Fresh vs. frozen

And we're not talking veggies ...

I have a follow-up appointment with my RE tomorrow morning. I'm hoping the conversation about what's next will go more smoothly in person.

I've heard some explanations of why the RE is probably pushing for another fresh cycle vs. FET that made some sense (more than the reasons she gave me). One is that because I'm not getting any younger, they want me to do another fresh cycle while I'm still responding well to stims, which could change at any time. For that reason it's not bad to hang onto the frozen because if I keep at this for a while, these frozen embryos will be from my "younger" eggs. The other reason someone mentioned hanging onto the FEs is in case of m/c, you have some in the bank if you don't feel up to another full cycle right away.

Those are solid reasons. But I still think I may be someone who does better on an FET cycle because my body is more relaxed. I'm a needle-phobe, having to stick myself repeatedly and then get an IV for a surgical procedure. Nothing about that is very relaxing to me, though I made it through, and I'd probably be slightly less stressed the second time around.

The frozen embryos are in good shape, too, according to the lab; they were reached blastocyst stage and were frozen on Day 5, which means they were *not* slow growers, as my doctor said. One's a 4AB, other a 2AB.

I feel like if we try FET and there's trouble with the thaw or it just doesn't work, then we know. I can start another IVF fresh cycle feeling motivated to do so. I think I'm still leaning toward FET. We'll see what happens tomorrow.

No bueno

My beta was negative. I was pretty sure that would be the case, but still not fun to hear.

My RE called with the news, and asked if I was ready to do another IVF cycle. I said that I would, but that first I'd like to try an FET cycle with the 2 embryos we were able to freeze from this cycle. Then things got really weird ...

First she said, no, you should "bank" those, that I might want to have a second child later and I should save them for that. I said we need to get me pregnant with a first child before that scenario makes any sense at all. Then she said that *at my age* the embryos don't always thaw that well. I said that I was surprised to hear that, because vitrification, a new method of freezing embryos, has an excellent thaw rate and makes FET success rates much better than they used to be. She said, "I see you've done some reading" but said in her medical opinion, I should do another fresh IVF cycle. I said I'd need a few days to think about my next move.

Can someone please tell me what that was about??

She completely contradicted herself. First my embryos are good enough to save for that mythical second child (having a unicorn for a pet seems about as likely right now), then they aren't high enough quality to survive a thaw? I don't want to think it's about money for the practice. I'm wondering if she thinks by saying I want to do FET next that I'll never try IVF again? Because I was a pretty nervous first-time IVFer, I'll freely admit. (And ideally, FET would work and I wouldn't have to do another IVF.) But I will try IVF again if the FET wouldn't work.

To me it makes sense to give my ovaries a break this cycle but still feel like I'm trying by doing the FET. If that is not successful, then I can move on to another IVF cycle. I don't see the down side to that. I may call her back today and try to get to the bottom of what she's really trying to say.

Anyway, I went from feeling sad but semi-zen about the negative results to being agitated and angry. Yippee.

To pee, or not to pee ...

That was the question in my head all last night. Finally went out and bought HPT at about 9:30pm. I went ahead and did POAS this morning. The first one didn't work! Really?? Nothing happened in the control window, which apparently means the test did not work properly. Had the thought that maybe it's a sign that I should just wait for my beta. But I then read in the directions that if you're not testing especially early (and I'm 13dp3dt), you can test any time of day. So I tried again about 4 hours later. This time, it was a resounding "not pregnant." Certainly not the result I was hoping for ... but I'm keeping a sliver of hope alive that maybe it is too soon to be testing at any old random time of day, rather than first thing in the morning. But I'm bracing myself for my beta tomorrow ...

My ever-changing moods

That's the title of such an upbeat song by The Style Council (I'm dating myself here), but "upbeat" is not the mood I've been in of late. I think all the progesterone/Endometrin is really catching up with me; I feel ... volatile. Mood swings would be putting it mildly. Started the day OK -- it was sunny and warm, who can argue with that? I guess I can, because by noon I was feeling really gloomy about everything, not just IF. I had acupuncture today, and some of the points really, really hurt -- that doesn't usually happen. And it usually lifts my spirits a little but didn't much today. There's no easy way through this time -- guess you just have to gut it out and try to be kind to yourself.

Crazy dreams lately, too, including one last night where someone who I knew in my dream to be Gary Coleman was following me around a mall, trying to get me to give him a piggyback ride.

