4:30pm, Monday July 27th... could it be?

I think I have a symptom! Hurray!

I feel icky, kind of like I ate something that isn't agreeing with me. It's not bad enough to affect my comings and goings. This just might be morning sickness! Of course, it's not morning here, but it's always morning somewhere. Maybe my morning sickness just flew in from Hawaii and is a little jet-lagged and behind schedule.

I've never been happier to feel a little icky.

no symptoms here

Still no symptoms. I remain bloated- not as badly as the week after ET, and I can "fit" into all my regular clothes, but pants that used to require a belt stay up on their own. And the pants that didn't need a belt are uncomfortably tight. I don't believe that has anything to do with being pregnant. It's more likely lingering bloat from OHSS.

We've remained faithful to not telling anyone but our two closest couple-friends and C's father, and one friend of mine who lives three states away. I feel like a fraud for even telling them, since I still have nothing but a couple of blood tests and a handful of two-lined pee-sticks as evidence. Nine more days until our first u/s. That should make it more real, assuming everything looks OK.

Well, maybe I do have one symptom. I've been very sleepy lately. As soon as I sit down on the couch after dinner, my eyelids succomb to gravity and I struggle to keep them open. Doesn't matter what time it happens to be... 7:00, 8:30... that's it, I'm done for the night. I also find myself sleeping on my side a lot, instead of on my back as is my norm. And I desperately want to nap at around 10:00am and 1:00pm at work.

I had a baby dream the other night. Someone gave me two babies, both boys, to take care of for a few days. The boys were very dissimilar in appearance- one being very dark, with an olive complexion and dark eyes and hair, while the other was very light. They were given to me in swinglike contraptions, a confusing array of straps and buckles that provided a handle of sorts with which to carry the boys around. I could sling one over each shoulder, like purses. And I could hang them from hooks on the door when I needed my hands free for something else. They were angelic little guys, never crying, but looked at me with confusion in their eyes as if to ask why they were with me and not with whomever had cared for them before. I don't put much stock in dreams, but it was interesting.

I learned this week that our donor bears a resemblence to Kevin Love, Matthew Modine, and Michael Rappaport. That's a new feature on the sperm bank's web site. Interesting. I don't really see similarities among the three, so I guess the donor shares a feature or two with each.

is angst a symptom?

Morning commute. Speed limit on secondary road is 45. The guy ahead of me is gawking at something off to the left, ambling along at 35 mph. I rejoice when he finally pulls off into a coffee shop parking lot, but my joy is short-lived as an 18-wheeler pulls out in front of me in the break created by slow-man exiting the road. Long, slow hill... adds at least 4 minutes to my commute (time is precious, isn't it?). Not a happy drive. Just annoying.

Arrive at work just as irksome co-worker pulls into the spot that I usually park in. When I began parking there, no one, and I mean that quite literally, would park in that little slice of the parking lot except me. It's an area that's well-shaded from about 2:00 on, so my car isn't a thousand degrees inside when it's time to leave work (I do not have a/c). At the same time, there are no trees or branches directly overhead, threatening to fall on my poor li'l vehicle in stormy weather. It's further from the front door than most spots, but I like the walk. But once I'd been parking there for six months or so, co-worker decided that on days when she arrived before me, she'd park where I like to. But not quite IN the parking space... no, she can't seem to maneuver her mid-sized SUV completely between the lines, so her front tire is always on the line separating that space from the one beside it, which is my default spot... still shaded after 2:00, but not smashed against the bushes that flank the only other spot in that small area. So I park, perfectly centered in my space for the day, and it's a tight squeeze to get out of my car.

If I'd not gotten stuck behind slow-man and lost those 4 minutes, I could have parked happily in my usual spot and co-worker would have parked where she used to park before I got her thinking about trying something new. Grrr.

My office-mates and I were planning to take two colleagues to lunch today to celebrate their birthdays, so I did not bring a lunch. I ALWAYS bring my lunch. I NEVER go out to lunch (except when we're taking colleagues to celebrate birthdays, 5 times a year). C and I go out to eat maybe once a month. Our "eating out" budget is puny, and I'm not about to waste any of it on lunch when a simple tomato sandwich is pure heaven to me. Speaking of which I have two huge tomatoes waiting to be sliced for sandwiches. They're perfect, and that's what I would have brought today. The husband of one of the birthday girls is unwell. B-day girl may not come to work today, in which case we're postponing lunch. Dammit. I can't justify going out and buying a lunch today and then having to go out again in the next week or so for the birthday thing. So, lunch today will consist of two granola bars, an apple, and a yogurt. Great. Just great. I could've had a tomato sandwich.

