E2=MG Stalled (Help Needed)

I went in this morning for my E2 (Estrodial) and CBC (platelet count). In order to get the clearance to start FSH and hMG (Follistim & Menopur), your E2 level needs to be lower than 70. When I went in last week to get instructions for administering Lupron, the nurse reviewed our calendar and explained how things would proceed step by step from here on out.

On January 20th, I would take my last active BCP and wait for my period to show. My next appointment would be January 25th, today, for the E2 & CBC. She then explained that if my period hadn’t shown by today, my E2 levels would likely not be low enough to get cleared to start stims. I tried not to panic this weekend as my spotting noticeably cleared up (just in time right?), and then fortunately yesterday morning she made her appearance. And let me just say her presence is much more substantial than normal. So naturally I was pretty pumped. I knew that her presence by yesterday would mean that my levels would be dropping considerably. This morning Brian and I happily showed up at 8:30 for my blood draw and for the rest of the instructions on how to work the Follistim Pen and how to mix Menopur. The nurse was sweet and told me she’d call herself when she got the results back. And so she did. And as soon as the phone rang I had a funny feeling the news would not be good…


My E2 level? 346.


Fuck.


So. I was told as of now, not to start stims Thursday night. But I will need to go in Thursday morning for another E2 check, and an ultrasound to rule out any cysts. Fuck.


I have of course consulted Dr. Google only to find horrible information that makes me think IVF will never work for us. Basically one site indicated that elevated levels can point to a problem with ovarian reserve. Which can significantly lower IVF success rates. The only thing that kept me from hurtling myself on to the train tracks, was that I pulled up my records from my Full Blood panel on CD3 in October, and my E2 was 34. So the other possible scenarios, which I discussed with my nurse are:


A) It could be due to a Cyst. I have never had or been diagnosed with a cyst before, but I am technically poly cystic – so maybe now is just the time. Fanfuckingtastic.

B) My nurse said she has seen cases where Lupron actually causes stimulation instead of suppression, which in that case would cause a higher E2.


Now comes the part where I get to stew and over analyze things without having factual information to back it up. In the last few weeks I have, off and on, felt a strange pinching twinge on my right side near where my ovary would be. My right side is my dominant side, if that means anything at all. No pain, just a weird pinch while sitting up in bed, sporadically. It could have been gas, who knows.


Here are my concerns: I’m only on 10 units of Lupron per day. Which seems low compared to other bloggers – I know, I know, you’re not supposed to compare cycles since everyone is different. But really it seems low.


I could really use some more information about this, whether from experience or a reputable website.


HALP!

Because I Made My Own Bed

Previous to falling face first in to what is certainly the most challenging period of my life, I had imagined growing old with the small group of close friends we kept.

Old and gray, with grandkids in our laps.

But things change. I’ve changed. And as our years in the realm of infertility have gone on, I have slowly removed myself from the bulk of what once was a close group of friends. They have kids now. And seeing them makes my heart ache in the worst possible way.

Infertility has greatly impacted every single one of my friendships. And more often than not, I’m sorry to say, it has been negative.

I’ll fully admit that 95% of the friendships that have waned are a direct result of my actions. I have chosen self-preservation over sucking it up and throwing on a smile at yet another friends baby shower, or baby’s birthday. Hell, I can barely even manage to keep my shit together during a simple dinner when children are present.

So I suppose it’s only natural that at some point, after so many declined invitations, said friends would stop inviting us to parties and or casual gatherings. And while I'm sure that their decision was not easy one to make, I can’t help but grieve the place where we used to be. And I struggle with whether it was wrong that they didn’t even bother to invite us, or if they actually did us a favor by letting us off the hook? But basically my choices are feeling bad about not going or feeling bad about not being invited. Nobody wins.

I have made a lot of truly incredible friends within the ALI community. Seriously, some exceptionally amazing people. And I wouldn’t trade those friendships for the old ones I had. But I hope to hell that if I ever get out of here, I might someday get them back.

2011 ICLW

Greetings ICLWer’s, and Happy 2011! Whether 2010 was your year or it sucked more than Sex and the City II, I’m sure you’re likely glad to see a new year come around.

As for me, I fall in the latter category but I have a sneaking suspicion 2011 is going to make up for that and the heinousness that was the last three and a half years. My husband and I have been ttc since the summer of 2007, and it’s been a whirlwind of heartbreak, desperation, and general ickiness. All of which I feel lucky enough to say has brought us infinitely closer. (Though 10 months of marriage counseling didn’t hurt either). We took most of 2010 off to recuperate emotionally and financially, you can read about our long drawn out history here, or check out the bullet point version in the timeline tab up above for time's sake.

On this very fine day, you should know that I am on day 6 of Lupron and took my last active BCP yesterday. All this for our very first (and very much hopefully LAST) IVF w/ ICSI cycle. Next Thursday I’ll start Follistim, Menopur and Dexamethasone. We’re looking at a potential retrieval date around February 6th -9th , and hoping for a day five transfer. Does anyone else feel like I should be telling you what altitude we’re flying at? Sorry if this intro was a little lackluster, I’m currently, and equally overwhelmed with excitement for our cycle and my job workload.

At any rate, Happy ICLW and thanks for stopping by!

Ten Units Please!

Lupron shot number one is DOWN! Annnnnd my husband is a total rock star for two reasons: 1) I am still alive and 2) I didn’t feel a thing! I panicked only a little in an excited-giggly-school-girl kind of way, but got over it pretty quickly when I realized he was doing the shot but it didn’t hurt a bit! I am by no means a needle-phob, I’ve just never had anyone who wasn’t professionally trained, jab a needle in my arm. Good times. So as recommended by my in-cycle nurse we are doing the Lupron in the fatty part of the back of my upper arm. (Ironically the place I like to torture the people I love with a surprise pinch when they don’t know I’m behind them.) Because at one point we will be doing three shots per day, she recommended not using all of the “real-estate” on my stomach since it can get sore. Sounds fair to me.

So call me Spotty-Mc–TMI-Spotterson, I’m still spotting but it’s starting to clear up RIGHT IN TIME for me to finish up BCP’s on Thursday and wait for AF to show. Nothing like having your period for two weeks... So the spotting actually got worse starting Friday night, and stayed that way through Sunday. (Like bright red, and requiring more than a liner) I did call in and actually spoke with Dr. 3 since he is on call after hours. My nurse told me to call if it got worse, so I did. I felt a little sheepish bugging him for something that seemed so trivial, but A) I don’t know enough about IVF to gauge if my spotting should even be considered trivial, mostly due to fact that Dr.Google, and all of you seemed to have been treated differently per your respective clinics. And B) I remembered how much we’re paying this chump, he can take a three minute phone call from me don't think he minded that much. Anyhoo, he diplomatically, and promptly explained that it was fine. That they prefer not to ask patients to double up on BCP’s because most people just end up complaining of nausea and go back to taking one per day anyway.

