Friday, September 28, 2007

Ready, set, wait

The transfer was yesterday. We transferred two embryos -- "Uno" our lone embryo from our last fresh cycle - 4 cells - and "Dos" from our first fresh cycle - 9 cells. They were grade B and B+ -- I can't remember which was which. Interestingly, they performed assisted hatching on them and to our surprise we learned yesterday that they had apparently performed assisted hatching on our last cycle. I have to admit that surprise is not the only emotion I felt at this news.

I actually wasn't expecting to hear any news of our embryos until Friday, as that was what happened on our last cycle. When I talked to the nurse on Wednesday, she did not have any news other than that the first 3 embryos had been removed from the freezer (I'm struggling over the terminology here -- it is all just a little weird when you put it into writing). But on Thursday, the lab called and talked to K. They were asking about removing the additional embryo (Uno) and informed us that the embryos were grading as A and A-. Then on Friday morning the lab called again and talked to K and said that they wanted to perform assisted hatching (in part because they had done so last time). I had been trying so hard to remain calm and proceed with life as normal, that I had gone into work on Friday morning. So K calls me at work and of course I end up in the hallway on my cellphone (I work in a cubicle so the only privacy I get is by going in the hallway or downstairs to the lobby) trying to figure out what was going on. I called our nurse to try to find out some more information. I let her know that I was pretty upset by the fact that assisted hatching had apparently been performed last time without our being informed--especially considering that this is not the first instance where our clinic has failed to tell us information. So then she transferred me to the lab so that I could talk to the embryologist directly. Apparently, assisted hatching is very commonly performed in our clinic (again something that was never discussed with us) and that she wanted to do it because 1) our embryos were not dividing well and 2) it was done last time. She assured me that overall the embryos looked good but that this would just give them an extra chance. So I agreed.

When we went back for the transfer, the doctor showed us a picture of our embryos. She had already marked 2 of them as "Y" and 2 as "N" One of them had divided but looked abnormal (the cells were all the same size and they aren't supposed to be). I can't remember what the deal was with the other one that we didn't transfer except that it obviously hadn't divided as well as the others. The 2PN (frozen on Day 1 of our first fresh cycle) had divided to 9 cells and the Day 3 (frozen on Day 3 of our second fresh cycle) was 4 cells and had not yet divided but looked as though it was about to.

So there you have it. I have been trying to stay off my feet and have moved from one couch to another over the last 24 hours or so. Trying not to freak out too much (I'm actually doing a better job than K). I've already determined that I am not waiting for the blood draw this time (which will be on October 12) and am trying to decide how soon I can realistically to a test and expect anything close to an accurate result. Tomorrow? Probably a little too early. I'm also trying not to think too much about our clinic. It's hard though. I can't help but feel very frustrated by our experiences there. But, on the other hand, there are some really good things about it as well. And honestly, I don't really have anything to compare it to. I don't know anyone else (in person at least) going through infertility right now. My sister and both of my sisters-in-law went through infertility but they only ever did IVF once. So I don't really know anyone that has had the kind of sustained contact with a clinic that we have had and what that experience has been like. It's hard for me to put our experience into any kind of real perspective, but it just seems like the fact that they have failed to tell us things like this is not ok. But, in the end, how much difference does it make? And what can we do about it anyway?

Wednesday, September 26, 2007

Never mind

I spoke too soon and so I felt the immediate urge to correct myself. My backside is now officially sore -- tender to both touch and movement. So apparently the thinner oil only ensures that the immediate aftermath of the shot is not as unpleasant as it could be and the soreness kicks in after 12-14 hours. Ouch.

Cycle update

Estrogen Patches
I briefly mentioned my estrogen patch woes in my last post but have decided that the issue deserves more attention than that. For those of you who have never gone through a frozen embryo cycle, let me provide a little background information.

In a fresh IVF cycle, estrogen patches are used after retrieval. You put one patch on and leave it on – only changing it once or week. Or so I’m told. Since both my IVF cycles were cancelled after retrieval, I never really made it quite that far. But, I understand the theory. A frozen cycle has none of the bells and whistles (e.g., Lupron, Follistim) of a fresh cycle but lots more estrogen patches (assuming that, like me, you are doing a frozen cycle with hormone replacements rather than a natural cycle with monitoring). So, you begin on Day 1 of your cycle, which by the way isn’t really Day 1 as in the day you started your period (so why in the hell do they ask you for that at every appointment?).

