Tuesday, September 27, 2011

6dp5dt

Want to be cautiously optimistic with me?


Sorry the pic is so dark and blurry. I should have tried to get a better one. But, I think you can make out the important part. :-)

Cautious optimism, okay? I am endlessly excited and grateful to have seen two lines this morning, but also nervous to share something that feels so precarious. I know too well what can happen between now and my beta. That said, this morning's line was at least as dark as the "most positive" test I had with my chemical pregnancy, so I'm trying to draw reassurance from that and tune out the rest of the noise.

Please keep growing, little one. I am so happy to know you are here.

Monday, September 26, 2011

confessions of a early testing addict


When I was a kid, I used to get into swimming pools an inch at a time. I’d sit poolside on the hot concrete lip and dip just my toes into the icy water, concentrating on holding my legs steady so that no strip of skin slipped below the surface before I gave it permission to do so. Once my toes had acclimated, I’d drop my knees a bit so that half of each foot was submerged. Once my legs were in as far as they’d go, I’d turn around and lower the rest of my body in at the same slow, deliberate pace. Hips… Waist… Chest… Shoulders… I’d focus on this task and ignore the trembling in my muscles for as long as it took. I had unwavering confidence in my strategy, despite my brother entering the pool via cannonball over my head and my dad’s assurance that, no really, it would be so much easier to just jump in and get it over with.

And so it goes, for me, with testing. I admire those of you who can hold out until 14dpo and take one test, knowing that whatever result you see is the final answer, let alone those of you who wait past 14dpo and go straight to your beta without having peed on a single stick (Cannonballers!!). I am soo not one of you. I need to ease into my BFNs, each day shining a little more light on the answer, like watching a scary movie through slightly-fanned fingers. In all of my 16 previous cycles, I have started testing around 9 or 10 dpo, not because I thought I had a chance of getting a BFP that early, but because I needed to acclimate myself to staring at a BFN. Once I had a couple of “fake” BFNs under my belt, I felt ready to start absorbing the real deal. Each day, the stark BFNs chiseled away at my hope, but left some intact as well. Maybe it’s just too early. Maybe there will be a faint line tomorrow. Probably not, but maybe. By the time I hit 13 and 14dpo and knew that the BFN was real, I had eased myself into it by degrees. I was ready for it; eager, even, if only to stop the parade of pee sticks and uncertainty.

Until this cycle. This cycle brought something surprising and unfamiliar. I have had NO desire to test. More than that, I've been genuinely fearful of it. Don’t get me wrong, it's not because I'd rather dive right in to the deep end. I want nothing to do with it altogether. Like, maybe I can just skip my beta and go on not knowing until I either have a baby in 9 months or not? A test means the end and if the end is bad news, I’m simply not ready for the hard decisions that come next. When M asked me yesterday when I planned to start testing, I told her I didn’t know and that I didn’t even have any tests in the house. This is crazy, people. I used to buy pregnancy tests by the metric ton and look at them every day, counting down the seconds until I could rip one open and pee on it. (Oh, the crazy things I have admitted in this blog!) M was – understandably – surprised and offered to grab some at the store for me. She asked what brand I wanted. I said “I don’t know, whatever is on sale I guess. Actually, no, don’t get any. I don’t know what I want to do yet.” And I went to bed last night knowing that I would wake up on 5dp5dt with nothing to pee on. It felt right last night. Well, right-ish. Most relatively right? OK, let’s be honest: I was really just avoiding the issue as if that would somehow make it go away.

This morning, it didn’t feel right at all. It turns out the only thing more scary to me than testing is NOT testing. I woke up and, within moments, felt pure, unadulterated panic. What had I done? I got my BFP with E at 6dp5dt. That meant that this morning was my last chance to take a pregnancy test with nothing of substance riding on it. From here on out, they count. Scary, scary. I briefly pondered the idea of waiting until my beta, or at least the weekend, now that I’d already missed my preferred entry point.  The mere thought of setting myself up to be at the mercy of a single test, a single three-minute window to prepare myself for an answer of this magnitude, was more terrifying to me than any test result I could have seen this morning. Clearly, I had made a tactical error.

And that is how I ended up going to Dol.lar Tree on my lunch break and squinting at a pregnancy test in the fluorescent lighting of my work bathroom. It was completely and unsurprisingly negative. Aside from being ridiculously early and not FMU, I’m still chugging water by the gallon at my nurse’s insistence, so there’s barely a concentration of urine in my urine at the moment. Still, it felt good to pick up the security blanket of my practice BFNs. I should have known that abandoning the only strategy I've ever used would feel more scary, not less. The days march on. The answer is coming, whether I want it or not (NOT). Better to get it on familiar terms than to start diving headfirst into the pool now.