I know the world doesn't revolve around me. Four minutes is nothing in the grand scheme of things, and parking is first-come first-served. I'm sorry that birthday-girl's husband is ill, and I hope it's nothing serious. But I feel like crying and yelling and I just want to go home because I've only been out of the house for an hour and nothing has gone well. Is this pregnancy?

another reason to be grateful

Without the warm, thoughtful, and wonderful comments I get from you who read what I blog, I'd be losing my mind right now wanting to tell someone that we're pregnant. I haven't been thrilled with the response from the two couples we did tell IRL. Yes, they're excited for us. But they really don't understand what it took to get here and they don't have the interest to ask, nor the patience to listen when we begin to explain.

You, though... you get it. You understand. Even though our paths have not been identical, you recognize the gravity of finally reaching this point. Even more, you understand the tremulous tightrope that follows a BFP, which is no guarantee of anything. I've followed your blogs and wept over your losses. So many have made it past where I am now only to lose everything. We're all doing everything right, but there is so much that is beyond our control and which can take it all away in a heartbeat. Our friends IRL simply tell us, "You'll be fine." The IF community empathizes, understands the mixed emotions we're experiencing now- the joy of a positive beta and the worry that this could disappear without reason or apparent cause. You're encouraging, as our friends IRL mean to be, but you recognize how much has been invested in TTC. I don't know if I've expressed it clearly enough, but I want you to know how thankful I am for all of you, commenters and silent readers alike. I wish I could hug you all. And I hope beyond anything that we'll all make it to the other side of TTC with our arms and hearts full.

rising

Woohoo! Hcg at 512 today. I found an online calculator that computed my doubling time as 1.72 days or just over 41 hours. Sounds good to me. I'm still pregnant, even though I can't tell. I have an u/s scheduled for August 3rd, so I'll remain PUPO for at least another two weeks. Meanwhile, I'll research how likely I am to see a heartbeat at approximately 6 weeks 4 days.

The nurse who called with my beta number also provided me with a wonderful resource. I don't know if it's available outside MA, but if you have a health-care product that you are thinking of using and want to make sure its ingredients are safe for pregnancy, call 800*322*5014. You should have specific items' ingredients in front of you in case the actual item is not in their database.

I've never been so happy not to eat sushi or drink beer!

fact or fiction

I'm having a hard time believing I'm pregnant. Aside from a few pee-sticks and a call from a nurse, there's no evidence. Sure, I have a bit of a gut, but that's as likely to be leftover from the mild-moderate OHSS as it is to be pregnancy related. Besides, no one develops a bump at 4 1/2 weeks. I'm probably just pudgy from prolonged inactivity during an IVF cycle.

I'm an empirically-driven person. I might sort of believe something I can't see, but I want as much evidence as I can get my hands on before I'll fully commit. Even then, evidence can be misinterpreted. I struggled in high school physics after my first philosophy class, where we read Plato's Cave Metaphor from "The Republic." Gravity, you say? Prove it! Time and space? Human constructs. They don't exist as absolutes. (I still love The Cave. It was honestly one of the most influential pieces I've ever read in my life and I can't imagine who I'd be today if I hadn't read it at 17.)

I'd really like something internal to signal that a life is growing inside me. Some sensation I've never felt before that I can point to and say, "when I felt ____, I knew I was pregnant." I know there's plenty of time to develop symptoms, and I'll (hopefully) be whining about them soon enough. But if these first weeks are all I ever get (dear God, please let that not be the case), I want something to make this time in my life unique and special.

I'm waiting for a call from the nurse with today's beta#2 result. A good number will mean so much. But I'd like to FEEL something too (besides all the fantastic emotions that well up whenever I remind myself that I am, at this moment, pregnant).

