Catching a bit of a break

Wow.  Much has gone on in the past month or so, and I have about 3-4 posts worth of stuff bouncing around in my brain, but I guess the big infertility related news is...
... IVF #5 is off and running.  (But holy Sh*t.  Five?  That is waay too many needles.)

It's actually pretty amazing that this is working out.  My d&c was May 29 and the OB/ RE both said my period should come back in 4-6 weeks.  My clinic was closed for cycle starts until July 11, so if it came back early, I'd be on bcp's until just before the 11th.. AND, the complicating part about that is we are going away on vacation for two weeks on the 27th.  We will be driving distance away, but it would be pretty much impossible to be mid cycle while I was on vacation (especially since my clinic does daily morning monitoring the second week of stims).  So if I had not been able to start on the 11th or 12th, we would have just bagged this month and waited to start until August. And I would have been pissed off, since I already resent that I had to delay so much for the pregnancy that wasn't.

But, despite my fears that I would never get my period again and that this whole miscarriage and d&c sh*tshow had ruined everything, my period arrived at 9pm on July 10.  Pretty much exactly perfect timing.  Everything looks normal (although thanks to the new Dr. wielding the wand, I was too uncomfortable to really look at the screen. I have much to say about how I'd prefer not to be a training ground for vaginal ultrasounds, but perhaps another time) and there appear to be 10 or so antral follicles. (Back to the training wheels on the ultrasound wand.  He had an awfully hard time finding my left ovary, so I thought, what better way to break this uncomfortable tension than with a joke "Oh -- looks like they took it out when they did my d&c in May."  That got his attention and perhaps communicated the point that I was not entirely amused with all of the poking.)

So I am doing it -- tonight is 3rd night of shots and it's just like riding a bike, except with sharp needles and no fancy bell to ring.  Actually not like riding a bike at all, except that I remember what to do.

I'd really really really like this to work.  Out of the 4 cycles I have done, I've gotten pregnant 2x.  We've put back in a total of  9 embryos over those 4 cycles.  It took 5 to get to the one that is probably having a nap right now and another 4 to where there was a visible heartbeat.  Not terrible percentages. Not fabulous, but neither is being 42 and trying to have a second child.  (Incidentally, can you all tell that I retreat to numbers and meaningless analysis when I am stressed? There are so many statistical errors in how I am thinking, it makes my head spin.  Yet somehow I find it comforting.)

Please please work.

I feel like sh*t

In case you all were thinking that I bounced back from the past two days and am now back to my normal, relatively chipper self, I'm not.

Talked to my RE yesterday afternoon.  His view is, this is very concerning and unlikely to end with a take-home baby, but let's wait and see what happens and go back next week (Tuesday) for another fancy ultrasound with the really unpleasant and not especially gentle with the wand tech.  So I'm back to waiting.

I feel like I am just walking around, going about my business, while this embryo -- this little tiny potential -- is dying.  And I cannot do a f*cking thing about it.  This is maddening, and terrifying, and sad all at the same time.

And I am at work and I am terrified that the scary bleeding will start again without any notice, just like it did before.

And I fear that this was my one statistical shot at pregnancy and I have blown it.  That somehow I did something wrong -- picking up B too many times, vacuuming the apartment, walking stairs -- that caused this bleed that is ending the pregnancy.

And I don't want to have to be cheerful with my 23 week pregnant coworker (remember her?  the "I told my family at a positive pee stick and I've got my crib set up at 9 weeks"?) nor do I want to have the conversation with my boss today about how I will have to do her job during her maternity leave.

I just want to curl up and hide and go back to Sunday at 5pm before the sh*tshow started.

Remember my post from about 2 weeks ago?  The one that laid out the options?  This is clearly the worst one.  The problem is that each time I made it over another hurdle, I grew more and more comfortable with the idea that this pregnancy would make it. And now, well now it's just gutting me to know it will not, and that we will have to wait until the end of the summer to try again.

