Saturday, December 29, 2007
Remember the triplet boys on Christmas Day story? If I do switch to IVF at the time the RE is recommending, and if my cycles stay regular until then, my predicted due date will be... December 26th. How funny is that? Of course, if I were to get pregnant with triplets, there's no chance they'd bake a full 40 weeks. The mantra may need to change to triplet boys due on Christmas Day. Hmmm...
I'm not pregnant. I'm sure that's no big shock. If I'd had good news, you better believe I'd have found a few minutes to shout it from the cyber-rafters. I'm halfway through this month's round of Clomid. No symptoms so far to speak of, but last time, they didn't hit me until the 2ww, so the fun is probably yet to come.
I had an ultrasound on Thursday morning. It was perfect. Of course. Perfectly healthy with absolutely nothing to fix. Damn it. I asked the doctor about the laparoscopy and she said (again) that she wanted to do two more Clomid cycles and then she would encourage IVF, but would consider a laparoscopy at the time if that's what I preferred. She also said that she would recommend IVF over laparoscopy because the IVF would likely be the treatment for anything the laparoscopy might find, so basically, if we're "to that point," why not just skip to the finish line. I'm not so sure. If they find Endometriosis in the lap, they can clear it out and it's possible I could get pregnant on my own after that. I'd really like to avoid IVF if possible (duh), and it's not just because of the $15,000 price tag that my insurance won't touch. At least I have two more cycles to think all that through and seek out a second opinion. I hate every single tiny part of this TTC garbage.
Interesting phone calls yesterday: So, the new RE won't use KD without the quarantine restrictions, right? That means that until mid-February (depending on how quickly we can get KD in for an infectious disease screen once the 6 months elapses), we need to stick with KFed. The RE was less than thrilled by our choice of banks and explained it would require some more administration on their part because they'd never worked with our bank before, but agreed to do it. My task was to call the bank and have their CLIA certificate and FDA registration faxed to the RE's lab for pre-approval. I called yesterday. I reminded the sperm bank lady what donor we were using and she notified me that we "might" have an availability problem for next week's IUI. They have some vials of his in storage, but aren't planning to screen him again until the end of January so the vials have to be held until then. She asked for our second choice. I told her I couldn't remember so we'd have to check the profiles again and get back to her. Blech. I hate daddy shopping. HATE. Then I asked her to fax the info to my RE. Turns out, they don't even HAVE a Clia certificate!! Here I am thinking this is the most straightforward part of the whole call and they don't have the damn certificate so the RE won't use them. The best part of this is that it is the afternoon of Friday, December 28th. The next day I'm likely to find people in their offices is Wednesday, January 2nd, and I may need to inseminate as early as the 4th. There is NO WAY IN HELL that we can set up an account with a new bank, choose a new donor, and have the vials shipped to arrive by the 4th. Not gonna happen. And please recall that I'm 3 pills into my Clomid, a drug I do not want to take for a month longer than I have to.
There are three choices as I see them: The first is that I fly out to KD's next weekend and we go back to doing things "the old-fashioned way." Not that way, the other old-fashioned way. You know, a business meeting? This is less than ideal seeing as I just put KD on a plane this morning and I already have a big trip planned for later this month. A second, less-preferable option is that I can just pick up a vial myself from the bank and do an ICI at home. One drawback to both of those routes is that ICI is less effective than IUI so it's a partial waste of the Clomid cycle, but at least we won't lose the cycle altogether. The third and best option (cue heavenly music here) would be for my NP to do the insemination. She'll do an IUI, she's cheaper, and she'll use KD's swimmers. I need to call the RE and ask her about this option and I hope she'll give it the thumbs up, but I'll do it anyway even if she doesn't. The worst she can do is refuse to count this cycle toward the two more I need before we go to the next step (since she didn't end up having control over all variables), but at least I won't miss the cycle. I also have to ask the NP if she's willing to do it, but I feel like she will be. After nearly a year of monthly meetings, I think she wants this for us just about as badly as we do.
Sooo, that's all the news that's fit to print. I'll do a better job of updating - should be easier now that the holiday chaos is going back into hibernation.
Monday, December 17, 2007
Tuesday, December 11, 2007
This post has been brewing for a few days, and when it started, it was going to simply be an "I really, really hope I get pregnant this cycle" post. Since then it has been trying to evolve into a raging vent with lots of swear words. I'm hoping to meet myself somewhere in the middle here.
