Looking Back and Looking Forward

Where to start? First of all, thanks to everyone for your kind comments, emails, voicemails, and text messages. I cried hearing/reading every single one of them. This process really is gut wrenching and B and I are lucky to have so much support both from our family and friends and from this online community.

Sunday was devastating. I took Monday to grieve and stayed home from work by myself. B had to go to work and he took the dogs to daycare, so I had the house to myself which is rare. I sat in the front living room (which I never do) on the couch in the sun for most of the day reading, crying, staring out the window. I went back to work on Tuesday and actually had a decent day. I was able to distract myself with work for minutes at a time which was nice.

And then Jen got some truly horrible news and it was all I could think about. At least it kept my thoughts off myself for awhile. If you have a minute, please stop over and grieve with her.

Today was a different story for me. I had trouble focusing. I got frustrated easily, angry easily and teared up at the drop of a hat. One thing that is making this week more difficult than it need be is that a project has come up that is requiring me to work much more closely with one of the pregnant ladies in our department. In the 2+ years we've worked in the same department, we've never really worked together. All of the sudden, I have to delegate to her, review her work, rely on her to get tasks done. I have to check in with her frequently, answer her questions. This is no reflection whatsoever on her personally or professionally, but she is possibly the last person I want constant interaction with this week. Such is life I guess. And I'm starting to realize that the grieving process for this will take awhile. Even if I feel great one day, I might feel completely horrible and down again the next.

Off and on over the past two years I've thought about going to therapy to talk to someone about what we are going through. I kept putting it off thinking the next cycle would be it and all our problems would go away. This time I'm biting the bullet and moving forward with it. At the very least I need someone to convince me that I'm not crazy and obsessive (even though I am). Our clinic has a counselor on staff and we have an appointment set for next Tuesday. I don't know if we'll go just the one time, or if it will become more of a regular thing, but I'm ready to give it a try and luckily, so is B. I know he's not looking forward to it (not that I am either), but he is willing to do this for me and that means the world and makes it so much easier. I likely won't write too much here about our session Tuesday or going forward if we stick with it simply because it just feels too private. But I will let everyone know if I think it is beneficial.

Okay, now to the looking forward. We're getting back in the game-immediately if we can. AF showed up today, so I'm officially on cycle day 1 and I'm waiting to hear back from Dr. S to see if he's okay with us moving forward this cycle or if we need to wait a month or so. Dr. S did call me on Monday to check in and see how we were doing. He apologized and was pretty sympathetic. He said he isn't sure whether my lining was the problem or if there was something wrong with the embryos.

One way to get a better idea of the quality of the embryos next time is to let them grow out longer to the blast stage (5-6 day embryos instead of 2-3 day). The standard FET protocol at our clinic for embryos frozen at the 2pn stage (the day after retrieval), is to transfer them the day after thaw. I'm not sure, but I think that would make them day 2 embryos. At that stage, you can't tell too much about quality which has a huge effect on whether or not they will result in a viable pregnancy. In a fresh cycle at our clinic, the transfer would either happen three days after retrieval, or five days after retrieval at the blast stage. The standard protocol is to try to get them to blast for a 5 day transfer and 3 day transfers only happen if the embryos maybe aren't doing so well or if the embryologist thinks the embryos would do better in their natural environment (in the uterus). Whether to transfer sooner or later is still somewhat controversial, but our clinic generally believes in trying for day 5 transfers instead of day 3 transfers.

The scary thing about trying to grow embryos to blast after a thaw is that they would want to start with as many as possible and, therefore, would thaw all 14 of our totsicles at one time. Assuming most of them survive the thaw, I would expect many of them to not make it to the blast stage and would hope that at least 2 did make it. But they could all stop growing prior to that and the transfer would be cancelled. Then we would be back to square one having to start over with another fresh cycle (stim and retrieval included along with risk of another bout with OHSS-hopefully avoiding the emergency room). However, if this gives them the best shot at picking the two best embryos, maybe it's worth it to risk all of them. If we ended up with more blasts than we were willing to transfer, they could refreeze the rest. So this is a decision we will have to make in the near future.

Dr. S was receptive to trying a natural FET this go round. He agreed that it is possible that my body just doesn't like the extra hormones and it is possible my lining might do better on its own, although we don't know until we try. There are risks to doing a natural cycle-mainly that I could ovulate through and would have to cancel the transfer. What is sounding really attractive about going this route though is that I wouldn't have to take the Lu.pron shots or the estrogen patches/suppositories AT ALL. And rather than doing the PIO shots, if we made it to transfer, we would just supplement my natural progesterone production with progesterone suppositories. That's right ladies and gents, a shot-free cycle!

I have to go into this natural FET knowing full well that there is a chance it could get cancelled either because I've ovulated unexpectedly or because my lining didn't cooperate. And regardless of how prepared I am for that possibility, I'm sure I will be just as upset if it doesn't work out. But since this whole process is one huge scientific experiment anyway, I figure it can't hurt to try something new if Dr. S supports it. Yes, I'm feeling rational today.

So now we just wait for word on whether we can try a natural FET this cycle, or if we need to wait. We then have to decide if we want to go the standard thaw/transfer route, or if we want them to thaw all 14 embryos and grow them to blast before transfer. I also still need to decide whether I want to continue with regular acupuncture or with the electro-acupuncture. Dr. S was pretty indifferent about this. A lot of decisions to make in the next couple of weeks. Feel free to spew advice (or assvice) in the comment section here if you have any thoughts on any of these alternatives.

I'm a little behind on my blog reading, so I don't want you all to think I've forgotten about you. I'll catch up this weekend if I don't get a chance during the week. And for the ColoBloggers, I'll see most of you on Saturday. This meet up is coming at a great time-I could use some advice and company.

