Apparently this is "four weeks"

I think it is weird that pregnancy is counted from the first day of one's last period. I guess it makes sense for most women, since they may not know what day the pregnancy started. In my case I know EXACTLY when I ovulated and implantation occurred, given the way it happened.

Yes, this means I am pregnant! After over two years of trying, after two years of stressful failures, uncomfortable tests, expensive procedures and emotion-wrenching drugs - it worked!

So, I'm here at week four. I took two blood tests this week - the first indicated an hCG level consistent with pregnancy, the second was confirming and showed an increase appropriate to two days later. After the first test I was a bit teary - and so glad that Jill (my favorite medical assistant at the clinic) gave me the news. I still didn't let go emotionally, but after the second test results I felt more comfortable about this, that it might actually be true.

In a couple of weeks I will get an OB scan that may show a heartbeat. Wow.

Retrieval day

Friday morning Chris and I went to the doctor's office early and were brought upstairs to the retrieval room. I sat in a reclining table/chair dealie, got hooked up to an IV (antibiotics, pain medications, other anesthesia). After chatting with the medical assistant for a while, I remember the doctor coming in and talking to me, but I don't remember much else. Chris says I wasn't totally out - I responded to questions and made it clear when I was feeling discomfort, but I was fairly out of it.

Before we left they told us that 16 eggs were retrieved.

When I woke up, Chris was in the waiting room (he'd been providing his part of the genetic material while I was recovering) and we went home. I was pretty crampy. We came home and I went to sleep on the couch. Chris got me snacks and movies, which allowed me to stay on the couch most of the day. I felt ok - if a little groggy - most of the time, but when I stood up I was in a fair bit of crampy pain. It even hurt to pee. Not in the way it hurts if you have an infection, but in an internal muscle-related way. I can see why they had me use the enema. A bowel movement would have been unthinkable on Friday.

Ellen brought Avery over in the late afternoon and I played with him for a while. Making him smile is a really fun game, a little bit like the baby version of crack. Chris made me mexican meatball soup, and we watched movies. I felt bad, but not any worse than I'd feared.

I had acupuncture on Saturday morning and then had breakfast with Chris and Adam. We went to Powell's so I could look for books on twins - specifically the decision to have twins. I will have three embryos implanted assuming all goes well, so there is a chance that two or three will implant. I won't have triplets - it is too dangerous for me and gives the fetuses a much worse chance of developing normally. But two - Chris and I are talking about it. We recognize it will be really hard for a lot of reasons, but it would mean that we'd have two kids and not have to go through this again. Unfortunately for me, the books on twins all assume that you are having them. The books on fertility don't address twinning except in general discussions about the impact of fertility drugs on the odds of multiple births.

When we got home we got a call from the clinic. Of the 16 eggs, 15 were developed enough to try ICSI (intracytoplasmic sperm injection). Of those, 13 worked. Thirteen fertilized eggs are percolating away in the lab now.

As of Sunday I am still crampy and bloated, but feeling better. Tonight I start daily projesterone injections - shots in my ass that Chris has to administer with a scary big needle. We had the medical assistant draw guides on my butt so C would know where to put the shot. I am not excited about these shots, and neither is Chris. He was pretty cute about it, saying he's not looking forward to this, but recognizes that my worry is probably bigger.

Tomorrow three eggs get returned to me and we hope for the best.

Of course you are

7:30 appointment today, plus likely one tomorrow and the next day as well. So, no carpool and I will be late to the first day of Leadership Academy. Oh well.

My closest grad school friend is coming into town tomorrow for work. We missed one another by phone yesterday, so I called her on my drive down from pdx after my appointment. She told me she is 3 months pregnant. Of course she is. I knew she and her husband were trying, but the timing is tough for me. I was loving and supportive, saying I thought it was great (which is true, I think she and her husband will be great parents, plus they are huge like us and will help populate the world with tall tall people). She said she knew this might be hard for me and appreciated my support. She basically said that if the positions were reversed she wasn't sure she'd be able to be as supportive. Interesting, and probably true. I told her that I am very upset about how long and hard this road is for me, but I also know that her being pregnant doesn't make me less so.