Dear Universe: if you are going to be a d*ck, please do so quickly, instead of dragging it out and really allowing a false sense of hope to accumulate.

Gone -- Updated

Heartbeat is gone.

 I am sad. That's an understatement, as I'm sure you can guess. Just empty, really. Can't really muster crying. Going in hopefully later today for hi res u/s to confirm what we know. Then will decide what to do.

Update: It's worse than we thought. Per the fancy machine at the maternal and fetal medicine office, embryo only measuuring 5w5d but still has cardiac activity -- 71 bpm. So it's not dead but dying. And there is a big subchorionic hematoma there as well.

 This means I'm going to have to do the whole thing over in a few days.

 Fu*k me. This could not be any harder.

Oh no

Just started cramping and bleeding and there was a big clot of something that I think was this pregnancy. Going in tomorrow to confirm but think its over.

Breathing

I can take a deep breath.

There was a heartbeat, at about 140 bpm, and a perfectly round yolk sac, and a little peanut shaped embryo measuring 7.7mm, or exactly 6w5d.

My RE has given us 80 percent odds of coming home with a baby in 34 weeks.  I will take those odds.

My RE has also checked me out and sent me off to my OB, who I hope will let me come in next week and every week thereafter for u/s.  Frankly, I'm not ready to leave yet, but... I'll take this over the alternative.

I am pregnant and I am relieved and I am happy.

Today, I am a crazy person

I've managed to keep the crazy at bay for the most part for the last six days.  But today?  Today I can barely focus on a simple task because all I can think about is tomorrow's u/s.  Which, for those who want to tune in, is at 3.30 pm.

I've been having some brown spotting, which I know is nothing to be worried about (but of course it makes me anxious nonetheless), still having some pulling/ stretching feelings from down below, and am a bit tired and constantly starving, but otherwise... crickets.  No other symptoms. And frankly I'm probably tired because B gets up at 6am.

29 hours seems like a long time from now.  Maybe if I actually did some work (heaven forfend) the time would go faster?

Well, there is something in there

A gestational sac was seen today in my 42-year old uterus (yesterday was my birthday).

While I would have loved to see a fetal pole and maybe a little cardiac flickering, since I am only at 5w4d and we all suspect a late implanter, my RE said things all look good.

They took blood too to check on HCG, estrogen and progesterone, but those aren't back until tomorrow.
UPDATE:  They are back.  Beta is 2664 at 22dp3dt.  E2 is now at 75 and progesterone is 22.
Doubling has slowed a bit to 49 hours, but I guess that is supposed to happen after HCG hits 1500 or so?

Either way, I'm clinically pregnant. Crazy. And exciting.

Now just 7 days until the next ultrasound.  Wow that is far away.

One step forward.

Beta more than doubled again to 920.  Doubling time of 40 hours.  I'm (I can't believe I'm writing this) 5w1d.  Or 19dp3dt.

Per the smart people on the internet, my beta levels are still well within the normal range.  I just appear to be 1-2 days behind.

And estrogen, while still low, is on an upswing at 41.  Progesterone 23 (due to the 1 inch needle I jab into my ass nightly).

The nurse and RE seem very happy with where things are going.

I am still terrified, as this is just so much lower than my values last time.

Just for recap, because typing these numbers calms my brain, here's where things are:
12dp3dt   39
14dp3dt   104
16dp3dt   264
19dp3dt   920
u/s at 22dp3dt or 5w4d

My one other experience with pregnancy?
10dp5dt 254
13dp5dt 1326
u/s at 5w6d

Frankly, I'm still convinced that this is going to end badly.  Here's my options:
- Nothing in my uterus on Thursday.  I think this is not that likely because doubling has been normal, but it's a possibility.
- Empty sac.
- Sac and fetal pole but miscarriage sometime before 12 weeks.  Because I read research (thank you, google!) that indicates that beta levels lower than the median are indicators of increased miscarriage risk, especially in older women (happy birthday to me).  And I can't even think of how horrific this would be, but I know already that it would gut me.
- Sac and fetal pole and then heartbeat and other good stuff.  I can't yet wrap my head around this one.

