One decision that is.
As some folks here and lots in other places noted, I’m clearly not ready to give up on this pregnancy/baby lark.
I had some New Age Time with my chiro (rolling my eyes at myself), after which I realized my fear about trying again stems from how terrible I felt for, really, two years after my last failed IVF. Hence, in hindsight, my friend’s order to examine how I’d feel if I tried and failed again. Which is, obviously, within the realm of possibility.
Here is the deal. Things were bad there, for a while, y’all. Not like thoughts of suicide, but generally just not good. But then, last summer I started to feel better and now, as evidence by several things (my energy level for cooking and gardening most prominent among them), I feel, well, like my normal self. No longer broken! Fixed! It’s nice.
Even if I fail miserably at this, even if that failure makes me miserable, it looks pretty clear that I’d be able to, given time, come out the other side and feel ok. It might take a while. It might be really hard. I might alienate *all* my friends this time. (That’s a joke.) But I’ve done it before – with complicating factors – and so I trust I could do it again.
Done and done. That part at least.
So I had a Saline Sonogram on Friday. I took the entire day off for it, which was a great plan, not because the procedure was bad, but because – woo! – day off! Dr. Hot wanted to get a look-see at my ute to be sure everything looked normal post the miscarriages.
She was as cute as ever and it was easy and everything looked normal. Yay, right? And all my new and re-done bloodwork looked normal, too! Yay! Right?
Sort of. Everything normal means that there is still no known reason for my infertility. No easy fix to something that got overlooked before. No clear “you will never carry a pregnancy past 10 weeks, so don’t even try”. Honestly, I was really hoping for one or the other.
There is one test for which I have not yet received results. Dr. Hot seems as into genetics as Dr. E (nice old RE) was into auto-immune. She ordered a karotype test that will be back in a few weeks and will, to quote the paper for from the cheater RE’s, be “expensive”. Oh, yay. There is a 5% incidence of chromosomal abnormalities in cases where there have been at least two miscarriages. Heck, I hit that number three summers ago! Anyway, Dr. Hot is interested in my genetics, it seems. If I do IVF again, and, wow, is that ever a big if, she strongly recommends PGD (yes, that’s a wikipedia link – it looks legit). She even gave me the name of a guy in New Jersey so I could look him up – which I should do, at some point – because he is at the forefront of genetic testing. Which sort of gives me hives, because that sort of thing is a slippery slope, I fear. But. But.
But it’s so highly unlikely that I’d do IVF again. It’s just so damn expensive. And I am barely holding my financial head above water from the transfers I did, all willy-nilly, over the past
two three (Jesus.) years.
Let’s break it down:
- basic IVF package price is $8,400 – that’s $5000 for the clinic portion and $3400 for the Laboratory
- the average cost of meds is $2,500 – ouch. Last time I got these for free from the ever generous IVP
- cryopreservation of bonus embryos is $470 and then storage is $150/quarter and $470/year. If memory serves, storage at the Richmond RE was cheaper, but maybe prices have gone up everywhere.
You do the math. Don’t forget to add something huge for PGD. Although, wow, I feel sketchy about that. And not just because of the (unknown amount of) money.
If I had a million dollars, I’d do it in a minute. I respond well to the meds; I make a shit ton of eggs; it was unpleasant but not terribly so (and it might be better if I wasn’t unknowingly at the beginning of the end of a relationship). But I don’t have a million dollars. The cheater RE has some sort of payment plan (pay some amount at the time and then pay monthly for a year), so I guess I will call to see the ins and outs of that.
Then there’s the option of making this the summer of IUIs. Dr. Hot wants, if I do any more IUIs, to throw my old friend femara as well as gonadatropins (with whom I has a short fling back in 2009, thanks again to the ever generous IVP) into the mix. More targets, as Dr. E, the nice old RE, would say. I can’t find the price list for any of that, but let’s guess around $600 with the meds? Damn. I wish I could find that page on the cheater RE’s website. I swear it was there.
Then there’s buying sperm. So factor that in. Let’s call that – wait, I can look that one up – let’s average it and call that $700. That’s without shipping.
Then there’s throwing the towel in.
I’ve decided on one option or the other about 50 bathousand times in the past two days. Heck, I’ve decided on one option and then another forty-eleven times writing this. Each ones seems equally valid and perfect and equally wrong. Ugh.
My wise friend Susie said to think about how I would feel if I tried and failed. Which is good to remember. And why it’s so hard to decide. If trying again was a sure thing, then that would be the obvious answer.
I’d love to farm this decision out. Can’t somebody decide for me? Dr. Hot has refused, for the record.
