A whole lot of nothing

Not a whole hell of a lot to report from these parts, except that (gasp) I am still not pregnant. Period came and went, and so now I am prepping for our last shot with our frozen embryo.

The Boy and I have spent a lot of time talking about what's next and making plans, since we never thought we would get to this place and still find ourselves somewhat surprised to be on the statistical short end of the stick.

What have we recently learned?
- After putting back in 4 embryos (2 5day and 2 3day), I am still not pregnant, although I did manage to have a very low-beta chemical pregnancy.
- My hormone levels are all still good (my FSH is under 7, for chrissakes)
- My thyroid appears to be working too hard, as my TSH was 4, but all other thyroid and antibody levels normal. With daily synthroid, I'm at 2.1.
- I am heterozygous for the MTHFR mutation (no, I don't know which one), so am now also taking folgard and baby aspirin in addition to my prenatal.
- Despite everything, I continue to have clockwork cycles and ovulate regularly.
- We have blown through our insurance coverage, and will soon be paying out of pocket for everything.

So what are we going to do?
- We are going to switch doctors from the "very convenient, like our RE, like the nurses, takes our insurance, really don't like the clinic overall" to the "across town, very smart very nice RE, great lab, nicer space, more individualized attention, noticed some things in my chart that he would do differently" but can't start right away because their lab closes for a while this month.
- In the interim, we are going to do a non-medicated FET and use our last frozen 5-day blast this month. In fact, it's CD8 and I am all estrogened out (2x daily) and then will go in Friday for a lining check. Transfer date scheduled for June 15. Really looking forward to the 3x daily progesterone suppositories. I should buy stock in whomever makes pantyliners, since I'm keeping them in business. (I hate that word -- panty. It's ridiculous. Makes the whole situation seem like something out of a 1960's era sitcom.) Incidentally, I think it's pretty entertaining that they consider 2x daily estrogen, 3mg cetr.otide, and 3x daily progesterone to be unmedicated. I guess it's the lack of lu.pron that earns it that label?

How do I feel about all of this?
The FET is a throwaway -- I have no hope that it will actually result in a pregnancy or child, but I figure I might as well use the embryo since I already have it. I was kind of hoping to have 2 shots on goal, and be able to try naturally and transfer the embryo back in, but apparently they frown upon that at my current clinic, so this weekend I will be shooting up with cetrotide to prevent ovulation. I think it sort of stinks, but I'll live.

I'm anxious about switching clinics, not because I don't think they will do a good job, but because I know that I will expect it to work the first time there. And that's a lot of pressure on me and on everyone else involved in this process. And, although this is probably weird, I feel bad about leaving my RE, as she has been really quite nice and pretty responsive most of the time. I wanted our relationship to end with me heading off to the OB with a healthy pregnancy, and somehow I feel disloyal for even meeting with other REs. That said, I can't keep doing the same thing over and over, and so need to go with something different. But I feel bad, all the same.

Am I excited about any of this? Hard to say. I'm starting to believe that this never is going to work.

Inch by inch...

Slowly, slowly we are making progress towards our FET... this is a very different feeling than the first IVF cycle and so it seems somehow less fraught with expectations/ terror/ hope/ etc.

Here's the schedule and where we are:
- 2 weeks of lu.pron 10units -- check
- Begin 2 estrace per day and drop lu.pron down to 5 units for another week -- check
- Start progesterone pessaries 3x daily -- check
- Transfer date: 17 Feb

A couple of things about this cycle:
- lu.pron is such a nothingburger shot after all of the mixing of the stimulation drugs. Seriously, I think I can do it with my eyes closed. Yay for me!
- the lu.pron did not make me as full of inchoate rage this time around. In fact, I had practically no side effects, and no cyst either. Again -- Yay! (and the Boy is incredibly thankful, too, since he was nearly rent limb from limb last go round).
- the estrace pills are really small, and I am really clumsy, which means that I have lost a couple down the drain. Not the end of the world, but making me really grateful for good Rx coverage.
- Pessary. The word somehow makes me think of the word dromedary. So I laugh every time I shove one of them up inside, and am grateful I don't have to put a camel up there.
- 3x per day pessaries? seriously, that's just a whole lotta mess. But I just keep thinking that this is for a good cause.

We actually met with our RE yesterday for a discussion about our embryo quality, and learned that both that were frozen had started to hatch, so that was a good, positive sign.

We also spoke with her about the twin risk, and about doing two SET instead of transferring two back in. We are still undecided for the very important reason that the Boy and I have slightly different perspectives (again -- please please understand that our desire for a singleton pregnancy is just what is right for us as a family, and should not be taken as our opinions on other people's choices):
- I would be more unhappy to hear I was not pregnant than I would be unhappy to hear I was having twins
- the Boy would be more unhappy to hear we were having twins than he would be to hear I was not pregnant.

But the Boy is reasonable, and knows that a lot of the burden falls onto me, so I ultimately get to make the decision (yikes). Here's what I think is likely to happen: we somehow end up with identical twins, regardless of how many I put back. Because my life is just ironic like that.

Frustrated, part deux

Alas the clinic was closed today, so I couldn't reschedule the appointment for our RE, but yesterday (Sunday) I did get this message from patient services:

Hi! It says in your file we can leave confidential messages on your voicemail, so I just wanted to followup nurse K's call and tell you that since you need a sonohystogram, I've scheduled it right after your consult with the RE on Tuesday. Please call me with any questions."

