Debrief

Finally my period has started. Even with the "definitively negative" phone call, I still had the tiniest hope in the back of my mind that it might be a false negative. It's good to KNOW know.



We had our debrief with the doctor over the phone yesterday morning. He wasn't very helpful, and we weren't surprised. He said lots of people think that when it doesn't work, it's a rejection issue; but usually it's more likely that it's a problem with the embryo's genetics. He mentioned the possibility of genetic testing, but didn't ask if we wanted to do it. He also mentione the fibroids he saw in my ultrasound back at the beginning of the process; he said that might be a cause of decreased chances of implantation. But I find it hard to believe that a few fibroids that he didn't care about back then could be the cause of our negative tests now.



Then he brightened, and said "you know what I think? I think we should be aggressive with this next try. I think we should transfer all four embryos, and then reduce if we need to. What do you think?" I said sure, go ahead and put that in my file, but we are out of money so we're taking a break. I didn't tell him that our break will most likely last forever. With OHSU's success rates the way they are, there's not much of a reason to sink more money into them.



So today the plan is to wait for two years or until we can pay off either the car or the failed IVF, and then start fresh with Oregon Reproductive Medicine, which has an amazingly good success rate - I think I read over 10% higher for a fresh cycle than OHSU. They also have a money-back plan which looks pretty attractive right now too. And in the meantime, C will do another semen analyis and see if anything has changed, and we'll be back to timing more natural tries.

Sad

I am just totally, hopelessly sad tonight. I cried for so long that C fell asleep in the middle of it and here I sit, still, just overwhelmed with sadness.

Aftermath

Well, I don't feel as horrible as I did last time. Maybe it's because I was steeling myself for it. Maybe because it was less invasive than last time. Maybe because I didn't have that blind optimism I had the first time around.

Now we have to figure out what to do. I have four embryos left, but they're of lower quality than the ones we transferred. I doubt my RE will tell me whether I should even try with the lower quality ones or if we should just try again with new eggs and sperm. Or try something else.

Or I could go with another clinic. One of the things I've been beating myself up about this afternoon is not going with the clinic that had higher success rates. At the time, the only reason I went with my current RE clinic is because they had an earlier consultation appointment available, and I didn't want to pay another $400 to go to the other clinic's consult too; and I frankly thought that once we did ICSI I'd be pregnant like that. Why oh why was I so optimistic? (Because I had no option to hindsight!)

I guess either way I have to wait, because another FET isn't covered in my current financial package so that'd be another few thousand dollars out of pocket, and switching to the other clinic would be another $10-15 grand. We MIGHT be able to figure out how to do another FET relatively soon, but switching is out of the question until we get the current failures paid off.

Well, at least they called earlier this time.

Negative. Again.

D-day

Well, here we are. Stood in in the rain waiting for the lab to open with about eight men, and was second in line for my blood draw. The phlebotomist was nice; we chatted a little about IVF. (I think I didn't look very excited, which made her ask me "so are you hoping for a positive or a negative test?") She taped a cotton ball to the inside of my elbow and sent me on my way. (I hate the tape, it always takes arm hairs with it when it gets peeled off.)

I'm strangely calm right now and I realized it's because I don't WANT to know. Throughout the year that we tried naturally, I think I took only one pregnancy test. I just don't want to hear bad news and I'm so sure it's bad news.

Two week waits suck. And my wait isn't even ten days.

Yesterday I had the pleasure of attending a double baby shower at work. I brought a hat-in-progress with me (I have a tiny skein of only 185 yards, so after much searching I finally found a knitted beret that would work) because I had a feeling I would need something to keep my hands busy, and I'm glad I did. The first little while was fine; even watching them open their gifts; but then everyone started in with the advice and the questions (things like "so how do you think the big day will go?") and I had to knit really fast to calm my thoughts. (My coworkers are great, and I was happy to go and support them at their shower, and of course they shouldnt take my fast-knitting personally, heh.)

It was kind of a downward spiral from there; now all I can think about is Monday afternoon and the phone call with bad news. I keep sitting quietly, barely breathing, trying to feel as hard as I can. Just like last time, there's nothing. Of course. Because it has only been five days. But in the back of my mind is that little voice that says you didn't feel anything last time, and you weren't pregnant. So you know what not feeling any symptoms THIS time means!

I don't make our IVF a secret among most people; C and I are just fine with sharing it. But now I'm in this weird place where I hate to bring it up to people because I imagine they think "oh jeez, again with the infertility talk?" But it's like opening the door to a dryer that's too-full of clothes. My thoughts tumble out through the cracks. I just can't wait for this to be over so I don't feel like I have to share all of my insecurities and desperation with anyone who stops near me long enough for my dryer door to open.

Transfer

Things were pretty hectic leading up to transfer today. C and I both went to work for the first four and a half hours, and he had a meeting up until noon on the dot. We stopped at Starbucks and then hit the road. It was after Starbucks that C remembered that they wanted us there at 1:30 and not 2. So some speed may have been picked up. Sort of. Because we kept getting stuck behind car after car. Usually when we go up, traffic isn't that heavy, but I think Friday afternoon may have had something to do with it.

We were only five minutes late when we missed the exit. Yes, we, who have been to that clinic a dozen times, missed the freaking exit. So I frantically whipped out my phone to map out how to turn around. The directions included driving on a road that was closed. So we had to detour. When we finally parked a block away, the meter wouldn't take my coins. We finally showed up at 1:45. (And then the nurse took my blood pressure and asked if I was nervous. Nope, just freaked out for a half an hour and then ran up here, no biggie.)

I got onto the table and the nurse did an ultrasound. And of course, the empty bladder struck again - the 27 ounces of water I'd had were not enough. So she gave me two more cups and after I downed 'em and waited five minutes, the bladder looked OK. (Woo!) So in came the doctor.

The transfer itself was quick and easy. The embryologist had spoken with us before the ultrasound to tell us we had two 3AB-grade embryos, our two 5-dayers, that both made it just fine out of their frozen slumber. (Vitrification apparently has much higher survival rates than regular ol' cryopreservation.) In they went, and then I lied there for half an hour.

And I'm proud to say, I did NOT have to use the bedpan. :D In fact, it wasn't unbearable until I had about ten minutes left.

And then we were done!

I cried a little half-tear when they were finished; same as last time; and I felt super relaxed afterwards. I was surprised; last night was rough emotionally and I figured that I'd still be that way afterwards, trying to protect myself from the results of the pregnancy test, but I was happy and hopeful again. Of course, I keep going back and forth, being excited and then trying to keep myself in check. But positivity is always good.

One More Day

Transfer is tomorrow.

I don't want to go. I feel like a little kid waiting for the wooden spoon to come down hard on my bare bottom; dreading it and wincing in advance of the pain. I don't want this to fail. If it does, that's it, no more chances for at least three years. There's so much riding on this transfer tomorrow and I've been so good about not caring up until now. Or at least pushing it out of my mind. But now I think about it (and I can't stop thinking about it) and just want to cry.

