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She heard the heartbeat last week and they’re officially out of the first trimester. Nothing better than hearing a friend talk about how nothing tasted good and how she had to go out and buy new bras since the girls were getting too big while you’re busy bleeding through a super plus tampon from your second failed IVF.
I love you Chardonnay (actually, I don’t really love Chardonnay at all, it’s just the only white wine they had on special today).
Alright, enough moping. Moving on with life.
Tonight is Girls Night Out at the Melting Pot with a couple of my friends from high school. We aren’t super close anymore, but try to get together once a month or so to catch up and keep in touch. While I should be looking forward to yummy fondue (yeah, that “you can’t eat anything that tastes good” diet of mine is out the window!!!) and good times with my friends, I have a hunch that one of them is going to announce her pregnancy tonight. The cryptic Facebook status updates and her calling up out of the blue to request we get together for dinner has me convinced she has news for us.
This particular friend told us in early 2008 that she and her husband were going to start trying one month after they got married, which was in June. We found out in November that she had been pregnant, but sadly had a missed miscarriage. When she told us about the miscarriage, which was when she first told us about the pregnancy at all, she said that they would start trying again as soon as they could. I knew it was only a matter of time before she got pregnant again, though I kept telling myself that by the time she was pregnant again, I would be pregnant too. Well we all know how well my plan to get pregnant has gone. Two IVF cycles after she announced her miscarriage and I’m still not there yet.
Anyway, the thought of her announcing her pregnancy makes my stomach turn. As I’m sure most who have struggled with infertility can relate to, pregnancy announcements are not something I look forward to. I hate that other people can so easily achieve what I’ve been trying to do for over two years. I hate that they get to experience things that I can only dream of. I hate that I’m being left behind by my own dreams, hopes and desires. I hate that I’m powerless to change my own situation.
Of course I will be happy for her, but at the same time I know that I will be absolutely miserable for myself. This announcement will bring to the surface all of the unhealthy emotions of anxiety, envy, stress, jealousy and unfairness that I have been trying to eliminate from my daily existence. Those are things that I still haven’t figured out how to successfully deal with in a rational manner. Who am I kidding? I haven’t even figured out how to deal with them in an irrational matter. My initial reaction is to avoid the situation, but that won’t get me anywhere. I can’t avoid reality forever. Mark pointed out that she’s probably less than three months along at this point, so she likely won’t even look pregnant yet, which is helpful. It will be infinitely more difficult for me to handle as the months go by and she gets bigger and bigger. For some reason, it’s the pregnancy itself which is the most painful thing for me to endure. Once the baby is born, things become easier for me to handle again. I guess maybe it’s just because I so passionately want to experience pregnancy. To watch others experience what I’ve been waiting for for so long is such a struggle for me.
And it makes me feel like such an asshole for feeling the way I do. But I just can’t help it.
Thank god for drink specials for Girls Night Out…I’m going to need it.
Thank you all for your wonderful comments; it’s always nice to know that there are people rooting for you and wishing you the best when you’re feeling down.
My beta was supposed to be either today or tomorrow, but I went for my blood draw on Thursday since I knew I wasn’t pregnant and didn’t want to continue the PIO shots until Monday. My nurse called back in the afternoon and I was going to just let it ring through to voicemail, but Mark said I should pick it up, so I did. As it turns out, I was glad that I did. She was really sweet and said that my beta was negative and I told her that I knew it would be. She said she always holds out hope even if the patient is testing negative. She was very reassuring and told me not to lose hope. She said my doctor has lots of “tricks up his sleeves” and has already been thinking about me and what we will do next. That was a small pick-me-up and definitely helped me to close the book on this cycle and move on emotionally.
So as seems to be our pattern after a failed cycle, we ran away. We decided to head to Indiana where my sister lives and spend some time with her and my parents who were also visiting. We took advantage of the great state forests and parks near her house to do some geocaching and mountain biking, which was a much needed distraction. Being out in the beautiful spring air and getting some exercise was a much needed change of pace.
