All the Embryos Stopped Growing

The end of the end.

The Fear

Right on cue, the fear is setting in. The fear that I will have no normal embryos and that will be that. I mean, I don't even know why I am stressing so much. I even had a nice dream last night about adopting, and being handed my child, and I woke up feeling like it was a lovely and perfect thing to do. And then my brain started churning, and by the time I was in the shower I was worked up that I'd let myself get optimistic over these embryos and that I'll probably have the rug pulled from under me.

I really am at peace with what happens. I am. I guess I am just invested in these embryos. I suppose that what I am at peace with is that, in 5 years time, I know I will have a good life. I will either be a mother somehow, or I won't, but whatever happens, life will turn out OK. It doesn't stop me hoping that this particular cycle works out. I'm sure it also won't stop me hoping that a particular adoption situation works out if I go down that route. You see the joy coming your way, and you want to grab onto it and get it here as quickly as possible.

So, there's a part of me that wishes I had just done a straight IVF this time, and had transferred my three good embyros. There's a part of me that got so excited about hearing the day 3 news that I started imagining at least one normal embryo, and a successful transfer, and pregnancy and....even having a real, live, healthy baby. And yet there's a big part of me that thinks that 70+ previous eggs (counting my IUI's) all being bad does not bode well for these ones. Especially as I did all those caffeine- and alcohol- related no-nos. I mean, sure, I was zen about them at the time, but now the fear is whispering in my ear that due to a cup of coffee I can't possibly have a decent egg this time. Which is crazy talk, I know. But since when has IVF not made anyone crazy?

Good news!!!!

Oh yay!!!! Happy talk, keep talking, happy talk...

The RE just called. They are biopsying all 7 embryos, as all of them are over 5 cells today.

Of the 7, 3 of them "score" well. LV Clinic scores by assigning numerical values at each stage of the process (details here) - basically anything above 70 is good. An embryo that scores a 100 is an 8-cell grade 1 according to the lingo that other clinics use. My top 3 have scores of 100, 95 and 75. AND, and, and, they did the embryo marker expression test, and the 100 and 95 embryos are marker POSITIVE. Basically, with a positive result then that embryo has twice the chance of producing a positive pregnancy test (for a given age) and there is half the likelihood of miscarriage.

The RE said he was VERY hopeful that this time we will have 1 or 2 normal ones. I never found out my scores or marker results last time as we only swapped voicemails on day 3 and he didn't volunteer any information (although I think he would have volunteered if the results had been good). Now, of course, you can have abnormal embryos that go on to produce pregnancies but end up miscarrying later (or result in Down syndrome children), so again, it's not an exact science. But what good news for the day!

I have a big grin...

Day 3

I am slowly catching up on sleep. Slowly catching up on work. And slowly getting to the bottom of the source of the funky smell in my kitchen.

My suitcase turned up yesterday afternoon, so I was able to be reunited with all the important things in life, like my conditioner and razor.

I gingerly stepped on the scale this morning, and am up 5 pounds. Hopefully 2 of those will drop away quickly as I'm hoping that'll be water weight. Which should leave me just 3 pounds to work off to get back to pre-IVF weight (plus the other, ooh, 43 or so from there). I am determined to get back to healthy eating - I actually missed it while I was away, although that could also be due to frustration at not having (m)any healthy vegetarian options available in the restaurants that were close to the hotel. And I'm pretty proud of myself for facing up to the weight issue this morning, rather than delaying weighing myself for another week as I was tempted to do.

Today is embryo day 3, and somehow I managed to leave my cellphone sitting at home. Which is great in that it'll be nicely charged when I unplug it, but not so great in that I was hoping for a call from the RE about how the embryos are doing. I have emailed and asked if he can call my work number instead, but am not entirely hopeful. Meh.

Fertilization report

Do you find yourself going through all the possible outcomes in an IVF cycle and telling yourself what the best result would be, what would be a good result, and what would be a respectable result.  And of course, the result below which you will not be happy.  Followed closely by shaking your head and saying to yourself "I can't hope for anything, I will be happy with whatever I get."

So, for example, on being told that you have X follicles, you might go into egg retrieval secretly hoping for X-2 eggs, although telling yourself that X-4 would still be just great, but anything above X-6 is fine, fine, fine.  And knowing that if it's X-10 or lower, you'll be pissed. And then feeling bad that some people don't have anywhere near that number of follicles, so anything above 1 should be considered to be a blessing.

I dunno, maybe it's just me.  But, after hearing the news that I had 9 eggs yesterday, I admit that I started thinking that the best that I could possibly hope for in my wildest dreams would be 7 embryos.  But 5 would be more normal for me.  And I've had 3 out of 9 before, so anything equal to or above 3 would be OK.   I try not to do this to myself.  And you would think that this cycle, when I'm actually at peace with whatever the outcome is, that I would definitely NOT do it.  But I still do/did.  I still run through all the possible scenarios, mentally torturing myself.

The RE just called.  I got my wildest dream for this many eggs, people!  7 out of 9 were mature, and all 7 fertilized normally!!  I have 7 embryos!  Hallelujah!  This is now equal to my previous best cycle, where I got 7 embryos out of 14 eggs retrieved (out of 20 follicles).  So to get 7 embryos out of 9 eggs retrieved (out of 16 follicles) is grrrreat news, as Tony the Tiger would say.  Yay!!

