Playing tag

I've been tagged by Katedaphne. Actually she tagged me a while ago and I've been putting off answering because I can never think of things about me that might be interesting and which I have not posted before. However, today she has such an eloquent post about moving on (or trying to) from that genetic link that I felt the need to send people over there. So go on over! She's a great writer.

The Rules:
1) Link to the person who tagged you.
2) Post the rules on your blog.
3) Share six non-important things/habits/quirks about yourself.
4) Tag at least three people at the end of your post and link to their blogs.
5) Let each person know they have been tagged by leaving a comment on their blog.
6) Let the fun begin!

OK, so, ummm.

1) I never did ballet as a child. I whined and whined to go to ballet classes, and when my mother finally relented and took me, I stared in through the window of the door at the class going on before mine, panicked and threw a tantrum to go home again. I was just too shy to try it out. Eventually I joined a gymnastics class and liked that just fine so I tried to convince myself that I liked gymnastics better and that ballet was for sissies, but was really secretly jealous.

2) I have started collecting coins. Sort of. My dad collected coins for my brother and I when we were kids, one proof set for every year since we were born. In honor of that I took the plunge last year and ordered a set of the new presidential dollar coins in the hope that maybe I'd have a kid to share them with. But I'm thinking of getting all the state quarters too just to have even if I am never successful with the whole pregnancy thing.

3) I don't like raisins or currants or sultanas (golden raisins). Never have, never will. Don't even try to get me to try one just in case my tastes have changed, as my grandpa does every year without fail. Ewww. And especially don't try to force fruit cake in my face.

4) I am such a geek that one of the high points of my life remains playing with one of the telescopes at Jodrell Bank while at college. It's such a fabulous name, Jodrell Bank, as immortalized in The Hitchhikers Guide to the Galaxy: "The huge yellow somethings went unnoticed at Goonhilly, they passed over Cape Canaveral without a blip, Woomera and Jodrell Bank looked straight through them—which was a pity because it was exactly the sort of thing they'd been looking for all these years".

5) I love custard, and on bad news days am very glad that my local supermarket carries it for a bit of good old fashioned comfort eating. But I don't love the skin that forms if you leave it sitting out. Blech.

6) Allegedly I can't pronounce "sixth". I think I pronounce it perfectly well, but a certain friend of mine keeps making feeble "Return of the Sith" jokes every time I have to say it. I'm now developing a complex.

And here's where I break the rules of this game shamelessly. I'm not going to tag anyone else specifically, because most of you have been tagged before and some of the rest of you may be like me and be unable to think what to say. So, I'm tagging you if you want to play along, and if you don't, that's fine too.

Me and my drinking buddy

The damn nurse hasn't called back. Don't they think that two panicked phone calls from a patient in quick succession saying "wait, I didn't quite understand the instructions, what do I do?" and "I'm about to run out of lupron so need a new prescription, quick" count for a call back? I guess not. If they don't call by noon today they shall get another message and a large piece of my mind.

The bleeding may be lessening today. I think I might ask if they can see me on Saturday, not Tuesday, given that I'd already planned to go there on Saturday anyway. I just am getting depressed being on lupron this long, not to mention that bleeding depresses me too. Plus, it'd be nice to not have to delay a whole week, what with the potential fresh cycle in March to get organized.

But, just to do another gratuitous photo post, here is me and my drinking buddy from last night. OK, so perhaps only one of us was drinking wine. I just have to say, though, in the interests of vanity, that my nose is not quite as big as it appears here. It's the angle, dahlink.



ETA: I did call the nurse again at 10.30 because I decided not to wait any longer as it was annoying me. And she finally called back at noon. I got an unequivocal "no" on whether I could go in on Saturday and not delay a whole week, even though all of a sudden I am just down to spotting not bleeding. Gee, thanks. Thanks for caring. But at least she's calling in the lupron refill today. Gee, double thanks. However, she wouldn't even say whether they are aiming for a transfer on the 14th or not, because now it's all "well, we'll see how you're doing on Tuesday". So I still hate the world.

Effing hell

I am delayed again. They want me to stay on lupron and estrogen patches at the dose I'm currently on for another week and go back for another ultrasound and bloodwork on the 5th. Which means that transfer won't be until the 10th at the earliest, I suppose. Presumably later because I was supposed to ramp up the dosage in advance of Saturday's appointment as that was supposed to be the fake ovulation date. So if I am on a level dosage and not ramping up, does that mean that I only start ramping up after Tuesday so hence my transfer won't be until like the 14th or 15th.

And that's if the bleeding stops. What if it doesn't? What if it just continues?

Fuck it. I just want to cry. Not that a delay is that huge in the grand scheme of things, but I am trying to organize a fresh cycle out of town if this frozen cycle doesn't work. And every delay cuts into how easy that is going to be to arrange. And I have to rely on friends for a ride to the clinic, so every time I delay it means not only that I have to rearrange my days off but my lovely chauffeur has to rearrange her schedule too. If she's available on the new day of transfer, that is - probably not now, and where am I going to find someone else?

Not to mention that I'm about to run out of lupron and have to reorder and I don't even know if the doctor's office had called in two prescriptions or just one, and trying to get a hold of a nurse is a freakin' nightmare. And I have to order it from some stupid pharmacy connected with the insurance, and they are NOT easy to deal with. AND being on lupron for this length of time is seriously driving me crazy.

Fuck. I hate the world.

ETA - Just told my boss I was changing the day off that I'd asked for, assuming that I'd need the 14th instead of the 7th, and he made a big deal that I was asking for Valentine's Day. Imagine that - the single girl asking for Valentine's Day off, must have a secret lover that we need to find information about. Did I mention that I hate the world?

There shall be wine tonight.

