Thursday, July 30, 2009

Follicle Disappointment - July 30, 2009

Today was my pre-IUI ultrasound to see if this cycle is a go or a no-go. It dawned on me today (thanks to a friend's questions) that when I mention these ultrasounds that I'm going through, people tend to think of spreading goo on top of your belly and rubbing a device around on it. Sadly, this is wrong. Think an uncomfortable wand and where it would go to look at ovaries. There you go. Fun.

Today I saw Dr. Shortstick again, as Dr. RE is away on vacation. Lucky man! Unfortunately, due to a lack of vacation time remaining, my hubby was unable to attend this appointment with me. Many women go to these types of appointments alone all the time. I prefer having my hubby with me, but you deal with the situation as best you can, and today that meant going it alone.

So last month I had three nice mature follicles, which is just the right number (3 - 4 is ideal) for getting pregnant. This month, I have only one. Well, we think I have only one. My left ovary has given me problems before (it hid during the HSG causing all of that fun, and it was hard to find during my last ultrasound, causing cramping from a procedure that really shouldn't), and this month decided to be even more difficult than in the past.

Dr. Shortstick couldn't find my left ovary at all today. When she asked "Do you have a left ovary?" I felt a twinge of panic. "Oh no," I thought, "Did it fall out or dissolve in the past month? Oh lord, are we getting further from success instead of closer?!" I shit you not - intelligent, well-educated people do have these irrational fits of panic where the most ridiculous things seem plausible, even if only for a moment. Once I fought down that wave of panic, I responded that it has been difficult to find in the past as well. She continued to dig around for another minute causing horrible cramping - I mean really, imagine a long wand shoved up inside of you into tight quarters being twisted and turned in all directions looking for something elusive. Can you imagine a time when this wouldn't cause significant cramping?! I thought not. In any case, Dr. Shortstick decided to give up. It just wasn't worth it, as we were going to move forward with the IUI anyway, since I had one mature follicle on the right side (22mm for those keeping score at home) and a good thickness to my endometrial lining (10mm).

I'm pretty disappointed to have only one mature follicle. I mean, I ovulate normally, producing one follicle each month without any medications. For as crappy as the Clomid makes me feel, I really feel that I deserve to have multiple follicles. I suffered the nasty side effects, I deserve the reward for it! *sigh* It's too bad that life doesn't really work that way. With our already low chance for success from this treatment, we need all the breaks we can get. At least with the multiple follicles last month I felt like there was something working in our favor. This month, not so much. It's hard to feel positive right now. I just want to move on toIVF. Actually, I just want to spontaneously pop up pregnant so that I don't have to go through IVF or wait any longer.

Tonight I get the trigger shot. Last month my butt was sore for several days from the injection. I'm going to make my hubby massage the injection side this time, as I've heard that it can help it to not be so sore afterwards. Yep, hubby's going to rub my butt. Heehee. Well, wish me luck. Tonight I get a shot and the IUI is set for Saturday morning, bright and early (7:30 AM).

Monday, July 27, 2009

Confidants and Intrigue Series: Confidant #2 - June 2008

Confidant #2 came about in a rather interesting way. I had my first confidant and was really, really planning to stick to not telling another person until we turned up pregnant. I knew my hubby didn't want a lot of people knowing, so I was trying to respect that. We were still on our first cycle at the time, so it hadn't even been that long yet!

Every year we go to several gaming conventions. For those of you who don't know what I mean by that, think massive amounts of geeks getting together to play all kinds of games. I prefer role playing games (RPGs) most of the time, with a few others mixed in for variety. These conventions are all over the place, but we usually stick to the ones that we can drive to in a few hours. We've developed many friends over the years, and some who have become very close friends.

So last June while at one of these conventions, we were sitting at a table in the food court at one of the convention centers having some lunch, when one of our friends mentioned that they were adopting a child from China. I looked up at her with all sorts of thoughts and questions rampaging through my mind and, trying to act nonchalant, I think I stammered out something lame like, "Oh yeah? That's interesting." Nice. Way to show your support.

She wasn't even phased. Between her and her hubby, I found out that they were torn between looking for a boy and a girl, and that they really just wanted a child, however it worked out. Special needs would be great, because she and her hubby have the ability, patience, and love to care for and help a child in need. I also found out that the adoption process is a long process, with lots of ups and downs, tons of paperwork, and more waiting and uncertainty than you can shake a stick at (I really have no idea how much uncertainty or waiting you can shake a stick at, but this process has more).

After hearing all of this, I just looked at my hubby, and although his look said "keep your mouth shut woman!", I ran off with my friend to spill the beans to her anyway. We went to the bathroom, and on the way back I stopped her and the words just gushed out of my mouth, "We're trying to get pregnant and I think I might be now because I'm sure it won't take long for us and I'm really excited and nobody knows yet and I just feel so close to you because of what you just told me about and are you adopting because you've tried everything else and it didn't work or is this something you've always wanted to do and it feels to good to talk to someone else about it and oh man my hubby's going to kill me and you have to keep this a secret, OK?!" *huge gulp of air*

I can't remember much else about the conversation after that, but I do remember feeling all warm and fuzzy, and that I was really glad that I had confided in Confidant #2. Although we're on opposite ends of the spectrum today - she has no desire to do what I'm doing now, and although I do keep the option of adoption open as a possibility in the future, it is not the right choice for me at this time in my life but is the perfect option for her - we have such a similar desire to love, cherish, raise, nourish, and teach a young person that we do not yet have to hold, that I cannot help but feel a kinship to her as we each take our steps toward bringing that additional person into our family.