Wait. I lost my train of thought. Where was I? Oh, right. Day 1. Place one nice, small estrogen patch on your abdomen (preferably below the waistline where your underwear can help keep it from falling off). Replace patch every other day. After about a week, increase to 2 patches. Then go up to four. Then down to 3. Then down to 2 but change after only one day. Then back to changing every other day.

Don’t get me wrong--none of this is a particularly big deal. Aside from having to consult my schedule on a regular basis to remember whether I’m on an “on” or “off” day and to double check the number of patches to apply, the 1st couple weeks are a breeze. It’s just when you get several weeks in, like I am now, and the number of patches keeps increasing that things start getting sticky – literally. I mean, there’s only so much room on my lower stomach, especially considering that you’re not supposed to put a new patch in the same spot as an old one. So Sunday night as I’m trying to put my four new patches on, I look down to discover that there are little sticky squares all over my belly, red from trying to get the gunk off, and I can’t figure out where to put all of the new patches. So, I move to my ass – there’s plenty of room there…

Last night, I believe I discovered an effective method for removing the sticky residue – pumas stone. Don’t even ask me how it is I decided to try something I use on the calluses of my feet on my stomach, but I did. And it seems to work. Yes, it’s a little (a lot) abrasive, but if carefully done, the sticky stuff is conquered. My stomach looks remarkably better today (if you ignore the three new patches).

Progesterone shots
I feel like a total veteran of infertility and infertility treatments and in a lot (most?) ways I am. But on the other hand, when it comes to actual treatments, there is a lot that I haven’t done. I’ve only ever had one transfer. We never did IUIs, so the one transfer is my only experience with the whole catheter thing. And since both of my fresh IVF cycles were cancelled after retrieval, I’ve only done the weeks of progesterone shots for the one frozen cycle. (For the last fresh cycle we did the HcG trigger shot and one shot of progesterone). Last night we began the progesterone shots and while I was sort of blasé about the whole thing, I was also still somewhat anxious. I mean, there is just something strange about having your husband inject medicine into your rear end with a 2 ½ inch long needle. Luckily, the nurse had ordered progesterone in a thinner oil than what we used last time and it really makes a difference. I don’t want to speak too soon because often the soreness seems to build up over multiple injections, but for now, I am relatively un-sore. So I feel that perhaps I/we have this progesterone shot thing figured out (hope I’m not speaking too soon) and so I will pass along some tips that I have learned:

My tips for progesterone injections:

ë Lay down. The first intra-muscular injection we ever did I was standing up and it hurt a lot worse and I was much sorer the next day.
ë Warm the oil up ahead of time. We have a heating pad ready to go and use it to heat the oil up.
ë Count down. I tend to be a little jumpy, so to avoid this I have K touch the spot where he is going to do the shot and let me know exactly when he is going to do it.
ë Massage the injection site and apply a heating pad afterwards (especially with the thicker oil – for the thinner stuff this might not be as necessary—I’ll let you know in a few days)

The Thaw-out
I just now realized something and it is really making my heart pound. Our embryos will be thawed out today. I’m not sure what time and I don’t even know whether they will be calling to let us know (which means I will struggle with the decision of whether to call and bug them or be strong and wait for them to call). And speaking of thawing them out – isn’t that a really weird concept? It sounds like we’re talking about defrosting a chicken or something. Although, I like to think about my embryos more as popsicles.


Friday, September 21, 2007

Bored

Frozen cycles are really pretty boring. I know I shouldn't complain -- I mean, the good thing about a FET is that it is easy: less expensive, less invasive, etc. But, it's boring. No shots, no blood draws, only one ultrasound monitoring. Where's the excitement in that? Last cycle, I was shooting up with Lupron at a campsite. Now, all I get is some lousy estrogen patches. Of course, tonight I get to bump up to four patches. I can't wait. I love having strange, sticky patches all over my body that no matter how hard I try, I can't remove all of the sticky residue that they leave (FYI--alcohol does not work. Goo-Gone works pretty well but it's a little scary putting something that works on car grease on bare skin).

This morning was my first, and only, pre-transfer appointment. I went in for a quick visit with my good old friend -- The Dildo Cam. Of course, all they are looking for is a properly-thick lining in the uterus, and in my case fluid in the uterus (which thankfully there was none). I have to say it was not the best feeling in the world to be back in that office.