Oh geez, you guys. I'm so nervous. I just don't know what I'm going to do if this cycle is a bust.

I've had a lot of cramping since 2 days post-transfer, lots of breast tenderness, and a couple other... well, let's just call them oddities. I suspect they can all be chalked up to the combination of PIO and continued recovery from the ovarian stimulation and retrieval. As I said to a friend over email this weekend, I’m just hoping that I happen to be pregnant, too. You know, incidentally to my many "symptoms."

LMaF2: Donor Sperm



I am throwing my hat into the ring for the Love Makes a Family Blog Carnival. This week’s theme is donor sperm. I have written a lot about donor sperm over the years so I figure the best way to do this without beating too many dead horses is to give a recap of our story for anyone who is new to my blog (Hello! Welcome!) and include links to some of those past posts in case there’s any part of our donor dealings you’d like to know more about.

We started out with a KD, my partner’s brother. [more] We did 8 or 9 tries with him before two things happened: (1) We ran into an absurd logistical roadblock [more] and (2) our desire to Get Pregnant Now outweighed our desire to have the bio link to M’s family and we switched to an anonymous donor for two tries. [more] Our selection process that time was uncomplicated. We were using a small bank (Midwest) and the options were quite limited. We read through the bios on all of the available donors and picked the guy we most wanted to be friends with. Easy peasy. Those two BFNs bought us the time we needed to resolve the issues with KD and the peace of mind to know another donor wouldn’t be a “one hit wonder” and we switched back to KD. Our son was conceived using KD’s sperm on try #15, our first IVF. We were also lucky enough to end up with 5 snowbabies after that cycle.

Shortly before we began TTC #2, we learned that KD had taken it upon himself to get a vasectomy several months earlier. [more] I did not take this news well at all and it led to some very dark days months around our house. I felt like the anticipated FET was already scary enough because I was so desperate to avoid another fresh cycle, but now the stakes were raised exponentially. Those five snowbabies were our last chance to have the specific family I’d been dreaming of for so long. Our RE and embryologist were adamant that we thaw all five despite our repeated requests for them to offer us an alternative plan. It’s a good thing we followed their advice too, because only two of the embryos survived the thaw, and neither were in great shape. We transferred both this past January and had a chemical pregnancy.

There is no way for me to capture in words the amount of grief and anger I felt at that time. Even now, I have to consider it indirectly, the way you would look at a solar eclipse or one of those goofy Magic Eye pictures, to avoid the white-hot burn of the emotions. I was sad that I wasn’t pregnant, of course, but mostly, I was grief-stricken/angry/heartbroken/frustrated that we were at the mercy of donors at all; that their decisions and whims – whether or not to donate at all, whether or not to get a vasectomy, whether or not to come in for STD testing – could have such epic consequences for my little family, and there was nothing I could do to shield us from it. The climb out of that hole was a steep one and took time. [more] We eventually decided to move forward with anonymous donor sperm. [more] Right away, we found a new donor we were really excited about and I felt like the stars came back into alignment. [more] Then that donor turned out to be a flake (Bad genes, I’m sure!) and we had to go back to the drawing board. [more] The process of picking yet another donor was much harder. There was no clear winner like before; no “love at first sight” to soothe my superstition into trusting we were on the right path. Instead, there was an abundance of candidates, all of whom were… fine, but nobody that made my heart sing. I couldn’t figure out how to sort through them. [more] Eventually, time ran out and we had to make a choice. [more]  I continued to feel angsty about it for a while. As recently as a few weeks ago, I still didn’t feel settled on our decision. [more] But last week, we transferred two embryos that anonymous donor's sperm helped us to create. It wasn’t until we were sitting in the waiting room on transfer day, watching a UPS carrier haul in the unmistakable tall, rectangular box someone else hoped would be the answer to their prayers, that I turned to M and told her I’d completely forgotten the donor was ever part of our puzzle. Those embryos in a lab down the hall could not have felt any more ours, and the fact that I’d ever worried using an anonymous donor might take something away from that seemed completely absurd.

All of that said, I know I am still harboring some wounds from how our transition back to donor sperm played out. It’s not unlike having E at the end of a terrible labor. Was I happy to have the baby? Yes. More than I can ever say, yes, of course. But it didn’t stop me from grieving the parts of myself I lost along the way. Having him didn’t stop me from wishing I could have a baby and also feel strong and accomplished and in-control. There were important lessons learned along the way and, in time, I know I will come to feel grateful for them. I’m also hoping with every fiber of my being that, 9 months from now, I will be holding a tiny someone who will give the ultimate meaning to every twist, turn and bump along our road.