So where we go from here? It’s a good question. When the nurse called, she told me to schedule our WTF appointment in a couple of weeks to discuss things with the doctor, which I am really looking forward to. I am very interested in what he has to say about this cycle and what his plans are for our next cycle. I am very curious to see what kind of tricks he has in store for us.
This is post 100.
100 posts ago I started this blog filled with optimism that we would soon become parents. 100 posts ago I was sure we were just one diagnostic test away from figuring out what was preventing us from getting pregnant. 100 posts ago I was sure that the next cycle would most definitely be our last cycle.
100 posts later and I feel absolutely no closer to having my one small wish granted. As expected, today’s test was negative.
I’ve often felt more like a casual observer of this cycle than an active participant. I can think of only three times when I actually had a real emotional reaction to something. Once at our first monitoring u/s when I saw how good things looked, again when I felt the disappointment of our fertilization report and once more when I found out that we only had one blast and one morula left at transfer. Other than those instances, I feel like I’ve been on auto-pilot for the rest of this cycle.
Perhaps it’s a self-defense mechanism – to not let myself get emotionally invested in the cycle means much less disappointment if it doesn’t work out. Of course if that was the theory, then it certainly didn’t work. I’m 99% certain that this cycle is a bust due to the recent appearance of spotting and complete lack of symptoms, and for not being too emotionally involved, I’m surprisingly sad. I was really hoping that the better quality of our two embryos this time around would lead to a better outcome, but it appears that is not the case. It seems this cycle will fall by the wayside along with every other cycle that I’ve ever had. Will this ever get any easier?
No, that’s not emergency room, that’s egg retrieval room. I guess it would be more accurately called the egg retrieval waiting room. At my clinic, it’s simply a room that has curtains which allow them to compartmentalize the space down into three smaller private areas. Two of the compartments are larger and seem more for the intended purpose while the third seems more like an afterthought, with the entire space being MAYBE four feet by six feet. About 15 feet away from this room is the actual procedure room where they do the retrievals and transfers.
Anyway, the way things work is once they call you back, they send you off to the bathroom to change into your gown, hat and booties. Once you’re appropriately attired, they set you up in one of these compartments in a comfy recliner, take all of your vitals and get your IV going. Then it’s just a matter of waiting until the woman who was scheduled for retrieval right before you is done and put back into her compartment. Meanwhile, the woman who was scheduled for retrieval before the one who is currently in retrieval is hanging out in the third compartment coming off of the anesthesia in the company of her husband/significant other/whatever. It’s a fine system and it seems to work well for them; patients flowing in and out quite efficiently.
I wasn’t too concerned about egg retrieval during our first IVF, for some reason. Even though I’ve never had surgery before and had no idea what it would be like to be under anesthesia, I really wasn’t worried about it. I generally like to think of myself as a tough cookie and figured that I’d be able to handle whatever came up, so I guess I didn’t put too much effort into worrying about the whole procedure. I was confident that everything would go well and I’d be back to my normal self in a couple of days.
We showed up at our appointed time and were put into the tiny compartment since there were already women in the bigger compartments. The tiny compartment is pretty much right on top of the nurse’s station and directly facing the door to procedure room. So I’m sitting there in my chair with Mark while they take my vitals and get my IVF going feeling pretty good about the whole thing. Then, all of the sudden, I hear moans coming from the other side of the door down the hall. At first they started out as low, sporadic moans. Mark and I exchanged glances upon hearing the low moans, wondering what exactly laid ahead for me. Eventually the moans became increasingly louder, more frequent and more frantic. Now not only did we I exchange glances, but raised eyebrows too and terrible thoughts started racing through my head. I wondered what in the hell was going on in there that was causing this woman so much pain and agony. At points, she would actually be screaming incoherently. I kept glancing at the nurses to see if they were having any reaction to the commotion, trying to get a read on whether this was typical or not. They didn’t give anything away.