Not so fluffy

Not so good news from this morning's ultrasound - my lining is at 7.5mm. And she measured it three times just to make sure. This is not terribly thrilling news, as I'm on cycle day 12. Normally by now I'd have a nice, 15mm trilaminar lining but today, yeah, not so much. So I guess the bleeding really has been damaging things. Sigh. I mean, I expected to have problems with this FET in the sense that the embryo may not survive the thaw. I expected that and have been steeling myself for that disappointment all along. But to have problems in this phase, and especially lining issues which I have never had before, has caught me by surprise, I have to say. I suppose there's a first time for everything. I just wish my body wasn't trying to give me the whole smorgasbord of infertility experiences, because I'd like to escape from this nonsense without going through some of the many fun things on offer, thanks.

So now we wait and see what my estrogen level was, and then see if they'll have me racing around the county trying to fill a prescription for something else to add in to the mix, or if I'll be filling up my entire torso with a bazillion estrogen patches. Or worse. I hope not worse. Can you even get cancelled from an FET?

Stuck pig

I don't know where the phrase "bleeding like a stuck pig" comes from, but it's certainly in my mind a lot at the moment. And with that said, the local clinic wants me in for bloodwork and ultrasound tomorrow just to see if something's going drastically wrong with the FET, or if something's just going a little bit wrong and they can give me more and/or different meds, or if everything is perfectly OK. Fun, fun, fun.

Gratuitous kitchen photo

People, I discovered the most amazing cleaning products this weekend.  I love them so much I actually want to clean!  You just have to go down to your local Whole Paycheck and sniff
this stuff and then try to tell me it's not the most insanely divine smelling cleaning product range in the world.  You won't be able to, I promise, because it is dee-vine.

And just to prove that I did actually clean, here's a photo showing off my shiny kitchen because I'm very proud of it.  Sadly it's not smell-o-vision, because damn, it smells good.

Second period

Is "second period" kind of like "second breakfast" beloved by the Hobbits in LOTR? I think probably not quite as much fun.

Yup, I am bleeding.  Started spotting yesterday at lunch and it kept building up.  I will call the nurse on Monday if it's still going on but I expect there's not much they can do about it so will tell me it's normal.  At least the good thing is that I've never had an issue with a thin lining so if I lose some hopefully it won't matter.  I just hope I don't lose it all.

Yay me

Remember how I had all those cholesterol problems last year? Personally I always thought it was from all the IVF meds.

At the end of July, I got my total cholesterol down to 190.  From a scary high of 264 in May that almost gave my doctor a heart attack, let alone me.  I tell ya, I'd have been straight on L.ipitor if it hadn't been for the whole "trying to get pregnant" thing.  Then I did an IVF cycle.  Next time I took it after the cycle it was 236, then 212, so my theory was holding out, but in a huge blow to scientific research around the world, it then bounced up again to 247 at the beginning of November, before my next cycle.  So I thought maybe it really wasn't the IVF cycles after all but was just bouncing around dependent on my diet.  My HDL cholesterol never got above 33, and several times was lower than the meter could register (25 is its minimum value).  If I'd been really dedicated to science I'd have measured it a lot more often on my handy dandy home meter but cheapness and laziness won out.  It would be interesting to measure it all through an IVF cycle though, just to see what happens.

Anyway, lately I've been trying to follow that infertility diet, you know, with the full fat milk.  Even though I'm good elsewhere, have oatmeal for breakfast, lots of almonds, am vegetarian, blah blah blah, I have cringed at the thought of what my cholesterol might be.  I meant to test it before starting estrogen patches for the FET but I was too much of a scaredy cat.

So this morning I decided to be a very brave girl and just see what it was before I start ramping up the patch dosages.

Total cholesterol = 164

HDL cholesterol = 42

I thankyouverymuch.  Hell yeah, am I fabulous or what?  OK, so the HDL is not as fabulous as it was before all this IVF nonsense (67 with a total cholesterol of 165), but at least it's above the level of 40 required for "good".  Yay me.  It definitely makes me less worried about possibly having insulin resistance, because I know that off-balance cholesterol readings and triglycerides are one indicator of IR.  Hey, maybe even the whole milk diet actually helped to bring the levels more into balance even though it's hardly a low fat diet?

Reassured

Last night's email from the RE reassured me on the protocol. He didn't say this, but it seems that most women get only 2-3 embryos because the women that get put on this protocol are essentially candidates for donor eggs. I think this is the protocol of last resort. Or one of them, at least. So most women going on it are poor responders to start with. He said it won't reduce the number of follicles, but will help the cohort to grow more evenly - which is exactly what I need. So if it's a cycle where I was going to get 14 eggs, I'd still get 14 eggs (hopefully). But hopefully more of them will be mature than on other cycles - which would be huge for me. I mean, it's kind of disappointing to have only 50% of the retrieved eggs being mature. I dream of having like 12 mature out of 14.

He also said that sometimes it is worth doing CGH with only 2 or 3 embryos, especially in a woman with a lot of IVF failures or miscarriages. It can be worth finding out the answers as to what is really going on. And they are finding that the CGH normal embryos DO survive the thaw. The theory is, if it's normal, it'll make it to blast and through freezing. If it doesn't make it, it wasn't normal to start with.

So, I think I may sign up for the study. I mean, it is cheaper for me to do the study than not do the study if I end up doing 2 cycles (and let's face it, that's more likely than not). So I just have to take the risk of transferring nothing and essentially being no worse off than transferring abnormal embryos and getting a BFN, but having answers as to exactly how chromosomally crap my embryos are. It's a bit of a mental leap, but there's something that makes me think I shouldn't pass up the chance to get this testing done for free.

ETA: No, wait, I changed my mind again. I'd rather put back all embryos than risk having nothing to transfer or damaging them. Argh. Why do I keep spinning around on this? Damn it, this FET better work because this is too hard to figure out.

