My life: November 04, 2012 - December 08, 2012

Alright, detail oriented peeps, who really like to track my every movement.  Here's my calender for the first half of my Frozen Embryo Transfer cycle.  Doesn't look that much less complicated than my IVF calender, but let me tell you that I will not miss those Menopur and Follistim shots, nor the slowly growing ovaries of doom that went along with them.  I also would not have missed the loopy Lupron that makes me sleepless and insane, but alas, apparently my stomach will not be spared those nightly injections this time around.  

Where do we go from here?

The first, and very most important point of this blog post is to tell everyone how incredibly overwhelmed and touched I was by all the support I got on Friday and beyond.  I didn't reply to most of you (I don't know that I really replied to any of you) because I just sort of couldn't.  I probable never will, but I want you to know that every comment on the blog, every comment on the facebook page, every twitter reply, every text, every word or touch or hug in person and every email made my load a little bit lighter to carry, and for that I am incredibly grateful.  I am so so lucky to have so many people who care about me and Ian and I wouldn't trade my life, the good or the bad, for anyone else's.  Not in my darkest moments.   

I still feel sad and I have my moments of real grief, but I am feeling a lot better than I was, generally.  Aside from all the love and support, which was a huge help, I also felt much better after a phone call with my nurse, Olga, allowed me to start looking forward very quickly.  This provided me with exactly what I needed to stop merely dwelling on our failure, and to start looking at what our next steps will be.

Ian and I were anticipating having to wait several more months before we were able to jump into this.  We travel for Thanksgiving, for Christmas/New Year's, and I have my ALA Midwinter Meetings in January.  We figured that the clinic would want us to take a break between cycles and then all of this travel would kick in.  Well, it turns out that break isn't needed.  It seems that we can move straight into a Frozen Embryo Transfer (FET).  Hurrah!  

Olga spoke to Dr. Tran and called me back and said that he wanted to give me the option of a controlled cycle or a natural one.  With a natural cycle, everything is timed with my body's own natural cycle (hence the clever name).  The only medication I would be on is the Medrol (the steroid that helps keep my body from rejecting embryos as foreign material) and the Valium for the actual transfer.   With a controlled cycle, also cleverly named, my cycle is controlled by medication.  In this case I would be on birth control pills, similar to my IVF cycle, as well as an Estrogen patch and Progesterone injections.   I would not be on all the stims I was on in my fresh cycle, as I will not be trying to create a gazillion eggs in my tiny ovaries, and will not be going in with a needle to remove said eggs.  This is just a far less invasive procedure, pretty much like the second half of my IVF cycle - everything that happened *after* the retrieval.  

Anyhow, Olga and I agreed that because of the complications of my travel, if we wanted to get started right away, we would need to do a controlled cycle.  This way we could make a calender that will work with when I'm out of town.  I was told to start birth control on day 2 of my cycle, to call her and let her know when I get my period (it should start when I stop progesterone support), and she would work on a calender.

Well, apparently for some women it can take a week or 10 days to get their period when they stop the progesterone.  For me?  Three hours after my first missed dose.  So, there's that.  What does this mean?  It means I'm already on Cycle Day 4!  Olga will send me a calender today and we'll chat about it tomorrow.  Fingers super duper crossed that she can make it work for us!  

I am super nervous about the progesterone butt shots.  They are referred to as PIO because it is literally Progesterone in Oil.  Usually peanut oil.  These are injections that are very very different than the stomach ones I did before.  They are much longer and thicker needles, and they have to go into the top side of my butt.  Every single night.   I hear they hurt like a mofo.  I really wanted to avoid them.  But, apparently I did not want to avoid them enough to postpone this process.

And I guess that's just it.  There is a lot I am actually willing to do.  If that hasn't become quite obvious already.  So, we meet with Dr. Tran on November 7th and at that point I'll have more information about how an FET works.  I am curious how many embryos they thaw and how many they want to transfer etc.  We have 8 of them frozen, but I know not all necessarily survive the thawing process.  I'm curious for more details.  I have a phone date with Olga tomorrow to go over the calender, too, so at that point I'll have more information about what the timing of this will look like.

