I Always Knew Robert and I Had A Lot in Common

I thought I’d go ahead an give a bit of an update, since we have received some additional information that is going to affect our attempts to conceive. Tuesday one of the labs that we had done was received by the doctor’s office. I don’t know if the other two are completed yet, but this one came back in and provided some answers for us. As well as introduced, or I should say educated us, on a hurdle that we are going to have to overcome in this whole baby making process.

Of the “optional” tests that we opted to have run, one of them was to test our DQ Alpha/HLA. Basically it is checking to see what two genotypes each of us carries – which is probably a super simplified explanation of what it really involves. As I understand it, generally speaking each couple will have four distinct genotypes. When the sperm and egg meet, and create an embryo, that embryo will subsequently inherit two genotypes – one from the mother and one from the father.

Well, it turns out that Robert and I share one of our indicators. This means that instead of having four genotypes between us, we only have three. So what does this mean? Well, it’s complicated and I’m not sure I fully understand everything yet (we have about 10 questions for the doctor), but the short answer is basically that one of every two embryos (50%) will be incompatible with my body, causing my body to attack and reject the embryo.

As I said, a hurdle. And while it is going to be difficult to overcome, it’s not insurmountable.

Well, this all sounds rather unfortunate, doesn’t it? (I agree!).

Because Robert and I only share one of our two genetic indicators, we have what is considered a “partial” match, meaning that only 50% of our embryos will be unsuitable. This means that we still have a 50% chance for a successful pregnancy. It would be a whole lot worse if we had a complete match, meaning that 100% of our embryos would be unsuitable (requiring a surrogate or adoption). But, it will still be challenging.

After emailing with the nurse yesterday with some questions, it seems that there is apparently a lot of controversy about the treatment options amongst the medical reproductive community on how to best treat for success. Based on what the nurse told me yesterday, I suspect I know which side of the fence my doctor is going to fall on – but we see him this afternoon and I hope to be better educated at the end of that meeting. I have an entire list of questions written out for him.

Of the things that we are going to discuss with him is his opinion on just jumping into IVF next month (assuming this IUI isn’t successful), given the new information that we have. Robert and I were originally decided on doing one more letrozole/IUI cycle since I have another round of letrozole at home still – but given this new information, I think I’m ready to just pull out the big guns and get down to business. Additionally, given this new information, I think we are pretty decided on going forward with the PGD testing (although we had some additional questions for the doctor today). Our thought is that if we are already at a 50% chance of success, it is probably in our best interest to make sure that the embryos going in have at least that 50% chance and are otherwise genetically sound.

Granted, our insurance won’t cover the PGD testing (I have a call in to confirm that the DQ Alpha/HLA results are not sufficient for coverage, but I’m pretty sure something needed to come back in the Karotyping tests to be eligible for  insurance coverage for the procedure) so there is going to be a finite number of times that we can afford to undergo this extra step. But we are going to run with it as long as we are able. I also have to find out from the insurance how many IVF treatments are covered – I don’t know if there is a set number or if my plan allows unlimited treatments.

Anyhow. I should have more answers and information after my appointment this afternoon. I’m also glad to have at least some insight into why this has been so hard for us, and (potentially) why I am experiencing recurrent losses. I know that having answers doesn’t necessarily solve problems – but for some reason an explanation helps me understand, which subsequently makes me feel a little more in control. And for now, I’ll take that.

Moving Forward

I thought I’d go ahead and give a little update with where are now and where we are going. We saw that doctor last Friday to discuss my last early loss and what our next steps are with regards to trying to get (and stay) pregnant. Ultimately, he is still feeling very positive that I am going to become pregnant – and did point to the fact that I’ve gotten pregnant twice as a positive sign (despite the fact that it doesn’t MATTER if I can’t hold onto it).

We had a lot of questions for him. He had answers for us.

One of the things that I like about my doctor is that he never really pushes you into doing something. He will subtlety guide you in the direction he’d like to see you go, but will remain completely open to what you want to do. I knew that there had been some discussion with the nurses about moving into IVF, which I’m not opposed to doing, but remained concerned that IVF wasn’t going to solve my early loss issues. So we talked quite a bit with the doctor about this.