ETA again: After the edit above, I shot an email off to Dr. F. asking whether I could back out of the study based on embryo numbers, and he just replied and said I could.  So we could agree that I would transfer all back if I have say 4 or fewer embryos, and do the CGH if I have 5 or more.  That makes me feel better and less worried about the whole thing, but I must admit I am having panicky feelings all of a sudden.  I mean, it's Las Vegas Clinic!  The reasons I hated them in the past are all still there.  The thought of deciding to do this is stressing me out.   Maybe I am not yet over my love affair with New York Clinic, although frankly doing the same exact protocol again is underwhelming to say the least.

A study in finances

I had the talk with the financial lady from Las Vegas Clinic yesterday. It was all very interesting, and basically I think it would make most financial sense to do a 2-cycle plan with the CGH as part of the study.

Of course, that brings up the whole issue of doing 2 more cycles, when it's hard to think about that. They'd be my 7th and 8th fresh cycles. That's a whole lot of crazy right there.

But I emailed a bunch of questions to Dr. F., and he responded in quite an unsatisfactory way. Essentially, however, he got me worrying about doing CGH at all, because on the protocol he's proposed the average woman gets 2-3 embryos. There doesn't seem to be any point in potentially damaging the embryos with a biopsy, taking them out to blast, freezing them (all of which could just kill off the embryos anyway), waiting for the CGH result and only transferring the normal one(s) when I can just shove 2-3 embryos back in and hope for the best. Hell, at this point, I can shove 5 or 6 back in and not worry about multiples.

So I have emailed yet more questions about the protocol and whether CGH really does seem like a good idea or not. I may end up opting out of the study. Not sure. I should have asked if I can start off in the study and opt out based on number of embryos, but I forgot, even though that was on top of my mental list of things to ask him. Duh. I guess he'll be getting another email, then.

Distraction

So, as part of the whole "my body is a fertile temple" thing I have been trying to switch to all natural skin care and body products. And laundry products. And cleaning products. You name it, I'm switching it.

With some things I have been more successful than others. For instance, natural cleansers and moisturizers are pretty easy. Fabric softener and dishwasher rinse aid too - to my mind they don't have much of a job to do, so it doesn't matter if the natural product doesn't function quite as well as the synthetic one. But deodorant was one of my last hold-outs so I have been poisoning myself with good old antiperspirant for a long time. Not that it probably makes a difference as far as getting pregnant, but I don't like to leave any stone unturned just in case. You never know, it could be the last little piece that makes a difference. OK, don't laugh. But if we really are being assaulted by all these toxins and radio waves and other unnatural things, maybe just reducing the amount will help our bodies get back into line again.

Now, sure, I tried some natural deodorants. But they left me stinking by the end of the day. Not to mention sticky and uncomfortable. And some of them had me stinking by the start of the day - they just had some weird compounds that didn't react so nicely with my skin chemistry. Awful stuff. But I finally found one that works reasonably well on me. Except it has a different smell than I am used to, even though it is a floral scent it has some other things mixed in that it can't quite hide, like lichen. It's not a bad smell at all. Just...different. So naturally my thoughts turned to perfume. I have not been a huge wearer of perfume, but want to step it up as I would like that extra security blanket of something that will go well with the deodorant and also provide a bit of help with the whole "smelling nice" thing.

Except of course now that I am (mostly) all natural, I figured it should be a natural perfume. So I started googling to see if I could find any. And, oh my. There is a whole world out there of perfumistas and fan sites and review sites. And niche perfume houses and cult fragrances. And yes, little tiny places making natural perfumes. All of that. And once I started reading about this stuff, I just couldn't stop. It's quite addicting, really. You read a review, and realize that your own thoughts of "that's nice" or "blech, too chemical-y" or "soapy" really don't even begin to scratch the surface. So I'd read a review and start getting interested in the synthetic fragrances too. I mean, these people are smelling things in perfumes that I just don't recognize. So I've been digging out old samples that I've got free over the years and comparing my impressions of them with the reviews. Uh, yeah. I'm still at "flowery" or "soapy" but whatever. I know which ones I like and which ones I don't.

But, I have to say, it's been a lovely distraction from all matters ovary-related. You can get quite obssessed researching this stuff. And I took the plunge at the weekend and ordered sample sizes of a bunch of perfumes from some fancy-schmancy retailers, and got an email that my first order was shipped yesterday. Squeeee! I am so giddy with excitement! Who knew you could even order samples? Not me, that's for sure. Of course it makes sense if you're buying perfumes from the internet but I'd never thought about it before. I am nervous too, I mean, some of them are really different from the mainstream perfumes and I'm not sure if I'll fall head over heels in love with the most expensive perfume evah (probably a yes on that one, knowing me), or if I'll put something on and be so repulsed by it that I want to vomit.

Vegas, baby!

Thanks for all your thoughts and views.  They really helped.

I was really struggling with this.  I mean, I have never been a fan of LV Clinic.  I have said bad things about them.  I never ever seriously considered going there.  Ever.  Ever ever ever.

But, I have to say first of all, that it's wonderful that there are choices for me at all.  That after all my failures, there are clinics out there who are willing to work with me and whose RE's aren't just hooting in derision when I talk about cycling again.  I mean, sure, all of them mentioned DE as an option, but just as an option and didn't say another word when I said I hadn't quite decided yet but thought I might want to do another cycle with my own eggs first.

So, once again, this decision came down to WWTCCLR?  Not what would Jesus do, but what would the crazy cat lady regret?  See, oftentimes I project myself into the future, and imagine myself at 80 - childless, still single, miserable and the crazy cat lady of the neighborhood.  I imagine myself sitting there and regretting the decisions in my life which led me to becoming the crazy cat lady.

