Subterfuge

First of all, thank you to everyone that commented and reassured me that the spotting was (is) probably nothing. Although the spotting has continued (every.freaking.day), today is my last day of the birth control pills, so I am ready to gleefully usher in my full-on period. Of course, my body being the perverse being that she is, I fully expect to get no AF now that I am ready for it.

-------------------------------------------------

This week, I am taking my last vacation of the summer. Actually, it is quite a hectic week. For the first half, we will be traveling with my dad and step-mom. Then, we will spend the weekend with my in-laws who will be watching our dog and who have a big Labor Day party every year. When we first planned this outing, my only thoughts were of fun, relaxation, and fitting everything in while still setting up my classroom. I completely forgot that I would not just be traveling with D, but also my meds.

Right now I am just on the Lupron, but it needs to be refrigerated.  The problem is neither my dad, nor D's family, knows that we are heading into IVF (or even that we are trying). Personally, I don't really want to tell either set. I think both would be thrilled for us - I am not worried about judgement or anything like that. It's just - how many people need to know?* If we were still doing it "naturally" I would certainly not say, "hey - I am ovulating this week. Mind if D and I excuse ourselves and get busy on the guest bed?"  Plus, there is something nice about having SOME people in this world who will hear about this child as complete surprise.  For D's parents, this is is the first grandchild. Throughout this whole process, telling them we are expecting is one of the biggest things I have been looking forward to; telling them that we are trying dims that a little for me. And of course,there's my fear that the IVF will not work and by telling less people, at least I've staved off some pity.

Therefore, I have been wracking my brain for ways to hide my meds. I've considered in a putting it in some kind of food container (like a tofu box - both sets of parents would steer clear like it was a nuclear warhead), but of course my fear is someone will accidentally throw it out. I could say it is a medication for something else, but my step-mom is a medical secretary, so I feel like I would be on pretty thin ice there. I've even considered just keeping it on ice packs in our room, but of course I am afraid that will somehow compromise this cycle, and I don't want to do anything else to jeopardize it (I learned my lesson from the late pill).

So for anyone that has gone through this - any ideas? Did you have any great disguises for your meds? Is there some infertility genius that has capitalized on this need and already marketed materials for this very purpose? Or am I just being crazy and should spill the beans? D is all for telling them. He feels the more prayers and support, the better.



*you know, besides my mom, that entire side of the family, my closest friends and the entire world wide web. It's amazing I have not taken out a billboard. But I think because it's because I have told so many people that my desire to have a secret from some important people is so strong.

Unresolved ... update

So I got Dr. O on the phone. She seemed to feel it could be from the "missed" pill (although I still call shennanigans...it was 5 hours later than usual; that just happened to be the next day. If I normally took the pill at 1pm and took it at 6pm instead, would that still be missed? But I digress....)

Anyhow, she seems unconcerned. She said I may spot, and then, when I stop the pill, I may get nothing. But the important thing is that as long as I keep taking the bcp and the lupron, hormonally we are still setting everything up for how it should be. So as far as she could see, for now, we are still on!

Whew. I think I took my first normal breath. Of course, if this turns into a full flow, I might call her back. But for now, I am trying to think positively!

Unresolved

So I was hoping to post a whole, "silly me, I am such an over-reactor, it's crazy what our minds do alone at night" kind of post this morning. Even me, who always expects the worst, was not fully expecting the spotting to continue this morning.

But it has. And it has gotten redder and heavier. Still only when I wipe, but it can sustain several wipes (I will pause for a mental eeeeew).

And I am freaking out. I called the answering service this morning because I was not sure what this means (if anything) and did not want to start the lurpon in case I need to make this cycle a wash (because I would still want to try naturally or do injectibles). The non-helpful on call doctor said I should start the lupron, and if the cycle is a no-go, they will find out when they do bloodwork / us on the 7th. Oh sure, let me inject myself for the next two weeks for no purpose. No big deal or time lost to me.

Again, over and over, I am telling myself there is no reason it should be my period. Back in my younger days, when I thought I needed birth control (haha), I would occasionally miss a pill for an entire 24 hours and never get my period or spot. So why would I now? And besides the mock transfer, they did roughly use the wand for about half an hour. However, what scares me is that, although I spotted Tuesday after the wand, it had stopped until last night. And why is it getting redder?

I have a call into my nurse, so hopefully she will call me back. Until then, I am going to continue to worry.

You know, I knew I sucked at getting pregnant. Who knew it was equally as hard just trying to take birth control.

Nervous

So, tmi (as if everything in this blog I guess), I just wiped and had brown spotting.

