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.

7dp3dt: nope

I was nervous and sickish all day, because the last time I got a positive on the evening of 5dp5dt, which equates to 7dp3dt.

Not this time. Stolidly negative.

I can't decide whether I should be holding on to hope or preparing myself for failure. I believe that attitude counts for bupkiss, so it's strictly a question of what will serve me better. Probably that means I should be steeling myself for the negative. After all, no one needs preparation to be happy.

Right now, in my progesterone funk, all I can think is I can't do this. But of course I can, and I will. I'm not close to quitting, and the alternative to quitting is marching on. My insurance allows three IVF attempts, but unlimited IUIs. I could keep going for a long time. I don't know what else to do.

4dp3dt: wild mood swings

Things I had at this point last cycle that I don't have now:

1. Heartburn
2. Lots of cramps
3. OHSS
4. A sore bum from the progesterone shots

Things I have now that I didn't have at this point last cycle:

1. The ability to stand up straight
2. Possibly a few little tiny cramps that disappear in the surge of adrenalin as soon as I pay any attention to them
3. A numb bum/upper thigh from the progesterone shots.

Stuff I'm grateful for:

1. One of my 8-celled embryos turned into... wait for it... a 5AA hatching blast! It was cryo'd on Monday, I believe. I'm stunned and grateful. I really didn't think I was going to get anything frozen out of this cycle. As me old mam used to say, there's no security like embryos in the bank.
2. As I type, some sturdy young men are installing our new Ikea kitchen. So! excited! Soon we will have actual cabinet space, and counter space, and ev'rything. Cannot wait. It's wonderfully distracting. I may not be able to will the world into giving me a baby, but dammit, I can with certain success go out and get myself a kitchen.
3. All the people who left me "fingers crossed"-type comments. Knowing that there are all these people out there pulling for us -- it's. well. it's nice. Really nice.
   

I am careening wildly between believing that this IVF worked and being sure it didn't. Stared at the baby stuff in Ikea last night, but also planned in great detail how and where I'm going to cry if it's negative. On the whole, considering how batshit crazy progesterone makes me, I'm doing okay.

Compacting Embryo On Board

Out of the four survivors, three were still chugging along. Two 8-cell grade 2, one grade 2 "early compaction".

No grade 1s this time. Last time I had 7 8 cell grade 1s on day 3, so who knows why the quality was down this time. Compacting is good, though, slightly ahead for the timeframe.

There was zero chance of going to 5 day. We transferred the compacting embryo. It's odd for me to imagine because a 3-day embryo needs 2 more days before it is ready to implant; right now, it's not attached to my uterus, it's just... hanging out in there.

I dearly hope.

Beta August 20, stick-peeing commences next Friday, August 15.

O.O

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.

Retrieval Day

Still groggy, but I wanted to note that

- I feel a thousand, million, quizillion times better than last time. I thought that maybe I was a real wimp, but in fact getting 25 eggs sucked out while you've got OHSS is an entirely different experience than having 9 eggs sucked out when you're healthy.

- Right, 9 eggs! I don't think for a second that any more than the 6 we saw will be mature, but maybe I am hopeful that all 6 could be mature. Maybe?

- Anesthesia is truly a miracle.

- I'm kind of sore, kind of sleepy, but I can totally imagine getting dressed and going to work tomorrow. Did I mention SO MUCH BETTER THAN LAST TIME.

- It's only 11am, which means I have a long lovely day stretched out ahead of me involving naps, the last two episodes of House, Magnificent Seven, and Project Gutenberg (where I have been working my way through Horatio Alger's oeuvre. No, I can't explain it. Perhaps the exploits of boot-blacks and newsboys just show my current life situation to good effect).

Sleepy now! Hart to all of you who sent me lovely warm thoughts.

Day 10: And then there were six

Six follicles at today's scan. That'd be Harry Luck that we lost, then. Didn't expect to lose one so soon, but the scriptwriters like to keep some surprises, don't they?

I trigger tonight at 8 pm. Retrieval 8 am Tuesday.

