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TTC is hard, and basically sucks.

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Welcome.

Welcome to my little corner of the blogoverse, or blogosphere, or whatever it is that hip millenials call it. Welcome.

If you were looking to follow along an inspirational journey of trying to conceive, and all of the hope and wonder therein, then this is probably not the blog for you.

If, however, you were looking for something to sympathize and empathize with, for the documenting of the rollercoaster of extreme emotions and frustration and stupid things people say when you’re trying to get pregnant without success, for a journey you could actually relate to and commiserate with, well, then, this is it. Probably.

Because, ultimately, for those of us who don’t just get it on the first try, or who just happen to have a much welcomed “oops”, this journey is hard, and it sucks. It’s full of the full range of human emotions, including excitement, hope, fear, frustration, disappointment, anger, and resentment. It’s cycle after cycle of wondering, waiting, analyzing every twinge and cramp, every alleged symptom, of two week waits that feel like eternities. It’s watching every single friend and relative announce their pregnancies, share their amazing birth photos, and then announce another unexpected pregnancy they weren’t even trying for.

It’s the worst.

And it can be so, so lonely.

It can feel like you’re the only person in the world whose body just won’t work.

It can feel like you’re broken.

It can feel like you’ve been betrayed, by how easily relatives achieved pregnancy, by our entire culture that can’t even be bothered to teach basic reproduction accurately.

And no one should feel that sort of loneliness, not on this journey. I don’t want to feel that way; I assume you don’t either.

And though our partners can be and often are supportive, and are walking this journey alongside us, I don’t think it compares to how inside our heads we get, because we feel things. We experience the cramping that may or may not be gas. We experience the heaviness in our breasts that might be the same as last month when we weren’t pregnant, but of course, maybe it’s different this time? We experience the spotting on the toilet paper that could be aunt flow starting, or wait, is that implantation spotting maybe? Our partners often aren’t privy to these private moments and experiences. They can often easily go about their days without agonizing over everything happening or not happening in their bodies, not to mention their minds.

And so, I started this blog. A place mostly for me to get out all my frustrations, all my resentment, all the things I’m thinking but am too afraid to say for fear of hurting someone’s feelings, or, worse yet, hearing, for the millionth time, that I just need to relax and it will magically happen.

Feel free to come along on this journey with me. Feel free to leave your experiences in the comments.

Please DON’T try to offer advice or suggestions on treatments, improvements to our technique, or tests that need to be done. That’s not what this is about. There is a time for advice and suggestions, and there is a time to just allow people who are struggling to feel in their feelings and cry and scream and hate anyone who appears to have it easier than they do. This is the latter, and to try to explain down to them all the things they could be doing differently or instead (read: everything they’re so¬†obviously doing wrong, because hey, after several years being at this, it never occurred to them to time intercourse, or eat healthy, or go to the doctor) is incredibly invalidating. Please understand that this journey has so very little space made for it in daily life, so if this trick or that trick worked for you, great, but please don’t offer it here unless specifically requested. Being at this as long as we have been, there’s pretty much nothing I haven’t already considered, tried, or gotten started.

And maybe, hopefully, one day, this blog will allow me to document our success in achieving pregnancy. Maybe I’ll end up as one of those moms with a blog who writes about diapers and quick, easy recipes, and how to avoid scams when wanting to work from home.

But for now, let’s allow ourselves to honor the journey and all of its ups and downs, let’s allow ourselves to sink into the feelings of rage and frustration and desperation, and just be in it, together. Because some days, on days like today, trying to conceive is hard, and basically sucks.

When cancelled cycles lead to positive outcomes

Well, it’s August now, and I feel like so much has happened since my last update, even with not much actually happening in terms of our transfer.

We attempted our FET again at the beginning of this cycle, but my TSH came back even lower — less than .01, barely detectable, right where it was when we started this adventure with my thyroid two and a half years ago. When I got the call from CNY that we couldn’t move forward with the transfer again, I wasn’t even disappointed — I was pissed. I told the nurse that my endocrinologist was useless, and that I was making the call as soon as I got off the phone with her to get in with the new endocrinologist, because I was so over my current one.

I made the calls, got the referral from my PCP, and last week I was able to get in on a last minute cancellation (and it was truly meant to be, because I would otherwise have had to wait until October to get in).

Let me tell you, when you go from being gaslit, dismissed, ignored, and blown off by any members of your medical team, to have someone empathize with you, show compassion, listen to your concerns, and validate you, it’s a breath of fresh air. I had to hold back tears right there in Dr. Field’s office, because I was so relieved to finally be heard and seen in my pain and frustration. And he confirmed for me what I’d finally begun to suspect: that Dr. Abdul was just keeping me sick, and the treatment plan he had me on was not ever going to work.

