Crap that Sucks, Part I

Methylenetetrahydrofolate, also known as MTHFR, and affectionately referred to as MoTHerFuckeR.

Methylenetetrahydrofolate reductase is an enzyme that is involved with amino acid metabolism in the body.

A mutation in the gene that produces the enzyme can affect how a person’s body processes homocysteine, which is an amino acid found in blood. (There are several different types of mutations, but this is a blog post not a medical transcript so I’m not going to get into the variances between the different types. But my NP did say that if you have to have a mutation, mine is the one you want to have {two mutations of the A1298C, Homosteine level is 10.5; normal is below 10.4})

An elevated level of homocysteine increases the risk of blood clots, and typically decreases the body’s ability to metabolize Folic Acid and other B vitamins.

Common risks associated with blood clots are Cardio Vascular Disease, Coronary Heart Disease, and Stoke. In pregnancy: Recurrent fetal losses that can occur in any of the three trimesters, Placenta Abruption (when the placenta detaches from the uterine wall before delivery) Small Gestational Age (where the baby is smaller due to clots in the placenta which results in a lower supply of blood delivered to the baby) Preeclampsia (High Blood pressure, proteins in the urine)

It should also be noted that the decreased ability to metabolize Folic Acid and other B vitamins leaves your baby susceptible to Neural Tubal Defects (Spina Bifida, and a whole mess of other scary birth defects), Preeclampsia and Blood Clots.

So part of the reason that not all doctors test for this is because the link between the MTHFR and recurrent Miscarriage has not been conclusively proven, therefore has never been formally introduced as a risk factor that should be routinely tested for.

I wrote this post because doing the research was therapeutic for me. And unlike my ability to properly absorb Folic acid, having to decipher the data and regurgitate it forces me to really absorb the information, and now I might not kill myself. KIDDING. This shit instantly mattered a whole lot less when I got the NK Assay results back. I still have a lot more reading to do there.

Please, please, please, please, please do not hesitate to contact me if you see the slightest bit of misinformation in my statements above. You can also email me for my references.

Annnnd the last of it; Dr. 3’s preferred method of treatment:

• 2.2 mg of Folgard daily, which is a high dosage of Folic Acid, B6 and B12 (starting now, and pretty much for the rest of my life)
• A prescription strength prenatal vitamin (starting now)
• Low dose/ Baby Aspirin (81mg) (starting now)
• Heparin: Likely started just after my transfer, I will need to give myself two shots per day until I’m at least twelve weeks along, possibly longer - pending future blood tests and the actual occurrence of me being pregnant.
• Calcium: 500mg twice per day, because heparin can cause bone loss. (after I begin heparin)

I'd like to thank all of you for your incredibly thougthful comments, success stories, and information. I'm so grateful for all of you, and especially those who are active participants with the LFCA.

No Refunds

I went in to the Blood Centers of the Pacific this morning for my first donation of Whole Blood. The appointment moved rather quickly once I got through the paperwork. They took my blood pressure, checked my iron and sent me over to the comfy lounge chairs where I began my donation. I barely got situated and into my book before the delicate chimes began and they told me I was all done. I couldn't believe how quickly it was all over. They asked me to stay in the chair for a few minutes and then escorted me to the cafeteria area. I had my choice of several juices, and a basket full of high calorie sugary and salty treats. I picked up my book where I had left off when suddenly, I noticed the lights dimming. I mentioned to the girl next to me that I was feeling a little light headed and the next thing I know there were four people in lab coats standing over me, calling my name, and placing cold compresses on my neck and forehead.

Literally the last thing I remember was struggling to tell a stranger I wasn't feeling well, and the stranger telling me she'd see if she could get somebody. Apparently when she came back, she and a lab tech found me slumped over in my chair still holding my cup of juice. (Thank god I didn't fall out of my chair and crack my skull open or something!) So they pulled me out of my chair and laid me down on the floor. Once I came to they helped me remove my jacket as I was sweating profusely. While I laid there, staring into the florescent lighting I watched people silently scurrying around me. Turning on a portable fan, to help with my sweating. Setting up a privacy screen, which I sort of think was more to shield me from scaring off other new donors, rather than to save what was left of my pride. They took my blood pressure again, which apparently was disturbingly lower than when I came in.

I laid there for almost an hour while they continued to check my blood pressure every 15 minutes. The one tech who stayed with me was very kind, but needlessly honest. When I was finally lucid enough to begin feeling embarrassed I asked him if my incident happened often and he didn't hesitate to tell me no. That in fact it didn't happen very often at all. Just then another donor poked his head in and told me he threw up in his own lap after his first donation, which he thought was much more embarrassing than passing out in a chair. Although I have to agree with him, it was not so easy to accept while I was still laying on the checkered linoleum.

After some questioning it was determined that I had not drank or eaten enough before I came in. As well as the fact that my donation went faster than it should have. Probably because I was a little nervous. They said they like to see a pint withdrawn in about 7 - 10 minutes. Mine only took four. Just an unfortunate combination of circumstances, I suppose.

They finally were able to get me to sit up enough so they could transfer me to a bench I could lay down on. Shortly after that someone called Brian to come pick me up. There was no way they were going to let me drive home, and I wasn't about to disagree with them. When Brian came in, he looked down and smiled and asked the tech how many gallons they took. He told him it was just the one pint, but that they didn't offer refunds. Deposits only, he said smiling and cautiously laughing.

