secondary infertility | Laughter Through Tears

How Old Is Blob? And Other Confounding IVF Questions

I am 5 days past our embryo transfer, which means Blob is 11 days old.

Or is he?

Blob was conceived on November 11th of last year. Technically he has been on this planet as a viable life for 4 months.

After Blob was whipped up in a Petri dish, our precious little ball of cells grew and divided for 6 days before an embryologist removed all of the fluid from him and flash froze him. In an instant, he stopped growing. And stopped living?

I don’t know. He was sure enough alive when they warmed him up a few short days ago.

Even more confounding, our daughter Spork was over a year old before she was transferred and I became clinically pregnant with her. While Spork is advanced for her age as any child of ours would be (gag), she is still very much two years old, not three.

All this ocassionally makes me ponder when life begins. I sporadically question when soul and spirit develop if I think about it too much.

I try not to think about it too much. Infertility adds enough uncertainty to a couple’s life without having to perfectly resolve feelings on the universe and life’s purpose.

Image: Don McCrady via Flickr

My mind first started swirling with these universal questions when my wisdom teeth were removed as a teenager. Going under and then instantly waking up with no sense that any time had passed made me question where the identifiable inner “me” went for that 30 minutes or so. I experience the same thing when I go under during egg retrieval.

It’s freaky deaky Twilight Zone stuff.

Image: Allen via Flickr

If I had more time and energy, I would explain what scientists are learning about the “block box” experienced when a patient is down for the count. Maybe someday when I am feeling less pregnant I will “nerd out” again and tell you all about it. Until then a Radiolab podcast I recently heard does a fine job of beginning to peel back the layers on the mystery of anesthesia.

If you have never heard of Radiolab, it is the best podcast out there for amateur geeks like me. If you carry a dweeb gene you should definitely add it to your Stitcher favorites.

Click to navigate to Radiolab and stream live audio of “Black Box”

Now back to IVF.

These are just a few of the many reasons why IVF can be so controversial. It touches on some ultra- sensitive subjects. Embryo freezing is the tip of the iceberg. There are other touchy topics like embryonic research, the morality of gender selection, selective reduction of multiple pregnancies, embryo destruction and donation, and now the over-blown and largely misunderstood concept of designer babies.

Speaking of gender selection, my clinic already knows whether Blob is a boy or a girl. They won’t tell us until we are 12 weeks in order to avoid possible legal and moral issues associated with gender selection. I tried to convince my nurse to come out for a couple of giant margaritas so I could pull it out of her, but she swore that only the embryologist knew.

I tried but he wouldn’t talk.

Image: Bradley Gordon via Flickr

All we want is a healthy baby, but of course there are those on the fringe that push the moral envelope of Assisted Reproduction Technology (ART). Debating IVF issues is not my agenda. If you wonder why, simply read the title and subtitle of the blog. Heated spiritual and moral arguments don’t fit with my mission.

I just like to think about it all from time to time.

Personal Update: As I mentioned, I do feel pregnant. I am bloated and have tightness and subtle aching in my lower abdomen. I am totally exhausted. “The ladies” are a little bit sensitive. These are all good signs, but could also be the high levels of hormones or the start of PMS. Oh Saturday! How I long for you…

Prodigious Progesterone

It’s a slow news day. Day two after transfer is creeping slowly along like most days between now and the blood test will.

That means its time for me to get all nerdy on my readers again and explain a bit more of the science behind this miraculous process. In previous posts I’ve described the role of lupron and estrogen. Both hormones are pretty awesome and make it possible for Blastocyst Blob to grow into a bonafide baby. However now an even more captivating hormone is in play.

Prodigious Progesterone.

If all the IVF hormones and drugs were characters in the movie Grease, Progesterone would be Danny Zuko. It’s one slick dude and most definitely the leader of the pack.

Image: John Irving Via Flickr

For the last several weeks my reproductive system has been in a holding pattern. The lupron injections stopped ovulation. The estrogen patches and pills helped build the uterine lining. Theoretically this could have gone on forever with no effect or change, but of course that’s not the point.

Once the lining ultrasound scan and blood work checked out okay we added our final drug, progesterone. That is when things really heated up in this radical game of chance.

Blob needs a perfectly prepared endometrium in order to nestle in and grow into our bundle of joy. For this to happen, my lining must be receptive and ready for him to implant. Amazingly, there are only a few short days in which Blob and the endometrium can make a love connection. Progesterone starts the clock on this critical time frame.

Progesterone changes the lining, making it slightly thinner and replacing the triple layers seen on an ultrasound with a white cloud-like appearance. Whether in natural pregnancy or through assisted reproduction, progesterone gets in the game 5 or 6 days before implantation begins. Administration of progesterone for IVF is timed when ovulation when ordinarily occur in a natural cycle. In a natural cycle it is secreted by the corpus luteum and eventually by the placenta.

During the five and a half days prior to transfer of the embryo, progesterone helps the endometrium develop tiny little finger-like structures called pinopodes. Those pinopodes typically appear 5 to 7 days following ovulation, right around the time the blastocyst hatches from its shell and begins to excrete enzymes which will allow it to attach. The fingerlike pinpodes are only present for two to three days and it is theorized they must be present for implantation to occur.

