So . . .

Thank you for all of your comments. I've been so wrapped up in this that I haven't written. Or checked on other people. Which is not how this is supposed to work.

After the 73 hour doubling time I think I had to wait a week for a sonogram. It was excruciating. The Husband was with me at the appointment. When the nurse turned on the sonogram so we could hear the heart beat I burst into tears. And my now-fat stomach (because really, fertility drugs and me do not a flat stomach make) jiggled like a horrifying bowl full of jelly. Then we had another week to wait. And that sonogram was good. Then last Wednesday, and the heart rate was in the 180s which freaked me out a little but she ensured me that it was good. Then I graduated from ye ol' fertility clinic. And tomorrow I go see my new OB/GYN. And I'm scared out of my mind. So, last week measuring 8 weeks four days (supposed to be 9) so this week will be 9 weeks 4 days? We'll see. We'll see.

Fool me once, shame on you, fool me, you can’t get fooled again . . .

I know. That’s the longest title in history.  The “fool me once” statement is from our friend George W. Bush. And it makes me laugh every time I think about it . . . which is bizarrely often (anyone else have those weird things that stay in your head off and on for like, ever?).  But it’s appropriate here. How many times can one get pregnant and for some reason be totally certain that it’s going to work out . . . until of course, it doesn’t (“fool me once, shame on you, fool me twice, shame on me”). I was really feeling good about this one – from the get go – because I was pretty sure I wasn’t going to get pregnant in the first place (I mean, what are the chances? ONE good embryo. ONE.). Then the numbers didn’t quite double (51 to 96) and I was in full-on panic mode. Then they went up quite a lot (to the 1300-range). So I was feeling good again. Then . . . then they started doubling every 73 hours, not 48. This was not good, not good at all (“Is that bad?” I asked the nurse in the quietest voice possible, full of fear. “It’s not bad OR good. But the doctor is definitely watching it.” Oh, OK.). Then my breasts stopped feeling sore – no matter how often I poked and prodded them. Or stared at them in the mirror (do they still look swollen? A little, yes. Still blue and veiny? Yes and yes. But do they hurt? Not really). Then it came back this morning. The twingey, weird, boob feeling of yesteryear (it’s been awhile since I’ve been pregnant folks, like seven years). It’s not incredibly strong but they feel weird. And a little achy. Or tingly.

As I’ve said to the Husband, I just keep thinking about the following: this little guy made it through retrieval, fertilization, the 5-day blast stage, being frozen, unfrozen, biopsied, refrozen, deemed normal, thawed, transferred and implanted. Then he made it through a flimsy doubling time (OK, it was really close) to a pretty stellar rock star doubling stage . . . (and now to a pretty lame doubling time). As I said before, some of those charts say that after 1,200 IU/L the doubling time is 72-96 hours. So I would be totally in the normal range there. But I can’t help but to read how everyone continues to discuss doubling times in a 48 hour period, not 72-96. And one study I read found that even with a good sonogram, doubling time in excess of 3.2 days pretty much spells doom (“Doubling-time (DT) of beta-hCG levels was defined as DT exceeding 3.2 days. Patients with slow rising beta-hCG levels should not be given an optimistic prognosis even if viability is demonstrated at eight weeks.”). This last draw the doubling time is 73 hours or 3.1 days.

I’m kicking myself for making any kind of plans. I mean, really, what the hell was I thinking? Part of me thought, I’m just going to try to enjoy it, so f* it. And I was pretty f’n excited. I got out the baby naming book! I made a list! And I convinced the Husband to move because we’d need more space with a second kid – to a place with a washer and dryer and dishwasher because you know how horrible that is when you don’t have one and have a new baby (some of you may not know . . . but those of  you who live in NYC, yeah, you know). Will I regret moving some place where we’ll never be able to save any money for a down payment but my kid gets to have a backyard? I won’t. I really won’t. OK, maybe a little bit. I think . . . I mean, really, if you saw the size of our apartment you would be shocked. Ever since law school, I have to say, we’ve been pretty stupid about money. Our kid went to one of the best day care schools around which cost us an arm and a leg and put us in massive debt. Then we did fertility treatments since 2010. So, yeah. Not. Smart. About. Money. Strangely, I don’t regret the fertility treatment costs. It’s only been massive since 2013. We didn’t want to have to fork over that huge amount for donor eggs . . . but I’m afraid if I add up we spent since 2013, it might be close (PGD anyone? Yikes). Maybe we should have just gone ahead and done that. But if I’m completely honest, there’s a part of me that was very worried about doing donor eggs. I fear that someone (and not my husband, thankfully) would lord it over me forever, the notion that I am not biologically related to my child but they are. I see a lot of potential issues with that. And it’s troubling.