Highlights of the visit:


1) I didn't weigh as much as I did last time I was there (but I still weigh several pounds more than I used to...)
2) K using some piece of equipment that looks like a microphone to call for "vagina scan on aisle 5"
3) K taking a picture of me laying on the table (me, flipping him off in the process)
4) K and I looking around at the other couples in the waiting room to see if anyone appears more veteran (i.e., downtrodden) than us (they didn't) and then trying to make ourselves feel better by referring to them all as silly freshman
5) Me not remembering, and not even making a very good guess, the first day of my last period (I mean really -- how is that possible? Wasn't I just posting about that? But, no. Couldn't remember, even when handed a calendar. So, I guessed. And then got it wrong. It was listed in my chart from when I called to tell them that I had started. So why did they need to ask???)

That's about all there is to tell about this cycle for the moment. We start progesterone shots some time next week. So I'll be sure to check in by then. Finally, some excitement.

Wednesday, September 19, 2007

Emotional lows and lowers

I’ve been writing posts in my head for days now but haven’t put anything down in actual writing. So, here goes. You know how I said I had “calmed down” and “made a plan with K”? I guess that was premature of me. I had, in fact, calmed down and discussed a plan with K, but I only managed to stay calm for a few days. I thought that I was still being calm, but in fact, no, I was back to desperate, semi-crazy behavior. I can’t say that I am doing much better at the moment, but I have at least, once again (and maybe only for the moment) reached, if not a state of calm, then a state of semi self-control.

The back-story…I have mentioned before my feelings about adoption, but I don’t know that I have fully expressed my feelings. That may be, in part, due to the fact that I am not exactly sure how I feel. It varies day by day, hour by hour, minute by minute. Some of the time I am still feeling very hopeful about being pregnant – about my actual chances of getting and staying pregnant – and very much longing to experience pregnancy. Other times, the thought of going through the waiting and wondering of pregnancy scares the shit out of me – my entire experience of pregnancy has been short-lived and negative and it is hard for me to visualize myself experiencing anything other than that. I also feel that I have been waiting to have a baby for so long, that the 9 or so months of pregnancy is too much. I want my baby now! Even though I try not to, I can’t help finding myself regretting and questioning decisions that we have made. The number of times I think “if only we had…” is enough to drive me crazy (and perhaps it already has…).

“If only we had started the adoption process rather than pursue IVF… If only we had decided not to go through with the tubal… If only we had done a frozen cycle instead of a fresh one this last time…” and on and on and on. While I dwell on many of these “if only’s” the first one and variations of it, haunt me the most. If we had moved straight to adoption, we’d very likely have a baby by now. But at the time, it seemed that the most expeditious route towards starting our family was IVF. We had every reason to believe that it would work for us: I had gotten pregnant before, so we knew that we were technically able to conceive. I responded well to the Clomid and all my blood work looked good. IVF worked for my sister on her first try.

But nonetheless, it hasn’t worked for us, and yet we still haven’t officially moved on to adoption. Instead, we are in a sort of in-between mode, waiting to have one more shot (or one last shot) at a pregnancy while dipping our toes into the adoption waters. But in my state of desperation, there is a part of me that keeps hoping that a situation will fall in our laps, that we’ll get a phone call about a baby being born this weekend and that we’ll be “saved” from making any more tough decisions or going through any more waiting.

While there is still a part of me that longs to be pregnant and that hasn’t fully resigned myself to the idea that I may never get to be pregnant and give birth to a child, there is another, equally strong part, that just wants to be done with the whole thing altogether. I just want to be a mother, and I know that adoption would/will be a very positive choice for us. I am ready for all of this to be done, one way or another. And so I have found myself desperately searching the internet for information on adoption. But rather than being systematic and thoughtful, I have been completely haphazard in what I am doing.

Prior to making the decision to move forward with this frozen cycle, we agreed that if it didn’t work, we would move forward whole-heartedly with adoption. We had not made any decision as to whether that would mean signing on with an agency or more aggressively pursuing an independent/designated adoption, but we had both agreed that this would be it for infertility (at least for a while). I had determined that I would work on getting everything ready for adoption (e.g., finishing our adoption profile and photo album, creating a website, research funding options and agencies) so that when/if the transfer didn’t work we would be ready. I think all of these things would make sense to do and would fall into the “systematic and thoughtful” course of action. This is not what I have been doing. In the process of researching these more sensible areas of adoption planning, I ran across several websites that post potential adoption situations. The postings are mostly from adoption facilitators but also some from agencies, attorneys, and, in a small number of cases, potential birthmothers. The sites are somewhat addictive because it makes it all seem so easy and so very close and real. I have emailed about several of these situations and have gotten myself excited about them actually panning out.