If you research implantation, you will find many studies show the window can be as much as 6 days or even more, but its solely a function of not being able to pinpoint exactly when all these necessary steps take place. The true implantation window is likely equal to the life of the pinpodes. This time frame has to be matched with a blastocyst that is hatched, healthy, and ready to go.

If the blastocyst is too slow to develop, game over.

If the blastocyst develops, hangs out, and then dies before the lining is receptive, game over.

Image: Mykl Roventine via Flickr

This sliver of an opening is occurring inside me right now. For me to meet Big Blob someday, at this moment I need to have pinpodes that are closing in on Blob who has re-expanded and continued to grow to the point where he is burrowing in and about to excrete enzymes.

If Blob doesn’t make it, the absence of HCG will tell my body its time to begin the process of shedding my lining in which would normally occur in a week or so.

Isn’t it mind blowing that anyone ever gets pregnant?

Isn’t progesterone one bad mamma jamma?

Progesterone for IVF is also like the young and spunky Travolta character in that it can be a little oily.

Image: Thom Wong via Flickr

There are three ways to administer progesterone, by pill, vaginal suppository, and injection. The pill metabolizes inconsistently so only the suppositories and the injectible are used in IVF. The injectable is progesterone suspended in oil and astutely called “progesterone in oil” (PIO). I am taking both because my doctor likes to hedge his bets.

The PIO injections are hands down the most painful in IVF. Intramuscular injections, progesterone shots cause bruising and soreness in the hip area where administered. Many women need to ice the area prior to the shot and comfort the target area with a heating pad and massage after. This process helps alleviate some of the discomfort.

Endometrin (a disolvable insert), Crinone (a gel), and Progesterone in Oil

Side effects of progesterone are pregnancy symptoms which are experienced when taking the hormone at high levels whether pregnancy occurs or not. This totally messes with the mind of a hopeful momma wannabe as she ponders continuously;

Is it pregnancy or progesterone???

These side effects include bloating, abdominal pain, nausea , breast tenderness, headache, drowsiness, mood swings, irritability, and vaginal discomfort. Of all the drugs it mimics pregnancy the most, but for me at least it seems to balance the effects of estrogen and I feel better when I am on it.

Outside of its reproductive role, progesterone boasts many other riveting attributes. Progesterone relieves water retention in cells which is why some of my bloating from other drugs subsides for a short time when I begin taking the hormone. Most interestingly, progesterone inhibits the breakdown of the feel good neurotransmitter serotonin. As a result, the hormone has been proven to successfully treat addictions like nicotine and cocaine. The hormone is also being tested as a treatment for multiple sclerosis, certain skin disorders, and cancers.

Finally, it appears a reduction of progesterone is associated with cell death and scientists theorize administering the hormone could slow the signs of aging. Yes! Its a well deserved upside for those of us who have been on and off the hormone for years.

Our eggs may be getting older and we may not easily get pregnant, but at least we get to sip more than our share from this hormonal fountain of youth.

At least there is that.

Image: Sarah Veale via Flickr

UPDATE- This post was written yesterday during my long wait at the airport. Today we are three days past transfer so Blob should already be nestled in tightly. Now he should be dividing into two layers that will eventually become the baby and placenta. Unless of course he divided into two identical twins or is a little on the slow side. I am feeling a little crampy and bloated which could be a good sign. Unless its just the progesterone.

It will be at least another day and probably more before Blob is producing enough HCG to turn a pregnancy test positive.

Not that I am thinking of testing…. I am not thinking about that at all. Nope. Not happening. Really. It’s not. Never.

To Pee, Or Not to Pee

Once upon a time, many cycles ago, there was a naive wife and banker who never ventured outside of her simple yet pleasant little northern village. Life for this young wife was easy. She developed a blossoming career and married a prince of a husband. The merry couple traveled, played, enjoyed friends and family, and nestled into their quaint little corner of the world to live happily ever after.

Then one day this wife decided she needed more. Something was missing and she knew just what it was and where to find it. Thus, the determined wife and her doting husband set off on a sojourn to the Kingdom of Parenthood.

The merry couple knew others that made the trek many times without event. Therefore the couple was confident they would safely arrive and be warmly welcomed into this coveted community. However, along the way the happy pair was tragically lost.

The merry couple awoke one day shocked to discover they were stuck in the Land of Infertility.

At first, they tried to find their way to Kingdom Parenthood with only the help of the doctors. But after a few wrong turns, the wife eventually met and was warmly taken in by the Royal Family that rules the Land of IF…

The Queens and Princesses of Pee.

Image by Scott Andress via Flickr

Bill and I didn’t try to conceive for long prior to learning my tubes were blocked and IVF would be the only way for us to have a baby. In fact, by the time we started IVF I took more pregnancy tests hoping not to be pregnant than I took praying for those two magical lines. As a result, after our first IVF it never occurred to me to take a home pregnancy test. I simply assumed the clinic knew the exact date your pregnancy test could be positive and taking a home pregnancy test before the scheduled blood test would be futile.