Next up in the carnival: An Offering of Love

Thursday, September 22, 2011

the lone ranger

We have one snowbaby. I took the call at my desk and was concentrating so hard on keeping my side of the conversation discreet, I didn't ask what stage it was frozen at, but I'm okay not knowing. Hopefully it will become a moot point thanks to a BFP. And yes, I will be sure to update on my adventures in testing as they unfold. :-)  Last time around, we had a bunch of outside-the-computer friends and family we wanted to tell before risking them seeing it online. This time, we've told almost nobody, so you all will be the first to know!

I had a tiny bit of spotting just now - first I've had since the transfer. Just noting it.

Wednesday, September 21, 2011

2w 5d

Here's hoping, anyway!

We transferred one blast and one late-stage compacting embryo at 1pm today. More details about the transfer to come (just 'cause I want them recorded somewhere) but that's the critical information. We should know tomorrow or Friday whether we have any snowbabies. Many of the embryos have already arrested but she said we might get one or two blasts or morulas that are suitable to freeze. Hopefully they won't be needed!

Thanks to everyone who is still reading this blog despite all the crazy that's been seeping into it over the past few days.

Beta is October 3rd. At-home testing to begin in about a week.

Tuesday, September 20, 2011

corrections

Hey, did you know that 8 cells is not the minimum standard for Day 3 embryos? It’s actually the precise stage of development they look for. It’s a subtle difference, but an important one. Some experts even believe that dividing too quickly (>10 cells on Day 3) is just as much an indicator of poor quality as dividing too slowly. I guess a lot of you did know all of that, but I didn’t. tbean’s comment yesterday inspired me to consult Dr. Google and… Oh. Oops.

I never researched Day 3 embryo quality during my last cycle because when I got the anticipated update call, I clung blindly to the nurse’s reassurance that everything was perfect. “Anything 8 cells or higher is great for this stage,” she said. This led me to understand embryo development as More = Better, without qualification. I used that schema to evaluate my update this time around, and I got myself worked up over something I shouldn’t have.

Here’s the thing: I’m just nervous. So, so nervous. I keep trying to find a measuring stick that will help me prepare for whatever the outcome of this cycle will be, even though I know such a thing doesn’t exist. When I got what I thought was a not-so-great update yesterday, I vomited my nervousness all over my blog before even taking a moment to think about it, let alone research what it actually meant. Rest assured that I’m feeling rather humbled today, and also extremely lucky and grateful to be where we are.

Transfer is tomorrow at 11:30am. Our clinic uses a surgical rotation and the doctor that will be doing the transfer tomorrow is the same one that nestled E into place 3 years ago. That feels like a good sign. I had acupuncture today and she planted three "seeds" in my ear that will remain there until Thursday evening. I'm ready. Let's do this.

Monday, September 19, 2011

serenity now

I just got the call from the hens at the RE's office. All 12 embryos are doing their thing to some extent. Here's what we have:
  • 2 4-cell
  • 1 5-cell
  • 2 6-cell
  • 3 7-cell, and
  • 4 8-cell
They are dividing slower than last time. So, that's a bummer. On the flip side, we still have 12 embryos, so feeling lucky about that.

My main goal right now is to keep myself centered in the belief that anything is possible. Every little bit of news that comes in tries to lure me into the dreaded all-or-nothing thinking...
  • Stimming doesn't seem to be going as well as it did last time. It's not going to work!
  • My BFF In Loco Parentis contributes the single most important ingredient to our BFP cocktail. It's going to work! (P.S. Thanks for the toddler!)
  • The nurse tells M we only had 11 eggs retrieved. It's not going to work!
  • Fert report comes in confirming 19 eggs retrieved and 12 embryos. It's going to work!
  • Embryo update pales in comparison to where we were last time around; many are lagging behind where they want to see them. It's not going to work!
I'm doing an okay job of staying open and hopeful, but it's hard, and of course there is room for improvement. To that end, anyone who wants to tell me success stories about sluggish embryos is kindly requested to pull up a chair. Also, if anyone can remind me when I'm supposed to start eating pineapple, that'd be awesome too. ;-)

Saturday, September 17, 2011

OMG

Fert report is in and it's very, very good.

20 eggs retrieved. 19 mature. 12 fertilized (4/9 ICSI, 8/10 conventional).

As you know, they'd only found 11 eggs by the time we left yesterday. I made the nurse double-check that she hadn't switched my chart with someone else's because the news seemed to good to be true. She pulled my records up in the computer to verify there hadn't been a transcription error and reported that I "can be happy all day."

That is only one less embryo than we had last time. Un-freaking-believable.

We made an eleventh-hour decision to do partial ICSI (like, in my cap and booties three minutes before the retrieval) as an insurance policy against the "no reported pregnancies" concern. Not only did we not need it but, apparently, it hurt rather than helped us. Oh well, there's no way to have known that in advance and with 12 embryos dividing in a lab across town, I am nowhere near complaining.