They helped Brian walk me and my things out to his truck, and told him to take me across the street to IN and OUT to get some fries with extra salt and a milk shake. They asked me to eat frequently for the rest of the day, especially foods rich and salt and to drink plenty of liquids, like water and juice.

I spent the rest of the day in bed, watching movies and debating whether or not I would blog about my fun filled day. I decided that it would be best to post about it so that anyone else who might be considering donating, would know to gorge themselves before heading off to a clinic. Even if the moron receptionist they spoke to a week before said there was nothing in particular they needed to do to prepare before coming in to donate for the very first time, EVER.

Not What I Planned

Where, oh where, do I begin?

When I made my initial appointment for today's IUI, they told me that Dr. Rawks was not going to be in. Which was fine, I've had six total IUI's during my last three cycles and Dr. Rawks has only done two of them. Not a big deal. I was able to make an appointment with a Doctor that I've had before and really liked. But when we got there today, my IUI nurse told me that this doctor was no longer available. No problem, just give me anyone with a degree in Reproductive Endocrinology, and I'll be on my way... So the doctor walks in, and I suddenly realize I've had her before. And she was not good. Not good at all. Not only does she lack a personality/bedside manner, but after my last visit with her I abhorrently nicknamed her Dr. Cantfindmycervix. I literally felt bruised after the last IUI she gave me.

After reintroducing herself, she tells me that the counts of the vial they thawed only had 9.6 million. The bank we purchased from guarantee's a minimum of 10 million. I realize that this is a very small difference, but I am not happy. Since my first IUI the total thawed counts have only gone down. My first vial had 26 million - a FANTASTIC number. But the vial before this had 15 million. Still not terrible, but not as good as 26. The minimum amount that my clinic prefers for an IUI is 10 million. Dr. Cantfindmycervix, seemed to think this sample was adequate. But I just didnt feel good about it. This my FOURTH FUCKING SHOT. I NEED this to WORK. I can't do this anymore. It's really starting to wear on me... So I ask her if it's possible to thaw another vial. She tells me again, that the vial does meet their minimum requirement, but that if I wanted, they could thaw another one. She warned me that doing so, may not necessarily increase my odds. But I just didn't feel good about the single vial. I can't settle for their "minimum requirement" - I won't. Not when we've got three failed cycles under our belts. My peace of mind is worth more than the expense of an extra vial. If I had settled for the single vial and this cycle didn't work, I could not live with myself for not following my instinct and insisting on a second vial.

So it's done. The Dr, once again, had a difficult time locating my cervix for some ridiculous reason. And once again she fumbled around while giving me the play by play -"You're going to feel some pressure now", blah blah blah.... HEY LADY, THIS AINT MY FIRST RODEO. I know what a fucking speculum feels like. How's about you work a little harder on being delicate with my girlly parts, and little less on your dialog, huh?!?! So like I was saying, it's done, and I've been resting somewhat comfortably since this afternoon. I'm pretty sure I ovulated on my left side while I was typing this, and now I can feel my right side starting to ache. So I'm happy with the timing I guess. But man, was this a crappy ending to what I have so far, felt pretty confident about. But I'm not going to dwell on it. I need feel good about the rest of this cycle, I'm tired of feeling sad...

Please commence crossed fingers.

Another Round

I went in this morning for my second IUI, and spent the rest of the day being completely useless. It was just as fabulous as it sounds. Seriously, it's almost 9pm and I am just getting around to writing this... The IUI went remarkably well, a little crampier than the last ones though. Between the two IUI's we have a total of 46 motile swimmers. They tell me with a frozen sample they hope for at least 10 million per IUI, so I'm feeling good about that.

As I mentioned before, I started up acupuncture again. I am a huge advocate of acupuncture. I did it for three months last year, long before our diagnosis, and although it didn't get me pregnant (because of MFI). I did notice a lot of improvements. My pms was very noticeably minimized, my digestion was more ... regular. And my feet weren't as cold as they normally were. I was able to see a vast improvement in these things about a month into treatment. Digestion wasn't even anything I complained about- It just got better. Aside from whatever the needles physically regulate or alleviate, I think that taking the time to meditate during each appointment is beneficial in itself. I focus on my breathing, and do my best to clear my head. TTC or not, I believe it's a healthy way to nurture mind and body.

The last place I went was an old timey Chinese medicine clinic. Complete with a display of decanters filled with mysteriously celestial looking ingredients. It was a family practice, mother and son. Clean, quiet, efficient. The reason I looked elsewhere was because I was hoping to find someone that focused more on reproductive health. Which is exactly what I found. I am really happy with my new clinic. It's a small place, I think there are only two practitioners. When I first sat down with Ms. B (I don't think she is technically a doctor but she's got a boat load of credentials according to the amount of initials after her name, and certificates on the wall) I told her that I was currently undergoing unmedicated IUI's. She asked about my basic medical history, and then more specifically about my reproductive medical history. I explained that as far as we knew there weren't any issues with me, and that we were dealing with MFI so we would be using a donor. She nodded and told me that she works with a lot of patients dealing with IF, and that 3 years ago, she and her partner used donor to conceive their now two year old twin sons. I was shocked, and thrilled. Someone who'd been there. Yes it was under entirely different circumstances, but still. It felt good to know someone else who knew what I was dealing with. She is sweet, and compassionate, and warm. She says things like "You're welks" (you're welcome). And she couldn't weigh more than 97 pounds. She's funny too. I feel good when I leave there. Her confidence is a little unnerving, but I sort of like that because it's nice to hear a medical professional be hopeful.

