Friday, November 28, 2008

Today's Forecast: Mostly Sunny

Pregnancy is starting to feel like the weather in New England: You never quite know what will happen next, which makes trying to plan anything a challenge. And no matter how much of an "instinct" you think you have about what's coming, you quickly realize it's totally beyond your understanding or control.

This morning I went to the clinic for my third beta, my sense of dread having become an all-too-familiar sidekick as I entered the office. The nurses were even more understanding and sympathetic than usual about the difficulties of waiting, assuring me that this was all beyond my control, that they're looking for data points on what's happening and that's all we can do. They promised to walk my blood downstairs right away and call as soon as humanly possible. I left exhausted, my body and mind heavy with the consuming worry of the past two days. Once again, I was ready for the sad call. Every instinct in me said this was not going to turn out well.

Once again, I was wrong. They called, mercifully, within an hour. And once again, instead of the dreaded words I expected to hear, I heard reassuring news: my hcg has nearly doubled in two days, increasing from 183 to 337. They are "happy" with this result. It reflects an upward trend, well within the range they like to see.

They want me to come back on Sunday morning to check it again. I so wish I could be a "normal" pregnant person now, free from these betas as a reminder of how tenuous everything seems when you've tried so hard to get here and are desperate for it to work out. Free to just relax and enjoy it, without any concrete reason to think it won't turn out well. I wish I could feel 100% optimistic right now, instead of just strongly encouraged. But for the next two days I am going to try and tell myself that the forecast from here looks mostly sunny. It's all I can do.

Thursday, November 27, 2008

Numbed by Numbers

I'd been told that the angst of infertility doesn't end with a positive pregnancy test. But I guess I thought once I heard about mine I'd be able to let go of some of the worry and pessimism that had set in after so many failed treatment cycles and let myself enjoy it. I was wrong.

Yesterday's beta showed an hcg level of 183, which is about a 60% increase over my level of 112 on Monday. I could look at this two different ways.

If I had known nothing about hcg levels in early pregnancy when I finally got the call from the nurse at 2 p.m. yesterday afternoon (having mentally concocted worse and worse scenarios the longer I waited), I probably wouldn't be that worried. She said a 60% increase is "fine" and that they wanted to see me back on Friday morning "just to make sure everything is on track." Not so bad, right? A consult with Dr. Google (Yes, I admit it: I could not resist the urge. I am weak.) confirmed that in a normal pregnancy beta hcg levels double every 48-72 hours, and an increase of 60% or above over 48 hours is still considered normal.

My husband says I should focus on all of this. It did increase, and it increased within a range that could mean everything is a-ok.

And I've tried. I've tried to repeat those things in my mind, to focus on the fact that, for this moment, I am still pregnant. That I even can type those words is completely amazing to me.

But that's what scares me the most. These stakes are the highest yet. And that is why I can't shake this horrible feeling. Can't stop remembering that originally they'd said they wanted to see that number double in 48 hours. Can't imagine what will happen to me if something happens to this pregnancy. Can't understand how I am supposed to survive the next 24 hours until the next beta.

Monday, November 24, 2008

Pins and Needles

This morning, after a sleepless night (and two weeks of nonstop anxiety and obsession), I walked, still symptomless, into the infertility clinic for my pregnancy test, my sense of impending doom growing with every step. I dreaded the day ahead, the call, the tears.

My name was called by the one medical assistant in the practice who can never, ever find my veins, which only darkened my mood. She asked me if I felt any symptoms. Not a one, I said. No sore boobs? she asked (really). Nope. This is just a guess, but maybe if she spent more energy focused on my veins and less trying to "diagnose" me, she may not have had to do what she did next: use my hand. If you've never had this experience, don't start anytime soon. Because let me tell you something about the top of your hand: It doesn't like to be stuck with needles. It hurts. Also, it's gross. It may have been the only time I've ever felt lightheaded about giving blood.

By the time I got back to my car, I was a sobbing mess. My blood -- the answer -- had been left behind and all I could do now was drive away and wait. The stinging in my hand felt like insult on injury and I decided, right there, that if there was ever a day to work from home this was it. Crying hysterically at work may not be career suicide but it sure doesn't help anything.

I settled into my spot on the couch and tried to remain calm. My husband, home waiting to go to his late-morning doctor's appointment, was in full keep-her-happy mode, making me a snack and doing pretty much anything I asked him to. He was sitting with me on the couch when the phone rang, much earlier than I'd expected. As my hands trembled and my mind braced for the bad news I thought I'd hear, I answered it -- and instead heard three words that I truly thought would never, ever be used in reference to me: Congratulations. You're pregnant.

