CD8

Bloodwork and an ultrasound this morning. Estradiol levels are good and high, so I'm down to the minimum dose of Gonal-F tonight, just 37.5IU. They counted 7 measurable follicles, which I'm told is good. There's a slim chance, depending on what they find in tomorrow's b/w and u/s, that this could potentially maybe be converted into an IVF cycle. I don't know exactly what they need to see for this to become an IVF cycle, and it's only a very distant possibility, but the prospect has me a little excited and a bit anxious.

I have developed a near-steady ache in my abdomen, about 4-inches left of my navel. The sensation swells to more than just discomfort when I stop abruptly (i.e. hitting the brakes aggressively in the car- not me, but the woman I rode with to lunch today). I am very bloated, and my pants are a bit too tight in the waist. Tomorrow, I'll have to wear something with a drawstring.

This may sound overly simplistic, and I am one of those people always looking for "signs," but denying their relevance at the same time. Today is my birthday. I pay more attention to birth year than calendar year when it comes to judging whether a year has been good or bad. 2008 was not a good year, but for me it really didn't end until yesterday. We lost my mother-in-law and my husband's dog while I was 40. My husband was laid off for 6 months and I was afraid we were going to lose the house. We found the root of our fertility issues while I was 40, and endured 6 unsuccessful IUI cycles.

Today, I am 41. My new year, my 2009, began today. I've responded well to the OI meds. The cryobank is waiving their usual same-day shipping fee TODAY ONLY (shipping fees are not covered by insurance). This cycle's IUIs will most likely be on Thursday and Friday this week, and C will be able to go with me because, while he expects to be called back to work any day now, he hasn't been called yet. Then there are the non-IF good things that happened today... my most favorite musician in the universe released a new live solo album. I found out that the Dalai Lama is teaching and giving a talk in my home state in May (yes, I'm going).

Happy new year! Let the luck begin!!

speed

Wow. I figured the gonal-f would have some effect on the length of my cycle, but I didn't expect to be on the brink of triggering already. Heck, it's only CD7, and I normally ovulate on CD16. BW this morning indicated elevated levels of estradiol, as expected. So my fsh dose tonight is down from 187.5 to 75IU, and I'm scheduled for another blood draw and an u/s tomorrow morning. One of the nurses will discuss the u/s with me tomorrow while I'm at the doctor's office. I'm looking forward to understanding a little about what we're seeing in the u/s images. Apparently, triggering is imminent, but without images of the hormone-induced follies, they can't say if it'll be tomorrow or in a few more days.

I admit I'm a little worried about the hcg shot. Intramuscular. I'm not sure I can do it myself. C seems more than willing to assist, motivated perhaps by the fact that he's kind of an outsider to so much of this process. This is his chance to participate and contribute in an active way.

No significant side effects. I've had a mild headache since last night which occasionally explodes across my forehead for about 2 seconds then disappears. It's nothing, really. I feel a little bloated and tender around the middle, too. Maybe my ovaries are full of beautiful nearly-mature follicles. But not too many of them. I'd hate to be cancelled for having too many.

I did it!

For anyone facing the daunting prospect of moving on to injectibles for the first time, I just want you to know that the second shot is immensely easier than the first. Knowing what it would feel like broke the mental barrier that kept me from poking myself the first time. Admittedly, these are the easiest of the injections. The Gonal-F needle is tiny. But, if it turns out that I'll need more than this and the hcg, this is the ideal way to get used to needling myself.

No side effects so far.

tougher than I expected

Yesterday was rough.

I had my first encounter with the dildo-cam, which wasn't as bad as I expected. The tech, however, would not tell me what she was looking at or looking for. Even though she left the images on the screen after she was done and I had plenty of time to stare at them while I dressed, I have no idea what, if anything, I was seeing. Apparently, all was well because I got a call from one of the nurses in the mid-afternoon letting me know I should start the gonal-f that night. The nurse seemed rushed, and my cell phone reception is lousy at work, so I didn't get to ask what they'd looked for on the ultrasound, or what they'd seen. I go back on Monday for "bloodwork only." I'll be more aggressive then and will find out just what they're looking for and what my results are.

