Viability

I hit 24 weeks and official viability this past Sunday.  It was appropriately the day after Munchkin's 6th birthday, and the day of her party, so for reasons other than pregnancy obsession, a countdown to this date has been on my radar for at least a month now.

Interestingly, the lead-in to the weekend was rough.  For me, sitting on the cusp of viability was uncomfortable.  I can't describe it any other way.  There was some anxiety over what I considered to be a short-ish cervix as measured during my followup anatomy scan a few week ago (btw, baby was fine, as was her head size.  I just don't grow large babies, or large-headed ones for that matter).  And then there was just a fear that something bad would happen before this mythically magical date.  I don't think that my husband has felt at ease at all about this pregnancy, so his signs of concern throw me off.  For me I think I read too many PPROM stories recently because all of a sudden, my mind went crazy: "Is that an unusual amount of discharge? Could that be my mucus plug?  Is that blood?  No, really, is that blood?  Could that be a contraction?  Hmm, maybe that was a contraction.  Should I continue on my run?  No, I should stop and walk.  But I like running.  But will I regret it if I keep running?  Okay, fine, cut the run short and finish by walking."  Blah blah blah.

It was rather unpleasant.  And I annoyed myself.  I like to stay level headed and not get too emotionally charged around these sorts of things, so I was just driving myself crazy, but once I got started, it was hard to stop.  Go figure.

Thankfully that all has passed and I am able to focus on other, more important things.  And my body seems to be back to normal.  The baby is appropriately active, I can tell that I'm not having contractions, running is fine again, and I have found something else to be stressed about (some things never change).  :)

BTW, thanks for the advice on the pants.  I spread a wide net and did some mall shopping in addition to online shopping ,and bought from a number of places, but in the end I liked the yoga pants from Kohl's the best (and their B.lack Friday prices were great), so everything else got sent back.

Okay, off to bed.  I am fighting a cold that descended on me as soon as the crazy weekend was over.  I would like to beat it asap so that I can enjoy the holiday break with as much energy as possible!

20 Weeks

Time has been marching along.  Sorry I haven't posted, but I really haven't had much to say.  This has always been an infertility blog for me, so posting pregnancy related news, or non-news, seems foreign.

Since I hit 20 weeks, I thought I would post an update for anyone who still follows along.  I had thought about a 12 week, 14 week, 16 week and 18 week update, but I guess they just never happened.

Things have been relatively uneventful.  When I wrote a few months ago, I had just completed a mild bleeding episode.  And that was the last of the blood.  For the most part, my toilet paper inspections have yielded nothing out of the ordinary.

In early October my kids came down with slapc.heek, also called Fif.th's Disease.  It's a common virus among children where their cheeks look bright bright red and my kids also got rashes on their arms and legs.  For those of you who have dogs, it's also parvovirus (I thought, "great, my kids caught a virus that I vaccinate my dog against!").  Anyway, apparently this virus is cause for concern if you're pregnant because it can impact something relating to blood with the baby, potentially requiring a blood transfusion to the fetus.  Sounds scary, but didn't seem to be that big a deal because it's common to get when you're a kid and then you're immune.  My first blood test indicated that I have never been exposed, so I had a follow up test a few weeks ago which also showed that I hadn't been exposed.  Thank goodness.  I believe my OB's words were, "I've never had a patient with this condition, and I don't want you to be the first."  No kidding.

Running is still great.  I usually run 3 1/2 to 4 miles a day, 5-7 days a week, and when I have more time or rest, I'll go 5 or 6, but it's not that often because I can get pretty tired later in the day.  I don't know how long I will be able to keep this up for, so I will enjoy it while I can.  All my pregnancies have been at different times of the year (December, August, and now April due dates), and I've never been visibly pregnant and running during the cold season, so I don't have any running pants.  I've tried some yoga pants, but haven't found anything good.  For now my normal running pants are very old and stretched out, so I can still wear them and not care if I ruin them, but my Nike capris (with nice wide waist bands) are getting rather tight.  And I'm too cheap to go spend a bunch of money on something I may only wear for two months.  Must find cheap yoga pants that can double as running pants while I can still run, or lounge/walking pants when I'm done.  Please pass on any advice.  :)

Lastly, I had my anatomy scan this morning.  The baby was confirmed to be a girl, which is cool but scary (OMG, 3 girls!), but then again, I would be scared with a boy too (they're so squirty!).  At my NT scan in September, the doctor got a good shot and predicted girl (70% certainty), so it wasn't a surprise, but it was nice to be confirmed.

The baby's head is measuring small - maybe by about a week, so still within the normal range - but I need to go back in a couple of weeks to make sure that she just has a small head and doesn't have any developmental issues.  This pregnancy is keeping me on my toes.  I am trying to locate my ultrasound reports from my other children to see where they measured, but I guess the best thing to do is just wait and see.  The doctor didn't seem concerned, but just wanted to confirm.

Anyway, that's about it for now.  I do want to write at some point about the commercialization of infertility clinics.  One clinic has a lot of commercials on the news station that I list to, and I thought, "well, of course, they are a private clinic", but then one morning I turned on the TV to check on the status of a local transit strike and saw that my clinic (which is affiliated with the local university) was sponsoring the news ticker!  I guess there's a lot of competition for patients, especially when insurance isn't involved, but it just surprised me since I always considered my time at the clinic to be very private, personal and confidential (not that advertising made any difference in the way they treat you).

Work is beckoning, so I will sign off.  I hope all is well with everyone.  I do still read, but don't comment as often.  That's mostly due to the fact that I've had to increase my sleep!

And then it stopped...for now

It's one day at a time over here...again!  The bleeding episode ended as quickly as it started and I am very thankful for that.  I took it easy and only went for a walk Wednesday and Thursday, and resumed running yesterday and today.  So far there have been no ill effects.

However, I have to say that the bleeding has definitely put us on edge.  I will be 11 weeks tomorrow and I have only told two people: one friend who called a couple of weeks ago and asked whether we were still considering another child (crazily, I told the WHOLE story.  It's so unlike me, but then again, she's a friend that I've known since first grade, so if there's anyone I can trust, it's someone I've known for 34 years.).  The second person was a designer who came in the other day to give us some ideas on our house.  We currently are poorly set up for a family of 5, so I thought it was important that he know why our goals are what they are.

I have an appointment with my OB a week from Monday, so maybe I'll feel more comfortable then, or perhaps I will wait until the end of that week when I have my NT scan.  I wish I could tell my parents, but it's just not time.  For now, I will continue to suck in my stomach whenever I see them.

I just can't get over the idea that it's entirely possible that the baby has died, but my body hasn't realized it yet.  So for now, I stay quiet, hope for the best, and try to hold off on moving up my appointment for next Monday!

Updates

I have been meaning to update for quite some time now, but I find myself needing more sleep and falling asleep before I have the chance to turn my computer back on.

Anyway, I had my two 8 week appointments almost two weeks ago.  They were both good.  The embryo and the sac both measured on track and the heartbeat looked good.  At my new OB appointment, my OB did notice a sub-chorionic hematoma and said that I might have some bleeding.

True to her word, I started having some bleeding if you could call it that.  I don't even know how to describe it other than a slow leak, maybe?  It went away last Wednesday, which was a relief, but it returned for real tonight.  I don't have any cramping, so we'll see what happens.  I just hope it's the SCH doing it's thing.  We'll see what happens, but for now I think exercise is off limits for two weeks.  Not having that stress relief may be the hardest part....

My OB also ordered all sorts of tests.  I am in the middle of a 24 hour urine sample (yes, it's as gross at it sounds) and I have to do a one hour glucose screening asap (yes, it's early for this!) in addition to the standard first trimester bloodwork.  I think she's looking to gather baseline information in case things start to change later in the pregnancy.

I need to turn in my jug-o-pee tomorrow at the lab which is in the same suite as her office, so I might try to see if she can sneak me in for a quick ultrasound or doppler check (can you locate a heartbeat via doppler at 10 1/2 weeks?

Before I got my little surprise a little while ago, I was expecting this update to be a whole lot of nothing.  I hope it turns out that this bleeding episode really is a whole lot of nothing.

All Cleared Up

Sorry for the radio silence....  The spotting that I had right after my 6 week ultrasound cleared up within a day.  I never called the clinic because I didn't think that a day of spotting was something that I would want to go in for.  The other option for advice would have been to wait and see...something I was planning on doing already.

So here I am today assuming that I am 8 weeks pregnant.  It was right around this point in my last pregnancy that my embryo died.  Thankfully, I have a fair number of symptoms that are lobbying for me to be convinced that this pregnancy is progressing normally.  But still...I've been thinking about it a lot, especially since I had been convinced I would have the baby this weekend, even though it was a month before the due date.

So anyway, I have my intended "graduation" appointment with my RE on Wednesday, and then an appointment with my OB on Thursday.  I had to do some appointment juggling because I do not want a repeat of last time.  If this pregnancy is not meant to be, I want to find out at my RE's office.  After all, who wants to have two appointments that will confirm that there is no heartbeat?  Not me.

Plus, I need Thursday to include a good strategic conversation to see if there's anything I can do differently to advance this pregnancy to full term.  I hope it's not a matter of "let's do more ultrasounds".  That's seems so passive, but maybe it's the only path to take?  It makes me wonder if an appointment with a perinatologist would have any value.

