Tuesday, September 29, 2009

IVF Scout Motto: Be Prepared

Is it a bad sign for my state of mind, and overall faith in reproductive science, that I have already made a detailed list of WTF follow-up consultation questions and am contemplating scheduling the appointment? I haven't decided if I would switch clinics or give my current RE a "best of 3" opportunity. I suppose it would depend on her proposed plan of action and my gut feeling at that point. Also, incidentally, emerging details of the embryo mix-up between the Ohio and Michigan couples make me very strongly suspect that my current clinic may be The One. Awesome. 
  
This is officially the longest week ever, the latter half of the godawful 2 week wait. Since the last one and possibly until the next, anyway.

Saturday, September 26, 2009

Ambiguous at Best

I am bored of the two week wait. I am angry at the two week wait. I want to pee on everything in sight but it's too soon, so I am bored and angry with that, too.

I have symptoms. But of what? Is that very early nausea or is there still doxycycline in my system? Are those weird twinges in my uterus or are they just my ovaries sucking back in the empty follicles?

Some things are different this time versus the last cycle, but it means nothing.
  • Last cycle, I had Very Sore Tits. The kind you can mush every day to relish in the possibility that it Means Something (besides that you are getting stabbed lovingly by your husband with 50 mg/day of PIO i.m. every evening). This time, nothing. 
  • Last cycle, I felt fine the day after the retrieval and the bloat dissipated over the next two weeks. This time, I feel like a bushel of fruit is wedged into my belly (let's hope so, right?) even though the stimulation-induced bloat-weight has disappeared. 
  • Last cycle, the PIO shots were annoying but not too bad. This time, those mother effers hurt. Really hurt. This has led to my husband's great culinary-science fusion theory that the sesame oil supension hurts more than the olive oil emulsion because sesame oil has a higher smoke point. Genius. If we are successful, I hope the baby gets his brains.
The biggest difference this time? I am an emotional wreck this week. It's a little soon for this to be PMS for me, especially considering that my stay at the Red Roof Inn came quite late after the last cycle (and I would expect it to be a little late after any IVF cycle, in light of all the hormones my body remains jacked up with until the RE calls off the dogs). What does this mean? Fuck-if-I-know.

I'm not really sure what I will do if this doesn't work out again this time. I'm trying very hard not to think about that, to instead pretend that I am pregnant until proven otherwise, but IVF and OCD are like peas in a pod so my efforts are semi-in vain. Would I try another cycle in a month? Would I take some time off?  Would I stay with the same RE or move to the other local clinic (the MD there has been described to me as the "Cadillac of REs" which probably means he comes at a price)? The correct answer is, I hope, that I will be pregnant and none of this will matter. We'll see. One more week.

Wednesday, September 23, 2009

Soapbox Time

WARNING: If you are Catholic, maybe skip this post. It's not nice to your peeps.

Catholic Bioethicist Discusses IVF Embryo Mix-Up:

[This is] in many ways just the latest absurd chapter in the wild west that is the unregulated world of IVF. *

It is tragic that this multi-billion dollar industry has been able to play on the emotions of thousands of vulnerable couples to make the very prospect of regulating this industry not only a cultural taboo but a potentially fatal political third rail for anyone in congress who would dare to take it on. **

"It not only perpetuates the emersion of thousands of embryonic human beings into the absurd fate of deep frozen suspension until their eventual destruction (only a fraction of embryos created ever make it to live birth), but it sets the stage for on-going and tragic ‘mistakes’ like the one made with the [recipient family]." ***

*FACT: IVF and all forms of approved ART are regulated by the FDA. The medications dispensed and procedures employed must be agency-approved, and laboratories must be certified in accordance with good clinical and laboratory practice regulations (in the code of federal regulations). And REs are guided by, and subject to, accepted medical standards of care in their practice (don't forget that licensed OBs have among the highest malpractice insurance rates, so sticking to the standards is wise). Unfortunate mistakes occur in medicine and pharmacy all the time. Patients are given drugs to which they are allergic, even though their allergies are scrawled across the top of their chart. Doctors' handwritten notes are mistaken for ten times the dose intended for short-acting meds. Chemo is given to a patient who was supposed to receive an antibiotic. I have personally witnessed all of these mishaps in a hospital setting, where nurses check and (by state law) double-check the patient's ID and doctor's orders. In the grand scheme of the universe, shit happens.  