Transvaginal Ultrasound Wand, It's Been a While

Today C and I made the 90-minute trek up to the RE for a quick ultrasound to check out my uterine lining, and a quick blood draw to make sure I didn't ovulate. There were TWO babies in the waiting room, leading me to almost post to FB "two babies in the infertility waiting room: advertising, or inconsiderate?" (I didn't, though. And for the record, I didn't think it was inconsiderate, I could just see how someone else may have felt that way.) The ultrasound was the quickest I've ever had - probably about 30 seconds, tops. Lining looked good, OK, all done.

Next was the blood draw. Somewhere along the line someone decided that I don't do regular needles well, apparently, because the last several times I've been in there they've used a butterfly needle. I actually looked at it this time. (Usually I just look away, for no good reason, because they don't really freak me out that much but watching just doesn't sound like fun.)

And then we were done, and after picking up some very cheap progesterone (only $10 for 4 vials, with all the needles and the sharps container to boot!) we went back to a very busy office to await the nurse's call.

The phone rang late in the afternoon, which brought back sad memories, but the nurse was chipper. "Your progesterone was at 1.32, which is good, and you're all set to go! So decrease your estrace to 2 per day, and start your daily 2cc of progesterone tomorrow night." I asked about the level of progesterone doubling, which she said had to do with how my body is doing less work with the FET than it does with a fresh cycle, and needing more help. She also confirmed transfer day is November 4, and that they'd call the afternoon before with an appointment time.

After that we talked about the transfer itself. I have two vials that each have two day-6 embryos inside, and one vial of two day-5s. My doc had talked to me last month about how they were going to transfer two of the 6ers. But this morning during their team meeting (where they review everyone's protocols and talk about everything) the embryologist mentioned that the 5ers were in better shape than the 6ers. So the nurse asked for my consent to transfer the 5ers instead. It kind of worried me that the older ones looked worse than the younger ones - was that why the last cycle didn't work? Does that mean the 5ers will suffer the same fate, shriveling away after day 6? Only one way to find out.

Back in the Saddle

I had a lovely break-cycle. I didn't think about IVF much, and C and I enjoyed ourselves.

But Friday it was back to business. I called the nurse to tell her it was time to start the FET cycle, and she gave me the new protocol:

Sunday, October 16th-20th: Estrogen 1x/day
October 21st-24th: Estrogen 2x/day
October 25th-28th: Estrogen 3x/day
Blood draw/ultrasound October 28th
If all looks good, estrogen 2x/day and 2cc progesterone starting October 29th, and the actual FET on November 4th.

Then a comedy of errors kicked off the weekend: because it was late in the afternoon on Friday, I asked the nurse twice to make sure she called my local pharmacy with the order right away because I wasn't sure if it was open on weekends. She assured me she was doing it right after the phone call, so after work I went straight to the pharmacy. The pharmacist hadn't gotten the order. So on Saturday morning (we had plans to go to Portland mid-morning) I called the pharmacy. They still hadn't gotten the order. I called the on-call doctor, who said she'd call it in. I waited for 45 minutes and called the pharmacy again (around 9:45). The audibly annoyed pharmacist still hadn't gotten the order, so she took my number and the doctor's number and told me she'd call me when it was ready.

Two hours later, I still hadn't heard from the pharmacy. I had an appointment in Portland in the late afternoon and I needed time to get up there, so I called the pharmacy again, intending to let them know I only had two more hours before I HAD to have the prescription, and they said the pills were ready. Upset that they'd never called me to let me know that, I ran to the pharmacy. "Oh, it's Megan!" the pharmacist said with a weird look when she gave me the estrogen. I thought that was odd until about ten minutes later, on our way out of town, when my phone suddenly beeped to let me know there was an incoming voice message. It was the pharmacy. They'd called at 9:55. And my phone hadn't gotten the message from the voice mail system until almost 1. No wonder the pharmacist talked to me like that - she thought I'd been nagging them because I was in a hurry and then didn't show up to the pharmacy for three hours after they'd hurried to get the prescription filled. Oops. Sorry, pharmacy. It wasn't my fault.

FET Time

I talked to the RE today over the phone about the next steps. Our conversation was kind of weird at first; I was on his speakerphone and I could hear him typing as he talked to me, and when he talked to me it was all stilted like he was thinking about something else. Then he abruptly had to hang up because he got an emergency page.

Five minutes later he called back and everything was much better - he was paying attention to what he was saying and he made more sense. He apologized for the IVF failure; he said he was very surprised based on how well the rest of the cycle went, and he was very optimistic for this FET. Then he had a lot of questions: do I want to take only estrogen pills or estrogen pills and Lupron? (5% of patients who take only estrogen ovulate, which means the FET must be canceled, but Lupron is an extra $600 and he doesn't usually recommend it. That was cool with me - only taking a pill and not having to make C poke me with Lupron needles - yay!) Do I want to thaw more if one of the two embryos they thaw die? (Yes!) If the second vial containing two embryos is thawed and both live, do I want him to transfer all three embryos? (Yes, if I have a better chance of success.) He told me to call with my next cycle (he likes to give patients a cycle between to kind of calm down, organ-wise) and we would get going again.

It ended up being a relatively quick phone call, but it was nice to feel like we're picking up and moving on. I'm still not sure exactly what I think about transferring three, even though part of me is still not optimistic about this second chance. I would hate to be thrown from the position of not-being-able-to-get-pregnant to the position of being-pregnant-with-too-many and having to decide what to do about it. But I also don't want to waste embryos, especially if that third popsicle was the one that was going to make me a mama.

On the Mend

I feel leaps and bounds better now. I think I scared some family members when they read my last couple of posts, and I guess I can see why - I was so optimistic, and so happy, and then when I crashed I crashed hard. Sorry about that.

I feel so lucky - I have such a great support system, and I'm so lucky. C and I have both gotten telephone calls and encouraging emails. My aunt called last night (we don't talk very often, so it was nice to hear from her) and she helped so much. And time helps too. Today I spent time with my grandma and I talked about future children again as if I was back in July, with hopefulness and happiness for the future. I allowed myself a few days to be bitter and unhappy and angry at the world, but I feel like I've officially picked myself back up to try again. Although this time I'm treading a little heavier; I feel like I'm not bursting in on this cycle singing and throwing flowers. I'm more tiptoeing and looking around suspiciously. But at least I'm moving forward.

Babymaking: Nailed It

Two days.

Physically, everything is back to normal - my period arrived yesterday as if nothing has been happening the past six weeks, Sharpie rectangles on my backside which showed C where to stab me with progesterone needles are faded to almost nothing, the mark on my arm where the pregnancy test blood was taken is healing, my belly is back to its normal size.

Emotionally, I feel like the physical normalcy is nyah, nyah-ing at me. I superstitiously kept my Diva cup out during the 6 weeks of IVF, "just in case," even though I was sure I should just put it away for a year. Using it yesterday was sad. I don't feel like I'm grieving the way that I did the first day, but I still feel lonely, defeated, frustrated, and bitter. I wonder about the other lady who had a transfer on the same day as me. Did she get good news?