I am not a number, I am a free man

I am back from retrieval.  Finally.  The finally is only because the hotel shuttle bus wouldn't come early for me as they had an airport run to do, so I had to hang around for an extra hour.  But never fear, I filled my time (and face) having pizza, coffee and chocolate pudding from the hospital cafe.  Ahh, the breakfast of kings.

They retrieved 9 eggs, which is a tad disappointing, as I had more follicles than last time, yet fewer eggs.  Oh well, what really matters is if there's a normal one out of the bunch.  And 9 is still a respectable number, after all.  Besides, I'm not going to let the number get me down.  Que sera sera.

So that makes 14, 5, 9, 7, 14, 10 and 9 eggs retrieved for a grand total of 68.  Hey, that's the year I was born.  Maybe that's my lucky number?  But, that's enough for anyone, I think.  My ovaries have been prodded enough!  No more stims for me.  It is quite a relief, actually, to think that I'm finally done on that score.

I am a bit crampy but otherwise just dandy.  I'm going to try to snooze now, except that housekeeping has not yet come to clean my hotel room, so no doubt they'll interrupt just as I doze off.

IVF Musings

I triggered last night, and for the first time I am wondering if I did it right.  My first trigger cycle I think I did an HPT the next morning, just to check.  Then in IVF cycles both local clinic and NY clinic have you in for a blood draw the next morning, to check both estrogen and HCG.  So there was never any need to worry as there was always some sort of confirmation that I did the shot right.  And I've always had a fairly obvious reaction the next morning - nips at full attention, slight nausea, and just that weird slightly dizzy feeling.  Last cycle, I don't remember anything so I guess I didn't give it a second thought, but this time there is something...I don't know...wrong.  No nip reaction, no nausea, no nothing.  I mixed the meds carefully, like I always do.  I injected it carefully at precisely the right time.  No problem.  Except I keep grabbing the empty vial out of the trash just to check that a) it really was HCG, and b) that it is empty.  

I was going to post about how zen and at peace I am.  And I really am, fundamentally, happy and at peace.  It's a deep, deep contentment.  I am amazed that it is still here, so am hopeful that it is a permanent shift.  Thank you for your comments on my post mentioning child abuse, by the way.  They did really help me.  I kept looking for the meaning, but why should I?  I have moved past finding meaning in why I had to go through infertility.  It was just something that happened to me.  No rhyme or reason that I can see.  Just, on the face of it, random chance.  We just have to work with the cards that we are dealt.  So why should I look for a reason for child abuse?  I shouldn't, and I don't have to.  It is something bad that happens to people, that causes suffering.  I shouldn't look for some deeper meaning than that, but should just hope that at least some of the victims can find peace.

But anyway, I also need to learn that being at peace with what is happening in my life doesn't mean that I'm not going to worry about whether I did the trigger shot correctly!  It doesn't remove everything - after all, I still have to function in society, and if that means checking that I turned the gas stove off, then that's an appropriate thing to check.  You can't drift through life blithely assuming that you don't have to look when crossing the road, because you'll only die when you're meant to!  There is a need for basic common sense, after all.

I also wanted to post about the things I have done differently this IVF cycle.  Given that I decided that it will either work or it won't, and I don't have any control over that, AND that if the doctors say my issues are due to chromosomal damage/aging, I decided that having a cup of coffee in the last week is not really going to change anything (and thanks to Margie for that realization too).  So, so far I have kept drinking alcohol - pretty steadily during lupron/estrogen priming, and since starting stims I have had 1 beer, 1.5 glasses of wine, and 1.5 rum & cokes.  I haven't gone crazy, but I haven't stopped completely - after all, when you walk into a restaurant for dinner and they are having a rum promotion and offering as many free rum & cokes as you'd like to drink, it's rather churlish to refuse, no?  I have also been drinking coffee.  In fact, this week I have had two cups a day of the caffeinated stuff, and on some days I have had a decaf coffee as well.  Well, you can't make a good cup of tea without the proper equipment, and an English girl needs good tea or no tea at all!  Besides, there's a coffee shop opposite LV clinic that serves Illy coffee, and that's my favoritest coffee evah, so I couldn't resist.  I have also had diet cokes, which is something I don't normally drink any more.  But, you know, it is hot in Vegas and a nice, ice cold coke sometimes does the trick better than anything else.  Oh, I sat in a hot tub briefly the other day (what?  I was cold when I got out of the pool, yes, even in Vegas).  There's been chocolate.  A packet of doritos.  Chewing gum.  Chemicals galore.  I had a pedicure yesterday, which was lovely.  I have kept up with my Chinese herbs instead of dropping them during stims, as they aren't supposed to interact, and I figure I will need building back up again after ER.  I have been quite sporadic with the prenatals.  And probably a few other things that I am forgetting to mention.  And so far, I've had a good response to the meds, so none of that has made a difference, except made me feel more relaxed about shit.  And, I'm not going to beat myself up for drinking coffee if this cycle doesn't work, because I avoided it every other cycle, and those didn't work either.

