Dear Boy

Remember Sassy Magazine?  Well, I sure as shit do!  Not only do I remember it, but I still have two prized possessions from Sassy.

1.  My copy of this issue, in great condition:

2.  And this record (they were completely my favorite band at the time, so I was pretty psyched):

Can you now guess exactly how old I am and precisely who I was in junior high/high school??

Anyhow, Sassy had a column called "Dear Boy" wherein you could write in and ask a real live boy real questions!  And by real live boy, I mean real super-awesome alterna-famousish-men!  Here's a bunch of the columns, actually, if you want to read them.  My boyfriend forever Greg Dulli is even in there.

Dear Boy...that's what we're about to be doing here.  This super-awesome alterna-famousish man is gonna answer your questions!

I keep asking Ian if he wants to write a post on the blog, because really this is OUR journey, not just MY journey, even if a lot of what happens is sort of happening to me.  His answer is usually some sort of a "not really" kind of response, mostly because he doesn't know what to say or how to format what he might want to say and he's just less of a writer type than I am.  So, I asked him tonight how he'd feel about answering some questions and he dug the idea.  I just thought that some of my readers might want to know what he thinks/feels/has to say about some of what's been happening with us, and I'd love to give him the format he needs for sharing some of his thoughts and feelings.

So, please please, ask him some questions or give him some ideas of things you might like to hear from his point of view.  You can post them in the comments here, or on the Facebook page  or to twitter or just in an email (which I'm not gonna link or type out cause duh spammers, but dearanxiety at gmail), if you'd rather be more anonymous.   Look at him sitting there, all serious-faced, waiting to hear from you.  Don't leave a bro hangin'.

Is Hope the Thing with Feathers?

Yesterday was, of course, my embryo transfer, so I wanted to let everyone know how it went.  There's not a whole lot to report, since the process has become so familiar to me, and I've posted about it all here before. Basically, I took my valium and had a lot of water to drink to fill my bladder an hour before the schedule transfer and went in to UCSF.  I got gowned up, and Ian got gowned up and in we went....

They thawed two embryos successfully and they both looked good, so that's great news.  It means we've still got 6 frosties left if these two don't take.  So, first the doctor (we had Tran, which was cool) did the hCG wash - putting some quantity of hCG through the catheter into my uterus.  Then we had 7 minutes to chill out while it sat in there hanging out doing whatever it was doing.  Once the 7 minutes had passed, in went the embryos (and we did do assisted hatching, so they've been poked pre-going inside me).  He said it went very well - better than the practice transfer he had done with us way back when.  So, that's good.  He also said our embryos look great.  So, that's sort of that.  Now we're back to the waiting game.

It's strange how much less into it I am this time compared to the last transfer.  I guess that's just how it works for me, though.  I get my hopes up once for a procedure to work, and then when it doesn't, I sort of don't open myself up the same way again.  I don't know.  I'm sure I'll still be devastated if this doesn't work, but I don't have the same excited floaty feeling I had after the last transfer.  I keep forgetting I have two embryos hanging out inside of me.

I'm sure some of that, too, is this new job.  I am just really focused elsewhere right now in a way I wasn't last time.  So, that's good.  There are actually moments of the day where this isn't on my mind.  Which feels pretty miraculous.  I'm sure once I start feeling more symptoms that can be attributed, potentially, to pregnancy I'll become more insane.  I do feel some hope that this was so much easier on my body so that's gotta be good for something, right?

One thing that I am acutely aware of at all moments of the day, is my ass.  So, yeah, those PIO (Progesterone in Oil) shots that I have every night?  They suck.  Ian is amazing and a total champ and we were both so scared the first night and now we're already experts.  But after 6 nights of these, I feel like I can barely walk.  It is really one of the least pleasant things I've ever had to do.  I hate it a lot.  I am every kind of sore and I have to have a giant needle shoved into my already sore sad spots every single night.  I can't even look at the needle without panicking - I have to close my eyes.  And this is after becoming so accustomed to injecting tiny needles into my stomach that I barely cared.  This is just a different ballgame.

