The nitty gritty

The details of our cycles and pregnancies:

IVF # 1 (NYC): September '07, age 35
Long Lupron Protocol
300 Follistim, 5 units Lupron
22 eggs retrieved, 20 mature, 14 fertilized
2 blasts transferred on day 5 (3BB, 1BB), nothing to freeze
BFP!
Betas double appropriately
Fetus measures on track
HB: 140, 151
Missed miscarriage at 8 wks, 4 days.
Cytogenetics: female with trisomy 21 and monosomy x

IVF #2 (NYC): February '08, age 36
Long Lupron Protocol
225 Follistim, 5 units Lupron
11 eggs retrieved, 10 mature, 9 fertilize with ICSI
For personal reasons freeze 6 at 2pn, culture 3, transfer one at day 3.
BFN
(When 6 are thawed three years later, none survive in culture)

Natural Pregnancy: March '08, age 36
Betas double appropriately (223, then 425, then 831)
Missed miscarriage discovered at 7 weeks.
Cytogenetics: Lab loses sample

Natural Pregnancy: May '08, age 36
Beta fails to rise appropriately
Natural miscarriage
Cytogenetics: male with trisomy 16

IVF #3 (NYC): November '08, age 36
Long Lupron Protocol
225 Follistim, 5 units Lupron
12 eggs retrieved, 10 mature, 8 fertilize without ICSI
three embryos transferred at day 3 (8, 7, 6 cells, moderate fragmentation)
BFN

IVF #4 (NYC): February '09, age 37
Antagonist Protocol with endometrial co-culture
Day 2 FSH = 6.8, E2 = 32.7, LH = 5.47
200 Follistim, 75 Menopur
15 eggs retrieved, 14 mature, 11 fertilize without ICSI
five embryos transferred at day 3 after co-culturing (9, 9, 8, 8, 8 cells, minimal fragmentation)
BFN

IVF #5 (NYC): May '09, age 37
Antagonist Protocol with endometrial co-culture
Day 2 FSH = 7.0, E2 = 30, LH = 7.5
200 Follistim, 75 Menopur
Trigger one day early (Day 9)
6 eggs retrieved, 4 mature, 3 fertilized without ICSI
Three embryos transferred at day 3 after co-culturing (9, 8, 7 cells, grade 1 and grade 2)
BFP
HCG levels: 9dp3dt: 23; 11dp3dt: 48; 13dp3dt: 36; 15dp3dt: 17
Chemical pregnancy

Natural Pregnancy: June '09, age 37
Beta #1 (15 dpo): 188!, estrogen 271, progesterone 39
Beta #2 (17 dpo): 585!, estrogen 301, progesterone 36.45
Beta #3 (19 dpo): 2,413
Beta #4 (21 dpo): 3,159
Beta #5 (23 dpo): 5,221
5 wk u/s: gestational sac, yolk sac
7 wk u/s: baby w/ heart rate of 167 bpm! Measuring 7 wks 4 days.
8 wk u/s: baby w/ heart rate of 185 bpm! Measuring 8 wks 1 day.
9 wk u/s: no heartbeat (8/6/09). D&C performed.
69XXX - triploidy

IVF #6 (Denver): March '10, age 38
Microdose Lupron Protocol
Day 3 FSH = 5.5, E2 = 33.2, AMH = 1.4
300 gonal-f, 150 menopur, 20 ml lupron every 12 hours
.33 Saizen, .5 dexamethasone
19 eggs retrieved, 14 mature, 16 fertilize with ICSI (13 immediately, 3 more after in vitro maturation with Day 2 ICSI)
7 blastocysts [6BB (Day 7 blast), 4AB (Day 7 blast), 2 x 4BB, 4AA (from Day 2 ICSI), 3BB, 3AB]
Freeze all
Sample sent for sex chromosome FISH testing and microarray to test all chromosomes

Results indicate three normal blastocysts!!!

IVF #7 (Denver): June '10, age 38
(For two months ahead took inositol, coenzyme q10, and melatonin to improve egg quality)

Microdose Lupron Protocol
300 gonal-f, 150 menopur, 20 ml lupron every 12 hours
.33 Saizen, .5 dexamethasone
25 eggs retrieved, 22 mature, 18 fertilize with ICSI

Freeze all
Sample sent for sex chromosome FISH testing and microarray to test all chromosomes

Results indicate five normal blastocysts!!!