But I get ahead of myself.  I'll work through this after Wednesday.  I'd like to do something, but I am not good with coming up with meaningful gifts.  Any ideas?  Ironically, Wednesday marks four years since my first consultation with my RE.  We obviously had a long break between my graduation with mini-Munchkin and the beginning of this journey for #3, but still, it's been a long time.  And the battle for #3 has certainly required confidence in the plan and trust in my doctor.  I respect her so much and have valued her advice and the fact that she was always able to back everything up with data.

I will miss her, but am not sad to be moving on!

Ups and Downs

It's never easy, is it?

My ultrasound yesterday was great.  The embryo had a nice strong heartbeat and measured right on target at 6 week 4 days.  The sac size was normal, even ahead by a few days.  My RE commented that this looked straightforward and appeared to be a much healthier pregnancy than the last.  Good news all around.  What a relief!

Then this morning when I got back from my run, there was blood on my panty liner.  Not bright red, but not super old looking brown either.  It's not a lot, but I found more blood up close to my cervix when I inserted the AM progesterone suppository.  UGH.

I know that bleeding in early pregnancy can mean nothing, or it can mean something.  Regardless, it's concerning.  I just checked my logs from my first two pregnancies and I had spotting during my 8th week on both of them.  This is a bit earlier, but maybe this is just something that my body does?  Still, I don't consider this encouraging.  Who knows.  I'll take it easy for a couple of days and see what happens.  Hopefully it will stop.  And hopefully I will be able to refrain from visiting my good friend dr. google....

Confidence

A woman confident in her pregnancy feels a cramp and knows her body is adjusting for the new life inside it.
An infertile confident in her pregnancy feels a gush and curses her progesterone supplement.
A woman confident in her pregnancy lets herself plan for the next nine months and beyond.
A woman confident in her pregnancy lacks symptoms and considers herself lucky.
A woman confident in her pregnancy looks forward to her OB appointments.

A pregnant woman fearful of the worst feels a cramp and wonders whether she's starting to miscarry.
A pregnant woman fearful of the worst feels a gush and rushes to the bathroom to see how bright the blood is.
A pregnant woman fearful of the worst chides herself for talking with her husband about the future as if the take home baby is going to become a reality.
A pregnant woman fearful of the worst has no symptoms and assumes her baby has died.
A pregnant woman fearful of the worst spends way too much time inspecting toilet paper for signs of blood
A pregnant woman fearful of the worst s terrified of her OB appointments.


Things have been quiet here as I progress through the limbo of very early pregnancy.  I want to be the same confident person that I was in January and early February, the one who had no qualms about planning for the future, both near and far.  And in many ways, I do have confidence.  My symptoms are stronger than last time.  I feel pregnant.  I want to plan.  But on the other hand, in some ways it feels like deja vu.  We are having many of the same conversations that we had 6+ months ago that turned out to moot.  (What kind of a car will we need to support our larger family?  Should we try to take a family vacation before or after the baby is born?)  These are healthy conversations to have, but I also feel the need to protect myself.  After all, there are no guarantees.

Thankfully, I am staying somewhere in the middle of the spectrum.  I am not blissful, naive, or unaware of the vulnerability of these first few weeks, but I am also not paralyzed by the fear of the worst.  I hope my appointment on Thursday brings me no new data that should cause me to worry.  I will be 6 weeks 4 days, which is the same point I was when I went for my first ultrasound in my last two pregnancies.  At least we will have two data points for comparison.

Beta #2

We're back safely from our vacation (it was fabulous!) and have a few days of work before we head up to Lake Tahoe for a long weekend with my husband's family.  I can't really afford the time off, so I'll work a half day Thursday and all day Friday, but will at least be able to enjoy the family time in the evenings, and Saturday.

As planned, I went back to the lab Thursday afternoon for Beta #2.  It came back at 2100.  Nice!  I will save my comments on my fear of twins for another day.

My ultrasound is currently scheduled for the 15th.  I will obviously be looking forward to that day to find out what's going on.  When I was pregnant back in January, everything looked good, but my RE commented that the sac was on the low end of normal...nothing to be concerned about just yet, but something to watch.  This time around it won't be good enough to see a heartbeat; I will be paying close attention to the measurements as well.

Until then, I am not going to worry.  Or at least I'm going to try.  I know there's really nothing I can do, so I'm going to do my best to be normal.  Of course I'm will wondering whether there's anything that makes an IVF pregnancy more "fragile" than a spontaneous one, but I'm going to assume the answer is no and carry on with my current exercise schedule.  It keeps any nausea at bay so it's kind of critical.

Beta

Doubt started creeping in on Monday.  We've been constantly on the go this vacation and I've been exercising a lot (so much fun to have so much time to work out!!!), but that also meant that I hadn't taken much time to sit still and pay attention to what my body was doing and how I was feeling.  I couldn't get a good assessment of what I thought was going on in there, so when I had a free hour Monday afternoon, I immediately decided to head to the local lab to get my bloodwork done.

After jumping through a few hoops, the results were finally sent to my clinic and I got the results this morning.  My beta was 584 and my progesterone was 36.6.  That's rather high for a singleton at 15 DPO, but no complaints.  I will take it!  A few nervous thoughts about the possibility of identical twins have definitely crossed my mind (and the possibility that they accidentally transferred two blasts!), but hopefully they will be laid to rest in a few weeks.

I'll be back at the lab tomorrow afternoon and hopefully I'll get some good results and can schedule my next appt.

It worked

It worked.  The FET worked! 

I tested this morning at 8DP5DT.  The symptoms were all there.  I didn't doubt that I was pregnant.  And when I tested, there was no squinting.  There was no waiting until the three minutes were up.  There was none of that.  The second line appeared quickly. 


Obligatory HPT photo

 The mood in our house is very different from last time.  Last time, I was confident...too confident, as it turns out.  I had a chromosomally normal embryo.  I knew that my problem was getting pregnant, not staying pregnant, so I let myself go. I even wrote that I knew that I was probably being overly confident and that karma would come back to bite me.  A little foreshadowing maybe??? 

We are much more subdued this time.  I can tell that my husband is not ready to get attached.  He needs time.  And me?  This time I am focused on upcoming milestones and am simply very grateful for the opportunity to take on the hurdles that will be presented over the next 8 weeks.  The first step that opened the door was the positive pregnancy test.

I am not sure what I will do about the beta.  There are in-network labs nearby that I can go to this week, but I don't know how much time it will take away from our vacation to head over there, deal with insurance info, get the blood draw, and then come back.  Does anyone know if HCG doubling times remain the same at 5 weeks?  Is there any harm in waiting until I get home and testing a week later?

7DP5DT - Back on the exercise wagon

Ahhhh, I went for my first run today since the transfer.  That was nice.  Six days away from running is a long time!  I went for walks everyday, but it's not the same to come home without being sweaty or with a high heart rate, etc.

I know I could have gone running (or swimming, or biking) this week.  My RE has told me that there have been studies that have shown that exercising does not move an embryo once it's been placed in your uterus, but on the other hand, when you've spent a lot emotionally, physically, and financially on trying to get pregnant, you don't want to do anything to jeopardize your chances.  With that in mind, I run the morning of transfer and then minimize bouncing, just so that if it doesn't work, I never look back with regret, wondering whether I did anything to cause the cycle to fail.

So today is 7DP5DT.  I have my trusty (and trustworthy!) pee sticks safely stowed away in the bathroom cabinet.  I decided to wait until tomorrow to test so that I could focus on the mountain of work that I have to get done before I head out for vacation.  Information, positive or negative, would be very distracting.  Plus, I have a 5 hour drive tomorrow, so there will be plenty of time to think and plan.

One more day.

5DP5DT - Mind games

Ay ay ay!  The darn two week wait (that isn't even a two week wait when you're doing a frozen transfer) is quite the mind fuck.

So yes, I'm just checking in to say that yes, time is creeping by as slowly as I had expected.  It's so amazing to me that the weeks have just sped by over the past few months, even while I was cycling, but once the embryo was transferred, it stopped.

So what's new over here?  I ordered some FRERs for my testing pleasure at the end of the week.  Yes, that was a big step for me.  I love Amazon Prime, so I timed the order so that they will arrive tomorrow night, which will keep me from testing before Friday.

Google has been a friendly companion this week.  Everyday we get to google something new: 3dp5dt, 4dp5dt...sigh, you get the idea.  I've tried to stay away from symptom watching because I know that I don't tend to get pregnancy symptoms other than cramping (that I will get pregnant or not) until after I have a good amount of HCG in my system. 

Despite my attempts to stay away from stress, it has sought me out this week.  I am in a constant state of holding back tears. It's extremely professional...not!  I am so unhappy and really hope I can get away from the crap called work when I am on vacation next week, but I am not confident.  I work on a small team of three and am posing as two full time roles on a project while my coworker is on sabbatical for two months.  I've held up pretty well for the first have of her absence, but everything seems to be unraveling.  I am not handling things well.  So not cool!
Anyway, I feel like an excited teenage girl as I am waiting for the day to come when I can POAS.  I don't like the feeling, but it's comforting to be so excited about something that had been slowly drifting away from my visions of the future.

And then time stood still

My biggest fear of doing a frozen transfer is that the embryo won't survive.  Many of you know the anxiety that comes in when you get close to that last attempt...and I wanted to have these two chances before I hang up my shoes.

Luckily that fear went unfounded today.  My transfer was uneventful...and then off I went to work!

