Sick and tired

It's official: I am sick and tired. Not of being pregnant, although that is certainly contributing to the tired aspect. I'm actually sick, like porcupines have danced in my throat and the mucus is trying to drown me slowly sick. It came on fast, but I chose wisely to go see my doctor and get a note off from work for today--Merry Christmas!

Anyway, in all of this complaining about my upper respiratory infection, I actually do have some updates on the pregnancy front. We went to our first regular obstetric appointment on Wednesday, at exactly 9 weeks pregnant. Since we had an ultrasound at week 7 and everything looked great, this was just a vaginal exam and culture and a chance to talk with Dr. B about what to expect over the next seven months. Yes, we're only seven months away from the arrival of Wisebaby! Eek!

I was hoping that she would say that I could stop Crinone, but, to no avail, I have ten more days of the nasty stuff. I was also hoping that she would agree with the OBs of my fellow heterozygous Factor V'ers (Wisesister and my bestie from HS) and take me off of Lovenox. That was also to no avail. I appreciate the caution, as I don't want to lose Wisebaby or end up with some sort of life-endangering clot myself. I don't appreciate the fact that I will have been on Lovenox for almost a calendar year when this is all said and done. It's expensive; it's painful; it makes me want to cry a little.

On the Factor V front, the other thing that Dr. B wants to do is schedule an inducement for week 38-39 so that she can switch me to Heparin, which is a twice a day blood thinner, a few weeks before my delivery, and then off of it, timed perfectly, for delivery. As she said, she'd rather control the situation to preserve my cardio-pulmonary system and protect Wisebaby. Again, I appreciate that, but it will definitely be a different experience than the one that I had in my head. Of course, I don't know why I should have expected anything different since nothing about our Quest for Wisebaby has played out the way it should have.

So, Wisebaby is due on July 24, so his/her arrival should be scheduled sometime between July 10-17, just in time for my niece's third birthday. Until then, I'm going to hope to continue to be tired for then next few weeks, but praying that I won't get any more sick.

An Ace in the Hole

We've been calling our Wisembies Ace and Base over the last few weeks, and today we got to see for sure if one or both of them stuck.

Our sonographer was running behind, so it was maybe more hurried than we had anticipated because I needed to get back to my school by 1:05 for my sixth period class. She did give me a big hug and a congratulations, which felt so real and genuine  Wisehubby and I both agree that she is by far the best part of our fertility clinic.

Anyway, the big news is that we have an Ace in the hole! One of our Wisembies implanted and flourished. We were exactly 7 weeks today, but little Ace is measuring 7 weeks 1 day, and his heart rate (131.58) is very strong. We could see his heart beating with no problem, and it was crazy that we could see the yolk sack and umbilical cord distinct from Ace's little blobby body. He measured 10.81 millimeters long!

We feel like we've been playing the long game and have finally scored; it is amazing to see that something you have chased after for so long is truly coming to fruition. We know that the weeks and months ahead of us are long, and uncertain, but we're excited for this next phase in our quest for Wisebaby!

Thanksgiving

After ninety-three shots, I am starting to believe that this pregnancy thing might just stick. This cycle went so much more smoothly than the last one; not just because it actually worked, but for several other reasons. I am so thankful for the following changes in circumstances:

1. We didn't have any major home repairs crop up during this IVF cycle.
2. I wasn't taking graduate classes.
3. My new boss is very easy going, so taking personal days and getting a substitute didn't stress me out.
4. Someone--or many someones--in every aspect of my life (work, church, family, friends) knew about our cycle. Having people asking after you makes dealing with an exciting and stressful situation more pleasant. 
5. As much as I bitched about Lovenox, it is relieving to know that the male Dr. B crossed every t and dotted every i in order to make this cycle perfect. Factor V probably didn't cause my early miscarriage or failed IVF cycle, but it definitely won't be the complication in this pregnancy.
6. Wisehubby bravely put his balls on the line in order to get an improvement in his sperm quality that is barely quantifiable. There is no way of knowing how important this factor was, but we got much better quality embryos this cycle.
7. Dr. B reduced my stimulation drugs down. I felt much less uncomfortable throughout the process, and we got fewer and healthier eggs.
8. Wisehubby was even sweeter this time than last, which I didn't think was possible.
9. Dr. B helped us with the costs of the lab, which is especially good considering the cost of the Crinone and Lovenox prescriptions is outrageous! Crinone costs $263 and Lovenox costs $200. The pharmacist at Walmart keeps asking if I really want my prescriptions. Uh, yeah!
10. We got a frostie! Having a frozen blastocyst takes a lot of pressure off of the transferred ones. We probably couldn't afford another fresh cycle for a few years, so it is great to know we've got a back up hanging out in a lab down the road.
11. So many of my infertile friendships are also in a good place right now. IWF, Dear Friend, and MyLazyOvaries (Twitter friend) all have had BFPs, and that is such a wonderful thing. 

Relaxing a touch

I'm relaxing a touch now that we've gotten through both blood tests, and my HCG levels are rising appropriately. I cannot wait to see the Wisebaby(ies) via ultrasound on December 5, but I guess I will have to.

BFP! BFP! BFP! BFP! BFP!

So, I swore to Wisesister when she went with me to CVS to buy pregnancy tests that I wouldn't be that crazy lady who tortured herself by taking a million pregnancy tests. It turns out that I lied.

Sunday was six days past transfer, and by 5 PM I couldn't stop myself from peeing on a stick. Luckily, I was rewarded with a nice pink line. It's faint in the picture, but I swear it is there. It is about half as dark as the control line. I repeated my tests in the afternoon on Monday, Tuesday, and Wednesday. The only day that was really crazy to do was Wednesday, since I had already gotten the call from my RE that we were BFP according to the blood test. My HCG was 112, so that's good according to the nurse--I have zero frame of reference on this one.

Tuesday did freak me out because the line faded visibly from Monday, but I'm ninety percent sure it was because I chugged some water in order to try to pee again in a short period of time. I was done in by my over-hydration.

