OK, well I feel like I can half-exhale now. Just got a call from the nurse after going in this morning for Day 0 bloodwork and an ultrasound. I have 8 follicles on my right ovary, 10 on my left — they didn’t tell me the sizes, but I assume they’re nice and small. The problem is that my estrogen is higher than it should be. It’s at 320, and it should be 200 or less. My progesterone was 13 (isn’t this a bit high?), and my LH was 2.

So, this means I need to stay on the Lupron for an extra week and hope that my estrogen drops. If it goes down by the 18th, then I can start stimming with the Gonal-f and whatnot.

I guess this is better than having my entire cycle cancelled, but I’m pretty bummed about something not going right so early in the game. I’m also pessimistic about my estrogen actually decreasing, and now paranoid that my lining is getting even MORE stale. On top of this, I had my endometrial biopsy this morning — where they “nick” the lining to make it get extra sticky and help the embryo(s) implant — but if it’s going to be weeks before I get anything inserted in there, I highly doubt the stickiness will last. Why they scheduled the nicking BEFORE they’d gotten the results of my bloodwork, I have no idea.

Finally, if this cycle gets pushed back any further, I’m pretty sure it’ll mean that my hubby will be away for the transfer. He’s booked a work trip in early February that cannot be cancelled, and ugh — it will suck for him not to be here when they put the embryo in.

At this point in my life, the gimme-a-damn-baby stage, one might assume I’d be thrilled to miss a period — oooOOOooohhh, maybe I’m pregnant! But no. Now it’s got me paranoid. I have no idea what cycle day I am because I started taking the BCP sometime in the middle of my last cycle, then it overlapped a bit with Lupron, which is meant to suppress everything before I begin my artificial Day 0 and Day 1 that leads into my IVF round.

Confusing, right?

The point is: I was told that I’d have a period while on Lupron, and I haven’t. It’s worse than being told there are loot bags coming at the end of a party and then realizing it was all a lie. A horrible, vicious lie. In any case, I phoned the nurse and she said not to freak out if I don’t have a period, and also not freak out if I do. Translation: “Don’t call us, we’ll call you.” I’m trying not to worry, but I was under the impression that bleeding was sort of necessary because I’d need to clear out the “stale” lining from last cycle before I build up a nice new lining for my prospective tenant, Mr. Blastocyst.

Further paranoia stems from the fact that I respond like crazy to any and all fertility meds, so now I’m convinced the Lupron has over-suppressed me and my ovaries have gone into Sleeping Beauty mode and won’t wake up until the endocrinology prince comes along and punches them in the face (let’s be honest, kisses do nothing).

Does anyone with Lupron experience have any words of wisdom? I haven’t had ANY side effects so far, except for this anxiety, but I’m just waiting for something else to hit me — like a hot flash, or night sweats, or a swarm of flying monkeys… you know.

I used to be the patient who had to lie down before getting a shot of anything because there was a serious possibility I might faint. In fact, my friend’s mom once tried to do some acupressure on my neck using a sharp pen, and despite the fact that it never actually punctured my skin, I fully passed out on their kitchen floor.

Now, I’m injecting myself with needles constantly, and am totally over it — in the stomach, thighs, butt cheeks, both subcutaneous (just under the skin) and intramuscular (right in the muscle). And here’s proof that exposure therapy REALLY works: I’ve actually gotten so bored with these injections that I’ve begun timing myself, to see how fast I can administer a Lupron shot from the moment I unbutton my pants to the second I put the alcohol swab on my skin to stop the bleeding.

My times so far:

Jan. 2: 1 min, 42 sec.
Jan. 3: 1 min, 33 sec.
Jan. 4: 1 min, 30 sec.

The secret to speed largely comes down to whether or not there are any air bubbles in the syringe, and also how fast the alcohol swab packet tears — sometimes it’s a nice, clean break, but other times it’s like wrestling with a stubborn packet of cereal. Of course, my hubby has warned me many times, “THIS IS NOT A RACE”, and I obviously don’t want to sacrifice my health or risk getting the dosage wrong. But honestly, we need to inject some fun into these infertility routines (see what I did there? inject? Eh? Eh?)! Maybe I should add a fun soundtrack, too, like Flight of the Bumble Bee!

What do you guys do to make injection time inneresting?

