday, but I do tend to be drier in the winter, when the heat is constantly going. We keep the house at 65 degrees but it's been so cold I barely hear the heater turn off.

To get my mind off of imaginary "symptoms" and concerns over my inability to stay asleep (it has to be excitement/anxiety, right?), I figured I'd give an EZ Diet update.

Here's a quick timeline:

10/6: Start working out with the 21 Day Fix DVDs again.
10/13: Start the EZ Diet; record starting weight.
11/2; Start estrogen priming.
11/10: Start stims.
11/14: Last 21 Day Fix workout.
11/20: Stop stims.
11/21: Trigger w/ Ovidrel.
11/23: Retrival day.
11/24: Start PIO injections, every other evening.
11/25: Start progesterone pessaries.
11/28: Transfer day; start Lovenox and prednisone.
11/29: Starting estrogen.

Between 10/13 and 11/14, I lost 9.8 lbs. total. Between 11/14 and 11/23, I lost an additional 1.8 lbs., bringing the grand total to 11.6 lbs. Between 11/23 and this morning, I've lost a whopping 7 lbs.

Grand total lost: 18.8 lbs. in just under 7 weeks.

I have some theories about this. For one thing, the first time I did the 21 Day Fix DVDs, I started building muscle almost immediately. Building muscle, especially in the beginning, makes you retain water. You start losing muscle mass about a week after you stop the resistance/weight training, as well as the water you retained when you were building muscle to begin with. So, it's entirely possible that some of that 7 lbs. is water weight.

For another, I historically gain weight in the four to six days prior to ovulation. I don't know if it's the rise in estrogen or something else wacky but I've followed this pattern ever since I started charting my cycles. Then, about a day or two post-ovulation, I drop weight like crazy. A few years back, when I was doing Weight Watchers with the BFF, I would get so discouraged because each week I'd lose like 1 lb. or .8 lbs. or 1.4 lbs. Then, the weigh-in after ovulation, I'd drop like 3.5 to 5 lbs.

After my first IUI, Dr. God Complex had me taking progesterone pessaries, 400 MG once a day and then later twice a day. I lost like 10 lbs. that cycle, no joke. Every time I'm given progesterone after a cycle, I drop a LOT of weight in a very short amount of time. I don't know if this is water weight or actual weight or what, but I don't tend to put it back on right away. This was not the case with my back-to-back IVFs, for which I took estrogen supplements right after transfer.

I start the estrace again today.

So, I'm going to enjoy this 18.8 lbs. today and know that tomorrow, some weight may start creeping back on. Or, it may not. I'm eating so much healthier than I did with most of my cycles. Even with the holidays!

For Thanksgiving, when I didn't have any eggs/embies on board, I cheated a little: two bites of stuffing, two bites of scalloped potatoes, a couple of tablespoons of homemade applesauce, a small drizzle of gravy, two spoonfuls of rice pudding, two bites of apple pie, two bites of pumpkin. Mostly I tried to fill up on turkey, green beans, and corn, and ate a lot of turkey before I indulged at all to try to reduce any spikes in insulin.

Last night, at my second Thanksgiving, when I did have two embies on board, I cheated even less: a smaller drizzle of gravy over my turkey, a spoonful of wild rice (which, technically, is on the So-So List and not even a true cheat), one small bite of a cake-like thing my aunt made and one small bite of pumpkin pie.

I'm determined to stay as strict as possible until beta. If it's positive, then I'll stay as strict as possible until the end of the first trimester at least.

Here's the thing: the EZ Diet actually does allow me to eat more outside of the Good list than I typically do. I'm not on the restrictive phase any more, and haven't been for three weeks. This means that, according to the diet, I can have items on the Bad List 2-3 times a week, items on the So-So List 3-4 times a week, and a Cheat Day once a week. I could never determine if it's meant to be a whole day of cheating or just one meal, but I haven't been indulging regardless because, hi, trying to create a tiny human here.

Right now my larger concern is inflammation, and trying to control it. This is why I've been eating half of an avocado at breakfast almost every morning. I'm lucky in that I am not insulin resistant - my fasting blood sugars are perfect and not even close to prediabetic range - but I have this huge fear of inflammation and it wrecking implantation. Is it an irrational fear? I don't know. But I do know I'm pretty happy with how this cycle has turned out so far.

Tonight, Mr. Hope and I are having dinner with Kindred and her husband, and I'm so excited. I don't remember if I posted this here but Kindred is PREGNANT with one healthy singleton from her 10/30 transfer. We've both confessed having dorky fantasies about being pregnant together. I'm hoping - WISHING, PRAYING, HOPING - that this particular dorky fantasy becomes my uber-dorky reality!

Friday, November 28, 2014

transfer day.

Heading to Posh Clinic this morning, Mr. Hope and I didn't know what to expect. There'd been no Day 4 update, remember? We tried to be positive on the drive but both of us were nervous. I kept saying things like, "Well, they didn't call us first thing this morning, so that must mean we have SOMETHING to transfer."

We ended up getting to the clinic early. I like to park on the street (it's free) and then take the 2-minute walk to the building. Mr. Hope does not. I tried to convince him that a brisk morning walk would send blood supply to my uterus. I won.

When the nurse called us back to go over my post-transfer instructions, she was all smiles. She ran down a list of items, including when I'd start my estrace, Lovenox, and prednisone (tomorrow, today, and today). Then she left to get the embryology tech.

I turned to Mr. Hope and said, "She was really chipper. This has to be good, right?"

The tech that came in was the same one who called me on Wednesday. She's got one facial expression: flat. I don't mean this in the bad way - I just mean she wasn't as smiley and friendly as everyone else we typically deal with. 

She gave us a picture that had individual shots of our five embryos. The ones that had been As on Day 3 (ours and one of the donors') were now Grade B blastocysts. "I'll take it," I told her. Because HOLY SHIT, we were transferring a blastocyst of our own making! Of the three remaining embryos, one arrested at five cells, one was lagging behind as a morula, and one was an early blast. They were pretty sure they could refreeze the early blast but weren't sure what the morula would do. My guess is it's out, too.

So let me recap for you: My "rotten" egg managed to make an embryo that not only made it to blastocyst, it also outperformed three of the embryos created with a 30-year-old's eggs. 

On the ride up, Mr. Hope and I were still talking about whether or not we wanted to transfer one or two. I'm a little nervous about twins, in part because of my weight but also because hi, twins cost a fortune. And there's no way one of us can be a stay-at-home parent, so in addition to double the cost of everything else we'd have to contend with double day care. Mr. Hope, on the other hand, was all, "Twins are great! Twins are an instant family!"