So we have two vials left in storage. Each cycle requires two. If it doesn't work this month I will immediately order 4-6 more, providing our donor is still available. And now that I think about it even if it does work I will order more for potential siblings.

And so begins another tww. Let's hope I can sustain a little clarity throughout the next 14-16 days. I honestly don't have any idea when my period will come because I ovulated six days later than normal.

P.S. I'd like to thank Daega99. She left me an Award on her site, but her comment profile lead me to inactive blog... Daega can you send me the link to your other blog, or if anyone else knows it - can you leave a link to it? Thanks!!!

Panic, Anyone?

Hello ICLWer's, you can check out my original welcome here. Or just scroll down =).
So my first DIUI is tentatively scheduled for the middle of July. Brian and I finally chose a donor - yeay! What's next? How about excitement? Yes, that's a given. Hope? Yes, ever so cautiously. So what is this knot I feel in the bottom of my stomach? Oh right. It's SHEAR PANIC because I need my vials in three weeks and the bank just told me they need a month to process new recipients! WTF?!

I called yesterday to make THE purchase, and they gave me a lengthy list of hoops to jump through and told me that they usually need a month to process everything!!! The bank we decided on is a small non profit organization and the person who deals with registration only comes in TWICE A WEEK. So I have all these ridiculous consent forms that have to be filled out, two of which need to be approved and signed by my RE. That will be followed by incessant begging and groveling to the registration manager to process my application. I've sent email's and VM's to my clinic asking them to expedite the forms because of the time crunch and NO ONE HAS CALLED ME BACK!
The only exception is from my RE who graciously indulged my insanity by answering a silly question or two in an email. Now that I am a little more calm, I realize it was probably somewhat of an insult to question his plan of execution and timing of my cycle. Well done Melissa!
Here is the email:

Hello Dr. RAWKS,

I have my first DIUI tentatively scheduled for the middle of July. I noticed that once I get a positive LH test, I tend to get ovulation pains about 12 hours later. I know we have back to back IUI's planned, I just wonder if the window will be right...
So here are my questions:
1.Is the ovulation pain that I feel a legitimate/accurate way to judge/affirm ovulation?
2. If so, say I get a positive test in the morning and then come in for my 1st IUI, then ovulate that night- Is coming the next morning going to be too late? I've read that the egg can only last 12-24 hours...
I look forward to your response.

Here is his reply:

The pain around the time of ovulation usually precedes the actual event and I suspect it is due to the rapid follicle enlargement before, not the ovulation itself. Eggs live for about 24 hrs post ovulation so the 2 insemination's should cover things just fine. Timing has been confirmed by multiple studies over the years. See you soon.
Sincerely,
Dr. RAWKS

So anyway. I'm trying to hold my shit together, and praying that the registration manager will be a reasonable human being. Cross your fingers for me!


************************************************************

Update:

I just had a "Well I don't know WHO you talked to..." conversation with another person at the bank. Everything is going to be fine. She said I have plenty of time, and that she guarantee's my registration will be completed by Thursday, or Monday at the VERY latest. Which is AWEOME. Right after that my clinic sent me an email with the pdf's of the signed and approved consent forms that I needed. So I sent everything over to the bank and even called to confirm. THEY HAVE IT. We're set.

Pick and Choose

Okay, okay. I know I'm way over due for a post, but I've been hard at work on this one. I've had to walk away from it a few times just to make sure I covered all my bases. So buckle up, because it's gonna be a long one. I've wanted to write about how I've been dealing with DI for along time but I just didn't know where to start. And honestly I don't think I was ready.

My experience so far has been pretty tumultuous. There are just so many questions that come with DI, and the more I understand, the more I realize that it will be a lifelong process. Which seriously scared the crap out of me. I realize that choosing to have children is a lifelong commitment, and its well known to present demands and unexpected challenges. But this isn't something I was prepared for at all. Nor did I have much knowledge of, or experience with. I was so naive going into TTC, that I really didn't realize that DI was something that heterosexual couples had to deal with. I'm cringing as I re-read that sentence, but it's true. It just never occurred to me, that MFI was A. So prevalent, and B. So definitive in terms of conception limitations.

I used to be one of the dumbass fertiles, that I now curse for being so damn callow, and uniformed....

The first time we sat down and looked at donors wasn't too bad because it felt so far away. It wasn't real yet. We were pretty light hearted about it, looking for a genius with Brian's heritage and height. The next time we looked, a month or so later, made me want to jump off a bridge. It was terrifying because now - this was going to be our reality. And in my eyes, none of these donors would ever be as good as Brian, and I wasn't able to look past that. Because I hadn't fully accepted all of the complications that came with our choice to do DI. I felt overwhelmed by the unknown. And I was so caught up in my crap, that I didn't think Brian was being honest about his acceptance of all this.

