Lilypie - Pregnancy

Tuesday, October 27, 2009

Happy blogaversary!

I missed it! I have been blogging for one year this past Saturday. It hasn't been the happiest year in terms of infertility, but otherwise it's been great. Quick review:

- Finally left my OBGYN and found an RE, right after reaching the one-year ttc mark
- Did 4 clomid cycles, with 3 IUIs
- Went to Italy and spent a nice couple weeks in the snow with my in-laws
- Participated in a great sock exchange
- Got third place in a triathlon (!)
- Went to Alaska for a summer vacation
- Turned 31 years old
- Had ACL surgery on my knee
- Attempted IVF and failed
- Avoided PIO for all of 2009
- Planned another trip to Italy for Christmas!

Wow, it's been a long year. Here's to a good winter, and a new year that brings better luck to all of us, and babies, too.

Monday, October 26, 2009

IUI #4, here we come

I'm sorry, I'm so far behind on commenting. I appreciate all the comments recently and will be catching up with all of your blogs this week. Things have been stressful.

Also, something (either the Lu.pron, the Fol.lis.tim, or something else that I haven't figured out) has been giving me major headaches, which isn't fun.

I think my heart is already not in this cycle anymore. I forgot my Lu.pron injection this morning, the last one of this cycle. I took it an hour late, and called the clinic in a panic. They said that since I don't have that many follicles, there's not much danger that I will ovulate. Gee, thanks!

We went in yesterday morning for our ultrasound, and everyone was annoyingly cheerful and telling us that this is great that we learned so much about how I stimulate and people actually try to have an IUI cycle just like this and they just had a patient last month who got pregnant in exactly this situation.

I just wanted to say "STOP SMILING!" And stop acting like this is no big deal. To you, it's not a big deal. You are still getting your $1000 and the pharmacy got their $2500, and now I'm going to have to do it all over again. And in the meantime, we lost 2-3 months for this cycle, and I can't cycle again until January because I will be gone for Christmas, so that's not only at least 6 months wasted for a badly managed IVF cycle, but thousands of dollars, and days of headaches and something like 35-40 injections. But no big deal, right?!

Anyway. Still had 5 big follicles, plus a few smaller ones. IUI is on Wednesday. No progesterone this time, so after tonight, no medication at all for the rest of the cycle. HPT on Veteran's Day, November 11. At least I have the day off to cry in bed if I get a BFN.

Friday, October 23, 2009

Follow-up

I was so shell-shocked yesterday that I just spewed what I was thinking onto the computer screen and hit post. Today I'm still shell-shocked so it's probably not going to get much better, but I want to at least answer some of the questions and try to organize my thoughts.

1. My clinic does not do any monitoring until the 9th day of stims, and then they do one ultrasound to check on follicles, and one follow-up ultrasound if things need more time. And that's the total monitoring for an IVF cycle for everyone. No bloodwork at all. This is their standard operating procedure and they do not personalize it, at least for IVF #1. Since it is a package deal, extra monitoring would cost them money.

2. We have to decide what to do on Sunday, when we go in for the next ultrasound. Maybe our choice will be clear - we'll have a few more follicles (the dr. didn't think so), or a few less. Having five is sort of crappy, because it's borderline.

3. Everyone in blogland seems worried about multiples, while my husband and I are actually pretty convinced that the only realistic result of an IUI is a BFN. Given our two years of trying with four prior medicated cycles and never a hint of a BFP, I sincerely doubt that our chances of high-order multiples are anything other than 0.000000001%. I don't think our chances of even a singleton pregnancy are much higher than that.

4. The doctor has pretty much offered us our money back if we switch to an IUI. If we do the IVF, I don't know if we can switch our payment option from the 2-cycle option to the 1-cycle option. Even if we can, and we do IVF and then leave this clinic after this fiasco, we'll be spending about $11,000 for an IVF cycle that could have possibly been saved if the RE had just monitored me a few days earlier.

5. We're going to Italy for Christmas, which means we won't be able to start a new IVF cycle until at least January. Given that we already put this cycle off for several months until after knee surgery, that really sucks. I am 31, which isn't THAT old, but I'm not getting any younger.