And then, and then I have to say here, somewhere, that even though I’m trying to sound jovial, that I spent most of yesterday crying.

It’s really hard for my brain to come to terms with the idea that THIS IS IT. I keep coming up with contingency plans and then remembering that, no, no, this is it. No more retrievals. No more drugs. We won’t be adopting. We won’t be doing donor eggs. We won’t, we won’t, we won’t. It’s done. Donezo. Fini. Complete. It’s time for us to move on. To pack it up and say good bye. Thanks for the memories, infertility! Don’t let the door hit you on the way out!

Same Day Nothing New to Report

Since I haven't given a lot of detail here . . . . In 2013, I switched from World-Famous-IVF-Clinic (WFIVFC) to a clinic that specializes in "mini-IVF." After inumerable IUIs, I finally convinced Dr. Superman to let me try IVF. It did not go well. A retrieval that ended up with nothing, a long cry in the lobby, a conversion to an IUI, and I was pretty much done. I was also forty. I happened to run into a colleague who was switching to the Mini IVF clinic. The sister of a good friend was just finishing up there - after getting pregnant. We decided to do the switch. We did a retrieval there, no drugs, and they broke the zona on retrieval. I was again ready to give up. The nurse convinced me to try another cycle. I did and they were able to retrieve three. If I remember correctly (and shockingly I don't) it was totally natural (birth control pills first).  But I think I must have been on Clomid. Anyway, three is crazy. All three fertilized, all three made it to blast. I repeated this process until May of 2014. At this point I had six blasts. Six pretty good looking blasts. But things were going south in the retrieval department. It seemed as though it was progressively getting worse . . . it was beginning to look like everything that they retrieved wouldn't make it to blast. And they only wanted 5 day blasts for me. They convinced me to do PGD, which I did. Only one was healthy. One. From that second cycle. The cycle that had three.

After a uterine scraping, two endometrial biopsies, and a trial run, they were finally wiling to do the transfer in December. But I balked. I wanted to be able to fly home to see family over the holidays. I didn't want to fly at all, not once, not ever, subsequent to the transfer until I knew the results. And once I did, if positive, I was most certaintly not getting on a plane (with every other miscarriage, I'd been on a plane).

So, we did the transfer in January. January 19th. Martin Luther King Day.

And . . . so . . .

Transfer Monday, January 19th.

Beta #1, seven days past transfer: 51  (Monday, January 26th)

Beta #2: nine days past transfer: 96 (Wednesday, January 28th)
Doubling time: 2.2 days or 52.6 hours (88.2% increase)

Beta #3: sixteen days past transfer: 1382  (Wednesday, February 4th)
Doubling time: 1.8 days or 43.66 hours (114.13% increase)

Beta #4: twenty-three days past transfer: 6762 (Wednesday, February 11th)
Doubling time: 3.1 days or 73.34 hours (57% increase)

So, I don't know. Some places say that at this point 72-96 hours is when to expect doubling. Some still say it should double within 48 hours. Or 48-72 hours.

I don't know what to think.

I can't really go there.

If you know what I mean.

HCG Land

So, on Wednesday, February 4th my blood results were somewhere in the 1300s, which was good. This is what I'd calculated. Today I calculated that my HCG results should be somewhere around 13,000. It was 6,000 (something). Today is six weeks.

The Husband is trying to remain positive, but I'm feeling pretty down.

Feeling kind of stupid that I was feeling pretty lucky, optimistic, I could see him in my mind, etc. I want to remain optimistic but pretty much everything I read leads me to believe that this is not good. Not good at all.

