Trigger time!

Today I was given the go ahead for the hcg injection.  The drug my doctor is having me use for this is Pregnyl.  He said after they received my bloodwork and gave me the results that I was to take it right then.  Which means I had to give myself the injection.  Which I've never done before.....

First, I had to prepare the drug, which is very.....ummmm....nurse-y and I am not a nurse.  It's intimidating, using a syringe to suck water from one vial, trying to get exactly 1 1/2cc's, then squirting it into a vial containing the powdered hcg, mixing it, then drawing that back into the syringe, changing the needle to a smaller one that I will use to inject myself, then pinching the fat of my stomach and injecting it.  The needle didn't hurt but something in the medication makes the injection site quite sore.  I did one dose of 10,000 IU today and I was so sore afterward I would wince everytime I had to flex my trunk.

Tomorrow I do one more dose of 10,000 IU of the Pregnyl and by Friday I should have one or two eggs release.  We do the IUI that morning!

I sure felt like biting that x-ray tech

I was scheduled for an HSG on Monday.  A hysterosalpingogram.  The secretary from my doctor's office asked if my husband was coming along with me.  I told her he had to work and she responded "....oh.....o-okay."  After I hung up the phone I thought maybe I should do a bit more research on this.  I mean, my doctor just kept calling it an x-ray but the sound in her voice.....

What I find online is a description of the procedure followed by comments from women who have had an HSG.  Most of them were negative.  Then there were those who said it wasn't so bad and you just had to be able to handle pain.  I knew that I would be in that latter category.  I'm no wimp!

Well you know what?  I am a wimp when it feels like I'm being stabbed in the cervix for 2 minutes.  I'm not going to sugar-coat this.  It was horrible.  The doctor inserts a cold speculum, then pushes a catheter through the cervix.  He then injects a dye into the cervix and they take x-rays as it flows into the uterus and up and out the fallopian tubes.  It's done to make sure there are no blockages or cysts in the uterus or tubes.  And it feels like a hot poker is being repeatedly stabbed into the tender tissues of my cervix.

As this is happening, the x-ray tech is asking me if I've seen 'Alice in Wonderland' and starts to blather on about how it wasn't as good as 'Avatar'.  You know what?  How 'bout I bite you?  Is that as good as 'Avatar'?  I just take deep breaths and glare at him.

Some other good info to have before going in:
- you will be made to change into a hospital gown and will more than likely have a "recovery room."  Being escorted to my "recovery room" before the procedure immediately put my guard up.  They should call it something different.
- you may bleed afterward.  I brought a pad with me and it's a good thing because I did have some spotting plus that dye leaks out for the rest of the day and, in my case, into the next day.
- you may have some cramping.  The doctor said I could take Motrin.  I didn't have any cramping but I did feel tender inside for the rest of the day.

This is what I know.

Gonal-F pen & Ganirelix

"The doctor said that if you aren't nice about this, he is sure he can come up with something for me to inject into you," is the warning I gave my husband as he swabbed my ass with an alcohol wipe.

On my cycle day 7, we started injections of gonadotropin hormone, or FSH - follicle stimulating hormone.  It's used to develop multiple follicles.  I'm on a low dose - 75 IU.  This is the third day of injections.  Today we switched over to my left ass cheek 'cause the second one in my right side last night left me feeling a bit sore.  We inject another 75 IU tomorrow along with Ganirelix.  Ganirelix blocks LH - luteinizing hormone.  It's commonly used in conjunction with FSH injections because the body wants to release all those follicles and we don't want that to happen until we are ready to do the IUI.

We must keep our sense of humor about us as we give this a go!  So, for your entertainment.....

Drugs....

Got a big bag of drugs today.  Now to make sense of all of them....

I was wrong in the last post about the drug I'm starting with.  It's Arimidex.  Eight pills today on cycle day 2, eight tomorrow.

What does the interweb tell me about Arimidex?
****
By suppressing estrogen production, aromatase inhibitors trick the pituitary into producing LH and FSH.  This boosts follicle growth.  Many aromatase inhibitors are released from the body within 45 hours. This suggests that taking oral doses of aromatase inhibitors should pose little to no harm to the body or the developing embryo.
*****

My doctor says that it is commonly given to women diagnosed with breast cancer.  The tumor is removed and then they take a dose of Arimidex every day for the next 5, 10, 15, etc. years so that their body doesn't produce too much estrogen. 