That was the easiest part of the day.

My husband's dog, E, turned 19 on March 20th. It's hard to explain the relationship between a man and his dog, and since I know I won't do it justice I'll just say they were close. They were together for almost all of C's adult life, through some mighty significant ups and downs. His demise was swift. He stopped eating on Monday; stopped drinking on Wednesday. Yesterday, he stopped moving all but his head. So yesterday, we took E to the vet for the last time. We have an extremely compassionate vet's office. We sat with E for nearly an hour until C said it was time to let him go. We didn't want to leave E alone, but we couldn't stay and watch her administer the anesthesia, so the vet came into the room as soon as we said we were ready, and gave us as much time as we needed to say one last good bye. It was a sad, sad day.

That was the hardest part of the day.

Then it came time to administer my first shot from the gonal-f pen. It's a nifty gadget, and I know from reading other blogs that the needle is so thin I would hardly feel a thing. But I just couldn't bring myself to pierce my own skin. I pricked myself a couple of times, but just couldn't do the deed. I finally had to call C into the room to do it. It didn't hurt. I felt almost nothing. I hope I manage it by myself tonight. No side effects yet, but I've only had one dose. I'm on 187.5 units for now, with the first adjustment coming after we see Monday's bloodwork. I have back-to-back soccer games on Sunday night (potentially- it's playoffs, so if we win the first one, we play again) and will need to inject in between them, so I have to be not only capable but proficient by Sunday night so I can do it in semi-public.

vices

Beer and sushi for dinner last night, as the AF-preamble announced the results of the current cycle. AF will begin in earnest on Sunday or Monday, and by Wednesday I'll be poking needles into my belly every night. I'm playing soccer tomorrow with no worries about exceeding some arbitrary heart rate, and I might indulge in some caffeine and dark chocolate today just because I can.
I think I got most of the frustration and anger out of my system on Thursday when my body made it clear that our 6th IUI cycle had not succeeded. I cried on the way to work, on the way home from work, and several times in between. I let my coworkers think I just had a cold, and even my own mother didn't notice my puffy red eyes. I'll finally get the monitoring that I've wanted all along. If we don't succeed this cycle, at least there's a chance we might learn something. A little knowledge might make the failures easier to swallow, but more importantly it'll move us close to a baby. Two OI/IUI cycles, and then my insurance will cover IVF. I'm still hopeful we won't have to go that far.
My birthday is in just over a week. First, I was disappointed that our child wouldn't arrive until after I turned 40. Now, I won't even be pregnant before I turn 41. I am older than my mother was when she delivered my youngest brother.
I was wrong- the anger and frustration are still here, just beneath the surface and threatening to erupt with the slightest provocation. If not for alcohol and dark chocolate, and a concert tonight by an old college friend, I think I'd like to spend the day in bed with a book and my cat.

who knows?

It's kind of strange how I've filled some people in on what C and I are doing in pursuit of creating a family, while other people that I'm much closer to haven't a clue. I think pretty much everyone I socialize with knows that we've been "trying." I haven't had an alcoholic beverage in public in almost 2 years- not even on my 40th birthday. Even my relatively-new next-door neighbor knows we're trying, since she invited me over for a drink and guessed my reasons when I turned down a very tempting glass of wine in favor of water. I carpool to my weekly soccer games with a teammate who lives nearby, and we chat along the way. She's heard all about the heart rate misadvice and the process of selecting a sperm donor.

We've been completely open with one of C's three brothers and his wife, but haven't told the other brothers anything at all. I tried to have a conversation with my co-worker brother (before he was laid off... he's back to work elsewhere now, and much happier, thanksforasking), but he squirmed and turned red, so I figured it was too intimate a subject for him to handle. My mother knows we're trying, but doesn't seem to remember any of the details. Rather than be disappointed with her reaction, I just don't say anything to her about IF. My father and the rest of my siblings are completely in the dark.