Needless to say, I was starting to get nervous. Eventually the screams and moans subsided and the door down the hall opened. The woman was walking right at us on her way to her compartment to recover. I snuck a peek at her and she looked like hell warmed over. The nerves ratcheted up yet another notch.
By this point, the woman who was waiting out her anesthesia in the other compartment was ready to get changed back into her clothes and on her way. She and her husband got up and went into the bathroom and a few minutes later, he came out and told the nurse that his wife was feeling really nauseous. The nurse went off to get something for her and he went back into the bathroom to be with her. A couple seconds later, we can clearly hear her vomiting in the bathroom. Oh good lord. For someone who came into this completely confident and not at all concerned, I was now a bundle of nerves. One woman screaming like her insides were being ripped right out of her, and another throwing up after her procedure where not things I expected to have to deal with.
As it turns out, the second they put that magical medicine into my IV, I couldn’t care less about what had just happened. I felt instantly drunk and everything was fine with the world. I walked down to the procedure room, hopped up on the table, felt them shoving some cotton in my va-jay-jay and the next thing I knew the nurse was telling me I was done. I hopped off the table, back to the waiting area where I had been nicely upgraded to one of the bigger compartments, plopped into the recliner and went to sleep. When I woke next, Mark was there with me.
All told, the retrieval was a breeze. As far as I know, I was not a moaner, though I guess I’d have no way of knowing if I was. I suppose you’d have to ask the woman who went in for retrieval after me. And there was no nausea for me either, which was a definite relief.
My second retrieval was uneventful which was somewhat disappointing. There was one woman already in recovery when we got there and by the sounds of her extremely loud snoring, she seemed to be doing just fine. At least the snoring was mildly entertaining.
Lesson learned: retrieval is no big deal. Of much higher importance is to remember to start taking a stool softener once you trigger. From my experience, the pain of being backed up is FAR worse than the pain from retrieval.
I promised a picture of the two embryos that we transfererred, and here they are.
For your reference, here are last cycle’s embryos.
These definitely look better, right? (Note: even if they don’t look better, just lie to me and tell me they do. I purposely don’t ask what grade my embryos are until AFTER the cycle is over, just so I can continue to believe that they have a fighting chance of implanting and becoming babies someday. It’s my new strategy. I call it the ostrich theory – keep my head in the sand so I’m totally unaware if anything bad is going to happen. So far I like it.)
Because Kami asked, and because these are things I wish I knew BEFORE doing my first PIO shots, here is a list of things I found helpful.
According to me (and I’m no authority on PIO), PIO shots are just like real estate: location, location, location! From my experience, nothing plays more of a factor in whether your shot will hurt like the worst pulled muscle of your life or not than location. After the debacle that was my very first PIO shot, I decided to ask some experienced women for advice on what I was doing wrong, and here’s the info they gave me.
“The point of reference I always use for my hubby to shoot me up is basically behind the hip bone. That is the place where the diagram shows in my pictures from my RE. So I always put my hand on my hipbone and then he matches the area on my behind.”
“Two ways that help me visualize where the area is (which is more on the back of the hip than the butt, even though we call them “butt shots”) are: 1) Draw a vertical line up from the center of your butt cheek and draw a horizontal line across from the top of your crack. Take where they intersect and then move UP about two inches. Or 2) Have your DH line up the outside (pinky) of his hand with your hip bone (where you rest your hands when you put your hands on your hips), with his thumb extended (so his hand makes an “L”). The area that’s framed by the the “L” is where you give the injection. I can find the area that way using my own hand (I give myself the injections), but it’s harder to explain b/c I twist my hand all around.”
