Starting the 3rd Trimester, Finishing the Year

As the year winds to a close, my third trimester is kicking off (I’m 31 weeks today).

When I pause to think about being in the 3rd trimester, I am overcome with a “how did I get here?” kind of feeling .  I still feel that way in regard to the fact of being pregnant at all, and even more so related to being this far along in pregnancy.  The 3rd trimester, and 30+ weeks, always seemed like being REALLY pregnant.  While I now fall into that camp and talk with others about getting ready for the baby, there’s still a voice in my head that worries about something going wrong between now and the due date.  It’s not as strong a voice as it used to be, but it hasn’t entirely been silenced.

Thankfully things seem to be progressing okay with the pregnancy (knock on wood).  I was going to have a growth scan at my next visit, but at my last visit, my fundal height caught up, so the Doctor cancelled the ultrasound.  It would have been nice to see my baby girl again, but as it’s not medically necessary, I’ll try to have faith that she’s doing alright in there, and be reassured by her movements, even as I still wonder whether they’re “regular” enough.

I remember last year at this time.  It was the end of a difficult year of infertility treatments- 3 failed IVF cycles (two that ended in miscarriage, and one that ended after retrieval with nothing to transfer).  I threw out the holiday cards we received from others with pictures of their kids on them.  I had a little hope left in me because the 4th IVF cycle I’d be starting in the new year would at least be with a different Doctor at a different clinic, but I wondered whether IVF would ever work for me, and what we’d do if it didn’t.

I am extremely thankful that two cycles later, it did work, and now I’m reflecting on my personal blessings this year.  It wasn’t easy going into a 5th round of IVF after a BFN on the 4th cycle (so much for a fresh start at the new clinic).  Of course this is easier to say in retrospect, but I’m so glad I found it in me to keep trying a little longer.

It was a lot of treatment to have in a relatively short time-frame- I pretty much did my cycles back to back without too much of a break in between (only when breaks were forced upon us, such as waiting an extra month after a miscarriage, or waiting to get into a new clinic).  I’m not sure whether such a pace was good for my mental or physical health, but just plodding along was the way I decided to do things.

I have a feeling these last couple months of pregnancy will go by quickly, and I’ll have more hard to believe moments coming my way soon.  While I’m on this leg of the journey, I still keep in mind those who are struggling and wondering if their time will ever come.

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A Few Months to Go

I’m now 26 (and a half) weeks pregnant, so in the final stretch of the second trimester.  As the pregnancy progresses, I am trying to feel more confident that everything will work out in the end, but the worries about something going wrong haven’t entirely disappeared.  Earlier on, I would look up the chances of miscarrying after a certain week.  Now that I’ve passed viability, at least I’m looking up the chance of the baby surviving after a certain week.

Since the last blog post, I have started to feel the baby move.  This has been both very exciting, and another cause for concern.  We hear that no two pregnancies are alike, but comparing symptoms can cause unnecessary anxiety.  This has been the case for movement.  For me, the movement was very subtle at the beginning (starting during the 20th week), and easy to mistake for digestion rumbles.  Over the past month, the movement has gotten a little stronger and more frequent, but not in a drastic way.  I would read pregnancy guides saying things like “by now the baby is moving up a storm, and you should be feeling all those kicks!” That’s not exactly what my experience has been like.  I took reassurance from the fact that my doctor doesn’t want me to monitor movement till the 28th week, since it may not be more regular/noticeable till then.  Still, two days after a recent OB visit, I felt worried about a long stretch of time without much movement, and called the office.  They had me come in for an ultrasound, and thankfully, the baby looked fine.  It was reassuring to actually see that when she’s moving, I can’t always feel it. There’s still some room in the womb.

