A year later

Coming up on a year since I was last pregnant, with what is looking increasingly like my last pregnancy. September 16 was the FET. It was all over by October 6.

At some point over the last three years -- I think it was between miscarriages #3 and #4 -- I started taking Prozac. I was so incredibly fatigued that I couldn't get anything done, so I went to my GP. She looked at my recent medical history and said "Hey, I think you might be depressed. Prozac?" Sounded plausible to me.

It turns out that the Prozac did nothing for my fatigue (changing my blood pressure medicine was what fixed that) but it did lift and steady my mood quite a bit. Better living through chemistry, yay.

At the beginning of August I stopped taking it. I just wanted to see what was under there. I felt like I didn't want to make any decisions that I couldn't live with unmedicated.

The verdict: now everything makes me cry. It's not necessarily a bad thing. The Prozac muffled my affect to some extent, and although I'm very grateful for it -- my affect was in great need of muffling -- it's kind of nice to have life in full-HD again. But everything makes me cry.

Things I have given away or sold in the past few months: baby gates,  baby wipes, strollers, carriers.  Maternity clothes. Baby clothes. I keep telling myself, if I find myself pregnant, I'll buy more.

I'm premenstrual, and possibly perimenopausal. A good stiff breeze can make me cry. Driving time is pretty much crying time for me. American Pie on the radio made me cry, for chrissake.

Dreaming

I've been feeling emotionally pretty steady, but my subconscious is working hard. I dream about children almost every night.

Last night's: I had two children. Small Boy was 6 and the other one was maybe 1 or 2 (in real life, Small Boy is almost 5 now.) Small Boy asked if he could take the baby for a walk and I said "Sure".

He returned later without the baby. I was panicked and started searching the town, running up and down streets calling out, crying, looking all around. In the pit of my stomach I knew the baby was gone and we'd never find (her? I think it was her.)

In my dream, I didn't blame Small Boy at all -- I blamed myself for letting him take the baby, for not thinking it through well enough when he asked.

Sometimes I comfort myself by thinking about this: there's a decent chance that my secondary infertility was caused by the c-section. I never had lining problems before. The two miscarriages due to SCH, that's an implantation problem, which is something I also didn't have before. It seems likely that my uterus just reacted really badly to being swabbed out after the surgery.

I have finally accepted that the c-section was about as necessary and inevitable as they come. See also: obstructed labor, impacted fetal head, obstetric injury, obstetic fistula, stillbirth, maternal mortality. I am goddamned lucky. I needed a c-section, and I got it, promptly. I spent the months after Small Boy's birth angsting about breastfeeding and PPD, not dealing with grievous injuries and the death of my baby.

If while I was in labor someone had said to me: hey, I'll cut you a deal. You give up your future fertility, and I'll guarantee you that Small Boy will be healthy and happy and everything awesome.

I would have taken that deal in a second. I cared about nothing at all more than getting him here safely.

Maybe I did take that deal; I just didn't know it at the time.

Everyone rewrites narratives until they find one they can live with. Maybe this is mine: that there is no world in which I got to have Small Boy and another baby. The price of Small Boy and his truly enormous 98th percentile noggin was my future fertility. It's a price I would have agreed to.

In Sandman, Death once tells someone who -- upon dying after a long span of time -- says "I did pretty well, didn't I?" and she says "You got what everybody gets: a lifetime."

Maybe I got what everybody gets: a family. This is mine. Railing about wanting a different one makes no sense, because if it were a different one, it wouldn't be mine.

I guess it's realizing that wanting more family for me really means wanting a different family. And I don't want that.

Disposition

I just mailed off a notarized form requesting to have our remaining vial of Small Boy's donor's sperm destroyed.

I asked our donor-parent group and nobody wanted it. I think the ones who wanted more kids have already all had them now. They're done.

Saving the vial didn't make any sense. I'm 40. My eggs are now problematic. If I want to try again, my best bet is my remaining frozen embryos.

I'm continuing to reconsider how good a bet that is at this point. I started trying for #2 at 37. It looked different, then. Her Indoors is older than I am. I've had four miscarriages at this point, three of them consecutive. There are lots of different ways to parse the statistics from here on in. None of them look good.