As Dr. Field explained it, toxic nodules, like Henrietta (what I named mine) really do function autonomously, and without really following a pattern. They can fall back on their own, and they can flare up on their own, without rhyme or reason and without warning. To try to control a toxic nodule on medication alone might work … eventually, but it’s not likely to keep it suppressed for any length of time.

Which would explain why my symptoms continue to return again and again, and why, even on medication, my TSH drops every few months.

He explained that surgery to remove my nodule (and that half of my thyroid with it) would cure me. No more antithyroid medication, no more heart palpitations, and quite possibly, no more infertility. Whenever Dr. Abdul had mentioned surgery to me, he never mentioned it was a cure, and he always tried to steer me away from it as an option. He never fully explained the impacts of surgery versus no surgery, just “it’s not a guarantee, and we probably don’t want to do that,” without giving me the opportunity to fully assess the option for myself.

Now to hear that it really would cure my hyperthyroidism??

Dr. Field also mentioned that many of his patients who have had trouble conceiving with a toxid nodule have gone on to get pregnant naturally once it was removed. That really gave me a lot to process. Hope that surgery will get us our baby, finally. Anger and frustration at the years of heartache and loss, and the tens of thousands of dollars on fertility treatments and interventions. Resentment and anger towards Dr. Abdul who seems to think my desire for a child is frivolous and funny, and that my need to be in better health is just a neat little detail he can ignore.

Obviously we won’t know until we know, but if this stupid freakin’ nodule is the only thing that’s been standing in our way, and he’s just let it sit there? I fully intend to bring a law suit against him. Really. He has cost me years of my life, my potential child/children, tens of thousands of dollars in fertility treatments, therapy — and for what? The billings? Completely unethical, bordering on willfully negligent.

Dr. Field did say that there is a possibility of being hypothyroid after the surgery, temporarily or permanently, because of how long the left side of my thyroid hasn’t had to function because of the nodule (which has been doing all the heavy lifting for years now). Another thing that could have been prevented if Dr. Abdul had referred me for surgery two years ago. The good thing is that hypothyroid is apparently far more easily managed, and far less detrimental for fertility.

So I’m going with surgery. I’m just waiting for the ENT surgeon to call and schedule our consult appointment, and hopefully I can get in by October, and as long as my numbers look good after surgery, we’re good to pursue our transfer right away.

When I left Dr. Field’s office, he sent me off with an increase in my methimazole and a new prescription for my heart palpitations (propanolol, which I’d been asking Dr. Abdul to prescribe me since the beginning), and wouldn’t you know, the first day of taking the new medication my heart didn’t feel like it was trying to burst out of my chest.

I’m disappointed in myself for taking so long to advocate for myself, but I’m glad I finally did it. It needed to be done, and I think I’m finally on the right path for getting my thyroid taken care of. And who knows, maybe 2021 can start off with a BFP.

Betrayed by my body … again

I feel like my body is never working in my favor. I know our bodies hold a lot of wisdom, and they do the best they can, but sometimes I really feel like my body is just doing the bare minimum and calling it a day.

I spoke with my nurse at CNY about my upsettingly low TSH, and she agreed with me that it wouldn’t be wise to continue on with our transfer, so our FET is cancelled until further notice. She also apologized profusely for the fact that no one addressed it with me until today, after I had brought it up, and she was already in the process of escalating the issue up to prevent it from happening again. I really appreciated her accountability.

She also forwarded my TSH results to my endoc (the second time they’ll be receiving these results in two weeks, so they better get them and actually go over them with me). Once I hear from them what the plan is, I’m getting a new endocrinologist. The fact that I have been euthryoid for only about three months in the past 2 years isn’t right, and the fact that he keeps just adjusting my meds, when he’s already seen that it doesn’t help anything, is also not right. So this week I’m advocating for myself and getting a second opinion and a new doctor.

And in the meantime, I also need to make an appointment with my gynecologist to get my Vicodin refilled, since I know I’m not getting pregnant this month, and I only have one left, and that will not get me through my pain on CD1.

And so now I just feel sad. I’m glad my cycle was cancelled — I would have pushed for it myself if CNY hadn’t. But I’m still disappointed that it was a necessity at all, and I’m just so frustrated and sad and feeling hopeless and betrayed by my body. I wanted so badly to be pregnant at the beach this year. I wanted to be able to announce my pregnancy when visiting my mom and sister and brother for the first time in years. I wanted to be round and waddly at our yearly Renn Faire trip. I wanted to have a fun pregnancy related Halloween costume.

I don’t get to have any of that this year, and knowing how long it takes my thyroid to stabilize, I’m really scared we won’t get to even transfer until the end of this year.

I just … I just feel sad. One step forward and two steps back. Each setback feels like it’ll never happen.

Updates from IVF land

Well, it would appear that our journey continues. IVF was never a guarantee. We knew that going in, but the statistics were so enticing that for a good several days there I dared to have hope, and I even tried connecting with our little embryo. But on June 1 we learned that our first transfer was not meant to be; my beta was negative.