The people around me are mostly supportive. My coworker who'd gotten pregnant accidentally and took weeks before she could announce her pregnancy to anyone without crying - she hasn't said anything to me, even though I know the news spread like wildfire after we left work in a teary rush. I texted my sister yesterday and said "did you see that I wrote on Facebook that the test was negative?" and she replied "yes. I just didn't really know what to say." That was kind of hurtful. Most everyone else has been nice. I know it's hard and awkward to have to interact with someone who's hurting. I feel that way myself. So my rational brain forgives and forgets, but my lonely, defeated, frustrated and bitter brain wants to slap them. Even though I know that's wrong.

We have a follow-up telephone appointment with the doctor on Tuesday. I'm going to tell him I want to do the frozen transfer right away. And really, the only reason I want to do it is that our financial package is for a fresh and a frozen cycle, and I want to get my money's worth. I'm not doing it because I think it's going to work. All of the optimism I had during IVF is completely gone; now I just want to get the FET over with.

Negative

They were supposed to call me after 1:30. They didn't call me until 3. As the time ticked on I knew what my quiet phone meant. When it finally rang C and I dashed into the hallway to hide from coworkers.

"I'm so sorry I don't have better news..."

C got my purse and we left without a word. Home now, in bed, trying to think happy thoughts. I get to have a beer at Oktoberfest this weekend! I get to stop being poked in the rear with needles! I get to try this again (with frozen embryos) one more time before we have to take a 3-year break to pay off the IVF loan before we can try a third time!

But really I'm thinking mostly things like I don't know what went wrong and I feel broken and like I'm not meant to have kids; that I should stop trying because it won't work a second time if it didn't work the first time. That I have to have done something terrible in a past life and now I'm destined to be punished by having to watch everyone around me get pregnant accidentally and easily, and then ask if I want to hold their babies with my barren little arms.

Eve

I've been coping so well during the big Two Week Wait. Last week I was easily able to push it out of my head because it was too far in the future for me to think too much about, and I had to prepare for the renaissance faire. Then this weekend (plus Friday) I was running non-stop from gig to gig at the faire, in the 95+ degree weather, sweating through my corset. I got home Sunday night and took a shower (post-faire showers are the BEST) and got all the dirt and sweat off of me, and got into bed and realized test day was three days away and had a good cry. Of course, most of the cry was from being exhausted, but it was the beginning of the nervousness that I knew would pervade the rest of the Wait.

Yesterday and today were better; I was busy at work and was able to keep my mind off of it for the most part. And now tonight, I don't want to go to bed.

Tomorrow morning the lab opens at 7:30 and I'll be there waiting at the door. (I don't have to go all the way to the fertility clinic, thank goodness, I can just do the test in town.) Then they have to fax my clinic the results and then my clinic will call me at some point during the afternoon, after 1:30, with the results. (Yay for at least six hours of pins and needles!)

I have a good feeling about this, but I'm trying so hard not to get my hopes up. Everybody else says they're sure it'll be positive, because what else are you supposed to say to an IVF patient who's on the verge of finding out whether it worked. And I know that no matter how well I keep my feelings in check before the call, if the answer is no I'll have the same reaction.

Here's to a quick Wednesday, whatever the outcome. I'm ready for this chapter to be over.

Seven More Days

I told myself I wouldn't think about it, but I am. Of course. Do they like it in there? Are they happy? And why can't I feel it yet? In my head I know that's so silly, that the progesterone isn't giving me sore breasts and so the lack of sore breasts doesn't mean anything. I'm keeping myself busy with work, and this weekend with the faire, and the time will fly by; but of course down in the depths I'm wondering if they've found a nice little cozy spot to hang on and grow. Grow, little guys, grow!

Sonogram

Here is a photo of the ultrasound at the moment of transfer. If you click through to Flickr and hover over that photo you'll see notes that kind of help explain things, but the black mass on the top and down the right side is my giant unhappy bladder, and the bulbous thing on the lower half is the uterus with the cervix off to the right. In the center of the uterus is a horizontal line: that's the catheter as it's transferring the embryos.

Cryo Report

The embryologist called and left a message: yesterday after the transfer he froze two embryos, and today he froze four more. So there are 6 little embryo popsicles waiting for us if we have any issues with the two who are hopefully busy cuddling up to my uterine lining, or waiting for some other couples who haven't gotten any uterine cuddling yet.

Transfer Day!

Today was transfer day! After a nearly painless PIO shot last night, I was happy and ready to go at 7:45am. I filled up my water bottle with 20 ounces of water, and after a stop at the rest stop promptly at 9 I chugged the water and was ready to to by 9:30. The embryologist came and talked to us about how the embryos were looking great, and we would definitely have some to freeze.

At 9:45 the nurse had gotten me into a (super cold) room, and she did a quick ultrasound on my lower belly. "I can't even see your bladder! I'll go get you some more water and give you fifteen minutes." She came back with two 12-ounce cups and left me to it.

At about 10:10, the nurse came back and did another quick ultrasound. "That looks better, but not good enough. I'll go get you some more water and give you fifteen minutes." She came back with two more 12-ounce cups.

As I was drinking that water, the doctor came in and chatted about how many embryos we wanted to transfer. I told her about how after the retrieval that doctor had mentioned maybe only transferring one due to my OHSS risk, but that I'd been weighing and measuring myself and everything looked good and I felt fine. So two it was.

At about 10:30 the ultrasound finally looked good, but now the doctor was seeing to another patient because it was taking me so long. So she left me to lie on the table for awhile until she could round up the doctor and the embryologist.

Finally as my full bladder started to get hard to bear, in came everyone. The ultrasound was pushed hard into my lower belly, and the doctor put in the speculum and then the catheter. When it looked like she was in the right place the embryologist came in and handed the doctor the embryos, and she transferred them in. I wanted to watch and enjoy it, but I had to dig my fingernails into my other finger pads, I had to pee so badly. But I was holding on for when they were done, when I could pee and then lie flat for half an hour.

Except then they said that I had to lie flat FIRST and then they'd let me pee.

They all left and I was surprised by happy tears; it was so nice to finally get to this point!!

I lasted about 8 minutes with the urge to pee completely killing me, and then C went out and asked the nurse if there was anything they could do. She came in and grabbed a bedpan from the cabinet and let me do my thing in there. It was a really weird feeling, lying on my back to pee. But once that was done I was able to actually focus on relaxing and making my uterus look extra pretty for my new tenants. Please move in, new tenants!

PIO Update

Last night we attempted the second progesterone in oil shot. And it went swimmingly! I warmed up the dose and iced myself well, and C was great - it barely hurt at all!

Day 3 & Day 1

Yesterday afternoon the nurse called to tentatively schedule a Friday (Day 3) transfer. She didn't really have any news about the zygotes, but she said the embryologist would call Friday morning to let us know whether we should hold off until Sunday (meaning the zygotes were doing well enough that they didn't have to immediately be transferred back into my uterus). I reminded her that we had to drive an hour and a half to get there, and so the embryologist should call as early as possible, but our launch time this morning came and we hopped in the car and figured we'd wait for a phone call en route.

