counting the days

* 366 days since we lost C's mom.

* 14 days until my next trip to the RE, for u/s & b/w.

* 15 days until the lupron begins (assuming u/s and b/w are normal).

* 16 days until C's cousin's wedding- hoping for no lupron side-effects to ruin the day.

* 19 days until our second wedding anniversary, the second anniversary of the start of our babymaking efforts.

* 21 days until the first birthday for my friend B's baby S. When she told me she thought she was pregnant in October 2007, I thought I might have been too. And now her daughter will be one year old and my children haven't even been conceived.

* 23 days until the next visit from AF. The last for a long while? We hope so.

* 27 days until stimming begins.

* 38 days until hcg trigger (estimated).

* 40 days until ER (my guess).

* 43 days until ET (theoretically).

* 54 days until I can hardly resist the urge to pee on a stick.

* 57 days until C turns 43. Beta day? Maybe... except that it's a Saturday, so...

* 59 days until beta (if we're very very lucky).

hangin' around

Nothing much happening here. I settled quickly back into the BBT habit and have been relieved and heartened to see my temperatures follow the same pattern as always, even before we enlisted the help of midwives, REs and drugs. I didn't catch a +OPK, but I think I started testing too early and simply ran out of tests before the LH surge happened. The AF-preamble has begun and I expect to see her in earnest tomorrow.

Then the fun begins. The countdown to our first intentional IVF cycle. AF will kick off the whole process, followed by lupron, another visit from AF, then stimming, ER, ET, and... I won't think beyond that. Or at least I'll try not to. One step at a time. One milestone at a time. I've been privvy (by blog) to too many heartbreaking BFNs and losses in the last several weeks to believe that a textbook IVF, or even a BFP, means we've made it through to the other side. It will be a challenge to rein in my forward-thinking, to focus on what's happening in-the-moment. I could fret myself into a panic by worrying about who's going to accompany me to the retrieval (C may be working, and I'm afraid of the repurcussions if he tries to take a day, or part of a day, off), or any other thing that may or may not happen.

I'm finding that one of the challenges of IF is the jump from daily monitoring to TWW; from focusing on this day and this cycle to looking forward to the next after a BFN. If the hormones weren't enough to cause mood swings, this schizophrenic lifestyle would be.

inward

We're invited to a friend's daughter's birthday party this weekend. The friend has a cousin who reversed his vasectomy when he married his current wife. TTC wasn't easy for them, but now they're pregnant after a successful IVF. They'll be at the party. I don't want to go. I hardly know these people. I don't want to hear about their difficulties (gut reaction = dammit- he had a vesectomy! He was DONE having kids. He did this to himself!). I do feel empathy for this couple. I'm really not a heartless, self-centered bitch. I'm happy for them. But I envision the party being like a set-up... we'll somehow end up sitting together and everyone else will drift away so we can "talk about what we have in common." Sorry- I've been with C for five years and we've had plenty of opportunities to socialize with this couple. If we weren't close enough to pal around with them before, we still aren't and I don't feel comfortable swapping TTC stories with them.

Lately, I've found myself keeping our IF and TTC travails a little closer to the chest. I don't want to talk to anyone about it. If C has to work on the day of our next ER, I'll drive myself in and he can pick me up on his way home from work. I cringe at the thought of involving anyone else; of having to explain what's going on and how I'm feeling and how hopeful but guarded I am; of hearing the ignorant platitudes that do nothing but make my skin crawl. I especially don't want anyone but C by my side while I wait and recover.

I'd kind of like to disappear for a while and not come back to this world with people in it until we're pregnant enough to share the news with the whole world... say around 25 weeks. Instead, once we have a more concrete timeline, I'll schedule a vacation to coincide with the first half of the TWW so I can essentially hide under a rock for a while.

if you ask, O will come

Just like that, my BBT shot up this morning, presumably indicating that I ovulated yesterday. Of course, the temp has to stay up for several days to be semi-conclusive, but I'm conviced I started testing too early. New bit of information in my self-awareness arsenal- the cycle after a failed IVF (converted last-minute from IUI due to "exuberant" response to gonal-F) will include ovulation at approximately CD19. The norm, unmedicated, is CD14. On clomid, CD17. And so far, the luteal phase is consistently 14 days regardless of what drugs have entered my system.