6. One thing I don't like about my clinic is that for IVF, they get everyone on the same calendar and run the whole thing like an assembly line. They like to talk about how everything is personalized, but the further I go, the more I realize that it's actually very standardized, and it's standardized to make it easy for them, not to benefit the patients. I'm not ok with that.

7. ICSI - apparently, the doctor had decided that since we don't know what's wrong and why we can't "achieve pregnancy", it would be a good idea to ICSI half of my eggs and let the other half fertilize naturally to see if the problem lies with fertilization. It would have been nice for her to tell us about it before we were instructed about paying for it, yes. Now that we only have 5 eggs, if we do go ahead with IVF, I'm not sure if it would be a good idea to throw more money at this situation and do ICSI anyway. Would it be throwing good money after bad? Or would it be paying a fee to raise our chances enough to make the whole thing worthwhile? It would make our total cost for this cycle, including ICSI and meds, about $12,500.

8. There are other clinics in the area, especially in Sacramento where I work, but not in the town where we live. Which means my husband will have to take a lot of time off work for appointments instead of me, and it's a lot easier for me to take time off. Also, I'm no longer sure about how to choose a good clinic. And at this point, I want to feel confident in my clinic.

9. I've been dreading PIO, but I always thought it was worth it to have a good chance at getting pregnant. I'm not so sure it's worth it just for a shot-in-the-dark hail Mary. If we do IUI, I skip the PIO completely and if we get pregnant, that's a lot of injections I don't have to do. On the other hand, if we do IVF and we don't make it to transfer, I at least don't have to keep taking the shots, and if we do make it to transfer, then it might be worth it in the long run.

10. We paid for a package deal - one IVF, up to six FETs until frozen embies are gone, and then another IVF (in that order). If we continue with this, we probably won't have any frozen embies, and we'll have to move straight into IVF #2. If THAT doesn't work, we'll be paying for future FETs, which seems stupid. The package deal seems great if you have a good response during the first cycle and you just fall on the wrong side of statistics with a BFN, because then you have plenty of back-up options. If you have a poor response during the first cycle, the back-ups aren't really back-ups anymore - you've just wasted a lot of money.

11. Since we have so few follicles/eggs, does that mean that our eggs are probably of higher quality? I don't know. Should I ask the RE? Should I trust her answer?


Here are my thoughts now:

IUI - In my opinion, the most likely outcome is a BFN, but we'll get our $14,400 (minus the IUI fees). We'll have had a learning experience, and we have time to look for another clinic. I'm really not worried about high-order multiples. I'll also spare myself the PIO completely, including if a mircale happens and I do get PG. It would be nice to spend a first trimester without a daily shot in the ass.

IVF - We'll spend a lot of money and our chances are still pretty low. I'll have to do PIO, but see #9 above - if we get to transfer, it'll be worth it, if we don't I can stop. We might learn something about our infertility - then again, we might not. We might end up with nothing at all (no eggs, or no fertilized eggs, or no embryos) and wonder if an IUI might have worked out after all.

Clinics - I think we'll switch clinics after this, no matter what. It's just a matter of how to salvage this cycle at this point.


This is torture. I can't believe I'm in this situation. I can't believe it's been almost two years since we started ttc and we are in the same damn place, except now we're older and we've been through a lot of shit and we have nothing to show for it. I can't believe this is happening. I hope I wake up tomorrow morning and it was all a big joke.

Thursday, October 22, 2009

I can't begin to tell you about what a disappointment today has been. I'm sad and angry and frustrated and pissed off. And I need advice.

I have five follicles. The RE said it was borderline on whether we should continue with IVF or convert to IUI. She doesn't know why, at my age and with no known issues, I only have five follicles.

So here are my questions:

1. I have been taking L.upro.n for 16 days and f.olli.st.im for 8 (today will be 9). Until today there has been no monitoring, no bloodwork, no ultrasounds. Now it is too late to affect the number of eggs by adjusting the dose of my medication. Is this normal? Shouldn't there have been some sort of monitoring before now? This is an awful lot of money to throw at a problem without checking to see if the proposed solution is working until it's too late.

