9 Weeks Graduated!

Well there's Little H. I got to visit with him/her yesterday at my CCRM graduation appointment. Those folks there are really fab and I especially love Ruby, the new lab technician. Emily has been a sweet ultrasound tech, doing nearly every one of my appointments, and Dr. M herself gave me a lot of confidence in the two appointments we had with her. My new nurse, Lana, as darling as she is, was really only the harbinger of my exciting change of status - I've hardly seen her at all since she was assigned to me only for our pregnancy cycle. But, when all is said and done, I don't want to see any of them ever again!! If you've had to work with a fertility clinic, you know what I mean. If you've been diagnosed as "unexplained infertile," you get it. I'll spend the next 18-24 months praying that the next time I want to be pregnant, I'll be able to do it the good ol' fashioned way. I mean, who knows?! Stranger things have certainly happened.

So I was very unceremoniously graduated from the clinic yesterday, praise god. The u/s tech and my nurse were extremely pleased with how the little bugger was measuring and moving. My, oh, my, this little one has places to be! We got a look at him at approximately 2:30 in the afternoon and he looked like he was getting set to sprint across some imaginary finish line! Hands were waving, feets were shuffling, it was really incredible. And I could see her little heart muscle pump-pump-pumping. Emily was especially enamored with her feet flying around. The head is laying near my right side and the feet extend sideways to my left. Seems like an odd position but what do I know...

At 9w4d I am feeling remarkably unpregnant. Virtually no nausea and my exhaustion could easily be chalked up to the crazy move we did about 10 days ago and my daily 5:20am alarm setting. Not feeling crazy emotional either, peeing seems to be a rather normal schedule. Some days I feel nervous about the lack of typical symptoms, but Nurse Erin said to roll with it and love every minute. So that is what I shall do :) I do have pretty tender boobs though. And a funny moment today: one of my colleagues is in her 2nd trimester and I was in a meeting with her this morning that wrapped up close to 12. She was commenting that we really needed to finish soon cause she just had to eat and I agreed saying, "Yeah I'm ravenous. I don't know why I'm so hungry!" Her response to me? Amusingly: "Hey, maybe you're pregnant." Haha. yeah, maybe I am ;)

Thus far, I think I've been subconsciously very guarded about this little one. While I've been very outwardly excited with anyone who knows, deeper in my heart I keep feeling concern and I think I've been staying a bit disconnected. In a way that's an easy default setting for me because of how difficult the last year+ has been. And I'm sure most first-tri mommies go through that when there aren't many (or any) physical signs of what's happening. But now, after such a strong showing at her 9 week appointment, I think I'm ready to really go all-in, emotionally. I also took a hospital tour over the weekend and that helped push me forward a bit. Our chances of having a healthy, full-term birth are no better or worse than anyone else's - I need to just believe in this, 100%, no questions asked. So I'm going for it.

Emily printed several extra copies of our best u/s images and I promptly cut them out and placed them in the engraved silver frames that are currently on a flight to my dad in NY and my grandmother in FL. The news is seriously on its way and we plan to tell the family friends we're spending Christmas with. 

Surprise! 

Baby H

Arriving July 2015

135 bpm

We had our first regularly-scheduled ultrasound today! My office says I'm 6w5d but the little blueberry in my uterus says it's been 7 weeks even. I guess he's big for his age??? We weren't able to actually hear a heartbeat, I suppose because blueberry is just so itty-bitty, but we saw that little heartspace fluttering away on the screen and our ultrasound tech, Emily, said it measured at a strong 135bpm. The top mass that is longer shaped is Baby Blueberry and the mass just below her (?) that looks like a heart shape (or a triangle, if you're less of a romantic) is the yolk sac that's keeping her fed.

I'm letting myself think about all sorts of wild things like... what it will be like to have a little one toddling around the new house a couple years from now... how strange it will be for a carseat to be a semi-permanent fixture in the backseat... the logistics of our mothers coming to stay with us after the birth in the summer...how we'll plan our holidays next year when there is a 5 or 6 month old to consider. It's so, well, shocking to my system to think about all of it! I pushed those thoughts away for the last year so it's a bit like uncharted territory.

