Friday, December 21, 2007

Ticket to Ride

I'll be leaving tonight for vacation in California with my SIL & BIL and their kids. First, though, we'll be staying at a resort in Palm Springs where I will be shopping, eating good food, and getting my first maternity massage. I can't wait. Admittedly, I'm a little nervous about something happening to Blobby, either from the flight itself or from the stress of travelling. Even though the stories you hear about radiation or lack of oxygen are probably just myths, I still worry. Just in case, my SIL gave me a couple of names of high-risk OBs so I have somewhere to go *just in case*. Also, I got copies of my medical chart to carry with me so if something *God forbid* were to happen, the doctors there would know exactly what was going on.

And just a couple of updates. We met with the genetic counselor at my hospital to discuss amnio. We went into the appointment quite undecided about having the amnio and left leaning more towards not having it. I know I'm of 'advanced maternal age', blah blah blah, but I'm not really sure how we would use the information we learn. I'll go into details at a later time. We have some time to decide for sure, and between now and when I would have to make a decision (around 20 weeks), I will be having another NT scan and an AFP blood test at 16 weeks. Plus, the day of the amnio, I am scheduled for a Level 2 ultrasound which should flag anything that appears to be not quite right.

Also, per my doctor's orders, I have been on a lowered dose of Prometrium for the past 6 days. I was on 200mg twice a day, and now I am on 100mg twice a day. Because I was so nervous about weaning off of the progesterone supplements, I went in for a blood draw yesterday. Thankfully, my p4 rose to over 50, so it seems like my placenta has started kicking in its own supply of progesterone. On Sunday, I will lower my dose once again to 100mg once a day and have my blood checked after I return from my trip. Hopefully, in two weeks, hormone supplements will be a thing of the past.

Lastly, we rented a doppler fetal monitor and I've been having a lot of fun playing around with it. I posted a link way down at the bottom of the page, to download Blobby's heartbeat if you're interested in hearing it. To me, it's the best sound in the world. Listening to it has an immediate calming effect and it has been a great way for me to continue to bond with my baby.

Saturday, December 8, 2007

Strawberry Fields Forever

Today is December 8, 2007. John Lennon was killed 27 years ago today. I'm not quite sure what I want to say about this that hasn't already been said by millions of people. Except that he will always be one of the people I respect the most, for his music, his social activism, his love for his family, and his dedication to making this world a better place.

Every year on this day I become so melancholy, thinking about how such an amazing life ended so abruptly and way too early. This year I have been thinking mostly about how important it is that DH and I instill in our child the same values that John fought for.

With all the horrible wars and genocide and atrocities going on in the world today, it's often so scary to think that we will be responsible for bringing a new life into it. What will the world be like when our child is old enough to understand that there is something beyond his or her tiny universe? I shudder when I consider the answer to this question sometimes. All we can do as parents is to do whatever we can to try to make this world a better place, not just for our child, but for everyone.

"You may say that I'm a dreamer, But I'm not the only one, I hope someday you'll join us, And the world will live as one"

Just imagine. :-)

Thursday, December 6, 2007

Mother Nature's Son

I do a lot of day-dreaming and mind-wandering as I shower. Sometimes I really have to concentrate on what I am doing so that I do not overlook the cleansing of any important body parts. This morning, I had an interesting internal discussion. And it's no wonder either; after so much research on genetic issues and screenings, and breathing a huge sigh of relief that so far everything looks good, my mind is clearly still focused on this issue.

I started thinking about how so many things can go wrong during pregnancy. I have come to know so many women who unfortunately have lost pregnancies at varying lengths of gestation. I have also read so many stories about babies who were born with various disorders. However, there are people in this world who parent perfectly normal, healthy children, and who dote on these 'perfect' children until the time comes when they find out that their child is gay, lesbian, or bisexual.

It just boggles the mind how anyone could look at any healthy child and not feel completely blessed to have had him or her, regardless of gender identity or sexual orientation. I can't understand how some wouldn't feel most fortunate to have been able to produce such a perfect offspring, especially considering how much can go wrong during a pregnancy. I just don't get it.

If you happen to find out that your child is lesbian, gay, or bisexual, please count your lucky stars that your child is healthy and has the potential to lead a happy, fulfilling life. Be supportive of his or her lifestyle. I for one, would be so grateful if my child is born healthy, with ten little fingers and ten little toes, and an unlimited potential for growth. If this baby turns out to be a girl, my wish for her is that she lead a fulfilling life and find love with whomever she pleases. And if I have a son, my greatest hope for him is that he lead a fulfilling life and find love with whomever he pleases. And if he becomes a famous stylist or fashion designer, that would be great too. ;P

Tuesday, December 4, 2007

Do You Want to Know a Secret

I'd say that for the most part, the cat is out of the bag. That is, my big mouth couldn't stay shut any longer. I told my job last Thursday (only the people I work closely with), I told two of my close friends over the weekend, and sent out a mass email last night. My carefully thought-out plan to wait until after today's follow-up appointment at the OB went right down the crapper. After all, it's not like I was going to gain any more information about the pregnancy today. We had already seen the baby on ultrasound and had learned that so far, all genetic screenings came back fine. Today was just more like a touching base with my doctor. Plus, I gave the ok to my parents to tell whatever family members they wished. Which basically means that the entire family will know in a matter of minutes.

My doctor's appointment went pretty well today. First I was weighed. Strangely enough, I lost 3 pounds since the last time I was there three weeks ago. I had my blood pressure taken, which was normal. I had to PIAC (pee in a cup) so the nurse could dip those strips in and watch them turn various colors, indicating that my protein and glucose levels were also normal. I discussed with my doctor my primary concern which remains my fluctuating progesterone levels. Last time I saw her I was switched to the oral progesterone and I wanted to know if I would be weaned off of them, now that I am in the second trimester. She agreed to wean me off of them slowly, continuing with 200mg twice a day through the end of this week, then lowering the daily dose to 200mg once a day, after which I would have my levels checked. If it appears that the placenta is starting to kick in with its own supply of progesterone, I'll stay on 200mg/day for the next couple of weeks and then go down to 100mg/day for a bit and have my levels rechecked. I appreciate that she understands my concerns and is willing to monitor my levels before discontinuing the medication.

So my poor vein was attacked yet again. Two different nurses had to try to get some blood out of my one poor, collapsing vein. Neither could get anything so we had to go in the hand, which HURTS! The sweet nurse who was doing the torturing said such a nice thing to me. She said that I was already such a good mom because I was willing to sacrafice so much for the good of my baby. I thought that was just such a nice thing for her to say, as she bandaged my soon-to-be bruised, throbbing hand.

We also heard the heartbeat. It was the first time that the doppler was used, and it worked. Good to know. We will be renting one without a doubt. There's something about that swish swish sound that brings me just as much joy as the sound of my kitties purring.

So my due date of June 14, 2008 was confirmed. Of course, due to my myomectomy I would be going in for a scheduled C-section 7-10 days earlier. I'm not supposed to go into labor, which could put pressure on all of the healed incisions remaining from my prior surgery. I hope that nothing out of the ordinary happens before then. I would like (please, Whoever is in Charge of This) this to be a very uneventful pregnancy, thank you very much.

