Chaos and due dates

June 28, 2013 § 28 Comments

Friday through Tuesday was a little wild.

By Friday night, we had decided that we were definitely going to move forward with IVF at my clinic home base. I was excited. I felt closer than ever to being pregnant. I would be stimming in early August and that seemed sooo close. I was relaxed. At ease. Over the next few days, our discussions turned financial. We went back and forth on whether or not we would do the shared risk program*, but we seemed to be leaning toward it. My parents were on board, too, thinking it would be better bang for our their buck. We had some reservations about this option, though.

First, we would be required to transfer two embryos. Now, I know that I should be happy with any baby at all and that two babies is better than no babies. But the idea of twins is (at least at this point) pretty effing overwhelming for me. I’ve worked as a nanny in the past. I am not pollyannaish about what parenting will be like. It is hard to care for an infant. Really freaking hard and exhausting. And two infants? Well. That honestly sounds impossible to do while still maintaining happiness and sanity. That is not to say that we won’t eventually choose to transfer two embryos if and when the time comes, but I just don’t like the idea that we wouldn’t (for up to three IVF and as many FETs as there are embryos during the course of that year) have the choice. That didn’t sit well.

Second, as I have whined about several times (sorry), we may be moving next May or June, and the year time frame for the shared success program wouldn’t be over until August. So we wondered if it made a difference that we may only be able to squeeze in 4 cycles instead of 6 (if we need them), or whatever the math ended up being.

My appointment to start the IVF process was set for Tuesday morning at 7 AM. I was scheduled to get my calendar and a blood draw before being put on birth control pills. If we were going with shared success, they also had to take height and weight measurements as well as do a nicotine test, and I would have to “pass” those in order to be accepted into the program.

By Monday afternoon, we still had not made a decision about the shared success, so I decided to have the additional lab work drawn to buy us a little more time. We wouldn’t REALLY have to make up our minds until the consent signing the next week. (Do you see what an odd anxious procrastinating duck I am? How much good will an addition 7-10 days do us? None. That’s how much.)

Then Monday evening. The Artsy Engineer gets home from work, and I can tell he is really on edge. And I’m on edge, but I don’t know why. At the time, I think it’s just the excitement of IVF. The I-can’t-believe-we’re-really-doing-this-es. And then all of the sudden, The Artsy Engineer tells me he doesn’t feel ready. That he wants to do the last IUI, because this is the doctor’s orders, and because if we were to do IVF right away, he would always wonder if that last IUI would have worked. I knew he had reservations about moving forward after only two IUIs, but we’d discussed and discussed (and discussed) and seemed to both come to the conclusion that we were on board. Of course, I offer all of the reasons why I’m hesitant to do this. And then we go back and forth about it for awhile. Me trying to defend our initial decision with solid reasoning (it’s so unlikely to work, the timing will be better, etc etc). And him offering equally good arguments against it (it’s cheaper per percentage point of likelihood of success, we’re still within the first three during which our odds don’t go down yet, IVF is hard on my body and associated with increased, though small, risks to the offspring and what if something were to happen and we were to always wonder if we really needed it.. if that one last IUI would have done the trick).

The clinic is closed for part of August but I don’t know the exact dates, so I know that if we do the additional IUI, we might not be able to move onto IVF right away. I’m stressed (and therefore irritable) and I make this shitty comment about how I want him to sit down with me and count through the calendar so we can see if we can squeeze in one more IUI before IVF without screwing horribly with the timing or getting mixed up in the clinic closure, because “I’m the one who has to do everything and you just SWOOP in at the LAST MINUTE after I’ve spent hours and hours and hours gathering the information and try to CHANGE THE PLAN.” Which actually wasn’t fair, because he’s been involved. He just can’t possibly be as involved as me. And at that moment, that was pissing me off.

And he was stressed, so that comment (which would likely not bother him when he’s feeling good) realllly upset him. And he shot back with something equally hurtful and untrue.

And then I left the house. And I went to the dog park and sat like a creepster in my car for an hour and a half in the rain and cried and watched the dogs play.

When I came home, we apologized. Blamed it on the stress of the decision. Still did not make said decision. Fell asleep.