And there's another thing I have been resolutely ignoring. I loved being pregnant. Loved it. I had little to no morning sickness. Never threw up once. Slept beautifully, the sweetest, deepest, most satisfying sleeps I've ever had. Somehow I managed to carry Small Boy in a perpendicular fashion, poking straight out from my (extremely shortwaisted) body -- I was simply enormous, measuring five weeks ahead for the whole thing, everyone assumed I was having twins. But because I was carrying him in such an absurd way, it was darn comfortable. He wasn't pressing on my lungs, stomach, bladder. I could breathe fine, I could eat a full meal, and I didn't have to pee THAT often. Because I spent about two months looking like I was about to give birth at any second, I was vastly amused by the mingled fear and solicitousness my condition constantly inspired from bystanders. Totally fun. I could've kept going. And having Small Boy be part of me like that was pure magic. I would lie awake at night and thrum with joy.

But. But. But. All that aside.

I had insulin-dependent GD that was only barely controlled with large doses of insulin. I've since then developed high blood pressure, which is a strong risk factor for preeclampsia.  I had a totally un-fun flirtation with peripartum cardiomyopathy, which can, oh yeah, kill ya.  It took ages for my liver function to return to normal after the pregnancy. I felt fantastic. But I wasn't fantastic. My body was successfully juggling something that wasn't at all easy for it, and managed to keep all the balls in the air long enough to carry Small Boy full term and get him here safely. I will never stop being grateful for that.

But. Getting real old. High chance of miscarriage. High chance of complications.  A few years ago I was willing and able to plug my ears and forge on ahead. Who can pay attention to statistics when there's a chance of a wee tiny baby with soft soft skin and little fists? Who could be cold-hearted enough to consider the numbers when there's an entire life, an entire family member on the line?

Me, I guess, increasingly.

Small Boy is an funny little independent soul, an introvert who likes his quiet time. He's not begging for a sibling. Her Indoors thinks that one is the perfect number of kids. It's just me who's having trouble letting go.

Never is such a long time, though.

A third of a way through the hiatus: some peace and gratitude.

I record the hard times here, but I rarely bother to record the good times.

Today I'm feeling very peaceful and very grateful. I am a human being and humans look for patterns, no matter how spurious. For a while I, mired in self-pity, imagined my theme as I don't get to have what most people have, what I always thought I'd have.

I always thought I'd have a big wedding, with an enormous white dress and dancing till dawn. But when real life hit, we didn't have the money for a huge wedding, and getting married quickly seemed more important than getting married in the way I'd fondly thought we would. So this is what we had: a tiny, beautiful wedding, with our very dearest close to us.

So I'm trying this on as my new theme: Small things, done with great love (HT Mother Theresa).

Small things, done with great love, are not a bad way to make a life.


My beatific mood is helped by the fact that we've gotten some very good news. Small Boy was offered a place at a private school that we love but could never afford, with enough financial aid that we will be able to pay for it and eat food.

So yeah, feelin' lucky. Feeling peaceable with my uterus. I'll see where I am in a few months, but right now, the where-is-my-infant pain seems to be fading, not increasing.

Taking a break, or, Shore Leave for the Pequod

When Small Boy was born, I went into labor at 6:30 in the morning. I wasn't fully dilated until 2:30 a.m. or so, and that's when I started pushing.

I pushed hard. I pushed really hard. I wanted Small Boy to be born. I wanted to stop laboring. I pushed really hard for more than 2.5 hours. I'm in mediocre shape at best, and by the end I was so tired I could barely breathe, but I knew I couldn't stop. After 2.5 hours Small Boy had progressed downwards not at all. My cervix was good and swollen, but the situation was otherwise unchanged.

Then Small Boy (who had been a trooper the whole time) started having some decels, and the OB called a c-section for fetal distress and failure to descend. He had been monitoring me remotely; when he burst into the room and was like "lady, you are done here" I burst into tears.

