Costs

The hysteroscopy is going to cost as much as an IUI cycle.  I didn't want to think about it, but I raised the question of what if we decided to just stop here and not get into all this, but Papa Bear said he would want me to do the hysteroscopy and remove the polyp anyway because of the fear of cancer.  I don't think my mom's cancer was genetic, but it was such a freak kind of cancer that we don't know for sure.  Now we're having to look at which of the trips we had planned this fall (related to volunteer work but also then involving seeing friends we never see) we can cut so we can afford this shit.

Where to next?

Yesterday was our follow-up consult with the new doctor, now that testing is all done.  I felt too shitty about it to post last night, so I'm taking the plunge on that now.  We knew about the SHG and needing the hysteroscopy and still being scared of complications.  What we didn't know until yesterday is that my AMH has dropped from 0.87 in August 2016 to 0.47 in July 2017.  We also didn't know until yesterday that here in Georgia an IVF cycle costs twice what it did in Maryland 5 years ago.  Because of that, we're going to try IUI for a round or two, despite the odds only being 10-15% with my age and only one ovary.  I don't have much of any hope of it working, but we can at least afford to try it by then.  If it goes to IVF, we only get one shot.  We had to finance a car in January when we hadn't been planning to.  We might be able to get financing through a medical financing group to finance the cost equivalent of one brand-new sedan for a single cycle.  I highly doubt anyone in their right mind would finance us for the equivalent of two or more brand new cars, even with it being a medical loan rather than a commercial loan.

I hate my body for betraying us in this way.

I'm a Failure Again

We tested today.  Papa Bear was getting even more antsy than I was about testing.  He first wanted to test on Friday morning after the kids were gone, but then he wanted to test this afternoon when we could both be home for lunch.  I didn't mind testing, since I wanted to know.  But I knew right away that it was a no, as the control line got dark right away with nothing else showing.

Papa Bear is more sanguine about this BFN than I am.  He sees it as more information to work with, that maybe we really need the progesterone that I had been prescribed with the Clomid before in order for a baby to stick.  He still has hope for next month and, if necessary, the ones after that.

I don't.  I had hope this month.  I really thought that with FOUR eggs, we had a chance.  I thought that we would be likely to become pregnant and that the biggest question would be how many babies there would be.  I was still scared of a no, more scared of it than Papa Bear, who was much more scared of higher order multiples.  But I thought there could be a yes.  I had hope.

Not anymore.  It feels like hope is a finite resource and I blew it all this month.  I used too much, and now I have nothing left.

The Waiting Game

I've been resisting the urge to test.  I'm at 12 DPO.  Last month, I started spotting on the Friday night and had a full CD1 on the Saturday.  So if this cycle didn't work, I expect to find out this weekend.  Which will be a pain, since I have orchestra concerts on Friday and Sunday.  At the same time, if this cycle did work, since the concerts are with my church, I would have people to pray with me for a healthy pregnancy, even before I would know how many babies are in there.  I haven't had any implantation bleeding, but that doesn't necessarily mean anything since I did with the first pregnancy but did not with the second.

Last weekend, we had the birthday party for the now-10-year-old, and today we had an appointment for one of the kids that I had been thinking about a lot.  Now that those are past, I do have the concerts this weekend with rehearsal tomorrow and Thursday nights.  However, that's the only thing major enough to distract me from thinking about whether I have a baby inside me or not.  I have a huge convention coming up at the end of the month that I'm looking forward to, but I can't see anything past this weekend and the concerts and finding out whether this cycle worked.  I have plenty of things I SHOULD be working on, but I can't see anything past this weekend and the concerts and finding out whether this cycle worked.

I think about whether this cycle worked when I'm going to sleep and Papa Bear has his arm around me resting on my belly.  I think about whether this cycle worked when I'm driving to work.  I think about whether this cycle worked when I'm tending my toddler, wondering whether I will be able to give him a sibling (or more than one).  I think about whether this cycle worked when I'm piddling around on Facebook and playing my silly Game of Thromes game.  I even think about whether this cycle worked during client sessions (along with thinking about what my client is saying...ahh, the magic of ADHD).