Back to the World of the Living

Just a quick note to let everyone know I'm doing okay. I did go back to work yesterday and it helped to keep my mind off of things for a bit. I'll write more this evening with an update on my conversation with the doctor on Monday.

It's Over

I woke up this morning to a tiny streak of red on the toilet paper and immediately felt an impending sense of doom that I couldn't shake. I rolled over for the PIO shot thinking this could be the last one for awhile. But that one streak was it, the rest of the morning was uneventful 'down there' so of course a little hope remained. We got to the clinic around 8:30, got blood drawn pretty quickly and then sat down with one of the nurses. I showed her the results of the patches where they were removed from my lower back yesterday: angry, puffy, splotchy, red skin under where each patch had been. She agreed that was not normal and suggested rubbing My.lanta or something similar on my skin prior to applying the next patches (tomorrow).

We left the clinic to grab some breakfast at a cafe and the nurse called me to let me know she had spoken with the doc on call about the patches. If I was pregnant today, they would switch me to another brand to see if it would help. We then wandered around a local furniture store to kill some time while waiting for the mall to open. And so ends the better half of my day.

We got the call earlier than expected and happened to be walking out of the mall. I've never been punched in the gut, but I imagine this is what it feels like. A mall parking lot is not the best place to get this kind of bad news-lots of people with kids, strollers, babies walking in and out of the mall. Salt in the wound.

I feel so fragile right now, like I could at any moment break into a thousand tiny pieces.



The only other time I can remember feeling this way is when my first dog, Pippen passed away. She the first pet that was all my own, she was my best friend, there through the good and the bad, through different boyfriends and apartments, always there wanting nothing but to curl up next to me on the couch. She had pancreatic cancer and the vet came to our house to put her down. I held her in my arms while the vet injected the lethal dose of poison. I felt her go limp, I felt her heart stop beating, and I sat there quietly with tears streaming down my face. The vet was crying, B was crying. The minute the vet left with her body, B and I held each other and sobbed together. And the house felt empty.

But there are differences between this grief and what I felt when Pippen died. At least I could take comfort in the fact that she was no longer suffering. I pictured her in a doggy heaven of uber-green grass chasing after squirrels. Lying in the sunshine for hours on end. There was no rain or snow, no cold weather in this doggy heaven. I knew she was happier and we had done the right thing. My embryos didn't have a chance to grow into anything that could even be seen by the naked eye. Where did they go? Did they just disintegrate into my body and absorb into the tissue, or leak out with the goop of the suppositories? Regardless of how small and insignificant those embryos may have been, the pain and grief is just as real. Just as deep and raw.

The other difference this time is that this feels like my loss-not our loss. Instead of holding each other and sobbing, B was the one holding me while I sobbed. No tears on his end, just trying to pick up the pieces. I think it's difficult for a guy to get attached to embryos like us women do. We try to nurture our bodies and are constantly aware that they are inside of us and hopefully latching on and growing. We endure all of the poking and prodding, the endless violations of privacy, the ugliness of the side effects, the constant reminders of what we don't have and are working so hard to achieve. Every bit of our mind, body and soul is invested in this process. And that is part of what makes this so hard. I know B feels bad, but I can't help but feel like I'm going through this alone. This is my problem, my defective body, my guilt, and my broken heart.

None of this makes sense. The fact that we can't get pregnant on our own. The fact that the IUI's didn't work. The OHSS, the crappy lining for FET #1, and now this. I wonder if maybe we don't have enough faith in G-d. Maybe this is payback for the crap I did as a teenager, the crap I did in college and my early twenties. For not being nice enough to other people. For not volunteering and contributing to a cause. Maybe I'm not fit to be a mother. Maybe I should have forced B to start trying earlier even though he wasn't ready to be a dad. Maybe those embryos never stood a shot with my anorexic lining and I should have let the doctor postpone the transfer. Maybe, maybe, maybe.

I know in my head that none of this is true. This isn't my fault. I did everything I could. It's just the shit luck of the draw. My heart feels differently. I know I will eventually pick myself up and start all over. And the shit part of this process is that no matter what we've been through up to this point, we are starting over, from square one. There's not really such a thing as a lesson learned with IVF. Your body can react differently to the drugs every time you take them. There's no way to go back and pinpoint what we could have done better, what would have made the difference. And to top things off, there's no such thing as a second opinion when you're supposedly already seeing the best.

When we got home I removed the 4 patches from my belly one by one. I thought how appropriate the number 4 was. As I removed the patches one at a time, I thought of each of our lost embryos. The one that didn't survive the thaw, the one that didn't survive back to freeze, and the two that didn't survive my body. My fucked up, traitor of a body.

I will survive this. I just don't know how I'm supposed to go to work tomorrow and pretend everything is fine. That nothing happened. That my world hasn't just been shattered to pieces.

1 Day to Beta-Plan B

I am trying to prepare myself for a negative. I know some people would say I should be thinking nothing but positive thoughts, what you receive is the energy you put out into the universe, blah, blah, blah. I just want to have plan B (well, we're really on around plan Q by now) in place in case. Something to focus on if this cycle ends up like every other cycle so far-in the trash. And I am thinking about this now so that I won't have to tomorrow. Tomorrow will be for grieving if that's what the universe has in store.

So here's my plan. For the next FET, I'm thinking of asking Dr. S if it makes sense to try a natural cycle. No Lu.pron suppression, which would mean the actual transfer date would depend on when I naturally ovulate. This protocol has some risk to it because if you miss ovulation (about 10% chance according to Dr. S) the transfer is cancelled because they don't know when you started producing progesterone on your own and, therefore, don't know when to do the transfer. It also makes it more difficult to schedule the transfer date (and give work notice to take a couple of days off for bed rest).