Ultimately, it sounds like he still believes that my losses are likely the result of a genetic abnormality in the embryo. So we are running a few more tests and both Robert and I had blood work sent down to a lab in California for testing. I also had some additional lab work run on just me. These are the last series of tests to be run. On my chart, all of the boxes will now be filled with lab results. I don’t know what we expect these results to show, but at least we will have ruled everything out.

Additionally, the doctor wants me to have a Saline Infusion Sonohysterography (SHG) completed. This is a procedure where they will place a saline solution into my uterine cavity and ultrasound my uterus. The purpose of this test is to look for any abnormalities within my uterine cavity, such as polyps, fibroids or cysts that may be causing, or contributing to miscarriages. I’m not entirely sure what I’m expecting them to see/find, but it’s one more test to check off the list and one more thing to review for potential problems.

The doctor is also having both Robert and I do a ten day antibiotic treatment together, in the off chance that we are passing some sort of bacteria between the two of us – and I was actually happy to hear him recommend this, as it is one of the things I’d read about doctors doing. However, after my bout with C. Diff. and my digestive tract still being a little out of whack, I’m a little nervous about an extended antibiotic treatment. Nonetheless, we are going to move forward with it. I’ll just keep pumping probiotics into my system and having some frozen yogurt every day (I can’t stand regular yogurt! But many frozens still have active cultures in them).

In our chat about next steps, the doctor indicated that moving into IVF he recommends that we do a process known as Preimplantation Genetic Diagnosis (PGD), given our losses and my age. Robert and I haven’t decided on this yet, and are doing a little more research into the pros and cons of the process, as well as the extra cost (which we haven’t confirmed, but are guessing my insurance won’t cover). We have a reconference with the doctor on the 18th, and will have a few more questions for him regarding the PGD testing. We don’t have to make a decision on it yet, but we do want to be fully informed in order to make the best decision for us.

If you have any factual information or resources on PGD, I’d love to hear/read them. However, please note that I am NOT interested in your opinions on if you think PGD is “right” or “wrong”. That is a decision for Robert and I to make – and since we are both fairly big believers in science, you aren’t going to sway me by telling me I should not play god – you are just going to piss me off. So just don’t.

I guess that brings us to what, exactly, are we going to do next. I know I mentioned that the doctor seemed optimistic about our chances of a successful pregnancy – and addressed most of our concerns (figuring out why we are miscarrying, prolonged use of ovulation stimulation medication, not wanting to utilize a donor egg for IVF, etc.). He was also very impressed with how well I respond to the letrozole treatment that we’ve been doing for the past 8 months, indicating that I have an above average response to the drug. And in his subtle way, despite our conversations regarding IVF, he seemed inclined to do a couple more IUIs and see where they went, and/or if the additional testing revealed anything.

While we are  worried about my age, IVF is also a very invasive and difficult procedure. I very much want to get pregnant, but I also want to make sure that we’ve explored every option. As such, we decided to do up to three more IUIs. If the test results come back and indicate we should move into IVF before then, we will. If I have another loss, we will go ahead and move into IVF. And if I just decide that I’m fed up and done with IUIs, we will also move into IVF.

The doctor DID say that if we do three more IUIs and aren’t successful, we need to seriously consider IVF as our next treatment. And I’m onboard with that. I probably would have been on board if his inclination had been to move into IVF now. If I’m being 100% honest, part of the reason I’m doing a couple more IUIs is to make sure we’ve met the insurance guidelines, without question, for moving onto IVF. And I guess since I’m being honest, I’m also not sure I’ll make it three more IUI cycles before saying “fuck it” and moving forward.

Although, there are some benefits to taking a few more months before IVF. I’ve been steadily losing weight – and the more I am able to lose the better off everything will be. Hopefully in the next few months my medications will have my CRP/inflamation down to “normal”, or at least less high, levels. Which would also be good. And while it’s not huge on our priority list – a couple of months will also give us time to make sure our finances are in order if the insurance doesn’t cover the PGD testing and we opt to do it anyhow (which is the way I think I am leaning right now). And – who knows – maybe I’ll get pregnant again and this one will stick, rendering all of the above moot.