FET #1 (Denver): October '10, age 38

Medicated cycle

Took Depot Lupron for two months prior to cycle to improve endometrium/reduce endometriosis
One month of twice weekly electro-acupuncture to improve blood flow to uterus

Transferred 3 FISH and microarray confirmed chromosomally normal blastocysts
(Embryo #5 - 06/10: Day 6 6BA, Embryo #14 - 06/10: Day 6 4BB, and Embryo #6 - 03/10: Day 7 6BB)

BFP

Start 40mg lovenox, 10mg prednisone, 40mg pepcid, 10mg claritin, baby aspirin, and intralipids for potential immune issues

Beta #1 (9dp5dt) = 26.8, estrogen = 526, progesterone = 4.87

Beta #2 (11dp5dt) = 56.0, progesterone = 28

Beta #3 (13dp5dt) = 145.5, progesterone = 33

Beta #4 (17dp5dt) = 690, progesterone = 22

Beta #5 (20dp5dt) = 1702, progesterone = 11, estrogen 543

5w5d u/s: gestational sac and yolk sac

6w2d u/s: larger sac + fetal pole?

Beta #6 (31dp5dt) = 12,691, P4 = 23.12

7w3d u/s: no heartbeat, debris in gestational sac. D&C performed.

Cytogenetics: 46XY. Chromosomally normal male baby


FET #2 (Denver): February '12, age 40

Medicated cycle

Took Depot Lupron for two months prior to cycle to improve endometrium/reduce endometriosis
One month of twice weekly electro-acupuncture to improve blood flow to uterus
One IVIG treatment 10 days before transfer to reduce NK cell activity

Took 40mg lovenox, 10mg prednisone, 40mg pepcid, 10mg claritin, and baby aspirin for any immune issues
Transferred 3 FISH and microarray confirmed chromosomally normal blastocysts
(Embryo #3 - 03/10: in vitro matured Day 7 4AA, Embryo #5 - 03/10: Day 7 4AB, and Embryo #21 - 06/10: Day 6 3AB)
BFP
Beta #1 (7dp5dt) = 69.3, estrogen = 442, progesterone = 34.3
Beta #2 (9dp5dt, 4w0d) = 155, estrogen = pending, progesterone = 31.16
Beta #3 (11dp5dt, 4w2d) = 445, estrogen = pending, progesterone = 38.68
Beta #4 (15dp5dt, 4w6d) = 3,032, progesterone = 28.2
Beta #5 (18dp5dt, 5w2d) = 7,681, estrogen = 844, progesterone =11.5
Beta #6 (20dp5dt, 5w4d) = 12,362, estrogen = 1,185, progesterone = 70.7
Beta #7 (25dp5dt, 6w2d) = 45,785, estrogen = 616, progesterone = 32.82
Beta #8 (28dp5dt, 6w5d) = 65,543, estrogen = 683, progesterone = 53.15
6w5d u/s shows hb = 127bpm, baby measuring at 7.1 wks

7w5d u/s shows hb = 154bpm, baby measuring at 7.6 weeks 

Beta #9 (36dp5dt, 7w6d) = 140,934, estrogen = 732, progesterone = 39.4

Beta #10 = (42dp5dt, 8w5d) = 182, 833, estrogen = 1,169, progesterone = 57
blood work at 10 weeks, 3 days = estrogen = 852, progesterone = 28.13
blood work at 11 weeks, 2 days = estrogen = 1,116, progesterone = 35.44

Pregnancy continues with partial placenta previa, which resolves
Gestational diabetes develops at 28 weeks but is controlled through diet and overnight insulin
****Baby girl born at 39 weeks, 1 day!!! - via c-section after failed induction****

Natural Pregnancy: February 2015, age 43

Beta #1 = 106.5
Beta #2 = 198.1 (not quite doubling)
Beta #3 = 264 (really not doubling)
Natural miscarriage

FET #3 (Denver): August 2015, age 43

Medicated cycle

Took Depot Lupron for two months prior to cycle to improve endometrium/reduce endometriosis
One IVIG treatment 5 days before transfer to reduce NK cell activity

Took 40mg lovenox, 10mg prednisone, 40mg pepcid, 10mg claritin, and baby aspirin for any immune issues
Transferred 3 blasts, 2 FISH and microarray confirmed chromosomally normal blastocysts, 1 no result
(Embryo #11, a Day 7 FISH/Microarray normal 4BB blast, Embryo #15, a Day 6 FISH/Microarray normal 3BB blast, Embryo #20, a Day 6 FISH/Microarray no result 3BC blast)
BFP
Beta #1 (7dp5dt) = 22.3, estrogen = 1127, progesterone = 10.1
Beta #2 (11dp5dt) = 

The consult...a look back, plus a plan

So you saw our questions in the last post. Now we have some answers. Thank you for all of your ideas about what to ask - both those left as comments and those privately emailed. Will and I appreciated all of your thoughts.