Among our close friends, we've been open if anyone asks, but haven't really volunteered any information. As a result, one couple knows e-v-e-r-y-t-h-i-n-g, and even offered to help us pick a donor, while the others just know that traditional "trying" won't work in our case. When we go out together, I feel like they're all watching me like hawks, hoping to be the first to spot some sign that I might be pregnant.

And then there's the guy in charge of my second job. His wife is on my soccer team, but I haven't told my team in general, only the one player I carpool with. I was working kind of late one night (late for me is anything after 9 pm) when he commented on trying to start a family with his wife and that the one thing getting in their way was having the two of them in one place at the right time. He asked if C and I were planning to have kids and I told him about my "hot dates" with syringes. I tell him each Friday when I can work the following week, so he knows when I'm TWWaiting (and taking it easy) or working my tail off to take my attention off the latest BFN. At this point, he knows more about what's going on than any of my friends. Almost as much as C knows.

Two years ago, if someone had asked me who I'd confide in if I ever found myself in this situation, I would never have guessed this.

ignorance would be bliss

Try as I might, I just can't stop thinking about the TWW. Thanks to Melissa , I have this nifty visual to help me imagine what's going on and where exactly (sorry it's blurry... not sure how to adjust the resolution on the blog... it's perfectly clear when I simply open the file).

I am trying, really trying, not to misread every twinge, cramp, headache, yawn, and belly-rumble as a sign of pregnancy. At the same time, I am acutely aware of everything going on with my body right now. I want to pinpoint the first moment I feel "pregnant," but I'd love to stop thinking about this. Honestly, I haven't felt anything that could be realistically called a symptom. I don't get noticeably PMS-y, so I don't have any indication that AF is or isn't on her way. I'm flying blind through this TWW and trying to resist the urge to buy pee sticks. I can have a blood test on Monday. That seems so far away.

Bonus Ball has arrived!

Congratulations to Vee and Jay on the arrival of their baby boy! I'm thrilled for them and can't wait to meet the little guy (in blogland, that is). It took a very long time for Vee and Jay to reach this point, and I'm certain whenever they look at their darling BB they know he was worth all the heartache.

Who knew that when they chose the nickname BB, for bonus ball, it would eventually mean beautiful boy?! Welcome to the world, little man!

timing is everything

I think we've all learned by now that timing is everything. We're all keeping our personal calendars, too, which sometimes preempts the calendar everyone else is following. Ask me what day it is and I catch myself thinking "CD20," then I have to think twice to figure out that it's March 11th to most people.

I called the other IF center today. I'm beginning to see that I didn't plan far enough ahead to transition seamlessly, without losing a month of trying. The earliest appointment I could find was 3/25. In my universe, that's likely to be CD3- the day I should start follistim for my first injectibles-IUI cycle. Once I start medication, I can't change doctors until the next cycle. To top it off, I expect C to be back to work in the next week or two, and the new doc wants C to attend the initial consult. We have no idea where C will be working, but he'd definitely have to take time off to make it to an appointment between 8:30 and 2. Unless he's on a night crew... hmm, with a shift differential and midday availability, I might like to see him work nights for a while. But we just don't know right now, and no one will say for certain when he'll be called back to work, let alone what shift he'll be on (or where in the state he'll be assigned). So many things are up in the air, and with thousands of construction workers unemployed right now, I don't want to send him to his first day of work with a note from his wife explaining that he should be excused early for a doctor's appointment. They'd laugh him right off the job site and fill his post with the next guy in the unemployment line.