Here's the "I really, really hope I'm pregnant" part:
I am so very tired of this rollercoaster. I have been living my life in two week increments for 15 months now, and each month, I spend at least one day soaring on the highest highs and another weathering the lowest lows. It's downright draining. If this cycle works, my due date will be August 30th. This would suck from a weather standpoint, but that's why God invented air conditioning, right? From every other angle, it would be perfect. M would be totally done with school so she wouldn't have to tear herself away from a newborn to deal with class stuff. It would be early enough to not interfere with our goal to move in the fall but late enough that I probably wouldn't have to go back to work after my maternity leave. It really is just kind of perfect. Also, we were able to use KD as the donor, something we might not be able to do again for a few months.
Since then, I've become totally overwhelmed with all this TTC nonsense, and I am sooooo ready to be done, and not in the fun, optimistic "Gee, I really hope this is my month!" way. I had the consult with the RE last Wednesday and it was completely depressing. I don't even know where to start in explaining why.
1. She is not willing to use KD's stored vials without them passing quarantine. I knew this would be the case, but it still felt like a punch to the gut for some reason. The reality is that KD is who we want to use, and despite all the rationalizing I did to come to terms with using an anonymous donor, KD is still my first choice. At the time, I could justify the switch by needing to rule out incompatibility issues between KD and I. But now, with two failed inseminations using KFed (half the medical "best practice" for ruling out donor issues, but still), I feel comfortable enough to want to proceed with KD as the donor, whatever that takes. I think I talked her into compromising on the quarantine issue enough to count the time the samples have already been in storage toward our 6 months (giving them a release date of 2/1/08), but I won't count that chicken until it's hatched, grown, and laying eggs of it's own. Not after the experience we had with the evil cryobank.
2. I went in with a mental list a mile long of options I expected to be presented with: injectibles, trigger shots, mid-cycle ultrasound monitoring, laparoscopy... She suggested none of these. What she suggested was repeating an ultrasound I had several months ago, 2-3 more cycles with Clomid (but at 100mg. rather than 50mg.), then IVF. That's all folks. I have wrestled with this nonstop since my appointment. I feel like we've paid our dues and I'm ready to fast track this pregnancy. For perspective, you have to remember that we're figuring we only have 3-4 more months to try before we have to take a year off to relocate. So, if IVF is what it will take, then IVF it is, and bring it on sooner than later, please. I just can't believe I'm really at that point. The only explanation I've come up with for why she didn't suggest any of those other options - right or wrong - is that they are all designed to address specific fertility issues, none of which I have based on the battery of tests I've completed. So I guess she's just not wanting to waste time on fixes for things that ain't broke. I'm just disappointed that she didn't think any of those things were worth trying. I really wanted her to believe that those options were viable for me, not in a patronizing or indulgent way, but in a genuine, I-believe-you-CAN-get-pregnant way. It's heartbreaking to hear that the professional opinion is that my only hope is a couple tries with one drug, then IVF. I'm thinking about getting a second opinion. The only problem is time. The waiting period for new patients is 2+ months in most practices - that's what it took me to get in with her. Also, she wants to hit the ground running with the ultrasound and 100mg. Clomid pretty much the second my period arrives, which is less than two weeks away. That doesn't give me a lot of time to make a decision about possibly switching doctors. The more I think and talk this out, the more I realize I need to at least have a consult with someone else, just for my own peace of mind, so I'll work on that. And I guess I'll probably just be stuck with her in the interim, which isn't a big deal. It's only money, and my sanity of course. The one other thing I'm thinking of doing is going back to her and (a) flat-out requesting a laparoscopy - no reason she shouldn't want to do that if I'm willing to pay her for it, and (b) informing her that if all she's planning to do is Clomid and IUIs, no ultrasound monitoring or mid-cycle bloodwork, I'd like to do that with my NP who charges half as much as she does, and return to her having saved up our $$ for IVF when the time comes to cross that bridge. Of course, I have to check with the NP and make sure she will prescribe the 100 mg. of Clomid, but I don't think that will be a problem. You're starting to see the issue though, right? Too many variables. Too many possible configurations. And the clock continues to tick...
