Postscript

So, the nurse just called and said my Estradiol (estrogen) looked a little lower than they like.  Each follicle creates a certain amount of estrogen, so if that number is low than it can mean my follicles aren't developing like they should.  They are going to increase my stims slightly to see if that helps.  So, now basically I've gone from worrying about over-stimulating to under-stimulating.  I can't win!  (when I just typed 'win', I accidentally typed an 'e' at the end...to which I thought...yes, please.)  In other sad first world problem news, I think I'm too uncomfortable for the massage I had scheduled tonight.  I know, wah wah wah. 

Follicle Check #1

I had my first follicle check this morning.  I was a little nervous because yesterday I started feeling bloated and uncomfortable already...which seemed a lot earlier than I have in past cycles.  However, everything looks good - about a dozen follicles on each ovary, but the good news is that they are all about the same size.  Previously, I've had a couple of follicles get a little diva on me and grow far quicker than the others.  We want them to all grow steadily, so that's great news. 

The doctor didn't really have an answer for why I am already feeling uncomfortable other than to say he thinks I've just been lucky in the past that it took awhile for me to get to this point.  Great.   However, the best news is that the nurse got my vial of blood on the first try.  Hooray! 

Revenge of the Pincushion

I've been a little....grumpy this week.  A couple of factors are to blame - lack of sleep (allergies - argh!), lots going on at work, and vacation hangover.   It's important to note that I am not one prone to hysterics, public fits of crying, or snapping at medical professionals.   I consider myself a fairly well-adjusted person who, having worked in various fields of customer service, goes out of my way to be polite to anyone in that field.   All this by way of saying - I think I may have scared my nurses at the clinic this week.

I think I've explain my blood draw woes here before.  But for those of you who don't remember...I have the saddest little veins you ever did see.  Because I'm sadistic, I counted up how many times I've had my blood drawn in a year - 26.  Twenty-six!  I would say once out of every four times, they are able to get a vial on the first try and without blowing a vein.  Frankly, I'm surprised no one I work with thinks I have a drug problem based on the near constant bruising on my arms and hands.

I am 99% certain that the nurses at the clinic draw straws to see who gets to deal with me.  Below is a re-cap of my most recent experience.

Nurse: Okay, Sarah - did you drink a lot of water before you came in?  Remember, that helps!
Me: Yep!  (Gold star for me!  Also, I am going to float away in my attempt to get an A in water-drinking)
Nurse:  Let me take a look at your veins.
Me: The right elbow is useless; there's one you can get on the left side but it's sort of hidden. 
Nurse: :::Pokes my left arm repeatedly::: Hmmm....it's really hiding, isn't it?
Me: :::Nervous laughter:::
Nurse: Okay, I think I found it.  I think.
Me:  :::Panic rising:::  You know what?  Why don't we just take it from my hand?  Really, it's okay. 
Nurse: No, I think I've got it.
Me:  (thinking to self - don't be a hero, nurse!  Take it out of my hand!) Okay! (trying to be cheerful and optimistic) You can do this! (I've taken to giving my nurses pep talks)
Nurse:  Alright, here we go... (dig, dig, dig)...I think I see it...(dig, dig, dig)
Me: :::Trying not to faint:::
Nurse: Oh, dear.  That didn't work.
Me: ::::tries not to scream I told you so!:::  Well, guess we should go with the hand.  Here's the vein on the hand that works the best.
Nurse: Nope, I don't like the looks of that one.  I am going to try and get this one to work.  :::Points to sad looking vein:::
Me: Um, are you sure?  
Nurse:  Of course!  I've been doing this for years.  Trust me.
Me: Um, okay.
Nurse: Here we go again!  Okay, I'm in.  See -  I told you!
Me:  Yay?
Nurse: Oh, dear.
Me: What?
Nurse: Your veins aren't cooperating; the vial isn't getting filled all the way.
Me: :::screaming in head:::
Nurse:  I'm going to call in Other Nurse and see what she thinks.  Maybe this is enough for the test.  (Ed.note - almost all of my blood draws involve calling in Other Nurse for back-up and consultation.  It typically ends with both of them clucking in dismay over the sad state of my veins, which I KNOW.)
Me: Why don't we go ahead and try the other hand?  I've got a really great vein on that one.  :::Points to awesome vein and wiggle my hand in an attempt to attract their attention:::
Other Nurse: This is not enough blood.
Nurse: Well, let's check.  ::::clearly has given up and wants to be done with me:::: (to me) You can wait, right?
Me: Um, okay.
Other Nurse:  Hey, are you the person that Other Other Nurse did a blood draw on and she blew your vein really bad?
Me: That would be me. (infamy!)
Other Nurse:  Wow - she was so scared after that, she couldn't draw blood for a week!
Me:  I am not sure what I am supposed to say to that.
15 minutes later
Nurse: This is not enough blood.
Me: :::on verge of breakdown, but trying not to lose it::: Okay, let's do this!
Nurse:  Other Nurse, why don't you try this time? (Nurse has clearly lost her blood draw mojo)
Other Nurse: Okay, I choose this sad looking vein on your other hand.
Me:  Not this really good vein that works every time?
Other Nurse:  No, I like this one.
Me:  ::::screams in head::::
Other Nurse: Okay, here we go.   Oops, I blew that vein.

