Another 2ww

As of Sunday morning, we are officially in the 2ww again.  This one might be particularly rough for a few reasons. 

Firstly, there are so many more hopes and expectations associated with a picture perfect cycle - those two follicles, the lining measurements, a strong sample count.  No matter how much your infertile voice tells your brain not to get its hopes up, those churning "mommy" chemicals in the rest of the brain can't let it go. 

Secondly, my pregnant co-teacher is having one of the most exciting and joyous days of her life tomorrow - right smack in the middle of my 2ww.  Despite her PCOS, she was able to conceive her first child after just rounds of Clomid, and now the second after just another round.  I am happy for her, but it is also so hard to be excited for her when she is lapping me with Baby #2.  Tomorrow, she finds out whether her baby is a boy or a girl and she has taken the day off for the ultrasound. 

As her friend, I am excited to find out and I am happy for her, but my mind is racing.  Will I look excited enough when she tells me?  Will I be able to hide my obvious mixed feelings?  Will people look at me when we discuss it with those piteous looks?  Only time will tell.

As infertiles, we repeat this mantra to ourselves over and over - someone else's fertility does not affect my infertility.  But your brain and your heart just can't see eye-to-eye on this one. 

I hope this cycle makes it all worthwhile...

IUI #7 is in the books...

For the first time ever, we got the go-ahead to trigger on CD12 which landed on Friday.  Earlier that morning, I went in for a follow-up ultrasound.  On Wednesday, I had an ultrasound on CD10 with very positive and surprising results.  For the first time ever, I had two lead follicles in the right ovary and they were rapidly maturing.  Back on Wednesday, the on-call RE even said that her hunch was that we would be ready to trigger on Friday.

Recall from previous cycles that I have never triggered on CD12.  I have always had to go back for a repeat ultrasound on CD14.  Most of the time, I have triggered on CD14, but there were two occasions when I had to wait until CD15.  To trigger on CD12 with two healthy follicles was definitely a first.

Despite the cyst in the left ovary that persists to this day, my hormone levels are still "perfect" and the cyst itself has not grown. 

On Sunday morning, we went in for IUI #7.  C's count was fine - after wash it was around 15 million with 97% motility.  The IUI went perfectly, as usual, and now we are officially in the 2ww.  I will return on Sunday for more bloodwork and a follow-up ultrasound, then we will find out whether or not seven really is our lucky number the following Sunday. 

Last cycle was so crushing and it was so much like all of the others, I really believed that I could never go into another cycle optimistic again.  I don't know that I am going into this optimistic per se, but at least hopeful.  When treatment has only ever given me one follicle and a CD14-15 trigger and I suddenly have two and a CD12 trigger, you can't help but wonder if maybe something will be different this time...  Or at least hope that something will be different this time...

Seeing Double

For the first time ever, I have two follicles growing in the right ovary.  It seems like I am responding a little better to the meds this time around.  Both follicles were around 15mm, which also means that they seem to be developing a bit more quickly than usual.  As a result, I was quite pleased when I left the office this morning.

I know I always say the same things, but I am really hopeful this time.  This is our lucky #7 IUI and it looks like the IUI itself will be on the same day as that fortune cookie prediction that has an irrational but powerful control over my psyche for whatever reason. 

I haven't received the call from the RE yet, but I will most likely have to go back for another ultrasound on Friday (CD12).  If this cycle is like the others, I will also go back on Sunday, then possibly trigger Sunday night.  We'll see how it goes!

Lucky #7?

After finding out that IUI #6 was a bust, we began IUI #7 almost immediately. 

I went downtown for the CD3 baseline ultrasound and bloodwork on Wednesday and they dispensed the meds for this cycle.  I was not allowed to start, however, until the bloodwork showed that the cyst in my left ovary was not affecting my hormone levels.  Later that afternoon, I got the call that my estrogen levels were completely within the normal range and that we were cleared to begin with Lucky #7. 

Just last night, I took my last study pills and I am going in on Wednesday morning for a CD10 ultrasound and bloodwork.  Last cycle, CD10 was on a Saturday, so all of the follow-up monitoring ended up throughout the rest of the business week.  Hopefully, two of the monitoring appointments this time will end up on the weekend, though I will most likely have to come in really late on Tuesday or Wednesday for an IUI. 

Last cycle, when my beta was negative, the on-call RE called with the results of the test, but then the research coordinator herself called and spoke to me and was genuinely "not OK" that it was negative.  Obviously, the nurses and doctors always wanted success before, but it really seemed like Jean was more supportive and more personally involved in my case and that they have higher expectations of success in the study.  Afterall, their success rates are much higher than at the clinical level.

Obviously, her level of concern or how supported I feel is not going to affect the outcome of the cycle, but it has been so much easier to cope in this study than the lonely, herded feeling of clinical practice. 

From here on out, were betting on Lucky 7s!  Maybe a trip to the casino is in order!

It's a mystery no longer...