In our IVF orientation, the embryologist stressed that Day 5 transfers (when the embryo has reached the ‘blastocyst’ stage) are where it’s at. They have higher rates of success — so much higher, in fact, that any clinic doing Day 3 transfers probably doesn’t even know what IVF stands for they’re so dumb. But then I hear from other friends going through treatment that their REs and fertility docs are insisting Day 3 transfers are better, that Day 5 transfers are what embryologists in the Stone Age were doing (and yes, I’ve totally researched this — there were embryologists in the Stone Age).

Anyway, I decided to turn to Dr. You-Probably-Have-AIDS-or-Cancer, otherwise known as Dr. Google, and found this page explaining the difference: Basically, it seems that 5-day transfers have better success rates because they’ve progressed further and therefore the embryologist can get a more well-rounded view of whether the cells are dividing on schedule and fragmenting as little as possible. The advantage of a Day 3 transfer, on the other hand, is that the cell may have a better chance of implanting, especially if it’s growing at a slower pace. Also, Day 3 embryos may fare better in the freezer than their Day 5 counterparts, however this could all depend on the freezing technique used at your clinic.

UGH. Do any of you have coherent thoughts on this matter? Seeing as I’m scheduled to get a Day 5 transfer, I really could do with some reassurance that this is the right choice. Yes, my fertility doctor is a man I trust, but he is also a man who has sperm-shaped stress balls in his office and a pile of Crocs by the door.

(Note that the above image is from Million Dollar Baby, which is appropriate because our own quest for a baby is costing exactly that.)

When the hubby and I signed up for our first IUI, we had to fill out reams of legal consent forms saying that we understood the sperm freezing and thawing process, that we didn’t hold the clinic responsible if the treatment failed, and so on. There was also a part where we needed to stipulate what we wanted to do if hubby dropped off his sperm sample and then suddenly divorced me or died before the IUI was scheduled to happen — did we want to leave it up to me to decide what to do? Did we want it destroyed? Did we want to donate it to science? All I could think was, “The window of time between jerking off and separating the good spermies from the bad ones and getting that stuff up in my bizness is about three hours. What is the likelihood that my husband will run off with another woman or DIE in that time frame?!” Furthermore, the forms then asked us what we wanted to do if BOTH of us died and there was sperm leftover at the clinic. Seriously? WHAT KIND OF APOCALYPTIC SHIT IS TAKING PLACE IN THE 10-MINUTE DRIVE BETWEEN OUR HOUSE AND THE CLINIC??

Honestly, lawyers and their lawyering.

So of course, we got a stack of very similar forms for our upcoming IVF, which ask the same questions about what we’d like done with our embryos if we kick the bucket in between retrieval and transfer. What’s interesting is that this isn’t a fill-in-the-blank situation — if we both die, we only have two choices, and our final choice must be indicated with a checkmark. The first option is to destroy our embryos. The second is to donate them to science for research purposes.

Um, hello, where is the option called “Give our precious bundles of cells to infertiles looking for donor embryos or even, like, my sister, so at least our genes might get to survive in this cruel world that killed off two perfectly lovely people in the prime of their lives who would have made great fucking parents”??

Rarely in life do you get to experience a teaser for what’s to come about 20 years down the road. Sometimes, after shovelling snow off the front sidewalk, you’ll get a backache and think, “Man, I guess this is what arthritis will be like when I’m old.” Or maybe, when put on the spot, you can’t remember how old you are for a few seconds and think, “Crap, is this what memory loss is going to be like when I’m 70?” Now, I get the distinct pleasure of starting my Lupron shots and settling in for the preview of a film I like to call This is What Menopause Will Be Like, Sucker! I hear Roger Ebert gave it a very bad review. My mother also rated it poorly, giving it zero stars and declaring, “You won’t sleep at all.”

For those who have no idea what “Lulu” is all about, it’s basically a drug that suppresses the ovaries. This means they stop producing estrogen, and also don’t go right ahead pre-selecting an egg to release during ovulation—this, in turn, means the fertility doc can take better control over the whole reproductive system and help the ovaries produce MANY eggs, rather than just one, and it all happens on his (or her) schedule.

So, yes. Here we go with all that. Got my assortment of syringes and alcohol swabs and a needle disposal tub ready.