2. What do you think I should do? I've done 4 cl.omid cycles and always had 1-2 follices, and always got a BFN. Will having 5 follices really make an IUI that much more likely to succeed for me? On the other hand, continuing with IVF will realistically get me at most 1-2 embryos to transfer and nothing to freeze, and will involve a surgical procedure and weeks more of injections. And it will use up one of the IVF attempts we paid for.

3. Should I switch clinics? This clinic is no longer really inspiring much confidence in us. Today, when I checked in, the receptionist told me that our ICSI fee would be due at retrieval - this is the first time anyone has mentioned that we should even do ICSI. Neither the doctor nor our IVF coordinator nor the embryologist had mentioned this to us at all. Shouldn't someone talk about whether it is appropriate with us earlier than now?

I have to run to a work meeting. But I would love to hear your thoughts. Thanks.

Tuesday, October 20, 2009

IVF #1 - CD 7

Good news! My husband is not really sick anymore. He had a pretty bad weekend of fever and sore throat and headache and general achiness, but now he only has a cough as far as I can tell. And I don't seem to have caught anything from him (knock on wood).

I've had a horrific headache, but I'm chalking that up to my IVF meds, because I think that's one of the side effects. And also the headache has been coming and going since last week sometime and I don't have any other symptoms other than a very mild cough which also doesn't seem to be developing into anything else.

ANYWAY. Husband will hopefully move back to the bed tonight and I will hopefully get a hug and kiss for the first time in a week. I can't say I'm not excited.

But bad news too! The house we're trying to buy - goodness what a mess. The owner is an elderly woman who has already moved out of state and may be incompetent to enter into a contract. We don't know what's going on with the other offer. We gave our realtor numbers to write up an offer, and then never heard back, so we called him last night ... it turns out he was beaten up by the parent of one of his daughter's field hockey teammates at a game. I can't believe people actually do shit like that - what the hell is wrong with people?! Our realtor is such a nice guy, in a genuine nice guy kind of way, not a schmoozy realtor kind of way.

A little house-hunting background, skip this if you don't care: We've been looking for a house for about three years. We live in Davis, a university town near Sacramento, with a small-town feel, a very active involved population, great restaurants, and growth limits. Meaning, almost no new houses get built ever. And everyone wants to live there. So houses are expensive. You know how house prices in some parts of the country dropped by 50% recently? Not in Davis - we've seen pretty much no decline in prices at all, and prices were pretty expensive here to begin with. On top of that, even the "cheap" houses aren't worth it because they are typically student rentals and are mostly destroyed - old, filthy, falling apart, garages converted into extra bedrooms, etc. Sellers expect that buyers will rent out the houses again, not live in them. Also, yards are very small, so it's not like you can even buy a house for the land and remodel or rebuild and have a nice yard. The house we've found has a nice big yard which is mostly grass, so we could landscape how we like. It is small enough for us to manage, but big enough for a family. It doesn't need any remodeling before moving in, except maybe replacing the carpet in the bedrooms with wood, because we hate carpet. It's expensive, and it's not in the best location, but there aren't any good houses in the "best" locations in Davis. It might be a long time before we find another place like this in Davis. It's not our dream house, but it's close enough that I'll be sorry if this doesn't work out. And I don't expect to find another house we'll like anytime soon - rather than selling in this market, people are generally just renting their houses out - even if you don't want undergrads, there are plenty of grad students, researchers, and professors here. So there isn't much on the market at this point either. It's a dismal situation.

OK, back to IVF! Today is CD 7; my CD 9 ultrasound is Thursday! Only 5 more injections until then, one of which I'm about to take care of. Fingers are crossed for an appropriate number of well-behaved, nice-sized follies! Egg retrieval is probably within a week!

Friday, October 16, 2009

Non-IF-related crappiness

Have to find my zen, have to find my zen, have to find my zen.

Dammit, where did it go?

My husband is sick. The guy who NEVER gets sick and NEVER misses work and even works every weekend is at home in bed. I'm really worried. I'm worried about him. I'm worried about our IVF cycle. I'm worried about me getting sick, too. It's just so unfortunate not only to be sick, but to be sick RIGHT NOW.