Mom and I started to throw around shower ideas this week which, on one hand seems nutty, but on the other... well, it just seems smart! I would love if it could be a surprise - that's what I'd always imagined. But living across the country now and having to schedule flights. It's just overwhelming to consider all of it being done clandestinely! Truthfully, I'm happy to have input because I really don't want to do a traditional thing anyway. Definitely want to throw a co-ed bash! Now that we're so far away, it seems like one of very few opportunities to see extended family and friends and to eliminate 50% of them cause they are male? Well it just don't feel right! This obviously turns it into a more low-key party because we're starting with an 80-person guest list (eeep!) and throws a small wrench into the where-to-host-it matter. We'll have friends and family coming from Long Island, Manhattan, Central Jersey and Bucks County, PA. Manhattan is obviously the most central, but bound to be most expensive. What's a girl to do?!

For now, I'm just focused on getting my blueberry to keep on growing safe & sound. Oh, and also to get permanently hired before anyone figures out I'm pregs!

Baby's First Photo

So I called my darling nurse Lana on Monday to report my dizziness and the sharp pains in my right pelvic zone. After checking in with Dr. M, I had an appointment made for me at 1pm. They were obviously concerned about an ectopic so I was slated for a urinalysis, sonogram and blood work. No matter the results I was so relieved that I wouldn't be spending a whole week at home in NJ wondering whether or not I was having a tubal pregnancy.

My sonographer, Emily, got the dildo camera right up in there and immediately spotted the gestational sac and yolk sac right where it needed to be. Massive sigh of relief, accompanied by the heart-racing excitement of having good news and seeing that little ball on the screen. 

Once Lana and Dr. M saw the sonogram results there was no need to take blood, phew. Being only 5 weeks and 4 days, there was no heartbeat to check for yet but I did get to take two pictures of my little lentil to show daddy back in New York. 

We also decided to tell family this week since we don't know when we'll see everyone in person again. Wednesday was my mom's birthday and we had reservations for her fave restaurant. I'd ordered a pair of silver earrings and a silver necklace with a ruby pendant for her and we'd also invites J's parents to join for dinner. After our apps course, I pulled out the two jewelry boxes and when she opened the necklace I explained the significance of the little pyrite bead on the back and then said, "And the ruby is the July birthstone." That comment seemed to fall flat until my step dad questioned it after a few seconds. So J and I each repeated a couple times "yup, birthstone for July" hoping it might sink in. Finally, Mom looked up at me trying to figure out why it was important and all the pieces started to come together. She totally cried like a baby, just as I anticipated :p 

Needless to say, we all had a great time at dinner. Everyone was pretty shocked. Well, 'cept J's mom who was expecting us to "make an announcement" this visit. She also squarely believes we've got a girl cooking. I'll take it!

P.S. My boobs are out of control painful, it is The Worst to take my bra off every night. On the flip side, still no running to the bathroom to puke so that's pretty awesome!

No Beta Dramas Here

My dear nurse Lana took her sweet time calling with my blood test results today. I mean, I still love the girl and I know she has a serious job, of which phone calls are only a small part, and always done in the late afternoon. But daaaaaaamn I thought I'd hear back before 4pm! I was totally zen til maybe 2pm when I started falling asleep at my desk and feeling anxious to just call it a day.

I waited and waited for hours and hours. I checked my phone and email over and over again in case there was any message that came in during the 3 seconds that I wasn't paying attention. When Lana finally called, when I had completely given up on hearing today, I was in the car blasting music and completely missed the call. Doh! But, being the fab nurse she is, she left me a perfect message full of detail!

hCG Level: 2673 mIU/ml (CCRM wants to see it over 50) 

Progesterone Level: 73.8 nmol/L (should be between 32.6 and 140)

Bottom line? At 19dpiui, I'm pretty gosh darn pregs and Dr. M sees no reason to do a follow up beta test. Woo! I'm supposed to call back tomorrow to schedule my first ultrasound. squeeeeeee!