So yeah, I am portending doom. Not because I want failure, but because I need to protect my tender soft parts that are trying to attach to the idea of something growing inside of me.  I want this to work quite badly, and I will be devastated if the little flicker of life goes out.

This is hard.

Am I just being set up for disaster?

Beta today is 264.  I'm 16dp3dt.  Doubling time is 35 hours.

On the chart from BabyMed I appear to be really quite close to their average (which I assume is a median) for 19 dpo, which is 303.  (And thanks BabyMed.com for making it impossible to include my fancy chart.)

I go back for Beta #4 on Monday and then have an u/s (are you kidding me?) scheduled for Thursday.

But my E2 is still a bit low (no, I don't recall what it is), and this started so low that I can't get past the fear right now that this will go on for a bit and get me convinced it is going to work and then all come crashing down.  Last time I felt much more confident since my 10dp5dt beta was 254 and it was above 1300  3 days later.

Only time will tell, I guess. But sweet Jesus do I hate this part.

So, in summary, today, things look good-ish*, but I am scared sh*tless that this will all end badly.

*I have to qualify this because I don't want to jinx it.

I'm still in the game

Beta is 104 at 14dp3dt.

Doubling time is slightly less than 34 hours.

Back in for another test on Friday (they initially said Monday but we decided that was unacceptably long!).

Huh.

I have to admit I am surprised.  And pleased.

So this is kinda complicated

I'm pregnant-ish.

Beta at 12dp3dt was 39.

I had tested Saturday and got a negative result, despite me trying to convince my husband that there was a second line there.

And I am spotting a little bit of brown since yesterday. (Yeah, yuck.  Sorry.)

So I expected to get a negative result today and then plot timing for another cycle.

Instead, I guess I go back Wednesday to find out what's up.

But even if this goes south, as I sort of expect it will, I've already beaten the odds a bit.  Because in my age cohort there is only a 20% chance of pregnancy per cycle, and I managed to achieve that.

So maybe in this cycle or in some future one I can beat the odds again?

I've convinced myself that this has worked

Which is basically a recipe for disaster.

Before we get into how my head is completely f*cking with me (because you know, its my *head* and I couldn't possibly control it), I think that it's important that we review the numbers:
- National SART stats for likelihood of live birth per cycle for women 41-42 (with previous ART cycle and prev. live birth): 14.5%
-My age: 41 years and 50 weeks
- Number of embryos I transferred: 3, all 8-celled
- Days post-transfer: 7
- Days remaining until test: 5

What I'd really like to know are the cumulative live birth rates for my age cohort, but I can't seem to find that.  If anyone has them, feel free to share!

So while several of the comments raise the possibility of triplets (and here I say Heaven forfend!), I think that I am much more likely to have zero babies than any number greater than zero.  Because I am old.  And my eggs? They are even older.

But instead of understanding these numbers and internalizing the very low probability of success this cycle, instead I am letting myself open the door to a bit of foolish optimism. It's absurd, and violates my belief in always assuming the worst and then being pleasantly surprised.  Because at heart, though I am cynical, and bitchy and dark, I am an optimist and I just can't really believe that 15% means just that -- a 1 in 6 shot.

So why have I let my head screw with me (see above for how my head is totally on its own here, and pretty much outside of my influence)?  Because I am crampy.  Not in a "I'm getting my period" sort of way, but in a "something is afoot down there, there are all sorts of pulling and twinge-y things occurring."  So that has me totally convinced that I am beating the odds and am actually going to get pregnant with a take home baby this cycle.  I know that's ridiculous, but there you go.

Also, because we've never put back nearly this many embryos before (we are usually eSET people, but at my age we decided after much discussion that it was a waste of time to take that approach), my head equates more embryos in with much higher chance of pregnancy.  In short, I believe that it now HAS to work.

I'm heading for a huge, tremendous disappointment.