Oh, hey, just a brief mention of another first for me - I shot up last Friday on the plane.  While in the air.  After going through some turbulence (but thankfully not while going through some turbulence!).  I am the injection queen!  I have no fear! OK, so I only did the follistim because it's super easy with the pen, and waited until I landed before doing my other shots, but hey.  So now I've shot up in the back of a moving car, and in a moving plane.  And plenty of public bathrooms.  It's probably a good thing that I'm stopping treatment now, because no doubt I'd have to shoot up on a rollercoaster next, just to show that I could.

No, just fat

Trigger tonight, ER on Saturday.  It's all good.

Today he counted 16 follicles, however I think he said 11 were of a good size.  Not coincidentally, that's the same number of follicles he counted in the first scan.  Which just goes to show that there's no point getting excited about additional follicles that pop up as the cycle goes on because they can't catch up fast enough.  But hey, last cycle we retrieved 10 eggs, so 11 will definitely be a better result.  And if maybe he can suck out 12 or 13, so much the better.  Although, frankly at this point, ANY eggs retrieved is a good result so I won't mind whatever the number is.  It really all does come down to the chromosomes, and 1 normal egg out of 1 is really the same result as 1 normal egg out of 20.

I was talking to a woman in the waiting room who had given me the evil eye on Monday.  I couldn't quite work out then if she was reacting to the lack of a wedding ring on my finger or my poofy belly, as they were both in kind of the same area that she was staring at.  Turns out it was the belly, as she said today that she thought I was pregnant.  So not for the first time in this IF journey I was forced to say "no, just fat".  I did add "and bloated from the meds" to which she agreed that she, too, was bloated from the meds.  Uh-huh.  So you're sitting in an IVF clinic, bloated, and a woman comes in on her own for an appointment and you think the poofy belly is not stims bloat but rather pregnancy?  I know, I know, logic doesn't really get a look-in when we're in the midst of infertility angst, but really.

Anyway, I think we're both doing retrieval on Saturday and she was very nice so we wished each other lots of luck and had quite a nice conversation.  After she knew I wasn't pregnant, that is.

Numbers, numbers

As usual in an IVF cycle, I have been dwelling on numbers.  Do you know, if I count the FET and the cycle that got cancelled on CD2 for a cyst, I have started 10 IVF cycles?  And I started 10 IUI cycles too.  Strange symmetry there.

I completed 8 IUI cycles, as two got cancelled due to early ovulation.  One IVF cycle didn't make it out of the starting gate due to the monster cyst (although of course I'd already done a cycle of suppression and estrogen priming at that point), and one got converted at trigger to an IUI because of a poor response, so that makes 8 IVF cycles completed if I count the present one.  More symmetry.  

This egg retrieval will be number 7, and I have done 6 transfers.  I wonder if I will get to do a 7th transfer?  Maybe 7 will be my lucky number.

The news this morning is that the RE counted 15 follicles.  15!  They range in size from 12mm to 19mm.  Of course, the 12mm guys are very unlikely to produce mature eggs, but if he can retrieve all 15 that'll be my best response yet, as my previous best was 14 eggs.  I am going to continue on stims for another day, and go back for a look-see tomorrow, but it looks very likely that I will trigger tomorrow for retrieval on Saturday.

I had actually run out of ganirelix and luveris, but the clinic very kindly gave me some donations of those this morning, so now I am good for another day.  I have to say that I am liking LV clinic more and more.  I appreciate that they are very laid back and that there are fewer blood draws and ultrasounds than other clinics.  I appreciate that they appreciate the costs involved in all this stuff, and do their best to keep the costs down.  I appreciate that they do some outside the box thinking and experimenting, even if it doesn't always turn out perfectly.  At least they try.

Las Vegas: not exactly set up for pedestrians

I am here in Las Vegas.  It's IVF a-go-go.

I've got to say my weekend was fantastic.  I am so so in awe of how much things have changed for me all of a sudden.  I just had so much fun playing with the babies and NO bitter jealousy at all.  Wow.  In fact, as I was sitting at the airport waiting for my (delayed) plane on to LV, I started weeping tears of joy and gratitude as I was listening to groovy songs on the old ipod and thinking back over the last 5 days.  So if you were in a certain airport on Sunday night, and saw some girl with a goofy grin on her face, purple earphones and a purple handbag (oh yes I did buy purple earphones), and tears rolling down her cheeks, that was me.  I promise they were happy tears.  Because I am, finally, fundamentally happy with my lot.

And thank you all so much for the kind comments.  I used to believe that it wasn't possible to reach peace with infertility.  But it is, trust me.  If you are struggling right now, oh I know how it is.  I was there for the longest time.  And part of me will stay there with you.  But there can be a way through and a way out.  I am so lucky to have found it.  SO lucky, I know.

I'm staying at the hotel down the street from the new swank LV clinic location.  Last time I was a block away, and yet had rented a car that cost me a fortune.  As I walked to the clinic every day and hardly went anywhere else due to stims bloat and tiredness, it seemed like a massive waste of money to have a car.  So I figured I'd see how it went this time without one.  Except that it's 105 degrees and the clinic is 1.1 miles from the hotel this time so it's a tad bit harder to get by.  

