Tuesday, November 3, 2009

Struggling

I am hating my job right now. I'm bored out of my MIND. I hate paperwork and bureaucracy, and that's all I do. Worse, I am enforcing regulations that I think are not good policy. I don't like being part of the system.

I've stuck with this job for two years because 1) I kept thinking I'd be a SAHM by now; 2) my boss has been pretty cool with all the time I take off for If appointments, surgery, and trips to Italy; 3) the pay is pretty good; 4) I like the people I work with - most of the time, anyway; 5) I've never worked at a job longer than a year and a half and I wanted something longer-term on my resume.

But this job has no future growth for me. The promotion I have been eligible for since May is being held up due to paperwork issues, and there is no end in sight, while most of my peers have been promoted ahead of me. I've been ttc for almost TWO YEARS with no success. If IUI #4 doesn't work, we don't move onto our next IVF cycle until January/February. I will be stuck here another year at the very least.

I'm feeling down and depressed and unmotivated and hopeless.

On the other hand, I'm looking into maybe teaching English as a second language. Right now I'm looking at sitting in a cube until I retire, and I think I need something more exciting to work for. Some sort of goal that will help me figure out what I want to do with my life. Something that helps me get up each morning looking forward to the day, rather than dreading it.

I'm also giving more serious thought to adoption. I don't know if I can keep going through this shitty emotional roller coaster.

My POAS dreams have already started. I wish they'd stop. I only have eight days to go, and I need a little peace of mind.

Monday, November 2, 2009

November

I hate the 2ww.

Hate it hate it hate it.

I am only 5 days into it, and have 9 days to go (I love my little ticker at the top of my page - love it love it love it).

I had a busy, busy weekend, but no plans for this week at all. I'm worried it will go by slowly. I tend to break up long waits into manageable chunks of time. The first chunk was getting through the weekend, which was easy.

Now I have to get through to Friday, which is hard enough under normal circumstances (maybe I'll just try to be extra-productive this week, hahahaha). Then I have to get through next weekend, which should be a bit easier (but getting closer to D-Day, which makes it hard). And then I have two weekdays which will probably be REALLY hard. November 9 and 10, I've got to figure out a way to make them go quickly.

Only 9 days. 5 days, then 2 days, then 2 days. No problem. Ha. Maybe I'll try to break the 5 days down into some sort of milestone.

Regarding IUI #4 - insanity is doing the same thing over and over again and expecting a different result. At least I'm not really expecting a different result, so I guess I'm not technically insane. Right?

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!