adjustments.

Yesterday I went back to the cardiologist's office and met with her PA. You know how I got all freaked out about my test results? I'm not entirely sure why that happened. According to the PA, I had very mildly elevated pressure in my lungs. When he listened, he heard no fluid. But the edema is still a problem, so he agreed to a short course of HCTZ to try to reduce some of the swelling. I took the pill on the way back to the office and peed my brains out for the rest of the day.

By this morning, I was already down 3.5 lbs.

Guess what hasn't improved, though? HURTY HANDS. They're definitely less swollen - I can actually move the skin on the backs now - but the numbness and pain has somehow INCREASED. I don't get it. Even typing this short post is giving me so. Much. PAIN.

Saw the OB today. She said, "I want you to start getting mentally prepared for not making it full term." Oh, Dr. Direct. I'm so far ahead of you there. I told her my goal was to make it to 36 weeks. This, she thinks, seems reasonable. She did tell me I might have to go on desk rest and work from home at some point. This, too, I was expecting, so NBD.

The good news: Today's BP was 124/81. No protein in my urine. No sugar either. So, even though pre-eclampsia is likely going to happen at some point, it hasn't claimed me yet.

Dr. Direct thinks that I'm still a good candidate for vaginal delivery. This makes me happy. I found out today I can have 4 people in the room with me. So that's good. I can have my placenta for encapsulation. And if I end up needing a C-section, they'll make sure Mr. Hope can't see over the curtain. 

When I talk about drawing up a birth plan, these are the things I'm pretty much talking about. The only thing I forgot to discuss with her was the delayed cord clamping, but we still have time.

Jellybean's heart rate was in the 150s today. He ran from the doppler (again). Dr. Direct said, "He's having fun in there!" I told her how he punches and head-buts me constantly. I am so in for it with this kid.

Tomorrow Mr. Hope and I head out to the shore for a long weekend. Our version of a babymoon. I'm excited to unplug from the world and be in the ocean and spend some alone time with my husband. We need this. Like, badly.

Okay, my hands are giving out. I swear, the pain. THE PAIN. 

More later.

12w0d.

Baby's size: Plum.

Next appointment: May 19 (just a BP check - next OB appt. isn't until June 12!)

Total weight gain: 11.8 lbs. To be fair, a little more than four lbs. of that was added since yesterday, when I discontinued the HCTZ. This is exactly what I feared. I've read that after going off of it, people pack on up to 20 lbs. of water weight and that it can take them up to a month for that to start to come off. Yeah, this isn't going to fuck with my head at all.

Exercise: OB is encouraging me to walk. So I should probably start doing that.

Sleep: Crappy this week. Have been peeing a lot in the middle of the night. Then have trouble getting back to sleep. It doesn't help that Mr. Hope is a psycho-snorer.

Food cravings: None this week.

Food aversions: None.

Symptoms: My boobs are crazy sore. Like, so bad that I don't even want to release them from my bra at night. Also this bloating. MY GOD, THE BLOATING.

What I'm loving: Our families' reaction to the news. Also that we bought a crib. That's huge for me.

What I'm not loving: Where do I start? My anxiety level, the overnight water weight gain, waking up to pee 12 times a night, the fact that I still haven't gotten my MaterniT21 Plus test results (though my OB's nurse said I should get them today).

What I'm looking forward to: I am hoping that the test results are good and give me some peace of mind. Also that I don't keep packing on pounds of water weight. I literally drank 18 8 oz. glasses of pure water yesterday, plus another two of lemon water, two of decaf coffee, and 4 oz. of milk. So I was surprised by the scale this morning. I don't know what else I can do. Might just have to ride this out.

Best moment this week: I don't know. Maybe it was when I didn't freak out after Dr. Direct said she wasn't going to give us an ultrasound? I feel like if I get those test results and it's good news, then that would be what goes here.

plodding along.

I should have written this update Monday, after I got back from seeing Smiles. I know there are a few lovely people who've been following my story and I honestly didn't mean to worry anyone by not reporting back. I am very sorry. 

Here's what's been going on:

Went back to Posh Clinic on Monday. They took me back for blood work while Mr. Hope was still parking the car. I see a piece of paper on the top of my file with an hCG number. It was in the 67k range. I don't  know if this was from Wednesday or Friday, as I had blood draws at the satellite clinic both days. But I do know the number is low, especially since the previous Monday it had been in the 56k range. Immediately feel sick to my stomach.