We rolled right into an FET cycle. We had the momentum going from the first transfer, and I’m desperate. But I can already tell that if this frozen transfer doesn’t take, I’m going to need a break.

I’m already feeling like this cycle has failed. My TSH came back this past Monday at 0.05, and no one seems to be worried about this but me. I was able to get CNY to send those results to my endocrinologist, but when I got an email back from him, he only referenced my results from last month, which were still within range. I had wanted to call CNY to discuss my concerns, but I’ve been so busy with work this week that I literally haven’t had a free moment to call them. Monday will be the soonest I have any free time to reach out. I think in the meantime I’ll message them through my patient portal and hope they get back to me before Monday, when I’m scheduled for my next monitoring appointment. I just don’t want to keep wasting meds if we’re not going to transfer this cycle, and I don’t want to transfer our best embryo if my body won’t be safe for a pregnancy.

Sometimes I just wish that I didn’t have to always advocate for myself and that for once, my medical team had my back. As great as CNY has been (and I mean, immensely better than Shady Grove), I still feel like I have to push to get my concerns addressed.

I’ve been feeling really sorry for myself lately. I just want so badly to have a baby. I keep looking at my husband and knowing what a great father he’ll make, and I just want to give that to him. So many of my clients at work are pregnant and I’m so jealous. My friends are pregnant and I’m jealous of them too. I’m even beginning to feel bitter towards others in the infertility community who get their BFPs, especially if we’re cycle buddies. It’s just not fair, and I can’t stop the anxious thoughts of “well, someone has to be that person that it never works for.”

I haven’t been able to have a therapy session in over a month, and I know that’s having an impact too. I really just feel so hopeless. I thought for sure IVF was going to be it, but now, even with 6 embryos in the freezer, I feel like my body will just continue to reject them. I know I shouldn’t give up after a single failed cycle, but I follow so many people who got their BFP on the first transfer, I figured that if it was gonna work, it would have worked then. I wanted it to be me.

But I’m still waiting, wondering when it’ll finally be my turn. If it’ll ever be my turn.

A different day 3 waiting

At the beginning of any treatment cycle, you have to do what’s called day 3 testing, which is essentially your baseline hormone levels, follicle counts, and endometrial lining check. But when you’ve recently done an egg retrieval for IVF, day 3 has a whole new meaning. It means we’re waiting to hear back from the clinic how many of our embryos have made it to day 3.

Saturday was our egg retrieval and it went so amazingly well I cried with joy when I woke up from the anesthesia (also, can I just say that that anesthesia was like, the best nap of my life? I need to find out where I can get that stuff OTC for the nights when my anxiety won’t let me sleep lol). The first thing I asked was “how many eggs did we get?”

EIGHTEEN!!

I had been so anxious and nervous up to that point, between the medications and the scans, and the whole drive up to New York I kept getting paranoid that I hadn’t done my Cetrotide right (why? I have no idea! I did it right!) or that I’d somehow done too much of my trigger shots, and that I had already ovulated all my eggs and they were gonna get in there to find empty follicles. But no, all my eggs stayed right where they were supposed to, and when they went in they collected 18 of them.

Twelve were mature and inseminated, and as of Sunday morning, we had 10 embryos (and the other two they were watching because they couldn’t quite tell if they had fertilized or not)! I cried more happy tears. It was such a relief to have such a high number, especially since the attrition rate is between 20-30% for each stage (20-30% of eggs collected will be mature and fertilize, 20-30% of those embryos make it to blastocyst (which is around day 5-6), and then the attrition jumps to about 40% with what can be transferred). So for right now, the odds are definitely in our favor. And the best part is that we’ve been cleared for a fresh day 5 transfer on Thursday morning (which must mean that our embryos were/are really good quality, because generally the lower the quality, to sooner they transfer)!!

Emotionally, it’s been a weird couple of days. After getting our fertilization report on Sunday I had expected to feel more than just relief, but I think my emotions were so high the day before from the retrieval that my stores were just a bit low. Plus, it all just feels so surreal. I love every single one of those embryos already, but I know not all of them will make it, and it’s so hard to feel like this is real. I don’t know. It’s hard to explain. Physically I feel fine after the retrieval. The day of and after I was pretty achey in the ovaries region (understandably so, considering they had stabbed me in the ovaries with a huge needle 18 times). My boobs hurt from the hormones I’m on to prep my body for transfer (estrogen and progesterone suppositories, and then a progesterone in oil butt injection, which is surprisingly not as bad as you’d imagine). Otherwise it’s just business as usual.

