Weird Goodbye

It's confirmed: Pregnancy is not viable. We had our ultrasound today and I should be 5w5days pregnant if everything is normal. Instead we saw a very small gestational sac that measured under 4 weeks. Dr. Sage and Dr. Optimism agree on the diagnosis: blighted ovum. Medication has been stopped. I have a D&C scheduled for Wednesday.

I'm numb from all of this. Part of me wants to be angry and bitter over all of this. To scream at everyone who told me coming up to this moment that everything would be fine and that I simply needed to relax. But the other part of me is simply at peace because the roller coaster from last week is now over. Grey and I will move forward with our plan; we will try again with our other 6 embryos. And though we don't know the outcome of this plan, we do know that we will expand our family. For now, we have some closure.

The other question I'm struggling with is whether this is actually a loss. I hurt so much right now because I wanted this baby, but in truth we didn't get very far with this pregnancy.  We never saw a heartbeat; an image of a fetal pole. It's more like the loss of an idea instead of the loss of something that was real. Because of this, I feel guilty for even grieving, for calling this a miscarriage. Because I know so many of you have lost your babies, experienced the pain of no longer seeing your baby's heartbeat.

So this is my weird goodbye to this baby. My tribute to my child who I will never hold in my arms. Your father and I loved you and will always love you. We both wish today would have been different, that a miracle would have happened. Instead, all I can say is I'm so sorry I couldn't protect you and help you grow. That I couldn't bring you into this world. You will always be in our hearts.

Hope?

Beta history (i.e. "the rollercoaster)

28 December 2011: Beta #1 = 66
30 December 2011: Beta #2 = 124
1 January 2012: Beta #3 = 91 (diagnosis: chemical pregnancy)
3 January 2012: Beta #4 = 119
5 January 2012: Beta #5 = 300
7 January 2012: Beta #6 = 887

I have an ultrasound and beta #7 scheduled for Monday morning.

Crawling back into my cave now.

Limbo

Short post today. My mind is racing and putting together coherent thoughts has been very difficult.  

Here's why: apparently I'm still "pregnant."

On Sunday, Grey and I received the news that my HCG levels were down from 124 to 91.  Dr. Practical suggested that it was a chemical pregnancy and that I should stop the meds. I pushed for one more beta to verify this (I'm a biologist and I like to see trends). Tuesday morning ultrasound showed some blood in my uterus.  Dr. Sage was pretty convinced that I would start bleeding that day and that we would be reassessing in two weeks.

Then I got the phone call that evening. It's never a good sign when your RE starts the conversation with "there are days when this job really isn't easy." Take home message: HCG levels were back up to 119.  Another beta scheduled for Thursday. I'm ordered to stay on medications. Mourning has been put on hold.

I'm pretty sure that everyone believed that I would be bleeding by now and that the next beta would level off or drop. Imagine all the new confusion when, today, we learned that my HCG levels are at 300.

Let me be clear: no one is celebrating at this point. There's a lot of doom and gloom, with my medical professionals preparing me for the worst. There's the very real possibility that me being "pregnant" means the only thing that is growing is placenta (blight ovum). So I may have to have a D&C (tentatively scheduled for Monday). Then there's the all so fun possibility of an ectopic. 

But the other possibility is that I only lost one embryo. That the other one implanted late and is now growing. This is something that is talked about after the fact, because it's rare. Add to the fact that Grey and I have learned that HCG isn't really a great indicator for how the pregnancy is progressing (think PSA tests for prostate cancer), but it's the only early marker we currently have, and that adds a whole new level to the anxiety mix.

I want an answer. "No" hurts, but at least I get to grieve and have some closure. Limbo is it's own special hell and Grey and I are beginning to wonder what we did in out past lives to deserve this.

Beta #6 is on Saturday. 

Picking up the pieces

The last couple of days have been hard ones. Harder than I every imagined. I've cried a lot, both in private, with friends and with Grey. I've watched him cry too, which broke my heart all over again. I've bargained with the universe, had moments of sadness and anger. But mainly I've been kicking myself for allowing myself to finally feel some peace follow the first couple of betas. Though short, those few days where everything was progressing allowed me to feel that we might actually be able to move forward for the next few months. How foolish of me.