We got to the appointment in the morning with the plan of asking the nurse if we could squeeze in the additional IUI and start the IVF cycle immediately afterward and then taking 5-10 minutes to decide what to do. We did that, and it was fine. And we decided on IVF now.

So he left for work and I got the blood draw. And I got into work and put the dates into my calendar.

And then I just felt sick to my stomach. And it didn’t go away. And my mom called and asked if I was excited, and I just started crying. And then I realized that I wasn’t ready right this second either. That I needed to be sure that we were ready to spend a shit ton of someone else’s money and put my body at risk for this and that I wouldn’t be sure until we had exhausted all of our options. And then I felt like an ass because this is clearly how The Artsy Engineer felt but I didn’t want to listen to it. My desire to be pregnant as soon as humanly scientifically possible was making me a selfish partner.

I called the RE’s office and asked the administrative assistant if she would kindly ask the nurse to call me back. I wanted to pull out. And could they still squeeze me in for a baseline ultrasound for the IUI? Was I too late?

(This is the point at which I wrote the last post.)

It took three hours for one of the nurses to get back to me, and there was only an hour left before the clinic closed. I was already on CD 3, so I knew that if I was going to do a letrozole+IUI cycle, I needed to get this done immediately. I was really worried that it wasn’t going to happen, and that I’d wasted a cycle. But the nurses were so understanding. I left for the clinic the minute I got off of the phone with them, and they squeezed me in just before close. There was some good-natured teasing involved, which I appreciated. I was embarrassed and exhausted and I needed a little humor.

And then ohhhh the relief. This decision felt worlds better.

I am ready to do IVF. In fact, we have a tentative calendar in place for when this IUI does not work. Because the odds are that it will not work. I will be starting birth control pills in a little under a month, and I’ll take them about a week longer than usual to get us out of that blacked out time when the clinic will be closed. Lupron will begin around August 19th. And I’ll start the stim meds around the 30th. Retrieval is penciled in for 9/11.

I am ready to do IVF. I just wasn’t ready right that minute. Whether or not it’s logical, I need to do this first. I need to know that we need it. And, for some reason, this last IUI will make it official. So maybe we’re paying $1500 for peace of mind about our decision to move forward. But, so be it.

And, yes. This would put our estimated due date (if the first IVF works, which it very well may not) around the time when we may be moving. But. Fuck the schedule. This is my family we’re talking about here.

And also, if I had not lost the only pregnancy I’ve ever had, my due date would have been tomorrow.

I plan on burying myself in backlogged patient paperwork.

Emotions? Who needs emotions?

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A post to announce a post

June 25, 2013 § 13 Comments

The last 48 hours have been ridiculous. I have shed a lot of tears. There has been one door-slamming house-leaving argument. Nothing is horribly wrong or even a little bit wrong, but apparently big decisions turn my brain into apple sauce and my typically healthy psychological coping into a farce.

I don’t have time to get into it now, and I don’t even know if it’ll happen. But. Spoiler alert: I changed my mind 18 bazillion times and decided on an option that wasn’t even on the initial list. Holy crazy person. Ohmygod.

 

Edited to add: Please don’t get too excited! The option we chose was not exciting at all. It was just a “lively” decision-making process. I’ll add more when I’m not taking my physically and emotionally exhausted ass to bed before it’s even dark outside.

13dpiui#2

June 22, 2013 § 26 Comments

Once I started, I couldn’t easily stop. I tested again on Wednesday, and the test line on the Wondfo was even lighter, which I did not think was possible. And while that mostly answered my question about whether or not my first “positive” was the result of the trigger shot, it still left a little room for hoping. Of course, I googled “pregnancy tests lighter before getting darker” and learned that it can, in fact, happen. But then on Thursday morning, it was gone completely. No line. So, going into my beta was a bit heartbreaking. I knew it would be negative. And it was.