I'll end the dialogue here because at that point, I had been there for 45 minutes, was late for work, and just started crying.  Which I never do in public, which is fairly indicative of just how frustrated I was.   And while I am poking (ha!) fun at the nurses here, I really do love all of them and they've been very good to me...I think they're all scared of my veins and I'm scared of the draw and none of that makes anything go any smoother.

On this particular day, the draw culminated in my tearful claim to the nurses that "I...(sniff, sniff) told you (sniff, sniff) so....."  I think they took pity on me and decided that there was enough drawn to get the tests done.  Which there must have been because later they called and said my levels (estradiol aka estrogen and FSH) were fine.

In other news,

• (Okay, I promise this is the last needle reference!)  Stims started yesterday.  It's interesting to see how laissez-faire I've become to the injections.  When I first started doing them, we had calendars and reminders and alarms and this time, it was like 'oh, hey - I've got to go stick myself.  Be right back'.  Except I'm on a new follicle stimulating drug called Bravelle.  It's far more complicated to prepare (lots of vials and powders and such).  I ended up calling Uncle and had Nick come help me.  He's good at this type of stuff.  At any rate, follicles are officially being stimulated!  Huzzah!
• Last night, we went and saw Hunger Games. (Finally!  I was so sad to miss out on going to the midnight release with a group of girlfriends last week)  It's so rare that I like a movie as much as the books but in this case, I do.  Nick made me dig up the second and third books in the series when I got home so he could find out what happens next. :)

Alright, my friends.  I'm off.  My momma will be here soon.  We are co-hosting a brunch bridal shower tomorrow and we have a date with some quiche. :)

Proof I Haven't Lost My Sense of Humor

Not really sure that I have enough going on in my world to warrant a full post, so instead - you're getting a post full of random thoughts.  It's like a peek inside my brain.  Be scared.

• a friend recently dubbed my 'support group' the YaYa Sisterhood of TTC (trying to conceive) Friends...she needed a fertility drug question answered and came to the infertility mecca - me and my infertile friends.   I have laughed (out loud, no less) about this repeatedly.  Mostly because when the book and subsequent (horrible) movie came out, Nick would just yell out "Yaaaa-Yaaaa!" at random intervals.  Sort of like he had a tick or something. 
• she also dubbed me the Obi Wan of IVF.  I'm not much of a Star Wars buff - do I get a light saber?
• It's only in the last couple of months that I have found a lot of infertility humor on the Internet.  I know - infertility doesn't seem that funny, right?  Wrong!  Turns out it is EXCELLENT comedic fodder.  This will probably not be funny to you fertiles out there, but trust me...it, as well as this totally kills with the infertile crowd.
• I make it a practice not to discuss work on here (because you know, I value my job), but without getting into all the details, work has just been unbearably bad the last couple of weeks.  HR issues that I never imagined myself having to deal with fell into my lap and I've been navigating murky waters ever since.  The issues have stressed me out, caused me to lose sleep and just generally give me a headache.  Fortunately, there is an end in sight.  One of my favorite bloggers use to be in HR.  She recently posted an excerpt from her soon to be released memoirs and this post made me laugh so hard I snorted my lunch out of my nose.  Gross, I know, but true. 
• I'm guessing you probably want to know what's going on with our IVF cycle, too.  Geez, you people are so nosy.   All of our paperwork is complete and my medicines were delivered to the office this week.  I start the stims on March 30th and the retrieval is schedule for either April 10th or 11th with the transfer to occur five days after that.
• I was commenting to someone the other day (probably a Ya-Ya) that my excitement for each cycle has proceeded sort of along these lines.
• Cycle 1: YAY! I am so excited to be doing IVF! Look - needles! I'm going to have me a babbbbbyyyyyy!
• Cycle 2: I am still very excited to be doing this.  It is going to work I just know it!
• Cycle 3: I am cautiously optimistic.  With no exclamation points.
• Cycle 4: Again?  Really?!
• In more exciting news, Nick and I are off to Boston this weekend to visit friends.  We both really, really need a break.

