Not 12 weeks

Today I'm not 12 weeks. 12 weeks, the last week of the first trimester, the time when most people start sharing the news. I'd be scheduling my nuchal screen.

I'll stop this self-pitying countdown eventually, I'm sure. I'll just forget one day, and not remember until Thursday or Friday or something. I'm not trying to be mopey about it. It's just Wednesdays are hard not to count.

My body is apparently remembering by offering a fresh bright red bleed. I guess it's good? I mean, action is good, right? And maybe it'll help my beta come down, in case there's a wee clump of trophoblastic tissue somewhere generating hCG.  My pee sticks aren't notably lighter, which makes me grumpy. Last Friday my beta was 467; recheck in two weeks.

Here is my riddle: how is a BFN different than a chemical pregnancy different from a 6 week miscarriage different from an 8 week miscarriage?  After all, they all end up in the same place: unpregnant.

I am not sentimental about embryos. With eyes focused on the bottom line (i.e. chances of success) I have always pushed for the production and cryopreservation of as many embryos as possible. If we have any left over, I will cheerfully donate them to Science.  If I am not sentimental about embryos suspended in cryoprotectant, then why be sentimental about embryos in my uterus, or no longer in my uterus?

There is a difference, and that difference is the difference between missing a bus by seconds, minutes, hours, days, weeks. How hard my heart was pounding, how much I thought I'd make it, how ferociously I clench my fists and dig my nails in frustration.

A BFN is missing the bus by weeks, I think. A pre-heartbeat loss is missing it by days, and a post-heartbeat loss is missing it by hours. I can only pray with all my heathen heart that I never experience missing this particular bus by minutes or seconds.

I didn't even know I was supposed to be worrying about that.

Turns out I have Asherman's Syndrome (a.k.a. intrauterine adhesions or scarring of the uterus.) Impossible to tell whether it was caused by the c-section and then went on to cause the miscarriage and subsequent D&C, or whether it was caused by the D&C.

There I was all worried about my estrogen and follicles, when I should have been worried about my uterus.

Well, fuck.

I'm not sure what comes next. The online Asherman's support group say that it's very important to be treated by an experienced surgeon. There's one a few states away, near where my sister lives. I could go up there, I guess. I don't know. Maybe I should do a freeze-all cycle first. I'm 38.5 and not getting any younger. I don't know. It's all so exhausting to think about.

I would just like one fucking thing to be easy, thanks.

CD 11, stims day 9

Not so great an appointment. My lining has somehow magically shrunk to 7.5. Where did it go? A few follicles around 14.

I don't understand why I'm getting the craptastic linings lately. I hate this. I hate the rollercoaster. I hate the endless appointments, waiting and waiting and waiting in the doctor's office (40 minutes this morning, an hour and a half on Monday) and then waiting and waiting at the lab, I hate waiting for the phone call to see what my lab results are, I hate slipping into work after unexplained disappearances and hoping that no one noticed, blood draw after blood draw, I hate this, I hate this.

sigh.

It's okay. I know I'm actually lucky, super lucky that this is a torture I can freely choose, and have chosen. I just wish it sucked less.

E2: 648
LH: 7.7 (elevated)

CD20: No beginning in sight

I've had 5 blood draws so far this cycle. My estrogen is still low and no ovulation is in sight. My ovaries appear to have retreated into a defensive huddle.

Obama's polls are down and I'm not feeling that great either.

May there be new hope, new energy, and a shot of luck for both of us in the future.

12dpt3dt: beta day

It wasn't a big shock to me that the beta was negative. Of course I had been peeing on sticks all along, and although I know that some people get negative HPTs right up until their betas, that's rare. And rare things are... not common.

So here I am. It's amazing to me that I am now in the category of "two failed IVFs". Shouldn't I at least get partial credit for the miscarriage? Like, a D-? But no. Unlike horseshoes and nuclear weapons, close don't count.