I’m a little bit ashamed of myself for getting so worked up. I should have known better. Part of me feels embarrassed about showing you all my raw, unfounded excitement based on nothing more than a mixture of intense hope and stronger than ever progesterone supplement symptoms. I typically don’t type things out in real time, especially when these things are super emotionally charged. I craft my posts after the emotional intensity has worn off a bit, which feels safer. Less vulnerable. I feel like I let myself get pranked. In front of a large audience. For a person with a decent amount of social anxiety, that is less than ideal.

But that is that. I’m not pregnant. We’re moving on to IVF. Another IUI feels pointless. There were three eggs in there available for fertilization this last time, and The Artsy Engineer’s numbers were better than ever. The only reason we would do another IUI is if we decide to wait to see if a space opens up in the clinical trial. When I realized I was being put on a waiting list, I emailed one of the research assistants to ask if she would be able to give me some idea of when spots might open up and if I was high enough up on the list to be hopeful that I might get one. She responded briefly by saying, “Possibly till the end of July, but there are very limited spots.” That didn’t quite answer my question to the extent that I was hoping, so I emailed again asking for clarification. This time I got the following reply.

[Lentil],
We may not take candidates until end of July.
We have been running for almost 4 years and have reached capacity for the trial currently, we are not closed yet and will be taking a few more. We will be looking and re-reviewing the prescreening and screening questionnaires. When spots become available we will contact candidates.
I’m reading this to mean that it’s unlikely, right? If I were high enough up on the list to remain hopeful, wouldn’t she say so?
..
This is important because of timing. I know I should not be thinking of timing. Because it will work out regardless. But I’ve been focusing on my career for so long that it’s a hard habit to break. You guys may remember that I will likely be starting an internship next summer, sometime between June 29th and September 1st. And I will likely have to move to whichever state the hospital I’ve been placed is located. We can do IVF right now with my RE. Starting asap with birth control pills as soon as these progesterone supplement leaves my system and I get my period. Say it miraculously works on try #1. The potential baby would be due in late April or early May. This sounds ideal. It would give me more time at home with this potential baby, more time before the move. If we wait (and, again, if it miraculously works on try #1), this potential baby would be born while I’m on internship and I would very likely only be allowed to take 6 weeks off. Yikes. And I’ve also never known anyone who has had a baby during internship. Everyone does it during postdoc (which will be the two years following this internship year), but I have never even heard of somebody who knows somebody who has had a baby during internship.
.. 
I know all of this may be a moot point. There is so much that is out of my control. I might not match to an internship at all. 25% don’t. And IVF often does not work on the first try. But my doctor sounds so confident. Based on her stats with my age range and diagnosis in addition to her “clinical opinion” (based on my all of my numbers and my “strong” response to treatment), she believes we have a 60% chance. She even said she thought we had a 60-80% chance, but that saying that out loud makes her squirm, because she rarely puts people in that range and she hates to give people that much hope when there is, of course, always a chance that it simply won’t happen.
.. 
We also qualify for the shared risk program. If we pay an additional $10,000ish, this would allow us to have the “insurance” of two additional IVFs (and as many FETs as possible) during the course of a year if the first IVF fails.
..
So the options are this:
1) wait until the end of July to see if space opens up in the clinical trial
pros: much (!!) lower cost
cons: seems unlikely to happen, timing would be less ideal, i would have to travel to and from NY during a really busy time work-wise, increased stress levels from travel/working from elsewhere, the clinic has a lower success rate than my clinic at home
2) move forward with IVF with my RE using the simple pay-as-you-go method
pros: it might work the first time, less stress, better timing
cons: it might not work the first time, $20,ooo is very expensive, FET costs around $4,000
3) move forward with IVF using the shared risk plan
pros: three IVFs plus as many FETs as possible better freaking work, so i would venture to say this will likely get us pregnant
cons: $30,000 is holyfuckingshitoutofcontrol expensive and what if it works the first time and we feel like we just gambled away an additional 10 grand
So this is where we are. The plan is to choose one of these three in the next few days. Eeeep.
Anyone want to make this decision for me? I struggle with deciding what to order off of the menu when we go out for dinner. In fact, I usually convince the Artsy Engineer to order one of the two things I want and share it with me, so I get both and I never actually even have to come to a decision. How on earth are we going to figure this one out?

