5 weeks, 4 days

So here we are, still pregs. I've been reading a crapload of fertility blogs since the summer and it's always been interesting for me to see which women continue to post after a positive test and which feel like it's time to move on. It seems that for many who decide not to continue, there's a concern of making other infertile sisters who are still going through the ringer feel bad by posting all the fun pregnancy updates. And you know, I totally respect that decision and understand those feelings. I think I'm in a different boat at this point... Here are some thoughts.

1. This blog got started with the purpose of sorting out my feelings because, since our move to CO from the east coast, I have few friends that I feel comfortable sharing all of this information with. And J, being the stoic that he is, can only handle so much of my chatter. The other purpose was to have a holding place to document and summarize everything I was doing on this journey. And my feeling is that this journey continues, just with a new chapter.
2. Let's be real - not many people read this! I only have one friend who I shared this link with and since we don't get to catch up nearly as much as we'd like, I'm thinking she's open to reading all my blather whenever she gets time on the train ;)
3. I've been totally freaked since yesterday evening that there is cause for concern and I'll be calling my nurse in about 20 minutes when the office opens. I was lightheaded or dizzy very frequently over the weekend and that was accompanied by a fabulous stabbing pain in my lower right side last night. These are two things she cautioned me about with the words: Call Me. My frenemy, Google, explains that these can be symptoms of an ectopic. Jesus, that's all I need. It makes me sad to think that I'd step away from this blogy thing because I got good news and then as soon as something bad happens, I come running back. Isn't it better to have happy things to write about, too?? :)

I'd hate to think that my course of reasoning sounds selfish or cold. I hope that it makes sense. There are plenty of wonderful, beautiful, and, at times, heart wrenching stories being shared out there in the blogosphere. And if you stumble across mine and it doesn't resonate... Well it's totally cool to move on until you find something that's the right fit. I know I've certainly done my share of blog surfing, passing on the stories that I just know I won't be able to stick with for one reason or another.

And in the meantime I'm going to continue to silently lose my sh!t here at my desk until my nurse calls me with useful information.

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 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.

The Lengths We'll Go To

I'm eating out of the ocean.

Seriously, I've needed to become accustomed to breathing only through my mouth when eating and drinking several things these days. Making my salad tonight was a real... learning... experience.

Last week I bought a new cookbook, Cooking for Fertility, focused on fertility foods because I felt I needed more direction than just, "Oh yeah, that's a whole food. I'll eat it." I wanted better guidance on recipes rather than just eating salads and lentils. One of the first items I decided to try out was this Kale, Cucumber & Seaweed salad. Figuring that sushi works for me and I've tried a little seaweed salad from those sushi places before, it seemed doable.

Welp. Lemme tell ya. Woof.

For about a month I've been using a greens powder (Garden of Life Perfect Food) that has enough spirulina and chlorella to make you think you walked into the fish market. I religiously chug the mixture in two breaths, being sure not to breathe through my nose after each chug. Yuuuuuck! Additionally, the cookbook I bought made a suggestion to drink kombucha. It is a fermented tea and therefore smells a little like a brewery. It's funny, you'd think that would be easy to take, but just knowing that it isn't really a beer somehow makes it a beverage that I gulp down without breathing through my nose. Yawn.

You'd think I'd be used to this... But a seaweed salad is a new level! Most of what's in it is pretty good! Base of kale, chopped cucumber and red onion, shredded apple, black sesame seeds. The dressing is apple cider vinegar, pineapple juice, sesame oil, garlic. Of course there's also soaked Wakame and toasted Nori. Weeeeeird! The wakame seaweed comes in a zip bag all dried out. I put it in a measuring cup with some water and walked away. WOWZERS! I came back maybe 10 minutes later and it had blossomed out of the cup! Kind of a neat trick. But I'm a texture person and man is it slimy. Eeeeep :(

I'm trying to choke it down here remembering that I'm nourishing my body. A big piece of frosted chocolate cake may be easier to gobble up and have seconds tolerate but it sure isn't helping heal the imbalances in my body. So, seaweed it is... Man, when this baby gets here one day, he or she is gonna have a lot of stories to sit through!