And it came to me, as a sort of peaceful KNOWING.  I would always regret not trying a different stim protocol, whereas I would not regret not doing another cycle at NY Clinic because I have already given them two shots.  So there's my answer - Vegas, baby!

I found out more information about the stim protocol and it seems to be indicated for women who are worse off than me, in terms of FSH or embryo quality or age, and then I thought, hey, wait a minute, I think failing 6 fresh IVF cycles qualifies me as pretty badly off.  So if this is their protocol of last resort, so be it.  Bring it on.  I don't know yet if I'm going to sign up for the study or not, or if I'm going to sign up for their two cycle plan or not.  That'll depend on the financials.  And I'm going to ask if I can make the CGH decision during the cycle, based on the number of embryos I have - for example, do it if I have 6 or more embryos, don't do it if I have 5 or less.  

All this is of course only if the FET fails.  I'm not writing it off.  But I've got to have a backup plan in place to stop me from falling apart if the embryo doesn't survive the thaw.  So there we are.  I'm going to Vegas! Maybe.

Head. Spinning.

Well, well, well, I had my consultation with Big Snake Oil Immune Issues Clinic, who shall henceforth be known as Las Vegas Clinic because that other nickname is too damn long.

Well.

It was not what I expected.

I have always been wary of Las Vegas Clinic - in fact it is part of a chain - they have clinics all over the country.  I'm sure you know the one.  It was started by a controversial guy who does things his own way, is very much the show man and who pushes immune issues.  I am not a big believer in immune issues.  I mean, if the success rate for donor eggs is so high I think we can safely assume that none of those women had immune problems in the first place, but rather crappy eggs.  Sure, it has to be an issue for some people, but I tend to think that they are the ones with known problems like lupus or recurrent miscarriage or other such things.   Anyway, frankly I think they are pushing snake oil when they try to get people to do things like IVIg.

I would not have contacted them but for seeing that they are running various studies and as the financial resources are dwindling, the thought of getting an IVF for cheap was quite appealing.  I mean, if I am going to do another IVF with my own eggs, it might be nice to still have enough cash to do a donor egg cycle afterwards if it fails.  The RE, Dr. F., emailed me and said I might be a good candidate for their CGH study.  This is where they biopsy the embryos like with PGD but test all the chromosomes (PGD only tests some).  I have been worrying about this.  I mean, if I end up with only four fragile, crappy-looking embryos, might they all self-destruct if they are biopsied?  Even if one of them might have been normal?  And I had been saying that if an RE could tell me that all my eggs are abnormal, it might allow me to draw a line under this process and move to DE.  But surely the fact that none of my IVFs have worked leads one to the conclusion that all the eggs produced so far have all been abnormal.  Hence why they haven't worked.  So what is a test going to tell me that I don't already know?  In other words, I am my own assay.  We stick all the embryos back in and the good one sticks.  Or not.

So I was really just going through the motions when I went through with the consultation.  I was leaning heavily towards another cycle at Big Clinic.  Or perhaps they should now be called New York Clinic to lessen confusion somewhat.

But the RE was nothing like I expected.  He was very nice.  I liked him.  He had clearly gone through my file carefully and thought things through.  He did not mention immune issues once.  Not a once.  He first went through the final stages of follicular development, stating how the eggs are very responsive to the hormonal environment in the follicles.  He said how in the natural cycle the body picks one egg to ovulate, and that egg becomes responsive to estrogen in the final stages of development.  The rest of the eggs that had been developing along with it now respond to androgens that are also circulating, and die off.  He said how they believe that as we age, we are producing more androgens and also producing more LH too early.  That some of us (namely me) become over-sensitive to androgens and our follicles are reacting to the androgens by dying off or not developing appropriately.  That it is essential to avoid androgens.  And that he believes, by doing this, it may be possible to influence the quality of the eggs at the time of ovulation, because he believes that we can manipulate the hormonal environment enough that more of the eggs will develop properly.  As if they were the dominant follicle, and therefore will react to the estrogen and not go into apoptosis because they are instead reacting to the androgens.  He thinks this is why I have a dominant follicle problem - not because I'm producing FSH too early but because I'm producing LH too early and am too sensitive to the androgens.  That it's not that one follicle starts developing too soon, necessarily, but that the other follicles are going into death-mode too soon.

So he said he thought my issues were caused in part by the stimulation protocols that I've been on.  That I've been on too much LH too early.  That nobody's been controlling my androgen levels He said they had a new protocol that is being published in one of the fancy journals in February that he would like to try me on.  It involves BCP, preferably one like Yaz or Yasmin which has a good androgen-lowering effect (though he said all BCPs do it to some extent), then you start Lupron as if doing a long lupron cycle.  But they stop Lupron when you get your period and switch you over to antagonist on day 1.  Then they add estrogen and only after a few days on that do they add stimulation meds.  And they use FSH only to start with, and start adding small but increasing quantities of LH as you get closer to trigger day.  But much smaller quantities of LH than I've previously been on, and they use Luveris instead of Menopur.

Hmmm.

He didn't know if it was worth trying CGH either.  For all the reasons I had worried about it.  But he said I could try it if I wanted, and I could be in their study if I wanted.  But the study doesn't involve a cheaper cycle, but instead a very reduced cost second cycle if the first one doesn't work.  Which they kind of let you do anyway if you buy a two-cycle plan from them.  And CGH costs extra money so I am not sure that is worth considering at all.

I am going to speak to their financing lady on Wednesday to really crunch the numbers.  He said I could cycle at the end of March if the FET doesn't work.

Hmmm.