I felt sad when we talked, but now feel ok, if a bit weepy. Her news was a trigger for my tears, but I'm not feeling worse than my usual weepyness these days. I am glad she told me by phone rather than waiting to tell me in person. This way, when I cried I could still sound (and actually, be) happy for her. In person all she would notice is that I was welling up.

I love hormone injections

Let’s see, where are we?

I’m up to three injections a day. I’ve got lots of little bruises from the needles, making me worry what I’ll look like when I start the progesterone injections (18 gauge needles instead of the tiny ones I’m using now).

I’ve got a headache most of the time from the meds. I’m cranky cranky cranky.

Today was my second ultrasound/blood draw to see how the follicle stimulating meds are working. One ovary looks good, the other is a little slow – Dr Lee says maybe he’ll up my dosage.

My appointment was at 9:30, but I went in early and got out of there by 9:30. I got to work by 10:20 and made it to a meeting that was going on all day. My desk is a horror show, I am not up on all my reading, but when I get to my desk I just want to cry and run away. At home I just want to sleep.

On the up side, I also had a follow-up on my breast tenderness problem with the obgyn. I’ve had no pain for a week or two, she felt nothing weird, confirming her view that it was fibrocystic changes and totally normal. Yay! Plus, she said my outfit was cute.

* * * *

Oh - the doctor's office called. My lab results are back - my estradol is at 45. (Crap - WHY don't I carry that book on ivf around everywhere? If I had it I could look up what that means. Instead I foolishly carted in a book of essays by people who have dealt with infertility, some help THAT is today.) So, Dr. Lee says its time to change my meds. (Did I mention that the drugs have already cost me $3,000?) I didn't even ask what the Repronex is going to cost.

Yes, time to add another drug - Now I've got 225 IUs of Gonal-F in the morning (up from 150), continuing the 10 units of Lupron at night, and substituting 3 vials of Repronex (an HMG) for the nightly 150 of Gonal-F.

Both Repronex and Gonal-F are follicle stimulating hormones, which are supposed to make my follicles nice and plump. I stay on the Lupron to keep me from ovulating, but at a lower dose than before - I dropped it to 10 on Friday after my appointment - the doc said I looked sufsuppressed supressed on the ultrasound and my blood test apparently agreed. I decided not to argue about whesuppressed supressed.

Chris is picking the drugs up for me this afternoon.

IVF part 1

So I started the IVF process, and I want to be talking about it (ok, I'm DYING to talk about it), but the more people who know I'm doing this, the more people I'll have to tell if it doesn't work. So I'm posting privately, to become public when I'm done.

Here's where I am with the fabulous world of IVF:
I started taking birth control pills on 9/1. Immediately got super bloaty and felt horrible. Beach ball in my stomach. After a week I decided to email my obgyn, because I'd had breast tenderness for two weeks. (I know, I know, some causes of breast tenderness: being pre-menstrual, check; birth control pills, check; stress, check.) Obgyn had me come in, told me that yup, she sees some fibrocycstic changes in my breasts, but that it is nothing to worry about. She'll follow up in a month to be sure, hopes to see me pregnant soon.

On Thursday (9/16) I started taking 20 units of Lupron - this drug stops me from ovulating, so that I can grow some nice big follicles without having them ripen before my doc is ready for them. The Lupron is administered by subcutaneous injections - thin short needle like the kind diabetics use. I set up the needle, filled it with Lupron, cleaned the injection site . . . but could not stab myself. I started to cry - Chris said "you can do this", to which I replied, "no I can't" and handed him the needle. He jabbed me and it didn't hurt. The next day I did it fine by myself.

Some possible side effects of Lupron: headaches, hot flashes (!), mood swings, nausea . . . I've had a little weirdness with temperature, which might be hot flashes, I'm not sure. No headaches.

Saturday I started going for acupuncture again. A German study showed a 40% improvement in IVF success rates for people who did acupuncture. Not sure if it really does anything, but I feel the need to try everything I can. It might be doing something - it makes me cry every time. Not from the pain, which is minimal, but from some kind of emotional release. Weird. Plus, I feel all calm and floaty afterwards, so it is at least worth doing for that.

Feeling MUCH better.