So HOLY CRAP we’re really doing this! I’m feeling really good, and taking a lot of time for myself by thinning out our schedule. It’s been really nice to have the extra alone time with Brian, and not having too much going on socially is a bigger relief than I realized it would be. By the way, thanks so much for all of your thoughtful comments. Even though it’s still early in the cycle you’ve been extremely supportive and super cheerleader-y and I really, truly appreciate it.

GO INJECTABLES!

Break On Through - Updated

Let the "Oh crap, what does this mean" moments begin.

I started spotting pretty heavily this morning, dark red. It's only CD 21. I haven't missed a bcp and I've been taking them around the same time every night.

I left a message on the non-emergency line with my In-cycle nurses, because it doesn't seem like an emergency. What say you veterans? Should I be concerned with a little break-through bleeding, or just annoyed at the inconvenience?

Thanks in advance!

____________________________________________________________________

Thanks to all of you who shared your experiences or even just left an encouraging comment. I did hear back from my nurse. She said it's totally normal, and yes annoying, but not to worry. She warned that if it turns into more than spotting, I need to call them and they may have me double up or even come in for an u/s. So far it's lightened up a bit. The other side effect I've had from bcp's has been really sore boobs (which is a common pms issue for me) for about the first two weeks, but they're fine now.

Thanks again ladies!

Meds

This afternoon the Mr. and I will head down to our clinic for injection training. I'm quite certain he's been waiting for a legitimate reason to stab me since about September of 2007.

Saturday I cruised over to the pharmacy to pick up my stash. As the technician handed me the neatly packed bag, I felt surprisingly underwhelmed by the size and weight of it all. The bag containing my burger and fries from In-N-Out that I picked up on the way there weighed more than the $3,800 dollar's worth of medications I now held at my side. Not that I anticipated needing a hand truck to get to my car or anything, but it sure didn't feel like much. It wasn't even all that real until I started taking the pictures of my loot, that it really hit me.

This is for us

For our IVF cycle

It's here. FINALLY.

Hers.

His.

My list of meds to date:

Folgard

Metformin

Pre-natal

Low Dose Asprin

Birth Control

Calcium

Humira

Lupron

Dexamethasone

Cipro - antibiotic

Menopur

Follistim

(Complete with lucky pen)

Novarel - trigger

Brian's meds:

Cipro.

(nice, huh?)

Although to be fair he's been taking a hefty load of supplements since June. Six pills twice a day. Remember the tic tacs? They worked - sort of. Not enough to get us there the old fashioned way. But enough to have made it worth it.

I start Lupron Sunday.

Holy crap.

New Year, New Way for Life To Point And Laugh At Me

Holy Hell people, the last few weeks have been such a whirlwind, I hardly know where to begin. Oh wait! Happy fricken' 2011! Sweet Jesus was I glad to see 2010 go. I learned a lot, I grew a lot. I'm OVER IT, and ready to kick some mayjah infertile ASS, à la a viable pregnancy. Savvy?

Good.

There have been lot of changes in the last few weeks, lots of ups and downs - none of which I have blogged about. Mostly because I've been trying to process everything internally, and with Brian. I don't mean to make that sound scary, and no I'm still not running for Governor. We've recently had an epiphany of sorts regarding finances and really just how far we're willing to go into debt to make this whole parenthood thing happen. And well, it made me feel pretty blue at first. The reality of how much your financial parameters impacts your ability to pursue treatments really sucks balls, and I threw myself a little pity party in lieu of.

Realistically we are able to do this IVF cycle. And I know there are plenty of others who can't afford to get that far. But my eyes were a little bigger than our pocket book and the long term actuality is such that the two package deal we wanted to do is a little out of our grasp. We can afford the cost of the package itself, but if we have to do additional cycles we'd have a hard time coming up with the gravy to cover additional meds. Meds for a fresh cycle will run us about 6k, and FET's will be at least 3k. Not something I could have know until we got all of our prescriptions from Dr.3. So. Since we're about two shakes from knocking of a liquor store to pay for this cycle as it is, we decided to draw the line at one fresh IVF (and of course any FET's, if we're lucky enough to end up with frosties). And if after all that we wind up with empty arms, we can move on to Foster Adoption knowing we gave it the old college try, without putting ourselves in financial ruins. It's really the most sound decision we've made since the determination to take last year off, and it feels so right.

So last week we signed our lives away and I wrote the biggest check I've ever written (my hand was actually shaking as I wrote it, and for a split second I forgot how to spell "thousand"). And yesterday afternoon I ordered and paid for all the meds we'll need for this cycle. Pickin' em up tomorrow! Wooo!

And about an hour after the confirmation from my pharmacy for the meds, I got a call from the University where we got our second opinion. Can you guess where this is going? Cause I sure as hell couldn't. Like three weeks ago I finally got the bill for the consultation we had LAST January, so I thought this was a "where's my money, fool" call. But, no. This was from the Research Department. For Clinical Trials. She wanted to know if I would be interested in adding my file for review of eligibility for an ALL EXPENSES PAID Cycle of IVF, under an FSH study. Seriously. And SERIOUSLY?!?!

The review for candidates wouldn't be for a few more weeks, so asked to keep my name on the list. After we hung up, I pulled my jaw off the floor, and started to process all of the information she gave me. Here is what I realized 1. I am being reviewed for eligibility, so this isn't even a sure thing. And 2. Even with that phone call, as much as it took my head clean off, I don't regret having signed and paid for our current IVF cycle with Dr.3 - mostly because I genuinely believe it's going to work the first time. But also because it gives me the tiniest bit of hope that if it doesn't, we might, maybe-a-little-bit, have the possibility of qualifying for a clinical trial at some point and that all hope of someday being pregnant won't ride on this single cycle.

Up until this phone call I had forgotten that a few months ago in a brokeass and hopelessness induced fit, I had called their research department regarding clinical trials only to find out we didn't qualify for anything - at that time.

So in summation: Life goes on. The plan is this, A) Obviously go on with our current cycle, it's fucking paid for now. B) Wait for her call. If she calls next month I'll see what the time lines are like and ask for an extension until the end of February, when I'll know where we stand. C) Hope for the best on all accounts. If there is one thing I learned during my 2010 recon mission, it's patience, and that I truly believe things work out the way they are supposed to, which I know from experience means: never the way you planned, so get over it. Quick. So as for the new year, I have no fricken idea what 2011 might bring me, but at this very moment I have a buttload of hope and aspiration for greatness.