He chose to give it to me because it is less potent than Clomid and I don't need that much stimulation. I grow nice follicles just fine on my own.  He is hoping for one or two more than usual since my hubby's sperm do not do well at trying to hit one small moving target.  Now they will have more to aim for.

Taking 16 pills was easy.....

Who else starts their morning this way??

I would guess that most couples, at some point, have had some *fun* in the morning before work.  It's only the ones with fertility problems who then put their husbands semen in a vial, tuck it into their bra strap and hop on the bus to take it downtown.

I made it to my doctor's office with five minutes to spare.  My doctor was sitting at the front desk and when I said "good morning," he said "good morning!  Do you have a package for me?"  This is why I love this doctor.  He didn't need my chart in front of him to remember why I am there.  Even more impressive, he then started to go on about my blood results and the next steps we should take. 

This is what I learned this morning:
- He will test the semen sample I brought in and compare it to the other two.  Hopefully the results will be closer to the second analysis, which was the better of the first two, meaning the sperm are not so bad.
- During my luteal phase, on my cycle day 21 (when I had my blood drawn on Monday), my estridol should have been 10x as much as my progesterone.  He said he likes to see estridol over 200pg/ml.  My progesterone was around 19ng/ml.  He said in a perfect study he would draw blood from me every 20 minutes and we would see if the progesterone was going up or down.  He would like to see it over 20ng/ml (as 10x that puts my estridol over 200pg/ml). 
- Of course, those levels (and should they remain that high) would indicate a pregnancy.  At this I scoffed and he giggled.  I'm glad he's not trying to force me to be overly optimistic.  We just had regular ol' sex this month.  That hasn't worked in the last 2 years & 7 months, why should it  work now?

So, today he will get results from the sperm and on Friday I will call him and we will discuss those results.  On Monday or Tuesday I should start my period.  After I am done with my period and before I ovulate, we will probably do an x-ray of my fallopian tubes to make sure there are no blockages (e.g. a weird mucus plug or something).  He said he will more than likely give me something to "stimulate" my system - meaning a fertility drug - but he didn't say when I would start that. 

I don't want to be stamped with the label "unexplained infertility" but weeks of testing, the stress of waiting.....it's rough.

Oh, more questions, more answers yet to come.....

Good thing I never had the urge to do heroin

I'd chicken out before I could get the needle in.  Last week when I had blood drawn I watched her put the needle in my vein.  

Today, I watched as my nurse, Maria, tied the rubber band around my arm and wiped the front of my elbow with an alcohol pad.  I squeezed the foam ball she gave me and saw my vein pop up, thick and blue.  Then she aimed the needle towards it and I looked away.  I wanted to make a scared, squeaking noise but Maria is the type of woman you could describe as a "tough old broad" and I don't want her to think I'm a pussy.

I turned back to watch the blood leave my arm and fill the two vials she had waiting.  I should be getting a call with the numbers from these test results in about an hour.  On Wednesday, I will bring in a sample from my husband and on Friday we will have those results plus my blood work.  I spoke with my doctor briefly today and he said on Friday we will map out our plan!  Seems that by mid-March, we will be trying either IUI or IVF, depending on these test results!

2nd Post Coital

Back to the doctor's office for a second post coital test! 

Today is cycle day 14.  We abstained for two days, up until last night when we were instructed to have relations again. 

Today, I was told that my cervical mucus is a little too thick.  The doctor could see some sperm swimming in there but not many.  Could be because it was cd 14 and we missed the day when it would've been at just the right consistency - maybe yesterday.  Yesterday was Sunday, so no office visits.  We also could see a 23mm follicle on my right ovary, meaning that I should ovulate any time now.  My uterine lining was also very thick and had the right amount of layers, ready to accept a fertilized egg, should one be in there.

I had blood work today, as well.  The results were:
Estridol - 169pg/ml (picograms per mililiter)
Progesterone - 1.3ng/ml (nanograms per mililiter)
FSH - 12mIU/ml (mili-international units/mililiter)
LH - 49mIU/ml (mili-international units/mililiter)

Some of these are to be done on cycle day 3 so I don't really know what the numbers mean when the tests are done on cycle day 14.  I go back on Monday and get more blood tests done and bring in a sample from my hubby, so I'll get answers about these results then.