I get one more try before my insurance runs out. One more try before IVF moves from "expensive" to "cripplingly expensive" and possibly "unfeasibly expensive".

I'm sore, emotionally and bum-wise. Over the past two days my bum has tipped over from "pretty much okay" to "owowowowow".

I'm sad. I'm scared. But this isn't the suckiest point of my journey.

Below I would like to submit My ratings of the suckiness of negative cycles, in ascending order ot suckitude.

6. BFN, home inseminations #2-8
5. BFN, home insemination #1
4. BFN, IUIs #2 & 3
3. BFN, IUI #1
2. BFN, IVF
1. 6w4d miscarriage

At least this time, unlike last time, I don't have the overwhelming sense of having been a sucker.

On the plus side, I managed to avoid both Chatty Phlebotomist and Inappropriate Lab Administrative Assistant and got my blood drawn by Ultra-Sweet Lab Manager. Also, after two months of metformin, I have effortlessly dropped 5 lbs. That might not seem like a big deal, but it's extremely difficult for me to budge even small amounts of weight without going all-out no-carb, and I'm pleased to have a bit more room in the ol' jeans.

Now I stop the progesterone and wait to bleed. Then a new cycle begins, hopefully without too much delay. I think I'm going to do an IUI next cycle, just to keep a hand in, y'know? Just a single IUI because I can't see blowing over $1200 on something with such a low chance of success (and yet, somehow, blowing $600 on the same chance seems perfectly reasonable. Hey, it's only half as crazy.)

The auguries were really great this cycle, too. Stupid auguries.

On that subject, I offer the following dialogue with The "Softscape" Promotional Magic 8-Ball that I got at some trade show:

Me: Why didn't the embryo implant? Was it something I did?
Softscape Magic 8-Ball: VERY LIKELY
Me: Is this ever going to work for me?
Softscape Magic 8-Ball: CANNOT FORTELL
Me: Am I going to lose my fucking mind?
Softscape Magic 8-Ball: PROSPECT GOOD

Maybe I've just been asking the wrong augurs. This one seems bang on.

Fertilization Report

The good news: 8 were mature.

The bad news: only 4 fertilized, even with ICSI.

Heading for a three day transfer, if one makes it.

God this cycle sucks. Do I have to chose between being having OHSS and barely/not making it to transfer?

I'm sure my mood will come around but right now I just feel so goddamn sad. Sad that this all has to be so painful and difficult and scary and expensive. Scared of what will happen when we run out our last covered cycle and have to look at raising (read: borrowing) the money.

And of course the chances are that we won't have multiple high-quality embryos, which will greatly up the pressure to transfer more than one, and I've already decided that we can't do that, we just can't. But it will make it all the more painful knowing that our chances are farther reduced from last time, and will torment me all the more if it doesn't work. 3 day transfers are less successful (possibly because people who do 3 day transfers generally have fewer embryos to choose from, fewer eggs, lower quality).

I don't know. I'm sore and I'm sad and I just don't know what to do.

#$^&^%$

Warning: it's Self-Pity Wednesday

It is now day twenty fucking five of this cycle and no sign of ovulation.

CD5: E2 33
CD18: E2 48 (LH 4.6)
CD24: E2 36 (LH 8.2)

That's right. It went DOWN. I'm waiting for it hit 100 before we can be reasonably sure that I'm on the path to ovulation. I had been encouraged by the fact that it rose a little between CD 5-18. But now it's practically down to the start. Those E2 levels are right about normal day 3 values. This means we are weeks and weeks from any action.

I just want to get started again. I just want to move on. I am unreasonably furious. I hate this. June, July, August. The world is speeding along and I'm waiting and waiting just to get another chance. Time moves differently for those who are pregnant, for those who have children. Time is not my friend.