I was doing better yesterday, and then Chris and I went out for dinner and had such a nice evening. I think we really needed a good night together without other people. I love spending time with E and J, but I need to remember to make time just for Chris.

We walked over to Noble Rot (which I love love love). We had champagne and sat at the bar for dinner. The waitstaff are so friendly and thoughtful, it is a treat to go there.

C and I talked about the sperm-penetration test results, my desire for a "fertility holiday" for a few months at least, wanting to get IVF, etc. He said that although he was sad to find out that he's likely the reason we aren't conceiving, he is happy to have more info and to know that it isn't me. He knows I have been blaming myself and wanted me not to worry that it was my fault. I actually had the reverse feeling - I was kind of hoping the test would be negative because I didn't want him to feel bad that it was him.

We also talked about our summer plans. He and his brother are leaving town early next month, on their way to New Mexico via a visit to Josh in Colorado. C will be working in NM for about a month and my plan is to visit around July 4. Hopefully E won't go into labor until I get back!

I mentioned my desire to go to Spain, so we are planning on going during C's fall break. I have been putting off things like trips because I keep thinking "next month I could be pregnant." I realize this is silly and need to just live, whether or not I am pregnant.

I'm not really able to express how nice this evening was. The combination of the weather, the walk, sitting in this restaurant we love, eating great food, talking about important things and laughing and feeling happy together - it was so great.

I read in one of this week's nyt articles on infertility that a high percentage of couples who have gone through fertility treatment have high marital satisfaction. I'm sure it is not the process, per se, but it is good to know that the process doesn't have to rip people to shreds.

Me, me, me, him?

The whole infertility thing feels very weird right now. By the nature of the thing, most of the focus was on me. Am I ovulating, are my tubes open, other reasons why I might not be pregnant. Plus, for two years, I was the one to track my cycles – taking my temp right when I woke up every day, so that I could see when I ovulated. Peeing on a stick to get a day’s heads up that I would ovulate. Initiating sex even if I was exhausted or depressed, so that we could time things right, listening to my body’s symptoms. Getting the monthly physical announcement that I wasn’t pregnant.

Two years is a long time to do this, emotionally speaking. This has been about me and my body, so of course I assumed that it was something wrong with me that was causing the problem. This was seemingly confirmed by the good test results Chris got earlier this year (good number of sperm, shaped fine, moving, etc). Hearing that the problem is from his side rather than mine is a bit of a shock. I feel a little relieved that it isn’t me, but I also feel bad for thinking that.

Why doesn't it feel like good news?

The endocrinologist called today to give me the results of the sperm penetration test. (Since C's sperm looks normal, moves fine, etc, they tested how well they could penetrate ova). The sample tested 2 standard deviations below the normal population, showing a "significant reduction" in sperm penetration.

I really have been sure that I was the reason we weren't conceiving. Knowing that is not it (and knowing what is wrong) doesn't actually make me feel better, though the doctor acted like this was great news. At least we know what is wrong and can move right to IVF (when we scrape up the $10,000 it will cost). Still, not feeling as perky as Dr. Lee sounded.

To get pregnant given this hurdle, the clinic will pump me up with hormones to get me to super-ovulate, extract my eggs, and use a super tiny micro-pipette thing to jam a sperm into each egg. Then they grow them a bit and then stick a couple back in my uterus with the hope that one or more of them will snuggle in.

I wish I was strong enough to say "screw ivf, let's adopt" but I don't think I am. Although I like the idea of adopting a child and giving him or her a life that would have otherwise been unavailable, I see two adoption down-sides. First, I am not sure I am comfortable with the (natural) desire for an adult child to find his birth parents. I know that this would be a long way off, but right now - in the throes of wanting a child - I can't imagine being as open and loving as will be required when this child goes looking for his "real" parents.

The other thing is a horrible snobby fear that we'd adopt a child who wasn't that smart. Not that I am the brain of the world, but excitement about academics and achievement was a big part of my childhood and Chris's. I know we'd still love a child who wasn't into that kind of thing, but as long as I'm being honest I need to admit that this bothers me. I worry that the likelihood of this happening grows when one adopts a child from another country, where the mom's health care could have been bad, the child may have lived for months to years with poor nutrition and medical care, not to mention neglect.