So my new calculations put AF at May 24th, lupron to start June 15, another AF on June 22. The unintentional IVF consisted of ER on CD11 and ET on CD14. I think they want to stretch follicle development a day or two longer this time, so I'll guess ER on CD13 with ET on CD16... that will be July 5 and 8. And an expected due date of 3/29/2010... two days before my 42nd birthday.

I'm not counting on this timeline, but I love thinking about it... perhaps a shared birthday with my first-born. I can't think of a better way to celebrate.

where's the O?

Today is CD19 and I haven't ovulated yet. I used up my last 5 OPKs in anticipation of seeing either a darker line or a smiley face, but all I got was the complete absence of a second line, and a big fat digital zero. I'm discovering that this break is harder to tolerate when its end becomes uncertain. Will I ovulate at all? If I don't, will the cycle ever end... and when?

So, I have questions that I didn't think to ask the RE last Thursday. Maybe the blog-world has some experience to share? I'm just curious if anyone else experienced either delayed ovulation or an anovulatory cycle after a failed IVF. If delayed, by how long? If anovulatory, how did the length of the cycle compare with a normal one? I'll talk to the RE's nurses if nothing has happened by Friday, CD24. It's not so much the length of this break that concerns me, it's the not knowing when things will or should happen. I'm not sure I'd recognize a real problem if I were having one, so I'll ask for a little guidance.

In happy news, I received the approval letter from my insurance for IVF #2. We're covered for the whole shebang- donor sperm, ER/ET, with assisted hatching (because I am old- that makes me laugh).

Oh yeah... It's Mother's Day, and I haven't cried about not being a mom at all. That's really good.

what's next

I met with the RE this morning to review my failed IVF and to find out what the plan is for the next attempt. The good news is that she's submitted a recommendation for an IVF cycle to my insurer and fully expects the procedure to be approved. The bad news is that I turned 41 and have entered a whole new statistical bracket, full of very depressing numbers.

First, the recap...
I responded well to the gonal-F, but only 5 of the 11 retrieved eggs were mature. The RE normally likes to see 70%+ maturity. Three of the five mature eggs fertilized, which is acceptably "normal," and actually pretty good considering my age. A moderate amount of fragmentation was noticeable on all three fertilized embryos. Fragmentation is associated with embryos not implanting in the uterus. The transferred embryos were 10-, 7-, and 5-celled. Ideally, embryos should be 6 or more cells for a 3day transfer.

The plan...
Eleven eggs is roughly the goal of stimulation for an IVF cycle. In order to increase the number of mature eggs, I'll start lupron three weeks after my next CD1. The goal is to grow the eggs a bit more slowly and consistently so we end up with most of the eggs maturing at the same time. I'll be injecting gonal-F starting around CD5, 225units twice each day. The dose and frequency both increase over the last cycle to compensate for lupron's suppressive effect. So, even though I'll be injecting more than double the gonal-F of the last cycle, I should develop about the same number of eggs more slowly than last time.

There's nothing we can do to influence the amount of fragmentation, but my uneducated guess is that a more mature egg will develop less fragmentation.

I was a little disappointed to learn that the "start" of an IVF cycle is three weeks into a cycle. So, instead of taking one complete cycle "off," it'll be more like 1.75 cycles. That's seven weeks of doing nothing. We're looking at lupron starting around June 11th, with ER and ET in the week of the Fourth of July.

I hate that my mind does this... I immediately started thinking that the ultimate birthday gift for C would be a pregnancy annoucement. His birthday is July 18th, and our beta would be right around then if I counted this out correctly. Our due date (because I just can't shut off these thoughts) would be right before my 42nd birthday.