But I'm resisting the urge to test.

#MicroblogMondays: Good News and Bad News Leads to What?

Not sure what #MicroblogMondays is? Read the inaugural post which explains the idea and how you can participate too.

I hadn't had time to blog this last week because I was leaving town, but I had my mid-cycle follow up last Tuesday.  The Femara worked...a little too well.  I had FOUR follicles maturing.  The doctor asked whether we would consider selective reduction if we went forward with the cycle, and both Papa Bear and I could not do it.  She then offered to use a needle to aspirate two of the eggs that day, but Papa Bear did not feel good with it ethically (I wasn't sure how I felt about it, but if he's not comfortable with it we won't do it).  So we were told to use protection for the rest of the week.  I talked to my parents about it (who made my sister on the 7th or 8th treatment cycle), and they thought we should try anyway because two of the follicles were smaller than the other two and because the chance of higher order multiples is still pretty low.  I prayed about whether we should try or not.  Man, I wish God gave clear yes/no answers.  The next day was my birthday.  We had made it to New York for the holiday and, through a twist of fate, got a second suite comped to us at the Residence Inn for the kids so that we had a king-size bed/room to ourselves with no kids on the other side of the wall.  Seemed like a sign for sure.  So now we wait and see.

New Protocol

I had my follow up with the RE today, on CD4.  Despite the fact that this last cycle didn't work, the appointment started with great news...my AMH was up from 0.87 to 1.6!  Papa Bear was able to come with me this time, so he got to meet the RE and form his impression (most awkward appointment ever in his book).  Since we've now had 2 Clomid cycles not work, despite 2 really good-looking follicles last month, she's switching me to Femara 5mg.  Who all out there has done Femara?

No shots of any type with this cycle (especially since we'll be out of town for Thanksgiving at BD time).  We will see how it goes, but it's nice to be making progress.  Before leaving for the holiday, I'll have an appointment for a mid-cycle ultrasound, and we'll be able to get results from more testing for me and Papa Bear both.

For the record, I absolutely adore the phlebotomist at this clinic!!!!  I have a HUGE needle phobia, but she has now stuck me twice without me wanting to cry, even with my vein not cooperating today!

#Microblog Mondays: Fear and Trembling

Not sure what #MicroblogMondays is?Read the inaugural post which explains the idea and how you can participate too.

I keep swinging back and forth between being glad we have a chance to try and being certain that nothing good is going to happen because my only remaining ovary is too broken.  I think I've been reading too much on the internet/FB (I know, irony, right?) and seeing people told that Clomid won't help them and maybe they should try egg donation.  Papa Bear feels like that would defeat the purpose of having a baby that was the two of us.  I want to be pregnant and carry a baby, I think even if it weren't my eggs, but I can't justify that much of an expense for a possibility when we have three kids to provide for both now and in the future.  But I still want a second child that is MINE, that calls ME Mommy and Papa Bear Daddy.

One Small Step

This is a really weird post to write.  I thought about writing it last night, but I didn't have the emotional energy to be able to.  I still can't believe I'm here.

I took my first pill of Clomid yesterday.  That puts me farther in some ways on the fertility journey than I've ever been before.  My ex and I had prepared to do IVF, but one thing after another kept getting in the way right before we could start the first shot.  So I have never actually taken a fertility medication before yesterday.  I've had a box of medications and syringes on my dining table for months on end before, but until yesterday I had never gotten to take a dose.

