A Memo to the Internets

...apparently I've recovered enough to rant. This is inspired by a cluster of interactions, recent and not so recent, which bugged the hell out of me.

Dear Internet,

Following please find a list of reproductive scenarios. If these scenarios happen to you, you shouldn't be smug about it -- you should be grateful for it. To wit:

If you conceived on your first or second try;
If you conceived at home without any medical intervention;
If you conceived with minimal medical intervention;
If you had an uncomplicated pregnancy;
If you gave birth at full term;
If you desired and had an unmedicated birth;
If you desired and had a vaginal birth;
If you desired to and were able to breast feed.

Don't be proud of these things. Be grateful. The fact that you wanted {whatever} and got what you wanted is not a marker of your of moral superiority. It's a marker of having been lucky. There are plenty of people who wanted exactly what you wanted and still ended up with IVF/ICSI preterm drugged-to-the-gills Caesarean births. (please note: I also don't think you should judge yourself superior to those who didn't want those things in the first place... but that's really a separate rant. Don't worry, I'll get around to it.)

The proper reaction to luck is not to explain to everyone exactly what you did to get to {desired state}, and what {those who have not enjoyed the desired state} are doing wrong. It is to be grateful, and also to shut the fuck up.

For the record, although I joked in my tags about being a good little layer, I didn't do a damn thing that other people haven't done, people who end up with few or no embryos. I've been lucky, that's all (lucky and slightly polycystic), and darn tootin' I am grateful, and praying that my luck holds. If it does it'll be because I was... lucky. No other reason.

What (Good Things) Happened Overnight

Final egg count: 25
Mature: 21 (!)
Fertilized with ICSI: 16 (76%)

Chances are excellent for a 5-day transfer, which is just what we want.

I slept sitting straight up all night and only woke a few times to shuffle to the bathroom. Pain is much better. I still don't feel like moving, but I am suffused with gratitude every time I take a deep breath and it doesn't hurt. Maybe I can finish watching Scrubs today.

Yesterday I was hardly there -- just sunk in misery and watching the minutes pass by. Now I'm looking outward again. And just for today I'm not googling about anything that could go wrong.

done!

At home!

Preliminary count = 21 eggs "so far"; they were still looking through the fluid when he gave us the report. Doubtless many of those won't be mature (at the last ultrasound he counted 15 likely-looking follicles), but it's a lovely (lucky?) number to be starting out with.

The anesthesia was a trip, I've never had it before. Man, that stuff works. One minute I was lying there under the huge light, legs strapped into leg-elevator things, thinking about alien abduction. The next second I was someplace else entirely. I couldn't believe it. The very first thing I mumbled -- no fooling -- was "Anesthesiology is a noble profession." The anesthesiologist looked startled and said "thank you". I was just floored that it was all over, just like that. Floored and grateful.

Then I noticed OW OW OW OW. I am not shy and I communicated OW OW OW, and was rewarded with an IV of some narcotic (Diludid?). Unfortunately, it only took the edge off, and it took another few minutes to figure out that a big part of the pain was that I desperately needed to pee. Sadly, we have no pictures of My First (and hopefully Last) Bedpan.

All hospital staff extremely nice. Nurses rock.

The bad part is that now I feel like utter shit -- I can barely hobble half-curled to the bathroom. My list of woes: breathing deeply hurts. Laughing hurts enough that I had to turn off Scrubs. Moving hurts. My shoulder is randomly cramped and hurts as much as my abdomen. Gas pains keep bubbling up. I'm just sort of skating from one moment to the next, convinced that I am moving in the right direction because time is passing, and nothing will fix this but time. Every half-hour is an achievement. Who the fuck are these maniacs who go jogging round the block after their egg retrievals? When the nice nurse dropped her voice and advised me no sex, I could only stare at her in disbelief.

The good: my beloved is taking wonderful care of me, hovering with SmartWater and homemade chicken soup and pillows. I have this neat microwavable heating pad that feels really great on the shoulder. And I know all this is temporary.

Right now, though, right at this moment, I can't imagine ever choosing to do this again. Though I know that if we did this whole process again we'd rack back on the stims, I wouldn't get as many eggs, and thus would not feel so shitty. I'm told that there's a direct relation between the number of eggs and how wrecked you feel afterwards.

Musings on the day before retrieval

Hey, you know what I think is really funny? This. For them as don't like following links, it's the abstract of a paper entitled "Low negative affect prior to treatment is associated with a decreased chance of live birth from a first IVF cycle". First time I saw it I misread it as perhaps you did: "Low affect prior to treatment" etc. That would mean that, basically, being mellow reduced your chances for success. This was a delicious enough possibility that I clicked on and realized it said "Low negative affect". That's right. Being insufficiently anxious and cranky can reduce your chances of conceiving via IVF!