WRONG.

Once that first cycle failed, I did what any type A overachiever would do and began surfing the web in attempt to understand what happened and how I could fix it. Four years later I still don’t have those answers and never will, but what I do have is a community of women, and a few men, that I can lean on for advice and support. These strong people are my close neighbors in the Land of Infertility.

Among women living in the Land of Infertility there are two distinct groups:

Those who POAS (Pee On a Stick) during the two week wait, and those who don’t.

Most women are fanatics either way and actively try to recruit other infertiles to their side. Self titled “Pee Princesses” are the worst of the bunch and among them are a few higher ranking queens. These Queens of the Pee are so hooked on home pregnancy tests they aggressively work to convert other hopeful infertility sufferers to their cult. I assume The Queens are attempting to live vicariously through aspiring Pee Princesses when they themselves are between cycles and can’t get a fix.

By the time our third transfer rolled around, I decided to dip my toe in the water and give peeing a try. For me, an over-thinker and worrier, the choice was devastating. I started testing at 9 days past retrieval which is not the earliest you can get a positive result, but its close. At 9 days you are still more likely to get a negative result than a positive.

Of course my test was negative. And so it went for days 10, 11, 12, and so on. I was a weeping mess by the time of the blood test. A horrible, negative, stressed out, depressed, weeping mess.

I promised Bill I would never do it again.

The next cycle gave us Spork and I kept my promise not to pee after the last emotional disaster. Instead my blood was drawn as scheduled at a random clinic in South Carolina while I was there for 10 days on business. I learned the best news I ever received by listening to a voicemail while on a break from a meeting. I was finally pregnant! Of course after the call I immediately went out and bought several pregnancy tests just so I could see that beautiful second line for the first time in my life.

Spork tainted my pee and turned pregnancy this test positive on May 19, 2011

Two years later in our effort to give Spork a sibling I forgot my promise to Prince Bill and dove head first off the pee wagon. I even went so far as to buy 50 cheapie tests from the Internet for our fresh cycle last spring. When those ran out I ordered 50 more and eventually used every last one of them.

Its not pee stick related, but who doesn't like funny cat photos?

Its not POAS related, but who doesn’t like funny cat photos?

During second cycle for baby number two, our miscarriage cycle, I was testing three times a day or more to assess whether the lines were darkening. I lined all the tests up chronologically and glued them to a piece of paper to review the progression, writing my HCG levels next to them on blood test days. I compared my obsessive little chart to others on the Internet, attempting to divine the outcome of the difficult cycle with the erratic blood test results. I tested every day for TWENTY days.

These are only the best of the tests.
I took a total of 44 over the course of the cycle.

For our most recent cycle in January I had only 5 tests remaining from the original 100 and vowed they would be the last sticks I would ever douse with my pee.

Every test, every day was Negative. Negative. Negative.

I would stare at the tests under different lights and even go outside to see if I could spot a line in natural light. I revisited tests several hours after I took them, examining the result area closely for what seemed like hours. I even fished tests out of the trash the next day to make sure that a line didn’t develop overnight.

I spent countless hours on Countdown to Pregnancy, my favorite Pee-Aholic site. It is one of literally hundreds out in cyberspace dedicated to fueling this horrible addiction. The sites will tell you how likely you are to score a positive result by brand of pregnancy tests and by number of days past ovulation. You can post pictures of your pee sticks and have others weigh in on whether they see a line. And so much more…

Who knew such a network of pee stick pushers existed? Sadly, I became one of their highest ranking members. I was a full on Queen of the Pee and I needed to kick the habit. It was hard on me and it was even harder on Bill. His hope was also dashed with every negative test, but he had the added bonus of dealing with my sadness every time my pee would let me down.

This cycle I am turning in my crown, stepping down from my throne and going back to life in the other camp of infertiles.

No more pee sticks for me. Not now. Not ever.

Make no mistake, there are advantages to peeing on a stick. The miracle second line could appear, showering you with exultant joy and taking the edge off the two week wait. Additionally, for long time inhabitants of the Land of Infertility, learning that you are pregnant the “normal” way is quite appealing. So much of what we go through to get pregnant is is clinical. Learning through a home test instead of yet another blood draw just feels so natural.

Finally, some women let their pee flow because they like to be prepared mentally for the phone call from the clinic, especially if it is bad news. Its no fun crying to a practical stranger over the phone. This was a primary motivator for me, as much to make it easier on me as to make it easier on the nurse calling me. No matter how many times they do it, I know those calls are hard for the nurses.

So there are many arguments for peeing prior to the HCG test. I do not begrudge any princess her tiara. It would be hypocritical for this reformed abuser to do so. Unlike many recovering addicts, I also refuse to push my new perspective on anyone else. I’m not saying my way is the right way.

Its just the right way for me.

Knocked Up

It’s done!

And yet it begins.

“Blob” as we are calling him (or her) is now resting peacefully at home, preparing to burrow into my lining and take root for the next nine months. It was a harrowing, exciting, and ultimately pleasant experience which began with our wondering whether we would be transferring Blob at all.

