My Trench is Taking on Water

This is probably more of a post for my peeps still in trenches with me, as it were. I kind of feel like not only am I still in the trenches, but my trench is filling with water and I'm drowning in this hole I've dug myself. Those of you currently pregnant or parenting are surely drowning in a nearby though totally separate trench and I hope you understand that I'm not actually asking anything of you here and I'm not trying to hurt your feelings. I'm also fairly certain I've seen others write posts just like this before. I'm feeling a little derivative, but this is where I'm at. I know I'm not alone, not the first infertile to visit this space. That's really what will make me hit publish. So that maybe someone else will see they are not alone.

I know "Once infertile, always infertile", but my Twitter timeline and my blog reader have made a significant and painful shift recently. Huge numbers of the internet friends I made when I first stumbled into this community have now crossed over to the pregnancy/parenting side of things. Most days, it feels like all I see is pregnancy plans and questions with a healthy dose of nursing/diaper habits. It's really starting to get me down. Like Thinking-of-Seeking-Therapy Down. Even my online support group is becoming just another reminder of the ways my body is failing and the dreams I can't seem to fulfill. I am feeling worse and worse by the day about my chances of completing an IVF cycle, to say nothing of a take-home baby. Hell, with the failure of this most recent attempt at an IVF cycle, I'm even feeling jealous of those of you who just make it to retrieval. Relieved for you, but jealous all the same.

My initial instinct is to unfollow out of self-preservation and it may yet come to that, but I don't really want to lose my connection to these women. They are still infertile, they have been supportive, they have been where I am (and where I hope to be) and they have feelings too. I don't want to hurt them by disappearing.

For those of you who have written this post before me, how did you handle this?

IVF The Remix (Conversion)

For those of you not on Twitter, my Monday morning monitoring revealed only TWO viable follicles at 22mm each and estradiol holding steady below 200. Basically, fuck all.

My clinic has a 4 follicle minimum for IVF retrieval, so they recommended to convert to IUI. When I explained the situation with my FSA money, they gave me the option to move forward with IVF if I really wanted to. But. The success rate for IVF with two follicles versus IUI with two follicles is the same. Obviously, IVF comes with some risks that IUI does not have. It is surgery and there is no guarantee that they will actually collect the eggs.

There is no chance of another IVF cycle this calendar year. I called the FSA administrator and they confirmed that if the procedure is not performed before December 31, 2011, I WILL lose the money in my FSA. So we are now poring over the eligible expenses list to see what we can use the balance to purchase.

This was our choice. And we chose the IUI. As badly as I want to close the book on this process and as heartbreaking as it is to essentially get cancelled again... this feels like the right decision. Silver lining: No PIO and we get to have sex as soon as the IUI is done.

Not-Penny's Baby Shower

Today is Elphaba's virtual baby shower. Everybody say "Hi" to our guest of honor and our lovely hostess Mo... Now grab yourself a drink (punch or tequila, as you please) and a tasty treat and plop your butt on the couch with the rest of us Infertiles while we celebrate one of our own as she prepares to cross the Finish Line!

According to our hostess, I'm supposed to write a little bit about what Elphaba's pregnancy has meant to me, but I'll admit to feeling slightly inarticulate just now. I've been excited for her, worried for her, relieved for her, proud of her, impressed by her (and worried for her and relieved for her again) and finally... insanely jealous of that amazing Canadian maternity leave. I will probably never be as eloquent as Elphaba, but I sincerely hope that someday, I get the chance to be as cute and feisty a pregnant lady as she is!

Elphie, I hope that these gifts will bestow upon you some peace and quiet (and a touch of sanity) here and there.

Obviously, since I'm still battling Primary Infertility, I don't have any significant personal experience with newborns. I do however, have scads of fertile friends, and they tell me these two items are life savers. So here's to Elphaba and Mr. M and Baby Girl Yolk. She will always be "Penny" in my mind!

IVF The Remix (Update #3)

So yesterday sucked. That about covers it. For those of you who are playing along at home and require more in depth analysis of the game thus far...