If our embryo had been a Grade A, I may have pushed harder for eSBT (elective single blastocyst transfer). But the fact that both of the front-runners were Grade B made me think I shouldn't chance it. So we stuck with our original plan to transfer both.

At my clinic, here's how this works:

They take you back to a room with lockers. You change into a gown, hair net, and slipper socks, then drape a thin blanket around your shoulders like a cape to cover your otherwise-exposed bottom. You lock your stuff up and take the key with you. Then they take you back to the transfer room, where you wait until they're ready to load your legs into the leg holder things.

I sat there, alone in the quiet room, and started to cry. Not because I was sad or upset, but because I never thought we'd get to that moment. I never thought we'd have a viable chance at making a baby from my egg and Mr. Hope's sperm. My first RE, Dr. God Complex, wouldn't even consider going to transfer with one follicle. He actually scared me into thinking I was putting myself at risk by doing that because it was such an "invasive" procedure. 

But here we are, retrieving a solitary egg for the third time, and the damned thing turned into a blast. 

I told Mr. Hope, "I can't even...I don't even have the words."

He joked, "They should've sent a poet."

We laughed.

So I cried a little, and then the nurse who assisted on my second IVF came in and said, "Aww, why are you crying?" I told her they were happy tears and filled her in on everything. She said, "It only takes one, right?"

I'd already had about 35 ounces of water before I came to the clinic, but the nurse who went over my post-transfer instructions seemed concerned that I hadn't had more. So I chugged another 16 ounces. I was fine until the transfer nurse told me to put my legs into the holder things. As soon as I swung a leg over I felt the pain in my bladder. She said, "Do you need to release a little?" I said, "No, that would make it worse." And then powered through.

Dr. Smiles came in a few minutes later. He said, "So, we have two good blastocysts today," and I said yes and then he said, "Let's get you pregnant," which is what he says every time.

I barely felt the speculum go in and I didn't feel the catheter at all. In fact, I didn't know it was over until he started to pull the speculum out. I said, "That's it? I didn't feel a thing." Dr. Smiles quipped, "That's what I've been hearing from ladies since I was 16 years old."

I told him I owed him a hell of a Hanukkah present and he said, "Just get pregnant. That's present enough." And then he left and Jen said, "He's right, you know. You getting pregnant is the best present ever." I said, "I'll do what I can. You know, it's not like I've been trying to thwart the process along the way!"

I stayed on the table for another 10 minutes. Around minute seven, my bladder started to hurt. I called out the nurse's name softly. The next minute, I called it out a little louder. A minute after that, I really raised my voice.

No nurse.

More minutes ticked by. As the clock approached 9 a.m. I thought to myself, if she hasn't come back by then I'm getting off the table and going to the bathroom. She didn't come. I was debating how bad it would be if I got up when finally - FINALLY - she walked in. 

As soon as I tried to sit up, I thought I'd pee myself. I told the nurse, "I don't think I can do this." She said, "Want me to get a bedpan?" I said, "You might have to." Then I decided I'd try to power through anyway. 

Holding onto the nurse, I swung one leg over and did this weird tuck and roll off the bed. Then scurried to the bathroom where I peed for so long I felt like Tom Hanks in A League of Their Own. Seriously, it was the neverending pee.

And then I got dressed, and Mr. Hope and I went out to breakfast. We came home and I took the prednisone and my first Lovenox shot. We tried to watch a movie but I started passing out almost immediately, so we stopped it and went to bed for a long (like two-hour-long) nap.

I'll be honest: I don't know how this cycle will turn out. I'm nervous about the B grade on the blastocysts. And even though we used an anonymous donor through the clinic, I'm a little bummed that we only ended up with one good quality blast and one decent one. You'd assume that using young donors would give you at least ONE Grade A blast, right? If not more? The fact that we only have one decent one to maybe freeze means that if the donor embryo is the one that sticks, there's not a great chance of a genetic sibling.

Of course, there's still one scenario in which both embies stick and we end up with super-fraternal twins.

I'm not someone who's big on prayer, but I have been sending positive messages out in the universe. And I have a lot of people praying on my behalf. So maybe - MAYBE - that will help?

I want this to be our time so badly...I really, truly hope it is.

Thursday, November 27, 2014

something to lose.

As happy as I am over yesterday's unexpectedly good news, I'm also feeling a little...well...scared.

I mean, I was fully expecting to be told that Mr. Hope's and my embryo didn't make it to Day 3. I was pleasantly enough surprised when I thought ours was hanging on at a grade C. But to learn that my presumed-rotten egg had managed to produce a grade A embryo? 

I don't even have the words.

In a split second, I went from expecting the worst to hoping for the best:

  • Our embryo makes it to blast
  • We transfer it on Day 5
  • It sticks
  • We have a baby that's half Agony, half Hope

I keep thinking about the dream I had early in my stim cycle, the one in which I was holding our Agony/Hope baby and thinking, "I almost missed out on this. I almost gave up on this." Could this actually happen? Could we end up with a bio baby after all?

Even if our embryo makes it to blast, we still plan on transferring the best of the donor embryos, too. So I keep chewing over this wacky scenario in which both stick and we have fraternal twins from entirely separate parents. How wild would that be? 

So, yeah, there's a part of me that's thinking about these things. And then there's this other part of me - the realistic part of me - that knows there's still a good possibility that our embryo won't make it to blast. How would I feel Friday morning if I got that call? Would I be devastated? To come so close and yet not quite make it there? IT'S A GRADE A EMBRYO. That means cells of equal size and no visible fragmentation. 

This thing that I never dared think possible? It's not impossible. It's just not. 

I don't even know what to do with that.

Plus my overthinking brain is going in all kinds of crazy directions, like, "What if the embryo from the last transfer was good but my toxic, broken body killed it?" I think about this a lot, actually. And yes, I know plus-size women carry healthy babies all of the time, but I'm not basing this on my weight alone. There's the psoriasis. What if that has caused bad inflammation in my body? What if, even on this EZ Diet, I'm eating too much saturated fat? I won't do low-fat dairy because I know that can have adverse affects on a woman's fertility, too. Will the half of an avocado I've been chowing down at breakfast each morning counteract any negative effects from the full-fat cheese?

You see how this works?

On Tuesday, even before we got the happy grade A update, I told Mr. Hope that we were going to get pregnant this cycle. I just knew it. And then I immediately regretted saying the words, because it was like tempting fate to come along and kick me in the teeth.