Actually the walk wasn't too bad.  Have floppy sunhat, will travel, and all that.  It helps that I live somewhere pretty darn hot too, so I'm used to it. The snag was getting lunch afterwards.  I'd noticed a big group of restaurants on the other side of the street, a little way back from the hotel.  In the other direction from the clinic.  So I walked 1.1 miles to get wanded, crossed the street at the nice pedestrian friendly traffic light up there, and walked 1.2(ish) miles back for lunch.  And then couldn't cross the effing street to get back to the hotel.  The closest lights had big "no pedestrian" signs everywhere, to prevent people crossing the street there.  Then there was some big freeway junction that I didn't fancy walking over either.  The next set of lights back in the direction of the clinic were at least a quarter of a mile away. At least.  If not a half a mile.  And with four lanes in each direction of speeding traffic coming at me, and no median/island in the middle.  Except for one teeny bit of curb at a point a little way off.  I dithered for a long time about jaywalking when I got level with the median.  No break in the traffic was forthcoming, so I gave up and walked off towards the traffic lights again.  Which seemed to be receding further and further into the distance.  And then there was a huge gap in traffic.  But no median.  So I thought "bugger this" and walked back to where the median was, figuring if I got arrested I'd give the cops a piece of my mind about how the setup practically forces pedestrians to take their lives in their hands.  No gap in traffic so I stood there like an idiot for an age.  I dithered again, and almost set off again towards the lights when a good jaywalking opportunity finally opened up so I darted across.

Ridiculous, I tell you.  They actually have nice sidewalks which have a little curvy, winding path with plants on either side, very good for walking along.  Apart from the vacant lots where you have to walk over gravel.  But there is no way to get from the sidewalks to the shops or offices, so you have to walk over the flower beds to get there, or go around to the parking lot entrance.  And no way to cross the damn road for almost a fucking mile in either direction.  It's like the city was built by people with no concept of why anyone would want to be on the nice pretty sidewalks.  And the crazy thing?  I was by no means the only pedestrian, as you might have imagined, despite it being so hot.  I tell ya, I would be writing angry letters to the local paper if I lived here.  Not that anyone would care.  But use your brains, city planners, use your effing brains.  It's a bus route too, so I thought of taking the bus when I go back, but then I'd have the street crossing issue again.  I guess I might be ordering in for dinner. 

OK, on to the clinic.  The new location is much MUCH swanker and nicer than the old one.  Except they kept some of the old pink stuff from the vagina palace and I guess felt the need to match the decor to the pink exam tables.  But fear not, they didn't go back into the 80's again, but went with peach, brown and cream decor.  Still not exactly my cup of tea, but much better than the floor to ceiling pink they had previously.

The RE pronounced that I have 11 follicles, ranging in size from 11mm to 16mm.  He said he didn't think the 11's (or even the 12's) would catch up but we'll see what's going on on Wednesday and decide whether to trigger then or if we'll push it until Thursday.  If there's only one or two out in front, I think I will push to go an extra day in the hopes that the rest will catch up.  But we'll see.  Dr. F. doesn't know about my super fast follicle growth that can happen, so I have some hope for the smaller guys.

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Just want to say that I am not an internet genius, so if you post a comment asking a question, but don't include an email address or have a blog where I can post you a comment in return, it's hard for me to answer because I can't track you down.  I guess I could answer in posts, but my blog is disjointed enough as it is!  I also don't particularly want to publish my email address for the world to see because after all some people think that SMC's are the spawn of the devil for wanting to reproduce without a husband, so you don't know which crackpots will want to send me nice messages.

But OK, I'll try answering some questions.  1.  I think endometrial coculture can be a good option, but frankly if the eggs are chromosomally bad, will it help?  I don't think so.  Coculture gave me pretty embryos, but no pregnancy.  I don't think it can change fundamentally bad eggs.  2.  I live on the east coast of FL, not the west coast, so don't know about RE's over there.   3.  I already have a modeling contract, thanks, so don't need an agent right now, although I think I could squeeze in a multimillion dollar cosmetic campaign if you really want me. *

*OK, so one of those answers is to a hypothetical question.  I bet you can't guess which one.

Why is it...

...that my life seems to explode into craziness the minute I start stims? So much for remaining calm and zen and doing that famous "just relax" crap. Now, OK, part of the craziness is I'm sure due to having to be out of town for my cycle, and the extra preparation and planning that that involves. But there always just seems to be random craziness on top.