Y’all, the cheater RE is a private hospital. My old RE was in an endocrinology clinic in the public hospital. I knew all this. I’d compared and contrasted public and private medical establishments when I went to the Richmond RE for IVF. It was fancy pants. The button to call the elevator was normal elevator-call-button sized, but the marble (!) inset around it was bigger than my head. The elevator call button at my nice old RE’s sometimes had a piece of paper with an up arrow drawn on with ballpoint pen. (For years – yes, I was there for years – it was forbidden to take said elevator to the 3rd and final floor there. So it was mysterious! One of the nurses told me it was just full of old chairs, but it was still full of mystery to me.)
I went for lab work Friday. So, yay me, right? Right. But, wow, did it make me miss my old lab people.
At the old RE’s, the lab was clearly a Lab. Not just because Amir and Michelle and the other nice lady whose name I wish I could remember wore white coats. But because there were Science Things in there. Not just a red bio-hazard sharps container and boxes of gloves, either. There were those racks where you stick everybody’s blood vials, and important looking notes stuck to the walls, and millions of drawers that were filled with More Science Stuff, and stacks of papers around the computer where they sent out orders for pick up and processing like “STAT”. (For real. Remember that? No. Because everybody who read my blog then is dead because I’ve been doing this for so damn long.) There was something of a partition so two people could get stuck at once, and there was a random hard chair by the door in addition to the chairs with the giant funny arms for the stick-ees to rest their arms on. Sometimes you’d even get to see the courier people come in to pick up all the bloods! So exciting! It was all Science! and Medicine! and Lab! But also they were so nice there, Amir and Michelle and that other nice lady. They always remembered me, even when it had been over a year since I’d seen them. And Amir once sat me down and gave me a very serious pep talk, drawing parallels between football and ttc, saying things like “you just have to stay in the game” and “you might be tired and feel like you are loosing, but keep playing – stay in the game.” Those are not direct quote, but you get the idea. Anyway. My lab people. Winners.
Now, if you’ll consult back to the top of this (already rather long) post, you’ll see that the new cheater RE is at a private hospital. This was pretty apparent at my first visit with Dr. Hot (whom I saw two weekends ago at the farmer’s market with her husband, whom I mistook for an adorable, tiny butch lesbian at first): fancy water cooler, matchy-matchy upholstered chairs, etc, etc. But it was this recent trip for blood work that really hammered the difference home. Y’all, the walls in the little “room” where I actually got stuck (by a nice blonde 12 year old – really, she was 12) were painted not one but two colors and the upholstered chair in the corner matched both of those colors. All the Science was hidden away somewhere else, but there was a chair that matched the walls. Who was supposed to sit in that matchy chair, I don’t know. I certainly didn’t get stuck in it – no blood on the goods! As we used to say in the costume shop. Maybe it’s for if you bring company into the lab? But it’s too far away from the chair where the business gets done for any hand-holding to take place, if you were the sort who needs hand-holding. Weird. And matchy. For all the (obvious?) care taken in the decoration of the little “room” it was strangely devoid of feeling. Or, rather, it’s feeling was empty. There were other little “rooms” off of the tastefully painted hallway from the (second) waiting room, so I guess the idea was confidentiality and comfort? But it was really not very comforting in there. And I could hear the chatty lady in the next “room” perfectly well. So really, I don’t know what they were trying to achieve.
It was fine, of course. I’m a bloodwork rockstar. The 12 year old who stuck me laughed at my jokes. She was good – it didn’t hurt at all. I got paper tape and gauze rather than a big itchy wrap bandage. But, wow, I missed my old lab people a lot.
CD 1. I wasn’t sure I’d ever write that in relation to myself, but I am. Bloodwork within the next couple days. I hear the lab guy at the cheater RE is nice. But I did love my old lab people so much. I wonder if this new guy will be willing to give me gauze and paper tape rather than a big stupid wrap?
I’ve stolen that shamelessly from May. She pulled from Shakespeare, but he’s dead and so cares very little what May or I do.
The trick here is that I am, maybe, going to try to knock myself up again. Clearly, this is not for public consumption. See the password you entered above. Ahem. Prior to hitting publish, there were six people to whom I’d spoken about this. Which seems like a lot when I count it up on my fingers, but really, for me, isn’t very many. I’m the girl who had her boss chase down the fedex guy to take his picture when he delivered my first shipment of sperm (*sniff* – so long ago…) to school. I’m still firmly in the camp of “share the story” because it might make other people feel less alone, but this go-round, or possible go-round, I’m just so damn tired of having to fucking explain everything. And, believe it or not, I am still fending off well-meaning comments about how relaxing/doing it “naturally” might work. From my peers. Picture me on my couch rolling my eyes.
