FET #5: estrogen day 4

Final grade for the NuvaRing: B+. It did eventually engender in me a certain amount of irritability (ahem) and sore breasts. The most distressing side effect was a cystitis-y bladder irritation. I was annoyed enough that I took it out on 2 am of the day I was supposed to remove it. Overall, though, a solid performance. OCPs get a straight D.

I think my favorite thing about the NuvaRing was the way it did not require me to do anything every day. I couldn't feel it, and for those 21 days  I could just forget about the whole TTC thing. Good stuff.


I'm now on intramuscular injectible estrogen. It's a small quantity, but since the carrier oil is very thick it still hurts sometimes. But it's only every three day, so no biggie.

I am also, following on the lining success of my past two cycles, taking via-oh-god-please-don't-spam-me-gra. Except when I ordered it from my grey market Indian pharmacy I did not order enough for three cycles. I guess I thought it would be... negative? Pessimistic? Evidence of a disturbing lack of faith? Anyway, I got enough for two cycles. But for various reasons, I have just enough now to scrape thinly over the third cycle provided I use the bonus "buy some get a free gift!" tablets, which were a higher dosage. I'm cutting them with a pill cutter, so fine. The funny part is that the free ones? Soft chews. So the ones I am cramming up my nether regions are fruit flavored.

Lining check on the 11th.

Three

Last night I dreamed that I was pregnant with triplets. I gave birth and as each one came out, I found out that it was dead. I kept thinking "surely the next one will be okay" and at the end I was sobbing with grief and anger and disbelief.

Three means a lot of things. My family as it is right now is three. This is my third FET at Big Shiny Fertility Factory. My insurance allows three attempts per live birth. I have had three miscarriages. When I was little, I always thought I'd have three children. I wanted to have my children three years apart. Small Boy has three donor siblings currently in utereo.

It's just a number. My fave bit from Foucault's Pendulum -- actually the only bit I remember much -- is when the protagonist's girlfriend, mother of his child, gives him the big ol' eye-roll for his numerological conspiracy theories.

We move on to the magic numbers your authors are so fond of. You are one and not two, your cock is one and my cunt is one, and we have one nose and one heart; so you see how many important things come in ones. But we have two eyes, two ears, two nostrils, my breasts, your balls, legs, arms, buttocks. Three is the most magical of all, because our body doesn’t know that number; we don’t have three of anything, and it should be a very mysterious number that we attribute to God, wherever we live. But if you think about it, I have one cunt and you have one cock, shut up and don’t joke and if we put these two together, a new thing is made, and we become three. So you don’t have to be a university professor or use a computer to discover that all cultures on earth have ternary structures, trinities.

She moves through all the numbers, the point being: all and none of them are sacred.

I'm on the NuvaRing now, getting ready for FET#5. It's all happening quickly, so quickly that all the bills from FET#4 haven't rolled in (and been disputed by the insurance company) yet. High, high marks for the NuvaRing so far. Only side effects are mild nausea and sore breasts, and vague irritability. Birth control pills give me severe nausea, migraines, and constant blinding rage towards the universe. It's better this way.

8dp5dt: nope.

Game's pretty much over. For some insane reason, Big Shiny Fertility Factory likes to do their betas two goddamn weeks after a 5-day transfer. This makes zero sense, except in the respect that it save them the effort of even dealing with women with short-lived chemical pregnancies. By 19dpo, either you're showing up good and dark on a plain ol' urine test, or you're negative and have been for some time. Which means that you've spent at least a solid week getting painful, expensive, and unnecessary rump-injections. Worse, many women (not me) may have spent an entire extra week consuming neither alcohol, caffeine, nor sushi.

I delicately pointed this out to my nurse, who agreed to let me come in on Friday (15dpo). Much better. At least I can spend the weekend letting my glutes recover.

I'm okay. I'm starting to try to wrap my head around the possibility that this may not be the story of my difficult journey towards the family I have always envisioned. It may be the story of my journey towards letting go of that vision.

I have an embarrassingly large collection of beautiful high-end baby carriers. I guess when the time comes I'll sell them and buy myself something really, really pretty.

