Halloween

Time may fly, but
Maya doesn't.

You know the saying, "Time flies when you're having fun"? Well, it flies when you're not having fun, too. I absolutely cannot believe that it's been over a year since we began the IVF process and it boggles my mind to think of all that occurred in the span of that one little year. And here were are, on the cusp of Halloween, staring this monster in the face yet again.

And a monster it truly can be - full of surprises, scares, and sometimes, laughs. Just this last Friday, I went into the office for my first ultrasound. (Not the fun "let's see the baby" kind, but the kind where they shove a wand up your vagina and poke around to make sure there are no cysts or other obtrusions.) When I went to check in, the receptionist asked in a hushed voice, "So have you started your cycle yet?" I didn't think twice before correcting her. "No. I'm still taking the birth control pills like I was told." But it was really that monster lurking and preparing to spring out from the dark. I was supposed to stop taking those pills four days prior. My heart sank and the receptionist said, "Well, he'll go ahead and do the ultrasound anyway." But what did that mean? Was I going to have to wait until January to do the transfer? I had a million questions that kept tumbling around in my mind and I had plenty of time in the waiting room to feel them turn and crash in on each other. And each rotation brought my spirits lower and lower.

Luckily, my mistake did not turn out to be as catastrophic as the receptionist implied. Since this is a frozen embryo transfer, it seems there is a lot more wiggle room with the process. They were able to push back my blood test to see if my hormone levels were dropping as they should, and I even got confirmation that, if those tests are okay, I can do the transfer towards the end of their week in the hospital so I won't have to take time off of work. And more good news: I found out the pills I had to "take" vaginally during the last cycle I get to take orally for this one. Unless you have had these types of treatments, you have no idea how happy that can make a girl. Aside from the news that I wouldn't have to endure (and pay for) meds for another two months, that was the best news I had gotten all day!

But all of this reminded me of the hesitancy I have felt since we started trying 2 1/2 years ago. Although we made this decision together, after 33 years of being childless, it's hard to imagine the changes a baby will bring. But it was even more than that. From the start of our first cycle, I knew we would end up with twins. It was our joke. I had what the lab tech called a perfect uterus. (Too bad no one else will ever see it.) Every blood test came out perfect. I had absolutely no problems at all. None. Yet something in me felt like this wasn't going to work out. Like it wasn't meant to be. And yet we planned, shopped, dreamed. But at every appointment, I waited to hear some sort of bad news. I wasn't dwelling on the negative; I just had this nagging somewhere deep inside. I don't even know if I ever articulated it to anyone, but it was always there peeking out of the crack in my closet door like the monster it was. So although I didn't expect the setback to be my fault, there was a part of me that thought, "Well, there it is," when the receptionist exposed my mistake. I held my breath when Dr. Sueldo came in to do the ultrasound because I was sure he would say I had to wait until January. But he came in, opened that closet door, and "poof!" that monster was gone.

Don't let this monster chase you;
he's super speedy!

And yet, here I am on the eve of my blood test - the one that will determine if my body is responding appropriately and is, therefore, ready to move forward in this cycle - and in the back of my mind I see myself getting negative results. I'm sure there will be some sort of hang-up and we won't be able to go ahead with the procedure. But if the test is okay, which it probably will be, I have another ultrasound (this time to check the thickness of my uterine walls to see if I'll be ready for the transfer) on Halloween. You might think, "Well, that's fun!" And that's exactly what we thought last year when the first ultrasound we had of what we then confirmed were twins fell on Halloween. Really, what are the odds? There's that pesky little monster again, popping up when you least expect him, eliciting some emotion you thought you had conquered long ago. But I supposed, just as in any monster movie, you have to forge ahead. You can, of course, do that running, screaming, and flailing; but you either run ahead or you die, and I'm not ready to die. So, tomorrow, a blood test. In a week, another ultrasound. Until then, I will do my best to peek under the bed, throw open the closet door, and march bravely down darkened halls without fear. And if, by chance, there is a monster in there... well... there may be a little screaming, but I'll do my best to make it out alive.

And So It Begins

A familiar package of meds, but
far fewer than last time.

As you know, we decided to do another IVF cycle this November and my first "protocol" appointment was yesterday. And, despite his busy schedule, Brian was even able to meet me waaaayyy out there and then rush back to work.

Just like the first time, it is mind boggling how much happens on that first appointment. But my first mistake was likening this to my informational appointment last September. As I was getting ready a the crack of dawn that morning, I thought, "I guess I should shave my legs, huh?" But then I thought about my first appointment last year - a nice, sit down and chat sort of thing, and decided I'd be fine with a little stubble and a little less speeding on my way to work. That wasn't the right call. We walked into the office to find the full spread on the counter. (Women, you know what I mean. All the little swabs and cups and tools.) I was thrilled, but what could I do?