I almost didn't get this far.  I almost got stopped again right before I was going to be able to TRY something instead of sitting on the sidelines waiting for my turn.  My AMH level came back over the weekend and, because the doctor was in surgery on Monday, did not get read until late in the day Tuesday (my day 2, when I was to start Clomid on day 3).  The nurse had called me, but I wasn't able to call back before 5 because I was with a client.  She left the message that she needed to talk to me.  So of course I was panicking all night Tuesday night, and I was right to.  Yesterday morning, the nurse called to tell me that my AMH was 0.87.  According to the website I had been looking at, "low normal" is 0.7-0.9 and "normal" is 1.0 and above, although it said there was disagreement about where the borders between categories really should be.

Through the nurse, the doctor first said that he was not going to prescribe the Clomid and that I should see an RE.  I completely broke down sobbing on the phone with the nurse because I was pretty damn sure that there was no way we could see an RE this calendar year, between leave for Papa Bear (especially with his boss about to go out on paternity leave) and the question of whether appointments would even be covered, even with an endometriosis diagnosis.  And all the while that we can't get in, months and cycles are ticking away.  We had to wait months to be able to afford the HSG before having a chance to try, months of eggs dropping away unused, and now it was going to be even longer, making my ovarian reserve worse!

I was lucky that the client I was on my way to see canceled, so I went to church to talk to one of the pastors.  Just before the pastor prayed over me, my phone rang, but I let it go to voicemail.  As I left church, I checked my voicemail, and it was the nurse.  She said that she talked to the doctor again and reminded him that we really couldn't go see the RE, and he decided to write the Clomid anyway.  He said that he did not think our chances were good, so he would rather we work through the RE for their expertise.  But since we can't, he's at least going to let us try.  We also have estrogen for days  8-12 and progesterone pills for after day 18.

Papa Bear asked me how I felt after taking the first pill yesterday.  I didn't really know what to say.  I didn't feel bad, but I was afraid to feel good.  The best description we could come up with between us for how I felt was "guarded."

We're trying to get information on what is and is not covered (after our massive deductible, of course) if we can see an RE.  The first answers we have on that raise some questions for us, and especially Papa Bear to address.  It turns out that IVF is covered at 80% (which a lifetime max benefit of $2000, so it's like they pretend to cover IVF and really don't give a fuck), but IUI is not covered at all.  Papa Bear is Catholic.  IVF isn't allowed by the Catholic church.  Amusingly, IUI is, but only if the sperm is gathered from a condom after sex.  That could make getting samples in the little room at the clinic interesting, since even if we can't do IUI, there's still the testing for him that the clinic will want.

So yeah, it's been a weird couple of days.

Answers and Questions

Well, I don't have fibroids, at least.  I hadn't been sure how to feel at first, because at least it would have been an answer, but Papa Bear had pointed out the possible complications from fibroids and I felt better about not having them.  That still leaves no real answers about the extent of my current...experience, though, because it's symptoms beyond what is expected with endo.  Best guess is hormone changes, but apparently there's not really much of any research on hormones in people who lose an ovary.

The answer about the fibroids was mostly washed away by the whole nightmare experience of the ultrasound, though.  The last time I was lying on that table, I was being told that my baby no longer had a heartbeat.  To make it worse, it was the same tech, and she didn't remember that fact until Papa Bear reminded her.  She didn't even see in my chart about what happened last year, so she was asking me about why I didn't have a right ovary.  At least the doctor said they have 2 ultrasound techs at this point, so if I get that far, I can ask for the other one.

Since I don't have fibroids, getting that far now looks to rest on Clomid.  The doctor still wants me to get an HSG to make sure my remaining tube is clear, and it looks like we'll be doing that in September.  Provided it's clear (or gets clear from the dye going through), we'll start Clomid after that.  One thing we're not sure of is how much of a real LH surge I'm having to even trigger ovulation, since last month I had the line on the OPK get darker than it had been but not darker than the control line.  But the doctor said if that's what's wrong, Clomid will help.

He did also say that Clomid tends to make people feel cranky and have less energy.  For those who have tried it, what has your experience been?

Now What?

I was stupid.  I thought maybe I was having symptoms of implantation.  I should have known better.  Instead, today I got CD1, a good 5 days early.  I guess the one thing I can do right is not have it interfere with being at the beach next week?