Until that is, we got a little help. I have to say that seeing a counselor should be on the top of anyone's list who is considering DI, it's just too complex to deal with alone. Talking to a professional who is experienced in dealing with DI, and IF in general, played a pivotal role in helping me gain acceptance. She validated so many of my feelings, thoughts, and concerns. Seriously when you are dealing with something so paramount and you begin to struggle- don't wait until you find yourself staying in bed all day watching tivo'ed episodes of Scrubs, crying for no reason, and wearing the same pajama's Monday morning that you changed into Friday night. It's not healthy. GET HELP.

Okay the public service announcement portion of this post is over. On to the good news. We've narrowed it down to two donors. Initially we were very explicit about our requirements. We essentially were searching for Brian's clone. I'm not going to list all of our requirements out of respect to our future child(ren) and to Brian's privacy, but basically we were REALLY specific about not only physical characteristics and nationality, but interests, hobbies, education, religion, medical history, and family dynamics. And I think it was just too much information. We began to wonder how much of those details would really shape this human being that we are going to raise together. The more we discussed it, the less details we felt we needed as far as education, hobbies, etc. We believe that you are a product of your environment. So while genetics are a factor of our identities in obvious ways, our surroundings seem to shape much more of who we become. Basically we think we're quite capable of screwing up this kid no matter who's DNA it has. It's the concept of Nature vs Nurture, and it seems to be a common discussion in the DI world. Brian and I both have brother's who are VERY different from ourselves, so it kind of proves to us that where you come from genetically doesn't necessarily dictate who you will become. Nor will it make you the same as your parents, or brothers and sisters. People are going to be, who they're going to be... Simple as that.

Another aspect that became important is whether we choose an open or anonymous donor. Choosing an open donor will give our child the option to contact the donor when they turn 18. When we sat down with the counselor, she asked us if we planned to use an open or anonymous donor. We told her that we had planned to use an anonymous, because we would be the parents, and they'll have medical history and what not to refer too, so the donor's presence wouldn't really be necessary. She nodded and said that our reasoning sounded fair, but that she would like us to consider choosing an open donor. She gently explained that picking an open donor would at least give our child the choice to find their bio father. She said according to recent studies and surveys, most donor conceived children would prefer to have the option to contact their bio parent. EVEN WHEN they had happy childhoods and maintain a loving and healthy relationship with their parents. We sat on it for a bit and decided that we would want the option if we were in our childs position.

Please understand that I don't think there is anything wrong with choosing an anonymous donor. That was our preference for at first too, and everyone has their own valid reasons. There are other circumstances that could prevent always using an open donor as well. Because open donors are saught after, they are therefore more expensive and less available. So you typically end up having to give up certain phyiscal traits to stick with the open option. Which is exactly what happened to us. We have decided that choosing an open donor, with our heritage, and one particular physical trait will be the most important requirements we look for. After that the donors medical background and personal essay will be the deciding factors. So there it is. A big congratualtions if you made it through all that with out a nap and/or a bathroom break.

When to Play Your Infertility Card: A Lesson For The Appropriate Use In Your Professional Life

Most of us have gone to great lengths to conceal our infertility from our employers. I am fortunate in that the owner of the company I work for, also happens to be like a sister to me. We grew up together and I've worked for her for almost four years now. So needless to say she has been more than accommodating with my situation.

I know that most of you don't have the luxury of confidentiality and flexibility in the work place that I do; so other than confiding in your boss to notify them of your upcoming baseline ultrasound appointment, when is the right time to play your IF card? How about when you mistakenly send an inappropriate email to a client instead of a co-worker? Check out this beauty:

In a message dated 5/27/2009 11:41:38 A.M. Pacific Daylight Time, melissa@xxxxxxxx.com writes:

Hey Teresa,

Can you please follow up with Carol about this? She is complaining about it like its our responsibility...

Thanks!

Melissa

So instead of sending that to Teresa, I sent it to Carol...

If there was a word that described being so mortified that it warranted walking out into oncoming traffic; I would use it. I called Teresa immediately to tell her what happened and ask for much needed advice. I told her that she could send an admonishing email to Carol, CC'ing me. Teresa laughed and said: "Um no, you're going to call her and apologize. You need to tell her that you're having a bad day or something".... Then there was a long pause... And she says: "No wait! This faux pas calls for the big guns. Carol has been trying to adopt for three years. YOU NEED TO PLAY YOUR INFERTILITY CARD."

And so I did. AND IT WORKED LIKE A FUCKING CHARM. I am still to this very moment distraught by my email, but Carol was extremely nice about it. Probably more so than I might have been had the situation been reversed. So lesson learned. Email protocols have been adjusted accordingly. And my punishment for being less than professional in an email to a client? Besides incesantly re-living the moment in my head. Probably a lifetime of having my chops busted about it - by my "sister".

*** By the way I welcome any comments regarding your email or texting mishaps. Thanks Clare***

Shrunk

I'd never been to see a therapist before yesterday. My clinic has a licensed Marriage and Family therapist on staff who specializes in IF. She's actually dealt with IF herself. She was much warmer than I expected. I was completely prepared for a sterile room (no pun intended), open ended questions and bouts of silence. Like you'd see with Tony and Dr. Melfi. But there wasn't a moment were one of the three of us didn't have something to say. The validation we got from that session was like a divine intervention. It was about as reassuring as a conversation with god himself could have been as far as I'm concerned.