Another scan probably means another big bill from the hospital.  While it’s a good thing that my husband started a new job this fall, it means we had to pay one health plan’s deductible earlier this year, and now we’re starting on a new health plan’s deductible.  And we’ll have to start all over again come the new year.  Also with the new year will come the expenses for a lot of baby items.  I will not be having a baby shower.  My family isn’t throwing me one because it’s not custom for my culture to do so.  My in-laws are too far away.  And I don’t have much of a social circle.  The plus side of not having much of a social circle is that I wasn’t invited to any baby showers while struggling with infertility, so I didn’t have to face the difficult choice of whether to go and figure out how to cope if I did.  I don’t mind so much not having a shower, it’s more the reminder of how much my health condition has isolated me that can be distressing.  I’ve still created a baby registry so that my husband and I can have a shopping list and take advantage of the registry completion discount.  In fact, I’ve registered at two places so we can have two completion discounts.  It’ll still be a lot of money to spend, but at least it’s money going toward something concrete, versus the gamble of spending money on infertility treatment.  My parents were nice enough to help us out by buying a crib, and we already have that set up in the nursery.  It warms my heart to see the room that’s been empty since we moved into this house finally have something in it.

As the due date gets closer, I’ve also been having more concern about how I’ll do caring for a newborn with my health condition.  I know the early days with an infant are very challenging, and my twitter friends in the infertility community who’ve recently had babies are attesting to such.  It’s not a walk in the park for someone in good health, so I can only imagine throwing chronic fatigue into the mix.  But as with other daunting prospects I’ve faced over the years, I will roll up my sleeves and get through what needs to be done when the time comes.  And I’m still very grateful to be having the chance to roll up my sleeves for this particular task.

Half-Way There

As of today, I’m 20 weeks pregnant.  I re-read the blog post I wrote at the end of the first trimester, and I still have a lot of the same feelings.  While on the one hand, the reality of being pregnant is sinking in more, on the other, it still feels like something that is happening to somebody else.

We recently had the anatomy scan, which was a very moving experience.  But one of those experiences that happens to other people, right?  What was I doing on the exam table, looking up at images of the baby in utero?  We recently walked through a baby store. Again, what were we doing there, looking at things we’ll eventually be buying?  After so many trips to the infertility clinic, these experiences can have somewhat of a fantasy quality.  I suppose some fertile people might take for granted that these experiences will eventually happen to them, but infertiles know all too well what it’s like to wonder whether we’ll ever be able to do these things.

I’ve only recently started to look a little more like I’m actually pregnant versus just having a bit of extra pudge in the stomach.  It’s not glaringly obvious yet, and no strangers have questioned or commented on my appearance.  And because I’m not working (or out socializing much) because of chronic illness, I haven’t felt too much like a pregnant person out and about in the world.  Still, as my appearance changes, I have felt more self-conscious running errands or going on walks in my neighborhood.

We started to share the news with a few more people after the anatomy scan (so much for feeling more comfortable after the 15 week OB visit).  I don’t match the excitement level of the hugs I receive in person or the exclamation points I receive electronically.  It’s not that I’m not excited about the news, but I’m still nervous about something going wrong, or jinxing myself.  Oh yeah, and most of those IVF meds are still in my fridge.

I am extremely grateful for having made it to 20 weeks.  I see people still struggling in the twitter community, and try not to feel guilty that I ended up pregnant on my last cycle.  5 fresh IVF cycles was still a lot to go through to get to this point.  It seems like time has gone by slowly during the first half of pregnancy, with having to wait a month between doctor check ups, but also that the half-way mark has snuck up on us.  Perhaps another milestone for which I’m waiting- feeling the baby move- will be another step in making this experience seem more real.  While I’m waiting, I continue to try to relax and enjoy this special state a little more.

Nearing the End of First Trimester

As of today, I’m 13 weeks and 4 days.  So only a few more days until the second trimester.  My deadline for feeling more relieved seems to keep getting pushed back.  While signs point to things still going well, I haven’t had an actual check in on the baby since I heard the heartbeat at 11 weeks and 4 days. I know I’m going to feel a little anxious till the next heartbeat check at my 15 week OB visit.

This is around the time when others might start to feel more comfortable about their pregnancies, and share the news with others.  We’re still holding off on that for a bit, though (only immediate family are in the loop now).  We received the results from the non-invasive prenatal testing (NIPT) recently, and thankfully, the screen was normal.  But still…while the chances of something going wrong in the second trimester are greatly reduced, bad things can still happen (and I think being in the infertility community, we’re aware of more of those stories).  I think after a trying history of infertility, it’s hard to believe that you could be in the clear for a change.

