Hope be damned

I had (yet another) realization about this IVF yesterday. As I was expounding to Cali about how nothing is as important about getting knocked up, it kind of hit me in the face. Nothing is as important as getting knocked up! You may not think that was exactly a blinding realization, but it was actually helpful. Because the fact that I am struggling with hope does not matter. It does not matter if I have hope or not. What matters is flying to NY and going through the IVF so that I have a chance of getting knocked up. The end is what is important, not the means, and definitely not how I feel about the means. The truth is, I have to do this IVF. Hope be damned. Hope may come back later, but for now, going through the motions is much more important.

So that makes me feel, bizarrely, happier. I can just go through the motions. Or, in other words, fake it till I make it.

In other news, I had a tiny bit of EWCM yesterday, on cycle day 8. So I think that I may just surge early because my body probably doesn't realize that it hung on with a 16 day luteal phase and probably thinks that I had a shorter luteal phase. I bet it started cooking my eggs early, like it likes to do. So I'm hoping for a surge at the weekend (maybe). But, whatever. Whenever. As long as it comes.

Moody

I don't know what is up with me lately, I seem to swing wildly between moods. I was doing just fine yesterday until I went to acupuncture. And cutie acu was telling me about one of his fertility patients who had been in an hour before - she is now very pregnant apparently, and doing well. He likes telling me about the successes. Which is very nice and all, but it doesn't give me hope any more so it just makes me sad that I may never join them. And then we were talking about me starting the lupron this cycle, so he was saying how it's been shown that acupuncture really helps the response versus doing it without acupuncture and we'll hope for lots of fat, juicy eggs. Ummm, yeah, again, all very lovely, but I've been doing acupuncture for every single one of my IVFs. Just how do I hang on to hope that this time I will get the magic response? So I get sad that even his illustrations of how I should have hope actually make me sad.

And then of course on the other hand, I do realize that I am doing better this time. I can definitely tell that I have changes in my energy levels and in day-to-day pain levels. My digestion is improving more. It is all good. I suppose I am feeling a bit down because of the period not being as I had hoped. You know, I was hoping it would be a perfect turnaround, a perfect flow, as Randine Lewis loves to tout in her book, of the "her cycle balanced within weeks, and she was pregnant the following cycle" success stories ilk.

It is just so so hard to hang on to hope. Obviously I have hope, because I am going forward with the cycle. But it is a tenuous hope. A feeble hope that flickers like a candle flame in a breeze. I try to focus on what I am doing differently, and twice-weekly acupuncture is one of the differences. Previously I did once-weekly acupuncture. Will it be enough, though? Will I actually get the golden egg, or am I just doomed to failure because I am using donor sperm and therefore not trying every month. Did I pop the golden egg last month and waste it because there was no sperm there to meet it? Was that my last chance and I blew it?

I think the pressure has ratcheted up because of my self-imposed "this is the last cycle" stuff. I am so paralyzed with fear that it won't work and I won't have another cycle to try again. I just can't face the thought of giving up on my family's genetics. But I have to stop at some point. It is just not healthy or realistic to keep going indefinitely. Not to mention the fact that I can't afford to keep going indefinitely. And yet, I just really don't feel ready to say that this is where my grandparents stop. Where my parents stop. That their genes don't get to travel forward into the future, into this grand experiment that is humanity. That they become a stunted branch of the family tree that will wither into nothing. I think in many ways, this would be a lot easier if I had other family members that were procreating. But we are a small family, and have too many people that are not having kids for various reasons. Between me, my brother and my 4 cousins we have produced one kid. And that may be it, because even the fertile one may not have any more due to some quite nasty birth complications. I feel this crushing pressure to try everything I possibly can, but it is just stifling at times. Like now. It is hard to breathe.

Doing the (mini) freak out

So, I called the scheduler yesterday, as I mentioned. And she left me a voicemail when I was on the phone. Darn, if that isn't always the way. I can be sitting waiting for that phone to ring for hours hoping she'll call, and then the second I have to actually do some work, she calls. Damn work, getting in the way of my life yet again.

She moved my pencilled-in appointment for the coculture biopsy to the 8th. When I'd already booked the hotel and the time off work for the 6th. So I started having a freak out, and imagining not being able to change my hotel reservation, or worse, changing it, and then surging early and having to change it back again to the 6th. And not being able to because of the hotel being booked solid for a conference or something. And then there's the little matter of a team mate of mine who has booked the 9th off, and asked for the 8th as well if possible. So it'd be hard for me to be off on the 8th as well. And I'd have to travel crazy late after work on the 6th to be able to get there in time for the morning blood work that is necessary the day before the biopsy.

