Big Head Sperm and the Monsters

Just thought I'd post a longer update on what's going on with us in terms of next steps as well as mind-state.  I like to think that this blog serves a few functions:
1.  To help me get my thoughts out, my feelings out, and to chronicle a hard journey.
2.  To keep friends and family posted without having to repeat myself too often, especially the lows.  It allows people to follow as passively or actively as they want, so there is no such thing as TMI because you are choosing to be here.
3.  A place for me to receive comments, kind words, information and insight.
4.  To help anyone who may stumble on this blog who is going through anything similar - friends, strangers, etc, with the emotional aspects and/or with actual information.

So, here we go.

On Monday I go in for my Sonohysterography  and trial transfer.  The trial transfer is just to get the exact information needed about size/shape/location of everything so when they go to do a real embryo transfer they can complete it successfully by making their way into tiny spaces accurately.  The Sonohysterography is the saline ultrasound that will tell them more about the shape of my uterus and what might be inside of it.  This will tell us if there is anything there that could be causing problems and preventing implantation, so we can fix it, if possible, before attempting IVF.  I am partially hoping they do find something, because then there is something to fix which might make me more hopeful for future success.  BUT at the same time, finding something wrong will equal a surgery for me (scary) and a delay in moving forward with IVF.  So, I dunno.  It's all information, and information is good.

Ian needs to call and set up his Strict Morphology.  When trying to find out more information about what that means exactly, I came upon this image, that I'm a little obsessed with:

He might have two-headed sperm!  Or giant-headed sperm!  Or super weird pointy-headed sperm!  Who knew all the weird wrong un-penetrating shapes sperm can be??!? If he has any of these creepy spermy-types in too large of numbers, that means we'd likely need to do Intracytoplasmic Sperm Injection (ICSI).  Basically, instead of letting the sperm find the eggs in a petrie dish, they will be injected directly into the eggs. Forced insemination.  INSEMINATING AGAINST THEIR WILL!  Anyhow, I don't know.  His sperm count and motility is really high, so I just assumed that meant the spermy mcsperms were fine, so it's strange, at this point in the game, to find out there is more that can be wrong.  

I like to imagine that a big-headed sperm creates a big-headed baby and a tiny-headed sperm creates a tiny-headed baby etc.  Truth is, I don't know if they would use those abnormal sperm or if they'd find the good sperm and only use those.  If it turns out this is a problem for us, obviously we'll get more information.    

We still have a lot to talk about and figure out in terms of how many IVF cycles we are willing to try.  There's a financial aspect to figure out.  There's how much I can handle physically.  There's how much we can each handle emotionally.  I am a planner and it's hard to not have a plan, but I am having to learn to take things as they come and to have no way to take control.  Ian and I are at different places in terms of imagining next steps.  What I require for coping is sort of the exact opposite of what he requires.  He needs to feel hopeful and trusting that whatever we are about to do is going to work for us.  I need to feel hopeful and trusting that when whatever we are about to do doesn't work, we know what is coming next and it is doable and OK.  Both of these ways of dealing with this process are fine, of course.  And so far we've always come together on any decisions and reached the same conclusions.  This is how our marriage works a lot of the time, in general, so it's no surprise that it's working this way now.

Ian has made sure that I understand that I have full decision making power over wanting to stop this process at any time due to physical concerns.  And I have made sure that he understands that changes he makes in his life for financial reasons are entirely up to him.  And we both know that we will come together and be on the same page about whatever decisions we make - and in some cases it may take time, it may take therapy, it may take tears, but we will be excited about whatever the future holds and whatever path we end up following to parenthood. 

So, maybe I'm ready to get excited about adoption just because I can't allow myself to get excited about IVF cause it's too near and too scary and too heartbreaking.   And maybe Ian isn't ready to give up on the "part me part you" aspect of a biological child because that's too scary and too heartbreaking.  And really, maybe this is actually the same thing - because we are both scared of being heartbroken and I still really really want to be pregnant and to have a baby that is genetically ours.  Otherwise, I wouldn't put my body through all of this.  I am also just ready to realize that I will be just as happy if that's not how it works out and that whatever child becomes ours will be ours no matter how it comes into our lives.  So, Ian and I - we'll end up in the same place when we need to.  And for now, we balance each other just right, I think.  