Olga told me that she and Dr. Tran have no reason to believe that this won't work for us eventually.  I am still young.  I responded really well to everything.  Sometimes it just takes a few tries.   

So, anyhow, yeah.  FET coming up.  If it isn't successful we'll see where we go from there.  I feel willing to potentially do another full IVF cycle and whatever frozen cycles that one would provide, if we don't have success with this one.  But, at the same time, I think I'll want to start talking Plan B at that point, simultaneously.  I'm getting ahead of myself here, though.  I really do hope we don't get to that point.  Man, though, is hope a motherfucker lately.  

Stupid Stork Vlog Challenge

Ok, so this is a little silly, and I don't think anyone who knows me will want to watch this whole thing.  Or anyone else, necessarily.   But, basically, I've been becoming more active in the world of infertility blogging, and this video is a challenge that was issued by Stupid Stork.  I am doing it because it is really nice for me to see the faces and hear the voices of the women whose journeys I am following, so I wanted to give them that opportunity with me.  It really is a lovely and amazing thing - the support one can get from strangers who are in the midst of similar struggles.  Between that and the support of family and friends, I can't help but feel incredibly lucky, even through the hardest of times.

Speaking of... I do have another update coming in the next 24 hours in terms of how I'm feeling and what is actually going on with me.

But for now, embarrassing video ahoy!

The Cat is Dead

I woke up in the middle of the night last night with a migraine and knew it was over.  It's my sure-fire tell-tale sign that my period is about to come.  Until that moment I had been so hopeful that all my symptoms meant I was maybe actually pregnant.

This morning, as planned, I took a home pregnancy test.  The result was negative.  My first IVF was not successful.   I took an Exederin.  Not on the approved list.

Ian and I had about an hour together before he left for work.  When he walked out the door, I lost it.  He got off his shuttle at the next stop and came back home to me.  He took me to the lab to get my blood drawn for the hCG beta test that I know is going to come back a big fat 0.   He dropped me off at work and took the car to Google.  And here I am.  I don't know if I'll be able to answer the phone when the nurse calls with my results.  Although I do want to know what our next steps are.   I still took my estrodiol this morning.  I still inserted my progesterone.  For some reason I feel like I shouldn't stop until they actually call and tell me to.

So this, right now, is when I start to feel conflicted about how open I've been about all of this.  At least now you will all know why I am sort of not OK...why my eyes are red and I am so sad and so quiet.  But at the same time, I know so many people were rooting for us, and I feel like I've let everyone down.   I posted on twitter this morning, "First ivf = failure.  Not pregnant.  Don't really want to talk about it, so if you see me, let's not."   And I don't.  I don't want to talk about it.  I am reminded of my last major breakup, a gazillion years ago.  That sense of wanting everyone to hear the bad news at once...not wanting to have to tell the sad story over and over again.

This hurts more than I thought it would.  So very very much more than any time in the past.  I feel like my heart is breaking.  I can't really breathe.  I know it won't feel like this forever, but it feels like this today.   I don't know how many times I can put myself through this.  

Ian is Smarter Than I am

Ian and I had been wondering from what point in our cycle is the % of success close to 50%.  Do 50% of people who start a cycle have a baby?  Or is it more like close to 50% of people who make it to transfer with super awesome embryos like ours have a baby?  So, today I found the page with all these very specific statistics about our clinic (linked if you are interested).  Of course, these are just averages and may have nothing to do with what our specific doctor thought our chances were in our specific case.

Anyhow, I sent it to Ian.

"Interesting.  Yet frustratingly empty of answers as to what is happening for US!" says Ian.

Instantly summing up my life the last week of frantic and near constant Internet searching.

Why is he so much smarter than I am?