42nd Time Wasn't the Charm

This month represents our 42nd cycle of trying to get pregnant.

Normally AF's appearance would be greeted with a glass of wine and a good cry, but today it means something else.

It's CD1 of our first IVF cycle.
(and hopefully only)

I'll start BCP's the day after Christmas. My nurse gave me our tentative schedule, and I haven't been this excited about anything in a very, very long time. I want a BFP so fucking badly I can taste the after vomit from morning sickness... (too far? oh well.)

12/26 Start Birth Control Pills

12/29 & 1/12 Humira Injections (for Immunology Issues/ Neutralize Cytokines)

1/16 Start Lupron Injections

1/20 Last BCP

1/25 Estradiol & CBC, Blood Tests

1/27 Start Follistim

2/2 Estradiol, Prolactin, NK & TH1/2, Ultrasound & back up Semen Sample

2/6 - 9 Estimated Retrieval

2/9 - 16 Estimated Transfer (they prefer a day 5 transfer)

Beta at 13 days past transfer

Fall 2011 - We become parents

Presumptuous? Yes. But monkeys? I can't afford to be anything BUT hopeful....

Anyhoo, this might be my last post for 2010 (and good riddance to this year, I'm so OVER it). So I'd like to take this take this opportunity to thank all of you who offered unwavering support through my year of "recovery", then wish everyone a Merry Christmas; if that's your bag, but more than anything I wish you all a very, very Happy 2011.

December ICLW

Oh ICLW, you sneaky monkey - how could it possibly be the 21st ALREADY?! Sorry I was a bit un prepared, I'm days away from CD1 of our first IVF cycle and entirely absorbed/terrified/excited about it. This fall we started with a new RE, dubbed Dr.3, whom diagnosed me Ovulatory PCOS (different than Classic PCOS), Elevated TH1 & TH2, and Natural Killer Cells, and MTHFR (2 mutations of A1298C). I've been on Metformin, Folgard, Low Dose Aspirin, and prescription Prenatals since October. BCP's should be coming up right quick!

So here's a little (actually alotta) history:

My husband (35) and I (31) started TTC in the summer of 2007. I genuinely believed that we would get pregnant on the first try. Ha. Fourteen months later, we moved on to testing through my OBGYN's office which revealed a severe male factor. She promptly pointed us towards the RE who I now hate told us IVF w/ ICSI or Donor Sperm would be our only options. After MUCH deliberation we chose Donor over IVF, partially because it was the most financially attainable option (our insurance covers NOTHING for infertility, not even diagnostic testing) and because we were concerned about the implications of the severity of his diagnosis might mean for our future children.

Fast Forward to December 2009 when we completed our SIXTH and final DIUI. All of them left us with straight up BFN's and a fair amount of debt. Our RE at the time and the second opinion we got a month later were dumbfounded and couldn't explain why none of the IUI's worked because my charts looked so great. Umm yeah, neither of those doctors caught the OPCOS which is clearly evident in an u/s and with knowledge of the fact that my cycle is 30 days. And interestingly enough, neither of them test for immunological factors... But at least I have an answer now as to why none of the dIUI's worked.. Not that it's any consolation.

That brings us to January of this year, I'm not going to lie- I was a complete basket case. We decided to take the rest of the year off to focus on our marriage and restoring my mental health. By March we had decided to plan for IVF in 2011 - with my husbands sperm. In the mean time, we've been doing our best to appear somewhat normal to the rest of our friends and family.

So there you have it. I look forward to reading all of your blogs, and hope you enjoy the last ICLW of 2010!

Tree Hugger

Brian sent me an email Tuesday morning with the Subject reading:

Looks like u two have some things to do tonight.

Teresa my boss/bff was aware of my indecision about getting a tree this year, and last year- but still did her best trying to coerce me into getting a tree; to no avail. I down right refused. So when I got this email from Brian the first thing I did was forward it on to my friend, and a chain of emails quickly ensued.

From: Melissa G
Sent: Tuesday, December 14, 2010 11:25 AM
To: Teresa
Subject: FW: Looks like u two have have things to do tonight


Check it out. =)

(picture attached)
_______________________________________

From: Teresa
Sent: Tuesday, December 14, 2010 11:31 AM
To: Melissa G
Subject: RE: Looks like u two have things to do tonight


:) That's so sweet. I want to hug him.
____________________________________________

From: Melissa G
Sent: Tuesday, December 14, 2010 11:33 AM
To: Teresa
Subject: RE: Looks like u two have things to do tonight


I know, he totally made me cry.
___________________________________________

From: Teresa
Sent: Tuesday, December 14, 2010 11:33 AM
To: Melissa G
Subject: RE: Looks like u two have things to do tonight


Me too. If you want a friend to decorate with you, let me know. :)
______________________________________________

From: Melissa G
Sent: Tuesday, December 14, 2010 11:39 AM
To: Teresa
Subject: RE: Looks like u two have things to do tonight

Awwwwwwwww. Thanks, but I think I'm going do it naked as a "thank you".

__________________________________________________

Are you happy now???

Good, me too.

The One Where I'm All Over the Place

I spent the last two days in bed. Watching the heinous excuse for entertainment that is daytime television. Not to mention two movies that equal four hours and fifty-two minutes of my life that I'll never get back (Valentine's Day and Sex and the City 2). AWFUL movies, in case you were wondering...

The two days in bed were brought to me by a hellacious cold, courtesy of a co-worker. I can't completely fault her though, I seem to get sick whenever anyone around me has something. (Elevated Natural Killer Cells, MY. ASS.) Please don't correct me if I'm way off base on the NKC thing - it was a joke and I'm still entirely too foggy to reply with much more than a hand gesture, which you'll obviously never see.. So let's save each other both some effort, yes?

So at the very least I was able to cross a few things off my list. I got the 'Clean bill of health" (ironically) from my GP, along with a copy of my last Pap Smear results. And sent them over to my Nurse Coordinator at Dr.3's office. Whom by the way, is not exactly the sharpest tool in the shed, I'm sorry to say. But more on her later.