Confidant #2 has been there for me as I went from my first cycle (where I just knew I was pregnant!) through all of the rough times of uncertainty, and is still there for me now as I work through all of these medical treatments (which are truly not her favorite thing) in hopes of having a child. And I know that if these treatments do not work and I need help navigating the world of adoption, she will be right there with me then too, guiding me when I need it and helping me stay steady when the weight of it all might bring me to my knees. Thank you Confidant #2 for listening to me babble on ad nauseum about things that I know squick you out! Thank you Confidant #2 for being a friend.

Saturday, July 25, 2009

Still Waiting - July 25, 2009

I go for my ultrasound next Thursday to see how many follicles have grown. I'm done taking the Clomid for this cycle (thankfully - that stuff sucks). So for now, we're just still waiting.

Wednesday, July 22, 2009

Just the Blues : July 22, 2009

I guess I just have the blues these days. I've started creating more posts about various confidants, but I just haven't had the energy to do the stories justice. So, here, have an informational update instead. =)

We have to wait awhile to move on to IVF-ICSI. It kind of stinks, because we've decided that we want to go there ASAP. Unfortunately, it's a very long process, and we won't be able to start until September or October because the hubby will be in Japan on a business trip at a very bad time for our IVF to work out. Meh. So we've decided to do another round of the IUI this cycle. I'm on my third day of the Clomid today. I'm having all of the same side effects as last cycle, but nowhere near as intense. I go on the 30th for my ultrasound to see how many follicles are maturing. I hope that I have 3 again, along with a nice thick lining for embryo nourishment. Not that I really think I'll have any embryos to nourish, I just like the idea that everything is functioning at a healthy level in there, just in case. The Clomid is known to thin out the lining though, and my period this month was very light for me, so I'm actually a bit worried about it. Only time will tell.

Friday, July 17, 2009

Confidants and Intrigue Series: Confidant #1- April, 2008

OK, so I'm really not a good secret keeper. I guess, when I really stop and think about it, I started having confidants before we even started trying. Funny how I thought it was for-evvv-er before I started sharing this information with anyone. When I reflect on it at this point in time, it's really pretty funny how bad I am with keeping secrets.*

At one of the last class sessions for completing my MBA, I overheard another girl in my class who was talking about starting prenatal vitamins soon, as she and her husband were planning to start trying as soon as they sold their condo. I already had the prescription for my prenatal vitamins at that point in time, so I couldn't help myself! I turned around in my seat (yes, this was before the session had actually started, to all who would be aghast that I might chat in class) and exclaimed, "Me too!" We started chatting, and I discovered that they would probably not be starting to try for another few months. I also discovered that she had moved to the same suburb that I live in - just about a 5 minute drive away. And did I mention that we work for the same company? WOW! We started gushing about how great it would be to have our pregnancies be close together and have time off work and walk our babies together. It was fantastic! I hadn't even begun trying yet, but here was my very first confidant. Funny enough, she remains one of my closest confidants to this day. Oh, and my husband didn't know that I had told anyone about us trying for at least 7 months. Whoops, I guess I just spilled the beans! Sorry dear.

In any case, Confidant #1 started trying to conceive about 5 months after I did. At that time, I thought she would travel a road similar to mine. I thought I was being all helpful and big-sister like when I gave her this advice:

"Don't let your body fool you and get your hopes up. You'll think you're having symptoms of pregnancy, but that's just your body adjusting to being off of the birth control pills. I know it's hard not to read too much into every little thing you feel happening with your body. I felt that way too. You have a bit of a road to travel first though, but it'll happen in good time - for both of us!"

Pfft. Boy did I think I had it figured out. As it turns out, she was pregnant. On her first cycle off the pill. She is due to give birth to her little boy in four weeks and four days. One month from now. She started five months after me, and she is due in one month. And here I am, starting my period today. I'm happy for her, I really am. I wish her the healthiest and happiest of babies. I'm just so sad that we won't be together in this. And that I'm still waiting. I don't wish that she wasn't pregnant (I know, double negative - deal with it), I just wish that I was pregnant too. Even if I was just one month pregnant.

I'm so tired of waiting. I'm tired of always having to work so hard for what I want. I wish things would just be easy for me. I've busted my ass to be where I am in my career and in my life. I've made difficult choices, and make good decisions for the long-term. I've thought things through and made wise decisions. I don't take risks. I play it safe. I make sure I finish what needs to be finished and accomplish what needs to be accomplished before moving on. Somehow though, it always feels like I get the short end of the stick, despite working hard and making good choices. I'm ready for my break. I'm ready for something good to fall into my lap without a struggle. I'm ready to get preferential treatment in something. I don't want to work any harder right now. I'm tired of working so hard. I'm just tired. When is it my turn?

*note to friends - it's really only my own secrets that I cannot keep. I keep the secrets of others quite well actually.

