Tuesday, March 25, 2008

On to IVF

I have been in an anti-posting mood lately; it probably has something to do with working 6:45 AM to about 6:30+ PM every weekday during March. I am simply not as hardy and resilient as I used to be during residency, so I find these hours pretty exhausting. Especially when I get calls (via the page operator) from patients or the ER at 1:30 AM and 4:30 AM, like I did last night.

Anyway, I think my post's title tells the tale... another BFN for us after the latest IUI. My temp starting dipping last Friday, came back up on Saturday, and then jumped to its highest on Sunday (CD15). Luckily, I did not get excited, thanks to an utter lack of any promising symptoms. Thus, I was not surprised when I woke up sweaty Monday morning, found that my temp had started to crash downward, and that my period started Monday afternoon.

I called the RE's office and got at least partial clarification of upcoming events:

---Tomorrow (CD 3) I have to go in for an ultrasound (included in the IVF fee) and CD3 bloodwork. Having to pay separately for that bloodwork really irritates me since I already did that last June, and my FSH and estradiol were perfectly normal. However, I guess they want to make sure that I have not suddenly entered early menopause. Given the striking regularity of my period, I think this is rather unlikely. :> I will also be tested for the cystic fibrosis mutation. If this were to be positive, I don't know quite what would happen. I know S would need to be tested, too, but how much would we be delayed? We're going on vacation in mid-May, so I guess I better find out ASAP!

-- Friday (CD5), I have to start birth control pills. I forget which brand, but it's something I've never used before. I will take them for 10-21 days, depending on their schedule. Hopefully on the order of 10 days, because I want to get this party started. I'm also supposed to start taking baby aspirin and continue prenatals. I assume I should continue metformin, too, although I haven't specifically asked about this recently.

-- Sometime soon (not sure when), S and I both have to take doxycycline twice daily for 10 days. This makes me feel like they are treating us for an STD (which we do not have!), but apparently this clinic recommends this for everyone prior to IVF.

-- Next Tuesday (CD9), I will have a trial transfer, where they somehow determine how they will get the embryo(s) to the right spot in the uterus. I don't know why they don't already know this, considering that they have used an "embryo transfer catheter" for 3 out of 4 of my IUIs, but again, I don't really understand the process.
They wanted to do a saline sonohystogram, too, but I already paid them $450 for this EXACT test in October, and it was 100% normal, so I will literally REFUSE to do this test again. I will throw a giant fit if they say otherwise. As it stands, I already need to bring a cashier's check for $10,525 to this appointment. This does not include the cost of meds.

-- Once they tweak the duration of birth control pills so that they can fit me into their IVF schedule, at some point I'll start Lupron together with the birth control pills. Then, after 5 days, I stop birth control pills and expect a withdraw bleed. Soon thereafter, stimulation meds start... Wow.

I know I say this all calmly now, but I did shed a couple of tears yesterday after I called the office. I get really angry when I'm asked to repeat tests that I have already done and paid for. It's one of the few things I can get mad about and try to have control over, I think, so I do! However, I try to be firm (but not rude) to the staff, because I don't want them to dislike me.

We're really ready for this, though. I'm tired of the months and months of waiting. S and I transferred the money into our checking account last night, and I guess I'll pick up the cashier's check on Saturday. It will be 100% worth it (of course!) if it works. But if it doesn't....ugh! I need to clarify with them about what happens if the cycle is cancelled at some point. At what point is it non-refundable?

Of course, I'm just thinking about the financial what-ifs because I don't want to think about the emotional what-ifs. I think I know the answer, though. We'd do any FET cycles and probably even another IVF or two. I just PRAY that we don't have to. Please please PLEASE let it work.

Sunday, March 16, 2008


And as usual... no symptoms yet. I actually enjoyed the past week. Not needing to worry about an impending ovulation or wondering whether I felt any symptoms. My mom and S both asked me several times whether I felt anything unusual, to which I said, "NO! It's only 2/4/6 DPO!" But from now on, I'll have to really think about it and admit that no, I don't feel anything unusual.