This would also mean going back to using ovulation predictor kits ("OPK") and dusting off my Clear Blue Easy Fertility Monitor ("CBEFM"). This would feel a bit like taking steps backward because these are the tools we used for timed intercourse before getting into ART. But, it would mean no Lu.pron which is definitely a positive.

My reasoning for wanting to try a natural cycle is to see what my lining does naturally on its own. If this FET fails, I will blame it completely on my lining. My retarded, anorexic, uncooperative lining (of course, I reserve the right to take back all of this name calling should this FET turn out successful). Back in the day before we saw an RE and I was going through testing with my OB, I had a great lining, cycle after cycle, until we introduced Clo.mid into the mix. It just seems that my lining doesn't like artificial hormones and medications. I must have a hippie lining-all natural, all organic, all the time.

Dr. S doesn't actually believe my lining can get thicker than an 8 on its own because this is the thickest measurement in my chart. I tried to tell him during FET #1 (which was cancelled) that I had documentation of thicker linings in cycles past where I was unmedicated. He scoffed at this idea because those measurements were done by my OB's office. He doesn't trust any measurements or tests performed by anyone other than his own U/S or lab technicians. While this is incredibly arrogant and self-important of him, it is also a trait that I think is good to have in an RE. I want my RE to have full confidence in his staff and to believe their training is the best. But with my experience a couple of weeks ago, I'm not so convinced the measurements by his U/S technicians are all that accurate either.

Anyway, I would be curious to see what actually happens with my lining when left to its own devices. The thing is, there are different protocols that go along with natural FET's that span all ends of the spectrum. From absolutely no hormones or medications, to everything except the Lu.pron (still doing the estrogen patches, PIO, baby aspiring, etc.). So again, there would be more decisions to make that likely requires yet another regroup appointment with Dr. S. I hate those regroup appointments. The inevitable "no, we don't know what happened." They never know.

So now you know what's going through my head today. Of course I'm still hoping that none of the above will come into play (at least not for another year or so) and I can move forward blissfully ignorant of natural FET cycles because my fully medicated FET cycle did the trick.

2 Days to Beta-Nada (Updated)

Not much to say from here lately. The long wait continues. My right posterior hurts worse from the PIO shot this morning than usual. Not sure why. It was difficult to sit in my office chair all day today and walking was difficult too. These damn shots better be worth it.

I think it's weird that almost 50 people have voted in my poll and the yes's are now winning. I doubt 50 people even read this blog, so I have a sneaking suspicion some of you are voting over and over again. No fair. Regardless, I have no plans to POAS. I figure if I can avoid the grocery store and drug store until Sunday I can avoid temptation, or at least delay defeat.

*Updated*

Since Rhonda asked. The peace lily is doing fine. The one flower did splendid for awhile and I snipped it off at its peak so that it wouldn't shrivel away to nothing. The plant is now back to normal, but holds a quiet new magic for me. I will now always think that there may be another glorious flower just waiting to pop up out of nowhere after a couple of years when I least expect it.

4 Days to Beta-Life at a Snail's Pace

Time is absolutely crawling. Longest week. Ever.

For some reason, I felt much more busy and productive at home on bed rest than I do at work this week. While on bed rest one hour just melted into the next and there was no schedule other than morning shots and evening suppositories. At work, everything is scheduled. The clock rules everything and it just ticks by every so slowly.

It's not that things aren't busy at work. They are. In fact I should probably be working longer hours than I am and I should probably have more of a sense of urgency around certain projects right now. But I don't. I just don't care right now.

I feel like life is moving in slow motion and that it just stops at Sunday. Sunday is either a dead end or a pot of gold at the end of the rainbow. There is nothing beyond Sunday. I can't think past Sunday. Work moves on without me. Meetings for next week get added to my calendar, deadlines approach, people discuss next week, next month, this summer, etc. But none of it exists for me right now.

This is not the best way to live your professional life. I don't think my work product is suffering for it, but I certainly am not getting through things as fast as I normally would. While it obviously bothers me enough to write about it here, it isn't bothering me nearly as much as I would have expected. I guess there's only room in my head for one obsession and nothing else.

In case you are all wondering, I have pretty much decided not to POAS. At all. I'm just to scared to do it. Of course, I reserve the right to change my mind. And I reserve the right to test at home and (shhh) not tell anyone (including all of you in blogland). Heh.

5 Days to Beta-Update

Where to start. Around 6:30pm last night, I realized the nurse hadn't returned my voicemail so I called the on-call nurse to at least ask about the Viv.elle patches. I've always had problems getting the patches off and they always leave some redness and residual adhesive behind. But lately the redness has been getting worse and started to itch. Bad. The on-call nurse told me to try topical Ben.adryl or some hydrocortisone cream and I told her I has some other questions if one of the nurses could call me back during normal business hours. She said she would send an email to my assigned nurse to call me.

I got antsy this morning and ended up sending my assigned nurse an email (I just recently got her email address when she sent me the list of acupuncturists) with all of my questions. Although she didn't reply until 4pm, she answered all of my questions and it was a much more effective way of communicating. I didn't have to worry about my cell phone ringing during a meeting or missing a phone call. Here were my questions and her answers:

1. Viv.elle patches. Is there anyway to avoid the itchy red weltiness or is there anything else I can do to make it go away faster?

This is a common complaint with these patches and as long as the red welts don't start spreading outside the outline of where the patch was, that it isn't anything to worry about and can't be avoided. Continue using the Ben.adryl or hydrocortisone cream.

2. PIO. Any tips you can give me to make these a little less painful (not the shot itself, but the soreness afterward)?

Nope. Again, a very common complaint, but not much you can do about it. (I guess I'm just being a baby on this one)

3. Does Dr. S ever recommend using progesterone in ethyl oleate (which I hear is thinner than the PIO in sesame oil and therefore easier and less painful to administer)?