Life has been skipping by quickly the past few months.  Busy work days and long evenings have made the weeks fly by.  We decided at the beginning of the month that work shouldn't take over our lives so much that we didn't have a vacation together this summer, so we booked a vacation down the coast and we head out next Saturday for a week!  I have a lot to do to prepare, both personally and at work, so in some ways I welcome the inevitable time stoppage that happens during the two week wait!

It has been SUCH a long time since I've had this wait.  My last transfer was 6 1/2 months ago!  Wow, that is a long time, but I'm sure it's like riding a bicycle.  Ha.  It's still transfer day and I'm wondering how things are going in there.  I think I will fit right back into the two week wait seamlessly.  Of course the neurosis will really set in on whichever day I end up working from home!  It will be even more fun when I get up the nerve to buy some HPTs.

Okay, I'm settling in for a fun ride this coming week.

Crutches

I have always been an independent person.  My parents enjoy telling stories of me as a two year old yelling, "leave me 'lone!" every chance I got because I just wanted to do something myself.  

Not much has changed over my lifetime.  I don't like to ask for help.  I like to let my body take care of itself.  And I prefer to not take medication.

When I starting TTC many years ago, it took me more than 15 months before I got up the nerve to schedule an appointment with an OB/GYN and ask for help.  I didn't like the idea of taking medicine that could turn me into a raving bitch (thankfully that didn't happen until I met Lupron).  It just seemed unnatural, but what could I do?  I wanted a baby...and it wasn't happening.

Fast-forward almost 8 years.  I have been around the infertility block a few times...and I find my viewpoint shifting.  I have accepted that I need help and in many ways have swung to the other end of the spectrum where I feel more comfortable with help.  I don't expect my body to be able to work on its own.  I was a bit of a leap of faith when I agreed to do a natural cycle for my FET.

I had a monitoring appointment last Friday, CD12.  Per the instructions for this cycle, I used an OPK that morning.  It was positive.  I couldn't decide if I was happy or not.  My body appeared to be working, but could I count on my body to ovulate on time?  And what if it wasn't a strong ovulation?  I don't want to waste an embryo.  Did I make a mistake by going natural?

I then dutifully tested again.  The instructions I was given said to test with SMU.  This one was negative.  Well, crap.  I had no idea where that left me.  

At my appointment, we found good lining, one good-sized follicle, and blood test revealed that my LH was relatively low, so I was directed give myself the HCG injection.  I felt such a sense of relief.  I didn't realize how much I had grown to lean on these fertility drugs, but I can't tell you how happy I was to "have" to take the medication to direct my body to ovulate.  

Transfer is set for Friday morning.  I am excited.  I hope this turns out better than last time.

Regret Management

It was a little over a year ago that we decided we were ready to try for a baby.  I must have had some memory loss about my infertile status because I worried about a holiday due date, a pre-term holiday due date, and other frivolous things that a mostly infertile woman should never let enter into her baby-making formula.  We did an unmonitored Clomid cycle with leftover meds in May and then returned to the clinic in June.  

It was a little under a year ago, August 16th, to be exact, when a cyst resulting from a second failed injectible IUI cycle put me on the bench.  The next few weeks included a lot of thought regarding my next steps.  To IVF, or not to IVF?  To "go backwards" and use clomid, or not to use clomid?  The injectible drugs were not working for me.  They were cyst creators, not baby creators.

Plus, it was scary.  I was getting 4 or 5 follicles, but I only wanted one baby!  I just don't see how I could make it through a pregnancy with multiples.  And selective reduction?  I just don't think that's a path for me.  It's just best for me to avoid that possibility.

During my decision process, I asked for a lot of advice.  At one point, Sunny suggested that I look at the situation with respect to which path might cause more regret.  For example, if I spent months on failed Clomid cycles and then went to IVF and it worked vs. spending money on a failed IVF and then returning to Clomid and having success(!!), would one give me a bad taste in my mouth?  (Isn't it nice that both those options end in a happy ending?  Thank you for the positive thinking!).

In the end I decided that IVF gave me the best odds at getting pregnant as soon as possible, so we proceeded down that path.  What I didn't know, and couldn't have known, was how my body would respond, not just in terms of number of good eggs/embryos, but also in terms of the post-cycle recovery.

I have spent much of the past five months waiting...waiting for a normal period after my miscarriage, waiting for the IVF cycle to start while I was on BCPs, and then the longest of all, waiting 53 days for my body to recover from the latest fresh IVF cycle just so that I can have a chance to try to get pregnant.

A 53 day cycle will mess with your mind.  I spent a lot of time thinking...thinking about whether going the IVF route was the best decision.  It's hard to think back on the past year and to know that in the past 12 months, I have only had FOUR opportunities to get pregnant.  Okay, I agree, I am glossing over the fact that I actually did get pregnant one of those four times, but somehow it just doesn't count when it becomes a miscarriage.

How would I have felt if I had done Clomid or some other stimulation drug for several more months?  Is it harder to go month after month of failed TTC, or is it harder to have fewer opportunities with seemingly higher probability of success?  Not doing IVF is nice because then you always have that to fall back on, i.e. "if this doesn't work, then we can bring in the big guns and do IVF", but it's also hard because I would sometimes wonder if I was just wasting time by trying treatments that had a lower chance of success.  Doing IVF brings a lot of pressure, i.e. "If I can't get pregnant with IVF, then what is left for me?".

Thankfully, the end of a marathon cycle brings new hope and less despair, but I still wonder about what would have happened if I had taken the other path.  Deep down, I don't regret my decision.  I do believe it was a good one that just had a bad outcome.

I just hope that the path I'm heading down results in a good outcome.  Fingers crossed....

Au Natural?

CD1 arrived on Monday and I finally got in touch with one of the nurses at the clinic yesterday.  I had thought that my doctor was going to push hard for a natural FET, but when I talked to the nurse she said that I could do a natural cycle if my periods have been "regular" or we could do Clomid to ensure ovulation.

I don't know what to do.  In theory, I am on board with the natural cycle.  In reality, I wonder if it will just set me up for a cancelled cycle, or worse, a failed cycle.

I have never gotten pregnant without Clomid, so there's definitely the emotional comfort that I have from using it.  I know I ovulate on Clomid.  And who knows whether I will ovulate on my own.  In the past year, I have either been on a recovery cycle or a treated cycle, so there's no telling whether my body is ovulating on its own.

On the other hand, Clomid thins uterine lining.  In fact, my RE was ready to cancel the cycle last time when I hadn't progressed very far by CD11.  It turned out okay and my body did what it was supposed to do.  Also, we have no information as to why I miscarried last time.  The embryo was euploidy....  My RE's thought is that perhaps a more natural environment could work better.

I think I am leaning towards her recommendation, but I don't feel 100% comfortable.  I have been waiting a long time for July, and it would be unfortunate to watch another month slip by without an opportunity to get pregnant.  On the other hand, it's only one month.  At this point, is it that bad to skip a month?

I haven't spoken with her in over two months since they did the biopsies, so hopefully she has a sound argument that will help me jump on board when I have my baseline u/s tomorrow.

Oh yeah, happy 4th of July!  If it's as hot where you are as it is here, stay cool and enjoy the day!

Stress

I have a lot of stress in my life.  And I know that most of it is my own doing.  I have a choice of how to respond to a set of circumstances...and I often (usually?) respond with stress.  I respond with action, but also with stress.  A perfectionist by nature, I want everything to be just so.  It is so hard to let go.

Today is CD53 (ouch!) and there are finally signs that AF will be here shortly.  I have been waiting for this upcoming CD1 for a long time, practically since the unfortunate discovery at my OB appointment on Valentine's Day.  

I want this cycle to work. I want to do everything I can to have my body be receptive to the embryo.  I need to be healthy mentally and physically, so I have committed to myself that for this cycle, I will go to bed at a reasonable time, I will eat well, I will exercise, and I will make every effort to minimize the stress that I let into my life.  

Wow...that is one tall order (it almost makes me stressed just to read it!)!

I am looking for tips.  My work situation is rough - simply put, I have a ton of it.  My natural response is to work more in order to mark items off the to do list and create a more relaxed situation, but that approach has been really bad for my sleep.  And I want to go on vacation, but I'm worried that this project I am leading would suffer (causing more stress). 

How do you keep stressful situations from getting to you?  This is something that I have never been good at.  Running has always been a savior, but I've been finding that I can't turn my mind off at night to fall asleep in a reasonable amount of time (which makes those early morning stress-reducing runs less appealing!).

Does IVF Cause Menopause?

Seriously...it seems as though the IVF sucked the last remaining eggs out of my ovaries and left my body with no need to have a period!  Today is CD48 and there is no sign of the end of this cycle.  Not fun!  With any luck, returning from my blogging hiatus will be the magical wave of the wand that my body has been waiting for in order to start a new cycle.

So yes, I'm alive.  The last several weeks have been relatively blah.  They have been filled with the usual trio: too much work, too much stress, and not enough sleep.  It's no wonder why my body is going on strike.  This certainly is not the recipe for getting pregnant.

Life has gone on in ways that once again make me take pause and realize that I have been on the TTC train for too long.  My younger daughter had a breakthrough, and as of Saturday, is out of diapers.  This is a big milestone.  When I think about the family that I am trying to build, it makes me sad that I am not in the typical rush to get the toddler potty trained before a new baby arrives.  Instead, I am here wondering whether I will have the opportunity to have a child in diapers again.  

Hopefully AF will arrive soon so that I can feel like I am working towards a direction, one way or another.