Blob’s First Baby Photo

Yesterday at the top of Breck’s Peak Six, I picked up a call from the clinic asking if I could come in right away for a cautionary ultrasound. It seemed the doctor was concerned about my cyst and the pain from the night before. Rather than blow our day of boarding we opted to arrive very early this morning to check on the status of my temperamental reproductive system. Until about 7:30 this morning we feared we would be coming home empty handed (or in this case empty “uterused”). Luckily the lining, ovaries, and vitals all checked out fine and we continued with the embryo transfer.

Our first hurdle overcome.

Next up was the transfer.

Because our ultrasound and lab appointments were at the break of day, we had time to kill before the 11:45 transfer. We spent it at Target where I picked up these groovy lucky socks. These socks were so perfect they jumped into my shopping cart and I was wearing them before we left the parking lot.

Fertility green and orange with the luck of the Irish thrown in for good measure.

So far the knee highs worked their magic.

Ease of transfer is one of the many critical factors that lead to enhanced odds of success. A fundus (top of the uterus) touched by the catheter used to transport the embryo is a lousy precursor for implantation. Much effort goes into making sure the depth and shape of the uterus is understood before the procedure so the doctor can avoid the edges. It’s like that game of Operation we played as kids, except on a fuzzy black and white ultrasound screen with no buzzers to tell you when you screw up.

Image by Mykly Roeventine via Flickr

The doctor gracefully guided our little bundle of cells to the exact right spot without a single hiccup. Dr. S navigated Blob to the sweet spot with the precision of a fighter pilot landing on a aircraft carrier. What makes this feat more impressive is the embryo can barely be seen by the naked eye. Try landing that in a tiny little spot on a computer screen with only a bit of guidance from an ultrasound tech.

Way to go Dr. S.

Catheter releasing Blob in the perfect spot

Another hurdle overcome.

Blob was a busy little fellow this morning and hatched completely out of his shell prior to transfer, earning a final grade of 6BB. When the lab flash froze him after genetic testing back in January the embryologist graded him a 5BB. He’s overachieving already.

You can see the incubator holding Blob who is waiting in the background while we prepare for transfer

Blob’s incubator in the background

You may be wondering, what the heck do those letters and numbers mean?

Embryo grading is a complicated process, but essentially this means Blob was at stage 5 when he was frozen. This is the final blastocyst stage right before he hatches and burrows into the lining. The letters are grades for the inner cell mass (ICM) and the Trophectoderm Epithelium (TE). The ICM is a clump of cells that will eventually become a baby. The TE will grow into the placenta which will replace all the hormones I am taking between 7 and 10 weeks.

6BB is a good quality embryo. 6AA would be perfect. Both are fully capable of becoming future Rhodes Scholars.

Blob as a Rhodes Scholar

Typically an embryo reaches stage 6 on the fifth day after fertilization. Blob started slowly and took six days to get there. This is the main reason Dr. S gave Blob slightly lower odds than other genetically normal embryos. However, Day 6 blastocycsts like Blob fair much better with a frozen cycle like ours. This is due to the surprisingly short window in which the lining is receptive. Unlike in a fresh cycle, in a frozen cycle the doctor can control the timing of the lining receptivity and match it to Blob’s developmental stage, increasing the odds he will stick.

While our overachiever was quick to break out of his shell, he was slow to expand. If you have ever taken a balloon from a warm place out into really cold weather you know it shrivels up and loses its fullness until warmed again. Embryos are the same. They compact when frozen and then begin to expand when warmed. We are slightly concerned that Blob didn’t expand more prior to transfer, but encouraged that he is still developing. Most important, every last one of Blob’s cells survived the warming process.

A final hurdle overcome.

Post transfer I remained on bed rest for an hour before being wheeled to our car. We are now at the hotel where I will spend today and tomorrow at a 45 degree angle, able to rise only to powder my nose. Butler Bill enjoys this part of the process because it is the time he is most involved in IVF. I enjoy abusing my personal butler and make the most of being cared for by the love of my life at this sensitive stage.

If you look hard enough you may be able to see all the way to Blob through those nostrils.

If you look close enough you may be able to see Blob through those nostrils.

Butler Bill will bring me food, water, and medicine for two solid days. I will read, watch stand-up comedy, blog, goof off on the internet, meditate, and try not to obsess about possibilities. I am allowing myself only a half hour with Dr. Google to see what I can learn about slowly expanding embryos. After that half hour I am firing that negative jerk in order to relish being pregnant.

Pregnant.

In the IVF community we describe this part of the cycle as being PUPO (Pregnant Until Proven Otherwise). I am so done with the uncertainty implied by “until proven otherwise.” This mama has decided she is straight up knocked up. I plan to prove it on March 22nd.

Our countdown begins anew…

Making the Most of It

We made it.

We are finally in the same state as the 100 celled baby we are taking back home on Saturday.