Fortunately, the whole stabbing myself in the stomach part doesn’t bother me. The only annoying thing is, I have to do this every night at the exact same time, between 5 p.m. and 10 p.m. I’m thinking it makes more sense to do it closer to 5, because if I’m ever out for dinner with friends, I don’t want to have to rush back home immediately after the main course or, worse, sneak off to the bathroom and start unpacking my mini nursing station.

Otherwise, I guess I just have to prepare myself for the symptoms of not having any estrogen: Hot flashes, night sweats, hair loss, bone loss (?!), depression, fluid retention and weight gain. No problem!

Just as I was getting used to all my hopes and dreams being pinned on the magical day of January 20th, turns out the nurse at my clinic made a mistake in her voicemail yesterday, and I’m actually scheduled for a possible retrieval on January 25th, meaning the transfer would be closer to January 30th. Now, I should say that I do trust the staff at my clinic, but slip-ups like this kind of freak me out a bit. Note to self: Quadruple-check the label on the sperm sample before we hand it to the RE this cycle.

On a separate note, I went in this morning to learn how to administer all of these injections, which was kind of boring seeing as I’ve already figured out how to stab my own ass with PIO shots, thanks to some very helpful YouTube demos. But anyway, I had to do yet another patient intake and my blood pressure was off the charts. I sort of knew it would be, but it scared me nonetheless. Here’s the thing: Whenever nurses or doctors take my BP reading, they always seem to think the machine is broken — I guess because I’m young-ish, I’m not overweight, and the numbers that come up just seem inconceivably high. So they switch arms and take a second reading. Then they ask me to relax and stop talking and take a third reading, before finally sitting back and blinking their eyes in astonishment as they conclude, “Wow, you have really high blood pressure!” Note to medical staff: Letting your jaw drop right in front of me does not HELP with this condition!

My reading this morning was around 154/104. Yeah.

The (barely) reassuring thing is that by the time I got home and started working and took another reading with my own monitor, it was down to 135/95. And I just checked it again now, and the systolic has dropped so it’s 125/95 (proof is right here):

In the “yellow” range, according to my device.

Whenever I check it late at night, when I’m about to go to bed, it’s usually around 120/85, which is totally respectable. Still, I know this puts me at risk for pre-eclampsia if/when I do get knocked up, and I get somewhat panicked about this.

Do any of you guys have hypertension at all? What do you treat it with? I’m really curious to know just how bad it gets during pregnancy; I’ve heard it actually can go down initially because there’s more estrogen in your system, but eventually will start going up again as the baby gets bigger. Thoughts/advice?

So, first off, I feel the need to say that I won’t be posting anything about the fucking HORRIBLE atrocity that took place at Sandy Hook Elementary—partly because a lot of other bloggers are doing such a great job of it and you should be reading what they have to say; partly because, as a treehugging pacifict Canadian, I have pretty unwavering convictions about gun control; and partly because I feel weird turning this space into anything other than a snarky infertility diary. The only thing I will say is that, according to statistics, most likely one or more of those kids shot last week belonged to parents who had gone through infertility treatment. I cannot imagine enduring years of negative pee sticks, IUIs and IVFs, miscarriages, etc., and then finally feeling like I made it to “the other side”, and then having that ripped away in an instant. Horrible.

——INSERT SEGUE BACK INTO SELFISH BLOGGING HERE——

So I received the beginnings of my IVF schedule, all of which was communicated in a voicemail message, meaning it’s a bit scattered, but whatever—still exciting. I’m on these antibiotics now, and on Sunday reacquainted myself with dear old birth control. I must say, just opening that 21-pack of tiny pills was like running into someone from university that I purposely have not kept in touch with. It was like, “Ohhhh, hey… you! Uh… long time no see? How’s it going? You totally look the same! But, like, different in a way!”

It matches my Estrace!

And it’s true—BCP hasn’t really changed, except that instead of taking Marvelon (was anyone else on that? I have this weird suspicion that I was the only person who ever got put on Marvelon), I’m now taking Apri (where on earth do they come up with these names, anyway? It’s like they just forgot the last letter of April and couldn’t be bothered to correct it). So far, no side effects, although I never seem to get any to begin with.

Anyway, after the BCP, we kick it up a notch!