Speaking of Christmas tree's, we still haven't decided whether or not we're going to get one this year. (Nice segue, huh? Well that's how my cloudy little brain works while stifled by an illness- get used to it.) We've put lights up on the house and a few decorations on this inside but I still haven't come to a conclusion about a tree... We've always been hardcore Christmas fans, and if someone told me that one year we'd decide not to get one, I'd have driven off the closest bridge embankment without a second thought. But about this time last year I had begun my descent in to the sixth circle of infertile hell, and could not for the life of me find a single reason to celebrate. This year I'm no where near that state of mind, I'm listening to Christmas music regularly (not crying on the way home from work every night allows time for radio play) But I still don't feel 100% there. Brian says it's up to me, that if I want a tree he'll be on board, but I just don't know. Part of me thinks that it's a good idea just to get one, in the same way that it's important to listen to upbeat music when you're down instead of indulging the sadness by listening to the melancholy stuff. Which I'll totally admit was not my Standard Operating Procedure in the past - I have to thank cgd for finally getting me to stop that)

Will I regret getting a tree? Probably not. I guess the side of me that's holding out is the side that feels like it wants to put certain things on hold until there is a baby G (or two) to celebrate with... All the while I know it's not okay to put your entire life on hold and allow the infertility to swallow up yet another aspect of our lives. Still I'd be kidding myself if I said that we hadn't been 95% devoured by infertility anyway, because just like raising children becomes a main focus in your life: not having them, as well as the journey to get them, requires the same amount of attention. Would you agree?

Procrastination Nation

Between the lines of inclination and procrastination exists a dimension of balance and symmetry. I know nothing of this realm, simply because I can only function on one side of the spectrum or the other. I excel to the nth degree of practice in each field. Thin or flush, all or nothing.

For I am my own driving force, and adversely, my own filibuster.

Where am I going with this you ask? Well, right after the seminar I was all gung-ho to get this IVF partay started, but the crappy test results and impending financial burdens really knocked me down, and I immediately started to run the other direction. Cause I'm mature like that. Running away is always the answer - something I am totally going to teach my kids. When I have them - oh wait...

So you know those tests I have to go back for? The ones I complained about like two weeks ago? Well I sort of knew about them two weeks before that. And I've sort of been avoiding them. I know, my ninja like dawdling skills are mind-boggling, yes? Fortunately the grown up in me started to remember how crappy it is to have to scramble to get my shit in order, following a procrastination bender such as this. And also how much I'd like to avoid being committed to a county facility, cause Ima' 'bout to loose my shit if I don't get on the road to parenthood right quick. Plus I would be incredibly disappointed if my cycle got pushed back just cause I was being a douchebag.

So here's my list of shit to do:

• Get Brian's blood work requests over to his GP so that he can order them under something other than infertility in the hopes that the miserable bastards at our insurance company will cover them.
• Get my bill of clean health from my GP, and letter stating that my last Pap was clear.
• Get the Tuberculosis test.
• Get the other blood tests for the gene mutations I can't pronounce let alone spell.
• Call to process my application for free IVF meds.

While we're on the subject, an update on the miserable bastards at the insurance company front. The initial statement I received for the denial of claims on my blood panel was evidently only a portion of the blood tests. The immunology stuff was sent to a lab in Chicago and submitted at a later date. So I received a separate letter from the miserable bastards stating THE ALLOWED CLAIMS. Out of the $1,400+ dollars worth of testing for the immunology, I am responsible for $89.00. HOLEE-CRAP-THEY-BOUGHT-IT. Annnnnnnnnd, I called about the other work (the $3,800 in denied claims), it turns out it was sent to the wrong branch and has since been resubmitted and is currently in review for coverage- YARHOO. I know that isn't a guarantee that everything will be covered, but it's a step in the fucking right direction.

So do I feel bad now about calling them miserable bastards?
No. Fuck, no. Not one bit, because they deny shit that should be covered for people in much worse situations than me on a regular basis and for that I hope their descent to hell is a slow and painful one.

Just to clarify.

So who's ready for the weekend?!

Trying to Hold On

Dr 3's office called me this weekend. I missed it, but my nurse coordinator called to say they'd like to have me do a few more blood tests.

More? REALLY?

Twenty-fucking-four vials didn't give them enough information already???

During my Genetic Counseling session, which Dr.3 requires before he will treat you, I mentioned that like 30 billion years ago there was some Jewish heritage in my family, (doesn't everyone, sort of?) so he wants to check me for some ridiculous gene mutations that I have never heard of (not tay sachs- already tested clear for that) They also want a blood test to see if I've ever had any kind of exposure to Tuberculosis.

Part of the reasons I'm annoyed with this is because my insurance declined to cover any of the blood work we've done so far. $3,800 dollars worth. My NP at the Obgyn's office who was trying to assist us in the insurance deception department, told me that I should call and ask that it be resubmitted. She also said she would provide a letter to them, if it'd help. All of which I plan on doing, despite my intense want to pretend none of this is even happening.

The other reason? I'm angry. And exhausted. From all of this. Sometimes I wish I didn't want a child so badly. Because my life outside of infertility is pretty great. And the parts that aren't, well, are more than enough for me to handle. I don't really need any more difficulties. REALLY UNIVERSE, YOU CAN BACK OFF NOW. MAILBOX FULL. OKAY?!

I had a dream last night, that a foster adoption we had applied for came through. (our next plan if IVF doesn't work). They placed a baby in my arms, and I instantly fell head over heels. Then I had to leave the a baby at home with Brian while I rushed out to by a car seat and clothes because we weren't at all prepared. But it was exciting. And wonderful. And I just want so very badly to be at that point all ready. I don't know how much longer I can do all this - I wish I could let it all go. The longing, the emptiness. I'm drowning in it.

I'll start BCP's in about a four weeks. And I'm excited, really. I'm honestly thrilled that we're finally going to have our first real shot at actually being pregnant - in a very long time. But I mostly just want to get it over with. To be done with this part of my life. To move on.

I'm sorry this post sounds like I'm down, which I guess in relation to IF, I am. But otherwise I'm pretty happy. Looking forward to Thanksgiving and the new Sweet Potato recipe I'm going to try out. And on that day, I'll give thanks to all of you - for every single ounce of support you've offered me. And pray with eveything I have that each of our journey's comes to a swift and blissful conclusion.

November ICLW!

Each time I participate in ICLW I try to come up with some new-fangled concept for and intro. And today is no different! With that, I give you: Contributing factors in an Infertility Bloggers Life; via Bullet Point. Autobiographical.