When we had been driving for almost half an hour the nurse called again, and said that she'd looked at the embryologist's report and the zygotes are doing really well! So she scheduled the transfer for Sunday at 10. It's a quick procedure, and then I lie down immediately afterward for half an hour, and then I spend the rest of the day on the couch. Unfortunately, I have a choir rehearsal - last one before the upcoming renaissance faire - and I was hoping I wouldn't miss it. So everyone else is deciding whether they want to come up here to rehearse or if I'll just miss it.

Yesterday was day 1 of my progesterone shots. I had been dreading it all day long, and in the evening beforehand I'd all but forgotten about it but this lingering sense of dread was hanging around and I couldn't figure out what was wrong. Oh yeah.

I warmed up the dose between my thighs for awhile, and then paced around icing the spot, and had a hard time settling down to drape myself over the counter so C could do the deed. He even hesitated a few seconds after he said he was ready, and when he finally did it I jumped. Once it was in it wasn't so bad, and I feel better about doing it today, but it didn't stop me from crying last night after it was over, mostly from the anticipation and nervousness leaving. Also, I haven't cried much at all during this whole process so I guess it was time.

We have Zygotes!

The doc called this morning with the numbers: out of 32 eggs collected, 24 were mature, and of those, 18 (75%) were fertilized normally! That's better than the 70% rate they like to see. So today is Day 1, and on Day 3 a nurse will call to let me know how they're doing and when to come in for the transfer.

Apparently yesterday when they were wrapping up, the doctor told C that it was likely they'd only transfer one embryo because of my risk of OHSS. I was a little disappointed when I heard that afterwards, mostly because of the decreased opportunity for only one embryo to implant. But it would be much easier and cheaper to take care of one little one! And OHSS complications are not very much fun (and last longer when one is pregnant).

My mom was happy to hear the news. She is calling them her Grandzygotes already. :)

I took today off work again, and have been sleeping here and there. Still feeling pretty swollen and uncomfortable. But I'm off the pain meds, so that's progress!

Retrieval

C and I got up at 4:30 this morning, showered, and hopped in the car. I'd slept better than I thought I would last night; I laid there being worried for several minutes before dropping off, but once I was out I was out all night.

We got there probably 20 minutes early, and had to wait about 20 minutes after we were supposed to be there for everything to be ready. I met the nurse and the anesthesiologist, and they went over what would be happening. Off went the pants, and they covered my lower half with a sheet while they hooked me up to the cardiac monitor and stuck the IV in. The IV was painful; it stung a lot and the anesthesiologist said it was probably because it was poking a valve in my vein. She adjusted it a little but it wasn't super helpful. She also put on one of those finger clamp thingies. Meanwhile, the nurse called down an order for more meds so we could pick them up in the downstairs pharmacy.

Then the doctor (the same one as my last two ultrasounds; I like him) came in with a resident (she squeezed my hand and it felt weird to be on the receiving end of a hand squeeze; no idea why) and had me sign consent forms. One was for the procedure and the other was so they could use my discarded eggs (ones that don't fertilize, or immature ones) for a study several of the doctors are working on that has to do with mitochondrial DNA therapy for fertility.

Once all of my thinking was finished, they went ahead and started the sedation. It worked FAST. I kind of felt weird for a minute, and then felt super tired. They got my legs up in the stirrups and turned the lights down, and then C said goodbye to me as it was time for him to give his sample. Turns out he missed the whole thing; they sucked out all the eggs and did some painful poking on something up in there (I can't remember what they were doing and I wasn't quite with it enough to say anything) and then got me out of the stirrups and I was lying there recovering when he got back. He was there, though, when the lab tech stuck his head through the door and said "We got THIRTY TWO eggs!" Holy cow. The doc said transfer would most likely be Sunday or Monday.

So I lied there for I don't know how long; maybe fifteen minutes, and then they started gradually sitting me up to see how well I was recovering. I was OK until I stood up and was helped back into my pants, and then I got super dizzy and sweaty and I told them I was going to have to lie back down. (I'm not surprised; even when I give blood I tend to need several extra minutes to lie there before I can get up.) So back down I went, and C stroked my arm and face for awhile. They had taken all of the heart monitor things off of me so they put the cuff back on and checked to make sure my blood pressure was OK. It was; and I slowly sat up again and this time was able to stand up and get over to a wheelchair. While I was upright, the nurse drew big rectangles on my butt so C knows where to put the progesterone.

The nurse wheeled me downstairs to the pharmacy, who had not checked their messages yet from earlier in the morning so they weren't ready for me. So C wheeled me out to the car where I called Mom to let her know I was doing well, albeit groggy. C came back to the car twice; once to give me a bottle of water and a scone, and once with the pain meds (acetaminophen and hydrocodone) and to drive me home. I slept for an hour in the car, and another hour once I got home, and now I'm taking it easy for the rest of the day.

Pre-Retrieval Jitters

Been a little jittery today, with retrieval thoughts in the back of my head, behind all of my work projects and underneath all the conversations in my meetings. It was mostly present in my feeling nauseated most of the day, just a little bit, like I had a migraine but without the headache. I ended up taking my lunch break in the car with a towel over my face and the windows down, and slept for awhile. That helped. I was worried a bit about OHSS but it's too early for that.

While I was bored yesterday, I counted: 46 needles have been in my belly and in my arm for one reason or another since we started IVF.

Tonight is the dreaded (but only by my husband) enema, in preparation for surgery. Seriously, he is more freaked out by it than giving me shots and can't even be in the same room while I do it. I have no idea why. It's like the least of my worries. We're all stocked up on Gatorade (to replenish electrolytes) and food, and I vacuumed, and will prepare the couch to receive me post-procedure. The only thing we didn't do was get my pain medications, which the RE was supposed to have called down to my pharmacy but my pharmacy had no record of it as of an hour ago. So we'll ask the RE when we get up there tomorrow; maybe they can redirect it to the pharmacy at the hospital instead. I kind of want those meds.

Stims Check #4: Last one!

C accompanied me to my final blood test and ultrasound today. The doc was happy to explain to him what we were seeing on the screen: softball-sized ovaries with lots of big ol' follicles inside. It took him about three seconds to decide that it was time to ovulate! So the nurse scheduled the retrieval for 7am on Tuesday and told us to trigger tonight at 7:30.

I'm so glad that it feels like it's happening so fast. Part of me is nervous, but the rest of me is happy to be moving forward.

Stims Check #3 - almost there!

Had my third check today. The nurse who took my blood put the tourniquet on way too tight so it hurt more than the needle, which hurt more than usual because with the too-tight tourniquet my arm was more sensitive. Then she had issues getting the bandage on (it popped off the first time she tried), and put that on too tight too, saying "well, that's not the prettiest job I've done..."