In the waiting room, start running numbers through a doubling calculator on my phone. I know at this stage that it's normal for it to take up to three and a half days to double. If the 67k draw was on Wednesday, it had a doubling time of seven and a half days. If on Friday, fifteen days. Neither one looks good.

I look at hCG ranges by week. I'm still in a great range, number-wise. Even my chart had a "HIGH" flag on it. But I'm less concerned with the overall number than I am doubling time. I know this is because my numbers never doubled properly with the last pregnancy - that it's now an anxiety trigger for me. I figure I will ask Smiles about it when I see him.

We go back for the u/s. As I'm pulling down my pants I tell Mr. Hope that I have a bad feeling. He asks me why. I tell him I don't know; I just do. He gives me sad face. My heart is racing. I'm sure it's over. I am "sure" it's over before every u/s, but this time I'm really sure.

K, our favorite u/s tech, gets right down to it. Within seconds, we see Jellybean's heartbeat. I blurt out, "OH THANK GOD," and Mr. Hope squeezes my hand. I start asking questions. "Give me a minute," she says, not unkindly. 

Heart rate is 137. I panic for a second before she assures me this is a great number for where we're at. The crown-rump length is 10 mm, only one off from where they'd predicted last Monday. These are all good things.

The bleed has gotten slightly bigger and changed shape. It's no longer a pencil eraser but a long, skinny banana. Like a crescent, or the back end of parentheses. K tells us that it's in a good place for a bleed, behind the baby and not on top of it. This is reassuring.

We don't wait long to see Dr. Smiles. I am still a ball of nerves. When I walk into his office I say, "You know I'm about to lose my shit, right? You know this is happening." (Have I mentioned how much I love my doctor?)

He goes over my meds with me and decides to discontinue the lovenox (blood thinner) to see if it will help. Then he tells me that I'm still on bed rest.

I say, "Can we talk about this for a second? What are the advantages of full bed rest over modified?"

"None," he says. 

Um, okay.

He tells me that he's sure I've Googled enough to know that bed rest can't prevent a miscarriage, but to him, resting when there's a bleed seems intuitive. I ask about sitting with my feet up so I can work. He didn't realize that I can work from home, and when he does, he says, "If you're telling me all you're doing is moving from the couch to a chair with bathroom breaks, I'm fine with that." No standing too long, no cooking, no lifting, no walking the dog, no anything other than laying on the couch or sitting in a chair or using the potty.

This is an enormous relief to me, because the stress of not being able to work wasn't doing me a damned bit of good.

I ask about the hCGs and how they're not doubling any more. He tells me he doesn't care about that, because they plateau at a certain point anyway. But he didn't care about my ridiculously low hCG last time around, and we all know how that ended.

So then I say, "Be straight with me. What are the chances that this baby is going to make it?"

He chews this over for a second, then says, "Ninety-eight percent." 

"Really?" I say. "You're that confident?"

"Yes," he says. "I am."

As we leave the clinic, Mr. Hope says, "Those are really good odds." And he's right; they are. If someone told me I had a 98% chance of winning the lottery, I'd buy a ticket, no questions asked.

And yet the broken part of my brain thinks, "How can he be so sure?" and "What if I'm in the other 2%?" and "Why am I still terrified I'm going to lose this kid?"

At home I log onto my work laptop and see that I have 550+ emails backed up. This is with me checking sporadically on bed rest. We have a big event scheduled for the next day and I dive right in. Initially I think I'll work for two hours and then rest, but I don't. I work for five hours straight before feeling so exhausted that I have to lay down on the couch. 

I figure I'll update my blog in the morning. But when I wake up, the day of the event, I log on early and just never get off. I work steadily, with only a short break for a therapy appointment with Quirky and another to talk to Mr. Hope when he gets home for work, until eight o'clock. Seriously, it was 8 p.m. when I finally logged off. I got on the couch and was passing out within a couple of hours. 

So that brings us to today. Tomorrow morning, it's back to the clinic for another scan. I will say that I've had less discharge the past two days on modified bed rest than I did on the four and a half days of full bed rest. I hope this means the blood is reabsorbing or working its way out. I can handle modified bed rest, but during my session with Quirky I apparently talked without breathing for 20 minutes (I know she was thinking MANIC). I think this is because I went from working in an office where I'm in meetings with different people all day to being at home all by myself for most of the time. I think I miss interaction.