Anyhow…we hiked up to Tolmie Peak on Mt. Rainier the week before last and I thought I’d share some pictures. We are going up again this weekend since the cloud cover never lifted last time so we didn’t get the view from the top of the peak, but the view from the hike up was still pretty beautiful!

 photo 930B1C5F-9F19-4E55-B8C8-D8C306646B35.jpg

 photo 8E1D326C-2E56-4D67-9A44-B1C24DFDB393.jpg

The Things That Often Go Unsaid.

Struggling through infertility is challenging. It’s hard on your body, and harder on your spirit. One of the hardest things for me to deal with is pregnant women. Not that I fault them for being pregnant, or am angry at them that they are pregnant and I am not, it’s just that a pregnant woman is simply a reminder of my own failures in trying to become pregnant. While mot people are “ooing” and “ahhing” at the ever expanding belly of the pregnant lady, most are not aware of how that makes the not pregnant lady feel. There are so many things that go through my mind, yet go unsaid, when dealing with a pregnant lady.

Saying them would make me look rude. Or insensitive. Or, I don’t know, fill in some other negative descriptor. But what frustrates me is the blind insensitivity of others. Often not intentional – but no less hurtful or heartbreaking. And, well, I’m tired of letting things go unsaid, so I am going to say them. I am not going to apologize for them, and I’m not going to feel bad about saying them. Because my feelings are also valid.

  • I understand that your back aches, your stomach is ever growing and your breasts are swollen. But I don’t want to hear you complain about problems that I’d be thrilled to deal with. You are pregnant, something I am not but very badly want to be, I have no sympathy, or ability to empathize, that you are experiencing the symptoms of being pregnant. I would love to have your problems.
  • I don’t care if it’s rude, when I go out with my husband to “get away from everything” for a bit, I don’t want to be seated next to a pregnant lady, or served by a pregnant server. It’s not their fault that they are pregnant, but I don’t want the constant reminder of it while I’m trying to take my mind off the fact that I’m not pregnant.
  • Please don’t tell me “I didn’t want to be pregnant”, “I wasn’t supposed to be able to get pregnant” or “It was an accident”. Because, well, fuck you. I would happily be in your place. I would be THRILLED to be pregnant. You are most definitely complaining to the wrong person.
  • Along those same lines, making jokes that you “have extra” kids when one gets injured pretty much makes me want to punch you in the face. Congratulations on being overly fertile and having more kids than you can manage. I would have given anything to have even a single one of them.
  • Please don’t talk to me about how HARD it is to get pregnant when you’ve been trying for less than a minute. Hit me up when you pass the 9-12 month mark and are now part of that illustrious minority of people unable to become pregnant within a year’s time.
  • Please don’t complain about your age and how challenging it’s going to be to get pregnant if you aren’t yet thirty. Put yourself in my shoes – just for a minute – not only am I 37, but I am also struggling with infertility. Tick tock, your clock. I promise it’s not as wound down as mine.
  • Please don’t get upset if I make a comment about how your comment makes me feel. I am entitled to my feelings. I am entitled to tell you that your commentary is upsetting to me. Just as you are entitled to offer your commentary to me.
  • Unless you’ve experienced the physical and emotional struggles of infertility – please don’t pretend to know what I’m going through or how hard you “imagine it must be”. Because you probably don’t have any idea. You probably think that you do, but you don’t. Talk to my husband after our 20th negative pregnancy test as he tries to console me.
  • I don’t want to hear about your second cousin who is pregnant again. With her fifth child. In fact, I don’t want to hear about your sister, brother, friend, secretary or spouse who is pregnant. I don’t want to TALK about pregnant people who aren’t me. And since I’m NOT PREGNANT, I just don’t want to talk about pregnant people period.