Then I had my ultrasound. My ovaries are now 1.5" across now, which makes sense considering they feel like golf balls. My lining is getting thicker, which is kind of fun to see, and the follicles are all close to 16-17mm. The doctor said they were super close but he wanted one more check tomorrow, just to be sure. He tentatively scheduled the retrieval for Tuesday - coming up quick! It'll be nice to stop the stims. There is bloating, and I'm pretty sure I now know why they prescribed an enema for the night before. (I Googled it just now, though, and people don't really complain about it until they start taking progesterone, so I don't know what's going on.) I don't really want to ever button my pants again, basically. For the sake of my coworkers, I'll be happy when this part is done. :)

Stims Check #2

Raced up to the clinic (it's about 75 miles away) for my second estradiol test and ultrasound this morning. Same on-call doctor, different resident, and I got the big room, which was nice. The resident looked like he was from Israel or someplace similar; and again I hung out for awhile after the follicles were measured so that the doc could show the resident around my organs.

So my follicles are now about 10-12mm, and my estradiol was 1097 (big jump!) so now I'm backing off on the Menopur; only doing 1 powder vial instead of 2. And I can tell things are going on in there; sometimes I feel like I have golf balls for ovaries and sometimes I just feel kind of full. Not super uncomfortable though. And I'm not moody at all (I don't think; maybe I should ask C!) which I'm happy about - the birth control made me moodier than the stims!

Afterwards, my friend E and her daughter L were kind enough to meet me downstairs and we chatted and played in the grass and the water fountain and the dirt for an hour. E has been my go-to girl online when I want to talk about this IF thing, and she's been so supportive; it's great being able to visit in person once in awhile. And her toddler is super cute too.

So back I go on Saturday! I'm looking forward to it; since I don't have to rush back down to go to work straight away. I'll stick around in the city for a few hours first.

Stims Check #1

After dropping C off at work, I ran up to get my estradiol tested. I was early, and was able to get into the blood test chair ten minutes before my appointment, which was good - I was hoping to get back to work to catch the tail end of a teleconference. But then the nurse asked me if I needed to use the restroom before the (transvaginal) ultrasound. Surprise!

I stripped down and wrapped the sheet around me and sat on the table... and sat... and sat for just over half an hour until the on-call doctor made it in with a resident and a nurse in tow. The nurse went to her place at the computer behind my head, and the doctor got started, but when he started measuring my uterus the nurse said "I've got computer problems, hold on a minute." So I got to lie there with the ultrasound wand for a couple of minutes while the nurse tinkered, and then we continued. It didn't take long; he measured several follicles (he wasn't even that interested in being accurate with a count because it's early yet, but there were at least 8 on one side and closer to 12 on the other I think, and they were all 6-8mm across) and measured a couple of fibroids (one of them he was a little concerned about interfering with the uterus so he was going to review my chart but I'm not too concerned because my doc wasn't concerned when he saw them last time). And then he spent another couple of minutes panning around my organs for the resident. I was glad I had put too much time on the meter!

This afternoon they called and said my estradiol was at 346, which was too high for a day 4 level, so they're having me back off on the Follistim by 50 units and they'll see me again on Thursday.

...and I missed the teleconference. :)

I'm dead inside!

Went to the doc this morning for my suppression check. The nurse took blood for an estradiol test and then the doctor did a quick transvaginal ultrasound to look at my ovaries and uterine lining. He also measured three or four fibroids but said that they didn't look like they'd be in the way of anything. He took snapshots of my ovaries, apparently, though I didn't see a thing on the screen, and then they sent me on my way. I met C out in the waiting room, who had been in the other room giving a backup sample to be frozen, just in case the one he'll be giving on retrieval day doesn't cut it.

The nurse called at about 4 to tell me my estradiol was at 28.2 and my ovaries looked good, so we can start the Follistim and Menopur tomorrow! I go back up on Tuesday for a quick hormone check.

Last night we used the last syringe that was in the Lupron kit, so tonight we had to use a different style. Not sure why, but it hurt a lot more than the kit needles. Guess I'd better get used to it; I hear the stims are pretty sting-y.

Birth Control: Done!

Yesterday was the last day of birth control. It feels good to be clearing hurdles!

The Knife and the Needle

The Knife

Last Tuesday night, I rolled over in bed and felt a weird pain down by my left ovary. I continued to feel it throughout the night; it would wake me up any time I used my lower abdominal muscles. I woke up a little worried that I couldn't tell the difference between wonky ovaries and pulling a muscle in that area.

The next night I felt it again but to a much lesser degree, and I slept through the night.

Thursday night I let the dog up on the bed, and as I shifted my weight next to him I got knifed in the right side of my groin. That's what it felt like, anyway. I yelped and ordered the dog off the bed, and stood up and leaned over the bed. C was so worried about me going into the IVF process with a problem that he told me he would stop talking to me if I didn't call the doctor the next morning.

On Friday morning the pain had diminished but I could still feel like something was a little off. As I was getting ready to go, I talked to C about why I didn't want to call the doctor. He'd either say it was nothing, or that I'd have to put off the IVF for another month. And that was about the last thing I wanted to do. I went without my breakfast and coffee, I was so upset.

And then, as I was putting on my shoes, I sneezed. Oh, man. Again, the knife. It was enough for me to decide to call and leave a message for the nurse when the RE clinic opened.

I got a phone call back pretty quickly, which was surprising considering how long it took last time. It was the nurse who had taught C and I how to administer my shots. After sharing a few details about what I was doing when it happened and how it felt the next morning, she concluded that it was most likely a muscular thing and that I should just wait and see if it went away on its own. And it largely has. After the first day of avoiding sneezes (at one point I drew in my breath to let one fly and at the top of the breath I remembered the knife - and that urge to sneeze disappeared quick!) it hurt less and less, and now it's just a dull, slight pain that I catch when I sneeze or throw my leg over my bike or something like that. What a fun little scare to start off my active IVF cycle!

The Needle

Saturday was our first Lupron injection! I thought about it all day and got more and more nervous as the afternoon wore on, mostly because I knew C was nervous too. (I don't really have a complex about needles; but being at the receiving end of one who's powered by a nervous first-timer was nerve-wracking.) I even bought myself a bottle of Beringer Cabernet Sauvignon just in case. I'd read the Stirrup Queens' Guide to Sub-Cue Injections a couple of times, and while C was drawing up the Lupron I started painting a spot next to my belly button with an ice cube. He went through two needles and several minutes, trying to get all the air bubbles out of the syringe, and once we were both satisfied I leaned back on a chair and he went to it. And it was fine, he did great! I felt a little poke (the same as when nurses do it) and the site was a little uncomfortable immediately afterwards (I think because of the medication) but it was fine! And then we were both so happy that we did it afterwards that we hugged and kissed and all my nervous energy let itself go and I felt really weird. I think I was just proud of us and all the day's nervousness was evaporating through my head or something.

So we did it once, and tonight we did it again, and it was fine! I was still nervous though, and C has learned to loosen his grip on my belly as he injects the Lupron and pull the needle out a little bit slower because when he kept squeezing me and he popped the needle out some of the Lupron beaded on my skin. Oops. I also made a pretty little rice pack for the stimulating injections that will happen in a few weeks. Never hurts to be prepared.

I'm still nervous about the intramuscular progesterone-in-oil, but that is fodder for another day, when it's actually staring me in the face.