I wish I could write more. But I just can't right now.

Ultrasound next Wednesday, February 18th.

What the?

Yeah, so, I had a blood test on Monday, January 26th: HCG: 51, progesterone 12. On Wednesday, I had another blood test: HCG: 96, progesterone: 16. I'm kind of freaking out. Just a tad. Just a little in the googling-until-my-fingers-bleed territory.  They told me that they're not worried. But I am (it didn't double in 48 hours). Also, I'm on 40 of the generic Lovenox - last time, with the Kid, I was on 60. This also concerns me. Meanwhile, I felt like I was going to pass out I was so dizzy today. I can't remember that happening before. But I chalk it up to the 1,0000s of progesterone pills I'm on. Righty-o. Trying to stay positive here.

April Showers Bring May Flowers

I’m having trouble concentrating at work – or doing much of anything. I keep googling things like, “day 3 8 cells 6 cells”. You can only imagine what I’ve come up with. Let me back up. I switched fertility clinics. I switched from the uber-famous clinic that’s considered one of the best in the business, to a clinic that’s known for it’s mini and natural IVFs. It seemed like such a crazy thing to do – for several reasons, the main one being we’ll have to pay for some of the costs out-of-pocket (yikes). One of my closest friend’s sister, after several years of trying, went there and is now pregnant (she’s due in October). She’s 42.  Then another friend of mine, who’d I met at the old clinic one day is now going to New Place as well. I met with the main doctor, who I really liked (even though I had some trouble understanding him). He said, “So, you were pregnant four times, completely naturally?” “Yes.” “And then you did an IUI on clomid and got pregnant on your first try?” “Yes.” “And you’ve done multiple IVFs and only made it to retrieval once?” “Yes.” “And it didn’t work out? Isn’t it interesting how the lower tech it is the more successful you’ve been? And the more and more drugs they throw at you the less likely it will work?” “Yes.” The doc recommends I freeze a bunch of embryos (if I’m able to get any), in order to bank them, so that I don’t have to wait months between treatments (i.e., you go through a cycle, you get one or two eggs, they fertilize but you don’t get pregnant – now you have to wait several months for the next cycle, etc.). This way, I just keep going in month after month, get a bunch of eggs, put them on ice, and then start having them transferred, perhaps two at a time until we hit the jack pot. The first time I did no drugs. None. They just monitored me. Then I came in and they did the retrieval with the one egg. And it broke. IT BROKE! A broken zona. I’ve read multiple things that say it could be the quality of the egg or it could be the method by which it’s retrieved. They are very skilled at the retrieval so I didn’t think it could be that – but the doc said he actually thinks it was the timing. They either got it too early or too late, I can’t remember which. I was pretty crestfallen (I’d gone through three IVFs, the only one that they let me go to retrieval, which was at my insistence, they got nothing). The Husband was pretty much done. He wanted to pull out. I talked to one of the nurses at length who was so great. She recommended we do it at least one more time. So . . . this time they had me on Clomid and one other drug. I managed to produce two good size eggs and one small one. Last time it hurt pretty badly – the ovary was in a strange spot and they had to practically jump on my abdomen (fyi – they do their retrievals with no anesthesia). This time, I got a valium (yay!) and they managed to retrieve all three eggs. And they looked good. Last Sunday I was at a baby shower (yes) and got a call that two fertilized and that the other was pending. Then yesterday I got a call that the runty one didn’t make it but that the other two, on day three, are at 8 cells and 6 cells. From what I’ve read, “Typically a good normal growing day 3 will contain between 6 and 10 cells.” So, I’m pretty excited about those two. I won’t know how they are doing until Saturday, when they let me know if they’ve made it to the deep freeze. Here’s hoping!!! Yay SPRING!