I'm an ogre for complaining. I'm truly lucky to be having a beta#2; lucky to have reached this point. I'm grateful, really. I'm just having a hard time believing the pee sticks and Thursday's beta.

doubling time- after a little research

You're all too kind, really, especially those of you who've been through the multiple betas that follow a BFP and who know that hcg levels are not supposed to double every 48 hours. If this were information that anyone in my family knew, and if any of them were aware of this blog, you can bet they'd have corrected me as quickly as they could type the words, "You're wrong."

I did a little research and learned that hcg levels should double every 48-72 hours in the first couple of weeks. I'm glad I found out before Monday's beta#2, otherwise I'd have been terribly disappointed with a perfectly acceptable result.

So, 103 yesterday. Four days between beta#1 and beta#2. (I love math)- I'm hoping for an hcg level of 240 or better on Monday. My research also revealed that an increase of as little as 60% in 48-72 hours has resulted in perfectly healthy births.

C's new hobby- he's been looking up baby names on the internet. And he likes to call out the possibilities to me from the office. While I'm trying to sleep. It's sweet, but I fall asleep in spite of him.

we knew, and now the RE does too

Hcg is 103 today. I am definitely pregnant. I go back for another on Monday, by which time it should be over 412, if my math is correct... doubling every 48-hours or less, so in 4 days it should double at least twice, right? It's a little more real now, and I'm planning to spend the weekend reveling in being pregnant, but I know Monday's results can make or break us. It's still so incredibly early.

No more little blue pills (estrace)! Yippee!
Crinone continues... yuck. But worth it!

Still no real "symptoms" of pregnancy. No change in appetite or food preferences. Maybe a little thirstier, but since this is the first week that has even come close to resembling "summer" around here, the thirst may be more weather-induced than biological. I might be a little sleepier than usual, but that's hard to gauge. I get goosebumps every few minutes- but that's because I keep reminding myself that, for the moment at least, I AM PREGNANT !

5:35 PM, 9dp3dt...

I'm a lousy photographer, with shaky hands on a normal day. This was the only one (of many attempts) that's even close to in-focus. There is absolutely, without-a-doubt, a second line there. You may have to click on it to see it a little bigger in order to find the second line. It's a little darker in real life. I can hardly wait for some numbers to go with this. Thursday... just a day and a half away (cuz you can bet I'll be there when the doors open at 7am).

I need some decent photo-editing software.

"Sweetie, get your glasses and wake up." He saw it too.

The most ghostly, faint, barely-there, nearly imperceptible, am-I-imagining-this line appeared on the HPT this morning. C thinks he saw it too, but only if he held the test just-so and looked at it askance, with his eyes slightly squinted. Could it be? I'm all goosebumps and breath-holding now. Two more days until beta. No real symptoms, but a few maybes that haven't been worth mentioning.

I can't even take a picture of it because the line I think I see is too faint. It won't be real, and we won't truly believe we're pregnant until the beta results are in. I was convinced this cycle had failed. Now, I'm thinking just maybe...

7dp3dt- negative

I bought a 3-pack of HPTs. I decided I have nothing to prove to anyone by not POAS, so why the heck not. Today's was negative, but since it's still fairly early, I can take that with a grain of salt. It's by no means a BFN- I consider it simply evidence that the trigger is definitely out of my system, so a BFP on some future date can be celebrated without question. Besides, if we pay any attention to the accuracy statement on the package, we can't trust anything it says today, roughly 10 days before CD1. It's only 53% accurate 4 days before CD1!

Geez, now that I think about it, this really is a blatant waste of money. My beta is Thursday, 6 days before expected CD1, and the HPT isn't supposed to be used until 4 days before. I'll already have my answer by the time the HPT is more than 50% accurate. It's still fun though... maybe I'll use one on Wednesday, preemptively, and then if I get a positive beta, I'll use the last one next week. There's got to be some satisfaction in finally seeing that second line, even if it's already known. I really want to see a second line.

Obviously, HPTs were not designed for the IF community, although I'm pretty sure we're their biggest customers. Do they really think any of us could wait until a missed period to test? Besides, with all the drugs we've taken, how the heck do we know when AF is supposed to make her next appearance?

I won't post photos of negative pee-sticks, but if I get a BFP, even after a positive beta, you can bet it'll be here for all to see. We could all use some proof that those things tell the truth once in a while.