Oh yeah ,we also found out today that Frozen Transfers are not covered by our insurance.  So that is a bit interesting.  That means we'll be paying out of pocket for this cycle and any others we need.  It is way cheaper than a full IVF, but it isn't peanuts.  

Anyhow, so, another blogger arranged an awesome sock exchange for people in this infertility world of bloggers, so I wore the socks that were sent to me all the way from England by the lovely Arwen for my transfer.  I loved that like 5 different people (nurses, primarily) noticed and commented on them.  Here I am all ready to go, showing them off.  The valium was really working at this point, by the way, people.  

This is on topic I swear, so, OK, I get this email everyday from Timehop that tells me what I was doing on that day the year before based on all my social networking.  Yesterday after my transfer I checked my email and found this photo in my Timehop email.  Apparently one year before my FET was the day I had my HSG, which was a horribly unpleasant experience wherein we discovered my fallopian tubes were AOK.  It was just interesting to see that photo of me in a hospital gown right after taking another photo of me in a hospital gown.  Just sort of put my year in perspective...  there's been a lot of nudity from the waist down, mostly not in a fun way.   There's been an entire solid year of dealing with Infertility.  A year of Dr. Tran.  A year a year a year.  It's almost 2013.

Anyhow, these are the tiny little embryos that are hanging out inside me right now.  Stick, little guys, stick!  I think you're pretty cute and I want you to hang out like forever!  Especially the one on the bottom.  Cause it's clearly the more attractive potential child.  

The Quickest Update

I'm all ensconced in my little office/cubicle today on my first real work day in this new position.  Wanted to take a super quick break to update everyone on my transfer, since it's tomorrow!  Don't have a ton to say about it, but wanted to at least mention that it was happening - 1:30pm.  So, wish me and my little frozen embryos luck!

I'll post more soon.  Gotta tell you how those butt shots are going, at least.

Two Awesome Things and an FET

Two awesome things happened this week (both on the same day, in fact)!  I got a pretty amazing promotion and I finally successfully ordered that damned Nexus 4 phone.  Of course one of my first thoughts was, "Wow, my luck is finally turning around!  Maybe that means this cycle will work too!"  I don't actually think it works that way, though.  So, I'm trying to celebrate the positive things in my life without attaching them to anything else. If this cycle works, it will be a truly joyous end to 2012, and if it doesn't, well, I don't want that to take away from other accomplishments and good news.

It's been quiet in blog land here because I just haven't had a ton to say.  I was with my family for Thanksgiving, which was awesome, and I'm just sort of chugging through this cycle, which has involved so much less pain stress and hassle than the IVF cycle did.  Why, you might ask?  Well, here ya go:

• one shot per night vs three shots per night - just the lupron, which is the easiest one, really
• not growing a million eggs - ovaries not bloated and swollen and painful
• no monitoring appointments - because i'm not growing a million eggs, i haven't had to go in for blood work and ultrasound (poke and prod) multiple times per week

The way the FET cycle (with my protocol) works is sort of simple.  Basically I'm on the Lupron to suppress my ovaries from doing what they naturally do (ovulate) and I'm on estrogen patches (Vivelle) to trick my uterus into thinking my ovaries are doing what they naturally do so that it develops the lining required for an embryo (or two) to implant.  That's pretty much that!

So, we had our only monitoring appointment for this whole cycle this morning, and it went well.  It was merely a prod, no poke (ultrasound, no blood draw) and it was solely to check the state of my lining and make sure it looked good and I had no fluid in there.  Lining is 8mm (good, apparently) and my ovaries are quiet with no large follicles (also good). We are set to move forward with the transfer.  So, I got my next set of instructions from the nurse, signed consent forms and the transfer was scheduled for Wednesday (December 5th).  We won't know what time until they call us on Monday, but it'll be more towards the middle of the day than last time because they do the Egg Retrievals first then the fresh transfers and then the frozen ones.  These are my instructions for the next weeks...  butt injections start on Saturday night. EEEEEEEEEEEEE.  Anyone been through 'em and wanna tell me how to not be terrified?