I had rather wanted an unmedicated birth. I had badly wanted a vaginal birth. But when I burst into tears, I wasn't upset because I wasn't going to get the birth I wanted. I cried because I was so relieved and grateful. I knew that I could not keep going much longer. I was just too tired.

We later found out that Small Boy's head was severely impacted in my pelvis, and that there was no way he was exiting in any direction other than out of my abdomen. I could have pushed for hours more, I could have been twice as strong and determined, and nothing would have changed.

I'm too tired. I'm putting this down for six months. My plan for spacing my kids is scuppered. My plan for giving birth to both kids before 40 is scuppered. I'm never doing a fresh cycle again. The embryos aren't getting any older. I need to stop for a while. My family needs me to stop for a while. I need to let this white whale go, for a time, at least. Maybe I'll return to it and maybe I won't.

Maybe I'll learn that I can live with this, and that the pain of the missing person grows less over time. Maybe it'll get worse.

In any case: right now, I am putting this down. In six months I'll see where I am.

The good and the bad and all kinds of beautiful

First, I'll get the bad out of the way: the bills are coming in and they're fucking depressing. Transfer, beta, beta, beta, ultrasound (pregnant uterus), beta, the end. I would prefer just to forget about the whole thing, you know? Pretend it never happened? But people deserve to get paid, and so they shall.

On the happier side: this weekend I took Small Boy to his soccer lesson. Then we went on  a walk through the woods in the crisp fall day, all oranges and yellow and reds and crunchy leaves and good smells. We turned out of the woods and found ourselves at the zoo, where we happen to have a membership and I happened to have the membership card on me. So we went to the zoo. And we dawdled and wandered and looked at lots of animals and somewhere in there I started humming a song. Pop lyrics are the bardic poetry of my generation and it's how my subconscious communicates with me. OnceI was on an elevator and started humming "Miss Otis Regrets" and only noticed on the way out that the elevator was made by a company named Otis. Anyway.

The song lyrics I was humming turned out to be


one life
is all we ever get
and all we ever give up for it in return
is all of 
the ones that might have been
just one kind of beautiful, each in our turn...

 I walked, and thought about it. One kind of beautiful is what I get. This life is one kind of beautiful. It's sleeping in and spontaneous zoo trips and money and time and just a very relaxed, civilized way of living. Since we have him outnumbered, when one of us is out of patience it's very easy to say "here, you deal with it." I wouldn't have that luxury if there were two.  We never have to operate at the edge of our ability to cope. It's just all very comfortable and peaceful.

Would I trade for the infinite richness of a larger family? Hell yeahs. There's no question. The material and lifestyle advantages are all things I would throw away in a minute, if I could. I mean, for the past two years I've been attempting with both hands to throw them away.

But if it turns out that I can't -- this is one kind of beautiful.

If I can hold onto this feeling, I'll be fine. I know these things tend to be a spiral, passing the same point again and again on a different plane. I know I'll be back to desperate sadness, jealousy, anger, grief. But with any luck this is one of the places in the spiral and I'll see it again, the place of feeling peaceful and grateful and wistful, not angry and grieved. And now I know that this place exists, that there is a world in which I never have another child and I am okay.

Two years later.

A lot of women who miscarry have problems with anniversaries. Sure, I remember some dates -- the very first time I was pregnant, the due date was supposed to be December 21; for my second miscarriage,  August 1; July 31 for the third and June 3 for the fourth.

I remember these dates but they really don't have any heat in them. I thought I was pretty impervious to date-ghosts. But the other day Her Indoors mentioned this year's Christmas Tree Festival. Now, I'm Jewish, but I love a good Christmas tree festival as much as the next girl, and of course Small Boy adores it.

And it was like a sock to the gut. 'Cause the last time time we were at the festival, I had a backache and was walking slowly because I was easily winded in that weird early-pregnancy way. That was what turned out to be the Sea Monkeys, miscarriage #3.

Why hasn't the date of my miscarriages bothered me before? Because duh, I've always managed to be pregnant again. First miscarriage, 5/08; in 5/09 I was pregnant with Small Boy. Second miscarriage, 12/11; by 12/12, pregnant again, although to no avail.