5dp5dt: the evidence for and against

Data that support my being pregnant this cycle:

1. I did a super good job of distracting myself. In fact, we decided to up and get married with two weeks' notice, which definitely took my mind off Things.  The planning was a bit crazy, but the wedding was lovely. And three days after the wedding, we transferred two blastocysts to my uterus.
    
2. My lining rocked, which is to say that it was over 8mm, which for an Asherman's patient is awesome.
    
3. It would be hilarious if I got pregnant the same week I got married, so people could count back and make jokes about shotgun weddings.
    
4. I have been chock full of symptoms. Heavy draggy cramps, sore breasts, I got 'em. I have been quietly Sure for days.
    
5. My acupuncturist said I had really good energy. 

Data that support my not being pregnant this cycle:

1. It's 5dp5dt, or 10dpo, and my test strips are stark, stark white. I have been pregnant four times, not counting the lame-o chemical. I have never not had at least a faint line by now. Good betas, bad betas, I always had something by now.

There are 5 reasons why I am pregnant this cycle, and only 1 reason why I am not. The mathematically-inclined observer will note that 5>1.

Sadly, though, I think that single piece of evidence against rather outweighs  the five votes for.

Pills and newborns and ramblings

The first step to an IVF cycle is the taking of birth control pills, and believe me, the irony of this is lost on no one.

I hate this bit. They make me depressed, they make me nauseated, and I have the sneaking suspicion that they're not actually necessary. But I'm also apparently not interested in fighting it, so the little yellow pills I do pop.

I just got back from a solo cross-country visit with my best friend and her family, which consists of a husband, two preschoolers, a two month old baby, and an adolescent dog the size of a Shetland pony.

I had a great time. I was a bit nervous that my Crazy would boil over and get all over the newborn's sweet fuzzy head -- this is the baby that BFF was pregnant with while I was (briefly) pregnant with the Sea Monkeys, and I had so fondly imagined us being the mothers of newborns together.

But it was better than fine.  There was a certain leaning-on-the-bruise aspect, but it was far outweighed by the sensory delight of handling a tiny baby again. I got to wear him a good deal, and I love wearing babies. I smelled his head and stroked his wee crumpled hands and gave him bottles and it was not even bittersweet, just sweet with a side of wistful.

The only really painful moment was an unexpected one -- I was wearing him on my back and BFF and I were picking up the two older kids from nursery school. One of the other moms was chatting and airily said to BFF, upon being told that I was visiting "Oh, my best friend doesn't have kids either, it's great because they can help out, huh?"  It was a perfectly innocent thing to say, but I was just overwhelmed with ouch and couldn't say a thing back. I just froze. What felt like a year and was probably a few seconds later, BFF firmly corrected  her and said "no, she has a little boy at home with her partner".  And the world started again and everything was fine.

I mean, it wasn't a crazy assumption. How many mothers can just take off across the country to visit a friend? (Mothers of one who have a tolerant partner, that's who.) And how was she supposed to know, looking at me, that I am a mother? She couldn't see my c-section scar. I wasn't wearing a pin that said I gestated a child, ask me how!

I don't know why that spiked my grief, or why even remembering it now is so painful. Maybe because just for a minute it dangles me over the cliff of how close I came to not being a mother at all. It's becoming clear that my body doesn't love producing babies. Maybe our little guy was a complete fluke, a one-in-a-million. Maybe someone is going to show up and tell me that it was all a mistake and I don't get to keep him after all.  Nope. I don't care. I'm not giving him back.

This morning I was telling my boss about my trip and seeing the new baby. "It didn't give you ideas, did it?" she joked.

"Hahaha!" said I. "Ha! Ha."





It was a lovely trip. We ate stunningly good food, got massaged, got manicured and pedicure'd, and engaged in plenty of the activity I've missed most: chatting aimlessly with my best friend within hugging range. I'm awfully glad I went.

Here we go.

HSG is scheduled for tomorrow at 1:45 pm; I have to be there at 1 to rock the backless hospital gown.