While I still have my guard up, I am starting to accept that it’s more likely we’ll have a new member of the family in about 6 months time (!)  My husband and I talk about all the things we have to do to prepare, though we haven’t really started on any of those tasks.  I know there’s still time, but a part of me remains worried about those efforts and expenses being in vain.  Likewise, I haven’t gotten much in the way of maternity items.  If things keep going well, I know I’ll have to get some new clothes at some point.  After so many IVF travails, it seems overwhelming to make the transition to being a visibly pregnant person. It’s like having a shift in identity on the outside, while still carrying the scars of infertility on the inside.

I’ve also held off on disposing of my extra IVF medication.  I’d love to clear the fridge out, and hopefully by this point we don’t need to worry about a “plan B,” but I’m holding on to the medication for a little longer.  I did get rid of some extra needles, though- after 6 cycles with injectable medication, I have way more unused needles than anyone needs!

I have experienced some of the challenging first trimester symptoms.  My blog url of “double my trouble” took on a new meaning, with now coping with both POTS and pregnancy symptoms.  For otherwise healthy women, “feeling off” may be a new experience, but it’s something with which I’m all too familiar.  My already fairly restricted activity calendar has been even quieter this summer.  I was prepared for this to happen though if and when I became pregnant, and I wanted nothing more than to get pregnant, so I’ll take any extra symptoms that are thrown at me.

We decided to find out the baby’s sex with the NIPT screen.  We were planning to find out anyway at the time of the anatomy scan, so didn’t mind learning that a little earlier. Suffice to say, it was a very exciting phone call, and my intuition about what we’re having was correct (I know, there’s a 50-50 chance).  The cautious part of me is still waiting to share that piece of news with the blog community – perhaps till the time when we’d find out via ultrasound.

First OB Visit, and A Little Scare

Well, what do you know?  I’d been worried about jinxing myself, and two hours after publishing my “7.5 Week Ultrasound” blog post, I had my first bout of spotting with this pregnancy.  I know the timing was just a coincidence, though I couldn’t help but think how I had been concerned that if I wrote about something good happening, then something bad would follow.

Thankfully there wasn’t that much blood, it wasn’t red, and it wasn’t accompanied by cramps.  Still, it’s disconcerting to see any kind of blood when you’re pregnant, even though first trimester spotting is a common enough occurrence.  The spotting started on Saturday evening, and I decided to hold off on calling the on-call Doctor.  I will call the office on Monday to report what happened and see what they advise.

The spotting has mostly tapered off by now, but I was already worried about seeing blood when I go to the bathroom, and now I’m even more worried.  I had some very dark thoughts when it first started: “it’s the beginning of the end,” “of course this is happening, as if I could have a successful pregnancy.”  I’ve pulled out of that mind space for the time being, but my confidence has been somewhat shaken.

Anyhow, getting back to what this blog post was intended to cover: my first OB appointment.  It was a 3 and a half week wait between my 7.5 week ultrasound and my visit with the OB.  It almost seemed like an eternity.  During those few weeks, some of my pregnancy symptoms got worse, and I tried to take some comfort in that (for instance, why would I be throwing up if I weren’t still pregnant?)  It’s been a little challenging managing both POTS and pregnancy symptoms, but it’s not something I’m going to complain much about because I want to be in this situation.

I went off progesterone at 10 weeks.  I was very glad to be done with the Crinone gel, but a little concerned how my body would react to being off the supplement.

The OB is at the same hospital at which my first RE practices (the RE I’m not very fond of). At least my bad memories weren’t too triggered because the high-risk office is in a different part of the hospital, whereas regular OB shares a waiting room with reproductive endocrinology.