And now we wait

This cycle did a bit better in terms of yield:

15 retrieved

6 fertilized

6 still going on day 3 (although 2 were kinda cruddy looking and one was mediocre)

Transfer of three lovely 8-celled embryos was yesterday afternoon, and now it's time for waiting.

I hate the waiting. Really. (Yeah, we ALL hate the waiting but I hate it Right. Now.)

Plus, they told me not to lift heavy things, which means I can't pick up my baby for a few days. Sniff.

I'll know what's up by Monday the 30th. That is AGES from now. Thankfully, my mom is coming in for the weekend, so that should be a good distraction.

On competition

I'm not that competitive. Well, let me strike that. With things I am good at, I like to to well and to win. With things that I am not yet that good at? I couldn't really care less. That train led me to become a rather good student and a rather mediocre athlete, because I never could muster up the energy to try to beat people who cared more and might actually have been better.

Case in point, I was at a friend's and they wanted to play with the Wii. Ive never used one and I don't especially like video games (and as it turns out have very little facility for them). All I wanted was for the annoying loud game to stop. I sucked, but I also didn't try because I didn't care.

But on Words With Friends, which I have just started playing (late adopter of the iPhone) where there is a good shot of me winning? I'm kind of crazed. And although Liz at Womb for Improvement just handed me my ass in a game, I really try.

So what's the point? The point is that I am now bound and determined to get pregnant and have a second baby because I ran into my friend (and here) in the waiting room at morning monitoring. Despite her adamant protestations that she was "one and done" since it took her many cycles the first go round, there she was at 7.30am. And even though she says "oh we are certainly not going to do that many rounds again" I don't really believe her. At all.

So I know that everyone has the right to share or not share what they are thinking about their family planning choices. I know that, and I do much the same thing. And I know that people change their minds about what they will and will not do. But still, I'd like to think that I would just not say anything about what we would do in the future instead of firmly stating a position. Especially to someone that I am supposed to have some sort of trusting relationship with and who may have shared some personal information or thoughts with me.

Either way, there she was.

And now, despite the fact that we went into this new IVF-athon with some boundaries set (we said we would do up to 5 embryo transfers, since that's what it took to get B), now I'm thinking all bets are off. Because I would really like to have two kids and I certainly don't see why she should get what she wants and I should set some sort of arbitrary limit on getting what I want.

OK. When I write that, it sounds ridiculous. And so perhaps I was more sanguine about the limits before I started up with the shots and the calendars and the daily monitoring again. Because now? On the eve of my second transfer? I want this sh*t to WORK.

It was funny, actually. As I was walking to the subway after I ran into my aforementioned friend, I said out loud to myself "Damn. Now I HAVE to make this work." I knew immediately that her trying for a second baby would make me feel differently about our attempts at the same. What I can't really understand is WHY her presence jolted me out of my more lackadaisical attitude. Could it just be competitiveness? That's crazy and stupid. I actually think that it is closer to the truth about how I feel and I've just been trying to be lower key about this attempt. At least I hope that's the truth. Because having a baby because someone else is is idiotic. Really, even I know that and I'm all hopped up on injectable hormones.

Maybe a little competitive streak isn't bad when it helps surface feelings that you were trying to hide because they were scary and could lead to disappointment. But the wanting is out there now -- I'm not as convinced about our limits on cycles and I'm not convinced about our eSET approach (more on that in another post). What I am convinced of is that I really want to have another baby.

I am having a no good very bad day.

I'm feeling very emotionally fragile and hypersensitive and I cannot for the life of me shake it. It started on Friday and I've just been on the brink of tears intermittently since then. I know I have a lot going on, but this feeling of just "I'm crabby and pissed off at the world and don't look at me funny or I will cry" hasn't come around in a while.

I wish I could blame the shots (which I just typed as "sh*its" in a Freudian slip of the fingers), but I can't as they started on Friday and I felt pretty ragged all day. I just feel as if I am doing a crap job at everything -- at being a mom, being a wife, being an employee, being a friend. I feel like I am sucking at all of them and still running ragged.

