Public Service Announcement (UPDATED)

I feel like a total idiot, but I need to share this with you all just in case you are as un-observant as I am.

I was cleaning out my fridge this weekend and organizing my crisper full of Gon.alF by expiration date and I made a discovery.

The expiration date on the pharmacy's prescription sticker was NOT the same as the expiration date on the actual box the pen came in.

Big revelation, huh? I hadn't even realized there was a date on the actual box. I only saw the one printed on the pharmacy sticker. My pharmacy is part of my health insurance company. Those sneaky bastards put an expiration date FIVE FULL MONTHS earlier than the one printed on the box. And the most recent batch of meds I received... the pharmacy sticker has a date that is THIRTEEN months earlier than the date on the box.

Anyway, the moral of the story is check your prescriptions carefully to be sure of the expiration date. Don't let the insurance bastards put one over on you.

UPDATED: (re: Rx expiration vs Meds expiration) Excellent question C, and one I asked myself at first as well. But no. I know this because when I called the pharmacy in January to order a refill, they told me the Rx had expired and I would need my RE to call in a new one. The last box of medicine I had left over from the previous Rx had an expiration date of 3/01/2011 on the pharmacy sticker. More than two months after when the pharmacy told me the Rx had expired and yet five months earlier than the date printed on the box.

Siren Song of a Seed Packet

The ground is still covered with a light blanket of snow. The temperatures have been topping out in the low 30's. I hate working out in the yard at any time of year.

And yet.

With the imminent change of seasons, out come the display racks filled with colorful seed packets. And I can never resist. Last year it was parsley. This year, I bought cilantro seeds because I always resent buying the huge bunches in the produce section at the grocery (seriously, who needs that much cilantro?). Whether or not I will actually PLANT the seeds is another question entirely. But I just couldn't resist the little yellow envelope. I never can.

Hope springs eternal in almost every aspect of my life. I cannot for the life of me fathom how or why.

I'm OK

Just don't have anything to say at the moment.

Things to Feel Good About

So now we wait. Again. There really is no end to the waiting in this game is there?

I call with my next CD1 and we do a bunch of baseline stuff & blood work. Depending on our calendars and my cycle lengths, I will probably start BCP in early May. In the meantime, I don't really have much to report. I'm trying to focus right now on the good stuff, things I can be grateful for in the midst of all that is so unfair about this situation.

Aside from the fabulous support group I've found here and on Twitter...

• I already have most of the meds I will need for IVF and what I don't yet have, shouldn't be too costly.
• Our cars are both paid off.
• My student loans are all paid off.
• Our back taxes are all paid off.
• Our only remaining debts are our mortgage and one credit card (though it IS a doozy).
• Prof has contracts booked through the end of 2011. This is huge!
• 2010 tax materials have been passed to the accountant and she said they "look good". No whammy, no whammy!
• We have not yet needed to use the (tiny, tiny) savings we put away last year (knock on wood).
• The weather should only improve from here on out.
• My boss is back in the office, so my work stress should decrease.

These are all good things. Breathe in, breathe out. Let go.

Why Bother?

DISCLAIMER: This is probably going to seem like a really random collection of thoughts, but (if you roll with it) it should all fall into place by the time I'm done.

In facing down IVF, I'm also facing down a lot of doubts and fears:

I am not psychologically strong enough for IVF.
My eggs and I are just too old for even IVF to succeed.
Once won't be enough and we'll go broke trying again. And again.
I will never feel like I can stop trying.
IVF will work and I won't be "up to" motherhood.
Prof and I will survive IVF only to be driven apart by parenthood.

The one I'm particularly stressing on at the moment is my age. I know chronological age really means nothing in this game. I know some women in their 20's are facing early menopause and some women in their 40's can still get knocked up on their own. They are the outliers.

I am 38, and 39 is approaching faster than I care to acknowledge. My FSH is 10.7 and my AMH is .33 - not good numbers for a woman trying to make a baby with her own eggs. So the clock, it is a'ticking.