I keep Googling, though I don’t know what I’m expecting to find, or what I think I can do. My part is done until Thursday. I keep looking up pictures of embryonic development for each day, imagining what our embryos must look like. I wish I could see them (we’ll get pictures Thursday when we go for the transfer). It’s also really weird to think that in a couple of days, one of those embryos will be inside me. I will literally be carrying a potential baby. It’s really hard to wrap my head around after all these years. It will be the closest to pregnant that I’ve ever been. I will be PUPO (pregnant until proven otherwise). And then we’ll have to wait until June 1 for the beta HCG (blood test) to see if our little embryo decided to stick around for the long haul.

I’m still pretty firmly planted in the hope zone, but there are still lots of doubts that keep trying to clamor into my headspace. Doubts because I read a story of a person who got 37 eggs collected and only 1 of all of their embryos was genetically normal (they had had their embryos biopsied and frozen before transfer, which we have decided not to do — the only ones we’re freezing are the ones we aren’t transferring on Thursday, but we’re still not having them tested). Doubts because I know that 1 in every 4 pregnancies ends in miscarriage. Doubts because I know that statistically, the first transfer doesn’t always stick. Doubts because I want this so badly and we’re SO close and it could all fall away at any time. We could even get the day 3 call today and be told that none of our embryos have made it. That would be devastating.

But I’ve been holding to my faith, my hope, and have been gratefully receiving all the prayers and good vibes and positive thoughts and hopeful intentions of all of our supporters and loved ones. I really do feel optimistic still. I really do feel like this is it, in spite of the doubts and the worries. It’s just hard because so much of it is still out of our hands, and we just have to hope and pray that nature and the Universe work in our favor.

I feel like we’ve had a lot of good signs up to this point, especially in the woowoo way. We collected 18 eggs, which I was told by a friend is a Jewish lucky number. Eighteen is also The Moon in tarot, which is about faith and trust and holding strong in the face of doubts and fears and darkness; it’s also a traditionally associated “feminine” card, linked with fertility. It also happens to be one of my favorite cards in tarot anyway. Eighteen also reduces down to 9 in numerology, which happens to be the number for the month of May, and represents coming to the turning point where everything changes. It means “almost.” It means something new and exciting is about to begin and woo, boy, you better hold on. Nine is The Hermit in tarot, associated with communing with the Divine, associated with lifelong wisdom and faith and knowing that it’s all gonna be okay, that the Universe has a plan, that everything works out the way it’s meant to (even if it freakin’ hurts, man, and I’m not ready to accept that there is even a possibility this won’t work).

It all literally feels like it’s in the cards for me, for us. We just have to endure the waiting. And we’ve waited three and a half years almost, so what’s a couple more days for transfer? What’s another week and a half for the beta?

We’ll just keep taking it one day at a time.

IVF Updates

I have no cute or clever title for this post, except for what it is: updates!

We are almost at the end of our IVF cycle. I’ve been on stims for 7 days, and a medication called Cetrotide for 4 or 5 days, to prevent me from ovulating before they can go in and retrieve all the eggs I’ve been growing.

It has been an emotional rollercoaster for sure, but not in the way you’d expect (or at least not in the way I expected). Physically and emotionally, regarding the injections and hormones themselves, I’ve actually felt pretty good. I expected far more mood swings, irritability, weepiness, even a skin breakout or two, but I’ve actually felt relatively calm and stable, and my skin has been so clear! My ovaries feel a bit tender, but that’s because there are close to 30 developing follicles between the two of them (with 13 mature follicles as of yesterday morning!). Normally, you only have 1, maybe 2 in rare occurrences.

No, the emotional rollercoaster came from my own anxiety, which really reared its ugly head at the start of stims. See, to save money on medications, we ordered my most expensive ones from overseas (this saved us about $2500, so for anyone reading this who may be preparing for IVF, I highly recommend IVFmeds.com — just allow about 2-3 weeks for delivery). This meant we got the European packaging of the medications (my Cetrotide was all in Polish, my Gonal-F was all in Greek, but the pharmacy sent the instructions in English as well, and plus there’s tons of online resources and videos). The bacteriostatic water that came with my Menopur came in glass ampules instead of vials, which requires a special filter needle to draw the water up and prevent any small glass shards getting into the mix and injected into you. I didn’t have filter needles, and had forgotten about them until about 3 days before my period was due to start (I think I mentioned this in a previous post). I was able to buy some from someone in one of my infertility groups, because she had a bunch left over. Then, once we started stims, I started freaking out about my Gonal-F, since mine was in the preloaded injector pen and not the vials. The first night, I didn’t give myself the full dose because I didn’t realize I had to press the plunger all the way down, so I had to shoot myself again to finish the dose. The second night, I also didn’t give myself the full dose at first, because the preloaded pens only came with a dose and a half in them (450ius, and my dosage was 300ius). But after I realized this, stuck myself a second time with the Gonal-F, and finished my full dose, I began to panic. The instructions I had from my nurse were for the vials, but there was something about the vials saying 600ius, but there actually being only 300ius, and I was trying to translate that to my pens (was there really less than 450ius in the pen? Had I been underdosing myself??). I freaked out for about an hour, trying to make sense of the patient portal instructions, the instructions that came from the pharmacy, and whatever information I could find online. Finally I just called the 24 hour nurse, who was immensely sweet and helpful and set me straight. I was mostly good from that point on.