I'm nervous as hell. Not only was the last one quite amazingly painful, but it was when I got the news about the Asherman's. It sucked. I'm not really looking forward to being in that room again. In fact, my last few visits to this particular hospital campus have not been the funnest experiences ever. Well. It already is what it is in there, it's just me knowing, right? And I always have to know.

In a few more months it'll be a cool two years since we started TTC #2. I won't say it's been a miserable two years, far from it! Over this time Small Boy has transformed from a toddling baby to a sturdy preschooler, full of ideas and plans and words and strategies. He's got enormous grey eyes and delts sculpted from playground tumbling and long, long legs on a rather short torso (sorry, kid, that one's all me). Sometimes it hurts how much I love him.

Other good stuff has happened. We got another four years of Obama, and my state got marriage equality, which means a tremendous amount to me.

It hasn't been the easiest two years, either. It's certainly had its moments. The ultrasound moment when the doctor said "I don't see a heartbeat. I'm sorry," feels like it's preserved in amber, but I hope that someday it will quietly dissolve.  The actual aftermath was not as terrible as that moment. In retrospect, it is something I'm kind of proud of. I worked, I researched, I stuck to my guns about the misoprostol. I was given a humane amount of pain relief and it was over quickly. I'm even glad I got to hold those two rather revolting little sea monkeys (although the positive nature of that experience was perhaps influenced by the aforementioned "humane amount of pain relief"). They were grody, but they were mine. I don't know if they were people. I know to some they would've been. But it's possible that they just weren't equipped to be people, they simply didn't have what they needed, there was no world in which they would've been people because they were just missing some vital ingredients.

I mean, it's also possible that they were perfect and my stupid Asherman-y uterus killed them, but whatevs. I can't know. I could've known, maybe, if I'd gone ahead and had the D&C so I could've had an analysis of the fetal tissue. But what would it have changed? I'd have been risking a future actual child in order to know more about what happened to these. So I guess I don't always have to know.

So here we are. In a lot of ways I'm in the best place I've been for two years. Calmer, happier, healthier. Ready to roll the dice two more times, and then, if I must, to put them down and walk away.

Gulp. Tomorrow I start rattlin' the bones.

Doom and gloom

So, there's a colleague of mine who for paperwork reasons became aware that I was doing IVF. She was really sweet about it, warmly wishing me luck. A few months later, she turned up pregnant for the first time (how do I know it was her first time? Because she announced it immediately. Women who've had a miscarriage don't do that.). She's in her mid-40s.

It was not a great leap for me to conclude that she had had fertility treatments, quite possibly donor egg, and that it was a long road for her to get there. She was due in November.

The other night, lying awake I suddenly thought "What ever happened to Nice Colleague's baby?  I never heard anything about... oh, god." I checked her online registry and only a very few things had been purchased.

And I lay there for a while, thinking about the fact that I don't know her well enough to sally up and say "hey, dead baby or what?" and feeling awful that at the end of what was probably a long journey, things turned out badly. And hurting for her for what it must have been like socially, given that she told everyone and then some.

So the next day I went to my friend who knows her a bit better and said, "hey, what about Nice Colleague's baby?" My friend furrowed her brow and said "Ummm... Ella? No, that's not it. Katie."

And that was that. Katie is fine. She was just low-key about it, didn't announce the birth to the whole world I guess, maybe had another registry someplace else or had friends who liked to buy things off-registry. She's fine. They're both fine. She and her husband are new parents.

I was staggered with relief. And then I thought huh, maybe I should try not to jump directly from didn't see a birth announcement  to oh, dead baby.

*   *   *

In other news, having an HSG next month to see if my pathetic periods are because my adhesions have returned, or because of who knows what. Please no adhesions. I would really rather not have to do all that again.

32 days later

I sort of got my period again on Sunday. It's so very, very light. Red when I wipe, otherwise nada. This is pretty much what my last one was like, and I thought it was just because it was the first one post-misoprostol. I guess not. It's not nice to have your heart sink every time you pull down your pants. I hope I'm not too broken.