Some (not nearly all) of the shock has worn off. I am now a whirlwind of conflicting emotion. There are many, many steps in front of us, I know. Many miles to go before we sleep. And yet, there is this victory. After a year of gut-wrenching, mind-spinning, heartbreaking effort with little to cheer us on, no incremental wins, just the head-down, blinders-on quest for a positive pregnancy test, we finally got one. I'm going to sit here for a minute and soak it in. And thank those reading this for every one of your words of encouragement, which mean more than you know.

Saturday, November 22, 2008

Holding out Hope

This two-week wait has been a rough road peppered with land mines. The end of it is near, and I'm not sure I like where it leads. Right now, all signs -- or lack thereof -- point to nowhere good. Still, I'm trying to keep my eyes on the road and pressing on, because I guess I know somewhere deep down (and therefore not always accessible by my overactive mind) that even if I'm not there yet, I may be headed in the right direction.

Two weeks after they put real, live, fully-formed embryos in my uterus, I feel absolutely nothing. Nada. I have heard countless women tell me that they, too, had no symptoms and dreaded the call from the nurse after their test -- but turned out to be pregnant. I have saved those friends' emails and read them obsessively, poring over every word like a heartsick teenager with a text-messaged love confession from her crush. But these messages from real people who have achieved real pregnancies do nothing to appease my growing sense of doom. Logically, I hear what they're saying. But logic can never shut the other part -- the worrying part -- of my brain up. Did they really not have one little inkling that something was going on? Couldn't I just have a sore boob for good measure? A little nausea for hope's sake?

Along the way, it appears I've been tested by the infertility imps just looking for a poor sucker to prey upon. That cute gifts catalogue I thought would be filled with unique holiday ideas? Also contained a baby onesie that read, "I was worth the wait." After I recovered from that hysterical crying jag I went into my office to search for something and found, instead, the stuffed dinosaur I bought when I thought this would be easy, because it was the softest toy in the land and I thought my baby should own it. Apparently, nowhere is safe for the infertile anymore -- not even her own house.

Another thing that was not helpful was my co-worker bursting into the cubicle where I was talking with a colleague and waving around the card she got for the birth of her granddaughter, which featured a disturbing photo of a baby's head being held by two hands, taken from the top of the head (Note to everyone I know: If I ever find myself holding a baby that is mine and am lucky enough to get a congratulations card from you, please do not pick the one featuring one or more babies in unnatural or vaguely humiliating positions or outfits. This includes being dressed up like flowers or animals. This practice is not okay and to my mind should be banned by law.). I'm not sure what her point was in showing this to us, although my sensitive/vaguely human side does see that one might be excited about a granddaughter. But still. I just really, really do not need to be reminded about my infertility while I'm at work trying to forget about it. Can we all agree to that? Yeah, thanks.

The other award for unhelpfulness goes to Dr. Google. Sure, doctor, you are always there -- 24/7 I know I can count on you when I want to fulfill my sick urges to search for "no symptoms after IVF" or "can you push out your embryos by coughing." You tell me what I want to hear, but my friends have told me you're unreliable. They question where your ivy league diploma is. So I'm quitting you. For now.

So here I am, somewhat exhausted by these two weeks and, in a way, just thankful that the wait will soon be over. On Monday morning, I will find out whether my first IVF, the thing that was supposed to be the holy grail, my golden ticket to motherhood, worked. So much depends on a positive beta. I don't know what life looks like beyond a negative, and I don't want to know. I don't know what there will be to hold on to. So for now -- for tonight and tomorrow -- I am holding out hope.

Saturday, November 15, 2008

Classifieds: Womb for Rent


One-room womb. Cozy accommodations. All board, including meals, provided with 9-month lease. Monthly rent is free. Plenty of room for one or two. Well-appointed and super deluxe. Environment particularly supportive of personal development and growth. A gem!

House rules: no wild parties. Must agree to an uneventful, painless eviction when lease expires.

Must be at least six cells to apply. Interested? Move right in and make yourself at home. (Please.)

Monday, November 10, 2008

Buns in the Oven

I was a bit of a late bloomer myself. My first bona fide boyfriend arrived on the scene at about 16, and I didn't start getting really good grades until college. So it comes as no surprise that the two embryos they transferred yesterday are slow growers -- six cells each, to be exact. But you know, those embies are 6 cells going on 6000. I can just feel it. I hope to confirm this with my pregnancy test on the 24th (let me just reiterate my call for more advanced technology allowing for earlier post-fertility treatment pregnancy tests...come on, genius scientists across the world). In the meantime, all I can do is wait. And obsess (Can I go to the bathroom? Cough? Laugh? Are they still in there?). And obsess some more.

There are a number of ways I can look at this. The doctor who did my transfer yesterday did not seem concerned by the slow growth, and cited a couple of times the "excellent" pregnancy rates the clinic has for my age group. And I have heard and read several times now the fact that perfect looking embryos do not always produce babies and by the same token, imperfect looking embryos often do. No one seems to be at all gloom and doom about this news -- but me.

