23 weeks, 2 days

Merry Christmas, from the three of us!

21 weeks: Good baby and shopping

Babies are expensive!  And I am turning in to a bargain hunter.  So far this week, I have acquired a crib, a pack n play, a car seat and extra base, and some adorable clothes -- all on sale!  After cruising the clearance racks at Tar-jay, I have discovered my baby dressing principles: bright colors (rather than pastels), big pictures, and no silly sayings.  Fortunately, the Boden winter sale catalog arrived today, and baby made out like a bandit.  Within a matter of days, it's going to really look like a baby is coming to this house.  High on the to-do list: clearing out the "box room" we've been using for storage so there's room for all his stuff. 

Since I've started to feel him move in the last few weeks, my anxiety level has skyrocketed.  I didn't expect it, but now I'm obsessed with his movements.  And when he's quiet for hours on end, I panic.  The heartbeat monitor has seen a lot of use the last few days.  Of course, you get what you wish for, and Monday night he kept me up for hours with the kicking.  Happily, since then, he's settled in to a much more reasonable routine, just some occasional kicks to let me know he's okay, without being distracting.  Good baby.

20 weeks: Halfway to baby!

By popular demand, here's Mama from Thanksgiving Day, 19 weeks, 1 day:

19 weeks, 6 days: It's a ...

stubborn, willful child who was not particularly cooperative with the tech.

But is also most likely a boy!

19 weeks, 1 day: Thankful...

...for a Rockwellian-Pacific Northwest Thanksgiving, frosted with snow, with 22 members of the extended Bangs family;
...for my own growing nuclear family;
...for the miracle of science;
...for Dr. Eli Reshef and all the nurses and lab techs at the Bennett Fertility Institute;
...for mandatory infertility insurance coverage in Massachusetts;
...for 18 months of COBRA coverage;
...for our new home, friends, and church family in Norman;
...for the endless love and support from you, our extended tribe in Boston, NY, DC, NC, UT, OH, NJ, CA, OR, and on and on;
...for our family in AZ, CA, WA, IA, WV, MD, VA, and PA (and anyplace I left out!);
...for Grandma Mason's 97th birthday today;
...for my two best friends, Brent and Sarah;
...for my parents and brother;
...for my IF buddies, Sally, Kate, Monica, Emily, and the giant circle of support on the internet;
...and looking forward to next Thanksgiving, when over the Sound and through the woods to Grandmother Gigi and Papa Bill's house we'll go!

Happy Turkey (and pie)!

16 weeks, 5 days: Second trimester screening results

Everything continues to look good! Risk of Down Syndrome is now 1:7400, Trisomy 18 is 1:1000, and neural tube defects is 1:6000. Our big ultrasound on Nov. 30 will confirm that all is well ... and let us know whether we're shopping for pink or blue!

We interrupt our regular programming: It's almost Hal-LEO-ween!

Our wonderful friend Leo is turning two tomorrow. He has made amazing progress this year with his mobility and communication. But there is still so much more to do. Please consider sending Leo a birthday gift to help fund tools and services that will help him continue the progress, including trips to see consulting doctors, adaptive technology, and Feldenkrais lessons. Visit Leo's blog to donate via PayPal. Thank you and have a happy and safe Hal-LEO-ween!

15w1day: Bumping out

My friend and colleague Emily looked at me the other day and said, "Things are becoming more obvious!" 'Tis true ... the belly is beginning to have a bit of roundness distinct from, ummm, too many cookies. I'm still not quite ready for real maternity pants, but the time is not far off.

My second midwife visit was yesterday. No new pics, but everything looks and sounds great. Of course, I expected nothing less, since I've had no problem picking up the heartbeat at home. The interesting part was that it was the first appointment I've had since, goodness I don't remember, that I wasn't hyperventilating beforehand. I believed it was going to be okay; I wasn't panicked that the other shoe was about to drop. And neither Brent nor I had any qualms about my going alone. He was free, but decided to stay behind and get some work done. (He'll be with me for the big anatomy scan after Thanksgiving, not to worry!) What an amazing thing, to feel normal.

I had my first, and hopefully last, true morning sickness incident during a conference in DC on Friday morning. The carsickness passed a couple of weeks ago, but coffee after fruit and yogurt for breakfast (no carbs) was apparently objectionable. Ooops, won't make that mistake again. But really, at 14 1/2 weeks? And at a conference? At least it didn't happen during class, I suppose. I'm still so tired, but otherwise feeling pretty good.

I passed my early glucose screen with flying colors. I guess that's good, but it makes it harder to motivate myself to stop. eating. cookies.

We have a stroller (or rather, a stroller frame for an infant car seat). I guess there's really an infant coming.

13 weeks, 4 days: Updates

It's hard to believe, but the second trimester is only three days away! I'm still exhausted, but the carsickness has passed. I'm enjoying eating ... and cooking again. The final results of our first trimester screening were reassuring: chance of Down Syndrome is 1:880 and chance of the other trisomies is 1:8800. Since the normal risk of Down Syndrome at my age is 1:250ish, this is great news. We'll do a second round of bloodwork in a couple of weeks, but we are feeling pretty confident that everything is fine. I'm borrowing a fetal heartbeat monitor (a doppler) from a friend, and I've become quite good at finding the kid's heartbeat and distinguishing it (fast) from the placenta (slower) and my own (slowest). In fact, since I've figured out how to find it and it's always there, I'm not even checking regularly anymore. :)

11 weeks, 6 days: Put your hands up!

At my first midwife appointment last week, the kid was dancing up a storm. S/he was so active the midwife had a hard time getting a good picture. But here s/he is, raising the roof:


Our friend Michelle took one look at the picture and said: that is a spirited child! Looks like we'll be buying this book soon. Today was our first trimester screening appointment, to assess the risk of Down Syndrome, Trisomy 13, and Trisomy 18. It will be another week or two before the blood work comes back and we get the numbers, but everything looked great on the ultrasound. The maternal-fetal medicine doc said he'd be surprised if the blood work was abnormal, based on the pictures. So that was a huge relief. Today, kiddo was working hard to suck his or her left thumb:



Does this mean we've got a southpaw like Daddy?

11 weeks, 2 days: Yes, we went shopping

10 weeks, 1 day: Taking the (final) plunge

Last night was momentous: the last injection of the cycle! After several weeks of little needles to grow follicles, the disastrous trigger shot, and eight weeks of progesterone shots (1 1/2 inch needles injecting medication suspended in thick oil), we are finished! At 10 weeks, the placenta is supporting itself and doesn't need any additional support. I am looking forward to recovering from the bruising, welts, and lumps.

I also took the plunge and bought some elastic waist Old Navy maternity pants. I haven't gained any weight. (In fact, this week, I may have lost some -- I haven't checked.) But I'm uncomfortable enough that the idea of real pants, especially jeans, makes me cringe. And I'm running out of knit skirts! This purchase makes things seem very real.

9 weeks, 6 days: Update

Everything looks fine, thank goodness! Baby is measuring on track, with a giant head (gets that from both mom and dad). We were able to see arms and legs and lots of wiggling around. I still feel pretty terrible, both headache and nausea/vomiting. But the doctor thinks the headache is primarily the result of anxiety, not the pregnancy. (You called it Niamh!) I am hopeful if the headache resolves, I will go back to my usual carsickness. I've got some painkillers that take the edge off for a while, but I can't take any real migraine meds. So mostly I have to wait this out and hope that the painkillers don't cause rebound headaches.

9 weeks, 6 days: Heading to the doctor

I was up most of the night with a migraine and vomiting. The migraine worries me, since it's a new and very different "symptom." The nurse called in some painkillers for me this morning, so I was finally able to get some rest. But we're heading in for an appointment this afternoon to check on the pregnancy. My migraines tend to be triggered by hormonal changes. Scared.

