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Archive for February, 2009

Before my first IVF cycle, I took Ortho Cyclen for about 5 weeks (Maybe longer? I’d have to go back and look at my calendar, but whatever, it was a while). My last two weeks on the pill I cried every day. Multiple times a day. I thought that pretty much sucked and I didn’t love it. But you know? I could live with that, especially since I’m only slated to take BCPs for 3 weeks this time. I mean, really, the crying didn’t start until week 4 last time, so maybe I’d miss out on side effects all together this time, right??

Think again, Oh Perky One.

Last time the BCP was prescribed by The Hatchery before I knew I’d be switching to Ye Olde Fertility Clinic. But then I switched clinics while I was already on the BCP. No matter, I just stayed on the BCP while we got all my ducks in a row. No proplem, I had plenty since The Hatchery had planned on me being on the pill for at least 5 weeks anyway.

This time SuperDoc prescribed the BCPs. And he ordered Nortrel. No problem. I mean, seriously, what could possibly be the difference, right? Of course right.

Think again, Oh Perky One.

Since starting to take it my migraines have been out of control. Did I mention that birth control pills are actually contraindicated for hemiplegic migraines? And that I’m actually not supposed to be on BCPs at all? And here’s another lovely side effect for you: I wake up every single morning completly sick to my stomach. I picked up one of my monsters yesterday and almost dropped her because I thought I was going to throw up, it was that bad.

So… what to do? Just switch pills since I happen to have an extra pack of the Ortho Cyclen laying around? Or ask permission first? SuperDoc is out of town right now, but of course my nurse is around and could talk to a different doctor if need be. What to do, what to do…

In other news, my celebrity status has been revived!

J, Marketing Supervisor Extraordinaire, called me yesterday and asked if I would mind being interviewed by a newspaper for a story on eSET. No problem, I said. Anything I can do to help. (But I swear, next time I’m holding out for free cryopreservation for all the good press I’ve been giving them!).

Er, not that I had anything to freeze last time, so not that I can count on anything to freeze next time…

ANYwhozit. The point, as if I ever had one, is that I got interviewed by a reporter yesterday. She wasn’t the crispest cracker in the box, if you catch my drift, and she spent far more time focused on the HOM factor instead of the eSET factor for my tastes, but I think I did a great job bringing her back en pointe, if I do say so myself. She did ask the ever-present question on every reporter’s mind: “So after this one, will you be done??”

You know what? I don’t know. And I don’t have to know that yet. It’s a decision that my husband and I will make when we get there, but right now we know that our family isn’t complete yet.

And she chose that context to bring up the Octo-mom. In any other context, I’d have understood it. But you know? It felt a bit like an unfair and accusatory comparison. I don’t have six kids already. I am not transferring six embryos (au contraire! her story is on eSET! hello?!). My husband and I both have full time jobs. My clinic, the reporter has already acknowledged, has some of the best eSET success rates in the country. How can she possibly compare my choices to those of Ms. Suleman’s?

Argh. I cannot begin to understand Ms. Suleman’s choices. I am not even trying to judge them except inasmuch as they are reflecting so poorly on the choices of every woman who seeks fertility treatment and every mother of higher order multiples out there. But it is so unfair to compare ME to HER.

Anyway, hopefully the story will turn out to be a very balanced and reasonable story on the value and benefits of eSET. I hope that it will. And when it is published, I’ll be sure to let you all know about it, because I’m sure it’s bound to be entertaining at the very least. And the best news is – it was a print interview, not a film interview – so no cheesy shots of me walking down a long halway just for the sake of me walking down a long hallway. 🙂

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I had someone contact me recently who came across my original infertility blog who has premature ovarian failure. She just found out that she literally has parasites attacking her ovaries. Has anyone else heard of such a thing or had personal experience with it? If so, could you please either comment here, pointing to your blog, or email me directly? (My email address is in the sidebar, as always, but it’s chezperky [at] gmail [dot] com)

I’m also going to ask Mel to post this on the LFCA, but seriously, if any of you have heard anything about this, please do let me know!

