Baby Godot

2008-12-19T23:40:00.003-05:00

Today marks one year since the egg retrieval that helped bring our little man to us.

We have been remiss in updating this blog. It's hard to want to sit in front of a computer when I look at this baby who is happier than anything when he's being held. In the past couple of weeks, he has learned to laugh, and we are greatly enjoying helping him practice.

I hope this finds anyone who happens to read it well and happy and on the path to building or raising the family of their dreams. I don't know when we'll write more; this blog feels like a story that has ended for the the time being. We were perhaps luckier than Vladimir or Estragon. We didn't have to wait by the road forever.

All the best --

JF

As of 9 p.m. on 9/10

2008-09-13T09:32:00.003-05:00

He's here. He's lovely. We are all healthy but tired. More soon.

only half mad ... really ...

2008-08-30T20:50:00.002-05:00

Mostly I'm not as crazy as the previous post. Our therapist pointed out that during the first trimester, I was terrified of losing the pregnancy; during the second, I was afraid of someone breaking into our house in the middle of the night; and now, during the third, I worry the world will end. It's only a matter of scale.

Things are still coming together. SF put the carseat in the car this afternoon. We have clean clothes, receiving blankets, and bumgenius diapers with a supply of disposables until we get our feet under us. The fridge and freezer are stocked with food for September, and the new freezer arrives Monday. Our doctor said the baby is moving down, and that she expects we'll be among the 80% of her patients who go between 39 and 41 weeks. Guess it's time to finish packing that bag for the hospital ...

Full term

2008-08-21T21:43:00.002-05:00

This week, we reach full term.

I find that SF's and my worries have diverged a bit at this point. SF is afraid that something will go wrong during the delivery. I am worried that the delivery will go fine but the world will end.

Seriously. I mean, come on. I know it's crazy. But all of those scary little news stories that the media publishes -- "ha ha ha! this could cause big problems!" -- don't leave my mind so easily just now.

Case in point

Did the start date have to be my due date?

I guess I'm just not ready for things to end just as it seems like they're about to get good.

In saner news, most things are going well. Everything important is going well. The wallpaper border fell off the wall of the nursery, but we'll work that out. We have basically what we need to care for a baby at the start. In theory, anyway. All we have to do is wait on here.

changes

2008-07-19T18:33:00.002-05:00

In the past two weeks, the kicking has become much, much stronger. I don't know whether it means stronger legs on #14 or that the placenta moved out from the front, but it's been a very different feeling. It's strange how something can be both disconcerting and reassuring at the same time.

I talked to a friend on the phone yesterday, and she asked me whether we had the nursery all ready. HA. Maybe if I would stop moving out to that bed at 4 a.m. we'd be more inclined to take it down.

One step at a time. Today's was the linen/medicine/cleaning supplies closet. I have a lot to learn about what kinds of baby accoutrements we might need space for inside it, but at least now we have the space.

2008-06-29T19:07:00.003-05:00

1. I am fascinated by my belly button, or lack thereof.

2. I passed my second 3-hour glucose test.

3. Our therapist asked whether we are able to imagine what it will be like to have a baby. I wasn't sure. I can imagine a baby being here, but not well. In my imaginings, though, the baby is never doing anything. It's like there is a massive gap where the child's personality should/will be. SF reassures me that imagining inaccurately is still imagining, but it's a strange feeling. It's much easier to think about things -- a stroller ... with a baby in it. A crib ... with a baby in it. But always a generic, inanimate baby. I'm afraid to think about my eyes, SF's nose, hair color, temperament, whatever mixture of our personalities we might see reflected in a child. In some ways, it's maybe not surprising. This time last year, those were things I was preparing to say goodbye to as we discussed with increasing gravity the possibility of using donor eggs.

4. I seem to have passed from a phase of not being able to sleep into a phase of sleeping and sleeping and waking up still tired. This probably has less to do with pregnancy than with work -- I'm currently doing half of my on-leave boss's job, as well as my own, during the busiest time of our year, in 24 hours per week. Am I looking forward to my own leave? Naaah ;) (Note: much easier to imagine not going to work than having a baby. I have, in fact, not gone to work before. Babies are still uncharted territory.)

5. We have a meeting in a week with a nurse to discuss things like labor and birth and circumcision and pain relief preferences. It feels like too many things to find out about between now and then. This past appointment, though, was the first time we have seen our actual OB/GYN and left feeling reassured and not dismissed. I recounted some of the (scary scary) stories people have told me about hospital births, and she talked a little about why some things are the way they are, and how they try to avoid unnecessary c-sections, and how patients in our town tend to want more discussion about choices than patients in her previous practice did. We are still planning to look into engaging a doula, but I feel a little better after having talked to the doctor.

6. We survived the family reunion with 7 kids under age 5, including 3 under 6 months, with only one off-stage meltdown (on my part, set off by food). Small victories.

No gnews is good gnews ...

2008-05-30T09:42:00.002-05:00

Just checking in since we've been passing an awful lot of days without posting. Things are still progressing, and we've gotten to the point where we feel a little more comfortable doing some preparations. Other things remain hard --

I hate telling people I'm pregnant. We're to the point now where it's obvious in person, but there are still people I haven't written or called to tell. It's a little worrisome; we've already had some people we know in town get porky with us because they didn't know earlier. I realize it sends a clear signal if you actually give birth to a child and don't tell your purported friends, but I still wish we could wait until we have an real live THB before making any big announcements.

That said, everything is looking blissfully normal. I'm getting kicked reliably often enough (and the OB's doppler has demonstrated more than once that I don't feel it every time it happens). I'm a couple pounds ahead of the curve on weight, but laying off the cheese ravs will help keep that in check. They want a repeat of the 3-hour glucose test next week, which is gross but manageable even if I fail. Prenatal swim has been going well and keeps the only problem I've had -- leg/groin stiffness that makes walking and sitting painful and difficult -- at bay (at least as long as I stay in the water). And I have learned that I would rather give myself a shot in the stomach than pee in a cup.

25 weeks down. I am reminding myself not to wish the summer away.

Ultrasound done

2008-04-25T16:05:00.001-05:00

Everything seems to be okay, and we've learned the little tyke is The Fetus Formerly Known
As Embryo #14.

Ultrasound

2008-04-25T09:34:00.002-05:00

So, our 20-week ultrasound is this afternoon. Nervous as all get out.

Every previous big test felt like it was a hurdle we had to get through so that everything would feel "normal". And what happens every time is we are happy for a day or two, and then we fall right back to grim hope again. As a result, I'm not really hoping today will make me feel better about things; I'm mostly praying it doesn't make me feel worse.

Still hanging in there ...

2008-04-03T10:10:00.003-05:00

There really isn't much going on. I'm finding that, although it is fun and somewhat reassuring (in the absence of an anatomy scan) to watch my belly grow, I still have trouble believing there's anything inside it. We don't seem to be people who talk to -- or even much about -- "the baby." Maybe that comes later. Like in September.

There have been a few little fluttery motions, but given some of the other effects of pregnancy, I'm hesitant to attribute them to anything but gas until they feel more like a right hook than a butterfly.

Pass

2008-03-21T16:28:00.002-05:00

Much to our surprise, considering both the history and how much the test took out of her, JF passed the "long program" glucose test yesterday. Yay!

Fail

2008-03-18T20:56:00.002-05:00

I flunked the short glucose challenge test on Friday so will be performing the long program on Thursday. It involves three days of a high carb diet, three hours of sitting in the blood lab, a triple salchow and sequins. Except the last part.

I probably shouldn't have been surprised that the levels came back elevated; after all, it's not like the insulin resistance part is actually a surprise. I'm just afraid it will make them tell me I can't have the fruit I've been going crazy for (or the summer fruits I've been craving -- I'm counting the days until they hit their seasons ... strawberries ... blueberries ... peaches ...)

We Now Return You To Your Irregularly Scheduled Blogging

2008-03-11T05:10:00.002-05:00

Yesterday was our first ob/gyn appointment in nearly four weeks. Everything was fine, with a lovely fast heartbeat. This means we have successfully made it out of the first trimester.

But Wait, There's More

2008-03-07T17:52:00.004-05:00

Discussing the previous two posts with JF, we came up with the rich man's way of skirting around restrictions against screening embryos. Simply line up enough surrogate mothers to handle every possible embryo generated -- and once you have a pretty good idea N children are likely to be born, line up N-1 adoptive parents. Then once they're born, you do the screening process (genetic testing should work just as well on a live kid as on an embryo), keep the best kid for yourself, and give the others up to the adoptive parents.

Now, if you're anything like me, your first reaction to that is "Yuck!"

But think about it. If you take the "no screening embryos" exception as given, where is the downside here? The rich guy gets the kid he wants. N-1 other families get kids they desperately want. The surrogate mothers pocket a nice chunk of change that they apparently wanted. As long as no one is coerced, this is a win-win-win situation.

If there was some medical reason for the screening (risk of a terrible disease, perhaps), you can argue that you are more likely to get a kid who actually has the disease this way; but each individual embryo's chance of having the disease is exactly the same as before. And the judgment that every embryo is inviolable rests soundly on the notion it is better to be born with the terrible disease than not born at all, so I cannot see that as an argument against doing this.