9 weeks, 4 days: Trying to take it one day at a time

The yuckiness has been significantly better since Friday. On the one hand, I'm relieved; on the other hand, I'm terrified. My midwife appointment next Wednesday seems so far away without the reassurance of the yucks. Of course, it doesn't help that I broke down and bought some new, ummmm, more supportive undergarments and a couple of pregnancy/baby books. Now I am convinced I have tempted the Fates too much.

8 weeks, 5 days: Graduation Day!

Everything looks great -- baby is strong and healthy, measuring a few days ahead (nothing wrong with being bigger than average at this stage) with a heartbeat of 181. A normal fetal heart rate ranges from 120 to 200, with higher better. So the kid is excelling already! We graduated from Dr. Reshef; and my next appointment, in two weeks, will be with the midwives at the University. I'm really excited to have this option. They deliver at the hospital as part of the regular OB-GYN service, so they offer a nutty and crunchy birth experience with all the medical back up one could need. Labor & Delivery is also connected to the Children's Hospital and NICU, so I feel very safe.

Last night was the worst yet for the nausea. I think this is the first time in my life I've actually liked mornings! I'm even glad to be teaching in the mornings; I might make it through classes this semester. I'm not prepped for tomorrow's classes yet, though, so I'm keeping my fingers crossed for a reprieve tonight.

Any suggestions for getting a sweet, overprotective husband and father-to-be to stop worrying?

Now we settle in for the wait. I'm sure I'll check in occasionally as the pregnancy progresses to update you. And I'm sure I'll have some ongoing thoughts on infertility, the pain of which, I can tell already, will never go away. But tonight, we're celebrating! (With ginger ale.) Today's picture is below, still looking more kidney bean than human. The bigger end is the head, and you can see the faint outlines of the umbilical cord.

8 weeks, 4 days: Carsick

Ah, the irony! I said to both Brent and my mom this weekend, "We spent two and a half years and how many thousands of dollars so I could feel this bad?" After a week of this, the next four or weeks seems like it will stretch out interminably. Mornings are okay, if marked by ravenous hunger. Afternoons are lousy, though, with a constant feeling of carsickness. Naps don't seem to help; I wake up still feeling yucky.

The good news is that if you'd asked me yesterday, I would have told you I had no doubts we were going to get good news at tomorrow's appointment. Now, with the appointment less than 24 hours away, I'm definitely feeling anxious again. But the yuckiness is reassuring enough that I'm not completely panicked!

7 weeks, 5 days: Afternoon sickness?

I am beginning to think this might be the real thing.

Exhibit A: afternoon fatigue, shakiness, general yuckiness several days in a row;
Exhibit B: ravenous hunger followed by feeling full after just a few bites;
Exhibit C: the garlic I put in tonight's dinner made me gag!

It's all pretty minor, for which I am thankful. But I am also thankful for some reassurance. We are trying our best not to be consumed by anxiety. It all feels rather schizophrenic. Sometimes everything is fine and we are talking baby names and cloth v. disposable diapers. And then the pendulum swings and we are convinced that this isn't going to happen for us. It's exhausting!

One more week to go!

6 weeks, 5 days: The most amazing sound

I spent most of the day wandering around in a terrified fog: palms sweaty, heart racing, butterflies in my tummy. But it was worth it. Before he even started taking measurements Dr. Reshef knew everything was fine and told me to start breathing again. I didn't believe him; the heart was beating so fast that I could barely see it (unlike last time, when 90ish beats per minute was easy to spot).

He measures gestational age from transfer, which puts me at 6 weeks, 2 days, rather than retrieval (6 weeks, 5 days). Since due dates are largely meaningless, it doesn't matter, as long as the bean looks healthy. And it does! It is measuring exactly 6 weeks, 2 days, with a heart beat of 131bpm (anything over 120 would have been good). So we are not even borderline! We were even able to hear the heartbeat -- the most amazing sound -- which is not always possible this early.

Dr. R was cautious (but optimistic): he put our ongoing chances of pregnancy loss at 15 percent for the next two weeks, when we have our next visit. But if everything looks good then, he will be confident to release us to ordinary prenatal care. Baby is expected to arrive in late April.

I feel a whole mix of emotions -- excitement, joy, fear, anticipation, anxiety. But I am hoping to enjoy the next two weeks as much as possible, preserving the worst of the anxiety for the day of the next ultrasound.

Symptom watch: still not much. I have the nose of a bloodhound, which is making life interesting. But I don't have any morning sickness to speak of, just some queasiness after eating, usually dinner. Maybe I'll get lucky?

Now for the moment you've all been waiting for: baby's first picture! The big fuzzy blob, marked by dotted lines, is the fetus. The smaller blob is the yolk sac.

6 weeks, 4 days: One more day

It's almost here, thank goodness, since I've managed to drive myself insane these last few days. I had a total meltdown this morning after a series of markedly lighter pregnancy tests. Why am I still taking them? Because it makes me feel like I have some measure of control. But, of course, I don't have any control. And the lighter tests -- which may mean doom or may mean nothing at all -- sent me into a tailspin. But tonight, after going to church and taking a luxurious nap, I'm feeling much better. And even if I hadn't taken the tests these last few days, I'm sure I would have found something else to panic about with the ultrasound 24 hours away. It will take a long time to recover from the rounds of failed treatment and the scary ultrasounds; even if everything is okay tomorrow, I will need to fight the feeling that I'm simply waiting for the other shoe to drop. Although I'm not feeling confident about tomorrow, at least I have some hope back. The appointment is in mid-afternoon.

4 weeks, 3 days: Fear

I told myself yesterday I would celebrate all day. That lasted about an hour, before I started obsessing about the fact that the beta hcg number is still low compared to so many of the women on the listserv I belong to, worrying about whether it will keep doubling appropriately, imagining a bad ultrasound on the 30th. I realized I have a little bit of PTSD regarding pregnancy ultrasounds. At our first one last cycle, I had this moment, when I could see the heartbeat, when I thought everything was going to be okay. Then it came crashing down when I saw that the fetus was measuring a bit too small, the doctor's face fell, and he told me the heartbeat was too slow. I am so afraid of that happening again, or not seeing a heartbeat at all.

This is probably our last cycle. If this pregnancy doesn't stick, by the time it's over, it will be too late to do another cycle before our insurance runs out (unless we cancel Thanksgiving plans). Plus, I'm not sure I could handle it emotionally. But the fear of another miscarriage is nearly outweighed by the fear of quitting. I just never imagined my life would turn out this way; I was sure I'd be a mom by now. Sometimes I still can't believe it's real.

But I am trying to remain as positive as I can. I talk to my belly whenever I can: "Hold on, baybeeeee! Grow, grow, grow!"

4 weeks, 2 days: Lucky Friday the 13th

It's good! My beta this morning was 159.27, doubling at 47 hours, which is practically perfect in every way. Obviously we have a long way to go, but we're breathing a sigh of relief and allowing the teensiest bit of celebration! We'll have an ultrasound on Aug. 30 to look for a heartbeat. Hopefully we'll get a good strong heartbeat and we can be more confident that this pregnancy will make it. But for now, we're excited to have a healthy bean!

And in other good baby news, we're expecting the arrival of our first bio-nephew today (as opposed to our many beloved, honorary nieces and nephews). So it's turning out to be a pretty great day!

Adequate

The level of hcg in my bloodstream was 78.4 today. It's awfully close to where we were last cycle (52 on day 13 and 112 on day 16 means we were approximately at 72 on day 14, today). So I'm still more terrified than excited. We go back on Friday to see how fast it's rising. Maybe we'll get more reassuring news then! I hope, I hope, I hope.

Thank you for all the sweet messages of support and enthusiasm over the last few days. Please keep those fingers crossed for good news on Friday!

Some POSITIVE news! ;-)

We have a little secret ... we have been getting positive pregnancy tests since last week! We are excited, but mostly terrified after the two previous miscarriages. We want so badly for this one to stick, but we are not sure we can believe that it will. We have our blood test tomorrow. It will confirm pregnancy but also give us some useful information. The test measures the amount of free hcg in my bloodstream. We are hoping for a result close to 100, which would indicate a healthy pregnancy. (You may recall that we were in the 50s last time, and even lower for the first pregnancy and miscarriage last year.) Then we'll have a follow up, probably Friday, to see how fast the hcg is rising. We'll be looking for a doubling time of close to 48 hours. Please keep your fingers crossed, think good thoughts, pray, whatever you've got ... we really hope this is it.