I almost forgot to mention that I got a call yesterday from my genetic counselor, who told me that the genetic sequencing I had done two weeks ago did not reveal any Tay-Sachs mutation anywhere on the gene. Thank you again. Things seem to still be going well for us, knock on wood, cross your fingers, poo poo hand to God.

Just please, let it continue.

EDITED TO ADD- Today's p4 level was only 21, so my doctor wants me to continue with 200mg of Prometrium twice a day instead of tapering off. I'm very glad that my doctor is being so proactive about this.

Saturday, December 1, 2007

Hello, Goodbye

I spent the summer of 1978 in summer camp, as I had done every summer since 1976. Except 1978 was a special year. It was the year that the organizers of the annual Rah-Rah show decided that it would be an all-Beatles production. Each group in the camp was to learn a particular Beatles song and perform it at the show. Our group's song was Hello, Goodbye.

And so began my undying love for the music of the Beatles, and everything that followed from John, Paul, George, and Ringo. The typical camp songs we sang on the long bus rides were replaced with Ob-La-Di, Ob-La-Da, Octopus's Garden, and Yellow Submarine. I ran out and bought the red and blue albums (album being the operative word here, since after all, this was 1978) and listened to them constantly. Camp was such a special place because it introduced me to new things that I might not have otherwise gotten to experience.

Camp will also always be very special because it was there that I met my friend, Tricia. Except she was always Patti back then. We went to camp together every summer from 1977 through 1985. We went to different schools during the year, but every summer were reunited as if we had never been separated. After camp ended, we went our separate ways to high school. Coincidentally, we ended up going to the same college and bumped into each other on occasion; but we were so different than the kids we had been at camp, and hung out with different crowds. Patti was a sorority girl and hung out at all the cool sorority bars, and I was so not the sorority girl. Even so, we had a long history together and acknowledged it whenever we met by accident.

Years later (1999), I was working at my first Audiology job. Strangely enough, in a weird sequence of events, I found out that Patti (now calling herself Tricia) was also an Audiologist and was working with a friend of mine. A very bizarre coincidence, especially considering that our college didn't even have an Audiology program and therefore we both had to go back to school to first take pre-requisites, and then earn our degrees. It was such a strange feeling, to know that the little girl I had befriended so many years ago ended up on the same path as I did. We got together a few times and reminisced about the good old days. Eventually, I switched jobs after much prodding from her and my other friend. Now we were working together and it was so great to see her (almost) every day and to know that we shared a special experience from our childhood.

Except that things weren't going so well for Tricia. She had been diagnosed with a rare form of cancer and was undergoing chemotherapy every week. Her full-time position at our company turned into part-time, when keeping up with medical appointments and overcoming the effects of the chemo and other various medications became too much for her. Eventually she quit when life became too overwhelming for her. She wasn't only trying to deal with her own illness, but was mourning the loss of her father in 2005 and subsequently, her mother in 2006. Nobody should have to go through the pain that she went through. It broke my heart.

Despite her own troubles and declining physical health, Tricia would talk to me about my infertility and was a great listener. She wanted to try to forget her own problems and would always ask me to tell her what was going on in my life. Of course, at that time, the only thing I could focus any attention on was my struggle to conceive. She told me all the time that she would pray for me. Tricia was a very faithful person, and even though I didn't believe that prayer would miraculously fix what was broken, I appreciated so much that she was taking the time to include me in her prayers, when she clearly had so many other things to worry about.

This past summer, Tricia got very sick. Her cancer spread to her lungs and her brain, and she was living in a hospice on the other side of the country. By the time we found out that her health had declined so drastically, her brain had already deteriorated so much that she couldn't carry on a conversation. I was just beginning my IVF cycle and couldn't talk to my dear friend, whom I knew would want to keep me in her prayers and hope for the best for me.

The day I had my third beta drawn and found out that I was indeed pregnant, I debated whether to somehow tell Tricia. By that point, she was barely conscious. I had attempted to talk to her the week before, but it was a difficult conversation. I had no idea if she was even understanding what was being said. However, the doctors were giving her no more than a couple of weeks more to live. I wanted her to know that her prayers had been answered. I also knew that if I waited, it might be too late. But I also struggled with the idea because the last thing I wanted to do was to make her more upset about her situation, since she wouldn't be around to see my baby born and subsequently grow up.

Knowing the kind of person Tricia was, I decided that it would make her happy to hear good news. She was always about wanting the best for her friends. So I emailed her aunt, who had been a loving and attentive caretaker in Tricia's final weeks. I told her aunt that if she noticed a moment when Tricia appeared to be lucid, to please pass along the message that I was pregnant. A couple of days later, I received a reply from her aunt, telling me that she sat down with Tricia and told her my news. Tricia smiled and nodded, and her aunt just knew that Tricia understood.

Five days later, Tricia passed away. It was a devastating day. Knowing that she would never know my child made it especially hard. However, I was somewhat comforted to know that somewhere in her deteriorating mind, Tricia understood. I was glad that I had made the decision to tell her, and she was the first of my friends to know.

I strongly believe that Tricia came back into my life for a reason. During the brief time that we were reunited as adults, she became a source of strength for me. Tricia was a little thing: short and thin and so delicate-appearing; but she was the strongest person I've ever known. What she endured, no one should have to endure. What she taught me is that no matter what is going on in your life, there's someone who is much worse off than you, so be thankful for what you have. Her situation helped put things in perspective for me. As I was struggling with my infertility, I kept reminding myself that in the grand scheme of things, I was so lucky. I was healthy, had a wonderful family, and was fulfilled in every other aspect of my life. Tricia was the model of a survivor. She was a fighter and hung on until the very end. I miss her so much. There was a reason that our paths crossed. They were meant to cross.

I feel like by the time we said Hello again after so many years, it was time to say Goodbye.

After her death, I asked her to be my baby's guardian angel and look after us. As I am typing this, I have made it to 12 weeks, and I just know that she is here, watching over my baby. I'm not a very religious person, but with so many odds against this pregnancy, I really don't have a better explanation for why our Little Embryo That Could is still hanging on. Our baby is so lucky to have the love of DH's mother Elaine, my grandparents Lillian and Isaac and Elizabeth, and now my dear friend Tricia, to see it safely through.

Wednesday, November 28, 2007

Tell Me What You See

Today was our Nuchal Translucency screening. Severe nerves all day long. It's so hard to concentrate on your job when all you can think about is the health of your unborn child. Knowing that later on in the day I could be getting news that was really, really good, or potentially really, really bad, made time pass oh so slowly.

First, the ultrasound tech did my scan. I was surprised that I didn't have to change into any embarassing little gown, or even remove any clothing. I had to push my skirt down to expose my bloated belly, but that was all. I got to experience the infamous cold ultrasound jelly on the belly. Wasn't so bad; I'd take that any day over a transvaginal. The most significant part about the u/s experience was that this was the first time I've had an ultrasound EVER that didn't involve a dildo cam. Hooray for belly cams!