Protocol!

Today C and I went up to learn how to do shots, and get the medication! I feel weird now, like a weight was lifted (in that now I know when and how everything is happening), and like another one has settled down (in that now I have to actually DO this stuff, not just talk about it happening someday).

The nurse was a cute, very Portlandy-looking lady with an eastern European accent. She sat us down in front of a table littered with little vials and syringes and round skin-colored lumps, and C practiced drawing liquid out of the vials and sticking it into the round lumps. It kind of reminded me of CPR class, with the victim stand-ins.

Then we went downstairs and sat for about an hour waiting for the meds to be gathered together in the pharmacy. They gave us a little pager a la restaurants-with-a-long-wait, and I crocheted and C used the wifi for a bit.

When the pager flashed at us, we went back to the pharmacy, dropped $3045, and came away with a cooler and a grocery-sized paper bag full of medications.



So here's the protocol:

Continue taking birth control until 8/13.
On 8/6 (this Saturday), start taking Lupron daily.
Go up to the RE for an ultrasound and estradiol test on 8/19, and wait for a phone call that says all is well. (If it's not, they'll rewrite my protocol.)
If all is well, decrease Lupron by half and begin Follistim in the morning and Menopur in the evening.
Go to the RE for a blood test on 8/23 and then again every 1-3 days while they check my hormone levels.
Retrieval between 8/28 and 9/2 (enema the night before, and of course trigger shot 36 hours before)
2 days after retrieval, take progesterone in oil daily until a positive pregnancy test and weekly for several weeks after that
Transfer 3-6 days after retrieval

Bada bing, bada boom. Hopefully. For now, we're squarely in the hopeful and happy phase.

Rawr.

The clinic just called. "We got your fax for your husband's blood draw results and we noticed that he didn't get an RPR done [for syphillus]! If he can get it done before Thursday we can go ahead with the procedure even though we're technically not supposed to without the results..."

So my local lab is supposed to be calling me back. They'd better be quick. (They also forgot to check his cholesterol levels when they tested him last time, so I guess I'm not surprised that they missed the syphillus screen too.) Thanks, clinic, for being so quick to look at my fax and call me back! (It was only a week!)

Update: Crisis averted. C was able to get a hold of the local clinic after they should have been closed and he's got his blood test tomorrow morning. We'll likely have the results by our Thursday RE appointment if they hurry up!

CD1!

My body enjoyed teasing me for the past three days, spotting ever so slightly and then stopping. But my temp dropped yesterday and then again today, just in time to go away to work the renaissance faire all weekend. Yay for navigating port-a-potties in giant skirts AND having to deal with a period. However, I am assuming(/hoping) it'll be the last one I have for a year so I'm trying to be nice to it.

So, for now, the plan is to fax some paperwork in to the doc on Monday, have C pick birth control up for me tomorrow while I'm at the faire and I'll start taking it on Sunday when I get home, for 12-21 days. And on the 4th I have an appointment with the nurses to go over my protocol and learn how to give myself injections and figure out where and when and how everything is going to happen.

I'm excited, but this really feels more like another step in the hurry-up-and-wait process and so I'm being very conscious not to let it be the main focus of my life. That makes it way easier to wait.

19

Today was trial transfer day. C was busy at work so he couldn't come, which was OK because I'd read the procedure wasn't that big of a deal. (My grandma came, though, to keep me company in the car and so she could be a part of the process, which was nice!)

The doctor (mine was on call, which was nice) inserted a catheter through my cervix and measured my uterus, and then he inserted an ultrasound wand as well and his assistant injected saline into my uterus while he looked at the ultrasound. He counted about a half dozen fibroids and measured them; but he said they were far enough away from the uterus that they shouldn't pose a problem for implantation. I have no idea how he could see them; I had a hard time seeing what he was looking at and I wondered why that black spot was a fibroid when this other black spot wasn't.

He also counted my follicles: 7 on one side and 12 on the other. I found a table of follicle counts and their IVF success; it looks like my 19 is a pretty good score!

It was over in 10 minutes, and then we talked briefly about the future. The doc asked if I had done all of my other screening, and I told him I'd brought the results the last time I was there; so he planned to start putting together my protocol. I didn't think quickly enough to ask when that would be ready, but I know it'll be in the next three weeks and I suppose it's OK not to know exactly when to expect their call.

Now I cross my fingers that this stuff doesn't get in the way of the renaissance faire I'm performing at next month!

FSH and Estradiol

A few weeks ago, I realized that a long-planned camping trip with my two best friends might be cut short by needing to get my CD3 blood draw for FSH and estradiol tests (measuring follicle stimulating hormone and sex hormone levels), and then the vitamin D was wreaking havoc so I thought maybe it'd come after camping was over. But of course last Thursday night, the night before we left, there it was. Luckily that meant that we only had to leave early on Sunday instead of late morning. So we had a good trip, and woke up early yesterday to tear down camp and run up to Portland for the test.

While the nurse (Annabel - she made sure to introduce herself to me and I realized later it was because I'd most likely be seeing a lot of her in the next two months) was labeling my blood vial, a woman poked her head around the corner and whispered "Annabel! I'm so sorry, but I'm going to explode!" Annabel went off with her to the bathroom and I could hear her telling the patient that she could only pee this much; and then she came back and smiled at me and said "that's going to be you soon!" Heh.

So the blood draw was over quickly, and then on Thursday I go back up for my trial transfer. I sort of know what to expect, but like any procedure you read about on the internet, reactions and pain levels go from zero to horrible. I'm aiming for zero. After all, C can't make it on Thursday so I'm gonna do it by myself! It mostly involves a trans-vaginal ultrasound, counting follicles, measuring the uterus and filling it with saline. Gonna be a spendy visit though; I thought for some reason that it was covered in my financing plan but it's not. And of course it's the last day before I get paid. So I'll be cashing in those savings bonds on Wednesday at the latest so I can be ready!

We also looked into Aflac today, for short term disability (helping pay for maternity leave) and another plan that helps pay for the delivery (insurance covers a lot of it but not all of it). It would definitely pay for itself by the time I'm done using it, but another $100/month is an awful lot when we're still paying off the car and about to start paying off the IVF loan, on top of all of our other monthly expenses. We'll make it through but ack.

Waiting already? But I haven't even started!

When my doctor sent my six vials of blood to the lab, he had them do a full workup, which included cholesterol and glucose and all that stuff, just for funsies. The day after I gave the blood, his assistant called and said "you have a Vitamin D deficiency, so the doctor put in a prescription at your pharmacy for some D." So off I went to the pharmacy, and picked me up a bottle of dark green pills, with 50,000 units of vitamin D in each one. Whoa. Guess I was pretty deficient.