**FACT: This is a very sad mistake, and it is not made better by proselytizing or judging. Who is playing on the emotions of vulnerable couples here? The medical professionals with the tools and support to help infertiles achieve pregnancy (if and when possible), or the man in the frock with the microphone looking to make an example of every sinner in his wake? You're rubbing salt in good people's wounds. This mix-up is a rare tragedy, and the media coverage will undoubtedly lead to at least some short-term increase in scrutiny (whether warranted or not). Look, sometimes bad things happen to good people. But, the exception to the rule does not the rule make. More regulation is not required in response to this exceedingly rare mistake. A kerfuffle ensued after Octomom made her disastrous debut, and life went back to normal because she is a sociomedical freak, as is her singular, unethical RE. So don't give me your papal mumbo-jumbo and "I told you so's." This medical technology serves an incredible purpose. I suppose it's just god's will that I can't get pregnant, right? How to put it politely...Fuck you.

***FACT: Absurd? How about an organization that demands verboten birth control in third-world countries with out-of-control population growth and rampant HIV, spread largely by poverty-induced prostitution and unwanted pregnancies? Is that absurd enough for you, friar? Because I actually think that a medical technology that allows me, a productive member of society who desires to raise a child, the means with which to do so when nature cannot, is far from absurd but rather (to co-opt your terms), miraculous. My vote goes to condoms for prostitutes and IVF for infertiles. Fair enough and everybody wins. So just stay behind your pulpit and get outta my vagina. Yours is a school of divinity, not a college of medicine.

OPINION: The wild west is a better description for the medical wasteland that these moral highgrounders would have us take: Can't get pregnant? Pray on it. Go to church. Eat a vitamin. JUST RELAX. Whatever. This is the reason why many of us still feel a twinge of discomfort discussing IVF at work, in public, etc....because misinformation fosters disbelief that it is a validated, safe practice no different than any other therapeutic medical intervention. Modern medicine has come a long way, baby, and if your man in the funny white hat and Prada shoes can't get with the program, tough tits -- stay out of mine.

P.S. NOT every sperm is sacred. Most of them are useless duds. Only my RE and embryologist can find the good ones. 

Tuesday, September 22, 2009

A+

One perfect, 8-celled embryo was transferred today. The embryologist gave him/her the highest grade possible in our clinic: A-0 (regular, even blastomeres with zero fragmentation). I am going to ride out the rest of my lovely valium wave for the remainder of today and take it easy all week long....today is a good day.

Hello, beautiful:


Sunday, September 20, 2009

Report Card

Math: 11 eggs - 2 overripe - 4 immature = 5 ICSI - 3 duds = 2 embryos.

History: History does indeed repeat itself, ovary-wise.

Social Studies: Two chances to make a baby are cohabitating in a dish.

Science: Grow, little fertilized cell masses, grow! Muah-ha-ha-ha-ha!

Statistics: Two was my lower limit for reassurance. 2 > 1. Better odds.

Psychology: I feel good about this, at least until the day 3 report. 

Home Ec: I am buying a pineapple today.

 

Saturday, September 19, 2009

Eleven

Surprise!

There were 11 eggs retrieved. I am so relieved I can't find the words.

If even half of those eggs are mature and will fertilize, we will be astronomically better off than the last cycle.

Please, please, please let me get what I want this time....

 

Thursday, September 17, 2009

The C Word

My RE wants to cancel the cycle.

We have 5 potential follicles.

Last cycle, it took 7 follicles to produce 1 embryo, that is not a baby.

We are going to retrieve anyway on Saturday.

We can only conceive an embryo with IVF/ICSI because we have severe MFI, but we can't make an embryo that survives with IVF/ICSI because I don't grow enough mature eggs to fertilize. The only thing my body can achieve is failure. No reason. No fix. Just failure.

I don't know how many more times I can do this. I don't know if I can give up either.

I feel more fucked than ever.

 

Wednesday, September 16, 2009

One of These Things is Just Like the Other

We are on track for a Saturday retrieval. I wish I could be more excited.

This morning we saw only 2 large follicles on the right, and 3-4 on the left. That's it. There are a bunch on both sides <10 mm, but what good are they? This is IVF #1 all over again. I am overwhelmed with the feeling that I am just going through the motions to get to IVF #3 now. This sucks. Everything about this sucks. Maybe the Menopur did its job and the puny number we collect will all be mature, and all will fertilize. Ah....but for the super shitty sperm situation. I feel fucked.