These weekends always fly by so quickly! I got stuck at work until about 9:30 Friday night. This resulted in me getting to bed really late, and then sleeping in for half of the morning on Saturday. After that I played around on-line, and then was sort trapped indoors while S ran to the gym and did some errands, waiting to see whether our HOA's gardener would be dropping off approximately 2 cubic yards (54 cubic feet) of potting soil for our new raised beds / future vegetable garden. He occasionally does errands/hauling and projects (ie fence-building/sprinker repair) for people in our neighborhood to make extra money beyond what the HOA pays him to maintain our front yards. However, he didn't come by. It's OK though, he had said, "either this Saturday or next" so it wasn't like he flaked on us. After that, S returned home and I was able to leave the house to go on a gentle run. I'm not in prime shape right now. Blame a mild cold, followed by months of iffy weather and a busier work schedule... I can still run, but I tend to stop and walk a bit here and there. Don't wanna push my maybe-baby body too hard on implantation day, right?? :)

I then met my mom and sister at Nordstr.om Rack for a completely non-productive shopping expedition, followed by an even less productive stop by Lenscr.afters. Two weeks ago, I spent about an hour in Lenscr.afters (by myself) and found four frames that I wanted to show to S or someone else for feedback. I carefully wrote down the designer/brand, style number, color, and size of each pair. Well, yesterday I could only locate one of the frames that I had previously chosen. I asked for assistance, and the employee who was out on the floor informed me that, "those are probably sold out by now." I expressed my disbelief that 3 out of 4 frames would be completely sold out in a two week period, and he basically just shrugged and told me to keep looking on the racks. I sort of loudly expressed my disbelief and disgust with the sympathetic comments of another customer. Soon, the store manager came trotting out, saying cheerfully, "I understand you need help locating some frames." Well, at least she tried, but she then confirmed that they a) keep zero inventory or record of what frames they do or do not have in stock, and b) have zero frames in storage; every frame in the store is out on the shelves, and c) have no idea if or when they may receive a given frame ever again, and d) have no way of ordering an out-of-stock frame. What a stupid business model!!

After a disastrous attempt at trying to eat a quick meal in a nice restaurant in Bal.boa Park (we arrived too late without a reservation, and even the bar was 100% full with many people already waiting for a seat), S and I ended up eating a non-romantic dinner at McDonald's! There are zero quick options in the vicinity, and we didn't want to be late for the Ban.ff Mountain Film Festival at the Natural History Museum. This was our second year attending, and it is really great! The 6 films ranged from 9 to 60 minutes, with topics ranging from snowkiting in Norway, to kayaking in Reunion/Norway/Canada, to base-jumping across the world, to crazy mountain biking in British Columbia to climbing ice in abandoned Swedish mines. If you like the outdoors, I would highly recommend this film festival. It's actually different films on each of three days, and I regret that we can't attend of the other days, too. It has been completely sold out for both of the past two years.

Today was another lovely sleep-in morning followed by a long hike in Miss.ion Tr.ails Regional Park. Again, tons of wildflowers, and S and I actually explored a section of the park where we have never been before. We didn't see another human being in that area, and we're definitely going to go back that way because we don't know how far north you can go along these certain trails. Next we went on a mongo-grocery run, and pretty soon we're going to prepare a nice meal. Ahhhhh....weekend bliss.

I wish my bliss could last, but I'm sure that I'll start feeling grouchy once I return to work tomorrow AM, and as the reality (IVF/ICSI! soon!) of a few more days without symptoms sinks in.

Saturday, March 8, 2008

Last Chance IUI (#4)

Yikes, sorry for my long silence!! At first I had nothing to say... and then I got busy with work. I am "on the wards" this month, meaning that I'm spending my days on the inpatient Hematology/Oncology service, rather than my usual, more leisurely lifestyle working in a lab. It is busy! 3 weeks and 1 day more to go (thru March 31st). This month's busy schedule is what kept me from doing IVF this month. Working in the hospital is stressful, but the time goes by pretty quickly.

