The Not-So-Sexy Infertility Adventures of a Girl in the Big Apple

Saturday, October 29, 2011

Halloween Blizzard

Woke up this morning and saw snow and sleet blowing sideways out the window.  Jeez people, it's not even November yet.  I had a long list of errands I wanted to run today, but that's definitely not happening now.  I guess it's going to be a blog and wedding ceremony writing day instead.

It's been an okay week.  H has been off travelling with his family for a week in advance of the wedding.  They came from Europe so they decided to make a longer trip of it.  So I've been alone at home doing lots of tedious arranging of various things - the wedding, IVF, and the remodel of our bathroom.  The latter has been the absolute worst - just a comedy of errors and incompetence.  I can't even talk about it here, it makes me too steamed!

As my IVF cycle date nears, I find I am getting increasingly anxious.  I am trying very hard to stay on an even keel, and realize that what will be, will be.  Instead I fluctuate wildly from (unrealistic) fantasies about having an amazing cycle with lots of eggs to getting depressed at how poor my chances are given my past response.  Every time I find myself too far on one side of the spectrum I try to bring myself back to the middle, but it's hard.

I just read a blog from someone who is almost exactly the same as me in terms of stats, age, and past cycle response.  She cycled again with a new protocol and (surprise surprise) had exactly the same response.  Isn't the definition of insanity doing the same thing over and over again and expecting a different result?

Not that I regret my decision to cycle again - I don't.  I feel very comfortable that we need to do this if only to move on emotionally from using my eggs.  And I am also going to let myself off the hook for feeling negatively about this cycle.  I read this post from the Infertility Therapist on "the negatives of positive thinking," and I think it is spot on.  For those of us who have consistently had poor results and have been told by reputable doctors that our chances of success are small, it would be crazy to be overly hopeful.  But somehow our culture tells us to stay positive, to not give up, as if it is a failing to accept reality rather than a rational response to difficult circumstances.  By the way, if you haven't already you should definitely check this blog out - all of it!  I think she is just fantastic - a very balanced, nuanced perspective on dealing with infertility.

I am so thankful that I have the wedding next week to distract me.  It will be nice getting out of here and into some sunshine and scenery.  Not to mention spending time with family - we all live so far from each other that it's rare for us to get together in one place.

And when I get back, there will just be one week until I hopefully kick off this cycle.  I can't wait for it to be over, honestly.  Just want to stop the endless wondering and speculating about what will or won't happen.  So tired of it.

Sorry for what has turned out to be a gloomy and disjointed post - a reflection of the weather and my state of mind!  I think when the sun comes out tomorrow a more sunny attitude will come with it...here's hoping.

Monday, October 24, 2011

Now What?

Big day today.  I shipped off the Day 3 bloods that had been burning a hole in my freezer since Thursday.  And I went to my old clinic/RE to do an HSG.  All I can say is....ouch!  That shit hurt.

But none of that would have been a big deal if she hadn't found something kind of suspicious looking on the xray.  My tubes are fine, but there was a round, dime-sized, unidentified something on my uterus that looked like...well, like it could be something (a fibroid maybe, she wasn't sure).  My doctor offered to perform a saline sonogram (which I've also had done before) to see if she could see anything, but we agreed to first let Dr. S take a look and decide if we need to.  He did perform a hysteroscopy at my ODWU and pronounced my uterus fine, although he said there was a slight bowing at the top that he worried at first was a fibroid.

I really really really REALLY hope there isn't going to be a call for further digging around and, G-- forbid, more surgery.  I've already had a saline sonohystogram, a polyp removed, a hysteroscopy and an HSG.  I have zero bid for any more procedures that don't involve getting eggs or putting them back in.

Oof.

At least that's over with for now.  And I've started testosterone and estrogen priming - so far no chest hair, Adam's apple, or any other craziness.  Although I have been threatening my husband that if he messes with me next week I might be feeling manly enough to bitch-slap him.  

Anyone reading/listening please send a collective prayer to the Powers That Be that this dot on my xray turns out to be nothing and I don't have to do any other procedures.   Pretty please?  With agave nectar on top?

Friday, October 21, 2011

Donor Egg Discussion

I've been meaning to write a post for a while about donor eggs.  It's something I've been giving a lot of thought to as we get ready for our last 1 or 2 cycles with my eggs.

When my doctor first brought up the idea, which was right after my first failed IVF, I was stunned.  Both H and I had a very strong "not for us" reaction.  But after another poor response to IVF and several depressing second opinions, I have completely transformed my thinking around this issue.  I really believe this could be a great solution for us if things don't work out the way we planned.  In fact, the only thing that keeps me going sometimes is knowing that we have a real shot at succeeding with donor eggs should all else fail.