I'm starting to catch up on day job but am still behind on the freelance project. The project manager is getting antsy. She knows my history and I told her about being on bed rest but now being on modified. Her response was "Great! How far have you gotten?" Since I lost almost a full week, and went on bed rest literally the day after she asked for the last status update, the answer is NOT BLOODY FAR. But I didn't really say this. I just told her I was plodding along.

This is kind of how I feel about my life right now. I am plodding along. I get up, I do some stuff, I go to bed. Waiting for something to happen, or to not happen. Time moves slowly and quickly all at the same time.

I don't know what it will take for me to feel comfortable with this pregnancy. I felt good for two days after we saw the heartbeat and then I gushed red. So now I feel like nothing is guaranteed, it could end any second, and feeling comfortable just means setting yourself up for disappointment. It's not healthy, but it's where I am.

Tomorrow I will be eight weeks. We lost Nugget between weeks 8 and 9, but the weight week ultrasound already showed a slower heartbeat and signs of lagging growth. The gestational sac was too small, the yolk sac too big. All of my sacs are appropriately sized right now. So, maybe tomorrow. Maybe if the growth is appropriate and the heart is beating strong and there's no sign that Jellybean is going the way of the Nugget, maybe then I'll feel better?

Maybe?

and the first beta is...

...35.

The NP (not Fave NP, but this young little blonde who always makes me feel dumb) said that this was "appropriate" for where I am. I checked out some online charts (because that's what Agonies do, yo) and it seems just under the  median for Beta Base (47). I'm trying not to stress too much, because last time I had a great first beta (in the 500s!) and we all know how that turned out. This time, I'm more concerned with appropriate doubling times.

Getting the beta drawn wasn't easy. When I asked Blondie to run it, she said, "Do we usually run the hCG this early?"

I said, "No, but I've been getting positive pregnancy tests and if you don't run it I'm going to make myself crazy staring at lines."

"There's a reason we don't run them this early," she said. "Because it's too early to really tell anything."

I told her I wanted to run it again on Friday and that I'd still come in for my OTD on Monday. "I just need to know," I said. "I need data. I was in beta hell for weeks last time."

She grudgingly agreed, but wouldn't let me schedule the Friday appointment. "Let's see what the physician advises."

I kind of wanted to flip her the bird.

When she called with the results, it was in a voice dripping with condescension. Keep in mind that this girl has be at least a decade younger than me and probably has the eggs of a teenager. She's young and fit and pretty enough to be a catalog model.

"We're not going to bring you back until Monday," she informs me.

"I'd really like to run it again on Friday," I said, "to see if it's doubling appropriately. I can get it drawn at a local lab if you like."

"Hold on."

When she gets back on the line, she says, "We can bring you in, but I want you to understand that if it's not going well, there's nothing we can do. There's no medicine we can give you to fix it."

"I know that," I said, in a semi-snappy voice. "If it's bad news, then I can prepare. I just want to know."

"Fine."

She booked me for Friday at 9:45 a.m.

I'm proud of myself for insisting on the second beta. I wish I'd stood up for myself more the previous pregnancy.

I am a little worried about my hormone levels. My estradiol was 117 (I think) and my progesterone was 11.5. Both seemed low to me but Blondie wasn't concerned. Even so, I'm upping my progesterone tonight to 1.5 cc. That's what the prescription was written for, but the clinic told me to do 1 cc and I'd already self-upped to 1.25.

I'm also on the suppositories, so that might be why they're not concerned - those supposedly don't show up in the blood work.

It would be fantastic if I could relax just a little, and enjoy these early days of pregnancy. I doubt that's happening, but you know - it's nice to dream.

mistakes, I've made a few...

Something you should know about me: I am med compliant. I always have been. If a doctor tells me I need to be on something, I take it. The only exception to this is if the doctor tells me to take something and it doesn't do good things to me, like a blood pressure medicine I got put on more than a decade ago that left me with a constant tickle in my throat, as if I'd always just swallowed a hair.

But my point is, I take my  meds and I take my vitamins like the good girl that I am. I even have a really elaborate old-lady pill calls that I dutifully fill with said meds and vitamins each Sunday afternoon, so I can keep track of what I'm taking and when.