Last night I dreamed that I was in a rowboat. There were lots of dogs swimming around, but I ignored them. Then a puppy¹ came paddling right up to my boat. I hauled him out of the water. He shook himself off and wriggled around and I thought "shit shit shit, I really wasn't ready to get another dog, but clearly I'm keeping this one."² I then noticed that the dog was female, not male, and was surprised.

My subconscious isn't too subtle, huh?

I am sort of conflicted about moving forward. If I try again, either I'll get pregnant or I won't. If I don't, it will hurt. If I do, then either I'll stay pregnant or I won't. If I don't, it will hurt. If I stay pregnant, either the baby will be okay or he or she won't. Etc. It's... just going to take me a little while to screw up my courage to go again.  





¹A swift google tells me that the puppy was probably a St. Bernard, possibly a Landseer Newfoundland.

²The last of our three dogs died not too long ago, and we've vowed to remain dogless for a while.

Year of the Wood Horse

I possibly, sort of got my period last week. I had outpatient surgery the week before that and the preop bloodwork went off without a hitch, so I'll assume that my hCG is down to zero (they tend to get tetchy about operating on pregnant women). Which means I could start again, right now.

I'm not. For the first time since starting TTC, I am taking a voluntary break. Since I began (both the first and second time) I've always felt like there was a drill sergeant barking "GO GO GO" -- just imagine one wearing a hat that says "FSH" on it.

Well, that drill sergeant is in the freezer next to my embryos and several pints of Ben & Jerry's. My eggs aren't getting any older. My ovaries will never be called upon again. No matter what happens, I'm not going to do another fresh IVF cycle.  I am lucky to have a generous batch of embryos. When I run those out, I'm done.

Any other haste would be driven by a desire to control the age-gap between Small Boy and Smaller Sibling. I wanted three years, didn't get that. Won't get four years either. Does a few more months really matter? I think not. I think if the sole consideration is temporal spacing, a few months' rest is not significant.

And I really want a few months off. I want to live on my own schedule, not buffeted by hormones and nerves. I want to do house projects and snuggle my child and future-wife (fiancee?). I want to plan our wedding.

Interestingly, I have experienced the exact same phenomenon all three times I have miscarried: while my HCG levels were declining, I felt a burning urgency to get pregnant again ASAP, and despair over how long the time gap would be until I could try again. And all three times, after my HCG had faded completely, so did the suffocating need to get pregnant immediately. *shrug*

I will, kinnehorah inshallah god-willin' and the crick don't rise, start again at either the end of April or the end of May. Until then, I'm just going to enjoy living.

Either of these dates would put any possible delivery in the Chinese year of the Wood Horse. I think that sounds like a really nice year to have a baby. Wood Horses are warm, stable, strong. I like it.

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.

Not 11 weeks

Today I am officially precisely not 11 weeks pregnant. It's been two weeks since I took the misoprostol, three since the ultrasound where the RE said "I don't see a heartbeat".

Things are okay. I had a followup appointment two days after the misoprostol, and everything looked good and clear. That was the best I could've hoped for. My pee-sticks are still a lot darker than I'd like, but I guess it takes some women a really long time to clear out all the hCG. I can't start another cycle until my level is all the way down and I have another period, so I'm just spinnin' my wheels here. I have another followup on Friday. I imagine they'll start doing blood tests every week or two until I'm at zero.

Time floats by so aimlessly when you're unpregnant. Pregnant means that every day is an achievement, and is moving closer to Something Big. Unpregnant you're just waiting for something that may or may not happen. And if you can only conceive with fertility treatment, you're waiting to start waiting for something that may or may not happen.

I'm mostly back in the TTC mindframe (as opposed to the pregnant mindframe). I know how to do this; I've spent a lot more time trying to get pregnant than I have actually being pregnant.  But some part of me, maybe 10%, is still stunned and saying wtf happened here?  See, it all just seemed so right. The transfer was exactly on my birthday. The due date was exactly my mother's birthday. My BFF is pregnant right now, and we were going to be pregnant together. Some things are just meant to be, you know?

Some things, but apparently not this one.