I thought I'd done a good job of staying chill all day while I waited around, but as I listened to her message and began tearing up (let's be straight, I was on the verge of hyperventilating), I finally realized how much anxiety I'd been holding. Would the number indicate a chemical pregnancy? What about ectopic? Would it just be low enough to cause general concern about the viability? When I listened to her recount the numbers in the message, my jaw literally dropped. It was so much higher than I expected! 

The news makes me feel a little more confident about telling my family over Thanksgiving. Even though it's traditionally "too soon," I can't imagine not sharing this news face to face and, sadly, I have no idea when I'll get to see them all again. We still will wait to tell J's family until they visit us at the end of December. At that point, we'll be closer to the second trimester. Not sure when I'll actually get to have the ultrasound since I'll only be in town until next Monday. That will mark 5 weeks and I'm sure that will be too early. Waiting over a week until I'm back in Denver is going to build up some crazy anticipation!

The month of November is carrying an unreal amount of gratitude for me this year. Thank you, thank you, thank you, Universe! <3

Here We Go

This fertility journey sure is insane. You're always on a roller coaster, though some days you find that you've gotten off one ride just to board another one. There's the Hope Coaster, the Depression Coaster, the Anger Coaster. And maybe if you're doing a lot of yoga, meditation and acupuncture, you get a few spins on that lovely, relaxing Ferris Wheel with great views. 

I've been hanging out on the Ferris Wheel for a bit now, I'm glad to say. It's a ride I always enjoy at any kind of amusement park. I just love the feeling of looking out and seeing everything spread out below me. There's so much to see and imagine, so much that is happening below you that you aren't even aware of. If I were getting philosophical I'd try to wrap that into some metaphor for living a beautiful life. But I'm busy at work (yep! I got myself a job about a week and a half ago. Go me!) and don't have a lot of space in my brain for flowery metaphors. 

Turns out it's time for me to board a new ride. I've been so scared that I was going to have to get in line for the scariest ride in the park - one that's sure to shake you about, turn your stomach, make you question what you've done wrong in life, and whether you'll actually come out in one piece - the IVF Coaster. Now, I love the thrill of a good, adrenaline-boosting ride, but I've found that as I get older, these rides aren't really agreeing with me. Last summer I blacked out on a roller coaster in Wisconsin! I've never blacked out in my life. Well... 'cept that night in college... Totally different. But I was so scared by the prospect of that ride that I didn't fully appreciate how it would feel if it turned out that I didn't need to get on that ride. That maybe, just maybe, all the stars would align and I'd be getting on the I-Just-Got-My-First-Ever-Positive-HPT Ride. 

Yeah, it's true. That's my new roller coaster. Here's the proof:

I'm not sure what to make of it still. As I start to think about what may lay ahead in the next 9 months I actually feel like an imposter. Like I'm on stage acting out a part from a script. It's someone else's life. I'm just standing in and pretending to be the girl who needs to figure out when to tell family, when to tell friends, what hospital to deliver at, when maternity clothes will be necessary, how long before someone at work notices. There are some emotional scars that remain, for sure. PTSD? Eh, that's probably overkill.

What's going to make it real? When will I feel safe from the infertility monster? I guess my blood work tomorrow will be a first step. Those hcg numbers will surely tell a tale. But after that? I probably won't feel settled in for the long haul until January. Maybe when CCRM graduates me to my regular OB. The truth is, full-term pregnancy is an honest-to-god miracle. There are so many things that can go wrong. Whether or not you're aware of it, you probably know someone who has had a miscarriage or a pre-term birth. It happens more frequently than most people are willing to recognize in polite company. Because it's goshdarn terrifying and no one wants to talk about it.

