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!

5 DPIUI

Today is my last day as an unemployed! Woot woot! My new job is a contract position, but here's hoping they like me so much they want to hire me full time at the conclusion.

As for being 5 days past IUI... I'm feeling nothing really. Still hopeful though! I felt so much amazing, positive energy following the IUI last Thursday that my plan is to just roll with that until I'm proven otherwise. In fact, one of the nurses in the room with me that day pronounced, "Now you're pregnant!" as soon as we all watched J's sample get injected into my uterus. We all laughed, commenting things like - hope it's that easy!

The only thing I can report right now is feeling some gentle cramping in that sweet little uterus fig. Not anything like a period, just a little action going on there. But every single cycle feels a bit different so I can't read into that at all and it's been going on for the last 3 days so... yeah. I'm back to temp charting again, but at this point in the cycle I can't say that those temps are revealing anything interesting; just elevated, as they should be post-ov.

It Takes Two to Tango? Try Six...

This morning was IUI transfer day, take 3! Alarm at 5:20am, J's contribution at 7am, time for breakfast in between, the transfer at 9am. I was home to walk the doggie by 10:10.

The normal math of having a baby is pretty basic: 1+1=3. Being infertile, however, math never works the way it's supposed to. I had to laugh this morning when I was up on the table, naked legs spread-eagled and there were 4 of us in the small little mood-lit room. One of the techs remarked, "Don't they say it takes a village?" just as I was saying "How many people does it take to have a baby?"

Today, there were six of us: me, J, the andrologist Edde, the tech who measured my lining again, the nurse who did my transfer and the nurse who was training her. But how can you leave Dr. M out of it? Or our nurse who just left the practice and talked me through all of the protocols? Or our new nurse who is such a ray of sunshine?? That's nine folks, there. That number doesn't include some of the nurses who have filled in "ad hoc" like Carolyn and Sara or the tech in Denver who always does my ultrasounds, Jessica. Twelve. Really?

I suppose when all is said and done in two weeks, maybe there is no baby and so counting up how many people were directly involved today is kinda silly. On the other hand, I just have this *feeling* like this could actually be the one. There's just this pervasive feeling in me this afternoon that the stars are all aligning. 

Hopefully next week I'll be starting a contract position with a great company that I'm pretty fired up about. I hope that will set my mind at ease about my professional situation. And the reason I needed so many people this morning to help with the IUI is because of my wonky cervix. I've had a total of 5 procedures that involved a catheter going through the cervix and this was the only one that didn't hurt like hell. The nurse was super gentle and slow and the observing nurse brought the tech back in to ultrasound my belly so that there was visual guidance for the catheter. It went in so smoothly and I got to see onscreen the transfer of J's little soldiers straight into my uterus. So neat! There's just something about that moment that irrationally makes me feel like this must be it. Maybe a year from now, it will actually be just two to tango, plus a little one asleep in the nursery ;)

This could be my new math lesson: 1+1+4=3

Double Down on the Emotional Rollercoaster

Long time no see, huh? See... the thing is... everything was feeling really stable for a while there. I felt like I was on a really good track going the natural route. And then the Clomid hit.

Well I guess that sounds misleading. Rewind the tape. Go back about 5 weeks. We visited friends in Cali (with a side trip to Napa, woo!) and while we visited this super sweet family with two little boys and a brand new house, I started my CD1. Yep, blood in the panties (ugh, what a gross word, panties, makes my arm hair stand up). Given our surroundings at the time, I guess J and I got to feeling antsy so I made the phone call to CCRM on Monday saying that I'd like to go for another Clomid cycle. A day later, I went for my cyst check, was obviously all clear, and started up the same 50mg clomiphene prescription. The IUI was relatively uneventful and the following two weeks were equally uneventful. I   knew before the two week wait was over that the only thing I was waiting for was the dreaded period. But, lord, did that motherhecker hold out on me. I spotted for 4 days before it finally came through. When I called CCRM to report my CD1 (again) and schedule a cyst check (again), I learned that Dr. M wanted me to try this final IUI cycle with 100 mg.

So we're doing a big, bad double down on the Clomid. In the real-life world, I've had massive drama with my brother; a big fight with my mom due to the drama with brother; we adopted a puppy; I interviewed for a job, got the offer and turned it down; we fell in love with a house, put in an offer, won the bid, and then were told 20 minutes later the other buyers outbid us; ate and drank plenty of things I shouldn't have; and my dad was in a car accident (dad is fine, car is totaled).

ohmigosh.breathe

Through all of that, I frequently found myself thinking, "Gosh you're handling this well. Prior to the acupuncture and yoga biz, you'd be flipping out right now!" Welp! It took me a solid 2+ months to get on that straight & steady track and took 2 days of Clomid for all that hard work to unravel. I just totally fell apart last night. Looking back, I don't even know what the catalyst was. I recall going into the bathroom to get ready for bed and just staring a myself in the mirror. I felt overwhelmed by a feeling of worthlessness, hopelessness. Cognitively, I knew there was a lot of blame to be placed on the medication, but that surely didn't stop the tears from coming on hard and fast. It's hard to shake the feeling of failure when you believe you're doing everything you can and still finding no success. Helpless.