Since the only experiences that I've ever had with conceiving have ended with a BFN or a chemical pregnancy, I'm feeling decidedly anxious. However, always a believer in positive thinking, I am just chanting to myself BFP! BFP! BFP! all day long as I anxiously await the results from my beta HCG tomorrow to see if things are indeed rising the way they should.

Join me now: BFP! BFP! BFP! BFP! BFP!

Days Past Transfer

5-Day Transfer

Days Past Transfer (DPT)	Embryo Development
One	The blastocyst begins to hatch out of its shell
Two	The blastocyst continues to hatch out of its shell and begins to attach itself to the uterus
Three	The blastocyst attaches deeper into the uterine lining, beginning implantation
Four	Implantation continues
Five	Implantation is complete, cells that will eventually become the placenta and fetus have begun to develop
Six	Human chorionic gonadotropin (hCG) starts to enter the blood stream
Seven	Fetal development continues and hCG continues to be secreted
Eight	Fetal development continues and hCG continues to be secreted
Nine	Levels of hCG are now high enough to detect a pregnancy

We're wrapping up day one past transfer, and I've become obsessed with the above chart that I procured from the NYU Fertility Center website. Today I tried to lay around as much as possible while our Wisembies are hopefully hatching.

With a lot of time on my hands to lay around staring at their picture, I decided to name the Wisembies Ace and Base. Ace is the AA embryo and Base just seemed like the right partner to Ace. Hopefully they see the welcome sign down in my uterus and stick around.

Today my mom, dad, sister, niece, and nephew came over at lunch time, so I turned off the TV and spent all afternoon talking with my favorite people. My niece took my husband to play at the playground, and I got to cuddle my infant nephew, who was able to be there because my sister is still on maternity leave.

It felt right having the family together with Ace and Base trying their hardest to join our family. Only time will tell though.

After the transfer

Here's a picture of my Wisembies taken in the embrology lab and then given to me to take home. It's backwards because of PhotoBooth, but you get the gist. The blastocyst you see at the bottom is a perfect AA and the one at the top is solid AB. Last time, we didn't have such good ratings going into our transfer, so that is very hopeful.

I'm back at home with my feet up feeling like maybe I'm pregnant already. :-) I'll know for sure in a week and two days.

Excitement

IVF is a crazy roller coaster ride of emotions, and this morning we are definitely in the excitement phase of the process. In the moments just before our day five transfer, we can't help but to be filled with  unbridled enthusiasm  for the possibilities. Today, we're getting pregnant. Today, we'll hear that all eight of our excellent embryos are grade A blasts, and that we'll have six for freezing. Today, our journey of infertility is finally going to turn into our journey of parenthood.

I know that all of this could be crap, and we could end up in the same place we were at, just light another $10,000, give or take--thanks again for the discounts Dr. B! But in my heart of hearts, I know that I must believe that today holds something more for us--something greater.

"For I know the plans I have for you,” says the Lord. “They are plans for good and not for disaster, to give you a future and a hope." - Matthew 11:28-29

Eight

I'm ecstatic about how we have eight excellent quality embryos growing on day three. Eight is an auspicious number, and I have such a good feeling about all of this. It is beginning to feel like all of Wisehubby's pain last winter is coming into fruition. Either that, or I was right when I flipped through my organized curriculum binder and told Wisehubby, "We can finally get pregnant now that I've figured out how to stay organized at work."

Retrieved, take 2!

This morning I rolled out of bed and into the car that rolled north to our fertility clinic for egg retrieval. I fell asleep quite a bit in the waiting room and again in the recovery room in which we got all situated.

My nurse was nice, but she put the IV line in too tight and it pinched my skin the whole time. I complained to the anesthesiologist who promised to get me put out soon so that I wouldn't notice.

Wisehubby was, as always, very sweet and kept coming over to kiss my forehead and hold my hand. I tried to put him on blanket patrol too, but Dr. B covered me with my blanket after walking me personally to the bathroom. Methinks the nurse may not be invited back to work there again.

Anyway, everything went smoothly, and they retrieved 19 eggs for ICSI fertilization. I'll know more tomorrow about how many fertilized. Last year, 19 fertilized initially out of a batch of 33, but Dr. B was trying to avoid getting so many immature follicles that wouldn't fertilize and grow well. Here's hoping his plan worked! I'd love to have two for transfer and a few for freezing, but I'll be happy no matter.

I pretty much slept all day after we got home, and I had some amusing dreams since Wisehubby used my lack of consciousness for a rare news marathon. I dreamt the I was riding a bus with President Obama, and we ate Kit Kats.

We had some friends come over with dinner for our weekly Homeland viewing party, so now Wisehubby and I are just chilling. Tomorrow I'll be home alone, but my parents are coming over with lunch, so I should have a pretty good day.

Final note on retrieval day: Wisehubby didn't want to be bugged with trick-or-treaters while I'm recovering, so he hung a sign on the door that reads, "Sorry, no Halloween at this house! Thanks!"

Silly Ovaries

As of this time tomorrow, I should be about twenty eggs lighter, which is no joke because as of Monday, the sonographer--who is normally one of the most confidence inspiring medical personnel I've ever met--temporarily mistook my left ovary for my right. "Silly ovaries," she quipes, "you're too close together!"

Ah, shit! My ovaries are so swollen that they had seemingly merged on the sonogram machine. What?

My meds dropped down to the bare minimum dosage for Saturday and Sunday nights, and we were rewarded on Monday with thick uterine lining, growth on the follicles that were more mature on Saturday, and slowed growth for the immature follicles. My right ovary is out-producing my left, both in size and quantity. Either way, my sonographer swears that I'm overachieving and doing great. They scheduled me for a 7:30 trigger shot on Monday, which meant no more Lupron, Follistim, or Menopur. I also dropped the Lovenox, but that will come back tomorrow night.