Logically, I know that it is probably from the mock transfer yesterday (I had some bleeding afterwards which they said could happen). But of course, I am paranoid it's because I forgot to take my birth control pill yesterday until I remembered at 3am this morning (and by "remembered" I mean woke up panicked from a deep sleep) and now my period is coming. If my period comes, this whole cycle has to be cancelled.

Of course, only time will tell. I am supposed to start the lupron tomorrow so i will call the nurse if there is still anything there in the morning.

Ugh, why do I think I can kiss tonight's good night sleep goodbye?

Soundtrack from a Mock Transfer

Welcome if you are here from ICLW week. We are currently gearing up for our IVF cycle. You can read our back story on how we got here by clicking on my crib notes.
 *******************************************************************************

Today was my mock transfer. That sounds a lot more exciting than it actually was. Basically, they were just trying to make sure the catheter would be able to get in without any problems. So it was kind of like an IUI, but without an potential.

Far more interesting was the back and forth between Dr. O and her new nurse. Apparently,  my ultrasound time was used to help train the nurse on how to use the ultrasound machine (which is fine by me. If Dr. O can get my pregnant, she can broadcast my vag cam shots in Times Square). However, here is a sampling of the *oh-so-encouraging* dialog going back-and-forth:

Whoa - check out those PCO ovaries!

She has an amazingly retroverted uterus. Look at where my wand is? See how it's almost straight up and down?

Oh yeah, this one also has a weird uterus. It's T-shaped.

That's [the machine is] saying it's a fibroid. Is that a fibroid? 
                 No - don't worry her. She has enough going on!

Where's her ovary? I can't find her right ovary. (a back-and-forth passing of the wand ensured here)

 That's where you would measure the endometrium? I would measure it there... Where'd it go? Now I can't find it.

How can you tell the follicles from the gas bubbles? How do you know which one is which?
 

So, yeah, maybe not so encouraging. I'm trying not to be disconcerted because I really do like my doctor and the new clinic. Instead, I've decided what I can take away from this is (a) I apparently clearly fall into the "multiple factors for infertility camp" and (b) at least they take the time to do training for their new staff.




 
 

Niggling little fears

I’ve heard the saying that idle hands are the tools of the devil, but I think an idle cycle may be just the same. Last month when we met with Dr. O and decided to persue IVF, I was so excited. I was full of hope and confidence that we made the right decision and that we were getting this much closer to getting our take home baby. However, this month has been a quiet one where I’ve had to do nothing but pop a birth control pill each day in preparation. And I’ve noticed that in those quiet little moments while waiting in line, surfing the internet, or trying to sleep at 4 in the morning, fear and doubt have started to creep in.

Currently, I have a running list of fears that cycles through my head like the NYSE ticker on speed. At any given moment one of the following thoughts flickers through my head:  

nothing will fertilize, 

we'll have nothing to freeze, 

my T shaped uterus will make us miscarry if it finally does work,

my dog will jump on my stomach during this IVF tww and I will have to remember how cute she is so I don't put her up for adoption right then and there.

And then there is my biggest fear, the one I keep going back to  – did we move onto IVF too soon? Not too soon in terms of timeline, but in terms of having truly exhausted all of our other options. I really like my new RE. She has diagnosed things other doctors of mine have missed, and she agreed that the last doctor triggered too soon and stimmed too much. Plus, they redid D’s sperm analysis and while his mobility “might be the best they’ve ever seen”*, his morphology, while not a concern, was “a little wonky”. With all of this in mind, I wonder if we were too hasty in jumping the gun to IVF. This doctor might have been able to monitor my follistim cycle correctly so that we actually had a shot (no pun intended). Or, she might have come up with a different concoction of drugs that gave us our miracle baby. Shouldn’t we have at least given this one last try?

Logically, I know this does not make sense as my biggest fear. While yes, a different injectibles combination may have worked, so might this. In fact if you do the math, it is a no brainer -  57% odds will always trump 20% odds. But I don’t think it is as simple as a numbers game. If you look at my list above, most of my fears come directly from doing an IVF cycle. It’s irrational, but I am blaming IVF for making me feel this much more - for making me be this much more invested.  If we had done another injectibles cycle and it had not worked, I would have been disappointed, but not surprised. If this IVF does not work, I will be devastated.

And I know that if I really have these doubts or feel this strongly, I still could cancel this cycle and try injectibles for a little longer. And I guess logically we could. But I know I won’t. Partially because we have already come so far on this cycle. We are one week away from starting Lupron injections, insurance has been cleared, medications have been ordered, and deposits have been made. I feel like the train has already left the station and it is too late to turn back. And more than that, I don’t think deep down I want to turn back. I really do want to the greatest odds at making this baby. It is just a scary journey trying to get there.