The complicating factor aside from hating myself for letting myself hope is that tomorrow is my ultrasound to see if there are any fibroids causing problems.  Supposedly the ultrasound can be done at any time during the cycle, but when I called the office today, they said that it would be better if it wasn't a heavy flow.  She also said that if I had to reschedule, it would be several weeks before there would be another opening (because of the need for the doctor and the ultrasound tech to be there on the same day).  Hopefully it will be light enough by then?  I want to get some damned answers finally!!!

So Now What?

I had my doctor's appointment today.  It was SO hard being there while not being pregnant, especially since it was the first time since the follow up appointments after the surgery.  I was crying in the waiting room, although I was able to distract myself with my book and my silly Game of Thrones FB game.

It was better once my doctor came in.  He greeted me with a hug and immediately understood how hard it was for me to be there.  He said he had been rereading his notes from my case last year and that the hair on the back of his neck had risen again at how close a call it had been.  One thing that I have appreciated with him has been that he has been very human through this.  It would have been harder if he had been more of the "I'm always right, even when I'm not" type of doctor.

I told my doctor what has been going on, what symptoms I have been having that make me think the endo is back.  He confirmed that there was endo tissue that he hadn't gotten on the left because there hadn't been time while keeping me alive.  However, he also said that the symptoms I've been having may be more consistent with polyps than with endo.  He did say the pattern I have been having with my cycle falls into the realm of "normal" but could also make sense with the endo still being a problem.  I did forget to ask what stage the endo had been, so I'm going to call the nurse tomorrow and ask.

The key thing that he said, though, is that now that I have been diagnosed with endo, I can get things covered by insurance because it's testing and treating the adhesions from the endo, a diagnosed medical condition, rather than treating "unexplained infertility."  The first things he wants to check are the possibilities of polyps, a luteal phase defect, or another blocked tube.   He wants to do a kind of ultrasound to look for polyps, and he wants to do an HSG to see if adhesions are blocking my remaining tube.  I'll be calling around for prices on the HSG since that isn't in his office and even though insurance would cover it, I still have to be price-conscious because of having a deductible.  To check out the possibility of luteal phase defect, he wants me to start doing OPKs again so that he can then test my progesterone level a week after ovulation.  I wonder if I should start doing BBT again to go with it.

Depending on what we find out, we may be looking at anything from oral progesterone to Clomid to IUI.  Whether it falls into what insurance will cover or not, I can do anything short of IVF with him instead of with a fertility clinic.  I feel good about that, at least.  I know that, after what happened last year, he will pull and work anything he can to help us.  He thanked me for coming back to him after what happened, but it's what felt the most right, both because of how committed he is to us and because of the midwives there, who kept my son from being a c-section.

We will see what happens, but it's nice to be able to do something other than wonder and then despair every month.

Doctor, Doctor, Gimme the News

Tomorrow morning I go back to the doctor who had done my D&C and, in the process, found my endo.  It's time for my yearly fun appointment, with all the fun since my mom died of a gynecologic cancer.  I need to talk to him about it seeming like the endo is back and discuss what we should do about it.  And then I most likely get to consider the finances and whether to pay for more surgery if it's recommended or whether to keep masking it with NSAIDs.  Fun timing, especially since this Sunday will be a year since we found out I was pregnant with Otter.

Decisions, Decisions

I got a call from my nurse earlier today, and the cycle is officially dead before it began.  Again.  After having said that the pre-implantation genetic diagnosis (PGD) probe needed to be done before I started shots, my doctor switched up on me (again) and said that he won't let me start pills until it's done.  This is at least the second time he's switched things up on me, after originally saying that he would prefer a day 5 biopsy instead of a day 3 one and then changing "would prefer" to "will only do."