Time to have relations!

On Thursday, my cycle day 10, my husband and I had "relations," as my doctor puts it.  So on Friday, cycle day 11, I went into the office for my first post-coital test.  The doctor removed some of my cervical mucus from my cervix and peered at it under the microscope to see if it was being kind to the sperm my husband sent in about 12 hours before.  Turns out, it was a little inhospitable but some of the little guys were still hanging out.  Good sign.

We also got a look at my ovaries and uterus.  The lining of my uterus was where it was supposed to be, though now I'm forgetting the exact measurements.  Ten milimeters, maybe?  We saw a 15mm follicle on my right ovary, so this month I will be ovulating from that side.  My doctor said that follicles grow about 2mm per day, so by my cycle day 14 it should be around 21mm in size.  Eighteen milimeters and over is great, in the world of fertility testing.

Since it was only my cycle day 11 and my cervical mucus was not in prime consistency, I will go back on Monday for another test and to have my blood drawn to check my hormone levels.

Hi, Science, I like your syringe.

Yesterday I was talking to someone about how we are on the IVF path now after having tried many alternative treatments.  This person, being very much into alternative treatments, encouraged me to keep on the holistic path.  She was very positive about it and when we parted ways I felt renewed, like I could keep trying.

I came home, removed a wooden carving that I felt might be sending out negative vibes, set the herbal supplements on the kitchen counter, and starred the dates on my calendar for the days when I would force my husband to have sex no matter how tired he might be.

Later that night I realized that, once again, I was bamboozled into taking advice from a woman who could just look at her husband and get pregnant.  A woman who has no idea what we've been through.  

I want to be one of those women who lie on their back, snap their fingers and get knocked up.  And you know what?  That will happen.  It will happen when I lie on my back, feet in the stirrups and have a syringe inserted through my cervix and a embryo placed in my uterus. 

I'm tossing out all those supplements and erasing those  little stars from my calendar.

Knock me up, science!

Reproductive organs don't discriminate

This is what I have to remind myself of as we yet again receive a phone call with that bittersweet news - "I'm going to be a dad."

Remember....
Reproductive organs don't care if you love each other very much.
Reproductive organs don't care if you just bought a bottle of cheap wine and pity fucked each other.
Reproductive organs don't care if you have money or don't have money.
Reproductive organs don't care how old you are or if you have a nice car.

My asshole uterus certainly doesn't care what I want.  And my husbands balls?  They're doin' their own thing, regardless of what he wants them to do.

I'm working my way through these angry feelings.  Give me 24 hours.

Oh, reproductive organs...

I have an announcement

*clink, clink, clink* (fork tapping on wine glass)

"Excuse me, excuse me!"  Everyone stops talking and looks directly at me.  "Thank you all for coming," I say.  Oooo, the anticipation is building now......

"I have an announcement."  People look over at my husband but he is staring up at me with the same bewildered look, no clue as to what the big announcement is.  One of the couples looks at each other with knowing grins on their faces.  A tear comes to my eye.

"I just don't like artichoke hearts."  I begin to ramble, "I've always thought of them as a classy food, though I know they come in a can just like a simple pea or carrot, but they've always seemed to impart a sort of upper-class salad to me and I really wanted to be that girl who eats high society salad." 

Distressed glances are being shot my way.  Stephen is headed toward me for our romantic embrace.........no.....he's leading me out of the room.....

Last night I was laying in bed, thinking about making that announcement - "We're pregnant!"  I admit it, I've thought about it before.  About how I'll tell my Mom, my brother, my friends.  There is just no other announcement that I can think of that would be as exciting to them as this one.  "I've got a human being growing inside me!"  That's a pretty rousing announcement.

I can't make that announcement.  So, what can I announce?  I think if I could just get it out of my system, that desire to make a big announcement, then I could let that fantasy go.

Oh, I hate artichoke hearts!

The question of the hour

How do you stay sane while trying to conceive?

People who aren't struggling with fertility issues will never understand this.  I'm not trying to be judgemental and fit all of you who can conceive "normally" into one box but I have yet to find this statement untrue.  You can nod your heads in empathy as those of us who struggle with this express our woes to you but at some point in the conversation it will enivitably be said......
......"you could just try having sex more."
......"if you relax and stop thinking about it, you'll get knocked up."
....."if you guys do adopt, then you'll get pregnant."