Have consumed 1.5L of SmartWater today, planning on doing the same until OHSS danger has passed. I have to say it tastes like... water. Seriously. Except it costs $1.69 for 1.5L. How do I know there even are electrolytes in there? Would I know an electrolyte by sight? I would not. I will add "fear counterfeit electrolyte beverages" to my worry list, pursuant to previous paragraph. I am proud to say that I am truly doing everything I can to make this cycle work.

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Replies

Shannon asks: What does triggering mean?
Well, Shannon, pull up a chair, I'm glad you asked! Triggering = a precisely timed injection of hCG. hCG is what pregnancy tests measure, but in this case, it's used as a stand-in for LH, which is what ovulation predictor kits measure (I believe it's used instead of LH b/c LH has an unhelpfully short half-life, but don't quote me). LH and hCG are very similar, which is why OPKs are reasonably good pregnancy tests (although the reverse is not true -- see this helpful page for more details).

Anyway, the hCG injection performs the same function as does the LH surge in your body: it prompts the eggs' final maturation (what that involves I have no idea -- licking the envelope? tiny diplomas?) and also induces ovulation. This is why it needs to be so precisely timed, 36 hours before retrieval; if you do your shot too early you'll have already ovulated by the time they try to Hoover up the eggs. Do it too late and you'll get immature eggs.

I was paranoid enough about timing that I had time.gov up on the laptop screen. B stuck the needle in at 8:00pm, although it was 8:01 by the time she finished.

Also, thank you for the dockweed suggestion, but since I will be wearing a hospital gown for both the retrieval and transfer, no dice -- however, I could make a sort of dock seed tefillin to wear in between... hmm.

Dawn, my doctor is frustratingly non-committal. He has no problem with letting me have my own way about just about everything, and basically told me that unless my E2 was ridiculous (over 10,000) I could make the call. I had decided to trigger up to 6000, but I'm so glad that I didn't have to make that decision.

I am a tiny bit annoyed at him for forgetting that we are planning on doing a single embryo transfer. It's a decision I'm anguished enough about (more on this subject later) and I don't want to have to have that discussion more times than we have to. He even tried the old "the worst thing that can happen is twins." No, doctor, the worst thing that can happen is not twins. Garrr. Post on that subject later.

Thanks and love to everyone who has commented with their support!

Day 11: Trigger Day

That's right, girls and... er... girls! You read the title correctly. No, I am not hosting a photo exhibition honoring Roy Rogers' horse. I am triggering tonight, because my E2 was 4356 as of ass o'clock this morning.

4356, what can I say? I can say that

1. It's above some clinics' cutoffs for retrieval/transfer, but below others'. A lot of clinics use 3500 as the cut-off, but others use 5000.
2. It's much much much better than I had feared. See, I was getting what I believe is called a geometric progression -- doubled between days 5 and 7, almost tripled between 7 and 9... the fact that it only went up to 4400 between days 9 and 11 is marvelous.
3. It still puts me at risk of OHSS, but whatever, right? People say it's unpleasant, but it's not fatal. And you know what else would be unpleasant? Doing this whole damn thing again if I don't have to. I'll take my chances, spike the retrieval IV with albumin, and hope for the best.
   
4. It's a very cool number because if you transpose the first two digits it's 3456, a numerical keymash.

Once again my prodigious powers of worrying have, by the force of my mind, managed to avert disaster.

Retrieval is scheduled for 8 am Wednesday. Have to be there at 6:30. Without having had coffee. HAHAHAH. Still not sure how we're going to get there -- cab, I guess. My darling doesn't drive and I'll be in no shape to be driving home afterwards

EE EE EEE! Excited! Happy! Mood swingy! I LOVE ALL OF YOU -- YES, YOU OVER THERE, ESPECIALLY YOU.

Day 10 of Stims

When some people need to be soothed and inspired, they go to church. I head to Value Village. Today I was richly rewarded for my faith: for $1.21 I picked up a copy of Robot Building for Beginners.

I really think this could change everything for me.

the stats that don't show up on the lab slips

Number of hours spent obsessively Googling all that could go wrong with this cycle: 5
Number of women I found with E2 lower than mine who got canceled, had OHSS, or both: nine gazillion
Number of women I found with E2 higher than mine who were just fine, proceeded to transfer, and now have adorable bairns in their sigs: dunno, I'm sure I wasn't looking, why read about that when you could read about the bad outcomes?
Prolonged hysterical crying fits I had on my beloved's soft bosom: one
People who are now allowed to use the internet only for pre-approved purposes: me