2009 - my infertile year in review

If you've been around the IVF blogosphere much, then you've probably seen the tongue-in-cheek description of "IVF Barbies" that makes the rounds. My compressed version is below.

• Newbie Barbie, AKA BabyDust Barbie, is a bright, perky, Barbie, filled with optimism and confidence that IVF Will Work. She is thinner and usually younger than the other IVF Barbies. Her accessories include rose-tinted spectacles, a pineapple, a positive bank balance, healthy insurance coverage and a million questions. This Barbie only says pleasant, optimistic things and believes that Attitude is Everything.
  
• Veteran Barbie is the Anti-Barbie. They are a whole lot plumper than the Newbie Barbies, less perky, have a few gray hairs, a largely negative bank balance, plenty of bruises and marks and a cynical attitude. Their accessories include a wealth of knowledge of reproductive protocols, the ability to practically do their own cycle, little tolerance for stupidity, a well defined sense of humor, a fondness for wine/beer/crack and a strong aversion to pineapple, baby dust and Newbie Barbies.

Even though it took 3-1/2 years to conceive Waffle Girl, I figured I was still a Newbie Barbie because we got beginners luck with IVF back in 2007. But now the crappy events of 2009 definitely put me deeper into the Veteral Barbie camp. Hmm.. where to start?

When we first went to see Dr. Snaggletooth this March, it seemed reasonable to hope that we could fit in two IVF cycles by the end of the year. That's what my insurance would cover and that's the effort we were willing to put in. I wasn't greedy or naive enough to assume it would work on the first try (again) so I expected to do two rounds this year. But who knew there were so many ways to delay and screw up that first attempt?! Read here for a recap: http://theinfertilebreeder.blogspot.com/2009/08/so-much-for-fast-track.html

After 6 months down the tubes, we got an actual IVF cycle going in September. This one was really great, though, I must tell you. Not only did my ovaries give a stellar performance for a 39-year-old, but my response to the meds was even better than it was with the same dosage when I was 37. Instead of having 2 blastocysts to transfer, this time we had 6 to work with. The quality was good enough that the doc advised us to do a single embryo transfer and freeze the rest. Well it's a darned good thing we have those "extras" because the first one didn't quite work out. At 7-1/2 weeks it was evident that the embryo wasn't viable. I stopped taking progesterone supplements and miscarried naturally a few days later.

So 2009 was a bust. I am full of Veteran Barbie wisdom and ill will toward those who annoy me. And my level of black humor has gone up a notch. You can imagine how I cackled out loud when I popped open the latest vial of Lupron (pictured above) and noticed that is says "FLIP OFF" on the cap. Well, you don't have to tell me twice! I'll flip 'em all off! The doctors, the nurses, the technicians, the receptionist.. the pregnant ladies on the street.. the chick at my gym who complained that she had her second kid too soon after the first. Grrr.

But the truth is I'm still very optimistic and Newbie-like. We're in good shape for 2010. I have started Lupron shots for our FET in January. If that doesn't work, we'll do a second and then a third. If those don't work, we still have insurance coverage for a second fresh IVF cycle. If that doesn't work, then who the hell cares? I have my Waffle Girl and Mr. Foxy and that is enough.

resuming awesomeness.. now!

Actually, the awesomeness started a few weeks ago.. but I was waiting until I saw Dr. Snaggletooth and had something reproduction-related to post. Various updates follow:

My awesome fitness/diet regime is perking right along. I've been going to my office gym 2-3 times a week. The first couple times I went on the treadmill I couldn't manage a proper jog, because I would get jabbing pains in my butt where all the progesterone-shot-induced welts were still hanging around. So I switched over to the elliptical trainer. Now I've lost a few pounds (less painful jiggling!) and the welts have gone away, so I can trot on a treadmill like the wanna-be hamster that I am. My pants fit me again and I feel much better about myself.