The high-risk OB I saw a few years ago for the pre-conception visit is no longer taking new patients, so I was assigned to someone else, and she seemed good.  She’s even treated a POTS patient before, which was reassuring as many healthcare providers aren’t even familiar with the condition.  At first I was told they would just be measuring the heartbeat at the visit and I wouldn’t be getting a scan.  That’s because I technically didn’t need a nuchal translucency scan since I’m over 35 and would be getting the non-invasive prenatal testing (NIPT) blood panel.  It took a little time for the nurse to find the heartbeat, and how nerve-wracking that wait was!  But she eventually stumbled upon a healthy heartbeat, and it was great to hear.  Then I was pleased that the Doctor agreed to sneak in a scan because it would otherwise be a long wait till I get another one.  The baby looked fine, and more human-like at 11 weeks than 7.5. When I got home, I put the picture of the 12-cell embryo next to the picture of the 11 week ultrasound, and marveled at the development.

We also met with a genetic counselor to go over the NIPT testing.  She shares a waiting room with OB ultrasound, and I know my infertility scar is still present because it got to me a little bit seeing all the pregnant women come through (my husband had to remind me of the obvious, “you’re pregnant, too.”)

The Doctor said that while something can still go wrong, the chances of a healthy pregnancy by 11 weeks are pretty good.  We’re actually in a situation where the odds are in our favor, but that’s hard to get used to.  And having the spotting scare over the weekend didn’t help.  So I will see what the office recommends when I call tomorrow.  I’m trying not to push myself too much, but that isn’t always easy for me.  I feel run down a lot of the time, but usually force myself to be fairly active.  And it’s back to more waiting.  We should be receiving the NIPT results by late this week or early next, and we decided to find out the gender with that screen!

 

 

The 7.5 Week Ultrasound

After my beta at 5.5 weeks, it was another couple weeks of waiting till my 7.5 week ultrasound.  This was uncharted territory for me, as I’d never had a pregnancy last this long before.  I felt like I was “bad” at IVF, since I never produced many eggs (despite being on max doses of medication) , and only have had 3 day transfers with no leftover embryos.  It seemed like most of the success stories I saw in my online Twitter community were people who were younger than I am, and had 5 day transfers.  I tried to hope that my 35+ diminished ovarian reserve eggs still had something good in them- it really only does take one, after all.

The two embryos I had transferred were both 12-cell at day 3.  One was average quality and one was poor.  We were banking on the average quality one and saying “come on 12B” as encouragement.

Between the beta and ultrasound, I started to development some pregnancy symptoms.  They came and went, but I know they can fluctuate, so I tried to feel some relief that I at least had some symptoms some of the time.

The morning of the ultrasound came, and I told my husband, “I don’t want to go.”  That’s not exactly true- I was having very mixed feelings.  On the one hand, I was eager for an update on how things were going, but on the other, I was scared to find out.  I had some queasiness on the drive to the clinic and I don’t get queasy from being nervous, so I hoped that was a good sign that the embryo was still healthy.

We arrived at the clinic and it felt a little funny to be showing up for an OB ultrasound, after the countless ultrasounds I’ve had for evaluation and monitoring follicle growth. There was one couple ahead of us, and we could tell from their behavior when they came out that they had received good news from their scan.  I was eyeing them with envy, wanting so badly for us to soon be looking at pictures of our tiny baby.

The nurse called us into the ultrasound room, and while I was half-dressed and about to get on the table, I felt a moment of great apprehension.  While I had a little hope, I was so scared that all our dreams could come crashing down.  It’s not like we have much of a safety net if this doesn’t work out: no frozen embryos waiting for us, a 6th IVF cycle not seeming that appealing, and donor eggs seeming too costly.

The nurse came back in the room and put in the ultrasound wand, and almost right away, we saw the little baby on the screen!  She said “that’s your baby,” and I was flooded with relief and joy and grabbed my husband’s hand.  I had thought about this moment so many times, but was never sure whether it would happen for us after failing 4 IUI’s and 4 IVF’s.  I imagined I might have cried, but I’m not really a cry in the clinic type, so I held it together.  I also was in a little bit of shock, so may not have been fully processing everything.  Because I had two embryos transferred, the nurse looked around my uterus to “make sure there’s not a stowaway in there,” but it was just the one (12B? Likely, but we’ll never know for sure).