As an aside, one thing I found interesting - I woke up this morning with symptoms of ovulation - primarily a back ache.  It made me feel a little bit concerned that maybe the Lupron hadn't worked, but when we saw that I clearly had nothing in my ovaries to ovulate I mentioned it to the nurse practitioner who was doing my ultrasound. She said that yeah, it's normal and just another indication that the estrogen is working and my body really believes I am about to ovulate.  Something about that is really fascinating to my nerd brain.  I think that I just like how this process helps me really understand how my body works and what causes each thing.  When I ovulate each month and my back aches I know now that this is clearly not actually a pain caused by an enlarged ovary or the process of ovulating.  It must be something else.

As another aside, as you can see above, I'll have my pregnancy test on December 19th, which is the day before my birthday.  For our last cycle, I tested on October 19th, which was 4 days after Ian's birthday.

If my test comes back positive, I will have a second test 2 days later to make sure the hCG levels are rising appropriately.  If I am either not pregnant, or am pregnant and everything looks good, we'll be happy on our journey to Switzerland.  If not pregnant, I will drink tons of wine and eat so much non-pasteurized cheese I explode.  If pregnant, I will eat chocolate, and I'll have to be very very careful before I get on the plane to travel back home at the end of the trip.  If I have any any any odd symptoms at all, I'll have to make our friends in Zurich help me go to an Emergency Room for an ultrasound to make sure there's no ectopic pregnancy before I get on a plane and potentially have some rupturing and death occurring during my journey back home.

The third possibility, though, is one that will totally fuck up our trip.  If my pregnancy tests show a pregnancy, but are strange in some way (not high enough, not rising appropriately etc) I will not be able to travel and my trip will be cancelled.  That will suck big old donkey balls, but Ian and I decided it was worth the risk.  (The only other option would be to cancel this cycle entirely.  No thank you.)

With that, I shall sign off.  But first, here are some fine images to show you the State of Sharon's Mid-Section (both taken in my work bathroom, cause I'm classy like that).

This is my belly (as of a couple of days ago).  Here you shall see some bruises from where I've hit blood vessels (the one that you can barely see is now as big and purple as the one that is more visible in this photo) and my 4 estrogen patches along with a bunch of leftover adhesive from the previous patches.  I finally went yesterday and got some baby oil and scrubbed all that adhesive off before applying 4 fresh patches last night. 

And here's my back!  I have one of these circles drawn with sharpie on each side (by the nurse) so Ian knows where to aim the Progesterone injections.  He was told that he has to be quick and basically throw them in like a dart (without letting go like you would with an actual dart).  Good times. You can see that this isn't really my butt, it's more my hip/almost back.  Whatevs.  Butt enough.

The No New Phone Blues

This morning I woke up bright and early to try to get my hands on a Nexus 4, 16GB phone.  I broke my phone two weeks ago and have been using an old one with limited functionality.  (It seemed super fancy when I got it 2.5 years ago).  It has almost no storage and the headphone jack doesn't work.  Since almost all of my music listening happens through my phone, this has been frustrating, but ya know...it's just a phone.  Ain't no big deal.  Especially cause I knew I could buy the new Nexus 4 this morning and it was just a couple of weeks to hold out.

Last night, Ian warned me it sold out in Australia pretty quickly.  So, this morning I woke up bright and early and ready to go.  As soon as it was time and the phone was available, I hit the button and added it to my cart.  And the website went nuts and stopped working and it disappeared from my cart.  I hit refresh for about 5 more minutes until it showed up as available again, put it in my cart and the same thing happened.  Then it was gone.  Sold out.

Well, maybe this doesn't sound so traumatic to you, but I was, first, violently angry.  Then I got in the shower and cried my eyes out.  A little bit dramatic, perhaps?  Yes, I thought so too.  So, why?

First of all, I think there is some PMS happening here, so I'm sure everything I'm feeling is somewhat hormonal.  I stopped taking my birth control pill on Saturday night and am expecting a period any minute now and have some signs that it's on the way.