I don't know why I freak so much. It is all changeable. I haven't booked my flight yet because the date is not definite until I actually get my LH surge. If the hotel is booked up, there are plenty of other hotels in the city, they'll just be more expensive. Work will sort itself out. I know all this logically, and yet there's this "ohmygodthingsaregoingwrong" part of my brain that just panics.

Having calmed down, I called her back this morning. And she changed it for me, and put a note on the computer that it might still have to be the 8th, but they'll try to fit me in on the 6th. No fuss, no bother, just a teeny note of annoyance in her voice, but hey, she's a busy lady. So I freaked for nothing. As usual.

But now, I am praying for a nice, early surge, so I don't have to call her back shamefaced and ask her to change it back to the 8th.

Oh, and in case it isn't clear what the plan is for this cycle, it is:

1) monitor for LH surge;
2) have coculture biopsy between 5 and 12 days after the LH surge; and
3) start lupron at 7 days after the LH surge.

So I could start lupron before or after the biopsy, but that doesn't affect things, apparently. And no birth control pills, which is nice. Then I will start stims after my next period. And hopefully stop this crazy IVF nonsense once and for all by finally getting knocked up. Hahaha, don't all laugh at once at my ridiculous hope there.

Ohferfuckssake

Nothing. No period. Now working on three days of cramps, backaches and poor sleep. And literally, every darn second, it feels like my period is starting. I have been running to the bathroom to check so often, it is ridiculous. If I wasn't irritable before, that's definitely enough to send me over the edge.

Sigh.

16DPO and counting. Why oh why can't my body be consistent? Last cycle I had a 12 day luteal phase. Not that that was good, but why couldn't it go back to 14 days instead of 16? Eff eff even took away my cover lines and told me I didn't ovulate when I entered this morning's temperature. Nasty mean computer! I changed the calculation method and it put them back, but still, it's enough to get a girl jittery.

I'm sick of this. And remember on Thursday how I was all worried my period would start early and mess my timing up? Har har on me. Now I'm going to mess my timing up the other way. I mean, for the actual IVF it won't matter, and in fact, a few days later is better. But the coculture would be so much better done on the day I am pencilled in and not on the following Thursday. I don't even know if I can get a spot on the Thursday, or if it is all booked up. I cannot, absolutely cannot contemplate missing the coculture this month, because that would mean bumping the IVF to December. And I'm pretty sure Big Clinic is closed when I would need to be cycling, so essentially I would get bumped to January. Urgh.

Where did the time go?

Um, hey, you know sometimes how things hit you? I was just mulling over the IVF timing and realized that I'm actually doing an IVF soon! I should start lupron a month yesterday. My coculture biopsy should be a month today. The actual cycle should start in 5 weeks or so. Yikes! How did that creep up on me?

Not that I didn't know. I always knew. I suppose I just pushed it to the back of my mind because I was so ambivalent. But wow. It's soon. And then I'll be done (most probably*) with my own eggs. Done, finito. Apart from the one little frosty I have that probably won't survive the thaw. It's a weird weird feeling.



*reserving of course the right to be completely crazy and change my mind at some point.

Gobble gobble

So, I did end up getting the turkey-containing meal from the diet place. Blech. Luckily I poked around in it and saw the meat before taking a bite so I didn't end up eating any by accident, but still, it's unacceptable. So I did end up cancelling. I have one more week's worth of food that just arrived, and then I am out on my own again. I have managed to lose 6lbs in 4 weeks, so that's not bad for me. I am usually verrrry slooooow at losing weight, and while it would have been nice to lose 10+lbs in 4 weeks, I'll take 6lbs. I'm going to try to keep limiting the portions, but eat more whole foods and fewer processed foods in order to be healthy for the IVF.

Or not.

The "or not" is relating to the IVF, by the way, not the healthy eating part. I'm very ambivalent about the whole IVF thing at the moment. There's a very big part of me that just doesn't want to do another IVF and doesn't want to go through with it. I think, well, OK, I'll be honest, I know, that it's because I keep daydreaming about TTC'ing naturally with the cute acu. Who I was trying not to write about much just in case he ever finds this blog and realizes who I am. But my schoolgirl crush is still going strong! However, I need to find out once and for all if he is single and interested soon, so that I can either stop daydreaming and start concentrating on the IVF again, or I can try to change daydreaming to reality at some point. It's hard though, because I'm so lame at flirting and so shy about just speaking up and saying "hey, do you want to go get a drink together sometime?" It's the sort of thing I need Dutch courage for, and you just can't turn up to an acu appointment sloshed, now, can you?

