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Posts Tagged ‘infertility’

HCG = 11.7

…which is, of course, bad news.

It is not, however, the worst news.  Doc feels confidant that this is the remains of a chemical pregnancy, NOT an ectopic in process.  He said that if my numbers next week start rising up into the 30s, 4os, 50s, then we might have to reevaluate, but that this level of rise looks more like a few cells sputtering to a halt rather than something strongly taking root where it ought not.

Relief.  Pure, giddy relief.

Yay!  I’m not pregnant anymore!  Woohoo!

Ok, irony aside, it was a very good consultation.  We have a new game plan, and the idea is to put it into place almost immediately.  Like as soon as my period starts we’ll get going on cycle #3.  Like maybe next week.  Whoa.

Doc chastised me gently about my “womb of death” mindset, and said that in his not-so-humble opinion, it was more a case of ‘less-than-stellar embryos making an against-the-odds go inside a fabulous uterus’.  He was willing to come right out and say that he’d rather see a chemical pregnancy than no sign that anything “took”, and that if anything, it would make him more, rather than less, optimistic about giving it another go – either with my own or donor eggs.  Old though I am.

Since my insurance will cover one more go for me but a donor cycle will have to be pretty much out-of-pocket, the Doc recommended giving it one last try with my eggs, as long as I feel that my heart could stand the possibility of another walloping.  (This is why I like this doctor.  He actually thinks about – and voices – such concerns.  Well, that and the fact that he took a call from his wife while we were there, and I heard him call her ‘honeybuns’ & then he told her that he loved her even though we could obviously overhear, which I liked.  He’s a nice guy – a genuinely nice guy, which does make a difference to me.)

He spent almost an hour with us, answering questions, asking questions, offering options and ideas.  He also compared my two cycles and showed me how he was looking at The Plan at this point.

Interestingly, and something I hadn’t realized previously: although he retrieved the contents of 12 follicles in my first cycle, we only got 6 eggs out of it – the same number of eggs in this past cycle.  Which means that there was really no difference at all between the cycles in eggs retrieved & fertilized 6/4 both times.   Because of this, he suggested that this next time we should try a no-Lupron protocol.  It’s riskier, since I could accidentally ovulate OR conversely, the antagon protocol could stop follicular development cold when we have to put it into play.  Still, he thinks I might respond better to it than I have to the Lupron-based microdoses and get us a few more eggs to play with.  I like having something new to try, since simply upping the medicines didn’t do much good.  

And since at this point, some of my anxiety is due to the feeling that my range of options is shrinking, the idea of not yet using up my “initial, insurance-covered IVF” option sounds good to me.  The idea that I will be able to start this new cycle as soon as my period begins sounds even better.  Like, as early as next week.  He recommended getting going right away if I felt up to it – why waste all the hormones still hanging out in my body, seems to be the notion.  Plus, less time spent on evil DHEA this way.  Plus, actually DOING something instead of being placed back in IVF limbo.   Yeah, I feel up to it.  

And tonight I’m having a Guinness, I’m thumbing my nose at my medicine cabinet  while I dance my bruised ass away from all the pointy things, and I’m planning to waylay my husband when he comes home from his poker game.  

And I can start weaning myself off prednisone tonight, which makes me happy since it’s a scary-ass medicine and the less time I spend on it the better, even though I’ll likely start taking it again in earnest just about exactly when I’m just finished my last dose.

But that’s ok.  Going out to eat to celebrate the “no real fear of ectopic” news, (well mostly because we have had damned little to celebrate in the last month or so and we’re both feeling a bit ragged, and some wonderful food washed down with nice wine would be good for both of us.)  

I’m (obviously) feeling better than I have in a while.  I love having a Plan.  

*deep breath*

This isn’t the end, this is another chance, and I’ll take it.  I’ll grab it with both hands and hang on tight.

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Doing a bit better this morning.  Aided by the fact that since I’m working late tonight, I got to sleep in as late as I wanted (which was pretty late), PLUS the dog has figured out how to use her dog-door in the middle of the night, so I can safely ignore her when she wakes up and walks around nervously.

Lots of sleep is a good thing, and right now?  I’m making note of every single good thing I can find to dwell upon.

