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.

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?

Reason (or something like it)

March 31, 2013 § 22 Comments

We’re trying to decide what to do next.

Say next cycle works. Next cycle’s maybe baby would end up birthed in early January of 2014. For those of you who have stellar memories, you may recall that this coming December-January is also the time that I will (hopefully) be interviewing for internship positions all over the country. Yes, I could probably arrange phone interviews for one or two if absolutely necessary. But I can’t help but assume that would put me at a disadvantage. And, yes, I could turn down all interviews that were not within driving distance. But only 3/4 of applicants match to a program at all, so limiting my options is not something I want to do.

My RE has said that we have the option of either continuing with one more round of letrozole+timed intercourse or moving ahead to IUI. Of course, there are other possibilities. We can do no treatment and still try. Or we can take a month off to ensure that I can go on interviews.

Y’all. The idea of taking a month off is met with a huge “hell no” from my brain. I can’t even think about it rationally. My brain doesn’t give me the opportunity. I’ve tried to think clearly about the pros of doing this, but it’s immediately blocked by the much more overwhelming need to continue to push forward. It may be the best option. But it’s such an aversive idea that I can’t even think about it. That is some seriously powerful shit, friends.

If I’m not going to even entertain the thought (which apparently I’m not), then I guess we’re trying. And if we’re trying, maybe we should go all out. Skip ahead to IUI. But then what if I get pregnant and don’t match to an internship and have to spend an entire additional year in graduate school.

So, because both of those options are scary, I’m leaning toward the nonsensical decision that looks something like this. We try (so treatment, in general, is a yes). But not so hard that we actually might get pregnant* (so IUI is a no). Letrozole cycle #3, then?

That “logic” is so absurd.


*Because if we did get pregnant, of course we’d be thrilled and of course I would make it work. And maybe I wouldn’t even care if I had to tack on an additional year to graduate school even though that would make it 7 years instead of 6 and even 6 is INSANE and right now I REALLY, REALLY CARE. So much so that I am being SCREAMY about it, apparently.

Fallopian fun

March 18, 2013 § 14 Comments

I have been bloggy boring even myself lately.

I have a mildly decent excuse, though, I guess. Non-internets life got in the way.

Somehow, despite recently quitting my only paying (very) part-time job, I have managed to stay really busy off of the internet, and it’s actually felt marvelous. Now that I’m home more often, it took me awhile to figure out how to be not “at work” and to be still working. When I was in classes it was easier, because there were deadlines. But now I have no hard deadlines, and the ones I set for myself just aren’t anxiety-provoking enough to get me moving.

I’m home two days a week now. These days are supposed to be research days – days during which I am focused on manuscripts and my dissertation. Of course, instead of writing, I often surf the web, do the laundry and other household chores (that I typically don’t do unless I’m avoiding doing something else), and read all of your lovely blogs.

All of the sudden, over the last few weeks, I’m finding myself better able to concentrate than since before my miscarriage in October. That was a real productivity killer, let me tell you. I don’t suppose it will last indefinitely, but I am immensely thankful that it’s happening and am trying to take advantage of it while it’s here.

In other news, I ovulated during the middle of last week and am now 5 dpo. Over the last six months or so, I’ve been using a lot of cycle imagery. You can call it hocus pocus if you’d like. But I find it’s a powerful coping mechanism. It works for me. Lately I’ve been picturing an embryo traveling down my fallopian tubes, and I sometimes talk to it (not out loud yet, thank god), offering encouraging words. It’s kind of like I would do if I was cheering on an exhausted marathon runner at mile 21. You’re almost there! Hang in there! Put one foot in front of the other! Here, drink this water! If there is indeed an embryo in there, it should be nearing the end of my fallopian tubes very soon and descending upon the entry to my uterus. Make it happen terbs.


Sick Day Sunday

January 27, 2013 § 8 Comments

Today is Sunday. For the last 5 years, since I started my doctoral program, Sundays have been work days. They are typically the day when I panic and start worrying about all of the things that I haven’t gotten done yet: the ongoing qualifying exam (which is only a couple of months from being done), several manuscripts that are in preparation, clinical reports that I haven’t finished, the dreaded DISSERTATION. By Sundays, I’m in the position where the anxiety of not getting enough done in the previous week is all but crippling and the knowledge (from hundreds of Sundays of experience) that I will not get enough done in the coming week is downright frightening. But.

But today I feel like I need a sick day. A mental health day. A trying-to-conceive-for-over-a-year-and-in-the-second-half-of-the-two-week-wait day. Today I am 9 dpo. I have a headache (don’t worry, this morning’s test came back negative). I woke up two hours before I wanted to. At 5 AM. On a weekend. Probably in anticipation of taking my temperature.

See, if I get pregnant on this cycle, I’ll be due in October. My birthday month. The month I lost my first pregnancy. And the month that I have to submit applications for my clinical internship. Friends, this internship process is a mess. I will very likely have to move to some other part of the country for it (there is only one of these positions in my whole state). It’s a year long appointment. And then I have to do a two year fellowship (which will likely be in a totally different location). But I’m getting ahead of myself.

For this internship, there is a matching process. You send out applications in October and go on interviews from mid-December to the end of January. There is really no way around it. You can’t not go to the interviews. You can’t reschedule them. There are specific “interview days,” so a site might give you 2-3 of these days to choose from. And you’ve gotta show up or else you’re not considered. People are basically out of town for as much as that 6 weeks as they are in town. Then you submit a ranking of your favorite sites, and the sites submit a ranking of their favorite applicants. And a fucking computer program decides where you’re going to have to move for the next year.

If I get pregnant this cycle, I’ll be due in October. I can manage getting my applications out early in preparation for an impending lentil. But I can’t imagine traveling for several days of every week for 7 weeks (if I get lucky and get a lot of interviews) within a month of giving birth to a baby, so November would a far from ideal due date. December-February would be even worse, though, because most airlines won’t let you fly when you’re in your last trimester. And, of course, being visibly pregnant at a job interview is never on the list of things you should do to increase your odds of landing a job.

We’re not going to stop trying. It’s taken us so long that I don’t want to miss any opportunities to create this child for us. But if it doesn’t happen this cycle, my immediate career plans might take a bit of a hit. I’ll have to see if sites will allow me to do phone interviews. And we all know that if everyone else is interviewing in person, and you’re interviewing on the phone, your odds are probably not as good. I’ve got a pretty warm smile, and I can’t let it do it’s magic through the telephone wires, y’all.

All of this is to say that I’m having a very bad day as far as two week wait days go. I usually don’t test so early, but I’ve tested every day for the last three days. They’re all glaringly white. Negative. Nada. Going into this cycle, I felt really good about it. Like weird intuitive good. Like this was IT. (I’m usually not so optimistic.) And now I just have my negative tests, an unproductive Sunday, a headache, significant irritability that is being directed at The Artsy Engineer (poor guy), and my empty womb.

I know, I know. It’s still too early to count myself out. But in my head and in my heart, it ain’t.

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