A poem has been stuck in my mind: A Refusal to Mourn the Death, by Fire, of a Child in London. I don't know why. I have only a weak affinity for poetry, and almost none for Dylan Thomas; most of it just reads as word-salad to me. But this one has been drawing me back. I guess "unmourning water" is really a pretty good description of the resting place of those two tiny embryos, poor miniscule brine shrimp, released unto the municipal sewer system.

Day 6 embryo report

Nine. Nine. Beautiful, beautiful nine fucking frozen embryos.

Two made the grade yesterday at 7 am or so; one more joined them at 10:30 am, so that's three frozen on day 5. An additional six joined on Day 6.

Day 6 have been sometimes found to be less likely to implant than are day 5; a 2001 study found a 50% reduction (from 60% to 30%) -- but a much larger 2006 study found almost no difference (32% vs 28%).  The fact that the 2001 5-day blast group had a pregnancy rate of 60% makes me think that their population must have been a bit unusual, anyway -- I don't know of anywhere that can claim a 60% pregnancy rate, unless all their participants were 20!

Anyway, even the worst represents a good solid pregnancy rate, and did I mention six of them fomg.

And -- I might need them. I freaked myself out yesterday by reading a lot about Asherman's Syndrome, and it sucks. Makes it harder to get pregnant, and makes miscarriage a lot more likely; one source reports a miscarriage rate of 45%. Just what I need, huh? But it's also easy to find stories of women with Asherman's who have three or four miscarriages and then a live birth. If I have the balls to keep rolling the dice, there's a decent chance I'll eventually win.

Basically, if I go ahead here, I have to be prepared that it may take a few false starts. I have to figure out how to not go completely mental the way I did with the other two miscarriages. I have to figure out how to stay sane. I probably have to stay out of the forums where people assume that a positive pregnancy test means a baby.

This all sounds grim, and I was pretty damn down last night when I thought I had two embryos, or just one try. But now that I have 9, which could well be four tries, I'm feeling much more hopeful.

I think I am tough enough for this. I think I can do this. It helps to know that I can stop any time. Her Indoors is more than okay with keeping our family the way it is -- frankly, she's indulging me on this endeavor. There will be zero pressure on me to keep going. If it's too much, I can pause or walk away. It's not like my family sucks the way it is, you know? Yes, the wordless longing of my heart is for one more. Yes, I feel like there's still someone missing. But really, I could be wrong. I've been wrong before. Maybe our family's the way it's supposed to be. I have to try, though.

For the historical record, our family roster now consists of:

Hatching blasts:
2 - AA Good
2 - BB Fair

Expanding blasts:
2 - AA Good
2 - AB Fair
1 - BB Fair


FWIW, I'm not particularly hung up on embryo quality. Have I mentioned that a little 2BB blastocyst (different rating system, but prob equivalent to the BB Fair) turned into our entirely acceptable son? And I have seen many perfect embryos come to naught. Anecdotal, yeah, but it's anecdotes that make up my story, so.

In conclusion, beautiful, beautiful nine!

Rallying, and making plans

Okay, I think I'm done with the wallowing-in-self-pity portion.


I have a plan. My plan is:

1. Go ahead with the scheduled IVF. We can put the pedal to the metal as far as stimulation goes, because hyperstimulation will not be an issue because
2. We'll be freezing everything.
3. Five days after my period arrives post-IVF, I am going to fly up to Boston for hysteroscopic surgery with Dr. Keith Isaacson, who is by all accounts one of the two best Asherman's surgeons in the US. I'm extraordinarily lucky in that he accepts my insurance, and that his hospital happens to be twenty minutes away from my sister's house. The surgery is apparently a quite minor one, although very dependent upon the skill of the doctor: no anesthesia, in-office, little to no recovery time.
4. If all goes well, several months later I should be cleared to transfer the frozen embryos.

My RE -- who is a good RE -- appears to be somewhat insulted that I don't want him to do the uterine surgery. I know this because he made a great show of telling me how much he's not insulted and how he has no professional jealousy and that surgeries like this aren't very profitable anyway. Furthermore, he feels my case is not very difficult, and he's never heard of this Dr. Isaacson I'm going to see instead.