Tick tock, tick tock

The clock seems to be moving so slowly. Our pregnancy test next Wednesday seems so far away. Getting ready for school should keep me busy and distracted, but all I want to do is hide under the covers for the next eight days! Or go to the beach. Or something! It doesn't help that I'm not going to the gym this week, so I am a bundle of nerves with no outlet.

Brent called the lab yesterday. Of the four remaining embies, three were still progressing and one looked like it might be good enough to freeze today. We'll find out on Thursday. Even if none of them make it, I'm pleased that one was still looking good. That bodes well for the three we transferred, which were of higher quality to begin with.

PUPO: Pregnant until proven otherwise

We had a great transfer this morning! We transferred three, and they looked good. They grade embryos on a scale of 1-5, 1 being best. Last time the embryos had crapped out by now - we had two six-cells and one 7-cell, graded 2 and 3. But today we have a 9-cell grade 1 and an 8-cell and a 6-cell, both grade 2!!!! So they look much better. (And that 9-cell is just about perfect, at grade 1 and nearly double yesterday's size.)

Because they were progressing well, we had the option of waiting for two more days. But the doctor recommended going ahead. Even though the last cycle ended in miscarriage, the fact that I got pregnant suggests that day 3 embryos find me to be a hospitable home. It was also pretty aggressive to transfer three. Given the quality of the bigger two and my age, standard practice would be to transfer two. But he asked if the worst case scenario was not getting pregnant or getting pregnant with triplets. We agreed that not getting pregnant was much worse than triplets! (And I suspect he suspects that 6-cell isn't really going anywhere anyway.)

And we still have four left that might make it to freeze. In all likelihood, we'll end up with at most two frozen, but that's something.

I am feeling much better!

Cell division

As of this morning we still have seven embryos:
1 5-cell
3 4-cell
1 3-cell
2 2-cell

It's almost exactly identical to last time:
2 5-cells
2 4-cells
1 3-cell

The goal is 2-4 cells today, so they're all fine. But because it looks about the same as last cycle, they want to do the three-day transfer again. (It sounds like they probably wanted to see six or seven at the 4-cell stage in order to keep going to day 5.) So we go in first thing in the morning. We'll want to see the four biggest at 8 to 10 cells tomorrow. Last cycle, their growth slowed and our largest was 7 cells. If we're at 8 to 10 cells tomorrow, I'll feel a whole lot better about this cycle. I'll be curious to see how many they want to transfer tomorrow; I'll probably push for three or four.

I'm sad and disappointed. I really wanted to hear, "They look great! We'll transfer Monday." I'm afraid this will end the same way as the previous cycle.

100 percent!

All seven fertilized normally. We have embryos, and "they look good." We are very happy here, and thrilled we didn't ruin everything Monday night! We'll be back with another update tomorrow.

Lucky number 7

As predicted, Dr. R got seven eggs this morning. So far, there's no indication that our misadventures Monday night hurt anything. We'll hear tomorrow how many fertilized; we'll have a better sense then if they matured properly. But the nurse told us a sad story of a patient just last week who did her trigger shot wrong and ended up with no eggs. We were praised for calling the doctor to come up with a plan; that patient didn't. I've taken a long nap and am still groggy, with some abdominal discomfort. But things went really well.

So nervous

That's a relief!

I'm pregnant! Okay ... not really. But the trigger shot is the same hormone that is produced by pregnancy. So I took a pregnancy test this morning to make sure we had actually succeeded last night. And sure enough, it came up positive. So the trigger is on board. Next up: will the eggs mature in time for retrieval tomorrow?

And everything had been going so smoothly....

Well. That was a disaster. I don't know whether we had a bad needle or I had somehow screwed it on wrong, but we ended up spilling some (half? most?) of the trigger shot when we tried to inject it. After several minutes of panic, my hero Brent paged the doc. They discussed the options, and we were fortunate to find a pharmacy not too far away that actually carries the medication. (That's a surprise, since its most common use is as a steroid, so pharmacies don't like to sell it.) The doctor called in a new prescription. And while things still did not go altogether well, we did get another half-dose injected (while looking like junkies, no doubt, in the Walgreens parking lot). Now we hope that it wasn't too late and the eggs are mature by the time of retrieval on Wednesday.

Ready, Aim, Trigger!

We have six ginormous follicles, and at least one more that might have a mature egg. We trigger tonight at 8 p.m., with retrieval Wednesday morning at 7 a.m.

Cycle 2: Follie check #4

I should start to trust the doctor. The follies grew a lot over the last 48 hours, and the largest is 15.88mm. That explains why I've been feeling uncomfortable! We'll almost certainly trigger on Monday night, with retrieval set for Wednesday morning. He expects to get between 5 and 8. It looks like I produce about 7 eggs, as he said, "no matter how hard we beat on you." Brent called me "Old Faithful." I guess that's a good thing. Back on Monday morning to confirm the plan.

Cycle 2: Follie check #3

There appeared to be six viable at yesterday's appointment, with a few more stragglers that could catch up. I'm definitely starting to feel uncomfortable, so I know things are happening. We go back again tomorrow morning. Dr. R. thinks retrieval could be as early as Wednesday. My money is on later next week.

Cycle 2: Follie check #2

We're holding steady here. The nurse counted eight follicles yesterday morning, with five ranging in size from 7-10mm. I'm bummed that it's looking like we're going to get roughly the same number of eggs as last cycle, even with the new protocol. But maybe they'll be healthier? They're growing at a good pace, so they haven't increased my meds at all. Here's hoping! We go back tomorrow.

Cycle 2: Follie check #1

Dr. R. was able to see and measure seven follicles this morning. I was definitely hoping for more on this new protocol, since seven is what we ended up with last time. But it's still early. The biggest one was 8mm, and some clinics don't even start counting them until they reach 10mm. So we have a long way to go until they reach 18mm for retrieval, which means that there may still be more to come.

Check mate!

Everything looked great this morning -- lots of tiny resting follicles but nothing active. So I started the microdose of the diluted lupron after the appointment. The idea is that in the first two-three days the lupron will kick-start stimulation. I add the regular stimulation drugs later this week, with an appointment on Sunday morning to check follicular growth.

We have crossed the first hurdle on which we stumbled last time.

Checking in

It's been a while, as the suppression phase is quiet. I took my last birth control pill last night. I had only one migraine (brought on almost certainly by dehydration rather than the BCPs), so it was definitely easier than last time. We go in to see the doctor on Tuesday, with fingers crossed that the suppression has worked. If so, we'll start the shots that day.

There's no news about the insurance. They're reviewing the contracts with the doctor to figure out whether I really need to pay the balance. It's slow, but the woman I've been talking to at the insurance company has been very responsive and has promised to keep track of this next cycle too.

Thanks to our 10 days on vacation, I'm feeling pretty relaxed. As of yesterday, I'm restricting my coffee intake. And I've stopped drinking wine as of this weekend, rather than waiting until transfer.

Approved!

That is all.

Revving up -- or rather, revving down

We're underway! Prescriptions have been ordered; the doctor's office will get the pre-approval from the insurance company; and my first appointment (suppression check and payment) is July 13. I'm keeping my fingers crossed that everything goes more smoothly this time around. I'll start the birth control pills for suppression this Thursday. And if I'm properly suppressed (no follicles, no cysts), we're looking at the last week of July for retrieval and transfer.

I've finally made contact with the insurance company. No results yet, and probably not for another couple of weeks. But I have a human being with a name who answers the phone, so that's progress. And the doctor's office is being reasonably patient.