In an effort to do everything possible to bring this IVF adventure to a successful conclusion, I decided to head back to acupuncture again and to hit it as hard as I can, even when the insurance coverage runs out. I hadn't been in for acupuncture since last Fall before my "second opinion" with the clinic recommended so highly by my acupuncturist. If you've read that post, you'll understand the quotation marks. If you haven't read it, you should, because it was a trainwreck of a second opinion.

As I was catching up with Dr. Needles and bringing her up to speed on the plan, she asked if I was still seeing my original RE... and I could see where she was heading with that. I explained to her that I had been for a second opinion with her recommended clinic last Fall and I gave her a brutally honest report of my experience there. She was surprised and suggested I should definitely share my thoughts with them, but frankly I don't see the point.

She explained the reason she recommends them so highly is that she has had several patients who were turned away by my clinic but then went on to achieve a successful pregnancy at the Spa. The upshot of this is that my fertility clinic won't treat just anyone who walks in the door. I suspect their higher success rates may be due in part to the fact that they will apparently turn patients away who they don't feel they can help. At the time of this conversation, I had not yet seen the newly released success rates, so I obviously didn't bring them up.

I admit I'm a little conflicted about this. It's comforting that they don't just take the payments and let people go through treatments that aren't likely to work. At the same time, it's disconcerting that they are making calls about who to help or not.

So this is one more thing that CAN give me hope, one more thing that tells me it is worth going through this ordeal. If Dr. Original didn't think he could help me, he would have said so and he probably wouldn't treat me.

So that's one reason why I bother to push forward on this path.

Watch This Space (UPDATED)

My pre-IVF appointment is this afternoon, so I'm sitting at my desk biting my nails.

I'll post an update when I get home from acupuncture this evening.

UPDATED: I forgot to take my list of questions. Not the most auspicious beginning to the IVF process. I managed to remember most of them, and I'm putting them down here for my own reference as much as anything else. 

We got a whole checklist to get in order before we get started and a raft of new blood tests got ordered (I call in with my April CD1). Prof has to have an extra-special-IVF-SA which they will freeze as back-up for the IVF. In the vent of his untimely demise, those sperms are to be used to get me knocked up if I so desire. It's written and signed. Beyond that, we start whenever we are ready. I think we're gonna shoot for June.

Melatonin (forgot to ask, not really worried right now)
Acupuncture On-Site: (forgot to ask, still time to check later)
Success Rates: My clinic has been improving themselves since the last batch of success rates were published! A new batch came out last week and my clinic actually had better rates than some of THE BEST clinics in NYC. They beat the pants off the Second Opinion clinic (like, triple the success rates).
My lining: Has never been of particular concern.
Egg Quality/Mature Eggs: Dr. Original said my stimulated follicular phases were textbook length, not too short and the Lu.pron is what will give us time to get the most mature eggs.
Protocol: The whole team of RE's in the practice review each patient's charts before an IVF cycle and they decide collectively what the protocol should be. Kinda cool! He thinks mine will be pretty standard, BCP/Lu.pron/GonalF/Ovi.drel/PIO. The BCP will be the same brand I always took before we started this whole baby-making gambit, so that's a comfort. I have almost enough GonalF in my vegetable drawer for IVF. I think I know how to get more. Dr. Original stated that my stimulated IUI's were relatively low-dosage for a woman my age and he thinks I'll use one pen per day during IVF.
ICSI: Yes, due to my age and our lack of real success in other cycles. Although, we will probably go with PICSI (partial-ICSI). This means they will ICSI half of however many eggs we get and let the rest fertilize naturally. We like this option because we feel like it may give us insight into what our problem might be. And if we get a baby girl, I'm totally calling her Pixie. No one ever needs to know.
Assisted Hatching: Yes. Due to my age.
PIO vs Crin.one: PIO for the 2WW. He said I could use whichever I preferred, but that HE recommends the PIO until beta. He did say they would probably switch me to Crin.one once pregnancy was established.
Financials: We've decided to do one round to see my response and what quality eggs/embryos we get. We'll revisit the B2G1Refund option if needed.