Friday several members of my team went out to lunch and didn't ask me. Happens more often than I'd like to admit (they are all younger, single, hang out after work, etc.), but it really has started to grate on me. I feel like I am in junior high school. And what's more annoying is that I care as much as I would if I were in junior high school, which is crazily stupid on my part, but I just can't stop from feeling bad.

On Saturday night we went to dinner with a friend from Chicago and her husband. At the last minute she invited along our mutual friend who lives near me but has been pretty much absentee as a friend, despite the fact that we are both moms of boys the same age after several years of IVF. And it was just awkward, because I couldn't get past the fact that I resent the woman who has essentially dumped me as a friend. There were some other details that are too boring to mention, but I need to just get over it and yet it has deepened my sour mood.

So basically, I feel as if everyone I come into contact with is being incredibly annoying. My tolerance for bullshit is about zero, and my ability to fake it and be nice is also somewhat impaired.

I walked in the door yesterday evening. Early! To spend an extra bit of time with the wee one! And he started to cry and asked his nanny to pick him up. So I took a deep breath, took the dog outside, and continued to take deep breaths until the desire to bawl my eyes out passed. And while B got over his crying by the time I got back with the dog, I felt even worse than I had before I came home. (Of course, it took only 3 minutes with him before I felt better, so coming home early turned out to be the right idea.)

I don't have the faintest idea what I am doing. Am I making the right decision to work? I kind of need the money and health insurance, so stopping is not really an option. Am I making the right decision to pursue a second child when I can barely keep my head above water with one? What is wrong with me that I feel so incredibly lonely right now and when I think of how much I love my little boy I can barely keep from crying?

I feel I need a nap. Or a cookie. Or a hug.

Distraction of sorts

Monday morning I got the news that a months worth of shots and early-ass appointments were for naught.

Monday was also the year anniversary of my grandfather's death, and he and I were very very close.

Monday at 5pm our babysitter cancelled so I had to miss a dinner out (and was therefore home solo).

Monday at 550pm I get a text from our nanny that B's pooping has, well, increased markedly, and she is worried he is sick.

Monday at 7pm right before bedtime I get vomited on. Like something out of the movies, except that the vomiter is not a scary alien but a somewhat confused but still relatively cheerful 13 month old baby. Who knew a baby could hold so much stuff? After stripping us both down and taking a shower, baby goes to bed and I begin the process of cleaning up the wreckage.

Tuesday 8am back at work. Very very busy. B is totally fine, but on bland diet and no milk.

Wednesday 128am wake up nauseous. No, not pregnant. Oh shit, it's the stomach thing. Am up hourly until 5am. Really very unhappy. DH appears to sleep through it all.

Wednesday 630am B awake. Am shivering and covered in sweat and do not move for the remainder of the day.

Thursday 645am feel human. Get call from nanny that she has been felled by the disease. Email work again. Do my best to work from home, and B accommodates by taking 2 1.5 hour naps exactly when I have conference calls. Congratulate myself on being supermom. Then promptly let him smack his head on sandbox in playground. Rescind supermom award.

Thursday 7pm. Try eating some food. Poor idea. Stomach cramps for a couple of hours. Get period for good measure.

Friday 630am. Up and at 'em! Spend morning with B, who demands breakfast upon waking since he cannot have his baba (although he yells for it all the time) and then head to work.

Friday 9am. Try eating muffin. More stomach cramps. Perhaps more chamomile tea instead.

Friday 9.30am. Get "I am 3 months pregnant" email from coworker who was worried about how long it was taking in October. Feel like I have been punched in the chest.

Friday 10.40am Decide that this week has been a bit of a sh.itshow and wish it would end soon. No tears or hysterics on anyone's part (yet), but not an awesome week.

But starting BCPs tomorrow for another round.