Hope and Fear

And then there were two.  Of the seven embryos that were biopsied, two are normal.  Once again, I feel like my decision to do PGD has been rewarded.  Four of the seven embryos looked really good, but only two of them were good.  I have been rewarded with two opportunities where I know I could get pregnant.  Will it work?

The info on the two good ones is this: one is graded 5AA and one is 5BB.  They are both the same gender, but I didn't ask which.

I am filled with hope.  And fear.  And relief.  And disappointment.  And anxiety.  And happiness.  And stress.  And more relief.  The emotional rollercoaster is back.  I guess you could say that I have reconnected.  I am all in.

Two. So there are two.  Two is good , and two is scary.  Two would be more scary if I weren't doing a single embryo transfer, because then I would have one chance.  Yes, all I need is one normal embryo to stick (and stay stuck).  But it's hard.  I feel a lot of pressure for this to work.  I know there are a few of you out there gearing up for your last chance, and I've been thinking about you a lot...the decisions for where to cycle, the gearing up for the final FET.  There is a lot at stake.

That was my commercial interruption.  I now go back to waiting.  It's likely to be a month or more.  Last time I ovulated around day 28, and this could be even longer since my body seemed to be more taxed by the cycle.  Thankfully many of you have exciting milestones coming up, and I am more than happy to cheer you on while I wait.

What's the hold up?

It's a well known theory (or is it a fact?) that the "good news" phone calls from our clinics come earlier in the afternoon than the "bad news" phone calls.  On beta day, it never bodes well for the phone call to come after 3 or 4PM. 

Sure, that's a gross generalization, and maybe not even true, but I'm beginning to feel some doubt about the test results on my embryo biopsies.  I received an email this morning from my contact at the lab.  It was just an invoice and a receipt to indicate that they had initiated the charge on my account, but it made me realize that they had probably completed their tests, so I emailed the woman back this evening to find out if the results had been sent to my clinic yet.

She replied that they were sent on Monday.  MONDAY.  It is Thursday night.  I don't think I need to count out the number of days, but that was three days ago!  Deep breath.  Technically my results are not urgent and technically I don't need an immediate call.  But it's been THREE DAYS!  Deep breath.  My doctor is off on Tuesdays, and I know that she's been reducing her time in the clinic.  I think she's been focusing more on research, so I suppose it's possible that perhaps she's traveling or has been out of the office for some other reason.  I don't know whether to expect a call from her or from a nurse, but I know that she needs to review test results prior to them being released to a patient.  So maybe they were faxed over and are sitting on her desk.  It's possible, right?  Realistically, it's probably better that I'm finding this out after three days rather than after one, because it's less likely that the silence is due to the "bad result pity".

Needless to say, I'm enduring a wee bit of anxiety over here.  I'm in meetings all morning tomorrow, but I will call for an update as soon as I have a few minutes.  Fingers crossed that I'm causing myself some unnecessary excitement.  It would be a shame if there weren't any normal ones in the bunch.

Moving along

Ten days past retrieval and AF arrived last Thursday.  Wow, that was fast.  Hopefully this cycle won't be much longer than six weeks....

The best part of CD1 was being able to go out for a run.  The first few weren't pretty and didn't feel good, but my morning runs are such a big part of my life that even when they feel like crap (like the first two did after 15 days of not running, being sick, not eating due to sickness and/or humungous ovaries), they put a smile on my face.  It's been almost a week and my insides feel like they are back where they belong.  Yay.

Anaheim was great.  The weather was HOT down there (I saw 99 a few times on my phone) this weekend, and I was glad to be able to go on Splash Mountain.  Small victories.

My focus now is getting back into shape over the next several weeks and reconnecting again with this process.  Once again I feel so disconnected...and it's killing me.  I don't like wondering whether I'm doing the right thing, questioning whether this path was the right one for us.  While it's nice to not feel the daily ache of TTC, I still wish I felt more engaged, and believed that this could be right around the corner.  Maybe it will happen once I get the results from the lab.  Hopefully I'll be hearing something in the next few days.  I think normal turnaround times are a week to ten days. Sigh.

And now we wait

I got the cryo report yesterday.  7 embryos made it to blast (6 on day 5, one on day 6) and were biopsied, frozen, and the samples were shipped to the lab yesterday.  My contact from the lab emailed today.  She had the instructions wrong...they thought I was going to do another fresh cycle and wanted to test the samples from both batches at once.  We got it straightened out and they will run the tests at their leisure.

So now we wait for the results.
And we wait for AF...
So that I can wait for another (probably 6 week) cycle while my body heals.
And then, if I have at least one normal embryo, only then do I finally get to the point that I have been waiting for ever since I miscarried three months ago...the chance to be pregnant again.

In the meantime, I am in a very comfortable place.  The initial disappointment of this long drawn out process has been more than made up for by something that puts me completely at ease: a plan.  Even before my WTF appointment with my RE, I knew that we would likely not do a fresh transfer.  Having this plan has allowed me to plan.  And that makes me happy.

I do not need to be available for any appointments at the clinic until mid-June at the earliest, so this is the perfect opportunity for us to take advantage of the freedom.  We are heading down to southern California this weekend to visit the happiest place on earth for a few days.  And then we're trying to schedule a diving trip the second week of June.  I hope that works out, but I'm not sure if it will happen....  It's nice to have a lot to look forward to and to plan for things that I wouldn't be able to do if I were pregnant. 

I'm sure the time will fly and before I know it, I will be in the two week wait...then time will stop.

My boobs hurt. Could I be pregnant?

Sorry, that's a little "freeze-all" humor.  I know it's not very funny, but oh well.  I think I've spent too much time searching on the forums over the years looking for answers to my various questions and finding off-the-wall threads.  Today is 5 days past retrieval and my breasts are sore.  I wonder what it could be from?  My progesterone levels should be low (yay for no PIO or Endometrin!) and I am most definitely not pregnant!  Maybe my body is just trying to make some sense of what happened to it this week.

My RE called this morning to confirm the plan.  Nine embryos were able to be biopsied and six of those were advancing well.  I agreed to biopsy all nine.  I continue to be hopeful that we'll find at least one normal one in the bunch. 

More Biopsy Stuff

Thanks for the thoughts on the biopsying.  I had been leaning towards picking the best 8 and saving myself $800, but I also sent my RE a message yesterday to get her opinion. I figured that she's been doing this for years and she always has very sound advice that is based on data.  My engineering mind works well with the logic she throws at me for every decision we make. 

So anyway, I was very relieved to see a response from her this morning.  I wasn't sure whether she stays on top of her inbox or not.  Her response was:

I would definitely suggest that we biopsy all embryos that reach the blastocyst stage. Although embryos that appear to be somewhat advanced may be abnormal, there have also been normal babies born from embryos that are not at the textbook 8-cell stage, and they could be normal. 

Reading this I don't think it's a blanket statement to try to biopsy them all, but rather all of the ones that become blasts.  I have actually experienced the opposite of what she is saying as being true (two perfect looking blasts were abnormal), so it makes sense as jAllen pointed out, and several bloggers that I follow have found out first hand...a fragmented, or otherwise non-perfect looking embryo can make you a mom.

I certainly am not going to cut corners on a process that I am so invested in, but I do want to be smart about where my money is going.  It reminds me of wedding planning, or house remodeling, or some other project (I guess you could call making a baby a project!) that costs a lot of money.  I don't want to become desensitized to the amount of money that's being spent.  Oh, it's just $1000.  Wait, what????

The lab is supposed to call before they do the biopsy so we can make a final decision.  I guess I should hope to have to spend the extra money.  More blasts = higher probability of one or more normal embryos.

Day 3 Report

Yesterday was a pretty miserable day.  My insides were in pain, it was difficult to move, and I hardly ate.  I just felt full all day.  Yuck! I powered through it by reading scary stories about OHSS.  I slept in the couch so I could be a bit upright and woke up at 4AM feeling much better, so I crawled into bed for the next couple of hours.

Today has been better.  I was actually hungry for breakfast (a feeling I haven't had for days) and the discomfort seems to be manageable again.  I'm feeling full again at the moment, but maybe it's because I actually ate dinner!  I must say that I am glad that I am not scheduled for a fresh transfer.  The thought of OHSS hitting me again in another week does not sound appealing.

I spoke with the lab early this afternoon.  My phone didn't ring when the embryologist first called and her voicemail said "I have a report of what your embryos look like today.  If you are interested in a detailed report, please give us a call and let us know....."  Seriously? IF?  Aren't these phone calls what keeps us going in the few days after retrieval?  It made me laugh.

So anyway, it looks like we have 5-7 good looking embryos.  From what I understand, at this point, we want the embryos to have 7-9 cells.  Anything less is lagging a bit behind and anything more is too fast and  can indicate a problem.

The contenders are four 8-cell embryos, two of which are already starting to compact.  Again, I haven't studied up on this, but it sounded good.  And then there is a 9-cell one plus two good looking 6-cell ones that could catch up.

So here's the question I'm currently considering.  It's probably jumping the gun a bit, but I like to have a plan...it makes me feel like I'm involved.  The flat fee for the PGD (or is it PGS?) is for 8 embryos, and then it's $200 per embryo after that.  During my last cycle, I had 8 that fertilized and the lab was able to biopsy all 8, even though only 4 looked good.  All the poor quality ones had multiple issues, and then two of the great looking ones also had a problem.  So now if I have 12, 5 of which are not looking so hot, should I just ask them to pick the 8 best to biopsy?  Or is it worth the extra $800 (assuming all are biopsy-able...Is that even a word?) just in case?  I'm all in for this cycle, but if I can save several hundred dollars here or there without sacrificing the result, I'd like to take that option.  I sent an email to get her thoughts, but am interested to hear your perspectives as well....  Thoughts?