I Don't Wanna Wait in Pain

This waiting is torturous.  I am now 11dp3dt, or 14dpo.  Totally could test today.  But still want to wait till the Beta on Friday.  Which makes me sort of insane feeling.  It's torture to not know, but I'm not ready to know.  Ya know?  I have had cramps off and on pretty much this whole two week wait, and as it gets closer and closer to test day, I react worse and worse to each one.  It's just hard to imagine a different outcome than the one we've had every time so far.  So, even though I know how common cramping is in early pregnancy, and even though I know progesterone also causes cramping, every time I feel a strong cramp I get a horrible sinking feeling that this did not work because it feels like every single other cycle that did not work in the past.

Other current symptoms:
* Extreme exhaustion that hits in the afternoon/evening.  This is the sort of exhaustion where I feel like I need to pry my eyes open, Clockwork Orange style, to get through the day.  It reminds me of being in my 20s and going out partying and dancing till all hours of the morning and then dragging myself to work the next day.  But without the partying and instead with the laying on the couch and the going to bed early the night before.
* Food aversion - Not to anything in particular, but sort of to food in general.  Maybe loss of appetite is a better description.
* Nausea - it's not terrible and it is in and out, but it comes, in particular, after I drink my morning coffee, after I take my Estradiol pill, and after I eat a little bit.
* Previously mentioned cramping - ranging from sudden strong sharp pains that come and go relatively quickly, to an almost constant dull ache that feels closer to how I feel when I ovulate than how I feel when I have my period, with occasional short spurts of very period-like cramps.
* Sore boobs - still.  Hasn't gone away since before my transfer.  At this point I wake up in the night because I'm sleeping on my stomach and it's hurting them too much.

I guess I'm just chronicling this for my own future reference, mostly.  I know these things could mean ANYTHING.  There are as many sets of symptoms as there are pregnant women.   And I'm also giving myself two out of the three hormones that cause these symptoms in pregnant women (Progesterone and Estrogen.  I am not giving myself hCG, which is the other cause of symptoms.)  So, I'm trying really hard to not over-analyze and to relax.  I did great over the weekend.  It's so much harder at work.  Two more days.

  

Peeing on Schrödinger's Cat

The other night, in the midst of a long discussion about if and when I should take a home pregnancy test, Ian remarked, when he finally really got exactly why and how I was going back and forth about it in my mind, that it was totally like Schrödinger's Cat.  

So, to start, for those who don't know who this Schrödinger dude is, and what his cat has to do with anything, here's the shortest ever summary, leaving out all the complicated quantum physics parts:

It's a thought experiment. (No actual cats are harmed in the thinking about Schrödinger's cat.  In fact, I'm pretty sure Schrödinger didn't even have a cat.)  You've got a cat, you've got a box, you've got some sort of unstable radioactive thing that could kill the cat.  Or it could not.  The cat is in the box with the radioactive thing.  The box is closed.  Is the cat dead or alive? Until you open the box, the cat is both dead and alive.  Once you open the box, the cat is clearly one or the other.  And when you add in the quantum physics, there's the idea that by opening the box you affect the outcome of whether the cat is dead or alive.  

OK, I am not a physicist (quantum or otherwise).  I'm a librarian.  So, I don't really need to understand it any further than that for it to help me resolve and understand how I'm feeling about things.

Here's the situation.  I am 8dp3dt.  When Ian and I had this chat I was 6dp3dt.  I get my Beta test (the blood test that is done to check for hCG in my bloodstream that would indicate a pregnancy) on 14dp3dt.   But 14dp is actually 3 days later than it *really* needs to be done.  It is commonly done 14dpo (days past ovulation).  My transfer was already 3 days past ovulation.  It seems, from the Internets, that many/most clinics do Beta tests on day 11 or 12pt.  This makes sense because at this point the hCG should be fully detectable.  This is the same time I had my tests done during my IUIs and it's the same time home pregnancy tests should be able to pick things up.  It's 14dpo aka the day your period is due.  If you look at the chart I posted the other day, you can see that as of today, if I am pregnant and this cycle was a success, hCG is being produced.  People start to get positive home pregnancy tests as early as 7dpt.  Some, of course, don't test positive at home until after the Beta test (which is much more sensitive).  So, false negatives are relatively common.  False positive do not actually exist (once the trigger shot is out of your system).  A false positive generally means that you *were* pregnant, but no longer are - a chemical pregnancy, or super early miscarriage has likely occurred.