Nonsense on Stilts

2008-03-07T14:46:00.006-05:00

The Nancy Gibbs article JF talks about is a good example of how to wrap extremist BS in a nice-sounding package -- and how to call for government intervention based on hypotheticals that produce a "Yuck!" reaction.

She starts by invoking a bunch of over-the-top scary examples, then cites both conservative and liberal objections to make herself sound balanced and moderate. Then she jumps straight into a radical, hard core position without examining what its implications. As JF points out, the first effect is radically decreasing the odds of IVF working -- there would only be a 50% chance of transferring even a single viable embryo! Mind you, we're talking about an expensive, emotionally consuming procedure that only has about a 50% success rate starting from the best possible embryos.

But that's just the tip of the iceberg. Because if you think it out, the next step is to say, well, why not transfer a bunch of embryos and then selectively reduce if too many implant. This is far less safe than the way they do it now (and strikes me as bordering on morally reprehensible), but it seems to fit with the rules printed in the article. But not the spirit. So clearly their program will require outlawing this form of abortion. (It seems like it also would require outlawing any timed-intercourse cycle which routinely produces many eggs, as they always have a scary chance of producing dangerous numbers of embryos.)

If they take the principles they state seriously, the logical conclusion is you have to outlaw abortion altogether for all couples, not just IVF patients. (Well, I suppose they might allow a rape exception.) There's just no sane way you can hold that embryos are inviolable, but fetuses are disposable.

Notice the way this works: in two short paragraphs, Gibbs jumps straight from the freakshow example of trying to give birth to an entire softball team at once to outlawing abortion and preventing couples from using the best available assisted techniques to help them get one or two healthy children. There's no chain of logic there; just two examples of something that could hypothetically be done via IVF, one normal and sensible, one ridiculous and completely imaginary to the best of my knowledge.

In the next paragraph she jumps to European countries that limit the number of embryos that can be implemented -- for financial reasons! Of course, this is allowing the law to overrule your doctor's good judgment of the best treatment for your issues to save a few bucks. And it's completely unrelated to the idea of not allowing screening -- you can bet that these let you make more than embryo and choose the best possible.

Let me point out "reproductive tourists" show the complete insanity of trying to ban this sort of thing. Unless that ban is enforced across the entire globe, it's just going to make couples head for greener pastures. On average, the ban would add about $30,000 (and loads of extra heartbreak) to the cost of a successful IVF cycle. That makes plane tickets to India seem like a bargain.

Then another freakshow "Yuck!" example, apparently of what might happen if you only partially enacted the suggestions in the third paragraph (all embryos must be transfered, but at least you get to screen them). Also note that this touches on some deep philosophical issues -- is Gibbs implying those embryos would be better off not being created than being raised by adoptive parents?

The final paragraph attempts to scare us with the specter of screening. It skips right past how the unambiguously positive screening for major diseases would be outlawed under the paragraph three rules. (Nothing like doing your best to add to the sorrow in the world, while patting yourself on the back about how ethical you are being.) Then it presents screening choices that are at worst crass, and concludes that the government has to intervene -- even though the major parties that are harmed if they don't are embryos that are not used. It's moving past "We're doing it for the children!" to "We're doing it for the embryos!"

SF says issues like this will make a libertarian of me yet ...

2008-03-07T09:17:00.014-05:00

In "Wanted: Someone to Play God" in the March 3 issue of Time, Nancy Gibbs expresses her opinion on your medical life.

There is much worth discussing in this column, even moving past that it is yet another instance of a journalist using "implanted" when she should use "transferred."

-- Gibbs claims that there is "nothing to stop [doctors] from implanting[sic] 10 embryos in a woman hoping to give birth to a softball team."

This assertion introduces the tone for Gibbs' column, which paints an extremely unflattering and offensive picture of infertile people as having lost their moral guides in their desperation to reproduce. It assumes that people undergoing ART do not weigh the options presented to them by any measure other than how likely the options are to give them what they (selfishly and desperately) want.

If legislators feel that they have to start making laws to limit everything doctors might do that is against conventional wisdom (and against the health of their patients), then we're really in trouble.

-- Discussing the book Embryo: A Defense of Human Life: "Their defense, less theological than biological, is that the embryo is a whole, living member of the human species in its earliest stage of development, not just a potential one or a part of one--and if destroyed, that particular individual has perished."

After having miscarried three times, I have a different view of whether every embryo is a "whole living member of the human species." They are so fragile -- I have an extremely hard time seeing them as fully-footed in this world during the "earliest stage of development." Even under the best of circumstances, natural or assisted, they don't all survive ... so, in that sense, they are still only potential.

-- "From that conviction arise their rules for both research and reproduction: Don't create more embryos than you will implant. No freezing, no choosing, no storing for future use and no experimenting on them.

This approach would all but end IVF as a practical treatment (not to mention, as SF points out, abortion at any time during pregnancy as well as the morning-after pill). At each stage of IVF treatment, there is a relatively high average failure rate. It would be perfect if you could retrieve one egg, fertilize it, have it grow to a perfect day-5 blastocyst, transfer it and have it implant perfectly and grow to a full-term baby. But that's not the way it works, even in unassisted cycles. In my case,

we retrieved 17 eggs.
10 fertilized.
3 of those were genetically abnormal.
2 stopped growing.
We transferred 2.
One implanted.

Three more are waiting for us, so that we can try again without my having to undergo another painful egg retrieval and possibly have my eggs have deteriorated to the point where they are unusable. So: from the 10 fertilized eggs, we got 5 potentially viable embryos. My doctor and nurses indicated that this was a relatively good outcome: lots of eggs, decent fertilization rate, a choice of which blastocysts looked promising -- NOT, I would point out, which had blue eyes, high IQs or musical talent -- and a few left for another try.

The column goes on to say:

"Adopting these rules would mean that America is catching up with Europe, where governments subsidize more of the costs and so control some of the risks."

One of the ways Gibbs suggests we might "catch up" with Europe is to allow the transfer of only one or two embryos at a time. If you are only allowed to create as many embryos as you will transfer, and you can only transfer one or two embryos, then you really could only try fertilizing two of those eggs. To try more would be to risk creating "too many" embryos.

Given the numbers I had -- which I was led to believe were a relatively good outcome -- that approach would have cut our chances of success drastically. 42% of my eggs didn't fertilize AT ALL. So you first would have needed the luck of having chosen your two eggs from the lucky 58%. Then they would have to be two of the five that continued growing and were healthy.

Picture it this way: you have a bag with 5 red marbles and 12 black ones. You get to pull two; red represents the eggs that produced viable embryos. My mathematician husband worked out an 8.6% chance that you would get two of the "winners" -- and a 49.8% chance that you would get none at all. And, as I said before, transferring two "winners" doesn't equal two babies; it might not even result in one.

--"Could patients create as many embryos as they like and pick the best, as long as they line up couples to adopt the rest--or sell the extras to offset the costs? This is no wild plan; in the U.K. researchers offer women reduced rates on fertility treatment if they agree to donate half their harvested eggs for research.

Here we have a cognitive jump from embryos, genetic engineering and "designer babies" to research done on gametes. I wouldn't be surprised to find people saying that research on "harvested eggs" is morally wrong who would never consider saying the same thing about research on sperm. Eggs and sperm are not people. We produce tens of thousands/millions more of each than will ever become "whole, living member[s] of the human species." I don't see how doing research on gametes is somehow a special case requiring legislation.

--"This is a moral wilderness, full of hope and traps. I don't expect aspiring parents to bring order to it when all they want is to survive the journey and make a family. That job is surely one for policymakers, to monitor the immense social and scientific experiment we've been conducting in private and make sure that we weigh the risks before we embrace the promise."

If the policymakers' science and logic are as bad as that in this column, we are all of us in trouble.

2008-02-25T16:35:00.002-05:00

Sorry for the long silence. There isn't really a lot to say, other than we are still hanging in there. Our next ultrasound is two weeks away, which is a freaky thought... just two weeks ago we were averaging better than one a week.

Update

2008-02-12T18:47:00.000-05:00

We had a surprise ultrasound today with the RE. It's hard to explain the crazy shifts of a day like today: the two hours of fear starting when JF tells me she's just scheduled an ultrasound, followed by the cool excitement of seeing the little fellow wave around his limbs on the ultrasound.

The RE did a great job of explaining that we weren't crazy to want an ultrasound, while reassuring us that things seemed to be going well.

More Good News

2008-02-06T16:20:00.000-05:00

Today's ultrasound went well: strong heartbeat and appropriate growth. The doctor and JF said they could see limbs, though I couldn't really make them out. He also poked around a bit and found the cause of the spotting which has been driving us past our wits' end. The bad news is that it doesn't sound like it is likely to stop; the good news is that it doesn't seem to be a major problem, either.

After killing twenty minutes at the comic book store, we then had our first meeting with a nurse from the ob/gyn's office. She was very nice and reassuring in her manner, though she seemed distressingly unprepared to figure out how to make an IVF pregnancy fit into their computer system. She also was much more conservative than our RE on the subject of what JF is allowed to do activity-wise. (Sigh.)

I feel like my mood has shifted very noticeably in the last 24 hours or so. I think I may be ready for the return of hope and optimism.

Attempted Bravery

2008-02-06T12:06:00.001-05:00

My every superstitious instinct says I shouldn't post this. But I think maybe getting over that may be the first step to starting to feel normally, so here goes.