I'm tired, I'm bored, I'm sad, I'm so, so angry. I guess the anger should be a clue that on some level I feel entitled, that I deserve this. Really I know that I don't, any more than I deserve my good health or ludicrous wealth. All the grazillions of people who conceived since I started trying, they don't deserve it, but neither do I. There is no desert, just dumb, dumb luck. Fertility rains on the just and unjust. I've been on the right side of dumb luck for health and wealth, so naturally I feel entitled to be on the right side of luck for this too.

Huh. I just looked up the "just and unjust" quote. It's originally from the Book of Matthew in the New Testament, to wit:

...He maketh his sun to rise on the evil and on the good, and sendeth rain on the just and on the unjust.

I'm not Christian (nor well-read in such matters), so I wasn't familiar with the original source -- I knew it only from the Victorian jingle

The rain it raineth every day
Upon the just and unjust fella,
But more upon the just because
The unjust hath the just's umbrella.
(somewhat uncertainly attribute to Lord Bowen)

I'm pretty sure that the rain in the New Testament quote is meant to be a good thing, in a agricultural sort of way, whereas by Bowen's time it's clearly an urban annoyance.

There's some philosophical nutmeat there but durned if I can be bothered to pick it out.

In conclusion, I still don't like Wednesdays.

I don't like Wednesdays.

Reasons:

1) Wednesdays are what's referred to in my organization as "core day". That means you don't schedule any meetings outside the building, which guarantees that your day will be studded with meetings inside the building. Today I had meetings from 8:30-10, 10-11:15, 12:30-2 and 2-3:30.

2) Because I have a short attention span and most of these meetings are very, very boring, traditionally this has been the time during which I jot tiny calendars in the margins of my agendas, with arrows and circles to indicate ovulation, etc. This has not been particularly uplifting as of late. I don't know when I'm going to ovulate again, so there's isn't much for me to do except sit there and think about

3) the fact that Wednesday is my egg-retrieval-versary, and thus was my pregnantversary. Today should have been 9 weeks. I know I'll stop counting the Wednesday eventually, but eventually is apparently not today. It is also my unpregnant-versary, as it was six weeks to the day when I had that grim doctor's appointment.

Last Wednesday was pretty good, though. I escaped from meetings long enough to go for an ultrasound. I have two large (>21mm) cysts on my right ovary, but they're "inactive" -- not pumping out estrogen -- and thus shouldn't interfere with the next cycle too much. My left ovary was meek and quiet. My beta from the previous Friday was down to zero, a piece of information I was personally unable to extract from Bitchy Office Assistant. Thankfully, my doctor had better luck. Uterus looked empty, lining thin. Estrogen was low, progesterone was low. Peace reigned in the pelvic girdle.

He suggested that once I got my period in 4-5-6 weeks, I call the office and we'd make plans for the next cycle. We told him that we didn't want to wait and that we wanted to do an IUI this cycle. He was non-nonplussed and suggested that I come back for bloodwork in a week to check my estrogen and see if my ovaries are coming back online. He also used the word "miscarriage" several times, which I found oddly comforting. More than once I've felt like this whole crazy thing was in my head, how absurd to think that I ever was pregnant.

And my ovaries, they are coming back. I can tell, with my mysterious mucus-scrying ways. I've started peeing on sticks and I feel pretty sure that I'll be ovulating again before too terribly long. I'm so eager to start again, although the eagerness is no longer nearly as desperate as it was.

Right after the miscarriage I felt a tortured craving to be pregnant again, right this second. It was horrible, like I needed a drug that no one could sell me. I would have done anything.

That sensation has steadily ebbed, not coincidentally as my hormone levels have approached normal. Now I want to be pregnant again, soon, but there are things I wouldn't do to make that happen.

But you know what I would do? Stick a catheter up my hooha, that's what I'd do. Especially now that I've already maxed out my deductible, which makes all medical treatment FREE, that's right, FREE, I can go and get my ovaries scanned and it will cost my hapless insurance company but not me personally. So laissez les bon temps roulez!