IUI Cycle 1: Fail. - July 17, 2009

Sorry that things have been quiet around here. I've been filled with such conflicting emotions these past few days, that it was easier to say nothing at all. I began my period about an hour ago, so I guess at least I have my answer for this cycle. It started with a huge wave of cramps that nearly took me off my feet. I was walking to the bathroom, and my lower-left abdomen and into my leg started to throb, and I almost couldn't finish walking to the restroom. They were very odd cramps - not like normal menstrual cramps at all. Then, 30 minutes later, I started bleeding. I think it's going to be a hell of a period. I'll post more this weekend about all of the other stuff going on, as well as some other stories from the past 14 months.

Tuesday, July 14, 2009

Quick Update - July 14, 2009

Just a quick update and prediction. I'm having some decent cramping today. I would normally start my period on Thursday of this week - cycle length of 27 days. I think I will start right on time, and that I will indeed start. I just heard back from my RE's nurse: My progesterone and prolactin were good this month. Not sure what the prolactin is or should be, but the progesterone was 11, which is right in the good range of 10 - 15 that she said I should be. So next month we will be doing the same dosage of Clomid with the IUI again. I don't know if I'm really up for more than two rounds of this before we move on. We'll have to see how we feel about doing rounds 3 and/or 4 before moving on to something with a better chance for success. This kind of just feels like wasted time and money.

Monday, July 13, 2009

Added Waiting - July 13, 2009

Today I found out that though my normal cycle length is 27 days, I can expect to wait 30 days this month because I normally have a short luteal phase (the time between ovulation and the start of the menstrual period), and the Clomid that I took this cycle will extend that phase. That means that I need to wait until Sunday to test rather than Thursday. Grrr.

Sunday, July 12, 2009

Saying Goodbye to Grandpa - July 12, 2009

This past weekend we said goodbye to my grandpa - my father's father. He was 96 years old. He was a hell of a man, and hearing the stories of the lives he touched was inspiring. Yesterday there was a memorial service for him in an old church right up the road from my grandparents' home. The church itself was a plain building - just one room with several rows of pews, many windows, and a raised area in the front with chairs and an altar. It didn't seem like much to me, but apparently there is a considerable amount of history there for my dad and his family, and that made it kind of neat to be there for me. It was blazing hot, and the building was not air conditioned, so we were all sweating like sinners in church, or however the saying goes. I was moved by the stories that were told by my family at the service, but any emotions that I feel at events such as these are always overshadowed by the bloviating of the priests/pastors/reverends/whatever. The whole "this day is all about god and not about the person who died, so think about jeebus" shtick always makes my blood boil. It's the same thing at weddings and funerals that I've attended throughout the years. You'd think I'd just be able to ignore it, but it seems so disingenuous every single time that it just gets my heckles up. This afternoon, however, I was able to feel pure emotions, not tainted by such things. At the very last minute, as we were heading out the door for the 3.5 hour drive home, my dad and his two sisters decided to spread the ashes of my grandfather in my grandma's garden, next to Grandpa's favorite dog that he buried there years ago. At first, each of his three children and his widow took a handful of ashes and began to sprinkle them. Then a few more of us came in and took a handful to spread. My little 4 year old cousin took a handful that apparently had some sort of token with information to identify the ashes as my grandfather's if something happened. My grandmother took it out of my cousin's hand, and at first, I thought it was a bone chip or something like that. As my grandma spread the last of the ashes, she began to cry. She cried for the first time since Grandpa died. Her daughters joined her, and my dad looked on until Grandma was ready to move out of the garden. Dad took her arm and led her to the patio to sit in the shade, as she had done every summer with Grandpa for the past 67 years. Something that, for the first time, she would do alone. I cannot even begin to imagine how that feels. I cannot begin to understand the sense of loss and sorrow that she must feel. That home that he built with his own two hands is filled with memories of him. I don't know if that will ultimately be a good or a bad thing for Grandma, but she has made the choice to continue to live there. I hope she has peace. She saw Grandpa live a good life - he served in World War II, was the father of three wonderful and unique children, lived to see some of his great grandchildren (though unfortunately not from me), saw his children marry wonderful spouses who love them so much, built and ran a hardware store, built his own home, and just enjoyed the simple things of his life. His life was rich and full, much like his personality. He was such a sweet and hard-working man. This world is richer for having had him in it. We miss you already Grandpa. Goodbye.

Friday, July 10, 2009

Quick Update - July 10, 2009

This morning I've been feeling nauseous. It could be because I'm rushing around to get things done. Time will tell. This morning we went for a blood draw to check my progesterone level, something that I think was called Prolactin?, and to check for toxoplasmosis (since I volunteer at a clinic for stray cats and do lots of cleaning there, and have several strays in my own home as well - we're really suckers for animals!). The nurse had trouble finding my veins, which isn't abnormal for me. They love to hide. She stuck me and had to move the needle around trying to find the vein, but it was in vain. =) She had to try again on he other side, and was successful right away there. Now we're waiting for my parents to arrive at our house and then we're going to carpool over to Pittsburgh for my Grandpa's memorial service this weekend. I should have the results of these tests back early next week. I don't know if they tell me much that I want to know, but I guess every little bit of good news helps these days. Have a good weekend everyone - I'll post again when I'm back and have internet access again.