One thing I’m going to dwell upon right now is the support you all are giving me through this.  Knowing there are women out there feeling just as helpless and rageful as I do is comforting.  (Not in a misery-loves-company way, because I find myself sincerely rejoicing with fellow-bloggers who are enjoying a pregnancy, but in an “I am not alone” way.  As much as my husband loves me, he does not understand this.  As much as my face-to-face friends love me, they do not truly understand how much this process affects every breath I take every single day.  Having a network of women and men who know what it is like to want something so basic, so everyday, so maddeningly out-of-reach, is helping me to deal with my own reactions to being thwarted by biology.  It helps.  Thank you.  I don’t know what I’d do without you.

Another good thing is that my husband is wonderful.  He really is.  And I’m damned lucky.  And I wouldn’t trade my life with him for all the goat-farms in the world. (Though I fully intend to campaign hard for a change of living venue once his youngest daughter is in college next year.)  And he’s supportive of this sprog-quest of mine – which he wouldn’t have to be – and I’m fortunate in that, as well.  He truly wants to do whatever it takes to make me happy.  I’m blessed, and I feel like a bit of a schmuck for having given in to self-pity on the “my whole life sucks” front last week.  

Yet another good thing is that I’m really enjoying my morning coffee again, now that fear-of-miscarriage is not, really, an issue.  

I suppose I should be documenting “signs & symptoms” until we find out what my beta-numbers are tomorrow.  If it’s an ectopic, it’s still a pregnancy, just a very slow-moving one, so I suppose it’ll help me in the future to be able to remember what it felt like when…  God knows I looked back on my May/June entries these last few weeks.  Ok, then.  A couple of things I’ve noticed in the last few days:

  • Boobs are finally getting really sore – especially on the outsides.  This probably IS an HCG thing, rather than PIO general-tenderness, since this is the same odd feeling I remember from last spring.
  • Hair isn’t shedding (from the DHEA) anywhere near as much.  I’ve noticed this for about a week, and just put it down to the estrogens in the PIO & prometriums finally balancing out the androgens or something.  (what I don’t know about endocrinology would fill volumes, I’m totally talking out of my ass here.)  But it’s a nice change to NOT stop up the shower every time I bathe, and it’s nice to not be wondering if I’m going to start flashing scalp when the wind blows.  Last pregnancy, I noticed a definite cessation of hair shedding entirely.  Clean hairbrush, no stray hairs on black clothing, etc.  So this just might be related, or it might be the results of the aforementioned battle of the hormones.
  • I’ve also been seriously craving protein.  In any form whatsoever.  As a carbs/sugar kind of gal, this is noticeable enough for me to comment on.  Last pregnancy it was salt & crunchy, this time it seems to be eggs.  Or milk/cheese/yogurt.  Or meat (still sort of nasty for this previously-vegetarian-for-almost-20-years to get used to.)
  • Skin’s clear again.  Again, about a week ago, and I put it down to the DHEA finally losing its battle to turn me into a teenaged boy.  

Ok, a confession: I spent most of last night online looking for any miracle stories.  Stories where the initial HCG levels were so low, and they rose up high enough and turned into viable pregnancies!  A miracle!  

Ahem.  

Those stories really aren’t out there.  I found many many stories of women with “low” numbers in the 100s & 200s “becoming” viable, but nothing like a 7.9 beta-level turning into a real-live baby.  And part of my squirrel-brain is shrieking, “But Mom & all her sisters & all their kids had morning-sickness-free pregnancies, which likely means naturally low HCG levels, (which, long-time readers will remember was my private rationale for why I shouldn’t worry about my low HCG levels last time.)  And part of my squirrel-brain is still rambling on about “maybe proto-sprog just implanted really really late, and is only, actually, like 2 days old!”

Sigh.  Yes, I do know better.

So then I try to gently steer myself back toward reality, where the best possible scenario is that this was just a chemical pregnancy that is being easily reabsorbed by the womb of death.  I really don’t want to live through an ectopic.  A high-school friend hemorrhaged to death at age 22 from an tubal rupture, and I’ve read far too many blogs of women who’ve had to deal with inducing an abortion via drugs.  I really don’t want to go there.  Everything else aside (pain, fear, hopeless rage), I don’t want to have to wait months for the chemo-like drugs to leave my system before trying again.  The clock is fucking ticking here!

And that’s this morning.  A long day ahead of me at work, and a long and crappy day scheduled for tomorrow.  Four hours on the subway – oi!  But at least I should have a bit more information one way or the other.  

And right now, info is another good thing that I want more of in my life.  That, and coffee.  And can I say that I’m really looking forward to a heavy drinking session one of these days?

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My beta-test came back, and in the immortal words of the tech, “well, you’re not not-pregnant.”