I personally use the “L” strategy and that seems to work the best for me. I line up the pinky of my right hand on my left hip bone with my thumb extended out towards my crack. That gives me the right spot to inject horizontally. Then I use the two inches above the crack rule to figure out where to line it up vertically. As I’m sitting here though, feeling that pokey part of my hip bone that juts out in the front of your body is almost EXACTLY where I do the shot, only on my backside, so the advice from the first woman seems spot on too.
The thing about finding the right spot that was really challenging to me was to realize that the shot is not a butt shot at all. I think I thought that since women always talk about their “butt shots” and how their butts are so sore that the shot needed to be much lower than it really should be. Plus I felt like the higher up I went, the less “padding” there would be and it would hurt more. I couldn’t be more wrong. I’m sure there’s an upper limit to where the shot can be done, but I certainly haven’t hit it yet, and to me it is definitely more of a hip shot than a butt shot.
So once you’ve got the location mastered, here are some other tips that I’ve stolen from other people to make things go smoothly.
Does anyone else have any fun PIO tips they’d like to share?
Edited to add that Stephanie’s comment on yesterday’s post includes a GREAT description of where to give the shot, and a picture to boot!! Be sure to check it out and while you’re at it, head over to her blog and wish her some luck today with her beta!
And here’s why. Today is 2 days after my 5 day transfer, which, if you do the math, equals 7 days after egg retrieval, which is the equivalent of ovulation. So I’m 7 days beyond ovulation today. Given that your typical luteal phase is only two weeks, that means that I’m already half way through my TWW! I really appreciate the lab taking good care of my embryos for nearly five whole days because it means that I don’t have the burden of doing it myself. Those last five days of my cycle are usually the worst and when I start to go stir crazy, so to take those five days out of the equation means that I have pretty good chance of staying sane for the remainder of my TWW.
Only time will tell, of course, but right now waiting one more week to test seems like a piece of cake. Targeted test date: March 18th. Stay tuned.
In other news, I FINALLY found my PIO sweet spot. I got all cocky this time around and didn’t even ask the nurse to mark the shot locations on me after retrieval. I figured that by now I was a pro and didn’t need anyone to draw on me, I would just figure it out. Needless to say, that didn’t happen. While I didn’t inflict any crazy bruises or serious butt muscle pain like last time, they were definitely more painful than I was used to.
I was beginning to get a little ticked off, but I finally remembered the “locating” tips that a couple of women gave me last time and now it seems that I’m back on track. Avoiding the “pulled muscle” pain with PIO is all about finding the right spot, and I was doing my shots a good two inches below where I should have been. Moving up a couple of inches has brought me back to the pain free state that I remember from last time. Hallelujah!
Today was transfer day. My clinic is kind of goofy in that they don’t provide daily updates as to how the embryos are developing. It’s my assumption that they subscribe to the “less handling of the embryos the better” theory, so I’m guessing that they only check them on day 1 for the initial fertilization report and then again to see if it’s necessary to do a three day transfer (90% of their transfers are on day five). Anyway, what that means for us is that we literally have no idea what we have still viable until we get to the clinic on transfer day.
Last time our doctor was there to greet us when they took us back to get prepped and he told us right away that we had one blast and one morula. Well this time around was a bit different. We went back and got prepped and sat in the transfer room for about 10 minutes before the doctor was ready for transfer. All this time we had no idea what we were dealing it. It was a little nerve wracking, though I tried to think positively.
Finally the doctor came in and handed us the photo and said that we had one blast and one morula to transfer. Again. It seems that we just can’t get two embryos to develop at the same rate so that we have two blasts to transfer. After he handed us the photo, he said he’s had more than one set of twins born from a one blast/one morula transfer. I know he said it to temper any disappointment that we were feeling, and it was a small bit of reassurance, but again, I was hoping for better.
I took a peek at the photo, but couldn’t really remember too much what our last ones looked like, so I passed it on to Mark. Right away Mark commented to me that they looked better than last time. I gave him a quizzical look because what in the hell does he know what a good blast/morula should look like? He said “yeah, the morula is nice and round whereas last time it was all curvy like a jelly bean.” Wow. He’s got one stellar memory. I made a mental note to compare when we got home and I could look at our previous embryos.