But then I think:

We are in a good place, Mr. Hope and me. We're in a better place physically, emotionally, and financially than we were even nine months ago, during our first IVF. I am ready to be a mother, no matter how I get there. Nine months ago, it was still more about being a mom to a baby Mr. Hope and I created together. Now it's about us being parents together, period.

Maybe I had to go through all of that to get here, to where we are at this very moment in time. 

Or maybe it's all just completely and utterly random. Who knows?

The problem with having hope - genuine hope - is that in some way, it sets you up to be let down. Hope has given me something to lose. In some ways, expecting bad news, and being okay with getting that bad news, was easier. You don't get a sucker-punch to the gut when you're ready to hear the worst.

I'm rambling. And it's Thanksgiving! There are so many things I am truly thankful for. Like my excellent health care coverage, and a top-notch clinic, and a husband I love who loves me back. 

I guess I need to spend more time thinking about those things than I do wondering about the what ifs. 

Wednesday, November 26, 2014

day 3 embryo update.

Got the call just after 9 a.m. We have two grade A embryos, one grade B, and two grade C. When the tech told me, I assumed that the Agony/Hope embryo was one of the grade Cs.

It's not.

It's not the B either.

No, our embryo is one of the two As.

When the tech told me ours was an A, I said, "Really? REALLY?"

I was completely floored. How? How is this possible?

I still can't believe it.

My transfer is slated for Friday. The clinic doesn't call with Day 4 with updates, so I won't hear about my embies again until I go in for the transfer. They'll pick the two best and that's what we'll transfer.

Did I mention that I am completely floored?

Tuesday, November 25, 2014

day 2 embryo update.

Crazy day at work kept me from updating this until now, but here goes:

Posh Clinic typically calls with updates between 7:45 a.m. and 8:30 a.m. Yesterday's call came at 8:33 a.m. Today, at 8:33, there was no call.

There wasn't one at 8:45 or 9, either.

I had this fear that I wasn't hearing anything because it was bad news, and they save the bad news calls for the end of the morning.

Then, at like 9:37, a voice mail popped up on my cell phone, for a call I'd missed 16 minutes prior. But here's the thing: I WAS SITTING BY THE PHONE THE ENTIRE TIME. The ringer was on. It just never rang.

The report was left on voice mail. As soon as she started giving it, I knew it had to be good news. They wouldn't deliver a bad news report over voice mail, right?

Our embryo (the Agony/Hope one) was at four cells and "looking good."

The four donor embryos were all at two to four cells and "moving along nicely."

At first I was like, "Why only two cells?" for the donors, but they weren't even thawed until after 8:45 yesterday. So it would make sense that they were a little bit behind. Either that, or one of the donor embryos is a two cell that isn't going to make it.

Regardless, this was good news to me. All four donor embryos survived the thaw! They were moving along nicely! OUR EMBRYO WAS AT FOUR CELLS!

Tomorrow will be the real test, though. I've never let my embryo progress to Day 3; they were always transferred at Day 2. I'm fully expecting to be told that it arrested. Of course, I'm also hoping that by some miracle of miracle, our little bugger makes it to blast.

Transferring one of each would be the best of both worlds. And if they both stuck? Just imagine what a story that would be!

embryo adoption awareness day.

Today, November 25, marks Embryo Adoption Awareness Day. From the blog Wishing on a Snowflake:
"November is already known as National Adoption Month, so what better time to recognize EDA and spread awareness than during November? Also, with it falling near Thanksgiving, it gives us the ability to discuss the gratitude that EA brings to many families."
Liz is one of the most vocal advocates of Embryo adoption I've encountered. She's the founder of the super-secret Facebook support group I belong to for women pursuing the EA path - the one Kindred added me to before I knew I was definitely going to be pursuing that path myself. Interestingly enough, I actually found Liz's blog when I was researching whether or not you could get a colonoscopy when TTC. Then started following it. It took me a week or so to recognize the super-secret FB group connection.

The world works in mysterious ways.

Liz, who has severe DOR like I do, has been all over the news lately, sharing the story of how she and her husband came to adopt their daughter Sammy as an embryo. She recently wrote a post that includes links to the coverage and a segment that appeared on Good Morning America.

The other person I feel compelled to mention on this day is Sara from Chronicles of An Adoption. She's a frequent commenter on this blog and has been just a lovely source of support. Sara's pursuit of parenthood is admirable and inspiring, and if you're not familiar with her blog, I encourage you to check it out immediately.

Here's Sara's post about Embryo Adoption Awareness Day.

This day of awareness is important to me personally, too. In the relatively short time I've been on this path I've educated at least two women about using donor/adopted embryos - one who's a confirmed infertile who thought traditional adoption was her only option, and one who's concerned that she may be infertile but doesn't have confirmation of this yet. I've educated others as well, but I think these two stick out the most because having this information could someday change their lives as it has mine.

And though she'll likely never read this, I want to say thanks to G, a woman from my in-person Resolve support group who became a mom through EA earlier this year. I'd never even heard about using donor embryos myself until I met her and listened to her story.

I wish I could contribute more to the cause, but I'm still a closeted infertile, for the most part. And, when it comes to using donor embryos, I'm not sure how much I'm willing to share beyond my innermost circle.

But I applaud these women, and am grateful for all that they've done and continue to do in our corner of the IF community.

Monday, November 24, 2014

fert report.

I missed the fert report call this morning. My phone was on silent and we were running around like crazy people because we're down to one car temporarily. This means having to leave earlier AND we had to drop something off at the post office.

Anyway, we got Mr. Hope off to work and when I was switching over the car so I could drive it, I plugged my phone in. That's when I saw the missed call. I was like, "Oh, right, I forgot about this part." It was kind of good that the morning was so hectic. I wasn't obsessing in the least.

So I called Posh Clinic back (on speaker phone). The one egg fertilized normally with ICSI. I wasn't surprised. This was what I'd predicted all along.

Now comes the unexpected part. With my two previous IVFs, I did Day 2 transfers. This time, we're going to see if we can grow the embryo out to blast. 

I have to be honest: I don't expect the embryo to make it. Since I have DOR, I figure my infertility must be the result of low egg quality. If the little bugger DOES make it to blast, I will be pleasantly shocked. Even so, when I get the call that it's arrested, I know I'm going to cry. This really is our last shot at a bio baby. Saying goodbye to that possibility will be hard, even though I'm expecting it. (Does that make sense?)

The nurse also asked me to confirm that I wanted all four donor embryos thawed. This was my third or fourth time confirming this info, but whatever. She told me I'd get an update about them tomorrow, when I get the update about our embryo. 

I thought I would at least get a thaw update today. Since I didn't hear back from anyone I'm going to assume that the thaw was fairly uneventful. I mean, if all four donor embryos died in thaw, they would've called me today, right?