I think it's pretty clear JF's body thinks it is pregnant. She's got morning sickness (well, mostly evening sickness, actually), despite which she is frequently ravenously hungry. Her clothes that fit two weeks ago now fit strangely or not at all, yet her weight is exactly the same. She requires extreme amounts of sleep. Her lower back aches every morning. Etc.

Now with any luck, the ultrasound in an hour will confirm that JF's body knows what it is doing.

Just to be on the safe side, I'm wearing my lucky undies.

Probably ...

2008-02-04T16:45:00.000-05:00

... when you call a therapist and can't get through leaving the voicemail message for her without completely falling apart, calling the therapist was a good idea.

What She Said

2008-02-02T12:06:00.000-05:00

I still remember what it felt like when JF was pregnant back in '06. We were on top of the world. We thought we'd finally beaten our reproductive issues, and everything was going to be fine and easy from then on.

We had that notion quite thoroughly stomped out of us in the ensuing eighteen months of heartbreak and struggle. And now that it really does seem like maybe we're back on the road again, it's very hard to stop thinking we should be bracing ourselves for yet another failure.

2008-02-02T10:11:00.000-05:00

SF and I keep talking about how we want to put up a blog post, but we can't figure out how to give voice to what we're feeling. He's out skiing with the dog this morning; I've decided to give it a shot.

Despite the reassurances of our doctor, we're both finding it hard to relax and stop worrying. My body seems to be misbehaving just enough to suck the joy out of every day: the spotting stopped for about 4 days before the last appointment, but it started up again, heavier, on Thursday. Then just a spot Friday evening. Nothing so far today, but I expect it's in the mail.

Every good thought I have seems to risk bringing misfortune down upon us. I know that sounds melodramatic. I know it is melodramatic. But I can't deny the feeling is there. It's strong enough that, after going through three miscarriages and 2 1/2 years of ART without the help of a therapist, I'm considering calling the one our RE recommended to see if she can help us relax and find the joy in what we're experiencing.

It felt like a risk to request the information packet from our hospital. It felt like a risk to call the OB/GYN. It felt like a risk to stop the PIO injections.
Our doctor has given us a 3-5% chance of miscarrying at this point. We've "beaten" the odds in so many ways before, though, that SF and I are both fully aware that those numbers above the 95th percentile still represent people. Logically, I know that requesting the hospital packet doesn't cause miscarriages, nor does filling out the OB's paperwork, nor sneaking a peek at cribs online.

Emotionally, though, it's a different story. SF sat me down a couple of days ago and said, "It's all right if we pretend we think things are going okay. If we don't, we won't ever do anything to prepare, because there's never a guarantee that things will continue as you hope."

This post feels clumsy ... but so do I.

Good News Continued

2008-01-28T11:25:00.000-05:00

Ultrasound today also went well. 9 mm, strong heartbeat. We were told that we didn't have to continue either hormone any further, and to schedule an appointment with JF's regular ob/gyn, which she just did.

Will try to make a longer post soon. I'd like to talk about the caution we both still feel; after all the setbacks we've had, it's hard to internalize the fact that things are going well. (Knock on wood.) But I'm having trouble finding words, and I need to get some work done, too, so it will have to wait for now.

Good News

2008-01-21T13:58:00.000-05:00

We have a heartbeat.

I cannot begin to say what a relief this is -- we've both been worried sick the last three days (see JF's previous post).

I'm afraid I'm finding it hard to be coherent enough to post, so I'll leave it at that.

TMI all over the place

2008-01-19T10:12:00.000-05:00

We went shopping yesterday and as we were getting ready to leave the store, I went to the ladies' room and saw the thing I've been dreading for weeks -- bright red blood.

Reassuring:
-- The quantity seems to be decreasing and the color fading to more brown
-- Our doctor said maybe to expect some spotting through week 10 because my ovaries are still huge and abused
-- I have had no cramps

Worrisome:
-- Definitely red, not pink
-- A couple small clots
-- Initial quantity was scary

We still have the ultrasound scheduled for Monday morning. I don't see much point in calling them earlier, on a weekend, because if it's a miscarriage I'm pretty sure there's nothing they can do.

Ultrasound done, now waiting for next ultrasound

2008-01-15T09:59:00.000-05:00

2.7 mm, no heartbeat yet. We are scheduled for another ultrasound next Monday. My impression is that everything seems to be normal so far.

I know we were both hoping for an early heartbeat today. We got this far before, and everything fell apart in the week that followed. And now we've got to wait the next six days knowing what happened then.

Is it possible to be optimistic and still gut-wrenchingly anxious?

Lying low

2008-01-14T09:54:00.000-05:00

Sorry for the radio silence this past week. SF and I are just trying to get through all of the days until we find out whether this pregnancy is viable. Or at least the ones until the next milestone -- the heartbeat. We've got an ultrasound scheduled for tomorrow morning, 5w6d. I know it's still early to see a heartbeat, but I'm hoping.

Good News

2008-01-07T15:48:00.000-05:00

The beta today was 741. That's a 56-hour doubling period (three days since 306), and to quote the nurse, "Things couldn't look more perfect or normal than they do."

I'd say I told you so, but honestly, I've spent the afternoon quaking in my socks at the thought of taking this phone call.

So our next scheduled test is the ultrasound on the 15th.

Resilience

2008-01-06T20:23:00.001-05:00

I've been vacillating all weekend between "que sera, sera" and "Please let this cycle work ... I can't do it again." There seem to be tons of examples around the web of people who had one less-than-ideal doubling rate and then went on to have healthy pregnancies. There are also tons of examples of people who went on to miscarry. This time tomorrow, we'll at least have another number to add into the mix.

The trouble is, I seem to have used up all of my resilience. At each step in this IVF cycle, things have gone basically well. Not just basically -- better than we'd hoped. But as soon as something doesn't go perfectly, I'm lost. Paralyzed with fear. Every time in the past, the first less-than-perfect milestone has been a marker for eventual failure.

The web says doubling within 48-72 hours is acceptable, but there seems to be a clear message (emphasized by my RE's nurse) that they really want to see doubling within 48 hours.

SF is a paragon of strength here. He believes if not this time, then surely the next. I'm just hoping to be able to rely on his strength over the next day or so, fearing that I may need to save my own for later.

It's still all about the waiting

2008-01-04T20:14:00.001-05:00

Well.

The nurse called. The beta rose from 181 to 306 in just about exactly 48 hours. That gives us a doubling time of about 62 hours, far short of the 48-hour ideal.

We are to return on Monday for another test.

Actually ...

2008-01-02T19:52:00.000-05:00

... I am fully planning on a second blood test on Friday. Because why get stuck once when you can do it twice? Seriously, though, I think a doubling beta might ease some lingering fears. Temporarily, anyway.

Thirteen More Days of Shots Scheduled

2008-01-02T18:54:00.000-05:00

Which is to say, good news today! The blood test came back positive. In fact, it came back high enough (180-something) that they didn't feel we needed to have a second blood test on Friday. Instead the next test is an ultrasound scheduled for 13 days from now.

We've gotten this far before and failed, so we know we're not out of the water yet. But tonight the F household is very happy.

One more day ... or three ...

2008-01-01T17:47:00.000-05:00

Beta is tomorrow. I am finding it well-nigh impossible to focus on anything else. Except maybe napping ... I've been exhausted all week. Progesterone? Most likely ...

Are 14 and 15 still around?

I have no idea.

SF just asked, "Is that blog post about how your cruel husband won't buy you a pregnancy test?"

This is the first time I haven't taken one ahead of the beta. I have to admit, after three hpt positives leading to no babies, he does have a point about their limited usefulness. They can't change the eventual outcome.

But I still kind of want one.

The Transfer (The Good Parts Version)

2007-12-26T07:48:00.000-05:00

As promised, let me go into a bit more detail on why Monday was so great. Back in March, the doctor told us that between the miscarriages and not producing very many follicles on the first round of injectables, we might be looking "reduced ovarian response" (probably not exactly the right medical term). If that were the case, we would be facing the likely possibility that none of JF's eggs were any good, and donor eggs would be the only viable option. The next round of injectables, at double the dose, went much better, but the doctor left us both with the impression that there was still serious doubt to the quality of those eggs. So I, at least, spent the last nine months thinking there was a good chance that we were going to eventually start IVF, spend the first round learning that it was hopeless, and then move on to donor eggs. The doctor did tell us this month that he no longer considered this a likely diagnosis, but that wasn't enough to clear the idea out of my mind.

So I spent the weekend trying to enjoy the early Christmas with my family, while inside I was bracing myself for disastrous news, either in a phone call or at our appointment on Monday. I'm pretty sure JF felt the same way -- she said she had nightmares that only one embryo made it far enough along to transfer. I found myself thinking that wouldn't be so bad, at least in her dream there was one that worked! But I didn't want to say anything that would get her down.

So Monday morning we said goodbye to my family, and I drove us to the fancy IVF center with dread in my heart. (Example imagined bad scenario -- there is nobody else there when we get there, because we missed the message saying none of the embryos made it, and it being Christmas Eve they just stayed home.) Because it was a fairly long drive, in winter, we left early, and arrived at the center 30 minutes early. Moments after we got there we were ushered back by a nurse, and that's when I knew we were really in trouble -- surely it could only mean they wanted to give us the bad news quickly.