The RE's main point was that we shouldn't lose hope. He feels our prognosis is still very good. That we had bad luck with the chromosomal abnormality and miscarriage our first cycle ("That could have happened to anyone"). And that we can't read too much into the failure of cycle #2 because we only cultured three embryos (freezing six others at 2pn stage) and only transferred one.

He still thinks we can succeed with our own eggs (and even said he would not allow us to use a donor at this point if we wanted to, which we don't). Surprisingly, he felt the embryo quality throughout the three cycles has been fairly good. (Could have knocked me over with a feather with that statement. I was like "Really??!")

He continued to say that PGD would do more harm than good and that CGH is still too experimental (he said he thinks that the technology is still years away). He said they don't do micro-dose lupron except in the case of poor responders ("and you're not a poor responder," which was nice to hear). He seemed so-so about assisted hatching (but I think we'll ask for it anyway).

In terms of what's next, he said we should probably do endometrial co-culture and he's changing our protocol, removing lupron, upping the dosages of the meds a bit, and adding Ganrilex and menopur.

We are on the cancellation list to try to get in to do a co-culture biopsy in late January. I'm going to stay on progesterone through Friday to delay my cycle starting (who thought I would ever agree to extra PIO shots?!). If we're able to get the endometrial biopsy done in late Jan, we'll be on to cycle again in late Jan/early Feb.

So it looks like we're on to (gulp) IVF #4.

I can't believe we have to cycle again. But since we do, it feels so so much better to have a plan.

By the way, it is freakin' COLD in NYC today. Like Minnesota cold. Those of you who live in northern climes (Canadians, I am talking to you), I applaud you. I don't know how you do it.

Thank you again for all of your encouragments, stories, suggestions on blogs to read, and medical advice. I never realized how interactive blogging can be. Your thoughts and comments have been an enormous help.

We are past the solstice. There is a bit more light today than yesterday. Hoping for brighter, warmer days ahead.

Mo

Blue Christmas

Despite white snow blanketing New York City, it looks like we're in for a blue Christmas this year.

Today is 11dp3dt. Beta would have been today except that my clinic doesn't do betas over the weekend. HPT continues to be negative. It's over.

Will and I have been wrapping our minds around the likelihood that this cycle was a bust for the past few days, so the unbearable sadness is already starting to give way to a grudging acceptance. This IVF is tougher because it feels like three failures is significant. Like maybe we aren't going to get through to the other side and have a child. Which is excruciating.

It seems fitting that today is the winter solstice: longest night of the year, shortest day. Am hoping that metaphorically this means things will begin to improve. That this will be our lowest point in the journey toward a child.

We will see the RE tomorrow to get his thoughts on where to go from here.

These are the questions we are considering for him:

1. What happened? Where do you think this cycle went wrong?
2. How did embryo quality compare to previous two cycles?
3. A year ago after the first miscarriage, you said our prognosis was "fabulous." What is our prognosis now?
4. What have you learned from this cycle about how to go forward?
5. Would more aggressive stimulation help?
6. How about assisted hatching and fragment removal?
7. Or endometrial co-culture?
8. When can we cycle again?
9. Would varicocele surgery help? How long afterward would we have to wait?
   

Anything we aren't thinking of? Please chime in; we're both a little numb.

Mo

9dp3dt

It's nine days post our three day transfer and I feel like the window of hope is closing. I continue to feel no pregnancy symptoms. I continue to test negative.

Will and I are both starting to feel pretty hopeless, not just about this cycle but about our chances of having a biological child in general.

As you know, I've had a bad feeling about this cycle for a while, first during the stimulation phase and then at the transfer when I saw how fragmented the embryos were.

I have loved all of your encouragements (they have really, really helped, thank you), and especially Nancy's that she got a positive very late in the two week wait (Nancy, I continue to hold on to your story as my singular hope), but I also know my body. I've been pregnant three times and I know what it has felt like for me. I also learned from the whole Hodgkin's experience that it is vital I trust my instincts about my body. To trust that sometimes I just know that something is wrong.

So I'm still not downing margaritas or stopping the PIO (although I've broken out in hives again - neck, arms, chest, back. Like some extra cruel twist of fate. So much for switching from sesame to olive oil). I'm going through the motions, but really, I think it's over.

Will and I are both feeling so strongly this way that we decided to pre-emptively schedule the WTF meeting with the RE. I realize this sounds maybe a little ludicrous, but the idea of sitting with all of our feelings with no information until after the new year seemed unbearable. We figured we could always cancel the meeting if I turned out to be pregnant.