Thursday, July 9, 2009

The Waiting Game - July 9th, 2009

The waiting game continues. It's terrible, but every little thing that happens to my body makes me wonder what it could mean. I had some light cramping earlier today. There's a good possibility that my ovaries are swollen from the super stimulation of follicles earlier this cycle. Or it could be that my body is just starting down the road to PMS. But I cannot help but feel hopeful, which I find upsetting. I don't want to be hopeful. It's such a long shot, and I don't want to set myself up for disappointment again. I've had so many disappointments already, I hate to set myself up for failure. I really can't help it though. And earlier today I had some light spotting. It was only one time, and it was very, very light - but it was definitely there. Spotting and light cramping can be signs of implantation. They can also be signs of many other things. But I'm not hoping for other things, so my brain won't squash this little hopeful twinge I have, no matter how much I wish it would. I have a feeling it's going to be another long week.

Wednesday, July 8, 2009

IUI Round 1 - July 4, 2009

The morning of the 4th of July, we were supposed to be at the lab with our sample in a cup, ready to go at 7:30 AM (note that during periods of no traffic, Dr. RE's office is about 30 minutes from home). The sperm wash would take about an hour and a half, and we were to be back at Dr. RE's office by 9:00 for the procedure.

Apparently my hubby was pretty much feeling like a piece of meat, just told when do perform. When you're a 20 year old guy this might be cool and desireable, but as a 34 year old husband, this actually wears on your self-esteem. I have a feeling that he is about as tired of that as I am of getting poked, proded, and showing my nether region to vast quantities of people. This resulted in us having problems obtaining the sample. We didn't leave our house on time because he was trying to get the sample, but to no avail. At 7:35, we left our house (yes, that is after we were supposed to be there, which was half an hour away).

The entire ride was in silence. I didn't trust myself to speak, because I could say nothing helpful. I was filled with negative thoughts and energy, and even expressing the slightest negativity would have only made things worse for my hubby. I was so afraid that we were too late - that we would not be able to have the procedure that day. It was a holiday, a Saturday to boot, and these people couldn't wait around all day for us! All those hormones from the Clomid and from the trigger shot were whirling around in my body. I had endured hot flashes, the sweats, headaches, exhaustion, and more all month and it was about to be for nothing. If you miss the small window, you're done. And I didn't know if the doctors would wait for us. I was pretty sure that we were late enough that they wouldn't.

We arrived there just after 8:00. The lab technician was surprised that we didn't have the sample, but neither of us could stammer out an explaination. I have a feeling she's seen this before. After a brief scuffle over the use of a fresh container, I left my husband in the lab and went out to the car to cry. I cried for about 10 minutes, then collected myself and just sat there.

I was swallowing everything at that moment - I had to collect myself. I finally did. My hubby came out at 8:30, and informed me that we were still on, and we should come back at 9:00. I was very surprised - with as late as we were providing the sample and they would still keep the original timeline - it just blew my mind! This further reinforced in my mind that Dr. RE and his staff and supporting lab are just top-notch. We are in really good hands with Dr. RE - he knows this business.

We ran to a local coffee and pastry shop and managed to choke down some breakfast, then ran back across the street. I was surprised when we got there to see six other patients and their mates in the lobby. I thought there wouldn't be many of us, but I was wrong! That was interesting. We were the last called back, which made sense.

We were waiting in the room for about 20 minutes. It was a similar room to the one we had been in for the ultrasound, but without the equipment. There was a little packet of something taped to the wall, which we both thought was awfully funny. We later realized it was smelling salts, in case someone faints. Interesting.

A different doctor came in to actually do the procedure, let's just call her Dr. Shortstick (for having to work on the holiday). She came in, put a piece of paper on my lap, stuck a vial in my face, and asked me to confirm my husband's name on the vial. I was taken aback, but quickly confirmed that the name was that of my husband. I looked at the sheet and quickly tried to figure out the information I was seeing. There were numbers and formulas all over the place - this was my hubby's semen analysis results! And look at that! 8 million sperm, 1.8 after the wash! Yay! I guess it was worth the wait for the sample to make its entrance for those results. They weren't great, but they were much better than the 2 million with 7% good ones that our chances for success were based on!

On that good news, I laid back and got in the naughty-bits-reveal position. First was the speculum, which I'm used to, but still don't like. My husband was next to the table, holding my hand. Dr. Shortstick informed me that I was about to feel something that some women don't like, but can't really explain. She asked me what it felt like to me. I told her it felt like burning in my belly. Apparently she hadn't heard that one before. She stopped talking for a second, and apparently my hubby saw concern in her face, just before he saw me blanch and my eyes roll back in my head. He thought I was passing out, but I wasn't. I guess it was just some more mild shock - not nearly as bad as the HSG, but certainly not fun. And there continued to be burning in my belly. Dr. Shortstick told me to lay there for 5 minutes or so, and then I could just get up and go - we were done. I laid there for nearly 10 minutes, because my belly really hurt. It slowly went from burning to cramping. That unpleasant feeling was with me for the rest of the day, and a few hours later I had bleeding which lasted the rest of the day. I spent the rest of my 4th of July laying on the couch and researching the IUI procedure and experiences that others have had with it. I have found a few new boards on infertility forums that have been a really helpful place for finding information and support. I may invite some folks from those forums over here, as I have a feeling that we'll have some things in common. ;-)

I was now officially entering the dreaded two week wait (2ww), the time during which you just don't know if the treatment worked or not. At the end of the 2ww, you either begin your period and thus a new cycle of treatments, or you don't. If you don't, you test for pregnancy, and hope for a positive result. Two weeks is an awfully long time to wait. I feel like a child saying that, but it's true. As I write this, I am ending my 5th day of waiting. 9 days to go. Nine days seems like an eternity to me right now. I'm going to go pet my puppies and kitties and be thankful for the quiet time that I have with them for now, k? kthxbai. Good night!