Then we got into this week and I began to panic again. What if I didn’t have enough medication to get me through my protocol? I had enough Gonal-F to get me through to last night, and if we did egg retrieval Monday, I’d need two more pens worth. Why hadn’t I ordered the right amount? How had I gotten it so wrong? I spent hours in the midst of a panic attack, anxiously trying to solve this problem (because fertility drugs can’t usually just be picked up from your local CVS, and you all may remember my last adventure trying to get my trigger shot the day I needed it and having to drive all over Northern Virginia to find it because Shady Grove never ordered it for me). Once I remembered that debacle myself, and reminded myself that I am immensely resourceful, and that I haven’t ever NOT figured it out, I realized CNY’s pharmacy could overnight me any additional meds I needed (it would be expensive, but at this point, what’s an extra couple hundred dollars?), and if not, I knew where that pharmacy in Northern Virginia was and I could pick it up from there. Turns out, I had the right amount of everything anyway. Crisis averted.

I also had mini panics about my AFC (antral follicle count), which is the number of undeveloped follicles you start with before your stims. For someone of my age, they like to see 7-10 of a certain size. I had 3. So for several days I moped around, feeling sorry for myself and my sad ovaries, and lamented that we’d have very few eggs to collect and make embryos with. It was really hard to be excited when I saw all these other people starting with 10, and collecting 30 eggs and having lots of embryos to transfer. But I made my way towards peace with it. Even if we ended up with only 1 embryo, that embryo could still be our baby; it could still be enough.

Fast forward to Monday’s monitoring scan where I had 17!! developing follicles, and 4 that were close to mature (still lower than what I’d like, but I knew those 17 could really turn into something, and they did). Two days later, Wednesday, yesterday, I had 24 total follicles developing and 13 that were mature (which is the sweet spot truly — once you get more than 20 or so, you start to sacrifice quality). And CNY called with instructions to begin triggering tonight!

So here we are. I took my last dose of Cetrotide this morning (which is the only medication that’s caused me any sort of real discomfort — it leaves a huge, red, itchy welt, but I learned that an ice pack really helps diminish that; the Menopur apparently was supposed to burn, but I felt no burning at all). Tonight we do our first trigger shot (a combination of HCG and Lupron, and the nurse said I can mix them into a single syringe so I only have to stick myself once tonight, which is good — my skin is really tender at my injection sites now, even with alternating sides each night, and the inflammation has been causing a bit of blood afterwards. That’s at exactly 10:30 tonight. Tomorrow morning, I repeat the trigger shot at exactly 10:30am with just the Lupron. That’ll be my last shot before egg retrieval, which is Saturday morning at 9:30am in Syracuse! We’ll be making the 5 hour trek up after I get off work tomorrow. Sunday we’ll know how many of my eggs fertilized and how many embryos we have developing.

In 3 days we’ll have embryos, little bubble babies just waiting to be transferred. If my body does okay with the retrieval, we plan to do a fresh transfer, which will happen either Wednesday or Friday, depending on how the embryos develop. If not, we’ll do a frozen transfer, probably next month (to give my body a chance to come down from all the hormones).

It feels surreal to be at this point. I never thought we’d be here, both in the sense that I never thought we’d need to go through this to grow our family, and in the sense that it seemed like we’d never be able to reach this step to grow our family. But we’re here, we made it, and so far everything has been going right. I have a ton of doubt that I’ve shoved into the back of my brain, because I don’t want to listen to the voices reminding me that plenty of people get to this point and have nothing, no embryos, nothing to transfer, or their transfers don’t stick. This hope feels so good — I feel like I’m floating. Right now, in this moment, our chances of bringing home a baby are 50-60%. That 50-60% is where I want to live for as long as I can.

I’ll have more updates after the egg retrieval (probably Sunday, since I’ll likely be sleeping my anesthesia off all day Saturday after the retrieval). For today, which happens to be a day off from work for me, I’m going to bask in all this hope.

Drop it like it’s … cool?

My temperature has been steadily dropping the past few days and I have never before wanted my period to start as badly as I do now. I keep waking up every morning, hoping for that temp drop below my coverline to signal that my period is just hours away. I honestly can’t remember the last time I had my fingers crossed in the hopes that my temperature would keep getting lower.