So it doesn't make sense to me that I have so many issues with the fertility meds. When it comes to them, I screw up a lot. It's not because I don't want to be taking them, or because I disagree with what I'm being given - though I did get really pissed at a nurse on the phone yesterday, who insists my treatment plan calls for 1 cc of PIO every other day and not every day. It's honestly fueled by sheer forgetfulness. 

See, the meds I mess up the most are the ones I'm supposed to take right before bed. I don't go to bed at the exact same time every night. If i'm really exhausted, I'll turn in by 10 or 10:30. If I'm not, I'll push it another 30 to 60 minutes. How careful I am about my pre-bedtime routine often depends on how loud and insistent my inner monologue is. It wasn't so many years ago I required an anti-anxiety medication to be able to shut that inner monologue down. Now I can mostly manage on my own, though I did spend a few weeks post-miscarriage on the ol' Klonopin, trying to get some quality sleep.

Anyway.

Last cycle I missed a few doses of the progesterone suppository. Usually, when this would happen, I'd bolt out of bed with a gasp, either in the middle of the night or first thing in the morning, and shove that puppy up inside me as quick as can be. I'd get so angry with myself. YOU HAVE ONE JOB RIGHT NOW, AGONY: KEEPING THAT BABY ALIVE AND HEALTHY.

This cycle, I've fucked up so many things I'm almost ashamed to admit them here. There was the day I had an appointment at Posh Clinic and completely forgot to take my Lupron in the AM. I didn't end up shooting up that day until almost noon, four hours late. I spent a week thinking I'd ovulate through the drug.

There was the day I discovered an Estrace tablet on my kitchen table and didn't even know which dose I'd missed. When they had me start shoving the Estrace up my lady businees, I forgot exactly twice and was convinced I was going to lose my lining.

I didn't start my doxycycline the right day because I didn't realize until the evening of the day I was supposed to start that the nurses had forgotten to order it for me. I had to page Dr. Eyeore on a Sunday and have him call it into the pharmacy. This turned out to be not catastrophic, since I ended up pushing my transfer back a day, but still. 

The day I was supposed to start my Medrol dose pack, I forgot until dinnertime. So I was already four pills behind. I ended up slamming them two at a time in about a six-hour period. 

Quirky would say that this is understandable. That I am under an enormous amount of pressure with my job, with the freelance project deadline, etc. and that it's only natural that I would make some mistakes. Some being the operative word. I've made more than "some." I've made a ton.

Which brings us to this morning, when the alarm went off and I woke up with a weird pounding in my head. I think to myself, "This reminds me of the headaches I got when I stopped the prednisone."

Cut to me bolting upright with an "oh, fuck!" 

Yep. Forgot my bedtime does of Medrol. Which means I also forgot my bedtime does of Estrace. The nurse told me not to take any Estrace before my transfer, only after, so by the time I'm allowed to take it, I will have gone almost 15 hours between doses. 

I took one Medrol first thing and will likely take another before transfer, even though I'm really only supposed to take one this AM and will be allowed to take a 20 MG tablet of prednisone afterward. I already packed the Estrace and prednisone in my purse and will take that as soon as I'm able. I also packed my Lovenox and an alcohol wipe because typically I do that shot in the AM, too.

I'm trying not to panic. My lining was "gorgeous." My hormone levels were perfect as of last week. I have one Grade A embryo and one Grade B embryo ready to transfer. At least, that's what they were graded at the time of freezing. I won't know what they are now until the embryologist shows us the little picture just before transfer.

This transfer - I need it to work. I mean, I know we all need every ART procedure to work. But as I said to Mr. Hope the other night, "I've never failed at something for four straight years and kept going." I want a baby so badly - to add a tiny human to our family full of love - and at the same time, I don't know how many more cycles I have left in me. I've had three failed IUIs. Two failed IVFs. One miscarriage.

I know women who've lost so much more. Who've been through so much more. I don't know how they do it. 

People often tell me that I am stronger than I think. I kind of want to cry bullshit. I'm pretty sure I know exactly how strong I am. Which is to say: strong, but not unbreakable. 