Hurricane Sandy kept one of my very favorite people in town for a few extra days, so instead of quietly triggering at home, like last time, I packed up my insulated lunch sack and headed out on the town. I triggered in the women's restroom at a Turkish restaurant, which is probably weirder for a Texas girl than the sports bar of yester-cycle.

Today was a great day at work, despite a rough parent phone call, and I finished it up with a late meeting with my district curriculum writing team. I work with some amazing men and women, and it was really nice to see them all in person and hear their well-wishes for our retrieval tomorrow.

I'm just a little anxious, and I'm determined not to toss and turn, so I am just watching Dancing with the Stars and trying not to notice my seriously swollen, very silly ovaries.

Shots on the go

Here are some different places that I've taken shots during my IVF journey:
-The bathroom of a sports bar (Ovidrel, trigger shot before retrieval)
-The bathroom at a watch party or three (Follistim and/or Lovenox)
-The front seat of the car in the parking lot of a restaurant in Addison (Follistim and Menopur)

The weirdest and best location of all will definitely be this Saturday when I take my Follistim, Menopur, and Lovenox at the medical clinic at the Gaylord Family Oklahoma Memorial Stadium during the OU/Notre Dame game. Hopefully the security staff won't give me too much crap about bringing in my sack of injectable meds.

Here are a few tips about shots on the go:
1. Avoid it if possible. Seriously, it is much easier to do them at home with your trusty sharps container.
2. Have a really cute insulated lunch sack. Mine is almost indistinguishable from my purse, so I don't look bizarre carrying it around.
3. Pack back up bandaids, sterile gauze, and alcohol pads. Who knows when you'll get a gusher!
4. Find someplace private and somewhat clean.
5. Consider how you're going to deal with the sharps in advance. Don't discard the caps and such; many times you can recap the needle. Bring something to wrap or close them into if not.

Happy travels fellow IVFers!

UPDATE: They dropped Menopur for the remainder of my cycle, and we were running a touch behind, so I injected Follistim in the hallway of Catlett Music Center at the University of Oklahoma so Wisehubby could run the drugs back to the car and not carry them around the whole day. With no drugs to mix, I just took my prefilled syringe of Lovenox to the bathroom under section 18 of the stadium after OU's last scoring drive and gave it to myself in the stall.

What swollen ovaries feel like

Swollen ovaries kind of feel like off-centered bladder infections.

That is all.

Injecting the crazy - Side effects

I started stimulating with injectable hormones last night, and have already given my dosage for tonight. Last year, I took Lupron in the mornings and Follistim in the evenings. This year, my protocol is Lupron in the mornings, Follistim and Menopur in the evenings, and Lovenox at bed time. I suppose that I could switch Lovenox to the evening time period, but man, it burns like hell and I don't think I could stomach it as shot number three.

Here are my feelings so far on side effects:

• Lupron (prevents ovulation) - Though everyone on message boards bitches about Lupron headaches, I don't know if I've ever gotten one. I get sinus headaches all the time, so there could have been many a Lupron headache lurking in disguise that I just attributed to other things. I can tell you that my left eye has been twitching, but I don't think that has to do with the hormones so much as the stress.
• Follistim (stimulates ovaries) - Last year I took this and my only effect was really heavy, sore ovaries, which is the intended effect. It's not comfortable, but it is what I signed up for.
• Menopur (stimulates ovaries) - Everyone on the internets complains about how it burns, but these people have clearly never taken Lovenox. I did have the most amazing nausea and stabbing stomach pains this morning, which I am chalking up to the Menopur, as I did not experience this last year. It was so bad that I went to our school nurse to get my temperature taken, worried that I'd contracted a virus. Nope, it was just all the crazy I've been injecting into my system. "Oh, well, it's the new medicine I am on, I suppose," I tell the nurse. 
• Lovenox (prevents blood clots) - HOLY MOTHER OF WHATEVER! Have I complained about this to you yet? No? Well, let me rectify the situation. Lovenox is the devil shot. It is putting me off of shots all together, which is not good. Not only does it stab like a @#$%@# when you inject it, but once you finish it burns and aches for a good thirty minutes while the medicine creeps slowly around your abdomen. Enjoy! I had to tell my friend, Dr. B the hematologist, that he should give it a try sometime before he decides to prescribe it again. It is pure evil. "I'm so glad that I found out that I have a genetic blood disorder," said no one ever.

Today, I felt pretty normal, but after my second injection, I immeadiately felt my ovaries. It is a very distinct feeling, this noticing an organ that you don't normally notice, so it could just be the medicine I'm injecting, or it could be that I'm injecting a dose of crazy. Only time will tell.

It burns like hell

It burns as bad or
worse the nurse
warns, matter-of-fact.
Where am I supposed to
put four shots a day?
My already inky belly?
The fleshy bit of
my thigh.

Every night,
Every morning
he watches as I
stick myself.

It burns like hell.

Thirty-two Shots and Counting

I'm thirty-two shots into this IVF cycle, and we still haven't started stimulation. It's just making me really tired; the stress is exhausting and both Lovenox and Lupron list tiredness as common side effects.  In fact, if you Google Lovenox, two suggested searches are, "Lovenox burns like hell," and "Lovenox fog". I have spent a disturbing amount of time in the last week since I started Lupron in combination with Lovenox staring at my computer screen, attempting to will my brain to work productively.

I've stopped the birth control pills, so I should start my period tomorrow or Friday. Once I do, I can set up a plan for when to start stimulating with Menopur and Follistim, putting my daily shot count up to 4. I was looking over my timeline from last year, and it looks like we'll have the retrieval and transfer in about three weeks.

Sorry this one is not a witty or even compelling post. Just sitting here letting the Lovenox burn like hell and put my brain in a non-witty fog.

IVF Playlist

I've got a new playlist for this IVF cycle, so I thought I'd take you through it a bit so you can get a glimpse into Wisehubby's and my head space, as well as our sense of humor.

The first part is an ode to the money woes.