Fert Report

I heard from the lab this morning.  Of the 20 eggs, 12 fertilized.  That's a good start.  I don't know all the terms related to unfertilized eggs, but from what I could gather, 5 of the ones that didn't fertilize were immature.  Still, that's a good number to work with.  It's like a year's worth of TTC consolidated into one month.

Physically, in some ways I feel better today, but because I am moving better, I think my husband thinks all is back to normal.  I wish I had a picture of my insides to give him an idea of what I'm dealing with.  Yesterday, I felt like I didn't want anything inside me to move, but today that seems to be a bit better.  It is a bit unfortunate that I've had a nagging cough.  I keep trying to get into a position where I can immobilize my torso so minimize movement and discomfort.

I had forgotten how I felt post-retrieval, but it's certainly coming back!  I think I'm a bit more uncomfortable this time around simply due to the number of follicles that were growing and am focusing on keeping the OHSS at bay.  I think/hope it will be okay.

It has been great to hit this retrieval milestone.  The physically hard part is almost over, and for the next few weeks, it will feel like things are happening and progress is being made.  Since we're doing a frozen cycle, I'm not going to pay for next day results on the PGS, so I will have one more update about two weeks after the cryo report (does that happen on day 6?).  Yay for a trickle of information to keep me engaged before the long wait for my body to recover and be ready for transfer!

Retrieval

Thanks for the well wishes.  My retrieval went well this morning after a bit of a rocky start to the morning (I overslept by 40 minutes....) that led me to arrive at the clinic 20 minutes late!!!  

The end result is that they retrieved 20 eggs!  I'm very pleased with that number, but know that it doesn't mean anything about my end goal.  Attrition can and will be quick...and I need quality.  So I will take it one day at a time and see what we have to work with tomorrow, and on day 3, and on day 5, and then ultimately, after the biopsies.

Physically, I'm doing well, especially since this cycle produced more eggs than last time.  I don't have much discomfort other than the standard "full" feeling.  I'm parked on the couch, willing myself not to start working.  So far, so good.  I'm a bit backed up on our recorded shows, so that's a nice distraction.

The only issue with the procedure was my blood pressure...again.  This time I prepared and got approval to take my medication this morning prior to the procedure, but it didn't really seem to do much good, if any.  I was running late, but tried really hard to stay calm once I got in the car.  After all, there wasn't anything I could do to speed up traffic.  My BP was high before and after the procedure.  It was apparently okay while I was sedated, but I still got a lecture from one of the nurses.  Eventually it dropped low enough for them to be willing to discharge me and figure out where to go from here.

I'll check it in a bit, but for now will sit and relax with my favorite furry companion.....  I'll send an update tomorrow with the fert report.

Monday it is

Wow, that went fast.  Retrieval is scheduled for Monday and I have just two injections left.  Wow.

I'm feeling pretty good, but my appetite has been non-existent the past two days.  I am not complaining(!), but it's weird.  Hopefully it will last for about a week and I can drop a few pounds that I've gained the past several weeks.   

I was thinking today about how I've continued to stay disconnected from this experience.  It just seems so surreal, which is so different from how it was for my cycle in the fall.  I was so excited about planning for my summer baby.  I really thought it was going to work and I didn't really let myself think about the possibility of failure.  I suppose I'm more realistic this time around having gone through both a BFN and a miscarriage, but also, my transfer is still about two months away.  Regardless, it's hard for me to grab a hold of the fact that the next few weeks will be filled with fertilization and growth reports, followed by the biopsy results. 

I guess reality will hit hard when they stick me with the IV on Monday morning.  Yikes. 

Day 4 Scan

I had my first monitoring scan this morning.  My body has had a strong response to the medications, which didn't really surprise me because I started to feel my ovaries yesterday.  At first I thought it was due to the number of Oreos I was eating (I blame my husband for buying junk food and then leaving town....  I have zero discipline with chocolate!), but then realized that it was more likely my ovaries.

So here are the numbers after four days of meds:
Lining: 8.6mm
Right: 16, 16, 15, 15, 15, 13, 13, 12, 11, 10, 10, 10, 9, 8 < 10mm
Left: 16, 14, 12, 12, 11, 11, 10, 7<10>
I am to stay on the same medication (apparently dose changes in the medication doesn't make the follicles grow faster, it just recruits more follicles) tonight, go back in tomorrow for a scan and bloodwork and then make a decision.  It's likely that the retrieval will be on Monday.

I hope we can find a few good eggs in all these follicles....

Reset

This past weekend provided me the break I needed to hit that reset button.  We went to Sedona, Arizona and hiked (and hiked...and hiked).  The weather was perfect.  The views were spectacular.  The company was great.  Ahhhhhhhhh!  We may just have to go back next year....

I made it through the airport with my needles without any issue, which was nice.  And I shared the story of my struggles with my one friend who I traveled with.  She was the same person who knew about my first cycle, the pregnancy, and the miscarriage, so it was natural to get her caught up.  It was a nice conversation.  She had a miscarriage before she got pregnant with each of her children, so she's been there.  I'm sure the others are curious since we talked about whether any of us want any more kids (yes, me!), but they didn't push.

I got home Sunday night and had to rally to start stimming!  I had my baseline ultrasound before I left on Thursday.  Everything looked good - 9 antral follicles on the right, 8 on the left, and no cysts.

I just completed my third night of stims.  My protocol was confirmed to be 150 IU of Follistim and 75 IU of Menopur, plus the 5 units of Lupron.  My RE decided to increase the Follistim dose in the hopes to maybe recruit a few more follicles.  She's not worried as much about OHSS this time around since we're planning on a banking cycle.  I hope it works. 

I went for a run this afternoon and felt pretty good.  The weather was in the 70s so it would have been difficult to not enjoy the fresh air.  I think I get cut off from exercise after tomorrow, but maybe she'll let me squeeze in one last run on Thursday. 

The days are ticking by quickly.  I have my first monitoring scan Thursday morning, but in the meantime, I am getting organized.  My husband flies out to Arizona tomorrow for an annual golf trip, so I am flying solo with my Lupron-induced short temper.  Wish me luck!

I am a mess

OMG, I am not in a good place.

Tonight will be shot #8 of Lupron.  I am quick to snap at people.  This was expected.  Work is seriously stressful.  I was hoping to avoid this.  I had a 1:1 with my manager this morning.  I brought up my workload among some other things and the best he could offer me was "Don't worry".  Don't worry?  Seriously.  I feel like my work must be trivial because if it weren't, perhaps he would have helped me walk through some solutions, rather than give me a verbal "there, there" pat on the shoulders and tell me not to worry.

Or maybe he's right.  Why am I staying up late, sacrificing time with my family, and getting stressed over this when I could be happier by doing what I can and saying F#$% it to the rest?  But honestly, I just want to be doing something that matters, and while I've known that my manager doesn't really care what I do (he is located in Europe and inherited me and a couple of other people a year and a half ago), it would have been nice if we could have had a conversation about this.

Someone just stopped by my office to touch base on something and asked if I was okay (apparently I don't look okay) and I almost started crying.  At work.  Ugh.  I hate being that person.

So I am flying tomorrow night (with needles) for a girls weekend.  I really hope it goes well, but I am so worried it won't.  I can just feel that I am not in the best state of mind.  When I anticipate conversations, my annoyance is right there on the surface (and it's not even a real conversation!).  I don't want to share about my upcoming IVF, although I know that may not be realistic since I can't really hide the meds.

So deep breath.  My mind is a mess.  My emotions are a mess.  I am a mess.  But I need to find a way to keep it together.

Disconnected

Wow, I am behind.  I'm looking forward to making some time in the next few days to see how everyone is doing. I can't believe several friends I made last summer (when I jumped back into the blogging world and TTC) are charging into their third trimesters, in awe that they may just have a take-home baby in a few short months.


Honestly, the past couple weeks have been weird.  I've felt incredibly disconnected from my upcoming IVF cycle...and I can't tell if it's a good or bad thing.  Maybe it's a little bit of both. 
 
On the good side, time is marching on rather quickly and I'm not dwelling on what could have been. 

On the not so great side, I caught myself a few times wondering why I'm going through this again and wondering whether this is really a smart decision.  I've found myself to be lacking in patience in my parenting and just not "all there" in the evenings.  My laptop is always open, I'm always trying to sneak an email in during breakfast or while making dinner.  It makes me wonder whether I can really handle my current life +1.  Of course that +1 would be a beautiful, wonderful creature that would bring so much joy and completeness to our family.  I guess that's why.  But I still question myself.  I'm a bit overwhelmed and don't have a good plan for adjustments that we would make.

So last Friday afternoon, I was sifting through my growing stack of papers when I came across my IVF schedule.  I opened it up and realized that my Lupron injections started today (Wednesday)!  Yikes!  Seriously?  How did that creep up on me?  I hadn't made plans to find time during weekday business hours to stop by the pharmacy and pick up my medications.  The big box o' meds is the "sign" that IVF is a go!  and here I am ignoring (or maybe it's trying to forget) it.

And then I was driving into the office after my appointment this morning and I realized that assuming everything goes according to plan, my retrieval is less than three weeks away.  Wow.  I need to shift my focus.  I don't want to fixate on this, but I need to make sure to take good care of myself.  I don't think we would do another cycle if it doesn't work.  (Wow, it seems to final to say that, but I do think this is it.). 