So I called. And the RE's assistant said that he didn't have an opening to meet with Will and me until Jan. 20th. HA HA HA HA!

I got off the phone and hit bottom emotionally. I know our RE is a busy guy. I know he has probably more patients than he should because he is so good at what he does. And I know that their office is closing for the holiday. And that he's probably taking some vacation. I do realize these things. But honestly, I felt a bit abandoned. And a wee bit resentful. Like it's expected for Will and me to turn our schedules upside down but when it comes time for a 10-minute talk so that Will and I can try to have a decent Christmas, he's too busy. Too busy FOR A MONTH.

Can we all say progesterone-induced insanity syndrome? I'm not usually a nutty, entitled person. Truly I'm not.

Anyway, I spoke to Will, and he offered to email the RE to see if there was any possibility of something earlier. No drama, no pushing, just simply asking. And twenty minutes later, the RE emailed back and now we're going in on Monday afternoon, probably about 2 hours after we get the "official" negative beta. Thank God I have an MD spouse on the same faculty as our RE. I am grateful but slightly saddened that if we weren't fortunately connected we'd be waiting a month. Anyone in our situation deserves to get a chance to discuss matters in a reasonable amount of time (say within a couple of weeks).

Maybe we'll get a miracle positive on the hpt in the next two days but we are starting to accept that we probably won't. And it is a huge consolation that we can talk with the RE and come up with a Plan B (or is it Plan D at this point?) so quickly.

Mo

How the two week wait stole my sanity and replaced it with tiny pizzas

I haven't been posting because I've been too busy trying to stay sane.

I'm struggling to focus on work, which has received scant attention of late. I've been able to pull it together for my patients, but when I'm alone...not much productive going on.

Instead, I'm spending lots of time trying not to think about the presence or absence of every strange twitch and bloat in my body. You know the symptoms everyone goes on and on about: sore breasts, uterine cramping, light spotting, fatigue, nausea, urinary frequency?

Well, I have some of those. Maybe. If I squint my eyes and focus my mind hard enough.

And now I'm trying to remember back to my last "successful" IVF (by the clinic fellow's standards, at least). What was I feeling? I remember thinking I was going to test positive. Didn't I think that? I had uterine cramping. Perhaps. Not really sure. Definitely. Ugh.

But the more I think about it, the more I realize that all I know is I am jacked up on progesterone. Or maybe I know that I am pregnant. Or maybe (more often) that I'm not. As I monitor my insides repeatedly, I think: abdominal cramp. Must be gas, embryos implanting, nervousness, embryos implanting, intestinal blockage. Im-PLAN-tation.

My breasts? I roll over at night and two massive globular entities wake me up. Soreness! Will marvels at them, at the widening, darkening aureolas now the size of tiny pizzas. The boobages may be large, Will, but back off! They are made of glass. Sign of pregnancy? Sign of progesterone. Were they more sore last time, when I was "successful"? I think so. Maybe not. Definitely. Are they more sore than yesterday? Yes. No. Yes. Ugh.

And I'm a little nauseated. It's the fast food I ate. It's the progesterone. I am PREGNANT. I have food poisoning. Wait, maybe it's passed.

Happy Holidays. Miserable holidays. White Christmas. Blue Christmas. Criminy.

Why did we decide to do this right before Christmas anyway?

It's 6dp3dt. Tested negative this morning.

I can obviously conclude that (1) this cycle is a failure. Or (2) this cycle is a success but it's really early. Or (3) who the hell knows, but at least the HCG is out of my system.

The only thing I know for sure is that suddenly, I have a hankering for pizza.

Mo

Pics from the petri dish: Don't judge an embryo by its cover

So without further ado, here are the three embryos that are hopefully now nuzzling in and taking firm root in my endometrium. One 8-cell, one 7-cell, and one 6-cell.

The bigger circles are the cells. And all that smaller debris is fragmentation, which unfortunately is not such a good thing prognostically (the embryo on the lower right looks especially ominous).

I'm really pulling for these guys to make it. Truly, I am. But I have to say that as the staff handed me the picture and started oohing and ahhing over it in the OR right before the transfer, I was crestfallen.

When my RE had phoned earlier that morning and said, "Three look better than the rest," this was not what I was imagining.

I had pictured each embryo would look like this:

which is to say, perfect and 8-celled with minimal fragmentation.