Look, it does not work that way.  We do not have what it takes.  We are working with 2% viable sperm.  True, that is not zero percent.  But if a "normal" couple, a couple with almost 100% viable sperm, has a 25% chance each month of getting pregnant, than we, a couple with only 2% viable sperm (and hold on here because math is not my best subject), have a .05% chance each month.  Less than 1%. 

So, those of us struggling tend to reach out to others that are in the same position.  And, thanks to the internet, it is possible to connect with thousands of other couples with infertility. 

Having realized we have a problem, even before medical tests confirmed it, I went looking online for support.  I'm sad to say, I haven't found it.  All I tend to find are women who seem to have only one foot still on the ledge.  Come on, ladies!  Isn't there more to life than becoming a mother?  I say that there is.  And though I think my husband and I would be fantastic parents, if we never get that chance, I will still feel that I have lived a life worth living.  And I work every day to make that statement even more true.  

So, what can you do to stay sane while trying to conceive?
~  Focus on the good things in your life. 
Do you and your husband have a fabulous relationship?Revel in that! Not everyone has that and aren't you lucky!
Do you love your job?  Work to become even better at it and enjoy every day, realizing that you make a difference!
Are you taking fabulous trips?  Don't you feel sorry for those people walking the aisles of the plane trying to calm a restless baby?  Enjoy the fact that you don't have to worry about that right now!
~  Start a new hobby or become a master at an old one.
Now is the time to finally become a fabulous seamstress!
Always wanted to learn how to play the violin?  You have the time now to do that. 
Make gourment dinners and serve them at your beautiful dining room table.  Have friends over and enjoy good conversation over a bottle of wine!

What is that you say?  Shut up, you glass-half-full, optimistic bitch?  I know. 

Oh, but we must try to stay sane, girls!

Alternative Methods Part 2.....or.....What I will force my husband to try in order to avoid IVF

So I find myself sitting in the very last row of seats in the back of the bus with four little bottles wrapped in foil tucked under my arm, inside my jacket, wondering if I'm far enough away from the electromagnetic waves or if I should get off the bus and walk in the -2 degree weather.

Ummm....wait....let me start this at the begining. 

What do you do if you realize that your baby makin' attempts aren't working out but you are against modern medical intervention? 

Visit a homeopathic doctor, of course.

Luckily, I happen to work with a chiropractor who is also a homeopathic nutritionist and a NET (neuroemotional technique) specialist.  After having gone through treatment with her (which I will touch on another time), I convinced my husband to see her.

The session started out normally enough.  Health history, talks about diet and exercise, some allergy testing.  And then she explained that she would like to give him some homeopathic medicine that would work to clean out his liver, spleen, bladder and testes.  And he said "okay" and told her to place the order for the medicine.

The medicine arrives and she gives it to me, along with the instructions.  And this is where it gets strange.......

The medicine, I'm told, will be adversely affected by electromagnetic fields.  She's wrapped it in foil and wants to know how I will get it home.  Being that it's freezing outside, I tell her that I'll be taking the bus home.  She makes a "tsk, tsk" noise and warns me to sit as far to the rear of the bus as I can, away from all the electric implements near the driver.  She stops short of telling me that I need to wrap my head in foil because the aliens are trying to read my thoughts......

Then come the instructions for use.  Each liquid is to be taken in two drops under the tongue, four times a day for one day.  And my husband needs to.....wait for it......stay as far away from electromagnetic fields as he can that day.

So, on a Sunday, we find ourselves in our bedroom void of the alarm clock, the laptop, cell phones, cell phone chargers, lamps, space heater, and power strip, all of which have been moved into the living room.  As I am able to come and go into and out of electromagnetic fields as I please, I slip out of the room to make us lunch and dinner and bring in things like candles so that we can entertain ourselves by reading and playing board games (both of which we enjoy but much more so when not trying to do it in the flickering candlelight). 

Twelve hours pass by so slowly when you are being glared at by a husband who has been forced to spend the day sitting on a bed in a quiet room without his video games.

Needless to say, this treatment got us nowhere.  My husband is now even more distrustful of my alternative suggestions than he was before. 