Other than feeling like kind of a fraud when J and I talk out loud about The Positive, I'm freaking elated. I took a test at 5:30am on Saturday morning and totally silent-cried in the bathroom as I watched the second pink line slowly darken as the seconds ticked by. I couldn't fall back asleep so I took pups for a walk and then we hung out on the couch watching tv til J woke up. I still wasn't ready to tell him. I was afraid it wasn't real. I'd hidden the test strip under my side of the vanity and kept going back to look at it, as if the line would have disappeared or that I dreamed the whole thing. 

The inspection on our new house was at 9:00am and, being a total novice, I thought it might take 1-2 hours. WRONG! We finished up at 1:30, at which point we took a lunch break. Knowing that the results of the inspection were pretty positive with only a handful of minor fixes, we were ready to appliance shop. But I couldn't keep it back much longer. It felt so anticlimactic to just spit it out and, frankly, the words "I'm pregnant" sounded far too risky in my head. So I asked J to drop me in front of Target after lunch so I could grab something. Truthfully, I needed nail polish remover but I also wanted something to hand over. A concrete object that would tell J: this is happening. We are going to start crib shopping whilst we search for a dining room table. 

I looked for a cute onesie but was far from impressed by the selection. Nothing called out to me as the "right thing." No precious little shoes either. And then I passed a section of monogram mugs. There was a green and white chevron one with a big letter D. And I immediately thought: Daddy. Into the basket for check out. 

As we pulled into a spot for Crate & Barrel, I said to J, "I hope you don't mind but I got you something in Target." He seemed intrigued as I fumbled to grasp the mug in the plastic bag. I handed it to him and said, "This," grandly, "is your new favorite mug."

"OK, but what's the D for?"

"It's for Daddy."

"Well," with kind of a sad and confused laugh, "don't I actually need to BE a daddy first...?"

"Yeah," nodding. "Well, you're going to be."

Poor guy. He didn't know what was going on for a good 10 seconds. And then it hit him like a city bus. His face turned bright red, I'm sure I spotted a little dampness in those eyes, and he grabbed me into him over the console of the car. And then after he released me, he grabbed me back again. For such a stoic and unemotional fellow, that was a much greater reaction than I ever expected!

The rest of the day was full of high fives, hugs, and washer/dryer shopping. We're both still wrapping our heads around this.  My guess is that I'm a little more guarded than he is after all the reading and research I've done this last year+ but I'm still incredibly thankful to have this first step forward. 

And to KRQ: whenever you read this, you're likely the 1st person to find out! So, shhh...That's what you get for following this story ;) Miss you!

Double Down on the Emotions Part Deux

Oh, Sunshine & Rainbows!

What a turn the day made. Number 1: we got our shipment of wine from the little family vineyard we visited in Napa last month, Bremer. They make the most fabulous wines, oh yesyesyes!

Number 2 requires a quick backstory. Last weekend we needed to go to the Lone Tree branch of CCRM for me to do my cyst check and bloodwork and we had the sweetest most enthusiastic nurse meet with us. I actually told J after we left that if we move to that area some time soon, I would request her as our nurse. Our current nurse is, well, clinical, and not very personable but I thought it would be a karmic no-no to request another nurse. She gets the job done just fine, being the conduit between Dr. M and us.

So I was in the midst of a nice, relaxing yoga session when my phone rang. I don't get many calls these days so I picked it up and SO glad I did! It was our CCRM nurse calling to let me know she'd taken a new position at the university and so our case would be transferred to another nurse. Well, wouldn't ya know, we're being transferred to the awesome nurse from last weekend! I'll call her Lana. She's awesome and I'm so pumped. Turns out, Lone Tree was just her weekend assignment.

Just the good news I needed. It feels like such a good omen. This cycle has to be a good one.

LH Surge? Whaaa?!

I wanted to check, just to be sure. Just because I'm so damn curious. I took out the cup and dipped the OPK strip in it, truly not expecting anything. There was a faint little line which, to me, was too inconclusive. So I waited another 12 hours and did it again.

My Lord.

Dark double line. My luteinizing hormone is surging. Wowzers. Apparently this "lost cycle" may not be so lost! Oh, the optimism!