Case in point - work. They fired two people on Monday, and another person quit. Yesterday I was asked if I could take on additional responsibilities, so I felt the need to tell the person that wanted to give me more stuff that I wanted to go part time. Which forced me to immediately go and reveal my plans to the big boss. Without my usual preparation of what I should say, or how I should argue things, and not knowing if it was even possible. And then the big boss told me he already knew all about my plans. I have a suspect in mind of who must have told him, which is annoying but I should never have told that person in the first place as I knew she could not be relied on for secrecy. However, she's supposed to be a friend, and would definitely have been offended if she hadn't known in advance. It's complicated. But really, the big boss could have had the class to put on an act that it was a surprise rather than just leer at me that "there are no secrets here". Ugh. The man's an ass. Anyway, at least I think the person who quit helped me out, because he was amenable to me working 3 days a week, though has to clear it with the bigger bosses. And we have to figure out the whole benefits/office thing. As I would be working less than 30 hours a week, apparently I no longer qualify for an office, health insurance or an administrative assistant. Not that the office matters, as so many people have left that there are plenty of empty ones so the big boss said I can just hang out where I am until the place fills up again, but I will need to clear my personal crap out of it so that it can be a guest office on days I am not in. And not that the admin assistant matters either, because I share and never get any of their time anyway. But health insurance is a wrinkle, even though I knew it was probably on the cards. Hopefully they will let me stay in the group plan but let me pay the group rate - they must have other part timers working less than 30 hours. Anyway, I will shop around for an individual plan too. Haha, and you know that because getting pregnant would really be a problem right about now due to shopping for health insurance, that there's a part of me thinking that this is the one that will finally work. Of course, being as I'm doing CGH again I'm not actually doing the transfer this time, so I can get the insurance in place before doing that IF there's a normal embryo. Which is a really fucking big 'if' as we all know.

Oh, and I had an appointment at the community college yesterday, and the advisor told me I need to take 5 classes, and do the math placement test in addition to the English placement tests. Even though I am not doing any math, but apparently to get the general education credits I need it. Or something. I looked at a sample test and didn't have a freakin' clue. So I will be studying math while in Vegas so I can take the placement test when I get back. Joy joy joy.

So all in all it was a very stressful day. And of course one of my work buddies wanted to go out last night to discuss how much of a miracle it was that I didn't get fired, as he was convinced that that was on the cards for me, due to my previous slacking. So I did, and I had a beer even though I started stims and shouldn't have. But really, I have avoided alcohol like a good girl on every previous cycle and none of them have worked, so I have lost the will to be the perfect IVF patient. I just had one, and it was gooood. And needed, after the day I had.

The newbie

I went for my baseline u/s today, even though Aunt Flo hasn't made her appearance yet. I guess normally the baseline would have been on Monday, and what with the holiday and all, it got switched. Seeing as all they are doing is checking for cysts, I guess the actual timing doesn't really matter all that much.

But oh dear oh dear oh dear. The normal u/s technician at Local Clinic was off today. Normally that would be a good thing, because she always has to comment about how gassy I am and tsk and tut like I deliberately filled up on beans just to annoy her. And I did have a nice meal of lentils and brown rice last night, so this could have been a day for plenty of gas-related discussion. But she got the day off. And they got a temp in. Who is a new u/s tech. And I don't mean new as in "new to them", I mean, new to the job. A fresh graduate. Doesn't know what the fuck she is doing new.

So, being as she was as slow as molasses, I didn't even get in to see her until about 10.10 this morning. When my appointment was for 8.30. And I'd had my blood drawn so long ago, the needle stick had healed and grown fresh skin. In fact, I think I acquired a couple more freckles on my arm as well, and a few extra wrinkles around my eyes, it took that long. So I was not in the best of moods when I got in there. Then she couldn't understand the whole "yes, I go to a different clinic, but I come here for local monitoring" concept, so that took some time to explain. Then she left the room while I went to pee, and left the wrong screen up on the computer, showing me everybody's full names, and breaking who knows how many HIPAA rules. (Or is it HIPPA? HIPPAA? Whatever). Then she didn't come back in the room in forevah. I felt like going out there in my paper drape and asking her to get the fuck on with it. I mean, I don't know how much privacy she thinks we need to get on the table, but the other tech just stays in the room so that she can get going as soon as we're ready. There is a changing area with a curtain, after all.

But we finally got started. And she wielded the u/s probe like a teenage boy wielding his dick. In other words, like she was a blind person operating a battering ram. Luckily she gooped it up with so much lube that it finally slid towards the right opening, although I admit to being worried for my urethra for a while there. And then there was silence. She rotated the wand around a bit, staring intently at the screen. More silence. More gyrations of the wand. After a few minutes of this, I offered to press down on my belly if that would help her find my ovary. She said she'd found the right one, but was trying to get a pretty picture. I felt like telling her that nobody's gotten a pretty ovary picture out of me yet, what with the gassiness, but I kept quiet. Another age went by. I again offered to press down on my belly. Stand on my head. Anything. And she finally started counting, and pressed the button to generate a print. I think she counted to 7, but it could have been 6. She certainly didn't share the information with me, but as it was all far too much to do without having to count semi out-loud, I was able to read her lips for the information.

Then we went searching for lefty. Infamous lefty. The ovary that has been left out of numerous ultrasounds. That was even left out of an entire egg retrieval because it had swum up to nestle somewhere near my diaphragm and the RE didn't have a needle long enough to reach it, even with a nurse pressing her full weight on my belly. So, newbie tech hunted for a while. She rotated that wand like she wanted to carve me a new va-jay-jay because mine wasn't quite big enough. I tried offering helpful hints like "it's high up and over to the left", and "let me just press down on my belly to move it for you", but she refused the belly push. Instead she got up, and said she was going to try to move my bowel out of the way, so started trying to almost grab a section of bowel and push it sideways. Needless to say, that didn't work. She asked if anyone had ever used a transabdominal ultrasound to find it. I said no. Cruelly. Well, it is true but I guess I could have told her that other techs have just given up and said that if I had a cyst they'd be able to see the ovary so they just hoped it was all fine. I just didn't trust her to make such a judgement call. She dithered over getting the transabdominal attachment out. There was more rotating of the wand. I think my poor vag got more action today than it has in a very long time. It was certainly getting sore by this point.