I emailed about a couple of situations that I never heard back about. But here’s the breakdown on the ones that I did:

Situation #1: This was through an agency. I actually talked to someone and think that it was a legitimate situation but 1) it was going to a lot more expensive than what we were hoping for and 2) there were circumstances that neither K nor I were comfortable with. I/we made this decision right away, so nothing lost. I also had the agency send me general information about their program, just in case.

Situation #2: This was through a facilitator. A match had already been found but…she would keep me in mind for future situations. She emailed me later that same day about a baby that was due that very weekend. If we were interested she would print off our profile and overnight it to the birthparents. I said “yes!” and to please call me if she needed anything else. She never called. I emailed her a few days later to see if there was any news. She never emailed me back.

Situation #3: This was through a facilitator. A match had already been found but…would we be interested in this other situation? Yes. I emailed her our online profile. A few days later she called me and asked if I was still interested and if so, she would mail our profile. I emailed her a more complete profile. That Friday I called to check in and was told that the FedEx with our profile had not arrived but that they were trying to locate it. On Saturday morning, I got up early and started doing some research about this facilitator. What I find out was not good. This woman does not have a great track record -- with adoptive families or birthmothers. Additionally, she has never called or emailed me since anyway. Needless to say, this was all a good reality check for me and led me to my previously mentioned state of calm and discussion with K.

But again, this didn’t last long as I found myself looking up the same sites the very next weekend in search of more situations. Which I emailed about. And heard back about two of them. K’s response was less than enthusiastic. At first, I was frustrated with his response. WHAT WAS HIS PROBLEM? THIS COULD BE OUR BABY!!

Then I took a step back and asked myself “What in the world am I doing?”

We had made the decision to move forward with a frozen cycle. If something turns up through one of the attorneys we talked to back in April, that is one thing. But for me to be randomly pursuing potential adoptive situations through unknown attorneys, agencies, and facilitators in various states across the country is absolutely ridiculous. Particularly since I am doing so without K’s true support and looking at situations that 1) he is not comfortable with and 2) he is not ready for. So…we had another long talk. We have decided that if this cycle doesn’t work, we will most likely sign on with the agency here in town that did our homestudy. And, I made him promise that we would have a good long talk about everything that we are and are not comfortable with at that point. I promised him that I would put a hold on my desperate searching and try to concentrate on what we are doing right now. So, I removed all the links to the adoption pages from my browser (Sad, I know, but I obviously have no self-control).

I can’t say I feel a whole lot better. But I know that this is the right thing to do. I can’t be splitting myself in two different directions. If we move forward with adoption, we need to do so with total commitment and put the infertility treatments behind us. But we’re obviously not there yet.

Friday, September 14, 2007

Frozen embryo transfer, blah, blah, blah

So I'm finding it very hard to get excited about this cycle. I FINALLY started my period and am scheduled for a transfer on September 28. But I'm just not really feeling it.

I really like the nurses at my clinic, the IVF coordinator in particular, but in terms of the doctors -- I could take 'em or leave 'em really and in fact, that sums it up pretty well as they seem to keep losing doctors. So, when the nurse asked if I wanted to set up a meeting with my doctor prior to transfer to discuss our options, I said no. I don't have the energy to go in there one more time than I have to and frankly, what is there to say? It's a frozen embryo cycle -- there's not a lot to do.

But, perhaps a meeting would have been nice. I had asked that they thaw 3 of our embryos from our first cycle (frozen on Day 1) and the 1 embryo from last cycle (frozen on Day 3). K went in today to pick up our consent forms and they told him that they would be thawing the 3 and only thawing the other 1 if the first three don't look right. Not really sure of the reasoning -- K is not exactly good at repeating information (in fact, I've yet to meet a man who is), so they could very well have told him something that made complete sense but he was unable to articulate that to me. Now, I had specifically wanted to try and transfer our embryo from the last cycle (I'm calling him "Uno") because I somehow have a good feeling about that one, but now it looks like that may not happen. I should be upset. And perhaps I am/will be. But right now I'm having trouble giving a shit. Maybe that's a good thing?