It was hard to believe there was good news coming out of an ultrasound.  I had had so many ultrasounds where the feedback I received was that I didn’t have many follicles growing. And now there was a 7.5 week embryo inside of me.  Everything measured fine, and there was a  good heartbeat, too.  It was pretty crazy to be able to see the heartbeat fluttering on the screen.

We went back out into the waiting room and waited to meet with a NP.  While seated, the nurse brought us our ultrasound pictures and said “congratulations.”  I felt kind of self-conscious being in the room with other infertiles and having congratulations bestowed upon me.  Hopefully some of them also received good news that morning.

We met with the NP, who gave us some paperwork and answered our questions.  We found out that we were already being discharged to OB…bye bye, infertility clinic!  I didn’t know what their time-table was for discharge, and was a little surprised it was happening already.  I kind of wanted a little more hand-holding- like the reassurance of a follow up scan before moving onto OB.  But I was going to have to learn to trust like the providers did that I was moving forward with a healthy pregnancy.

It was surreal to have a successful first ultrasound, and it was also surreal to call the OB clinic to arrange care.  It was like I was crossing over a fence, but still felt rooted on the infertility side.  A few years ago, before I knew of the fertility struggles we’d face, I met with a high-risk OB for a pre-conception visit (because I have POTS).  I reconnected with that clinic and was booked for a nursing intake.  The intake would be at about 9 weeks, and I would have to wait till 11 weeks to meet with doctor and check in on the baby again.  And so began another waiting period.

 

IVF5 Update: The Four-Week Wait

It’s been a long time since I’ve blogged about IVF 5- I don’t think I’ve posted any updates since the embryo transfer in early June.  The reason for my silence is that I’ve been feeling quite cautious and superstitious about how things have been going so far.  But I think it’s time to start writing again.  This will be the first of 3 blog posts to catch up.

As we all know, there’s a lot of waiting with infertility treatments.  I titled this post “The Four-Week Wait” because when I got BFP’s after my first two IVF’s, I found out around 5.5-6 weeks that I lost the pregnancies.  So in my mind, 6 weeks seemed like a danger point, and it felt more appropriate to think of the 2-week wait as a 4-week wait if I got a BFP again.

I’m happy to report that I did get a BFP with IVF 5.  The nurse actually sounded happy when she called me (shocker!)  With my first 2 BFP’s, the HCG level was positive, but on the very low side, so it was iffy whether the pregnancies would remain viable.  This time my HCG level was fine for a first reading.  I asked what my progesterone level was since that was also low with my first two pregnancies, but the nurse informed me that they didn’t measure progesterone till the 2nd beta (my prior BFP’s were with a different IVF clinic).  And instead of doing a follow up beta two days later, they would do one 4 days later.  It felt like a long wait and I was nervous, but I tried to have some hope that this pregnancy would be different because the initial beta was so much better.  I cried a little when speaking with the nurse- I felt more apt to cry from receiving good news than bad.

At the follow up, I found out that the HCG level had a good rise.  It was much higher than what it was with the first two pregnancies by this point.  And I got the additional good news that my progesterone level was also adequate.  I had previously stressed about whether I was getting enough progesterone supplementation when my levels were low, so I tried to have faith that my body was doing what it needed to be doing this time to support a healthy pregnancy.  While everything seemed encouraging so far, it was still hard because I’d previously seen my HCG levels rise and rise and then fall.

I was scheduled for one more beta at 5.5 weeks.  After my second beta, the nurse mentioned that I could go ahead and schedule my 7-week ultrasound, but I decided to hold off until I got the results of the additional beta.  As much as I tell myself that jinxes aren’t real, this was one of several examples of my not wanting to get ahead of myself, and worrying that if I did, something bad would happen.

I was quite nervous to get the results of the 5.5 week beta.  I’d never made it past this point before, and it was difficult to believe that I could be experiencing a pregnancy that was progressing normally.  Was my average quality 3-day embryo really the little embryo that could?  When the nurse called, her affect was rather flat which was a little disheartening. And when she first told me the figure I felt my heart drop- but then she added “thousand” to that number and I breathed a huge sigh of relief.  It was 5.5 weeks, and my HCG level was still skyrocketing up.  Maybe this one really would be different.