The waiting game

The official letter of complaint went in the mail to the insurance company yesterday, in the hope that they might agree to pay some of the outstanding charges. I've been fortunate; this is the first big medical situation I've had to deal with. I guess this is just the way they do business; right? They deny, deny, deny, then only pay after you put up a fight. The gamble is that most of us won't fight. Silly me, I thought the business model was about pooling risk so that we got the coverage we paid for. Some people pay in and need little care, taking out less than they've put in. And some of us, pay in and take out more than our share. But I left out the profit-making piece.

I know, I know that I should be grateful that the insurance covers any of it. The meds alone were a huge chunk that we didn't pay for. But the frustration stems from the fact that I am paying the entire premium out of pocket. That $9000 would nearly have covered a complete IVF cycle without any of this hassle. So now it feels like I am double-paying.

I'm also waiting for my cycle to rev up again. More than once over the last month I've thought we were just about ready. But I've been temping and using OPKs in vain ... no sign of ovulation, much less my period. If nothing's happened by the end of next week, I'll put a call in to the doc, and see if they'll do an ultrasound and bloodwork to figure out what's happening in there.

In the meantime, the pool is open, and I am going swimming this morning!

Frustration

All I want to do is focus on getting strong and healthy for cycle #2. But I have been spending hours dealing with the insurance and bills from the first cycle. Despite the fact that we properly obtained pre-approval, the insurance company has denied all but about $600 of the $10,000 charges!!! They paid $600 to my doctor (of the $2500) he billed, with no explanation for the denial of the rest, then proceeded to deny all of the charges from the hospital and the anesthesiologist. At different times I've received different explanations: 1) once the doctor was paid, no one else could be paid for the same services (ridiculous, don't doctors and hospitals bill separately all the time???); and 2) the name of the facility of the preauthorization was the clinic not the hospital (even though the clinic is just a subsidiary of the hospital). Happily, the hospital appears to have absorbed its costs and is taking responsibility for the mix-up. But not so much the doctor's office, and I still haven't heard from the anesthesiologist.

I have a call in to the business office at the doctor's office to see what explanation they received for the denial, and I have an email in to the insurance company about filing an appeal.

And in the back of my mind I keep worrying about how to make sure this doesn't happen next time.

Adoption update

That was fast! We got a call this morning from the adoption agency. Good news: "The review committee loved y'all!" Bad news: they won't let us proceed until we've stopped IVF. Not every agency does this, but my sense is the very best ones do. One point the woman made was that it's very hard on birth mothers, who are already in crisis, when parents they've selected discover they are pregnant. And that makes sense to me. I wish I could pursue multiple channels at once because of my need to have a plan B and C ... and Z. But we're in their system, they like us, and we just have to let them know we're when we're ready.

Next steps

Well, I am certainly glad the last week is over! After a rough couple of days, I woke up Sunday feeling all better physically. A long night's sleep in a luxurious hotel bed without a snoring partner (love ya' babe!) after delicious alone time with my brother and his GF, my BFF, and my parents was just what I needed. Not surprisingly, perhaps, Sunday was a more difficult day emotionally. At brunch with my parents, brother, and his A, the hostess presented a rose to my mother. I LOST it and ran out of the restaurant in tears. It was the first time I had really cried about this miscarriage. It was probably good for me; my practical stoicism is not always healthy. After a hug from my dad and some whining about the unfairness of it all, a mimosa perked me right back up. And I was fine the rest of the day, focusing on my mom and grandmother.

And at Mother's Day dinner, all the women got roses. And it's appropriate, I think, because don't we all "mother" somebody or somebodies?

Then we were on to the next hurdle, having some early skin cancer removed from my back. The procedure went smoothly, though the incision now alternates between stabbing pain, burning, and itching. It's fun ... or not. The stitches will be in for three weeks, which seems interminable. But it's for the greater good, and I'm relieved to have the spot gone.

Today was my post-op visit with Dr. R. Mostly he wanted to talk about politics and the Dead Sea Scrolls. I was like, "Dude! You have other patients waiting. This is not a social call!" But we get good treatment because he likes us, so I can't complain. As I expected, he isn't particularly concerned that we've found only bum embryos so far. He said, "The class of July 2010 is different from the class of March 2010" and made an analogy to my law school students. And it's true, some years are better than others. He also reminded us that only 30 percent of fertilized eggs ever turn into babies and we just need to keep trying to find our 30 percent. He did send me for some bloodwork for autoimmune issues and an updated check on my thyroid. But none of us think that's the issue. We're just dealing with old eggs and bunk sperm and we have to be patient.

He said to call when my cycle starts again. The nurse was, again, horrified, "Aren't you supposed to wait SEVERAL months? He's bending the rules!" Aaah, yes, but it'll be fine. After all, there's a rumor that women are more fertile in the months right after a miscarriage. So shouldn't we capitalize on it? Given how quickly I'm recovering, though, I anticipate that we'll wait two months, starting the birth control in early July and doing retrieval and transfer in early August, just before school starts.

In the meantime, we bit the bullet and filled out our first adoption application, for a very old and apparently well-respected agency in Fort Worth. They have a domestic infants of color program, as well as an Ethiopia program, which are our top choices. Even if we are ultimately successful with IVF in the next six months, we are very interested in pursuing adoption for child #2, so we figured it couldn't hurt to get the ball rolling. But I think we should probably fence the swimming pool if we have any hope of passing a home study. The to-do list grows longer.

Nagging worries

Physically, recovery has been a lot harder than I anticipated. I'm still having a fair amount of pain and other discomfort. Although I haven't done anything silly like go to the gym, or even walk the dog, I did have to get right back to writing my final when I probably should have taken a day or two to sleep this experience off. I don't think there's anything wrong: no fever or other signs of infection. It'll just take time. I'm heading to San Diego for Mother's Day. I know the travel will be physically draining, but I think running away to beautiful SoCal will be worth it for the soul.

As committed as I am to moving forward and doing another cycle, I have begun to have a nagging worry. In two years, we've had two pregnancies, both of which have ended in miscarriage. There doesn't appear to be anything wrong with my uterus, lining, or hormone levels; in fact, my body was showing no signs of letting this pregnancy go before the d&c, even though the fetus had passed at least a week before. Almost certainly, both miscarriages have been the result of bad embryos with chromosomal problems. I worry that maybe we can't make a healthy embryo. I worry that even if we get twice as many eggs next time, they'll still be bad and we'll have to go through this again.

I'll probably talk to the doctor about this next week. I suspect he'll tell me it's just been bad luck and we have a good chance of getting a good one next time. But I'm still curious about what he'll say.

I found a cool new blog today, with an awesome video for infertility awareness week. (Warning: if you have epilepsy or are otherwise prone to seizures, don't watch it. The choppy editing is a bit discombobulating.) The video is cool, and I love that the author named her blog after two of the barren matriarchs.

HT: Mo

Recovering

The d&c went smoothly today, with no complications. Dr. R was his usual charming and sweet self. He and B had a long talk about some book about the Dead Sea Scrolls that he is reading. They just adore each other! I had some pretty significant pain and nausea after I came out of anesthesia, but some pain meds and a nap had me feeling much better. I still feel a little bit like I got hit by a truck, but it's manageable. I've got Rx pain meds if I need them, as well as 5 days of antibiotics to ward off any future complications.

We'll go back in to the office next week to make sure everything is healing properly and to map out our next cycle.

I'm still waiting for the video from Brittany, though happily the state AG agreed not to enforce the laws while litigation is pending. After having been through the d&c today, I have some more thoughts about choice and abortion that I'll share when I have more energy!

Confirmed

We were able to confirm today that there was no heartbeat. And the fetus had again not grown at all. Although sad, it was also a relief to know that we can move on and get ready to try again. Unless I miscarry naturally before then, we have scheduled the d&c for Tuesday afternoon.

Our friend Brittany got lots of footage, so hopefully she'll be able to use it. I'm excited to see how it turns out!

If you're the praying kind, please send up good thoughts for our sweet friends M&J who also got bad fertility news today.