 

Monday, September 14, 2009

Our Lady of Perpetual Swelling

Subtitled: Life on Never-Ending IVF Stims and Other Happenings

The Never-Ending Story: So retrieval will not occur until this weekend. This is 2 full weeks of stimming, people. I'm over it. I'm lugging around a sack of potatoes in my pelvis and I ache and I am tired and it sucks donkey balls. I am now injecting nearly 2 mL of designer Rx nightly into my belly for the remainder of this entire week. I guess we are sacrificing the biggest 1-2 follicles to get all the mid-size crossover models to grow up, based on our experience with fat-looking but immature eggs last time around. There might be a few more follicles this cycle, but it's hard to know since my usual MD counts differently than The Other Guy. The Other Guy is also the one who called with any and all episodes of bad news last time, so I am his least enthusiastic fan. I appreciate that it is the fault of my sad, immature eggs and not his doing, but still.

Weekend Glory: We took a mini-trip to Chicago (cut short by an RE appointment, naturally) to see U2 at Soldier Field. I am a rabid, stalker-level fan so this was a very nice gift from my very nice husband (also a fan, but not as interested in banging Bono as I am). I truly, madly, deeply love U2 and their music. The show was phenomenal, visually and musically. It's funny how my current state of mind colors everything - songs like "One," "Still Haven't Found What I'm Looking For," "Stuck in a Moment You Can't Get Out Of" and even "Bad" really had new meaning. I could have cried.

The evening was capped by asshattery that is funny, if only in retrospect. We had great seats, 2 rows off the field, except for a group of rowdy, drunken European boys (I think I'm old enough to call twenty-somethings "boys," right?) who kept coming down the aisle to A) take repeated pictures of themselves and each other in front of the stage for each and every song and/or B) link arms, effectively blocking the entire aisle and my view, and jump into the air to high-five each other every 6-7 seconds. Now, I loves me a frenetic fan as much as the next gal, but I am a curmudgeon when it comes to these things. I paid for my seat to SIT IN. And see the show. You paid for your seat to also SIT IN (or stand near), not carouse in the aisle directly in front of me and cockblock my imagined romance with Bono. I asked them to move half a dozen times, as did the usher. The usher ultimately threatened to kick them out and they tried to pick a fight; I guess I was a little too close to the kerfuffle as my husband totally postured like was going to kick their football-loving asses for my honor (and unobstructed view)! They apologized with polite Eurocharm and all was well. (I'm not sure KB could have taken on 5 soccer youths loaded with liquid courage, anyway.)

THEN a drunken chick behind us starting hitting on my husband and actually asked him to buy her a drink. When he made a joke about his wife not liking that, she proceeded to ask to borrow $10 to buy her own beer. She offered to take down his name and address to send him a check, but he just gave her the money and said good-day. We decided that maybe we can bank good karma 1 crazy drunken bitch at a time.

AND THEN we got bad directions from a cop and ended up walking over a mile to get to the nearest major street on which we could hail a cab. We got routed through the bowels of the convention center on an underground service drive. When you feel like you are carrying two grapefruits in your belly, this is NOT GOOD. When we finally got a cab, a lone straggler was also trying desperately to get downtown, so we offered to share a ride with him. Turns out he was pissed drunk, but surprisingly coherent. He seemed in awe of me for some reason, and I figured maybe I was a little ripe from our long, humid walk...that is, until he asked me, sheepishly, "I hope you don't mind if I ask....but....are you Drew Barrymore?" HAHAHAHAHA.*

We are freak magnets. Undoubtedly.

Who, Me Worry?: Is this cycle going to be any better than the last? Will this strategy to mature the middle class eggs work or will we end up with worse results than before? Can I stand another 2 week wait if I know the egg quality isn't improved? Can I stand it even if it is? Can we manage to make more than 1 lone embryo this time? If you know the answers to any of these questions, please do tell because it continues to gnaw at me like a hungry, rabid squirrel devouring an infertility nut. I only want 2 things, really: for this to be over, and to work. Too much?

* Yeah, I'm Drew Barrymore and I'm gaining weight for a role in a period piece as a depressive, barren lady of the manor. As you can see, I am concentrating my efforts about the midsection primarily, trying to really accentuate the swollen beer-gut look with a muffin-top effect. How do I do it? Well, I'm a method actor so I begin by leading a sedentary lifestyle, inject myself with toxic levels of hormones, and consume a supra-renal daily intake of protein. Ice cream also helps.