I'm taking Endometrin 3x/day, wondering if I'd jeopardize anything by just doing it 2x/day. Probably worth a call to the RE.

My beta isn't until 5/31 ... it's gonna be a l-o-n-g holiday weekend. I'm thinking about POAS, which I didn't do with any of my IUIs.

Congrats to C+C Baby Factory (living up to the name!) on her recent positive beta! Way to represent for the 40+ crowd!

I just found a video clip from Ever-Changing Moods on YouTube ... and it did cheer me up a little. I love (and miss) the '80s. I added the link in the first line if in need of a pick-me-up.

Embryos on ice

Got some good news today: Two of our embryos made it to Day 6 and were frozen! While I'd certainly prefer it if this cycle would take, it feels like a bit of insurance to have some on ice.

I've been crazy tired and draggy today. I did a little bit of weeding in the yard  -- maybe 20 minutes' worth -- and then had to lie down! Weeding is an OK 2ww activity, right?

Transfer student

I'm now officially in the 2ww portion of the cycle. I had my ET yesterday (Day 3), and they transferred 3 8-cell embryos, and are watching 3 others (1 8-cell, 2 6-cell) to see if they can be frozen. The transfer went smoothly enough, but today just feels, well, anticlimactic. I thought I'd be thrilled to have the shots and surgery portion of this behind me, and I am, but ...

Maybe in part it's because on Monday it looked like I was headed for a Day 5 transfer, but I got the call early on Day 3 saying we should do it that day. From what I can tell, it's not that my embryo quality took a nose-dive or that some stopped growing—I had 6 embryos that were considered to be growing "normally." I think my RE blinked; she was afraid, because of my age, to gut it out till Day 5. The embryologist told me that I was on the line—that I could have gone either Day 3 or Day 5. I've read so much about Day 3 vs. Day 5 transfer, from scholarly journal articles to forum posts, and to be honest, it still seems like a crapshoot as to which is best. So I went with my RE's advice. It would have been a stressful wait until Day 5, wondering how the embryos were doing. It was probably the right move, but Istill find myself thinking about it.

A sidenote: My RE can hardly get a sentence out without referencing my age. I know how old I am; I don't need her to tell me ALL THE TIME. By contrast, the RE in the same practice who was on call over the weekend and performed both my retrieval and the transfer just referenced how well I was doing, what good results I had—no mention of "good for my age." I can fill in the blanks on my own. I may say something to my RE, will try to keep it light, but really, stop talking about my age! It serves no purpose other than to make me feel bad. I sometimes wonder if it's to prepare me for if the cycle doesn't work. She's washing her hands of me before I even get there. Sorry, it's a gloomy day, feeling uncertain myself.

The egg report

ER is over, and although it's not something I want to do on a regular basis, it was manageable. Once the IV was in, I was golden. I woke up after the procedure feeling the most calm I have in weeks ... sedation has its perks! And the doctor told me that she'd retrieved 11 eggs -- 2 more than I thought she would find, so that's a happy thing, too. I was tired the rest of the day, and had cramps that felt like menstrual cramps, but really, it was not all that bad. I couldn't really nap when I got home because I was so excited to have ER behind me, but I slept like the dead for 12 hours last night.

Dr. called this morning and said that 9 of the 11 eggs fertilized. I was stunned, and actually cried a little out of relief. We'll see how they're doing tomorrow, but for today, it was good news.

Also good news: I'm done with the portion of IVF that involves needles. Woohoo! Now I'm taking Endometrin, which made me laugh last night when I opened up the package -- it's like a pill for your vagina! I wasn't expecting that -- had taken Crinone before and was expecting another creme. Anyway, it's all good when it doesn't involve needles.

Almost ER time ...

Egg retrieval, T-minus10 hours. I'm a little scared—don't entirely know what to expect since it'll be my first time. Hoping I'll be able to sleep tonight.

I'm the nervous nelly about needles girl, and IVs are at the top of my needle freakout hierarchy, so once that's in, I'll be breathing easier and they can do whatever they want! I have a feeling I will babble away once the drugs start flowing ... it's been a stressful week (goes without saying in IF land).

Dr. says I have 9 follicles 14mm and up (top was 20mm on Thursday), and a few smaller stragglers. E2 was 864; I think she was hoping for higher. I've tried to figure out what exactly that number means but decided to let it be. Just hoping for the best.