...what the "mystery pill" is for the study.  I can say with confidence that it is probably Clomid.

Thinking back, I did always respond better to Clomid than to Femara and this cycle I had two follicles, even if one was not quite mature.  It took much longer to develop those two follicles, however, than it did on my previous trials with Clomid.

Without going into too much detail, there is another tell-tale sign that the pill was Clomid.  Let's just say that the period one experiences after taking Clomid is very recognizable, and that was just starting last night.  I will be counting today as CD1, which means I start this whole rigmarole of constant monitoring on Wednesday.

I doubt that I will actually be beginning a new cycle on Wednesday, however, given these two cysts that I developed.  Back in early 2011, I developed one cyst from two back-to-back cycles of Clomid and the RE left it up to me whether or not I wanted to continue cycling or take a break month.  C and I opted for the break, given a destination wedding we were attending that would have interfered with the IUI, as well as our shared exhaustion with the process.

With two cysts, however, it is more likely that I will have to wait one out and wait for the cysts to shrink.  I'm sure that they will make me return on CD3 for the baseline ultrasound and blood work and they will want to assess whether or not the cysts are affecting my hormone levels, but I think a break might be best for us anyway.  I will be giving the research coordinator a call tomorrow - more accurately, giving her voicemail a call - and letting her know that another cycle has begun.  We'll just have to wait and see what happens...

BFN

After the really disappointing adoption webinar, we've been dealt a few more blows this weekend...

After our IUI two weeks ago, we were told to come back yesterday for a beta draw.  Yesterday I had to attend a bridal shower in the afternoon, so I figured that I should probably test on Friday morning so that I am prepared for the phone call on Saturday.  I really didn't want a surprise, especially if I was going to be a shower. 

I tested on Friday morning - BFN, stark white.  I was pretty crushed, but not at all surprised.  After a year of testing and treatment, all with no answers but BFNs, I don't think I will ever go into another cycle optimistic again. 

Though it may seem trivial in comparison, I also had tickets for Game 5 of the NLDS on Friday night - the elimination game between the Phillies and the Cardinals to determine who moves forward to the NLCS and eventually, the World Series.  C and I are rabid Phillies fans and it is tremendously important to us.  Even though the Phillies had the highest record in all of Major League Baseball and the most intimidating starting pitching lineup in all of baseball, there was a strange mood in the stadium that night - one of impending doom. 

I kept saying to myself, I don't know if I can take this twice in one day.  For weeks, I have been saying that I would rather not even use my Game 5 tickets if it meant a win for the Phils to move on to NLCS.  I don't like high stakes games and to say that I internalize the stress of the game is an understatement.  Well, of course, the mood of the crowd was right and the Phils lost, 1-0, an infuriating end to a stellar season. 

The stress of both major disappointments was really tough.  I know that sounds ridiculous, but we were counting on some kind of October joy.  Hell, we even got a fortune cookie back in July that said, "Remember the date three months from this day.  Joy is waiting for you."  We thought that we would either be pregnant in October, and please remember the absolute perfection of an October conception from my previous post, or we would be dancing in the streets with our city celebrating another win.  The paper slip from the cookie is taped to the calendar right on top of October 27.  We really thought it was a sign.

I woke up yesterday with a screaming headache.  Some force would not allow me to get out of bed to go for that damn beta draw.  I don't know why, but I just couldn't do it.  Since my research coordinator is away for the weekend, I figured it would do no harm if I skipped it - there was no appointment anyway, just a walk-in blood draw - and went this morning instead.  I called, left her a message and slept in. 

I went to the shower yesterday and it was quite painful.  I even had people ask me if I was pregnant, flat out, then others talk about how wonderful it would be if I adopted a little boy like Sandra Bullock's Louis.  Not only did I feel uncomfortable and blindsided, and I let it show, but it didn't seem to stop the conversation.  It's a good thing I skipped the beta draw yesterday because if the call had come from the lab during that party, I might have had to run away.

Instead, I went in this morning.  I had my blood drawn and C came with me.  On the way home, we decided to run to the big Super Walmart that is about thirty minutes away.  As soon as we merged onto the Blue Route, we hit gridlocked, bumper to bumper traffic.  We spent over an hour just on that stretch of road, but it didn't matter because we both were having a great morning.  We stopped for coffee and doughnuts and just ate in the car, laughed and talked. 

We got to Walmart and were again in great spirits.  We laughed hysterically as we bought Yoda and Princess Leia costumes for our dogs and an ice cube tray that makes ice shot glasses. 

Then my phone rang.

I answered it and the on-call RE told me what I already knew, that it was negative.  Why would this upset me?  I already knew that it was negative.  C and I were having a fantastic morning.  I don't know why, but it still crushed me.

Despite the better-than-average mood of this morning, we rode home in silence.  I don't know exactly was C was thinking, but I had a lump in my throat and was just feeling sick-to-death of 2011.  This whole year has been tough - just filled with one disappointment after another.  I ran into problems at work earlier in the year, I have had all sorts of responsibilities foisted onto me this school year, I had a downright depressing summer of being broke and doing nothing, an unsatisfying raise (if you would even call it a raise), a disappointing end to the baseball season, and, of course, months and months more of fruitless fertility treatment.  I really feel like I am ready for this year to be over.