It was at this time that I called that the clinic to schedule my ultrasound.  They were all booked on the day that would be 7 weeks for me, and of course that day was a Friday, so I would have to wait till the following Monday.  Thus began another period of nerve-wracking waiting.

 

I’m Willing to Wait For It: “Hamilton” and Coping with Infertility

 

Great art has the ability to inspire and motivate us.  While going through my infertility journey, Hamilton (an American Musical) has been helping to keep me sane and hopeful.   It was during my 5th IVF cycle in the spring of 2016 that Hamilton began to serve as a fun diversion and coping mechanism.  I have a diagnosis of diminished ovarian reserve, and don’t respond that well to fertility treatments.  Additionally, I’ve had two early miscarriages over the course of treatment.  Being a poor responder and having a history of loss make an already nerve-wracking process even more stressful.   I was trying to summon as much strength and courage as possible to do a 5th round of IVF.  I wanted to go into treatment with some optimism, but felt like I was closing my heart off a little more with each cycle to protect against despair.   IVF involves a great expenditure of resources- of all kinds- with no guarantee of anything in return (it seemed as though Hamilton tickets might have been a better investment).  The 5th round has felt especially momentous, because I’m not sure what our next steps are if this cycle fails.

Hamilton has been both a distraction and source of encouragement during this difficult time.  It may seem odd that I could relate my infertility journey to a historical play about the first US Treasury Secretary.  However, the show’s creator, Lin-Manuel Miranda, infuses historical figures with a great deal of humanity and complexity, so it’s not hard to feel a connection to people and events from hundreds of years ago.  That sense of compassion is heightened by strong performances from the talented cast (disclaimer: like many fans, I have not seen Hamilton…yet).

I could listen to the Hamilton soundtrack over and over and not grow bored.  There is a great density to the lyrics, and the music covers a wide variety of styles.  My frequent early morning drives to the IVF clinic were made more tolerable by listening to Lin-Manuel’s music (I supplemented Hamilton with the soundtrack of his first Broadway musical, In the Heights).  I kept myself amused while administering injection after injection of fertility medication (I’ve done more than 200 shots in total) by thinking “I’m not throwing away my shot.”

In addition to being entertained by Hamilton, the story moves and resonates with me. Hearing Hercules Mulligan (the tailor spying on the British government) proclaim, “when you knock me down I get the f*** back up again” helped give me fortitude to get back into the ring for a 5th round of IVF.   This was another shot to try to get pregnant, and while the odds didn’t seem in my favor, look at Alexander Hamilton’s unlikely story and all that he overcame.  Just you wait.

One of the songs from Hamilton that especially strikes a chord with me is “Wait For It,” in which Aaron Burr highlights the difference in his temperament from Hamilton.   Unlike the less cautious Hamilton, Burr’s willing to wait for  action.  It can seem like all you’re doing is waiting for it when struggling with infertility.  Months and years go by, and others become parents while your life remains on hold.

Life doesn’t discriminate between the sinners and the saints

It takes and it takes and it takes

And we keep living anyway

We rise and we fall and we break and we make our mistakes

Bad things happen to good people (and vice versa).   Infertility can seem very arbitrary and unfair.  Yet despite the challenges of the infertility battle, we find it in ourselves to keep going.   Admittedly, there were some times when I wanted to shout back to the song, “god dammit I’m NOT willing to wait for it!”  But I try to cling to the belief that by continuing to wait for it, something good will eventually come of this endeavor.  And that it will have been worth the wait.

Another Hamilton song that hits close to home is “Quiet Uptown,” which reflects on how Alexander and Eliza Hamilton react to the death of their son.  I am not professing to know what it’s like to lose a child, or say that my heartbreak is on par with that situation.  Still, there are universalities with grief and loss.