 

Friday, September 11, 2009

Girl, You Have No Faith in Medicine

This is the point in the cycle when my patience goes bust. I am halfway through stimming, and I just WANT TO BE DONE. Menopur and Follistim are kicking my ass, much to my RE's glee and delight. Mind you, the follicles aren't super-sized as a result - not yet - but there appear to be about a dozen of them, which is an improvement over last time. Repeat after me: quality, not quantity; quality, not quantity. Can't I have both? Can't my ovaries be teeming with massive numbers of high-quality, super-star eggs? Come on - go-go-gadget follicles!

I am rather enjoying my high-protein diet. Eggs, eggs, eggs, like some kind of freaky infertility cannibalism. The only caveat is that it contributes substantially to my all-day full feeling, which is ever-present thanks to the activity in my ladyparts. I'm pretty sure there's a lead brick in my gut. Or a breakfast sandwich. One of those.

I have also reached the inevitable point in the cycle where I start to wonder if this will work. I am not one of those girls who can say "I just know it will!" because I am not wired that way. My neural circuits are set to "cynical." The only thing that will convince me is a good fertilization report. I would love to see a bunch of eggs retrieved, but I know that can be a trick. It only matters how many fertilize. And then, how many of the embryos make it to day 3. And then, how many of them have the right number of cells, minimal to no fragmentation, and are starting to compact. If [BIG IF] we make it to a day 5 transfer, I will be elated. You will hear me singing from the rooftops. If. For now, I remain my usual skeptical self. Sing it, Jack:



 

Wednesday, September 9, 2009

Strangelove: Or How I Learned To Stop Worrying and Love the Cramps

This Rx combo is killer. My RE warned me that I would hate her quickly since we are going in with guns a-blazin'. I am having very strange crampy sensations in the ovarian territories. After just 3 days of stimming. Hmm. I sure hope this is good. In celebration, I give you:



 

Monday, September 7, 2009

Hurt So Good

Menopur is going to be a challenge. Squooshing 1 cc into a subcutaneous space (although ample) does not feel spiffy. But, to quote Fred Durst, I do it all for the nookie. Well, if you substitute "nookie" for "IVF stimming," with the end result being the fixed variable (live baby), that's what I do it for. We're starting with a pretty rocking dose of Follistim with Menopur - so a total of 1.375 cc get injected into my belly until it looks like I got what I deserved for stealing Tyson's tiger. I can't wait until we add the antagonist next weekend. My abdominal s.c. layer will be the clown car of injected fluids - just keep packing 'em in.

I am cherry picking amongst suggestions for food rituals this cycle. I can do high-protein. I am prepared to make eggs and turkey sausage for breakfast. That's an improvement in my morning routine, not a sacrifice. I have the high-protein variety of my favorite cereal (not as good as the chocolately kind, but I'll bite the bullet). I even had a protein-fortified shake with breakfast today. I intensely loathe pineapple, but I will consider trying to choke some down at the end of next week when we get to transfer. That's pretty committed. I am thinking of skipping acupuncture this time. Getting to appointments, squeezed into a busy practice schedule - let's just say it falls short of relaxing and the benefits of acupuncture in IVF have not been demonstrated in an adequately controlled study, anyway. We'll see. I'd rather schedule massages around important dates, which have no proven benefit other than I freaking love them. All in all, I am convinced that the less I think about this cycle, the better. That includes ancillary appointments and consulting Dr. Google. I just need to keep distracted. (I finished the bathroom makeover. Now I have all those books I said I would read. And the new TV line-up starts this month. I wonder which one will predominate? Idiot box is a good bet.)

Day 1 of stims (day 3 overall) is under my belt now. Another week and we're ready to harvest from this egg farm.