Friday, September 16, 2011

home

I'm still really groggy and drifting in and out (mostly out) of consciousness on the couch, but the doctor thinks she got 11 eggs. We'll know more tomorrow when the fert report comes in.

Wednesday, September 14, 2011

Friday Follies

Triggering at 9:30pm tonight for a Friday morning retrieval.

Nurse said my E2 is "just under 4000" and I actually had 19 measurable follicles this morning, but many are still immature. She cautioned me that we might only end up with 5-6 eggs to work with. I hope that is a conservative estimate, but of course we'll be grateful for anything we get.

Fear and hope. Hand in glove. Thank you for keeping us in your thoughts.

The Part That Is Easier & The Road Taken

I've been working on two different posts during stolen minutes over the past few days. They are related, but not seamlessly, so my preference would be to post them individually. That said, I'm starting to worry that I'll never get around to finishing and publishing them separately between all of the cycle updates, so here they are. Together. Mind the gap.

I wrote this post a while ago about the parts of TTC#2 that felt harder than TTC #1. I was hurting and venting and it was completely one-sided. There are things that suck about TTC#2 that are different from what we went through last time, but there are also things that are better. One big one in particular: Elliot. No matter what happens with this cycle, I am already a parent. The "worst case scenario" is that we stay a family of three, not that we might have to re-imagine our future without a child in it. Knowing that is luxury I didn't have the first time around; a luxury my friends currently battling primary infertility do not have. It is true that the longing to not have an only child has a familiar fire to it, but it's not the same. The fundamental cross-over is really from child-free to parent, isn't it? Everything after that is important, yes, but it doesn't redefine everything from your morning routine to your overall identity the way becoming a parent for the first time does. I feel like a jerk for bemoaning the growing age gap and the omnipresence of babies and bellies everywhere we go without acknowledging the privilege contained therein. Sorry about that. I was in the quicksand at the time. Having stood on both sides of the fence, I can officially confirm that there's a whole lot of brown (and green) grass everywhere.

Another edge secondary infertility has over primary is that your life is a 3-ring circus and it is virtually impossible to obsess too much over the details of your treatment cycles. (To a fault, at times.) Time flies by, and your cycle rolls along with it. Here's hoping the 2ww passes as quickly as the last month has.

Choppy segue to more good stuff...

As I mentioned a few days ago, my FET cycle buddy gave birth to healthy twins last week. (And holy crap are they adorable.) It's hard to have such a tangible reminder of where we desperately wanted to be right now. They are the Road Not Taken. The only thing that makes seeing their beautiful faces bearable is that I guenuinely feel good about where we are instead. Back in February, I wrote this post including all of the silver linings to not being pregnant following the FET. Among them:
  • Fulfilling Maid of Honor duties for my out-of-town friend in April. Check. It was really fun, and really exhausting, and that was without any hit-by-a-truck pregnancy fatigue. If I were pregnant, there's no way I could have participated to the extent I did, if at all. Sharing in her wedding was so special and I'm not just being trite in saying I will treasure my memories of it for the rest of my life. The champagne was good, too.
  • Trip to England in June. Check. I had more than one bout of feeling cranky and disenfranchised leading up to this trip, but I knew that once we were there, it would feel worth every sacrifice, and it did. I met members of M's extended family for the first time (after 10+ years as a couple) and watched them play with and love on our son. We spent 4 days cruising up and down a canal - hiking mile upon mile during the day and drinking pint upon pint at night. We met the lovely Vee and Jay and marveled as our Transatlantic Twins took Legoland by storm - these two amazing beings we all spent years fearing we'd never conceive. I took over 1000 pictures (so basically a flip book) and every time I look at them, I feel deeply lucky that we were able to take this vacation when we did. Who knows when we will have the opportunity to go again and who of M's family elders will still be around to receive us?
  • Lose 10-15 pounds. Check. 14.4 pounds, to be exact, and at least a full pant size. This has come in extremely handy as my midsection expands to epic proportions in response to the stims. Both yesterday and today, I gingerly zipped myself into pants that haven't seen the light of day in months. Aside from the logistics of not having to go to work naked, it feels good to be hopefully launching a pregnancy from a healthier starting point. 
In addition to those items I laid out months ago, we've done other things that make the timing of all of this feel like it worked out for the better:
  • I was in a musical. Not just any musical - a challenging, rave-reviewed, all-out party of a show (See loss of 14.4 pounds above.) So much fun. So many memories. So, so glad I was able to do it.
  • We took E to Disneyland. It was one of the best vacations I've ever been on. Seriously. E (aka Evil Knievel) loved every second of it, and it's true what they say about everything seeming new and exciting through a child's eyes. Oh, and I was able to ride roller coasters to my heart's content. (Do NOT miss California Screamin' at the California Adventure park. Amazing.)
I have a good life and a great family. Things don't always (okay, almost never) seem to go as I plan them, but it all works out in the end. I'm hoping to the moon and back that my wishes for a successful cycle, a BFP, and a healthy pregancy will be granted. Of course I am. We've invested unfathomable amounts of money and effort and hope in this cycle. But we'll be okay, no matter what happens.