ETA: E2, 1938.

Day 8: still 7

This morning's scan says that the Magnificent Seven are still, well, seven. Doc did mention that my over-or-low response is is not atypical for PCOS women. That means that for next time/if there's a next time I'll get to choose between a small number of eggs or overresponding. Yay.

Holding the dose steady at 150/75. I'll get scanned again on Sunday, which will likely be trigger day. That will make for a Tuesday retrieval and a Friday or Sunday transfer. Which one will be entirely determined by the condition of the embryos on Day 3.

In other news, I see pregnant people. Rode upstairs on the elevator with a genuine belly-rubber, enthusiastically polishing her perfectly round belly as if it were Aladdin's lamp. Stood in line at the cafeteria with a woman loudly proclaiming only three weeks left to go. I'm choosing to see all this as good omen and not the universe taunting me.

I am so ready for the weekend.

ETA: E2 - 910

7 follicles, 7 days of stim

(note to Mel: no, haven't increased stims -- he felt that raising my dose at this point wouldn't produce more eggs, and he didn't want to speed development on the ones I have, which are already going kind of fast. 9-10 days is optimal, but at last check it looked like mine were going be be ready at 8 or 9 days. I'm hoping for 9.)


I've talked myself into a slightly better place. That better place is not in the general IVF boards, where crops of 15-20 eggs seem normal. No, that place is the Poor Responders board. There 7 follicles is doing well. Plenty of starving children starving infertiles people there would be delighted to have seven follicles. Seven's a lucky number, right? The Magnificent Seven is my darling's favorite movie, like, ever.

Chris and Vin want each other so bad. I'm just sayin'.

Okay, Magnificent Seven it is. I seem to recall that (spoiler alert, but it's a spoiler for a movie released almost 50 years ago, so boo ya) anyway, I seem to recall that three made it out alive. And three good strong healthy embryos would be just ace.

It's also struck me that I might not -- likely won't? get a 5-day blastocyst transfer. Have not really processed the implications of this. There's no good down that road. Never mind. I'm rolling with it. This is me, rolling.

As Vin once said

Reminds me of that fella back home who fell off a ten-story building. As he was falling, people on each floor kept hearing him say, "So far, so good." Heh, so far, so good.

Well. So far, so good.



I'm sorry to be so gloomy. I don't seem to be able to get out of that headspace right now. Recently a whole bunch of my friends-from-the-internets have gotten pregnant. People I really want to be pregnant. And to every one I've had the same reaction to the joyful peesticks: wincing and thinking to myself you might not want to be buying onesies just yet. I felt grimly sure that their parties would shortly come to an abrupt painful end.

But you know what? Every single one of those people is still pregnant and all look fain to have blessedly healthy babies. And I know that every single one of those people considered the chance of miscarriage and chose to celebrate the moment any way. Because that is what living is all about, innit.

It's the so far, so good. Because I'm going where gravity is taking me, so I might as well enjoy the ride. And you know, sometimes (maybe 30-40% of the time) there's a truck carrying mattresses driving by below, or a dumpster full of styrofoam peanuts, and the people who wailed on the way down are exactly as dead or saved as the people who didn't, except the people who didn't had a much better time.

So yeah.

So far, so good.

Day 6 of stims: word problems.

Someday I will do something and not worry myself sick about it. Then the world will probably end. Feel free to finish your coffee, though, since it's not going to happen any time soon.

This IVF cycle is a whole 'nuther ballgame. The lower dose (150 Follistim, 75 Menopur) plus the metformin seem to have dialed my response way back. My E2 on Day 4 was only 134. I'll find out today's later on. We only saw 7 follicles on today's scan.

Reasons this is good:
Egg retrieval will likely be less painful/incapacitating
Very unlikely that I'll hyperstimulate and be painfully immobilized for two weeks

Reasons this is not good:
Fewer eggs is, well, fewer eggs. Last time: 25 eggs > 21 mature eggs > 16 fertilized > 15 embryos > 6 blastocysts.