So I admit, when I heard the annoying nurse's message Saturday afternoon, I deleted it after hearing my blood tests were good to go but before listening to the entire thing, so I missed the whole SHG requirement, so it's pretty good that patient services kindly followed up.

But, umm, isn't the point of the SHG to look at my uterus? Because Tuesday will be day 24 of my cycle, and I'm pretty sure it's not all that good looking in there right now. In fact, everything I see from Dr. Goo.gle is that the SHG should take place between the end of one's period and ovulation. And ladies, as you well know, Day 24 is not there. I was there earlier this month, and could have come in then, and I ostensibly will be there again, but now, well, now it's just kind of a hassle, especially b/c I'm starting a new job in one week, and would prefer not to take a lot of time off. So unless there is something in my Saturday bloodwork that has indicated an SHG is necessary, I'm just wondering why I didn't get asked to do it BEFORE now, and before I started the drugs again. Because what if they find something that will make this FET a bad idea? Then this waiting and lup.ron will have not been very useful, now, will it?

Sigh. I shall just call tomorrow. And be put on hold, and then talk to a nurse, who I hope is a lot nicer than nurse K.

Frustrated

First, thanks to you for your many thoughtful comments on my last post - you gave me some good stuff to think about. In fact, I tool some of your very helpful questions with me yesterday morning when I went to the RE.

Pretty much the only thing that went right about the appt was that the bus came right as I got to the stop, so it was a quick commute at 700am on a Saturday. The rest, well, that was a shit show.

1) At my clinic, which is more and more reminiscent of the DMV, morning monitoring is done on a first-come, first-served basis. So you get there, fill out a little slip of why you are there, and then wait to be called by first name only (for privacy, of course). I checked the box "starting a frozen embryo transfer cycle." Then the crack receptionist looked at it and asked me why I was there, to which I responded "I'm starting a frozen transfer cycle today." And then, instead of sending me to billing to make sure I was all paid up (still no copay, people!), she told me to wait. While waiting, about 1000 people arrived. Then a nurse called me and said "why are you here?" to which I responded "I'm here to start an FET cycle, just like I checked on the sign in sheet." And then the receptionist wheeled around and yelled "You said you were here for your transfer." Ummm, no sweetie, that's not what I said, and I also checked off the fucking correct box on the stupid ass piece of paper you gave me, so if you bothered to read it, that should have prevented this misunderstanding before we started.

So then they sent me to billing. Behind the hordes who had arrived while I was waiting. Then the nurse calls me to do b/w, but I'm still in the billing line, so it's a whole big ordeal to get me to the front of the line before I go back, and it all sounds really petty and small, but it's 730am on a Saturday, and I am at a damn cattle call and I don't like it.

2) After b/w they sent me back to the waiting room to wait for an u/s room. And in walks a couple with their stroller and they park next to me. Yep. They brought in a small child (around 9 months, or so maybe) and that child immediately started screaming, so then was picked up and bounced on the lap of the woman next to me. Because that's what I want at the RE -- to sit next to a woman bouncing a baby on her lap.

3) I had my U/S (all clear) and then had to wait AGAIN to speak to a nurse to go over the protocol. By the time they called me, it was 830am. I got there at 720. I've been sitting next to a woman with a baby, and I'm not even going to talk about the couple across from me (it will make me seem mean and petty, so I won't share. But just let me say, it made it feel more and more like a bloody circus there. And not a good circus, but a kind where the clowns are all scary and you feel like you need to wash your hands.) So I get instructions that say "take lu.pron for 2 week and then come back and we will check up on you."

I thought it would be pretty reasonable to ask about the full protocol, just so I knew the dates, etc. The nurse gave me such attitude about how they really didn't need to do that now since nothing will happen until 2 weeks from now, etc. etc., that I was practically stunned into silence. But only practically, because I have a lot of questions, and I used this opportunity to share them all:

- I need to know the dates for monitoring and transfer, so that I can plan the rest of my life (including my new job) around this process

- why put me on a lup.ron protocol since it gave me a cyst last time?

- if we stay on this protocol, can I come in for monitoring before 2 weeks to check on cysts, so I lose less time if there is one?

- does this FET process really need to take a full 4.5 weeks? And why didn't we start on Day 2? I thought we were going as quickly as possible?

- Can you tell me the grading of the embryos that we have on ice? Can you be specific?

Now, I know that a lot of these questions are more appropriately for the RE herself (and the nurse was able to answer only the first), but was sort of at wit's end yesterday since I've tried to get the RE on the phone and couldn't do better than trading messages, so when the nurse refused to show me the embryology report, I pretty much lost my patience. I then waited more time to speak to "patient services" who really are just there to prevent people like me from publicly losing their shit.

So after unloading on patient services, I set up an appointment with the next avail RE in the practice for Tuesday. Alas, the Boy would rather speak to our RE, since aside from all of the BS, we really do quite like her. So tomorrow I will reschedule for my RE, and in the meantime, still take the lu.pron, and wait for transfer in mid-Feb.

Is it bad that the crazy has already come back to visit before I even started the lu.pron? That's probably not a good omen for the next few weeks....