Will and I joked in the recovery room that if one of these embryos turns out to stick and become a baby, h/she sure won't be winning any beauty contests. Which of course would be just fine. We just want a healthy baby (and we're not exactly winning any contests either, believe me).

And while I am worried and somewhat disappointed, I am also thankful that we have embryos to transfer at all. That we have our health. That we have each other.

I met a woman as I was waiting for the transfer who only had one embryo to transfer and who three months ago lost her baby at 20 wks gestation due to a fatal heart defect. Ugh. And do you know what she said to me? "My husband and I are just grateful that we got to have the pregnancy and feel the baby move inside me. Even if I never get pregnant again, we will always have that to hold on to."

I almost cried. I'm not sure I could ever find the silver lining in such a situation. But I admire her incredibly for doing so.

I am a lesser being, I think, one sometimes filled with fruitless anxiety and angst. That said, I am trying desperately to stay in the moment and remember that things could, just maybe, turn out ok. Just because they haven't before doesn't mean that they won't this time.

The beta is Monday 12/22. What will be will be.

Mo

Reports from the petri dish: Transfer

We received word this morning that the gang of eight are not looking strong enough to make it to Day 5, so we are going to transfer in a couple of hours.

Our RE said that three of the embryos are looking better than the others and will be transferred.

We had a lot of back and forth about whether to put back 3 or 4, but ultimately, the RE felt (and convinced Will and I) that our chances of pregnancy wouldn't be improved that much (he said only by 3%) by a 4-embryo transfer, while we would have a much increased chance of triplets of quads (18% chance of triplets with four put back, 2.5% chance of quads).

We are trying to be optimistic. I have to admit I'm not feeling so great. Had wanted to make it to a Day 5 transfer, so this news that we need to transfer today really throws me.

Will and I are both desperately hoping that we don't end up again in Pregnancy In-Between Land as we have the last three pregnancies (pregnant but with non-viable embryos/fetuses).

Now that we're at the transfer stage, all the old emotions of loss are welling up. We're both trying to focus on the positive, but it is tough because this pregnancy thing has just never gone in a positive direction for us. It's strange to be feeling this way, I keep thinking I should be elated. Instead we are hopeful but chastened. Cautiously optimistic but terrified.

So in two hours, we will screw up our courage, focus on the chance that this could actually work out, and head back to the IVF suite at the hospital.

Mo

Reports from the petri dish: Fertilization

Of the 12 eggs that were retrieved, 10 were mature. And of those, 8 fertilized without ICSI (Way to go, Will's little swimmers!).

Usually at my clinic they require a minimum of 10 embryos to consider a 5-day transfer, but the nurse who called today said that my RE wants to try to push us to day 5. She said to keep both Wednesday and Friday afternoons free. The clinic will call Wednesday morning to let us know whether the transfer will be later that day or Friday.

Feeling much better today physically and optimistic about how things are looking. We shall see what Wednesday's news brings.

Thank you for all of your comments and thoughts.

Mo

Egg retrieval

A normally stressful event was made somewhat easier by having our RE make an unscheduled appearance to do Mo's procedure today. He retrieved 12 eggs! Mo has been fairly uncomfortable (but very relieved) and resting most of the day. She will update on the fertilization report as soon as we get word tomorrow. We are very, very pleased.

More news soon.

Will

Cycle day 13 update: Trigger day

Will just gave me the HCG trigger shot and we're set for an early retrieval on Sunday. I can't believe we're here already.

Things have brightened since my last cycle update. There are now 7 large follicles and several smaller ones visible on ultrasound, so we are cautiously optimistic that things will go well on Sunday.

My RE did our ultrasound Thursday and said he will try to come in and do my retrieval himself, even though he isn't on call. We are thrilled and touched. Our IVF center is quite large, known for its clinical excellence but not necessarily for being a hand-holding kind of place, so his willingness to come in on his day off is especially meaningful.

We will keep you posted. Thanks, as always, for your warm wishes and thoughts.

Fingers crossed and full speed ahead.

Mo

Cycle day 10 update

Today's ultrasound was kind of a bummer. I had the fellow I am not so fond of again today and when she did the scan, it was clear that there was only ONE large follicle on my right ovary, and just a few decent sized ones on the left.

This is a significantly muted response compared to my previous two cycles (where 21 and 9 eggs were retrieved, respectively). Needless to say, since going in this morning, I've been trying not to get discouraged. The fellow did say that it's possible some of the smaller ones could grow enough to contain a mature egg ("That happens sometimes," she said, chipper and clueless, while I tried to suppress my urge to growl audibly at her).