Even though real romance is a no-no at this stage in the process, we are making the most of it by tagging on two days of snowboarding prior to transfer. This is our fourth trip to Colorado for fertility purposes and we are infusing some fun and sport into the journey. On the last trip we ventured to Vail. Now we are giving Breckenridge a go. We both love boarding and are paying for the flights, so why not? Especially since I hope to be done with boarding for the next nine months.

We discovered a rustic mountain lodge only a few miles away from Main Street and were upgraded to a mountain view suite without even having to play the “we are here to get pregnant card.” Sweet.

We arrived just in time for some grocery shopping and a leisurely dinner last night. We hit up the local Safeway to pick up a prescription, beer for Bill, and water for me. Turns out the labs from Sunday yielded low estradiol levels, again. Now I am on four estrogen patches and also talking estrace orally twice a day. Holy estrogen overload!

Once again, this shouldn’t be an issue as long as we fix it by Thursday morning. The lining is nice and thick and my progesterone levels are right where they should be to make a cozy home for baby.

When the clinic called to relay the need to pick up more meds, we also learned that Bill has to have blood work done prior to transfer. They want to make sure he hasn’t picked up any communicable diseases before they send us home with a baby. The sadistic side of me is eagerly anticipating him getting poked too. Its only fair.

But today we put all the meds, labs, and procedures in the back of our minds as we enjoy two pristine days on the slopes.

Breckenridge is crawling with people, its one of the busiest weeks of the year. The first board rental store we stopped at was completely sold out of boards and bindings for Bill. We start the search anew today. Worst case scenario, we will buy new ones. Both of our boards back home are more than 10 years old and its past time. Still, the trip to Breck is stretching our already taught budget and we hope to score rentals.

Despite the crowds and not having a reservation, we consumed a delicious dinner without having to wait. Tonight we aren’t risking it and made reservations at an upscale, gluten-free, vegetarian restaurant. Simply perfect for our pre-baby making meal.

I booked an apres ski couples massage in the hotel spa today. Between shredding the hills today, the massage tonight, and the clean dinner I am doing the best I can for my body and should be toxin free by Thursday.

As far as how I am doing, physically I feel amazing. Stopping lupron has done wonders for me. Emotionally, I continue to feel unusually optimistic about this cycle.

On the plane yesterday I meditated multiple times. I visioned all the cells in my body breaking apart and joining with all the matter in the universe, including all the cells of our chilly little embryo. Then I imagined bringing those cells back into me. It was beautiful. I feel as though my body is calling our baby home. I have felt this way before, but this time is more profound.

Only two more days and we will be reunited with our baby and will hopefully be done with trips to Colorado for “medical purposes.” While we appreciate writing off the travel expense on our taxes, the next time we come back we hope it is as a family of four.

There still may not be much room for romance then, but that will be okay with us.

Its Not How Far You Fall

Image by John Kollege via Flickr

I missed an opportunity to mark a special moment yesterday morning and it didn’t register until I was reviewing my protocol last night. I took my last Lupron shot yesterday morning.

NO. MORE. HEADACHES.

Too bad I can’t have a nice glass of red wine to celebrate.

I begin taking progesterone at bedtime but I don’t inject anything until Sunday (I will leave how I take progesterone to your imagination for now).

So today is a completely shot free day. Yes!

I love having little reasons to be happy in IVF. The roller-coaster ride of attempted conception has many loopty-loos and inverted twists, but is mostly made up of enormous hills and heartbreakingly rapid drops. No matter how hard you try you can’t smooth them out. But we still try. Its human nature to try to eliminate pain, even if it is impossible.

Whether its IVF or any other uncertainty in life, we make valiant efforts to protect ourselves and develop a variety of coping and defense mechanisms to help. We say things like:

“I have to stay grounded.”

“Hope for the best and plan for the worst.”

and of course the mother of them all:

“I don’t want to get my hopes up.”

I am one of the world’s worst offenders. Only three days ago Bill and I settled on Plan C and I immediately posted about it with the excitement of someone who had found the Holy Grail.

Why do we even need a plan C at this stage? If this transfer doesn’t work, Plan B will take at least three months and potentially even half a whole calendar year. Is it really necessary to have a back up plan in this situation?

Nope. But we have one anyway.

We do it for many reasons. Humans evolved this behavior because it has real life benefits. In days of old, when we fought for survival or chased prey it made sense to anticipate outcomes and prepare alternatives. These days its a useful skill in business negotiations and competitive sports. Professional pool players do well to “look six shots ahead.”

With infertility, some planning makes sense. For instance, We aren’t ready to buy the pontoon boat Bill has his eye on. Not yet. That wouldn’t be prudent until we know what is next and how it will affect us financially. Plan C is expensive. But its more than just pragmatism. Thinking ahead also provides a momentary sense of relief when the decision is made, giving the elusive feeling of control in an otherwise uncontrollable situation.

Planning has value, as long as its kept in check.

But hope? Hope is another thing altogether. There is no sense in losing hope or muffling it in a futile effort to protect ourselves from being hurt.

I have seen little value in “not getting my hopes up” in the two different ways I have approached IVF.

First I tried gathering as much information as I could, considered statistics, worried about outcomes and worked my tail off to keep my emotions in check. I feared and obsessed about low odds and potential losses.