Gahhhh

June 19, 2013 § 32 Comments

Well.

Against all of your thoughtful and accurate advice and against my better judgment, I tested last night. And, as expected, there was nothing. Cue cursing. Cue tears. Cue pretty intense self-directed berating.

Ten minutes later, Artsy Engineer got home. Scolded me for testing, which I immediately pointed out was incredibly unfair, since he is always trying to convince me to take pregnancy tests when it’s way too early. He started making ceviche for dinner. While he was in the middle of chopping ingredients, I said something childish and embarrassing along the lines of, “I don’t want that. I want pizza.” I was in a drown out your sorrows kind of mood. And that calls for pizza or macaroni and cheese. Not raw food cooked in citrus.

About 15 minutes into my tantrum, I went back to throw away the test and get rid of the evidence of my stupidity.

And there was a second line. A veryveryvery faint second line.

And then I immediately remembered that I took a trigger shot and that a second line is completely untrustworthy at this point. Somehow, in my deluded symptom haze, I forgot about this little (HUGE FREAKING) detail. What on earth was I thinking. This is why I haven’t even considered testing this early during any of my other medicated cycles. Because I know better. How did I forget about this??

Source. Alex E. Proimos

Facepalm. Source: Alex E. Proimos

And today, I’m feeling A LOT less pregnant. I slept soundly, I’ve been cold all morning, and the blown up surgical glove boobs are gone. Of course. And they have taken with them my optimism. Which I absolutely deserve.

Screw you, feelings. You suck.

Or not to test (9dpiui#2)

June 18, 2013 § 35 Comments

My pee is in a cup on top of my toilet right now and I am dangerously close to dipping something in it.

I hesitate to even type this out, but I freaking feel pregnant. I’m waking up all night, my boobs look like those surgical gloves after you blow them up (minus the fingers and the rest of the hand shape). I’ve had hot flashes on and off all day for the last two days.

Now, I am all about research and I believe the research that says that I should not be feeling pregnancy symptoms at this point even if I were, in fact, pregnant. But I also know that I felt this exact same trio of symptoms the first time I was pregnant, and I did not feel them before nor have I felt them since.

It’s too early to test. And if I test and it’s negative I will be crushed. I fully recognize that this is a big one. It’s this or IVF. I am extremely imaginative, and I would not put it past my body to go all psychosomatic all over my shit and create these symptoms when there is nothing there.

I don’t want to test, but I can’t stop thinking about it. And the Artsy Engineer is not helping. He’s been telling me since the day after the IUI that he just “has a feeling” that this is it. I know that when he gets home from work, he’s going to stick that test stick in the urine himself if I let him have access to it.

I know it’s early enough that if when I get a negative (provided that I test today), I could still very well be pregnant. That I shouldn’t be immediately crushed. But my brain won’t let me believe that. If it’s negative today, it will feel over. And I’m not ready for that either.

So, I’m going to do my best to wait this out.

Of fingers and dikes

June 16, 2013 § 29 Comments

Well.

I’m not sure where to begin. I think I’ve been missing for nearly 5 weeks.

It was not a premeditated absence. I planned to keep up with everyone while in Ecuador. And then I planned to write about the trip as soon as I got home. Instead, I forgot (mostly) about the fact that I am a person who is trying to have a baby and who can’t. And I withdrew entirely from this infertile world.

And it felt so freeing. I felt so light.

Not the part about being ‘away’ from you guys. That part I felt guilty about. And I wondered about you all. In fact, I lurked. Reading on the periphery but hesitant to dive back in, as if one comment here or there would be like removing my finger from the dike and would result in me (and those close to me) drowning in a wave of my infertileness.

This was not the only reason I was absent. I have also been the outofcontrol holy-shit kind of busy. Aside from two weeks in Ecuador, I was in dissertation boot camp for a week, writing for 10 hours a day in a semi-organized fashion in the library of the university (jealous?), had two friends staying with us for 10 days, and just got back from an extended weekend in Ann Arbor. We’ve been in the company of a good number of the members of our mishpocha. I have not been to yoga since pre-Ecuador, which is a pretty good marker for how off my schedule has been, since that is something I do rather zealously. The Artsy Engineer and I actually counted the days where we’ve had more than an hour to ourselves since May 14th, when we haven’t been sharing rooms in hostels in Ecuador with friends or sharing our home with friends or sharing our family’s homes. It comes out to 5.*

I’m not going to go into any crazy details with this post. I feel the need to just break the silence. Remove my finger from the dike.