And then.

My realtor called. The house we've been thinking about, the house we've been going to look at, the house for which we just got pre-approved for a loan YESTERDAY ... someone put in an offer. I called my husband to tell him, unfortunately waking him up (I feel SO bad about that), and he said there's no way he wants to pay full price OR think about making an offer today while he feels so crappy.

So we will probably not be getting the house. I've been through this enough times to know how it goes.

And I can tell that our realtor has just about had it with us. Not that I blame him. I'm mad at my husband for taking up so much of our realtor's time and getting my hopes up and letting me go ahead with getting our financial stuff together and going to see a broker and getting pre-approved and then not being serious about actually buying a house. I know I'm pushing for it a lot more than he is, but if he really doesn't want to buy a house, why doesn't he just freaking say so?

It's hard to be so mad at him when he's sick. Sigh.

Thursday, October 15, 2009

Biding time

I am feeling a little amazed by how easy the IVF process is so far. Admittedly, I haven't done any of the hard stuff yet.

Egg retreival makes me nervous, but doesn't exactly scare me because I won't be aware of anything that's going on. Maybe a little nervous that we won't get that far or won't get many eggs (or any at all).

Embryo transfer makes me excited, not nervous at all (well, slightly nervous about not being able to hold my pee).

PIO makes me so nervous I want to puke, but I'm just not thinking about it. Since all the injectibles so far have been way easier than I expected, I'm hoping that the trend will keep holding true for PIO.

The 2ww, eh, ok I'm nervous about that. That has always been the worst part of ttc and IF, and I don't expect that to change. I'm planning to keep myself incredibly busy (but not super active!) during that time.

I don't know if this feels easier than expected because my expectations were just wildly unrealistic, or that I'm so much stronger than I thought, or that my husband is so supportive and calm and helpful. Or maybe I'm just not far enough into it yet, and things start getting crazy from here.

I don't know, but I'm incredibly grateful that I am holding up so well and I pray that I and all those who are cycling with me this month find strength and peace for the next four weeks and for whatever comes after.

Wednesday, October 14, 2009

Moving forward slowly

I'm starting to worry about my IF clinic a little bit. They don't seem to have things 100% together, and it's really starting to piss me off.

Granted ... my IVF coordinator left the week before I started, and apparently didn't arrange the hand-off of her patients perfectly. But still! I'm paying thousands of dollars ($17,000!) for a service, and what's more I'm spending my time and putting all kinds of crappy medications into my body and I would NOT be a happy camper if the clinic to which I am entrusting myself and my money made my cycle FUBAR through their own incompetence.

Now that I have that out of the way ...

I showed up yesterday at 3pm for my IVF egg class. First I paid off the balance I still owed. Then they gave me my Fol.lis.tim pen because the pharmacy for whatever reason didn't send me one. Then I told the receptionist that I was there for the class.

Receiptionist, in a cheery voice: "Uh ... what class? There's no class scheduled for today."

Me: "The egg class. It's on my schedule. Look, right here." (Pulling out my doctor-reviewed-and-signed IVF schedule.

Receptionist: "Oh, well that must be a mistake. Look, here in the computer it has you down on the 21st." (Cheerfuly smile)

Me: "But, um, I took like 3 hours off work to be here and I dont' really want to do that again (considering how much time off I'm taking already for IVF!). And I'm not driving back to work in the hurricaine force winds and rain now that I'm already in the town where I live."

Receptionist: "I'm sorry, but it's scheduled for next week."

Me, loudly to husband across waiting room: "Well, they made a mistake and scheduled our class wrong, so I guess we should go." (I'm not normally like that, I swear)

Other couple in waiting room: "What? We're here for the egg class too! It's on our schedule too!"

Receptionist: "Um ..."

My new IVF coordinator passing by: "I'll see if the embryologist is available to do a special class just for you! Sorry, but the coordinator who just left must have screwed up everyone's schedules ..." (LIE! My old coordinator scheduled me for the 21st. The new one rescheduled everything when she moved me up a week - guess she wasn't supposed to reschedule the class. Nice try blaming it on the person who doesn't work there anymore).