Today I went in for my final blood draw. When I called the clinic to find out where I could pick up my lab slip, I learned that Dr. Sage wanted to see me after my blood draw. I barely held it together in the waiting room, dreading seeing all of them again. But I'm glad we saw him. Dr. Sage examined me and confirmed that, though the pregnancy didn't last, there were good signs that this cycle had been successful. He told me that he thought it was simply a bad roll of the dice and encouraged us to take a month off and then to proceed with a FET. I have an appointment in 2 weeks with Dr. Optimism to check on my progress of recovering and to talk about the future. In the meantime, I've been ordered to rest, allow menstruation to start and to take care of myself. Both Grey and I received many hugs and condolences as we were leaving, reaffirming how lucky we are to have found this clinic.

The question, now, is how long do we stay on this path. The answer is different for everyone; some stop at IUI and immediately move on, others will continue with treatment for many years. There's no "correct" choice and I would never be naive enough to suggest someone take a particular path. Yet it's something, if you've been on this road long enough, that you'll start thinking about.

Last night, something shifted. A good friend took me out for some tea and we spent 2 1/2 hours of me talking/crying and her listening, followed by 30 minutes of her offering words of support and comfort. During our "conversation" it became clear that I needed to begin the process of resolving my infertility. I've been on this journey for too long and I only have a short amount of patience left for treatment. That's when our conversation turned to adoption.

A bit of background on Grey and I regarding this issue: we come from families with two very different view points on this issue. Grey's family is rich from adoption; his maternal grandmother was adopted, one of his cousins and even his eldest nephew. He's always viewed this process as a beautiful thing, as without it he would not have the family he has today. My family views adoption as a great option . . . for everyone else. Like many others in this country, adoption is very misunderstood and is seen as something only "broken" people pursue. And adopted parents are seen as substitutes for the child's "real" mother and father. Granted, this is never spoken outright. Hell, they'll even deny it! But this summer, this view-point became glaringly clear after my mother and aunt conspired to have me adopt my cousin's son after the state threatened to remove him from my cousin's custody. My mother's response to my reasoning why this wasn't a good option of "no child you adopt will ever truly be yours" still echoes in my head.

My view on adoption began to change when I first meet Grey's nephew. Though physically different from the rest of the family, this child was clear one of them. And it was infectious, as they demonstrated to me that love was not a conditional thing. When Grey and I were starting off our marriage, adoption was something we talked about, something to consider after we started our family. It wasn't until last year that I was faced with really analyzing this option that it became apparent it was something I really wanted to do. As I talked with members of my support group about resolving, I realized that no matter if pregnancy was or wasn't an option, adoption would be the path we would take.

Now I know that the road to adoption is a hard one. The process is filled with many different options (domestic vs. international, closed vs. open, infants vs. small children) and I'm more than aware of all the stories of heartache from adoptions that have fallen through, delays and even stress from the process.  In addition, there are many things that need to be considered within the next few months, if this is going to happen, and none of it can be decided overnight. But I also see the stories of those who have come out on the other side and see how much they love their children. The joy that is there in those families. And I want that.

So, here's our plan for 2012: We're giving ourselves 6 months.  We'll proceed with the FET and hold onto hope for pregnancy. But in 6 months, if our situation hasn't changed, we begin the adoption process. I've already looked into local agencies such as AMARA and Holt, but plan on spending time that I normally would worrying about a cycle on researching our options.

Tonight, we are saying goodbye to our two embabies. We will tell them, though they were with us for such a short period of time, how much we love them and miss them. Tomorrow, we'll begin picking up the pieces and moving forward.

It's over

Beta #3 = 91.

Dr. Practical has agreed to do one more beta on Tuesday, but she's fairly confident that based on this trend, we had a chemical. I'll stay on meds till Tuesday and if the results indicate trending downward, will stop all medication.

Both Grey and I are in shock and denial. Heartbreak will follow soon.