I've never seen any patients use this.

4. Did our lone embryo make it back to freeze?

It made it to blast, but was poor quality that they did not think would survive a thaw so it was discarded.

5. Why doesn't the clinic do another progesterone level check in between transfer and beta like some clinics do?

We don't do it because we check the level on the day of transfer and adjust at that point if necessary. We then check with the first preg. test and adjust again if pregnant and if the level needs to be adjusted. If you want to, we can do an extra check for you this week.

Not exactly the answers I wanted to any of the questions. But at least they are answers. The Ben.adryl is helping the itch a bit. I'm debating whether or not I want them to do another progesterone check this week. It might make me feel better, but it is just another blood draw that they don't really feel is necessary (which means it isn't part of the shared risk program and I would pay out of pocket). Plus, getting to their offices during the middle of the week before going in to work is always a pain. It is hard enough to get my PIO shot in every morning and I've been getting to work later and later.

Not that I've been that productive at work this week. My mind has obviously been elsewhere and I've been a little flaky. When I got home from work today I went upstairs to change into happy pants and a sweatshirt. As I was walking back downstairs, I looked down and realized I was holding a bra in my hands. No need to bring it downstairs. Really. The hamper is upstairs, my dresser is upstairs...I must be a danger on the road these days.

I think it is sad that our lone embryo didn't make it back into the freezer, but I know we still have 14 others waiting for us to thaw. Definitely could be worse. I still cringed when I read the word "discarded."

6 Days to Beta-Torn

If you haven't noticed, the POAS poll is neck and neck (and at the moment is tied) between the yes's and no's. Funny thing is, it reflects exactly how I feel. I desperately want to POAS and see those two lines, no matter how faint the second line might be. Even if it is too early or if it really is negative, I still want to POAS just so I would KNOW (even though I know it wouldn't necessarily be accurate).

And I equally desperately want to wait until beta on Sunday. I don't want to see the stark whiteness of the strip (for the thousandth time). I don't want to lose any hope. I want to hang onto this feeling of "maybe I'm pregnant!" forever because this is the closest we've ever come (as far as I know). I'm hating the PIO shots and what gets me through them is believing it isn't all for nothing. If I were to POAS and see a negative, it could crush that belief.

So you see, I am torn. For those of you who voted, please comment and let me know your vote and why you chose to vote that way. I need to see all viewpoints of this. Even if it is just gives me something to think about for the next 6 days!

7 Days To Beta-The Lone Embryo

We have not yet received a call from the lab to let us know whether the 3rd embryo made it back to freeze. I'm expecting a call today and I will call them if I haven't heard from them by tomorrow. I know we have 14 others still on ice, so I won't be devastated if this one embryo doesn't make it to freeze. However, I feel like it might give me some clue as to what is (or isn't) happening inside my uterus right now.

Here's my thinking. If this lone embryo developed into a blast and was growing enough to make it to freeze, that means the two they transferred should be doing the same inside me. Assuming my lining was sufficient (eh, not sure about that one), they should be burrowing in nicely by now. I know that each embryo is different, but these were from the same fresh cycle, went through the same freeze process at the same time, and went through the same thaw process at the same time as the lone embryo. Might be flawed logic on my part, but that's what I'm thinking.

If however, the embryo didn't make it to blast, I will stick with the theory that they transferred the best 2 out of the 3 and that what happened with the lone embryo has no bearing on what the other 2 are doing inside me. See, nothing but positivity oozing out of my pores today. Or maybe that's the oil from the PIO shots.

I initially thought it was a good sign that the lab hasn't called yet because if the lone embryo had already arrested (stopped growing), they would have called to let me know it didn't make it to freeze. However, I think it is more likely that they would wait to even check on it until the day they would refreeze it (today?). So if it had arrested, they wouldn't even know until they went to freeze it.

This is driving me crazy.

9 Days To Beta

Three days into the 2ww (which is actually 12 days for us instead of 14) and all I can focus on is shifting from side to side to ease off my tender tush every once in awhile. For some reason, each PIO shot has gotten progressively worse. We've been warming the oil, warming the syringe while the oil is in it, heating my tush before and after and the tissue still seems to be hardening more each day. I'm not getting actual lumps, which makes me think the oil is dissipating, but for some reason I can feel the oil being injected more acutely each day. I try really hard not to make any noises while B is injecting because I don't want to make him feel bad, but sometimes it is hard. This morning he pulled the needle out slightly crooked and I let out a not so quiet little "ooof!" He said "sorry, we got a bleeder." Yeah, I felt that one coming.

Someone tell me that this gets easier over time and to stop being a baby. Or something.

I saw Ju.no with my mom yesterday. She tried to talk me out of it given the topic, but since I was prepared for the pregnancy-related theme, I was fine with it. I didn't want to miss out on the one movie lately that looked really good. And it was really good. Funny, quirky, touching with really good casting. It may have been a different experience for me if our cycle had been cancelled, if I had just gotten a BFN or if I was just in a different place. But I'm in a place of hope right now and so I could empathize with the character on the screen without connecting it to my situation at all. I'm such a grown up.

Since we were at the theater at 2pm on a Thursday, the other patrons were mostly old ladies. Sorry, senior citizens. As we were leaving the theater the common theme I heard from these women was "boy, things sure are different these days," and "I guess anything is acceptable nowadays," and "that wasn't acceptable in our day." I don't necessarily think the situation portrayed in the movie is commonplace (the parents' reaction to their teen's pregnancy and how they quickly accept the situation, the "easy" adoption, etc.). However, I think it's great we are living in a time where the topic in general is acceptable to portray in a movie in a humorous, but touching manner. I would be very curious to hear/read the reaction of our fellow adoption bloggers.