CNY is open for new IVF cycles, so we have the green light to start IVF. Finally!!! Tomorrow or Monday will be CD1, which means tomorrow or Monday I’ll be calling to set up my day 3 testing and next week I get to start stimming for egg retrieval. I’m so freakin’ excited and so nervous. I have so much hope and optimism in my heart that this is going to work. I feel like I just know I’ll be pregnant by the end of this month. I can feel it, see it, like it’s actually happening. I hope this is my intuition. I feel it far more strongly than I did for our IUI cycles. I’m trying so hard not to get caught up on the “well, some people don’t even get embryos to transfer.” I don’t know what I would do if we went through all of this to come out with literally nothing but a pile of debt. But I don’t want to think about that. I only want to think of the people I know whose IVF worked, who have beautiful babies because of this miracle of science. My babies are finally making their way out of my imagination, out of the ether of my hope and longing, and coming into the physical world.

I’m having stress dreams about it all already too. I dreamed last night that I woke up on the first day of stims, and was mixing my Menopur (I don’t even know if Menopur is one of the stimming meds — I think it is, because I have 10 days’ worth of it), which, prepping all the supplies for that was a bit of a stress last week (I realized at the last second that I needed filter needles, since my Menopur came in glass ampules — the filter needles are a special needle that you can twist onto the end of your syringe to filter out any glass that might get into your medications from the glass ampules, so that when you inject the medication, you don’t inject yourself with glass too), and in my dream, I accidentally touched the needle tip to the counter when I was opening it from its blister pack, and that somehow contaminated the bacteriostatic water (which, literally, bacteriostatic water is designed to be resistant to contamination), and it turned my Menopur yellow. And then I somehow used it anyway, and then I realized that all the clocks in our house were wrong and I had just given myself the medication at the wrong time (because many of the medications I’ll be on have a strict administration schedule to maintain the proper level of hormones for ovarian stimulation and ovulation suppression), so everything was screwed up. And then we were at CNY and talking to Dr. Kiltz (the founder of the clinic, and also my primary RE through CNY), and he was just shrugging like “welp, don’t know what to tell ya.” And then I received a package of more filter needles in the mail from them for free, and I was like “aw man, I didn’t know they were going to send me free filter needles, I could have saved the $6 I just spent to buy them.” And then I was stressed for the rest of my dream.

It reminds me a lot of the stress dreams I had right before we got married, where everything went wrong, and none of it made sense. I know it’s going to be fine. I know I’m organized enough not to screw this up (you should have seen me when the only two medications I had to manage for our IUI cycles were Clomid and progesterone). I’m just nervous and excited. I want this so badly. I can’t believe we’re literally finally here, a few days away from starting IVF.

So I’m going to spend the day working on my novel, and looking for that temperature to drop even further tomorrow morning. I’m going to allow myself to keep getting lost in the hopeful fantasy where we get our baby. I’m so ready for it. I’m so ready for it!!

Infertility in the time of COVID-19

So the world is pretty different from how we all expected it to be right now, and our plans for having a baby are too. For six months I counted down the cycles, and when my period started in March, I breathed a sigh of relief that it would be the last one before we could begin IVF. We did our comparison shopping with three different pharmacies to make sure we saved at least some money on all the medications, and we placed our orders.

And then the reports started rumbling through the social media space about COVID-19, how it was destroying China, and the anxiety began to rise a little, alongside sadness for all those Chinese who were getting so sick and not surviving.

And then we began to hear about it jumping to other continents, other countries — Europe, North America — and when it finally made it to the States, with typical American hubris we all thought, “eh, we’ll be fine — this’ll be just like swine flu and most people won’t be affected.”

And then we started to hear about businesses shutting down, about the virus claiming the health of people state by state by state. We’re in West Virginia and we were the last state to get it, and as the numbers grew in the states around us, so did our collective anxiety, and my personal anxiety. And still, the thing foremost on my mind (perhaps selfishly, but of course I was worried for the health and lives of others) was how this might affect our plans for IVF. I checked the CNY website and Facebook groups daily, usually multiple times a day, for any news, and they all kept saying the same thing. “We’re open, we’re not planning to shut down or cancel cycles, just keep doing what you’re doing.” So I was hopeful that we’d still be able to start on time, and focused my anxiety instead on the fact that it was taking forever for my meds to arrive from Europe. I ignored the people in my social media spaces who kept asking “why would you want to try to get pregnant right now anyway? Do you really think it’s worth the risk?” We had waited 3 years to get to this point. For me, it was worth the risk. If that gives you any indication of the desperation that goes into infertility, yes, I was and am willing to risk my health and potentially my life for this dream (and I technically am in the best case scenario when there isn’t a highly contagious deadly virus taking over the world).

And then my job sent us all home to work remotely as much as we could (we’re all essential employees, and working with victims and survivors of domestic violence, sexual assault, trafficking, stalking, and teen relationship violence does require some in person contact, especially for our shelter staff, which we all temporarily are on a rotating basis).