My reasons for spewing rainbows into the blogosphere this morning are two-fold: (1) I really wanted to get all of this down "on paper" before my retrieval. I'm worried that if things don't go well at any stage, I'm going to lose sight of some of this, and I want it documented to come back to. (2) I am a hot mess this morning and feel the need to off-set it a bit. It's gray and rainy, I look and feel like crap, I have purple and green bruises on both arms, I could pass for 5 months pregnant with all the bloating, and I woke up with a raging case of Pink Eye. Oh yes, I did. My doctor is calling in a prescription for the last item on that list so hopefully I can pick it up on my lunch hour. Still 18 follicles on ultrasound and they were bigger this morning, but barely. Now I'm nervous they're going to make me wait one more day which means more expensive meds to order and more waddling to do. I'm fine with whatever they think will give us the best chances of success, but I also wouldn't complain if they said I could be done sooner than later. :-)  More news as soon as I have it!

Tuesday, September 13, 2011

I can't think of a play on the number 18.

But that's how many measurable follicles I had this morning. Most are in the 15-16mm range or smaller, but there was one 18mm one in the mix. All newly-measured follicles are on my right side - left side tally remains at 4. Guess my left ovary is officially phoning this one in. No trigger shot tonight (yay!) and back tomorrow for another scan/stick. The nurse said she thinks that should be the last one. She didn't mention my E2 number and I didn't think to ask for it until after I hung up. I'm still queasy and tired, and this afternoon, I finally started feeling like my ovaries were reaching a respectable level of discomfort, so more reassurance that things are progressing. And that's the scoop for today!

Thanks so much for all of the support and cheerleading. It really means a lot to me. :-)

Monday, September 12, 2011

10-4

Today's update is in at last. E2 is 1799 and I'm up to 14 measurable follicles - 4 on the left and 10 on the right. 4 of them are still very small (10-11mm) but the rest are between 13 and 16. I had acupuncture during my lunch hour and she must have really stirred up my hormones because I feel lousy - really queasy and achy. That's a good thing though... right? Next stick/scan is tomorrow.

The nurse said there is still the possibility of a Thursday retrieval but it seems more likely it will be this Friday, which is GREAT news. M and I both have work responsibilities that make Friday (and the resulting Monday or Wednesday transfer) easier to accomodate than Thursday. We'll make it work whenever it falls, of course, but perhaps we'll be lucky enough to avoid the hurdles altogether.

I know 10 good-sized follicles are worthy of celebration, but it's hard not to compare this cycle to last time and feel disappointed in my lesser response. So, I'm adding a line to my mantra...

The odds are on our side.
This worked for us last time.
No reason not to hope for the best.
It only takes one.

Moving on... M and I are having an honest-to-goodness date night tonight! I can't remember the last time we had one. First we are cashing in a Groupon at a non-child-friendly restaurant (with wine! and award-winning desserts!) and then we're going to see the last Harry Potter movie. We've been aggressively searching for an opportunity to see it together since it was released and now, almost exactly two months later, we're doin' it! I'm super excited. I think this is exactly what we need to fortify ourselves for what is sure to be a week of emotional and physical intensity.

And on that note, I am over and out!

Saturday, September 10, 2011

Lucky 7

An 8am monitoring appointment on a Saturday with a side of extended vein fishing is cruel and unusual punishment. But hey, they don't give IVF stripes out for free, right? E2 came back at 736 and, after 7 days of stimming, I have 7 measurable follicles (5 on the right, 2 on the left) with another 24 that were less than 10mm. It's not as good a response as I was having last time at this point in the cycle, but apples and oranges and all of that and it only takes one so... yeah. Things are good. All meds stay the same. Next scan/stick is Monday morning.

I wrote a big long post about a story I wanted to share, but once I got it all written out, I lost the nerve to publish it. The abridged version is that due to a bizarre constellation of circumstances, something really cool unfolded for us over the past couple of days and has me feeling really lucky, and humbled, and like even the big ol' universe is pulling for us a bit on this one.

Wednesday, September 7, 2011

egg on my face

I just talked to the nurse and I messed up my meds last night.