Making lemonade

After a pretty good weekend, where I felt okay with where we are, accepting of the impending miscarriage, and eager to try again, this week has been hard. Usually school is a good distraction, but I feel sluggish and tired. I'm sure part of it is normal end-of-semester exhaustion, but I also know that it's harder and harder to act like everything's normal.

But I'm determined to ensure that something good comes out of this ordeal. The state this week enacted very strict abortion laws, over the governor's vetoes. One of the laws requires women to have ultrasounds and listen to detailed descriptions of the fetus prior to having an abortion. Although emotionally painful, this may not sound particularly invasive until you realize that a first-trimester ultrasound is done internally, with a large wand. I have these done regularly to check for follicle development (and more recently, to check on the fetus). And fortunately, I have never had much discomfort. But many women find these ultrasounds to be painful and even violating. The basis of the governor's veto of the law is that there is no exception for victims of rape or incest. I just can't imagine a woman who has already been sexually assaulted being forced to have an internal ultrasound. I don't expect to change anyone's mind about abortion, but I wish my fellow citizens knew what this law actually requires. So a local politician friend of mine is accompanying us to our appointment tomorrow to videotape various aspects of the procedure (preserving as much privacy and dignity as possible, of course). She had expressed a desire on Facebook to make a video about the law, and I just happened to have this appointment already scheduled. I emailed my awesome doctor yesterday to make sure this plan was okay, and he's totally on board. I don't yet know how the video will turn out; but if I can use this experience to educate people, then I will feel like I made the best of a bad situation.

I'm turning comment moderation on. I have had an influx of readers from yesterday's posting; and I assume most of them are conservative Christians who will object to this project. If I get unpleasant responses, you don't need to read them!

An amazing journey

I have read this blog for a while, and the story has taken an awesome turn. After six miscarriages and two disrupted domestic adoptions, this family has expanded from one child (a gorgeous boy adopted from Russia) to four in 13 months! It's a reminder to keep trying and to keep our options open.

Our Dream Come True

UPDATED: The green-eyed monster

For many people, infertility causes a lot of anger. I've heard that from fellow infertiles, and we have certainly seen that in the waiting room and IVF classes at our clinics. The anger at the unfairness of it all, at the doctors for not fixing it quickly, at themselves for failing is palpable. But for me, anger is rare. Instead, my uncomfortable feeling is jealousy. It's harder and harder to feel joy for friends and family as they get pregnant and have healthy babies easily. When is it going to be my turn?

UPDATED to add: If you are one of my loved ones expecting a little one of your own, please don't be afraid to share your joy with me. I am thrilled for you; it's just more work than I'd like it to be.

Hope (or why I love my doctor even though I'm having a miscarriage)

These stories are probably not going to come across as funny in the translation as they did in the moment, but here goes:

It was clear to me from the ultrasound that the pregnancy was not viable; I didn't need the doctor to confirm it. So when we went into his office for the post-ultrasound consult, he said, "If you weren't academics, I'd talk to you about hope. But since you are, I'll be realistic."

His (or maybe the hospital's?) policy is not to do a d&c until the fetal heartbeat stops naturally. This is probably a good thing, even though I was ready to march on over to surgery then and there. So we return in a week for a follow-up ultrasound to be sure. He said that normally he wouldn't plan the d&c until then, but since it was us, we should stop by the nurse's desk on the way out and get on the surgery calendar for after next week's appointment. Her jaw hit the floor and her eyes bugged out when we told her this; even though he's still not going to do the d&c until after the heart stops, I guess he doesn't usually concede that there's virtually no hope and that the patients should go ahead and plan for the d&c. I was like, yeah, but he's never had us as patients before.

And finally he said, "I suspect I'm preaching to the choir, but we should definitely do this again." And normally he'd say, wait two months and then we'll figure out where to go from there. But since it's us, he told us to go across the hall to the clinic and get on the IVF calendar for our next cycle (late June/early July start date). The nurse over there was also not prepared for us to show up before the miscarriage, but she took it in stride.

All in all, the doctor hit all the right notes with us. He was frank, realistic, practical and gave us a plan. But he was not insensitive: I got a pat on the cheek when he came into the exam room and a big hug on the way out of the appointment. I know CCRM in Denver is the best, but I can't imagine a better doctor for us. It helps that he thinks Brent's scholarship is fascinating. Plus, we get to see his benevolent face smiling down at us from a billboard each time we drive south on I-35, and that amuses us.

As for next time, the tentative plan is to switch me to the 35-and-over protocol. I've always been something of an old soul, so that makes sense. You may recall that we had roadblocks at each step of the way this time: I didn't suppress, then I over-suppressed, and then I under-stimmed (two weeks to get 7 eggs instead of the >10 he expected). Frankly, it's amazing that we got pregnant at all. The over-35 protocol basically works with the natural cycle and the natural hormones. Among other benefits, it's about two weeks shorter than the normal 7-week cycle, and there's a lot less loopyron involved. I'm excited to try it.

As Dr. R said yesterday, we swung the bat and made contact, we just didn't hit it out of the park. (See, he can read me like a book: a baseball analogy!) Brent and I are feeling really optimistic about cycling this summer.

The end is in sight

The fetus had essentially not grown at all. Last week it was measuring 5 weeks, 6 days, and today it was measuring 6 weeks. So it went from being 6 days behind to 12. The heart rate was 94-95 bpm, where it should have been 150-180. All this is to say that it is not a viable pregnancy. We are looking at a d&c around May 4.

We are both doing okay. Mostly right now we're feeling relieved to know for sure. We both feel better than we did before the appointment, although we know the sadness and grief will come. But as usual, I cope better with facts than with uncertainty.

And I have some good stories to tell from the appointment that will hopefully make you laugh! More to come soon....

7 weeks, 5 days: The day of days

It has been a long, hard week. I have been hunkered down, hiding out, avoiding phone calls (yes, that's you @msharp -- forgive me!) and emails. I had every intention of sending personal replies to all the sweet messages I've received over the last couple of weeks. But instead, I've been focused on remembering to breathe and putting one foot in front of the other. Perhaps if I stay curled up in a little ball, I can keep bad things away from me and the baby. I feel this way now; how will I feel when I have a real, live little baby to love and protect?

The ultrasound-of-truth is today at 3:15. It will be a long day, but since it's a teaching day (as is every weekday this semester), at least the teaching will be done before we get the results. For most of the week, today couldn't get here fast enough. But now that we're hours away, I'm thinking maybe I'd prefer not to go to the appointment. If bad news awaits us, I'd rather just not know.

This has definitely been the hardest week, days, hours of this infertility story.

6 weeks, 6 days: The Day After

Thank you for all your sweet, supportive messages yesterday, here on the blog and over email. I haven't written back personally to everyone yet. I'll try to do so over the next couple of days. But if I don't get to it (I have a final to write!), please know how incredibly grateful I continue to be for your love and support.

Although yesterday morning was awful, by evening I was feeling much better. Having been raised by an engineer and a math teacher, I need data. So even though the data we got yesterday morning wasn't what we were hoping for, I am happy to have some information so I can calibrate my expectations realistically. I know there are people (maybe some of my readers?) who can handle uncertainty with hope, but I have a really hard time with that. I'm more secure knowing exactly where we are, what has to change, and what our chances are. I took a restful nap yesterday afternoon and slept well last night, for the first time since Saturday.

Don't get me wrong: I am hope, hope, hoping that we get surprisingly good news next week, that the fetus has perked up and gone through a tremendous growth spurt. But I am not expecting it; it is one thing to overcome slow growth OR a slow heartbeat, but being faced with both is a significantly higher hurdle. And I'm mostly okay with that. This is the best we've ever done in two years of trying. Seeing the heartbeat was awesome; if nothing else, it was a signal that we can do this!

6 weeks, 5 days: 50-50

We were able to see a heartbeat this morning. But the fetus is much too small (almost a week behind) and the hb is very slow. Based on the ultrasound, Dr. R. put our chances at 50-50. He then sent me for bloodwork. The bloodwork, big surprise, came back borderline too. My hormone levels are consistent with the size of the fetus, but are too low for 6 weeks, 5 days.