Broken Egg

So, after 10 IUIs (one successful and two converted IVFs) I started at a new clinic that specializes in natural IVF (I don't respond to the drugs anyway - so what the hey). Things have been looking pretty good, that is, until retrieval. The doctor had a very hard time getting the egg out and once he did it didn't look good - apparently the egg broke (fractured-zona pellucida). I've been trying to do some research and I'm not coming up with a lot - there seems to be some evidence, via my google searching, that it could be due to the retrieval itself. Alternately, it could be a not-so-great egg to begin with. The doctor seems somewhat (strangely, I might add) confident that it won't happen again. As I said, it was very difficult for the doctor to retrieve the egg because of the position of the ovary. There was a lot of pushing on my stomach and a lot of, what felt like anyway, suctioning. I don't know. I'm looking for other people's experience and knowledge on the subject. They want me to come back in two weeks and try again. The Husband would like to go back to the other clinic where, although they aren't experts on natural IVF, will charge us nothing (insurance). The new place we have to pay 20% - which is really hard when it doesn't work out so early in the game.

The Fat Lady Is Starting to . . .

My birthday was last Friday. I turned 40. FORTY. The Husband and I were on the fence for a long time about trying for another. There were many reasons for the indecision, but avoiding having another miscarriage was up there on the list. I did not want to get crazy-obsessed about trying to conceive when I already have a child, did not want to go through the heart ache as well. There are also many benefits to having one child versus multiple (or so the studies say). That being said, last year we decided to make a go of it - and nothing happened. We did IUI after IUI. Finally, I pushed to start the IVF process. I did a round of birth control pills and was to go in on "day 2".  I couldn't figure out when "day 2" was, however. I'd never had such a light period in my life. I kept waiting and waiting. I finally went in on Monday morning - FOUR or FIVE days after my period started. My FSH tested at 23. The IVF was cancelled. My FSH, right before I had the Boy, was 6. That was four years ago (he'll be four in October). There is some evidence that those with the MTHFR A1298C (I'm homozygous) do not respond well to ovarian stimulating hormones and have (prematurely) high FSH levels. I'm not so sure I'd say it's all that premature now, considering that I'm FORTY but it's a little bit of a shock, nonetheless. And here's the kicker - only a few months ago, it was 16 (not great) but IVF wouldn't have been cancelled. Where do we go from here? I'm not sure that I have the energy to read a thousand books on high FSH, to start downing wheat grass juice, to do yoga and acupuncture, take folic acid and fish oil and whatever else. I'm not sure I'm up for it. I'm not sure I can put all my energy into something that just might not work. Doctor Superman said that he is "very concerned." He's never said that before - he was always pretty optimistic. That's scary. I don't want to have false hope, either. I don't really know what to do. It's a depressing position to be in . . . and although it might appear a little crazy in the first place to try to have a baby at forty - it wasn't my intention to try to have a baby at forty. I wanted to have my first at 34, my second at 36. That was a little bit old, but that's the age my parents were when they had me. I never anticipated that it would be years of miscarriages, years of trying. We got a pretty bum deal - but we got a great kid out of it, too. I'll always feel the loss of those four . . . and will always feel like someone is missing. There was supposed to be another one . . .  whether or not I can make that happen, only time will tell.

Another Day

Well, it's another no good cycle. I've really never felt so discouraged. I was really, really hoping that this time it would work out - and the due date, incredibly, would have been very close to our son's birthday. And I thought - wouldn't that be funny! And cool! And crazy! And I started making plans. I started thinking about this little girl (because I've decided that we're going to have a girl, yes, I know) . . . that she's going to be really spunky and independent and a wonderful, delightful handful. I started thinking about how I'm going to need to plan for the time off . . . and how we really need to start putting money aside. And then I worried about the Boy and how he would handle it. And then it didn't happen. Again. So, back to clomid. Another round. Another added three million pounds (clomid is not good for my waist line. Either that or I'm just plain eating too much. Obviously it's the clomid). Deep sigh. This is getting ridiculous. Onward and upward!

Oh, Le Sigh

I tested at 9 DPIUI and got a faint positive. I was excited. I was happy. Then I looked at the Boy and felt a little sad at what life is going to be like for him soon - how will he handle a sibling? Will he be OK? Did we make the right decision? Then today, totally negative. Snow white negative. So, probably the HCG was still in my system from the trigger shot but I'm hoping that I still have a chance so I'm going to keep testing. As much as I worried about The Boy, I was totally excited about the prospect of numero dos. So . . . we shall see. Waiting game. As usual.

And . . . we're back!