IVF: Part 4 - first update!

Today, we (well, I...Nick had a meeting he couldn't get out of) had an appointment with our doctor to go over the cycle in more detail and talk about next steps.  He still believes IVF with our own eggs/sperm is the best option for us so we are in the process of scheduling a cycle for April.  I asked a lot of questions, mainly about how our protocol will be changed to lessen the risk of hyperstimulation.

For our next cycle, I will be on a different drug to stimulate the ovaries and instead of using a mega dose of HCG as the trigger to send the message to the eggs right before retrieval, I will instead get a big dose of Lupron (which is the drug we've used to suppress the ovaries in previous cycles - I don't exactly understand how something that in one use can suppress ovulation and then in antother use, stimulate - but whatever.  I trust the doc.). 

This protocol is designed for patients with a history of hyperstimulation.  As you might remember, despite being on a lower dose of the stims in our October cycle, I actually hyperstimulated more and produced more eggs than is typical.  This protocol will hopefully 1) produce a more manageable quantity and higher quality of eggs and 2) keep me from being in such pain/discomfort subsequent to the retrieval. 

I went over that last point in great detail with our doctor because even though no doctor will say it, I cannot believe that being that miserable and in pain helps our chances of success.  If I was a little embryo, I doubt I would want to implant into such an angry uterus. :)  It's like there was a big red warning on my lady parts scaring off the embryos.   Geez, maybe I've gotten a little too comfortable talking about this stuff with you all; that can't be an attractive visual image.  Oh, well. 

He assured me that I should be much more comfortable in this cycle.  He said that when he's done the protocol in the past, the ovaries 'get quiet' (that's the term they use for when the ovaries aren't producing a ton of eggs) much more quickly after the retrieval and virtually go back to normal within weeks.  (It was two months after the last cycle before my ovaries 'quieted'.

Overall, I left the appointment feeling very positive about our chances and while maybe not EXCITED exactly...anxious to get started again.  I'm still pretty bummed about our recent failed cycle but I'm okay with that.  I think I just realized it is okay to feel sad when something like that happens.  But you all probably all knew that already.  :)

XO

ugh...

Please excuse all the typos, weird formatting and the fact that I wrote IVF shouldn't work for us when I should have said SHOULD. IVF SHOULD work for us.  Geez.  But it's late and I'm tired and cranky and I don't feel like trying to smack Blogger into submission right now, so just cut me some slack, okay?  :)

Hope, Heartbreak - Rinse and Repeat

As some of you by now know (and for those of you finding out by reading this, I apologize but it's easier than emailing/calling everyone), Nick and I just had another failed IVF cycle.  When the last cycle in October didn't work, we started talking about scheduling the frozen transfer 'secretly'...mostly because we just loved, loved, loved the idea of being able to surprise everyone like a 'normal' pregnancy.  We knew we wanted to give my poor body a break for a few months; with that information, our nurse suggested a plan that had the transfer scheduled for February 6th, aka my birthday, aka Most Important day of the year.  Those of you who know me well know that my birthday, well - it's kind of a big deal.  When the nurse mentioned that date as a option, my heart skipped a beat and I just knew, knew that doing a transfer on my birthday would be good luck.  How could it not be?

The frozen transfer is an immensely easier process than a fresh cycle and transfer, mainly because they are not stimulating my body to produce a lot of eggs; there's no retrieval.  All I had to do was take a couple of hormones for a few weeks and then show up for the transfer.  As you'll recall, we had three embryos left after our last cycle...we thawed all three and all made it through the thaw.  Because the chances of success are lower on a frozen transfer, our doctor advised transferring all three.  Because the chance of triplets was less than 5%, we decided to transfer all three.

It was one of the best birthdays I've ever had...truly.  Nick and I were giddy with excitement because again, we just knew this had worked.  Third time's the charm, three is a magic number, transferring on my birthday - all 'signs' this would be it.  And so we went throughout our week, nervously anticipating the bloodwork that would confirm what we thought would be true.

Several days before the blood test was scheduled, my willpower broke and I started testing using home pregnancy tests.  I got a positive two days in a row which coincided with too many distinctly pregnant symptoms (nausea, thirst, sensitivity to smells, etc.)...Nick had no idea was testing.  I was cautiously optimistic.  On Valentine's Day, I just couldn't let go of the idea of being able to tell Nick we were pregnant, so I decided to take a digital test at work.  It came back negative...I chalked it up to my having had too much water and the digital tests being less sensitive (which they are) but dread started building in my stomach.