There are moments that the words don’t reach

There is suffering too terrible to name

You hold your child as tight as you can

And push away the unimaginable…

The Hamiltons…learn to live with the unimaginable

Infertility involves a series of losses.  Not just the loss of being able to fill the parent role, but also the loss of the ability to conceive a child without a lot of science involved, the loss of control over one’s body, and maybe the loss of having a biological link to one’s child.  I attempt not to let the fear that I will never become a parent consume me.   Push away the unimaginable.   The two miscarriages I had following IVF treatment have been the darkest moments of my infertility journey.  To finally feel some hope that it might work out and imagine a future as a mother, only to have those hopes and dreams crushed.  In order to keep trying, I’ve had to put myself back in the position where that kind of loss could happen again.   Learn to live with the unimaginable.

At the time of writing this, I am waiting to find out how IVF 5 turned out.  It’s too early to know whether the treatment will result in a viable pregnancy.  During times of uncertainty, it’s easy to feel anxious, but I think of the Hamilton lyric, “Look around, look around at how lucky we are to be alive right now.”  In the midst of this infertility journey, I need to remind myself to remain mindful to my surroundings, and still find things about which to feel grateful.   I don’t know how this story will end, but I know that the music of Hamilton will be there to buoy my spirit.

 

IVF 5 Update

Wow, it looks like I last posted on here almost 3 months ago.

I decided not do step-by-step posts about my 5th IVF cycle, because it all gets kind of tedious after a while.  We’ve seen the “My Ovaries Are Crap” show before.

So here’s a recap instead:

For the first time, I tried an Estrogen lead-in to the cycle instead of birth control or no lead-in.  The other new thing I did was adding Clomid to an Antagonist protocol.  At this point, I wasn’t expecting miracles from medication tweaks, and I didn’t get any.  My right ovary decided to sit this cycle out- that’s the first time one ovary has been “quiet” for a cycle.  But at least my left ovary came up with 4 follicles, which is about average for me (I had 3 follies the first cycle, 4 the second, 3 the third, and 7 the fourth).  And I didn’t have the lead follicle issue that I seem to get when taking micro-dose Lupron.

When I went in for one of my ultrasounds, the tech looked at my previous scan and asked whether I was doing an IUI or IVF.  That’s not the first time I’ve been mistaken for a possible IUI patient, and it feels icky- I don’t need a reminder that I can’t produce many follicles.  Would it be so hard for them to look a little further into the chart first, or not bother asking a loaded question?  I’ve had countless ultrasounds by now, but this cycle, had some of the longest, most uncomfortable ones so far.  I don’t know what the techs were doing in there- if it took them that long to measure 4 follicles, imagine what it would be like if they were counting a more “typical” number!

I got asked another annoying question when I went in for my 5th egg retrieval- “is this your first time?”  Again, would it have been that difficult to check my chart?  Yes, I’m a transfer patient, but this was my second retrieval at this particular clinic.  Then upon hearing that it was my 5th retrieval, I got asked if I was trying for my second child.  Surely I must have a kid by now if I’d done IVF so many times, right?  *insert eyeroll* How about a little sensitivity for diminished ovarian reserve patients?

4 eggs were retrieved out of the 4 follicles, so I was happy there was at least no attrition in the retrieval step.  I don’t know how much has to do with my eggs and how much with the skill of the doctors, but this clinic has done a better job of getting eggs out of follicles than the last clinic.

3 out of the 4 eggs fertilized, so again, not too much attrition, which is a relief when your numbers are low to begin with.  I was on standby for a day 2 transfer, but got the call that all 3 were still going on day 2, so it would be a day 3 transfer.  I’ve yet to make it to a day 5 transfer after all this time- that just doesn’t seem to be in the cards for me.  Nor do left-over frozen embryos.

We arrived at the clinic for the transfer.  You don’t get the embryo report till you’re half-dressed on the exam table, so it’s a little hard to relax while waiting.  The doctor informed us that one of the embryos had arrested since yesterday, and we had two 12-cell embryos left for transfer (one average quality, and one poor).  I was a little surprised that both our embryos had divided so quickly.  This was my 4th transfer (we had nothing to transfer for IVF3) and upon hearing how many transfers I’d done before, I got asked again whether I was trying for my second child.  Right…

This was the most uncomfortable transfer I’ve had, to the point that I wished I’d taken up the offer for a Valium.  It took longer than usual for the catheter to be placed, and the doctor kept taking the ultrasound wand from the ultrasound tech and pressing it even harder on my very full bladder.  But I got through it.  I took DHEA and melatonin in addidion to coq10 for the first time this cycle, so wonder if those supplements did anything for the eggs- it doesn’t seem like it based on the embryo grading, but we’ll see.