It took a while to get all the measurements. Blobby (who looks nothing like the bean-shaped blob it was a few weeks ago) wasn't in the optimum position to do the necessary measurment of the nuchal fold. So the tech jiggled my belly a bit, and suddenly Blobby was all over the place. It was rolling over on its side, moving its arms and legs- it was absolutely incredible to watch. Then there was the time that it faced us and it looked a lot like the Alien from the Sigorney Weaver movie, but I won't talk about that. So yes, we saw hands (and definitely counted five fingers on one of the tiny hands, but the other hand was too obscured to see clearly), feet with clearly defined lines to mark where the toes were, a nose, a spinal cord, and it just completely blew my mind. I can't believe how quickly these things develop. A mere 5 weeks ago, we were looking at a little round blob, and today it was human.

Yes, I have sono pictures, but I don't have a scanner at home so it will have to wait until I can sneak off and scan them at work (and hope that nobody busts me, since our secret is not out yet). Blobby is measuring 5.14cm, which corresponds to 11 weeks, 6 days (I am 11 weeks, 4 days according to my LMP and date of ER and fertilization). Right on schedule!

So last week I had to prick my finger and mail droplets of my blood off to a lab. Even though I had mailed them off with more than enough time to process the results, they were not ready. Luckily the u/s tech was able to call the lab and make sure that the results were available, which they were. All they needed to complete the report were the numbers from today's scan, and within minutes we had the results in our hands. At this point, Iwas still thinking that even though Blobby looks like a human, there could still be serious issues to deal with.

And the results? The results were great. Today's NT scan screened for the risk of having a child with Down's Syndrome (Trisomy 21) or Trisomy 18/13. Before the screening, my risk of having a Down's Syndrome baby was 1 in 162. After today's screening, my risk decreased to 1 in 3,221. Before the screening, my risk of having a Trisomy 18/13 baby was 1 in 279. After today's screening, my risk decreased to 1 in 5, 561. What a relief. That's when I started to breathe again.

The Maternal-Fetal specialist and I spoke briefly about amnio, which i would be doing at around 16 weeks, so in about 4 more weeks. We would need to meet with this hospital's genetic counselor before we decide one way or another. Hopefully i'll get all the Tay-Sachs testing back before then so we can make a more informed decision. CVS (which would be done much sooner, like next week) was not recommended for me, because it has a higher miscarriage rate. If the results from today had been bad, I might have considered it, but now I'm breathing a little easier and don't think there's a need to do the CVS, considering the risks.

So WHEW! I am just in awe that I was able to see our baby moving. With little fingers and toes, and a nose, and IT'S REAL. I have a baby that is developing inside my body and depending on me for nourishment and protection. Holy crap. With so many ups and downs over the course of our rollercoaster-like IVF cycle, I have been expecting each appointment to reveal the part of the ride where you plummet and scream. Knock on wood, cross your fingers, poo poo hand to God, we are still going up. It's almost too much for my puny mind to process right now.

In 6 days I have a follow-up appointment with my OB-GYN. I have lots of newbie questions to ask her, so I hope she's ready. God, I hope I'm ready.

Friday, November 23, 2007

Eight Days a Week

Will 12 weeks never get here? While I am so unbelievably grateful to have made it to this point (just shy of 11 weeks as of today), I am still so anxious to be safely out of the first trimester. I know that bad things can still happen, but the likelihood of them happening significantly decreases once a pregnancy has hit the 12-week mark. Yesterday was Thanksgiving, and all day my head was filled with thoughts of thankfulness and gratefulness that I so wanted to share with all who attended our large Thanksgiving feast. However, only a handful of people were in on our secret, and therefore I couldn't go public with any of my feelings.

Next week I am having a Nuchal Translucency Screening. It is a first trimester screening that is done to assess the risk of having a child with a chromosomal disorder such as Trisomy 18 or Trisomy 21. Needless to say, I am quite nervous about it. Every time I read something about TTC when you are over 35 years of age, inevitably there is some mention of these disorders. The risk of having a child with a genetic disorder increases significantly for those of us who are to become older mothers. And the irony is not lost on me either: if it wasn't for my infertility, I wouldn't even be an older mother. I don't know which is the more frightening possibility, as a woman in her late 30's who was struggling with IF- the thought of never having my own biological child, or the thought of having one who would never enjoy the kind of life that chromosomally normal children do. And it would be my own fault. Me and my bad eggs.

Anyway, these are the kinds of things that go through my mind when I think of what I am faced with. It is not all doom and gloom, however. Sometimes, I actually allow myself to entertain thoughts about the perfect bouncing baby boy or girl we could be doting on in a little more than 6 months. But when you don't know what is going on in your own body, the imagination can really take over, and bad thoughts can fill your head. The not knowing has always bothered me more than the knowing; even if the news was not what I wanted to hear.

Which is why I am so anxious for Wednesday to arrive. We should have more information by then about the fate our our Little Embryo that Could. Then a few days after that, I will have a follow-up appointment with my OB-GYN, after which we will hopefully feel comfortable enough to share the happy news about this pregnancy with the rest of our friends and family.

So now we just wait. And waiting, for me, always seems to be the hardest part. Especially when the days crawl by and the weeks seem to last much longer than they really are.

Tuesday, November 13, 2007

The Fool on the Hill

I admit it: I'm a pregnancy newbie. I feel like such a moron sometimes because I really don't know anything about anything. As well-versed as I've become with infertility lingo, I find myself stammering when it comes to talking about this pregnancy.

Which is why I am relying so much on my doctor to tell me what is going on. In plain English. Like she's speaking to a 5 year-old.

Today, at 9 weeks, 3 days, I had my first appointment with a real OB-GYN. Not an infertility specialist, but where 'normal' women go when they get knocked up. It was very strange, being there for the first time for my first pregnancy check-up. I was hoping that she could provide the same kind of attention that my IVF clinic had. Most of all, I was terribly nervous that my Little Embryo that Could would stop could-ing.

Not knowing what to expect for my first OB appointment, I felt like an idiot. It was like my first visit to the 'girl parts doctor'. I was shaking and sweating and praying to Whoever Is In Charge Of This that everything would be ok. I was hoping that I would get to have another ultrasound for a few more weeks of peace of mind.

First, the nurse weighed me and measured my blood pressure. Surprisingly, I hadn't gained any weight. Probably has something to do with my food aversions and nausea. I'm sure that my weight is being distributed differently though. I have quite the belly pooch now.

Then the doctor came in and we went over some stuff. I made her aware of the progesterone scare I had a couple of weeks ago, and that this was the lone embryo out of 18 so I am still so nervous about this one not developing properly. I told her about the two fibroids that were seen during my first ultrasound at the IVF clinic. She assured me that fibroids do not grow that quickly and that I shouldn't worry that they're going to get too big.