Yeah, that’s right, folks.  I have an HCG-level of 7.9.  No, this is not cause to celebrate.  This likely means I’m dealing with an ectopic pregnancy.  I guess molar pregnancies have abnormally high levels & ectopic have abnormally low?  I always was an underachiever.  Hell, maybe all three implanted, only one of them turned molar, and two went ectopic & they’re just battling it out in the womb of death to see which major complication would be the most fun to live through this winter.

Fuck.

So, not only do I get no comfort-sex tonight.  I also get to keep on keeping on with the injections.  I go back in on Friday for beta #2, where the BEST I get to hope for is that my body’s just in the process of absorbing proto-sprog #2, and those numbers will have dropped to “not pregnant” levels.  Because all of a sudden, not-pregnant-at-all is my very bestest option.

I hate my life.

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so I suppose that means this is the official last day of IVF #2.

Not a great day.

I don’t plan on answering my phone when they call with the news, so I made sure to get my prednisone withdrawal instructions before I left. At least I won’t have to inject myself with anything tonight.

I also took the first step – which might also be the last step – in looking into beginning a donor egg cycle. Holy fuck. I had no idea it would be so expensive. Which set off a whole ‘nother round of panic/fear/helplessness/rage. The only thing I’m not feeling these days is happy or calm, pretty much. Apparently, my insurance won’t cover much at all. The out of pocket costs are going to be close to $30,000 cash. I’m not even sure we can do this, financially. I know I can’t do it on my librarian salary, and the Boy’s investments have been hit awfully damned hard these last few months. We’re not in great shape. Come to that, I’m not sure if we should do this even if we can swing it. I mean, if DE is the next step, and adoption the step after that, and the two are going to be roughly equivalent in incredible-expense, shouldn’t we just skip to the chase and assume that Sprogblogger’s womb of death will kill even the happiest donated egg?

In which case, does it make sense to take advantage of my insurance and attempt IVF #3? (which I can do at relatively low cost.)

How much is a baby worth? Priceless.
How much is a small chance of a baby who’s genetically related to both of us? Quite a bit.
How much is a small chance of a baby who’s genetically related to one of us? Quite a bit.
How about a baby related to neither of us, but the chance of which actually becoming ours is higher?

And how the bloody fuck is a person supposed to make these sorts of impossible decisions?

I have a consultation appointment with my doctor on Friday, so we can at least get an idea if he thinks that attempting to incubate an embryo is a stupid idea, at this point.

To be honest, waking up each day and going about my day is starting to feel like a stupid idea at this point. I want to wake up in someone else’s life, I think, which is a weird place to be. I’ve always sort of liked my life. Hah.

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…what to write about.  

No countdowns until or since – I am in IVF limbo.   And, like everything else associated with this process, IVF limbo sucks.  

Realize that I am a goal-driven person, never happier than when I have tons of projects all in-process.  Building a house while working full time and living without water or electricity was one of the happiest periods of my life because, by god, I knew what the next step was!  

And right now, I really don’t know what’s next.  Tonight will be my last PIO for a while.  Ditto Lovenox.  I imagine this will be my last day on the full prednisone levels (and sometime when I’m feeling more cheerful, I’ll tell you all the story of yesterday’s pharmacy nightmare that was involved with getting a refill in time to NOT go into withdrawal again.)  But I don’t really know what’s next.  Looking through pages and pages of donor files, I suspect.  Trying to find someone I’d like enough (and that I’m enough like, I guess) to want to raise her egg up into a sprog.  

*snort*  

Maybe “next” is simply getting smashed on absinthe and kitchen zen.  Christmas-cookie season is coming up, and that’s a good thing.  Much kitchen-zen to be found in the making of cookie platters.  That’s not sounding like a bad option right now. Plus, hey – absinthe!  Mmmm.  Licorice.  

And the dog appears to have figured out how to use her dog-door.  Finally.  Fear of Shelob (the evil, evil boiler), apparently, cannot compete with the lure of long-buried dog biscuits at 2am.  Whatever the incentive, I’m glad she’s figured it out.  I hate getting up in the night to deal with dog-digestive issues.  

And yeah, tomorrow I go in for my Beta test, and as-gently-as-possible squelch the well-meaning nurses and techs who will be so excited for the possibility of a positive.  And, I hope tomorrow, I should be able to schedule a consultation with my doctor to determine what our next step should be.  And then I sit around and wait for a period so that IVF #2 can be officially “over”.  Good times in Brooklyn.