Seeing the heartbeat was really exciting! I could see the little blinking light right away; there was definitely no mistaking it.

But I am feeling sad, discouraged, frustrated, and exhausted. It's like we can't catch a break. This cycle has been borderline all along, and I know that our pokey little guy could still catch up. But I was really ready to see a strong heartbeat and to graduate into the 5% chance of miscarriage bracket. I feel like it would almost have been better to see this morning that the pregnancy had already failed; then we would at least know and we could move forward. But instead we're still in limbo.

We go back in a week. Hopefully we'll learn something more certain then.

6 weeks: The Right Start

Last night, a student group I advise hosted a benefit for OKC Youth United, a support group for GLBT youth in the metro. In particular, we helped fundraise for the alternative prom they're throwing later this month. We figure we got this kid off to the right start by taking it to a gay club and exposing it to drag queens and burlesque dancers. Got to start the open-mindedness early, right? Hopefully we'll be forgiven for the secondhand smoke I inhaled in the process.

Still no symptoms; I've never wished for vomiting more in my life!

5 weeks, 5 days: Still here, still anxious

One week since the last blood test, one week to go until the u/s. As far as I know I'm still pregnant. But I sure would like some reassurance that things are progressing! I'm just a bundle of anxiety all the time. I wish my nonstop exhaustion could be reassuring, but worrying causes exhaustion just as much as pregnancy, I suspect!

But I will continue to distract myself with brainstorming baby names and imagining nursery decor. There's a fun Motherlode post today about picking the wrong baby name. Oh the pressure!

5 weeks, 2 days: T minus 10

Ultrasound is scheduled for next Thursday, April 15! Can't hardly wait!

5 weeks: Thank you

Just a quick note to say thank you for your joy and support yesterday. We feel so blessed to be surrounded by so much love. And we're a little overwhelmed by how lucky this little bean is to be so loved already.

Of course, after 22 hours of the giddy, I woke up this morning to abject terror: why do I have no symptoms? did something go terribly wrong overnight? This is going to be a long, long six weeks. I know from reading other IF bloggers that this fear is normal; but it doesn't make it any easier!

17dp3dt = 4 weeks, 6 days pregnant

Yes, indeed, we are counting pregnancy now! The hCG this morning was fantastic: over 800! We needed a minimum of 300, so this is awesome. There are many big hurdles left, starting with an ultrasound in about two weeks when we'll need to see a spinal cord and hopefully a heartbeat (though the heartbeat can wait a few more weeks, as long as we see the spinal cord). It's still pretty scary, but I think I might be able to relax for at least a few hours!

Estimated due date: December 4, 2010.

16dp3dt: Yesterday and tomorrow

As of yesterday morning, I was still pregnant, according to a home pregnancy test. (Honestly, I should have bought stock.) I'm going in tomorrow morning for the re-draw, since next week is crazy. I'll have news by the afternoon.

14dp3dt: Thought of the day

If today were two years ago and we had conceived naturally, I would be blissfully unaware that my hCG levels were precariously low and slow. I wouldn't see a doctor for at least another four weeks. And the home pregnancy tests would assure me that everything is okay. That bliss is one of the many things that infertility steals from us. But for now, I'll try to enjoy this: I am pregnant!

13dp3dt: Living on the edge

More borderline news today: my hCG (the pregnancy hormone) level was 112. It needed to be >107 to be viable. But >150 would have been better. hCG should double every 48-72 hours in early pregnancy. We're at 65 hours, high but okay. These embryos have been pokey throughout this process -- I was slow to suppress, the follicles were slow to grow, the embryos were slow to grow. But each step has eventually been successful. So we might yet catch up!

It's frustrating, as I was really ready for some solidly good news today. I'd been really optimistic that the hCG level was going to be between 150 and 200. But we'll continue to live on the edge of uncertainty for a while longer. They want me to come in again next Monday, which is actually a pretty full day. So I'll either go in Friday or Tuesday.

10dp3dt: The results ...

are at best inconclusive.

My HCG level was higher than I anticipated, but definitely borderline. Mostly I'm feeling relieved that it's not as bad as I'd expected. But I would have liked to know for sure! I'll have a repeat on Monday, where we'll look for the number to have more than doubled (hopefully tripled).

If you care about the numbers, HCG was 52. The clinic wants to see >50. Average for 13dpo is 62.

UPDATED: 9dp3dt: Deja vu all over again

UPDATED: We ran into our RE at the Bart Ehrman lecture tonight. Okay, we invited him. (And by the way, I heart Ehrman.) But anyway, he was very stern and told me not to give up hope. More tomorrow.

We had 24 hours of excitement after a very faint positive pregnancy test yesterday morning! But today the test was fainter and was accompanied by other, pretty conclusive, signs that the cycle was a bust. We're sad and disappointed, since we'd let ourselves get pretty excited yesterday. But we're ready to try again. I'll still go to the clinic tomorrow for a blood test. I am certain it will confirm that this is another chemical pregnancy (positive pregnancy test, but embryo stops developing before it can be detected on an ultrasound), just like last March. We'll wait a month, then start IVF#2. Thanks for all your love and encouragement through this process. We'll keep you posted!

5dp3dt: For Leo

We are celebrating here Chez Blangsdau. The bill isn't perfect (infertility coverage, anyone?) but it means that my friend Leo True-Frost will not be inhibited by lifetime caps, pre-existing condition exclusions, or chronic condition limitations. And that's a great thing.

4dp3dt: Laughter

The last embryo didn't make it to freeze, but that's pretty normal, so we're okay with it. We had a visit to the clinic this morning to check my progesterone level, which is fine. (B is apparently doing an excellent job of giving me a shot in the a** every night.) Dr. R came out from an exam room when he heard my "unmistakable laugh."

It reminds me of the video some of my students shot of me last week for the annual mock-the-professors show this week: "Professor Bangs, why is your laugh so loud? I mean, really, we can hear it all the way in the pit." Because it brings you joy, Jeff, because it brings you joy.

Halfway through the two-week-wait from retrieval to test; six days to go.

2dp3dt: Early blast

I just got a call from the clinic, which has been keeping an eye on our two remaining embryos. One stopped growing, but the other is hanging on and is in the early blastocyst stage (just about on track for day 5). Since the embryos they transferred back were of higher quality, and I quote, "there's every reason to think" one or more of those have continued to progress in their natural environment. The last embryo at the clinic isn't well enough along to freeze, but they'll check it again tomorrow to be sure.

Wee, bright flicker of hope -- eight days to go.

1dp3dt (1 day past 3-day transfer): What I've learned so far

Bed rest is not for wimps. After 24 hours, not only am I bored to tears (not that I'm doing the schoolwork on my to-do list, which would keep me busy and occupied), my muscles and joints (especially my hips) are already feeling the atrophy. Props to the mamas who do this for months on end to ensure healthy baybees.

I've also had loads of time to consult with Dr. Google.

Word on the interwebs, including from some MDs, is that three-day transfers at clinics (like ours) that normally do five-day transfers are nothing more than a face-saving/ass-covering maneuver. They'd rather the embies die inside the mama than in the lab. That way it's "our" fault, not their fault. According to these sources, the line (which we were fed yesterday morning) that the natural environment is better is, in fact, a bunch of bunk. Embryos that will thrive will thrive anywhere. I hate to think of our wonderful doc, whom we adore, lying to us like that. But whatevs, either these embryos will make it or they won't. And it is kind of nice to be PUPO (pregnant until proven otherwise) for a few days!

On the other hand, the internetz are full of stories of successful day three transfers of 7-cell embies. And so despite my neverending pragmatism, I can't resist that wee, bright spark of hope that keeps returning.

Nine days to go.