My nurse is also pissed at this point.  She's pissed at the gene lab for putting her in the middle and telling her to call me and tell me they needed parent samples rather than calling me themselves.  She's also pissed at the gene lab only saying at first that they wanted samples from my parents and then later saying they actually wanted samples from both sets of parents.  She's also pissed that I did what I was supposed to and that other people not doing their jobs is what is preventing me from cycling.  So at least I'm not the only one that's pissed.  She and I were kinda yelling to (and specifically not *at*) each other on the phone today since we were both upset.

So where does that leave me now?  Well, for one thing, swinging back and forth between numbness, tears, and anger.  Especially with getting the final word from my nurse, it's a good thing I had called in sick today (I'm basically ok, but running a bit of a temp and just feeling crappy), because I would have had a hell of a time holding it together for clients. 

It also leaves me with a major decision to make, about whether to cycle in one month or three, and I'm interested in opinions.  DH told me it was my decision and that he was ok either way.  Two months just isn't an option because of an event at the end of June that DH and I are running. 

If we cycle in one month, we have to have the probe done (which takes 3 weeks after they receive the samples from all 4 parents) by April 21.  Overnight FedExing of the sample kits each way, but I'm not going to have the last address until tomorrow at best.  I'm scared of the probe not being done in time and having to go through this emotionally again.  Cycling in one month would also mean missing something at the end of May that is fulfilling to me.  I've been told my friends will make it be ok if I choose to miss it, but it's something I get a lot out of and a chance to see friends I rarely see.  Cycling in one month would also make it possible to get a second cycle in before my plan year ends on 9/30 (DH's plan year is 1/1 to 12/31).  I have an out-of-pocket max of $3000 and an employer-paid deductible of $1500.  This year, we put the other $1500 on DH's flex spending account both so that we didn't have to pay taxes on it and so we had it all at once instead of having to save it up.  For a cycle after 9/30, we would need to either pay the $1500 between deductible and out-of-pocket max by gathering it together between 9/30 and the end of the year or by waiting for that next cycle until January 2013 so that we could have a new year's flex spending account.

If we cycle in three months, I don't have to miss my May event (although I would miss it next year if the cycle worked, but then I'd miss it less because I'd have a baby), and I don't have to be scared of the probe not being completed in time.  I would start shots while DH is at or just coming back from a curling trip (yes, in the summer), but I would be about at or already at the beach with my family, and several of my cousins are/were nurses (one's a doctor, but I dunno if he'll be there).  *Insert Smithers-like tapping of fingertips together*  I would have to wait longer to cycle, though, and I don't think there would be any way to get another cycle in before my insurance plan year ends.  So IVF #2 would entail either waiting until January or coming up with $1500.  Which I know isn't an astronomical about, but still.

I don't need to make a decision right away, but I do need to make it soonish since I need to buy plane tickets if I'm going to the thing in May.  I'm working on getting the sample kits out to the parents right away either way, to leave myself that flexibility, although if it takes long to get those back, that'll make the decision for me.  It feels like the two main things driving me right now are fear of the probe not being done in time for waiting just one month and not wanting to miss the May event.  What do y'all think?

Keep Calm and Carry On

I've been not-quite-almost-trying-desperately-to-keep-from-panicking for much of the past week. 

Before I left for Costa Rica, I was calling the PGD lab and the fertility clinic and then calling around to insurance trying to get the auth changed from the California PGD lab to the Maryland one.  The Maryland lab was telling me the fertility clinic was supposed to submit the changed auth because they don't get auths from insurance even though they do take insurance payments.  The fertility clinic was telling me they had done their part and that the PGD lab was supposed to get the auth and that if they didn't than I was supposed to.  The insurance company was saying that the fertility clinic was supposed to do it.  And so on. 

I wanted to get it done before I left so that DH and I could get the samples submitted and the probe could be made, since it takes 3 weeks if nothing goes screwy, and I started CD 1 for the cycle before our treatment cycle the Saturday before we left.  Finally, the Friday before we left, I reached G in the local office of the care management division of the insurance company.  She said she would get it taken care of by the Monday before we left.  I didn't hear back from her that day, but I had so much to do getting ready that I had to just go on faith and hope it was getting done.  Yeah, right.