She did a pelvic exam and took a cervical culture. It wasn't so bad. One thing I can say about this doctor is that she is very gentle. She said everything felt completely normal. That was good.
I asked her about getting another ultrasound. She said that she would be referring me to the Maternal Fetal specialist at the hospital, since I am more of a high-risk case. Which is fine, because I certainly want to be monitored more often, and by someone who specializes in high-risk pregnancies. But I also wanted another ultrasound today. I don't know how I managed to get her to offer to do one, but she rolled in the little cart and did a quick scan. The resolution on this equipment wasn't as good as the type that was used to at the IVF clinic, but it was really all I needed to get an idea that Blobby is still growing. We saw the heartbeat and Blobby is measuring 2.5 cm, which is about twice the size it was less than 2 weeks ago. The doctor told me that this size corresponded to 8 weeks gestation, but I looked here, and according to this table, we're right on track!

So, I feel much better about things today. I still feel like a worrying fool who has no idea what she's doing; but with any luck, in a few months I'll be worrying about our new baby.

Saturday, November 10, 2007

I Will

On this last day of National Infertility Awareness Week, 2007, I am very contemplative about where I fit in. The other 'pregnant after IF' women will understand this, I am sure. Being pregnant doesn't necessarily mean that my infertility has been cured. It has been temporarily overcome, thanks to a shitload of medical intervention; but my infertility is by no means gone for good. If we are ever lucky (and I use this term very loosely, since I do not believe that it has anything to do with luck) enough to have another child, it will most likely be via IVF. I am reminded of my friend Kate's signature from a forum I used to frequent. After she got pregnant using ARTs after several years of TTC, she wrote, "I am not a fertile, I am not a fertile, I am not a fertile". This speaks very strongly to me, because even though I have made it 'to the other side', I identify most with my friends who are still struggling to conceive.

Ever since I learned that I was pregnant, I have been struggling with the concept of being 'one of them'. A good friend of mine, who had gone through two rounds of IVF (and successfully conceived her daughter during the second round) told me that the first IVF is usually a learning cycle. That is, our bodies may not react to the medication the way they are supposed to, and even though the cycle may not be successful, the doctors will apply this information and adjust our protocol accordingly, for the next attempt. Many times, what is considered to be a standard IVF protocol just doesn't work. However, ours did. Despite being a 37-year-old woman, I responded well to the medication and they were able to retrieve 24 eggs. Lots of women my age have difficulty producing 1/4 of that number. Out of those 24 eggs, 18 fertilized, but only one of those 18 made it to blastocyst by day 5. And yet, despite losing 17 out of 18 embryos, there was something about that one little embryo that made it hang on. It is The Little Embryo that Could.
So what was it about me that allowed me to become pregnant when the majority of women I know, who are going through IVF, could not? I have been wracking my brain trying to figure this one out since I got my BFP. Am I luckier than the other women? I don't think so. I've always considered myself to be very lucky in other aspects of my life, but it's not like I believe that my IF friends are walking around with a dark cloud looming. It's not like I believe that I deserve it more than anyone else. It's not like I believe that I am in better physical condition than anyone else (and if you saw me, you'd vouch for me on that one!). And it's not like I believe that my IVF protocol was the only one that works. I really don't know the answer. Something just clicked, I guess. The right combination of meds and the right physiological conditions and the right timing equaled a recipe that worked for us.

And I know that had something about our protocol been just slightly off, I could be sitting here writing in my TTC journal, trying to figure out how the hell I'm going to find the strength to go through another IVF cycle and possibly another devastating failure.

I am on a message board forum that consists mostly of women who already have kids. Many of those women are pregnant with their second child and some of them are preparing to start trying for additional children. It seems like every time I look, someone else gets a surprise BFP. 'Oops' pregnancies are such a foreign concept to me, and I have so much difficulty relating. Imagine having sex with your husband a couple of times, and BAM- you find out two weeks later that you're pregnant. I am struggling to identify with and understand these fertile women, but I am having such difficulty making sense of it. After all of the medical intervention I have been through, it just boggles the mind that for some, conception can be so easy.

Which is why, as a pregnant woman, I will never lose sight of how much it took to get me where I am. I will never complain about pregnancy symptoms to anyone who would give her left arm to be experiencing those symptoms. I will never say to one of my IF friends, 'If it can happen for me, I just know that it will happen for you'. I will never pretend to see two pink lines just to make a hopeful woman feel better. I will always remember what it feels like to truly believe that I won't ever be able to be a mother to my own biological child. I will always remember the hopelessness that overcame me every single day. I will always remember what it feels like to feel broken. I will always remember what it feels like to hurt after hearing one of those insensitive comments. I will always remember what it feels like to believe that I am a disappointment to my husband and to my family. I will always remember just how much it hurts to see yet another BFN, staring me in the face. I will always remember what it feels like to be the only couple at a social event who doesn't have kids. I will always remember how bad it feels to not feel strong enough to hold my friend's new baby. I will always remember what it's like to be lapped.... yet again. I will always remain sensitive to my IF sisters who are still struggling. I will always be supportive of my dear friends who are still fighting the good fight, and I will always remain in their corners. And I will always remember that I AM NOT A FERTILE, I AM NOT A FERTILE, I AM NOT A FERTILE!

Wednesday, November 7, 2007

She Said She Said

On this 4th day of National Infertility Awareness Week, I'd like to pay respect to the millions of women who live with infertility every day. I've come to know a mere fraction of them and I think that one of the most important things to remember about infertility is that it has many different causes, and every single case is different.

Which is why those 'helpful' comments and suggestions that are offered to us- from people who think they know what they are talking about- are not just inappropriate, but are dead wrong. Like the woman who tells you that her cousin's accountant's sister-in-law went through the same thing as you and here's what worked for her; or the woman who heard that her friend's friend's sister went to a specialist and was told to pop some mystery pills and she got pregnant that first month. It is going to sound way obvious to many people who are reading this, but you cannot compare one woman's story to another. You don't know the complete medical history (and even if you did, do you have a degree in Reproductive Endocrinology?), so keep your opinions and advice to yourself and let us seek out qualified professionals to help us, if we choose (and can afford) to do so.

Not to mention that often, the woman passes her battery of fertility tests with flying colors, but her partner is the one who does not. I also have come to know women who are dealing with male factor infertility, which comes with its own set of challenges. Or women who are struggling with both female and male factors. Not only do they have to diagnose and treat two sets of issues, but they have to coordinate treatment and deal with the frustration of maybe having one partner's issues resolved, but the other's are not.

Then there are the unexplained cases. I know a few of these women as well. Their battery of tests comes back normal. Consultations with specialists do not reveal any issues. And yet, month after month after month, they get BFN after BFN after BFN, even after a full year of trying. How do you proceed with medical treatment when you don't know what you're treating?

Which leads me to the point of this entry. Instead of assuming that all infertiles are the same, please view us as individual cases with very different medical histories and physiologies. I invite everyone to take a look at my blogroll and read a few (or more) of the blogs that I've listed. Most of them are friends, and most of those friends are dealing with infertility in one form or another. Please take a moment to learn a bit about the people and the emotions behind the disorder.

Monday, November 5, 2007

All Together Now

When I read yesterday's entry from Baby Steps to Baby Shoes, I was reminded that November 4th began National Infertility Awareness Week. Here are some things you can do to raise awareness and be supportive of those who are living with infertility. It took me a long time to 'come out' about my infertility, for fear that I would be a disappointment to my family. I've very recently come to terms with the cards I've been dealt, and have rejected my past feelings that I am to blame for my medical issues.