We did four IUIs last year and . . . nothing happened. Nothing. I thought, "Hey, maybe we're OK as a family of three!" And really, I am OK. But then I told my mother that it was pretty likely that we were only going to have one, that we tried and it didn't work and that I was totally OK with it . . . and then I burst into tears. Unexpectedly. It caught me completely off-guard. So, I'm back at it again. Doctor Superman's plan is to do an IUI twice, if necessary and if that doesn't work, we move onto the big guns, IVF. Yikes. So, here I go, rolling the dice again. Oh, also, I thought I'd completely screwed up this entire cycle because I told Doctor Superman the completely wrong day as "day one". Whoops. According to the nurse it's OK because they monitored me, etc., etc., but this probably explains why the right follicle was strangely ENORMOUS and the left one was normal. So . . . they're pretty sure that if I do get P* this time around it's from the left side. Good to know.

In other news, I'm really old. Like, really old. I'm getting really, really old. So, this is kind of it for us - if this doesn't work out, we really have to throw in the towel. In other news! I have a lipoma on my back! And arthritis in my knees! Yes, getting older is as glamorous as it sounds! If you're lucky, you two can be plagued with non-cancerous lumps on your back and rickety knees! I really shouldn't complain, I feel pretty normal for my "advanced maternal age" and MOST people (except for my pre-pubescent interns) guess that I am wayyy younger than I actually am. Convinced yet? Yeah, neither am I.

*I hate to sound like a 5-year old but I can't bare to say it . . . not yet.

Defeat

So, I tested last night at 9 dpiui and it was a big old negative. Tested this morning, negative. Although it's early, I again don't feel like this one is going to work out. I'm feeling fairly un-pregnant. Doctor Superman gave me about a 12-15% chance with each cycle due to my age. Yikes. If I'm really "clogged up" (a phrase I frankly loathe) I don't know that I can even have a hysterosalpingogram (HSG) again to verify - as I've already had three (there's a limit due to the radiation exposure). I'm not really sure what the next step will be - I've already had four rounds of Clomid (one with a former RE). Clomid and an IUI again? I'm frankly sick of it (I know it's only been two times) but I'm not supposed to run for two weeks while we wait which is totally horrendous (and I believe, completely unnecessary but I follow it anyway). And then there's the whole Lovenox fun, too. The progesterone suppositories I don't really care about - it makes me feel more pregnant than not (soreness, etc.) but it's not really that big of a hassle (although I do kind of debate its efficacy in my case - since I used it in three (?) of my failed pregnancies).

In other news, my son's daycare is "concerned" with his "poor" pronunciation. I went to his pediatrician, fully expecting him to be nonplussed by the whole thing but instead he gave me the number for a specialist to have him evaluated. I suppose that is sound, but it worries me to no end and was not what I expected. It also makes me start wondering about dyslexia - which runs in my family. Could he be dyslexic? That's a very real possibility. Although the family members who are dyslexic are all very accomplished and intelligent people, it certainly made things like school more challenging. Plus the stigma alone is terrible . . . . In my experience not being able to understand a two year old all of the time is pretty normal. But perhaps that is not true at all.

Back to the waiting game.

