Beware o an Aberdonian

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

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 ...

... does it never get any easier?

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

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

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.

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

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.

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

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

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

Please stay.

Update

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

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

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.

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--

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?"

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

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

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

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

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!