Anyway, I took them twice a week like a good patient, and I got back into temping every day so I could gauge when it would be about time to call the fertility clinic to get my HSG/Estradiol test done. We also tried baby-making the old-fashioned way just for kicks, right around the time I usually ovulate. Except my temp didn't jump on CD17 like usual. It waited aaaaalll the way until CD23. I'm only 8 DPO now, but I'm already to CD31 which is a couple of days longer than my average cycle. I'm assuming it's the D, but I'm not completely sure. (I s'pose it could be stress from waiting for the dang cycle to be over so I can get the show on the road - how meta.) At any rate, I hope the RE doesn't judge all my cycles on this one. And I hope I get back to normal after I'm done with the D (supposed to be next month). And I hope it doesn't take too much longer for my cycle to end so I can get going on the procedures!

A Sign?

I like making signs out of things that probably aren't signs. Like, when things come together I say "oh yes, that's because this is supposed to be happening!" Of course, when they don't come together I just pout and don't usually say "oh yes, that's because this is NOT supposed to be happening!" I am such an optimist.

Anyway, when I called to get financing for the IVF, the account manager asked if I wanted to also finance the medications. I said no, because I was flustered and wasn't ready to commit. (I actually first said "can I think about it and add it later?" and the answer was no. So I said no.) After I got off the phone, I had a nagging feeling that I probably should have financed the meds, since they were going to be about $3100. I didn't want to have to try to foot that from our savings; we probably would be able to but I wasn't sure.

Then I remembered that my dad had given my sister and me about 50 savings bonds over the course of 14 years. I dug them out and did the online calculator, and the bonds that had met or exceeded their face value as of today are almost exactly $3100.

It's a sign! :D

Signing the Contract

Even though we were approved last Friday, it took us until today to finally sign the contract for financing. Yesterday I was on the phone with Mom and during our chat she said "if you do have twins, you won't be able to work! All your money would go to daycare!" and the more I thought about that the more the snowball rolled down the hill and the more bills and payments and worries grabbed on until I got clobbered with it. I had a rough afternoon, panicking about the next three years. Then last night and today C and I (separately and together) made peace (well, as much as we could) with adding another $330 monthly bill to our finances.

So I think that the hard decisions are through for this cycle, and now it's just the physical stuff I have to work through. My FSH and estradiol test will be coming up in about 2 weeks. Scary, but exciting.

Success!

We have financing!

$$$

Today, I called ARC, the company that my doctor recommended we go with for IVF financing. (The financial counselor recommended we wait until after we started our FSH, which went into effect yesterday.) And it tried to ruin my morning!

I'd called mostly expecting to get more information about my options, and figured that the questions the lady was asking me were mostly just to get me into her system, but about halfway through I realized she was filling out the credit application for me. She was pretty brusque, not really answering my questions very well and not sounding happy to be working at all. At one point she asked if I wanted my medication to be financed as well, and when I asked her if I could think about it and add it later she said "no, it needs to be on this application now; I have to send it right now." Then she asked for my annual gross salary and C's. Of course, C was out sick, and the HR manager was in an off-site meeting, so I apologized, put her on mute, and frantically tried calling C and trying to figure out how else to get that information. After a few minutes of checking in here and there with the lady and apologizing again, she asked if I wanted to call her back with it (uh, yeah, that's why I asked if I could!)

C had been asleep, which is why he didn't answer his phone, and when he woke up and called me back awhile later I was all flustered, and he was groggy and not feeling well and didn't really welcome my request to IMMEDIATELY GET ME INCOME INFORMATION, so we ended our phone conversation about as brusquely as the lady at ARC did with me.

But then I called back and talked to another lady and she was all sweetness and cheerfulness and made me feel much better. She offered to email me the form (why didn't the other lady do that?!) since apparently those forms can't be saved partway through the process, and now I'm sitting at home with signed applications ready to scan and email them back.

Too much excitement for one loan application, I say.

Oh, also, I got my bloodwork results back from last week's dribbling-into-the-vial visit. Everything looks fine except for Vitamin D, which I got a HUGE prescription for (50,000 IU per pill, to take twice a week!), but no STDs and all up to date on immunities. So that is good!

6 Vials

At our consultation, the RE confirmed what we thought - ICSI. He even told us that IUI, while cheaper, wouldn't be worth it to try before the ICSI. So we talked to the nurse about what to do and when, and we talked to the financial counselor about how much to pay, and I reminded myself all the while that even though I could start with my next cycle in two weeks, I didn't have to be so quick and it would be silly to impose a meaningless deadline on myself.

Turns out I don't listen to myself very well.

Last week, with the end of my cycle looming, I laid awake trying to figure out how I was going to get all of my ducks in a row before my next cycle. I furiously wrote notes and tried to come to terms with adjusting my spending habits and eating habits all in a week. And the deadline I told myself not to set was coming up, and I was so worried about missing it. I cried to C that I was nervous about missing the deadline even as I was annoyed at myself for setting it in the first place. It felt good to articulate what the problem was.

So then I slowed down, and filled out my Flexible Spending Plan application, and scheduled a day for myself to call Arc (a fertility financing company), and just let my next cycle come. And it felt much better, doing things at a normal pace and not stressing about making imaginary deadlines. This morning I called my primary doc about getting a prescription refill for blood pressure medication and was able to get in this afternoon. While I was with him I showed him my checklist of blood tests I needed pre-IVF, and he got the phlebotomist in right away and she took six vials of blood. We chatted while she did her thing, and I commented on how odd it sounded for my blood to hit the side of the vial - it sounded like dribbling.

Today is CD4, which means I have just under a month until we're starting this for real. And I feel good about it - the only time I really freaked out was the night before I filled out the FSA application. (The whole "use it or lose it" thing got me; it almost felt as big as the day we decided to start trying to conceive, long ago, only bigger since a decision like that doesn't usually cost $12,000.) Now I really feel ready!

Consultations, DI Ramblings

I called Oregon Health Sciences University, and Oregon Reproductive Medicine, last week to schedule consultations. Tomorrow at 9am is OHSU. I'm half hoping that I like OHSU well enough that I don't feel like I have to spend $350 just to talk to the doc at ORM. But we shall see.

C and I talked last night at length about donor insemination, and the pros and cons of that particular procedure. I think we basically came to the decision that we don't want to go that route unless there's no way I can get pregnant with C. It is so much cheaper to go the donor route, and that is very attractive to us right now; but we really want this baby to be a part of us both, enough that it's worth the extra money.

I hurriedly filled out the OHSU paperwork that assumes we're going to the doctor because *I* have a problem and not C, and scribbled some questions down from here. More tomorrow.

Palm Reading

So, I'm not a big believer of palm reading or anything like that, but I thought it'd be fun to go to one while I was in New Orleans for a business trip a couple of weeks ago. (The conference that I was working had a social one evening at Mardi Gras World; it included an amazing group of drummers, palm and tarot card readers, a couple of bands, and even fireworks.) I figured since it was free, I might as well try it, since if I ever had to pay for it I'd probably never do it.

After standing in line for an hour and a half or so...

The reader sat me down and hovered her hands over my palms, stroking the air, and asked "do you have any questions for me?"