I'm glad to hear that he feels my case is not difficult, but the fact that he's never heard of one of the very few experts who specialize in Asherman's tells me that I'm making the right decision by going to Boston.

Frankly, I don't care if he's vexed or pleased. I've only got one uterus, and I'm going to do everything I can to get it in tip-top shape.

@nutella, I'm pretty sure that my insurance will cover a freeze-all cycle just fine... it's just like a normal cycle except for the lack of transfer. I hope I'm not proven wrong about that, but I think it'll be okay. I don't see any exclusion in my policy. I am covered for three cycles, so in a way I'd be "wasting" a cycle by giving up the transfer, but under the circumstances I think the trade-off's worth it.

@lathany, thanks. I had never heard of it, either. Unfortunately this fits in perfectly with my anxiety disorder, which appears to believe that worrying about things actually prevents them from happening... because it's never the stuff you actually worry about, is it? Therefore, by worrying about everything, nothing bad will happen! Right?

@pajamamommas, it's one thing after another, isn't it? BTW, I keep going back to look at the pic of Tadpole asleep over the side of the bed. So. Damn. Cute.

@insertmetaphor, thanks -- I know you get it.

Waiting.

The good news is that I finally, finally, finally got my period, a cool 65 days after the D&C.

The bad news is that my blood pressure has inexplicably gone crazy, and I can't start an IVF cycle until it's under control again. If my cycle goes back to being regular (please please) then that means probably another 32 days.

Waiting, waiting, waiting.

On the interesting side, apparently two miscarriages and a chemical pregnancy adds up to "three losses", which won me a karotype and a recurrent loss panel.  I had about a pint of blood drawn; we shall see if anything turns up. I'll be surprised if it does. I honestly think it's just been a bit of bad luck. I mean, theoretically I know that for some people the ratio of positive pregnancy tests to babies is 1:1, but... it seems like a frankly ludicrous thing to expect.

I guess I'll spend this month, I dunno, inhaling lavender and doing yoga breathing and drinking pomegranate juice and stuff. I let a lot go by the wayside in order to survive the whole becoming-unpregnant thing:I guess this month is my chance to get as sane and healthy as possible before I get back on the crazytrain.

Selective attention

• Everywhere I go I see pregnant women and tiny babies and brothers and sisters clinging to each other. It's okay, it'll fade, it's just such an odd phenomenon.
  
  
• Her Indoors keeps dreaming that we lose Small Boy (literally, in  a crowd or something). Last night I dreamed that he was kidnapped, but I beat up a building full of thugs and got him back. He ran outside to my getaway car (and old Jeep. I'm not sure what that means) and I worried about the lack of an approved carseat, but threw up my hands and drove away anyway. So in the end, I guess it was an empowering dream.
  
  
• The bills from the D&C are rolling in and... I owe nothing! Turns out I hit my out-of-pocket maximum right before all that. It's surprising how soothing that discovery is.
  
  
• All quiet on the uterine front. Trying to get my medical records (fruitless so far), waiting for my appointment with Big Shiny Fertility Factory.
  
  
• Working up to a post on the subject of Ooops Pregnancies and the Infertile Blogger.
  
  
• My health insurance was actually real sweet when I called them. I was armed to the teeth in Sarcastic Mode and they instantly disarmed me. The person at the other end of the phone apologized twice, and said "I'm sorry for your loss." It is amazing just how good it is to hear those words from an outside party. I remember when going over my history with the nurse who was doing our non-stress tests, I had to mention the first miscarriage, and the nurse said "oh, I'm sorry". And I was so grateful to her for just stopping for two seconds to acknowledge that. It really does mean something.
  
  
• The last Saturday passed without notice. This is a good thing because it means I've stopped counting. I had to look at a calendar just now to confirm that yes, it would have been 9 weeks. But you know, it wouldn't have. That blast just didn't have what it needed to survive; there's no world where that particular embryo turned into our child. The aberration was that it implanted at all.
  
  I'm on one of those birth-month boards and at least 80% of the posters have a second child by now, or are in the process of building one.  Now I'm starting to see the posts from women who got pregnant at the same time I did, but with a happier ending. At first it was acutely painful, but as time goes on and our fates diverge, it starts to feel less personal. I was never on that road. I only thought I was.