Oh, alternative methods, I have lost some faith in you!

Planning, plotting....

All test results are in!  Neither of us has any stds!  Not that that was a concern......

I've scheduled the meeting with our doctor for January 18th.  Hubby has the day off of work, so it's quite convienent.  The first doctor I saw, "our" doctor, isn't in that day so I asked if we could switch and they allowed us to - and we got the doctor with the cute accent!  Not really sure what it is.....British maybe?  If another man besides my husband is going to be messin' around with my vag, he should at least have a cute accent.

If on January 18th we decide to go ahead with IVF, I think I will start the meds about 2 1/2 weeks after that.  I've read that the first injection is done around the start of your period and that won't happen for me until the second week of February.  Then, injections for 10 days (I think), then they take out my eggs, mix 'em with the sperm, put them back in three or five days later, more injections and *drum roll* we might have a baby around the middle of March!

So, lots of excitement for the next few months!  We leave for Thailand on Tuesday.  Two weeks later, I turn 30 and Stephen is planning something big, though I don't know what.  Then we start all this baby stuff.  *squee!*

Oh, exciting things happening!!

How to make semen specimen collection sexy

1.  Wear a hot pink push-up bra.

2.  Tear off the protective plastic seal of the specimen cup with your teeth, while winking. Say "rowr!" as you spit the plastic out.

3.  Dirty talk.  Some examples......
     - "Ooooo, this cup is sooo hard!"
     - "Mmmmm, I like the way you aim it at this cup."
     - "Are you gonna put it in this cup?  Are you?  Oooo, that's hot!"

Today my husband had his initial testing done - a semen analysis and blood tests.  The blood tests check for stds.  Thus, these tests can be run at any time during the month, unlike my blood tests which had to be done on certain days of my cycle because they checked for hormone levels as well as stds.  These initial tests are run on every couple.  If you test positive for HIV/AIDS the clinic will not allow you to proceed with IVF. 

We hope to have the results by next week, though we won't do anything with the results until January. 

Next step is to meet with our doctor and finalize our plans.  If the semen analysis results are still poor, then I'm sure the doctor will want to do IVF which is what he mentioned before.  If the results are better than the results we got in August, we might be able to try intrauterine insemination (IUI) first - which means no injections for me - though statistics show that IUI has lower sucess rates than IVF.  Due to those statistics, our doctor has already suggested that we just skip IUI.  Part of me thinks that he may also just be interested in having more IVF statistics for his research.  He was a bit pushy about it.

Oh, what happens next?!

Alternative Methods Part 1.......or.......What I will try in order to avoid IVF

Earlier today, I was thinking about how it's important to keep a keep a glass-half-full kind of mindset when faced with fertility issues.  I started thinking back on all the things we tried in the 2 1/2 years leading up to our decision to do IVF.  One night in particular came to mind and I thought it would be good to share.......you know, so everyone could have a good laugh!

So I had read on various online message boards that some women had conceived using Instead Cups.  What is an Instead Cup?  It's a small, malleable rubber cup that's sold next to the tampons and can be used in place of tampons - you squeeze the cup and put in inside your vagina, up against your cervix, and take it out and dump it when it gets full.  It's also been suggested that if you put your partner's ejaculate in it and place it up against your cervix, the alkaline sperm will be able to jump right into your cervix, bypassing the acidic vagina.  What the hell.......let's try it!

Wanting to get the sperm in there as quick as possible (though I've read that sperm can continue to remain viable outside the body for up to an hour or so), I have the Instead Cup in my hand as I, *ahem*, stimulated him orally.  As he tells me we are nearing "go time" (I'm trying to keep this as non-dirty as possible, people!), somehow the Cup flies out of my hand and disappears under the couch!  I dive under the couch and locate it, only to sit back up and realize that I've missed the finale.  No worries - we scoop it in the Cup and I put it in place.

Obviously, since I'm writting this blog, this method did not work for us.  I have serious doubts that it works for anyone, even those who claim that it did.  For couples who have no fertility issues, there is about a 25% chance each month that conception can occur.  I think the couples who claim this method works had simply won their game of chance in the lottery of conception, little plastic cup or no little plastic cup.

Oh, alternative methods of conception, I'm not done with your tales yet!