 

I am constantly shocked by the (usually unintended) insensitivity of others. And then further shocked when they are defensive or upset about learning how they made me feel. There are fewer and fewer people who really KNOW what it’s like to be me right now. To put my entire life on hold for a dream that I can’t quite reach. To pump myself full of chemicals month after month that make me nauseous, make my hair fall out, my skin break out – that make me FEEL pregnant. To have hope month after month and then to have it smashed into a million pieces – only to have to pick all of those pieces up off the floor and glue them back together so that you can move forward the next month to repeat the process.

 

So, no, I’m not sorry about saying the things that are usually left unsaid. Because sometimes I wish I would say them, rather than curl up politely, so as not to hurt your feelings, and instead let them hurt me.

Two Lines Aren’t Always A Positive.

Cycle 19 has come and gone, and I am again not pregnant. But I was. For a minute (or more likely two to three weeks). At the end of my two week wait I took a pregnancy test and was greeted by a very faint positive on my pregnancy test. So faint that I wasn’t even sure if I should call the clinic. So I waited until lunch time and took another test in the bathroom stall at work – where a less faint, but still faint line awaited me.

So I called the clinic.

I was told to come in for some blood work, so I went. Although I expected the worst, there was a shimmer of hope that MAYBE this was finally my month. Of course, that was shattered just a few hours later when the nurse emailed me to let me know that my beta HCG numbers, while positive, were very low (8.5) and while it was unlikely this would be a successful pregnancy, biology is weird and we would continue to monitor everything. I was to go back in 48 hours for additional blood work.

I didn’t need the blood test to know that, just like the last time, this wasn’t going to stick. But as instructed I went back 48 hours later, and my blood results came back with a slight drop (now 8.0) in my beta numbers – and that it was likely a biochemical pregnancy (early loss), but come back in another 48 hours for more testing. So I went about my day – not REALLY feeling the grief that I knew would, at some point, happen. And 48 hours later I went back in for testing – only I started spotting that morning, so I knew what the tests would show. And now by Beta numbers were down to 3.5 – but there was some worry about an ectopic pregnancy, so please come back in another 48 hours for another test.

By this time, my period had started in full force and I was trying just to move on with my week. But I went back in for the bloodwork, and my beta numbers had finally reached zero. Please meet with the doctor at your scheduled appointment to discuss next steps. We will see you after your August 7th period.

Wait, what?

I was told over the weekend that I wouldn’t be doing any treatment for cycle 20, and we should not try at home, because it is “generally recommended that you do not become pregnant the cycle after a biochemical pregnancy” – which, okay, I get. It upsets me, but I understand. But my period started July 5th – and it is reasonable that my next cycle will start prior to August 7th. So does that mean that my July cycle doesn’t count because my beta numbers didn’t zero out until two days after my period started? Do I also have to skip August’s cycle too?

This really distressed me.

So I emailed the nurse back, and after some discussion, the doctor indicated he was comfortable with beginning treatment in August. But what treatment? We are meeting with him to discuss “next steps”, because this is my second early loss. Are they going to want to move forward into IVF? I have concerns about this if they haven’t isolated WHY I’m not able to stay pregnant. Are they going to do more IUI treatments with some additional medication? I completed some advanced loss panels last month – did they show anything that will be helpful? I mean, what is the point of the extensive IVF treatment if I’m just going to miscarry?

While all of this was going on, my mother was in town visiting. I did tell her what was happening – but I really didn’t want to break down in front of her. Even though I knew that she would comfort me and hug me, I just needed to hold it together. For myself. After she left back home, I continued to occupy my time trying not to think about it. We went on hikes, made fondue, caught up on some TV. And I was mostly okay.

Until Tuesday.

One of my co-workers is pregnant. And she looks pregnant – as pregnant ladies are wont to do. And I had to do meeting with her. And I was in the process of having discussions with the nurse about the fate of my August cycle. And it just hit me. All of the sadness that I’d been sheltering away for the past week just came at like a tidal wave. And in one of my lowest points yet, I ended up sobbing in the stall of the bathroom at work – hoping that no one else walked in. All of that bottled up emotion that I’d been trying not to feel just unleashed.

It’s just so fucking unfair.