Ass it turns out, Mark was indeed correct. Our last morula was definitely “jelly bean” shaped whereas our current morula was nice and round. It also appears that our current blast is a little “clearer” which maybe means it’s less fragmented? I’m admittedly not well schooled in knowing what good embryos look should look like, but if it were up to me, I’d say that this blast did look better than the last. I’ll try to post a pic sometime soon so you can all weigh in.
Transfer was a pain in the ass, ahem, CERVIX again. It seems that my cervix has a stupid curve that does not make depositing the embryos too easy. After lots of pressure and pushing on the speculum trying to get the catheter to make the turn in my cervix, the doctor finally switched to a less flexible catheter which worked much easier. (side note: the exact same thing happened last time and he had to switch to the stiffer catheter then too, so shouldn’t he have known this and just started with the stiffer catheter from the get go? I will definitely mention this to him if we ever have to go back for a third round.) (another side note: I never had this problem with IUI’s. Is that because the catheter doesn’t have to go as far into the uterus for an IUI or is my cervix on a tirade of some sort?)
A funny interjection here: someone putting lots of pressure on your cervix is not exactly a fun and pain free experience, so I was squeezing Mark’s hand to try to take my mind off of the incredible uncomfortableness of the procedure. Meanwhile, the second I started squeezing Mark’s hand, he started squeezing mine back. The harder I squeezed his hand, the harder he squeezed mine in return. Ummm…hello? You squeezing MY hand does not help the situation! When the doctor finally gave up on the flexible catheter, I turned to Mark and asked him why in the hell he was squeezing my hand? He said he thought that if he was squeezing my hand that it would distract me from the other pain I was feeling. I literally had to laugh out loud at that! I smiled and thanked him for his effort and let him know that I’d rather be the sole hand squeezer, if that was alright with him. He graciously obliged.
The stiffer catheter was much smoother and the embryos were put into my uterus where I hope they make a nice comfortable home for another 38 weeks or so. (Mini-rant: they were NOT implanted. It drives me crazy when people refer to “implanting” embryos during IVF. It is merely a transfer, nothing is actually burrowed into the lining…the embryos have to do that work themselves. End of rant.) They inverted the table I was on so my legs were higher than my head and there we sat for a half hour playing 20 questions with each other. Nearly all of the subjects of our 20 questions subjects were places or things from our past, mostly from our vacations. It was a cool way to reminisce about all of the great experiences that we’ve shared and as an added bonus it distracted me from my urge to pee all over the table.
Finally we were released and began the long drive home. Mark made me some dinner and I ate my daily dosage of pineapple (yes, the core too). Now it’s all just a waiting game. Please let the time pass quickly!
Thank you all for your support and comments. I apologize for not updating last night, I just wasn’t sure how I felt and I wanted some time to sort through my emotions.
And I guess I’m still not sure how I feel, but I’ve kept you all waiting long enough. Apparently from the 18 that they retrieved, only 8 were mature. This was a huge blow to me. I can’t figure out how more than half of our eggs were immature. Of those eight, five fertilized normally, so that’s what we have to work with.
I felt really bad because after Mark told me that we had five, I put on my pouty face since I was definitely disappointed. He looked at me with a shocked face and couldn’t understand why I was upset with five. “It’s nearly twice as many as last time!” he protested. He told me that he thought that I’d be really happy to have five and pointed out that it could have just as easily been 1 instead.
While all of this is true and I am happy to have five versus the three that we had last time or the one that we could have had this time, I’m also really disappointed. For some reason I had just expected it to be better. He challenged me saying that it WAS better, but I wanted BETTER better. I was so hopeful that the change in meds and the strong start that we had this time would lead to a nice high number of embryos to chose from. I just wanted more than five. I don’t know what number would have made me happy, but five certainly wasn’t it.