As hard as I worked, when it didn’t work it hurt like hell.

Next I bought into The Secret approach. I tried visioning a cycle filled with good news and a baby in my arms at the end of it. I worked to cultivate full trust in the process and embraced all the highs along the way.

As hard as I worked, when it didn’t work it hurt like hell.

There was no measurable difference in the pain at the end, but there was a gigantic contrast in my mood and the ease with which the process was navigated in the second approach. I savored the peaks, holding my hands up in the air and screaming with pleasure. When I plummeted to the bottom I was washed over with pain. But I pulled myself together and continued the ride.

This time I am struggling to have faith in the process and let myself believe it could work. I meditated at acupuncture today, fervently willing my mind to give in to the possibility that I will be pregnant in a week. I couldn’t get quite there as hard as I tried. My human brain won’t let me after 6 failed cycles.

I continue to try. While I may not be able to fully believe, I am committed to enjoying the high points and making the most of our conception experience.

So today I am embracing the excitement of this part of my cycle. I am excited to throw the lupron in the trash. I am excited to be done with work for a full week, able to wholly focus on preparing for transfer. I am excited to enjoy my daughter this weekend before we leave on Monday. But mostly I am excited to be nearly three weeks pregnant on Thursday when our little snow baby comes back to me.

Sure, I could choose to say “I am excited to maybe be nearly three weeks pregnant on Thursday.” But it won’t make it any sweeter if I am pregnant, nor will it lessen the pain if I am not. I won’t know the outcome until March 22nd. Until then my hopes will soar.

Whether you fall from 10,000 feet or 1000 feet its going to hurt like hell when you hit bottom, but at least from 10,000 feet you feel like you are flying for awhile.

Friends in Low Places

Image by Treacle Tart via Flickr

Like Garth Brooks, I have friends in low places. Or at least one friend.

Don’t get me wrong, my friend Kristy exemplifies class and style, it’s just today she was literally in a low place.

Low meaning that she was sandwiched between a pair of stirrups below my waistline. She was there holding a wand while looking up at a video monitor to assess the size and pattern of my endometrium.

Kristy and I met and instantly became friends almost three years ago at a pre-natal exercise class. Everyone who meets Kristy instantly becomes her friend. She is a sweet social butterfly who never met a person she didn’t like and you’d be hard pressed to find someone who didn’t like her. Our kids were born only a month apart. We quickly formed a small play date group that gets together to drink a beer and let the kids run wild.

I love our little clan and Kristy is the glue that holds us all together.

Before I met Kristy my local monitoring was done by a hometown infertility specialist who partners with more remote clinics. She was nice enough and always willing to come in on weekends, but I never connected with her. So for baby number two I switched to Kristy for monitoring at the local hospital.

Trans-vaginal ultrasounds take a friendship to a whole new level. Moments like that shared among friends connect you for life. I remember how nervous I was the first time I went to see her. I am sure she was the quintessential professional, but I felt a little strange.

Fast forward a handful of scans and we gossip and carry on as she inspects my innards like we are knocking back brews on my deck in July.

Switching to her was a great decision and not only because she is a friend. Kristy is excellent at what she does. You may not realize it, but follicle monitoring is tough stuff. Its difficult for the tech to count all those tiny circles across the surface of our imperfectly round ovaries. Kristy is a whiz at this, arguably as good as techs at clinics that do it all day long and able to carry on a conversation at the same time (I’ve seen more than a few who can’t).

As good as she is, the best part is the friendship and that hit home today. After I left the appointment the obsessing began and we had the following text exchange:

Me: You are sure you saw three layers, right? They weren’t as obvious to me this time and we won’t check again before transfer.

Kristy: Yes, three layers and measuring 9mm

Me: Is it okay if I use your name in the blog? You might want to read tomorrow.

Kristy: I always read your blogs, your writing is funny and informative. Even though we don’t have infertility in common its good because it lets me know how you’re feeling and how my patients are feeling.

See what I mean? Sweet, right? I regularly freak out and text after appointments and she is always there to talk me down. You can’t get that from a stranger. She lies about my writing being funny and informative. She loves her patients and wants to understand how they are feeling. (Side note- this his smart on her part because Kristy can get pregnant by merely thinking about having a baby. A mutual friend and I are throwing her a small “sprinkle” for baby number 2 on Sunday.)

All of this is great, but here is where she did me in, where she sealed her fate and got stuck with me as a friend forever. As I am leaving she says to me:

Oh! I forgot to tell you, I wore my orange underwear for you today.

If you have read Orange Panties and Green Toes you know why that makes her the best friend and sonographer ever.

Thanks Kristy, it worked. Everything looks good and we are go for launch. Unfortunatley they increased my estrogen but that’s on the lab and not ultrasound. I guess we need to talk the phlebotomist into wearing orange panties too.

Now please just let me drink out of your glass on Sunday…

Twitterisms

How am I doing?

My middle sister asked me this question tonight, catching me off guard. She reads the blog religiously so I assumed that she of all people would know exactly how I am doing. The question made me realize that blogging daily and pouring your heart out on the world wide web doesn’t really tell people how you are actually holding up in the IVF process.