That's not to say I don't have reservations and concerns - I think everyone does at some point.  But they seem manageable in comparison to the scenario of having no baby at all.

Unfortunately, H is definitely not in the same place as I am on this decision.  I started to broach the topic with him right after our second failed IVF.  Knowing that he wouldn't otherwise think about it, I asked him to give some serious thought to the issue over the next few months.   He agreed to do so, but of course never really did.

I say "of course" because among H's many wonderful qualities is an ability to live in the now.  He takes life as it comes, and generally enjoys the hell out of every day.  I envy him this quality - I think this is how he maintains such balance and equanimity.  I, on the other hand, tend to grab difficult problems by the horns and try to work through them right there and then.  I think through possibilities, imagine and plan for future scenarios, and try to prepare myself emotionally for what's to come.  I guess that makes me sort of a control freak, but it also makes me more organized and prepared.

Last week I brought up donor eggs again, and we had our first serious discussion.  I asked him whether he'd thought about it since we last spoke, and he admitted that he hadn't thought about it much more.  He reiterated, however, that he wasn't on board with the idea.  If worst came to worst, he'd rather live child free - he feels we could still have a great life without children.  I told him that I didn't disagree - we could have a very nice life without children.  It would be very comfortable, much less stressful, and much more free.    But we would be missing out on one of life's great gifts, one of the things that connects us most directly to Nature and to our humanity.  And that thought makes me sad, and would continue to make me sad later in life.  Would it ruin my life?  Absolutely not.  Would I have regrets about it?  I'm pretty sure I would.

I probed a little further into what his reservations were.  Was it purely having the genetic link that was the issue?  After all, he has been willing to go to pretty extensive lengths to have our own children, so why not with donor eggs?  And we uncovered that, yes, not having children with my genetic material was the main issue.  However, he is slightly more comfortable knowing that the children would be genetically his.  If it were the opposite case (my eggs, donor sperm) he said he would really not be on board.

And this is where we left things off.  I am not going to push the issue too far while we still have a chance at my own eggs - there's no point.  But I'm hoping to slowly acclimate him to the idea and get him to evolve his thinking.  I don't blame him for resisting - I did too.  And I don't ever want to force him into such a big decision - he has to be truly on board, because he will be a 50% partner to me in raising a child and that is a huge responsibility.  But I am hoping that as he thinks about it more, he will come to the same place as I have.  All I can do is get him to think about it with an open mind.  The rest will be up to him.

More on this to come.  I hope we will never have to reach a decision on this topic, but looking objectively at our chances it's far likelier that we will then that we won't.  And I'd rather be prepared when that time comes.  In the mean time, am very glad I have a place to share all of these thoughts - sometimes I don't know what I would do without this blog (and all of you)!

Wednesday, October 19, 2011

Off to the Races

I woke up this morning with an even lighter period than yesterday.  I decided to call C.CRM and ask what I should do.  My nurse was out so I spoke to one of the backup nurses (Annie), who was really great.  We mutually decided that my period was probably lighter because of the hysteroscopy and that we should consider yesterday Day 1.  So I'm off to the races!

I get Day 3 bloods drawn tomorrow and will start estrace.  Friday I will start testosterone priming.  And Monday I have my HSG.  Things are moving along now.  The only issue I will have is doing another testosterone test while I'm off getting married - hopefully C.CRM will give me some flexibility on that one.

I really hope all of this effort won't be in vain!  I am going to try to keep a "what will be, will be" attitude for this cycle.  High hopes but low expectations.  

Sometimes I wish I had a fast forward button for life - I want to blow past all of the anxiety and fear and worry that will be coming over the next few months and arrive at whatever the result is.  Even if it's failure, at least I would know the answer.  It's the waiting that kills you....  

Tuesday, October 18, 2011

Full Flo?

Still waiting on "full flow before 5pm," the C.CRM definition of Day 1.  This is one of the weirder periods I've had - have been spotting with increasing (but not full!) intensity since Thursday last week, but it's still not here.  At least I think it's not here, am beginning to wonder.   It could be that the bleeding I had following the Hysteroscopy at my ODWU is giving me a lighter-than-normal period now.  In which case today (or yesterday) could be my Day 1?  I certainly have all of the usual signs - pale, fatigued, crampy, moody.

I guess I'll give it until tomorrow and see.  If I don't get anything more by then I think I'm going to assume there just isn't going to be more and call it Day 1.