8 days past D&C: the next act.

I hesitated over the title of this post. When TTC, everything has an anchor: so many days since cycle day 1, so many days past ovulation, so many days post transfer. Now? I'm floating. Cycle day nothing, as Dr. Stewart once called it.

Thing're okay. I always underestimate how much of my pain and stress is due to being jacked up on hormones. The frisky hormones are nearly gone now; the line on my pee-sticks is almost invisible, a ghost of a line that only a crazy pee-stick-scryer could ever see. My estrogen and progesterone should have plunged, accordingly. I never had a hard bleed after the D&C, just a week or so of desultory spotting, and very little cramping. I've been lucky. I think Dr. Stewart did a very good job with the D&C, and got everything he needed to get.

I feel good about the medical care I got during the whole debacle. So good that I'm having second thoughts about switching clinics.

See, for the past few years, I've had insurance that only covered a very few practices, including Dr. Stewart's one-man show. We'll call it Dr. S's IVF Shack. I think Dr. Stewart is a very good doctor, and I personally like him immensely (as you can tell by the fact that his nickname is inspired by my beloved Jon Stewart). Dr. Stewart is smart, kind, funny, and listens to me. He treats Her Indoors well, and gives a very gentle pelvic. His practice is literally five minutes away from where we work and live. And Dr. Stewart got us Small Boy.

But. But. But. Dr. Stewart really is a one-man show. If Dr. Stewart is running late or has an emergency, then we wait, sometimes for more than an hour. Dr. Stewart's embryology lab is an unknown quantity, and seems to have uneven results. Sometimes they've done well by me, but then there was the time when it took seven vitrified embryos to get to two to transfer (most places have a 90% thaw success rate with vitrified).  Dr. Stewart's ultrasound machine is old and fuzzy. Dr. Stewart does not do ultrasound-guided embryo transfers. All IVF practices have to report success rates to the CDC/SART for public reporting. Dr Stewart's statistics stink. Now, I really believe that this is at least partially because Dr Stewart does not cherrypick patients; I can't imagine him turning anyone away, no matter how hopeless their case. A lot of programs have restrictions so as not to damage their stats; won't treat women over a certain age, weight, FSH... I can believe that Dr. Stewart doesn't care about any of that.

But. But.

About 20 minutes away from me is another practice, let's call it Big Shiny Fertility Factory. As of January 1, my insurance will be one that is accepted by Big Shiny Fertility Factory. Big Shiny Fertility Factory has very good stats. I am sure that Big Shiny Fertility Factory has all the latest equipment. Big Shiny Fertility Factory is a group practice, and a friend who goes there says that it's a smooth-running operation with little wait for appointments or scans.

We have an appointment for a consult at Big Shiny Fertility Factory on January 4. Big Shiny Fertility Factory sent me a big, shiny packet of glossy brochures and welcome information.   Big Shiny Fertility Factory has patient-appointment liaisons who reach out to you to guide you through the harrowing appointment-making process (I am not even kidding). 

I don't know how I feel about all of this.  Sorry to be thinking of leaving Dr. Stewart. Excited about trying something new.  I guess I don't mind  being sucked into the Big Shiny Fertility Factory Machine if I get spat out the other side with a baby.

A strong point in favor of Big Shiny Fertility Factory: I just called Dr. Stewart to make my post-op appointment. I was on hold for a while, and it was awful. The hold music at Dr. Stewart's makes me instantly shaky and nauseated; just thinking of it makes my eyes well up. I've just gotten too much bad news right after hearing that music. The thought of never ever hearing that music again is an uplifting one.

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)

CD3: Hip hip hooray! FET #2.5 starts today!

Before I start getting excited about FET #2.5, I have something marvelous to celebrate:

Goldie is here! Goldie is the daughter of Olive and Fern from Insert Metaphor. I've been 'net friends with them for years, literally years. Difficult years.

Olive first left a comment on my blog in February of 2008. We were embarking on our first IVF after a year of unsuccessful home insems and IUIs.  They were just starting home insems.