"Circumstances", Shemekia Copeland
The words say it all:  Circumstances in control of my life; circumstances gonna rule me till the day I die.

"Billionare", Glee Cast Version
Proof that I'm a nerd: I don't even know who originally sang this song, nor do I care to find out. Why? Oh, I want to be a billionaire so freaking bad, buy all of the things I never had.

"Bills, Bills, Bills", Destiny's Child
I kind of want to shout this at the male Dr. B sometimes: Can you pay my bills? Can you pay my telephone bills? Can you pay my automo'bills? Then maybe we can chill. I don't think you do, so you and me are through.
OK, here comes my fucked up section. Enjoy the cray-cray!

"Bitch Went Nuts", Ben Folds
Oh, the bitch went nuts, but everyone thought she might, oh holy fucking shit. It's the stress that makes me crazy, not the drugs. I am prone to crazy ass mood swings, even when I'm not on the hormone therapy yet. Explain that one to me!
"Artificial Nocturne", Metric

I'm as fucked up as they say. I can't fake the daytime, found an entrance to escape into the dark, got false lights for the sun. It's an artificial nocturne, an outsider's escape for a broken heart. I'm me. All that I believe, I set myself free. So take all the time you need, and let yourself be.

"Scar Tissue", Red Hot Chili Peppers
Blood loss in a bathroom stall, southern girl with a scarlet drawl. Wave good-bye to ma and pa 'cause with the birds I'll share, with the birds I'll share this lonely view. With the birds I'll share this lonely view. 

This southern girl actually stopped in a bathroom stall at a place called Country Burger to take a pregnancy test during her miscarriage. How fucked up is that?

"Breaking the Girl", Red Hot Chili Peppers
"Twisting and turning, your feelings are burning. You're breaking the girl. She meant you no harm. Think you're so clever..."

"Annie Wants a Baby", Red Hot Chili Peppers
Annie wants a baby now. Annie wants a baby any way she can. Missing pieces, she's got a lot of em.
Time decreases, I wish I thought of em before. Before it's time to close the store. Oh yeah. Installation,
A lonely sink of fame. Some liberation, the only seed we ever plant. I wanna help you but I can't. No, no.

"Hallelujah", Jeff Buckley
Baby I've been here before. I've seen this room and I've walked this floor (you know). I used to live alone before I knew you. And I've seen your flag on the marble arch and love is not a victory march. It's a cold and it's a broken Hallelujah. Hallelujah, hallelujah, hallelujah, hallelujah...

Enough wallowing, here comes the upswing! Wisesister will be so proud! Also, can you tell that my favorite band of all time is Red Hot Chili Peppers? Weird, right?

"Factory of Faith", Red Hot Chili Peppers
Be my wife, I think you right that we should mate. Tell your friends, I got a factory of faith. Late last night, I had a dream that it was great. Tell your friends, I got a factory of faith. I got a factory of... Faith. And love.
"Let Go", Frou Frou

So let go. Jump in. Oh well whatcha waiting for? It's all right 'cause there's beauty in the breakdown.
"When We All Get to Heaven", Brad Paisley
Let us then be true and faithful, trusting, serving every day; Just one glimpse of Him in glory will the toils of life repay.

"View from Heaven", Yellowcard

And I'm sure the view from heaven beats the hell out of mine here. And if we all believe in heaven, maybe we'll make it through one more year down here.

"Way Back into Love", Hugh Grant and Haley Bennett

All I wanna do is find a way back into love, I can't make it through without a way back into love, and if I open my heart to you, I'm hoping you'll show me what to do, and if you help me to start again, you know that I'll be there for you in the end!

"Book of Love", Peter Gabriel

The book of love is long and boring and written very long ago. It's full of flowers and heart-shaped boxes and things we're all too young to know. But I love it when you give me things, and you, you ought to give me wedding rings.

"Such Great Heights", Iron and Wine

They will see us waving from such great heights, 'come down now,' they'll say. But everything looks perfect from far away. 'Come down now,' but we'll stay...

"Broken Road", Rascal Flatts

Now I'm just rolling home into my lover's arms. This much I know is true: That God blessed the broken road that led me straight to you.

"In the Waiting Line", Zero 7

Wasting my time in the waiting line. Do you believe in what you see? Nine to five, living lies, everyday, stealing time.

"Haven't Met You Yet", Michael Buble

I'm not surprised. Not everything lasts. I've broken my heart so many times I stopped keeping track. Talk myself in. I talk myself out. I get all worked up, then I let myself down.

I tried so very hard not to lose it. I came up with a million excuses. I thought I thought of every possibility.

And I know someday that it'll all turn out. You'll make me work so we can work to work it out. And promise you, kid, that I'll give so much more than I get. I just haven't met you yet.

I might have to wait. I'll never give up. I guess it's half timing,  And the other half's luck. Wherever you are. Whenever it's right. You'll come out of nowhere and into my life.

And I know that we can be so amazing. And baby your love is gonna change me. And now I can see every possibility...

They say all's fair in love and war, but I won't need to fight it. We'll get it right and, we'll be united...

I just haven't met you yet. Ohh, promise you, kid, to give so much than I get. (I said love, love, love, love...) I just haven't met you yet.

I just haven't met you yet.

"Many the Miles", Sara Barielles

Red letter day and I'm in a blue mood, wishing that blue would just carry me away. I've been talking to God. Don't know if it's helping or not, but surely something has got to got to got to give 'cause I can't keep waiting to live.

How far do I have to go to get to you? Many the miles, many the miles. How far do I have to go to get to you? Many the miles. But send me the miles, and I'll be happy to.

"Happiness Loves Company", Red Hot Chili Peppers

Make time for love and your happiness. The mothers of invention are the best. We all learn and struggle with some loneliness. A tender mess for everyone I guess.

"God Put a Smile on your Face", Coldplay

Where do we go? Nobody knows. Don't ever say you're on your way down when God gave you style and gave you grace and put a smile upon your face.