Game changer

Yesterday, I started a post talking about broken dreams and finding the need to move forward. In that post, I planned on talking about the biology behind IVF; how it's a great diagnostic tool as well as an effective treatment. How, before IVF, couples were subjected to living quietly with infertility, having no real treatment options, medically speaking. I think it will be a good post, particularly regarding the biology and the advances. But that will be for another time.

Yesterday, after posting about my anxiety disorder about HPTs, I went upstairs to shower and change out the Crinone. It was then that I found blood. Not a lot (none of it made it to the panty liner I was wearing), but enough that all I could think was "it's over." Grey found me in the shower, sobbing like a baby. Immediately, he took control of the situation, ordered me dress, out the door and into the car. His mission was to get me out of the house and to find sunshine, somewhere in the state of WA. So off we went, over the mountain pass.

We didn't find sunshine. But what we did find was snowfall. And during the drive, Grey calmed me down, reminding me that a little bit of blood is normal. And that he wasn't ready to throw in the towel. Because no matter what, we were going to expand our family. Our children exist, it's just a matter of time.

I hadn't seen snow in over a year. Standing outside as those big flakes landed on my face helped me remember happier times. And as I calmed down and began to listen to my body, I realized that even though I had zero pregnancy symptoms, I wasn't ready to quit.

This morning, Grey woke me up and told me it was time. Shaking and crying, I did my first HPT in over 6 months while my darling partner held my hand. And that's when, for the first time in over 2 years of this madness, we saw the second line.

The RE on duty called me 20 minutes ago about the results from the blood test: Beta #1 = 66.  Not as high as I thought it would be, but higher than I ever expected.  Second beta is on Friday.

Today, I find myself in unfamiliar territory. By no means are we out of the woods yet, but today we are further along in this process than I ever allowed myself to imagine we would be.  But I'm also sad too. I'm sad because I want all of you to have this too (outside of the hysterics . . . that I'll keep). I want to be able to wave my magic wand and to give all of us a baby, right now. Because all of you will be mothers, and awesome ones to boot.

Grey and I are off to go spin the prayer wheels.

POAS PTSD

I remember the first couple of months of TTC. Like most women, I was fairly confident that I would be pregnant within a couple of months of trying. After all, infertility was unheard of in the women in my family.  As time wore on, though, I started to become wary of HPTs. The anticipation of seeing that second line or only seeing the word "pregnant," began to be replaced with a sense of dread.

Today is 8dp5dt and I have yet to POAS.  Originally the plan was to take an HPT yesterday so that we would have some resolution before my birthday, but when it came time, I couldn't.  The anxiety of seeing only the one line and then having to wait until Wednesday to follow up with a blood draw was just too much. As much as I want to know, the rollercoaster ride that would ensue following the event isn't something that my heart can take.

I think I'm in the minority with this issue. Over the past couple of weeks, I've read many posts about follow IFers posting HPT result after HPT result. The anxiety I feel from reading these posts has made it difficult to follow a lot of these blogs and I've felt a lot of guilt for not being able to be more supportive.

Tomorrow morning, I go in for my beta. I will also bit the bullet and POAS. There will be tears for sure.  And shaking. And so much anxiety, praying, bargaining with the universe. But not today. Today I'm trying to hold on to this feeling that Grey and I have done everything we could.

A Case of the Mean Reds

The holiday season is in full swing. Last minute gift shopping is rampant, Santa hats are everywhere, traffic is crazy, you get the picture.  Grey and I are laying low this year, as we are in the middle of the two week wait.  And for the past few days, we've done a fairly good job of distracting ourselves while embracing the holiday cheer.

Until today.

The day started innocently enough.  I had finished all my grading and submitted it while Grey was off getting a hair cut.  We went  out to run a couple of errands and decided to stop by a local park to walk along the beach of Puget Sound.  As I gazed out onto the water, I spoke out-loud to the embryos, promising them that if they decided to implant and hang out for the next 9 months that we would bring them back there and spend a day in the sand.

And instantly, upon saying those words, I got hit with this overwhelming feeling of dread and despair. And a singular feeling that it was all over.