I made an apointment anyway. One of the docs in the practice has "late" hours twice each month. Two problems with that, though... HE doesn't practice at their less-distant facility. And he's a HE. I'd only need to travel the extra 30 miles when I am seeing the doctor himself. All the monitoring could be done at the office that's only 10 miles further away than my current RE's office. I'm torn. I have an "evening" (6 PM) appointment for CD41 (aka. April 1st), but I'm not convinced yet that I should jump ship. Obviously I'd love to be pregnant by then, in which case it's all moot. But if I'm not, I'll need to get all my records to the new doc's office by 3/25. And then I'd have to spend the next cycle, my first on injectibles, with doc #1... after having all my records sent to a new doc. That sounds like going to a concert with an ex who wasn't an ex yet when you bought the tickets. Awkward.

All in all, I'm thinking of just staying put.

Did Saturday actually happen?

Yesterday, C and I headed back to the RE's office for the second IUI of the cycle. The same staff were on as the day before. The nurse acted as if nothing out of the ordinary had occured on Saturday. No apology. No recognition that the experience had been at all traumatic. No acknowledgement that any of this is a VERY.BIG.DEAL. How can she be so oblivious?

Oh, and just another tidbit of disparate information- this nurse told me to keep my heart rate under 140 during the TWW. Last month's IUI nurse said no such thing, and nurse TMI thinks I should keep it under 130 at all times. And the doc just said I should not exercise to an extreme. Geez, why would a patient be confused or distrusting in an office like that?

I got the instructions for the next cycle, just in case this one doesn't succeed. Follistim will start on CD3, and a baseline u/s on CD 2 or 3 (I'm sure that won't be at all embarassing or messy). Another u/s on CD6 will determine if I need to change the dosage, then we watch for maturing follies to figure out the best time for the hcg shot. If we end up on follistim, I'll finally stop temping every morning. I've collected a full year of BBT readings; 365 days of consistently predictable highs and lows. It's nice to see how consistent my body is... like it increases our chances.

No soccer last night or next week. By the week after that, I'll know. I can have a beta on the 23rd if I don't see AF (or definitive signals of her imminent arrival) by then. Hello TWW.

it's not me, it's YOU!

At first, I got the impression that they just didn't really care on a personal level. That was OK. Business is business, and if their business is getting me pregnant, then I don't need to make any new friends in the RE's office. Sure, it'd be nice if they acted like they had some stock in the outcome, but if they're seeing lots of infertile women and our collective chances are low, maybe the "professionalism" is just a defense mechanism. I talked myself out of taking it personally, and tried to convince myself that I was overreacting. I am, after all, a frustrated infertile who has spent half of the last 21 months in the TWW. Throw in periodic doses of clomid and you've certainly got a recipe for overreacting.

Today, I felt as though the nurse actively did not want me to become pregnant. She was pleasant enough to start, and even joked that if today felt like an early morning, tomorrow would be even earlier (daylight saving starts tomorrow). We dropped off the box o'paternal genetic material and headed off to breakfast with instructions to return in an hour for the insem. Fifty minutes later, I walked back into the vacant waiting room (C stayed in the car to nap) and announced my presence by filling out the "I'm here to get BW/US/IUI/etc. done" sheet of paper and dropping it face-down in the bin. A couple of minutes later, the nurse who took the box from us came out and said, "We can't proceed. The container was tampered with."

What the...? I was speechless. She walked me back to the exam room and explained that the seal on the cryotank wasn't present and their policy is that the seal can only be opened by medical staff in their office. Well, I had instructions from the sperm bank that specifically said I should open the tank and confirm that the correct donor specimens were sent. So of course I opened the tank as soon as it arrived. That way, if there were a probem, I'd have time to fix it before ovulating. The RE's office doesn't receive or store donor sperm. It has to be shipped to me, and the doctors and nurses don't see it until I show up for an IUI. Why in the world would I wait until the day of the IUI to check the tank? On top of that, I opened the tank last cycle and no one said a word about it. Once again, it seemed the staff in this office was throwing obstacles at me every step of the way, trying to prevent my IUI with every bureaucratic snare they could dream of and withholding information from me until it was almost too late to save myself.