Only then she took us to a gurney, and gave us hospital gowns, and suddenly there was a ray of hope -- I figured it was unlikely they'd give us gowns to sit down and give us bad news. Then she casually told us that seven embryos had been cleared as normal by the PGD testing, and the doctor would soon be checking over to pick the best ones to transfer. That's when it finally got through to me that this might work out. I felt comfortable enough to joke that this was probably the only time children of ours would be considered normal. I think JF expressed a worry that maybe the doctor might still find a problem with all the embryos, but in my mind the situation had shifted from inevitable trouble to strong hope.

Finally the doctor showed up, and gave us the news. Of the seven, two were still a bit behind, and two were absolutely prime for transferring. (I think this means the other three were merely average.) The question of gender came up, and I momentarily panicked, because this was something we hadn't really thought of ahead of time. But luckily the situation was ideal -- the best two were one of each. The other five would be evaluated the next day (ie yesterday) to determine if any were suitable for freezing.

Exciting as that was, the big news was that the possibility of problems with eggs or sperm is off the table. It now looks like the issues have been hormones and timing -- things IVF is already designed to work around. All the pills and the shots every morning may be a pain in the arse, but they're a lot easier to put up with when it looks like they have a good chance of making everything work.

So there you have it -- easily the best news all year for us. It doesn't mean that this cycle is necessarily going to work. But it does mean there is a good chance it will, and plenty of reasons to be optimistic that things will work out eventually.

Which is pretty much the best Christmas present ever.

The Transfer (The Quick Version)

2007-12-24T21:30:00.000-05:00

Just wanted to say (for those of you following along at home) that the transfer today went smoothly. The PGD testing cleared seven of the ten from the last stage, and the doctor transfered the "best" two. So tonight we're exhausted, but incredibly relieved and filled with joy.

I'll try to post more in the morning; for now, JF has asked me to read to her from Gawain and the Green Knight.

SF: earning jewels for his crown

2007-12-21T17:38:00.001-05:00

(I first typed "corn" instead of "crown" and almost left it at that ...)

Well, I seem to be over the nausea, but all is not right at our household:

The dog has fallen ill.

She had some, erm, digestive problems that led us to feed her a bland diet yesterday ... which she then vomited up today. And then some. And then some more.

SF got up at 4 a.m. to take care of her and didn't really get back to sleep. The vet said it looks like she has a stomach bug and kept her for a few hours to give her IV fluids. We now have anti-nausea and anti-diarrheal medicines to give her tomorrow.

This has thrown a monkey wrench into our plans to visit SF's parents this weekend, but we'll figure it all out. We can't take a puking dog, but the vet says if she's not vomiting tomorrow, it's probably safe to go.

With the transfer set for Christmas eve, we've been in a difficult position: visit before the holiday and tell them we're a no-go for Christmas day itself and stay home and eat ice cream, visit after the transfer and hang out with SF's pregnant sister-in-law and her husband and try to shut out the evil green monster, or go for the entire four days.

None of these plans is perfect.

Fertilization report

2007-12-20T19:36:00.000-05:00

The nurse called this afternoon and said that of the 17 eggs retrieved, 10 fertilized. I don't know anything about quality yet. Maybe ... tomorrow?

Today was pretty slow for me. Between the anaesthesia and the pain meds, I've been pretty out of it for much of the day ... probably could have made it through work if I had to, but (a) I keep falling asleep and (b) we're closed right now for renovations, and the work that needs doing is primarily heavy lifting, which is off limits.

And ... I just threw up. So we'll have to see about work tomorrow. Thank goodness lunch was a long time ago, because it was Spaghettios, and not to be crass, but they taste like puke going in. I really wouldn't care to meet them again.

Home Again

2007-12-19T12:32:00.000-05:00

The retrieval fetched 17 eggs, a most auspicious number. I performed my duties successfully as well. I just successfully gave JF her first Progesterone injection as well.

All-in-all, it appears today has gone as well as could be hoped (knock on wood). Now it's just down to various housekeeping activities and catching up on my sleep.

Retrieval

2007-12-18T18:33:00.000-05:00

Retrieval is tomorrow morning. The facility is about an hour's drive away, so we're heading out tonight to stay in a hotel. I find myself extremely nervous about the entire process; I've no idea how JF is still functioning at this point.

I have a date!

2007-12-16T16:46:00.000-05:00

We'll going in Wednesday for the retrieval, which means a Christmas Eve transfer. I'm not such a n00b as to believe in the magical power of dates in this situation (after being due on my deceased grandmother's birthday -- twice -- and miscarrying -- twice -- these things lose their magic). Simply knowing the schedule will help us try to plan family stuff; they've been very patient with us as we offered them nothing but portions of our own uncertainty.

As I watch the crowd of five kids trying to shovel 11 inches of snow off our entire street, I am glad we decided on a hotel room the night before retrieval over trying to get to the clinic an hour plus away by 7 a.m. in winter.

Hopefully by next week they'll be able to find my uterus again, so they have someplace to transfer to. It seemed to be off roadtripping this morning. Can't blame it: I'd be off in Lungdon or Handsylvania or Puertoe Rico myself, given the chance. Probably stay away from Assyria, though ... I heard a rumor someone's planning on shooting up the place.

Excitement

2007-12-16T07:43:00.000-05:00

Just spent 30 minutes shoveling the driveway so we can run out for an ultrasound at 8:30 this morning! This is the one that should tell us our scheduling for this week and next -- if we can make it to the doctors'.

A New Twist

2007-12-12T16:51:00.000-05:00

Today's ultrasound went well, looked like there were at least 9 follicles in the 6-8 mm range. But there is a new wrinkle with the Gonal-F injections -- starting Friday we are to scale back slightly on the Gonal-F, and mix it with Luveris before injecting. I can't say I know the reason why, but I suspect JF will have thoroughly researched it on the web by this time tomorrow.

For all that I am still scared by the prospect of serious injections to come, I am kind of geekily excited by this. I think that's because it looks like giving the shot will be about the same difficulty level as a normal trigger shot, so not new and scary -- and there is the cool drug mixing stage with this. Okay, honestly, I don't know why that's cool, but it feels that way to me now. Guess that's better than panicking about it when the time comes.

Gonal-F shots now underway

2007-12-07T07:13:00.000-05:00

The call never came on Wednesday, which was supposed to mean we were to start the shots on Thursday. Let me tell all of you out there that this is a bad method of communication, because you're going to sit and wonder if no call really is a positive message or just an accident.

So Thursday morning, we called them and left a message asking the nurse to confirm. At noon I got the call confirming that the blood work was okay -- but this nurse thought that the ultrasounds warranted consulting the doctor, so we were to wait until we heard more. Finally a few minutes after the doctor's office closed, we got the go-ahead to start the Gonal-F.

Okay, that was new....

2007-12-05T13:29:00.000-05:00

JF and I went in for the ultrasound check this morning. It's the utterly routine check to make sure everything is looking groovy to start the Gonal-F -- old hat for us by now.

Only this morning, there were two nice sized (11 and 13 mm, I think) follicles sitting there on the ultrasound. The nurse did not seemed unduly fazed by this, but it sure surprised JF and me.

So now we're waiting for the blood work to come back. If it's good, we proceed as planned; if not we wait a week and check again. Apparently the Depo-Lupron should still be in JF's body; it may just take a bit longer to suppress her reproductive system down to the point we can start the process.

Afterward, we paid in full for this round of IVF. There was a bit of a glitch, too, as I had apparently (sensibly IMO) set a limit of $5000 per transaction on the card. I called the number on the back of the card and we sorted things out.

Update

2007-12-04T04:20:00.000-05:00

We seem to have fallen out of the habit of updating this blog, as our last few weeks have been extremely busy. Rest assured that we are still working on the IVF cycle, and things are about to get properly under way tomorrow with the first ultrasound and corresponding payment in full for the cycle. We should be back to daily Gonal-F shots on Thursday. (Knock on wood.)

So far, the big excitement on this cycle was last week's Depo-Lupron shot. It is much more serious business than the injectables we have been dealing with in previous cycles -- a longer (and thicker, I think) needle, and it goes into muscle rather than fatty tissue. Because we will have to administer shots like this daily later in the cycle, the nurse made me give JF the shot while she monitored things.

Can I just say how scary I found that? I just hope it gets less nerveracking after a few days of doing it every day. Still, it seemed to go fairly well. JF claims it barely hurt, and I think I know how to make it hurt even less next time.

Questions abound

2007-11-16T00:13:00.000-05:00

We have our initial IVF appointment tomorrow. It lasts about an hour. I'm not yet sure what it entails. They call it a "lecture." And so the IVF intimidation begins.

We usually talk to one of two nurses at our clinic. I've noticed we get consistently more complete information over the phone from one than from the other. This afternoon, I got a call from the mail-order pharmacy on my cell phone while I was at work. They were calling to confirm the list of medicines ... which I haven't yet seen (presumably it will be part of the lecture?) and which didn't match what I thought they had described at the consult last week.

I called the nurses' voicemail and left a message. For some reason, when they returned the call, my phone didn't ring. It was the less-complete nurse, and she left a message that didn't answer my questions ... but since the phone didn't actually ring, I couldn't ask them directly to her. She said the calendar of what medicine to take when should be in my mailbox when I got home, and it would explain everything.

It was. But it didn't. Not only does it also not match what I understood from last week, it also doesn't have all of the medicines the pharmacy listed on it. The procedure week was also four weeks earlier on the calendar than they said last week.