I was admittedly distracted when the call came in yesterday afternoon with my new doses, so that was the first strike. Then, it was not my normal nurse (who is very conscientious about explaining things slowly and checking for understanding along the way) and I got totally confused listening to her instructions on how to reconstitute the Menopur. I realized about 1/3 of the way in that I had no idea what she was talking about - she pretty much lost me at "Q-Cap." I told the nurse I wasn't following but knew there were videos on my pharmacy's website that I could watch. She said the videos are good but cautioned me to only use half a mL of diluent instead of the full mL shown. End of call. I wasn't overly stressed about it, but I did leave work early so I could look over all of the injection supplies while watching the video before my class to make SURE I had no questions.

The problem is that I was thinking of Menopur as a fixed dose med, like a trigger shot - one vial of diluent, one vial of powder and voila! I thought my only concern was how to mix it, not how much to mix. My stomach dropped when I watched the video and learned that you can dilute up to six vials of Menopur in a single mL of diluent because, you know, some people are supposed to use several at a time. Oh, shit. I had this very vague memory of the nurse saying something that might have been "and then you inject all of the liquid into the other vial," but I was so confused by that point I hadn't really absorbed it. What was it she said? What was it she said?! I picked up the phone and called the clinic immediately but it was just past 4pm and all of the phones were already set to nights. I called every number I had for various clinic staff - all straight to the main recording with no inbox to leave a message. My question didn't seem worthy of calling the exchange and I knew they probably wouldn't have access to my chart anyway. I did a quick Google search to see if I could tease out a "most common" initial Menopur dose - no dice. All I learned was that there is waaaaay more variety in people's IVF drug protocols than I ever imagined. I could not for the life of me (and still don't) recall the nurse ever articulating a numeric dose for the Menopur, but it's entirely possible she said it and I missed it. I eventually settled on using one vial with the rationale that it seemed like a more easily-corrected error to under-stim than to over-stim.

I was supposed to do two vials.

The nurse is checking with the doctor on whether it's worth it for me to run home and inject a second vial now or just let it go and start the full dose tonight. I know this is not a big deal - the worst case scenario is that I stim for an extra day. I just really hate making mistakes, especially those that could have been easily avoided with a little more preparation on my part.

The backdrop as all of this plays out? My officemates' loud and lengthy debate about who is most likely to be pregnant next. *sigh*

Update: The nurse called back. No catch-up shot today, just start the 150 tonight.

Tuesday, September 6, 2011

What's new?

Oh my, this post is going to be a complete hodge podge. Brace yourselves.

First up: What a difference three years makes. Stim day 4 E2 was 70 this morning. 3+ years ago it was 83. Nurse says 70 is a fine number. I find it interesting (yup, just interesting, not scary or dismal or foreboding or...) to see the difference my age has made on my response to the stims. Apparently there is some truth to that whole business about your fertility decreasing over time. Who knew? I started Menopur tonight which means the pharmaceutical road has diverged and I can no longer compare my monitoring results to my last cycle. Probably for the better.

Next up: What a difference 8 months makes. My local FET buddy delivered healthy twins today at 35w2d. I am happy to report that I did not fall apart as I predicted I would. There was special weight to seeing their pictures on FB this afternoon, but it didn't linger. I am grateful for all of the adventures we filled our break time with. It has certainly made it easier to make peace with being so far behind where I once wanted so desperately to be.

Sperm has been ordered. Delivery should take place on Friday.

I teach a class on Tuesday nights from 5:30-8:30pm. I'm supposed to do my injections between 6-7pm. As you may recall, tonight was the first night for Menopur. Here's a vignette for the baby book: Running upstairs to a secluded bathroom during our 7pm break, frantically reconstituting Menopur, prepping Lupron and Follistim injections, then administering the trifecta, all the while watching the time on my phone like I'm trying to meet some Olympic qualifying time. I'm adding it to the list of bizarre places I've shot up during this cycle. Already on the list: Multiple Disneyland/California Adventure restrooms, the main cabin of an airplane just after take-off, a city park restroom (grossgrossgross), and between rounds of a Bocce Ball tournament M and I played in over the weekend.