I've been pretty good about NOT thinking about the embryos (mine and the donors'). I went to work. I had to come home midday because I left my Medrol at the house. I went back to work. After work, I met the BFF at her gym to walk on the treadmill, You know, an average sort of day.

Tonight I'll start the PIO, which I only have to take every other day. I don't hate the shots as much as some of the people in my various support groups, but I'll still take the messiness of the pessaries over long-ass needles any day.

testing out the trigger.

I've often heard of women "testing out the trigger" shot - peeing on sticks from the beginning so that when they start testing after transfer, they can be sure it's their bodies producing the hCG, and not the shot they took to ripen their eggs.

I hadn't done this previously. With my first IUI, I waited until 10 days after the trigger shot to test (so, 10 DPO). I got a faint line on FRER that stayed the same color for a day before fading. I never knew if it was picking up the last traces of the trigger shot or if I had a chemical. The same thing happened with my second IUI but not the third; I never had faint positives with my IVFs.

So this morning, I captured my FMU in a disposable plastic cup, then dipped a Wondfo strip in it. Three minutes later, I didn't see anything. I literally took my trigger shot three days prior; there's no way it was out of my system yet. I passed the five-minute mark and only just started to see a hint of something, but honestly? If I'd take a picture you wouldn't have been able to see anything.

It wasn't until the stick was dry that I saw an actual line. Even then, it looked more like an indent evap than a positive test. I even did a second stick in the same FMU to see if it was just a bad one, but no. Same result.

I'm actually kind of glad I did that. I know not to put too much stock in Wondfo negatives now.

(If you come to this post through Google, here's the info on my particular batch: Lot W00130460-3 Exp: 04/2015.)

Sunday, November 23, 2014

retrieval day.

It was just as I predicted.

One egg.

I'm still cool with that.

It's been this weirdly peaceful and healing day. I got up before the alarm and started going into retrieval mode. I switched my meds bin over to the things I'll need when I start PIO (the day after retrieval) and Lovenox (either the day of or after transfer). I boxed up all of the needles I will never use again because I am done - seriously done - with stim cycles. I boxed up the Menopur for J, and before I left, I packed my one remaining box of Follistim (from my Feb/Mar 2014 cycles) in a cooler bag with ice packs.

I cleaned house, is what I'm saying.

In my purse I tossed the Medrol pack and my last two doxycycline pills, since I know they tell you to take these as soon as you go home. I also tossed my morning (non-fertility) meds, supplements, and prenatal vitamin, since I'd take those afterward, too.

I wrote out a thank you note to the IVF monitoring team, since they've been so wonderfully supportive over this past year.

All this before Mr. Hope even rolled out of bed.

I took a shower. While Mr. Hope took his turn in the shower, I slipped on my wide-leg cotton pants (kind of like yoga pants but even more flowy), a t-shirt, and my college sweatshirt. I grabbed my book. I added some snacks to the cooler bag for Mr. Hope, since his part of this would end much more quickly than my own.

We headed out.

When we got to Posh Clinic, J and her husband were waiting for us. She rushed out of the car and told me that she was sick so she didn't want to hug me. She handed me a card, though, and her husband DID hug me. They thanked us again for saving them thousands of dollars. J got teary. I got teary. Even Mr. Hope got teary. It was this lovely moment.

We promised to keep each other posted on our cycles.

Inside, we opened the card to find a lovely note...and a $100 gift card. I texted J that she didn't have to do that. She said she did and wished me luck.

There was a bit of a wait before they took me back to get changed into my clinic-issued gown and gear. Then it was full steam ahead.

I got to meet Dr. Colleague for a few minutes. She was nice. I got to chat with the anesthesiologist, too. Also nice. I got to talk to the embryologist for a minute. I told her we were really hoping for a girl, and she said she'd think Team Pink. Super nice.

All women. All awesome.

The prep nurse tried to run an IV in my right hand. It felt like she took a hammer to it. I usually have a decent tolerance for pain but it was bad. I said, "Well, you're going to knock me out in a few minutes. I guess I can deal." She said no, that it was better if she moved it.

She tried Big Poppa, the vein in my left arm that I always get blood draws from because it's the Best Vein Ever. Seriously, nurses and blood techs comment on it all of the time. The sound like hungry vampires when they do.

When the prep nurse couldn't run the IV correctly in Big Poppa, I had a feeling that the pain in my hand had more to do with her abilities than that vein itself. The anesthesiologist came over and ran the line in the much smaller vein in my right arm, the one nurses and blood techs always complain about. She was in like two seconds with zero pain.

We love the anesthesiologist.

In the procedure room, they arranged my legs in the holster things and knocked me out. When I started to wake, they told me they got the one egg. I snoozed for a few minutes more before letting myself get more conscious. Then it was water and crackers time. I let myself have two sips of ginger ale, a pack of saltines (two crackers) and two packs of graham crackers. These were big "cheats" for me, but I checked the carb count and it wasn't too disastrous.

And that was it. Afterward, Mr. Hope and I went to get breakfast at a little bistro known for its crepes. I ordered one, even though I knew there was a little flour in the batter. It was a savory crepe, though - smoked salmon and ricotta cheese and poached eggs with red onion and capers and a yummy sauce. All EZ Diet-approved, except for the crepe.

I know that technically the EZ Diet allows you to have things from the "Bad List" a couple of times a week, and from the "So-So List" a few more times than that, but I've tried not to indulge too much. I do let myself have grains with a couple of dinners - like some quinoa in a chicken chili, or a little bit of rice with Thai food. And I still am not sure if beans are on the "Good List" for this diet or the "So-So List," but we have those as ingredients in a couple of meals, too.

Whatever the case, I'm down 12+ lbs. And I feel good because I feel like I'm controlling potential inflammation by eating this way.

I guess we'll see soon enough!

Friday, November 21, 2014

rolling into retrieval.

Had my last follie check today with Fave NP. The 17 grew to a 19 overnight and kicked the rest of the follies to the curb. Yesterday's 12? Shrunk to an 8.

So I'm going to retrieval on Sunday with my one egg ("Maybe it's an uber egg," Mr. Hope said). Still feeling okay about that. The plan is to thaw the four donor embryos out on Monday, grow them to blast, and then do the transfer on Friday. The timing of this couldn't be better; we don't have to miss any work since my office is closed on Friday and Mr. Hope had already taken that day off. Black Friday embies for the win!

The only thing I do not feel super hot about is the fact that Dr. Smiles isn't working this weekend, so my retrieval will be done by Dr. Colleague whom I have never even met. The nurse who called to go over my retrieval instructions was like, "Oh, don't worry, she's nice."