I’ve resisted the phrase ttc for years now. Because post the Summer 2010 debacle (IVF itself wasn’t so bad, but Meghan leaving and the miscarriage pretty much sucked), I didn’t need to *try* to conceive anymore: it was already done. In vitro, if you will. But, as you may or may not know, I ran through all 10 of those embryos, plus an even dozen of donor embryos (What? Did you know? Right. I didn’t tell you.) and so now, if I want to continue on This Journey (N.B. skilful use of capitalization), I will have to, in fact, try to conceive. Again.
The jury (made up of one, rather hot, doctor) is currently out in just how to do this. Dr. Hot, because I call ’em like I see ’em, is an RE at the other hospital in town. I’ve stuck loyally with the public, research-y one, but now I have taken to heart my non-monogamous leanings and been wanded by Another Doctor. It feels like cheating, y’all. I do love my old RE. I do. But a second opinion seems smart, right? Justify my wandering eye for me, internet. No, really, I feel ok about it, but it still feels like cheating. Maybe because I didn’t tell him first.
Regardless, I had my wanding at the cheater RE’s and Dr. Hot was hot and also smart and clear and all those things and, wow, do private hospitals ever have fancier water coolers in their waiting rooms then public full-spectrum endocrine disorder clinics do. There is also a nice view of the mountains from said waiting room. Sorry I didn’t take a picture. But the radio (radio in the waiting room?!) was playing Cyndi Lauper, among other great and cheering songs, and so I was distracted.
To cut to the chase, my wanding showed 18 antral follicles. Whoa. So that’s good, according to Dr. Hot. She is currently refusing to weigh in with anything other than a desire for labs (re-do and new-do) and a saline infusion sonogram (the idea being that while my uterus looked good, back on the HSG films, maybe there’s been some strange goings on in there, post the miscarriages). After all that, then maybe things will move along.
Maybe. I was pretty clear with old Dr. Hot that I came to her looking for information, not necessarily for treatment. I told her twice that I was willing to hear anything – from “get the hell out of this office, you’ll never get pregnant let alone carry a baby to term” to “This looks like a fun challenge! Let’s go order so sperm!” We shall see what she says. (Those aren’t real quotes. There was no cussing. Dr. Hot and I don’t know each other that well yet.)
You’ll remember, or maybe you won’t, that my plan was to keep trying until I ran out of embryos or ran out of money. Well, I am out of both. But I just can’t quite give up yet. Not quite.
Once more unto the breach, y’all. Once more.
Yes, friends, that’s a doubling time of 77.something hours or a little more than 3 days. Not great, but not nothing.
And for your continued amusement:
Beta at 9dp5dt is 13.6
Lower than low. But not not pregnant (all y’all not pregnant people would get a beta of 5 or less). But really, lower than low. Lower even than the last time.
Here are some fun facts to keep you busy. We love Julie. Because she’s funny and she sites her sources. Lower betas for 5 day transfers? For here, please.
More blood on Friday. Cross ’em if you got ’em.
So. You want to hear about my IVF cycle? Yeah. I know you do. It’s a riveting tale of drugs! and money! and my bruised belly. Money! Drugs! Bruises!
Okey doke. Now that you’re all settled in and ready, let’s see if I can make this some sort of coherent narrative….
Sometime back in June, I started Lupron (meds and jabbies courtesy of one of the ever generous members of the IVP). Oh, it was fun at first! I had to draw up 10 units of liquid into my little syringe and then pinch up some belly fat and jab it right in – 90º angle! – and then push the plunger in and it fulfilled all my medical fantasies. So fun! I was so hardcore! I could stick myself with a needle every night and not care! Woo and hoo! Lucky for me, I had really no side effects from the lupron – maybe menopause will be a breeze?
And then it started to get old. The injection sites would itch a bit and I gave myself one good sized bruise and the sheer waste of using a new needle every night…. I mean, I was and am grateful that I pulled together the money to do this and I tried to keep my proverbial chin up, but sheesh…. The constant jabbing seemed like adding injury to infertile insult.