We'll get it all cleared up tomorrow, in plenty of time. Maybe they thought we didn't ask enough questions last week, so they spoonfed us some really obvious ones.

2007-11-14T21:21:00.000-05:00

SF's last blog post made me blush, a lot, not only because of his generosity in not blaming me for the problems we've had, but also because he's right about the other stuff -- my passport renewal form is sitting on the piano and has been for ... awhile. Sigh.

Friday started out on a rough note. Our cat had a tooth pulled a few weeks ago, and we were referred to a specialist with the news that two more of his teeth looked abscessed but were hard to get at. At his appointment on Friday, we found out he has resorptive disease and we needed to have five of his teeth pulled or consign him to a painful process as they dissolved and fell out of his head. The good news is that he seems to be recovering well from the extractions (he's curled up on my lap asleep right now). The bad news is that it was an $800 bill weren't exactly expecting, an we found out about it as we were walking out the door to go to talk about IVF.

Things went more smoothly with the RE than I'd feared they would. It was absolutely nuts there that afternoon. Every seat in the waiting room was taken, and everyone we talked to seemed a little punchy. I realize that sounds like a bad thing in a medical practice, but it really was what we needed at that point. We asked most of the questions we had, but we also laughed a lot during the appointment. Anytime I laugh more than cry in that room is a successful appointment in my book.

Although he did say he could see an argument for continuing on injectables, he pretty clearly agreed with our decision to move on to IVF. We went over a bit of the medical stuff -- he doesn't think the diminished ovarian reserve is likely to present a problem; he said he'd expect 1-3 follicles if it were trouble, but we've been getting 7-8. He seemed to think our chances were at least reasonable.

Then they brought out the price list.

My eyes went wide.

Eek! The new price listed didn't include the Preimplantation Genetic Diagnosis!

We brought that up so they could add it in ...

... and the result was still $3400 less than the price they quoted us in June. They have comped some of the procedures and have added an option of making payments (which we're hoping to avoid). And they've offered to do all of the monitoring and blood work for one set price now that our insurance coverage for even the lab has conked out.

We were ecstatic. We are ecstatic. It's still going to cost a lot of money, but it takes so much of the pressure off to know that we might have the option of doing a second try if the first doesn't work.

Responsibility and Bravery

2007-11-14T15:51:00.000-05:00

In response to JF's last post -- I simply don't see the see the point in holding her responsible for something completely outside of her control. When she leaves the eggs out after cooking breakfast, I'm happy to blame her. When she gets her passport photo and then leaves the application sitting around for weeks rather than mailing it in, I will blame her. But when her body misbehaves, it is simply not her fault. (And that's presuming that it is her body that is responsible, at that -- we have corrected all the issues we know anything about, so at this point we simply don't know where the problem is coming from.)

Where her own behavior is at issue, she has been an incredible trooper in all of this. I can't imagine giving myself all those shots. All the pills, the probings, the bloat... she has put up with it all, and is staring in the face of worse yet to come and getting excited at the prospect of another chance! She is as brave as any person I have ever met.

She deserves great praise, not blame.

Response and responsibility

2007-11-09T10:32:00.000-05:00

"It's a shame she had no real children; she would have been a wonderful mother. In a flash of insight, David sees that it's not her fault she has no children: Mr. Trotwood is to blame. That's the reason he's so outgoing and optimistic but prone to tears: he is a man without seed. Every kind thing he does for his wife is some kind of compensation, some small apology."

--Defect by Will Weaver

I, too, find it hard not to feel that way, when I'm the problem. I find myself, much to SF's chagrin, doing things like putting off my dentist appointment because we're already spending so much on my healthcare. It doesn't help the infertility situation, but it makes me feel a little better.

I wonder, though, whether such feelings and actions will eventually become a recipe for a marital difficulty. People don't tend to like people they feel sorry for, even -- especially? -- when they're married to them. No matter how bad I feel for cheating my fertile husband out of the dream of easy family-building, it seems like it's necessary to get past that guilt and sadness ... which is only really possible if the other person doesn't blame you.

So far, SF seems to be above casting blame -- a generous reaction, in my opinion. I hope someday I might get beyond holding myself culpable for the mess we find ourselves in.

Tagged

2007-11-08T20:52:00.000-05:00

The Rules:
- Once tagged, you must link to the person who tagged you. (Hi Tina623!)
- Post the rules before your list, and list 8 random things about yourself.
- At the end of the post, you must tag and link to 8 other people, visit their sites, and leave a comment letting them know they’ve been tagged.

8 Random Things about SF and JF:

1. After we were the closest of friends but before they were dating, JF thought, "SF and I aren't dating, but if he asked me to marry him, I'd say yes." Both of our mothers had already figured that out and thought it was a good idea.

2. SF makes the best pizza in the world: spinach, Roma tomatoes, bacon, fresh mozzarella and Gruyere. (This Random Thing is contested, but since I, JF, am typing, it goes on the list.)

3. We want to go to Epcot someday to check whether one of our favorite dead fiddle players is in a Circlevision movie there. (The Disney archivist didn't know.)

4. Our favorite place to vacation is Newfoundland. We've been there twice together.

5. We have four accordions, a piano, two violins, an octave mandolin, a guitar, two mandolins, a ukulele, a bassoon, a clarinet, 20+ tin whistles, a keyboard, and a cello in exile.

6. SF is a strong proponent of the comma before the final "and" in a list of items. JF naturally puts one there, too.

7. SF wrote JF a tune called "The Platinum Ring" for their wedding and surprised her by having all of their friends play it at the reception.

8. Together, we are German, Irish, Scottish, English, French, Finnish, Austro-Hungarian, Cherokee, Russian, and Canadian. But not necessarily in that order.

We don't really know who to tag ... we'll have to think about that part.

The Met Reducing Plan

2007-11-08T09:28:00.001-05:00

Turns out I was tracking my weight during the wrong part of the cycle. It didn't balloon upward until after the trigger shot -- when I gained five pounds overnight. That was three weeks ago.

In the past three weeks, I have lost ten pounds, putting me at my lowest weight since SF and I got married; this morning's measure was 3 pounds less than I weighed when we got back from our honeymoon. (Which, as a side note, took place in Northern Michigan in January during a cold snap and included a frightening quantity of Tater Tots. I was down a few pounds from pre-wedding stress, but it came back in spades on the honeymoon.) I have lost weight this week at the rate of nearly a pound a day.

I cut out pop about a month ago. That much sugar mixed with insulin resistance can't be a good thing. But I suspect a stronger culprit: the Metformin has been making me sick again. I don't feel like eating much, and when I do, it ... doesn't stay around long. Something to bring up with the doctor on Friday, I suppose, though I totally don't want him to take me off the drug. I will beg to stay on it, GI side effects and all. I just want to make sure it isn't going to kill me. He swears up and down that Met doesn't cause weight loss, but that equalization period as your body adjusts to its new state of affairs included, for me, dropping about 20 pounds -- plus a few more in the past couple of weeks. Now, if I can just get down about 20 more, I'll be back to what I weighed in grad school when I was subsisting on rice-a-roni and ramen.

options

2007-11-05T22:35:00.003-05:00

We have an appointment Friday to discuss our options. I don't know how long before we start the next round. Probably at least 3 weeks, and that's just until we need to start supressing my cycle. I have a box of junk to take with us in case they can use it -- extra needles, the Follistim pouch and pen from our first round, a box of Crinone they lent us in case we needed it. For the first time since the beginning of the year, the sharps container is the only drug paraphernalia in our kitchen. It looks bare, but also less cluttered, less stress-inducing. It's a kind of personal feng shui, I guess. It feels like the phase of those drugs has ended, and we're moving on to a different one.

Telling time

2007-10-29T17:35:00.000-05:00

When the news is good, they call around 3:00. When the news is bad, the nurse doesn't call until after 4.

At 4:30, the phone rang.

The test was negative. Bleeding for one day last week doesn't count as a period. It's unusual not to have a period after an hcg shot. If nothing happens by Friday, I should repeat the test "in case something weird is going on."

Even though we were expecting it after this morning, the news has still knocked both SF and me for a loop. I prepared myself mentally -- as much as possible -- for another miscarriage, but not for just an outright garden-variety failure to launch. And though this may technically be better news (in that it doesn't add to the disparity between pregnancies and live births), it doesn't feel that way just now.

Hopeful but not optimistic

2007-10-29T08:37:00.001-05:00

It's finally here.

Blood test day.

I called for a lab referral.

It feels like there's a lot riding on this one. If it's negative, we're most likely moving on to IVF.

The home test I took this morning showed one solitary line.

Something concrete

2007-10-27T10:35:00.001-05:00

No, not that.

The nurse asked that I call them with an update at the end of the week. I phoned yesterday to let them know the bruise was fading and that the spotting had stopped except for some brown goo.

As a child, I figured I just wouldn't ever take my clothes off in front of anyone, have any of "those" doctor's appointments, or admit to having a menstrual cycle or anything else related to sex. The ease with which I can now leave voicemail messages using phrases like "brown goo" still strikes me as odd, to say the least.

The irony that I am now posting that on the Internet is not lost.

When the nurse returned my call, she gave me some of the most concrete information I've had so far. She said that brown discharge with Crinone is normal if you've had a bleeding episode recently. She also said it doesn't take much blood to make it very brown, that it looks like more blood than it is, and that it is old blood.