My awesome research proposal has been funded! Most of the actual work will be contracted out, so I get to be the fancy scientist lady bossing people around and taking credit for it all. Is it too soon to nominate myself for a Nobel prize? Hmmm.. maybe wait until after our first team meeting tomorrow.

My awesome hubby, Mr. Foxy, has been mysteriously and uncharacteristically helpful around the house lately. He actually baked sugar cookies with Waffle Girl one day when I was at work. I walked in the house and was utterly perplexed by that lovely food-like odor. In getting ready for the girl's birthday this weekend, he actually cleaned the bathroom; afterward, he did all the dishes and took out the trash. Lord, please don't let this be a fluke.

Our awesome plan to procreate again is back on track. I went in to see Dr. Snaggletooth a couple weeks ago, as required before starting a frozen embryo transfer (FET) cycle. I went to the appointment solo, 'cause there wasn't anything major to discuss. Mr. Foxy is oblivious to most details of IF treatment, so I like to toy with him a little:

Me (coming home from work): "So honey, do you want to guess what the doctor and I talked about today? "

Mr. Foxy: "Umm, I guess you talked about how many embryos to transfer. "

Me: "Sure.. (curious about what goes on in his man-brain).. do you want to guess how many he thinks we should do?"

Mr. Foxy: "Well.. two at least.. maybe three?"

Me: "Oh, silly husband. The doctor and I agreed in about one-millisecond that we would do another single transfer because our embryos are really good quality. We'll only double up next time if this one doesn't "take". We actually spent the appointment with him explaining the timeline of birth-control-pills, Lupron shots, progesterone/estrogen supplements, and so forth. "

So that's our deal. I took my first BCP today. I'm supposed to start Lupron shots on 12/26 (Merry Christmas!), go in for baseline ultrasound and bloodwork on 12/31 (Happy New Year!), and I guess we're looking at an FET around January 20th-ish. Awesome.

going out on a high note

My miscarriage ordeal is nearly over. Let's just say I'm not really paying attention anymore. I went in last Thursday for follow-up ultrasound and bloodwork. The u/s showed that I still had a little chunk o' tissue, but my blood level of HCG was down to 2000 so they weren't too concerned overall. I'm supposed to go back later this week for another blood draw and thankfully no u/s. I will not bore you with any more details, as I'm sick to death of it myself.

I'm still feeling gloomy, annoyed, and cranky a lot of the time. But there are more "silver lining" moments every day. Some tidbits, in no particular order..

• I swell with pride when I think of how my maxi-pad purchases over the past month have stimulated the economy. I am a big part of the economic turn-around. I purchased Kotex for nostalgic reasons, Always "Infinity" for a taste of the future, and a few of store brands, with and without wings. You're welcome, American workers.

• I found the motivation to sign up at the Federal employee gym. I easily lost the baby weight after Waffle Girl was born, but fertility-treatment-weight is a different story. I'm required to take at least a 30-min. lunch anyway, so might as well work my ass a little. I've gone once so far and have serious plans for visit #2.

• I got to drink wine and champagne at my brother's wedding this weekend! We will do likewise, as a family, at Thanksgiving and throughout the holiday season. My wonderful new sister-in-law wants to try for a baby pretty-much right away. I told her to let me know the minute she's preggo and I'll run and schedule my FET then. This way, she'll still be a couple-few months ahead of me (she deserves the first-time mom attention!) but we'll still have kids of the same age, same school year. So even though my master plan of having a baby 2 years behind Waffle Girl has fallen through, this new master plan could be even better! It's genius, I tells ya.

I won't be posting for a little while. I started this as an infertility treatment blog and while I'm "on a break" there's not much that I'll need to get off my chest. No one needs to hear me gushing about the delightful Waffle Girl, the annoying-yet-adorable Mr. Foxy, or the great things I'm doing at my fancy government scientist job. Okay, on that last point.. I'll take this opportunity to brag that my $100K research proposal beat out a couple dozen other projects nation-wide and is now in the top 5 under final consideration. Oh yeah.