And now here I am again in the 2 week wait.  It’s been a while since I’ve fallen down the rabbit hole of googling IVF topics, since I’ve pretty much covered them all by now.  But of course I had to search “12 cell embryo day 3 success.”  I laughed at myself a little while doing so because I knew how unhelpful such searching would be.  Surprise, I found stories about people who were successful with such embryos, and people who weren’t.  And research that showed that it was a bad sign for embryos to divide so quickly, and research that demonstrated the opposite.  So I put an end to that particular search pretty quickly.

Our beta is right before Father’s Day.  What timing.  For previous cycles, doing another IVF was the plan if it didn’t work out.  But I’m not sure whether that’s the case for this cycle, and that makes the beta feel even more momentous.  I might have it in me to do a 6th fresh cycle.  Though I feel more like it’s not worth going any further with my eggs, and if I were to do so, that I would be doing it more to meet other people’s expectations instead of my own.  I’m psychologically ready for donor eggs, but we’re still not sure what we’ll do if this cycle fails because of the cost of that option.

But for now I’m trying to stay in the present and be mindful of the two embryos inside of me, hoping against hope that one of them finally hangs on this time.

 

In Between Cycles

I’m now in a waiting period between IVF cycles 4 and 5.  I’ll be starting cycle 5 in about 6 weeks’ time (well, the estrogen lead-in to cycle 5).  Here are a couple things occupying my mind in the interim:

  1. Logistics As I’ve discussed before, the logistics of IVF can sometimes be almost as stressful as the medical and emotional pieces of IVF.  It would be nice to be able to twiddle my thumbs over the next 6 weeks, but I know I won’t be allowed such a break.  There was already a financial mix up for cycle 4 (at least billing was more straightforward at my previous clinic), and of course I had to initiate calling about the matter.  While I’m waiting for that to be straightened out, I anticipate I’ll have to do my usual leg work to get the authorization and medications to fall into place.  One thing in my favor is that I’m not using Micro Dose Lupron this cycle.  I honestly chose the Clomid/Antagonist protocol not just because it’s more different than what I’ve tried previously, but also because Micro Dose Lupron is such a pain to obtain through my insurance.  While the home delivery pharmacy carries all the medications I’ll be using for IVF 5, I still have yet to have a cycle where I haven’t had to do proactive trouble-shooting for things to work out in time.  IVF really is like a part-time job!
  2. Social Media I haven’t checked my infertility Twitter account in a few days, and I think I might be taking a little bit longer of a break.  That’s partly because I’m not doing IVF now, and I don’t want infertility-related topics to be on my mind as much. But it’s also because in the small group I’ve connected with over the past year, many have become pregnant.  They’re lovely people (some may be reading this) and I’m very happy for them.  They’ve been nothing but supportive of me, and I know they understand the hardships of infertility.  A lot are still in the early phases of pregnancy and understandably still stressed out about how things will progress.  I’m having trouble relating to all the pregnancy talk, though.  Yes, I’ve had my two chemicals, so have been in the position of posting from the “pregnant” side. Yet my betas started so low that neither one seemed likely to last.  It’s difficult for me to imagine things like high betas, good pregnancy scans, pregnancy symptoms, and baby/maternity shopping.  I’m not really in the frame of mind to hear about those things now.  Recently when I’d been logging into Twitter, there was more talk of those topics than there was of people’s struggles with infertility.  My infertility Twitter was starting to trigger me as much as Facebook!  I really like my pregnant friends (and the ones who’ve already become moms), and don’t want to lose touch with them just because they’ve moved on, but I need a little time out at the moment.  I could try to find some others who are in more in the same boat of multiple failed IVF cycles/considering donor eggs, but it takes time and energy to establish such connections, and I’m particularly low on the energy (yep, I’ve got that chronic illness as well).