There was a pause, and then she said, "I'm glad that bruise went away ... I haven't seen anything like that happen in 10 years here."

I'm knitting with only one needle -- unravelling fast, it's true ...

2007-10-26T09:02:00.000-05:00

"I'm going slightly mad ...
I'm going slightly mad
It finally happened
It finally happened
It finally happened --
I'm slightly mad"

--Queen, "I'm Going Slightly Mad."

And that? Is how I feel about (a) progesterone, (b) the end of the two-week wait, (c) assisted reproduction, and (d) life in general.

Feeling pretty useless, too. Need to get off the couch ...

2007-10-25T22:09:00.000-05:00

I totally fell asleep on the couch this afternoon. Stephen Colbert, it had NOTHING TO DO with your book. I'm still in the Nation.

even if I did get it from the library instead of buying it.

(wh)eeew!

2007-10-24T07:42:00.001-05:00

The bleeding has backed off into brown gunk. I know everyone was just waiting with bated breath, dying to find that out.

Here's the thing: backing off seems like a good thing.

Given the choice, I'd rather have it back off than become a full-on period.

But I am so superstitious I almost can't write it here. There is some part of my head that honestly believes -- fears -- that writing it down will jinx any good things that might be happening, and that now I will be bleeding like a stuck pig by noon. What it boils down to is this: I am my grandfather's granddaughter when it comes to superstition, and --

-- it's still too early to tell anything.

bruising

2007-10-22T19:57:00.001-05:00

I have a bruise in my bellybutton. It was bright red and the size of a pencil eraser this morning. I called the nurse, and she said it might be leftover blood pooled from the injections. That seems strange to me, since we've been finished with them for a week.

I thought maybe it was from the button of my jeans pressing into my great bloated belly. But I didn't wear pants with a button today, and this evening the bruise is three times as big as it was this morning.

Very puzzled.

In other news, the nurse also said the bleeding/spotting is either (a) breakthrough bleeding that will stop, (b) breakthrough bleeding that will continue off and on into a period, or (c) an early period.

In other words, it's too early to tell.

Crinone -- spotting 6dpo

2007-10-22T08:27:00.001-05:00

We're not quite halfway through the 2ww, and I'm spotting ... bleeding? ... I'm not sure where the borderline is.

Last night when we got home, I had a couple of drops of pink. Then -- and I apologize for the TMI here -- overnight, I had cramping bad enough to wake me up, and the drops of pink turned into dark red blood combined with the typical crinone mess.

Dr. Google says "bleeding on Crinone is not uncommon" and "we found no evidence that Crinone causes early bleeding."

I find lots about pink spotting and brown and orange(?!?) discharge. My doctor says anything less than a full period isn't a period. We're not there yet, but ... I'm worried.

But -- 6dpo? Why so early?

So puzzling.

Gonal-F, round 4, 2nd day past trigger

2007-10-16T19:45:00.000-05:00

I am so stiff -- bloated, huge and sore. It's only 9:00, but I'm going to go beach myself in bed and read for awhile. Bleargh.

This morning's weight was something like +3 pounds overall, which is about 2 1/2 pounds up from yesterday.

Ovidrel on board!

2007-10-14T19:52:00.000-05:00

It hurt a little more than the Gonal-F, just about as much as the Ganirelix. The syringe is the same.

And now ... we wait. And, if the past is any indication, we bloat.

If I make it to October 30 -- 14 days past ovulation and 16 past trigger -- without a normal-to-heavy period, then they'll do a blood pregnancy test. We start progesterone gel on Tuesday.

Gonal-F round 4, day 10

2007-10-14T09:57:00.000-05:00

This morning's ultrasound looked great. Even after Wednesday's bleeding, my lining was 12mm. The nurse said they look for 9-12 and implantation doesn't happen in less than 8. There were several big follicles; the machine measures up to four, and the four they measured were all 18-20mm. We trigger tonight. Let's hope they're not all ancient shriveled up useless eggs!

Gonal-F and Ganirelix this morning ... we did the shot at the doctor's office after the ultrasound. Still not totally fond of the Ganirelix shot, but if it does its job I will forgive half the bad things I said about it.

Weight change since yesterday: -.2 pounds
Net change: +.4 pounds

Gonal-F round 4, day 9

2007-10-13T08:20:00.000-05:00

Today SF accidentally pulled the needle out of my skin while trying to shift his hand around to push the still-surprisingly-stiff Gonal-F plunger. No pain, but the first injection site bled a little. We switched needles before trying again, because I am a wimp, and, as I said before, we have 30 bizillion of them.

Today was the first day we added Ganirelix to the mix. Those shots always hurt a little more going in. The needles seem bigger, the small syringe is a little more difficult to handle when you're used to the giant gonal or follistim pens, and the injection site seems to get a little sore afterwards.

U/S tomorrow!

Weight change since yesterday: +.2 pounds
Net weight change: +.6 pounds

Gonal-F round 4, day 8

2007-10-12T18:34:00.000-05:00

Completely uneventful shot today, except that we had to do it 15 minutes early so I could make it to a meeting.

Weight change since yesterday: +.6 pounds
Net weight change: +.4 pounds

Gonal-F round 4, day 7

2007-10-11T11:19:00.000-05:00

Small bruise from yesterday's shot; no mark at all from today's, which was the first shot I couldn't see going in -- SF's hand was in the way. I kept bracing for it to hurt, and there was a small sting when the needle first touched, but that's it.

The bleeding has slowed but not stopped. According to the nurse, "With all the medicine we're using, it's not unusual to have bleeding at any point during the cycle."

It took her a couple of minutes to say that, though. She was obviously thinking about something else, though she didn't say it. Now it's got me wondering; I should have pressed her. They want me to keep up with what I've been doing, come in on Sunday as planned, and call them if anything changes again.

Weight change since yesterday: +.4 pounds
Net weight change: -.2 pounds

Bleeding?

2007-10-10T19:02:00.000-05:00

So. At work this afternoon, I started to cramp bad enough that I couldn't focus on putting the files in my filing cabinet in alphabetical order.

I took some Advil. An hour passed. I could hardly stand up.

Then the cramps went away almost at once. I continued to work and got a lot more done once I could see straight.

My boss stopped by about half an hour later and said she was leaving and I should too. I started getting ready to leave and discovered --

-- I had bled all over myself. Through my jeans and everything.

It's now about 2 hours later, and I'm still bleeding as heavily as a heavyish period. Guess I'll call the doctor tomorrow morning ... I've never had breakthrough bleeding like this before.

So. Very. Frustrated.

Ultrasound results

2007-10-10T12:39:00.001-05:00

I am the proud grower of 7-8 follicles of the proper size. Yay me. As the doctor pointed out, 8 follicles doesn't mean 8 babies. SF and I are already well aware of this fact, with many past follicles in our history and still no babies.

BUT -- everything looks good. The lining is thick and comfy looking, there was a good number of follicles of a decent size, no problems with the shots. We're adding a daily baby aspirin as of today. Ganirelix (to prevent early ovulation) begins Saturday. Next u/s is Sunday morning, 8 a.m.

In news unrelated to babies, SF and I went for dinner at the mall last night. It turned out to be more expensive than we'd anticipated; we splurged on this jacket in blue.

I am in love with it. Love love love. I love the color. I love the snaps in the back to snug it in at the waist. I love the down-ness of it. And you know what? I love that the weather is finally cool enough that I can wear it!

Gonal-F round 4, day 6

2007-10-10T07:46:00.000-05:00

A little bit of a scratch as the needle came out, but the shot itself was painless. We did the left abdomen today. There's plenty of padding there for the needle to go in.

Weight change since yesterday: +.2 pounds
Total weight change: -.6 pounds

I have an ultrasound in three hours with bloodwork ahead of time. Grow follicles grow!

Gonal-F round 4, day 5

2007-10-10T07:30:00.000-05:00

Completely uneventful. Right stomach. Didn't hurt. Didn't bleed.

I'm more puzzled by my weight. On day 5, it was:

Change since yesterday: -.8 pounds
Total change: -.8 pounds

I'm not complaining, but understand: I gained 7 pounds last time. Maybe I'm misremembering, and it didn't happen until nearer the trigger? Puzzling.

Off to do day 6!

Gonal-F round 4, day 4

2007-10-08T09:44:00.000-05:00

Today's shot provoked a disagreement. I remember yesterday's shot as going in the left side of my stomach; SF remembers it going in the right. There are no marks on me to prove who is right, so we did the only sensible thing: moved to my left thigh.

Right thigh would have been sensible, too, I suppose. I only specified which one so that if we need to remember, we have it written down.

A little pain from going to fast, but not much. A small drop of blood and a tiny red mark, but nothing needing a bandage. Four days down smoothly.

My belly is definitely starting to feel a little fuller. Not sloshy, like when you drink too much water, but just like there's more stuff in there than quite fits comfortably.

Weight change since yesterday: +.4 pounds
Net weight change: 0

Gonal-F round 4, day 3

2007-10-07T09:27:00.000-05:00

SF noticed a barb on the first needle he put on, so he changed it. Luckily, we have dozens of them. Each pen comes with 5, I think, and we usually only use one.