"Dog Days are Over", Florence and the Machine

The dog days are over. The dog days are done. The horses are coming, so you better run.

"Ever Ever After", Carrie Underwood
Storybook endings, fairy tales coming true. Deep down inside we want to believe they still do. And a secret is taught, it's our favorite part of the story. Let's just admit we all want to make it to ever ever after.

Starting your fashion, wear your heart on your sleeve. Sometimes you reach what's real just by making believe, unafraid, unashamed. There is joy to be claimed in this world. You even might wind up being glad to be you... Though the world will tell you it's not smart... The world can be yours if you let your heart believe in ever after.

No wonder your heart feels it's flying. Your head feels it's spinning. Each happy ending's a brand new beginning. Let yourself be enchanted, you just might break through to ever ever after...

"Dance, Dance, Dance", Red Hot Chili Peppers

Dance, dance, dance, dance! All night long, yes all night long! Dance, dance, dance, dance! We got strong, yes we got strong!

"What I am", will.i.am and the Sesame Street monsters

If what I am is what's in me, then I'll stay strong; that's who I'll be, and I will always be the best"me" that I can be. There's only one me, I am it. Have a dream, I'll follow it. It's up to me to try. Oh! I'm a keep my head up high, keep on reaching high! Never gonna quit! I'll be getting stronger. And nothing's gonna bring me down! (no!) Never gonna stop, gotta go. Because I know, I'll keep getting stronger.

"Damn Girl", Justin Timberlake

That's got me saying, "Damn girl, you're so fine!"

What's the plan, Stan?

Yesterday we had our final meeting of Dr. B(alls). Wisehubby will continue to go to him to be monitored for his hormone therapy, but we have beaten down the limited doors available to us on the male fertility end. Dr B(alls) admitted that although so many things have improved for Wisehubby--his ratio of estrogen to testosterone, count, motility, density--the morphology issue is likely to remain a permanent one, even with an otherwise mostly successful varicocele repair. He says that Wisehubby's case still indicates IVF with ICSI, and referred us back to our reproductive endocrinologist (RE).

I think Wisehubby is still disappointed that he went through so much pain and suffering, and we are still in the same place we were a year ago. I get the sense that he sees this as his problem that I must pay for with my body undergoing harsh procedures. Of course, that's not how I see the whole thing--it's OUR problem that we must work towards fixing through every possible treatment--but my opinion is neither here nor there.

Wisehubby is dreading the return of the twice daily sticks and frequent transvaginal ultrasounds because he loves me dearly and would gladly go through varicocele repair again if meant that he could spare me the pain and discomfort. Fortunately, after eight years together, I love him more deeply than ever, so I am down right eager for the twice daily sticks and frequent transvaginal ultrasounds because I know that the pain and discomfort is something that I can do to help us both achieve our dream of a family of three (or maybe even more!).

That brings me to today, where we met with our RE, the male Dr. B, to plan for our second IVF cycle. He remembered that we're both teachers, and made a point to honor our time and financial limitations in the creation of our plan. He spent time carefully reviewing the spreadsheet of medicine that Wisehubby had compiled so as to not spend money on unnecessary prescriptions; he "donated" some progesterone gel to us. We felt better about his bedside manner this time around, but maybe we're just used to his gruff, matter-of-fact nature. Maybe we were just so ready for a new plan that we over looked his less pleasant features.

So, what's the plan, Stan?

Our new plan will start with a fresh mock transfer, an ultrasound procedure done with a full bladder. There was a looming threat of some sort of uterine "stretching" which I hope does not come to bear. After that, it will be a waiting game for my next menstrual cycle, where I have my blood drawn for my FSH levels and then start on birth control to regulate my strangely short periods, and blood thinners to protect me from blood clots from my Factor V disorder. About three weeks later, I will start lupron to prevent ovulation. At the onset of my second menstrual cycle from now, I will stop birth control and start two different daily stimulation injections. We're going lower and slower with the dosing this time to avoid the hyper stimulation that lead to the removal of many immature eggs that did not lead to good, healthy embryos. After about ten days of stimulation, I will stop the lupron and blood thinners, and take one shot to trigger egg maturation. 36 hours later, the male Dr. B will remove about 15 eggs (the sweet spot amount) for fertilization in the lab, via needle. At that time, I'll start back on the blood thinners and add vaginal progesterone gel to my regimen--no progesterone in oil this time! Huzzah! Hopefully, about a week and a half later, a blood test will confirm that I am pregnant, and we will begin to plan for a pregnancy and then for a baby.

Did you follow all of that? Can you keep track? No? Honestly, I'm impressed that I can follow it myself.

My suggestion? Stay tuned to my Twitter and blog for updates as we go! If I've learned anything, it is that our quest for Wisebaby is full of twists, turns, and surprises. Let's just hope that this fall, we don't have our house coming down on top of us!

Seven Months Post-Op Visit

We visited with Dr. B(alls) a while ago about Wisehubby's latest semen analysis at his seven month post-varicocele repair visit. The news was mildly more encouraging than last time. Wisehubby's numbers have bounced in most of the major categories into a normal range. Only his morphology is holding on at a big, fat goose egg.

As a reminder, morphology is the shape of the sperm and is important because it can effect the sperm's ability to penetrate reach and penetrate the egg. A man only needs his normal count to be 4% or greater to be considered fertile, so the standard is set pretty low. Unfortunately, 0% normal morphology is considered to be just about terrible; you get a "Do not pass Go; report straight to IVF with ICSI" card when those are your results.

Dr. B(alls) counseled again that we be patient, as we were seeing improvement in Wisehubby's numbers, but the wait is not too far off at this point. He is hopeful that we may be able to get Wisehubby's normal morphology up to .5% or even 1%, which could mean less painful, invasive, and expensive ART treatments. How great would it be if we could do an IUI instead of IVF with ICSI?