Before I tell you more about this, I'd like to clarify that Brian and I both scheduled this session for the same reason - me. In case you couldn't tell by the last oh, 76 posts, I've COMPLETELY LOST MY MIND. Yes, she asked us both questions, and Brian answered everything wholeheartedly, but I'm sure by about four minutes in, the Doctor figured out that I was the main reason for the appointment... I told her about my fears. I told her that I worried that Brian had settled on DI just for me. And how I was afraid that I was being unreasonable by not wanting to wait an undefinable amount of time to save up the money for IVF. That we were rushing into this, because I couldn't wait any longer...

In a nutshell she responded with:

"Melissa, the people who spend the most money don't always win. And I wouldn't say you are rushing into anything. TWO YEARS of trying- completely voids the whole rushing in thing. Keep your eyes on the prize. If you want a family NOW, go get one. If DI is the most reasonable way for you both to attain that, then you're making a fine choice. And also: you're crazy. My receptionist will get you our standard issue straight jacket on your way out."

Okay so I might have paraphrased a little. And maybe she didn't actually tell me that I had lost my mind. Nor did she issue me a straight jacket. But its likely that she at least considered it.

In all honesty we walked out of there with the peace I had hope to achieve in at least eight sessions. I know that sounds too perfect, but I swear it wasn't all peaches and cream. She told us that some of our other fears would probably come true and that our struggles weren't close to over. DI is going to be a life long journey. We have a lot of learning to do, and its never going to stop. And I feel strangely good about that. I feel like this was meant to be in some way. Like we are supposed to deal with this challenge, and we'll be better parents/people for it.

She also confirmed what Brian had been telling me all along. That he really was fine with DI. Like I had already mentioned here, and here. She told me that I was projecting my own fears on to him, and assuming that he'd deal with all this like I would. She said he genuinely appeared to be on board with doing DI. Then she threw out some psycho-babel about how men don't think or process things the same way women do...

I would say that this appointment was worth every penny, but at some point during our discussion, the therapist mentioned that the clinic provides your first counseling appointment for free. FREE. SOMETHING OTHER THAN LIBRARY BOOKS - THAT WAS RELATED TO INFERTILITY- WAS FREEEEEE. Finally. But seriously I would gladly have paid a nominal fee for the advocacy we received from her. Someone who's probably had this conversation a million times in her 20-30 career. She gave us the confidence we needed to move forward. And so we will. And had I not had to get the rubella vaccine yesterday we'd be doing it next month. But instead we'll have to settle for July. We're bumping things up a month.

The Proposal

I knew today was going to be a good day. I have a new bra on, and some how that always makes the sky that much more blue... I spoke with my IUI Coordinator today. She was helpful and had a very soothing telephone voice. Which I totally appreciate because I am the freak who's blood pressure sky rockets whenever I'm at the doctors office. The anticipation KILLS me for some reason. And even when I receive a phone call from them I can feel my chest tightening, among other things...

She told me that she was going to walk me through each step of the preparation for my IUI and that I could take notes if I wanted but that she was also going to send me a list with all of the details. - A list? For Moi? Enchanté...

First I need to go in for more blood tests that probably won't be covered by my insurance. SHOCKING.

1.Blood Type, (which I should know but don't),
2.Rubella (which I hopefully don't have)
3.Varicella (which is Chicken Pox, had it when I was a kid)
4.Prolactin (which I'm told is the hormone associated with lactation, and I'm pretty sure there's none of that going on, but they're the doctors, so whatever. )
5.CBC - (Complete Blood Count - Checks the quantities of Red and White Blood Cells and Platelets, hearing that makes me think "CBC, and a CHEM 7". I loved ER)

In the packet she's going to send me I'll be getting a few different consent forms which will need to be notarized. They have to do with the actual Insemination procedure and the Cryo Preservation of our vials. And after all that is taken care of, as long as my blood tests come back clean, I mean okay, of course they'll be clean. Then we just wait until August...

Speaking of waiting until August, when we told our RE that we were planning to do it then, he said it was a shame that we were waiting so long because he's like to see me pregnant much sooner. Awwwwwwwwwww. He's a very soft spoken southern gentleman, with a perfectly lovely bedside manner, and good sense of humor. I LOVE HIM. I was really hesitant to see a male doctor at first because I have always had female Physicians. I like my mechanics to own their own car's, if you know what I mean. He's only seen my goods once for an ultrasound, but he has such a comforting presence that I didn't seem to be as nervous with him. He also told us that he thinks a double IUI would be best because we are planning an "Unmedicated Cycle". So I'll be doing OPK's to monitor. Then the morning that I receive a positive test I'll go in for my first IUI, and then again the next morning.

The feeling I have right now is what I was expecting after my last call with with our RE. I am so thrilled to begin this process, I'm just over the moon right now... I have another conference call with my Cryo Bank Coordinator. She just came back from vacation so I'm not sure when she'll be able to get back to me. Hopefully soon. And as for August? Well, lets hope that comes soon too.

*** Welcome ICLW Readers***

Flip Flop

If you've been reading this blog for more than three months you would know that when Brian and I were first diagnosed with Male Factor Infertility, we sort of made the decision not to have kids at all. We didn't swear it off forever, but we decided that we weren't going to pursue any treatments- therefore assuming it would never happen for us. It was a resignation of sorts, some might even call it a white flag. We were just so exhausted from the 16 months of futility. A few weeks later we decided not to make any decisions at all. For at least a year. And then a whole 2 weeks after that, we were all of a sudden ready to discuss our options. Partially thanks to our RE, who made things even more complicated by giving us two very different choices for conceiving.