*really? As if any man needs to hear that? We were lucky his head fit out the door on our way out! :)

IVF protocol

It's really happening. On Friday, I went to Dr. O's office for my protocol appointment. Here's my schedule for the upcoming month:

8/21 - ultrasound, practice embryo transfer and cultures

8/23 - Start Lupron shot

8/ 28 - End Birth Control

9/7 - Ultrasound / BW

9/7 - Start injections of Follistim and Menopurl. Reduce Lupron dosage

Continue for 7 - 12 days with monitoring

9/17 - week of retrieval

Transfer scheduled for 3 days later. On day 3, they will move to a day 5 transfer if the embryos look "perfect". Begin progesterone shots.

Bedrest for 48 hours

One week after retrieval - progesterone checked

Two weeks after retrieval - pregnancy test

I really liked the nurse that met with us. She was funny, gave tips for how to make the shots hurt less (her advice for the progesterone shot was - use a heating pad first, and then have the hubs deep massage the area afterwards to keep the gel from building up), and  was very realistic. Okay, maybe I did not love the realistic part. She was very clear that this was not a "baby factory", that their goal is not to get 30 eggs, they only do 5 day transfers of perfect embryos,  and that they only freeze really outstanding, Olympic-quality specimens. D loves how conservative they are. Me? I would not mind them to be a little more relaxed. But, really, all I care about is the end product. And if they can get me there, I am happy to take any path the recommend.

Hiccup - Revised

Last week I wrote about how my Dr. thought I had either a septum or a biconuated uterus.  To help her figure out what is going on, she had asked me to get my films from my previous HSGs (I had one in 2009 and 2011). After several unreturned phone calls, one really awkward conversation with Original Dr. D, and a two hour round trip trek to the radiology place, I was finally able to get the films.  Yesterday, I dropped them off with Dr. O, and today I was ready to have my MRI.

However, bright and early this morning, Dr. O called and told me to cancel it. According to my films, she said I do not have a septum or a bicornuated uterus. Apparently, I have something called a "T-shaped Uterus".

This concerns me on several levels.
1. My only previous knowledge of a T-shaped Uterus was from the movie Baby Momma (starring my personality doppelganger Tina Fey) where she is told she can't get pregnant, so she has to hire a surrogate.

2. Supposedly this is often dubbed the DES uterus because of the parent being exposed to the drug DES while pregnant. It is often taken by mothers who had recurrent miscarriages. I know this is not the case because, as my mother has frequently pointed out, she has never had trouble getting pregnant.

and perhaps most importantly...
3. How the heck did my first doctor miss this? He performed two HSGs on me!!

And 3 is the one I am really struggling with. Because it makes me wonder - was he wrong and missed it? Is she wrong now? Shouldn't we have done the MRI anyway, just to be sure? Do I need (heavens no) a fourth opinion to verify all this?

Thankfully, I have an appointment with Dr. O on Friday where she said she will show me the film and draw pictures for me to help explain what is going on / what this means for me. According to our brief phone conversation, she said she does not think this is affecting my fertility (of course not. Why would there be an actual reason for our struggles), but that it may affect my ability to carry to term/ cause miscarriages. From our phone conversation, I could not gather how much of a concern this really is.

So now, I wait. And hopefully on Friday I get more answers.

I just have to try and stay away from Dr. Google in the meantime.

Meds

The pharmacy called me on my way home from the beach today to confirm my medication order (I had not even known it was placed!). As I listened on the phone, the pharmacist rattled off the following list:

Menapur
Gonal F
Lupron
HCG
Progesterone
Doxycyline (??)
Estrace

And of course, as she put it, my complimentary alcohol wipes and sharps container. All due to arrive by the 21st of August.

Holy crap. This is starting to feel real.

A Hiccup

Today I had my hystersonogram with Dr. O. From what I gather, it is to just make sure you don't have any uterine abnormalities. Simple, matter of fact, protocol. But of course, it wasn't.

Turns out I have a uterine septum, or else a bicornuated uterus.  In both, your uterus has a wall, in essence making "two uteruses" (or two horns). With the uterine septum, you are at high risk for miscarriages (including second trimester losses), and with the bicornuated uterus, you are more likely to have pre-term labor, along with a host of other things. The uterine septum can be fixed with surgery, and the bicornuate uterus cannot.  I have to have an mri next week to figure out which one it is, and then we will move forward from there.

I am leaning towards thinking it is the septum, because original Dr. D said I had one at my laproscopy. However, he also said he fixed it. Google is inconclusive as to whether the septums can grow back. So now I am left wondering, if they can't, what the heck did he do at the surgery in 2009?

Of course, the kicker is, neither of these actually explain why I can't get pregnant. They are just another added bonus complication along the way.