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!

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! :)

Heart to Heart

We had a chat last night. A married people chat. The kind of deep conversation that I crave and wish we had more frequently. It usually happens every few months and often by force. Because I'm having a meltdown and finally J sits and listens. After Monday's shitty cyst news, J gave me carte blanche to be sad and mopey and talk about whatever I wanted. I kind of thought my special dispensation to be depressed would last longer than a few hours, but by Tuesday evening it was clear that J expected to me to be right back on the happy train. That was disappointing with everything else going on. I was really hoping for more emotional support.

So I did what a married person is supposed to do. I held back until I had my thoughts all sorted and then calmly expressed why I was feeling hurt and disappointed. No, really, that's actually what I did! I guess I was just feeling zen and collected after the yoga class. We ended up talking for probably an hour about this situation we're stuck with and the way we are both relating to one another about it. It was so refreshing to feel heard, to feel equal. The one thing that he said that really resonated with me and will probably stick with me for a while is something I've been aware of, but didn't have the right words for: I need a win.

One of the reasons this has been so hard on me the last year is that I've talked myself into believing that I have nothing else and being a mother is the only thing that will make me worthy. I'm unemployed - for about 3 months now - and having a hell of a time finding a new job, I'm fully isolated right now without family nearby and far away friends who are hard to stay in touch with, the people I've met so far here in Denver aren't people I feel a strong connection to, I've stopped running because it raises my heart rate too high I feel like I'm gaining weight but have zero motivation to workout and the one skill I cling to is cooking. Things that people often "define" themselves with, I've just run out of. And while that's kind of a sad realization, knowing a truth is an excellent first step towards fixing something.

But the bottom line? It was so nice to feel like J thinks about me and analyzes where I am in life. It was a feeling I had been craving and it felt so good :) Maybe if I just feel like I'm having a win in my relationship, maybe that can be enough to life me up a little bit.

9dpiui

Morning of the 9th day after our IUI. Things have been weird. Like... in my body, not life in general ;)

Life in General
I started volunteering at a cool non-profit this week. It was awesome to find an opportunity that actually aligns with my industry of event planning. Since they are a non-profit they put on several fundraisers each year so I am helping out with parts of an upcoming event. Right now there is a lot out of my comfort zone because we're cold-calling business asking for donations. That is relatively awkward for me and I haven't had a ton of success the last 3 days, but it will get better and I'm spending the days with a friend I met in the running group. We commiserate a lot about getting shot down repeatedly! Lotta laughs.

J has us doing another crazy fourteener hike tomorrow. I'm a little nervous about it because of A) the heart rate issue, B) the fact that he invited a friend to join, C) this is a double peak and we have to get up so incredibly early, like 3am (?!) or D) my new hiking boots haven't yet arrived and I'd need to wear light little sneakers. So if you're assuming it is all four, you would be correct. Oy!

Yesterday I got a couple interesting leads on the job front so I'll spend some time with that today.

Feelings
There is still a lot of hope in me - and J! - that this is our cycle. He asks me every day "When will we know?" He's never been this in-tune! It's a nice change even if it does feel like the line of questioning you get from a 4 year old rather than a sophisticated 32 year old financial analyst :-D
Mom calls frequently and asks in this veiled manner, "Anything new?" or "Sooooo, what's new?" This happens several times in one phone call so I have to give her credit where it's due for not flat-out asking me for updates everyday. I told her about the Clomid and then our plans to do the IUI, but wanted to save a few of the specific details of the whole situation to keep between just J and me. After all, if we were still doing it the of-fashioned way, I wouldn't be reporting that!!
I'm also feeling a small amount of anxiety. The root of it is this: I'm fully aware that this cycle may not be ours and we'd start the clock over again next weekend, but I'm anxious about how I would take it if that truly is the outcome in 7 or 8 days. What I want to avoid is shrouding myself in so much hope and positivity that if I do end up with a period in a week, my soul isn't crushed. I know we've got a couple more tries with Clomid/IUI planned and that protocol seems to fit us very well and it's so reasonably priced. The uncovered portion comes out to under $400 for us I think. So I'd like to think that I can keep my head above water next week if I get news I'm unhappy with. There is still time for us on this clock!