Nice? I don't care if she's a raging bitch - I just want to make sure she's able to retrieve the Lone Egg. This is very important to me, even though I'm fairly certain that she won't make it to blast.

Yes, our plan is still to try to grow everything out to blast, ours and the donor embryos. I am feeling like this is still the right decision for us. Thankfully, Mr. Hope agrees.

Tonight, at exactly 10:45 p.m., I will take my Ovidrel trigger shot. Then, 36 hours later, Dr. Colleague will go up in my lady business to retrieve the Lone Egg. They'll perform ICSI, and, if everything works out, our fertilized embie will start to grow, grow, grow.

Saying goodbye to Fave NP today was bittersweet. We've grown quite close, this cycle in particular. She hugged me at the end and wished me luck. I felt a little teary-eyed. Sure, it could've been the hormones. But it was more likely the fact that I genuinely like this woman, and feel grateful for the level of care and compassion she's shown me the past several weeks.

On my way out, I got hit with the $2600 bill for the donor services. I was expecting it, so the number itself wasn't a shock. But no one had warned me that the $2600 would be do that day. I had to move the money from savings into checking and then call the bank to get them to up my daily spending limit to accommodate the charge.

As I was working all of this out, I overheard a frantic woman talking with a nurse about being out of her medication. She was asking if Posh Clinic stocked any that she could buy. The nurse asked her what she took and she said Gonal F and Menopur. The Menopur alone was $67 for a single vial; each box holds five vials.

I interrupted them, apologized for eavesdropping, and let the frantic woman know that I had 10 full boxes of Menopur that I was going to donate to Posh Clinic. That's 50 vials of medication - way more than she needed this cycle, but enough for a subsequent cycle. She asked me how much I wanted for them. "Nothing," I said. "I've never had to pay more than $90 for my meds."

She laughed bitterly. "I've already spent four grand."

I knew I wasn't coming back to Posh Clinic until Sunday, possibly Monday, and J lived an hour in the opposite direction from me, so she still needed to buy a couple of vials of Gonal F and one of Menopur. While I was still on hold for the bank, she called the pharmacy to get some stop-gap medication, thinking it would cost less than the clinic. It didn't; they wanted another $3000.

She hung up the phone.

I felt even better about giving J the Menopur. We chatted and it turns out she was a fellow DOR gal, though not as severe as I am. She was also plus-sized (like me), pushing 40 (a little older than me), and had experienced several delays in her cycles - including needing to resolve her Type 2 diabetes (one thing I thankfully didn't have to contend with).

She got teary as we said goodbye and gave me a big hug. It was nice. She said she didn't have a lot of people she could talk about her infertility with. I told her to seek out some super secret Facebook groups of her own, as the one I belong to has literally changed my life.

I know I'll have to start my progesterone in oil (PIO) injections soon enough, but I am so looking forward to a couple of days free from injectibles. My poor stomach has gotten several bruises this cycle. Plus, mixing four vials of Menopur twice a day is kind of a time suck, and I'm always worried I'm not capturing enough of the meds.

Oh, and one other upside to all of this? I won't have anything inside of me on Thanksgiving. Which means I might allow myself a small sliver of pie. Woo hoo!

Thursday, November 20, 2014

it's time to call it.

So there's a lead follie. Again. When I went in for my check today, I had five follicles (versus the four I had last time): 6, 8, 9, 12, and 17.

"Looks like that big guy sucked up all the meds," Anti Q-caps told me. 

No shit.

On the bright side, my lining was at 6.9 with a triple stripe. So, it should be perfectly fluffy in time for transfer.

Driving home, I kept thinking, Looks like my body is every bit as stubborn as my brain. It's true. No matter what I use for priming, or what I inject into my body, or what supplements I swallow, or what foods I do or do not eat - the end result is always the same: one follicle. One embryo.

No pregnancy.

I wasn't sad when I was thinking this, or even angry. I was just...okay. Like I was finally making my peace with the situation. This cycle in particular, I gave it my absolute best shot, and there isn't a damn thing I could've done differently.

I go back tomorrow for another check. Anti Q-caps told me that I would be going to retrieval either Sunday or Monday. I think they would like to tease it out until Monday to limit what Dr. Smiles and his crew has to do on Sunday (understandable). Also, they were talking about thawing the donors out the day after retrieval, and if they do that, it would put transfer on Thanksgiving (I think). 

It kind of bothers me that ANY decisions about this cycle could be made based on weekends or holidays, but it's out of my hands now. 

I'm just ready to move on to whatever comes next.

Wednesday, November 19, 2014

the one thing he has to do...

Twice a day, every day, I have to prepare four vials of Menopur and inject them into my stomach, along with 20 IUs of microdose Lupron. Sometimes it hurts. Sometimes I bleed. Sometimes the needles leave nasty purple bruises that haven't even begun to fade.

Twice a day I do this. Every day for 10 days (so far).

And what does Mr. Hope have to do?

Per Posh Clinic's orders, he has to ejaculate every other day. 

That's it.

I'm shooting up all kinds of crazy hormones, avoiding sugar and flour and other insulin-spiking foods and beverages, driving an hour up to Posh Clinic and back for monitoring and blood work, finding new and creative ways to explain my repeated absences from work -

Meanwhile, my husband's current role in all of this is to make himself come on a semi-regular basis. And he almost always forgets to do it.

That's right. One job. ONE. It's not even an unpleasant one. Yet, every other day, I find myself asking, "Did you jerk it yet?" And every other day, like clockwork, he says, "Didn't I just do that yesterday?"

Oh, Mr. Hope. Dear, sweet, Mr. Hope.

Couldn't you, like, create an Outlook reminder or something? Because, honey, every time I have to remind you to pleasure yourself - literally minutes before I need to stick needles in me - 

Let's just say I silently weep for the injustice of it all.

Monday, November 17, 2014

slow growing.

Well, this is new.

I'm at CD9 today (Day 8 of stims) and this morning's check revealed a 6, two 9s, and a 10. I'm guessing the 6 is the same 6 from last time, and that fucker isn't likely to grow. But the 9s were 7s on Friday, and the 10 was an 8.

I took a look back at some notes I had on previous cycles.

IVF #1: on CD9 I had five follies that measured 7, 11, 13, 14, 14. So, three tracking the same size and two lagging behind. When I triggered on CD12, I only had one follie left. I don't have any notes about what size it was but I think it was around 20.