Thanks for reading my blog and for offering your support, humor, and insights. I'll keep checking in on my IF buddies in the coming weeks. And I'll let you know when we're ready to break out the frosties for another turn around the dance floor.

am i done yet?!

In case you were wondering..

How did they know that the embryo wasn't viable?

Well, my inquisitive friends, if an embryo gets to a certain size (5mm) and there isn't a little fluttering heart, then they know it isn't growing right. It is inscribed on my permanent record that our embie was 5.7mm and it had "no cardiac activity".

The most common cause of early miscarriage is chromosomal abnormality of the embryo. We didn't lose a baby. We lost something that could not have possibly ever grown into a baby. We lost 4 months of time that we could have been busy getting pregnant with a real baby. I've been reading the posts on the "Pregnancy loss" board of my favorite infertility support group. Frankly, a lot of the women posting there are deluded. Some of them were pregnant for just a couple weeks and yet they've named their "babies" and are mourning their loss as if they were fully-formed people. I don't get it. Maybe I'm missing a golden opportunity to be a drama queen.

So what has the infertile breeder been doing this past week?

Dr. Snaggletooth gave us two options: 1) stop meds and wait for the miscarriage to come on naturally or, 2) take a drug to bring it on. I opted for both. That is to say, I thought I'd wait a few days and take the meds only if necessary. The doctor gave me two prescriptions - one that causes uterine contractions and a painkiller.

Here's how it unfolded: our appointment was Tuesday. Then on Friday afternoon, when I was working at home, I had a few hours' worth of cramps and (TMI alert!) passed a bunch of blood clots. The cramping wasn't too bad. I figured that this was the worst of it, but that I'd probably have more heavy bleeding and stuff over the weekend.

Boy, was I mistaken! Last night (Monday) I started cramping again and went through much of the same as Friday. I managed to put Waffle Girl to bed about 7:15 (bless her heart, she's such a good sleeper) then it just got worse and worse! I wasn't even bleeding that much.. it was like a uterine version of the dry heaves. Seriously! I didn't have any pain meds, but I did have the prescription in hand - I could've called somebody to come rescue me, but I kept thinking that it'll pass soon.. and Mr. Foxy would be home from work in about an hour. So I writhed around in pain on the couch for a while and tried to use this heating pad that didn't do any good. Eventually hubby got home and found a stash of Vicodin that he'd squirreled away. Within the hour I felt a lot better and eventually went to sleep.

But wait, there's more! I woke up at 5am, cramping again. I popped another Vicodin and got back to sleep at 6:30. Working at home again today so I slept in 'til 8. I've been on pins and needles all day wondering "Am I done yet!?" Is there another wave of cramps to come? Shit! This was much harder and more miserable than I expected! I hope I'm done. Am I done? Oh, I hope I'm done.

PUPO, it's been real

Our ultrasound today (@7wk3d) confirmed that this pregnancy is not viable. I'm sad, tired, angry, and nervous about what happens next. I feel so jerked around.

It doesn't feel like I'm really headed for a miscarriage, since we were never pregnant in the first place. Not really. It's more like our 2 week wait stretched out to a 5 week wait with the biggest BFN ever at the end. How attached can you get to a microscopic embryo that was just the faintest shadow on ultrasound? The idea of it was pretty sweet, but we never got any closer than being "cautiously optimistic" that it could be a reality. Not that I'm trying to talk myself out of being sad.. trust me, I'm plenty sad and there's no avoiding it.

The big picture is still very good. We have 5 frozen blasts, three of which are equal or better quality than the one that grew up to be Waffle Girl. So I feel pretty sure that there will be a sibling. Vain as I am, it felt pretty good when Dr. Snaggletooth opened up my file today and said "God, you're amazing! I wish I could get my other 39-year-old patients to do this well!" Yes, through my tears I am comforted to know that I have fantastic ovaries.