In one hand we have the option of using Donor Sperm, also referred to as Donor Insemination or DI. The main reason we have considered it is because of our concerns with chromosomal abnormalities on Brian's side. Which according to our RE may not be a factor at all, as he once thought. It is not very invasive, costs about one thousand dollars, and has up to an 80% success rate each try, in the first 6 cycles. But with that comes a lot of emotional baggage that you can read about here.

And in the other hand, we have Invitro Fertilization with Intracytoplasmic Sperm Injection. Or IVF w/ ICSI. Which means I get a baby that is half of me and Brian. IF it works. There is only a 40-60% chance. I would have a few weeks of hormone injections, followed by an invasive process to harvest my eggs under sedation and local anesthetic. Once they are (hopefully) fertilized they would insert the fertilized egg into my uterus using a catheter. Oh and it costs like $15 grand.

So basically we've been flip flopping between using DI or IVF. First no kids, then IVF, then Donor, then IVF, then Donor again and we even got so serious that we looked into specifics on donor profiles.

This week we are back to IVF, deciding that we'll try it once and if it doesn't work we'll move on to donor.

Next week: Abduction

Oct-what?!-lets?

Something needs to be said in light of the recent spectacle created by the women who gave birth to Octuplets. I read a blog post written by a fellow infertile. I wish that I had the eloquence and wit that this women does because I would have written this article myself. Word for word.

Before you get started I am going to give you a small guide to the abbreviations because it's written in Infertilese.

HOM's - High-Order Multiples
ART - Assisted Reproductive Technology
IVF - Invitro Fertilization
FET - Frozen Embryo Transfer
IUI - Intrauterine Insemination

Once you finish the article come back here to read the rest of my post.

I'd like to gloss over my favorite parts of this article:

1. I LOVE that she points out the fact that if IVF were covered by insurance, there would be a lot less HOM's. Our insurance covers NOTHING.

2. In the same paragraph she points out that people who need IVF don't typically/purposefully put themselves in the positions to birth a litter. You only hear about them because it makes great news. Example: John and Kate plus 8. I personally like the show, but you see what I'm getting at. She also nailed it when she referred to the "the Fertile Public", insinuating that most people who don't have trouble getting pregnant have no idea what's going on with the latest treatments. While we've begun telling people about one of our options being IVF, at least 95% of them have assumed I'm going to have twins- if not more. I'd like to first say that in my case, they would only implant one fertilized egg because my plumbing is in good shape. From what I've read, when there is a problem on the woman's side, endometriosis, cysts and such, it's more difficult for a single egg to implant, so they tend to, but not always, insert more than one. Second, from the same people who assume we'll be having multiples comes the reaction "oh gawd, I would never want twins". Let me just say that when it's a real possibility that you may not have children at all- twins don't sound so bad.

3. I like that her ultimate judgment is on the doctor for implanting so many embryo's without doing further assessments into her situation. Also isn't there some kind of code of ethics that should have been called upon in regards to the health of the potential lives to be created from this procedure???? Not to mention the crazy mother's health? She has 6 other children to think about!! What if something had gone terribly wrong? Then the 6+ would be without their mother? AND what kind of financial impact it would make?!!!

I'd like to end this post with a big WTF?! And ask for your input on this travesty. Especially to my readers who are dealing with infertility.

Blogiversary

It's officially been a year since I started this little thing I considered to be an outlet. Although to be fair, I'd say the words "life preserver" should be somewhere in that description. The woman I am today is someone very different from the one writing this blog back then.

The past year has offered little more than despair and devastation. But its also made me realize how lucky I am to have Brian. Infertility is painful and consuming. And can break down even the strongest of marriages.  Brian has been supportive, patient and comforting from day one. Even after we received the test results- His optimism and stoic presence has pulled me back from the depths I never anticipated. There were many nights I crumbled in his arms and cried because I couldn't express a single word. I didn't know where to start.  And that's where this blog came in. 

Even with everything Brian offered I couldn't function without some other release, an avenue to solace. This blog has become that and more. To be honest, when I started this I had just barely grasped the concept of what a blog actually was. As silly as that sounds, I'd like to point out that my mother-in-law refers to it as a "blob". Love you Mom.  But aside from the bit of peace writing this blog has given me, its also directed me towards other women blogging about their own infertility experiences. It's like this massive world you had no idea existed until you're suddenly forced to become a citizen of it. It's a world full of anguish and grief and black humor. There's an excess of sad stories but then, fortunately, we stubble upon the ones with happy endings. They fill you with hope and anticipation that your day isn't as far away as it feels. Their stories give atonement and advocacy to every breakdown -public or private, every resentful glare towards a pregnant woman, and every night you cried yourself to sleep... I'm not alone. We are not alone. I hope that other people can learn as much as I have from reading and writing blogs.  I've spoken before about the profound healing powers this blog has given me, but I'd like to reiterate so that anyone reading this, now matter what there current life crisis might be, will be given another option for finding relief.

Even though we're moving on, I'm still on the mend. I don't know that anyone ever recovers or gets over infertility. Technically even if you conceive, through medical assistance, donor insemination, or miracle, you will be forever categorized as infertile. Because the odds of your next pregnancy will likely still be- well, unlikely without any of the above proceedings.  But hopefully we'll know better what we're up against and how to handle it. I actually think I'm a better person for having been through all of this. I don't take as much for granted. And I really believe the saying "You never know until you've been there" has never rang more true. 