Then Mark mentioned how at least this time we would have some to freeze so we could do a FET if this one didn’t work. This is the part where I have to remember that he doesn’t know as much about all of this stuff as I do. I had to gently correct him and let him know that most embryos do not make it to freeze. I know that our clinic has very high standard of what they will freeze and what they won’t, and I personally am not expecting to have any to freeze. Not to mention the fact that they may not all make it to day 6 to be frozen anyway. I’m not sure if he forgot that one of our three embryos from last time kicked off before transfer or not, but I’m sure that in his head, he’s thinking that five minus the two that we will transfer will leave us with three to freeze. I really, really hope that he’s right, but I also know that it’s not realistic.
I guess at this point I’m just frustrated. It feels like such an uphill battle all of the time. All of the sacrifices I’ve made in terms of activities I can’t do, foods I’ve given up, time I’ve taken off of work and money that I’ve spent just seems like such a big waste of time, money and effort at this point. I’m doing absolutely everything that I can to make this work and I just feel like we’re not making any progress.
On the plus side, our doctor did state that the quality looks much better this time than it did last time, which does help a small bit.
But it is what it is, right? Right now I presumably have five embryos growing strong and healthy in the lab just waiting to be tranferred into me to someday become our children. I need to focus on that. Everything will be ok.
I’m sorry to keep you all in suspense regarding the fertilization report, but I’m right there with you. After last IVF’s poor fertilization report, I’ve deferred all important phone calls to my husband so that he can filter out upsetting news so I’m not a wreck at work. As such, I too have no idea how my little eggs did when they hooked up with Mark’s super sperm. I sit here patiently awaiting my wonderful husband’s arrival home from work so we can listen to the message. I am a bundle of nerves!
We retreived 18 eggs this morning which is a great number. However, I find myself constantly thinking about the 19 eggs that we retreived last time, from which we got only 3 embryos the following day, and only two viable ones on transfer day. I’m sending all of my energy and thoughts towards great egg quality and hoping for a great fertilization report tomorrow.
Wow. This stim cycle has gone incredibly fast. Like “blink and you’ll miss it” fast. I’m guessing that a large part of the reason it went so fast was because we had to be in Iowa from Thursday night until Monday (yesterday) morning and we spent our entire weekend out geocaching. Literally. We would get up, eat breakfast, go to my monitoring appointment and then geocache until it was dark. Then we’d get a bite to eat, take showers and we’d be asleep before we knew it. It was great fun, kept my mind off of things completely and was probably good for my body to get some exercise too.
Anyway, the end result is that I was given the go ahead to trigger last night and retrieval is scheduled for Wednesday at 7:45am. I honestly cannot believe how fast this entire cycle has gone and that I’m having my retrieval tomorrow. Things looked pretty good at yesterday’s u/s with a few follicles on my right and a bunch more on the left. My clinic doesn’t seem interested in measuring every follicle, preferring instead to measure only the 3-4 biggest on each side. I would estimate 6-8 follicles on the right and 10-12 on the left, so we should be in good shape.
I’m trying to keep my expectations low, but I would say that from the get go, this cycle has appeared better than that last one. I guess I’m kind of in the mindset that since last cycle did not work out for us, anything that is different in this cycle must be a good thing, so triggering a day earlier than last time gives me some hope too.
Of course the biggest issue will be quality and I’m hoping that by doing Follistim and Repronex together will somehow make better quality eggs. I’ve read in the past that sometimes high doses of one drug can kind of “burn out” your eggs, so maybe using the two meds will lead to better eggs than we had with just Follistim last time.
Anyway, there’s lots of room for speculation of what could happen, and of course I know what I want to happen, now it’s just a matter of waiting to see what will happen. But I feel good and hopeful and optimistic about things. Bring on the retrieval!!!
One Small Wish...Granted 