Today, after transfer, we'll either head straight home or stop for a protein-rich restaurant meal, depending on how hungry we are. Then we'll come home and watch some comedies. At some point, I'll make the lentil soup I ate a bunch of times last transfer, when I was sick. It has coconut milk and turmeric in it and I jokingly referred to it as "implantation soup," because it was warm and comforting and full of anti-inflammatory ingredients. I won't do any day job work, but I will have to put in a little time on the freelance project (nothing stressful). And Mr. Hope and I may take the dog for a short walk, because I no longer heed the doctor's advice about 24 hours of bed rest (it just doesn't make sense to me).

Tomorrow I'm back to work, and the day after that I leave for my work trip. It's a lot. I'm not going to lie. I thought about packing for said trip last night, because packing tends to stress me out, but ran out of time. Also I still have yet to prep the decks for my three presentations, though I'm going to be recycling parts from previous presos so it hopefully it won't be as heinous as I fear.

Maybe this will all be a good lesson in learning how to manage my stress. A girl can hope.

where I've been.

Forgive me, Readers, for I have sinned. It's been almost three weeks since my last confessional post.

There has been a lot of wallowing in Agony land. Or, more accurately, had been a lot of wallowing. The first two weeks post-miscarriage were, in short, horrible. Not just emotionally but also physically, and in ways I didn't expect.

The headaches started immediately. Really bad ones, the kind that hurt so bad they'd wake you up from a sound sleep. This I attributed to the shifting hormone levels. Within a couple of days the headaches were accompanied by sinus pressure and, ultimately, goopy eyes, so this led me to believe I had some sort of infection. When my psoriasis flared up big time - like, deep cracks forming in the palm of one hand and on the soles/heels of both feet - I figured it was time to drag my ass to the doctor.

So, a week ago Monday, I went to see  my primary. I filled her in on the failed pregnancy and subsequent miscarriage. I told her that I was having trouble functioning because of the headaches and sinus pressure. Oh, and I wasn't sleeping. I could fall asleep just fine, but the pain would wake me up and then I couldn't get back to sleep. In the previous three days, I'd logged about 16 hours total, and it was taking a toll.

I told her that I wasn't sure of the culprit: infection? fluctuating hormone levels? anxiety? depression? stopping the prednisone cold turkey?

Her head shot up so fast that if we'd been in a movie, you would've heard a record scratch. She was like, "Say what now? "

When I miscarried, Dr. Smiles told me to stop all of my meds. He didn't give me specific instructions about the prednisone, but I'd been taking a 20 MG dose since transfer. So, almost seven full weeks. Stopping that without tapering off was apparently Bad (capital B intended).

My primary looked at my ears and nose and saw that yes, there was something ucky going on up in there. Her theory was that stopping the prednisone threw my body completely out of whack. You can Google it but basically when you take prednisone for an extended period of time, your body stops producing cortisol. When you quit cold turkey, your adrenal glands don't have time to catch up and resume natural production.

So, she ended up putting me back on the prednisone with a tapered dosage: four days at 20 MG, four days at 10 MG, four days at 5 MG. She also had me increase my Wellbutrin by adding an extra 100 MG in. And, since she was convinced my inability to stay asleep was due to anxiety/racing thoughts, she asked me to temporarily take .5 MG of Klonopin each night so that I could get some rest.

Within a day or two, I was feeling much better. More functional, at the very least. So there was that.

Last Tuesday I had my first post-miscarriage follow-up with Dr. Smiles. I wasn't sure what the ultrasound would reveal, since I'd had some serious EWCM and ovulation-type pains over the weekend. Sure enough, the ultrasound tech saw a follicle that was about to pop. Remember, this is two weeks and a day after I passed Nugget.

When Dr. Smiles and I talked, he said, "Your uterus looks like you were never even pregnant." He apparently meant this as some sort of compliment, but hearing the words was like another kick in the gut. THIS NEVER HAPPENED. SEE? THERE'S NO EVIDENCE THAT YOU EVER HAD A BABY IN YOUR BELLY.

Because my body bounced back so quickly - way faster than Dr. Smiles had expected - the whole timeline for my next cycle shifted up a bit. I go back today to confirm ovulation. If I have, indeed, ovulated, then I will start my lupron today. After I get my next period, I'll start the estrace and officially be in cycle.

I wrote out the $2600 check for the new cycle, which includes a new donor blastocyst. Just one, made by a 34-year-old woman. I don't love that part. We were given the option of two 2PNs, the mother of which was just 26 years old, but there were no guarantees we'd even end up with one blast there. So.