Somehow, we made it off the beach before I broke down sobbing.  I don't remember how we got home.  All I know is that I somehow made it to the couch and cried myself to sleep.

Part of all this is due to recent bad news from other bloggers, watching them as they go from utter elation to absolute despair.  The other part is this ongoing belief that there is no way this will happen based on the simple fact that I don't deserve this.  That, since birth, I was destine for this misery.  Logically, I know this isn't true.  Yet after 2 years without a single positive result, it's hard to refute that thought.

Tonight, while families around the world gather to celebrate, I find myself on the couch shaking.  My body is sore from the last month and my heart is bleeding from yet another holiday without my children.  Yet, somehow, we're expected to trudge on, suck it up and put on a smile for all the world to see.  And if I don't, I'm immediately reminded how "lucky" I am.  I don't have cancer or some life-threatening disease. I have a warm home. I have food to eat. I should remember how blessed I am, right?

Yet, what people don't take into account is that there are far worse things in this world than death. And that life requires more than simply physical sustenance. Soul-sickness can kill too.

I'm struggling. I want to desperately to believe that there's still a chance for this cycle. And I'm so very tired of hitting this point in the 2 week wait where all I can do is cry.  Just once, I'd like that happy ending; some sort of miracle.

The Weight Before the Door

First off, welcome all from ICLW. Brief background on me: after 2 years of TTC, we took the plunge and proceeded with IVF. From this cycle, we ended up with 8 embryos. 6 were frozen, 2 were transferred. I'm currently in the two week wait.

In an effort to distraction myself from analyzing every twinge and pang during this wait, I've been reflecting on my own journey so far and how it has changed Grey and me. Yesterday, as I was going through some old boxes, I came upon our wedding programs. The trip down memory lane was quite a bit of fun (we had a small wedding on a lovely summer day in June 2004. Overall, it was a wonderful day).  While flipping through the program, I came upon a story that we put at the end of it.  This story was collected in Morocoo in 1908 by Feridah Kirby Green, who was the daughter of a British Minister. I first heard the story while taking an African Storytelling course as an undergraduate and I fell in love with it's lesson immediately.

The Weight Before the Door

There lived once a man so rich that he measured his money by the bushel, as we poverty-stricken ones measure barley or bran. One day, he fell very ill, and, feeling that his last hour had come, he called his son and gave over to him all his wealth and property. He said to him, "My son, I leave your welfare in the hands of the Almighty, and to the care of such-and-such a one, who is my friend. Listen to his words, as if they were mine. I have instructed him to find a bride for you when you are ready to marry."


Having blessed his son, the man died.


After a time, the young man desired to marry, so, according to his father's last word, he went to the his father's friend, his guardian and informed him. The Guardian said, "It is well," and he set out and found a young woman. He made all necessary preparations, and caused a suitable feast to be prepared. The morning before the carrying of the bride to the groom, the Guardian called the young man and siad to him, "Son of my friend, I have found you a bride. But before we may know that she is the one destined for you by Allah, it is necessary that you should do this. Tonight, after the bride has been brought to your house and she is seated in your room awaiting you, and before you go to her, I shall cause a heavy weight to be placed before the door of the room. You are to attempt to remove the weight. If she is the fitting wife for you, you will succeed; if you do not succeed, you will know that she is not for you and you should divorce her tomorrow without so much as seeing her face." 


The young man wondered about this, but said, "It is well."


That night, the bride was brought with much pomp and rejoicing, and the bride was taken to the man's apartment and seated there in a rich robe to await him. Her eyes were closed and a veil covered her face.


The bridegroom, after tarrying a while in the mosque with young men of his acquaintance, came up to the door of the room. The door was agar, so that he could see the shrouded figure. Before the door lay the weight, of which the Guardian had spoken. The weight was round like a ball and not large.


The youth though, "I shall life it with ease and won't wait to go in to my wife." But when he tired to lift the weight, he could not move it---no, not the breadth of a finger nail. He tried with all his strength to move it by lifting and pushing and rolling it, but in vain.


He did not enter the room.