 

Saturday, September 5, 2009

The Pop-In

Aunt Flo, the bleeding bitch, decided to pop in unannounced today, with no fanfare or symptomology at all (other than the obvious). All of the signs and symptoms I used to rely on for bodily cues are long gone. Sore boobs? Daily occurrence with any estrogen or progesterone supplementation on board. Ute cramps? Can't really distinguish anything anatomically below the waist anymore, it's just a jumble of overripe organs and muscle twitches. Bloating? A mathematical constant. Anyway, the good news is that I can call the RE's office in the morning to tell them day 1 was today. This means day 3 will be Monday, baseline and start of stims. Labor Day? Could it be a sign?*

I thank anyone who took the time to read my previous post - I am not complaining, just observing. This is a complicated and delicate dance we do, infertiles trying to get pregnant, and lots of feelings are involved. I can sincerely understand anyone deciding that reading or commenting on certain blogs is too hard or feels too uncertain. I appreciate any and all support from anyone, whether still barren like me or a miracle of modern science and finally knocked up. I'll try to keep giving it, too.**

* I am not superstitious, but I am TOTALLY going to follow some rituals this cycle for kicks. So, Labor Day baseline is good. I am going to see U2 in Chicago next weekend, which for some reason feels like good mojo. And I'm adopting a few habits I've read from some successfully knocked up bloggers. High protein diet for stimming. Acupuncture (did this last time, will repeat). Pineapple on the day of transfer. Actually, can someone explain that to me? That seems so random. I don't love pineapple, but if you can give me a semi-solid reason I will absolutely do it. Am I missing anything good? Or at least comical?

** Let's all pinky swear not to post that shit on facebook, for everyone's sake. Saw another pregnancy post today, from a chick much younger than me working on her 4th or 5th kid. Her initial tease post was "Oops, we did it again." And when no one took the bait, she provided a maximum-word post with number of weeks, what genetic tests, gender, the whole works. As Christian Bale would say, "GOOD FOR YOU!"

 

All Aboard

The Topic: Jumping Ship.

The Objective: Discuss.

The phenomenon of bailing on a blogger the moment after she posts her "finally knocked up" news is swirling around the infertile blogosphere like purple haze. I can understand completely, since I've done it. It's not personal. I've lurked on blogs and then simply deleted the link from my bookmarks after the announcement comes. I've become lazier about checking infertility-turned-pregnancy blogs on which I used to comment. For some who have mutually followed my blog, I try to keep up with encouraging comments because I enjoyed the exchanges when we were still in the same boat, and I genuinely care about how they're doing. But we are in different boats now.

It seems the general impression is that I, the still-infertile, am the one jumping ship from the newly-pregnant-infertile blogs. I see it another way: the freshly minted pregnancy bloggers jumped my ship. I haven't seen as much as hide nor hair from a few now-pregnant bloggers who used to comment and give support on a regular basis. Guess what? That commenced immediately with their announcements. It is a two-way exodus. And it's not personal. For those of us who remain infertile and unpregnant, it is difficult to read about the beginnings of a pregnancy we have not yet experienced. There is comfort in commiserating with fellow bloggers on the same cycle, riding out the same physical and emotional choppy seas. When that changes we can't relate anymore and for the still-infertile, the combination of hardship in reading about someone else's pregnancy and the subtle chipping away at an online support system - well, it takes a toll, and sometimes the solution is to abandon ship. I've stuck with a few newly-pregnant bloggers, but am not sure they've stuck with me.

Most of the bloggers I followed closely when I started IVF (I had not blogged during my pre-IVF infertility phase) got pregnant right away, and suddenly my cycle "buddies" were gone. I viewed (and still view) my blog as a place to unload my mental burden, when the thought cup runneth over, and not necessarily as a way to make interweb friends in the online infertility world. I don't rely on camaraderie with anonymous bloggers as a support system, but it seemed to naturally arise and that is certainly comforting in a stressful time. But then....it just as quickly disappears. Imagine you happen upon a party taking place in a new neighborhood. It's not a particularly happy occasion, this party, but people seem to be engrossed in conversation that feels relevant and interests you and so you make a few friends, enjoy a few proverbial drinks, tell some jokes, laugh a little, cry together, and then *POOF* everyone at the party gets up and leaves; all at once you are standing in the middle of the living room with an empty glass and no one to talk to. So....you have to wander around the neighborhood in search of another party, and make new friends. You keep up with a few people from the first party, to see how they're doing, and because, hell, in this party scene they could end up back in that living room with you and an empty glass at any time.

Infertility is just effing hard. I don't want my outlet for the pain and frustration of it all to become a secondary source of frustration because support that I once enjoyed dries up. But, like all things infertile, it is what it is. I am still riding out the high seas of waiting-for-my-announcement-so-someone-can-jump-my-ship. All aboard.

 

Tuesday, September 1, 2009

You Have To Be Effing Kidding Me


The act of conception must be like throwing a hotdog down a hallway by now.