We're not really hopeful that things are going to get much better; we are prepared mentally, emotionally, and financially for another round of IVF.  However, the increase in the rest of his numbers does at least make us feel as though the decision to pursue the varicocele repair was the right one. As Dr. B(alls) pointed out, science does not yet know what makes the inside of one sperm more viable than another when creating an embryo. Since we were able to improve quantifiable things about Wisehubby's little swimmers, then maybe the crazy mutants are healthier now than they used to be! This could help us have a more successful batch of embryos; we might even get to freeze a few. This could also help the transferred Wisebabies implant successfully, something that did not happen with our first round of IVF.

All in all, we are in a better place now than we were in a year ago. Yes, IVF is still looming on the horizon, but we're older, wiser, and varicocele free.

Would you like my leftover meds?

Today I got to visit with a friend of mine who has been battling infertility for over seven years; let's call her my Infertile Warrior Friend, or I.W.F. for short. She and her husband had just finished a long year of unsuccessful infertility treatments and moved halfway across the country. Just when they weren't looking, they conceived naturally. A lucky, but painful, cyst on her ovary helped keep her progesterone levels up to help support the early pregnancy and avoid yet another heart breaking miscarriage. Her HCG levels have risen well, and they've even been fortunate enough to see the little nugget on ultrasound. I.W.F. is not out of the woods on this one by any means, but she's creeping up on eight weeks of a healthy pregnancy. All of this is making me so very hopeful for our own story.

This week, I.W.F. is in town visiting family. As an act of faith, she brought her spare meds with her to give to me for my upcoming IVF cycle. Since prescriptions for infertility are a horribly expensive (not covered by insurance) part of the process, I gladly accepted this beautiful, generous gift. Right now, Wisehubby is cataloguing our stash of meds (I.W.F.'s and our own) so that we can take it to our appointment in September with the male Dr. B.

I tell you all of this because I am so grateful to have a growing network of support in my real life. It is hard to open up about infertility, but once you do, you might just be surprised by who in your life can help to hold you up and provide realistic hope when things are tough.

When I put all of our IF questions on the back burner this spring, I didn't stop my campaign of honesty. Through that, I learned that a friend from church had struggled to conceive her two beautiful baby boys. When it seems like everyone at church is trying to overpopulate the planet, she'll sometimes lean in with a snarky or sweet comment that hits the spot. These infertile friendships have meant more to me than most anyone could ever know, except for maybe the brave women who have opened up with me.

Pay it forward might seem cliche, yet I look forward to a day in the near future when, after conceiving and seeing my own little Wisebaby (babies?) on ultrasound, I can take my own leap of faith, call up Dear Friend and ask her, "Would you like my leftover meds?"

Time off for good behavior

After my last post, Wisesister called and suggested that my coping mechanisms weren't doing the trick. She commended me for using Twitter and Blogger to express my feelings, but pointed out that I was becoming increasingly negative and hopeless. She suggested that I take a break from the internet, talk to a counselor, and focus on the positive things while we waited for Wisehubby to heal. I was skeptical at first, but Wisesister gives the best advice, so I took it.

Wisehubby and I called the male Dr. B's office and asked for a referral to a counselor. We set up an appointment with Ms. B--no joke, we found another infertility medical professional with a last name beginning with B. It was a good visit, and it served to ease our fear that we were not communicating or handling our struggles in a constructive way. She commended us for being on the same page, and recommended that we try to take some time off to focus on our relationship. Our homework was to spend our summer vacation relaxing together, setting aside time once a week to have infertility check up chats. Her advice sounded shockingly like Wisesister's, so I felt a little silly for needing to spend some money to hear a second opinion.

We did great with focusing on our relationship this summer. Wisehubby and I have had little pool parties where we watch trashy TV or the Olympics several times a week. We went to movies and made new recipes. We drove 2,400 miles through Texas, New Mexico, and Colorado, camping for four days where we could not get cell phone reception.

When we were off of the grid and seeking shelter from an afternoon rain storm in Mesa Verde National Park, we talked about what our life would be like without kids. We could travel, spend time volunteering, give ourselves over to our students and Godchildren, spoil our dogs rotten, and generally have a good time. I think that talking specifically about how we could not just survive but ENJOY having our dream of children permanently deferred allowed us to relax about the future. We still want to conceive more than anything, but we know that no matter what, we've got a happy family, just the two of us.

We're nearing the end of summer, which brings new challenges to our plate. I'm at a new campus doing the same job next year, and Wisehubby is starting a new position after two years of chasing that promotion. We're also looking at the nine month post-op mark at the beginning of September, so I scheduled an IVF planning session with the male Dr. B today. It brought back a whole flood of feelings, but it wasn't overwhelming or depressing in the way it was four months ago. After all, taking time off for some good behavior was just what the doctor (Wisesister) ordered!

Now what

Today we got some news that has left me without direction for the first time since we started down the crazy rabbit hole of trying to conceive. Wisehubby visited Dr. B(alls) and found out that despite his surgical repair three months ago, his count, density, and morphology all stayed the same--bad. His motility rose slightly, but it is still well below normal, as well.

Originally, Dr. B(alls) told us that we could think about IVF six months after the surgery. Today, he recommended nine. NINE! That means that the soonest he recommends trying again based on Wisehubby's recovery is September. That will be almost full year after our first IVF try, two and a half since we started actively trying to conceive, and three and a half years since I went off of birth control pills.

On top of everything else, I don't even know if we could do September. I am a school teacher, and my work schedule is very inflexible. It was incredibly hard and painful to work through my last cycle, both physically and emotionally. I do not know if I want to do it again. Part of psyching myself up for a second, more aggressive, round of treatment was the knowledge that I would be doing it from the comfort of my living room on vacation; I could wallow with my swollen ovaries all day long.

That means that, if we follow the advice of the man who knows best, we may not get a chance to conceive until summer 2013. The thought of that GUTS me.

All of this to say, now what? Where do you go from here?

To bed.