Still, I watched the CNY website and Facebook groups, I followed the Instagram posts, I began to follow the ASRM (American Society for Reproductive Medicine) online, since they’re the entity that makes the recommendations that all the clinics in the US follow. We were still open for business, we were still going to be able to push forward.

And on Instagram I began to see that fellow infertility warriors’ clinics were closing down, all over the world, their cycles were getting cancelled midway through stims, their transfers were getting postponed indefinitely. And I hoped and hoped and hoped it wouldn’t happen to us.

Then, March 17, the ASRM recommended a temporary moratorium on all new cycles, leaving it up to the clinics to finish out the ones they were already in the midst of. They would reassess on March 30.

So I was in the middle of my personal TWW, as well as the TWW for the ASRM to tell us what to expect for starting IVF.

March 30 came, and their position still held: No new cycles.

And with states closing their borders, there would be no way for CNY to help us anyway.

So the IVF we waited 6 months for, the highest chance for a biological baby that I’d get to carry myself that I have waited over 3 years for, is just … frozen. Stuck. My Menopur, the last of my meds, arrived the same day the ASRM gave their recommendation. And I have no idea when I’ll get to use it. Some of the medications expire in November this year.

I’m writing this through a bit of a Vicodin haze as my period started yesterday (today I should be calling CNY to schedule my day 3 labs and instead, I’m writing a post about how I have no idea when we’ll get to start IVF), and I’ve had a few days to process this information, so the frustration and the hurt isn’t as acute, but it’s still there. It’s still there as I read through all the COVID-19 memes about “people without kids, what is it like to be quarantined right now? Is it full of naps and awesomeness?” My feeling, of course, is no, it’s not full of naps and awesomeness; it’s full of hurt and loneliness and questions. Or the memes about all the quarantine babies that’ll be born this winter. That won’t be the case for us.

The part of all of this that chagrins me the most is that it’s nature, once again, taking all control for having a baby from me. We got so close to being able to make this happen (even though of course there are still no guarantees with IVF), and then, nope, here’s a virus to wipe out half a million people or more, and your government is instituting martial law because people don’t have the sense to stay in their damn homes.

And we go back to how infertility is nothing but a waiting game. Forever and ever and ever and ever.

The last natural cycle

Well, here we are. CD2 of the last cycle before IVF. I have a lot of feelings about being here, but most of them are positive, I think. I’m hopeful, excited, optimistic. Even in the midst of the $2500 medication bill, and the $3900 IVF bill. Of course I want to make this baby on our own, without having to pay through the nose for them, but knowing what comes next, knowing there’s a next step in place, makes this a lot less scary. I’m okay with either outcome — baby or no baby — at the end of this cycle.

It only sucks that we have to order all the medications now in order to have them here in time for next cycle. It would be nice if we could wait until the last minute, until we knew for sure we wouldn’t be pregnant at the end of this month. But since it could take several weeks to process, we need to get it moving now.

I do have some nervousness about all the shots, especially the Lovenox since I know for a fact that that one burns. Mostly I’m okay with it though. I’ve done two subq injections myself now with the previous two IUIs, so I know I can do those with no issue. Even the IM injections don’t scare me too much. I had my flu shot this year, and also a hep A vaccine a couple months ago for work, and both of those are IM injections, and neither of those hurt nearly as much as I would have expected them to. So as long as I don’t look at the needle and just make the husband shoot me in the butt, I think I’ll be okay.

I keep thinking about how in just over a month we could have frosty little embabies ready to implant. I keep thinking about how it’ll be the first time I can say I have babies. We have babies. It feels good. It feels exciting. This truly is the most hopeful and optimistic I’ve felt about all of this in years.

So yeah. That’s where we’re at. The last cycle. Maybe this is the sort of magical “relaxation” I need to get pregnant on our own. We’ll see. We’ll see.

Scheduling stress

So, true to my nature, I’ve begun all the last minute prep with IVF still a month and a half away (if it happens at all — still holding out some small hope that we won’t need to but it’s a very small hope, and I’m just ready to move on to the next thing). And, true to the nature of infertility, it is stressful.

Thankfully my nurse at CNY is kind and helpful (and not rude and useless like my nurse at Shady Grove), and got back to me first thing today after I had sent a message through my patient portal on Friday. I have the checklist of everything we need to complete before CD1 in April, and lab orders for a redo of my preconception bloodwork (has to be done every year) and my SHG (which is similar but different from the HSG).