I’ve done everything I’ve been told to do. I’ve lost weight. I’ve gotten more active. I’ve changed my diet. I’m getting more sleep. I’m taking a small pharmacy of drugs. And I still can’t manage to hold onto a pregnancy? And it took six months just to GET pregnant again? And in that time not one, but TWO of my co-workers have gotten pregnant/had a baby – who weren’t even TRYING when I first started trying to get pregnant. Fuck you world. Just fuck you.

I know that getting angry doesn’t really HELP anything. But right now anger just feels so much better than being sad. Because I am angry. And I am frustrated. And I’m tired of being hopeful, only to have that hope obliterated by sadness month after month. So this month I’m letting my anger and frustration fuel me. At least for now. Maybe by the time we meet with the doctor (in two weeks), I’ll have moved on from anger to resignation. And maybe the doctor will be able to tell me something that makes me hopeful again.

And now, here are some pictures from my hike this weekend. Because even though it was hard – I controlled the outcome. I decided that I could push my body to get to the bottom of the trail, and subsequently back up the trail. And at the end of the process there was something beautiful to see. And, unlike my infertility, pushing myself here was a process I was in control of and enjoyed. And because they are pretty pictures that make me happy instead of pissed off. And, well, I guess I felt this post needed something other than my anger.

 photo 9A22D14C-1485-442E-BF7F-C144B76AE7B4.jpg

 photo 7A5FA5BF-477E-41B8-BC0A-756A68F646C3.jpg

 photo D81B1127-6172-4368-AE7F-6A24B3B7F6C0.jpg

Stay tuned until next time. Where maybe something different happens. Or I’ll just start posting more pictures from hikes – and this blog about the shittiness of infertility will somehow become an exciting hiking blog where pictures of wildflowers and mountains will abound and you won’t help yourself but to be happy instead of angry. Who knows!

What Happened to Cycle 18?

I know I’ve been a little quiet lately, but a lot has happened in the last month. Ultimately, cycle 18 ended up not happening. And I went through a gamut of emotions ranging from extremely upset, depressed to content and happy. It’s been a hard month for me to cope with, and I’ve just now felt like I could (should) write about it.

The start of the cycle began the same as any other. I had my ultrasound, everything looked fine, I started my next round of letrozole. About halfway through my cycle, I ended up having severe diarrhea. Not your normal, metformin-esque, run to the toilet fast – but the kind where within five minutes of eating I had to find a bathroom. About 12 times a day. (Hint: Tucks Pads help alleviate some of the…discomfort with this).

Needless to say, I visited my doctor.

As it turns out, Cycle 16 was the gift that kept on giving. Due to the heavy dose, broad-spectrum antibiotic that I was given in the hospital, and subsequently sent home with, I ended up with a moderate case of C. Diff. C. Diff is an intestinal bacteria that lives within the intestinal flora of many people. However, what happens is that sometimes when you take a broad spectrum antibiotic it will kill off the good bacteria, and if the bad bacteria is resistant to the antibiotic, it starts to multiply. And without the good bacteria to help keep it in check, it can start to infest your gut.

Ultimately, if left unchecked, C. Diff. can cause severe problems and lead to a stay in the hospital.

Needless to say, this is not desired. As such, all of my doctors wanted to get on top of the infection and get it under control. Unfortunately (and somewhat ironically, the treatment for C. Diff is antibiotics. More specifically, Metronidozole. Which is not safe for pregnancy. In fact, it’s so hard on your system that the RE had me stop my Metformin for the duration of the antibiotic treatment.

I’m sure you can see where this is going…

Because of the infection and treatment, we had to cancel my IUI cycle. I was so upset by this, after cycle 16 in the hospital and cycle 17 where the timing was off, that I spent about a week just severely depressed. Just thinking about it made me tear up and cry. And for the first time ever, I broke down on the phone with the nurse at the fertility clinic discussing wether or not I should take my trigger shots (I was concerned about cysts). I apologized profusely about being upset, but the truth was that if one more thing went wrong, I was probably going to break. I simply was out of capacity to deal with it.