My parents are coming into town in a few days. They are going to take E on a mini-vacation while I recover from the retrieval. I'm a little anxious about the couple of days away from him, but if my recovery goes anything like it did last time, I know it will be better for everyone if he's off having fun somewhere else. If we're going through all of the angst of the separation, I wish we were at least getting some kind of a romantic getaway out of it (instead of the ultra-glam couch moaning I expect to be doing) but I guess a shot at expanding our family will have to do. ;-)

E is so freaking amazing and wonderful and adorable right now. His development deserves a post unto itself. In lieu of that (later? maybe?), I will tell you that his music of choice right now is the Jurassic Park soundtrack (in which he does a pretty darn good job of identifying the various instruments, for a 2 year old) and Peter and the Wolf. We've had more than one driveway tantrum brought on by our request that he come inside the house to play and he instead insists on staying in the car to "listen to the cellos." Hilarious. He's all about negotiating doing this or that for "a little bit" or "five minutes" and he says things are "just fine" all the time. A couple of days ago, he started exclaiming "Oh, wow!" in response to things. We have no idea where this came from. Tonight while he was in the bathtub, we played I Spy with different colored things, and in addition to finding things when I suggested a color, he would tell me the colors of things to look for as well. The best new development of all? When we tell him we love him, he will sometimes say "I love you too" in this very genuine, non-reflexive way, and it sounds like he truly understands and means what he says. Those moments alone make all of this IVF nonsense seem worth it.

Saturday, September 3, 2011

imaginary crisis averted

Thanks for your thoughtful comments and encouragement on my last post. I couldn't get an audience with my RE (that place is like Fort Knox sometimes) but I talked to the nurse who confirmed what we all thought: After all of the pre-screening the donors go through, the only variable left that might make someone a relatively better or worse donor is sperm count, and that is a moot point for IVF. So, we're going for it. And I feel good about it, thanks in large part to all of you.

Stims were pushed back a day to keep my first blood draw off their holiday workload, so we'll start tonight. I'm ready to get this show on the road!

August: Green


Thursday, September 1, 2011

Excuse me ma'am, your neuroses are showing.

So we picked a donor (see below) and I was feeling good about it. But then I didn't place our order. A day passed... Another day passed... And then a couple more. On Monday, our IVF nurse called to see what was up with our sperm order. I waited until Tuesday to call her back and told her I would place our order on Wednesday, even though I could have easily done it right then. I kept the cryobank page pulled up on my work computer all day yesterday but never pulled the trigger. I second-guessed every last thing about our donor choice, but I knew all along those "concerns" were just place-holders for the real issue: I still have hang-ups about our switch to anonymous donor sperm. It was mitigated with The Beatle by having found our perfect, sent-from-above donor. But without that golden parachute, it turns out I'm still angry and sad and, frankly, in denial that we really have to go this route. The timing for this is poor. I start stims tomorrow. We don't have time for me to freak out about using a sperm bank.

The "do as I say, not as I do" lesson is this: Be sure to finalize all donor decisions and orders prior to shooting up large volumes of hormones as you will not be able to think rationally about anything and will instead be reduced to a jumble of tears and emotions when asked to complete simple tasks.

M and I had a good discussion about all of this last night. How she puts up with me I will never know, but I sure am lucky. She gave me the pep talk I needed, reminding me of all of the reasons we have made the decisions we have made up to this point. And I felt good about it again.

This morning, I pulled up the cryobank page, put a vial into my cart and proceeded to check-out. I went back to review his profile one more time... oh yes I did, because I am THAT dysfunctional... and there is just this one fly in the ointment I can't get past. It's the one concern I think might actually be real and not just me setting up false barriers. He has no reported pregnancies.

Here are the facts:
  • I did some internet research on whether or not this should be a concern. The consensus is NO. (Possible dissenting opinion may be found here.) Any factors that might inhibit fertility from the male end are ostensibly screened out before a donor is released in the first place. There are many factors that play into whether a donor has reported pregnancies or not and, at best, this data point is a reflection of how long the donor has been active in the program, but even that has multiple limitations. And hey, KD had no reported pregnancies and 14 failed inseminations on his resume before he worked for us during our IVF cycle. Just sayin'...
  • I called the bank and he has been active since January of 2011, so only 8 months. The stuff I found online said it often takes around a year for a donor to show reported pregnancies. The bank was adamant that they do not consider his lack of reported pregnancies to be of any concern at this point. But really, what else are they going to say?
  • I looked at the 40 donors listed on either side of him numerically, so presumably, the 40 donors who became available immediately before and after him. Of the 40 that became available later, just over half still do not have any reported pregnancies. Of the 40 that became available just before him, only two (gulp, two) do not have reported pregnancies yet.
  • On one hand, I think that doing IVF makes this less of a concern because even if his swimmers aren't peak performers, IVF should make that a moot point, right? (I have a call in to the RE to discuss this.) On the other hand, this isn't IUIs where the stakes are relatively lower and we can switch after a month or two if we want. We get one shot. If none of the eggs fertilize, that's it. We're looking at another whole cycle (and another whole $12,000) if we want to try again. This cycle has already been rough on me physically. It's so much harder going through it with a toddler in the house. I can't imagine having to turn around and do it all over again, not that we could afford to anyway.
  • I have pored over the other options and I really want to stick with this guy unless we have good reason not to.
So... What would you do?