The Happiest Place on Earth

I got my period while wandering around Disneyland by myself yesterday, about 24 hours after I had already heard from my doctor that my pregnancy test was negative, which was a few hours after I had taken a home pregnancy test and saw the negative result which was 3 days after I had taken an early home pregnancy test (so Ian could be with me) and gotten a negative result.

Is it any wonder that I just don't believe I'll ever see a positive one?

Anyhow.  I didn't take it well any of those times I got the same news in the last couple of days.  This was my last try at IUI.  Things get way more intense from here on out.

And to add insult to injury - I have to take another home pregnancy test before my saline ultrasound, just to be super duper sure.  Can't wait to see another minus sign or "not pregnant" pop up!  Fun fun!

Thanks to my friends who were nice to me while I was going through this while attending a conference and away from the husband.  And also, I cried in front of people.  Which is some sort of a major breakthrough, I'm sure.  

Next Steps

Yesterday, Ian and I met with our doctor about next steps if this final IUI doesn't work.  I'll give you the short version.

* Another test, that sounds pretty painful (if anyone has had the saline ultrasound, lemme know.  similar to HSG?  That's what I'm assuming. I know you have, C.M.)
* Ian needs a fancier sperm test
* Potentially remove part of my uterus depending on what they see (I have a heart shape - perhaps it is too heart shaped and that is the problem and the peak of the heart will be removed.)
* Wait month for healing.  If no surgery, no waiting month.
* Move into an IVF Cycle, which we would likely try at least twice.  First time August or Sept depending on uterus heartness.
* At a cost of $10,000+ per cycle
* Maybe cheaper the second time if I have extra embryos to freeze the first time
* It involves daily blood tests during the time I am being "stimulated"
* It involves making 10-20 eggs ready to be "retrieved"
* A surgery (with general anesthesia) to retrieve them
* Fertilization in a petri dish
* Transfer of embryos (3-4 of them) to uterus.  Cross fingers that they implant
* There is about a 20% chance that any given cycle will be cancelled due to problems (over-stim, under-stim, eggs don't fertilize etc etc etc)
* There is about a 30-40% chance that any given cycle will result in a pregnancy
* There is a 25% chance of twins in any resulting pregnancy (with a 3 day transfer, which is what he recommends)

Am wondering if I shouldn't take a month off work during this.  Others who have gone through it, what are your thoughts?  How was the process?  What were the drugs like?  How did you feel?  How often were you in the dr office?

Dr. Tran says that the last two patients who had this consultation with him before their final IUI cycle was finished got pregnant in their final cycle.  I wish I had any hope left.

I am just so so tired. 

Boring Updatey Stuff and Things

I haven't been online much this week, thus haven't really been around here posting business and stuff.  My parents were in town, so I spent much of the week up in Napa with them eating and drinking wine like champs.  And then Saturday night I walked 18 miles overnight in the American Foundation for Suicide Prevention's Out of the Darkness Overnight Walk (wow, that's a mouthful).  I still hurt.  My poor right foot may never be the same.  But it was worth it and we raised a lot of money for a very important cause.  And later that day (post IUI) I did get to have an amazing hot stone massage and a great hot tub conversation with a friend right when I needed it, both physically and emotionally.

As for the topic of this blog - I don't have a lot to say right now.  We had our fourth IUI yesterday and it'll be our last try and marks the end of my time in the study.  Everything went fine, so we'll see in a couple of weeks if it worked.  We also have an appointment with Dr. Tran (our pre-study doctor from the clinic) on Wednesday just to talk about next steps and what we'll do if this doesn't work.  I am assuming IVF.  But there might be other tests they want to run...who knows?  Not I.  That's for sure.  I actually have scar tissue on my arm now from where they draw the blood every couple of days.  It isn't pretty - always bruised and full of holes and now scarred.  I have started thinking about how I might tattoo around/over/through that space when I reach the end of this all.  Closure in ink.

I'll be away when we find out if this try worked.  I think it'll be better for me than the time Ian was away and I was home by myself.  That month was also particularly awful with the chemical pregnancy and delay of my period.  This month at least I'll be busy with conference stuff and a little distracted.  But it also will be the end of our IUI attempts and the start of some other journey, so I'm not sure how that will affect me.