I'm attributing this good news to the major lifestyle overhaul of the last 2 weeks. Acupuncture, yoga, meditation and deep breathing, TCM style diet, no alcohol, (almost) no sugar. They were pretty certain at CCRM that I had nearly no shot at ovulation this month due to the cyst. But either way, this is good news :) My body feels healthy and in control of herself. Happy times!

IUI Day! IUI Day!

Here we are. The day of our first (only???) IUI. My anticipation for this day - Wednesday, July 9, has been building for weeks now. Here's how it all went down:

5:15am
ALARM! Took my BBT and it was slightly elevated (97.8 F). Since I had three follicles that looked like they would pop out three little eggies, I wonder if maybe one of them had already released in the wee hours this morning, elevating my temperature? Doesn't matter too much, the appointment is set no matter what!

6:15am
Left the apartment together with J's bike in the back so that he could ride home after work. Butterflies in the tummy! And some definite ov cramps.

7:00am
CCRM opens for business and J has an appointment with the cup. All went well.

7:20am
I drove J off to work about 10 minutes away and stopped for a delicious breakfast myself. Quinoa pancakes with fresh berries, greek yogurt and maple syrup. Heavenly. Put me in a right proper mood sitting out there in the gorgeous Colorado sunshine :)

9:00am
Took the elevator down to pick up J's washed sample from the lab. After washing, his numbers came to 90% motility, 3+ and 42.2 million count. The lab tech was very pleased with the sample and gave me many good wishes on my way out the door. (I also got a peek at the, uh, "sample procurement" room on my way out the door. Yup, Playboys. And a pad laid out on the chair. Sexy.)

9:20am
So here's where the magic happens. It was a room I'd already been in for a previous ultrasound, but this time the lights weren't dimmed since I wouldn't be watching anything on the screen. Aside from the massive discomfort I was about to experience, it was all very much like an annual pap. Speculum (but no cold jelly) and the bright light angled in. I warned the nurse, Helen, that many who have gone before her have been stumped by my cervix. She quickly became acquainted with the issues. It took longer than usual for the catheter to be inserted, but she was as gentle as possible and persevered. Evidently, my cervix has a couple of bends in it which it what makes catheter insertion so difficult. Surprise! Once she let me know that she was in, the whole thing was basically over.  For something so monumental (well, potentially) there is just about no pomp to the whole thing. Just a few pats on the back, a smile or two, and kind "good lucks" on your way out the door.

$425 later, I was in the car on my way home. It's funny, actually taking out the credit card and paying for it had some sticker shock associated. But when I was in my regroup meeting with Dr. M back in June and we decided on IUI, the "few hundred dollars" price tag was a massive relief after the "tens of thousands" quoted on IVF. Phew.

Immediate Impressions
Wow that was so quick and straightforward... I can't believe we might have made a baby today without even being in the same room... I totally hate my cervix and hope it straightens itself out on the day that I'm blessed enough to have a vaginal delivery... The next two weeks need to be the most zen, chill, stress-free weeks of my life... My perspective should be one of complete optimism and positivity. Feeling any negativity about the procedure can only hurt the outcome and it won't make me less disappointed in the end if this doesn't work... We still have some time and patience for a few more tries... But this feels really good, after all, it only takes one tiny egg and one teeny sperm to have a little love affair <3

Pre-IUI Ultrasound

Today was my first check up since starting the Clomid. The ultrasound showed some impressive results!

8:30am - Monday, July 7
The first part of my appointment was the actual ultrasound with Jessica. It was pretty straightforward and I watched on the screen while she measured various follicles. Not much was going on with my left side... as per usual, at this point... but there was some activity going on in the right ovary that she was checking out. The process didn't take long, maybe 10 minutes total. Afterwards, I dressed and headed back to the waiting room and gorged myself on back issues of US Weekly. Amazing how many freaking celebrity babies are in that mag. Including a special spread on North West's first birthday party! Oy...