It was strange.  Here is an RE telling me about my exact problem.  That he has clearly thought about and has a protocol tailored for.  Previously it's always been me telling the RE's that I thought I had this problem, and steering them towards long lupron cycles because of it.  Here is a protocol designed for women like me.  Not a standard regular-old IVF protocol that they're using because they don't know what to do with me.

And he recommended I check out the fertility diet published recently in Newsweek - http://www.newsweek.com/id/73354 - sorry, haven't figured out how to link when posting from the Mac.  Because it helps with insulin resistance and blood sugar, and therefore androgens and all that jazz.  I liked that.  I liked that he suggested stuff I could do.  I liked that he was focussed on egg quality and not immune issues.  I quite like the thought of trying something different. 

So now I have a choice.  Switch to Las Vegas Clinic and try this other stimulation protocol in the hope of getting better eggs.  Or stay with New York Clinic and stick with the same old same old but hope that coculture and a better lab save the day.

Hmmm.  What would you do, internets?

Giant blood draw #427

I have lost count of how many giant blood draws I have had in this process, but hoo boy, was today ever another one!

Went to the blood draw place and gave them my scrip for the thrombophilia panel. It caused all sorts of muttering. The tech said she couldn't read the doctor's name from the faxed scrip, nor the address, and the doctor's name wasn't coming up in the system so she'd have to type it all in. So I had to stand there and spell everything out for her while she two-finger typed the exceedingly long name. Not for the first time was I annoyed at why Big Clinic can't just officially be called Big Clinic, but rather "Rich Guy Benefactor-Big Clinic College of Medicine, Center for Reproductive Medicine and Infertility". That's a lot of typing right there with only two fingers - and did I mention she had very long nails that slowed things down even more? Dr. S's name isn't exactly short, either. Then of course these weren't the normal tests, so she had to look everything up on the computer, which caused more muttering but at least by that point she sent me off to wait in one of the blood draw rooms. All of this took an age, by the way. I think I could have looked up a few blood tests a darn sight quicker, but whatever.

She finally came over to me and said "oh, you are going to have a LOT of blood drawn". Meh, I thought. How much can it be? There were only about 9 tests listed (OK, maybe 11), and I've had way worse done. So she started grabbing vials. And kept grabbing. And then grabbed some more. At which point there were at least 2 vials for every test and I said "gee, I guess you weren't lying about it being a big draw". God, I hope she pulled up the right tests and I don't have to have them all re-done.

So we did it, and at least she cheered up when she got into my superstar vein and it performed beautifully. And fast. Which made me wonder if I'd stopped the low dose aspirin early enough - I haven't taken it for the last two days in the hopes that it wouldn't skew the clotting tests, but maybe I should have stayed away for longer as my blood looked pretty free flowing coming out into the vials.

And then of course as I was driving to work I happened to look down to see a completely saturated gauze pad with blood oozing down my forearm, which is a tad disconcerting when you start worrying if you're going to expire from blood loss half way down the road, and crash. Luckily I was wearing a short-sleeved shirt so at least I didn't have to go home to change. And luckily too I have remnants from many previous blood tests stuffed into the ashtray of my car. Other people have cigarette butts, I have old used gauze pads. Yes, I know it was hardly sanitary, but I whipped out a few old cruddy gauzes and mopped up the best I could. Luckily three it clotted up and I didn't bleed out. Luckily four my employer provides breakfast on random Fridays, which is sometimes a few doughnuts but today was miraculously a nice spread with bagels, cream cheese and all sorts of other tasty items. So I stocked up and replenished myself.

In other blood letting news, AF has arrived too. I had acupuncture last night so told cutie acu to work some magic to get everything going, but not so much that we made a mess on the table. He said not to worry, he'd made that mistake once and has never done it again. Oh dear, that poor woman, whoever she was! And he did do his voodoo that he does do so well, and it worked within 3 hours. And thankfully not all over the table. So I think I will start patches tomorrow and have the FET transfer on Feb. 7th. I know I said FET would be Feb. 6th if AF started yesterday, but I'm going to lie and say it was spotting yesterday and day 1 today, because that makes life easier for various reasons.

Yet more waiting

I wasted an inordinately long amount of time at the RE's today waiting to get my ultrasound. They said they'd been having problems with the machine. Yeah, uh huh. Right. Just waste an hour and a half of my life in a freezing cold waiting room, why don't you? I kept feeling like I should stomp up to the reception desk and demand my dues as a ranking senior member to be snuck into the front of the line. I mean, come on, I'm pretty darn certain that I was their longest serving patient in the waiting room today so you'd think that would get me some special treatment from time to time. If I can't get pregnant it'd be nice to at least pull rank every now and then. OK, so all the staff know my name but that doesn't get me anything, does it?

But anyway, I have no cysts and everything looks good. Except for the little matter of no AF. No flow. No crimson tide. The painters are not in town. So now I wait and see what they tell me to do. I think they'll delay me starting the estrogen patches until things have got moving, which means delaying the FET transfer attempt.

ETA: Yup, delayed. Everything looks good except my lining is too thick because it hasn't started shedding yet. Well, duh. I could have told 'em that. So I will start patches the day after I get full flow. If I get full flow tonight, that means the FET is pushed to Feb. 6th, and if it comes tomorrow I am pushed to Feb. 7th and so on.

Waiting, waiting.

I'm just hanging out. Waiting for my ultrasound tomorrow. Waiting for the old hag to put in an appearance so my FET transfer won't be delayed. Waiting for my rescheduled consultation with the other RE.

The old hag has been on the verge of appearing for the last two days, but alas seems to be only teasing by sending cramps and odd feelings, rather than actually getting a move on and doing something useful. Whatever.