But I timed it wrong this round. By all rights I should have put off the transfer for another six weeks, so I could have been pregnant on the miscarriage-aversaries and then had that miscarriage at the traditional time of year.  But nooooooo. I had to do it early, so this year's miscarriage was in October, and so for the Christmas Tree Festival I'll be walking around not only not pregnant, but not even in the middle of a cycle.

I can't believe I'm here a year later, not only not having made any progress but having made negative progress. I have fewer embryos stored and I'm at higher risk for miscarriage, having had three in a row.

But I guess in a way I have made progress. I'm further along the road I'm going down, and I know that road is not endless. I'm closer to the point where I give up and start to Deal. If I'm going to subject myself to years of this pain for nothing, at least those years are drawing to a close.

Right now I feel like I'm grieving in slow motion. Not really, just kidding, maybe a little, if I mourn properly does it mean I'll then get what I want? I don't know whether to hang onto hope or just let it go. I wish I knew which the operative cliche was.

 I find myself reassuring people, friends, medical professionals. "It's okay!" I chirp. "I got my little guy!" And it's true but it's also not true. It's what good infertiles say, grateful ones, ones who don't think I should get to have what so many other people have. I am grateful, every day, grateful beyond breath for Small Boy and how he's spun my life and heart right around like a record, baby, I am, I truly am. But at the same time I'm angry that I'm supposed to be grateful and content with what it seems like practically the whole fucking world takes for granted.

The other day I walked past a box of First Response Early Result Pregnancy Test with FREE Keepsake Due Date Calculator! And I audibly scoffed. A keepsake due date calculator, after the first pee stick? Getting a bit ahead of yourself, aintcha?  And that's assuming it's positive. How many of those suckers get bitterly tossed into the trash?

But then I realized it's not that ridiculous. Most pregnancy tests are probably purchased by women who already suspect they're pregnant. Most positive pregnancy tests result in actual children. A keepsake due-date calculator on a two-pack of FRERs is utterly laughable from my point of view, but my point of view isn't representative. It's just my reality.

Small Boy is four, and we're going on lots of kindergarten tours, meeting lots of other families. This is the age interval when most families are mid-spawn, or have recently spawned. Lots of babies, lots of newborns, lots of big bellies, lots of brothers and sisters. I suppose in another five years or so it'll all simmer down other than the occasional "oops". That will be easier.

Beta #3: still truckin' along

952, for a doubling time of 44.23.  No complaints.

Ultrasound a week from Monday..

from 19dpo-22dpo:

from 16dpo-22dpo:

 

gulp.

19dpo: a surprise comeback?

Recap: After coming out of the gate strong with good pee-sticks, she managed to muff the first fence, scraping over beta #1 with a score of less than 100. Her form has improved considerably between the first and second fence. Beta #2 came back at a very respectable 308, for a doubling time of 44 hours.  She's clearly rattled by the first fence, but let's not write her off just yet. This one may yet have a chance.

Okay, I'll... stop talking about myself in the third person as if I were a horse now. I'm a little punchy and adrenaline-y. My heart was pounding as I clicked open that email.

So! Here I am. Her Indoors is going away on a trip and then I'm going away on a trip so I get to learn how to give myself IM injections. Thank goodness my bum's mostly numb by now.

I'm grateful. What I wanted was either

1) A clearly good results, like this, or
2) A clearly bad results.

And, of course, I rather preferred #1.

I dreaded getting a 180, a 200, something like that -- not quite low enough to pull the plug immediately, but far too low to be healthy. So I'm damn grateful.

Next beta on Thursday.

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.

9 weeks: finding the reset button.

Today would've been 9 weeks. Last Wednesday I'd resolved to wait, zen-like, for my body to take care of this naturally, gently.

That decision lasted until the evening. I did a little research and found out that with misoprostol, it's frequently over within twelve hours. The old-fashioned way can take, literally, weeks. Weeks of bleeding, weeks of cramps, weeks of pregnancy symptoms.  I did the math (number of weeks multiplied by insanity factor) and by the next morning was super-keen to get the misoprostol.