So now that I am 'out', I choose to do my very best to raise awareness and promote sensitivity. Here is my contribution (again, not very original, but sometimes you can't improve on a perfect thing). The following links are excellent articles which I encourage you to read; especially if you are blessed with fertility and have friends and loved ones who aren't.

And finally, the following jewel. I'm not even quite sure where I found it but I had saved it so I could forward it to any insensitive fertiles I encountered :P. I tried to locate the original publisher so I could give proper credit, but I couldn't locate it! Anyway, it's a great example of how completely ridiculous some of the comments we hear truly are:

"So, what do you think people would say to you
if you were paraplegic instead of infertile?

1. As soon as you buy a wheelchair, I bet you'll be able to walk

2. You can't use your legs? Boy, I wish I was paralyzed. I get
so tired of walking, and if I were paralyzed I wouldn't have to walk

3. My cousin was paralyzed but she started shaving her legs in
the other direction and she could walk again. You should try that.

4. I guess God just didn't mean for you to be able to walk.

5. Oh, I know exactly how you feel, because I have an ingrown

6. Sorry, we don't cover treatment for paraplegia, because it's
not a life-threatening illness.

7. So... when are *you* going to start walking?

8. Oh, I have just the opposite problem. I have to walk walk
walk - everywhere I go!

9. But don't you *want* to walk?

10. You're just trying too hard. Relax and you'll be able to

11. You're so lucky... think of the money you save on shoes.

12. I don't know why you're being so selfish. You should at
least be happy that *I* can walk.

13. I hope you don't try those anti-paralyzation drugs. They
sometimes make people run too fast and they get hurt.

14. Look at those people hiking... doesn't that make you want to

15. Just relax, you'll be walking in no time.

16. Oh do my legs hurt, I was walking and walking and going up
and down the stairs all day.

17. I broke my leg skiing, and was on crutches for weeks, and
was worried I'd have a permanent limp, but I'm 100% healed.

18. I'd ask you to be in my wedding party but the wheelchair
will look out of place at the altar.

19. You're being selfish, not coming on the hike with us, and
looking at all of my track & field trophies.

20. Don't complain, you get all the good parking places.

21. If you just lose weight your legs will work again.

22. If you would just have more sex, you could walk!

23. You don't know how to walk? What's wrong with you? Here let
a real man show you how to walk!

24. You are just trying too hard to walk. Give up, and then
you'll walk.

25. Here, touch my legs, then you'll walk!

26. Just take a vacation, and the stress-break will be sure to
get you walking!

27. When *we* were young we only had to worry about having to
walk too much.

28. And I bet a paraplegic going to a bookstore doesn't find
books about paralysis stacked next to all the books on running...

So here's a little hint. If someone you know tells you that she's trying to get pregnant and it's taking longer than expected, DON'T tell her to just relax. Don't tell her to adopt and then surely she'll get pregnant with her own child. Don't tell her that God has a plan for her. Don't say, "At least it's fun trying!" Scheduling sex with the person you love isn't fun. Getting vaginal ultrasounds every other day and intramuscular injections in your ass twice a day isn't fun. Finding out every single month that - yet again - it didn't work this month either is Just. Not. Fun.

DO tell her that you're sorry she's going through such pain/grief/frustration. Do tell her that you're glad she told you. Do tell her that, even if you don't bring it up (because you want to respect her privacy and understand that she might not feel like talking about it sometimes), that you're there for her if she ever wants to talk or vent. And DON'T feel that because she told you that it's okay for you to tell your other friends, children, co-workers, neighbors, cousins, mailman, whomever - unless she tells you that it's okay to do so. Your need to share news pales in comparison to her need to maintain a shred of privacy and dignity. The last thing your friend needs is to be at someone's garage sale and get unsolicited advice from said secretary's sister's cousin's dogwalker's barista about how she and her husband just need to get really drunk one night and jump in the back seat of the car. Because she's probably already tried that, too."

Wednesday, October 31, 2007

You've Got to Hide Your Love Away

Today's bloodwork & ultrasound were great. What a relief. After using the progesterone suppositories for one & a half days, my p4 level rose to 15.5, which is right on target.

As of this morning, Blobby was measuring 12.6mm and the heart rate was 158bpm, which is also right on target.

Just thinking about what could have happened if I had not thought to monitor my progesterone level makes me shudder. The good thing about infertility is that it makes you educate yourself on hormone levels and how your body is supposed to react at different stages of your cycle.

Now the tricky part is going to be keeping this pregnancy a secret, when all I want to do is shout it from the rooftops. We've already told our immediate family: my parents, DH's aunt, uncle, and cousins, and my SIL, given how supportive they all were while we were going through the IVF process. And of course, all of my fantastic online friends know, and my medical practitioners, including my acupuncturist, know. The problem is that DH and I promised each other that we wouldn't tell anyone else until we got to 12 weeks. This is going to be hard! No wonder so many women announce their pregnancies so early- it's nearly impossible not to tell.

Not to mention how bloated I am. I already look like I have a significant baby belly, thanks to all the meds. I don't even know what I am going to look like in a month. Hiding my belly is going to be quite tricky. Yes, this is going to be a challenge. It's a good thing that my hips are not proportional to my waist, so all of my pants have larger waists than I need. Trust me, I'll be needing them very soon.

Monday, October 29, 2007

Don't Let Me Down

After being told last Wednesday to discontinue the PIO shots, I asked my IVF nurse if she would write me a script to have my progesterone checked in a few days. I was nervous that my body wouldn't be able to produce enough of it on its own, since I've always had low progesterone in the past.

So I went this morning to have more blood drawn. Good thing I advocated for myself on this one because my progesterone dropped down to 6 (from 25+ last week). I was so nervous about losing this pregnancy that I left work early so I could go home and start using the progesterone suppositories that (thank god) I had left over from my last IUI cycle. I am to use them twice a day, and I'm going back on Wednesday to have my level checked again, and to have another u/s for my peace of mind.

My dear friend Teri calmed me down a lot. She told me that the placenta doesn't start producing its own progesterone until 12 weeks so it's normal for the progesterone to drop after stopping the PIO shots. She was relieved for me that I caught this in time before any bleeding started. Hopefully she's right and the pregnancy is not in any danger.

I'm hoping for the best on Wednesday. Fingers crossed.

Chapter Eighteen: Good Day Sunshine

On Wednesday, October 24, 2007 we returned to the clinic. DH accompanied me. I was glad that he was coming too, but in a way, I didn't want him to be there if we were to be getting bad news.

The commute into the city SUCKED. We hit so much traffic and it took an hour and 20 minutes to get there. Then we had to wait another half hour at the clinic to be seen. With only four exam rooms, it can get pretty crowded there.

I was shaking as I changed into the examination garment. I had been there so many times before for an ultrasound, but never to see if I had a baby growing inside of me. This was old but new.