Body/Symptoms
For days 5-8 I was feeling some intense kind of cramping only on the right side of my lower abdomen/uterus. Every once in a while the feeling would jump to the left or be more centralized, but it was very focused on the right. Eventually, after 2 full days of it (5 and 6 dpiui) and then having it intensify the morning of the 3rd day (7dpiui), I was a little scared of an ectopic and called Elizabeth at CCRM. She said some ibuprofen is ok but if the discomfort comes through the ibuprofen, or if I have a fever, bleeding, or something else, call back immediately. So for the rest of 7dpiui, it was a discomfort I could handle (but pretty intense later at night) and I did some yoga and stretching before bed. When I woke up 8dpiui, I was almost worried that the feeling had subsided! It poked its head back in a little in the evening, but that's been it. So... who knows?! It could just be my right ovary normalizing itself after having to deal with being super stimulated by Clomid or being psyched out by the HCG trigger shot I took.
Breasts are a little on the heavy/tender side of things, but that's been somewhat standard in my cycle this past year so I'm not too excited about it. Also a good bit of watery/creamy CM, but you could easily chalk that up to me staying super hydrated.
My BBT hit a higher point than average this morning, 98.6, but I woke up just feeling so hot, it could just be an environmental influence. I've hit 98.6 a few times throughout the last year so it isn't completely unheard of during my tww. My chart is a little unusual looking though in that it appears as a steady climb up since ovulation. Once again, I'm trying to not read into it because it could just as easily start stair-stepping it's way down at any point and also my body had been introduced to a lot of chemicals it's never dealt with before which could easily influence BBT readings.


On the forums I've been visiting, there are a few ladies who got a positive HPT on their 10th day past IUI. I don't know if I'm totally crazy to try that tomorrow, but I'm tempted! Just unsure if there is a chance that the HCG trigger shot is still even a little in my system. Getting a false positive would in fact be a soul crusher.... I'll think a little more about it. Maybe wait till Sunday, 11dpiui.

5dpiui

We had a super busy weekend which is always a good thing when you are in the TWW part of your cycle. On Friday I had a million little errands to do including a mega grocery shopping trip to my favorite Whole Foods (I made a delish tofu stir fry that I was pretty proud of!). Saturday was a bit of a sleep-in day and then packing and food prep. J went to pick up a friend at the airport and we had some spicy egg salad sandwiches (sriracha! yes!) with arugula side salads and homemade key lime pie.

By 1pm we were in the car headed towards Leadville, CO. Based on the heinous traffic, we decided to stop at Breckenridge first to check in to our hotel. A second friend met us there and we strolled around town and had a snack on the sunshiny deck of Modis. Afterwards, J's ultra-runner friends went back to Leadville for the night and J and I celebrated his birthday (32! woo!) with Crepes a la Cart and then the best plate of nachos I've ever had!

Alarms were set for 3:15am Sunday morning. We rolled out of Breck by 4am and arrived in Leadville just after 5am for J's "Silver Rush 50" race. It was a pretty cool start and I was feeling oddly emotional. Was it pride for J? Was it the gorgeous rendition of the National Anthem? Was it just inspiration rubbing off from these 400+ insane athletes who train so hard and believe so deeply in their physical and mental abilities? But it could have been sleep deprivation or a weird hormone spike. Who knows... I've had a couple of weird medications thrown my way this month and I'm sure they are still affecting me.

So I had a long day of chasing J around the mountains, trying to catch him at various points. I spent a lot of time at a sweet little coffee shop and a lot of time in the car. I also spent a lot of time browsing - and subsequently killing my cell phone battery - through the forums on Fertile Thoughts. Very helpful to read notes from and correspond with other ladies where I am. There's a whole section for those of us going through IUI in July and I found one girl in particular who had her transfer on the same day.