But I did speak to Dr. S's nurse, and got the scrip sent over for the bloodwork they'd like to do. I'm pretty certain I've done some of it before, but I just can't be arsed to go and check back to see what I did and didn't do so I'm just going to have them all run. Besides, that was what? Two years ago? 18 months ago? Who knows if some of these things change over time. Oh, not the genetic tests, obviously, but those are the ones that I think were never done before.

We shall be testing PT/PTT, Anticardiolipin Antibody, Homocysteine, Factor V Leiden, Protein S Functional, PAI-1 Ag Activity, Lupus Anticoagulant, Antithrombin III, Prothrombin Gene Mutation, Protein C Functional and the good old MTHFR Gene Mutation. I made an appointment at the local giant blood lab place for Friday morning, in the hopes that I can get it all done in one shot and won't have to go to some specialist place. And no, the appointment is not at the other (evil) giant blood lab place that gave me the false Hep C result - I am boycotting them. And thank goodness that I have new insurance, meaning that I am no longer forced to only use evil blood lab, because that place is just too damn depressing.

Not so much with the duelling, then.

One of the RE's went home sick, so that consultation has been rescheduled to Friday.

But I spoke with Dr. S. of Big Clinic, and he thinks it's very reasonable to try again with my own eggs. He said we got a good number of eggs, got good quality embryos and he would recommend doing the same protocol again. He said the reason we haven't succeeded up to now is likely to be chromosomal issues due to my "greater chronological experience", to steal a phrase from Julie. And if that is true, then we've no reason to change protocol as it's partly due to luck whether we get a chromosomally good one or not. The only thing he suggested was perhaps delaying trigger for an extra day to try to get more mature eggs, but then said that they make that decision based on E2 levels, number of follicles, etc, so it's hard to say whether even if we say now we'll push an extra day, it will actually happen. And the reason they trigger early is to have good quality eggs, and mine have been good quality, blah blah blah, so why push it just to get another egg or two of questionable quality? The other thing we discussed was running a more detailed thrombophilia blood panel than I've previously had done, which he is quite happy to do. In fact, he said we could run that while I'm preparing for the FET if I like, so we have the results ready to go should we need them. [Or presumably I could incorporate the results into my treatment should the FET miraculously succeed.] I asked about doing a lower dose of stims to try to go a bit slower but he didn't think that was worth trying.

He did say that he'd be honest with me if he thought it wasn't worth trying again. He says he has patients who get fewer and fewer eggs with each cycle, or with worse and worse quality, and with those women he does tell them it is time to stop and move on. But that I'm not in that situation and it's really up to me whether I want to try again.

I don't know what to think, really. I guess we wait to see what Friday brings.

Better

The swelling was a lot better yesterday. I just had puffy feet last night rather than painful sausages, although my fingers are a bit achy this morning even though I didn't notice them swelling yesterday. I think it was a combination of the BCP and dehydration, so hopefully it will continue to improve as I will continue to chug lots of water and the BCP hormones should continue to work their way out of my system. I'm not on any steriods yet, nor have I been taking any stim meds, so I don't think it is anything like that.

In other news, I have my 2 duelling RE phone consultations today, so I will report more either this evening or tomorrow.

Swelling

I am having side effects, people. And not just the usual "I hate the world" side effects.

I am swelling.

By the end of the day my feet and hands are swollen little balls of edema and they are quite bothersome. Well, OK, I exaggerate somewhat. Technically I suppose they are more sausage-like than ball-like. But they still hurt. And then in the morning I am feeling arthritic-y in my fingers and toes.

I'm not quite sure what this is from. I googled whether the aspirin could cause this, but that just told me that aspirin brings down swelling. I haven't done anything else new this cycle, although I suppose that it could be a cumulative effect, that perhaps somehow I've reached the amount of lupron that my body was prepared to take in over a lifetime and now it is complaining.

Oh well, I'm keeping an eye on it. I am trying to gulp down water in case my salt balance is off somehow. I'm trying to keep moving just in case the swelling is due to sloth or weight gain. I took my last BCP on Saturday night (thank the lawd!) so that's one less drug swilling about, and we'll see if that makes any difference. In the meantime, if any of you have any ideas, let me know. I don't think it's worth calling the RE about, although I am having an ultrasound on Thursday, so I'll probably mention it to the nurse then if it hasn't improved.

Bah humbug.

Die, yappy dogs, die, die, die

So, where was I? Oh yeah, saying I'd probably be perfectly pleasant to everybody.

There I was this morning, a tad hungover. What? You thought I wouldn't drink after my protestations of worrying about the slide into alcoholism? Umm. Yeah. Well, actually I haven't had any alcohol since then, and I have been almost saintly. Apart from a daily cappuccino and hot chocolate. Not bad huh? So, where was I? Yes, well, this girl from work who started over the summer and who I've been getting chummy with has been saying that she's got these friends that she thinks I'd really like and would get along well with, blah blah blah. And I've put her off a few times when she's asked me out for drinks to meet them, because I was cycling. But this time, I thought, screw it. I'm only on lupron, it's only an FET, and not drinking during cycles hasn't got me anywhere in the past. So I went out for happy hour. And I only had 2 glasses of wine, but they were quite generous glasses of wine so they made me a bit tipsy. But I had a blast. It was so good being out with nice, intelligent women, having fun, and not thinking about the usual crap that goes around my head.

And then I got some Chinese takeout and probably shouldn't have driven home as soon as I did. I should probably stick to beers or something because two beers is probably a lot more sensible when one has to drive home than two large glasses of wine. So, yet again, my apologies for that.

But, there I was this morning, trying to snooze and have some precious extra time in bed when the yappy dogs were yap, yap, yapping and not letting me sleep. So I grudgingly got up and put the kettle on for tea, noting that my nightshirt that was a gift from my parents about 10 years ago really should get trashed because I'm so fat now it rides up and barely covers anything, and also because there's a big old food stain on the front. And then someone knocked on the door. Great.