Tuesday, July 7, 2009

IUI Round 1 Ultrasound - June 30, 2009

On the afternoon of Tuesday June 30th, we headed in for an ultrasound of my innards. We were taken back to a little room with only one chair, and a small changing closet (I really can't call it a room). I stripped my lower half and walked over to the table with my bum hanging out. My hubby was too nervous to make any snarky comments about it. We looked at all the big fancy equipment and both of us started to eye the "wand". It had a condom over it to keep things sanitary. That would have been funny if the thing didn't look so damn scary. I took a deep breath and tried to relax. Dr. RE came in quite soon thereafter, and things happened quite fast. He started poking around, which was crampy and unpleasant, but not really too bad. He immediately saw a good thick lining in the uterus, which was already thicker than a safe minimum thickness even several days out from ovulation. He then saw my right ovary right away. It had two nice big follicles maturing. He had to do some poking and twisting to find the left ovary - the same one that gave me the trouble during the HSG. Damn shy little bastard. He did find it, and took measurements on one more nice big follicle on that side. He estimated that they all needed a few more days to be "ready", so we were told to wait until Thursday night for the trigger injection and then we should come back on Saturday, the 4th of July for the IUI procedure.

All in all, this appointment couldn't have gone better! I had three mature follicles (which I later found out is the optimal number for success), and a good thick lining. I was all ready for things to go our way! But we still had the minimal chance for success looming over us. Our excitement at how ready my bits were for baby was dampened by our wondering if we'd have enough healthy sperm for the journey. We left the appointment slightly optimistic, but knowing better than to be hopeful.

The RE Initial Visit - June 23, 2009

June 23, 2009 was an eventful day. It was the last day that I worker prior to a short vacation. It was the day of my initial visit with my new doctor, the RE. It was also the day that my grandfather died.

He was 96 years old, and had lived a long, full life. He had dementia for years, but it wasn't that bad. Yes, he was forgetful. Yes, he slept quite a bit. But he was still full of life and living on his own at home. He had wonderful stories to tell, and he appreciated our company. We visited in late summer of 2008 and brought our three dogs with us. Grandpa just had the best time playing with and petting the dogs, and just telling us stories of his life. We were happy to sit with him and listen. I will always remember him that way - full of stories, appreciative of those around him, and happy with the simplest pleasures of life. Then about six months ago or so, he took a very steep turn for the worst. His last few months were lived in clouds of forgetfulness, with ever-decreasing independence. I thankfully did not see him during his last few months while he declined so rapidly. I truly prefer it that way. My last memory of him is when we were pulling away last summer, he was smiling and waving, wishing the dogs could stay longer (he really loved dogs). His memorial service is this coming Saturday, July 11th. I am looking forward to seeing my family, but is a shame that it will be under these circumstances. Grandpa, you will be missed.

Now on to the other experiences of 6/23. We were able to get a late appointment (6 PM!) with the RE, which was great! It allowed me to work all day and not take time off work for it, which I am sure that I will appreciate having the time to take later. =) We headed back to meet this man who shares a first name with my husband. There was a quick joke about it, and then we dove right in. We'll just call him Dr. RE. Dr. RE walked us through the numbers that we already knew, but for the first time someone took the time to explain more about what the numbers actually meant! It would have been great, except that the picture is so bleak. With the severely low sperm analysis results, we have only a 20% chance of ever getting pregnant without any help. In all likelihood, if it ever happened, it would be years away. =\ meh. So we have just a couple of choices.

Option #1: Intra-uterine insemination (IUI) with a sperm wash is the less invasive method. With this method, I take medication to boost my ovulation, preferably producing multiple follicles, thus increasing the chances of one of them being fertilized. An internal (read vaginal) ultrasound is done shortly before the probable time of ovulation to see how many follicles have matured, how big they are, and how thick the uterine lining is. The doctor then makes predictions for when the follicles will be ready to release their mature eggs, and the IUI procedure is scheduled. 36 hours prior to the IUI procedure, my husband injects me with a hormone "trigger shot" to cause the follicles to release their eggs on cue, so that the timing can be perfect for the IUI. Then, my hubby produces a sperm sample just before the IUI, which is then "washed". This means that the bad sperm and all of the other fluids and nutrients in the semen are stripped out, leaving just a tiny drop of the lively, moving, most spunky sperm, which are inserted directly into the uterus (bypassing the cervix and the long swim through it). All of this is to give the little guys a shorter swim, and to put them as close to the eggs as possible so that they have the energy to penetrate the egg and get their DNA where it needs to be!

The second option is In-Vitro Fertilization -Intracytoplasmic Sperm Injection which is abbreviated IVF-ICSI. IVF-ICSI with the related hormone treatments is pretty much as invasive as a treatment can possibly be. In IVF-ICSI, I would undergo hormone treatments even more intense than the ones for the IUI, causing me to produce lots of eggs. I'm not sure exactly what 'lots of eggs' means, but it seems to be standard to mean 15 - 25 eggs all at once. The doctor then surgically removes those eggs from the ovaries and a sperm sample is produced the natural way. The eggs are held with an itty-bitty instrument, and a single sperm is pushed into each one, forcing fertilization. Then the eggs are given a few days to see which ones turn into little zygotes and which ones die. The ones that make it are either implanted into my uterus, or frozen. Or if I'm feeling octo-momish and Dr. RE is a very irresponsible doctor, I can have all of them put into me at once, so that I can have tons of children that I cannot possibly hope to provide for without everyone else paying my way or me exploiting them. *ahem* Sorry, enough political commentary for the day.