The next morning, he went to the Guardian and told him what had happened. The Guardian said, "You must divorce this woman, my son, and I shall seek another for you." This was done.


The Guardian, after he had found a second woman, caused a yet finer feast to be prepared. The bride was brought, as had happened the first time, and the bride was seated in the young man's room. When he came to enter, the weight again lay before the slightly open door. Though he saw the veiled woman, and though he tried with all his strength to remove the obstacle and go to her, he could not---no, though he struggled until dawn.


When the Guardian heard that the young man had failed once more, he signed and said, "Nor is this wife destined for you by the All-wise. Let us send her back to her father and I shall seek again."All was done as he said.


When the young man came for the third time to try to enter the bridal chamber, for the third time he saw that the way was blocked. He said, "This time, I shall remove the weight or, if I cannot do it, I shall try no more.  If I do not succeed this time, I shall know that it is decreed that I should die unmarried." He bent his back and seized the ball with his two hands, and he pulled at it until he groaned with weariness, but in vain.


The young woman within heard his groans and she said to herself, "Shall I let this man who is my husband kill himself without striving to help him?" She arose, put aside her veil and her outer robe of gold and pushed herself through the half-open door. She approached the young man who was wrestling with the heavy weight and said, "Let me help, my lord."


The two placed their hands together on the ball, and pushed with all their force. The weight rolled on one side of the door, so that the entrance was free.


The young man looked on the fair face of the woman who had come to his aid and saw that she was in truth the bride destined for him. He embraced her and the two entered the room together.


The past couple of nights, Grey and I have been reflecting on the journey we've been on. The road hasn't been easy: there's been a lot of loss, a lot of pain.  In truth, there were many times where it would have been a lot easier if we had simply given up.  Yet I couldn't. He couldn't. Because giving up would have meant giving up on our family.

7 1/2 years ago, I stood with this man before friends and family, promising to move any stone in our path.  I never dreamed that some of those stones would be the size of boulders and that there would be moments where we would be working together to climb over them as we were unable to move them. Yet I can't imagine any other person I would have wanted by my side during this.

The moral of this story is simple, though not easy: A fruitful and blessed marriage will be one in which the husband and wife (or husband and husband or wife and wife) struggle with life's problems, problems that are represent by the weight before the door.

In 7 days, we will receive results from this cycle. I pray that weight is nonexistent.

A happy day

Sorry for the delay, but all the excitement from this morning left me pretty exhausted.

We transferred two beautiful embryos: one 5AA, that was just starting to hatch; one 4AA that wasn't far behind.  I cried when I saw them.  I've seen textbook images of blastocysts, but never ones quite as clear.  They are beautiful.

We ended up freezing down four embryos today and they are culturing the other three for one more day to see how they develop.  It looks like we may have one more.

The only hitch of today was me not having drank enough water ahead of time.  I really thought that after 4 liters I would be okay; learned that isn't the case.  My RE and I had a nice chat about horses and riding while we waited for my bladder to fill.

Tonight I'm meditating, relaxing and indulging in bad TV.  And praying that in 9 days I get the best birthday present of my life.  I'm also incredibly grateful for all your words of support.  I'm so lucky to have all of your support.

Transfer Day

Well, we're finally here: transfer day!  I heard from my RE on Saturday that all 9 embryos are growing and dividing at a good rate, so all are in the final media.  I cried like a baby outside the post office after receiving the news.   I'm so grateful that we've made it this far.

I'll update you all later today, but I wanted to share a photo.  This is a shrine my neighbor set up for us.  One tea-light for each embryo.

Quick update

Two things this morning, all.

1) I you follow Rebecca over at Pink Lipgloss and Prenatals, stop by this morning and give her a hug.  She had quite a scare yesterday all starting with a visit to Urgent Care.  Rebecca, I've already said it, but I will say it again.  Thinking of you today and sending you so much love and light.

2) RE called this morning with the fertility report:
           22 follicles
           18 eggs retrieved
           13 eggs mature
             9 fertilized
I'm so relieved because now we FINALLY know that it is possible for Grey and I to make embryos.  I now have one wish:  GROW!!!