So anyway, things are starting to move and it's time for me to re-engage.  Evil Lupron is now flowing through my system.  My baseline ultrasound is next Thursday, and stims start next Sunday right after I return from a girls' weekend.  Let's go!

Health Updates

Wow, this past week has flown by.  It was a busy weekend with Easter and unfortunately, work has sucked up all my free time, including the small window of time in the evening when I usually blog.  Tonight my husband is out at a hockey game with some coworkers, and the house is mercifully quiet.  I'm taking a much needed break from work and I am trying to catch up on my reading and commenting.

BP update
I went to my PCP last Thursday for a blood pressure check, and as expected, I had to increase my medication.  She didn't seem concerned at all and re-iterated that lowering my sodium intake would have minimal impact.  I think I'll still try a little bit.  She also confirmed that I should take the medication prior to any medical procedures such as a retrieval.  That was really helpful information because I skipped it for both the retrieval and the D&C (following the "no food or drink after midnight" instructions) and my readings both times were high enough that the nurses were raising their eyebrows.  I certainly don't want to have anything cancelled due to high blood pressure!  Delays or cancellations are not welcome!

Food Diary update
I completed four days of my food diary, and then I just couldn't take it anymore!  I did review the information and found it interesting to note the sodium content and calories consumed.  I was taking in about 2000-2100 calories a day and this is probably less than my normal consumption.  The only thing is that it wasn't a true representation or my regular diet.  I opted not to eat some food simply because it would have been too much of a pain to log it.  My sodium consumption was around 2700mg, which I thought was interesting...interesting that it was so high since I was still finishing up the leftover low sodium soup.  I actually bought some sodium free bread last week, just to see what it's all about.  It's not very good, but I'll finish off the loaf and then maybe try some low sodium bread as an alternative.  I know that it probably won't help with the blood pressure, but at least it's healthier.

Running update
A few weeks ago I wrote about how I needed a goal, and I wanted a running goal, so I picked one of my favorite hills to do test sets on.  I ran it one day and went hard up the hills and got a decent time.  I then ran the same route the following week, but prepped myself on the way there with a better warm up and accelerations.  I beat the time from the previous week by 33 seconds, which beat the goal that I had set for myself.  Oops.  While it's great, I was hoping to have to work harder for this. 

For the past two weeks I've stayed away from that trail and have done other hilly runs, including hill repeats (ouch!).  I plan to do another timed run in a week and a half.  I'll be interested to see how it goes. 

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My goodness.  Looking at the format of this post makes me realize that I am still in work mode!  I have little sections with bolded titles.  Sigh....I hope I can take a real break soon.

I have a calendar!

Yes, that is right!  AF arrived on Sunday night a few days earlier than expected, I called the clinic yesterday, and just like that, I have a calendar for IVF #2.

BCPs start Thursday
Evil Lupron starts 4/10
Last BCP is 4/14
Stimming starts on 4/21
Tentative retrieval on 4/30

Yee haw!

The time will go by quickly.  I will be out of town the weekend of 4/20-4/21 for a girls weekend and then my husband will be out of town the following weekend...and I bet he'll need it, because I did not like the way I felt/acted when I was on Lupron.  I was on edge all the time...at work, at home, to the dog, to my husband, to the kids.  Knowing in advance how I will feel, I hope I can hold it together a little better this time, especially since I'll be on my own for four nights while stimming.  I was already planning on taking the Friday off to ease my stress, and I hope that helps.

It's really interesting to observe my emotions about this whole thing.  The past two days I have really been dreading the whole cycle, which is interesting because I didn't think it was terrible when I went through it last time.  I had mostly been scared of the actual retrieval, which ended up being not bad at all.  I think the difficulty of the cycle was the hormonal roller coaster.  Now that I talked with the nurse and negotiated the dates to make sure my husband was back in town for the retrieval, I'm looking forward to getting the show on the road.  I dare say that I'm excited!

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Just a quick note on the food diary.  It's been great!  I pulled out my food scale, which is a huge help, and I've eaten much healthier than normal today while working from home two feet from the fridge.  No chocolate chips have snuck out of the freezer and into my mouth.  I'll call that a success!

Dear Diary

I started a food diary yesterday.  I've been wanting to do one for a while, but I've been putting it off because it's so time-consuming.  I measure out how much I'm eating and break down all the ingredients of whatever meal I'm cooking (and then measure how much I put on my plate).  I need commitment in order to make this work.

I have recently developed some bad habits that I wanted to force myself to work on.  Sometimes I find myself eating really really fast as if I were trying to keep all the food in the house to myself.  I have also been eating mindlessly while working on my computer.  When I work from home, my workstation is at the island in the kitchen, just three feet from the fridge (and freezer where the chocolate chips are!), so this is becoming  a problem.

I have also been worried a bit about my blood pressure.  I've been on medication for a couple of years now and am due to go back to my doctor to check in and get a new prescription.  I check my pressure on and off at home and it had been okay, but I noticed that it has been high at my doctor's appointments, some where I had skipped my meds (e.g. for retrieval and D&C), but some where I hadn't (appt with OB last month and consultation with RE a few weeks ago).  I had also taken it at home a few times while I was pregnant, and it was definitely high.  I made an appointment with my PCP, started tracking my pressure at home, and then sent the results to her.  She agreed that it needed to be controlled better and had me increase the dose.

I had a couple of friends over on Saturday.  One of them had some heart trouble a few months ago and was put on a low sodium diet.  She was only supposed to eat 600mg a day.  To put that into perspective, my morning bagel has 460 mg sodium in it.  And that's just bread.  An egg has 80 mg.  Two stalks of celery have 135mg.  Crazy, right?  I wanted to make a meal that she could eat when she was over, so I started looking at the sodium content of food.  It's amazing how much sodium there is in everything, especially knowing that the recommended amount is 2300mg/day.

This all got me to to thinking about my salt intake and its possible correlation to my blood pressure.  I asked my doctor about this last year and she said that if my body were to respond to a low sodium diet, it would happen rather quickly.  I didn't ever try it because my blood pressure seemed to be just fine with the medication and it seemed like a hassle to try to go low sodium.

I've decided that I am ready to try it out and see if it does make a difference.  If yes, then great, and if not, then at least I have more awareness of how much sodium I'm eating (so sad about cheese!).  First up though is the diary.  If nothing else, I hope it helps with the bad habits.  I definitely eat healthier when I'm writing everything down, not just because of the accountability, but because it's hard to track the handful of nuts, or finishing off my kid's sandwich.  Then I'll start to make adjustments (I hear Trader Joe's has no sodium bread!  Hmm, that doesn't sound good.  I think I'll start small....).

The bottom line is that I want to get this taken care of.  I don't want to be battling high blood pressure through the IVF cycle.  My RE doesn't think that this could have been related to the miscarriage, but for so many reasons, I really don't want this to be an outstanding health item.

Time for me to log that apple I just ate....

ICLW

Wow, I can't believe it's ICLW season again!  I've been participating off and on for the past few months.  Reading others' stories has been inspiring and keeps me entertained while I engage in the obligatory waiting periods that go along with IVF.

Here's a quick synopsis of my current situation:
- I had a miscarriage a little over a month ago and am waiting for AF.  Should be here in about a week.
- I am ready for IVF #2.  I'm planning to do a freeze-all cycle because we think that my body does better with an unstimulated uterus (based on a failed fresh cycle and a successful implantation on the frozen one).  I am signing up for a long process, but have high hopes for a baby next spring.
- I am dealing with some blood pressure issues.  I am on medication but it doesn't seem to be controlling it as well as I'd like.  I wish there was some lifestyle change that I could make, but I think this is all genetics, so off to the doctor I go next week.  I'd like to get this addressed before I start stimming.
- I am coming down off a stupid slip up yesterday when my super secret closetinfertile gmail account showed up on the google home page when I was sharing my desktop on a web conference.  I am trying to laugh it off, because I really don't have any other choice.  Luckily, I haven't heard a peep about it from anyone on the call.  You can be sure that tonight I deselected the "keep me signed in" option! 

Thanks for stopping by!

A blunder

I am mortified.  This morning I was on a web conference at work, and I was asked to share my desktop to test out something.  I opened up my browser (the default home page is g.oogle) and I was unfortunately, and unexpectedly, signed in to my gmail account.  My closetinfertile at gmail account. 

I looked at my screen and I just wanted to die.  And of course, the test I was running didn't work, so my browser just.stayed.on.the.page.  I finally just stopped sharing and signed out.

Given that I don't share my infertility struggles with family and close friends, you can imagine that it's never come up in conversations with coworkers.  On the call were a bunch of men and one woman.  I have worked very closely with the woman for several years, but I haven't shared this with her.  I have no idea who, if anyone noticed.  And I'm sure it's no big deal, but I can't stop thinking about it. 

Doh

A long road ahead

I had my WTF appointment with my RE on Thursday, and while nothing earth shattering came out of it, it confirmed how long this process is going to be. 

We agreed to stick to the same protocol (long lupron) since I responded well last time (14 eggs retrieved), but she was open to doing an antagonist protocol if "the length of the protocol was too long or I was uncomfortable with the number of shots".  As much as I would like to cut down on the length of the process, we don't know how I would respond.  I don't want to turn this into a test cycle.  The low dose (125 IU Follistim + 75 IU Menopur) seemed right on target.  I think the only thing I would like to improve is the number of eggs that fertilitized (8 of 14).