So here are the chances Dr. RE gave us: IUI over the course of 3 - 4 cycles, he gives us a 3 - 4% chance total. Not each cycle, but total. If we opted for IVF-ICSI, he gave us a 44% chance of success per cycle of treatment. Think about that for a minute. We have less than a 50/50 shot at pregnancy no matter how invasive the treatment, no matter how expensive it is, no matter what we do. I was pretty floored by those numbers really. I was expecting something like 15 - 20% for each IUI cycle and at least 50% for IVF. The good news of the appointment was that he was ready to start right away. He figured that there was no reason not to try a few cycles of the IUI first, even if it was a long shot, it was a good place for us to start. I had already started on the Clomid from the OB/GYN's suggestion, so why not? We scheduled the IUI ultrasound for one week later - 6/23 and headed off for our vacation.

Getting to the Bottom of it Part 2: The Semen Analysis and Progesterone Test (June 2009)

So riding high on the fabulous results of the HSG, my hubby headed to a lab for a semen analysis (well, actually he headed over the day before, but this is my story, dangit!). He had to go to a lab and produce a sample while in an impersonal little room, so I felt pretty sorry for him. That seemed like it would be really degrading. He took it well. Then we began to wait for the results. After a few days, my OB/GYN's nurse gave us a call. Actually, we tried to reach her several times first - it took nearly a week to get the results when we were told to expect three days. In any case, she ended up reaching me and providing me with the results. The analysis checked for several components:

1. Sample volume - this was normal. Good news, yay!
2. Sperm count - this was low. A low end of normal count is 20 million of the little guys, with 40 million being preferable. We had 9 million. Hmmm, that's not great news.
3. Forward Progression - also quite low. They like to see greater than 50%, and we had 11%. Ugggh, that sounds really bad.
4. Activity - also low. Should be 2+, and we had 1+ (I have no idea what this measurement is, just that it's outside of the norm). Meh.

The conclusion: Any man can have one poor test. Go back and try again in a couple of weeks. Mmmmkay. I'm sure it was just a fluke - the next one will be better!

Fast forward a few weeks. Hubby goes in for analysis #2: the retest. I also go in for my blood draw to check my progesterone levels on day 21 of my cycle. A few days later, I get a call from the nurse again. I headed over to a conference room for privacy. First, the progesterone level results. They like to see levels of 10 or higher, and I was at an 8.8. Based on the information that I had provided earlier about the LH Surges and specifics about my period, she was 99% confident that I was ovulating. They figured the test may have just been off by a couple of days, as I usually have my LH Surge later than would be expected (usually around cycle day 16 or 17). Just to be safe, she gave me a prescription for Clomid, a drug to encourage ovulation, oftentimes of more than one follicle. More information on follicles and ovulation later. The important part at this point is that I was almost certainly ovulating, but it wouldn't hurt to give me a boost with some hormones.

Now on to the semen analysis retest results:

1. Volume normal again.
2. Sperm count was 2.7 million.
3. Forward progression was 7%.

Wow. That was a really a blow. Not only were the results not better, but they were significantly worse. This means we officially get dubbed as "Male Factor Infertility". I began to pummel her with questions. What does that mean? What are our chances now? What can we do? What happens next? She had no answers for me. She said that we needed to go see another doctor - a Reproductive Endocrinologist (RE), and that she couldn't provide me with any other information at this time, except that my OB/GYN suggested a procedure called IUI, whatever that was.

I felt so confused. I was tired of waiting, tired of mystery and of cryptic information. I wanted some answers, and I didn't want to wait any more. I just felt like we kept getting shuffled around. It started to hit me that this wasn't just a silly exercise that we were being put through when everything was just fine. This was really happening. We actually have a cause, a reason that we haven't gotten pregnant yet. And we have no idea how to get around it, or if we even can.

Pregnancy Timing - May 2008

So when we initially started trying, we wanted to be into the second trimester before we told anyone that we were pregnant, if we could hide it that long. We initially hoped to make the announcement at Thanksgiving of 2008 (maybe before if we got pregnant right away). That timing then changed to Christmas 2008. Then we thought that as long as we had a positive pregnancy test confirmed by a blood test by Christmas, we would announce it, even if we were only a few weeks along. I remember laughingly telling my hubby that there was no way that I would see my 30th birthday before getting that positive pregnancy test. I turned 30 in January (of 2009). Meh.