As it was, we already had to postpone our re-conference with the RE and try two more IUI cycles, since we hadn’t TRULY completed the first treatment plan. I just wasn’t going to be able to handle something going wrong the follow month. At this point I pretty much felt the Universe was against me and that maybe this just wasn’t meant to be. In my mind, there was simply no other reason I could think of at the time for why this was happening.

It took some time, but once I accepted that we were going to have a set back, I started to feel okay. And then okay turned into better. And eventually better turned into good. In time I realized that the break was actually good for me. A month without stress. A month where I wasn’t constantly wondering about what my body was doing. And slowly I started feeling a little more like ME. And it was kind of nice. I just felt a little lighter, things didn’t seem so bad. And I was…relaxed. Something I don’t think I’ve truly been in a fairly long time.

In addition, some other good things happened. The best of which is that my last CRP results showed that my CRP was down to 6.5 (from 12.5 the prior 6 weeks, and 17 prior to that). This is probably the most exciting thing that has happened in a very long time. Unfortunately, I’m not entirely sure what is causing the drop, since 4 things I have changed since it dropped. I’d had a tooth infection cleared. My plaquenil has been in my system long enough to start noticing effects. I had an intestinal infection cleared. And, lastly, I swapped to mostly organic eating.

Robert teased me that this is the exact reason that they only change one factor when they are testing things at work. Because we don’t know WHICH change is making progress, and we don’t want to stop anything because SOMETHING is working and we don’t want to risk backsliding.

Regardless, it’s something that made me really happy. For the first time in a long time I feel like maybe my body is going to be on board with this whole baby thing. For the first time I feel like something is progressing. And, going into Cycle 19 I feel something that I’ve been too afraid to acknowledge for a long time: hope.

So my status right now is that I’ve cleared my C. Diff infection, I’ve restarted my Metformin (although I have to work my way back to a full dose gradually) and my inflammation appears to be going down at rapid rates. We are going to talk to the nurse about doing the advance auto-immune bloodwork this month and we have a re-conference scheduled at the end of July.

All things considered, even though the start of the month was heartbreaking, it turned out to be an alright month. And I find myself invigorated and excited to get started on my next cycle over the next few days.

Growing Up Out Of A Can

I have recently just finished reading this book on infertility. It was pretty interesting and I have a lot of thoughts on it, but that isn’t what I want to write about today. The reason that I bring the book up is that it echoed something that my other (not trying to have a baby) doctors have been pushing with regards to my autoimmune problem – which is to try and eat better. More specifically, try to eat fewer processed foods. This is something that was reiterated in this book and really got me to thinking.

Over time, as my medical problems have continued to stagnate, I have slowly been trying to move both Robert and I away from processed food. But it’s hard. Sometimes you just want an Oreo, you know? But it’s not even just the things that are obviously processed – it almost seems like EVERYTHING is processed these days. And even the “good” processed foods are riddled with other health concerns (like BPA from tin cans). It’s honestly enough to make your head spin. And, for me, it pretty much lead to a small meltdown in my office at work as I felt beyond overwhelmed with trying to figure out how to eat “right”.

For me, a child of the late 70’s and early 80’s it’s hard to know what is right and what is wrong. Almost everything that was fed to me growing up came from a box or a can. One of the things that I wish my parents had done a better (or could afford to have done better) was make sure that we grew up with fresh fruits and (especially) veggies. To this day, I hate veggies and it’s a constant struggle to force myself to eat them. But, growing up poor meant that my parents did what they could. So we had canned soup, and spaghetti-o’s and shit on a shingle. And as an adult, I naturally gravitate towards the things I know – the things that come from a box or a can.

But I’m trying to change that. I’m grown up now and there is no reason I have to keep eating out of a can.

It’s only now that I’m trying to conceive and having so much trouble that the importance of the shit I’ve been feeding myself for the past 37 years is really starting to dawn on me. And it’s only now that I’m realizing that I don’t know HOW to eat well. It’s not that I don’t want to. It’s not that I’m not trying. It’s simply that don’t have the toolkit (yet) to do it. For lunch, almost every day, I have a frozen meal at the office. I thought “hey, that can of spaghetti sauce has two servings of veggies, it can’t be bad!”. But it is. It isn’t necessarily terrible, but it also isn’t necessarily good.