1. An outlet of some sort became necessary approximately six months after we officially started trying, and my lovely husband couldn't understand why I cried alone in the bathroom every 31 days.
2. At that point I was still fairly certain that I'd see a positive pee stick in the very near future and shortly thereafter commence writing a wildly self-indulgent, and more than likely whiny pregnant-lady-type-blog.
3. Lingering only slightly in denial, we didn't have any testing done until after 14 months of trying.
4. A week before Christmas, 2008 we found out we had Severe Male Factor, and were instructed to go directly to a Reproductive Endocrinologist.
5. Before even seeing an RE, we promptly decided not to have children at all.
6. That resolution only lasted about two weeks.
7. Fast forward to now, and we are gearing up for our very first IVF cycle in January/February, though I'll likely be starting BCP's towards the end of December.
8. In an effort to circumvent my crying over MUCH spilled milk, you can read about my sordid past here. It gets down to the nitty gritty of exactly what happened from the time we were diagnosed, to the beginning of what would be a break in TTC, and ART for pretty much all of 2010.
9. The new RE we're seeing (referred to here as Dr.3) ran an obscenely comprehensive blood panel on me and it came back positive for MTHFR (two mutations of the A1298C gene, with a borderline homosteine level), Elevated TH1, TH2 and Natural Killer Cells. Awesomeness. Oh, and also Ovulatory PCOS - different than Classic PCOS - cause ya know - I'm an over achiever... Okay, not really.
10. None of the aforementioned diagnoses were ever found by my previous RE(s) because they don't believe in Immunological Disorders. Or paying close attention to Antra Follicle counts evidently, because the OPCOS is as clear as day on a baseline u/s, and should have been determined easily based on the knowledge of my 30+ day cycle.
11. I'm over the misdiagnosis - CLEARLY.
12. I know you have 742 other blogs to read and comment on, so I'll keep it brief and end it here; welcome you to my blog and thank you in advance for your comment, then tell you I look forward to reading all of your blogs as well. Oh, and if you're going to be cycling with IVF close to when I am, be sure to say so in your comment - I'd love to stalk you and compare Lupron induced rants notes!

Losing My Way

Blehhhhhhhh.

I got the writers block, yo.

I think part of it is because I've been a little overwhelmed with having gone zero to sixty in such a short period of time. Which lead to me spending recent days reflecting on the last year or so of my life. And cripes has it been a doozy. Especially when I think about where I was this time last year. (Cuckoo cuckoo cahchoo, man.)

Seriously, my chest feels heavy just thinking about it.

So I'm sorry for not posting much here, or being super great about commenting. I guess reading some blogs here, no matter what stage you're in - has been overwhelming in a different way - and that way, is part of what Brian calls "you'll never win, so don't even try". Those of you in the early stages reminds me of when I was there and the fact that I'm not any further along. Those of you who are parents already - for obvious reasons. Those of you cycling; well this one is tricky because I'm jealous and I want to be at the end of a cycle already, and at the same time aloof, because damn, I'm beginning to worry that I'm not strong enough to do this. And I kind of wish it was September again - before baseline ultrasounds, crappy test results, and specifics on financials for IVF came in.

Gah.

I'm not even there yet and I'm feeling a bit disheartened. Le sigh.

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.

Disturbing The Peace

Oh gawd, she's back. The whiny, and seemingly indecisive side of me that Infertility has capitalized on. And I'd love nothing more than to punch her square in the jaw.

I'm okay. But I think it's fair to say that last week was rough. I know that the three crappy diagnoses I've gotten in the last two weeks are not the end of the world. The hardest part for me was really that we've gone so long thinking that MFI was the only hurdle we had to jump. So hearing now that there are three significantly crappy issues on my side that could hold us back was pretty much the infertile equivalent of walking in on your parents. You turn away, alarmed, disillusioned, and in overall shock.

One more thing that sucks is that treatments could end up costing close to another 5k - worst case scenario. Which is pretty much infertility's way of pissing on the ashes that once was my retirement plan.

Now I need to clear a few things up. I'm sticking with Dr.3. I like Dr.3 (I'd say love, but we're still basically courting since I've only seen him in person once - and well, he hasn't gotten me pregnant yet - Hmm if you didn't know I was talking about IVF that statement could be misleading). AnyWAY, I believe in Dr.3. But I think it's my responsibility as a patient to question different and inconclusively proven treatments. While I'm not 100% sold on the immunological theories, my gut is telling me to go with it. Or maybe it's my uterus, since it's got a better view as to why SIX iui's failed...

Man, after taking two thirds of this year off, and away from treatments I've forgotten how truly overwhelming and consuming it is. It's like this whole other component in my marriage - it's like a second fucking job, even. Gah, I'm sort of tired of it already.

Cheese and Crackers, folks - NINE posts in one month. Are you guys sick of me yet, or what?

Well, If They Don't Know...

I'd like to thank you all for your incredibly thoughtful and supportive comments on my last post particularly. I'm still digesting the information but I can see clearly enough now to know four things.

1. The ALI community is AH.MAZ.ING.

2. I'm grateful that these issues have been diagnosed now, and not after an IVF failure or miscarriage.

3. A big part of me feels like we had to go through the failures at our other clinic to get us to where we are now.

4. I'm perplexed. I really, really don't understand how certain controversial medical, and scientific theories are not actively proven either way. I understand the contentions behind the Big Bang theory, but in my uneducated opinion: that shit happened a long ass time ago, and there ain't much any of us can do about it until Doc Browns visions come to fruition in real life. But how is it that with all the technological advancements we have at our finger tips and with the issues in front of us now, that there is still room to argue about things like global warming, possible causes for autism, and immunology's impact on reproduction? I realize that it simply takes time to run proper experiments and compile evidence, and that it's not remotely as cut and dry as I'm thinking it should be. I know I probably sounds like a moron, but I guess my point is that I'm frustrated that there aren't any irrefutable answers. Yet.

Friday I had been emailing with a good friend and fellow blogger, Sarang about how frustrating it is that some doctors practice the immunological studies and some don't. (As was also pointed out by a comment in my last post, thanks LC). There are two MAJOR Universities near me that don't test for immunological disorders. During the second opinion we got at one of the universities, the distinguished RE we saw diplomatically told me that it was 'nonsense' when I brought it up. But just a few hours before that, the OBGYN who works closely with the RE I'm seeing now, told me that his miscarriage rate had dropped by almost 20% since he started following the preventative care methods based on the immunological disorders. i.e. the IVig, and intralipid infusions, and blood thinners for MTHFR - clotting issues, etc. Still, I can't overlook the fact that there are the big guns like CCRM who don't practice this...

What does that say? Is my RE a trailblazing pioneer or a bohemian maverick?

The One Where the Universe is on a Roll

I got the call regarding the last bit of my immunology testing.

It's not good.

My TH1 and TH2 and Natural Killer Cell levels are elevated.

I know this isn't the end of the world, but sure feels pretty close to it at the moment.

And I know it can be treated, but right now, I really don't know if I want to.

Fucking. Fantastic.

How to be Misleading in an ICLW Description

You can start by abruptly ending your break (of 10 months) after attending a seminar given by the man who will become your new RE. After a phone consult reveals CD3 will be in just four days, you dive ankles first back into the stirrups. (for those of you keeping track that was six days after the seminar - four days after the phone consult) Two phlebotomists, twenty-four vials of blood and a baseline ultrasound later, you find yourself itching for test results whilst simultaneously remembering what it's like to be here yet again and suddenly becoming terrified that the test results could come back with BAD news... And they did... Not only was I diagnosed with OPCOS, at first over the phone then confirmed during my baseline u/s (which my first RE never caught), but my blood tests later showed that I tested positive for two A1298C mutations, indicating MTHFR. Which my first RE never tested for because he doesn't BELIEVE in Immunological Disorders.