ANYHOW.  That's a lot of background info.  

Ian and I have, in past IUI cycles, used a home pregnancy test (otherwise known as an HPT or POAS (peeing on a stick)) the morning of my Beta (or the morning before, if one of us was going to be away the morning of) so that we would get relatively reliable results at home together, as opposed to me getting a phone call from a doctor or nurse in the middle of my work day.  In the past, these results have always been negative.  I have never seen a positive HPT nor had a positive Beta result.  

Well, this two week wait is dragging far slower than any other ever has.  First of all, this is the first time ever that I've KNOWN we have a fertilized egg (2, in fact) in there.  This is the closest to pregnant I've ever been.  Also, obviously, the IVF was so much more of an investment in terms of time, in terms of money, physically, emotionally etc etc.  And the success rates are far higher than IUI.  And, let's be honest, I'm sort of attached to those 2 embryos.  Not attached like I love them and will mourn them as individuals if this doesn't work, but beginning to be attached the same way I imagine most pregnant women become attached to the aliens growing inside of them as soon as they are aware they are there.  I was just aware far earlier than anyone could possibly be if they weren't placed in there by catheter!   I have a picture of them!  I realize that there is a huge chance those 2 embryos won't turn into a pregnancy or into live human babies, so any hope I have is very cautious.  The attachment, however, is not really stoppable.  

So, the question that I posed to Ian was: Do we take an HPT and when?  

I explained to him all that I've explained here about days post transfer and when a home test is likely to be reliable.  We talked about at what point I would actually believe a negative result and how we would feel if we got a negative and then the Beta came back positive and how many days between those two things would we want to leave for that potential unnecessary sadness.  We also talked about the torture that is waiting (particularly for me, since I am unable to put this out of my mind, as it is happening inside of my body and I have, every single minute, so many physical symptoms, any of which could be either pregnancy, pms, or side effects from progesterone).  

At some point in all this talking Ian hit the point of, "OK, then maybe we should take the test at 12dp3dt (Wednesday) or 13dp3dt (Thursday)" and I suddenly realized how scared I was to actually POAS and I tried to explain to him why.  I explained that in a way it's total superstition, because I know that already either I am pregnant, or I am not.  That there's a little bit of wanting to delay the inevitable (because I think I can't imagine it won't be negative, because it has ALWAYS been negative), but that also I almost feel like by choosing to POAS too soon I am creating the negative result.  Clearly, not logical, but deep deep deeply felt by me.  I am basically both desperate to find out and terrified to find out and it's a constant battle going on.  When Ian suggested that we think about it and revisit this on Wednesday morning and decide if we want to do it them or wait, my brain started going crazy and I had to explain that the whole point of this conversation is that I need to decide and know so that I can stop thinking about at least this one aspect of things.

And then Ian, of course, points out the cat.  Basically, I am scared that by taking a home pregnancy test, I am going to kill the cat (make the result negative).  Right now the cat is both dead and alive (I am both pregnant and not pregnant) and the box is closed up tight.  Once I open the box (take the test) the cat is either dead or alive.  

I finally said, "Honestly, I think the most mentally healthy choice for me is to wait until the Beta test.  Or in our situation, to wait until the morning of the Beta test so we find out together."  And he agreed.  So, for now, I am both pregnant and not pregnant.  The cat is both dead and alive.  And will remain that way until Friday, 14dp3dt, 17dpo.

Unless I change my mind.