Bad Vibrations

Can someone tell the construction workers across the street to go home for the day? We live in a new construction neighborhood that is only about halfway built out and they are now building a house directly across the street from us. Seriously, how poorly are these houses made that my bed shakes every time they use some type of machinery?

I just hope the vibrations aren't shaking our embryos away from my lining! Paranoid. Who, me?

Also, please see the poll I added to the top of my sidebar and vote on whether I should POAS before the beta on February 10th.

My Perfect Appointment

Today was the day-I finally got my perfect appointment! We arrived at the clinic and only had to wait about 2 minutes before I was called back to get blood drawn. We then waited another 2 minutes before being called back into the surgery center. I changed into a gown and the acupuncturist came in. She put two needles into each ear, one in each hand (wrist), one on either side of my belly, one in each shin, one on the top of each foot, and one on the top of my head. She then turned on my ipod for me and put one of the ear buds into one of my ears. She left the room for 10 minutes while I listened to my "relaxation" playlist and B sat next to me watching a movie on our laptop. The acupuncturist came back in, twisted the needles in a bit more and left for another 15 minutes.

After the acupuncture, she sat me up in the bed to continue drinking water. A nurse came in and gave me a valium. By that time my bladder was pretty full and it was a relief when the U/S tech came in to check my bladder. Upon confirmation that it was full, I was allowed to go pee into a cup, but that was it. It was a little difficult to stop mid-stream, but I felt better afterwards. The doc came in and confirmed we wanted to transfer 2. The U/S tech then checked my bladder again and said it was still pretty full so I was allowed to go pee into 3/4 of a cup.

Then the embryologist came in and told us we had 3 good embryos to choose from. One was a 6-cell, better than perfect embryo. The other two were both 5-cell that she also referred to as "perfect." She said the 5-cell that they would transfer was what they usually refer to as "perfect," but that the 6-cell was even better and that they were excited because it is rare to see an embryo of that high quality. I was a little confused as to how anything could be better than "perfect," but I'll take it! I asked them if they would take pictures of the embryos for us and they said they would if we wanted to, but they prefer not to expose the embryos to more light than is necessary. Figured I would trust them and forgo the pictures. B got to look at our 2 embryos through the microscope and I was jealous. When I asked him what they looked like he said, "I don't know. Two blobs of circles over circles." Exactly what I was picturing.

The doc had a little trouble getting the catheter through my cervix (no surprise to me). He said it was a bit of a "winding road." I already knew that. I had a little cramping, but it was over in about 10 minutes. The doc said he was very pleased and that my lining looked fine (note he didn't say great, but he didn't say bad either). He agreed with my concern about waiting another week and was in agreement that it was best to go ahead with the transfer this week. Nothing like a little validation (and taking back a little control of your own healthcare). It felt really good. The U/S tech also noted that they didn't see any fluid in the lining anymore, which is good.

The embryologist then asked us what we wanted to do with the third embryo. She said they could discard it or that we could let it grow and refreeze it if it makes it to the blastocyst stage. We chose to refreeze if possible, so we should get a call in a few days letting us know if it made it to freeze and if it has rejoined its 14 siblings in the freezer.

They let me rest for about 15 minutes and then let me use a bedpan to empty my bladder. Not very pleasant, but necessary.

The acupuncturist came back in for round 2. She put one needle in my forehead, two in each ear, one in each hand, one in each thigh, and one in each leg. She came back in after 10 minutes to readjust and left again for another 15 minutes. I continued listening to my relaxation playlist on my ipod through one earphone. She took the needles out and then the nurse came back in and went through my instructions. Continue all meds, strict bedrest for today and tomorrow and then resume normal activity on Thursday (except no aerobic exercise, avoid climbing too many stairs, no caffeine or alcohol, limit sushi intake, and just take it easy, etc.). I have actually taken the rest of this week off of work so I can relax and focus on getting these embryos to stick.

So I am now resting comfortably in my bed. B is downstairs with the dogs and my Mom is sitting with me keeping me company. Our nurse called a couple of minutes ago to let me know the results of the blood work. My estrogen is at 926 (they want it over 300) and my progesterone is at 35.4 (they want it over 20). So everything looks great and we don't have to add any additional meds at this point. Yay!

Thanks to everyone for all the positive comments and well wishes. Let the 2ww begin!

Thaw Report (Updated)

The embryology lab called this morning. Out of the 4 embryos they thawed, 3 of them have survived. We won't know until right before the transfer tomorrow how the 3 embies are doing. Of course now I'm worried about them and if they will grow and divide properly, but at least they survived the thaw.

Please think positive growing thoughts for our 3 brave embies!

Sidenotes: The PIO shots are pain in the rear (pun intended). I'm having trouble sitting still in my chair at work today. My third electro-acupuncture appointment is scheduled for lunch time today.

*Update*

The nurse called with results from my blood draw this morning. My progesterone is at 22.4, which is good. They like to see it above 20. No changes to my meds.

A Long, Long Day (and a long post)

Yesterday was a really long day. After our appointment, we stopped on the way home to eat breakfast, pretty much in silence. Afraid to be happy about moving forward, but not sure whether to be upset anymore. In a weird limbo of confusion. I kept thinking the nurse would call back and tell us the doc had changed her mind. When we got home, B started getting ready for the wedding and I decided to skip the ceremony to get some work done. He left for the ceremony and I worked until he got home.