I am okay. Just okay, but that’s pretty good.

At times I am tempted to treat this blog like a twitter post and just quickly check in with 140 characters worth of emotion, experiences or wit. If you read regularly, you know I don’t do that. I want my words to have meaning and beauty which takes thoughtfulness, work, and time. But if I posted quick tidbits and insights they might tell more to the reader about my state of mind than a 1000 words of carefully constructed prose.

Let’s give it a try:

Ultra comfort? I can’t believe the manufacturer plastered that on my lupron syringes. Ultra comfort my @#&! You should see my bruises. #criminallyfalseadvertising

Nervous/anxious/excited about my ultrasound and blood work tomorrow. The trip is paid for. I’ll freak if we don’t get a green light and have to cancel. #whatsafewthousandmore

Overcommitted myself this week. Totally swamped as we get ready for our trip. I did this last time too. Ugh! #busyismycopingmechanism

The higher dose of estrogen this cycle made me cry at work again today. Embarrassing! And…Um…I have other estrogen symptoms too. #havetowearmymaternitybra

Sleep! I need sleep! Sooooo tired… Anxious and over-thinking. Laid awake until after 1AM and Spork got up early. #needcoffeeandnotallowed

OMG…What will we do if we get all the way to Denver and the embryo doesn’t survive the thaw? #2daysofdrunkendebaucheryatvail

No estrogen fueled fights yet. We are getting good at this! I think writing about all this is helping. #mybloggingsavedmyhusband

So that’s how I am and its common for me at this stage. The week before transfer is always hardest, stress escalates at this juncture and I vacillate between titilation and terror. Titillation at the possibility of being pregnant in a week and terror that I may not be or that something could go wrong.

If IVF is a roller-coaster, and it is, this is the top of the biggest hill right before that heart stopping drop.

Click…click…click… click… (deafeningly silent pause)…

So, all in all I am ok. Thanks for asking sis. It helps to stop and think about it.

A Destiny Determined before Dawn (Perhaps)

I suppose mornings were crazy before we had a kid, especially Tuesdays. We both have important meetings on Tuesdays. But now? Mornings are complete chaos.

So its strange that we may have made a major life decision this morning over coffee (hot water with lemon for caffeine free me).

Spork awoke a full hour earlier than usual today which means the whole house was up and going at the crack of dawn. As a result, Bill and I found ourselves in the kitchen with time to spare long before either of us had to leave for work.

Funny how life works. A few unplanned minutes with my husband may have changed our destiny. We decided to use the gift of time to settle on a Plan C (or D, E, or T depending on when you start counting).

This cycle is going to work, but if by some chance my attempt to shape reality through positive imaging fails we have our next step planned. This is not our morning epiphany, we have known this for some time and have already shared Plan B in the blog. Our quest will continue with one more full IVF cycle at our miracle clinic. But what would happen if that is a bust? If my eggs fail us in another full cycle?

Our plan didn’t stretch that far into the future, or at least that was true until today.

A few weeks ago a “friend” (read- therapist I saw the week after my last negative result) shared that it would be helpful for me to consider the possibility that this just won’t ever work and suggested I think through what that would mean for me. She asked me to answer the question:

What is the worst that can happen?

It was good advice, so good in fact that I haven’t been back since that first visit.

Truthfully, the question pissed me right off. That’s the real reason why I didn’t make a second appointment for the following week as she suggested.

I buy baby clothes, maternity clothes, and have a crib set up in my bedroom because I believe it is important to focus on what you want. I have always visioned my goals and achieved them. I don’t know why baby making should be any different. This therapist was asking me to send counterproductive thoughts into the universe that may destroy the good vibes I’ve sent. Bah.

Her question also made me cry. Making me cry in front of strangers, even if they are therapists, also pisses me right off.

So I didn’t go back (it helped that the hormones started wearing off soon after the visit). But I did start thinking about acceptance like she recommended. The therapist struck a chord because she felt that if I opened myself to the possibility of it not working and embraced what we have, it may just prepare me mentally and emotionally to welcome another baby into my being. That caught my attention.

So you mean accepting that I might not get pregnant may help me get pregnant?

Sheesh. I told you this fertility stuff is crazy.

So I pondered “what is the worst that can happen”. Turns out its not so bad. The worst that can happen is I have a great job, a loving husband, and of course Spork. I can live with that. Its enough for me. It took over a month of thinking and blogging to arrive at the conclusion that what I have now is all I need. I don’t need to move to donor eggs and I don’t need to adopt. I have been very clear on this for the last couple of weeks and it has lifted a huge emotional weight.

Which brings me back to my quiet morning with Bill. It was the first time I have been able to share this acceptance with him. And a funny thing happened.

Bill looked panicked. I have been driving this bus with him along for the ride for a long time. Today it was as if I pulled the bus over to a screeching stop and screamed “Get out!” without any warning and for no observable reason.