We also discussed doing a freeze all cycle, which I am okay with as long as we can have some flexibility.  It would be unfortunate to prepare for a freeze all cycle, and then find out too late that I had a chromosomally normal embryo that couldn't be frozen, or that was unlikely to survive the freeze/thaw cycle that could have been transferred fresh.  The next question is whether it's worth the $700 rush fee to not have to wait two weeks to find out whether there are any normal embryos in the bunch.  I'm hoping that when we get to that point, it'll be easier to make the decision based on the information we have about the embryos. 

If we do the freeze-all cycle, then I would need to take a cycle off she is highly encouraging me to do a natural FET.  Maybe if I thought I was going to ovulate (and if cysts had resolved themselves by then), it's possible that I could do it the cycle after the IVF, but I don't know how likely that is.  The reason for the wait is that because as she put it, the stakes are high.  It's unlikely that I would sign up for another fresh cycle.  And because I miscarried a euploidy embryo, she wanted to try to create the most natural environment possible for the embryo.  We'll have to see about that one.  I have never been pregnant on anything other than a clomid cycle, so I am definitely biased.  We'll see what happens.

So what does all this mean?  Assuming that things are similar to my IVF in the fall, it translates to a frozen transfer in the middle of July.  Ouch.  That's four months away.  This is going to put my patience to the test!  Honestly, I can't help but wonder, do I really have a better chance by going through all this and having one chance to get pregnant in the next 4 months vs. trying via some other method?  Unfortunately, my egg quality is not that great (~15% normal?), so the answer may be yes. 

AF should start in the next week and a half or so, which means that I should have a calendar for the first part of this process soon.  And once I have that, I'll have something to work off.  At least it appears that I am moving forward.  I also stopped in for a blood draw while I was at the clinic and my levels have returned back to zero.  It's too bad because I would much rather be 13 weeks pregnant than planning out an IVF cycle!

Looking up again

Things seem to be back on track again.  It doesn't hurt that the weather here in the bay area has been absolutely beautiful.  I was lucky enough to work from home yesterday and had just a really nice run in the warm sun in the late afternoon.  I know that it will cool off again, but I love that we get these glimmers of spring when it could/should still be cold and rainy.

I've been tracking my LH for the past couple of days and I surged this morning, so it looks like AF will show up in the next couple of weeks.  Yay for progress!

I live near an open space preserve that has lots of great trails.  There's one trail in particular that I love, and have been doing ever since I started running when I was 14.  I usually run to the park from home, but I've also run it when I lived with my parents.  And when I didn't live as close as I do now, I would often drive there and run up the loop and up the switchbacks from the parking lot.  

I don't run this loop as often as I like because I don't always have the time (or fitness) for a hilly 75 minute loop.  I could drive to the park and run it from there (only 45 minutes!), but the parking lots are always full, and I prefer not to take the extra time to or have the extra hassle.  Plus, dogs are not allowed, and unless my husband has already taken him out on a run before me, I usually have a canine partner.  Hmm, I seem to  have a lot of reasons excuses to pick another route.

When I was pregnant last month I kept trying to find a weekend to run this loop before I couldn't.  I've walked it before while pregnant, and while it's beautiful, it's not the same, so I really wanted to figure out a way to make the time.

I finally made it up there this past weekend.  And it was wonderful.  Again, nice weather makes everything better!  On my way in, I decided I wanted to switch things up and run up the hill hard.  Coaches will tell you that the way to improve performance is to continually challenge your body in different ways.  If you constantly do the same workouts week in and week out, your body will become efficient at them, and you will not improve.  I have become stagnant in the past year and a half.  I rarely run hard.  I don't have a goal that I'm working towards.  Running is nice, but it's kind of boring.  It's time for a change.

I decided to make a running goal (that I will keep!) and rather than make my goal be a race on a certain weekend or course, I wanted to focus on this route that I love.  I have always logged how long it takes me to get up the switchbacks.  It's a nice benchmark that gives me an idea of how fast I am running.  So I ran up as hard as I could (my quads were screaming) and compared it to my times over the years.  It's not terrible, but since I don't always go hard up the hill, it's clear that there's room for improvement!  I'm going to focus on trying to better my "go hard" time up the hill over the next several weeks and will do another benchmark run in mid-April.  I like to think I can drop 30-45 seconds and would love to drop more, but we'll see what happens.  I'll need to get in some hill repeats, I can do some tempo runs, etc., but honestly I think it will just be nice to shake things up.  I don't have the ability or flexibility in other areas of my life to do that, and I know that I will benefit from putting this out there for myself.

We'll see how it goes, but I'm happy to be doing those small things that make me happy.

Insurance woes

Before I get all worked up over my latest issues with insurance, thanks for the advice on projects/activities/things to keep me moving.  I definitely want to do a race.  It's really important for me return to the racing scene because I love it so much...and I do it so infrequently.  I need to get out there and give a hard effort and see where my fitness is (or is not).  I'm a bit limited on weekend availability, so I'm still debating between a few events that seem to be on the smaller side.  A date night sounds great, and I'm definitely needing some retail therapy (I haven't been clothes or shoe shopping in forever!  My closet is depressing!).  A home project, or better, a new piece of furniture (entry way bench or a real bed) is also on the list.  I can do all of these, right?  I also have this weird urge to buy a mini-van (odd, I know).  I am definitely holding off on this one!

So...can I just vent about my little problem called insurance?  For 2013, we decided to purchase coverage for me on both my company's and my husband's company's insurance policies.  This way if the FET didn't work, we wouldn't have to pay out of pocket.  I called this afternoon to check my current infertility balance and found out that I have ~$5K left.  Nice.  Both plans are with the same insurer, so I asked the representative how the switch to the new insurance would work once I reached the max since I was planning on IVF again (and we all know that $5000 will not cover it).  She looked up the coverage on my husband's policy and asked me if I was aware that my the other plan "was limited" with regards to infertility coverage.  Crap.  She told me that the coverage is only for diagnosis and treatment only for the underlying condition (i.e. bloodwork and ultrasounds) but not for any treatments that would help me get pregnant.

CRAP.  Okay, I do realize that this is better than nothing and that I have enjoyed fantastic coverage from my company, but I don't like surprises.  And this was not in the plan.  I just paid extra for this policy that is probably not going to cover anything because my husband's plan is a high deductible plan and it's unlikely that I would even meet the deductible with just ultrasounds and bloodwork.

And it's so sad because I did question the coverage during open enrollment when I read something that  indicated that perhaps treatment wasn't covered.  I asked my husband to research it to make sure that we knew what we were getting.  He said it was fine.  And then again in December when I created my online account, I saw something else that made me question the coverage.  This time I called the insurance company myself to question what the coverage was.  Apparently I didn't ask the right question, which would have been "is IVF covered?????" because the person I spoke to told me that YES, infertility is covered at 90% blah blah blah.

So I'm sad.  It doesn't change my plans, but I'm very annoyed.  I now get to pay out of pocket for quite a bit more of the treatment than I had bargained for PLUS I get to pay for the insurance premiums on my husband's insurance that I can't even use.  Deep breath!

I have a new mission.  I need to figure out how I can make the most of that $5000.  If you've been reading for a while, you know I'm analytical, and it won't surprise you that I have a spreadsheet that compares the estimate that I was provided for each of the IVF services, what I was charged, and how much the insurance paid.  My insurance company gets a nice discount on services.  They only had to pay 90% for some, 60% for others, and then only 25% for the transfer ($283 vs $1128 charged)!  It would be really great if I could figure out a way to pay for some services out of pocket so that I have some money left over to have the insurance cover the transfer and only pay <$300.  If this seems excessive, it did pay off. I caught a billing error for my IVF. I was actually charged for the pgd biopsy twice.  I had that reversed and got $1200 put back into the amount of available infertility coverage I have left.

So anyway, things are frustrating over in my corner of the world.  Good thing I skipped my run this morning. I could really use a good workout this afternoon!

I need a milestone

Gosh, I feel like I'm living in the past.  Well, maybe not quite in the past, but maybe more of the alternate universe where I'm still pregnant.  In some ways I'm doing so well, but in others, I feel like maybe I am trying too hard to move on. 

I normally wouldn't write about something like this, but we tried to have sex last night and I couldn't do it.  I just got sad.  Stupid miscarriage.  All I could think about was that my stomach was flat because I wasn't pregnant and my boobs are super-small again because I wasn't pregnant, etc, etc.    Of course I want a flat stomach.  And running is so.much.easier with small breasts.  I actually like them small.  But.  Well, you know...I had other plans.

So...I don't know.  I guess it's only been a few weeks (I found out on valentine's day).  And I'm sure this is normal.  And I recognize that being in this limbo-like period when I'm just waiting around for my period is definitely contributing to these feelings.  I just want out.  And I think what will really help is a milestone.  Something.  Anything!  AF would be ideal, but I'd be okay with signs of ovulation (unlikely), so that I would know that it's just two more weeks before I can get moving on to the next phase.  Right now everything seems so wide open.  I mean, I could be waiting for 2 weeks, 4 weeks, or even more.  This is not helpful for a planner like me.