Taxing

Throughout the last year, I knew that we were throwing a lot of money at our fertility issues. Because I was so desperate to make our dreams come true, I didn't stop to see exactly how much it was costing us until it was time to itemize our medical bills for our taxes.

As it turns out, IVF is a very taxing process, in more way than one. Since we did IVF last fall, we spent more than 14.5% of our income on medical bills, after insurance paid out: prescriptions, doctor visits, dentist visits, and lab work. That is over double the amount you need to claim an itemized deduction on your federal taxes. We did just that, plus we itemized our charitable giving and educational expenses (graduate school). We ended up getting a return big enough to pay back the loan we had received from my in-laws last fall to help soften the blow of paying for IVF in cash. I can't wait until it is processed.

The point of this is to say, please, please, if you are reading this, living in the United States, and seeking fertility treatment, be sure to keep bills for all prescriptions and lab work. As for doctor and dentist visits, I found that the easiest course of action was to call each office and ask for them to mail a year end statement to us. That way, we didn't have to sort out the dozens of visits to the male Dr. B, on top of several visits for Wisehubby and I to Dr. P and our dentist, Dr. H, each.

IVF is taxing, but you may get a little bit of relief at tax time if you remember to itemize!

Factor V

I've been joking about having a mutant baby for so long that I had begun to forget the horrible truth behind it all. I dismissed Wisehubby's morphology issues as mutant sperm because I was using humor to hide from the pain. Now, I have only to look at myself to find a *real* mutant.

That's right, I have a Factor V mutation. I didn't know a lot about this today when the male Dr. B delivered the news unceremoniously over the phone, so I once again was left reeling by his news. After reading a bit about it, I have a ton of questions, many of which I will get answered by my primary care physician, Dr. P--thank goodness, she's not a B!

Depending on the severity of it all, I might even have to find myself a hematologist, which is a ripe kind of fun because a dear friend of mine is applying for fellowships in hematology/oncology--his wife calls him Dr. B, but that's his first name.

From what I can tell from Dr. Google, I'll have to take injections of blood thinners throughout any future cycles, as well as throughout any pregnancies. This means that you have to be very closely monitored at all stages of the pregnancy, and many women have induced labor or scheduled c-sections to avoid placenta problems.

I'm just starting to soak all of this in, so this was a pretty dirty post. If you know anything about this stuff, please HELP! I'm a mutant, but I feel so powerless.

An email and a response

A colleague sent an email to our small group of teachers who specialize in the same subject recently that ruined my day:

"Just wanted to let everyone in on my week…

[We] found out that we are pregnant with #3 this week. :)

We had a blood test done on Wednesday because we have NO clue how far along I am, and turns out I am anywhere from 8 to 14 weeks. 

So…we have a sonogram on Monday to find out for sure.  I will keep you all posted.

TGIF.

Best regards,

[Fertile Be-otch]"

Then this today:

"Well, turns out I am 15 weeks along as of today, [our daughter]’s 1st birthday.
The baby has little man parts and we couldn’t/can’t pick our jaws up off the ground.  There is a whole kid in my stomach that I didn’t even know about for the past 15 weeks.  I’m amazed and shocked and really excited. ☺
Just thought you guys would want to know the update!

Best regards,

[Fertile Be-otch]"

I couldn't send the response I wanted, so I settled for nothing. If I was a brave, bridge-burning bitch, here's what I would have said:

NO! I do NOT want to know the update. I do NOT want to hear about how you are so fertile that you could conceive clearly without trying less than a year after giving birth to your second child. In the time that you have been knocked up not once, but twice, my husband and I have suffered through one miscarriage, one failed cycle of IVF, and one testicular surgery. I don't think it is cute or funny or kind for you to share. I want to punch you in the uterus, if you must know. Yup, that's about it.

Best regards,

Wiselady

"Elegy"

"Elegy"
from Want by Rick Barot

In this rain we are moved to anecdotes.
That people float candles out to the river.
That in a field there is the crickets' grief.
It could be colder just now but it isn't.
Though there are the posters' missing faces.
Though a car is upside down, wheel turning.
The day will only want to keep arriving.
We will startle for the clothes by the bed.
For the vein glowing green on the thigh.
The coffee will come black in its cup.
The bread will be made of something clean.
This will not seem enough and it isn't:
The white nouns of the moon, the paper.
The handkerchief pulled from an empty fist.

Wiselady's IVF Tips

Looking back on my IVF cycle, I learned so much about myself and IVF in general were I to do things again, here are some tips that I would follow.

1. Have band aids ready during injections. You never know when you'll get a little blood droplet, and Wisehubby had a better time not staining my waistband or cringing when he could quickly apply a band aid. It didn't really help physically, but it was easier on both of us.
2. Take off at least one day after the retrieval. I only took off the minimum amount of days by doctor's orders, and it was a little bit of a mistake. Retrieval was, to me, the most painful part of the process. Your ovaries still feel so swollen, even after being relieved of your eggs, plus you have cramping because the retrevial involved puncturing of your lady parts with a needle. I was totally distracted by the two week wait, anyway, so I wasn't any good to my students at work.
3. The needle goes straight in with a firm push. Seriously, push a little. Nothing sucked worse than the morning that I accidentally let my Lupron sharp bounce out of my tummy. Who wants to stick themselves twice?
4. Put on your glasses and double check the dosage. Wisehubby administered only half of the dose of progesterone in oil, which is delivered in big, nasty needles into the butt. Ok, so something did suck worse than letting my sharp bounce out. That was a rough morning, because we had to switch needles for drawing down, draw down again, and then stick the other cheek. It was the hardest day to keep from crying.
5. Get a good audio book to listen to while you're waiting. Wisehubby and I listened to Catching Fire, the second book in Suzanne Collin's Hunger Games trilogy, in the car and using headphone splitters. It got our mind off of all of the what-ifs that nag you while you wait, which you do a lot when you're going through an IVF cycle. Day time TV stinks anyway, so it was nice to avoid pretending to be interested in it while we waited after the transfer.
6. Make an IVF box. I had a plastic box dedicated for storing all of my non-refrigerated IVF supplies. I appreciated it after the male Dr. B confirmed our failure; I just put the lid on it and shoved it to the back of my closet. It'll be there for when we try again.
7. Make an IVF bag. I used a pretty insulated lunch sack for storing all of my refrigerated IVF supplies. I could easily grab it, throw in an ice pack, and go if I needed to administer drugs on-the-go. It also looks just like a lunch sack, so it reduced questions. If people saw it while we were out on the town, it just looked like a lunch sack or purse. If house guests looked in our fridge, it didn't stand out. I did tell a lot of people about our IVF, but it didn't mean I wanted them staring at our meds.
8. Wait until you are "all done" to get a log of all procedures and charges. I started off trying to provide substantiation to our FSA for every charge, but it got to be too much. Plus, the male Dr. B's office staff would file everything with insurance and then carry charges over into your next visit. This made individual visit receipts worthless to the FSA. You have a long time to provide substantiation, so I just asked for a complete itemized receipt of all services when I went in for our WTF follow-up appointment. Faxed to the FSA, it seemed to take care of business.