What you may not realize is that each appointment takes forever. I know some doctors take a long time, but usually once you get back in the room, things move along. Not with my experience with IVF. Yesterday, I filled out the mountain of paperwork, waited a bit, went back into the room, got changed, waited some more, had my uterus measured (they check for a clear path as "practice" for the transfer), talked to the doctor, changed, and waited some more. Then, we saw a PA who explained one thing, went and did something, came back with more info, left again, and so on. In other words, I should always bring a book. And this is pretty standard practice.

My appointment yielded some interesting news. My doctor was very sympathetic - like genuine sympathy and concern - about how our last IVF attempt, which was nice to see. Then, he reviewed our options and our odds for each. As I heard the first time, there is a 40% success rate for one baby with two blastocysts, a 25% chance of twins, and a 3% chance of multiples. He then said that in the 25 years he had been doing this, he had only seen six cases like ours. Six! I think that's way less than 3%! (And once again, I felt an urge to play the lottery.) He then explained that there is only a 17% chance of pregnancy with one frozen embryo, which was our plan. However, their last cycle had a 74% success rate with that same scenario, so clearly these odds are not always accurate.

Since the last time we did this we did a fresh transfer, he explained the frozen process, which was enlightening. Normally, they pump the woman full of hormones, but prevent her from ovulating, which causes the production of an excessive amount of eggs. They fertilize those, watch them for 3-5 days, choose the best looking two, and freeze the rest. We already did that, so we get to use the frozen ones. Because they normally transfer two blastocysts at a time, they freeze them in pairs. So in our case, they will defrost (I'm sure there's a technical term for this that doesn't make me think of thawing a turkey for Thanksgiving) a pair of blastocysts and choose the one that looks the best. They will then refreeze the second blastocyst and prepare the best candidate for the transfer. We have five fertilized eggs, so we'll have some backups if we end up in the 83% who's transfer doesn't take.

What I think has surprised me even more is how easy this process has been thus far. By this time in my first cycle, I was putting down $2,000 for meds and scheduling blood draws every week. I also had a special diet that basically left me eating apple sauce, grapes, and toast with butter. Today, I filled all of my prescriptions, which totaled less than $350 and I was only told to limit my caffeine and sodium consumption. I did have to have a second uterine X-ray (which was no fun and also required me to show my stubbly legs on Wed) but I don't have to have any blood work done in the immediate future. Piece. of. cake.

Well then... what do I need to do? I'm already taking birth control, low-dose aspirin, and prenatal vitamins. Now I will add Luprin (hormone) shots every night. I am also taking an antibiotic to prevent infection after the uterine X-ray, which is done kind of like an angioplasty, but with clear dye and a catheter... and definitely not in your heart. (I know you're jealous.) I have other meds that I will start taking later, but that's all I have to do until my appointment a week from tomorrow when the doctor will perform a vaginal ultrasound (again, I know you're jealous) to see if I have any cysts that have developed since we did this a year ago. If all goes well, they'll put me on some more meds (yay) and I'll go back in a week and a half for another vaginal ultrasound (I can see you're turning green with... envy. Let's say envy.) to check the thickness of my uterine wall. And when that's thick enough... whammo! We do the transfer. That will happen sometime during the week of November 5.

So, that's where I am right now. The visit really wasn't very emotional for me. It's rather easy to detach when everything is tests and paper blanket covers and unending forms. And that was pretty much how I felt the last time. It all felt pretty clinical until everything began to go downhill. Hopefully, that won't happen again, but I guess we'll know before too long. I can't believe how quickly time has passed. In some ways, February feels like yesterday; but in others, it feels a lifetime away.

Thanks again for joining us on this journey. I hope that you find my posts entertaining, educational, and even therapeudic. And I still encourage you to share this with others. I hope it will become a valuable tool for people to learn about IVF and coping with preterm labor loss. I'll be posting here before too long and giving brief updates on my facebook page www.facebook.com/imgonnabeawhat. Feel free to "like" me there for more exciting, hormone-filled, clinical baby-making commentary.

There's No Such Thing as a Free Baby

I'm sure you've heard the saying, "there's no such thing as a free lunch." It's really an economics argument, but the principle is clear: nothing comes without some sort of cost. Now, most people fear the cost of having children from birth to college graduation, but having fertility issues means you pay a lot for the same privileges that random sixteen year old pregnant girl in the mall got for free. (Although she'll probably pay far more for her baby in non monetary ways.) Our first go-round cost us about $13,000. Yup, about the same as my first brand new car. I'll find out on Wednesday how much our second attempt will cost. But point being, it's not cheap.

Now, I have said over and over on this blog and on my facebook site (facebook.com/imgonnabeawhat) that I'm not in this for the money. And I'm not. Seriously. (And obviously, since I haven't made a penny.) However, with the debt of our first attempt still looming over our heads and the new costs of the procedure, medication, and frozen blastocyst storage on the horizon, I started to think monetizing the site wouldn't be such a bad idea. So I reinstated my Amazon Associate account and here I am asking you for a little help.