But, I think, also, this was such a little thing and such a not big deal that I allowed myself to feel a disappointment over it that I haven't really let myself feel much of when it comes to bigger things in my life.  Then, as soon as I let that disappointment in, it just washed over me along with the water in the shower (how poetic).  I have had a fuck of a lot of disappointments over the past year.  Fertility stuff being primary, but professional stuff too.  Big professional stuff.  Disappointments that I don't deserve, if I do say so myself, on any front.   Every time I start to feel like things are going my way, something else that I expected to go right, goes wrong.

I think that most days I just can't allow myself to dwell.  If I dwell on the let downs and the losses, how can I keep going forward?  How can I keep, for example, sticking needles into my stomach every night without guarantee that it just won't just lead to more of the same feeling of disappointment?  How can I invest time and energy preparing for the interview that I have on Thursday without that same guarantee?  I'm not a quitter, but disappointment sort of makes me want to quit, so, I think I push it away really quickly.  Today, though, it's sort of lingering and I feel cranky and crabby and scared and I don't know what to do with any of it.  Fucking Nexus 4.

Plans for Frosty the Embryo

I've had a cold for a week and a half and it's really tiring.  I started my Lupron injections on Monday night, and the sleeplessness/restlessness kicked in solid a couple of nights ago.  So, physically, I'm not feeling my best.   I also haven't really been in the mood to write - have been trying to get to this post for days, for example.  I'm not sure why, except I think I'm just tired and sick, so it takes a lot of energy to get done the stuff I have to do (work and professional commitments), it leaves little for the stuff that is for me.  Which this blog is supposed to be.

This morning, through bleary eyes, I'm gonna finish this danged thing up!

SO!

We met with Dr. Tran on Wednesday to go over our failed IVF cycle and to talk about our upcoming FET cycle and other potential future plans.  I have said it before, and I'll say it again, but I love Dr. Tran for his straightforward manner, his sense of humor, his honesty, and his desire to really share all of the details of things with us while guiding us in making decisions, but not deciding for us.  So, he showed us all the data from our IVF cycle - the follicles I had, the expected number of eggs, the actual eggs etc.  He said the only thing that he felt disappointed about what that I really only had 10 m2 (mature) eggs, and it had looked, based on my follicles, that I'd have closer to 15 or 20.  We were still in the range he had estimated for us (10-20), so it's not a concern, just was a disappointment for him.   My estrogen levels got pretty high toward the end of the cycle, but not high enough, obviously, to cancel the cycle, and he feels like those levels were appropriate for the number of eggs that I had.

On the plus side, our fertilization was excellent.  On this front, we out-performed averages and his estimates for us in that 100% of our mature eggs fertilized and 100% lived to day 3.  Of those 10 embryos, we transferred two last time, and will thaw and transfer two more this time.

Our clinic grades the embryos with 3 numbers, and I got to see them for all our embryos.  The first number is how many cells the embryo has.  On day 3, 8 cells is grand.  6 or 7 is AOK.  Below that is less ideal, but potentially still fine.  Ours were mostly 7s and 8s.  We had a few 9s and a couple of 6s (if I remember correctly).  The second thing they look at is symmetry and the third thing they look at is fragmentation.  On both of those scales, our embryos fared pretty well.  No amazing perfect ones, but none that were duds either.  So we have a whole batch of good embryos.  Again, he is a little disappointed that none were AMAZING EXCELLENT, but this is still a great result.

I asked him some of the things I was curious about - How do we decide what day to transfer?  (Answer: it really is much more flexible than during our IVF cycle and can be determined a little by schedule.)  How many do you thaw?  (Just as many as you plan to transfer.)  What if they don't survive the thaw?  (There is time to thaw more if that happens.)

So, our plan is to transfer 2 embryos during the first week of December (I'm hoping for early in the week, so it doesn't affect our travel to Switzerland later in the month in terms of when I have to take my beta tests).   And we are going to add a couple of things this time.