The Breakthrough

Finally getting back to this...

So we had these two guys. Let’s call them Dr. Doolittle and The Boy Next Door. We liked them both equally, which is to say they were the best of the profiles we reviewed. I wanted one of them to reach out and grab me the way The Beatle had, but the longer I stared at the profiles, the more certain I became that we would have to use actual decision-making to choose one of them. But how? How do you weigh the relative values of this quality or that trait?

These were the criteria we used to narrow it down to Dr. Doolittle and The Boy Next Door, roughly in order of importance to us, and how they both rate in each category:
  1. ID Release: This has been non-negotiable for me since Bleu suggested it in a comment on this post. Both of these donors made the cut.
  2. Physical resemblance to M’s family: They both have it. Kind of. Neither are the ringer The Beatle was, but their features are fairly neutral and neither have noses or brows or chins that look dramatically different from M's family. The Boy Next Door might have a slightly greater resemblance to KD, and therefore E, but Dr. Doolittle looks a bit more like M, which presents an interesting option.
  3. British heritage: M’s family is deeply English in appearance, speech and mannerism. The Beatle was 100% English as well. Neither of the new donors are. Dr. Doolittle has some English in the mix, along with 3 or 4 other things, and The Boy Next Door is Irish and Welsh so, close but no cigar. At one point, this felt important to me. I wanted our kids to have the same answer to the “What are we?” question, as I remember going through a phase where my own cultural heritage felt very salient. I’m over it, though. I’m down with understanding culture experientially rather than biologically and in that respect, our next child will be 50% English, just as E is, no matter what his or her donor’s nationality was.
  4. Artistic: Both M and I are. Both of our families are. It feels important to us. The Beatle was. Neither Dr. Doolittle or The Boy Next Door claim any artistic ability. This criterion lost out to others when we couldn’t find a (second) perfect match, but I still feel a little unsettled about that.
  5. Intelligent: Huh, how to justify this one without sounding like a first-rate narcissist? M and I both come from smart-ish families (if not humble ones, ha ha!) and E is a smart little cookie. If we were starting from scratch, I'd prioritize kindness or creativity over intelligence any day, but we want to conceive a child that will fit in well with E and be able to hold his or her own in the inevitable sibling scuffles. We aren't looking for a rocket scientist, just someone of at least average intelligence. Both donors seem to meet this criteria. Assessing this is a total guess anyway. Sure there are test scores and GPAs and fields of study and interview responses, but how much of that is nurture, socialization and access to resources? Quite a bit, I'm guessing.
  6. Laid-back temperament: M has this. I do not. E does not. It seemed like it might be a good idea to balance our family out a bit rather than add another strong-willed cook to the kitchen. Both donors seem to have this, Dr. Doolittle more so than The Boy Next Door.
  7. No major health issues: This goes without saying, but to be honest, we weren't all that hung up on it. We kind of figured that anyone who would make the cut to be in a donor program would have a cleaner family medical history than either of us. Aside from one donor who got the ax for too many cancers on too many branches of his family tree, we didn't put too much weight into this category.
M was leaning toward Dr. Doolittle and, looking at the list above, I agree that he seems to have a slight edge. The clincher for M was the clip of his audio interview in which he managed to come off sounding smart, funny, easy-going, compassionate, and all-around amazing… all in a 30-second answer to a single question! But for some reason, I couldn’t get on board. It wasn’t because I wanted The Boy Next Door. I just couldn’t choose either one over the other.

The Breakthrough came when I read through each profile in great detail and tried to distill their most attractive qualities down to a 1-2 sentence summary. What I came up with was that I liked The Boy Next Door because he seemed like M’s people – smart, thoughtful, soft-spoken, laid-back – and he is studying the same subject both M and KD have made careers in. There is nothing particularly flashy or attractive about his profile. He’s just a good, solid candidate. I liked Dr. Doolittle because, well, he kind of seems like the perfect guy. Even the person recording his "staff impressions" clearly had a crush on him (no joke). He has cool interests and a cool field of study and cool belief systems and just seemed like the kind of genes you’d like to recruit into your family. But then I realized that a big part of what made Dr. Doolittle so attractive to me was his Other-ness; the novelty of his Philosophy major (we don't have any of those anywhere on our family trees) and the Mr. Cool voice in his audio recording (like all the popular kids I was too Type A to hang out with in high school and college). The opportunity to literally purchase qualities I admire in others was a seductive one. That said, if we are sincere about our efforts to conceive the child that is most genetically pre-disposed to blend in with our families and the child we already have, The Boy Next Door is the obvious choice. I shared these thoughts with M who agreed, and thus the decision was made.