Adoption Webinar

Even before I knew that we would struggle with infertility, I still looked into adoption as a viable family-building option.  It also gives me some peace of mind to know that I have a Plan B and a Plan C in the event of another BFN.  Knowing this, I signed C and I up for a webinar about domestic adoption through a local agency located in Wynnewood, PA.

Basically, the webinar was just a Power Point presentation with an adoption consultant speaking through a microphone. The webinar software allowed users to "raise their hands" electronically and ask questions, also via microphone.  Most of the information contained in the webinar was already familiar to me just based on my own research.  There were a few facts, however, that were startlingly grounding.

I knew that the application process would be grueling and that they could and would look into virtually every facet of our personal, legal and financial lives.  As I have said before, if we adopt, we would be relying almost entirely on help from my family.  When they listed the number of reports, histories and forms that they would analyze, I was immediately reluctant. 

I am not at all worried about passing a screening for any part of my personal or professional life.  We are hard-working, incredibly responsible people, but also lively, fun and outgoing.  My house is suitable in every way for children and I even already hold FBI, state police and Childline clearances as a teacher. 

I am concerned about the financial piece, however.  We have very little money outside of our bills and debts.  We are not irresponsible with money, but my job does not pay as much as I had expected when I entered the profession and we are still paying back loans for mine and C's education, as well as our mortgage, taxes and regular bills.  We do not live especially frugally, but I also feel strongly about living happily while we battle infertility. 

If they were to analyze my income and my savings history, I am not sure that we would pass.  It is like a knife in the gut that even if we were able to collect the tens of thousands necessary for adopting, our income, savings, and bills could still prohibit us from being parents.  And what really hurts is that it is up to someone else to decide whether or not we get to be parents.

Someone else watching the webinar asked about the statistics for birthmothers changing their minds during the process.  This was also somewhat disheartening.  In the adoption community, a "disappointment" is when a birthmother changes her mind and decides to keep the child before the baby is placed with the adoptive parents.  A "disruption" is when the decision is made after the child has been placed.  While both would be devastating, I hadn't even considered the latter too much, but during the webinar I learned that not only does this happen, but that in Pennsylvania, the birthparents have 30 days to do so. 

I had read over the fee schedule for adoption before and it was also shockingly high.  There were several fees on the list, however, that were marked with asterisks indicating that they might not apply depending on the situation.  Obviously, I hoped that many of these fees would not apply to us.  According to the estimates in the webinar, though, most of them will.  The estimate range that she gave was higher than expected.  In addition, the adoption tax credit is not as forgiving as we had originally understood, and it may be ending given the dire straits of the economy and tax-funded programs.

Overall, the webinar was disheartening.  Any information covered was either a rehashing of things I already knew, or a grimmer presentation of facts that I had already feared.  Adopting is already almost a complete financial impossibility and learning these new twists and turns made the realization even more difficult. 

It looks like trying even two or three cycles of IVF would be a lot more affordable than adopting, assuming that we would have any success, and it may even be less emotionally draining.  Let's hope we don't make it that far...

One week to go...

...until we find out whether or not this cycle was a success. 

Normally after my IUI, I just waited two weeks, took an HPT, then waited for a new cycle to begin and scheduled my next baseline ultrasound.  I have never had a beta draw because I guess I never really needed it.

This time, I was required to back to the RE one week after the IUI.  In the study, they do a post-IUI ultrasound and blood draw, though they really don't provide many answers at this point.  They measured the thickness of my lining, counted the antral follicles in each ovary and confirmed that both ovaries had, in fact, ovulated the lead follice on the left and the smaller, less mature follicle on the right.  Even though I knew that the second follicle was most likely immature and small, it did make me feel better to know that I had two this round instead of just one. 

Unfortunately, they found during the ultrasound that the left ovary cyst is still there and slightly larger than before, and there is a new cyst, also in the left.  If this cycle is not successful, that may mean that I need a break cycle to let these cysts shrink down, especially if they are affecting my hormone levels. 

After the blood draw, they never called back with results, so I am not sure what they were testing for, or if it was just more material for the study.  I was incredibly relieved that Saturday's appointment was the only monitoring I needed for the whole week because I was really getting tired of all those blood draws.  The phlebotomist also bruised my arm pretty good yesterday on my "best vein" and I am glad it will have a week to recover.

Next Saturday, I will go in for another blood draw, the beta draw, to see if we are pregnant.  I will definitely take an HPT this time because I think waiting around all day for the phone call would be torturous.  If the HPT is positive, I will just be looking forward to hearing how strong our numbers are, and if is negative, I will also be interested in hearing our numbers, and I can deal with it at home instead of wherever I am when the phone rings.  I hope this is it!!