Despite the substellar follicular development, my lower abdomen is extremely crampy - much more so than with the previous IVFs. Very curious. Based on the way my belly feels, something is going on in there. Maybe it's not follicles under construction, maybe my body is putting in a line of new condos or something.

In other news, Rocketman's ship landed safely last week in South Dakota and the results are in. Sperm chromatin was normal (which was a huge relief), motility was lowish, and morphology was abysmal. All in all not so different from previous testings. And nothing that's too major since we will be utilizing a petri dish (and perhaps ICSI).

So I know that none of the information gleaned today is terrible, but I left the IVF center feeling slightly glum and rather less hopeful about the cycle. Fortunately, my feeling one way or another should have just about zero impact on the outcome, as long as I can rally myself for my injections and make it to the retrieval on time.

I keep trying to remind myself that I don't need a legion, I just need a few good eggs.

But any words of wisdom from you guys would be most welcome.

Mo

Cycle day 8 update

We are back from our trip. We had trouble communicating with our IVF center while we were out of town, with lots of balls dropped on their end about letting us know dosages and what monitoring to do. It was disappointing (and unusual as our center is usually so super-anal about everything) and culminated in our having to email my RE at 9pm at night (pros of having an M.D. spouse). Fortunately, my RE came through as usual and emailed us back that night and again the next morning to make sure we knew how to proceed.

I went in for ultrasound and blood work today and I seem to be responding to the Follistim, as my dose was dropped for tonight by 75 units. Physically, I can feel something happening: have had abdominal twinginess, and today's aggressive ultrasound probing left me cramping on one side for most of the day.

I had vowed not to pay attention to the details of how things are developing, but my acupuncturist wants updates so she can adjust my treatments. So much for avoiding obsessing! I think they said they saw 2-3 on one side around 12 and 2 on the other side around 11, with several smaller ones. But it all happened so fast, I'm not sure. Oh well. I can never figure out exactly how what they see on ultrasound translates into what happens on retrieval day anyway. So am trying to pay attention enough to tell the acupuncturist while not getting caught up in any specific expected outcome.

Mo

Rocket man

I don't get many check-ups. Maybe since I am a doctor I think I don't need to have them, the "I know better" syndrome. Maybe I am scared of the unknown or of sharing my deepest secrets or most intimate body parts with a colleague. Maybe I think I know the limitations of medicine.

But with IVF, I cannot escape. Certain tests are dictated by our RE and others by my partner in crime, Mo. Deep down I want to be healthy, so the desire is also mine. And since Mo takes her shots and goes to her monitoring every day, I figure I can do my part too.

Which leads me to The Rocket.

My urologist wanted me to get my sperm DNA tested to be sure that a medication I'm taking is not affecting my swimmers. There is only one laboratory in the world that performs the test to detect damage in the DNA of sperm (aka sperm chromatin structure assay). And this lab is in - of all places - South Dakota.

To get my sample from New York to South Dakota, Fed Ex (for a cool $150) ships a sort-of-mushroom-shaped contraption that contains a white metal tank filled with dry ice. It is ridiculously bulky and even more ridiculously heavy - weighing probably 20 pounds. Mo and I took one look at it last cycle and christened it "The Rocket."

So when my urologist said I needed The Rocket again, I had it sent to my sister's apartment. Like I want my sister to know that I even have sperm! Sigh. But she has a doorman who will accept items like bulky steel rockets in the middle of the day. And Mo and I do not have a doorman (and with all we are spending on IVF, may never have a doorman).

When I heard The Rocket had arrived, I left work and headed to my sister's. I lugged The Rocket home and did my thing. The whole device is just...strange, with metal buckles, and pipettes, and whatnot. Adding to the effect is the fact that when you open The Rocket to put in the specimen, the dry ice inside emits a smokey fog. I felt like a mad scientist.

Next stop: Fed Ex. The curt woman behind the counter took one look at The Rocket, backed away, and said, "No way. I ain't taking that here. What is it?" I thought of being honest, but then decided that was probably a bad idea (plus, I couldn't bring myself to tell her the truth). So I told her a partial truth: that the tank contained dry ice. She stood her ground. "Sorry. I can't help you. We do not take dangerous materials at this Fed Ex." Now, I know dry ice is not dangerous, but I realized this was a dead end.

This exchange was repeated at three different Fed Ex centers. Picture me, schlepping this insane metal mushroom all over Midtown Manhattan, turned away at shipping location after shipping location.