Even if I had always known how to eat well and had a healthy diet, I would find it challenging to do today when 80% of what you find in the grocery store is processed and contains this preservative or that preservative. Maybe 60 years ago this would have been less of an issue. Then again, I have cookbooks from the 50’s and 60’s and I’m not entirely sure if that is true either.

It’s hard to be told to eat this or eat that and to try to do better, only to discover you aren’t doing as well as you need to be. And to make it worse, I’m super picky about what I eat (probably part of the growing up out of a can problem). I don’t like leafy greens. At all. Which makes salad a non-starter for me. I’ve tried several times in my adult life to change this, but every time it’s come back to the same thing: I simply don’t like it. For me, to combat this, I’m going to try sneaking these types of things into foods that I do like and can cover up the taste of what I’m eating.

I’m trying to incorporate more fruit into my day. I’m trying to add in veggies even though it’s a huge challenge for me. I’m trying to eat the grass fed meats. I’m trying to make things from scratch, even though it’s less time consuming to just open a jar and dump it into a pan. But it’s hard. It’s time consuming. And the task of differentiating what is okay to eat and what you should avoid is hugely overwhelming. I feel almost as if I’ve been asked to summit Mt. Rainier – a task that is neigh near impossible for me.

But, you will never get to the top of the mountain if you don’t take that first step. So Robert and I are reallocating our budget to add more in for our weekly groceries so we can afford to buy all the organic fruit and veggies that aren’t coated with pesticides. And we can buy the grass fed beef. And make things from scratch – that cost four times more than opening up a can. And buying glass tupperware to avoid the chemicals released when hot food is added to plastic storage.

I don’t know if any of it is going to make a difference. But at this point I don’t really see the harm in trying. At the very worst it’s going to make me a healthier person. It’s certainly going to be a challenge – but even if it doesn’t help me get pregnant, it’s going to have a positive effect the way I live my life. And when push comes to shove, not continuing on the tradition of growing up out of a can is probably a good thing.

For added benefit, last night Robert and I cooked dinner together, and it was nice. So in addition to eating “good” foods, we also spent some quality time together, on this little dinner project, and I really enjoyed that. It gave us a chance to be intimate with each other outside of the scope of trying to conceive and that is a very positive thing I think.

I don’t know how much longer this journey is going to take us, or what lies down the road ahead. But I think that even though this change is very overwhelming at the moment, it’s going to have very positive consequences in the long term. And, hey, we are even going to try homemade spaghetti sauce this weekend. With real tomatoes. I bought a food mill and everything. We will probably still use a good quality boxed pasta (for now), but it’s certainly a step in the right direction.

The Shaky Start of Cycle 17

After having made it through last month, I was ready to put things behind me and move on to our next cycle. It was to be another double IUI cycle, assisted by Letrozole and a trigger shot. My period started, I went in for an ultrasound, and started the letrozole on day 3 – thankful that day 5 fell on a Saturday, so my migraine day would be on a weekend and I wouldn’t need to use a vacation day for the headache. The nurse sent in my prescription for my trigger shot, and advised me I would have two this cycle. She then scheduled me to come back on day 13 for my ultrasound to see if my eggs were ready to trigger.

This made me nervous, since I’ve been ready to trigger anywhere between day 11 and day 14. But I’d asked for an earlier scan the prior two months and had to come back in a second time because I wasn’t quite ready to trigger. So I figured it would be fine. So I went home, started my letrozole, and waited for my shots to arrive.

Let’s talk about the shots for a minute. Previously, I’d been using Novarel. It came as powder in a vial that I had to mix when ready, and Robert (or someone else) needed to inject it into my rear. This is the only trigger shot that I’ve every used. This time, however, I was prescribed Ovidrel, which is a pre-filled syringe that you inject into your stomach. I was excited about this because it meant I could inject myself if I required the shot in the middle of the day, and I didn’t have to mess with mixing the shot. But it was different, and I was curious why. So I intended to ask the nurse about it when I went in for my Day 13 scan.