I have not been a great/consistent blogger during this process. I can usually laugh at the absurdities in life, but my sense of humor went out the window when I started this cycle. I might be more likely to crack some jokes after tomorrow's over!

Goodbye to Gonal

I think (I hope) I just gave myself my last gonal f shot for this cycle. Woohoo! I go in for an u/s and b/w tomorrow am but my dr told me on Monday that she thought I'd be ready to trigger on Thursday w/ ER on Saturday. I have 9 follicles, including one at 15mm on Monday. Dr seems pleased. Ganirelix shots aren't so bad, go much more quickly than the gonal f. If my friends who know the extent of my needle-phobia could see me now!

Too much?

I'm getting a little better about the shots, though there's still that initial *gulp* moment when I first see the needle in all its shiny glory. I'm using the Gonal f pen, and the days when I'm not starting a new pen are so much better—goes a lot quicker and don't have to think about it as much. However, since I'm on 450IU/day, I'm having to change pens every other day. (Sorry no update until now; I didn't think the cyclesista link to the blog worked, but I guess it does since two folks have stopped by—and thanks for that, btw.)

Speaking of dosage, I'm feeling like 450 is a little high for my first time doing IVF. I know I'm old  (and no medical professional ever lets me forget it), but I responded well to Clomid, so have to think I'm not going to be a low responder with the big guns. I called my dr., who in a voice msg told me it's the right dosage based on my age. But I'm on CD7, will be my 6th stim shot tonight, and I'm already bloating a little and tender down there. So it's good that something seems to be happening, but I'm a little concerned about OHSS. Is some bloating and discomfort normal this early in the cycle? I have an u/s and b/w tomorrow, but I hate to give myself another 450 shot tonight if I'm actually overstimming. I think I read somewhere that an antagonist protocol (what I'm doing) is less likely to cause OHSS; has anyone else heard that?

Another Mother's Day spent trying to avoid places where mothers and their young children might be. May it be the last—for me, for anyone who may be reading this.

One shot down ...

OK, I just gave myself my first Gonal-F shot -- put on a little Steeley Dan to try to get myself to chill out a little. Set-up is a little more involved than the Ovidrel, and you have to hold it in the stomach longer while the dosage goes in. It hurts, in other words—even though I iced the area first. But I did it. Will try to take it one day at a time and not think about the next one until it's time to do it. We'll see how that goes.

The pharmacy didn't send along any gauze, so I ended up sticking a band-aid on the injection site, which did bleed a little. It's a little sore now, too, as the icing wears off.

My dr. is having me take 450IU at a time. It seems like a lot, takes a long time to administer. Is this a pretty typical dosage, anyone know?

And for some reason, the link from Cycle Sistas isn't working, so I realize I'm talking to myself at this point ... will try to figure that out.

My first post, my first IVF cycle

IFfy is how I've felt about ART from the beginning. It's taken me a long time to get to this point of starting an IVF cycle (shots start tonight -- woohoo). I think a lot of my ambivalence is around submitting myself to the loss of control over my body, and what often feels like a dehumanizing process of going to a fertility clinic. I'm going to a much smaller, more individual-oriented clinic than when I first sought help, but even there today, for my Day 2 b/w and u/s to make sure I'm good to go to start this IVF cycle, I had a stick-in-the-eye reminder of why this process can really suck.

I've been nervous about the IVF cycle (after 4 medicated IUIs, one of which resulted in pregnancy and eventual m/c at 10 weeks) but I'm committed to trying it at least once. I'm needle-phobic, I should get that out there, but I've come a long way, no longer have to totally talk myself through blood draws, in part because this clinic has one phebotomologist, and she is awesome. I'll call her Cece. Talks me through as a distraction, has never not found the spot on her first try. Today I went in and there was another woman there with her, and I figured she was training her. Fine. When they eventually called my name (my dr. had forgotten to put my appointment in the computer so they scrambled a little -- first strike of the day), it was the new woman, who looked young and nervous. Uh-oh. Cece had left the office; no way to try to talk her into doing it.