In the end I lost patience, and just used both hands and pressed down hard exactly where I know I need to press down to make the darn ovary show up. And what do you know? She was suddenly able to find it. Who'd have thought? That I could help her find my own ovary? She counted six follicles. No cysts.

Finally I was free to go. I had so much goop everywhere, including half way down my legs, that it took me an age to clean up. I checked out of the clinic at 10.30. Two freakin' hours!! I told the receptionist that the u/s tech really needs to speed up, and she chirpily told me that the tech was only here today. Great. So, the one day out of, what, 4 months, that I need an u/s, I get the freakin' newbie. On the only day that she's there.

So, anyway, that's that. I am good to go for this cycle, assuming my estrogen is nice and low. Yippee-ay-yay.

The end of pills

Tonight I will take my last BCP. Possibly ever. I can't imagine myself ever using it again for contraception. Hahahaha, excuse me while I laugh maniacally at the thought of contraception. All there will be on that score will be disease-prevention methods until I can persuade any boyfriend to give TTC the old college try, after fully explaining the miserable odds of success and having "the talk" about what nasty microbes we might each be carrying. Assuming I manage to acquire a boyfriend before menopause, that is. Although I suppose the plan will be the same after menopause, but obviously there'll be no need to have the TTC/odds of success chitchat. I also can't imagine using it for regulating periods/acne/PMS/whatever. I think I'd rather go au naturel on that score from now on. I've taken more than enough hormones for a lifetime, so I would like to just let them do their own thing. Besides, now I'm hitting the big four-oh this year I figure I don't need the added blood clot risk. Besides besides, if one attends acupuncture school, presumably one figures out how to make oneself all healthy by sticking needles in oneself.

So, there we are. Unless I actually have normal embryos, and need to take BCP to get ready for the frozen transfer, I will be done with them.

It's crept up on me - just like starting lupron on Friday. I am just so not focussed on this IVF at all. In fact, that's kind of nice. Although I will probably forget a med one of these days and then have a panic attack, but assuming I can keep managing to check the calendar daily, I think I should be good. After all, one gets into an IVF routine, so a lot of it can go on auto pilot at this stage.

The lupron is going OK so far. I haven't wanted to kill anyone yet, so that's always a bonus. And I think I get to drop to a half dose tomorrow, so that's even better.

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Thanks for the comments and emails on loans, by the way. I have got it (mostly) straight in my head now, so that's one less thing to worry about. Phew.

I hate NY Clinic, part 2

NY Clinic had me in tears this morning over this stupid billing stuff. They are just so uncaring and bureaucratic. Apparently I do owe the money. Great, just what I need right now when I'm completely panicked about money and trying to pay for this last cycle while in danger of being fired and trying to figure out how on earth I am going to pay for college. Overextended much? If they'd have effing taken the money in November I probably wouldn't have noticed it, and it wouldn't have caused me palpitations. But nooo, just send me random bills six months later, why don't you? Gah, I really shouldn't have signed up for this last cycle. I really shouldn't have.

It turns out that for my July cycle, they included the anesthesia fee in the IVF fee that I paid. They didn't in November. Why? I have no frickin' idea. Apparently the anesthesia fee is $750 on top of the hospital fee of $1005. I was not aware of the subtle difference, before because I am not up on the intricacies of how the damn hospital in NY is run. Which their billing department seem to think that all patients should know intimately and therefore immediately understand when they huff and sigh and say "that wasn't for anesthesia". Anyway, as to why this fee was not included when I paid the IVF cycle fee, they just said that I have the choice to pay in advance or have them try to claim from insurance. So they assume that I opted not to pay in advance. I do not recall being offered this choice, and if I was, I'd have certainly paid in advance because I know my insurance only too well. Likewise with the coculture fee. I'd rather get a reimbursement later than be stuck with a bill for an IVF cycle that failed. Maybe it'd be OK if I was now six months pregnant, but I'm not, and those bills really sting. Especially when they are uncaring about the whole thing.

Not that they explained the whole "choice" thing that well. I had to dig through my old receipts and put those together with the scant information that I was offered and figure it out for myself.

At least my insurance company did cover some of it. At least it's only about $300 and not the full $1000. At least there's that. And I may be able to figure out a way to stay in Vegas for the cycle without renting a car, so hopefully I can save the money that way. It'll involve lots of walking and shuttle bussing but I think I can do it.

Oh, and in other news, I started lupron this morning. That totally crept up on me. I was sitting there last night watching TV and I suddenly had a thought of "wait!! Lupron starts tomorrow!" I'd even told the acu earlier in the day that I start lupron on Friday but I think I was thinking that it was Tuesday or something, because Friday seemed to be a long way off and certainly not the next morning. So there we are. Now lupron on top of the other stresses.