My aunt is recovering nicely, by the way. I never did thank you for all your kind thoughts, by the way, so thank you. I'm sure all the people that were praying for her and keeping her in their thoughts made a difference, so I'm very grateful for that.

Drinking coffee

I have noticed that at a certain time of the month, it is impossible for me to resist the siren call of the cappuccino machine at work. Today is one of those days. I have had two already and am about to go back for a third. I do make them decaf, so it's not as bad a full caff but I find if I don't give in to the need for coffee, it quickly degenerates into a full scale chocolate binge. And we definitely don't want that! Not while dieting, at any rate.

Anyway, it's a tad worrying, as it's a bit early for prime PMS time for me, and my temperature has dropped over the last two days (yes, I am lame, I still chart my temperature). So I may be having a short luteal phase and hence a short cycle this month. Not that a wacky cycle after a failed IVF is in any way unusual or necessarily a big deal. A wacky cycle is kind of to be expected, except previously I have had longer cycles after my failed IVFs. But every wacky cycle makes it harder to predict when my next IVF is going to be. I wanted to book the NY hotel as soon as I got CD1, and also book the kitty in to the vets to board her while I'm in NY next time. I don't want to board her, as the last time she was boarded she got incredibly stressed out and developed a urinary tract infection, but I think it is for the best this time. I will be away over Thanksgiving, and my friends who do not enjoy kitty feeding and poop scooping duty at the best of times may rebel at being called upon over Thanksgiving. And besides, last time they broke my $120 automatic kitty litter so it's not as if it is really free care anyway. But of course, Thanksgiving is a crazy busy time at the vets for boarding so I feel I need to book her in early. And she's probably due to have some shots or other, and no doubt a check-up, so I need a lead-in time to get her up to speed on that stuff. But, being me, I'm feeling a bit weirded out by not knowing exactly the dates I will be away so it's stressing me out a tad to have to book and say "it'll probably be these dates, but I may have to change them as we get closer". I know, I know, the vets office don't care why, but I always fret that I am just going to stand there and uncontrollably spill the whole IVF story to some random stranger who doesn't care about it and then I will feel like an idiot.

Oh, and I didn't cancel the diet thing. The customer service people called back extremely apologetic, and thanked me profusely for bringing the gelatin error to their attention. They are changing the meals with the offending gelatin, substituting them out from my plan in the meantime, and giving me a credit. So I am giving them another shot. As for the ground turkey containing meal, that looks to be a packing error. It looks like the person that had that happen received a meal from the regular plan (the Mexican style burrito) rather than the veggie meal (the bean burrito) that was supposed to be included. So that all made me feel better and I am sticking with it for now.

Decision done

OK, that's it, enough wallowing and mooning over trying to make decisions. I will do the IVF in November/December. I had a good talk about it with my aunt, and that is what I'll do. Yes, I will probably miss Thanksgiving because I'll be away in NY but that is OK if that's how it has to be. I will put off doing the coculture until the last minute as well. I was just really paralyzed trying to figure out how to pull everything off in October, and waiting until December and hence missing Christmas was not really an option either. Nor was waiting until 2008. So, November/December it is.

And in the meantime I will try to work hard at my job like a good girl, I will try to lose weight, and I'll try and snare me an acu man.

Yes? No? Now? Later?

The acu was no help in my decision making. At all. And it didn't help that he is so damn gorgeous and lovely and just plain nice that I want to be having his babies instead of the sperm donor's babies. Which makes me tempted to delay the IVF until November just so I can see if I have any chance of corrupting him before then. But it does make it hard to say "hey, EWCM!" when I know that that'll just cause me to blush horribly thinking what use I'd rather be making of my EWCM with him. I am bad, I am bad, I am bad to be thinking such thoughts. Although I do think he's single so it's not like I would really be corrupting him. Just a little. Maybe. I get the impression that he lives this pure buddhist lifestyle and is probably above all those things. Especially with someone who is a tad bit too chunky these days. He'd probably rather be with a skinny yogini or something.

But anyway, he says my pulses are responding well to treatment so he thinks October would be fine. Or November. And I don't think he'd have had any suggestions on the protocol so in the end I didn't ask what he thought about that. He's not all that up on IVF protocols, not being a fertility expert and all.

So I still haven't called to schedule anything and I'm still undecided. I thought I'd be gung-ho to do the next IVF, especially after my freaky good mood following the chemical. I'm even more happy about doing long lupron after mulling it some more. But strangely incapable of taking any action or making any real decision to go forward.

The differences

I emailed Dr. S. to make sure I understood exactly what the plan was, and there ARE some differences to IVF#4, so I'm slowly coming around.