Tomorrow is my teaching session for the injectables.
Dec. 27: I start on Lupron, 0.1 cc, taken at night once a day.
Jan. 11: Bloods and u/s, get other meds, return all consent forms, pay for IVF cycle and get another endometrial biopsy (which they probably won’t even look at—my doctor says they just do this because aggravating it makes the uterus extra “sticky”. Honestly, between the lasers and the biopsy-just-for-stickiness, I think my fertility doc is a little crazypants).
Jan. 13: Take more fertility meds (the Luveris, maybe?).
Jan. 15: Possible date for egg retrieval.
Jan. 20: Possible date for transfer.

Not totally sure where the Gonal-f will come in, so I need to clarify that, and I’m also not sure whether I’ll be going in for bloods and u/s every morning between the 11th and 15th (I assume I will), but otherwise it all seems pretty straightforward. There is a strong likelihood that I could be PUPO (pregnant until proven otherwise, as they say in the TTC community) by Jan. 20. Never has a date sounded so magical and full of promise… January Twentieth… just has a nice mouth feel, don’t you think?

Relief! Such relief. Met with Dr. No Nonsense this morning and he said the results of my lining biopsy were normal, other than a mild infection, which I’m going to treat with a couple weeks’ worth of antibiotics. The great news is that we’re all cleared to start IVF in January! I feel like giving my uterus a hug and a little pat on the head — ya did good, kid.

So I got my protocol. It starts with Gonal-f, which is pretty much like an old friend at this point, then moves on to a couple of newbies: Lupron (which I’ve heard crazy rumours about) and Luveris (a form of LH that improves egg quality). We’ll be doing ICSI (or “ick, see?” as everyone in the biz calls it) and possibly assisted hatching depending on how my egg shells look. Oh, and because we LOVE doing as many tests as possible, we’ll also be doing this thing called Oosight, in which our RE fires laser beams at my embryos’ spindles to see if their chromosomes have split up evenly (yeah, science! Wait, um, maybe slow down a bit, science). Last but not least, we’ll be doing a Day 5 transfer because Day 3 transfers are considered “so last year” by our embryologist. Depending on how everything looks, we’ll transfer either one or two embabies. And then I’ll be knocked up!

And no, I will not even entertain the possibility of a negative pregnancy test after all of this insanity. Not an option.

YAAA(panic)YYYYY!!!!!

So for my recent mock cycle, I had to take a buttload of estrogen and progesterone to mimic the insane hormonal situation I’ll be in when I eventually do my first round of IVF. New to me was this drug called Estrace, which I was pretty sure my doctor said was a vaginal suppository. But when I got home from the pharmacy, I looked at the bottle and the pills inside didn’t resemble those conical, waxy progesterone suppositories, nor did they come with any sort of applicator thingy, like the Endometrin. Instead, they were tiny and blue and looked like they were meant to be taken orally. The label even said, “Take with food,” so surely my doc was wrong?

I called the clinic and asked to speak with a nurse. She put me on hold, then came back and said, “You can do either with these pills, but Dr. No Nonsense prefers that you take them vaginally.”

“OK,” I said. “But the label says ‘Take with food’ — do I need to do that?”

And she says, “Oh no, don’t go putting any food up there!”

Now, I get that she probably hears some bizarre questions from IF patients, but did this nurse really think I was going to start shoving burgers and fries up my bizniss?

“Um, no,” I replied. “I just meant, do I need to EAT a meal around the same time that I take these?” Honestly, woman.

So moving on — I started using the Estrace, and it was horrible. I’m actually one of those lucky gals who never experiences side effects when it comes to drugs. Pump me full of birth control, methotrexate, a million vaccinations, whatever, I will never suffer any mood swings or nausea or headaches. It wasn’t any surprise, then, that when I took the Estrace, I didn’t really feel anything. But the leakage — oh, the leakage. With up to six of those tablets going up there each day, all of them desperately rushing back out like they’d seen a ghost (to their credit, my cervix probably does look dead), it was disgusting.

I told my hubby that I felt like a menstruating Smurf, 24/7.

His response, for the next three weeks, was to refer to this as my “blue period.” Because puns were REALLY what I needed at that point.

Anyway, needless to say, I’m not looking forward to Round 2 of this crap. Any advice on how to deal with neon-blue leakage? Do I just have to buy pads, or is it better to maybe use my Diva Cup?

A work from Picasso’s blue period. I call it, “What My Lady Bits Probably Looked Like While on Estrace”