Day 3 transfer: Embryos on board

This morning brought mixed news: fragmentation was minimal (5-15%, when what they want to see is less than 20%) but growth had slowed considerably. They should have doubled overnight, to 8-10 cells. But we had only 5, 6, and 7 cell embryos this morning. So they decided to do the day 3 transfer, figuring that being in their natural environment might perk them up. We also transferred three, instead of the clinic's usual two, because of their size. There's about a 35% chance of pregnancy, about 5% of triplets (compared to a 60+% chance of pregnancy if the embryos had made it to a day 5 transfer).

Nevertheless, the embryologist and the doctor were very optimistic. Dr. R. assured me that he was not just being "rah rah cheerleader." But he did answer my questions about a second cycle, if this one fails, instead of just telling me to go home and think positively! That made me happy; I always cope better with a plan B.

But in the meantime, I will think positively. I'm at home in bed/on the couch for two days, being waited on hand and foot. Then ten days until the pregnancy test.

2dpo: Good news and bad news

The good news is that we still have five growing embryos, and they're growing at a good rate:
2 5-cells
2 4-cells
1 3-cell
(The goal is 2-4 cells on day 2, so we have two that are even a little ahead.)

The bad news is that they're not very pretty. And we only want a cute baby.

The report from the embryologist this morning is that there is too much asymmetry (cells are different sizes) and too much fragmentation (portions of individual cells have broken off and are fragments are floating around inside the cell). If that trend continues, we'll transfer tomorrow instead of day 5.

Rates of pregnancy with a day 3 transfer are somewhat lower; with asymmetric and/or fragmented cells, much lower. So I'm definitely feeling a bit discouraged today. But I'm hanging in.

1dpo: Fertilization report

We're celebrating! We have six embryos this morning, an exceptionally good fertilization rate. The one egg that didn't fertilize actually didn't survive retrieval. So we had a 100% fertilization rate, truly unheard of! Since we've had a confirmed embryo only once before (the miscarriage last spring), we are jumping for joy. We might get to be parents! The lab will call tomorrow with a report on how they're growing. We'll likely lose some before the week is out, but this is a terrific start.

Retrieval Day

Dr. R got seven eggs this morning. I'm trying not to be too disappointed in the number. We only need one, we only need one. But everything went smoothly. The anesthesia was no big deal, and I recovered so quickly they released me early. Mom, Dad, and B were all in the recovery room. And my new friend M stopped by to say hi after her own appointment with Dr. R. We'll get a call in the morning with the fertilization report.

Cool or creepy?

We're leaving for the airport shortly to pick up my parents, who will be joining us on this big adventure this weekend. I realized yesterday that, if this cycle works, my parents will be with us at the moment their grandchild is conceived. And thanks to the miracle of modern medicine, neither Brent nor I will be present for that conception.

Final follie check; Mood = Trigger happy

We're a go! The follicles showed amazing growth over night, and Dr. R. definitely thinks we're looking at 8-10 eggs. I'm so excited I could jump out of my skin. Dr. R says if I'm anxious now, just wait until I'm full term. Brent's work starts tonight; he injects me with the trigger shot at 10 p.m. And then retrieval is 9 a.m. Saturday. We'll be back with an update in the afternoon.

Follie check #5; Mood = Getting excited!

Is this pregnant brain? I'm always a little forgettery, but I'm losing my train of thought in the middle of a sentence and am unable to get it back! If the meds are doing this, what would actual pregnancy do?

I had another good appointment this morning. There were 13 follicles, 8 that look big enough to contain eggs (though there's no guarantee). Although the biggest has reached 18mm, the doctor is going to put off retrieval one more day in the hope of getting a few more mature. So I have on more night of stimulation, then we'll "trigger" ovulation tomorrow night, with retrieval on Saturday morning. My folks will be here for the weekend, so I'll have lots of people holding my hand.

After a rough weekend (fortunately the Bl@ckberry survived!), my zen is back. And I'm feeling pretty good.

Follie check #4; Mood = Relieved

We're up to 10 or 11 follies this morning. They're still poking along, so I'll continue on the high-doses for two more days and return to the doctor on Wednesday. But both nurses said to me, "Slow and steady wins the race." I asked specifically, "They won't be overripe if we stim for more than two weeks?" And I was assured that slower was better than faster. It means our schedule remains in the air. The retrieval is likely pushed back again, maybe to Sunday, give or take a day or two. I'll probably start daily monitoring with my Wednesday appointment. I'm anxious to get there; but I'm more than willing to wait if it means more eggs and, hopefully, more embryos.

In other news, it appears I'm still employed for another year. Big sighs of relief all around.

Follie check #3; Mood = A wee bit frustrated

The good news is that there were nine visible follicles this morning -- that's more like it! But the biggest has only grown about 2mm, where 4mm would be expected. It's possible that the biggest is really a cyst, not a follicle. If that's the case, then the rest are growing at an appropriate rate. If it's a follicle, then it's being very sloooooow. Dr. R. keeps reminding me that the human body is unpredictable! The upshot is that retrieval has been pushed back a day or two to the end of next week. I go back on Monday for another check.

Follie check #2; Mood = Better

The good news is that the follicles are growing at an appropriate pace (about 2mm a day), and the biggest one on the left is now 12mm. So we're looking at a Tuesday or Wednesday retrieval next week. The less-good news is that there were still only six or seven visible. So we're probably looking at low numbers of eggs. I'm bummed, since we'll likely lose some at each step of the process. After some aren't mature and some don't fertilize and some don't grow, we may be lucky just to get two to transfer. But I'm handling the news, and life in general, better today. I'm physically exhausted and looking forward to retrieval and spring break and transfer so I can sleep for days and days! But my mood is brighter, which is nice. I stay on the high-dose of my evening med for two more nights, then back to the doc on Saturday morning.

Follie check #1; Mood = Blue

At this morning's ultrasound, I had four follicles on the left and two on the right. The largest follie is 7.2mm. Six is definitely fewer than I would have liked. The average number of eggs retrieved at my age is 12. But since mature follies are 17-18mm, we've got a long way to go. And Dr. R. was adamant that I not be discouraged; more follies could appear. My morning shot is discontinued, though my evening shot will be doubled over the next two days. Since this is the one that is now causing me giant, angry, red, itchy welts, more discomfort is in store. We go back on Thursday morning for another check.

Fortunately, B will be going with me on Thursday, as in the last week, I've had a reduced ability to cope with anything. Minor challenges have either put me on the edge of tears or filled me with dread. I finally figured out this morning that it's all these drugs (plus, you know, the fear that this is not going to work). I'm a little slow on the uptake.

Up!

I haven't seen Pixar's "Up," but came across this wonderful scene, a montage of a marriage including a miscarriage and infertility and a full, long, loving life without children. It also includes the death of the beloved wife. So it's happy-sad. But that's life, isn't it? Enjoy, but have those tissues handy.

Off to the races!

My blood test this morning was excellent, and I'm going to start stims tomorrow morning. I start the loopyron shots tonight, and then tomorrow I go to three shots a day. My next check is Tuesday morning.

Isn't it ironic?

After two years of infertility, now I'm too fertile to proceed with IVF this week. (Of course, it's probably a cyst not impending ovulation that's causing the estrogen rise, but still, it looks like fertility.)

Don't tell our doctor: we screwed up last night and didn't pick up the new meds before the local CVS closed. So I'm doubling up today, 12 hours apart, and hoping for the best when I go back in on Friday. At some point, will this go smoothly?

Moving in the wrong direction

At my blood test this morning, my estrogen level had gone up, instead of down. I was not surprised, given some symptoms I'd been having. And I am trying hard not to develop a defeatist attitude about this cycle. I will stop the Lupr0n shots and switch to some hormone pills for the week. This was unexpected, so I haven't done my usual level of research into the anticipated side effects. I guess it'll just be a surprise. I go back in Friday morning to see if they've done the trick.

Thanks for caring and keeping those fingers crossed.

Suppression #FAIL

At my check today, I had cysts producing estrogen. My level was 135, and it needs to be below 50 to proceed with the cycle. They want me to continue the Lupr0n for three more days and go back in Saturday morning to try again. I'm frustrated because this happens only in 10-20 percent of cycles and may mean more suppression check appointments on Wednesday afternoons, which in turn means canceling class. The doctor assured me that it won't affect our chances of success. But it does wreak havoc with our schedule.