Except it turns out that the misoprostol I was offered so lightly on Wednesday night was actually a pain in the butt to get. I called Thursday morning, with some idea that I could stop by the office on Thursday afternoon to get the prescription. Hahaha no.

I finally got a call back Thursday night telling me that someone would call me Friday morning. On Friday morning, the PA called and said she'd talk to the doctor and get back to me later in the day. At 5 pm she called me back and said "you'll have to come in for an appointment on Monday."  I'd dreamed that I'd be able get it all over with by the end of the weekend, and was bitterly disappointed to be denied.

Anyway, I dragged through the weekend -- I say "dragged" just because the pregnancy-fatigue was still going strong, along with the need to get up and eat a three-course meal at 2 am every night. Pregnancy symptoms are a lot of fun when you're going to have a baby. They're just an annoying inconvenience when you're not.

Monday morning I went in for my appointment. They'd mixed up the paperwork and had me down for an ultrasound even though I was only supposed to be there for a consultation. "What the heck," thought I. And maybe, just a little, maybe .05% of my brain thought what if it's all a mistake? What if it's a Christmas miracle? What if there's a little heart beating away in there?

There wasn't. There were two little embryos, measuring 6w2d and 7w4d, clearly sharing a placenta (i.e., identical). They looked like little packing peanuts curled up in there, two very quiet packing peanuts. I kind of wish I'd gotten a picture, but for some reason they don't offer you pictures of the dead ones. But in any case, I was still glad to have seen them again. Last week I hadn't gotten a measurement for Little Twin, so it was oddly satisfying to have that verified. 

The doctor's not a big fan of misoprostol. He gave a decent shot at trying to convince me to do a D&C. He assured me that they're "very gentle" and that they "only use suction" and "the chances of getting scars from a correctly-done D&C are almost nil". If I did a D&C it would all be over quickly. If I did a D&C I could have a chromosomal analysis done of the tissue. With misoprostol, 40% of women have to have a D&C anyway.

Unfortunately, I know that most of what he was telling me wasn't true. Don't get me wrong, I think this practice is very good at what they do, which is reproductive endocrinology. They don't know jack shit about Asherman's Syndrome. Yes, you can get adhesions from a properly-done D&C. No, using suction only doesn't prevent scarring.  No, a woman with Asherman's shouldn't get a D&C done unless there is absolutely no alternative. Misoprostol is more than 80% effective if you give it a whole week to do its work (this practice judges after three days).  I'm a walking dictionary of misoprostol trivia at this point. I spewed some figures and he sniffed and shrugged and said he'd go to get the consents.

He left, and then I cried. I wasn't really expecting there to be a living baby in there.  But seeing the pictures was still... hard. Little Twin was pretty indistinct, but Big Twin looked like such a perfect little fetus. Perfect, just dead.

I spent the next three hours getting my blood drawn (they require a hematocrit), waiting for the bloodwork to come back, waiting for this, waiting for that, waiting at the pharmacy. It was, apparently, lovely weather for a sleighride together with me. Also, I should have myself a merry little Christmas, and that's the Jingle Bell Rock. I did not stab anyone.

Four hours later I emerged with 8 200mg tablets of misoprostol, a strip of Zofran (anti-nausea), and a handful of Ativan, I guess in case the process made me edgy? I'd already filled a prescription for some painkillers.

I decided to wait until Wednesday morning. Misoprostol can be unpredictable, and if I were going to be doubled over/vomiting/yelling/cursing/hemorrhaging, I wanted it to happen when Small Boy was at preschool and not when the poor dude was trying to have himself a Merry Little Christmas.

So yeah. This morning I dropped him at preschool, went to the supermarket and picked up a party-sized pack of sanitary napkins. Went home, popped a Zofran and a Perc. Half an hour later I briefly dipped the misoprostol pills in 5% acetic acid, better known as white vinegar, and crammed four of them up the hatch (via my handy PreSeed applicator). I then waited for something to Happen.

An hour later I started cramping. Four hours later I felt like something was going to Happen. I shuffled over to the bathroom and then in a mighty rush, the entire universe fell out of my uterus.  In the space of five minutes I passed the gestational sac, the fetuses, and what Her Indoors was sure was at least some of the placenta (she's a biologist, so I have some faith in her identification).