On the adoption front -- nothing is happening and I haven't written about it because I think I'm a little embarrassed? I definitely think that I was acting in a completely desperate, haphazard way which could have easily led me to make a poor decision. Thankfully I calmed myself down (at least somewhat), talked with K, and I think that we have come to some resolution as to next steps if this transfer doesn't work. I will write more about this, and my forays into adoption postings online, in a future post.

Saturday, September 8, 2007

Oh, the irony

37 days and counting...

So I always find it ironic when I am desperately waiting for a period. About the same kind of irony as when I'm taking birth-control pills as part of an infertility treatment cycle. Or, getting my tubes tied so that I can get pregnant. Oh, the world of infertility is a strange, strange place.

Wednesday, September 5, 2007

34 days and counting

and still no period. Why am I surprised? Actually, I'm not surprised. Of course I haven't started my period. Of course it's late. I'm actually not going to be surprised when this whole cycle is going to have to be delayed another month or so because of lab closures. I mean, I have run into lab closures 2 out of my last 3 cycles, and the nurse I spoke with last week mentioned that I might be running up against another. (How often do they clean that fucking lab? Is that a good thing? Or should I be worried that it's dirty enough to have to be cleaned so often?) Oh, and the doctor that did my last retrieval--who I had determined I actually liked? He's gone. Been deployed to Iraq. So, this cycle is off to a great non-start so far...

Sunday, September 2, 2007

Waiting is intoxicating (really)

I've already talked a lot about how the hardest thing for me in all of this is the waiting. But, the fact remains that that continues to be the hardest thing and I can't seem to get over it. I am struggling with an overwhelming sense of desperation and a need to do something, when in fact, there is so little that I can do. It makes me so incredibly edgy and just feels awful.

I am still waiting to start my period so that we can get started with the frozen embryo transfer -- I am, of course, late in starting making the waiting even longer. I am having trouble being very excited or even engaged at all in this upcoming cycle. Of course, I've figured out the timing of everything already -- depending on when I transfer, when I could first take a test, have a first ultrasound if it was positive, finish the first trimester etc. etc. But that's just standard procedure -- I've being doing that in some way or another for years now...

In the meantime, I have been browsing the web sporadically and somewhat haphazardly for information on adoption. As I said, I'm feeling this awful sense of desperation and it makes me rather than less than organized or systematic in how I am proceeding with things. So, I stumbled across several websites where adoption professionals (mostly facilitators, some agencies) post adoption situations. I randomly emailed about a couple of them and while none of the ones that I had emailed about were still available, I was given information about a couple of other ones. Supposedly, our family profile is going to be shown to each of these birth mothers soon.(!)

But, I don't really know much more than that. Totally obsessive, impatient person that I am, I was hoping it to happen immediately and to get a phone call or email right away. That hasn't happened. I don't really know what to think or feel. On Friday, when all of this happened, I was feeling incredibly excited and hopeful. But by the very next day, I was already feeling let-down and disappointed. Which I know intellectually speaking is ridiculous but my brain and emotions don't always coincide and no matter how many times I tell myself that 1) it hasn't been long enough to think anything one way or another 2) we haven't gotten ourselves invested (really) in either of these situations and whatever happens will happen and 3) we are about to start another frozen embryo cycle which could work and I can look forward to that .... I can't stop myself from thinking and hoping about the what ifs. What if one of these situations is the right one for us? What if one of these will lead us to our baby???

I can't help myself. It's all I can think about. But, as always, there is really nothing that I can do. So, I have been trying to keep myself busy, and mildly intoxicated. It is 2:30 in the afternoon and I am on my second glass of wine (which came after a beer). So far this weekend I have pulled a lot of weeds from the garden and yard (although my fight against dandelions is really a pointless, losing battle), made a batch of home-made pasta sauce, frozen a dozen or so tomatoes (we still have so many tomatoes it's ridiculous), cleaned the kitchen and bathroom, read most of Harry Potter - Book 4 (for probably the 5th or 6th time), taken the dog for a walk, had sex (which is truly amazing--the fact that I wanted to have sex, not the sex, although it was not bad), and.... checked my email about 100 times.

And now, my second glass of wine is gone. What to do, what to do? It looks really lonely and sad, sitting there empty. Hmmm... maybe I'll go pull more weeds. And then see how I feel. Perhaps I'll check back in here later. Or, perhaps I'll just get drunk. Really good and truly drunk.