Getting to the Bottom of it: Infertility Testing (May 2009)

Finally, some progress (well, sort of). We were finally referred to see an OB/GYN to begin infertility testing by our doctor's office. It was sort of a fluke how it happened, really. I went in for some back pain, and saw another practitioner at my family doctor's office. While there, she made the mistake of asking me if I was pregnant yet, since I had been on the pre-natal vitamins for so long. After I whined for a few minutes, she told me that there was no reason to wait the full year, as it had been more than 9 months already. She gave me a name and number and advised me that it may take some time to get in to see the OB/GYN, so to call and get something on the calendar. I was so relieved! I called the very next day and scheduled the appointment for about two months out. In retrospect, I could/should have scheduled it for only about a month out. I felt that waiting two months of the three that I "should" to wait was a pretty good compromise. In any case, on May 19th, 2009, we went to see the OB/GYN for the very first time. I thought that I was nearing the end of my journey to get pregnant. For some reason, I thought that there would be some magic about entering her office and I would become pregnant almost instantly. I was very wrong.

I had to wait for my next cycle to begin, but when it did, I immediately scheduled several tests to attempt to determine the cause of our infertility. The first test up was an HSG. HSG is an abbreviation for hysterosalpingogram. Let's agree to just call it an HSG, OK? In this test, dye is injected into a woman's vagina through a very uncomfortable tube while taking an x-ray of her reproductive organs. The point is to see if the dye works its way up through the uterus, into the fallopian tubes, and then spills out. If there are blockages or growths, they would be seen in the images. I had a bit of trouble getting things ironed out to have the HSG done. It was on the calendar for a week, or at least, some sort of appointment was (you have to call on the first day of your period and it is scheduled for sometime between day 7 and 10 of the cycle). Mine was on the calendar for my cycle day 7. When I got to the appointment, the nurse took me back for my routine pregnancy checkup. Yeah, read that again. After I finished blinking in shock and stammering in discomfort in the hallway at her announcement of this, I got her to understand that what I was supposed to be scheduled for was an HSG. That was a fun conversation. She then said, "Oh, sorry. That has to be done at the hospital, not at our office (which mind you is inside the hospital building). We'll just set it up for next month." Next month? NEXT MONTH?!?! Five minutes later after I had finished bawling in the hallway and realized that I had crumpled into a chair (I don't recall willing myself to sit), she came to understand (through my blubbering) that although this was a Friday, it was my cycle day 7. That meant that my cycle day 10 (still within the cycle date range for the test) was the following Monday, another business day. She took me back to the waiting room, which was now empty as it was about 3:45 on a Friday afternoon, and had me wait there. It took her nearly half an hour to come back. In the interim I tried to stop crying, really I did. It wasn't much use though. As I sat there, I just imagined the gap of yet another month of just waiting and wondering and delaying the start of treatment even further. After the mental and emotional buildup that I went through just to get ready for the HSG - renown for being an unpleasant test - the thought of having to wait a whole month to build myself up for it all over again was simply too much. Thankfully, she came back with some pretty good news. I was all set for the HSG the following Monday. I stammered out a few expressions of gratitude, and made my way out to my car. That weekend, the last weekend in May 2009, was a very rough weekend for me emotionally. Let's just fast forward to Monday, shall we?

Monday came, and I had decided to take the day off work for my personal sanity. I was such an emotional wreck; I didn't trust myself in the office. I think it was a pretty good decision, even though I had to miss some meetings that I really should have been at. In any case, my appointment was at 1:30 in the afternoon, and of course, I showed up at the hospital very early. That turned out to be a good thing. After filling out my paperwork, and talking with an administrative nurse who collected some additional information from me, I was taken back to a changing room. I changed into my lovely gown, locked up my belongings, and paced around this new waiting room, which I had all to myself (thankfully). After about 10 minutes (it seemed like much, much longer), I was taken back to the x-ray room by a very nice radiologist. My OB/GYN was there waiting for me, so we got things rolling. The test was scarier than I thought it would be. The room was dark (I really didn't expect that - I'm not one who has had extensive experience with hospitals, x-rays, etc!), and there were lots of machines. I'm not sure what I expected, but this was not it. I lay down on the table and got into the "female bits examination" pose, which is always lots of fun. The tube was put inside of me, and I was told to slide back on the table and lay down, which I did. I turned my head to watch the screen that the radiologist was watching, and braced myself. I started to feel some cramping as I watched the dye move up in the image on the screen. Apparently I have a picture-perfect uterus. How's that for TMI? My Right tube popped up immediately on the image as well, with spillage almost immediately. Again, perfect. My left side was being a little stubborn for the camera. I was given the order to roll a bit to my side. So I did. The next thing I knew, I was blinded by pain. I heard the doctor talking in the distance, apologizing that she had put in too much dye at once. I heard the radiologist, from miles away, telling me to talk to her. I saw my left tube and ovary displayed on the screen - perfect again, I might mention. I saw the radiologist looking concerned. She asked me a few more times to talk to her. It was all foggy, and I remember thinking that I didn’t really feel like answering her at the time, but I’d consider it later. I finally managed to stammer out "ow" in response to their pleas for me to talk. There was some relieved giggling. Apparently I had gone into mild shock. My pupils had dilated rapidly, I had broken out in a cold sweat, and I had become non-responsive for a minute. The cramping was horrible for that minute, but then it subsided into a normal level of unpleasant cramping. After a few minutes, I got up and moved to a private bathroom to clean up some of the dye, which is actually clear, but very sticky. And that was it! I had a clean bill of health on my bits. They were just right and perfect for baby-making. Whew!