I'm definitely assuming the worst for this month.  I have become a bit gloomy about this all.  I think if I ever actually become pregnant I will have a very hard time believing/processing it since I've worked so hard at convincing myself it won't happen, so I am not so disappointed every time.  Will be interesting to see.

Today is my 5th wedding anniversary, so tonight Ian and I are going out for fancy dinner.  Back to work tomorrow - will be hard to get back into the swing of things after a week off, but it was a much needed break and I'm ready to return.  We have Ian's dad and stepmom in town this coming weekend and I leave for Anaheim for the ALA Annual Conference over the following weekend.  June is always a crazy busy month and this year is no exception.  I am hoping for a sleepy July.  With some time to regroup about the baby making stuff, along with everything else, one way or another.

low

This month is a rough one so far.  I've taken 3 days worth of my meds - 2 more to go.  They are affecting me way more than in the past.  I am so tired and so irritable, it's insane.  And not comfortable.  Especially when my job involves helping patrons and staff with a variety of concerns and questions all day long.   I am having a hard time getting out of bed and I'm having a hard time doing anything other than go to bed when I get home in the evening.  I know this is partly the medicine.  I suspect it is also partly due to my general mental state.

We are pretty sure - the doctor and I - that I am on Clomid, not Letrozole, based on the side effects I have and have not experienced - primarily that the side effects seem to be cumulative month to month.  At our appointment earlier this week to start this final cycle of IUI, I asked about upping the dose.  She looked at my information from the last 3 cycles and recommended against it, as it might cause hyper-stimulation (way too many follicles/potential eggs) and it could thin my lining (which has been thinning a little bit each month).

It was good to sit and talk with her and she looked over everything and said that in my case the study really didn't affect my treatment at all.  That she would have made all the same decisions if I was under her care outside the confines of the study.  So, that was good to hear.

I made an appointment with Dr. Tran for mid-cycle so we can start talking about next options for after this last IUI.  I'm going to take a month off.  Not a month off trying entirely, but a month off of trying with medical interventions.  Which would probably be necessary anyhow, since I don't know what is next and how it works and if we can go straight from an IUI cycle into whatever is next.  I just need a break from the blood draws and waiting rooms and missed work and last minute appointments.  It is so stressful to try to plan anything when I have so many appointments with so little lead time.  I need a chance to think about something else.  I don't know if I will be successful in thinking about anything else, but it might be easier.

Dr. Pittinger swears that she is getting me pregnant this month (with Ian's help, of course) and not sending me back to Dr. Tran.  I guess she can have the hope/confidence for all of us.  I can't stomach it anymore.   My heart can't take it.  My whole body can't take it.  In past months, I was feeling pretty good and quite hopeful during this early part of the cycle.  This month, not so much.  I am feeling worn out and beat down and with very little sense of humor left.  

In the meantime, there are babies and pregnancies everywhere.  Which I love.  But sometimes I feel sad when I know I should feel happy...just for a moment....a quick moment that passes.  But the guilt over each of those quick moments lingers much longer.

On the plus side, I have a much needed week off work.  If I get through today, tomorrow, Saturday - I am off to Napa with my parents and my dad's cousin and her husband and Ian.  There will be much food and much wine.  And 1-3 trips back into San Francisco for doctor appointments during the week (ARGH), the first one being Monday - the rest TBD.  But anyhow, relaxing!  That's what I'll be doing!  Not working.  Is good.  I really need the break.

I just re-read this post before clicking "publish" and it sounds so depressing.  I almost didn't post it because of that.  But this is the one place where I feel free.   So free I shall be.  

Beta Schmeta

I had about two hours of super-extreme cramps last evening.  The kind that tell me my period is going to come at any time.  So sure I took Advil.  Also, thought I would die without relief.  Some of the worst cramps I've had.  This morning I took a home pregnancy test (that's what we decided to do so Ian could be there when I get the answer, as opposed to the blood test, where I get a phone call when he's at work).  It was negative.  But I still dragged myself out of bed at 5:30 and out the door at 6:30 to get to UCSF by 7:30 for a blood draw so I could be back to work at 9.  When I left UCSF I got into my car and cried most of the way to Oakland.  Hoping that got it out of my system so I don't cry when I get the phone call.