Or maybe I just need to make a plan for something else.  Vacation would be nice.  I actually have a girls' weekend planned in April, but there was a LOT of drama in the planning that I can't bring myself to buy plane tickets.  So that doesn't really help.  Maybe a road race is a better option.  I've been reticent to sign up for any races this year because I thought I might be pregnant, and then I was, and now I'm not, but IVF is around the corner.  Maybe a good idea would be to find something that I could get ready for in 5 or 6 weeks.   I just need to reclaim some speed, so I would feel good about myself out there.  Maybe that would help.

I don't know.  I'm not very patient.  Any other ideas?

The comfort of the fertility clinic

I had another blood draw this morning to check HCG levels.  The lab is in the basement of the building when my clinic is.  As I walked into the building, I thought about how many times I've been there over the past few years.  It's been a LOT...even with the break that I had in 2010 and 2011.  When I was doing injectables, I would visit somewhere around five times in a span of ten or eleven days and then I'd be back two weeks later for more fun and to start it all over again.  Crazy!

What blows me away is how comfortable I am there now.  I remember dreading my first appointment.  It was August 28th, 2009.  I'm not sure why I remember the date, but I guess it was important.  I didn't want to be there, because to me it meant that I had to admit that there was a problem that we needed to deal with.  I wasn't comfortable with ultrasounds.  It was hard for me to adjust my work schedule to all these appointments and to not be noticed for coming in late.  But there I was, a newbie infertile, kicked out by my OB who had been kind enough to treat me for a few months before she went on maternity leave.

Fast-forward 3 1/2 years to two weeks ago when I had my appointment with my OB and there was no heartbeat.  I couldn't get out of there fast enough.  I barely asked her any questions (okay, so granted, I was shocked), but when I asked about next steps and she said that the clinic might have more options for me for handling the miscarriage, I knew that I wouldn't be knocking on her door any time soon.  And so I slipped out the back exit so I wouldn't have to walk past her office.

In many ways this surprises me, because I have been seeing her for over six years.  She was the person I first talked to when I was having trouble conceiving and she treated me with clomid for several cycles.  She was the one who saw me through my pregnancies.  I trust her.  I even went to see her about 15 months ago just to make sure that from a medical standpoint, my idea of getting pregnant wasn't stupid.  She has been a great resource...but when it came to my miscarriage (something I'm sure she sees more than I care to think about), I just wanted to get out of there back to the comforting nest of people who are constantly dealing with people who are struggling.  I guess going to the same office for so many appointments builds a strong sense of comfort.  And I must say that I am very happy to have a comfortable place to take my next steps in this journey.

My HCG came back at 18 so I need to go back in a week or two to make sure it drops back to zero, and then I have my WTF appointment on the 14th.  I'm not too concerned about that meeting.  I think we're on the same page for next steps, but I'm sure I'll come up with a few questions....

Progress...or not?

Ahhh, it seems like 1 step forward, 2 steps back, then two steps forward, and one step back.  I've been mostly doing really well.  Other than a huge bruise on my arm from the three sticks for the IV on Friday, physically I am back to normal.  My bras are not filled very well again and my stomach is flatter.  Spotting is pretty much non-existent.

We had a nice weekend and headed out to the coast for the afternoon on Sunday.  That's always a healing experience, even though it was a bit cold.  I guess it is February.

I can also feel that the wall I've put between myself and my parents over the past couple of weeks is coming down, and that gives me a big sense of relief.  For many reasons, I have kept all of my baby-making attempts and struggles very close to my chest.  This time around, I literally told one person (other than my husband, of course!) who didn't need to know for medical reasons.  Obviously this has its benefits and downsides.  Mostly it was okay, but this miscarriage really made it difficult with my parents.  I see them at least twice a week, and when I holed myself up over the long weekend, my mom wanted to know why I was MIA.  She thought that we must "have been having lots of fun"!  Uh, not really, but what do you say?  Anyway, I retreated for a while to protect and take care of myself the past 12 days, but have now returned to normal activities (i.e. not trying to end a pregnancy) and have been able to be normal and not so distant.

Little things still jab at me, and I know that's just not solved immediately.  I just wish I could expedite it because I just want to be normal.  Ha.  I was out running this afternoon and ran into a friend who had a baby three weeks ago and I didn't even flinch when she asked (again) if I wanted another one.  I gave her a carefree laugh and had just a little pang after we parted ways and I ran off.  But then when I got home from my run, my neighbor commented that I must be running more basically because I looked like I was losing weight.  I didn't tell her that was because I was pregnant a couple of weeks ago and my abs aren't strong enough to keep a pregnant stomach flat in the afternoon!  So I guess I looked fat. That's good for the ego. Time to work on my core.... 

Turning the page

I don't expect to close the chapter on this pregnancy until we start preparing for IVF #2, but I definitely turned a corner today with an unexpected morning.

I had to be at the clinic at 8, so that meant I would go alone and my husband would deal with the morning craziness.  I was more than fine with that because I tend to be independent and prefer to do these sorts of things alone (more on that soon!), although he was supposed to come pick me up and drive me home.

I did all the normal check-in stuff, had a minor freak out when I saw that the activity restrictions included no "strenuous exercise" for 7 days, and was led into the procedure room to get ready.  I spoke with the fellow who assists my RE and she assured me that I could exercise as long as I felt okay.  Phew. We also talked about sedation, medication and we agreed that I would only get Toradol, which is like super-Motrin and then get the heavier stuff if I felt too much pain.  This turned out to be a great decision, because when she did the ultrasound to see what was going on in my uterus, there was nothing there!  Apparently, I passed the gestational sac on my own (I take back every bad word I said about the four doses of Misoprostol because apparently it did work!) and I didn't have to have the D&C!  [Insert cheering here]

I have to say that this is the best case scenario that I could have imagined for today.  I am so happy to have avoided the procedure.  I left with no tears.  I enjoyed the time with the nurses (aside from the three sticks required to get the IV in...I was just a bit dehydrated!).  I did not have any pangs of sadness when I saw my empty uterus on the screen.  It's just great.  Of course, that's still just the surface, but today is a good day.

My RE did stop by to chat and we are in sync for next steps.  The plan is to move forward with IVF #2 and to do a freeze-all cycle with PGD.  We both have a feeling that I might be one of those people whose bodies are not receptive to embryos after being stimulated.  I'm okay with that too because when I do get pregnant, I want to live as normally as possible, and maintaining my workout schedule (not possible with a fresh cycle) is very important to me.  I did ask to leave the door open for a fresh transfer in case we end up with a chromosomally normal embryo that has questionable quality that might not make through a freeze/thaw cycle.

They took some extra blood to test HCG levels and I will go back for a follow up in three weeks.  Things are looking up.  I'm glad it's Friday.  I think I need to find something fun for us to do!

---
Update: Just got the HCG results.  It's down to 196.  Looks like I'm well on my way back to normal.

ICLW!

If you are visiting from ICLW, thanks for stopping by!

The quick synopsis of my situation is this:
- One week ago I was 8 1/2 weeks pregnant, happily enjoying my status as a frozen embryo transfer success story.
- Today I am picking up the pieces from an ultrasound that showed no heartbeat.  This wasn't the side of the statistics that I wanted to fall on.

I am currently waiting for a D&C because my four attempts(!!!) at a medically induced miscarriage did not work.  I am ready to put this experience behind me and focus on what the future has in store for me.  I know it won't be as easy as it sounds, but I am ready.

It looks like I might be able to get in for the surgery tomorrow.  The patient coordinator I spoke to on the phone thinks I'm crazy for not wanting to use the anesthesia.

I give in

Sigh.  Ugh, the medication didn't do the job.  I had some pretty strong cramps last night and went to bed around 11:30 expecting it to happen overnight.  I woke up in a sweat a couple of times, so I definitely know something was going on inside, but when I woke up around 4, there wasn't very much bleeding.  And now the cramping has returned to normal levels. 

I also noticed that I didn't find myself having the deep connection to the cramping pain that I had hoped for.  In fact, I found myself thinking about work for a while!  Perhaps I just needed time to be ready for this to happen.  It's been six days since I found out there was no heartbeat and after a conversation last night with my husband, I feel like I'm truly ready to try to put this behind me and figure out the path forward.

I've decided to call "Uncle" on this process and go ahead and schedule the D&C.  I put the call in to the clinic and will hopefully get an appointment tomorrow or Friday.

Processing the Process

So I was lying in bed last night (and quietly crying...an event which has become a regular occurrence since last Thursday) trying to figure out just why it was so important to me that I avoid the D&C.  Was it to avoid the invasive procedure?  Sure, that was part of it, but it wasn't the whole thing.  Was it the need to have some sort of control over this, where my body was doing something, rather than having something done to my body?  That certainly sounds like me, but that wasn't the heart of it either.  Then I got it.  I realized that during the past few days, I really haven't had a chance to really "process" the loss.  For one reason or another, I can't spend more than a few minutes at a time thinking about my future will (another IVF, ugh!) and will not hold (baby in August or September).  Part of it is my busy life, and part of it is my defense mechanism.

In my mind, I have this vision of the miscarriage as a period of time, maybe just a few hours, when because of some physical discomfort or pain, I will focus on what is happening to me, I will let myself cry and be sad, and I will not be distracted.  I don't know if this is how it will be, but having this time reserved to focus and acknowledge the situation gives me comfort that I won't find myself a few months down the road with residual issues.

Anyway.  I hope I get what I need out of this process.  The bleeding picked up a little bit today, so I'm hoping that the medication gets the ball rolling tonight.  Time to load up my cheeks like a chipmunk with contraction-inducing medicine and sit on the couch to watch some trashy tv.  I think work will need to wait until morning.