The night of Valentine's Day...I took another test...another negative.  I had felt no symptoms that day.  The awful feeling continued to build.  On the day of the blood test, I woke at about 3:45 am and took another test...another negative.  Sinkingly, I realized I was not pregnant.  I was anxious and crabby all morning while Nick left for work; he had no idea this was going on and was still positive about the situation.  I didn't want to burst his bubble until I knew for sure. 

The blood draw at the clinic was excruciating...the nurse once again struggled to find a suitable vein and I eventually just told her to take it out of my hand (which really, really sucks) because I just wanted to get out of there.  I then waited for two hours for the call.  As soon as I heard the nurse's voice, I knew the test had been negative.  There's a certain distance in someone's voice when they are giving you this kind of bad news; unfortunately, I've gotten pretty good at 'hearing' that distance.

I'm not going to lie - it was an ugly, ugly day...made worse by the fact that I had promised Nick I wouldn't give him the results either way until he got home from work.  I had to wait seven hours to do so...at that point, he pretty much knew, but I think he was still holding out hope.  I didn't have to say anything when he came in...he knew.  I just said "I'm sorry."

I'll be honest - this time, it's just so much worse.  It's been heartbreaking every time, but we were mostly just sad before.  This time, the sadness has a hard crust of anger surrounding it.  And bitterness.  I realize there are much worse issues to have in life and we both realize how much we have to be grateful for (we made a list), but going through this is like mourning the death of a dream of a family every time it happens.  Only most people don't understand because they haven't been through it.   Infertility is a peculiarly secretive topic...I wish people would be more open about it.  That's part of the reason for this blog...it has an admittedly small audience of our family and friends but I hope that by being open about our struggle it helps others to understand.

Which brings me to thanking all of you.  Those that we have told already have just been...well, great.  I have felt such love and compassion from so many people.  One of the blessings Nick and I count is the support of our friends and family.  And there are a couple of you out there that I allowed to see the good, bad and ugly of this secret/surprise cycle - and I will forever be grateful to you, in particular, for that.

IVF should work for us.  All three of the doctors we've seen have told us that.  I asked our current doctor if he ever has to tell people that IVF probably isn't a feasible option for them and he said absolutely.  If that were the case for us, we'd move on - whatever that would mean for us.  But people with our set of particular issues get pregnant via IVF all the time...and not with great difficulty.   We're just some of the unfortunate outliers that it is taking longer to work for. Although at some point the law of averages has got to be in our favor.

I also know that perhaps some of you are thinking why don't they consider adoption?  Why spend all this money when there are so many children in the world who need good homes?  I know you might be judging me just a little bit.  It's okay.  My response to that would be...why aren't YOU considering adoption? And why does a medical condition that is treatable mean that we should give up the dream of a child that is biologically ours? 

That's not to say adoption isn't something we've considered...believe me, we've talked about it.  And frankly, depending on how things work out - it's something we'll give serious consideration to when we want to expand our family.  I believe adoption is a wonderful, wonderful avenue for creating a family, but I also don't think it's something you take lightly...or that you decide on because you've run out of other alternatives.  I know from people in my life that have adopted that it is just of a painful and complicated process as IVF.  When we make that decision, it will be because it's right for us and we're ready to commit fully to the process.

Until then, this is the path we've chosen - chosen out of hope.  We know that this part of a larger plan and that perhaps some day it will make sense (frankly, I'd be lying if I said I understood it now).  In the meantime, we continue to count our blessings, chief of which is the amazing strength and resilience of our relationship which has truly grown in the last year in ways I thought weren't possible. 

So, this time, we'll invite you along for the ride again...woo!  Get excited!  Needles, Ultrasounds and Embryos, oh my!  You'll be a part of every thrilling minute of IVF: Part 4.  On a positive note, it was next to impossible for me to write on the blog the last couple of months because I am so terrible at secret-keeping.  I feared every post would go something like this.

For my birthday, Nick and I went out to dinner (and transferred some embryos!) and then had cupcakes (we're gonna have a baby!) and we went ice skating with friends (IVF! OMG!!!!!!!!!!!!!!!!!!!!).

So, get excited for more blog posts, too.   :)  

This one is hitting me harder...I think because I didn't allow myself to feel sad after the first and second time - it was just full steam ahead (and a lot of misguided Pinteresting and crafting).  I feel like I'm suffering from the cumulative effects of an entire year of disappointment and frustration.  However, it's nothing that a lot of snuggling kitties, watching Downton Abbey (seriously - I. Am. Obsessed), reading and the attention of a devoted husband haven't been able to help with this weekend. 

That said, hope springs eternal.  I just looked up the potential due date if we are successful with our April cycle.  New Year's Eve.  I've always hated that holiday...maybe that will change this year?  

XOXO