There were three very nice Haitian* ladies standing at the door, looking dressed for church. I figured they must be Jehovah's witnesses or something. I sucked in my gut hoping my nightshirt might cover a bit more of my upper thighs if I did so. The lady at the front said something that sounded like "ge-shur-shur". "Ah, sorry, what?" said I. "Ge-rar-shur?" said the nice churchy looking lady. This did not sound anything like "would you like to buy a copy of the Watchtower?" so it got me a bit confused. The yappy dogs were doing somersaults in their yard, and having a field day at People! On the street! People! Let's yap some more! OMG! People! My head started to hurt, and I thought longingly of the lovely tea I had been about to brew.

Churchy lady pointed at my house number. "Zees is one hundred twenty-see**? Ge-rar-ge-sur?" My brain clicked around seeking comprehension. She must be looking for 123 Greygoose Avenue, not 123 Greygoose Street*** which confuses everyone as they're parallel to one another. "Umm, this is Greygoose Street, Greygoose Avenue is one block that way" I said, pointing. She looked confused at how she could have managed to pick the house clearly containing the village idiot who couldn't understand anything. And then said quite clearly "Garage sale? Ze sign said 123. You have garage sale? Zees is 123, yes?" The other two ladies were nodding. They were all obviously very clear on what this sign had said, and started looking around the yard a bit, expectantly.

I don't know why my ears refuse to hear the obvious sometimes. But, in my defense I quite clearly don't have an actual garage, let alone any signs of a garage sale going on. Or a yard sale. Or any other type of sale. So it just was not computing there for a while that someone would imagine that I was hosting a secret garage sale in my living room while wearing my tatty old stained nightshirt and with the blinds closed.

"Umm, no, sorry I'm not having a garage sale. The sign must have meant another street if it said 123. Try Greygoose Avenue, which is one block that way. Sorry I can't help any more. Bye bye." And closed the door. And immediately ran into my bedroom to throw some clothes on in case hordes more people turned up for the garage sale that wasn't, noticing as I did so that my hair was sticking fetchingly straight up from my head. Great.

Why, universe, why? Why do you taunt me so when I am on lupron?





*information solely provided to aid the reader in imagining thick French-Caribbean accent.
**not my real house number.
***not my real street name, but perhaps more appropriate than the actual one, given the alcohol consumption.

Look away. Nothing to see here.

God, my life is boring right now.

It is so boring in fact that I had some spotting this morning and thought: "Ooh, spotting! I can blog about that."

How lame is that? No, no, don't answer - that's a rhetorical question. I am well aware of precisely how lame it is. I could instead bore you with my work woes or my immigration woes, but honestly they're so boring to anyone not intimately involved in the situations, that even I would probably fall into a coma while typing.

But anyway, an update on the boring FET for all those who desire it. 3 more days of BCP and then I stop. And then I have an ultrasound a week from today to see if everything is acting appropriately, and assuming I've had a real bleed by then, I will start estrogen patches to cushy everything up.

I have turned into a little bit of a Crabby McCrabbypants from the combined and delightful influences of lupron and BCP. But not horrendously so. I think this is more akin to my normal worst day of PMS rather than me turning into psycho bitch from hell, that delightful lady that has appeared on cycles past. Of course, I still have up to a week to go before I get relief, so I could still turn into psycho bitch from hell at any moment. But you should be fairly safe as long as you're not an idiot, or my neighbor with the yappy dogs, or a really slow driver that is blocking my way. Really, if you're none of those people, I shall probably be perfectly pleasant.

Duelling RE's

De ne ner ner ner ner ner ner neow.

That was supposed to be "duelling banjos" there. If you recognized it, I'll be amazed.

Hey! Internets! I have news! So, I got the forms from Immune Issues Clinic to set up a consultation on this study, I filled them in last night and scanned and emailed them off this morning. And the scheduler called back and has set me up a (free) telephone consultation for the 15th with Dr. F.

Right after my consultation with Dr. S. of Big Clinic. He he he.

De ne ner ner ner ner ner ner neow.

Duelling RE's!

Honestly, I would not have investigated this further if Dr. S. had been quicker on the uptake with my post-IVF WTF consultation. Or if it hadn't been rescheduled from the date that it was originally set for. Because then I'd be more mentally set into the idea of doing one more cycle with Big Clinic.

But now I'm kind of enthused by the idea of this study. Of course, I know very few details about it so far but cheap is goood. Testing is good. Different is good. Finally getting some answers on my eggs is good. Getting two RE's opinions on the same day is good. Choices are good.

S'all good.

Response from immune issues clinic

Just when I had given up on hearing from the Immune Issues clinic on my information request about that IVF study I mentioned, I got the following email today:

You may actually be a better candidate for our CGH study, which is just getting started.

I can review all of this when we speak to review your case together.

I’ll have #### set up atime.

Hmmmm.

Le lupron est arrivee

I started lupron last night. It was fairly anticlimactic. Wait, that would imply that I was expecting something, er...climactic in the first place. For the record, I wasn't.

For those first few IVFs, the first shot was always eagerly anticipated. I counted down the days, I made calendar entries and alarm prompts so I wouldn't forget them. I kept thinking "this time next week, I'll have started" or whatever. There was always a build up of hope, of anticipation, a thought that this cycle could finally work and I'd get pregnant.

This time is very different. I feel like I am just going through the motions, and that there's no real actual hope of it working. Part of this is of course because I am so beaten down by failure. But I think part of it also is because I am putting up defenses and reminding myself at every turn that the embryo could very well not survive the thaw, and then we have to skid to a halt right there and then. Perhaps if it does survive, then I will start getting excited. Well, OK, I will start getting very excited. This could very well be my last big hope with my own eggs.