Friends, that is some good stuff. I know everyone is not as lucky. Some women end up writhing and puking, and some women get no effect at all. But for me, it did exactly what it said on the tin. The cramping has been no worse than bad period cramps (admittedly, without the painkiller it probably would've been a whole lot worse). And holy god has it cleared a lot of underbrush out very quickly.

I've been bleeding briskly since this morning. The cramps have gotten better and worse, but the painkillers keep them bearable.  I won't know until Friday if the job's completely done. If it's not I'll likely have to fight not to have them "clean it up" with a D&C. But fight I will; if anything lingers, you bet I'd rather have another round of misoprostol.

Right now I feel wrung-out and crampy but so relieved, and grateful that the misoprostol seems to have worked for me. Fingers crossed that Friday finds that it truly is over.


¹The literature is a bit mixed on whether or not dipping the pills in acetic acid definitely speeds action/improves absorption. But I figured I'd try it on the grounds that at worst it would have no effect, and at best some studies have found it halving the time to completion (which otherwise averages about 12 hrs from administration). Since my uterus enthusiastically spewed four hours after inserting the tablets, I'm inclined to believe that it helped. It also makes a lot of intuitive sense to me. As soon as I dipped them they started to disintegrate. I was basically inserting a firm paste, not dry pills.  If any internet travelers stumble across this, I personally vote "yes" on dipping in 5% white vinegar.

That's what I'm talkin' about. (Beta 2:19dpo/14dp5dt)

My favorite bit isn't the normal -- this particular chart is very liberal with the "normal", and my two miscarriage betas squeaked in under the wire with a doubling time of ~69 hours. No, it's the 40.87 hours. That really is normal.

I'm dizzy with relief. Next beta Thursday. Rock on, little embryo. So far you are doing awesome.

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!

Day 5 embryo report

2 expanded blast (will be frozen)
7 early blasts, 6 fair, one poor
2 morulas
1 9+ cells
3 no change, on probation
2 no change, discarded

The early blasts and possibly the morulas are still in the game for Day 6. But at least we've got two safely in the freezer.

It's not what I'd fantasized about (I imagined my nurse's voice saying "all 9 were beautiful and we froze them!"), but it's far better than I'd feared (i.e., nothing to freeze, a big waste of a cycle).


*chews nails*

Day 4 embryo report

We have:

9 morulas (morulae?)
1 "9+ cells"
2 8 cells
1 7 cells
1 3 cell
1 2 cell
1 eager-beaver early blastocyst (the nurse thought this was a good thing, so maybe I'm wrong? but my research says too fast, man)
1 no change for one day, on probation
1 no change for two days, discarded

So, the wee ones are still dividin' like champs. Now is the time I'm super grateful for being at Big Shiny Fertility Factory, with their Big Shiny Excellent Embryology Lab. Although I loved Dr. Stewart's Discount IVF Shack, I just can't be confident in their lab. And from here on in, it's all down to the lab (and the embryos, of course).

We'll see how this batch turns out, but I've thought a bit about the "ugly duckling" stage that my embryos went through last cycle, when they slowed down mightily between D3 and D5.  I've since learned that a lot of labs aren't particularly good at blastocyst culture. Blastocysts have different needs than embryos, and between days 3 and 5 the labs have to make a lot of adjustments, I dunno, give them different food, plump up their tiny pillows, something, stuff, do I look like an embryologist?  It's also an awkward and trying time chromosomally, so it could very well be that my embryos weren't/aren't good at making the transition... but a different lab may help.

So! 9 morulas, full speed ahead!

Day 3 embryo report

Our brood is still doing well. They like to see them between 6-8 cells on Day 3.

8 cell: 4
7 cell: 4
6 cell: 2
5 cell: 2
4 cell: 2
morula: 1
arrested: 3

All of them were rated "good"; not sure exactly what that means in terms of fragmentation, but I'm okay with that.

I was puzzled at the D3 morula; that's a whole day ahead in development. I'm guessing it's the eager little bugger who was 5 cells yesterday. Too-fast development is also a sign of a problem, so I've put it at the bottom. Because really, when you work that quickly, you're gonna make some mistakes.