So we did the class. It was irritating. It was interesting. It was partly a big waste of time and partly useful. They presented all their data on their success rates and explained away any year or category that was low (there was a poor egg donor; and btw, our PGD outcomes are 100% when you only look at those who are choosing the gender versus those with actual infertility). They explained the entire embryology process in excruciating detail (far more than we needed to know), I suspect to make us feel like the thousands of dollars we spent was paying for something. And to make us feel totally safe that they will not mix up our eggs, sperm, or embryos.

All of this after asking us to change our IVF schedule with less than 24 hours warning, AND the coordinator ordering me a brand of HCG that I specifically requested she NOT order.

It all worked out in the end (except I guess I'm taking some HCG that I didn't want (this brand gives me a welt, none of the others did)). It just makes me a little nervous for the upcoming two or three weeks.

Fol.list.im starts today! CD 1 is here!!!!!!

Monday, October 12, 2009

Anticlimax?

Here I am, chugging along, taking my lu.p.ron daily. I stopped taking BCPs last Friday, and now all I have to remind me that I'm even doing IVF is my 2-minute morning injection session. It somehow seems ... anticlimactic.

This is actually going to be a busy week for IVF, though - tomorrow, I have another class from 3pm to 5pm, and Wednesday I start fol.lis.tim in the evenings. Then another week until next Thursday's ultrasound, the very first time when I have any clue what's happening in there, and the day I'll get at least a rough estimate of when retreival will be (I hope).

Right now I think we're looking at a retreival of October 24, 25, or 26, with a 5-day transfer (fingers crossed) on October 29, 30, or 31. I guess that would put beta around ... November 6-9? I'm not really sure. Less than a month, though - amazing!

***

Non-IVF things going on in my life:

1. Knee - my knee is doing great after the surgery. I have been cleared to walk with one crutch and it's going well. Unfortunately, I lost some of the flexibility I had regained after the surgery, which is making walking more difficult, but I hope to get that back pretty quick. I can try biking in the next week or two.

2. House - we're working on getting pre-authorized for a loan, but I've been through this before and I have my doubts it will work out (we live in a really tough housing market and we have various complications with my husband being a legal resident non-citizen and self-employed); but, if all goes well, we'll be putting in an offer soon. Good thing, too, if IVF works (whether the first time or subsequent times) and we are lucky enough to eventually have a baby, we'll probably need more space than our apartment provides.


That's all I can think of - but life sure FEELS crazier than that.

Hope all's well in blogland.

Thursday, October 8, 2009

One-word trivia and a few thoughts

Just did my second Lu.pr.on injection. I brought it to work with me (hoping that was ok), and in trying to check if there was air in the needle, I lost one unit of medicine (so I only got 9 instead of 10). Frantically emailed my nurse to see if that was ok. Yikes, this is stressful. I CANNOT believe that I am only two weeks away from an ultrasound telling me how many follicles I have growing. OMG.

I'm sorry if I am annoying any of you IVF veterans with my starry-eyed innocence. I feel like that sometimes towards bloggers who are going through their first IUIs. But then I think back 10 months and remember when I was going through my first IUI, and I regain my sense of compassion. I think that while infertility has made me, in the short run, cranky, irritable, and intolerant of certain things, I can tell that in the long run it has given me compassion, thoughtfulness, and empathy that I am so grateful for.


And now - ONE-WORD TRIVIA

I've seen this meme going around and I was just tagged for it by Mrs. Gamgee over at Hobbit-ish Thoughts and Ramblings (a name which I LOVE, being an avid fan of J.R.R. Tolkien and his works - I wish I was a hobbit; or an elf).

Anyway, here are the rules, and below is the meme:

USE ONLY ONE WORD! It’s not as easy as you might think. Copy and change the answers to suit yourself and pass it on. It’s really hard to use only one-word answers so try your best. (I say parenthetical thoughts don't count!)

Tag 6 other bloggers and let them know that you think they are 'Over the Top'! (I never do this - please, if you want to do the meme, consider yourself tagged.)