Fast-forward to getting home, and a day or two after getting back last week, I reached G again.  She hadn't been able to get a call back from the person at my clinic that she needed to talk to.  She wasn't going to be in the office Friday and would get back to me on Monday.  Yes, Monday that's a week and a half before CD 1 of our treatment cycle.  On Monday I couldn't get ahold of her, and yesterday she said she still hadn't heard back after bugging the woman at the fertility clinic again.  I explained the time crunch, and she said she was going to talk to her boss to see if she could make it happen without the fertility clinic calling back.  Later that day I was told that she could, and this morning she called me with an auth number.  Whew.

So now I can call my clinic and be able to go in tomorrow with DH to give our samples, right?  Wrong.  There are no orders on file for what to test for, since the Maryland lab didn't contact my nurse to give her that info.  My nurse called me again today (we also spoke yesterday after I called her in my not-quite-almost-trying-not-to-panic) to say that she's going to make a pest of herself with the lab until they tell her what they need from the samples.  Every day that ticks away has me more freaked out, though, even while I celebrate having the auth switched. 

If I can't cycle this month and I know that within the next week, I can't cycle one month from now unless the nurse agrees to use extra pills to move the cycle by a couple weeks, which she wasn't keen on.  I can't cycle 2 months from now unless she agrees to use extra pills to move the cycle by about one week.  So missing this opportunity could mean waiting 3 more months.  In both cases, this is because of things I already committed to.  I'm trying not to commit to much right now because of the possibility of treatment cycles, but how do I find that line between being available no matter what changes and putting my life completely on hold?  If I can't cycle this month and I find that out sometime after I start the pills, all bets are off as to timing because I'll have to completely figure out again when my CD1's will be for the upcoming months.

But of course I keep calm.  Right.  Or at least I carry on.  That's all I can do.

Querying the Blogoverse

OK, now that I'm ready to talk about Friday's appointment, I have questions for those who have done PGD.  When I was reading online, I only saw information about PGD done on day 3, with a day 5 transfer.  My RE was talking about that option, but also about doing a biopsy on day 5 and freezing the embryos for later FET.  Did y'all have that option?  Did y'all do day 3 biopsies or day 5?  Did you get more/better embryos to transfer by doing day 5 biopsy?  At this point, we might have to insist on day 3 biopsy and day 5 transfer because our insurance doesn't cover freezing, and we can't afford the cost of freezing, storage, and thawing.  Everything else is covered by insurance, but not that.

I did find out from the insurance company today that there is no waiting for approval for IVF since we're using an in-network clinic.  Now I just need to hear from the case managers at the insurance company about where is in network for PGD and fertility pharmacies, as well as whether a day 5 biopsy and later FET would count as 1 cycle or 2, since apparently insurance companies differ in how they count that.  Since we get three cycles per live birth covered, that is a key question!

Slamming on the Brakes

From cruising down the highway feeling the wind of my passing to...SCREECHHH!!! 

I got a call this morning from the doctor.  Not the nurse. The doctor.  My genetic testing had come back.  I figured I wouldn't be a carrier for any genetic diseases since there was no family history and I wasn't a part of any at-risk group.  So much for that.  Apparently I'm part of the 1 in 50 that is a carrier for spinal muscular atrophy.  So now we have to get DH tested before we can proceed with IVF. 

Under ordinary circumstances, this would take 3-4 weeks: time to order the test, get the kit sent to us, mail back a sample, and about 2 weeks for processing.  However, we aren't sure if DH's insurance covers it.  Which is better than being sure it doesn't...we have a chance because the test isn't necessarily for infertility.  If it's not covered, we'll wait a little longer to see if DH's new insurance covers it.  Yes, new insurance.  He starts a new job on 9/26.  For those that know us in person, you'll have to ask him about it.