I was starting to get annoyed. I was starting to feel a little sorry for myself. I considered shouting, "It's SPERM! OK? SPERM! Maybe with a DNA problem BUT SPERM!!!!" But I decided that would not be so effective. Finally, I went to Fed Ex's NYC headquarters where the clerk didn't even blink an eye. She acted like my rocket was the most normal thing to ship. In fact, she told me that there had been another guy there minutes before with a rocket like mine.

So just like that, when I was about to give up, The Rocket was launched. I picture it flying over South Dakota right about now.

I think it's gonna be a long long time
Till touch down brings me round again to find
I'm not the man they think I am at home
Oh no no no I'm a rocket man
Rocket man burning out his fuse up here alone

Mo starts stims Tuesday night. Wish us luck.

Will

Cycle day 3 update

Went in for bloodwork and ultrasound around (yawn) 7 a.m. this morning. Will came along and we signed all the consents and put the cycle on our credit card. Guess it's official.

The fellow did the ultrasound today. The antral follicle count was "more than five, less than ten" on each ovary. Good enough for me.

She then thumbed through my records. "So your first cycle was a success but your second was not."

I gazed at her and said, "Our first cycle was also unsuccessful. "

The fellow looked down at her notes for a minute and then back at me for a minute and then seemed to decide not to say anything more. I knew what she was getting at with her comment, but I couldn't let the teaching moment go. Note to fellow: a baby with double aneuploidy who dies in the first trimester is not exactly what I would classify as a "success." Certainly not the kind of success that we're looking for.

The IVF nurse will call tonight and tell us what dosage of Follistim to use and whether I start today or not. There's some question since we'll be away Wednesday through Saturday for the holiday. And although we'll be in a major metropolitan area with a fantastic medical center, the nurse made it clear this morning that our IVF center doesn't really trust us using any other lab. So they may delay my start date.

We'll see...I'll keep you posted.

Mo

Feathering the nest

We’re in the beginning stages of IVF #3, and after three pregnancies and then three pregnancy losses this past year, I’m frankly feeling a little detached from the whole process. I haven't hauled out the IVF books (still on the top closet shelf) and haven't scoured pubmed for the latest IVF research, like I usually do. I'm doing what I must: my shots, healthy-ish eating, and, yes, the one add-on of acupuncture. But I’m not engaging as much emotionally (at least I’m trying not to).

But my husband Will…well, he seems to be going a different way. As I looked around our apartment this morning, I realized that in certain ways, Will is taking a more active stance toward this cycle than I am.

I hadn't put it together before, as Will doesn't talk about IVF so much per se. But he has been quietly doing a number of things that taken together are quite striking.

For example, he just bought some kind of wireless radio/Internet thingie (he calls it the Squeezebox, I call it the Squawkbox) that will allow us to access to/listen to music all over the apartment.
(Me: "That's nice, honey.")

And he has been keen on putting wiring into the closet in our foyer, with the idea that we can move the printer, modem, router, and various other mysterious flashing electronic devices out of the second bedroom and into this closet.
(Me: "Huh? OK, whatever. Sure, fine.")

He also has been taking boxes and files and picture frames from the second bedroom closet to his hospital office all week.
(Me: Didn't even notice, actually.)

And then last night, he became downright insistent about getting to IKEA today to buy a third bookshelf-cabinet to match the other two in our foyer because, he says, we have to get organized. We’re renting a car and leave in two hours. There was really no talking him out of it.
(Me: Hmm...we're already pretty organized...this seems strange, but...ok.)

I don’t know how I could have missed the accumulating signs, but suddenly this morning it hit me.

Will is NESTING. Male nesting perhaps, but still.

This is a side of him I've never seen before. He may not talk about things so much, but there's a lot going on in that head of his.

It’s pretty sweet, actually.

Mo

How does your husband cope with IF/IVF? How do you wish he would? And any husbands out there, how are you dealing with it all?

Acupunctured

I went Thursday for my first acupuncture appointment. The practitioner seemed very nice. A good mix of soothing and professional. She asked several questions about my history of infertility, recurrent pregnancy loss, and menstrual cycles, then about my sleep and whether I'm generally hot or cold (as Will will attest, I'm usually freezing). She proceeded to prescribe hot ginger tea with cayenne in it and went to work.

The acupuncture itself was strangely stimulating and relaxing. More...um...penetrating...than I thought it would be.

A little like this...(except I have much less hair on my legs):


It felt like she was putting the needles in along the nerve pathways in my feet, ankles, calves, thighs, wrist, face, and head. She remarked that I was not reacting at all to the placement of the needles and I told her that between IVF and lymphoma treatment, she was going to have a hard time fazing me. After she placed the needles, she covered me with a thin aluminum sheet, dimmed the lights, turned on some soft chanting music, and left for about a half an hour.