Ha! And it wasn’t over! Once I hit cd 1 again, things really started getting good. I added – yes! – more meds! more needles! Now, let’s pause a minute to note that I really, really don’t mind needles. I have a mess of tattoos; I like to watch the lab guy do my blood draws; I pierced my own ears several times as a teenager (maybe we all did?). But the repetition of these all these IVF needles…. well, it was, as I said, getting old. So the news meds kicked in, one after the other: stims to rev my ovaries into overdrive, menopure to help with the overdrive and bump up the LH and then finally the big gun of the trigger. Looking at my protocol, I think I may even have been on the light side, in terms of the number of things I had to inject into my gut, so really, I know I didn’t have it as bad as other folks, but again, sheesh…
I was just… tired of it. Old, as I said. Do I seem to be repeating myself?
And in among the ritualized jabbings, there were wandings and bloodwork and phone calls. Oh, the phone calls. When you combine the new RE’s necessarily crazy schedule with my lack of a cell phone and inability to take calls at work, well, there was a lot of phone tag. See, for this IVF thing, I have become the proud owner of not one but two – yes, 2! – REs. My very dear doc here doesn’t have the facilities to do IVF, so he sends the serious infertiles to another RE in Richmond. All wandings and bloodwork are done here, retrieval and transfer in Richmond. There are, by necessity, a lot of phone calls and faxing. Anyway, it seems to be, in most cases, a very fruitful partner ship. My dear RE here very quietly quoted me a success rate that’s so high I don’t even dare to commit it to the internets.
So there were jabbed meds, there were wandings and bloodwork and phone calls and I threw acupuncture in there for good measure. And was it ever the best part of the whole deal. I really don’t want to sound too whiny here. I know other folks have a far harder time. It’s just I was, well, tired. From the meds a little, but more from five fucking years of beating my head against the same damn wall.
Um… where the hell are we in this “narrative”? Oh, yes. The trigger. For those lucky ones of you who haven’t been to infertility boot camp, trigger is the lay term for a big ass shot of HCG (that’s human chorionic gonadotropin to you, mister). In one’s ass. See, all those other jabs were in my belly, just into the nice layer of fat that’s there. But the HCG needs to go into the muscle. Fun times! I had a friend come over and do it for me. It’s too hard to stick your own self in the ass. At midnight. Because that’s how the Richmond RE told me to roll.
And now we get the the good part! Settle back into your seats, kids. Now we are at the egg retrieval part. This is where is starts to suck. Not in terms of outcome – go back and read the stats from the other day – but in terms of how I felt. Even with the tiredness and general blah of infertility, I never really felt physically bad. But, whooeee, was I a mess after the retrieval. Let’s tell it like a campfire story:
It was a bright and sunny day…… cho-girl and I left her house early so as to get the the new fancy pants clinic at my appointed time. I had, as instructed, neither eaten nor drunk anything at all since midnight. I was hungry. And I missed my bff, coffee, so bad it hurt. Poor me!
After getting almost lost and very certainly intimidated by the grand lobby of the fancy pants clinic, I was put in a gown and given cute socks and and allowed to pee and hooked up to an IV and then rolled away to the OR. I remember nothing after the rolly bed left the room. The drug guy, let’s call him Frank, as that’s his name, was good. And then I woke up. Still in the rolly bed, back in my room, where cho-girl had cued up the post egg retrieval playlist from the gf, who couldn’t be there herself. And then I was a little weepy. I think anesthesia does that to me? But otherwise ok. The clinic folks were so nice and they gave me crackers and ginger ale and continued to laugh at my jokes. Then they wheeled me out to the waiting Subaru to be taken home.
Oh, let’s make this a cliffhanger, shall we? This post is long enough as it is. Tune in later to hear how the aftermath went. Titled, “Hydrocodne and I Are Not BFFs.” or, “How About Some More Hippie Gatorade?”
6/18 – 7/11 – 10 units lupron
7/2 – 7/8 – 225 follistim
7/8 – 7/9 – 250 follistim
7/10 – 7/11 – 200 follistim
7/6 – 7/10 – 1 vial menopure
7/12 – 1 vial HCG
7/14 – 21 eggs
7/15 – 12 fertilized
7/16 – 6 graded (4, 4-, 3, 3, 3-, 2)
7/18 – 1 or 2 transferred
Hold on to your hats.
Because I love a list.
- laundry – bring in rags and towels already on line, hang out lights, start load of darks
- post microburst tidying outside: sweep steps and sidewalks, rake random mulch bits back into place, possibly trim edges
- scoop out poopy chicken straw, offer to neighbor whose garden took a beating in the storm and it’s clean up. Also give her plants to make up for ones the chickens killed
- turn on ac
- scrub bathrooms
- vacuum – floors, rugs, furniture
- call to schedule cd 3 baseline wanding
- call to get low-down on starting stims
- pick pits out of jam, transfer to jar
- buy coffee and new razor
- cry about the neighbors moving