And then there was the episode (two episodes, coughcough) of Transparent on Amazon Prime that had me choking back tears this morning. Oy. But there was going to be a peak to match my low, dark valley! Two bright spots in my day were on the way...

EWCM!

Just a disclaimer - this is definitely a TMI kinda post. If you aren't knee deep in fertility terms, this will probably be too much of an "ick" for you.

For anyone who was lucky enough to get pregs on an "oops" this is likely an unknown. But for the rest of us who have been trying for long months or years, we are very familiar with cervical mucous and the various patterns it goes through during a cycle. Anywhere from dry to sticky to creamy to... egg white! Yeah, gross. Comparing the fluid that leaks from your crotch when you're at your most fertile to a breakfast food is, in my humble opinion, super unappealing.

As unappealing as it is, egg white cervical mucous (EWCM) is both super critical to the babymaking - it helps transport sperm through the scary vagina and cervix into the lovely, welcoming uterus - and it is something I don't have. I've been looking for it every single month over this past year to no avail. I've tried all the tips and tricks like being sure to drink a ton of water so you're fully hydrated and taking mucinex around ovulation to thin out mucous secretions.  Still, nothing.

So imagine my surprise to notice it this morning! What's different? I've had two needling sessions with AJ in the past 11 days. I've taken 8 doses of the fabulous Chinese herbs. I've done 3 or 4 yoga classes. I've gone for 2 legit runs plus an intense trail run. I've been taking some form of the stinky, salt water smelling greens mix for the last 8 days. I'm doing lots of deep breathing exercises, repeating my mantra when I remember. I've had several days of no sugar, no alcohol, no caffeine over the last 2 weeks. I'm making a conscious effort to pull back on processed foods, white flour and refined sugars/carbs. I hate saying this so I'll say it quietly - I'm making a lot of freaking sacrifices here. 

On the other hand, I also feel like I'm finally on a good track. I feel like I'm doing something meaningful, working towards better general health. It seems that my moods and emotions are more even and stable which is a sizable relief for someone so ruled by emotion :) Those are subjective things though. I feel like I got to see a real, tangible side effect of all of this effort. I suppose I could be wrong and it's just a coincidence. But I'm choosing to believe that seeing a hint of EWCM is proof that what I'm doing is working. BAM.

I'm not expecting ovulation this month because of the cyst. But now I'm strongly contemplating giving up the IUI next month also, maybe give myself a shot at a natural conception. By then I'd have about 6 or 7 weeks of this lifestyle change under my belt. Do I dare start thinking of giving up the IUI for another cycle beyond that? That would mean a natural try in the first week of September and the first week of October. That sounds scary and liberating at the same time. But the bottom line here is staying strong with my nutrition and finding joy again. Running down Green Mountain yesterday was so thoroughly enjoyable. Better than eating handcrafted ice cream from Little Man? Well, it sure lasted longer! :)

1dpiui

That title looks like some kind of weirdo code. In a way, it is a kind of code. An abbreviation. What it abbreviates is that I'm 1 day past the IUI. Hopefully, when that code looks like "14dpiui" I'll be seeing a nice double line, a plus sign, a smiley face next to the text "Pregnant." I'll take any of those :)

So far there isn't much to report. I've been feeling mega lazy since being told that I should raise my heart rate over 140 bpm - running raises me far above that, an average of 175 bpm. For that reason I went out and had a leisurely 5 mile walk today. I absolutely had to bring my phone and make calls while I walked cause I knew I'd be thoroughly bored. As a reward, I stopped at REI on the way home to do some sleeping bag shopping and grab a few things for J's race this weekend.

When I got home from my walk and went in to shower up, I noticed some brown spotting. My heart kinda stopped for a sec. But I've spent some time reasoning it out. For starters, one day after the IUI means it isn't implantation bleeding. So my other theory: that obnoxious cervix of mine probably bled a little from all the poking around yesterday. After a long bit of movement this afternoon, I think the activity started up the mucous production which drained out the dried blood from yesterday.

There it is. That's my theory. I'm sticking with it. I also joined a forum website yesterday and found another girl on there who triggered and had her IUI the same days I did. Kinda cool! As of today, we have 13 days left in the eternal TWW (2 week wait).