Rise n Shine

I wish I could say that so far this year things have been very different for us. Unfortunately thoughts of babies still keep me up at night. Or in this case VERY early in the morning. I can't help it. After and hour of pleading with myself to phase everything out and try to fall back asleep, I just get up. Its silly to lay there, when I could be so much more productive right here. I missed you Internet. Its not that I haven't been thinking about you - BELIEVE ME. But I haven't been all that inspired to write.

I've been able to push most of the baby stuff out my head during the day. But in the wee small hours of the morning I still wonder what our lives will be like in five years, and whether or not they will include a child of our very own. It really is still that much in the air. The second round of tests that the RE ordered were to look at Brian's genetic materials. The RE said that Brian's severely low counts were indicative of a chromosomal error. Its called Y Chromosome Microdeletion. Its caused by missing gene(s) in the Y chromosome. This can lead reduced sperm counts, low morphology, the shape of the sperm, and low motility, the sperms ability to move. So let me put it this way, the old saying of "It just takes one" isn't actually true. You need a good pack of swimmers to get one guy to the.. ehhem finish line.

On that note, I will continue to leave us all in suspense as this journey of the infertile continues.

Is That An Ultrasound Probe, Or Are You Just Happy To See Me?

We met with the Reproductive Endocrinologist (RE) this morning. When I called originally they asked that we make the appointment in the middle of my cycle. The appointment includes a one hour consultation to discuss our test results and an ultrasound for me to monitor my follicles and to make sure I didn't have any cysts. The follicle is the fluid sac within the ovary that contains the egg, and is best measured towards the middle of your cycle. Now that I think about it I should have asked for a print out so that you could see what a phenomenal uterus I have. Doc said everything looks perfect. The main reason why that is relevant is because Brian's semen analysis was extremely abnormal. He's got the trifecta of bad results and it looks like our only option of conceiving a genetic child of our own would be through Invitro Fertilization with Intracytoplasmic Sperm Injection or IVF w/ ICSI. So I'm hoping the fact that my plumbing is in great shape gives us a much higher percentage that the IVF would be successful. And its all ours for the low, low price of $15,000ish. Did I mention how lovely you look today? That shirt is... something else... It really brings out your eyes. And that wallet, it looks so heavy, let me hold that for you... There, that's better....

SUCKAAAH!

Ugh. So yes, there is a shot in hell for us. And it does accept Mastercard or Visa. But the thing is, the monetary gamble is not the scariest part. The potential devastation we face if it doesn't work - is unthinkable. So needless to say we aren't quite ready for that yet. Emotionally or financially. So we are back to square one. Taking some much needed time off...

Just Say No

I have a relatively simple question for you. When are you going to have kids? 

In the past I always answered this honestly, but vaguely with "someday".  Brian and I have since decided that we would be pretty honest from now on, especially because this question would be coming mostly from people we know. But what do we say to strangers? People we've just met who ask very innocently if we have children at all.  It's already happened to me twice in the last week and so far I've just given a simple no. Brian thinks that I could come across smug and selfish by not explaining that we actually want them, and tried, but that it didn't work out for us. I however predict crickets during the BIG. GIANT. AWKWARD. pause from the people we JUST met who now know that we are barren. Infertile. Childless, not necessarily by choice.  Is it fair to saddle complete strangers with the news of our hardship? I would feel terrible if I just met someone then apologized for my cold and they said "Oh, don't worry about it, I have a rare form of extremely aggressive cancer".... 

So help a girl out. Will at  least one of the six of you that read this blog leave me a comment with your opinion, or suggestion?

Movin' On Up

So this cycle I decided to take the easier route in ovulation detection. I bought the Clear Blue Easy Digital Ovulation Kits. They take all of the guess work out of determining what is a positive test and what isn't.

With the tests I was using before, you have to decipher a positive test from a negative test. It shows you two lines, the control line and the test line. The control is always a dark pink line, but the test line varies in shades depending on the amount of the Lutenizing Hormone detected. A positive test is defined by the test line being as dark or darker than the control line. Although occasionally the test line will be difficult to read, part of the test line will be darker than the other so it seems like its not a completely positive test. You also have to pee in a cup and then dip the test strip in. It's a little inconvenient at work.

So with the Clear Blue Easy tests all you have to do is pee on a stick and then it tells you the results with no question. If it is negative it shows a blank circle, and if it's positive it shows a happy little smiley face. Which believe me after trying for so long, a simple little digital smiley can totally make your day. I fully intended to add a picture of that fantastic little smiley guy but I got my smiley at work yesterday morning and couldn't exactly bring my 35mm format digital camera into the bathroom with me. So while these tests are much more user friendly and convenient they are also like a billion times the prices as the other tests. The other tests which I get from EarlyPregnancyTests.com run around $0.62 a piece while the digital ones run about $4.28 each. And in any given cycle you can use anywhere from 3 to 7 tests. When you have a regular cycle.

Anyhoodle, so I'm pretty sure I ovulated yesterday. I got the positive test in the morning and then I had ridiculous cramping and a dull pain on the right side of my abdomen. They call ovulation pain like that Mittelschmerz. And I only seem to get it when I ovulate from my right side. So I'm on to yet another two week wait. Man I'm not sure how many more of these I can take... Commence hail Mary's.