I asked one of the nurses whether I should continue taking my Pills until we are able to start the cycle or if I should stop them instead.  She told me that I could do either one and that some people prefer to get off of them as soon as they can because of side effects.  Um, no, I'll keep taking them, thanks.  The worst part of TTC (until it reached the point of IF) was not having the Pill helping to keep me out of pain.  Besides, the nurse mentioned that if I kept on them, we could start the cycle whenever we had the test results since we wouldn't have to wait for me to take the Pills for 2-3 weeks.  Because of that, I don't have to start the cycle at any specific time of the month, which makes it easier to control (in a broad sense) when all the appointments end up falling. 

From what I've been told, it's not that big a deal even if DH shows up as a carrier for the same thing as me.  We would need to use PGD to make sure that no embryos with the wrong genes are transferred.  I shouldn't have any problem having enough embryos to still transfer, given the number of antral follicles I had.

At this point, the main thing I feel is stunned and jarred, as if I really had slammed on the breaks when driving on the highway.  I had a few tears come to my eyes as it hit me that we had to put this off, but I haven't broken down crying or anything.  I don't know if, as it sets in, I'll be sad or angry or what.  What does bother me is that putting off the cycle decreases the chance (already small) of DH's dad getting to meet a grandchild.  He's got a year at most left unless a miracle happens, and a year is with chemo that would be utter hell to go through.

As we were watching hurricane coverage tonight, DH noticed again an ambulance-chasing commercial for people who had given birth to babies with defects after taking antidepressants during pregnancy.  One of the antidepressants mentioned was Zoloft, which I've been told by multiple people (including my psychiatrist) is safe to take during pregnancy.  DH raised the question of whether taking medications at all during pregnancy is a good idea.  Like I told him, it's a very small percentage of people that have problems, but then again, it's a very small percentage of people who are carriers for SMA, too, which makes me less confident about trusting to chance even when the odds are that stacked.  If I was to do it without meds, I could.  I made it through worse than those hormones without meds.  The biggest issue would be DH's reaction to me, though.  He already worries enough about what pregnancy hormones would do to my depression, since a bipolar friend had to be off work for about 9 months after giving birth to get her meds straightened out.  I told him I'd ask one of the prescribers at work what she thought, and we would make a decision over time based on that.  I'm fine with the idea of being off meds...my original plan was to try to do it med-free.  I only went on the Zoloft when I felt myself dipping into an episode after losing a friend to cancer.  So, we'll see.

On Pins and Needles...

...when I think about needles going into me.  We had the mock embryo transfer and the injection class today.  The mock transfer actually hurt more than the HSG had, much to the pain of DH's hand.  The doctor said everything was basically normal (there was a blood clot in there, but he said that's normal while taking the Pills). 

After that, we had the injection class.  DH was the only husband there, which he and I both thought was interesting.  Then again, I was the only one there who knew she was way too scared to be able to do the injections herself.  I must say, I was shaking looking at the needles, but we both learned.

When I got to work, the receptionist told me that my box had come.  I was confused at first because the pharmacy had told me there would be some in the box that were in foil bags and needed refrigeration, but there were no foil bags in the box.  I called the pharmacy and found out that one type of one medication needed to be refrigerated, but I had been given the kind that did not need to be kept cold.  My Gonal F will need to be refrigerated once it is reconstituted, but not before.

Two weeks before the shots start...