Oh, Clomid

So, even though I was supposed to go in for a blood test, I didn't. It seemed, well, silly. So, I didn't. And then I called on "day three" because I couldn't bring myself to call before that. I've been finding myself resisting a lot - in fact, we first started discussing having a second one LAST YEAR. It took me this long to get the courage to start trying again. If I'm completely honest as to why I've been gun shy, there are two reasons: 1) I don't want to have another miscarriage and 2) I don't want to have another miscarriage. If I never get pregnant again, GUESS WHAT? No miscarriage. But I do want a second child. I see babies and I sigh a great sigh. When we were discussing whether or not to have another - and I voiced my opinion that maybe I was fine with just one, my husband said, "If we don't have a second, we could get rid of all our little one's old clothes!" Sometimes the husband boggles my mind. Boggles. Yep, that sounds like as good a reason as any to NOT have a second child - less stuff. Sigh. The Husband is going a bit crazy lately with our living situation. Honestly I am completely fine with it. We live in a large one bedroom and if he would let me do the things that I would like to do (which he won't without a huge battle royale) we could live quite happily. I don't understand this obsession with bigger, bigger, bigger, mcmansions, etc. I lived in Europe in high school (exchange student) and was completely blown away by my host family: they had one small, beautiful apartment in the city and one country house. They only had what they needed, nothing more, nothing less. And what they had was beautiful and cherished. My problem is that I haven't quite gotten that equation down - I have a lot of stuff, which as I mentioned, is driving the Husband batty. Which is driving me batty and so on (which by the way, means that if we are lucky enough to have a second bambino, I will relent and agree to move). Anyway, so, back to the point: I'm on 100mg of Clomid. ONE HUNDRED. WHAT?!?! This would scare me, except that last time I had three really good size-y follicles and then . . . nothing. NOTHING. I'm shocked, frankly. And a little worried about what this means. All three eggs were duds? Duds! THREE! Three duds? This makes me a tad concerned about the quality of my eggs - which I would imagine has a lot to do with my now advanced maternal age. ADVANCED MATERNAL AGE. Or could it mean that the eggs weren't even released at all? I mean, I had to be cleaned out in November. Could it be clogged up again? Anyway, I go in to see Doctor Superman on Tuesday and I imagine I'll have IUI #3 this Saturday. It's very strange and also very different, to be back here again. Until then.

Negatory

So, I tested (because I couldn't wait) on 10 days post IUI (10DPIUI) and it was negative. Tested again this morning, 11DPIUI, and again, negative. And wow, when it's negative IT REALLY IS NEGATIVE. No matter how many times I flipped that thing in different light it was still COMPLETELY, UTTERLY, NEGATIVE. I know that it's early, but I'm not feeling too positive - except for the soreness in that one area, you know the one, (which is likely from the progesterone supplementation) I'm not feeling it. On the other hand, the Husband found a sweet kitty on our doorstep yesterday evening. On the other hand, he took him to a shelter this morning. Sigh. He seemed like a really sweet kitty. And no, we don't need another pet but after losing our dog it was nice to spend some time with such a sweet animal.

Now I'm in the doom and gloom phase - it's never going to happen, etc., etc.

The One in Which We Wait . . . and Wait

So, trying to move on. Miss my dog. Made some horrible misjudgments, etc. But as I’ve been told a thousand times now (yes, I’ve been talking crying about this with everyone I know . . . ) we did what we thought was OK at the time.

So, Saturday. We had to be there at 8:15 AM. Which is a herculean feat in and of itself but even more so when you have, you know, a wee one to contend with as well (oh, who are we kidding? It’s me, I’m the one who is terrible about getting places on time). What to do with the Boy? Every time I see Doctor Superman he asks when are we bringing in the Boy. And really, he SHOULD meet him since he’s pretty much the why, the how, the etc. . . . So, for an appointment the other day I brought him . . . and was met with a few icy stairs in the reception area. I felt completely weird having him there – and he was, of course, completely disruptive as well (he flipped out, FLIPPED OUT when I put the car seat behind the reception desk – he loves that thing. We took a cab there. It’s strange, the City Boy’s attachment to a car seat. He’s crying, carrying on, saying mournfully, “Car seat. Car seat. MY car seat.”). I felt weird bringing him and then it was even more weird when I got an ultrasound because the Boy insisted on sitting on my lap – so, you can only imagine how graceful that was, not to mention the future therapy needed for the Boy. But it was wonderful for him to meet Doctor Superman. It was really great to see them together. Anyhoo, so, right. We check in. We go upstairs so that the Husband can deposit his, er, "sample". That was also weird. But we had the upstairs waiting room all to ourselves for awhile – which was great. I actually READ A MAGAZINE while the Boy flipped the light switch on a lamp on and off multiple times all while “reading” his own books. It was a glorious few moments. And then many other couples arrived so letting the Boy run free like a madman was no longer an option. Then we walked a few blocks away to get a breakfast of mediocre bagels and mediocre danishes and mediocre coffee and while away the hour or so that we had to wait. Upon our return we were whisked into a room, I threw my legs into the stirrups and Bada Bing! Done. And now, we wait.