SIDE NOTE: When reviewing the success rates, Dr. Original checked my chart for my age. He said, "Age... 38? Well. I wouldn't have guessed that." Have I mentioned how awesome he is?

I've Got Mail!

One of my responsibilities at work is producing the "Personal Updates" section of our organizational newsletter. This involves people sending me random emails with tidbits like:

I have a new job!
I'm relocating from Barcelona to London!
I've won a national award!
I just published a new book/article!
I got married!

And... Yes.

We just had a baby!

Great task for an infertile, huh? When I see notes come in from people who are older than me announcing the birth of twins, I just know. And I wonder how they would feel knowing a still-struggling infertile has to send all of those happy shiny congratulatory replies back to them?

Pre-IVF Consult

Our pre-IVF consult is scheduled for March 14th. The nurse who set the appointment for me mentioned consent forms. We've got questions, we're hoping they have actual answers. Leave me a note in the comments if you think of any other questions we SHOULD be asking (keeping in mind I may not have listed it here because I already know the answer, in which case I'll try to post that after the appointment).

• Can I continue to take the melatonin in the 2WW?
• Is there anything we can do to optimize egg quality?
• Is there anything we can do to ensure more mature eggs? (I seem to have a short follicular phase on injects and worry about potential immaturity)
• Is there anything we can do to optimize sperm quality (already seems quite good)?
• Discuss Crin.one vs PIO for luteal phase support.
• Is in-clinic acupuncture available? Can I bring my own acu?
• Will we use ICSI and/or Assisted Hatching?

We also have some thinking to do about the financial side of things.

Our clinic offers a very reasonable shared-risk plan. For couples in our age bracket, $17K gets you three fresh (and three frozen) cycles with 75-85% refunded if you don't take home a baby. I'm already not sure where we'll get the $7K for ONE cycle (though my FSA will reimburse most of that after the fact, we still have to pay up front somehow). But the way our luck has run, I'm really worried that one cycle won't be enough.

So... When Are YOU Going to Have Kids?

Talk about a common thread! We all get this question or some variant thereof at some point. And we all know going into any major family or social gathering that we're probably about to get it again (repeatedly). So this is by way of a reference post for IF'ers prepping for a situation in which the Dreaded Question is likely to arise. Below are some examples I have previously seen shared when one of "us" has had an impending need for such resources.

When in need, revisit this list of quick & easy responses to inquiries into your reproductive life. And for maximum points, follow up your response with a very derisive "But thank you SO MUCH for asking".


If and when God chooses to bless us. My personal favorite, said with a sickly sweet intonation. No offense to you Believers out there, but this one covers all bases. If the questioner is religious, they can't really argue with God's will. If they aren't religious, you can hope they have the sense not to argue religion with you in any event. In my case at least, if they know me at all, this shuts the conversation down entirely because they begin to suspect I've lost my mind.

I'm waiting to see how yours turn out first. Good for new parents.

When the CIA clears our files. (BumpyJourney) 

When you stop watching my uterus. (naturalmelnow)

The voices told me not to.

Actually, I am pregnant. I'm due in twelve months. Then walk away rubbing tummy. (carlnjessdewy) 

What and spend the next 20 years fat, tired and broke?

Kids are really expensive and I'd rather... fill in the blank with your favorite pricey indulgence (travel, shopping, technology).

Why? Are you selling?

When do you need to know?

To a single person: When you get married. (amvdm23) 

To a MIL/FIL: Well, I'm having unprotected sex with your son/daughter ALL THE TIME...

Are you worried about our sex life, because you don't need to be. Say it with bedroom eyes... Rowr.

I don't think our sex life is appropriate dinner conversation. (BornInABarnBaby)

I don't know, but I'll be sure and put your name on our list of people to notify as soon as we do!