Oh, before I forget- the bloating has nearly disappeared, although it was pretty fierce on Friday night when I squeezed into non-elastic/non-drawstring pants and went out for a nice dinner with some friends. Today, I can actually suck in my stomach for the first time in more than two weeks. There's still a definite bulge front and center, but that might be because I haven't done anything active in nearly a month. I return to work tomorrow, after taking a week's vacation post-transfer, and it's good to know I can wear my normal clothes and avoid speculation from coworkers. If they ask, I'll tell them (truthfully) that I bought C some gourmet cupcakes for his birthday and we've been eating them dilligently so they'll be gone before they're stale.

to pee or not to pee

I just don't know. Those sticks are evil, but I want to buy a few and use them up. I want to use one today, to see a negative and know it's because the trigger shot is out of my system. I want to use one tomorrow in the hope of seeing an early positive. I want to use one before my scheduled beta so I know before the nurses do, regardless of the outcome. I just want to KNOW. But those devil-sticks lie and manipulate and can't be trusted.

Here we are, 5DP3DT. I can't tell if the bloating has abated or I've just become accustomed to it. Most of my pants still do not fit, so I convince myself that I'm still experiencing mild OHSS, which would be a good thing because it would mean my HCG levels are rising, ergo I'm pregnant. Then again, I no longer have to stand or lie flat to take a deep breath (for a couple of days, there was nowhere for my diaphragm to go while seated), which means the potential OHSS is going away, which means no rising HCG and no pregnancy. Maybe if I POAS, I'll have an answer. But if it's negative, I'll just have to pee on another one, and then another, and then another because, honestly, it's too early to expect a BFP from even the most accurate HPT.

Yesterday, I self-medicated with gooey brownies. Tonight, we're going out to dinner with another couple, who know about last weekend's IVF. I just hope it's not the focus of our evening out. I know they'll drop the subject if I ask them to, but I'd prefer not to have to ask. There is more to life than TTC... at least I think there is. I'm having a hard time remembering that this week. I'm just ticking off the days until the beta. Six left to go.

a little look-see

Eeeny, meeny, miney, moe plus one for... luck?

I don't know which is which, but there should be three 8-cell, one 7-cell, and one 4-cell. I'm just hoping something sticks. I'm laying low today- did a little laundry, but otherwise haven't moved far from the couch. I'm already 3/4 of the way through the 2-liters of fluid that Dr. A recommended. The one great thing about IVF (aside from the higher success rate) is that the TWW is actually only 11 days, counting from ET. I'm already seriously tempted to pick up some pee-sticks so I can start using them on Sunday, 10DPO, aka 8DP3DT. Evil, evil pee sticks. I like to think I know my body pretty well by now, that I'll be able to tell definitively if I'm pregnant or not, but I know I'm delusional in that respect. I should still steer clear of pee sticks and just wait for the REAL answer on the 16th. I don't know if my will is strong enough though.

The BLOAT continues. Only shorts and pants that are normally several sizes too big fit today. I feel like a whale and don't really want to go out in public. This morning, I thought I'd shrunk a little, and I may have but just because I got up to pee 4 times last night. By the time I'd taken today's meds (2nd-to-last doxycycline pill plus three tiny estraces), washed down by a large glass of water, I was feeling as engorged as I did yesterday. My weight still hasn't changed, and my belly is still soft, so nothing to worry about there aside from embarassment. I feel OK- no residual pain from the ER, just huge and a little fragile- like I might pop.

eeny, meeny, miney, moe, plus one for good measure

ET today. Dr. Aggressive was on , so I did not have to justify our decision to any of the nay-sayers. This was the first time in my IF life that a male doc was involved, which was a little strange- especially since I'd never seen the guy before and had only spoken to him the one time, Friday, to discuss the fertilization report. Add to that the male who assisted (led me into the OR, arranged me in the stirrups, and slathered u/s gel on my lower ab), and it was almost awkward. But, as I'm sure everyone living the IF life knows, modesty has pretty much disappeared, so I got over it almost as soon as I realized these were the first two men to "know" me in an IF way.

Here's the real news of the day- we transferred FIVE embryos. At first, the quantity had me a bit alarmed. I was afraid it meant they were all crappy and had little to no chance of implanting, so they were just throwing the maximum in there to see what would happen. Not so. We had two 8-cell grade 1 (aka PERFECT) embryos, one 7-cell grade 1, one 8-cell grade 2, and a 4-cell grade 2 to round out the full house. Even to our untrained eyes, C and I thought today's embies looked better than the three we transferred in April. The rest of the 15 that fertilized apparently did not fare well, but I don't know the details. I believe there's nothing to freeze.