Warp Zone

All of a sudden everything for this cycle feels like it's going at warp speed.  Like I think I had mentioned, we're doing two weeks of Pills at the start of this cycle instead of three to make the timing work out better.  So on Tuesday, I went in for my day 3 bloodwork (just an LH check).  At the same time, I got my updated schedule, my nurse said she was putting in the orders for the meds, and I scheduled my mock embryo transfer and our injection class.  The injection classes are only done at the Annapolis office on Tuesdays and Thursdays, and I don't have much time before we're doing the injections, so the mock transfer and class were scheduled for only two days out, tomorrow morning.  Tuesday evening I got a call from the pharmacy checking the numbers of meds and supplies (as if I had any idea what the correct things were!) and telling me I had to have someone to sign for them.  I asked for them to be delivered to my work so the receptionist there could sign for them, and the woman told me that they would be delivered this Thursday.  I had no idea they would arrive that fast!!  So I had my bloodwork and scheduled everything on Tuesday, and now on Thursday I'm having the mock transfer, the class, and the med delivery.  It makes sense to get these steps over with now, but I guess I thought more of them would be next week, closer to when the rest would be starting to happen.  Heck, next week I won't end up doing anything except taking my Pills and worrying about how bad the needles will be!  I know what you said, Katie Z, but I'm not going to be able to believe it until I feel it for myself.  God, I can have faith in...needles not being too bad, I can't.

Beginnings?

A friend asked me tonight how I feel with it being day 1 of my IVF cycle.  I told her I wasn't sure, beyond "weird."  It seems like it is the beginning of me and IVF...but not at the same time.  All I did today was take my first Pill (and forget to call my nurse to schedule my mock embryo transfer and injection class; I'll have to do that tomorrow morning).  It's not like I started the hormone shots today.  On the other hand, with the mock embryo transfer and the injection class I will end up doing, I will have things that will make it feel more real before I do start the shots. 

Next Steps

So, in the ultimate of ironies, this infertile is going to start taking birth control pills in the next week or so.  That, oddly enough, is the first step of an IVF cycle.  Yes, folks, despite being a good candidate for IUI, we are about to start a cycle of IVF because that is what's covered by insurance.  Because my tests came back normal and those for DH came back basically normal, we have a diagnosis of "unexplained infertility."  In order to make sure we use only perfect sperm, we're going with Intra-Cytoplasmic Sperm Injection (ICSI) rather than just putting the sperm and eggs in a petri dish and telling them to have fun (see, no one gets to have fun through this, not even individual cells!).

Um, yeah, then we get to the really fun part, the needles.  They tell me that the needles for most of the injections are small, only half an inch or so.  Yeah. I'll believe that when I see it.  They also tell me that I'll be able to do most of the injections myself.  DH and I looked at each other at that point and laughed, knowing that he'll end up being the one to do the injections.  My mom was suggesting I do them myself to prepare for the day when I might have to do insulin injections.  We'll see, Mom.  Maybe by the time I get to the second or third IVF cycle.  The grand total is somewhere in the vicinity of 7 bloodwork visits, 10 gonadotropin injections, and one more major injection (the trigger).  Then I get sedated for egg retrieval and a day on bedrest after embryo transfer (several days later).  The trigger will be somewhere around September 23, with retrieval around September 25.  DH and I were planning on going away that weekend for our 5 year anniversary and his birthday, but instead we'll be hoping to create a birthday present for him. 

I mention "hoping to" and multiple cycles for a reason.  Given my stats, my chances of conceiving in a given IVF cycle are 50-60%.  At the same time, I know that the chance of not succeeding on the first try is thus 40-50%.  I also know that most people don't conceive on the first try or conceive and then miscarry.  However, many people who don't conceive on the first try do succeed on the second or third try. 

The mention of miscarriage brings me to a request that I have for those of you that I know in real life.  When DH and I first started TTC, my intention was to not tell anyone except DH and maybe our parents before I passed 12 weeks, when the chance of miscarriage decreases drastically.  I didn't really think I could handle the additional grief if I had a miscarriage of telling a ton of people there was no longer a reason to be happy for me.  However, there's no real way to write this blog without posting pregnancy results. 

Therefore, I request that, at whatever point I do conceive, you who know me in real life not talk about my pregnancy with anyone unless you know they also read this blog.  I know that people will slip up and word will spread, but I want to limit that as much as I can until I'm ready to announce it to all and sundry.  Don't worry, I'll let y'all know when it is common knowledge, and until then you can gossip with the people who you know read this and in the comments section.

Thank you all for your discretion about this.