I’ve been calling and emailing around to try to coordinate the remote monitoring. Thankfully the bloodwork part is easy. There’s a lab right by my house and my work that takes walk ins pretty quickly and easily, and I already know I like the phlebotomist. The follicle monitoring and the figuring out where to get the SHG done has been harder. There’s a place in Winchester (out of state, as per usual) that will do the follicle monitoring, but they can’t do the SHG, and the radiology department of the local hospital doesn’t even know what one is, so they referred me back to the terrible obgyn office where the doctor gaslighted me and told me my endometriosis and fibroid pain were just IBS. I left a message with the nurse line and I’m hoping they’ll 1. know what I’m talking about and 2. call me back to say that can do it. I have no idea what I’ll do if they can’t do it, because there aren’t any other options in this area. Apparently no one in the four state area does this procedure (I know that’s not true, but that’s what it’s beginning to feel like). Maybe the travel team at CNY will have some recommendations for me.

I’ll probably go and get my bloodwork done Thursday since I’m off early.

I’m also waiting to hear back from the genetic counselor I went to see last week about the possibility of having a mutated BRCA gene. It’ll probably come back negative (per the counselor), but she did think that my ancestry, as well as my family history of pancreatic cancer (apparently also linked with the BRCA genes) warranted a peek at my genes just to see. Most of the research I’ve read doesn’t seem to show any increased risk or development of ovarian or breast cancer from IVF stimulation, but I think the research is still relatively new, so who knows. Mostly I’d just like to know if my timeline for biological children has been shortened due to a risk of ovarian cancer. If it’s likely I’ll develop some sort of ovarian cancer by a certain age (I think I read somewhere that with a mutated BRCA gene, there’s a 50% chance of developing ovarian cancer by 40 or 50 or something — I don’t know, I’ll have to check again) then I’d like to know so I can decide what to do about my eggs.

I’m sure it’ll all be fine. All of my health concerns have turned out fine to this point. It’s just the waiting and the not knowing and not having all the information so I can plan that’s annoying and stressful.

So anyway, I guess I’ll hope for the best while waiting on all my callbacks.

Down the rabbit hole

Period started yesterday, about an hour into the full moon, so that’s cool I guess. That makes this the start of cycle five of six before moving on to IVF. I’m actually more excited than disappointed. I mean, I spent the entire day yesterday feeling dizzy and nauseous thanks to my Vicodin (it’s not fair to feel both drunk AND hungover for 12 hours straight) and binge watching all of season 6 of Parks and Rec, but IVF will get us real babies (hopefully). All of my hope is on IVF right now.

I’ve also been continuing my research of how to naturally balance my hormones and keep running into the frustrating and contradicting information about phytoestrogens. It’s super annoying to have health conditions whose treatments exacerbate your other health conditions.

Endometriosis and fibroids (as well as PMS and breast tenderness after ovulation) all point to estrogen dominance. For a while, the common knowledge was that you would avoid xenoestrogens, especially in food, to keep from having all this extra free floating estrogen in your body. But the newest research shows that eating phytoestrogens (estrogens in plants) acts basically the same way moisturizing your face does when you have oily skin: by giving your body estrogen, it tells your hormones to chill tf out with overproducing its own, and thereby balance things out.

But when you have a blood clotting disorder like Factor V Leiden (like I do), you continue to increase your risk of clotting by adding estrogen to your body (as happens during fertility treatments and pregnancy). But if phytoestrogens will chill my body out with excess estrogen, wouldn’t that help? But my hematologist seemed on board with me avoiding phytoestrogens that one whole time I saw them.

So it’s been a back and forth of what should I do. Should I literally risk my life by drinking soymilk and eating yams? Or is it risking my life not to? Also, why don’t people research this more (answer: because estrogen is a women’s problem and we’d rather spend more money on researching penis pills).

But I figure I’m already putting myself at risk by pursuing pregnancy anyway. I’m seriously considering trying the phytoestrogen route — swapping my almond milk for soymilk, eating more edamame, and going back to soy sauce on my sushi.

Which is gonna be hella weird, because I’ve spent almost an entire year avoiding soy as much as I can. I’m gonna have to get into a new brain space.

I’m hoping I’ll see some positive changes — less acne, less pain, maybe improved fertility? Who knows. I’m also considering going back on aspirin while I do it just to be safe. I mean, if I’m starting IVF in two months, I’m probably going to be on bloodthinners anyway. Guess it’s time to finally establish care with a local hematologist (for real this time — nothing ever happened of that last call I made where the two hematologists were supposed to communicate with each other).

Also, I have a meeting with a genetic counselor next week to discuss testing for mutated BRCA genes and the possibility of getting screened for other Ashkenazi related genetic disorders.

And also also, with IVF looming, I need to get my ducks in row for our remote monitoring.

A lot to do. I’ll probably be posting a lot more as we ramp up to our next phases of treatment. I’m really hoping I’ll have some exciting news to share in a couple of months. Who knows, I could finally, finally be pregnant at the end of April/beginning of May. I could get to go to my sister’s graduation with a 8-10 week baby bump (probably won’t be a bump — just my carb baby lol).

So I’m holding on to that, and if it happens sooner on our own, so much the better! But that I don’t really have much hope of. But at least I have hope for something.