Love

I remember hating Valentine's Day for years and years and years. The last good one was probably 1997, the day I got in to Harvard Law School. Of course, my boyfriend at the time was sitting shiva for his grandmother, so there was no celebration. But it was still a happy day. As my 20s ticked by, though, Valentine's Day was often spent alone. And of course, there were some not-so-good V-Days even before 1997. Don't even get me started on 1992.

But this year, I am positively giddy. What a contrast to my blue Christmas. Last Chance really hit the nail on the head:

There will be no adorable kids in costumes at my door begging for candy, there will be no cuties on Santa's knee, or folks with hands joined around the table counting family blessings, there will be no toddler's toddling through fields of spring flowers looking for Easter Eggs, there will be no days devoted entirely to Mothers and Fathers....today there will be me and DH and our love.

I am trying to remember that today is not full of roses for everyone. B and I did the facebook meme where we posted pics of us together and recounted how long we'd been together (married two years, eight months, four wonderful days today). I am filled with love and joy today. But there are still single friends out there lonely today, and I read some wonderful widowed bloggers for whom V-Day and the FB meme is like a shot through the heart.

I am so thankful today. B and I have been through some rough spots the last two years -- the job market, the move, the miscarriage, the seemingly never-ending treatments. And yet we're happier today than we were two years, eight months, four days ago. In fact, we are happier each day than we were the last. We are coming through this stronger. I am a lucky girl.

We loved this week's V-Day episode of "Grey's Anatomy." One of the patients -- always so full of life wisdom -- revealed to Meredith our own philosophy: ''Fifteen years ago, I made a choice, and I keep making it every day. That's what marriage is.''

And today I choose to be happy. I hope you do too. Thanks for reading. I love you.

Quick IVF update: I've been through 10 days of Loopyron. My mood is fantastic; I have not threatened to kill the husband, the dog, the students, or anyone else. The headache has been with me since Wednesday. It's somewhat reassuring: hopefully it means the drug is working. Doctor's appointment this coming Wednesday to make sure all is quiet on the reproductive front.

Naive

In less than a month our first IVF cycle will be over. More than once recently, I have caught myself harboring unrealistic expectations. I know that IVF doesn't always work the first, or second, or third time. And yet, I still believe that it will work for us this time: I'll be pregnant -- with twins! -- a month from now! Last Chance IVF's description of her first cycle sounded so familiar:

IVF #1: Oh how naive and stupid I was! I really thought all you had to do was IVF and you'd be pregnant. I resented doing IVF but I still embraced it. At ER we had 11 eggs. When my RE called to tell me that only 6 were mature I was disappointed; but 5 fertilized. When we went to transfer and we only had two that were even on-target we figured: oh well, none to freeze but what can you do? We've got two! We'll probably get twins.

But it didn't work for LC or for so many others in bloggyland and IRL. So I have to figure out how to stay calm and positive while not setting myself up for devastating disappointment.

If you're keeping track: last night was my last birth control pill. Hopefully my skin will clear up now! And it was my third night of Loopyron shots. No irrational rages yet, but I'm on pins and needles waiting for the next headache (even more than bcps, Lupr0n is associated with migraines). I've got an appointment with the GP on Friday to get an Rx for migraine meds. I haven't refilled in a very long time, because each month, I've been just about to get pregnant (see above re: naivete) and I can't take the meds while preggo. But I've got several weeks of the Loop to go before I'm housing any embryos. I'll take the meds; I'm keeping my fingers crossed I can make it until Friday.

Winter storm part 3

Winter Storm part 2

Winter Storm 2010

The stash

Side effects

Now I remember why I went off birth control pills! Last night's migraine had me just about ready to throw in the towel on this whole thing, what with the likelihood that the Lupr0n and Pr0gesterone will cause more headaches and our plan to attend an adoption info session next month. But since the drugs arrived despite yesterday's ice storm, I shall soldier on. It just doesn't bode well that I'm having just about every single side effect that the bcp info sheet warns about.

Approved!

Insurance company approved 1 cycle. So if doesn't work, we'll have to go through this process again. But for now, I'm just going to celebrate -- approved! Drugs are scheduled to arrive tomorrow. Stay tuned for a picture of the stash.

Seriously? -- UPDATED

After 10 days of antibiotics and birth control pills, shouldn't my skin be gorgeous and clear? Not so much. Hrrmph.

It's been two days ... time to harass the poor business manager at the clinic again, I think.

**Updated: According to the insurance website, the IVF pre-approval request is now in the system, pending medical review. Keep your fingers crossed!

Getting closer

I finally got ahold of the business manager at the fertility center, and they've finally accepted that I do have insurance. Yay! Unfortunately, they're out-of-network for IVF (even though the doctor is in-network as an OB/GYN -- weird), so I'll have to meet my deductible and pay 20%. But I'll take it! The business manager sounds totally on top of things and is getting all the paperwork taken care of, and they'll call before our next appointment on Feb. 17 to tell us how much money we'll need to bring. The business manager was super-friendly and super-helpful; I was really relieved to talk to her.

And the drugs have all been ordered with no problem, completely covered -- $3000 worth of drugs for a mere $150 or some such.

We're getting there.

An up-and-down update

We had a doctor's appointment this morning, and everything went well. From the doctor's perspective, everything looks good to start the IVF cycle. We have all our appointments set up for the next six weeks and are looking at egg retrieval between March 1 and 3.

Unfortunately, I got a call from the front office woman this afternoon saying that they didn't think my insurance covers IVF. I called back, and she was more annoyed than helpful. She kept saying that my chart says "diagnostic tests only," but wouldn't tell me where she got that information -- because, of course, my insurance documents don't say that! But she couldn't seem to get me off the phone fast enough. I efaxed the documents (which they already have) to her late this afternoon, and she said she was going to check with my insurance company. I'll give her a few days before following up. I know most people out here don't have infertility coverage, but I can't for the life of me figure out why she was being so difficult about it.

In the meantime, I've started to worry that some slightly abnormal (nothing to worry about!) results from a regular doctor's appointment may lead either the insurance company or the doctor to want to postpone this cycle, which would be really disappointing.

Fortunately, we are only in the suppression stage, so this stress will only serve to further suppress me rather than interfere with the stimulation phase! And hopefully in 30 days, when stimulation is supposed to start, it'll all be worked out. Keep your fingers crossed.

At the starting gate

Our first IVF cycle will be underway tonight when we start birth control pills (me) and antibiotics (both of us)!

It's a happy day on the interwebs...

Go meet Sprogblogger. She's going to be a mama.

Blue Christmas

I love the Christmas season; or more, precisely, I love Advent: the candles, the dark stillness, the anticipation, the carols on the radio, the lights on houses. But starting about 5 or 6 years ago, Christmas Day started losing some of its sparkle. With friends married and having babies, I felt "too old" for Christmas, which is, as Kenny Rogers sings, for kids. That feeling seemed even worse this year, whether because we're closing on in the two-year mark of infertility or because the pregnancy/baby announcements seem to be coming fast and furious. I couldn't even drag myself to church on Christmas Eve. Though the midnight service is not designed for children, there are always infants dressed in Santa outfits or other furry wear. I couldn't face it. Fortunately, Christmas morning brought a flight to Kauai, where I was able to escape from it all. But the blues have lingered. I had thought I might spend part of this vacation working on a "Dear Birth Mother" letter, but I seem frozen and unable to start it. I did spend a few hours on rainbowkids.com and found the cutest little Korean girl with a hearing impairment. I'd bring her home tomorrow if I could!

First dinner party

As part of the law school's annual fundraiser for the Women's Resource Center, B and I donated a wine dinner for four. A group of my students bought the dinner, giving us the opportunity for our first dinner party in Norman! Our dining room was cozy and sparkled with winter cheer.