If the questioner is a man... When is your next prostate exam?

If the questioner is a woman... When is your next pap smear?

And why exactly is that information that you need to know?

How do you know we aren't already trying and having trouble? (OldEggs)


When you pay for my next IVF cycle. (IVFJess & SassyNTubeless)

My darling Professor actually responded once, "So when are you planning to die?"

I saw this one on a message board (courtesy of Toxic) and I like it:

"There are thousands of couples, desperate to have a child, who struggle with infertility, mostly in silence. Every time they see smiling mommies at the playground, or go to a baby shower, it's a traumatic experience -- reminding them of the joy that they can't have.

I'm not going to tell you whether we're one of those couples or not, because it's not your business. I'm just going to tell you how hurtful your well-intentioned question is to someone who is.

Please don't ask me, or anyone else, again."

If you have any other brilliant suggestions, please leave them in the comments!

No News Is... No News

I don't really have much to say at the moment.* Still in the Pre-IVF Planning stage so nothing to report IF-wise. My iPhone tells me yesterday should have been my peak fertile day (cue psychotic laughter) so Prof and I have been relating appropriately. I believe there is a saying about counting chickens or eggs or something? I confess I don't honestly believe this is baby making sex, but the intimacy feels nice.

I'm clamboring back onto the weight loss bandwagon. I was doing really well in January and kind of slacked off during our final IUI cycle and subsequent vacation. I don't think I put any weight back on, but I lost my momentum. I'm renewing my commitment to that effort. Seeing the success of my efforts and feeling my waistbands loosen up was such a boost to my self esteem and I really want some more of that! Like so many others, I feel like this is one of the few things I can really control in my life, so I want to exert that control.

Cat One had to have some dental work done a couple of weeks ago. She has had this several times, poor thing. She really got some crap genetic cards dealt to her in the tooth department. This time was much better than the last (when we almost lost her to the anesthesia) but I really lost my shit when I left her at the vet and two weeks later she's STILL licking the shaved place on her leg where they put the IV for the procedure. Hurts my heart to see her worry that spot raw.

My boss is out of the hospital and resting at home. Thank you for your thoughts on her behalf. The plan is for her to return to the office mid-month. This is a huge improvement over the initial outlook. We were warned it could be three months before she could come back. Now she'll be back after only 6 weeks out - she's turned out to be quite the rockstar in the healing department. To say we've really missed her doesn't quite cover it. Nothing to what her family must have felt.

I mentioned on Twitter recently that I've been feeling like I'm mostly just watching other people's lives go by me. I'm not doing the IF obsessive thing, I just don't feel like I'm doing much of anything. Perhaps I Let Go just a little too much? I feel like I need to live it up a little.

*That was awfully long post for not having anything to say...

Plan Y

Plan A (Stop BCP)
Plan B (OPK+timed intercourse)
Plan C (acupuncture)
Plan D (Clo.mid+IUI)
Plan E (Clo.mid+triggered IUI)
Plan F (Gon.alF+triggered IUI)

We've tried so many plans and variants of plans and repetitions of seemingly successful plans, and yet. Here we are two plus years on with no baby. We are making one more plan. The next to last plan.

Plan Y (IVF)

Plan Z is taking the turn off of the IF highway to grow old with the Professor and start putting our spare income towards seeing some of the places we've always wanted to see and knocking off some of the items on our Life Lists.

Beating a Hopeless Horse

I just wanted to say a quick Thank You to all of you here and on Twitter who have been so incredibly kind and supportive. You've listened to me whine, putting up with my navel-gazing and moping. And you've done it in the most caring way and with such good grace, constantly reminding me that I AM NOT ALONE, I am not the only person who ever traveled this road, felt these fears and emotions. Not one person has told me get over myself, sack up and sally forth. Y'all are a warm fuzzy blanket and a cup of coco.

Thank you for continuing to beat that particular horse for me.