Now, leading up to the trigger shot, they have you start using your Ovuquick ovulation tests on day 10. The very first time I used these kits was during my clomid challenge test and they came back positive every single day I used them. I believe that this was actually a reaction that I had to the clomid, because my next cycle (back on letrozole) I didn’t have a single positive the entire cycle. Which brings us back to this cycle. I started testing on day 10, knowing it would likely be negative. But by day 11 I was really starting to feel my ovaries, and I suspected that I was probably getting close to ovulation.

Sure enough, I tested on Day 12 and I had a big fat positive. REALLY positive. So positive that the majority of the dye went to the test line, and the reference line was really pale. Knowing that there was no point in stressing over it, I called the clinic to let them know and ask if I should come in for my ultrasound that day. At this point, I will admit that I was a little flustered because we had company and were hosting a get together at our house in a few hours and I was behind on getting dinner in the oven and having everything ready.

Ultimately, the nurse told me to take my shots when I got off the phone and we would be in the next morning for an IUI.

Well, shit. I did not get an ultrasound, so I didn’t know how many eggs I had this cycle. I was on a new trigger shot and didn’t get the chance to ask why they changed. And I had no idea how to administer the shot. Thankfully, the internet exists and other fertility clinics and pharmacies post “how to” videos for giving injections.

However, that left us in the unfortunate situation of having an ideally timed set of IUIs. So after some discussion, Robert and I decided that even though we had company it was probably best to sneak upstairs for an afternoon delight as a precaution. So, up we went. With my new shots, a video on how to give them queued up, and some embarrassment.

I managed to give myself the shots, but it was not the most pleasant thing I’ve ever done. I am pretty confident that I could never become a drug addict. But I got it done. And, I’m a bit relieved, since if we require additional cycles I know that I can administer the shot(s) to myself. Afterwards we participated in a little natural insemination, and had an IUI on Easter Sunday (with 40 million sperm this round).

As for the Ovidrel, I’m definitely having stronger side effects from the medication. My boobs are killing me and I have some really wicked nausea. In addition, I’ve had a relatively upset stomach for the past two days. It’s possible that I may have a mild case of OHSS – but I’m not having any levels of pain that concern me. I’ll mention it to the nurse the next time I’m in the office. I don’t know if my reaction is because I had a higher dose, or from the medication itself. I’m not entirely sure how the dose of Ovidrel vs. the dose of Noravel compare since they are measured in different units and the internet seems to be largely failing me on finding this information. All I know is that I had two shots instead of one.

I am a little disappointed/upset that I didn’t trust my gut and indicate that I felt day 13 was too late. I won’t make that mistake a second time. I really hope that we didn’t blow this cycle by either inseminating too early, because we didn’t do the scan and trusted that the kit didn’t provide a false positive – or by missing the window and triggering at the wrong time. My ovaries definitely hurt yesterday and were sore, which is consistent with my other trigger cycles. But they’ve also been more tender in some of the other cycles as well.

Robert and I intend to go ahead and do a few more afternoon delights over this week, just to be sure we didn’t miss it. But as of right now we are technically into our two week wait. I really hope this cycle isn’t a waste because of timing.

In other (somewhat good) news, my most recent bloodwork from my appointment with the hematologist came back and there are some improvements. My white blood cell counts is just barely high – but significantly down from my stay in the hospital – so hopefully it continues to drop and get back to where it was when I had my February labs done. But, in more exciting news, my High Sensitivity CRP is starting to drop. It went from 17 to 32 back down to 17 (in Feb) and was 12.5 on Friday!

This is exciting because it means that one of two things is potentially happening: the tooth infection has been present for awhile and is the cause of my issues or the Plaquenil that I started back at the end of February is starting to work and is bringing my inflammation down. Either option is positive though, as my inflammation has been suspected of causing complications with my attempts to conceive. So despite the reason that I’m getting better, I’m happy to be finally be seeing some results on this front.

So, I suppose, all things considered things could be worse. I’m not trilled with the way that this cycle started, but I’m also not quite ready to write it off, since it’s quite possible that we caught my ovulation in time. I guess we will find out in two weeks, on May 4th, when I can take a pregnancy test.