The following day I had an appointment with Quirky, my infertility counselor. She was horrified by the prednisone thing, too. Her best guess was that Dr. Smiles forgot I was on it, since it's not a standard protocol but something I requested preemptively. We also talked about my stress level, which was sky high due to a variety of factors - work, home, cars, dog, money, and this massive freelance project I'd fallen completely behind on and would never in a million years be able to deliver by 2/15.

Quirky made me go through the list and pull off everything that was nonessential. Blogging was one of the things that I'd stopped doing because I couldn't pull it together enough to sit down and write. But what else could I do? Could I, a classic type-A overachiever, pull back at work? Give it an A- effort versus an A+? Could I stop cooking dinner every night and allow myself some takeout until I was feeling better? Could I talk to the person to whom I owed this massive freelance project and ask for an extension?

This was the big one. The elevator version is that years ago, I was doing a different freelance project for this woman that I never completed. Mr. Hope went through some rough times (different post for a different day) and it affected me deeply and I just stopped doing freelance work all together. I was worried that asking for an extension - especially the long one that I needed - would make the project manager think that I was flaking on her.

The good news is that the PM and I were friendly outside of our working relationship. Like, Facebook-friendly. Also we knew some details about each other's lives. I knew that she conceived her two littles through IVF, for instance. She knew we'd been struggling with infertility. When I knew my pregnancy was likely to end in miscarriage, I let her know. And when I lost Nugget, I let her know that, too.

We ended up talking on a Friday, because a mutual colleague passed away unexpectedly earlier in the week. He'd actually been the one to introduce us, so we wanted to connect. We talked about him and shared memories.

And then I did it. I told her how far behind I'd fallen - how the second my life started to implode I pretty much stopped working on the project.

She asked me if I was okay talking timelines and I said yes. She looked at the schedule and saw that we had wiggle room. I was given an extension until April/May. She understood that I wasn't flaking. She knew I was committed to the project. She cared about me and wanted to make sure I was okay.

The relief I felt at that moment was so overwhelming that I thought I would crumple to my floor and pass out right then and there. I'm not even exaggerating. I felt safe and sleepy and like everything was going to be okay.

Dealing with that stressor changed EVERYTHING. The next day I got caught up on paying the bills and updating my budget. I cleaned off my desk. I cleaned off the dining room table. I did a ton of dishes and wiped down the kitchen. I did the meal planning for the week and made the grocery list. I ran to Walmart with Mr. Hope to pick up things we needed. I met a friend at Panera where I worked on my freelance project for two and a half hours and knocked out twice my daily goal for getting the project done. I came home and had sex with my husband since the first time before my last cycle. I made dinner. I snuggled with Mr. Hope and Precious Pup.

I felt good.

The following day, I got up early and worked out for the first time since the beginning of my last IVF cycle. I made a healthy breakfast. I sent Mr. Hope off to work and knocked out some more of the freelance project. I had a lot of baking to do for a work function, so I started busting that out, too.

Crossing things off my to-do list felt good. Hell, before Saturday I'd stopped keeping a personal to-do list all together.

So I'm starting to feel like me again. The tapering off the prednisone has been amazing; currently the only pain I'm feeling is from the surrenders I did during Sunday's AM workout. My muscles hurt so badly that I couldn't work out again this morning as I'd planned - the last time I tried to push through pain like this I injured myself. But it's okay; I know WHY I can't work out today, and I know that tomorrow, when I should be way less sore, I will get back to it.

If all goes well today, I'm looking at transferring the first week of March. Which is, like, right around the corner. Crazy, right?

I have a lot of fears about this next cycle, the biggest of which is that I won't get pregnant at all. Or that if I do get pregnant, I'm headed for anther miscarriage. I want so badly to be on the other side of this whole process.

I am so ready to be a mom.

things I did differently this cycle.

Today's FRER line is nice and dark, and I finally had the guts to take my Clearblue Digital. Even my Wondfo is clearly positive today, though still not nearly as dark as I feel it should be. Regardless, I'm guessing this is the last one of these I'll need to post unless things start getting crazy light.

You can see a weird break in the dye run on the 9DP5DT test, toward the bottom. But look how dark the top of the line is! P.S. It might be time to start tossing some of these, huh?