All of my meds have arrived, and it's really hitting me that I'm actually doing this again.  I just hope that the testosterone and estrogen don't cause too many side effects just before our wedding.  Would be kind of embarrassing to go there with facial hair and a lower voice!  At a minimum I am expecting bad skin and/or moodiness.  Am really glad it's just going to be family...

H's sperm analysis came back - it was just okay.  He had normal count, low-ish motility and rate.  I think his sample was probably compromised by the fact that he had just come back from his bachelor party and was hung over, recuperating from a stomach bug, and had a bad cold/flu.  He's always been fine in the past.  They are recommending ICSI, which I think we would have to do in any case because of CCS.
My AMH came back at 0.5, slightly lower than it has been in the past.  It will be really interesting to see where my FSH comes out when I do Day 3 bloods - I've read that people tend to get higher readings from C.CRM then they do from other labs, don't know if that's true.

This is kind of a boring post...just twiddling my thumbs waiting for Flo.  Hope she gets here soon.

Friday, October 14, 2011

A Better Day

Thanks so much, ladies, for your comments and advice on my last post.  It's nice to know I wasn't being crazy for worrying.  I ultimately ended up sending my nurse a courteous and friendly email to her personal mailbox stating some of my concerns.  She responded back this morning and said that she totally understood why I would be concerned and apologized for getting confused.  She also clarified that while it would of course be easier to do the priming after they get Day 3 bloodwork that my treatment won't get compromised in any way.  It just means that things may be a bit more hectic and rushed as we get all the pieces in place.  She also said that she re-reviewed Dr S's orders and is confident we are doing the right things.

So I feel a bit better.  My husband still wants me to call them and see if I can switch nurses (he agrees with you, Sooz) but I am leaning towards not doing it.  Don't want to change horses mid-stream - might cause even more confusion at this point.

And after all the running around yesterday and this morning (blood tests, ordering meds, etc), of course AF is nowhere in sight today.  Barely spotting.  Ha!  Oh well, this just means I'll be better prepared as opposed to scrambling last minute...

On another note, I got a call yesterday from an interior designer (who happens to be a client/friend of H's) that we worked with a little on our apartment renovation.  She's my age and went to a college not far from mine so we have a lot in common.  We got to chatting and it turns out that she's in the midst of trying to get pregnant and will likely be starting IVF in the new year.  I probably scared her with the amount of information I downloaded on her!  In any case, it was nice to talk to someone my age going through the same thing, instead of the many, many friends I have who seem to get pregnant on their own with little problem.

Off to take care of a few more bits and bobs and then I am going to lie down on the sofa and assume a vegetable state.  Whew!

Thursday, October 13, 2011

Arrrgh.

This has been one of the more annoying days I've had since I went on leave 5 months ago.  I feel like I normally feel after an aggravating day at work.  I'll try not to bore you with every detail, but here's a synopsis:
1) I lost my internet connection and spent 2 hours with Time Warner Cable and various other tech helplines to fix the issues
2) My printer stopped working because it couldn't connect to my computer through the internet
3) I started spotting and cramping so I think AF is coming tomorrow (3 days early, off of an already short cycle - weird!)
4) Realizing that tomorrow might be Day 1 and therefore Sunday would be Day 3, I started calling around to labs to see where I could get my Day 3 bloods drawn & separated per C.CRM's instructions.  NO ONE would do it - not LabCorp, Qwest, Manhattan Labs, 2 hospitals.  They were either closed on Sunday or would not do the blood processing if they weren't being paid to perform the tests themselves.  I eventually called up one of the nice nurses at my old clinic and begged, and she was kind enough to get me set up there.
5) Also realized that if tomorrow is Day 1 that my HSG is now scheduled outside the normal Day 5 - Day 10 day window they give you.  It's now going to be on Day 11.  I hardly think that matters, but C.CRM might not agree.
6) Was supposed to get my Chem22 and testosterone checked today but with all that was going on I missed the window.  Also couldn't print out my orders because my printer wasn't working!
7) Called my C.CRM nurse to discuss all of the above and had an alarming conversation where it seemed like she was not at all on top of the details of my protocol.  This is the 4th or 5th time I've had a conversation like this and I'm getting kinda concerned.

Out of all of the above, the thing that bothers me most is #6.  I have probably corrected my nurse (very nicely and courteously) on things she has gotten wrong 10 times in the last few weeks - and these are important things, like which protocol I am on!   Because I keep questioning things, she has gone back 4 or 5 times to clarify things with Dr S and every time she comes back I have been right and she was wrong.  This is getting me scared - I shouldn't be correcting her, she should be correcting me, right?