I went upstairs to pull together everything we would need for the first PIO (progesterone in sesame oil) shot this morning. In doing so, I realized I wasn't sure which needle to use for the actual injection. There was one set of needles (already attached to syringes) that were labeled to draw up the oil. You were then supposed to remove that needle and attach a smaller (albeit still very long, large) needle. However, the only separate needles I had didn't match the size listed on our instruction sheet (even though they were labeled to inject PIO). And the only needles I had that were the right size were attached to syringes and meant to mix other medication (from my fresh cycle).

I immediately called the nurse to ask what to do. She told me that I could take the correct size needles off the syringes to use and that when I come in on Monday they can give me new needles. Apparently if I had used the separate needles that were labeled for injecting PIO, it would have been very difficult to get the thick oil out of the needle. Problem solved. I had completely forgotten that they were going to call with the results of the blood draw from the morning until she said they had the results back. My estrogen level was at 4,000! This sounded really high to me as it is approaching the level I had during my fresh cycle and my bout with OHSS (on its way up to a peak of 10,000). The nurse said she had left a message for the RE, but that she was sure he would still let me go through with the transfer.

I don't quite understand why it was so dangerous during my fresh cycle, but they aren't worried this go round? The nurse said it would be a problem if I were taking a trigger shot (HCG) to do a retrieval, but it shouldn't be an issue for just a transfer. What I didn't think about until after we hung up the phone was that HCG is the chemical your body produces when you get pregnant (this is the chemical that pregnancy tests measure). So I still have a nagging feeling I will get a call any minute to tell me the doc wants to cancel the cycle. It will be a miracle if we make it to transfer Tuesday without any additional scares.

Now to the wedding. The wedding was quite a reunion for us. We know the groom from the firm B and I both used to work at (and where we met 9 1/2 years ago) and many of the guests were also old coworkers. It was really fun to see people we hadn't seen in years. However (as the rest of you IF bloggers will relate to), when you are in your 30's and you see people you haven't seen in years, there are inevitably major life changes that you have missed. A marriage, a divorce, a pregnancy, a birth (or 2). The theme of last nights reunion was pregnancy. B warned me on the way there of one pregnancy. He did not, however, warn me of the second one he had just seen at the ceremony. And he didn't know about the third one because they weren't at the ceremony. These were just the people we know. There were at least 3 other very obviously pregnant women at this wedding reception along with a very newborn baby.

Among the questions/comments I got from these women (those who were pregnant and those with kids at home, some women who I know and others who I had just met):

1. Do you have kids? (No.) Enjoy it while you can!

Thanks. Yes, I'm really enjoying the heartache, mood swings, anger, frustration, shots, pills, suppositories and isolation of not having kids. Love it.

2. Did you know S is pregnant again? (No.) Did you know she got divorced? (No.) Huh. Well, she got divorced and now she's pregnant with #2 with her new boyfriend. She's really happy. (Good for her.)

This gem was shared with me by an old coworker who is currently 7 months pregnant with her second (yes, we've been lapped again) while she rubbed her pregnant belly.

3. Are you drinking water? You'd better stop unless you want to get pregnant! Look at all the pregnant women here! It must be in the water, just like it was last time S and I were both pregnant at the same time. (HaHa.)

Spoken by the same woman as number 2 above.

4. Oh, wasn't that weird when S and I were both pregnant and then M got pregnant too? Oh, doesn't M work at the same office as you again now? (Yes.)

Again, spoken by the same woman as number 2 and 3 above (this was my favorite conversation of the night--note sarcasm here). Fun factoid: when M got pregnant at the same time as this woman and S, it was her second child of a second father, neither of whom she married and she no longer speaks to either of the fathers (and one of them was in prison for awhile). Not to mention that everything this woman does screams of white trash. Life is SO fair.

On a positive note, the good thing about letting all of our closer friends know about what we are going through is that no one has to ask "so when are YOU GUYS having kids?" Word has slowly spread from our circle of close friends to our broader circle of friends we don't see too often. All of these people were very respectful and didn't even ask why I was drinking water all night. That was a relief. We did have one little mix up though.

When asked by various people why I wasn't at the ceremony, B had told one person that I was at a doctor's appointment (not sure why he didn't just tell the truth and tell her I was working). Her immediate response was, "on a Saturday? Is everything okay?" This person happens to be good friends with one of the groomsman (who was B's best man in our wedding). She apparently told him about this awkward conversation with B and so P (the groomsman) got concerned and came up to B at the reception to ask him if everything was alright.

Apparently B hadn't told P about our problems, which I found a little strange because he is one of B's closest friends. But he does live in another state and we only see him about once a year and I guess the topic just never came up (P is a single, gay man and so doesn't really ask those types of questions-how refreshing!). Anyway, at the end of the night as we were saying goodbye, P was pretty hammered, gave me a hug and a kiss and then looked at my face, down at my belly and back up at my face again. I'm pretty sure I know exactly what he was thinking and I wish we could have talked. He's always given me good advice and even though he can't relate to this problem, it felt wrong not to talk to him about it. Maybe next time.

It was past midnight by the time we got home and I was exhausted. We got up early this morning to do the first PIO shot and it went off without a hitch (this is the shot that goes all the way into the muscle in the upper buttock region). I have to say, B didn't seem nervous at all and just jabbed it in my rear all matter of fact like. He removed the needle and rubbed the spot for a bit and then I laid on a heating pad for about 10 minutes. So far no lump forming, but the muscle is already sore. These are gonna be fun.

Today I'm doing a ton of laundry and trying to clean up the house a bit to get ready for my bedrest this week. That's it for now. If you've made it through this whole post, thanks for sticking around!