ETA: Oh! I just realized that we get three paychecks this month. I'm paid every two weeks which means 26 paychecks a year, and means that two months out of the year I manage to get 3 paychecks. Which is awesome, but the months vary so I'm never quite sure when it is. Not only do I budget for 2 paychecks in a month, but some things they only take out of 24 paychecks so that 3rd check is actually bigger than normal. Can't remember what, but it might be the medical account thing and/or insurance stuff. Anyway, phew, phew, phew. The money might work out after all. That makes me feel so much better.

Panic at the disco

Still battling with the various NY billing departments. I suspect it'll be an ongoing theme of the next few months.

Anyhoo, my meds arrived yesterday. So I waited in for them, even though I am in SO much trouble at work for slacking off (that's a whole other post of its own but I'll save that for another day). I really shouldn't be staying home, but, you know, meds are important.

So they arrived at about 10.15. I ripped open the box and was horrified to find nine boxes of follistim. Nine. You see, thanks to some absolutely wonderful bloggging angels, I am the very proud and very thankful recipient of some donations, after my little whine fest the other week. I was able to get some follistim and ganirelix. And you know who you are ladies, but I feel the need to say THANK YOU again. Thank you, thank you, thank you. OK, so, while nine boxes was the original amount on the prescription, when I had ordered the meds, I'd specified the amount of follistim I needed, which was a lot less than nine, and the amount of ganirelix and told them that I didn't need any needles or syringes. This particular pharmacy charges for needles and syringes, and as I have enough to equip a small hospital, I didn't see the point of paying more money just to have exactly the right sized stuff that the RE thinks I need. Even if I have to use a 10ml syringe to measure out 0.2ml, or use an 18 guage mixing needle to stick myself with, I am going to save cash, damn it. Right, so, anyway, they got the ganirelix and needle/syringe instructions correct, but sent the full $4000+ amount of follistim. Despite me fucking triple checking with them on the phone, and sounding like an ass for being so paranoid. Wankers.

I have never dialed a phone so quick in my life.

I must admit, the girl on the other end of the phone was very nice, and didn't seem to mind that I was hyperventilating so much that I was practically heavy breathing. She apologized for the error and said she'd arrange for FedEx to come back and pick up the box, and I'd just have to repackage the follistim I didn't need, send it back and they'd credit me for it. Luckily I have so many cool packs in my freezer from previous IVF meds shipments that I have plenty on hand for just such emergencies. She put me on hold while she spoke to FedEx, and then came back and said they could only give me a four hour window of time in which they could come by the house. Now, in a normal, rational state of mind, I'd have just said "eff that, I'll drive to a FedEx dropoff location" but in my panicked state, all I could think about was getting fired for missing more work, and what was I going to do, oh woe is me. So I whined a bit about not having enough time to hang around the house for four hours and sounded suitably pathetic, until the girl on the phone said "hey, well, do you have time to drive to a FedEx dropoff location?"

Uh, duh. Yes!

So she gave me their FedEx account number, and I shot out the front door with the box o' repackaged meds under my arm so fast I'm lucky I was able to remember to grab my handbag on the way. And off it went. I was able to get to work by 11, so it wasn't so bad after all.

It's funny how if I buy a pair of shoes on the internet and they don't fit well that I slack so much that I never end up returning them and they spend their lives gathering dust in my closet before being donated to Goodwill. But an overcharge of $2500 or so puts a rocket under my arse like nobody's business.

Grudgingly getting on the cycle again

I have finally ordered my meds. I have been such a slacker this time around. I think it was because if I spent money, it would be confirmation that I really was going to do this. This pointless, waste of money, bad idea, I should have stopped treatment already, cycle.

But if I am going to do it, I need to start lupron on Friday, so I thought it was about time I got off my arse and put my money where my mouth is.

I still haven't booked flights or the hotel yet. I did check some travel websites at the weekend, but I was paralyzed with indecision and disgust at spending the money, so I postponed it again.

Sigh.

Maybe this weekend...

The money thing

I am tying myself up in knots over money these days, and I don't like it!

When I first starting this trying to conceive business, I'm not going to lie, I was quite comfortably off. I was rich, I suppose you could say, although not super rich. Not even alternative minimum tax rich. But I had more than enough for my needs. I have a well paying job, and I have always lived below my means and been a saver. Therefore, I had quite a large cushion of cash saved up. I imagined that cushion of cash enabling me to have an au pair for a year or two after the birth of my child. I imagined fully funding a pre-paid college fund. I imagined being able to take vacations to Europe as the child got older. I imagined buying a nice new, safe car like a Volvo. I imagined doing some work on the house to add on a bathroom. All of those things. I imagined not having to worry about money even though having a child on my own would be expensive.

And then the trying part of the trying to conceive thing got very...trying. Time dragged on. Procedures got more and more complicated and expenses piled up. I hated it, but what can you do? I was at least lucky enough to have savings. I didn't have to forego treatment because of a lack of money. I knew I was SO very lucky on that score. But now here I am. Over three years and so much money later I don't even want to admit it to you. I will own up to it being six figures. I am pretty much out of savings, although have a little bit scattered here and there. More importantly, infertility has changed me. I am not the same person as I used to be, and having a career is no longer so important. I want to be able to help others. I want to have balance and meaning in my life. So I hatched this crazy plan to go to acupuncture school. So I can help other infertile women NOT go through what I have gone through.