Tonight she got confused about when I'm supposed to start estrace - Day 1 or Day 3.  She originally said Day 3 and then today she said start it tomorrow.  I then asked if she was sure - wouldn't taking it Day 1 mess up my Day 3 blood test where they test for E2?  She said no, but then went back and read the notes and realized that Dr S had said to take it on the evening of Day 3.  I could tell she was kind of embarrassed and she said "This is what happens when you start the cycle before all of the testing is done (ie, making the decision to prime on the same month I'm drawing Day 3 bloods).  But as long as you're okay with it, I guess we can move ahead."

Okay with what?  I'm definitely not okay with my cycle getting screwed up!  If I thought that cycling in November would compromise the quality of my treatment in any way I would never have asked to do it - who would?  But they cleared me to go ahead so I am making the assumption that my care won't suffer as a result.  I think that should go without saying.

I meant to call her back to clarify that directly with her, but she left before we could speak.  I want to have that conversation directly though - it's important to me that she knows that I am not willing to rush things and have something go wrong with my protocol as a result.  Hopefully I will actually get in touch with her tomorrow (that's the other thing, no matter how many times I call I never hear back from her until 6:30pm EST time, which is really late!)  Has anyone else experienced these issues or is it just me?  I wonder if they are a little overwhelmed right now because they've grown to quickly.

Don't mean to whine & complain too much, I just had to vent some frustration.  I feel better now (exhale).

Here's hoping for smoother sailing tomorrow.

Monday, October 10, 2011

Making Progress

Have been slowly and steadily knocking things off the C.CRM to do list as the next cycle approaches.  Had my annual physical on Friday with a new ob/gyn in the neighborhood.  Probably not someone I'd stay with if I got pregnant because it's a small clinic, but she was very nice and gave me everything I needed.  One nice thing about the visit was that she kept saying the phrase "when you get pregnant..." to me.  Although she has no idea how difficult that may be for me, it was still nice to hear someone (a doctor no less) taking that outcome for granted!

I have my mammogram appointment tomorrow and will then have to get a Chem22 panel and my testosterone checked prior to starting priming.  I spoke to my nurse today to review my protocol and I am slightly daunted by the sheer volume of medications I will be putting into my body in the next 2 months.  I mean, I've done this twice before but I am adding 4 to 5 new medications on top of the usual heap.  I hope I don't become a raving lunatic!  The Clomid in particular scares me - I had very bad side effects with that, worse than any IVF drug gave me.

My husband is flying out to CO tomorrow night to get his testing done - basically just a sperm sample and blood test, in and out.  He looked at his schedule and said - so I have to fly all the way out there just to &*#& into a cup?  To which I responded - cry me a river dude, try being me!  However, he's going to have to deal with a psychopath whacked out on too many hormones soon enough - so things will even out.  Poor guy, I feel bad for him already.  Thank goodness he's a rock and nothing phases him too much.

I realized today that with the way my dates are falling, I'm almost certainly going to be in Denver over Thanksgiving.  Will be one of my most memorable holidays yet - ha.  The only thing I'm nervous about is fielding phone calls from family members while pretending to be in New York.  We've decided to keep this cycle completely quiet (I learned my lesson from the first two, it's better to tell people news when you're ready as opposed to feeling pressure to update them).  So it's shaping up to be an interesting Turkey day, to say the least....

Just want to close by sending best wishes to fellow C.CRMers turtlemama and 73goldie - they are both pregnant and I am thrilled for them and have my fingers crossed that everything continues to go well.  And I hope all the rest of us who are waiting in the wings have as much success - goodness knows we could all use a break!

Thursday, October 6, 2011

A Walk in the Park

Last night was so beautiful that I decided to go for a sunset walk along the waterfront in Lower Manhattan.  Bloomberg has done a fantastic job of building out these waterfront parks - I think they'll be one of his most lasting legacies as mayor.

I took some pictures, just for fun.  These are crappy iPhone pics and don't capture it completely, but you get the idea:

 Sunset across the Hudson.

Football practice with a bunch of totally adorable mini-footballers dressed in full regalia.

Another shot of footballers with an autumn moon.

I love this one - this guy was fishing off the pier and had just caught a fish (that little blob on the ground).

Beach volleyball game (yes, in Manhattan!)

The mini-golf course.

Mind you, all of this is crammed into a single pier that juts out into the Hudson.  Within that space they've managed to put a skating rink, a children's playground and waterpark, a mini-golf course, 3 beach volleyball courts, an astroturf field (which had one adult soccer game and the mini-football game going on simultaneously), and an area for lounging and looking at the water.  Talk about space efficiency.