And helping is so very, very simple. I'm sure you've seen the ads on my page. (I figured, well, why not include them.) I know sometimes they're not so relevant and sometimes they may be a bit offensive. (I don't control the content. Promise.) But clicking on those gives me money. I know this concept is probably familiar to you, but I thought I'd throw it out there anyways. The more interesting source of revenue is actually through Amazon. Their Associates program allows me to embed links to products that they carry. Clicking on those hyperlinks (even without buying) gives me a few cents. Plus, anything you choose to purchase via that link - it doesn't even have to be the product the link promoted - gives me some kickback. So, if you know that you're going to buy something through Amazon, you can use a link on my site and I will actually get some residual pay without any expense on your end. Fabulous, no?

So this is my plea. While you're enjoying my blog, could you click on a few things once in awhile? My debt and I would really appreciate it. In fact, I'll give you a chance right now. Check this out!

Now that I'm on the verge of a new IVF cycle, I'll be returning to a couple of key pregnancy books that we invested in at the start of our last pregnancy. The Pregnant Body Book is an awesome book that allows you to see inside the female body from fertility to post-conception. It's like the Grey's Anatomy of pregnancy books. It helped me to feel more connected and knowledgeable about how my body was changing and I will be unearthing it again shortly. The other book I completely fell in love with was the Mayo Clinic Guide to a Healthy Pregnancy. It has a ton of great, relevant information to help make pregnancy less scary.

So... please click on something. Pretty please? Remember, you don't have to buy this stuff. Click on the Pregnant Body Book and roam Amazon for your new favorite workout gear or some new music. Using my link helps me financially. And/or click on some of those ads you just scrolled past (on the right). I would really appreciate it. Thanks!

Here We Go Again

First round of meds from
round one IVF in 2011

Back in August I decided that I had better switch from daily vitamins back to prenatals. It was a small decision, but you'd think those first pills were hormone injections from the feelings of hope, anticipation, and dread I felt as they slipped down my throat.

Two days ago I had to call the fertility specialist and announce that I had indeed started my period. Now, this is not something I generally announce to my doctor, let alone the world, but I was following the rules. (I guess this would be an excellent time for a disclaimer. Since I am going through this process again with a reading audience, I will be documenting in much detail what I am experiencing. I will do my best to give warning if something might offend the sensitive reader, but some things may get past my already-lost-my-modesty-through-IVF-and-childbirth-three-times sensor. So consider yourself warned.) Back to my period. I'm not sure about all fertility specialists, but in this office they run all the women on the same schedule. So, when you start your period, you call them so they can get you on birth control pills. I know that sounds counterintuitive, but it's not if you really think about it. First, it helps them to get all of the women on the same schedule so that they can have a designated week when they're in the hospital for procedures. Second, birth control pills trick your body into thinking that you are pregnant, which is why you don't get pregnant. They will transfer the blastocyst when my body already thinks it is two weeks pregnant, so starting off with birth control pills is actually a natural choice... once you've really thought about it. And tonight I take my first pill.

Once again, a very small pill signifies something great and I'll admit, I've been experiencing mixed emotions as of late. I look at friends who are pregnant or who have new little ones, and there is a blend of anger, jealousy, and happiness. I have mourned with a friend over recent pregnancy loss, which took a toll on us both (although clearly on her more than me). I feel the hope of making it through this process and having a little person - someone half me and half my husband - and that seems amazing and somewhat impossible. And terrifying. I doubt every time I do something and I feel the weakness in my back or the grinding in my hip and I wonder if my body can make it through this again. I fear that searing pain and helplessness. My head fills with memories of hospitals, injections, ultrasounds, medication, tears, plans, hopes, inquiries, and uncertainties any time I let my mind wander. And I know I have full control over this decision whether or not to move forward, and yet it doesn't feel like a choice. It feels like it's the only option I have - we have - to ever feel whole again. And so we move forward and try not to look back too often. And it's all I can do.

So what is forward? Tonight, it's taking my first birth control pill in a year... along with my horse pill of a prenatal vitamin. Wednesday, it's returning to the fertility specialist for my protocol appointment where I'll learn how exactly this process will be different from our first. Then it's on to hormone injections, weekly appointments and blood draws, and waiting.

I've had several people ask how I'm feeling about this whole process. Although the true answer changes frequently, overall, I am optimistic. I believe the major issue was what my perinatologist called a "triplet thing" and, to some extent, really couldn't be helped. The secondary issue of my cervix shortening can be discouraged through a minor outpatient surgery. These things give me hope that our second time through will not be for naught. But I haven't yet stepped foot into that fertility office again and I honestly don't know how that will feel. On the one hand, it's a step in a positive direction for us. On the other, it may feel like a dark deja vu. I suppose it would be naive of me to expect anything in this process to be simple or straightforward. So, as my mom used to say, we'll keep on keepin' on, taking it one step at a time, and see what happens. Heeerrre we go again!