Nothing Left Beneath

It’s been a decade since I first slipped

this mask on,

the day my mother said

goodbye to her child.

You left me,

a broken girl, masked for protection.

I unmasked myself

only in that split second before I fell

asleep, drifting into a void

of feeling.

My mask became a part of me,

the way my friends don’t recognize me

without my eye glasses.

When I said goodbye last year

to my child

whom I’d never met,

I tried to take off the mask.

That’s when I found that there was

nothing left

beneath.

Ball is in his court

We went for another follow-up with Dr. B(alls) today, and things are starting to look better for Wisehubby. His steri-strips came off, and he doesn't have the world's worst case of blue balls, just a bad case of them.

The ball is in Wisehubby's court now; it's time to ease back into real life and hope for the best. He's now allowed to take warm baths to help alternate hot and cold (icing) for comfort, and in a week he can return to his normal habits. His abnormal recovery still looks like it is functional, and Dr. B(alls) finally said that everything should go back to normal eventually. Apparently, the alternative to letting things stay wonky would have been a risky extra incision which could have lead to the demise of a testicle. So, we're pretty glad that Dr. B(alls) decided to play it safe when he had Wisehubby on his table.

Wisehubby is going to have a few more follow-ups, so that Dr. B(alls) can help him through the recovery. He'll do a follow-up semen analysis at months three and six, and that is when we'll know whether or not this extremely painful, expensive gamble has paid off. Here's hoping for the best!

Why his throat hurts

Wisehubby has been complaining about his sore throat that appeared because of his three-hour long intubation during his varicocele surgery. A lot. He's never complained this much about anything medically related before. He even has been talking in this weird whisper voice that my damaged ear drums can't manage to understand.

Finally, today, Wisehubby confessed to why he keeps bitching about his sore throat. He said, "My balls are sore and my abdomen is swollen; nothing seems to be going right." He complains about the sore throat because it is something that he seems to have some control over. He should be able to kick this, but he knows that his fertility issues and the new issues springing from his varicocele surgery mystery aren't going anywhere soon.

If I could just heal the hurt, I would, but I can't. So, until then, I'll try to understand what he's saying when he croaks at me softer than I can understand.

Well, balls!

I'm not going to get into major specifics here because I'm pretty sure Wisehubby would kill me for talking too graphically about his reproductive organs. Plus, I'd have to kill you, dear reader, if I knew you were spending too much time thinking about Wisehubby's reproductive parts.

As vaguely as an over-sharer like me can be, here is the story: his surgery went textbook perfectly on one side, and left things looking a wee bit abnormal on the other. His urologist brought him back in early for a follow-up and swears that the functionality should be fine. There may be ways to correct the abnormality in the future, if nature doesn't right itself.

I know that almost every time I post I use the expression "it's been tough", but I mean it this time. Wisehubby has been my rock and source of comfort through everything, but I've been struggling to do that for him. The first couple of days post-surgery, Wisehubby was sore and drugged and lying flat on his back, so that was pretty easy. I brought him ice, gave him medicine, cooked him dinner, and even learned to mow the lawn. Since he started being more mobile, it's been harder to baby him and keep him from comforting me.

I know Wisehubby doesn't like being made a fuss of, but he does deserve to be treated that way. I learned to love aggressively from my family, and I am so grateful that they have supported me in loving him aggressively both this week and during our entire marriage. Wisesister called a couple of times a day, just to check in, since she couldn't make the drive out to see Wisehubby. My parents didn't ask if they could bring lunch; instead, they asked, "What would you like us to bring over for lunch?"

So, my family, his family, our friends, and I fought the good fight this week, but I don't think it's made much of a difference. Wisehubby has had a long string of bad news related to his manhood, and it is starting to take a major toll. First, he's got weird-shaped sperm. Then, his hormone levels are off and he has low count, too. Then, he's told that IVF with ICSI will overcome our problems, but none of our 22 fertilized eggs survive either in the womb or for freezing. Finally, his urologist offers the panacea of varicocele repair, a painful surgery that will supposedly improve many of these issues and the health of embryos in the early stages of growth. Of course, you know how that works out.

What's hurting Wisehubby isn't the longer than anticipated incisions, or his swollen and bruised man-parts, or even the sore throat that he developed because of intubation. What's hurting him is that he feels like he's failing. He longs for a family; you can see it in the way he plays with our niece and our friends' children. He knows how much I long for a family; he's never been able to say no or disappoint me. He knows how much our families long for Wisebaby; he wants our children to grow up surrounded by love. He knows how much our friends ache to see our desires fulfilled; they talk about the day that we have prayed for for so long. So, yeah, he's not just disappointing himself or me, but a whole slew of people that he would do anything for.

So, we'll just have to keep trying to love Wisehubby aggressively as he deals with another set-back. Well, we can also make a few good ball jokes along the way; he seems to like those.