 So 10 of the flock are in appropriate range, and a further 4 are not far out of range. Goooooooo little ones!

Day 2 embryo report

My little flock is doing well! They're supposed to be between 2 and 4 cells on the second day. Currently the breakdown is:

5 cell: 1
4 cell: 13
2 cell: 3
1 cell: 1

I feel protective of that poor little 1-cell. Can't help but think of the very-mediocre 2BB embryo that turned into our perfectly-splendid small son.

This practice calls every single day with an embryo update, which I really, really appreciate. I'm also trying to remember that, last time, my embryos were gorgeous through Day 3, went through an ugly duckling stage from days 4-5, and then bloomed out beautifully on Day 6 (including the one in my uterus).

It's nice to be sharing good news. <3

Holy moly!

My retrieval was yesterday. I haven't posted much because, well, I was kind of dejected.

By stim day 9, my E2 was up to 1400. By day 11, it was up to 2600. I was told that a dozen or so follicles were chugging along. I triggered the night of day 11, making for a ten-day stim period, precisely the same as my first and third IVFs.

By Thursday, Retrieval Day, I was feeling... tender. As in oh-god-I-never-noticed-that-speed-bump-was-quite-so-bumpy tender. I thought maybe this boded well, but I am nothing if not a rugged pessimist.

Retrieval went fine. Cab was eight minutes late, which reduced me to a rage-filled mess, but we got there fine, everything was fine, there was fineness.  As usual, I took the anesthesia flawlessly and woke up in a high good humor. I'm just super lucky in that whatever chemical pathways those drugs are supposed to tread are clearly wide open in my body; I go down like a sack of taters, and wake up like a sack of giggly taters.

I woke up, and eventually my doctor came by to say that he'd retrieved 27.

Whaaaa ---

My peak E2, the morning after trigger, was 3100. The most follicles I'd be told about was 13 or 14. My doctor had decided to switch from the Lupron trigger to the regular hCG trigger, airily saying "there aren't that many follicles, you'll be fine."

Where the hell were all of them hiding, is what I want to know?

It seems I may owe an apology to Dr. Stewart. For my third IVF, he counted 14 follicles and ended up retrieving 23 eggs. I attributed this mismatch to his rather ancient ultrasound equipment. But the ultrasound at Big Shiny Fertility Factor does everything but insert the wand itself. I'm going to have to form some theory that my ovaries are just coy little beasties, and sometimes they don't like to show their eggs until they absolutely have to.

When I heard "27 eggs" I immediately tamped down my expectations by reasoning that, with the E2 so low, most of them couldn't be mature.

Well.  Of the 27 eggs, 24 were mature, and 18 of them fertilized.

This is, in technical terms, awesome.

 So why was the E2 so low? Who knows. This cycle I took an antagonist, which various sources hint can lower estrogen levels and/or make estrogen tests less reliable. All I know is that a lousy cycle, my worst ever, suddenly turned into my best cycle in terms of mature eggs, and my second-best cycle in terms of fertilization (on IVF #1, I had one more).

I'm on OHSS watch, but I don't feel too bad -- tender and swollen, but taking it easy and sipping electrolyte drinks. Finally getting around to watching Legend of Korra (I was/am a huge A:TLA fan). Right now just being quiet, grateful, and wishing my best to the 18 little clumps of cells in a laboratory fifteen minutes down the road.

Yayyyyyyyyyyyyy!

Got confirmation that they've updated their plan description so that gay homosexual lesbians are now covered.

I am bouncing off the walls with gratitude and relief. Big Shiny Fertility Factory, here I come!

(yes, the picture to the right is what I imagine it's going to be like, except that instead of having a star on my belly, it'll be a baby in there.)

I have three big folders of information from BSFF in my desk drawer at work; I haven't wanted to look at them for fear that I'd be looking at what I couldn't have. Gonna take them home tonight.

Wheeee!

4dp5dt: photographic evidence

It's... not really that faint, is it.

Oh, my. Oh, my. Oh, my.