This represents 84% mature, 76% fertilization, 94% make it to embryo, 40% make it to blast.

If identical numbers this time (leaving aside the absurdity of embryo fractions... believe me, you don't want your embryos fractured): 7 follicles > 5.88 mature > 4.48 fertilized > 4.2 embryo > 1.68 blast. If that actually means 6 mature > 5 fertlized > 4 embryo > 2 blast then I have one to transfer and one to freeze. But as you can see, there's very little wiggle room, a decent chance I won't have any to freeze, and even a possibility I won't have anything to transfer. If that happens I'll defrost one of my Tiny Frozen Americans, but it would be galling to have this cycle, the second of my three chances, be a bust.

ETA: E2 -- 445. Dunno. Seems low to me.

CD2

Today's bloodwork
E2: 34
FSH: 7.7

Last cycle, my E2 was 52 and my FSH was 6.5. FSH is the ticking time bomb of fertility, so seeing it go up is never thrilling, but it's still safely under 10. And I believe that E2 pushes down your FSH to some extent, so it's possible that I'm in the same boat I was last time when my FSH was lower but my E2 was higher.

Meds are ordered, and I'm starting birth control pills and metformin tonight.

On my last entry, the lovely & talented Emily asked why I'm going through stimulation and retrieval again when I am, in fact, the proud mother of five tiny frozen Americans.

I'm doing it because my insurance is generous but dumb. My insurance covers 3 IVF cycles but does not distinguish between fresh and frozen cycles. A fresh cycle costs about $10k and has about a 30-40% chance of working. A frozen cycle costs about $3k and has about a 15-20% chance of working. Therefore, it's in my interest to do three fresh cycles and then pay for frozen transfers out-of-pocket, if necessary.

It's kind of messed up, and not the decision I'd make if money weren't an issue at all. But I'm damn grateful to have coverage, however arbitrary.

Plus, at the ill-fated end of my last IVF, I could not imagine jumping back on that train any time soon. Well, my period took not the 4-6 weeks I'd been told to expect, but 8 weeks to find its way home. Apparently 8 weeks is exactly how long it takes me to forget physical unpleasantness. Right now I'm nothing but eager to begin.

56 days later... another openin' of another show!

Man, I am impressed by those Endometrium pills. I admit that I was a bit skeptical that shoving them up my hooha twice a day could actually make a difference the way shoving a 1.5" needle into my ass did, but sure enough, it worked. The proof is in the luteal period; 17 days. I didn't get my period until almost 3 days after stopping the Endometrium. I've never had a luteal period longer than 14 days on my own. That's some good shit.

Yesiree Bob, that's right, I've started bleeding, which makes today CD1. Which makes today the first day of IVF #2. Tomorrow I go for bloods and, if all is well, I start birth control pills in the evening.

Tomorrow I will also start metformin. Doc read my carefully supplicatory-yet-insistent note and agreed that, on the basis of the paper I sent him, I looked like a good candidate for the protocol.
Either that or he glanced at the long paper and long note and thought "the quickest way to make her leave me alone is to write her a prescription for glucophage". Either way works for me.

To do:

1. Stop by SpunkMart and get some sperm. This time I'm going to buy the "ART" vials, which are (even) smaller and (somewhat) cheaper than the standard IUI vials. It's a shame they don't sell the sperm per each. Since we're doing ICSI we only need, like, ten.
   
   
2. Do the math, ask for a few days off around retrieval. Hopefully there'll be fewer eggs and no OHSS and therefore the retrieval won't knock me flat on my ass for five days the way it did last time. In any case, I'm going to try and pass it off as vacation time, not sick time. Everyone's already quite suspicious enough from my two-week bender in April, not to mention my constant needle tracks. Thank goodness I don't bruise.
   