"Tell me about babies!"
"Oh! You want them? When do you want them?"
"Oh, a year ago or so, heh."
"...Well, you don't have any barriers, you should be fine."
"That's true - it's not me, it's my husband."
"Ah, yes! So what are you doing about it so far?"
"We think that IVF is probably our only option..."
"I see that being successful once; but I see you having a few babies; it looks like all your husband really needs is a little help and then he'll be fine. And then you can have a whole baseball team if you want."

She also found ovals on my palms, which I guess represent something incredibly emotionally stressful and difficult that I've been protecting myself from; and that it happened a long time ago because I had the ovals on both hands. She told me that I'm very fertile (based on the striations of the crease between my pinkie and my hand) and that I'm frustrated about something in my marriage (based on a crease between my first and middle fingers of my right hand). She attributed that to the infertility too.

The rest of the night was kind of melancholy; just talking about it with a stranger felt kind of weird and sad, and renewed my disappointment that I was hundreds of miles from my husband during that cycle's fertile time. And though I still don't really believe that palm reading is truth, it was still worth my hour and a half wait just for the experience.

The Next Step

C completed his three months of Clomid, and on Friday he submitted another sample. The changes were negligible.

Today he had an appointment with his urologist, who shared the results and said "everything looks good except for motility." That was good news; I'd thought that the count and the morphology were crappy as well. So yay for that I guess.

C said that the urologist gave us the go-ahead to search out our own RE; he suggested OHSU and said that we don't need any referrals. I have a couple of options; I just need to do a bit more research. The urologist also said we might want to try artificial insemination first if we're worried about the cost of IVF; I'm not sure that'd be worth it if the sperm can't move but we'll see what the RE suggests.

We had small tentative conversations last night and today about the money issue, too. We took a hit this year in our taxes, and having a larger rent payment than the last place and having a car payment and that kind of thing is making C a bit worried that we're not going to be able to easily pay down another ten thousand dollar chunk of debt (that's more than half of our car). I worry about having the conversation "for real;" I'm always afraid in the back of my mind that he is going to decide it's not worth it to pay that much money just for the chance to get pregnant.

So in the meantime, I'll take another look at our RE options in Portland, and then once we visit them we can see if they can allay the fears about cost. I have confidence that ICSI will work, since as far as anyone can tell I have no fertility problems. But even though I feel good about moving onto the next step, actually being pregnant still feels so far off...

31

It was my birthday today. 31 is a little boring, especially on a busy Tuesday, but I enjoyed it anyway.

Month 1 of 3 for C's Clomid is about done. Patience is a virtue.

It was only a little bit hard today, reflecting on how fast my clock seems to be ticking. I feel worse for C, who will be 37 this year. I wished a few times today that we'd started trying earlier so we could have a lot of this behind us and not be looking forward to being "older parents", but of course hindsight is 20:20 and all that.

We Have a Diagnosis.

Well, sort of.

The urologist called C back last week, about his test results. "The blood tests came back fine - your testosterone levels are fine, etc. Your semen analysis, however, looks the same as the last one so we know it wasn't a fluke. However, I have no idea why you're having issues."

So the diagnosis is Unexplained Fertility, I guess. The urologist put him on Clomid, but with the caveat that it doesn't have a very good success rate. Besides the Clomid, he doesn't know what to prescribe.

So for three months while the Clomid tries to work, we will see if we can find a reproductive endocrinologist or a urologist with a background in fertility - and someone who is in our network - as this doctor isn't sure what else to do for C.

Urologist Debrief

The urologist visit was pretty straightforward. Urine test, quick physical exam for varicocele (varicose veins in the scrotum that can hinder fertility - C doesn't have them), and an order for another semen analysis and some blood work. I tell ya, it's rather odd to watch your husband making silly faces at you when he's getting squeezed on an exam table.

The urologist said that C's analysis was actually kind of unusual in that the count was OK but the motility and morphology were low. It's too early to tell what might be wrong but C will drop off his sample on Monday and we will get results soon after that.

So it's a step forward, which is encouraging, but if they're just going to treat C it'll still be a few months after they start that before we can expect to see any results. Patience is my new mantra.

Tomorrow

C sees the urologist tomorrow morning. I'm going with him, partly for support and partly because I know the time between his appointment and the time he calls me will seem like eons.

I've spent a little bit of time surfing around trying to figure out what to expect and what to ask. I'm assuming besides a physical exam & a lot of questions they'll probably ask for another sample and hopefully some bloodwork too. Surfing has made me feel better (I was nervous about the appointment earlier today), but I fear it's made C worse - he's not sure he can sleep now that I've talked to him about what to expect. Sorry, C.

Feelers

I'm spending part of the day (the part that I'm not crocheting) looking for people on the interweb that are in the same boat as me. So far, every male factor-related blog I've looked at is written by a relatively new parent. It's a weird feeling; I'm super happy that so many MF bloggers have babies since that means I have a good chance too, but I can't find anyone to keep up with who's not yet pregnant!

#

Sperm Motility: 2% (normal: 50-100)
Activity: Immotile
Directional: 0%
Volume: 2.3 mL (normal: 2.5-5 mL)
Count/ml: 20.5 million/mL (normal: 20-100 million)
Total count: 47.2 million (normal: 60-300 million)
Normal Morphology: 1%

Numbers

My doctor called me yesterday morning during work to follow up on the lab work from December 22nd. She reiterated what the nurse had told me about my levels; she said she'd like to see my progesterone at a 10 but my blood was taken a day or two earlier in my luteal phase than we'd planned so she wasn't especially worried.

Then I asked about C, even though I kind of half thought that she wouldn't be able to tell me any details, but she wasn't nearly as closed-lipped as the nurse last week. "It isn't good," she said. "Normal sperm count is 20-100 million, he is at 20.5 million. There was no motility, it was immotile. And the morphology was 1%." She went on to say that the issues could always be due to illness, and that he'd get tested again, etc.

I called Mom and cried. All my what-ifs and it's-not-fairs came flying at me at the same time, and I had to hide on the patio so none of my coworkers would stumble across me. I felt better after the news had a chance to sink in; I'm relatively quick to buck up but apparently I have to let go of it first.

C has an appointment with the urologist a week from today. Hopefully the options are easier, less invasive and cheaper than I think they're going to be. We can rise to meet whatever comes, but because I like to over-think I get worried when I don't know what our options are. Now to keep myself distracted for a week.

I called the doctor's office a few days ago to schedule a yearly and also see if I could get the results of the labwork that was done a few days before Christmas. The appointment-scheduler transferred me to a nurse, who sounded like she'd had a long day, and she said "your thyroid and MMR are fine, your progesterone is 8.78, and your prolactin is 18.4. We usually like to see prolactin between 3 and 18.6." She said she wouldn't release the results of C's lab to anyone but him, so I had him call.

C's results were low count and low motility. Nice double-whammy.

So we at least feel as though we're on the trailhead, rather than wandering around trying to find it like we've been doing for the past year. A urologist is going to be calling C sometime in the next week to talk about his options. I don't know any details yet in his case; it may be that they're just slightly low, or it may be that they're very low, so I'm not worried quite yet. But there's a possibility that we may have a very hard time getting pregnant even with help. I'll cross that bridge when we come to it, though. Or I'll try, anyway.