Monday, July 6, 2009

The Pre-Pregnancy Checkup - May 13, 2008

Being a responsible person, I figured that I should go to the doctor, get some bloodwork done, have a physical exam, and just generally make sure I'm a healthy person before getting pregnant. So on May 13th of 2008, I headed over to my family doctor for a rundown and to ask her what I should be doing to get my body ready for pregnancy. She ran a variety of tests, checked me over, and gave me a prescription for a prenatal vitamin. Being an overweight individual, I asked her if my weight would be problematic, as that was one pretty major concern that I had. She told me that losing a few pounds are never a bad idea for someone of my size, but that I should not try and loose a large amount of weight at this time. 10 pounds would be good and could only help, so that's the insight that I kept in the back of my mind. She also told me that when I did get pregnant, if I could limit my weight gain to 15 pounds or so, that would be really healthy for me and for baby. Good enough, at least until my hormones are telling me that I MUST eat chocolate every day, with every meal. Heh. So I set out to eat healthier, but not to try and crash-diet. Good enough.

A few days later, my blood results were ready. There were a couple of pieces of unpleasant news there. First, though I had always been borderline anemic, the test showed had crossed over the threshold into full-blown anemia. I had been taking an iron supplement, but not always regularly. The doctor informed me that I could not miss a day - I needed to take my supplement every day without fail, and we'd check my levels again in 60 - 90 days. Fair enough. She also informed me that my thyroid was out of whack, and put me on some medication to regulate it. Apparently that's a pretty big deal for pregnancy. Again, good that we found it early! So, now with three mandatory pills to pop a day, I headed into the trying phase knowing that I was taking care of any issues that may have harmed my baby! Good!

A few months later, I went back for a re-check of my levels. This was after a few months of trying, and after all of those nasty fake-out cycles that I mentioned before. I think this was around August of 2008. My thyroid had regulated (yay!), but my iron was still off a bit. The doctor's orders? More iron-rich foods, less tea, and stop forgetting to take those pills! Somewhere in there I also got several immunizations as well (measles, mumps, & rubella I think? Something with three components to it). I actually had a big angry red lump on my arm from the immunization and we were at my sister's house for something shortly thereafter. I think it was in late May or early June for my niece's birthday party, and I was in short sleeves! I had to make up some story on the fly about the big lump on my arm, and I am a really bad liar. Somehow though, I managed to fudge my way through the time with my family with no one the wiser. Whew!

So the months ticked on, relatively uneventfully, but with us getting more and more frustrated with each cycle that passed by, and each test that came back negative.

Sunday, July 5, 2009

Summary background - May 2008

My journey through infertility - though unknown at the time - began in May of 2008. I graduated with my MBA, had recently obtained the job I had been reaching towards for several years, had a great house, and just generally felt that everything was finally in place. My husband and I were planning on waiting a few more months to start trying, as we were certain that pregnancy would happen right away, but decided "What the hell!?" and stopped taking the pill. We immediately started trying. Those first few months were quite a rollercoaster - my cycles took about 40 days at first, and I had many of the traditional early signs of pregnancy. I had the headaches, sore breasts, nausea, bloating, and exhaustion. I thought for sure that I was indeed pregnant - but why did those pesky tests keep coming back negative? Well, they came back negative because I just wasn't pregnant. I wasn't really worried at the time. It was still early on in the process. Most couples don't get pregnant right away, right? No worries.

But the months ticked on, and still the tests came back negative month after month. I began tracking my ovulation with over the counter ovulation predictor kits, which test for a hormone surge called the LH Surge, which is the trigger for ovulation that occurs about a day before you ovulate. Every month that I used one of the kits, I had a surge, which indicated that I was ovulating. And we'd get the timing just right over and over, but still no luck. About 7 months in, I went to my doctor, as I was so frusterated with our lack of success. I knew that it was normal to wait 12 months before seeking help, but I wanted to see if there were any tests we could do early, or if we could just put a plan in place - something, anything to put my mind at ease! Unfortunately, she just told me to wait. Meh.

My husband and I had agreed to keep the fact that we were trying a secret, but I'm not very good at keeping things to myself. I'm a venter, and I desperately needed to vent to maintain my sanity! We really had thought it would happen quickly, so keeping it a secret at first was kind of fun and exciting. We actually made off-hand comments to try and throw our friends off the track - we really wanted it to be a surprise! Turns out that the joke was on us. I'll talk more about the secrets, our confidants, and all of this intrigue later. It's really an interesting tale with many interesting twists and turns. For now though, just keep it in the back of your mind.

Hi There

Hi there! This is my first attempt at a blog. I decided that I'd give it a try, as I know that it's been therapeutic for some of my friends. I'm going through quite a lot in my life right now, but nothing quite so unexpected as my journey through infertility. I never really thought in my wildest dreams that I would be unable to have a child when I decided that I was ready for one. I thought that it would happen very fast - in that first month really. My husband is such a worrier that we used two forms of birth control - every time - for years and years. Hell, talking him into quitting with the condoms and relying on just the birth control pill took nearly two and a half years after marriage! So it feels quite strange that we are knee deep in our 14th month of trying to get pregnant without a hint of success.
I intend to fill in bits and pieces of my background story, while also detailing my journey moving forward. I'll try to explain where each story comes in chronologically. I like to tell stories, just ask my friends or coworkers. =) Hopefully I'll be able to express my feelings in a way that you find informative and/or entertaining. I'm pretty open and like to share details, so feel free to pass over any of the squicky details if they aren't your cup of tea. So thanks for stopping by, and I hope you gain something for having read my blog.