I felt relaxed and alert. Not sure if it will help with our IVF cycle, but it was actually fairly pleasant. She wants me to return twice a week once I start the stims. I'm supposed to see her again on Monday.

Those of you who've done acupuncture, what was your experience like? Do you think it helped?

Mo

Lupron days and restless nights

Three days into Lupron and I can definitely tell it's working. I feel downright...menopausal. Reminiscent of the first two IVF cycles and of my symptoms after the abrupt halt of my menstrual cycle caused by ABVD chemotherapy for my Hodgkin's 9 years ago (thankfully temporary - my cycles returned approximately a year after stopping treatment).

Needless to say, I don't have positive associations to hot flashes, night sweats, and the general all-over-achiness I am currently feeling. I spent last night sweating, tossing and turning, waking up poor Will repeatedly.

In my groggy attempt at positive reframing around 3AM, I thought, "Well, at least I know it's not a placebo." That's the best I could come up with in the pre-dawn hours.

This morning, I reflected on my ability to "forget" the harder aspects of IVF. Call it some kind of protective mechanism, I suppose. For me, Lupron is one of the more physically unpleasant parts of the process (that and the dreaded PIO shots). Note to self: I will start to feel better once I start the stims. Another note to self: Take it one day at a time. Stay sane. You can do this.

Mo

Why couldn't conception be like this?

Wouldn't it be great if there was a Fertility Easy Button?

I'd say it's unrealistic, but then again, I know a number of thirtysomethings who seem to get pregnant at the drop of a hat...and stay pregnant. Like one who said, "Once you pee on a stick and you see that second line, you know your life will never be the same again."* Really? REALLY?! You have sex and two weeks later pee on a stick and just assume you will have a baby? And then you do?! Unimaginable to me.

Or the one who told me she decided to wait until a certain month, and then had sex and actually conceived a baby who is now almost a year old. This same woman then turned out to not only be uber-fertile but also to think that this was something to be taken for granted, and gushed to me, glowing with her accomplishment, "It seems like our bodies are just made for having babies, you know?"*

Forgive me, but I looked this second woman straight in the eye and said, "Not really...[pause for effect]...we're doing IVF...[more eye contact]." I then hated myself a little bit when I saw the crumpling realization of her faux pas spread across her face. Was I being mean, as Greeneggsnham recently worried she was when speaking to a similarly clueless person? Perhaps. But I was angry and also (rationalization alert) felt a need to try to educate her a little bit so she might avoid this mistake in the future.

But enough sour grapes. Our reality is that we are here, facing IVF #3, hoping this third time will be the charm. Should we get out the other side of this with a baby one day, we will be blessed not only with that child, but also with a deep appreciation of how incredible a privilege that is.

And while we understand viscerally that - at least for us - there is no Easy Button for fertility, there are certainly ways that the IVF process can be made easier or harder. How do I try to cope while cycling? I enjoy running and will keep it up until I start the stims. I'm eating healthy-ish and trying to get adequate sleep. As I said in my last post, I start acupuncture next week. And Will and I will do our best to keep the lighter moments of our relationship very much alive.

And what do I try to avoid in the spirit of not making this harder than it has to be? I try to avoid (ha ha ha ha) obsessing and (ha -snort!- ha) worrying. I try to stay in the moment and not get ahead of myself. Will is much better at not obsessing, not worrying, and staying in the moment, but then again, maybe it's easier when you're not jacked up on hormones and having an ultrasound probe thrust up your wahoo every other day.

I bet there are many other things that might help make things easier if only I could think of them.

So now I turn to you for your expertise. What strategies help you to weather your ups and downs, your anxieties, your what ifs, your hopes and fears? What have you learned makes the process harder than it has to be?

And back to the beginning of the post, what idiotic things have been said to you recently? And how did you respond?

Any and all thoughts are most welcome.

Mo

*actual quotes of friend and acquaintance

And we're off...

First Lupron injection was tonight. It was a little harder than I thought it would be to stick the needle in. Not because it would hurt - I know from the last 1,000 IVF and cancer-related sticks that it wouldn't be that bad. I was hesitant because it meant climbing back onto the IVF roller coaster again. It meant accepting that we are fully committing to IVF #3 and all the excitement and dread that goes along with it.

I also surprised myself by booking my first acupuncture appointment for next week. I'm kind of a skeptic about non-western approaches to medicine as the research for and against seems equivocal. But I figured, it can't hurt. I want to make sure all my i's are dotted and t's are crossed.

Please please please let this cycle be the one. Wish us luck!

Mo