I asked the doctor to check my tubes first. I was still so concerned about having an ectopic pregnancy. No, tubes appeared clear, and my ovaries looked normal too. Then we saw it. A little blob on the screen inside a black circle. That was our embryo. The doctor moved the cursor to a little blip of flashing light. That was the heartbeat. She turned up the volume and we could hear the rhythmic swish swish of the beat. Unbelievable. I was really pregnant, and we were watching and listening to evidence of that.

The embryo measured 4.4mm and the heart rate was 125. Right on target, according to the doctor. I was 6 weeks, 4 days pregnant!
I was to discontinue the PIO shots and schedule an appointment with my regular OB-GYN. As I am typing this, I am still waiting for that appointment. I don't think I'll ever be comfortable with the thought that I am pregnant until this baby is born!

Chapter Seventeen: Getting Better

So more waiting until beta #2, which was on Monday, October 8, 2007. I didn't have much hope for a higher number. A normally developing pregnancy is supposed to have beta HcG values that double every 2 days or so. I wasn't expecting much.
Surprisingly, my beta rose to 103, which was right on schedule. Things were looking up. However, the nurse, comparing my number to where a pregnancy should be at 17 days past ovulation, suggested that it could be an ectopic pregnancy. I was freaking out. I was under the impression that the chance of having an ectopic after IVF was far lower than with a natural pregnancy, because the embryo was placed directly into the uterus as opposed to the fertilized egg needing to travel through the fallopian tubes first. I was astounded when the nurse told me that the chances were about the same.

Then I started to wonder about the pain I had been having on my left side. Could that be an ectopic pregnancy in my left tube? I was freaking out even more.

I had to return on Friday, October 12 for beta #3. Four more days of waiting and I couldn't take not knowing anymore. After being so aware of everything that went on throughout the IVF process, no knowing what was happening inside my own body was driving me insane.

Beta #3 was 893. Unbelieveable. I was pregnant. When the nurse called, all I could say in response was 'Oh my god, oh my god, oh my god, oh my god'. I must have sounded like a complete idiot. That one little blastocyst was holding on. I was in shock.

My instructions were to continue with the PIO shots and return on Wednesday, October 24 for an ultrasound. By then, we should be able to see if there was a heartbeat. I couldn't believe I had to wait again. My husband was trying not to get too excited. I was trying to stay grounded.

Still, I couldn't help but POAS (pee on a stick). For the first time in my life, what I saw before me was a BFP (big fat positive). I ran out and bought a digital pregnancy test. There's nothing better than seeing the digital display say 'pregnant'.
It seemed like the 24th would never arrive.

Chapter Sixteen: Something

After two weeks of waiting, my beta day had arrived, Friday, October 5, 2007. I was so nervous because, despite everything that had happened, there was still a small chance that I could be pregnant. So I drove into the city early in the morning as I had so many times before, where my blood was drawn.

When the nurse called that afternoon with the results, I was shaking. She told me that my beta was 43. This was a very low number for 14 days past ovulation. A positive result, but a low number. The nurse suggested that it could be a chemical pregnancy. I was crushed. I wanted an answer. Even if the answer was negative, I wanted to be able to discontinue the PIO shots, move on, and prepare for the next step, whatever that may be.

So all that waiting, and I did not have a definitive answer.

Chapter Fifteen: With a Little Help From My Friends

One thing I haven't talked about yet is the wonderful support I had been (and still am) receiving from my friends in the online infertile community. For more than a year I have known many of these women who have been there for me during my most hopeless days. I am so grateful for so many of the friendships I have made.

When I would have a totally craptastic day, I could post about it and I knew that the IF girls would completely understand what I was going through. It has meant so much to me and I will always love these girls.

There's something about struggling with infertility that has brought so many different women together. These are women with very different backgrounds who live all over the globe, and who, other than sharing a history of IF, may have very little in common with me; and yet they have embraced me and shared with me their wisdom and empathy and friendship.

To all the IF-ers, I love you all dearly! ((hugs))

Chapter Fourteen: Wait

So now there was nothing to do but wait. I had to continue on with the very uncomfortable PIO injections. Why were we even bothering? With only one embryo making it to the blastocyst stage, and with the one blast not being of high quality, what should I even get my hopes up?

This was probably the longest two weeks of my life. When you're waiting to find out if you're pregnant, you don't know how you should act. Could I drink alcohol? Could I take medication? Could I eat sushi? What if that tiny blastocyst was implanting after all? It's such a state of limbo: pregnant but not really pregnant. It was seemingly, such a long wait.

Chapter Thirteen: I'm Down

I was feeling great. We had 18 embryos that were being carefully watched over by the embryology lab. Even if we lost half of them, we'd still have plenty to work with.

Wednesday, September 26, 2007 was my ET. DH & I had agreed, along with my RE, that we would transfer 3 if we had 3 good ones to transfer. I was willing to deal with multiples, and DH, well, he would have to deal with it! I was so excited to have our little embryos transferred.

Before the ET we met with my RE. It was then that she gave us the extremely disappointing news that out of the 18 embryos we had on Saturday, only one had grown and divided enough to be considered worthy of transfer. We had only one blastocyst. How terribly sad that so many of them did not grow. My RE also picked out two morulae, which, even though they were a day or two behind the blastocyst, we agreed to transfer them as well.

The ET was extremely painful. It was the worst pain I had ever experienced during any gynecological visit, EVER. And even more painful was the emotional pain I was feeling. Why did so many of our embryos fail to develop? Could we also be dealing with genetic problems as well? I cried during the entire procedure. I just knew this wasn't going to work, and here I was, laying on the table, spread eagle, going through all of this pain for nothing. This was probably the worst day of my life.

Chapter Twelve: Within You, Without You

So on the afternoon of Friday, September 21, I went in for my egg retrieval (ER). I was really nervous. The procedure consisted of long needles going through the vaginal wall in order to suck out the follicular fluid. Thank god I was given IV sedation and was completely under while the procedure was going on.

Upon waking up, I was told that they had retrieved 24 eggs! That was an amazing number, considering my age and that some women don't respond this well to the medication during their first IVF cycle. In fact, a good friend of mine had told me that in most cases, the first IVF cycle is considered more of a learning cycle, and does not work because there are so many variables to get just right. I was so thrilled that I had gotten over the first hurdle- I had plenty of eggs to work with. The goal was to have at least half of them fertilize, then transfer the best three and freeze the rest.

So after the ER I went home and rested. I was crampy but feeling pretty good about the way things had turned out.

The day of the ER I had to start taking two more medications, Medrol and Doxycycline. The following day I had to begin my Progesterone in oil (PIO) injections. These were also intramuscular injections and I relied on my DH to administer them. I would be on the PIO shots for at least two weeks.

The day after the ER we got a call from the clinic. Out of 24 eggs, 18 fertilized! This was fantastic news. This means we would have many more embryos to choose from. Our Embryo Transfer (ET) would be in 5 days. I was on cloud 9. I couldn't remember ever being this happy during the two years I had been TTC.

Sunday, October 28, 2007

Chapter Eleven: A Day in the Life

Simple, huh? There is a lot to learn and remember when you're starting an IVF cycle. Like when to start your meds, when to show up at the clinic for monitoring, when to stop certain meds and start others, when to overlap two or three meds, and most importantly, how to feign sanity.