No pain from the shot, aside from a slight sting from the drop of medicine on the end of the needle. Injecting the medicine slowly seems to reduce the sting from the dose of medicine. Fast and it hurts; slow and I don't even notice it.

Good job SF! Three down with no pain.

Weight change since yesterday: +1.0 pounds
Total weight change: -.4 pounds

I feel like I should be measuring my abdomen, too. I'm starting to see a little bit of tightness/pain there.

Gonal-F, round 4, day 2

2007-10-06T07:50:00.000-05:00

First the first time ever, I administered the shot today. As always, JF was very brave, and kindly claims I did not hurt her.

ETA: This is JF. It really didn't hurt at all. Honestly, the beardburn I got when I hugged SF afterward hurt more. Also of note: if yesterday's weight is 0, then today we have:

Weight change since yesterday: -1.4 pounds
Total change: -1.4 pounds

Gonal-F, round 4, day 1

2007-10-05T23:18:00.001-05:00

Smooth as silk! No blood, no bruise, no pain. Rock on.

Back in the saddle again

2007-10-03T08:08:00.000-05:00

This feels like a time for starting new projects. I bought a bunch of material for a new craft project, and I actually got it together and started the new project instead of just letting the materials sit around until inspiration either struck full on or left entirely.

I learned to prepare some of the fabric I wasn't entirely happy with to make it more suitable for my purposes.

I have also picked up an old stitching project again to alternate with the new one.

And ... I have an appointment this afternoon for a day 1-3 ultrasound. It's been four whole months since I've seen my ovaries. I miss them, lazy little bastards that they are.

Beware o an Aberdonian

2007-09-13T19:49:00.000-05:00

As of this evening, we've ordered enough Gonal-F to trigger the quantity discount. That's right -- 6 free pens and a free Ovidrel syringe, bringing the total for drugs for this cycle to a mere $1100. Woo! We still had to pay for four pens and the Ganirelix. Oh, and the Progesterone gel, but that's left over from my last failed pregnancy.

It's as close to clipping coupons as infertility treatment gets. If this results in a child, we'll have to give her a good Scottish name.

Keep moving forward

2007-09-06T07:34:00.000-05:00

I should perhaps count myself lucky that this summer was as busy as it was. There was no time to dwell on miscarrying for the third time, no time to obsess over our current plan of action (one more round of shots instead of moving on to IVF), no time to do anything other than work, clean up from work, and plan for the next bit of work. From June until August, I ran 5-6 children's programs per week. When that ended, it was time to prepare for my workplace's upcoming renovation, which means moving my office and clearing all of the library materials off of the mezzanine.

Did I mention the two out-of-town, in-the-wedding-party weddings in two weeks? And that my in-laws and newly-expecting SIL and BIL were staying at our house while we were out of state for the second wedding? So it had to be -- erm -- cleanish? (That turned out to be one of the blessings in disguise: we spent FIVE HOURS cleaning before leaving for Chicago, which meant that we actually came home to a clean house for once. It's nice.)

And did I mention that I finally got my period? I started spotting on about CD 63, two days before wedding #1, and that continued until the witch showed up in full, two hours before wedding #2. What was that I said about at least one crampy afternoon in a bridesmaid dress? Oh yes. And this was a port-a-john wedding.

The dress was red, eh, so how bad could it get?

Anyway, that's where we are now. I've begun a pack of birth control, after discussing again with the pharmacist that I do in fact have a reason for taking both BC and prenatals. Soon I will call the doctor and ask for a prescription for the next round of shots. If we're lucky, he won't have any unpleasant surprises for us. And even though he's been talking to other doctors to get their opinions on treating us, I don't hold out much hope that they've got some great idea he hasn't thought of.

I think, though, that this is probably our last round of injectables, our last chance to conceive a child in our home rather than in a hospital. But still -- I am thankful, truly, that this isn't our last chance at anything; only a few short years of science ago, we would have long past run out of treatment options.

Why ...

2007-08-28T08:06:00.001-05:00

... does it never get any easier?

I think it's time to call the counselor our RE recommended.

2007-08-17T13:15:00.000-05:00

Lower your miscarriage risk with new tests, treatments

Let's see what they recommend ...

2. Stop the stress
"British researchers recently found that feeling happy, relaxed, or in control is linked to a 60 percent reduction in a woman's miscarriage risk. What helps when you can't kick back with a glass of wine? Gentle workouts, dining with friends, or watching your favorite TV show might work (stick with The Office instead of nerve-janglers like 24 or ER)."

So, ladies, if you miscarry, it's because you watched the wrong TV show. I'm waiting for the prescribed list to come out. The marketing people out to get right on this ... are you listening, America's Funniest Home Videos?

Does it work the other way, too? Do 24 and ER do double-duty as erstwhile abortificants?

Maybe I should trust the unnamed British researchers and hope they had a way to correct for this, but ... Do you want to know what, in my experience, is the main cause of stress in early pregnancy?

Do you?

How about MISCARRIAGE OF ALL PRIOR PREGNANCIES?

Or, to simplify, as SF put it: Say you're newly pregnant, not worried about anything. Your doctor says, "You're at risk for a miscarriage." You begin to worry. Then you miscarry.

Clearly because of the worrying, wouldn't you say?

It's all about the waiting

2007-08-03T19:52:00.000-05:00

Like we didn't already know that.

I'm on something like CD44. The b*tch can take her own sweet time. I'm not calling her out yet.

Of course, with two weddings this month I can bet I'll be spending at least one crampy day in a bridesmaid dress.

That's the way it works, isn't it?

Whew.

2007-07-27T08:11:00.000-05:00

I have spent the last several weeks mostly not thinking about trying to conceive. Work has been a bear, so I've been busy. And we can't start again until I have a period after the last miscarriage, and we're five weeks on now.

Or is it six?

Ah, the bliss of not knowing. It's not very important. In fact, if it'll hold off even another week, I'll be able to stop worrying whether the end of August will involve trying to balance two weddings (one family wedding and the second where I'm matron of honor) with injections and doctor visits.

Our doctor gave us several choices at the last visit:

1. Do nothing for a few months. Take a break.

2. Do another cycle of Gonal-F.

3. Move on to IVF with genetic testing to see whether we can learn why every embryo we produce dies.

4. Egg donation.

He seems to want us to move on to IVF, though he admits he's not sure whether this latest miscarriage was a fluke. But -- he's a doctor, and the way I'm reading the situation is that he wants to know what the answer is.

I am less concerned about the answer and more concerned about the result. For that reason, since he's not sure, we've decided to try one more round of injections. When I told the nurse that, she made it clear she thought that was a fine path, which reassured me some.

The hard part is that, although that seems like the best choice for us -- least expensive (this round of drugs is discounted with the pharmacy and we already have the progesterone) and also least invasive -- it may mean we are effectively choosing another miscarriage.

I have to remember there are no guarantees with any path we choose, at any time. Even babies born at term do not come with a guarantee that they will live long, healthy lives and die in their beds at a hundred and two.

Surfacing for air

2007-07-16T19:45:00.000-05:00

Now that I've been gone so long probably nobody is even looking at this anymore ...

I'm still here.

Very, very busy ... but still here.

I'm still not sure when the next step will happen. It's good to have some time off.

2007-06-28T08:18:00.000-05:00

I am so sad and so busy right now I can barely keep my head above water. We have some hard choices to make, choices I will outline when I have a minute ... but not yet. Not yet.

Off for the third blood draw. Here's hoping 8 days is enough to get to zero.

Falling

2007-06-20T15:19:00.000-05:00

The test results came back earlier this afternoon. My hcg level dropped, so this pregnancy isn't viable. Right now the things I'm thankful for -- no Misoprostol, no ectopic pregnancy -- are pretty dreadful. But I'm still thankful, and hopeful, at this point at least, for next time.

beta 78, doubling time unknown

2007-06-18T16:31:00.000-05:00

Just came across this post from The Waiting Womb, and it brought me to tears.

Please stay.

Update

2007-06-18T13:11:00.000-05:00

JF called from work to say the official test this morning came back positive. (In the 70-somethings, I think she said.)

By itself, that doesn't tell us a lot -- we'll learn a lot more from Wednesday's test, because the big question now is whether that number is going up or not. But still, every test that doesn't come back negative is a good thing.

The limits of the Internet

2007-06-18T08:10:00.000-05:00

There is a lot of information on the Internet. Good and bad, right and wrong ... as a librarian, I spend a lot of time explaining to people what it's good for and what it isn't good for. Some things you just won't find on the web.

One of those things, in my experience, is whether or not your pregnancy will survive. I can find lots of information about spotting during pregnancy, and spotting from progesterone gel, and cramping from progesterone gel, and cramping and spotting in pregnancy, and conflicting information about whether each of those things is normal or a danger signal.

But nowhere out there have I found a page that says, "JF, your pregnancy will last" and gives me 20 reasons not to worry.

Al Gore, when you created the Internet, you should have made it clairvoyant.

Out of words

2007-06-17T08:33:00.000-05:00

After some spotting on Saturday, I woke in the middle of the night with cramps strong enough that they woke me up. No spotting then, but I'm afraid what we're seeing this morning probably means this cycle is over.

Ouch.

2007-06-16T13:07:00.000-05:00

I don't know what the story behind Kurt Elling's "A New Body and Soul" is, but it clearly is a father addressing his new child, and bits of it make me wonder if his story is not so dissimilar to ours.