Hi.

Still with me?

Good.

Here's some history!

My husband (35) and I (31) started TTC in the summer of 2007. I genuinely believed that we would get pregnant on the first try. Ha. Fourteen months later, we moved on to testing through my OBGYN's office which revealed a severe male factor. She promptly pointed us towards the RE who I now hate told us IVF w/ICSI or Donor Sperm would be our only hope. After MUCH deliberation we chose Donor over IVF, partially because it was the most financially attainable option and because we were concerned about the implications of the severity of his diagnosis might mean for our future children.

Fast Forward to December 2009 when we completed our SIXTH and final DIUI. All of them left us with straight up BFN's and a fair amount of debt. Our RE at the time and the second opinion we got a month later were dumbfounded and couldn't explain why none of the IUI's worked because my charts looked so great. Umm yeah, neither of those doctors caught the OPCOS which is clearly evident in an u/s and with knowledge of the fact that my cycle is 30 days. And interestingly enough, neither of them test for immunological factors... But at least I have an answer now as to why none of the dIUI's worked.. Not that it's any consolation.

That brings us to January of this year, I'm not going to lie- I was a complete basket case. We decided to take the rest of the year off to focus on our marriage and restoring my mental health. By March we had decided to plan for IVF in 2011 - with my husbands sperm.

Even though we had been planning for several months to attend the seminar on September 30th and follow up with a phone consult shortly thereafter. I really had no idea how quickly this would catapult us back in to the TTC/ART world. When I signed up for this month's ICLW, I thought it would be a nice way to tip toe back into the supportive waters that is the ALI community. And while I'm 1,000 percent ready to move forward, it's hard not to think about how comfortable and effortless things were just three weeks ago...

Thanks for stopping by, I look forward to reading about all of you.

What Has Two Thumbs

And tested positive for two A1298C mutations, indicating MTHFR?

Alright, we all know how that one ends...

So, craaaaaap. I guess with my OPCOS diagnosis and now this I can officially say we are a train wreck Male and Female factor IF. I know this isn't the worst possible senario, but having gone two and a half years and six dIUI's believing that we only had the male factor issue, well, it sort of makes me want to crack some skulls.

MTHFR is not something that my old RE would have ever tested for. Because it falls under immunological disorders. And my old clinic didn't believe in immunological factors... Some RE's do, some don't. And it's not being partial to CSI: Las Vegas over Miami, it's like different religions.

I thought science was a little more... black and white.

How does one not believe in a gene mutation?

I don't understand.

And more than that, I don't quite understand what this means for me.

And my likelihood of a successful pregnancy.

I'm scared.

I probably sound like a complete moron, and believe me, I know enough to know that I can't even begin to comprehend the complexities behind this issue. I just wish that I didn't feel so caught in the middle...

An MTHFR success story might be nice to hear right about now.

I've started reading up on it, but I don't really know what to consider a legitimate source. Any recommendations?

I'll Take "Financial Ruin" for $16,000, Please.

I had a conference call with our clinic's financial coordinator yesterday. Oy Vey, does this part suck.

This when the "oh yeah, this costs an assload of money" light bulb turned on. Not that I ever really forgot about it, but I'm wrapped up and snuggly in the idea that I might be pregnant in a few months so the rule of "Eyes on the prize" has jurisdiction over my brain. And my heart for that matter.

I don't talk about the financial side of this nightmare all that much here, mostly because I have a select few IRL friends and family that read this and I don't want them to feel bad, or like they should be doing anything other than supporting us emotionally - which if they have access to this blog they've clearly done an exceptional job at. I'm also a big believer in not discussing politics, religion, and specifics on finances (all to a certain degree). Really those topics just make things incredibly crunchy for me.

But in the true spirit of record keeping, and doing my best not to sensor myself , I find that I am overwhelmed with the urge to write about this. Mostly because I'm really struggling with it emotionally. We're going to be financing at least half of our IVF costs, and I constantly have to keep validating our decision to move forward to myself because technically, we do not have the money to do this.

If you've been reading my blog long enough you know that part of the reason we went the donor route before is because it was a lot more feasible financially. Which probably sounds callous but, after a few months of therapy I realized that our financial security is incredibly important to my sense of security in general, which translates to my overall well being. Not to mention how much of a burden finances can be on a marriage. And well, Infertility alone has already gone platinum on our asses so we won't be needing anymore of that, will we... We live very modestly. We haven't taken a real vacation since 2005. i.e. more than a long weekend that didn't involve a tent or the redeeming of hotel/airfare points, or bunking up with someone. Though our house was a big purchase it was a financially sound move.

Is it ridiculous that I'm still struggling with this so much, that I still feel the need to justify it even to a group of folks like you who totally get it?

I have to keep telling myself that this is a reasonable thing to go into (more) debt for.

That not spending beyond our means shouldn't apply to our dream of having a family.

That we can always make more money, but our window for having biological children is literally getting smaller every month.

So here's the actual genesis for this post: We will qualify for a 10% discount, but it can only be applied to a bare-bones IVF cycle that won't include medications (of course), extra monitoring ultrasounds during stims if needed; Cryo Preservation for the first year; or subsequent FET's (if the fresh cycle fails). So if the fresh cycle doesn't work it could end up costing us at least $3,500 more, not including meds.

Orrrrrrrrrr

We could pay $6k+ more for for the Two cycle program in which we would get first a fresh IVF cycle with unlimited monitoring, then FET's until we run out of embryo's. If all of that fails to get me to twelve weeks then we would be given another fresh cycle, and again as many FET's until we run out of embryo's, And it covers the first year of Cryo preservation storage.

So we can spend less (which we have the liquid cash for) on a BIG gamble, or sell a kidney to come up with the money to take less of a risk of us walking away without a baby...

Both options sort of suck. But either way, Top Ramen is starting to sound better and better.

Taking The Long Way

Hey kids, sorry for all the drama on my last post. I sort of forgot what it was like to have no control over my life whatsoever. Ahhh infertility, you haphazard bastard- I kind of missed you.

Okay, not really...

So my appointment wasn't all bad. Except for the part after I'd gotten home and realized that I had shaved one leg twice, and the other not at all. That must have given Dr.3 a great impression. ("She'll probably Follistim her eye out", I'm picturing him telling the nurse) And I know I did one leg twice, because I switched razor blades on the second round... In case the first explanation didn't quantify my incompetence enough for you.

I digress.