The month of September, 2007 was a complete blur. I was grateful for my handy dandy IVF calendar.

First I was put on 28 days of Birth Control pills (BCP) so my cycle could be more accurately timed. While on BCP, I had to start on Lupron, which is designed to suppress the system so I wouldn't ovulate unless I was given a particular injection. After I finished the BCP, I was to lower my Lupron dosage and begin on my stims, Follistim & Menopur.

I had already had experience with the Follistim pen, which was very user-friendly. It was the Lupron and Menopur that terrified me. These involved regular needles and syringes and vials of medication that needed to be drawn and measured. I was pretty nervous about this. And the Menopur consisted of a liquid and powder that needed to be mixed. I felt like I was part of my own labaratory experiment.

And then there is the HcG trigger shot. Instead of being given in the belly fat subcutaneously, this was to be given right in the arse, through the muscle on the upper half of the butt cheek. The needle is 1 & 1/2 inches long. Because it needed to be given in the rear, my brave husband had to administer the shot. He was a little too eager, if you ask me. We had to wake up at 2am to get the shot, since I had a 1:30pm appointment for my egg retrieval a day later.

It's amazing how doing IVF changed me. Who would have thought that I would have had the courage to inject myself multiple times a day? I was brave to go through this. But most of all, I was grateful that I could. I know so many women who for various reasons, cannot do IVF, even though it is their only hope to conceive.

Chapter Ten: Tell Me Why

I spoke to my RE to see if she could offer some explanation for why, despite having the surgery and going through more ARTs, I still wasn't getting pregnant. She seemed to think that the remaining scar tissue could still be causing a problem. Even though she lased as many adhesions as she could during the laparoscopy, surgeons are never able to make it perfect. While I was better than before, I still had 'crappy tubes'. Fantastic!

After a long discussion with DH, we decided that trying IVF was worth a shot. My doctor didn't think I had any egg issues, like poor quality or low reserve. My BBT charts and bloodwork had always suggested that I had plenty of eggs left, and there was no evidence that they were of poor quality. For women with decent eggs but nowhere for them to go, IVF is usually the next step.

So we scheduled an appointment to meet with my RE for an IVF consultation. This was certainly a direction we never thought we'd go. But yet here we were. We discussed the procedure, all the various medications I'd be on and the increased dosages, how I had to follow a very specific protocol, and how my chances for becoming pregnant would be about 50%. The goal was to retrieve about 12 eggs and get three good embryos to transfer; the rest could be frozen for later use. It all sounded so simple and very promising.

Chapter Nine: I'm So Tired

In May, 2006 it was back to ARTs. What a bummer. Back to early morning wake-ups, schlepping my tired ass into the city for them to poke & prod my aching body, back to the side effects of the injectible medications, and back to having a belly that resembles a black & blue pin cushion. This just wasn't fair. Why do I hear stories every single day about accidental pregnancies? Why do those women deserve to become parents easily and I don't?

And more importantly, why were both cycles of injectable IUIs failures? I had the laparoscopy. My doctor had supposedly fixed me. Why couldn't I get pregnant, even with the aid of hormones, and doctors probing me, and nurses shoving sperm up my nether regions? Somethinig was still wrong but nobody could figure out what it was. I'm just so tired of all of this bullshit.

Chapter Eight: Why Don't We Do It In the Road?

So now I was fixed and I should be able to get pregnant on my own without the help of ARTs. Right? Sure! I went back to BBT charting with a vengeance. I could pinpoint the exact day that I ovulated. Surely we would be able to get this done without doctors, or nurses, or needles, or meds, or catheters. This was going to be great. We could procreate like normal people.

Or so I thought. Four months passed. Four cycles of charting, and four more BFNs, or 'big fat negatives' as we say in the online TTC forum world. But I was supposed to be fixed!

Saturday, October 27, 2007

Chapter Seven: Fixing a Hole

After two failed IUIs, I didn't know how to proceed. Clearly, something was wrong. My RE suggested that it could be the presence of scar tissue that was left over from my myomectomy. I had remembered that first u/s at the RE consultation appointment and hearing her comment about how my left ovary was stuck to the back of my uterus. While it wasn't likely that this was causing the problem, I didn't want to go through more medicated IUI cycles if there was another roadblock. It just wasn't worth going through the emotionally and physically taxing process of doing more ARTs.

So we decided that I would have a laparoscopy. It would be an outpatient procedure that would only require a few days for recovery. It would be worth it if she could find something that was causing my infertility and fix it.

I had the lap surgery in December of 2006. After the surgery, while I was in recovery, my RE came to talk to me. She told me that she had lased a lot of scar tissue. I didn't quite comprehend exactly how much scar tissue was removed, until I had my post-operative appointment. As she read her surgical notes to me, I was shocked to hear about how messed up my insides were. This was what she found:
  1. My left ovary was adhered to the back of my uterus (we knew that already).
  2. My right ovary was adhered to the right fallopian tube and to the pelvic sidewall.
  3. My uterus was adhered to my intestines.
  4. I had mild endometriosis.

Wow. All of these adhesions were a result of the myomectomy I had had a little over 2 years before. So my fibroids, although gone, still were having major after effects. No wonder that, even though my two IUIs appeared to be the solution to my problems, both were a huge failure. My poor little eggs were probably getting all caught up in all that scar tissue and had nowhere to go. But now it all was gone. I was fixed.

Chapter Six: I'm a Loser

IUI #1 was a failure. So was IUI #2. I just couldn't understand why I couldn't get pregnant, even under such ideal conditions. What more could we want than my husband's sperm being placed where it needed to be? I responded well to the medication. I had always ovulated on my own, but this gave me even more eggs for the sperm to find. So what the hell was the problem?

There's something about being the only married couple you know without children that is extremely isolating. It's like a club that you're not qualified to join. Infertility is a very lonely place. I felt like I was broken- damaged goods. Our friends were having babies left and right. It seemed like everyone else could have kids except us. What's worse was that no one understood the loneliness and isolation. People would make inappropriate comments such as, 'Be happy you don't have kids- they're so much work!' (right, because I didn't realize that before- thanks for the warning; now I'm so relieved that I'm infertile!). Once, a friend of mine, who was fully aware of the medical intervention I had been through, was complaining about how her toddler was starting to throw temper tantrums and asked, 'Are you sure you really want one of these?' There's nothing more hurtful than someone who can have kids speaking lightly of your situation. There was no one in my real life who would understand. Which is why I sunk lower and lower and stepped farther and farther away from my friends.

Chapter Five: Come Together

The day had come. I had gotten my HcG trigger shot the previous morning, and now we were ready for my IUI. DH & I got to the clinic early so he could do his part. After a leisurely breakfast at Sarge's Deli, we returned to the clinic for my insemination. After verifying that the contents of the little tube did indeed belong to my husband, I was able to see the results of the semen analysis. Stellar, as always. While I'm always so happy to see that my DH's sperm are of good quality, it often puts more of the blame for our troubles conceiving on me.