I've had to let go of my master plan, which was to have another kid 2 years behind Waffle Girl in school. When we went for our first consultation in March, it seemed reasonable to hope I'd be pregnant by the end of October. I though we should be able to fit 2 fresh cycles into a 6-month period, or one fresh and a couple frozens. Well, thanks to our various delays, the cancelled cycle in June, and now this extra-long BFN, my timetable has been scrapped. I know it seems like a dumb, petty thing.. but it would have been so great.

Our earliest possible FET could be in December, but who wants to do IF over the holidays? Going in the dead of winter isn't appealing, either, so I may take a break until spring. Celine Dion waited 8 years to do an FET and have her second child. I could even be one of those hags that has an IVF baby in her fifties. Okay, that's crazy talk.. but I'll be happy to keep my feet out of stirrups for a few months.

another sucky week in the offing

Our first ultrasound today was another exercise in frustration. We are technically 6 weeks 3 days pregnant (the convention is to count back to the start of your last period). This means that we should be able to see an amniotic sac, yolk sac, tiny embryo (fetal pole), and possibly a heartbeat by now. Well I have all the right sacs, but nothing else. It's too soon to officially throw in the towel, but it's definitely not encouraging. We go back in a week to see whether the embryo catches up in growth or whether it's just a dud.

In the insult-to-injury department, Dr. Snaggletooth advised me that I have a honkin' big hematoma (blood clot) in my uterus. It's even bigger than the amniotic sac itself. So I can expect to keep bleeding.. maybe a lot.. for a while.

So here's my plan for the week:

• continue to inject progesterone in between the many welts on my ass.


• bleeding and mildly cramping at all times.


• wondering where the fuck my crystal ball is. If the embryo is genetically "off" then it was predetermined 4-1/2 weeks ago that the pregnancy would fail. The doctor quipped that we should pray this week. Screw that! The die is cast.. we're all just waiting to see how it plays out.
  

3 facts that kept me sane last night

It's been a rough week. After the period-like bleeding I had Monday night, I proceeded to have even more on Tuesday night. That was the worst of it and now I'm back to constant red spotting. Another alarming thing is that I lost 3 lbs. since this weekend, which I figure is the loss of excess water weight. I started to get that "not so pregnant" feeling when I realized my body was dumping excess fluids. This couldn't be a good sign.

Last night I was tormenting myself with internet research about early pregnancy bleeding and miscarriage. I was bracing myself for the distinct possibility that my awesome week-long pregnancy had come to an end. You can find plenty of anecdotes about women who had first trimester bleeding and went on with a healthy pregnancy. Are they the exception or the rule?

Here are the three tidbits of wisdom that helped me sleep last night and braced me for repeat bloodwork this morning:

• A 5-6 week embryo takes up a tiny space of the uterine wall. Most of the uterus is not "engaged" in supporting the early embryo. Your little embie can be snug as a bug in the East Wing of your womb while you're having total bloody chaos in the West Wing.
• The risk of miscarriage is 10% during 5-8 weeks of pregnancy (3-6 wks after conception). Who knows how real this oft-quoted number is, but I like my odds.
• When your hormone levels fluctuate, there can be a delayed effect. I figured this one out all by myself. When you take your last Pill, you don't get your period the next day - you get it 3-4 days later, right? Well my progesterone levels dropped Thurs/Friday last week and the delayed effect was a mini-period Monday-Tuesday. Tada!

Okay, on to the bloodwork results. It's all good. My HCG is way up to 5,300 (spot-on for 26 days past ovulation according to http://www.betabase.info/) and progesterone is back up at 20.

I have to run a very important meeting tomorrow morning at work, so I decided not to do my ultrasound tomorrow after all. I wouldn't want to get bad or ambiguous results and then be a pathetic wreck at the office. In fact, I think I'll put it off until Tuesday, when Dr. Snaggletooth is in the office and I can have my post-IVF meeting in the same visit. PUPO lives!