I am so excited to announce that I was offered a job this week! I already knew beforehand that I would be working at our local VA, but I will now also be working at the university's cancer center, where I will specialize in breast oncology. Yay!! There are still a lot of details to iron out, including amount of clinical duties, other expectations, benefits and salary. I don't want to spread myself too thin, you know?

Anyway... in the interest of not painting my life as all sun and flowers, S and I had a difficult couple of days about 2 weeks ago, but fortunately we were able to iron things out. (I think the discussions were valid and important, but our disagreements got blown out of proportion. Ugh!) One part of it relates to S's profession as a psychologist, and the fact that he feels extremely knowledgable about child developement principles. I am concerned that he will shut down any opposing ideas I have about parenting under the guise that "he's the professional," and that he won't be able to see my point of view. To give you an example, we have already had multiple discussions about daycare versus nannies. S is really committed to the idea of one of us staying home or having a nanny, whereas I want to explore those options AND daycare. More on this topic sometime after I actually need to worry about it!! Anyway, in many areas both of us want to feel knowledgable and to have the other person's respect, and we need to be able to communicate in a way that doesn't seem dismissive to the other person's point of view or opinions. Things got so ugly that S suggested marriage counseling. As a psychologist, he sees counselling as a great way to improve communication. To me, it is more like a last stop before divorce, so I was not thrilled with the idea, AT ALL, as I perceive our marriage to be really good and solid. Ironically, I ended up agreeing to try marriage counseling, and then he changed his mind and decided that we didn't need it! For a few difficult days there, I wasn't sure whether we would be doing IVF at all, but at this point all is well and we're going to go ahead with it.

So, this is my "natural" (non-Clomid) IUI month, as I apparently need to "give my ovaries a rest" before starting IVF meds. Because of this, I got a nice 4 week break from my RE's office, and didn't have to deal with Clomid, ultrasounds, etc. That also made this cycle much cheaper... ($260 for the IUI...versus the usual $260 + $150 + $150 [ultrasounds] + $30 [Clomid] = $590). It's all just a drop in the bucket compared to the expense looming in April!

On Thursday afternoon (CD 13) at about 4PM, I used an OPK and noticed that it was starting to blush toward positive. However, rather than calling the RE's office in a panic for a Friday appointment, I decided to wait until the stick actually turned positive. And I didn't let myself check again 'til the next morning (Friday; CD14). By that time it was bright positive, and I scheduled a Saturday IUI (CD15). I think I like the timing better this month than last month.

Originally, we had been planning to get busy on Thursday night, with the assumption that I would be ovulating on probably Sunday, Monday, or Tuesday. (Isn't infertility romantic! So spontaneous! Ha!) Anyway, when I realize that our IUI would be on Saturday, I still wanted to go ahead with the planned Thursday night nookie. For one thing, I was kinda in the mood, and it had been too long. Plus, I thought that it would be good to get in one fertile-zone session before the IUI. However, I know that S is always concerned that his supply might be less after less than 48+ hours of abstinence. However, we decided to try it.

The amazing thing was, after "only" 36 hours of abstinence, S got his best "totile motile sperm" count to date: 19 million. Our previous results were 11, 11.4, and 11.8 million. Yay!! I asked the nurse for a print out of all of his results thus far, but she said she couldn't get it for me today. (reason...who knows!) Instead, she let me look at today's results on the computer screen. Before the wash, his volume was 20 million/mL (a little lowish, but OK), volume 4 mL (OK), total count 80 million (OK), with EXCELLENT motility and "A" forward progression. Unfortunately, they don't check morphology on these routine IUI-day assessments, and that is our worst category. Anyway, I was pretty excited by the news. Dr W also did my IUI, and it again took only 1 minute using the stiffer "embryo transfer catheter". I like her more and more every time I see her. Thanks, Dr W!!

So, here I am in the 2ww yet again. If nothing happens, I'll have to start OCP's for 10-21 days before starting the hard-core fertility meds for IVF.

S and I are going to drive back to the desert tomorrow. It rained a lot this year, and the wildflowers are supposed to be peaking right about now!

Now I need to go and catch up on the happenings on the my Blog Roll.