I tried to engage new woman in conversation; she responded with simple answers. There notgoing to be conversation as distraction. She looked at my arm, and asked if this was the arm I wanted to use. I said yes, but if she didn't see anything we could definitely try the other. She said she'd try with this one. She poked around with the needle, I thought she was in and I asked if I could stop making a fist. She said no, she hadn't found anything yet. I asked if she wanted to try the other arm. She said yes, that she didn't want to hurt me. I'm getting pretty agitated at this point, but trying to make light, say I really don't like having blood taken. New woman says, "I hate it, too, but look, I'm here drawing it." Another internal uh-oh. I said, "Wow, I'm impressed you can do that if you hate it yourself." She laughed. We got the other arm set up, she asked if I'd drank any water this morning. I said that I'd had 2 tall glasses full, because I knew that helped with this process. She poked again and it was obvious she wasn't finding anything. Cece came back in, asked if she'd gotten in; new woman said no. Cece asked if she wanted her to do it. I'm saying YES internally. New woman says—I got in! Like it was a miracle. Sweet Jesus! That bloody hurt! New woman says to me, "You're shaking—are you OK?" I'm thinking no, but say, "Yes, I just hate this." I feel like I'm going to cry.

I excuse myself to the bathroom, where I do tear up. It's bringing back all the awful feelings around IF that are just under the surface, all the reasons why I loathe this whole damn process. It makes me feel so small, so out of control. I've been really nervous about starting this IVF cycle and now one of the most routine parts has gone awfully. I pull myself together and go back out.

Cece calls the name "Diane" and I keep reading my magazine. She says it again. I look up, see she's looking at me, and say "I'm not Diane." She says, sorry, I confused the names with someone who keeps calling and asking me questions. I'm feeling smaller ... check out the incredible shrinking woman in the waiting room. Strike 2 for clinic.

The dr. comes in, asks if I feel ready to start IVF. No, I say bluntly. She smiles. I ask if I can request that Cece do my blood draws from here on in. I mention that the new woman had to try several times and it freaked me out because as she knows, I'm needle-averse. I said it makes me not want to do any of this. (She knows; it's why it's taken me four months to agree to try IVF, insisting instead on IUIs w/ Clomid, despite having just turned 42. She knows, and gets it, and is having me do an antagonist cycle to cut down on shots.) Dr. says of course I can request that and that she's glad to know that about other woman. She says she's just training, and hasn't done blood draws for a while. I'm not surprised to hear this, but I feel a little bad. I say, "I don't mean to tell on her, get her in trouble." Dr. says that she's very thankful I mentioned it—otherwise, she'd have no idea and just assume everything's going OK in b/w department.

In any case, u/s goes well, no cysts, and I got the all clear to start Gonal-F shots tonight. She said to get dressed and come into her office to go over the instructions for the meds. I take a pad from the basket they have there and threw away the wrapper into what I thought was a trash can (and it looked just like one of those that you step on to throw it away, in my defense!), except as I toss it in I see that it's filled with blue liquid! Yep, that's apparently where she keeps her speculum. Great. I pulled it out with a Kleenex. Oy, will this office visit never end??

I tell my dr. what just happened, laughing nervously, thinking I've probably contaminated the set-up. She said that they tech people are coming to replace the liquid today anyway, so not to worry. She said, "You didn't touch the blue liquid, right?" I said that I got a little on me when I pulled the wrapper out. She told me that I needed to go wash my hands thoroughly with soap right away. Oh boy. I figured it was sterile.

Finally the dr. and I chat. She says that she's going to try to minimize the b/w for me, and she'll put instructions in my file that Cece (or the best person on staff, if I have to go to the bigger clinic -- I'm at a satellite office usually) is to draw my blood. I say thanks, and that next time I'll know to just insist that Cece do it. I feel a little embarrassed—I've handled b/w swimmingly until today. I'm sure Cece can tell I don't like it, but I haven't balked or been shaky. But the dr. is understanding about the needle phobia, and I'm thankful for that. I wouldn't be doing IVF if not for her understanding, to be honest. She suggests that I have my husband give the shots. I say that, strangely, I'd rather do it myself, and not draw more attention to the whole process than necessary, which only makes me more nervous.

So, an inauspicious beginning to the cycle. I'm going to have at least one bruise, if not two, on my arms. But I'm hopeful that it'll actually make giving myself that first shot tonight seem like less of a big deal. I know I can do it. I've given myself trigger shots for the IUIs, and while I get nervous and don't like it, I know it can't be worse that the blood draw I had this morning. So that's the bright spot, I'm thinking.

I'll fill in my backstory later. Just had to get that off my chest so I can go on about my day. Whew.