omens.

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.

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.

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?

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.

WHAT THE FUCK AM I SUPPOSED TO DO?

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.

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.

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 www.createhealth.org:

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.

• 
  

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.