The transfer itself was nothing spectacular, aside from the fact that this time I got to watch the u/s monitor while the embies were released. Mr. Nurse pointed on the screen to where I should focus my attention while Dr. Aggressive manned the u/s doohickey, pressing it almost painfully into my abdomen while a resident did the actual transfer. She was great- I'd met her in April, when she was observing procedures. I swear she didn't open the speculum as wide as the transferring doc did last time, and I didn't feel a thing when she fed the catheter through, so it would have been painless if not for Dr. A and the u/s.

I asked about OHSS- specifically, how much is "a lot" (i.e. "drink a lot") and of that amount, how much should be Gatorade-type beverages. Dr. A pressed on my bloated belly and said I have nothing to worry about because I'm soft and squishy around the middle and I haven't gained any weight since the retrieval. But he said I should continue to drink 2-liters or so daily (his definition of "a lot") just to stay hydrated, and at this point none of it needs to contain electrolytes. I'm not sure I buy his "don't worry" diagnosis, since OHSS often doesn't flare up until HCG levels rise with pregnancy. I'll keep weighing myself daily and paying attention to how much goes in and how much goes out. I'll be vigilant, but I won't worry.

I have enough to worry about... FIVE embryos and the TWW.

Just what I was aiming for

I just got the call with the fertilization report and another doctor's recommendation on how to proceed. Of the 40 eggs retrieved, 24 were mature. The number might have been higher if they'd anticipated that many eggs, but the 18 that were measured on CD10 were ready to go so that's why we triggered when we did. I'm extremely happy with 24. That's more than quadruple last time (11 retrieved, 5 mature), and more than I'd even hoped for.

Of the 24 mature eggs, 15 fertilized normally. That's 62.5%, which I guess is fairly normal since last time 60% (3 out of 5) fertilized and the RE was happy with the fertilization rate in IVF#1. So, I got the 15 mature, fertilized eggs that I was dreaming of. Hurray!

After the numbers, we discused the big issue- 3DT or freeze all. First, anyone with a reasonable response to IVF meds experiences some degree of OHSS. In fact, OHSS is the goal of all those shots; CONTROLLED overstimulation. Second, the doc I spoke with today says he's never seen a severe case of OHSS in a patient over 40 in all of his 15 years working with IVF (I forgot to ask how many 40+ patients had produced 40 eggs). He's confident that I will experience mild to moderate OHSS, but our chance of success is much higher with a fresh cycle. Given my age, he wants to be aggressive. I do to. I want more than anything for this to work. You all know how that feels. And if I decided to freeze all those embies and none of them ever became our children, I would second-guess and regret my decision until the end of time. We're giving it all we've got. If I end up uncomfortable and hospitalized, I'll know I did everything I could. We've been sacrificing for our children for years now. Why stop now?

I know I may regret this decision. Two REs and three nurses all advised against proceeding with a 3DT. It might have been different if yesterday's RE had been working today. Ultimately, I'm glad Dr. Aggressive called. I'm not holding anything back. I'm more than a little scared, but so hopeful that this will work. Fingers and toes crossed, here we go.

Uncertainty

I'm more bloated than yesterday, but I lost three pounds and I feel a bit better. There's still a lot of cramping, but I plan to medicate with a heating pad and lots of rest rather than narcotics. Again, I'm no martyr- if this gets truly painful, I won't hesitate to reach for the Tylenol-3. I want a clear head. I have a big decision to make, and less than 5 hours in which to make it.

Today is a holiday, so the RE's office is only open for monitoring. I may call and ask if they can do anything that would give me more information to base my decision on. But then I remember what yesterday's RE said about OHSS symptoms not flaring up until days after ET. I went to bed last night convinced that freezing them all is the right thing to do. But now, I'm feeling better and I'm not so sure.

I need to know, if they freeze all the fertilized eggs (assuming some fertilize- I know that's not a certainty either), how do they decide which ones to thaw for FET? Can they thaw them all and see how they grow and then freeze any viable ones we don't use? Or, can a poor little embie be frozen only once in its tiny life? Why is it better to freeze them right after fertilization instead of growing them for 5-6 days, as is generally done in a fresh ET that results in extra viable embies? Should I get my E2 measured today, and would that number help cement my decision one way or another?