"Waiting too long for a sign you would come was what
nearly killed the spirit in the house within me
and when you appeared you brought an answer after praying
like a sailor sighting landfall on horizons of green"

and much later

"And that’s why our teachers teach 'The Itsy Bitsy Spider'
to the smallest ones:
We need a fight song to keep us moving along
I should’ve sung it when thinking you gone.
You weren’t lost / you were coming"

There are certainly days when I could use a fight song myself...

Knock knock? Who's there? Impatient JF. Impatient JF wh--

2007-06-15T08:19:00.000-05:00

A friend gave me an extra test.

It called to me. I resisted.

It called again. Again I resisted.

It called again.

A struggle ensued. I peed on it. I'm not sure who won. Here's what happened next:

The oh-so-faint one is from yesterday, 11DPO; the darker one is from this morning. From what I can find on the web, the beta-hcg from the trigger shot should have left my system after 10 days.

I have to wait until Monday for a blood test, and then they will almost certainly want to check for doubling, so we won't know anything for certain for another week.

This is the earliest I've ever tested positive. The first time I got pregnant, the home test didn't go positive until CD36. The second time, a couple of months after that, I didn't test until I was almost 3 weeks past ovulation, and my first beta came back in the low 40s and didn't double.

This is just another kind of limbo. I guess in a way all of pregnancy is. Next week is so busy I'm sure it'll go quickly.

"So, what have you been up to?"

2007-06-10T19:08:00.000-05:00

SF and I spent the weekend at my 10-year college reunion. The high points included spending time with close friends we don't see nearly often enough, trying a new dish at my favorite restaurant there, accepting our favorite professor's offer of his office phone for a call to our absent friend in England, and a serendipitous ride in a golf cart.

More difficult moments included the main thing people ask at reunions -- "So, what have you been up to?"

I've talked a lot in this blog, I think, about the difficulty of knowing how much to say and to whom. Ann's current post also touches on the question. As one of my close friends pointed out this weekend, infertility is "like a job" in the amount of time and attention it can consume. So when people who don't need the play-by-play ask how things have been, especially in a somewhat competitive situation like a reunion, I feel like there's a gaping hole in what I'm telling them -- as though their only logical reaction would be "Wait -- that's *all* you do in a week?"

Truth is, they're probably not listening that closely. Maybe I should take Ann's science metaphor in a different direction: those dealing with infertility are like Mad Scientists, working on our secret chemistry projects, projects that we're keeping under wraps for now, waiting for the day when we will unveil them and rule the world! Bwahahahaha!

I don't believe we should always keep infertility secret, that it isn't something we talk about in our culture, but there are times when it's more comfortable to keep your mouth shut, if you can get past worrying what other people think about you. For those times, I'll think of myself as the Mad Scientist, plotting world domination, and I will laugh quietly into my collar.

Bwahahahaha.

1/3 of the way through the wait

2007-06-07T07:05:00.000-05:00

Back down a pound from yesterday -- still up 6 pounds since Monday with a great big belly. Not exactly where I want to be right before a class reunion, but whatever. At least it's college and not high school.

Yesterday was an early, busy day at work. I had to be there in time to visit four school grades before 11:00, which meant arriving at work two hours before I usually do. When I got home, we had dinner and SF decided to take a nap. I thought, I'm not really in the mood to sleep, but I'll go curl up and maybe read a little.

Didn't open the book. Also didn't wake up again, except blearily to take medicine, for 11 hours. SF blames the progesterone, especially since now (after 11 hours asleep and 1 hour awake) I could easily go back to bed. So weird ...

The last leviathan

2007-06-03T18:42:00.000-05:00

The ovidrel has kicked in, and my belly is huge again. HUGE. And sore. It was sort of funny last time. This time it hurts too much to be funny. My ovaries feel like they're about the size of oranges.

Replaced with pudding

2007-06-02T08:51:00.000-05:00

For the first time in months, we don't have any medicine in our house. None on the shelf of the fridge, none on the counter, none in the mail. Instead, we have bowls of butterscotch pudding cooling on the empty shelf in the fridge. It's a nice feeling, for the moment.

So far as I know, yesterday's ultrasound couldn't have been better. I have a 12 mm lining, 8 follicles, and good hormone levels. The doctor cautioned us that even cycles that look great on paper don't always result in pregnancy, but for now I'm going to hold onto the idea that things are looking good. He decided we had the "luxury" of one more day of stims, and the nurse gave us a sample so we didn't have to order (and pay for) another pen. We're to add progesterone suppositories for 12 days starting Monday. I'm not looking forward to that, but I'm game if it might help.

All this has had me thinking about his style of information-giving. Each cycle that we've learned had a problem, we thought was going smoothly. When I was on Femara and ovulated, we thought that was great. Later on, we found out the eggs were probably of poor quality. When I was on Follistim and ovulated, we thought that was great, too, but later found out our numbers weren't so hot -- 4 follicles when the doctor wanted to see 6-8. Last cycle, my numbers were up and we thought that was great, but the hormone levels showed I probably ovulated too early meaning, again, poor quality eggs. This time, we think he's fixed all of those problems, but I can't help but wonder what's out there that our doctor hasn't told us? What is he seeing on the ultrasounds and in the blood work that we don't yet know to look for?

I realize this is not an exact science, and I try to ask questions, but sometimes I don't know the questions to ask.

Day 7 -- G-F and G

2007-05-31T08:28:00.000-05:00

Today's Ganirelix shot was easier than yesterday's -- only one location -- but it hurt more afterward, and it left a big red spot the size of a half dollar at the injection site. That's on the list as a normal side effect, and it hasn't "persisted or become bothersome," so I'm not worried. Seem to be getting headaches this cycle, too, but nothing too bad.

Like any obsessive researcher, though, I've been trying to find stories of people's experiences with these two drugs and -- here's the tricky part -- timed intercourse. There are a million sites out there talking about IVF, but we're not there (yet).

I haven't found much, but even if I had, it would have been more to make me feel better than to acquire actual useful information; we won't know what the answer is for us until we get there. Ultrasound tomorrow, then inlaw-diverting, then the 2WW ... I think I can face it this time.

Saturday afternoon's party might be interesting, though, if I can't move any better than I could after the last Ovidrel shot! I blew up like a balloon last time. No better way to make an impression on family-to-be than to arrive bloated and stiff. Woo!

Day 6 -- Gonal-F and Ganirelix

2007-05-30T07:50:00.000-05:00

The Gonal-F injection went fine today; Ganirelix took three tries. The first two spots I tried hurt so much I yelled. Third place went in like a charm.

Good ultrasound results yesterday -- six "ladies," as my RE called them, all around 13-14 mm with good symmetry between ovaries (I think it was 2 and 4, but he called it good). We'll see him again on Friday and then trigger Friday or Saturday night. It could be interesting ... my parents, grandparents and in-laws will all be in town this weekend. We may have to send them out to dinner or something on Saturday if we trigger on Friday.

There was a time that would have left me mortified. The thing is, I completely lost my shame filter sometime around the time I lost track of how many transvaginal ultrasounds I've had. So if it comes down to a question of embarrassment about what we're leaving our families to go do or possibly wasting $2000 and another two months because I couldn't stand up for myself in an embarrassing situation ...

Well, let's just say that, for better or for worse, that's not much of a risk at this point.

p.s. Ganirelix sounds like a Star Wars character.

Gonal-F, Days 3, 4 and 5

2007-05-29T07:51:00.000-05:00

Days 3 and 4 -- We were at my parents' cottage. Trying to do this in a new place is always a little stressful, but it went okay. I requested a needle change (SF is in charge of the pen prep) on the second shot after one failed attempt. It seems to be that the closer I try to get to the centerline of my abdomen, the more it hurts. So I'm going to try staying a little farther out for the next few.

Day 5 -- this morning. We have an ultrasound appointment in a couple hours to see how things are progressing.

The excitement so far today is that I left the alcohol wipes and gauze at the lake, 2 1/2 hours away. SF suggested something from our well-stocked liquor cabinet, which would probably have worked fine, but I turned up my nose at it, and he ran to the drugstore for supplies.

Yes, I know alcohol is alcohol (except, as SF says, some alcohol is more equal than others), but ...

I guess the feeling comes closest to a superstition. We are given the steps to take. We follow the steps. The drugs work.

We deviate from the steps, the drugs do not work.

The more I think about it, the more it puts me in mind of the structuralism and fairy tales I studied in college:

interdiction --> violation of the interdiction --> bad stuff

Don't venture off the path, or you'll never have a child.

Gonal-F, Day 2

2007-05-26T07:42:00.001-05:00

Yesterday's shot did not bruise. It's only a small red dot. I can still see it, which I wouldn't be able to do if it had gone perfectly.

Today I chose a spot about 2 inches southeast of my belly button. The needle stung when it went in, and seemed to hang up with the pain increasing as I pushed.

I pulled it out without having delivered the medicine. A bead of blood welled up. SF replaced the needle, and I moved an inch or so east. No pain, no problem -- and no blood. I can't even tell exactly where the shot actually ended up being. I can only see the misstep, which still has a small bead of blood.

I am not an expert at this

2007-05-25T07:02:00.001-05:00

I messed up this morning's shot. The medicine all went in, but I moved my hand so much holding the pen that the needle went "ping!" when I pulled it out of my skin.

That's gonna be a bruise.