In any case, it looks like this summer and fall we are taking a little vacation from trying to conceive, while we collect some cash. The timing stinks, since June, July and August are the months Chris doesn't get paid (thank you university, with your 9 month pay schedule).

I was feeling so low yesterday, that I don't feel any worse today. I guess I feel a bit better just because it is so exhausting to sustain such a blue mood. That was part of the problem yesterday - I really wanted to not feel sad, but couldn't move on from it.

Cranking up

Man am I a crank-ass today.

I was feeling great for days. Friday we had a great time with E and J. We went out to dinner and sat outside in the warm night eating wonderful food. Saturday I was so happy to go to the farmers' market, spend some time at reed, hang out at a bbq and hear Split Lip Rayfield play.

Sunday was fine too, with garden puttering, etc. Even Monday was good, as I was busy at work and felt so productive.

Tuesday was ok until the evening. C and I went to the all-faculty end-of-year dinner. We sat with some of C's colleagues, including this prof who is pregnant. While I can be happy for friends who are pregnant, I find myself getting very annoyed and crabby about other pregnant women. How DARE she be pregnant again when I can't conceive once? Not very loving and open of me.

Speaking of not very loving and open. I haven't congratulated candace on her new baby.

It's a bird, it's a plane, it's super-ovulation girl!

I took hormones for 5 days last week so that I could "super-ovulate". Too bad this is just making more than the usual one egg women get each month. It sounds exciting, like I am a feminine superhero! The hormones led to several days of high energy and increased sex drive (yum) and then a few days of random crying due to sudden and intense feelings of despair. Even knowing that the moods were hormone induced, feeling so sad - not so fun, really.

Yesterday I had an IUI - intrauterine insemination. Chris gave the lab his semen, they got rid of all non-sperm stuff and then I showed up and they put it directly in my uterus. After the turkey-baster procedure, I laid on my back for 20 minutes reading a well-worn copy of People. Good luck to me, I guess. Not the most entertaining way of getting pregnant, but we are still trying the traditional method.

After this fun trip to the lab, I worked at home all afternoon. I felt a bit sorry for myself and didn't want to shlep BACK to Salem. Ellen cheered me up and when Chris got home he and I went for a walk. E, J, C and I went to the movies later in the evening and by then I'd restored my feeling that I live a charmed life.

What was coming

My period started this morning. I woke up to a 97.6 temp at 4am, which could either be low because it was early or because my temp was dropping as my period was coming. Turns out it was the latter - before 7am I was bleeding and cramping.

Yay for me, huh? Good thing I was such a basket case yesterday, in comparison today feels okay.

Now I need to go put in a new tampon before I bleed through my pants. Char-ming.

Infertility For Dummies

I started to write this to the reed conference folks, but decided there was no way to talk about it without implying a desire for sympathy. I really don't think I need sympathy right now, and I think getting it will just make me feel crappy. There is no tragedy here, especially not yet before I know whether eventually I'll be able to get pregnant. In any case:

Chris and I had our follow-up visit on the tests we took to see what's keeping us from getting me pregnant. All tests were normal for both of us. On the up side, I don't have undiagnosed diabetes and my thyroid is fine. On the down side, these test results win me a partially-insurance subsidized trip to Beaverton for a procedure intended to see if my tubes are open. The obgyn says that the test is at best uncomfortable and at worst very painful in a crampy way.

The results were pretty much as expected and I certainly don't wish that I had diabetes or some other chronic disease, but we are now moving into the realm of black box medicine. I'm trying to psych myself up for the next few months of tests and procedures, while I also try to prepare myself for discussions about what to do if none of that works.

After feeling freaked out last night, I now mostly feel ok. I am a bit annoyed that I have to wait almost 3 weeks for the next test - it involves getting a bunch of x-rays, so they want to do it when they know for sure I'm not pregnant. I just ovulated, so its a couple of weeks until I am into my next cycle and not actively bleeding. The worst part about all this is the time it all takes. (and yes, will, I know this is a good opportunity to practice non-attachment and to give up my desire for control. I've been thinking about that a lot lately.)