Sympathizing with a small brown dog

First off, thank you all for your comments and kind words! I'm so incredibly fortunate to have all this support as we go through this cycle. You all rock!

This post starts with a story about a small brown dog. Every year, my graduate program held a BBQ at the end of the academic year to celebrate the upcoming summer and to congratulate one another on surviving.  It was always a great party with faculty, staff and grad students, where we could toast getting through it intact and spend an afternoon not talking shop. It also was a time for graduate student mischief, usually involving kickball (side note: I loved kickball when I was 9 years old; kickball as an adult involving alcohol usually involved blood and bruising. This crew plays for keeps). Not long after I started my program, it became an annual tradition to roast a pig. This is a day long process and the area around the pit became a favorite spot for every dog within a 5 mile radius. Most of the dogs were very obedient, taking only what was given to them. But there was one dog who was food-motivated and a bit too smart for her own good.  Her name is Sara, the brown dog.

One year, Sara was making the rounds, convincing every naive soul that she haven't had her share of the pig. Near the end of the BBQ, the person in charge of the pit remarked at how quickly all the leftovers had been snatched up. No one thought anything of it. During kickball, Sara's caretaker commented that she had had a good day and was going to sleep well that night. We all lovingly patted the brown dog as the party ended and headed home. A couple of days later, I ran into Sara's caretaker, who was clearly pissed off. Turns out the brown dog had had an interesting night following the festivities. Around midnight, brown dog was twitching uncontrollably and couldn't stand. Afraid for the worst, she was rushed to the emergency vet clinic and admitted right away. After 20 minutes, the vet on duty called her caretaker to the back.  She was followed by two vet techs who had tears in their eyes. Once in back, the vet put up an x-ray of Sara's abdomen and announced that she had a diagnosis.  "You see, her stomach is very distended, filled with food.  Her problem is that it's stuck because her colon is full, because she can't poop.  And she can't poop because her bladder is full.  And she can't pee because her stomach is full." At this point in time, both vet techs were laughing uncontrollably and the vet had a grin from ear-to-ear. The resolution: a $500 enema.

I thought of Sara last night when I woke up at midnight because of a sharp pain on my right side.  Immediately I was freaked out that I had developed full-blown OHSS. It felt like I had a rock in my abdomen that was pressing on both my colon and my sciatic nerve, sending pain up and down my leg.  Grey grabbed cold washcloth to apply to the area and as soon as he put him hand on my belly, we both felt the gas bubbles move through my GI tract. "Damn" I thought as we both came to the realization what my issue actually was. Once I managed to relief some pressure, I felt better for a couple of hours, only to be awoken again due to the same problem. It occurred to me following the third attack that I was at a point where I could empathize with brown dog.  The only difference was that instead of a full stomach, I had enlarged ovaries.

This morning I went in for egg retrieval.  I was warned that following I might experience some pain and discomfort. Nurse S had a good laugh the story about the brown dog and how, like her, was actually feeling better following following some induced relief.

The report so far:  Started with 22 follicles.  18 eggs retrieved, 13 mature.  We should know tomorrow morning about the fertilization status.

In the meantime, Grey has me on a strict diet of soup and salad.  And he's threaten to have the brown dog come over to act as my nurse if I don't follow doctor's orders.

Doubts

I hate being a pessimist. Nothing is attractive about all the self-loathing and the second-guessing. When I was younger, I longed to be one of those girls who's so confident that "everything will work out for the best" or "though the rain falls, the sun will peak it's head out from behind the clouds soon." Yeah, I hated those girls.

My problem: to date, this cycle has been going really well. I'm currently at CD11 and have 22 follicles. That's right, 22. Any doubt I have about their existence is continually squashed by the lower back pain, the feeling of two cue balls pressing up against my kidneys and stomach and the constant feeling of nausea.  E2 level is 4728 as of this morning. We're triggering tonight for a retrieval on Wednesday morning. For all practical purposes, I should be very hopeful and optimistic. After all, the medical staff is elated. Yet instead, I'm finding myself waiting for the other shoe to drop.