I go through periods of feeling more and less sad about my own inability to get pregnant, more and less jealous of others who become pregnant so easily, and more and less desperate about my prospects of ever having a successful pregnancy. Lately, I've just been feeling "more" on all counts. Some days, I'm able to see my infertility as a gift, believe it or not. It's taught me so much about myself and M and our relationship, and helped me to empathize with a community of women who have endured this same challenge that simply can't be understood without having experienced it. But for the last week or so, I've just felt really sad about it all and wanted to go back to the blissful ignorance in which I conceived of myself as a healthy, normal person.
My non-TTC life has been a complete disaster lately, and that's not helping me have the emotional stamina I need to deal with all of this. M and I are both so ridiculously busy, we're lucky if we see each other for 10 waking minutes each day. We are beyond broke. I overdrew our checking account this week - something I haven't done in a looooong time and I'm at a loss to describe how much this stresses and frustrates me. I am drowning at work from having so much time off this month and last month. I feel like I'm on some kind of revolving object (merry-go-round? sit-n-spin?) and it keeps going faster and faster and faster as the world around me dissolves further and further into one big blur. Even acupuncture isn't cutting through the fog right now, and that's been my silver bullet for the last few months.
I have a decent break coming up for Christmas with M's family, and the guest list and agenda (or lack thereof, more accurately) pretty much guarantee that it will be a week o' awesomeness. Still, there's a part of me that is anxious about it because it's more time away from work, and being behind there is a big chunk of what is making me feel out of control right now. Once I get back on top of things at work - and it's totally realistic to do this before my last day in the office on 12/21 - I'm sure I'll be as overjoyed about having the week off as I am about the company I get to spend it with.
Really, what I need to do is sit still and think and talk about all of this. There is an answer and it's already in me somewhere. I just need to find it. I called M this afternoon and scheduled a "team meeting" for this weekend, so hopefuly we'll be able to work some things out. I have a feeling it will involve a significant amount of surrender.
Tuesday, December 4, 2007
If I'd written a dictionary two weeks ago, this is how the entry would have read:
Clo-madness (n.): 1. A transitory mental illness brought about by the ingestion of Clomid, a medication commonly used to treat ovulatory disorders; characterized by headaches, emotional outbursts, mood swings, antisocial behavior, and unexplained crying spells.
I'd heard stories of women screaming obscenities and throwing small appliances at their partners, friends, pets, and/or anything else that moves. Turns out, I was all prepared for nothing. With the exception of a couple of hot flashes, I was totally asymptomatic while actually taking the darn stuff. However, since stopping it 4 days ago, I have realized that a second definition is needed:
2. A secondary condition characterized by extreme frustration after learning through trial and error that Clomid F's up your ovulation timeline and produces false positives on ovulation redictor kit test sticks. Most commonly associated with taking an OPK on the same day as the last Clomid dose and being surprised when it returns a nearly positive result, causing one to panic and rearrange schedule to make sure IUI-ready samples are on hand for insemination which will surely occur within the next 24 hours. This is followed by the confusing state of continually peeing on OPKs which are turning less positive instead of more, coupled with the total absence of secondary fertility signs (a common side effect of Clomid) making it impossible to cross-check OPKs, and the knowledge that the tank only keeps samples at the appropriate level of freezing for so long. At this point, one typically calls the bank to verify that samples will last until ovulation (assuming it ever freaking happens) and is told that they can not guarantee it unless tank holder takes time off work to drive out to cryobank to have liquid nitrogen refilled. In the meantime, internet research is typically conducted that indicates (1) Clomid causes false positives on OPKs as late as 3 days post last dose of Clomid, even though ovulation never occurs until at least five and sometimes as many as NINE days past the last dose of Clomid, and (2) Clomid significantly delays ovulation, especially if started after day 5 (which would be especially interesting/useful to someone who started it on day 6 of her cycle). At this point, one typically concludes that ovulation is still a few days away assuming said person is only on day 14 of her cycle) and all the commuting back and forth to the cryobank, peeing on sticks, and general stressing that said person has done for the last four days has been totally unnecessary. And this - typically - does not make said person very happy.
If my NP had read the above entry, perhaps she could have told me a couple of things such as not to expect my ovulation to occur on time, and to delay the OPKs (which she requires I start on day 10) until 4 days past my last dose of the Clomid, seeing as it's hormonally impossible for me to ovulate before then anyway. At a minimum, she could have warned me to look out for the
false positives. Those pearls of wisdom could have saved me a lot of money, gasoline, and emotional reserve.