But. I will tell you that I am very much not pregnant. And I am doing remarkably well. IUI #1 was a bust. I snuck into the bathroom first thing in the morning, while our friends slept in the bed right next to ours, and took the test, then crawled back into bed and whispered to Bryan the negative result. We were momentarily (and, oddly, superficially almost) bummed. Then we got up, had rich coffee on the porch in our pajamas, and spent the rest of the day rappelling down waterfalls outside of a town situated in a valley where the Andes and the Amazon rainforest meet. It was hard to stay disappointed about anything. IUI #2 took place exactly one week ago, while we had friends staying with us. They are very close friends, and they know about our whole infertile history, so I didn’t have to make up any stories about going out to get bagels on Sunday morning when, in fact, I was being inseminated. They even watched, wide-eyes and jawed, as the Artsy Engineer gave me my trigger shot. These friends are the kind who say all the right things, ask all the right questions, and who have never tried to give us advice of any kind. You know the kind. They were a breath of fresh air. They are also psychologists, so I guess I shouldn’t be shocked that they know how to talk to people about difficult things. And even appear not just interested, but also curious and almost excited about the process. It was just so terribly nice.

Despite my attempt to avoid it, a lot of things have been happening on the fertility front. Last Friday, when I had the mid-cycle ultrasound to monitor follicle growth, I learned that I had three mature follicles (!!) and beautiful, thick lining. Letrozole and I, we clearly get along. I also scheduled and attended my first “what’s next” appointment with my RE, during which she was extremely pleasant and easy-going. She spent 40 minutes with me, which I thought was huge. And she answered every last one of the questions I had prepared without the slightest bit of annoyance. And she seemed to respect my thoughts and take me seriously. I was so relieved.

Right now I am 7dpiui and I have the most sore boobs I’ve had maybe ever (but that makes sense because I also had the most mature follicles I’ve had ever and, thus, the most corpora lutea to produce progesterone I’ve had ever). I’m hopeful. But we also are trying to devise our plan of what to do next. And IVF it is.

We haven’t decided the ‘when’ part, though. The thoughts on this will be included in another post, because this one is becoming a bit of a tome.

We have a couple of what I guess one could call possibilities. We’re on the waiting list for the New Hope IVF Clinical Trial, which would allow us to pursue IVF for the cost of several trips to New York. That is option #1. Options #2 is less good, I think, but we are incredibly lucky to have it. We drive janked up cars from the mid-90s. Mine died mid-left turn this afternoon after we picked up the dogs from kennel. We cannot afford IVF on our own. My parents have graciously (god, that word doesn’t do it justice or even anything close) offered to pay for the entire treatment, stating that they “cannot think of anything better to spend [their] money on.” But this idea is incredibly hard for us to swallow. My parents have some savings, but they are by no means wealthy. And IVF with our clinic is going to cost close to $20,000 when all is said and done. They pay for dinner when we go out together and it makes me uncomfortable. How am I supposed to accept a gift at this level of bigness?

Ok, More later. I have several things to expand upon. The Artsy Engineer and I have different ideas of when (and how) to move forward with IVF. I am beginning to think about which internship sites I will apply to, which is exciting and also terrifying. My parents are moving away in a month. My sister is dating a guy and I don’t like him and I feel like an judgy asshole about it. The dogs spent their first weekend at doggie daycare/boarding and I’m so proud of them for not freaking out and being miserable. Andonandonandon. Progesterone test is tomorrow. Conference in Chicago on Thursday. Beta is Friday. And go.

 

 

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*I am an introvert in the sense that I love to be around others, but I find it physically and emotionally exhausting if I don’t get a good deal of ‘me’ time in order to recharge. So this has been a wonderful but draining month.

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