IVF #2: Had my second check on CD8, which revealed four follies measuring 15, 12, 9, 7. For that cycle, I triggered on CD10 (so, two days later); only two follies remained (a 21 and a 19). The 19 was the one they got the egg from and it was immature, so they grew it in culture for a day before fertilizing with ICSI.

Other things I found out today:

My lining is at 5. I said, "That's thin, isn't it?" My favorite nurse practitioner (Fave NP) told me not to worry about it. She said my lining had the triple stripe and she felt confident that it would thicken in time. No one's ever mentioned me having a triple stripe before but I've never had a lining issue. Just a rotten egg issue.

My E2 was 71. I wish I didn't know that. It seems awfully low, even for a DOR gal like myself. When I expressed concern to the NP who called with my results (not the Fave NP but the one I think secretly hates me), she told me that I shouldn't count myself out yet. She said that since my follicles grew, I needed to stay the course until Thursday. If my follicles grow between now and then, she said, it's likely that my body will kick in and the E2 level will rise appropriately.

This cycle is clearly very different from the previous two and I don't know what to make of that. I'd been thinking that could be a good thing, since those cycles didn't yield tiny humans. But then I got my low E2 level, and now I'm wondering if I'll even make it to retrieval.

I don't feel sad, exactly. Remember, I went into this cycle thinking that if I ended up pregnant, it would be from the donor embryos. But, like, the AFC of 8 kind of fucked with my head. For a few days, I thought, "What if...?" Now, I'm back to thinking my eggs are shit and that my four donor embies are the Obi-Wan of this particular cycle (as in, my only hope).

Earlier today I told Fave NP that I wanted to try to grow my own embryos out to blast, even if that meant I had nothing to transfer. Ditto for the donor gametes. I did say that if Dr. Smiles disagreed, I'd defer to him, but really, I just want the greatest shot at success. She said she understood and made notes in my file.

What I don't understand is why I feel so completely hormonal. I mean, if my estradiol is that low, I shouldn't be crying at Beach Boys songs in the car. Right?

Another mystery of my broken body, I suppose.

Sunday, November 16, 2014


Last night I had this dream. I don't remember all of it, just flashes. But basically, I went to retrieval and they got 10 eggs. I was so stunned - 10 eggs from four follicles? - that I forgot to ask about the quality.

Then I was wandering around, waiting for the fertilization report, because surely not all 10 could've been good eggs? In the dream, I was thinking, "Wow, this must be my body's last-ditch effort to make a baby."

And then later (much), I was holding a little baby that was born from an Agony/Hope embryo. I was crying over the baby and thinking about the saying that's on the ceiling of my RE's exam room: "The moment you're ready to quit is usually the moment right before a miracle happens."

In the dream, I thought, "I almost missed out on this. I almost gave up on this."

Earlier in the day, Mr. Hope and I picked up the wishbone that had been drying on our window ledge. It was from a slow-cooked whole chicken, and in hindsight, I should've known that the bone had been made brittle from the process. But I didn't know that at the time.

We picked up the wishbone, each made a wish, and pulled. Both stems broke off from the center piece, which went flying. I have never seen this happen.

I said, "I'm pretty sure we both made the same wish."

Mr. Hope said, "So does this mean we both get our wish?"

I said, "No, it means neither of us do. This is a bad omen."

We compared wishes. Mine was for a healthy baby at the end of this cycle. His was for a girl. Mr. Hope joked, "Maybe it's going to be a boy," but by that logic, it would be an unhealthy one, wouldn't it?

I told him, "Maybe there won't be a baby at all. Maybe there never will."

So it's possible my dream was my psyche's way to responding to this fear. Or it could be a separate thing entirely.

Throughout most of this cycle I've been feeling like a baby was a done deal. I have the ringer embryos waiting to come up to bat. Either way - whether it's through some unlikely miracle embryo we make with my egg and Mr. Hope's sperm, or through the magic of embryo donation - I am getting that baby. We will be parents.

But the closer we get to retrieval/thaw, the more I start to worry. What if I'm wrong? What if I've been too cocky? What if...?

I wish I had some of the faith that so many in my particular community have. There is a lot of talk about  prayer and putting everything into God's hands and surrendering to His plan. But I don't have God in my life. I was raised without religion, for the most part. I tend to believe in what I can see and hear and touch, and in the absence of that, I defer to science. Science tells me my body is broken, spitting out eggs that spoiled much, much too soon.

I am not loving science these days.

Next follie check tomorrow. Hoping for good news, or at the very least, some not-horrible news.

A miracle wouldn't be half-bad, either.

Saturday, November 15, 2014

marching forward.

Had my first post-baseline blood work and scan yesterday.

GOOD NEWS: The two abnormally large follies are gone! I had a bit of spotting yesterday and the night before, so I'm thinking the cysts burst. Whatever the case, those fuckers aren't messing up my cycle so YAY.

LESS-GOOD NEWS: Of the eight baby follies, only four grew.

BETTER NEWS: As of yesterday, the four were measuring 7, 7, 6, and 8. In other words, they're all tracking around the same size. At the very least, they're closer together than I think I've ever had in a cycle.

All in all, I'm calling it a win.

Today, Mr. Hope and I need to get a form notarized that basically says we want to thaw all four of the donor embryos (they're all 2PN, so I want to grow them out to blasts) and transfer 1-2 depending on the results of my fresh retrieval.

This is the part of the process where I have to shut my ever-loving Agony brain off. Because if I don't, I'll start seeing every possibility:

IDEAL: My four eggs make it to retrieval, they all fertilize with ICSI, we let them grow, and they all turn into beautiful, hatching blasts.

MORE LIKELY: One or two eggs make it to retrieval, they both fertilize with ICSI, and the doctor opts to transfer on Day 2.

SLIGHTLY LESS IDEAL: Three eggs make it to retrieval, they all fertilize with ICSI, we let them grow, and I end up with one beautiful blast. We transfer that and one blast of the donor's.

MY FEAR: None of my eggs make it to retrieval. Or, if they do, none of them fertilize with ICSI. There's nothing of ours to transfer, and I went through this stim cycle for nothing. But we end up with beautiful donor blasts, so there's a light and the end of this particular tunnel.

MY EVEN BIGGER FEAR: We end up with no Agony/Hope embryos and none of the donor embryos make it to blast, either. We end up with exactly nothing, and we're several thousand dollars poorer for it.

Do you see how this particular rabbit hole works?

One thing I'm wrestling with is what I want to do with the donor embies. There is a large part of me that doesn't want to transfer anything that isn't a blast, because I can't take any more heartache. I mean, I know that just because they're blasts doesn't mean that they'll automatically turn into babies, but the odds are considerably higher. And yes, I know many people who transferred Day 3 embies that turned into babies but again: looking for highest odds.