Being on this path long enough results in hearing a number of IVF stories: there's the ones where everything was perfect from the beginning leading to a very happy ending. Everyone on this path wants one of those. Then there's the ones where things didn't look that great going in, but resulted in a healthy happy baby. I've done my share of cheering for those. And then there's the stories that people talk about in the third person or are not told till years later. The stories of the optimal cycle that failed.

Tonight, I'm finding myself on the edge of a cliff, getting ready to dive head-first into this next step.  Though I know that there is nothing I can do to change the future, I'm absolutely terrified. I'm terrified that in the next few days everything that I knew will be changed. There's a chance that all of this will work out wonderfully and the thought of that brings tears to my eyes. And yet the eternal pessimist looms, pointing a gnarly finger at the other possibility. I really wish that I had a bat to beat her up, knocking her out of commission, if just for one night. So that for once, that sense of caution and preparation for the worst was gone. That I could for the first time in two years embrace the unknown, excepting whatever the outcome would be.

Fog

One of my favorite things is to walk through the woods when they are covered with fog.  There's a quiet that sets in due to the land-cloud muffling any noise and a sense of mystery.  You never know what's around the corner.  The problem with fog is that it can be disorienting, masking potential dangers.  If it gets too thick, there is a very real danger of becoming lost.

The past few days, my head has been in the clouds.  I've been finding it hard to concentrate on the simplest tasks and have become incredibly forgetful.  It's gotten so bad that yesterday I had to stay home from work, concerned that driving would be disastrous.  The problem with being so foggy mentally is that I don't know what's good news from bad news, what's up from down.
 
Today was monitoring appointment #2.  Dr. Practical has been in charge of watching my follicles grow, upping my dosage of Gonal-F.  Today she had a resident and senior medical student in tow.  When they entered the room, all I could think of was "don't say anything dumb."  Nodding and smiling was something I can do without having to seem mentally together.  As I lay naked from the waist down on the table, allowing them to visualize the progress of the medication and ask questions/make observations, I found my thoughts drifting to the Muppets song 'Mahna mahna."  It wasn't until about 2 minutes in to playing this over and over in my head that I realized that the room was awfully quiet.  When I opened my eyes, I found Grey giving me the most amused, bewildered look.  I looked over at the three medical professionals who were starring silently at me and it was then it dawned on me that I had been humming.

Good news of the whole visit: I have 19 follicles, with the leading follicles being around 12 mm.  They want to see me Sunday morning for another visit, but I'm hoping that we're getting close.  Bad news: I'm now one of "those" patients; the ones that become immortalized for abnormal behavior.  So I have two options: fret about it, or run with it.  I'm all for the latter, but I don't know if I can come up with something as equally entertaining by the next visit.

Dear Gonal-F, I want my brain back

Quick update . . .

It's that time of year, again.  With the holiday season in full swing, finals week is looming.  My students are officially in full panic mode (I've been informed that I'm part of the problem) and demanding that some form of help comes ASAP.  So, it's bullet points for today.

• Had first monitoring appointment this morning.  And we have 15 follicles currently at 10 mm!  There are potentially more, but they won't be able to tell for a few more days.  Next appointment is Friday morning.
• The drugs are making me very sleepy.  Last night I passed out at 8 pm.  This means I was up at 4 am.  Jax and Dais were totally excited about the idea of 4 am breakfast.  
• Because of said panic, my students have requested two review sessions prior to the final.  One over the weekend (which I can do) and another right before.  Problem is, I may be doing the retrieval at that time.  So I had to level with them and tell them that I was going to be having surgery, but can try to set up a skype review session.  Now they're concerned I'm dying.  It's nice to be liked.
• We've been slowly decorating the house for Christmas and I now have two very happy furballs who are camped under the tree.  Jax has moved all his favorite toys and insists that play time center around him hiding under the branches.  When I'm more awake, I'll post pictures.
• With the holiday session comes holiday parties.  Grey and I are being selective regarding which ones were attending.  And I've thrown all caution to the wind and have been telling everyone who asks how we are about our IVF cycle. Found it's been a great way to get people to shut up regarding the "when are you going to have children" question and allows me to immediately deal with any misconceptions regarding this treatment.  I'm sure this will bite me in the ass at some point, but I'm officially done caring about what other people think.