The embryo is from my second IVF cycle, or, depending on how we are counting, my first. The first IVF that made it to retrieval and transfer, and wasn't cancelled for a poor response. I count it as my second though, because once you've been through all the IVF build up, all the meds, all the ultrasounds, all the pre-op stuff and been cancelled basically on trigger day, it's a whole different ball game from any other IUI cycle. So anyway, on my second cycle after a protocol tweak, I ended up with 7 embryos. We did a day 3 transfer, and put back one 8-celled grade 2 embryo, one 7-celled grade 2 and one 6-celled grade 2. I was told these were my best embryos, and that was that. What they didn't tell me until later was that I did actually have two grade 1 embryos on day 3 (grade 1 being the best, and relating to the amount of cell fragmentation, even development, etc). The problem was that my grade 1 embryos were 4 and 5 celled so they were slower developers than they should have been. When they took them out to 5 days, and I think somewhat to the clinic's surprise, they had caught up to the proper schedule, and the 5 celled embryo became a grade 3BB blastocyst, and the 4 celled embryo became a grade 3CC blastocyst. In this case, the grade 3 means it's an average blastocyst - an expanded blastocyst would be a 4, a hatching blastocyst would be a 5, and a morula would be a 2. So, really, a 3 is right on schedule, and 4's and 5's are over achievers. The letters relate to the size and condition of both the inner cell mass (which eventually becomes the fetus) and the outer cell mass? layer? - something or other. So a 5AA blastocyst would be the best, but a 4AA and a 3AA are just fine too. My local clinic only freezes grade 3BB blastocysts and above, so they only froze one of them and sadly discarded the 3CC. The two other remaining embryos had apparently given up the ghost by that point and stopped developing on their own. 3BB ain't bad at all, though, in my opinion. It ain't bad at all. And if I'd been doing a fresh blastocyst transfer, the 3CC would have been good enough to transfer so you never know. It could have been just fine too.

We didn't use the frozen embryo up straight away, because the RE thought that it wasn't worth doing an FET with only one embryo, given that it might not survive. So he suggested going to another fresh cycle, hoping we'd get at least one more frozen embryo and then have 2 or 3 to work with when it came time for the FET (for the sibling, you understand). Of course, that didn't happen and it's been a long hard road since then. But the delay does mean that IF it survives the thaw, it could be my best chance because (a) it'll be my only blastocyst transfer, (b) I know it was a grade 1 on day 3 and thus hopefully the quality is good, and (c) more importantly, this is from a cycle done when I was 37 years and 6 months old. Which is huge in terms of ovarian aging - it's nearly two years ago. So there's much more of a chance that this little embryo is chromosomally normal than anything I can produce today.

For the moment, however, yeah, lupron. Blah. Terribly dull. Oh, another cycle? Well, of course we must tell ourselves for the next month that it might not happen. We must under no circumstances get excited. We must just go through the motions. Again.

Burble burble

Not much going on with me.

The HSG went well - it hurt a bit, but not as bad as last time. The RE pronounced me "perfect" with wide open tubes. Not that being perfect is all that helpful, seeing as my eggs are crap, but whatever, it's good. I spent most of the day oozing gunge, but yesterday was down to practically nothing.

The lupron should arrive today, and I will begin shots tomorrow.

That's it, really. Work is completely nuts but at least it's keeping me busy. Just so long as I don't have a nervous breakdown before the FET transfer, I'll be OK. Staying sane could be a long shot, but hey, I'm strong.

A flip of a coin

Have you ever made an important decision by flipping a coin? I mean, a really important decision? Not just what to have for dinner, but something that will affect the rest of your life.

I have.

When I get to that point where I have agonized over a decision for days, weeks, even months, when I just can't sort out the list of pros and cons, when I can't decide which way to go, I have in the past occasionally flipped a coin.

Not that I necessarily followed what the coin told me to do. But it's very very revealing when that heads or tails comes up and you find out what your gut reaction to the decision is. Sometimes you say "oh yay!" and sometimes you say "oh. [sigh] Maybe 2 out of 3?" And then in that moment you know what your heart and your gut are really feeling about the decision, and you go with what you really wanted to do but were too afraid to commit to.

So thank you all for your comments on what I should do next. I found reading them to be very enlightening, and the equivalent of a mental coin toss, because to some of the comments I was "oh yay!"ing and to some of them I was "oh. [sigh]"ing. Which tells me a LOT about what I am really feeling inside but haven't fully articulated. And, yet again, the priority list has changed. One thing has moved down, and one thing has moved up. Thank you, thank you, thank you for helping me with my decision making.

Now, part of the decision still rests with my post-IVF WTF consultation with Big Clinic that I still haven't had. It's set for the 15th of this month, which seems an age away. And part of it rests with whether Big Snake Oil Immune clinic says I qualify for their study. But assuming Dr. S says it is worth trying again with my own eggs, and assuming I don't qualify for the study, here's the current plan.

1. FET
2. Another cycle at Big Clinic with my own eggs.
3. Donor eggs in S. Africa or somewhere.

I had in fact already emailed the S. African donor agency about getting on their list, and they responded this morning. So I got to see photos and short profiles of their donors while I was having my breakfast. And one of them actually looks kinda like me and is exactly the same height as me. I responded to the agency saying "well, I'm still a bit undecided as to whether I'll do another cycle with my own eggs, but thanks so much for responding. Actually "XYZ" resembles me, so that gives me confidence that I can actually do this and it definitely helped being able to see photos so early in the process." Or words to that effect. And wouldn't you know, they already responded with XYZ's full profile. Gulp! And I think I could actually use her. I think it might be a step I could take. Pretty huge, no?

In other news, I have my HSG at lunch time, which I'm not looking forward to. Please hope for no pain and no polyps for me!