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

Oving HARD

Ohhhhmygoodness! The ovulation of three little eggs is definitely a feeling you can, uh, feeeel. Oh lordy. No, it isn't painful and I think it would be a stretch to call it a "discomfort." However, I'm feeling it hard. It feels like subtle cramps. Which I suppose makes sense since there are two or maybe three little cells traveling down a miniscule tube. 2 or 3x what usually happens each month. Woof.

I practically didn't sleep last night, it was definitely after midnight when I finally stopped noticing my racing heart. And I woke up just before the 5:15 alarm, noticing the lightening sky through the shades. There's almost a "Christmas morning" aura around my day. It's a little buzz of anxiety and excitement, nervousness that everything go perfectly right, the thrill that this could be the day.

ahhhhhhhh!

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!

Rx: Clomid

So we had our regroup appointment with Dr. M on Friday the 20th. As I mentioned, I was kind of freaking out about it, expecting a bunch of news that I wasn't excited about. Stuff that would just extend our timeline.

Well! Wasn't I surprised!

VARICELLA
My number one freak out was about the varicella (chicken pox) vaccine. I felt devastated when our nurse told me that it was highly recommended that I start the series. It is a live virus vaccine taken in two doses separated by 30 days. After the second dose, you must wait an additional 30 days for the live virus to dissipate and not put a potential pregnancy at risk. Looking at my current cycle on the calendar, that was putting us at a three month delay which just felt like an absolutely crushing blow.

When I discussed my chicken pox history with Dr. M on Friday, however, she gave me a pass! Her opinion was that after having the vaccine only 2 years ago and having such decreased immunity to it, I am most likely in the small minority of people who are never fully immune. No continual vaccinations will change that. I just need to be careful, of course, about who I am around and the level of travel I plan over the next several months. No problem!

ENDOMETRIOSIS
After my fun trip to the ER on Day 1 of my last cycle, I had a hunch that Dr. M may suggest a laparoscopy to look for endometrial tissue outside of my uterus. She certainly was concerned after hearing my account, and the procedure was suggested. However. Dr. M also cited recent studies showing that removal of the tissue is really only effective for pain management, not fertility. Since my pattern seems to be a entire year without much pain at all, it seemed like overkill to have a surgical procedure to A) look for something that may not even be there and B), if found and removed, would likely not affect fertility. There are risks with even the simplest surgeries. If you were desperate to have a baby and someone was telling you that your entire reproductive area would be at risk for infection or worse... how likely would you be to sign up? I'm a total ninny about pain, but this pain only jumps out and grabs me once a year. It's just not worth the risk.

Putting a laparoscopy on the shelf also takes away a month (cycle) of surgery/recovery time. Deciding not to go forward was a major win for our timeline and also fully supported by Dr. M. We're feeling good about the choice. She also prescribed me vicodin as a "just in case" measure so I can stay out of the ER if there is a next time.

DRUGS/ASSISTED INSEMINATION
My next freak out was a bit of a catch 22. I'd started feeling really weird about the concept of someone else impregnating me in a lab. So impersonal, the very definition of clinical, it made me feel sad to think that J wouldn't even be in the room when I got injected with the magic juice. The catch 22 here is that I also realize that we are basically out of options now. There's no point in continuing to try unassisted.

Dr. M's assessment: I will start Clomid starting on Day 3 and we will try for an IUI cycle. Clomid goes for 5 days. Around Day 10 or 11 I am scheduled for an ultrasound to measure my follicles. At that time I'll also be doing OPK testing and then they schedule J to come in to provide his sample. The lab takes 2 hours to "wash" the sperm and then I will come in to have the washed sample inserted into my uterus. No, it's not romantic. But maybe it'll finally be the solution we need.

This should feel similar to having a pap smear. After the procedure, I get about 10 minutes to rest and then just go about my day. Go about my day? Seriously? No sure how I'll be able to do that. An IUI cycle is far less expensive than IVF and so we can go a few tries in terms of affordability. One caveat of a Clomid-assisted cycle is that you should only go for three cycles on this medication. I suppose because of the effect that it has on your hormones and the overstimulation of your ovaries, it starts to get risky to use it for more than 3 cycles without a break.

So we're starting right away. None of the delays that I was so worried about in the last couple of weeks. This pretty much puts us exactly where I hoped we would be on the calendar when we first started talking to CCRM. A week ago I was thinking that we had to wait for three months. Now, in one thirty minute appointment, I'm carrying this hope that in the next three months we may have some good news! What a relief. On the one hand, I almost want to celebrate. But that feels a touch premature right now. For the time being, we're happy to just feel a sense of relief and be able to finally make forward steps.