The ultrasound. Right. So I made Brian go with me. To a baseline ultrasound. At first I wasn't going to ask him to come, but then I realized that this was the first appointment meeting our new RE (whom I've named Dr.3) and I really wanted him there. And truthfully having him with me gives me a sense of calm. It's like having someone to sit with on the first day of school, ya know? Anyway, the ultrasound was pretty standard, he pointed out my uterus and the lining, my femoral (right?) artery pulsing, then went on to each ovary and the follicle counts. It was at this point that he casually mentioned the OPCOS, in the same demeanor I'd imagine he'd have if he was telling me I had green eyes. I realize that this is common place for him, and essentially good news, but all I could think about is how TWO other RE's who'd seen my charts and gave me ultrasounds had never seen this, but Dr.3 nailed it over the phone. Meanwhile the vein in my forehead began pulsing and I could barely construct a sentence. He finished up, and told me about the Metformin, while I nodded likely with my mouth open, and he sent us on our way.



I will say that I have not thus far, noticed any side effects from the Metformin. I've heard from two IRL friends that it can be pretty nasty so I was a bit apprehensive about starting it, but I'm grateful to say it's been fine. Except that I can't really drink alcohol with it. Not that I was a big drinker before, but Dr. Google says the use of alcohol with this medication can disrupt the normal functions of my kidney and liver... Not quite the same as putting up with the runs.


Having now had a few days to cool down, I am a little more grateful for the diagnosis and the fact that it's potentially a good thing. Dr. 3 wants to put me on a Long Lupron Protocol, though I'm very familiar with most aspects of IVF, the medication protocol is my weak spot. Have any of you done the Long Lupron protocol? So far I've read it's typically very successful for first timers but of course I've come across a few horror stories about over suppression. What say you veterans?

Something That Could Have Been Brought To My Attention YESTERDAY

Or two fucking years ago, before we spent six months and thousands of dollars on DIUI's that were NEVER GOING TO FUCKING WORK.

I have Ovulatory Polycystic Ovarian Syndrome. Different than "Classic" PCOS.

(Thank you Meg, for the link.)

Yeah, I've never heard of it either.

Maybe I would have, had I been diagnosed TWO FUCKING YEARS AGO. Because then I would have known that one of the symptoms of OPCOS is an elevated blood sugar level which can hinder implantation - KIND OF A BIG FUCKING FACTOR don'tcha think?!?!

So yesterday I had my CD3 Antra Follicle count. Our new RE (I need to come up with a name for him) wanted to see my ovaries in an "unchallenged state", meaning before there was a dominant follicle present. He quickly counted eight resting follicles on my left, and 12 on my right. FYI, the average for most women is about 10-12 total between the two ovaries. I have 20.

He mentioned something about this on the phone consult Saturday, but honestly I didn't have any idea what he was talking about, because I knew I didn't have any of the "Classic" Polycystic symptoms. But evidently he saw it coming because I have a 30 day cycle, which is a indicative of women with OPCOS. The only good thing about this is that it means I am likely to yield a higher reserve of follicles on a low dose of stims.

He wants me to start on Metformin asap. He says it will essentially make me "more fertile". And thanks to the link Meg sent me, I now know that is because the Metformin will regulate my insulin levels therefore bypass any implantation problems. He also said he will keep me on it until I am 12 weeks along, because it can also decrease the risk of miscarriage for someone like me.

I know I should be happy about the fact that it's finally been diagnosed, and our RE just kept reassuring me that it's actually a good thing because it means I'll be a better than average responder. But just having found out - I'm pretty hung up on the fact that this wasn't caught sooner. It kills me to think about how much time and money was wasted, but most importantly how the failed cycles caused such an epic amount of unnecessary heartache. Really the time and money was one thing, but the depression that followed not only comprimised my marriage but has forever changed who I am as a person.

Oh and now I have to sit with what else could come back from the rest of my blood tests. And all TWENTY-FOUR vials that they took!!!! It was twenty three, but the lab called later yesterday afternoon to tell me they had forgotten one. GAH. And fuck, what if the insurance deception doesn't work?!?!

Commence Meltdown.
(Number One)

Been There, Hoped That

Even though ninety-nine percent of me is brimming with excitement over our upcoming cycle and testing, there is still an echo of the fact that we've been here before. And more than that, I can't help but think of how many of you out there are still struggling after having switched clinics in hopes that the next ART cycle would be your last (meaning you got, and stayed pregnant) but then, to no avail...

But I can't keep thinking like that. Every situation is different. And it'll be in my best interest to stick with the positive thoughts instead of the "fuck,what if..." thoughts. No need to unearth the crazy just yet.

So the phone consult went great. Really, really great. He instantly acknowledged that we'd "been at it for a while". Yes, indeed we have. He said based on my previous test results, he was rather surprised that none of our IUI's worked. And if you're keeping count, he is the THIRD RE to make the same comment. He said after, six dIUI's, there would have been at least a 50% chance that I should have had some sort of positive. So he'd like to run a full immunological blood panel, as well as a refresher on the standard tests. And he was happy with the results of my first HSG so I won't need to do another one - yippiekiyay motherfucker, that shit hurt. He did say that he was slightly concerned that I may have an ovarian issue of the Poly Cystic variety - EVEN IF I'm ovulating regularly. (Boo.)

As for Brian, the doctor was very pleased to hear that he'd been on supplements since June. He'd like to get a current SA done, and would also like to bank 2-3 vials of his sperm for our IVF cycle. He said Brian will of course need to provide a fresh sample the day of my retrieval, but this will give us a fall back in case there are any issues with his sample on the big day. I feel really good about that.

After he finished his side of the questions he opened the floor up to us. My first concern unfortunately, was about money. I told him that we had met with an OBGYN earlier in the year who mentioned working with him. When we met with this guy in January I thought he was a total yahoo (still do), and referred to him here as Dr. Do Little. His only saving grace was his affiliation with our Doctor and that he offered to run a blood panel for me under "Infectious Diseases" as opposed to "Infertility" so that it would get covered by our insurance... This is the same exact panel that our new RE would like to order. Since I knew that might be the case I called last week to see if they would still be open to the insurance deception, and much to my delight they agreed.

I'm pretty grateful that my cycle just happened to coincide with the seminar and phone consult, so tomorrow I will go in for a CD3 blood panel, (FSH, Estrodial, etc.), then have three separate vials drawn for the immunological tests which will be shipped off to Chicago. And last but not least our RE would like to see me for a CD3 Antra follicle count (ultrasound). Not really looking forward to that one, but it will be nice to meet him formally. Can you even call it "formal" if I don't have pants on?