Luckily, I had the instructions in the car. If I hadn't had something in writing from the bank to show the nurse, I think this cycle would have ended right there... as would any relationship I have with that office. The nurse had to page the RE twice- once to alert her to the fact that the tank had been opened and again to read to her the instructions I'd received with the tank. The RE finally gave her approval, and the IUI was done, but I was so angry and upset that I was shaking and fighting back tears.

The nurse didn't seem to understand why I would need to open the tank upon receipt, as though verifying the contents were secondary to complying with some rules I knew nothing about. I told her that if I need to buy another round of donor sperm, I will again need to verify the contents no later than the day before my IUI. She replied, "No, you can't do that." I explained again that I would not wait until minutes before my IUI to discover a problem with the shipment. Again, she repeated that I cannot open the tank. We went back and forth like this two or three more times, and I was trying really hard to remain civil. Finally, I told her, "Fine- next time I'll bring the tank here as soon as it arrives and YOU can open it." She huffed, as if to imply that I would be wasting her precious time.

I think tomorrow will be my last IUI in that office. On Monday, I'll call the more distant clinic, the one with too many men on staff, to find out if they'll take me as a patient and how quickly they'll get me started. I'd rather just be pregnant.

in the middle

I know that I start imagining what's going on in the lives of other bloggers when they don't post for a longer-than-usual stretch. While I don't believe anyone is hanging on my every word, I do feel that there are people out there whom I've never met who do care what's going on. If I didn't believe that, I wouldn't blog publicly. So, knowing that someone out there might be wondering what's up, I thought I should post even though there's really nothing to say or report.



I took the clomid as directed and have had an extremely short fuse for the last week or so, but no other side-effects to report. I started taking a "pre-natal" vitamin each day, since my regular women's multivitamins ran out. I learned quickly that the DHA liquigel capsule should be taken at night so I sleep through the mildly fishy burpettes (not quite burps). I was also pleased to discover that these don't make me queasy like the regular vitamins do if taken without food. I'm annoyed to see that the USRDA of folic acid for pregnant women and those trying to conceive is 800 mg. My RE told me to stop taking an additional folic acid supplement with my daily vitamin that contained 400mg folic acid. I'm a rebel, though, so I continued to take the extra folic acid (hey- it's water-soluble, so any excess goes right out of my system. You can't overdose on folic acid) until the bottle was empty two weeks ago. Now, I don't feel like I was wasting my money on the extra dose. IN YOUR FACE, RE!



I should see the digital smiley face tonight, so I'm planning a couple of trips to the RE's office over the weekend and I warned my soccer team that I might not be playing. C will be going with me for the IUIs this cycle, both because he hasn't gone back to work yet and because they're on the weekend. Luckily, it's not supposed to snow so no plowing and no white-knuckle driving to an IUI (have any studies examined the affect of tense driving situations on insemination success?). The donor sperm should arrive at my office this afternoon.


Ah, the donor... we picked a new one, and I'm a little nervous about a decision we made in choosing this one. We made a list of our top 4 picks, and then narrowed it further to our top 2 based on availability and some of the items documented in their short (free) profiles. We bought the long profiles for our first choice and immediately discovered an extensive family history of heart problems. Both sets of grandparents, one parent, multiple aunts/uncles. So I bought the long profile for our second choice- immaculate health history! We're talking nothing but a little adolescent acne. No allergies, no illnesses, no nothing. You'd think that would make it easy to choose the one with the great health. The kicker is that the heart-problem-donor is open while perfect-health-man is anonymous. I know we'll probably have some identity issues to deal with either way, but I don't want my children to think I made the anonymous selection lightly or without consideration of what my children may one day want to learn about their genetic heritage. Hopefully, this is the first of a lifetime of decisions we'll be making in the best interest of the child we'll conceive this cycle.