9:00am - Monday, July 7
My nurse called me in to review the results and do a backdated IUI consult. (Normally this is done prior to starting your Clomid course. I couldn't do the consult at the proper time since we were traveling, but Dr. M went over a bunch of important dos and don'ts at the June 20 appointment.) Other than the superficial side effects from Clomid, like mood swings and hot flashes, there can also be internal side effects. It frequently dries up whatever cervical mucous there is (impeding the production of eggwhite mucous which is problematic for couples using Clomid with intercourse), and can hinder the growth of a nice, fluffy uterine lining which can complicate implantation.
My ultrasound showed really positive results! My lining measured a healthy 8.9mm, which is right where it should be, even in a 100% natural cycle. As the ultrasound tech had suggested, nothing was really happening on my left side. There were three follicles, all measuring less than 10mm and not nearly large enough to mature and rupture as eggs. On my right side, however, there are three good looking follicles. My measurements are 22, 19 and 15mm. Our nurse gave me two insights that I thought were particularly interesting: First, if there are more than 3 viable follicles, they will cancel the IUI cycle due to the chance of multiple fertilizations. Second, as you can probably deduce from that statement, it is more common for the Clomid to stimulate only two viable follicles rather than three and so we've just upped our chances of a multiple fertilization. I had to sign an informed consent form to go forward with the cycle as scheduled.

***

Let's just pause for a moment. People can get real fired up when they hear any of the following: "multiples," "twins," triplets," and "Clomid" even. For people labelled as "Unexplained Infertile" like ourselves, it's important to remember the law of small numbers you're dealing with, as well as the risks associated with multiple embryos. For starters, our chances of getting pregs this cycle are only 8-12%, which I believe is only about half the likelihood of a normal couple conceiving in a given cycle. If we are lucky enough to end up with fertilization and implantation and a BFP (yep, "big fat positive" test), the stats on having two of those eggs become fertilized and give us twins? Only 10%. I'm no mathematician, but 10% of an 8-12% window seem like awfully miniscule odds! And one step further, the chances of triplets - all THREE of my eggs being fertilized - would be under 1%.
In the years that Clomid has become a popular prescription for fertility issues, doctors have come under fire for the resultant multiple births and associated risks. Due to that, many REs (reproductive endocrinologists) are extremely sensitive to multiples and therefore do what they can to control the math.
Women have twins. It happens, naturally. What's the big deal?? That's what I had thought, too. The most common risks in a multiple gestation probably don't seem all that scary to someone who hasn't had a baby because we hear about happy-ending stories all the time: poor vision, pre-term labor, low birth weight. Modern medicine makes these things seem commonplace, but as an expectant mother, you don't want to see your infant up against any of these things. There are also very serious complications that range from miscarriage, stillbirth, diminished brain development (i.e. cerebral palsy) to problems for mom like elevated blood pressure, diabetes, and greater incidence of nausea/vomiting. So... no thanks.

***

The original plan Dr. M devised for me meant that I would monitor my cycle for ovulation with OPK strips and then call the office when I had a positive. Given my great response to the medication and the size of the three follicles, our nurse determined it was best to trigger my ovulation with Ovidrel (an injection of hCG, human chorionic gonadotropin). Waiting too long could either allow the follicle to grow too large, or allow ovulation to occur naturally at a time that wasn't ideal for the IUI transfer in the office. I was given a pre-filled syringe of Ovidrel with strict instructions to get it home to the fridge and then administer it PRECISELY 36 hours before my transfer. So, 9pm tonight. Yipes!

I'm excited. I'm optimistic. I'm hopeful. I'm also a little nervous. Excuse the pun, but I'm afraid of putting all my eggs in one basket - meaning, the mathematical odds of this working on the first try aren't terribly high. So I'm trying to toe the line between optimism and realism. Not an easy line to draw. The current strategy: put all of my faith behind this procedure - we are very strong candidates for success - and if it doesn't work out, know that we've still got plenty of resources to lean on for more attempts.

HERE WE GO!