Every time I go for a walk here I always have the same thought: that *if* I am ever able to have children, this will be a place we come often.  For walks with the stroller.  To the playground.  For skating or minigolf when he or she is older.  

So for now, this is a place I go to dream.  But maybe one day...  



Tuesday, October 4, 2011

False Alarm

So after much digging, googling, and tracking down of various people I managed to uncover that any FSA we could do through H's plan is likely to be negligible (I won't bore you with all of the details, except to say that with the amount of time I've spent on this stuff recently I am now practically bosom buddies with the guy who handles insurance for H's company - he sent me a note Friday asking how Colorado went!  Sad, but kinda funny.)  It is of course a bummer that we can't save thousands of $$ on the IVF, but it does makes the ultimate decision easier.

November it is!

THANK you ladies for all of your advice/comments - it is so nice to be in good company while navigating this hellhole.  And now I'm slightly embarrassed for posting 3 times in 2 days, so I'm going to quietly disappear now for a decent interval (or at least 24 hours!)

A Reversal

So I just got a mail from CCRM saying that I was cleared to cycle in November!  Great news, except now I have a dilemma.  I just realized that we could allocate money to my husband's FSA next year for these treatments and do them tax free - that is significant savings.   If we do 2 cycles, it might save us as much as $16,000.  So by cycling in November I would be missing out on $7 - $8k worth of savings from this.

Ugh, now I don't know what to do.  I am torn because I know that cycles can get postponed due to other factors (a cyst, poor response, etc) and therefore I think you need to take opportunities when you can, because you never know what can happen.  On the other hand, $7 - $8k is a lot of money!

Help!

Monday, October 3, 2011

Meh

An unfortunate update.  My nurse called me back and I started asking her some of the questions I had about estrogen/testosterone priming and when we would need to begin.  In the process, we uncovered that in fact I can't actually cycle in November because in order to do that I would have to have my Day 3 blood work and HSG done before my next cycle begins.  Since I'm already on Day 12 of this cycle, that's clearly impossible.

We might be able to get away with not doing the HSG yet since I only need that pre-transfer, but definitely not the day 3 bloodwork.  Argh.  

I asked her to check with Dr. S just in case he was okay with assigning a priming protocol w/out day 3 bloodwork, but I'm highly doubtful he'll say yes.  So looks like we're going to be waiting until January after all.

Meh.  Not a tragedy, but meh.

Manic Monday

First of all ladies, my sincerest thanks and gratitude for your responses to my last post.  Particularly with regards to my antral follicle count woes.  You lifted me up.  Now onto our regular news report:

Woke up too early this morning thinking of all of the things I needed to do today, a lot of which are on the IF front.  As of this morning I've made all of my important appointments - physical, mammogram, HSG - so that's a relief.  But it occurred to me today that if I'm going to do estrogen/testosterone priming the month before stims, that actually starts pretty soon and I need to think about getting medications filled.  Which means I need to get on my husband's insurance policy, which covers IVF drugs (but not IVF).  And then figure out what to do with my current insurance plan, which doesn't cover drugs (but covers testing and used to cover IVF until I used up my lifetime max).  Sigh.

I have a call into my nurse to see when priming begins and for how long.  I am also wondering whether or not they allow you to try naturally during that time.  Does anyone know?  I'm guessing not.  If not, then I should also schedule my varicella immunization during that month because you can't TTC after that either. Sheez, cycling out-of-state is complicated - to get all of the testing done in time, I'm going to be working with 4 different clinics/hospitals.  I swear the percentage of people in the city that have seen my lady parts is approaching double digits!

This has turned onto one of those "then I did this, then I did that" posts.  BO-RING.  Sadly, this is a true reflection of my interior life.  SERIOUSLY BO-RING.

Okay, that's not entirely true.  I do have one interesting recommendation, which I will leave you with.  Anyone who wants a break from the tedium of IF should check out the documentary "Senna," which is about Ayerton Senna, the Formula One race car driver.  Okay, doesn't sound like a topic one would normally flock to.  But Ladies.  LAY DEES.  Not only is the doc extremely well-crafted and gripping (they do a really good job of making the past feel like the present through lots of old footage), this man was something to behold.  Charming, humble, fiercely talented and, most importantly, knee-droppingly gorgeous.  My friend and I kept turning to each other in the theatre and mouthing "he is so HOT" to one another.

I hope you all find some time to see it - we all need something to fantasize about other than breast feeding!