**** Update****

Okay I did take a picture with the camera on my phone. I sent it to Brian to notify him of his pending duties. ;) It just took me a while to figure out how to get it on here.

Great Expectations

Today we met with an OBGYN that specializes in the early rounds of fertility testing. I was pretty much right on the money as far as my speculation of our first round of tests. I will start with a blood test that requires me to fast, (boo) but it can be taken first thing in the morning (yeay). I'll have to get to the lab at 7:00am in order to be on time for work (boo), but that should still give me enough time to swing by Starbucks for my very limited indulgence of a pumpkin spice latte (yeay).

The blood test will be examined for glucose levels to make sure I'm not diabetic. FSH levels which is the Follicle Stimulating Hormone, this hormone is what stimulates follicles to grow which will trigger ovulation, its pretty important to have good levels. And lastly a screening for Cystic Fibrosis, this test is pretty standard for us white folks. About 3% of Caucasian people carry this gene and when both parents carry it there is a 25% chance that you could conceive a child that will have the disease. Since my grandfather is half Portuguese and Brian's grandfather was 100% Italian our chances of carrying the gene are greatly reduced, but not eliminated. This blood test will be taken on the third day of my cycle, or CD3. The first day of my cycle being the first day of my period.

Then on CD8, or cycle day 8, I will have an appointment with a radiologist for a hysterosalpingogram, or HSG. This is a procedure used to diagnose certain problems with the uterus and or fallopian tubes. Blockage in one or both fallopian tubes is responsible for almost 35% of infertility cases in women. A blocked tube can prevent fertilization of the egg or the passage of a fertilized egg to move to the uterus for implantation. Basically they will inject a dye into my cervix that will pass into my uterus and fallopian tubes. Then using an x-ray machine that will be placed over my abdomen, they will determine any blockages or abnormalities. Evidently its somewhat painful, especially because my uterus will begin expanding from the pressure of the dye, and then later it will contract to expel the dye. So I'll be having contractions. Great.

The good news is that the likeliness of pregnancy after an HSG is slightly increased. It's speculated that the force of the dye can help remove blockages or debris that have previously prevented the egg from moving along to the uterus to implant. Many also believe that the oil-based dyes have a therapeutic property that improves the environment inside the uterus.

The doctor we saw today was very encouraging, and has given me hope that our quest to begin a family isn't far from our grasp. I hope she's right.

Oh and Brian? He gets to do it in a cup.

So You're Telling Me There's A Chance...

This is an article I stumbled across not too long ago regarding couples who have been trying to conceive for over a year. My personal doctor told me it typically takes 6 months. Great. And as I've said before every book I've read says that you should see a doctor if you have not successfully conceived within a year. Well here's a little something that says we actually have a shot in hell. It's called "Have Hope - Even After A Year". It goes on to talk about a new study presented at a reproductive medicine conference in Vienna, Austria, it showed that most healthy couples who haven't achieved pregnancy after one year of trying will ultimately conceive during the second year.

On that note. I made an appointment with a fertility specialist that works in my OBGYN's practice. It's on November 4Th. We will meet with her to discuss what our habits have been and what the first course of action should be. I'm thinking blood tests for me and a magazine with a sterilized cup for Brian. This is by no means an aggressive analysis. I'm just ready to take the first step. I'm not always an advocate of medical intervention, but I am a fan of getting my sanity back. Just like having a baby, trying to make one effects almost everything a woman does.

It effects the food I eat, it dictates the the beverages I drink - decaf, non alcoholic, sugarfree... It effects my social calendar and my overall happiness. All of the responsibilties with none of the perks. No count down until I get to meet this little person we've made, no grinning when I tell our acquaitances about my due date, none of the good stuff. We've known couples that took a well over a year to conceive. But my patience is fading. And so is my libido. Its time to make a move.

Nope.

Menses - men·ses - \Men"ses\ mehn-sees
pl.n. (used with a sing. or pl. verb)

• A period. Cyclic (monthly) flow of blood (menstruation) signifying ovulation, but failure to achieve pregnancy.

•  Menses - the monthly discharge of blood from the uterus of nonpregnant women from puberty to menopause.
  

Parolee

Time off for good behavior? Not exactly. I have developed a tremendously itchy rash. Sexy ehh? It's no big deal, doc says it should heal up fine. The original remedy she gave me didn't quite cut it, so now I have to take something slightly more toxic. Cooool. Anyhow, that means no baby making this month. The good news is - that is a whole 3 weeks of wine for me! Wooo hooo. Bad news is - it pushes my eternally potential due date back yet again. Interestingly enough she is not the only doctor I saw today.

I had my annual visit with my OBGYN. She's great by the way. We talked doggies and babies. We also talked infertility. She told me one thing I didn't want to hear: It takes most people about 6 months to get pregnant. But she did say something that made me want to jump for moderate relief. But I couldn't because my feet were in the stirrups. She said although most doctors recommend seeing a fertility expert after one year of no luck. Inertility used to be defined by 2 years with no luck. She said people just seem to be on the fast track these days and that plenty of couples will conceive after a year without medical intervention. Whew!

I guess its more wait and see. Something I have gotten used to. And better at.