The problem is, we now have a photo. Before I got over my mental and physical stumbling blocks and did this IVF cycle, it felt like I had nothing but a wing and a prayer going into the two-week wait and, when those cycles failed, dashed hopes and despair for the intangible loss. But now, there is a photo. I can see what they've put inside of me, and it is real. And if it/they do not stick, it will mean the loss of that something real.

It's not that I wish I had refused the photo. The realness of it also means that the opportunity here -- the chance for something real to develop from all of this effort -- is that much greater. Plus, don't tell me you don't think it would be cool to show future children what they looked like in a petri dish. It brings a whole new dimension to parental guilt trips ("I have been looking after your wellbeing since you were just six cells!"), doesn't it?

So the wait has begun. Some moments I think it seems like an eternity; others, not so bad. Some moments bring hope; others, pessimism. And while I can look at the photo of my little six-cell slow bloomers for inspiration, I can also look at my post-embryo transfer discharge sheet for some comic relief:

"Progesterone: Crinone - one application per vagina tonight. Tomorrow change to morning administration."

(I don't know about you, but one is about all I can handle these days.)

Saturday, November 08, 2008

We Came, We Saw, We Fertilized

I did it. All it took was countless words of reassurance from my husband, friends, doctors and nurses, two IV attempts, some really strong anti-anxiety medicine, and my unyielding desire for a baby. Oh, and conquering a long-held phobia of anesthesia.

It got off to a rocky start. First, a nurse came out to the waiting area and told me they were running about an hour behind. Nothing like an extra hour to sit still with your belly empty and your mind full of worst-case scenarios. By the time they finally called me back for the pre-op stuff I was an absolute basket case. Their two long attempts at getting an IV in me didn't help. What finally did help was whatever brilliant anti-anxiety medication they put in the successfully placed IV. Thank you, Mr./Ms. Scientist who made that stuff! And goodnight everyone! My husband knew it was working when I asked him, not quietly, if he thought my surgical hair bonnet was "sexy." It was like gulping down five consecutive glasses of Veuve Clicquot on an empty stomach. From there, I remember being wheeled into the OR, looking up at all of the faces around me and trying but failing to form a coherent sentence, and my legs being placed in the crazy hanging stirrups. That's it.

Next thing I knew, they were telling me it was done and I was wheeled back to the recovery area, where my husband soon arrived (directly from the "men's lounge"). I asked the nurses repeatedly whether they were sure they had really done it (I give them major credit for not telling me to shut up). I was quite groggy and in a lot of pain, but mostly I felt this tremendous relief and gratitude that it was over. The embryologist came out and told me they had indeed gotten 18 eggs. I smiled, and after a short recovery got dressed, came home (I'd be lying if I said I didn't enjoy the wheelchair ride to the car -- in my groggy state I felt like Ms. America of the hospital), had a few bites of soup and went straight to bed by 7:30 p.m.

Yesterday came the call that I'd dreamed of receiving when we started IVF and before I was sure I would get through the egg retrieval: the fertilization report. Out of 18 eggs, 9 fertilized. In a dish somewhere in the IVF suite at a nearby academic medical center, we have nine fertilized eggs. For the first (known) time, we've actually put egg and sperm together -- and something (nine somethings) is developing from it. I probably shouldn't be this excited about it -- after all, it's the first of many, many hurdles to climb before I am holding a baby. But when your quest for a baby goes back several years and the past twelve months have been filled with pills and shots and ultrasounds and bad news, the positive movement toward a real developing baby is something of a thrill.

To get here, I've had to climb perhaps the biggest hurdle of all: fear. The egg retrieval was a bravery test, a question of whether my will to have a baby could win over the convincing strength of a childhood phobia. I passed this one, and we have nine developing embryos to prove it. One or two of the best looking ones will be transferred tomorrow. Let's hope the trend continues.

(Thank you again to all of you for rooting me on throughout this process!)

Thursday, November 06, 2008

Numbers Game

Egg retrieval: 2:15 p.m. today

Level of anxiety: astronomical

# of follicles (estimated): 18-20

# of irritable people in my house doing the IM trigger shot at 2:15 a.m. yesterday: 2

# of expletives flying around during the process: 15

# of asses in pain as a result: 1

# of times I screamed into my pillow after the phone call in which my mother said, "I didn't realize it [infertility] affected so many things" in reference to my decision to leave candy on the porch rather than answering the door for trick-or-treaters: 10

# of ACLs torn by my husband playing soccer last week, in case I didn't have enough to worry about: 1

# of weeks until his surgery: 4-5

# of times I've thought of calling off the egg retrieval due to severe anxiety over anesthesia: 200

# of times I've realized that is not an option: 200

# of hours I need to go without food before the retrieval: 14

# of fattening, indulgent foods I will eat as reward for making it through: 5-10

# of times I've felt immensely grateful for all of the supportive calls, emails and comments from good friends and fellow bloggers: countless