Oh yeah, and I try to determine what – in this godforsaken economy – I can do with my life other than being a librarian so far away from home.  I figure if I’m going to be adrift and “starting fresh”, maybe it’s time to start fresh for real.  Do something different for a while.  My insurance has been keeping me at this job during the IVF, but I don’t think it’s going to do much for a donor cycle, so why not look around?  

At least that’s what I say.

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So, I had my appointment this morning with – Dr. Bigshot!  Some of you may remember that he’s the one who failed to find the fetus still hanging around in my bleeding uterus a month after the miscarriage.  You might also remember he’s the fellow who cavalierly diagnosed “the worst case of adenomyosis” he’d ever seen, on the basis of a 2 minute US and told me that the best way to deal with it would be to get pregnant.  Not my favorite guy at the clinic, despite his Bigshot-status.

Today, he once again offered up that diagnosis, DESPITE the words “no MRI evidence of adenomyosis” being on the front page of my chart.  I mean, really, I know it’s an assembly line set-up there, but if the techs and the nurses can manage to remember my name and case, surely the doctor should be willing to read the most recent entry in a chart before letting his mouth run on?  I didn’t want his ridiculous statement to actually be entered in my file, so I set him straight and had the satisfaction of watching the nurse cross out the transcript of his words (which felt better than it should have.)  And gently (no, really!) reminded him that his last US also failed to accurately diagnose the cause of my two-month hemmorhage. 

He couldn’t find pathology results from the genetic testing after the D&C, nor could he tell me why Lovenox was prescribed this time around.  He’s guessing it’s a prophylactic measure, but I’ll wait to talk to my doctor before believing that one.   

What a putz.  But, he found antral follicles on both ovaries, and the DHEA hasn’t yet provoked any weird cysts or fibroids anywhere (at least not that he could find), so unless I hear otherwise in my bloodwork results at 4:00, we’re a go for the start of IVF cycle #2! 

I’ll start Lupron tonight, and then starting on the 2nd, I’ll move up to 2 Bravelle and 1 Menapur + the 2 Lupron each day.  Blech. 

Woohoo.  Needles and blood thinners and steroids, here I come!

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It occurs to me that it’s probably not particularly healthy for me to get so much of my information from the internets, but, you know?  It’s just so tempting to google “DHEA mood” and see what pops up.  Apparently the giddy good mood I’ve been enjoying for the last two months, (er, ever since I started taking DHEA) is, well, chemically induced.  Doesn’t work for everyone, but this stuff is actually recommended in some places as a mood elevator.  

Um, yeah.  It works.  

Of course, it’s also recommended as a weight loss aid, and that’s certainly not happening.  Oh well.  I guess I’ll take happy and sturdy over miserable and scrawny any day.  

(I so don’t belong in NYC…)

And I learned about the various clotting disorders that I may (or may not – and this level of basic uncertainty is why one asks one’s doctor instead of googling shit! – ) have developed during this last pregnancy/miscarriage.  Oh my.  It looks like many women are prescribed Lovenox for their whole damned pregnancies.  Up until the last few weeks/days, when they go off the clotting inhibitors and onto bedrest so that doctors can more easily control the hemorrhaging/clotting that being off the drugs can provoke. Scary stuff, though given my dad’s history of DVT & his dad’s history of stroke, not too surprising that I’ve developed some of the same blood issues.  I did, however, read some encouraging (?) accounts of women whose Lovenox assisted pregnancies went without any sort of a hitch.  And it looks like the stuff is safer for developing babies than a lot of the other shit I’m putting in my body.  

Which isn’t, when I get right down to it, all that great an achievement.  

It would be really nice, though, to have a reason for the miscarriage.  Nice to be able to believe it was something that couldn’t be helped last time, but that we’re going to manage the hell out of this time, and which management will result in a normal, healthy pregnancy/baby.  

Of course, this is putting the baby carriage WAAAAAY ahead of the groovy-mom.  In the meantime, it’s looking like I’ll be on a 6-injections-a-day stimming protocol.  2 Lupron, 1 Bravelle, 1 Menapur, 2 Lovenox.  And that’s assuming that one can even dissolve 8 vials of B in a single cc of water.  Maybe I’ll have to break that down into two, as well.  Holy fuck.  It’s a damned good thing that these little insulin needles no longer have the power to worry me, or I’d be in real trouble.  

It is going to add half an hour to my morning routine, though.  No doubt about that.

Here’s to artificially elevated moods and totally clot-free uterine environments.  Yay science!

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