The Waiting is the Hardest Part

I am super distracted today.  The last couple of days before the beta test are just impossible.  My focus is a mess.  It's a time of the month that is not the best generally - I mean, PMS makes me anxious and in pain and distracted in the best of scenarios.  But now my brain is just constantly buzzing.  I try every cognitive trick I know to shut it up, to control my emotions, to move through my day like a reasonably functioning human being. But all of those tricks are sort of more brain spinning.  It's something like this:

I feel a symptom that makes me think my period will be coming (a cramp, a mood, nausea, sore boobs) and I immediately start to feel deep and crushing despair.  Then my brain goes nuts to try to halt that despair and I just start the thoughts spinning and spinning and spinning - telling myself that it could still be my month - that all these same symptoms can be pregnancy symptoms.  This is when I go online and look up whatever symptom it is.   My search history looks like this:
"feeling cold and goosebumpy and early pregnancy"
"cramps and early pregnancy"
"nausea and early pregnancy"
"strong sense of smell and early pregnancy"
"hopping on one foot while rubbing your belly and early pregnancy"
"sudden love of the album vital signs by the classic band survivor and early pregnancy"

I want to read if it makes sense at all, whatever day I'm in, to be feeling what I'm feeling and still be pregnant.  Of course, the answer is always YES because it's different for everyone and each of these things can be early pregnancy symptoms.   Yes, even the Survivor one!  Believe me, I was as shocked as you are.

Then I look back at all evidence I have of my past months - the calender where I've charted my ovulation and menstruation (and lately my cramps and other symptoms, to make this crazy part of this crazy process easier for me) - my emails etc and try to see if this month is different in any way to all those months in the past.  I can usually find something.  And this something is just more evidence.
"This month the cramps feel more like pulling"
"Last month I didn't get cramps until 3 days later than this"
"My boobs are definitely MORE sore this time."

So the despair is somewhat in check and I start to feel a little hopeful.  But with the hope comes fear, because if I get too hopeful, and it *is* just PMS (as it has been every single month for the last two fucking years) and I had been too excited, too optimistic, too full of possibility, I will be crushed.  And being crushed leads back to the deep despair that I was trying to avoid in the first place.

Sometimes I just have the thought, "Either I am or am not pregnant right now.  There is no way to know.  I am making myself insane trying to figure it out, but nothing I am thinking changes whether I am or am not." and that thought is sort of just crippling because I don't know what to do with it.  I mean, I know it's the reality of the situation.  But what am I supposed to DO with that?  It doesn't fix anything.  I just want to get through this time - if I'm not pregnant, I just want to get my period and know and move on.  And if I am, I wish there was some irrefutable sign.   

So, what can I do?  Try to calm myself down by keeping hope alive. But  work on keeping hope in check simultaneously.  I get totally stuck up in my head in thoughts spinning and spinning and spinning.  But if I stop them spinning then I might accidentally start to really FEEL which I know I can't deal with.  So, I don't have a choice, really.

I don't take Advil for my cramps - the only thing that stops my cramps - until I am sure I'm not pregnant.  Tylenol only helps minimally.  I try not to drink any booze, but I also feel a little bit like FUCK THAT after two years of negative negative negative.  I don't want to take a home pregnancy test, because deep in my heart I know it will be negative, and I'm not ready for that yet.  So, when I do give in, and it is negative (as it always has been), I go into this same mode of coping - I still don't fully believe it.  My brain finds all kinds of ways to remind me that it could be wrong and that I still might be pregnant.  So, what's the point?  Until I bleed (or get results from a blood test) I won't 100% believe it's a no.  So I wait.

I guess all I'm saying is that if you're wondering exactly what could be so distracting to me, here's a little insight to what's going on in my head.  This whole process has probably happened no less than 10 times during the writing of this post as I feel a variety of twinges in my lower abdomen.  Today is Tuesday.  Day 12 post-IUI.  I get my blood test on Thursday.  I've had minor cramps off and on since Thursday (day 7 post-IUI).  This is my life right now.