Saturday AM monitoring revealed:

Lining: 7.2mm (Really? How did it get thinner?)
Estrogen: dropped to 164 (drop ascribed to Ganirelix)
Left ovary: 2 follicles at 14-15mm, 5 follicles at 7-8mm
Right ovary: 2 follicles at 13-14mm, 3 follicles at 5mm

This is very disappointing. Even the RE seemed a little bummed by these numbers. I'm stimming more slowly than anticipated given the total lack of suppression with this cycle and the 4 months of preparatory DHEA. We're basically looking at four follicles of viable size. Yes, there are several little ones hanging back. Yes, I know "it only takes one". But. The doctor basically dismissed the 5-8mm follicles as not viable and that abysmal AMH level from last year is haunting me. I just don't have many eggs left, and apparently all the gonadotropins in the world aren't enough to really get my ovaries in gear.

They've upped my Menopur dose to 225. Still at 300 for GonalF. And FYI, Ganirelix has a sneaky afterburn to it. At least the Menopur headaches have gone. Look at me finding a silver lining.

IVF The Remix (Progress Report)

FIRST THINGS FIRST: Thank you all so much for all of your lovely comments in the last few weeks. You kept me from drowning in my own misery. At this point I'm doing pretty good to string a complete sentence together, but I need you to know how much I've appreciated your thoughts and words.

As I knew it would be, work is totally insane right now, so this is just a quick update on my monitoring this morning.

Lining 7.4mm
Estradiol: 371
Left: 11mm, 13mm, 9mm, 7mm
Right: 12mm, 12mm, 6mm

We lost a couple off the right ovary and progress is slow but steady. My dosage remains at 300 GonalF + 150 Menopur. I start Ganirelix Friday night to prevent ovulation and go in for another monitoring on Saturday morning before I go to work. For a 14 hour day. Hold me.

I'll check back in on Sunday.

IVF The Remix (First Peek Inside)

For my own records as much as anything else. After three days of shots (300 GonalF + 150 Menopur), the first monitoring appointment revealed:

Left Ovary: 4 follicles (9mm, 10mm, 7mm, 6mm)
Right Ovary: 5 follicles (10mm, 10mm, 6mm, 6mm, 8mm)
Estradiol: 141

The dosage remains the same and we recheck on Thursday. For the sake of comparison, I looked back at IVF Cycle of Fail and we now have double the number of follicles with half of of those at larger sizes than last time. The nurse was pleased with this progress, so I suppose I shall be as well.

Beats the crap out getting cancelled!

The Knowing

My RE's office is in a building that is dedicated solely to providers of women's health services. It is usually bustling with activity... patients and their loved ones, doctors and staff and those ubiquitous pharma reps. My midwife is in the same building, as is the breast imaging center where I've gone for mammograms in the past. I've lost count of the number of times I've visited this building over the last ten years.

But. My RE is the only provider in the building that sees patients on the weekend. In a town with limited options for infertility treatment, I'm pretty certain at least a couple of you have been to my RE. I've seen regular blog hits originating not only in my town, but in nearby smaller towns as well.

When I walk through the building on a Saturday morning and see only a handful of others (almost always couples on the weekends), all heading to or from the same door as I am, I know. We all know. The atmosphere in the building is just a little more relaxed, a little more open. People's voices are not quite as hushed as they are on weekdays. Because we all know why we're there and we're all there for the same reason. And I always wonder if I'm looking across the waiting room at someone who reads this blog, or whose blog I read myself.

That curly headed girl whose face lit up when she spied the pumpkin spice K-cups at the coffee station in the waiting room last weekend? That was me.

IVF The Remix - May I Vomit Now Please?

I went in first thing this morning to get my blood levels rechecked. Just got the call. My progesterone dropped and my estradiol was right on target.

I start stims tonight for IVF The Remix: 300 GonalF & 150 Menopur. First monitoring on Tuesday.

Seriously. I may vomit.

Once More, With Feeling! (UPDATED)

I called it at about 12:30 this afternoon. CD1.