Anyway, one more good thing. He said we qualify for both the Shared Risk Program- where we'd get 90% of our money put back on our credit card refunded if a fresh IVF cycle and subsequent FET's did not result in a pregnancy exceeding twelve weeks; and the Two Cycle Program - in which would would be given a substantial discount upon paying for two cycles upfront. The jury's still out on this one, vacillating blog post to come.

In summation my friends, I'm pretty fricken excited. Moderately terrified underneath it all, but so, SO ready to move forward.

Sensory Overload

WHERE TO BEGIN? I guess I'll start with when we first arrived. They had appetizers. I love this Doctor already. Turkey and Roast beef wraps (like pinwheels) with bell peppers and cream cheese. And an open bar. Okay not really, but I could have used a beer to take the edge off my nerves fo' sho'. With food in my tummy and a steno pad in my purse, I was more than ready to get started.

When we walked up to the desk to give our names the nurse coordinator greeted me with a huge smile and a cheerful "Oh, hi Melissa!". My first reaction was a little disconcerted, while I returned her smile I wondered why her demeanor was more like checking people in at a high school reunion and less like a symposium for a group of people who are (potentially) experiencing the biggest challenge of their lives. But as I listened from the inside of Conference Room A to her greeting other people, I had to laugh at my own jadedness. This wasn't a Rosary. We shouldn't feel sad or ashamed. And as the doctor began speaking I knew instantly that I was thinking like an asshole. This event should bring everyone attending hope and excitement. This man could FINALLY get us knocked up for Fucks sake - put a damn smile on your face!

But it was obvious that I wasn't the only one with trepidations, I quickly noticed that I was the only one laughing at the doctors attempts at jokes. Like when he said his head Embryologist was "Anal and scrupulous; not the kind of man you want to be married to, but definitely the man you want watching over your gametes".

The rest of the seminar was great. I don't mean to sound like a douche, but I was significantly well versed in most of the topics he covered. (But I'll chalk that up to the obscene amount of time I've spent reading so many of your well documented blogs.) The exception being the structure and operational elements of his lab and his philosophies on various topics.

• Day 3 vs Day 5: He almost always does Day 5 unless by Day 3 there is only a small amount of embryo's, or some other significant factor. He likes to see the embryo's as close to the hatching point as possible before transferring.


• How many embryo's to transfer: His decisions are mostly based upon age. Under 35, no more than two - barring special circumstances. Over 35, no more than four. (A post on this specific topic is in the works.)


• Vitrification: They use the vitrification process for freezing. Which freezes the embryo to -196 degree's Celsius in milliseconds, leading to zero crystallization. Which means lower attrition, and better thaw rates

Overall it was a really great experience. And I'll bet the folks who are newer to the process gained a lot from this meeting. It was very thorough, and included video's of ICSI, egg retrievals, embryo transfers. Things I had seen, but I knew Brian hadn't. We ended the evening with questions from the attendees, the only questions I had were pretty specific to our situation and I prefer to ask them during our consultation this Saturday. After our consultation, we'll get started on testing again, since it's been about two years since our last round. CD3 could be as early as Monday or Tuesday for me, and we'll be doing an updated SA for Brian - I CAN'T WAIT to see if the tic tacs worked!

I guess this means our break is over, huh?

FUCK YEAH IT IS.

It's Seminar Day!

Holy Crap it's the end of September already! We're attending the seminar given by our more-than-likely new RE tonight. I'm so fricken excited that I'm not even a little bit mad that I won't have time to eat dinner in between leaving work and racing off to the seminar. Hopefully I'll find the time to inhale an apple or something because MELISSA DOESN'T SKIP MEALS.

Low Blood Sugar + Melissa = Rage

Just ask Brian.

Poor bastard.

Wow, am I still talking about food? Hell yes, because Melissa hasn't eaten breakfast yet. And being hungry compels me to make statements in the third person.

So the seminar, VERY EXCITED. And Saturday we have our phone consult with the good doctor. SUPER DUPER EXCITED.

More to come!

Out Of The Frying Pan

I took a pregnancy test yesterday morning. Don't get excited - it was negative. I really didn't think that I would see more than one line, but AF is two days late, and I wanted to drink coffee and alcohol guilt-free. Also I think I'm coming down with an infection (awesome) and I didn't want to worry about scrambling our egg with meds- if you know what I mean. And of course, I know you always do.

I keep all of my TTC paraphernalia in a small storage box in my bathroom linen cabinet, and since January it has been tucked away on the bottom shelf, all the way at the very back. I had to get down on my hands and knees just to reach it. And when I finally pulled it out, it took me a good minute before I could actually open it. I suddenly felt very aware that I was on my hands and knees. Being in that vulnerable position, with that box, and everything it represented instantly flooded my mind with images of the person I used to be.

First the good memories; what it felt like the first time I took a pregnancy test out of that cabinet. The excitement, the realization that I was a grown woman, married, and ready to start my own family. The positive OPK's, and how fun it was to make love because we thought we were creating our family. Then slowly the bad memories crept in; the countless tests with single lines. The disdain I felt for the Dixie cups I used to collect my first morning's urine. The frustration of deciphering how dark the line was on the Internet cheapie OPK. The tears that flowed as I slammed that box back in to the cabinet after yet another BFN. And let us not forget the thousands of calories that I consumed to try to ease the pain. Followed by the deepest depression I've ever known.

I could feel my breath quicken, and I suddenly wanted nothing to do with that box. I haven't looked at it in eight long months. No hpt's not opk's, for the better half of 2010. I was different person last time I saw that box - if I opened it again what would that make me? Is this the beginning of the end of the peace that I've found from our eight month respite? When we move forward with IVF in January, will I lose sight of the strength and balance I've worked so hard to regain?

I read so many of the ALI community's blogs, and I ache as I see some of you in that place where I spent so much of 2008, and 2009. Knee deep in the trenches, overwhelmed with frustration and desperation. But still without the slightest waiver of determination in the quest to become a mother.

In the same distinctive way that some feel lucky to have been dealt the challenge of infertility, myself included, I feel lucky that we didn't have the money to jump right into IVF. Because I wouldn't have had that time to heal so many of the battle wounds, to free myself from the reigns of depression, to loose the 30lbs I gained from eating my feelings. To see how unhealthy I was, and how toxic my addiction to TTC had become to my marriage.

At the end of this month I will attend a seminar given by the man who will most likely become our new RE. And four days after that we'll have phone meeting to get us started on our path to IVF early next year. I feel nothing but bliss with the thought of me possibly being pregnant this time next year, but I'm terrified of losing myself again in the mix of all of it. It's just too damn easy to get swallowed up in the whole process. Expectations vs Results, Realism vs Negativity; I'm four months away from all of it, and already I feel like my strategy's are bullshit.

How did you cope? Did you have plans in place to help manage stress?