5dpiui Summary
Five days later, where I am with things? I had a dip in my BBT this morning, a surprising 97.9, even though I didn't feel chilly at all when I woke up. Haven't noticed much in the CM department, but over the last several days it's either been really wet or creamy. There's been a little <ahem> breast or nipple sensitivity, but I attribute that to the spike in progesterone that should happen after ovulation. I've been feeling something in between cramps and little twinges in my lower abdomen for the last few days. I'm continuing the following:
          Baby Aspirin (81mg)
          Prenatal Multi Vitamin (2)
          Immunotect capsule (2)
          Maca capsule (gelatinized)
And I've stopped taking the DIM supplement. For whatever reason, that seems to stand out in my research as something that should be discontinued after pregnancy so I'm being cautious. I'm reluctant to give up the Maca because I credit that hormone balancer with keeping my endometrial lining nice and thick.

Concerns
Was worried about the spotting I saw on 2dpiui but feel confident now that it was just residual blood from the transfer. With the cramping I'm feeling, I have a worry about ectopic fertilization. The feelings have pretty consistently been on my right side and that's where all of my eggs matured. I've read a few anecdotal accounts of ectopic pregnancies being more common in IUI patients than natural conceptions. But none of those are from particularly reputable sources so I have no idea.

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!

Shoot 'Em Up

... Ovidrel style!

So I managed to "administer" my injection last night. Don't you just love the euphemistic medical language? I poked myself with a needle. Yowzers. My entire life I have been terrified of needles. I would practically hyperventilate when going in for routine bloodwork. Probably until I was, say, 26 when I strangely was compelled to start donating blood. Racing heart, sweaty palms... I can't say I was a strong candidate for self-administering an injection. On the other hand, all of this fertility nonsense has me pretty accustomed to needles now. Surely I do not enjoy a needle to the arm (or belly, or anywhere at all), but if I look away I can handle myself at least.

Of course, the Ovidrel injection required that I look directly at that little pinch of belly fat while I stabbed it with a "quick dart motion."

I made J count down from 5 for me after the alcohol had dried over the injection site. Elizabeth was right, I hardly felt a thing. The anticipation of sticking myself, along with the sight of a syringe sticking out of my abdomen, were positively the worst parts of the whole experience.

I hope with all of my heart I never have to do it again. Not because it was that awful, I could absolutely do it again, with my eyes shut I bet! We just want this to be over. We want this to be it. No more cycles, no more drugs, no more OPK strips, no more weekly envelopes in the mail from Cigna. Just a big, fat positive on my next test.

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!

Cycle Day 7: BOGO Sale

Buy one, get one... Two posts for the price of one. Here's the update of what I didn't know when I wrote the previous post. 

1) I believe I have a new symptom to record: hot flashes. It's summer time and NJ has been having some wretchedly hot 90+ degree days with insane humidity, so I could be off-base here. However, the fact that I'd sit around the air conditioned house during the day and actually feel chilly enough for a blanket and then totally sweat my tush off when going to sleep kind of makes me think... maybe that's what a hot flash feels like! I was literally dripping sweat and had to throw off the sheet and turn the AC down a touch. I hold out hope that I'll never have need for clomid again (!!!!) but in case I do, remember the hot flashes...

2) No in-laws this holiday weekend, after all. Bummer. I've been sitting in the airport all evening waiting for my 5:15 pm flight to depart while they've been at the Philly airport also waiting. Unfortunately their flight was finally cancelled (it's now 11pm). As for me, I did get on the plane for about two hours. But a brilliant airport employee left the jetbridge unsecured and the storm that came through before we pushed off from the gate smashed the equipment into our wing. WOMP womp :( So we all deplaned and have been waiting ever since for a new aircraft to come in from another place in the country with no storms (not a lot of those tonight. hurricanes and storm cells abound!) Hoping for a plane in the next 30 minutes or so... which will get me into Denver just before 2:30am. Poor J needs to come pick me up then. Ouch. 

The Irony:

I really had stopped worrying about wacky mood swings with the in laws. All I'm feeling is a touch over-emotional, but I've been keeping good control of that when I realize it is a chemically induced over-reaction.

The Good News:
None of this effects our ultrasound or IUI schedule! Deep breath in, deep breath out..... Very excited about our dates next week. 

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.