Baseline appointment will be tomorrow (Thursday) just after lunch. Since the appointment is so late in the day, I probably won't get a call with my blood work results till Friday morning.

Deep breaths.

UPDATED: Same song, second verse... lovely ovaries aaaaaaaannd elevated progesterone. Retest on Saturday, but I've already given up hope. Fuck.

Is It Time to Panic Yet? (UPDATED)

I have a sneaky feeling I'm fucked.

iPhone says CD1 should be Monday and I'm just now starting to get some mild cramping and backache and acne. Just like last cycle (with the wonky progesterone levels), there are a few PMS symptoms that are missing. I have been running through various scenarios in my head surrounding the beginning of IVF The Remix, and none of them are particularly good. At this point, the only possible start date that won't end badly is if my CD1 is about a week late.* Not beyond the realm of reason, but not bloody likely either.

So this is sort of like one of those "choose your own ending" stories, but much more expensive. Here are the most plausible story lines I've worked out.

OPTION ONE: If CD1 shows up between now and next Saturday, and we get the all-clear to start stims, we are nearly guaranteed that retrieval will occur around the 21st-22nd. This is, naturally, the absolute most important two days in my entire work year. Roughly equivalent to the convenience of having retrieval on Christmas morning. Please believe that I am not exaggerating.

OPTION TWO: If CD1 shows up between now and next Saturday, and we do NOT get the all-clear to stim due to a repeat of last cycle's weird blood levels, I will probably be put on BCP for suppression. This would lead to a stim cycle with retrieval likely the week of Thanksgiving, when we have family staying in our house for the holiday. Oh joy.

In this eventuality, if we start stims but do not get to retrieval... we will not be permitted to try again in December. Which means I will lose the $5,000 still sitting in my FSA for this purpose. A not-insignificant chunk of my already small salary that I have worked for and would be forced to forfeit. This would also mean another year of maxing out my FSA (and the consequential tiny paychecks).

OPTION THREE: If we are stuck with Option Two and do not get the all-clear to start, then there remains a very slim chance that we could roll with an early December cycle. But really? If it reaches that point, I have absolutely no faith that anything might go our way.

Can you tell I've given this a little thought?

*I realize there is one last option, but we're not going to discuss that here. Seriously, please don't even bring it up. I will flip my shit.

UPDATED: In response to the first comment, because my IVF meds are covered in exchange for my final, un-used, covered IUI cycle and I've already met my co-insurance for the year... any meds I order before the end of the year will be covered at 100%. While this is lovely, it means that none of that will come from my FSA. And I have already paid the remainder of the IVF cycle in full, but the insurance (and thus the FSA) don't process any claims until the procedure is actually performed. So yeah, if IVF doesn't happen before December 31, 2011, that FSA balance is forfeit.

Dream Vacation

It's been quite a week in my dream life.

Last night, I dreamed that our fertility clinic was in Paris. Every time we had an appointment, we would fly over and book into the Ritz for the night. As you do. The coffee was amazing. And every time the front desk clerk gave me the bill for our stay, I exclaimed "Really? That's all? It's so reasonable..."

That doesn't take much thought to interpret. I'm starting to get the message that the cost of treatment is weighing heavily on me. What do you think?

Sabotage

Realization: I've been poking tiny holes in my chances of success with IVF.

I've been slacking on my efforts to be healthy in preparation. Nothing major. A glass of wine here and there. Not as much exercise as I should be getting and I still haven't dropped the last ten pounds to get me into the "Healthy" BMI range. I'm having a cup of coffee almost every day (granted, most days it's decaf *ptooie*). Prof hasn't been taking his vitamins and I haven't been pushing him to remember.

Yeah, I'm taking my prenatals and my DHEA. I'm doing my acupuncture. But I'm also letting a lot of little things slide. I admit, I'm sick and tired of staying on top of all these details. I'm starting to wonder if I'm setting myself up with excuses for what I see is the inevitable failure of this yet-to-begin cycle.