That's it- I'm calling the RE. The worst they can do is tell me they can't do anything that will make the decision any easier.

Fert report expected by 11 am today, at which time some decision has to be made. If we decide to continue toward a 3DT, we can still change our minds.

Less than 24 hours to make a big decision

Today's retrieval was not what I expected. Admittedly, my first ER wasn't exactly textbook, having been converted at the eleventh hour from IUI to IVF because of the number of follicles that had developed (11 on OI meds). This time, monitoring had revealed 18 measurable follies on CD10. I, of course, was not informed of this until this morning, at the hospital, minutes before the ER when the nurse reviewed my chart with me. My E2 was 3970, also on CD10. Anything over 4000 is considered high risk for OHSS (ovarian hyperstimulation syndrome), but since I'm 41 and E2 was a hair below 4000, they really weren't overly concerned.

Until they started retrieving eggs. Lots of eggs.

Now, I was preparing myself for a relatively high number. But because of my age, I was ready to make do with maybe 15 or so (even when "making do," I aim high). I was excited to hear that the last u/s had counted 18 measurable follicles. Eighteen is my lucky number. The nurse specifically told me that not every follicle would necessarily contain an egg, so my actual retrieval count might be a little lower than the 18 counted on Tuesday. Ok, I thought, we're back to my original hopeful expectation of around 15.

Nothing new in the procedure room- beeping monitors, super-high stirrups, masked faces popping into my line of sight asking if I'm OK. Speculum goes in just as I drift off to sleep. The next thing I know, I'm back in the waiting and recovery area. The pain is worse than the first time, but I was told to expect that. After all, there were a lot more follicles to handle this time. Friendly nurse helps manage my pain then tells me that the preliminary count (they were still counting when she had to finish the early paperwork) showed that 27 eggs had been retrieved. No wonder I was hurting!* TWENTY-SEVEN! not bad for an old hag.

It gets better.

After managing the pain, the nurse comes back to me with a final egg count. She had to repeat it a few times because I couldn't believe what she was telling me.

I
feel
I
must
drag
this
out
for
dramatic
effect...



40

Yes, you read it right. FORTY eggs retrieved today. Un-freakin-believable. Which brings us to the second criteria for anticipating the probability of OHSS- high egg count. My E2 was borderline worrisome, but my egg count is off the charts. The RE working today said that she's leaning toward freezing all the fertilized eggs because transferring them now would involve a high risk of OHSS. She confessed that OHSS doesn't affect pregnancy, and that freezing the embryos might damage some that would otherwise have been viable. She doesn't think taking a month or two to de-bloat and get my body back to normal would hurt my chances of becoming pregnant, but she also said that OHSS could be managed if it came to that. I have to decide by 11 am tomorrow whether to freeze all or proceed toward a 3DT. A doctor will call me tomorrow with the fertilization report and another opinion on the matter, but ultimately it's my decision. If I develop any symptoms of OHSS between now and tomorrow, or between now and Sunday (planned ET day), then the decision will be easy- freeze them until my body is ready again. But OHSS may not develop until several days after ET, when HCG levels start to rise with pregnancy.

I should have studied OHSS more, but I thought it was something only younger IVF patients had to worry about. I understand that severe OHSS is hell. I don't want to go through hell. But I so desperately want to be pregnant and I don't want to risk any of those hard-won eggs unnecessarily. MAYBE I won't develop OHSS. If I do, MAYBE it'll be a very slight case.

This is a lot to consider, in a very short time. And the pain meds (which I do need this time) are not helping.

*I will admit, because I'm no martyr and I want to present this realistically, I was in a LOT of pain- nine out of ten on the scale. I cried when I woke up because of the deep, intense ache in my left side. I was tensed and afraid to relax because it might hurt even more. The nurse added more pain meds to my IV, and it slipped to a 7 in a few minutes. A pain pill, with some apple juice and crackers (I was also terribly thirsty, and pretty hungry from the "no food/beverage after midnight" directive) dropped it down to 2 after about 15 minutes. By the time I'd eaten some graham crackers and downed another cup of juice, the pain was gone. This time, I filled the prescription for pain meds. Last time, all I needed was a heating pad.