Still Searching for that Perfect Appointment

This morning's appointment was a rollercoaster. We waited for about 20 minutes before they called me back. The tech first did a quick check of my lining and found the thickness to be only about 5.5 (it was 6.5-7.0 on Tuesday--WTF?!). She quickly moved on to the doppler to check blood flow seeing that I was visibly upset. Blood flow turned out to be much better this time (2.02 and 2.23), so apparently the electro-acupuncture did the trick. She then went back to my lining and commented on how she could still see the triple pattern (although it wasn't as clear to me on the screen as it was on Tuesday). She spent what seemed like forever taking more measurements of my lining and they ranged from 5.5 to only 6.0. NOT GOOD.

She had me sit up and said she would have me get dressed to wait for a nurse and I immediately burst into tears. B tried to calm me down, I got dressed and they brought us into a little closet of a consult room to wait for the nurse. The nurse came in and said "let's not get upset yet." Uh, too late.

The nurse seemed confused looking at the U/S pictures, kind of stammered around a bit, and then left the room. Apparently I had stumped her. "Step right up and see the circus freak with the thinning lining! Against all odds! We couldn't accomplish this if we tried!"

She then came back and said that it didn't make sense that the lining had gotten thinner unless I had been bleeding (I haven't). She confirmed I've been taking my Es.trace (I have) and the patches (I have). She also noted that the U/S showed a small sliver of fluid in my lining and that it could just be cervical fluid backing up into the uterus. She said it usually goes away once you start progesterone. She then explained that she wanted to have another tech do another scan because U/S can be subjective and it really didn't make sense that my lining would get thinner, especially since I've had no bleeding. We were then brought back out to the lobby to wait again until the other tech was ready for us.

Back for my second wanding of the hour I went. As the other tech was looking at the screen, she said "your lining is fine and the fluid is really small. They might just want to recheck to make sure you don't have more fluid built up before they do the transfer (or the thaw)." My response to this was "my lining is FINE?!" She said it was measuring between 6.4 and 7.2. So definitely better than the first, but still not really any better than Tuesday and not up to the 8.0 they hope to see.

I was so disappointed. We did everything in our power to try to get the stupid lining to grow. The nurse came back to talk to us again and she said that the doc would likely want us to stay on the estrogen and postpone by a week. I was having none of that. This was exactly what happened last cycle. They postponed me for a week and added Es.trace and my lining only grew by a little. I've already been on Es.trace since Tuesday. Then last cycle, they postponed me for a second week and that's when the cystic cells showed up. I just keep thinking that if we wait it won't get any better and it could get worse and I REALLY don't want to go through another D&C. I explained this to the nurse and she said she would communicate my concerns to the doc later today and I should expect a phone call this afternoon. I then told her we were going to be at a wedding and I wasn't sure I'd be able to answer my phone, but I didn't want to miss the phone call. So she decided to go up to the surgery center and talk to the RE on call in between procedures.

At this point I began to understand why they are sometimes so behind and we have to wait for our appointments. It's patients like me whose bodies decide to be difficult and unpredictable that cause all sorts of problems with their schedule.

Back to the lobby we went. We waited for awhile while she waited for the doc, talked to the doc, and while the doc reviewed my chart. She then called us back in to the little closet of a consult room. She said that the doc noted that my lining only got to about 8.0 with our fresh cycle, so she was okay if we wanted to move forward with the transfer this week. And she wasn't concerned about the fluid. Big sigh of relief. I am supposed to stay on the patches, Es.trace, and baby aspirin, take my last Lu.pron shot tonight (yay!), start the PIO shots tomorrow morning (ick), the progesterone suppositories tomorrow night (gross), and start the antibiotic and the steroid tomorrow night. I should also expect a pre-transfer call from the clinic tomorrow. Not sure if they will call this afternoon with the results of my blood draw this morning to check estrogen level.

I asked the nurse if it made sense to continue with the electro-acupuncture and she said it won't hurt anything, so why not. Plus since the last 2 sessions appeared to have worked, I think I'd like to stick with it (no pun intended). So I go back into the clinic on Monday morning for a progesterone check and I'll see if I can get in for another electro-acupuncture appointment on Monday as well. I also asked the nurse about continuing with the red raspberry leaf tea and she suggested I stop drinking it. Her exact comment was "let's not do anything herbal." I got the feeling she thought I was silly for trying it in the first place. Funny how different these appointments go depending on which nurse (and apparently which U/S tech) you get that day.

Although I don't have an overwhelming good feeling about this having a shot in hell at working, at least we get to make some progress, do something new, get further than we have in the past. That in itself is a battle won. We reasoned that if we got cancelled this cycle, it still counts against one of our 3 FET attempts in the shared risk program (this would be #2 cancelled before transfer). Since we have 18 frozen embies to work with, we don't think we have anything to lose by giving this cycle a shot. Even if it doesn't work, at least we gave it a chance, right? I'm exhausted and it's only 11am.

Tea

From Whole Foods:

Loserville

I thought I had successfully avoided the baby shower at work this morning until I discovered there had been a mix up with the food and the shower was delayed. I am now sitting in my office with the door shut and the lights off while the rest of my department celebrates two doors down the hall. I feel like such a loser.

But at least I'm a loser who is sitting straight up without her legs crossed, drinking red raspberry leaf tea, trying to take deep breaths and think positive thoughts.

Wired Part Deux

2nd round of shock therapy was today. It was pretty similar to yesterday, except I didn't feel quite as much of a "weight" on my back. She let me go an extra 10 minutes today for good measure since this is the last appointment before my next doppler U/S on Saturday. Having really mixed emotions about that appointment. I want it to be over and done with, but I really don't want bad news. I will not be a pleasant person to be around if we get postponed or cancelled this cycle (not that I'm all that pleasant to be around right now anyway).

I think what's adding to my anxiety about Saturday is that we have a wedding to go to (1pm ceremony/7pm reception) and I may have a very hard time being social and happy around other people if this appointment doesn't go well. Why can't I just crawl into a hole in the ground and not come out until I have a baby in my arms?