I was really nervous the first time I did my insemination. It involved stirrups and speculae, two things that I never enjoyed. This time it also involved a long catheter, through which my husbands sperm would be sent directly into my uterus. The procedure was very uncomfortable and caused a lot of cramping, but after 20 minutes of relaxing, I could leave.

Now there was nothing stopping his sperm and my egg(s) from meeting. Before IUI, you never knew if those little swimmers could get to where they needed to be. Now, there was nothing stopping them. So we thought.

After the IUI we hung out in the city for the remainder of the day. We went to see The U.S. vs. John Lennon and then walked through Strawberry Fields in Central Park. I thought that would bring me good vibes for conception. I was so hopeful that cycle. My first IUI with injectables just had to work.

Chapter Four: I'm Looking Through You

One of the dangers of ARTs is something called Ovarian Hyperstimulation Syndrome (OHSS). In order to make sure that this does not happen, my clinic monitored my hormone levels and follicle growth. The goal with ovulation induction therapy is that you want there to be two or three dominant follicles which grow much larger than the rest. The ones that grow large enough to be considered mature will release mature eggs once the HcG trigger injection is given. However, if the follicle growth is not properly monitored, they can be stimulated too quickly and many more follicles can reach mature size. This causes the ovaries to become very bulky and heavy and there is a risk of them twisting around upon themselves and cutting off the blood flow to the ovaries. There is also a risk of fluid being released from the cyst-like follicles and causing severe discomfort.

This is why I was required to return to my clinic every few days for careful monitoring of my cycle. This would consist of blood draw to check my estradiol (e2) level, and a follicle scan so the doctor could measure the dominant follicles. It was very much up to the doctor on call that morning to determine if the follicles had reached mature level. That, and my e2 level would determine when I was to receive my HcG trigger shot. I would watch the the doctor click his or her cursor on the u/s monitor at various places on each follicle to measure it. A follicle of 18mm or greater is considered mature.

Each day that I visited the clinic, one of the nurses would call me that afternoon to give me instructions for that evening's medication dose. These instructions were based on the e2 level and the size of the dominant follicles.

Chapter Three: What Goes On

IUI seems like such a simple concept: you go to the clinic, they place sperm in your uterus, and the little spermies swim around, find the egg, and fertilize it. There- instant pregnancy!

Well, it really wasn't all that simple at all. First of all in order to increase our chances, we decided to start on an injectible medication. This would help me to produce more eggs each cycle, which would increase the number of targets for the sperm. It also increases the chances of multiples, but that was a chance we were willing to take. After all, if I could get pregnant with twins, we wouldn't have to worry about doing any of this ever again.

So I went to my injectibles class and learned how I was to inject the medication. It seemed so simple: the medication came in a pre-filled cartridge that you placed into a pen. You attach a micro-fine needle and inject it into your belly fat. Simple.

Before I could start the cycle, I had to go in to the clinic for a baseline blood draw and u/s. They needed to be sure that my body was ready to start stimming. This was the first of many early morning visits to the clinic. My clinic was open from 7-9am for monitoring. Which means that I had to drive into Manhattan, find parking, and get to the clinic with enough time to have a scan and my blood drawn, while still getting to work on time. Which means that I had to wake up at the crack of dawn, battle rush-hour traffic, all while experiencing the side effects of the medication: mood swings, hot flashes, headaches, ovary pain, and a sore & bruised belly which resembled a pin cushion. The medication was enough, but add to it the early wake-ups and rush-hour traffic, I was quickly losing my mind.

Chapter Two: It Won't Be Long

So we moved on to the wonderful world of ARTs, or Assisted Reproductive Technology, in September of 2006. It's amazing how our views on this had changed. At the beginning of our TTC journey, we were in agreement that if we couldn't conceive on our own, that we'd pursue adoption. A year later, after 12 cycles and 12 disappointments, we thought we'd give ARTs a whirl. By this time I was involved in an online community of women who were experiencing infertility as I was, and my exposure to medical intervention was increasing. It seemed to be such a common thing, at least among the infertile crowd.

Fortunately, my health insurance would cover up to six Intrauterine Inseminations (IUI) and all the medication I would need. Fantastic. Except I was confident that I wouldn't need six. With my new RE and our new plan, this would surely work. I'd be pregnant soon.

Chapter One: The Long and Winding Road

First, a brief history about our journey. DH & I got married in October of 2002 at the ages of 34 and 32. We knew from the beginning that having our own biological children might be a challenge. I had been diagnosed with multiple uterine fibroids, which could cause major complications if I ever managed to get pregnant. Since we weren't planning on TTC (trying to conceive) for at least a couple of years, we decided to be proactive and remove the fibroids surgically. I had a myomectomy in August of 2004, during which 9 fibroids were removed. We weren't allowed to start TTC for at least a year, which brings us to October of 2005. However, we were told by my surgeon that I shouldn't have any difficulty conceiving; my uterus had been beautifully surgically reconstructed. Ha!

It's a scary thing to have unprotected sex for the first time. If everything I believed from Junior High School was true, I'd be knocked up the moment my legs were spread. They really don't teach you a lot in school about making babies.

For 6-8 months we continued this naive behavior. I was already 35/36 so I figured it might take me a little longer. I consulted my OB-GYN who sent me for some tests. I had hormone levels checked, I was sent for a HSG to determine if my tubes were open. That was such a fun test! It was performed by a male radiologist with absolutely no bedside manner and was extremely painful, uncomfortable, and humiliating. All of my testing came back completely normal. DH was also sent for a semen analysis, which also was normal. So why wasn't I getting pregnant?

So I decided to start BBT charting. Charting is good because it helps to pinpoint your most fertile days. Charting is bad because you find yourself becoming obsessed with it. Did my temp go up or down? Did I ovulate yet? Why didn't I ovulate yet? Oh no! I only got 2 hours of sleep before I took my temperature! Should I record the 4:30am temperature or the 6:30am temperature? You completely lose touch with reality and can't even remember what day it is, unless you're talking about what day it is in your cycle or how many days past ovulation you are. I won't even go into how you're supposed to check your cervical fluid.

To say I was obsessed with my chart is an understatement. My poor DH had to put up with my behavior. I hear so many people make jokes about how fun it is to try to get pregnant. After all, it's about having as much sex as you can, right? Well those people have never had to TTC while charting. No way. If you're a long-time TTCer, you know what I mean. Sex on demand is not fun at all.

This is turning into much more than a brief history. It's almost at the end, I promise.

In September, 2006, we were almost at the one-year mark of TTC. They say that the average healthy couple can take up to a year to conceive. Once you hit that year point, you're considered 'infertile' by the medical community (and by TTC forum standards too). So we decided to seek help from a specialist. I had my consultation with a Reproductive Endocrinologist (RE). She ordered blood tests, looked at my BBT charts, and did an ultrasound (u/s). Upon performing the u/s, she discovered that one of my ovaries was stuck to the back of my uterus. She thought it was most likely due to residual scartissue from my myomectomy. She didn't think it would cause a huge problem with conceiving, but as we would learn later on, that was just the tip of the iceberg.