Which means I'm also wrestling with what to do with OUR embies. If the doctor wants to transfer on Day 2, do I bother? Do I insist that we try to see if our embryos can make it to blast, even if that means we end up transferring nothing of ours?

This is what I keep coming back to: I'm tired of the cycles. I'm ready to be a mom. So I don't want to dick around anymore. I don't want to put in sub-optimal embies just to say that I transferred something. I want to put in embryos that have the greatest chance of becoming a tiny human.

How do you know if you're making the right decisions for the right reasons? I'm genuinely asking here, because I'm at a total fucking loss.

Tuesday, November 11, 2014

med o'clock (and other fun times).

Yesterday, when it was time to do my first round of stim injections, I had a moment of complete and utter panic.

First of all, I was a little disorganized. The gimongous carton of fertility meds arrived on Saturday, when Mini-Hope, Mr. Hope's daughter from a previous relationship, was visiting for the weekend. We shoved the box into the bonus room, pausing only to remove the items that needed to be refrigerated.

Before I went in for my baseline appointment, I quickly combed through the contents of the carton, to make sure I had all of the meds I'd need. I realized I was short a vial of progesterone in oil (PIO), but otherwise, everything was there. Then I pawed through a plastic bin of leftover meds and various other supplies from our last IVF attempt in March, to see what was still usable. The only thing that had expired was a box of Crinone, which I'd purchased thrice over and used exactly zero times.

When I got the go-ahead to shoot up, I went into the bonus room to pull together what I needed for the "active" bin. I find the gimongous carton a little overwhelming, so what I do is put a manageable amount of the things I needed in a small bin that resides on my dining room table (can you tell we don't get a lot of company?). Suddenly, my mind went blank. Which needle was I supposed to use for the Menopur? Which one was for the Microdose Lupron? WHY COULDN'T I REMEMBER ANY OF THIS SHIT?

I tried to read the Menopur package insert but I was shaking a little and the tiny printed words weren't making any sense. So I Googled it, found the correct needle size, and grabbed a bag of them for the active bin. At some point, I remembered that the MDL used an insulin needle. I grabbed a couple of cartons of Menopur, some alcohol wipes, a box of Band Aids, and a Sharps container and headed back to the dining room.

My hands shook the entire time I prepared the Menopur. I'm on four vials in the AM and four in the PM. Here's a little background for those of you who've never prepped Menopur: You start by drawing up 1 cc of sterile water, then inject it into a vial of dry powder. You gently swirl until the powder's been dissolved. Then you suck up all of the serum and inject it into the next vial of dry powder. This is where those Q-Caps come in handy. I'm a disaster when it comes to sucking up meds with a super-long needle; the Q-Caps save my ass every single time.

Except, for about three minutes yesterday, I forgot how to use the fucking Q-Cap. And ended up having to read the tiny-print package insert anyway.

But before you can even begin to mix the Menopur, you have to run an alcohol wipe over the tops of all of the vials. And you should really take the MDL out of the fridge about 10-15 minutes before you inject it, because when it's too cold it burns and leaves small, pea-sized bruises on your stomach.

I almost forgot that part.

It took me nearly 25 minutes to remember what I was supposed to do and how I was supposed to do it. But I got there. Eventually.

The whole process moved much more quickly for the PM dosing. And even more quickly this morning. By tonight - Dose #4 - I was back to being an old pro. I got all of it done, top to bottom, in about 14 minutes flat.

Not bad, Agony. Not bad at all.

In other news:

As of this morning, I'm down 10.2 lbs. and can do 40 modified push-ups. And today, I left my lunch bag of snacks at the office when I headed to a half-day offsite meeting. The snacks provided at the conference center included fancy cupcakes, granola bars, and bags of Cheese-Its. I didn't eat a single one of anything, despite the fact that about four hours after I'd eaten my lunch, my stomach started rumbling audibly. I gulped water and pretended like I wasn't ready to gnaw on my own hand.

All in all, I'm pretty proud of myself these days.

Tomorrow, it's back to the offsite location for a full-day meeting. One that starts at 8:15 a.m., which is about 45 minutes before I usually report to work.

Did I mention it's going to be a long week?

Monday, November 10, 2014

baseline (I think).

Drove up to Posh Clinic today for baseline labs and scan. I got the nurse who despises the Menopur Q-Caps today. She couldn't find my uterus for the longest time. I don't exactly understand why or how that works, but I'd reminded her that I only had a right ovary, and after a while she said (without a hint of humor in her voice), "You still have your uterus, though, right?"

These are not things that instill confidence in a woman, I tell you what.

Eventually she located it. But this isn't the interesting part.

The interesting part is that I had an AFC of 8. It doesn't sound like a lot, but my last attempt at IVF, I only had an AFC of 6. An AFC of 8 isn't so bad for a single ovary, especially when you're a woman of a certain age.

This would've been good news except for the fact that I have two other follies, a 13 and a 10. They may be left over from the last cycle, or they may be early growers. If they ARE leftovers, and they resolves themselves or don't grow anymore and some of the 8 babies DO grow, I should be fine. Or, even if they do grow but the 8 babies also grow, I should be fine. 

But if the two big guys grow and none of the little guys grow, I'm looking at being canceled.

Anti Q-Caps asks me, "If your retrieval is canceled, do you still want to do the FET with the donor embryos?"

Well, shit.

I don't know. I don't want to wait any more. I am ready to be a mother. Like, now.

But, um, that AFC of 8? That's a good thing, right? That's...potential.


Anti Q-Caps was asking a lot of questions I wasn't sure how to answer. Like, how many of the donor embies do I want to thaw? How many do I want to transfer? I kept saying, "I don't know, it depends on what happens with my cycle."

They're bringing me back in on Friday for more blood work and another scan. Until then, I'm to take my meds as prescribed by Dr. Smiles.

Here's the protocol for this cycle so far. I'm including it because whenever I read infertility blogs I always want to know what drugs people are doing and why.

  • Doxycycline, 100 MG twice daily for 10 days
  • Microdose Lupron, 20 IUs twice daily until told to stop
  • Menopur, 4 vials twice daily until told to stop

That's it (for now). I'll keep updating meds as this cycle progresses. 

And I hope it keeps progressing. Because if we have to make that call - whether or not to go ahead with the FET if our retrieval gets nixed - 

That's a really hard decision to make, is all I'm saying.

Sunday, November 9, 2014

perfect timing.

I'm spotting, which means I should hit full flow before day's end. Which means that I will be moving from the priming cycle into the IVF/FET cycle which means YAY.