#2 7dp3dt

And here we are. Nothing much to report on the "am I pregnant or not" front, except to note that I far preferred the progesterone suppositories to the enormous needle I stick into my rear end every evening.

Seriously, though, no symptoms at all -- not from the HCG or from the 1cc of progesterone I take daily.

If I believed it mattered, I would say that the last cycle I did that resulted in a pregnancy I also was completely symptomless, so that this is a good sign. But I don't really put much stock in that. (Ok, my brain doesn't. But the heart? The heart wants to believe.)

Beta is on MONDAY, which is like aeons away (they don't do them on the weekends).

In other news, B is growing increasingly confident with his walking (can go 5-10 feet on his own, although he is like Frankenstein with his arms out and legs kind of stiff), and continues to astound me with his vocabulary. Saturday, he pointed at my watch and said "watch." To which I responded "holy shit!" which, retrospectively, was ill-advised since he is learning and repeating words very rapidly. And he can now say the dog's name, and Dada, and his nanny's name. Mama? Not so much. But despite his preference for everyone but me, his mommy loves him very much and thinks he is the most wonderful baby in the whole world.

Caption for the attached: "Give me that cake now! I don't want any low sugar banana bread bullshit. I want the chocolate cake."

So here we are...

I am lying in bed resting pos t transfer. There is one "very good looking, almost perfect" embryo nestled in, and one more not quite so handsome embryo hanging out in a dish for a few more days to see if it will make it to freeze at 5 days.

The numbers? Retrieved 14 eggs, 11 mature. But only 2 fertilized, which had me all sorts of freaked out this weekend, and of course it was a long weekend and no one knew anything and I spent all morning and most of Sunday and yesterday panicking that they both were gong to die off. But they didnt and my happy embryo is now back with me.

(side note and rant: I don't refer to embryos as "embies" nor do I think follicles are "follies.". For some reason the infantilization of the language of conception strikes me as demeaning and even slightly patriarchal, like "look at those little girls playing with their eggies and their dollies. " I feel we need to respect our own maturity and fortitude a little more than that. I'm sure I sound like a huge bore, but there you go. Been stewing about that for a bit.)

Anyway, more research to do about why only 2 fertilized, but still waiting for the embryology and andrology reports to get to my dr. But what he said this morning also resonates with me: that even with Icsi, which we used, fertilization numbers are on a bell curve and sometimes fewer fertilize. Usually it's 70 or so percent, but sometimes it is just less, and that is also normal. Anyway, since we were only going to put one back in anyway ( yep, still the crazy eSet couple), this worked out ok!

And we are off!

Retrieval is this morning an so, while I intended to write a longer post while waiting, instead I have an IV needle in my hand and a. BP monitor on my right index finger, so I am a bit hampered by that.

There are at least 6 follicles ready to go and estrogen climbed appropriately. I am excited and hopeful, but feel somewhat disconnected emotionally because I don't have the same desperate feeling of want and need. Maybe it's not emotionally disconnected, but just that the emotions are not as heightened thus go round. But I will take that over the panic and fear. I'd realy like ths to work, but I guess am ok if it does not. Whereas last time? Not ok.

Anyhow, more when I have both hands!

My life by the numbers

372 -- days my baby has been out in the world. How did that go by so fast?

11 -- people who came over to lunch on Sunday to celebrate the big day. (No, there was no pony, no clown and no face painting. Just family having lunch and cake.)

8 -- maximum number of steps B has taken by himself. It's been a steep curve starting from his first step on Friday. I think we have walking. Wow!

2 -- boxes of Kleenex I have gone through at the office since Thursday as I have a cold that will NOT go away

2 -- shots I have given myself every night for the last five days

1 -- big bruise so far from hitting a blood vessel

9 -- follicles found on my ovaries at monitoring this morning

1 -- random acquaintance I have seen at the clinic

Obviously there is a lot going on at casa Irrational, but I am slammed at work but just wanted to get out a short post. I'm kind of amazed I am keeping it all together -- much more to say, but running to a meeting.