But the thing is, it's a three year full time program. And it's an hour away from where I live. And they say that classes could be any time Monday - Saturday because a lot of the faculty also have their own practices, so it's not even going to be easy to arrange part time work when I am attending school as I will only know right at the start of the semester what my schedule is going to be like. The property market has gone down the toilet, so I may not even be able to free up equity in my house while moving closer to school. I'm looking at a six figure student loan at this point, coincidentally or not about the same amount of money as I've paid out in infertility treatment. Hopefully my current employer will keep me on for 8 hours a week, which I can do mostly at home so I can fit in an hour or two here and there around classes. But I'm seriously stressed about the money situation. I have not been able to save much since deciding to do this, because a large chunk of my disposable cash goes towards feeding my flexible spending account. That I used to pay for an IVF cycle.

And then there's this final cycle. Which a large part of me thinks is completely pointless. But which I know I need to do for final closure and mental health reasons. I can't move on until I know that there's absolutely no hope left. There wasn't supposed to be a clinic fee because I paid for the two-cycle plan. But there is. Let's not use the words "bait and switch" but let's just say it crosses my mind on a regular basis. It is going to cost me about the same as an FET cycle. There is plane fare, hotel costs, rental car costs. And then the drugs. Oh my god, the drugs. I spoke to the pharmacy yesterday, and they told me that the follistim alone was going to be over $4000. Over $4000! I about had a heart attack. I mean, I knew that I was going to be taking a lot of stims, but criminy.

Thankfully, due to some blogging angels, after I sent one email whining about money to the biggest angel of them all, I may be getting some donations so I may have about half the follistim covered. And I thank you ALL from the bottom of my heart. Seriously, you have no idea (well, you probably do) how much this means to me.

And the RE says...

...that follistim is more potent than gonal-f, so I have been provided with the correct dosage of 625 iU. Hmmm. Well, I suppose all those times I was using both, I messed the dosing up. Oh well, it didn't seem to do any harm.

I don't really care, to be honest. At least a lower dose means a slight reduction in drug expenditure. And I don't think dosage matters at this point. I have no hope whatsoever about this cycle working, and am really resenting spending the money on it. I should have stopped by now. I mean, I shouldn't, because I would always think "what if" and so for my future mental health I know I need to do it. But I should have stopped. Because it isn't going to work and I am just throwing good money after bad.

Are gonal-f and follistim interchangeable?

Internet experts out there - what have you been told about gonal-f and follistim?

The reason I ask is that my medication calendar shows me as being on 625 units of follistim. I questioned it with the nurse, who told me that the dosing for follistim and gonal-f are different, and that 625 iU of follistim is equivalent to 750 iU of gonal-f.

I don't believe her. Previous RE's have said that they're completely interchangeable. In fact, I have been interchanging them for the last three cycles due to left overs, donations and uh, grey market purchases.

I've emailed the RE, as something doesn't seem right here. But in the meantime, what is your take on this? Are they one-for-one or different?

Prepare for ovary blast off

So, I spoke to the RE. Half an hour late - what IS it with docs and their inability to stick to a schedule?

We went over the cycle, and we were both actually happy with how the cycle had gone. Apart from the end result, obviously. Stimulation was nice and even, I got a reasonable number of eggs, the embryos looked good and did well getting to blastocyst, blah blah blah. They just sucked, chromosomally speaking. He thinks it's totally possible I could get a normal one, though, so he thinks all hope is not lost. He said one woman on the cycle got pregnant from one embryo, so he only needs one good one to work with. So when he suggested not changing much, I wasn't surprised. And unlike on previous occasions when docs have suggested not changing things, I wasn't unhappy at that.

We are, however, going to change very minor things. For one, I am switching back from gonal-f to follistim. He said he has a marginal preference for follistim. I didn't tell him that I actually did half-and-half because I had some leftover follistim, but whatevs. Then I am going to be on their highest stim dose. And when I say highest stim dose, I mean a truly, phenomally giant amount of stims. Oh yes, your average RE may say that the absolute maximum dose of stims is 600 iu, usually formed of a maxium dose of follistim or gonal-f of 450 iu plus some menopur or repronex. They may say that you can't possibly go higher than this. But I shall. I shall be on 750 iu of follistim per day. If that doesn't blast my ovaries into submission, I don't know what will. And we'll add lh in increasing amounts as we get closer to trigger. I said "so, clearly you don't subscribe to the theory that increasing stim dosage is actually bad for egg quality then?" and he said "no, I think the body just wastes what it doesn't use". Okee-dokee.

And that's it. He said we may push trigger for an extra day. We may try to do two vials of lh on the last day of stims.

We briefly discussed doing CGH again, and I said to sign me up. I think I'd rather know in advance than go through the 2ww praying and hoping and dealing with progesterone issues.

All in all, it was pretty much what I expected. And that's fine by me.