Here are the differences:

1. It's at a different clinic: Big Clinic as opposed to Old Clinic. The lab is supposed to be top-notch at Big Clinic, and Big Clinic triggers earlier with smaller follicle sizes so as supposedly not to overmature the eggs.
2. I would be doing a 4+2 protocol of 4 follistim + 2 menopur, instead of a 3+3 protocol of 3 follistim + 3 menopur (I'd forgotten that IVF#4 was 3+3).
3. I would not do BCPs the cycle before the IVF. I would just start lupron 7 days after the +OPK in a natural cycle, whereas at Old Clinic I did BCPs and then started the lupron after 2 weeks of pills (I think).
4. I would be doing coculture for embryo quality.
5. I'm a year older (this is not a good difference, obviously).
6. I am no longer sneakily taking DHEA, which I was during IVF#4 albeit at a very low dose. Not sure if this is a good difference or a bad difference, but I tend to think that DHEA was bad for my egg quality, not good as some of the studies suggest.
7. I may use estrogen during the luteal phase, after transfer.

Umm, that's it. I'm going to discuss it with the acu this evening, and mull it some more. I think I probably will go ahead and do it, but maybe have another month off. I still wish I was happier about this, but perhaps that will come once I've decided to go ahead.

Stimulate, rinse, repeat

I had my post-IVF consultation yesterday. It did not leave me feeling happy and looking forward to my next cycle. Instead, it left me feeling frustrated, sad and lonely.

Dr. S. basically said that my embryo quality was excellent, so coculture definitely worked for me and we would do that again. OK, check, all in agreement so far. Then he said that I didn't have enough eggs, so in order to give me a better chance at a pregnancy that sticks, we need more eggs so that we have a greater chance of at least one of them being chromosomally normal. Check again, I would definitely be happy with more eggs. But then it started to go wrong. I asked about the random weird follicle growth of 6mm in one day, and he brushed it off as "it can happen" and "different people measure differently". I asked about doing a mixture of estrogen priming with microdose lupron, and he brushed that off, saying that estrogen priming hadn't worked well for me.

So, out of his ass it seems, he suggested long lupron. Que? Yes indeedy, I am the only poor responder ever in the history of the universe [OK, maybe a slight exaggeration] who has been put on poor responder protocols and then gone backwards to long lupron not once, but twice. My 4th IVF attempt was a long lupron protocol, and I was all excited to try it, thinking that it would fix my suppression problem. And it did, mostly. I had nice even follicle growth. But I had a crap fertilization rate, and although I had one good quality embryo I also had two very poor quality embryos. But he said I'd responded well to long lupron, and he liked the long lupron protocol, and that, seemingly, was that. Or I could try a cycle without suppression in the prior cycle, to which I responded that that didn't work for me. So he said, OK, long lupron. There was no budging the man.

Then I asked about stim dosages, because of the whole "my lead follicle grew 6mm in one day" fiasco, and he said, well, OK, we can reduce your dosage back down to 4 follistim + 2 menopur. Now, just wait a minute laddie, I was thinking. Don't just reduce the dosage because I effing ask a question about whether my dosage was a tad high. I asked him about this, he responded that I got fewer eggs at a higher dosage so it looked like I plateaued on the drugs and may as well go back down. I think he was beginning to get a bit annoyed with me because I started saying stuff like "are you sure you're not just saying that because I asked the question?"

So, not only does he want me to go back to long lupron, he wants me on exactly the same dosage as I was for cycle #4. I'm getting this strange sense of deja vu all over again. Where was the carefully individually tailored protocol? Where was the personal attention? It felt like he was just randomly throwing suggestions at me. You know, let's try this, let's try that.

I am supposed to call the scheduler, but I so don't want to. Not that it's really a question of whether I will cycle again at Big Clinic, I suppose. I promised myself one final try with my own eggs, and I am too lazy to try to find another clinic and go through all that rigmarole again. I am not ready to stop or move on to donor eggs or adoption. Not yet. I need a closure cycle. But I'm just not enthused about any of it right now. So I'm tempted to wait until November to cycle, instead of October. Just because. Although that could very well put me in NY for Thanksgiving, which will be highly annoying.

Some days, like now, I just wish I wasn't doing this alone. That I had a husband or partner to run all this by, to help me make decisions as to what's the best thing to do to move forward. Although I'm not kidding myself that a husband could very well have pulled the plug on IVF attempts several cycles ago, but at least I'd have a shoulder to cry on. It would also be nice if I could have a minuscule hope that this month's ovulation and next month's ovulation could maybe possibly get me knocked up naturally instead of being completely wasted. And I'd get to have sex every now and then. Sigh.