*Edited to add* Oh, I forgot, she also sat down with me afterwards to talk about other "things" we can do to help the blood flow. The other things included avoiding caffeine (done), drinking lots of water (done), walk around, move around or get some exercise (I'm trying) and avoid sitting with my legs crossed (huh?) or being hunched over. I immediately uncrossed my legs and sat up straighter. She thinks that sitting hunched over or with your legs crossed cuts off blood supply. I guess it makes sense, I just never thought twice about sitting with my legs crossed (which I pretty much do ALL day long at work every day). Oops.*

On a more positive note, Jen got some amazing news today! Yay Jen!!!

Wired

I managed to squeeze in my first shock therapy session this afternoon. It wasn't too bad. It felt pretty similar to the e-stim I had as a kid on my back as part of physical therapy (except with the e-stim I had the controls in front of me and could turn it up or down-fun to test your limits!). The office is in the 2nd story of an old Victorian house only 5 minutes from my office. It's a comfortable and quiet office. C, my acupuncturist, had me lay face down on the table. She put 2 needles in each leg, one in the lower calf, and one in the upper calf. Then she put 2 needles on each side of my lower back. She hooked the wires up to the needles and told me to let her know when I started to feel something. One by one, she turned on the current to each needle and adjusted the strength based on my feedback. The idea is to make the current as strong as possible without causing pain or discomfort.

The sensation at first was that of a muscle twitching and as time went on it felt more like a vibration. Kind of like I was a car on idle. After all the needles were hooked up, C left me to my thoughts for 10 minutes. I tried really hard not to think. When that didn't work, I tried really hard not to think about work. That didn't really work either, so I tried to visualize the blood flowing through my body and specifically to my uterus. But the problem I have with visualization is that I can usually only do it with things I can see or feel. I've certainly never seen blood flowing to my uterus (other than on the U/S screen) and I certainly couldn't feel it. As a kid I was a gymnast and I used to visualize all my routines in my head the night before a meet to calm myself down and get to sleep. So I figured that I should visualize myself actually doing something (don't get the wrong idea here). The best thing I could think of was to visualize myself skiing through knee deep powder as that was the most fun I've had with any physical activity lately (again, don't get the wrong idea here).

So I was busy gliding down a mountain on my imaginary skies when C came back into the room. She asked how I was doing and if any of the sensations had become more faint. She said that the brain sometimes stops sensing the current after awhile, the sensation becomes fainter, and that allows us to increase the current. I did allow her to increase the current to my left leg, but that was it. The right leg still felt pretty strong and my back felt like I had a weight lying across it. The back was the only part that really bothered me after awhile and I'm actually a little sore in my lower back. Makes me wonder if I don't use those muscles enough.

C left me for another 10 minutes and then came back, unhooked me and I was done. All in all, pretty painless and maybe even a little relaxing. When I got back to work, I was sitting in a meeting and I could almost still feel the vibration going through my body. I was trying to think of the right word to describe it and what popped into my head was "wired." Funny considering I was literally wired to electricity just a few minutes before. I had one of those "ah-ha!" moments and finally realized why we use the word "wired" to describe that particular feeling. I'm sure I sound like an idiot, because of course that's what the term refers to-I just never thought of it that way.

Shock Therapy

I spoke with a nurse tonight and they do want me starting Es.trace tonight in addition to trying to get in for 1 or 2 electro-acupuncture appointments before Saturday (to be continued until and through transfer). I'll then go back in early Saturday morning for another doppler (hope the forecast on Saturday looks better than it did today). If the lining looks better on Saturday, we will stay with our original schedule. If not, they may want to keep me on the es.trace for another couple of days and push the transfer back. Sounds eerily similar to my last canceled FET where they kept "postponing" me until the bad cells showed up and I was officially cancelled. I really hope that those bad cells were there all along and that is what kept the es.trace from thickening my lining. I do have a proven history of es.trace helping from my prior medicated IUI cycles.

I also asked the nurse about red raspberry leaf tea (thanks Maria!) and she said it can't hurt as long as it doesn't have any additives in it. I'm guessing that it is the actual leaves and, therefore, wouldn't have anything added, but what do I know. So I'll be looking online to see where I can pick up some of this stuff tomorrow. Tomorrow morning I'll try to find an acupuncturist who does electro-acupuncture and try to make two appointments (for Thursday and Friday if I can get in). From what I understand, electro-acupuncture is just like regular acupuncture except they send an electric current pulsing into the needles. Sounds a little scary to me, but I guess I'll find out. Apparently studies have shown that electro-acupuncture can increase blood flow to the uterus.

On the blood flow issue, a friend of mine who just graduated from nursing school (yay, T!) and is studying for her boards did a little research and came up with the following:

"Pulsatility index is a calculation of arterial blood flow to the uterus, from what I gather it is a reflection of arterial blood pressure. (It is also calculated for other arteries like your renal artery in determining the success of a kidney transplant for example) The reason it is important is because it determines vascular resistance or in other words, it determines how well your uterus (or other organ) is being perfussed with blood. The reason it is not a straight up pressure and it is expressed in numbers like 1, 2, and 3 is because it is a calculation using blood pressure, which I can not find at the moment. Below 3 = less resistance = more perfussion, above 3= more resistance (because your artery is constricted caused by whatever causes high blood pressure, like caffeine) = less perfussion = less chance of implantation = infertility. This is what I've gathered through my research and relating it to what I know."

Please note that the above should not be construed as professional medical advice, but it helped me to better understand what the doppler measures.

Here are some interesting studies that my friend also pulled for me. I haven't read them yet, but they all look very interesting:

See first study here.

See second study here.

See third study here.