After that, we traveled together.  Our journeys have been  so similar; they too moved from home insems to IUIs to IVF. Along the way, Olive has written beautifully and vividly about the grinding pain, isolation, and weariness that goes with measuring your TTC time in years. Looking at her old entries gives me the same lump in my throat that I get when looking at my old entries, when every word beat a tattoo of please. please. please.


So welcome, Goldie, and welcome to parenthood, Olive and Fern. Thank you for sharing your journey with us. The road was less lonely with you along.

* * *

Hokay, onto the cycle news! We start shooting up Follistim tonight. Yesteday's CD2 appointment went well: 13 or so antral follicles, lining 4.4 (is that a little thick for CD2? Does it matter? Probably not.), E2 43, FSH 5.9. All just ducky.

100 iu of Follistim every night for the next four days, then a lining check on Saturday. Wheeeee! I'm in a marvelously moodswingy up-mood. The only thing that makes my stomach drop is thinking about thawing the embryos, how my poor little two vitrified (badly vitrified?) embryos might or might not survive, and whether the five slow-frozen ones have much of a chance. Did so few of my vitrified embryos survive because they were badly frozen, badly thawed, or because for some reason I make embryos that just aren't very cold-resistant? Please let it be the first. It makes some sense; they were vitrified within the first three months of my clinic beginning their vitrification program. Maybe someone forgot to, I dunno, add salt?

Breathe. I can't affect it. All I can do is try and grow a nice cozy lining, and hope for the best. I'm chugging wheatgrass juice and trying to think plush, loamy thoughts.

Rock on, FET #2.5!

Canceled for bad endometrial behavior

After four more days, my lining was... about the same, less than 7mm. I decided not to try the Viagra, given that the evidence was unconvincing and I was feeling kind of like cancelling this cycle and starting again, anyway. See, I always made not only decent linings but really nice linings before.  Even if I could have eked it up to 8mm with Viagra, I want to roll the dice again and see if I can't produce something plushy and 10mmish.

New plan: low-dose stims. It'll be as if I were doing a fresh cycle, except with lower doses of FSH, no Lupron (ovulation suppressor), and no retrieval. Hopefully I won't hyperstimulate, given the lower doses, and hopefully my body will react to the estrogen produced by its own follicles better than the little green Estrace pills.

I keep repeating to myself: marathon, not a sprint, marathon, not a sprint.

6dt5dt: the right way to get a BFN

5:30 a.m. Wake up when 2-year old decides to join you in bed.

5:35 a.m. Lie awake trying to convince yourself that you don't have to pee.

5:36 a.m. Consider that this pee will be FMU (that's First Morning Urine, for any of you not on the crazytrain).

5:38 a.m. Pee. Test.

5:38-6:00 a.m. Stare at pristine white test, willing a shadow of a line to appear.

6:01 a.m. Give up, crawl back into bed.

6:02 a.m. Have toddler jam chubby arm around your neck, nestling fragrant head under your chin. Breathe. Think about how lucky you are to have this small, strange, snuggly person unfolding before your eyes every single day. Twine ankles with your best beloved, in your comfortable bed, with your healthy child between the two of you. Cry a bit from the happy, and also the hormones.

6:15 a.m. Drift off for a second sleep, smiling.


So... yeah. Still BFN. Still wish it weren't. But you know, I think I'm on to something here. I'm going to start scheduling my HPTs for right before a designated snuggletime. There's a depth I just can't plunge to when the Small Boy shoves his arm around me and sighs.

I have also been thinking a bit about the Slow Path. A year or two ago, I was sure that my struggles to conceive had done nothing but damage me as a person. I was more guarded, anxious, cynical, angry, bitter. Damaged. I thought that I was a worse mother than I would have been if I had traveled a smoother path.

But I've started to think that it's not true. I think that I genuinely have, to a great extent, healed. I can tell, because some of the patterns I feel myself bending into now are simultaneously familiar and unfamiliar: my brain bends that way, but it hasn't for a long time. And that's very, very good.

I don't know if I'm a better mother because of infertility, but I'm starting to cautiously think that I might not be a worse one.