The great embryo debate

Okay, just to get this out of the way: I had my suppression check this morning and we are good to go!!  17 follicules and the RE on duty (I have three at this practice) decided to up my dosage of Gonal-F.  So I'm waiting patiently for the phone call for instructions for tomorrow.  

Before the ultrasound, I had a very tense discussion with the RE.  As I mentioned, there are three practicing REs at my clinic. Of the three, the youngest,  Dr. Practical, is my least favorite (The other two, Dr. Sage and Dr. Optimism are awesome!!).  It was expected that any serious discussion with Dr. Practical would be tense, as her bed-side manner is not very good.  The topic of discussion: Single-embryo transfers.

For those of you not familiar with this option, Elective single embryo transfers or eSETs, is a procedure where one embryo is transfered following fertilization or thawing.  Usually it is a high quality embryo that is selected from a large set of high quality embryos.  The whole push for this comes with the knowledge that a multiples pregnancy is dangerous, both to the mother and the fetuses.  And even after birth, there are long-term health consequences for the children.  

Grey and I are very well aware of this.  My BIL and his wife were able to conceive fraternal twins naturally and, though the pregnancy went as well as could be expected, there have been a lot of complications.  The delivery was very hard on my BIL's wife (she lost a lot of blood) and recovery took a lot longer than usual despite it being vaginal. Shortly after the twins were born, we flew out east for an emergency visit when we learned our two-month-old niece would be requiring surgery due to the fact that she wasn't able to keep anything down (luckily, the surgery was cancelled at the last minute).  And when we got there, we were immediately immersed into a world that had been turned upside down.  It took four adults to manage two less-than-healthy infants and though I loved every minute of it (feeding them, rocking them to sleep, holding them), it was obvious that this was a very stressful situation for the parents.  Even two years later, life revolves around what is best for the twins.  Though they are both healthy and happy, my BIL and his wife are still dealing with the aftermath of their birth and my niece still requires physical therapy.  

Knowing this, and also knowing the research, avoiding twins is something that is at the fore-front of our minds.

But I also know that single-embryo transfers have a lower rate of success.  For my own selfish reason, I don't  want to blow our chance of getting pregnant because we only transferred one. It's only slight (5%), but it's still there.  In addition, I have no idea how I will respond to the drugs, if we'll get eggs and if they will fertilize. And if we are so lucky to end up with embryos, we won't know the quality TILL they are being cultured.  

So even though Dr. Practical wanted to get a verbal agreement from me that if we have high quality 5-day-old embryos, that I would only do a single transfer.  She pushed, I stalled.  I stalled because I'm not willing to verbally agree on a hypothetical.  And it was obvious that this wasn't what she wanted to hear and the pressure to make a decision increased.  Thank G-d Grey was there.  He immediately started firing off questions and, between the two of us bombarding her, we made it clear that she wasn't going to be getting an answer today.

After the ultrasound, Grey and I talked.  I'm amazed at how well he is able to break down the situation, offering different hypotheticals for each outcome.  He agrees with me that no decision can truly be made until we have the data following the retrieval.  But he also told me that he'd really like to avoid twins.  And that, if everything is optimal, that eSET may be for us.  

I'm still processing all of this.  And as this cycle begins, I know that over the next few days I'll get more and more data to help us make this decision.  But right now I'm blocking it.  Partly because I don't like generating multiple hypotheses without any data to back it up but also because I'm scared that I'll jinx myself.  That after all this talk, I'll won't even end up with embryos and all of this will have been pointless.

In need of inspiration

Thursday is my suppression check.  I'm both excited and nervous.  I'm nervous they're going to find a cyst again, nervous that everything is not sufficiently quiet, worried that they'll put us on hold.

Today I'm trying to keep my hopes up, listening to music that will provide me a sense of peace and purpose.  This song from Charlotte Martin summarizes everything a little too well.