I'd been so worried about the timing, because I have a hectic week at work coming up (including a 2-day off-site meeting, one day of which I absolutely cannot miss). But assuming I do indeed hit full flow in the next 8-10 hours, then I'll go in for baseline tomorrow (I have a 12:30 meeting on my calendar but that's it) and, if I opt for the endo scratch, I'd go in for that Tuesday morning-ish.

I say "if" because I'm leaning against it, now, based on the timing. I don't typically stim for more than 10-12 days, and both IVFs have led to Day 2 transfers. Since my donor embryos are 2PN, Dr. Smiles might opt to transfer them as Day 3s OR wait until the develop into blasts. Either way, I can't guarantee that I'd get a full two weeks post-scratch, in which case I could actually be hurting the embryos' chances.

I really wish I could've spoken to Dr. Smiles when I first asked about the scratch, but I'm certainly not going to hold this cycle up over it. I'll just tuck it in my back pocket for any additional cycles I may desire/require.

Diet-wise, I'm still sticking to plan. Technically I can start adding in Bad List items a couple of times a week, but I don't think I will. Even on the restrictive phase, I'm still not dropping weight like crazy. Although I know I'll be shedding the pre-period bloat in the next couple of days, so maybe I just need to be more patient. I'm down a total of 9 lbs., which is about three shy of where I wanted to be after four weeks, but I'll take it.

Friday, November 7, 2014

to scratch or not to scratch?

That is the question.

I'd never even heard of the endo scratch until the ladies in my super-secret Facebook group all were talking about theirs. (To be fair, I didn't know what it meant to have a triple-stripe lining, either. So apparently I'm not as up on the world of IF as I thought I was.)

When I went for my ovulation check almost three weeks ago, I asked my Favorite Nurse about getting an endo scratch, which (if you didn't click through the link above) is basically where they insert a catheter into your uterus and gently scratch all four quadrants. The purpose for this is twofold. From

Increase of endometrial white blood cells. It appears that endometrial injury increases the production of white blood cells which secrete so called growth factors which in turn control embryo implantation.
Gene switching within the endometrium. Scientists speculate that sometimes embryos fail to implant due to genetic switching related to endometrial receptivity. That is, genes responsible for implantation of embryos are not switched on during the time when embryos are supposed to implant. Endometrial scratching may increase expression of genes (switching of genes) thought to be responsible for preparation of endometrium for implantation. 

Anyway, I didn't hear back. So I asked again when I went in for a second ovulation check the following week.

Still didn't hear back.

On Monday, I called and asked to switch out generic hcG for Ovidrel, because I found out that the Ovidrel comes premixed and I have such a bitch of a time mixing the generic stuff. The nurse I spoke with said that was fine, but she'd have to run some other med changes I asked about by the doctor (which I'd figured). Lastly, I asked about the endo scratch for the third time.

No response.

Wednesday morning, I left another message about how I needed these answers sooner rather than later, since at that point I was on CD 21, and I was under the impression that I'd be doing the endo scratch during the priming cycle. Also, my cycles can run short; last month, I got my period on CD 23. So I wanted to get my meds ordered ASAP.

Finally heard back from Dr. Smiles on Wednesday night. He'd left a long-ass voice mail message while I was at work, the gist of which was this:

He doesn't think the endo scratch will help, but it won't hurt, either. So, if I want to do it, we can do it. Ditto RE: my med change questions.

Basically, he bounced the ball right back into my court.

So, I asked the women of my super-secret Facebook group. Of the ones who responded, three said that they'd had success during cycles in which they did the endo scratch, vs. lack of success during cycles in which they did not. One said her RE was in the same camp as Dr. Smiles (skeptical of the research) and another said she had an adverse reaction.

I turned to Google for additional information/anecdotal evidence.

Of all of the various communities I dropped into, the majority of the women were in favor of the procedure. Many of them claimed success after having the procedure done. Was it the placebo effect? A combination of factors outside of the scratch? Who knows?

Yesterday, I called to schedule the procedure. I felt confident in this decision. Then the scheduling nurse told me that Dr. Smiles prefers to do them on CD3 of the transfer cycle. Not what I'd been expecting, obviously. I'm supposed to call back on CD1 to schedule.

I turned to Google again.

Now I'm even more confused than ever. It seems that the studies where the scratch proved helpful concerned women equal to or under the age of 37, who were considered good responders with high-quality embryos, yet still have two or more failed IVF cycles. I'm outside of that age range (not by much, but still), a very poor responder, with likely crappy embryo quality (Dr. Smiles did both my transfers on Day 2, one with a 3-cell and one with a 4-cell).

I've also read that if the scratch is done too close to transfer, it can actually lower implantation rates, not boost them.

I'm at least a day or two away from my period, so I have a wee bit of time to decide. And I'm thinking about calling Posh Clinic today and asking why Dr. Smiles does the procedure on CD3 instead of during the previous cycle. I just don't know if I'll get an answer in time.

Thoughts? Advice? I'm floundering here.

Saturday, November 1, 2014

priming cycle, advance!

Mr. Hope and I headed up to Posh Clinic yesterday, him for a sperm analysis and me for blood work and another transvag scan. Lining was 8.6, and there were three waning follicles all tracking around the same size (8, 7, 7). And yes, there was evidence of ovulation, confirmed by blood work. 

Due to the timing of Mr. Hope's sperm analysis, and his need to abstain for a certain number of days prior, plus the approximate timing of my ovulation, there's about a 0.0% chance of us having some kind of miracle natural conception. Meaning: no pressure, no symptom-spotting, no magical "what if" scenarios playing in my head. So this is good.

Also good: I've started to drop my pre-O water weight. It's so gratifying to see the scale start to go down, especially after how hard I've been working. 

Of course, now that ovulation has been confirmed, I start my estrogen supps tomorrow, to help prime for the fresh IVF. Twice a day until I get my period. Me on estrogen = near-instantaneous weight gain. So I think I better enjoy my small-but-significant weight loss today, because that's likely to stop.

I need to keep reminding myself that although weight loss would be nice, really I'm doing all of this in hopes of a successful cycle/implantation. I'm 38 years old and I have never seen a real positive pregnancy test, just a few faint positives that were the result of the trigger shot not leaving my system as quickly as I thought it would. 

On a completely different note: allow me to pat myself on the back for a sec. Yesterday was Halloween and I didn't have a single piece of candy. Not even a single BITE of a single piece of candy, though Mr. Hope and his offspring kept offering them to me even after I reiterated that I was off the sugar.

Apparently, I have willpower of steel.