1. Where is your cell phone? Purse
2. Your hair? Crazy
3. Your mother? Manipulative
4. Your father? Dead
5. Your favorite food? Cheese
6. Your dream last night? None
7. Your favorite drink? Wine
8. Your dream/goal? Motherhood
9. What room are you in? Cubicle
10. Your hobby? Gardening
11. Your fear? Flying
12. Where do you want to be in 6 years? Happy
13. Where were you last night? Picnic
14. Something that you aren’t? Pregnant!
15. Muffins? Chocolate
16. Wish list item? Snowshoes
17. Where did you grow up? California
18. Last thing you did? Injection
19. What are you wearing? Dress
20. Your TV? Old
21. Your pets? Whiny
22. Friends? Few
23. Your life? Unsettled
24. Your mood? Anxious
25. Missing someone? Dad
26. Vehicle? Matrix
27. Something you’re not wearing? Socks
28. Your favorite store? REI
29. Your favorite color? Yellow
30. When was the last time you laughed? Yesterday
31. Last time you cried? Unsure
32. Your best friend? Husband
33. One place that I go to over and over? Garden
34. One person who emails me regularly? Sister
35. Favorite place to eat? Italy

Wednesday, October 7, 2009

OMG OMG OMG

First, thanks for all the good thoughts yesterday about PIO! I do feel a lot better now.

Want to know another reason I feel better?

The clinic called me at 4:55 (nice timing) yesterday afternoon and told me that their October cycle group was rather large and the embryologist was requesting that not everyone cycle at once. They selected a group of people to move up a week, and they were hoping I wouldn't mind that they had picked me. Me!!!!! To start one week early!

So that means I am starting IVF TODAY!!!!!!!!!! We go in to our instruction class to get our meds and learn how to do all of it today at 1:30. And I get my first Lu.p.ron shot tonight.

I was so freaking happy. My husband, on the other hand, was pissed off. He has an important meeting at 1pm, and while his business partner can handle it without him, he is furious with the clinic for springing this on us at the last possible moment.

I was really upset with him for not being thrilled to drop everything to have an earlier chance to get started, but we both calmed down and got over it. I'm so excited!

So today is turning out to be rather busy. I won't have a chance to read everyone's recent posts and comment until another day or two.

Another note - we've found a house we're thinking about making an offer on. Another thing keeping me really busy. I guess when I finally catch my breath and catch up with things, I have a lot to chat about - IVF, the house, and my knee. Yay for good moods and good things happening!

Tuesday, October 6, 2009

PIO anxiety

I can't BELIEVE that IVF starts next week. Holy crap! Where has the time gone? Only 9 days until I start Lu.pr.on! Which reminds me, I still need to get that stuff ordered. And only 7 days until my injection class.

Speaking of which ... I'm having terrible anxiety about the PIO. I'm not thrilled about the dozens of sub-q shots I'll be getting, many of which I'll probably have to do myself. But I'm so freaking scared of the PIO. I know that everyone says it's not as bad as they expected, and it's better than the suppositories, but OMG. A huge needle. In my ass. Every day for weeks. And possibly months.

It's not even the needle that seems like the worst part. It's the idea of getting these shots every day and getting more and more sore and having to keep doing it. If it was just one, fine. No problem. I mean, I'd hate it and I'd probably cry, but then it would be over and I could go on with my life. The idea of getting it over with only to start dreading having to do it again in 24 hours - that's horrifying. I'm already anxious now, I'm not sure how I'm going to live with the anxiety then.

Even worse, to me, is the possibility that I could get these freaking shots for two weeks for NO REASON. IVF #1 could easily fail. Hell, it's possible we might not make it to retreival or transfer, of course I know that. But somehow the build-up to that point seems better - sub-q injections, hope, monitoring, ultrasounds. It all sounds very optimistic and positive and pro-active.

And then - two weeks of IM shots in my ass and having no idea what the hell is going on and what will happen. And I thought the 2ww was bad with the IUIs! I'm not even there yet with this IVF and I'm already stressing about it.

Trying to take my husband's point of view and look at the bright side - at least the 2ww is slightly shorter due to the 3 or 5 days the potential embies spend on the outside before transfer. It's the tiny ray of sunshine I'm hanging onto.

That, and the idea that maybe they'll finally figure out what's wrong with us.