   
3. Order meds from Awesome Online Pharmacy. Last time the doctor's office ordered the meds from a local pharmacy that seems to have a stranglehold on area fertility prescriptions. They'd never heard of my beloved ethyl oleate, and sent (and charged me for) crappy-ass syringes that B disliked so much that she swiped some better ones from her lab. Awesome Online Pharmacy not only overnighted me the P in ethyl oleate for half the price of the only local place that could or would compound it, they also sent, for free, decent syringes, alcohol swabs, and a sharps container. So this time I got the prescriptions myself and I'll be ordered everything from AOP. Actually, why be coy -- it's The Apothecary Shop. The eagle-eyed who know me in real life may be able to spot another random reason for my affection for this particular establishment.

In other ordered lists news, I have some good life distractions.

1. I got a fat promotion at work, which was extremely soothing to my soul -- at least my life is moving ahead in that way. Since the world has been generally failing to conform to my will lately, it meant a lot to me.
   
   
2. Not coincidentally, we're remodeling the kitchen, which has been in desperate need of help for a long time. We took Friday off from work and went to IKEA and just bought the whole freaking kitchen. It was very exciting. And I love shopping, so picking out the sink, faucet and cabinet knobs are all endlessly thrilling tasks. We're having it installed by the IKEA-branded contractor, mainly because I am unsure of my ability to hang the wall cabinets safely on our masonry exterior walls. Also because I would really like this done without lifting a finger, since my honey-do list is both long and neglected.
   

And that's all the list items I've got today.

CD54/ 15dpo

Well, that last IUI didn't work. Had the blood test this morning, got the call this afternoon. It's okay, I knew what the call was going to say -- I've been assiduously peeing on sticks since 10dpo, and each one has been blanker than the last.

It was a long shot, anyway.

It means I get to stop the progesterone, which is good, because progesterone makes me strong with the crazy. I cried hysterically at Move On's latest ad. Guys now is not a good time to be emotionally manipulative mmkay. Particularly not by deploying ads featuring a besotted first time mother dandling her perfect cannon-fodder infant on her knee.

Hey, remember Inappropriate Lab Administrative Assistant? The one who told me I looked 6 months pregnant when I wasn't, and wanted to know what was wrong with me? I forgot to record our dialogue at the last visit:

ILAA: Baby doing good?
Me: Nope.
ILAA: Oh, you lost it?
Me: Yup.
ILAA: Sorry.
Me: Thanks.

The next time she saw me she started chattering about air conditioners, so I am glad to say that there will be no awkwardness between us.

So, back to the reproductive plans: we are embarking on IVF#2. To do list includes:

• Fill prescriptions from mail-order pharmacy
  
  
• Wait a suitable time for the baby aspirin to get out of my system and then have my anticardiolipin antibodies tested. Abnormalities in this area are a fairly common cause of miscarriage, and this testing is part of a recurrent miscarriage workup. Now, no doctor would send me for a recurrent miscarriage workup after one miscarriage, so I'm just ordering the tests on the internets and paying for them myself. It doesn't make sense to me to risk a $10k IVF in order to save $151 on a test. Plus, have I mentioned that I would really rather not go through that again? If I do have antiphospholipid antibody syndrome then it will actually be kind of good news -- it's easily treated with blood thinners. Big thanks to Hope for bringing this possibility to my attention.
  
  
• Persuade doctor to give me some metformin once I start downregging (that's the lupron phase, for the uninitiated). I've sent him an article and a note, which I chewed my pencil over for a long time. I don't want to piss him off. He's my connection to get hooked up with my future children. But metformin shows promise in reducing both rates of OHSS and miscarriage. I'd swallow hedgehogs to prevent OHSS and miscarriage this time around. I hope he is okay with it and prescribes me the met. If he doesn't, I'm sorry to say that I will probably just get some from Mexico. I've satisfied myself that metformin's a safe drug in this context, and have I mentioned that I really, really don't want to have OHSS or miscarry again?
  
  
• Start my period. Hear that, body? Please? I took a progesterone suppository this morning, but obviously won't this evening, and it remains to be seen how long it'll take my body to bleed. I'm a little tickled that I'm responding so neatly to the progesterone. A 15 day luteal period, huh? And not even any spotting. But I hope my body gets the memo right quick and starts bleeding. Once I do we'll really be starting the next cycle.