For the first time ever we seriously discussed donor eggs. When I told him that I was afraid that I might not love a baby that wasn’t created from my eggs as much as Spork he said “but you will carry it for 9 months, you will make the connection, it will be your baby.” He was fighting for what he wanted. He looked fearful but was kind and understanding. He was quietly, lovingly and sweetly pleading.

It was a short conversation but I knew instantly what we would do. Plan C.

If necessary, someday I will carry a life that a lab will create with the reproductive ingredients of Bill and another woman, but it will be ours. This is not something I was even considering a possibility until now. I confess my fear of donor eggs is totally egotistic. I love that when I show pictures of myself as a child that my daughter swears “Its Spork! It’s Spork.” I wasn’t ready to give that up until today.

However if I can accept not having another baby at all, I can embrace having another baby for and with the love of my life. With my newfound acceptance I already have a deeply seeded knowledge that I can and will love the child as fully as I love my own genetic child. It is as if a switch was flipped in my brain during our daybreak discussion that flooded a whole new realm of possibilities with light. There is still much more to discuss, but we will tackle that when the time comes and probably not on a Tuesday morning.

Of course all of this is likely to be irrelevant. If this cycle doesn’t work I am sure the next one will. Or at least that is what I am focusing on for now.

For Writers- Infertile or Otherwise

Image: Chris Wightman via Flickr

I am dedicating a page of this blog to helping us become better bloggers. It is designed for weekend warriors and non-writers like me who want to be great writers but can’t quit their day jobs and live the life of a starving artist. It is complete with writing tools and guidance for amateurs who want to become better at the art of writing. But I am no expert, I simply invite you along with me as I learn from an expert I am following from a distance.

How can I help? First let me explain a little about how I ended up with a blog and why I am even interested in writing. I will get to what is in it for you after a brief introduction.

How I Began Blogging About Infertility

I blog because many years ago I wanted to be a writer, or at least convince someone to pay me to read every day, all day. Reading has always been my passion and the way I choose to spend my down time.

I majored in English Lit my first year in college. In only one semester I realized you can’t earn meaningful money writing or reading. Since I liked and needed money more than literature, I switched my major to Business and eventually earned my MBA. While the desire to write never left me, I squashed it for close to two decades.

That changed in January 2014.

That was when I read The Happiness Project by Gretchen Rubin. Rubin opens by telling the story of how she walked out on the field of law after clerking for Sandra Day O’Connor because she realized she didn’t love her job. Rubin found that her lawyer friends would research, read and discuss the law outside of work because they loved the law. She didn’t share the love. She refused to spend her leisure time reading briefs. Rubin’s passion was writing. So she quit. She left law behind her and dedicated herself to her dream.

The book made me think, what am I passionate about? To answer that question I began to explore what it is I do when I have a choice of how I spend my time.

I love my job, I just no longer want to read books about the banking industry in my down time. I did for many years and I’m done. I don’t care much about Jamie Dimon and his career or how Lehman Brothers fell. Outside of work, I also enjoy long-distance running. But at 37 I won’t be making it to the Rio Olympics in 2016. I am not so dedicated to the sport that I want to write about it when I unlace my shoes. As far as motherhood, I love being a Mom more than banking, running, writing, and reading added together and multiplied by infinity. I simply don’t have a desire to write about my experiences.

What does that leave?

Infertility.

While I despise my own personal struggle with trying to conceive, I love the science behind the process and all that I learned along the way. Over the last 7 years I clicked thousands of sites and read as many books as I could find. I totally missed my calling as a Reproductive Endocrinologist but I don’t want graduate Med school at a time when most my friends will be seriously contemplating their retirement age. However I can write about infertility which serves two purposes. Infertility provides an interesting topic that I have stashed away some knowledge about and writing on the subject allows me to process a difficult personal struggle in a positive way.

And there you have it. My topic. My niche. My passion. At least for now.

How My Blog Can Help Us Become Better Bloggers

If I do something, I endeavor to do it well. I may have started college as an English major, but when I finished school the language I mastered was one of numbers and symbols. I wrote quite a bit in my career, just not creatively. Business writing is somewhat different. My ink well is not dry, it could just use some stirring.

To improve my writing, each week I read and complete the exercises for one chapter in Writing Tools. 50 Essential Strategies for Every Writer by Roy Peter Clark. If you want to be a better writer without going back to school for your MFA, all the research points to this book. Its not about perfect grammar or appropriate citations, those are not my concern. The book is about giving prose more power through a variety of techniques.

Under the Writing Tools Tab I share the weekly concepts with links to posts I wrote to put them in practice. I will not paraphrase each chapter or provide a great deal of additional detail, if you want that you should buy Clark’s book. I will however share a sample of my writing and comment on what I learned. Its just a little teaser but hopefully a help to those interested in writing well. Or at least writing better, like me.

I have repeated this post on the page to explain the exercise. Just scroll down to the bottom of the text to see the first three tools and please join me if you like by checking back there on a weekly basis to see what is new.

I welcome you to post links to your own work, ask questions, and provide feedback on our progress. My goal is to connect a community of writers. You don’t have to be infertile to participate and enjoy the process.

School is in session and anyone is welcome!