Yesterday, I found this chart, which gives an estimation on the likelihood of miscarrying based on the number of days pregnant you are. I printed it out and hung it on our fridge, and now Mr. Hope and I are crossing off days together. Since yesterday, our odds of miscarrying went down from 29.2% to 28%. Or, as I like to think of it, our odds of carrying this pregnancy to term increased from 70.8% to 72%.

I've been thinking a lot about what I did differently this time around. You know, besides the obvious "adding a donor blast from a 30-year-old mother into the mix" thing.

I didn't take DHEA. When I started seeing Dr. Smiles in October 2013, he had me start taking DHEA. I'd been on it almost four months for IVF #1. I discontinued it after IVF #2 and never went back on it.

I reduced my number of supplements. For IVFs #1 & #2, I'd been taking L-Arginine, alpha lipoic acid, and selenium in addition to the stuff I'm still taking now (most notably Ubiquinol and forms of B vitamins that work well with my MTHFR mutation).

I changed my diet. I'm now a BIG fan of the EZ Diet. And honestly, it wasn't THAT hard to give up flour, baked goods, sugar, potatoes, bananas, and yogurt. (I say that now, of course, before Christmas kicks into high gear.) I can't say for certain how much this changed things, but eating this way certainly feels healthier.

I ate a LOT of avocados. I'd read about a study funded by the NIH that showed that a diet high in monounsaturated fats and lower in saturated/trans fats was 3.4 times more likely to result in a child from IVF. I love me some avocados (before the EZ Diet, Mr. Hope and I used to have avocado toast for breakfast quite frequently), so I figured it wouldn't hurt to ramp up my consumption. Nearly every day of this entire cycle, I'd eat half an avocado with breakfast. The day of transfer, I ate half of an avocado before and another half after. Again, don't know how much this helped things, but it certainly wasn't a burden to eat yummy avocados daily.

I was on a (somewhat) different protocol. This was the first cycle that I primed with estrogen (I took it for 8 days prior to starting stims). I stimmed with four vials of Menopur in the morning and four at night, same as IVF #2. But Dr. Smiles changed up my progesterone; this time I do a PIO shot every other day and a pessary every night. I think I respond better to the pessaries, which I used during my three IUIs and some natural cycles as well. I also take estradiol twice a day; I may have only taken it once a day on previous cycles but can't remember.

I skipped the acupuncture. My previous two IVFs, and for a couple of IUIs, I tried acupuncture. I didn't find it all that relaxing and it never seemed to do anything to help my lady business. I have heard of other women who did it and weren't successful, then did a cycle without and were.

I asked to trigger with Ovidrel. I've always used generic hCG for a trigger, but I am really bad about sucking all of the meds up with the long needle. So, this time I asked to switch to Ovidrel. It's a preloaded syringe and a subcutaneous injection instead of a muscular one.

I insisted on transferring blasts. My previous two IVFs were with Day 2 transfers. In hindsight, I could see that my first embryo was kind of uggo (cells weren't exactly even, and there was already fragmentation on Day 2). My second embryo was better, but still so young. I really rolled the dice on this one by insisting on growing everything out to blast. And I did so fully expecting to have nothing of ours to transfer. The gamble paid off, big-time. I mean, our one little embryo made it to blast! Even if it didn't end up implanting, you can't ask for a better chance than that.

I didn't do bed rest. This is a big one. My clinic recommends 24 hours of bed rest after transfer. I did mostly bed rest after IVF #1 (we had tickets to a show that night, ones I'd purchased seven months prior, so I did a little bit of walking in the theater) and serious bed rest for IVF #2. I never felt like bed rest was the right thing to do but Mr. Hope insisted. This time, I told him, I wasn't doing bed rest. I'd take it easy, I said, but I needed to move around to make sure the blood was getting to my uterus. He reluctantly agreed. And I did take it easy, for the most part. There were a few rounds of Celebrity where I was doing charades that got me a little schvitzy, but hey - guess getting my heart rate up a little was ultimately a good thing.

Here are some of the other things that I didn't do that I had on previous cycles:

• Eat pineapple core
• Avoid raw foods (I've been chowing down on salads like a boss)
• Avoid cold beverages
• Yoga
• Mediation
• Fertility massage

I will probably never know what did or didn't make a difference, but I wanted to document these things here because it's the kind of stuff I loved reading on other people's blogs.

Anyway, there you have it. Now if you'll excuse me, I'm actually feeling tired enough to fall back asleep!

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.

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.