1.  Assisted Hatching - Dr. Tran doesn't necessarily think this is required for us, but it can't hurt and it might give our guys a better chance of implanting.  Because of our long history of infertility (I hate even writing that, but let's face facts, it's a reality at this point) he feels like this is not a bad path to follow.  When I asked if there was any down side he said, "Just on your wallets."  Ok, so we are in.  Assisted Hatching (AH) basically just means that the embryologist will give the embryos' shells a bit of a poke just in case a thick shell is causing implantation issues.  It's so funny to realize that we hatch out of shell, sort of like chicks, just at a much much earlier stage in our development.

 2.  hCG Wash - I can't find very much about this on the various Internets, but Dr. Tran says that they have had some success with this for FETs and it seems like it's sort of a cutting edge new thing that's being done some places.  Basically since we aren't doing an hCG trigger shot, he's just gonna shoot some hCG up in there during the transfer.  This can help to make sure that my uterus is ready for some implantation.

At our clinic, the doctors rotate weeks in terms of who does the actual procedures (monitoring, transfers, and retrievals) and we are excited that Dr. Tran will be the actual doctor on duty the week of our FET.

The only other news is good news!  Dr. Tran told me that if I get pregnant, he'll let me switch from the PIO shots back to Crinone (the Vagina Glue), so I won't have to be doing those giant needles in the butt for potentially months and months!  I was so happy I almost cried.

We also discussed future plans if this FET doesn't work.  There is the potential to thaw embryos and let them grow for a couple more days to the blastocyst stage.  At this point they can remove cells without damaging the embryos and do genetic testing on them.   This can allow for a more accurate picture of which embryos are "best" and most likely to implant and survive.  So, it's something to think about.  It, of course, adds cost, and there is also the potential of losing embryos if you keep them growing outside of the body.  But the longer you go on the path of no success, the more these costs stop outweighing the benefits.  Just something for us to think about as we move forward.

In the meantime, Ian and I have done so little travel this past year compared to a normal year, because of all of this and we realized that we hadn't stayed in a hotel together since February, when we were in Tahoe with friends.  So we are going to Sonoma tonight when I get off work, just for one night to stay in a hotel, eat delicious dinner and brunch, and pick-up wine at a pick-up party at the winery where we are members.

Here's a tiny short video about Assisted Hatching, and a tiny short video that actually shows an embryo being hatched with assistance.  I love this shit.  #sciencenerd

Box o' Drugs - The Return

Halloween was a day of excitement among my successful baby-making friends.  One friend gave birth to a spooky Halloween baby boy and another found out that her unborn baby is a boy baby!  

In the meantime, for the less successful,  the excitement comes in the form of drugs.  DRUGS.  WOOHOO!

Brand New Box of Drugs!

You may recognize this Lupron from past posts filled with drug pix.

This is new.  This is my Progesterone (in sesame oil).  I will inject this in my bum daily (and by *I*, I mean Ian) starting  around the time of the transfer and continuing through a first trimester, if a first trimester occurs from this transfer.

And this lovely photo shows the difference between the size of the needles I used in my last cycle in my stomach (the bottom needle), which I will use again for Lupron, and the size of the needle that will be used in my ass daily for the Progesterone (the top needle).  Yes, it does need to go all the way in.  Jealous yet?

Valium again for the transfer, and Medrol, a steroid, again to stop my body from rejecting embryos as foreign matter.

Vivelle is the Estrogen patch I'll be using.  I start with one patch at a time, but end up using four patches at a time.  That'll continue for 10 weeks into a pregnancy, if the FET works.

And that's pretty much that.  I haven't posted much cause there hasn't really been anything to report.  People occasionally ask me "how is the fertility stuff going?" and when they do, I am so grateful that so many people read this blog and don't have to ask.  It's just a hard question to answer.

• "Well, not pregnant yet!"
• "The hormones and injections are awesome, thanks for asking!"
• "I haven't had a good night's sleep in 6 months.  YAY!"
• "I am managing to stay out of deep dark despairs of depression, barely."
• "So far, failure!"
• etc.

But ya know...I'm mostly joking.  I am glad people care enough to ask and I am happy to talk about it.  It just makes me feel like a bit of a downer, and I'm just gladder that many people who care enough don't have to ask.  

Hall and Oates hope you had a happy happy Halloween!

So does this scary scary witch.