Thanks a million!

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And Away We Go

I was talking to a friend today who is about to gear up for an FET in hopes of having her second child. Her first child was born 10 days after our babies were born. I started BCPs today gearing up for IVF#2. So if she and I both have successful cycles again, we could again have kids with similar birthdates. Except there’s no part of me that believes that’s going to happen. In fact even the tiny piece of me that believes it’s possible that I could get pregnant this cycle says, “but what are the odds of you carrying a baby to term?” After all, the only reason my friend and I had babies with similar birth dates last time around is because mine were born 2 months premature (right on time for HOMs, of course, but still a few weeks earlier than I would have liked).

My friend and I were talking about our plans for the future with regard to our current children and she said that a lot of it hinged on when she gets pregnant again. And I said, “Well, yeah, but I guess I’m not really counting on that happening for me.” And I’m not. I never felt this way the first go-around. The first go-around felt like a vast world of opportunity ahead of me with endless possibilities and no end in sight for the chances for me to get pregnant. This time feels like there are so many limitations on my opportunities and I feel like my ability to accomplish my goal within that limitation is… just not likely to come to fruition.

“But don’t you feel like it’s different this time anyway? Since you’ve got kids, there’s only so much you’re willing to put yourself through anyway? Last time I felt like there was no limit to what I’d go through to achieve a pregnancy, but now I feel like there’s only so much I’m willing to commit to to get there,” she said.

Not me. The first time around I definitely felt like there was only so much I could go through. This time? If money were no object, I *know* what the payoff is. I *know* what is waiting for me at the other end of the struggle. I *know* what happens at the end of the story. I’d go through anything to get there again. But obviously, money is an object, and there is a limit. I’ll know when we’ve hit the end, and that’s a tough pill to swallow.

Speaking of pills, I took my first BCP tonight. Thankfully, I won’t be on it as long as I was last time – just one pack this time. 21 days. Last time I was a blubbering mess by week 4. By week 5 I was crying 4 or 5 times a day for no good reason. I am hopeful that only three weeks on the pill will not do this to me.

I picked up all my medications for IVF#2 on Friday. It still feels weird to say that. I know I said a lot that I didn’t have high hopes for IVF#1… but going into it, I kind of did. I told a bunch of people privately, even though I was too scared to actually put that out there into the blogosphere that I had high hopes for George I. I don’t know that I have such high hopes for George II. The fall from hope really was pretty devastating, just as I’d feared.

But onward and upward, right?

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Onward and Upward

Today is Cycle Day 1. So tomorrow I begin BCPs again. Wha-frickin’-hoo! And around and around I go.

I admit that I did have an irrational fear that CD1 wouldn’t rear her ugly head after stopping the PIO and that I’d be waiting weeks and weeks before drawing a progesterone level, starting provera, and all that torture. It does happen to some women, but given how I was feeling, it was a completely irrational fear.

Anywhozit, irrational fears be-damned, CD1 is upon me, BCPs start tomorrow, and onward and upward it is. Which I suppose means I’m in the waiting game for IVF #2. Wow. I guess there’s a piece of me that never really thought I’d get that far. Well then. Gosh.

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Fall from Hope

On December 19th, the first day I started taking BCPs in preparation for my first IVF cycle, I wrote the following:

I know every woman starting an IVF cycle talks about the irony of taking birth control pills in order to get pregnant. I don’t think for me that I find it ironic. I’m struck with a profound sense of – change. This feels like a big step toward my new goal. Toward my new hopes of family building.

I fear that the fall from hope will be devastating.

So today I went in for my beta from that very first IVF cycle, knowing full well that my beta would be negative. I brought with me cookies for J (Marketing Supervisor Extraordinaire, who reports that he has not yet even had a chance to eat my delicious snickerdoodles!), SuperNurse, and yes, even SuperDoc. The receptionist at the front desk was tickled pink when I left the box of cookies for SuperDoc, by the way. It was pretty adorable. I almost felt badly that I didn’t leave any for her, but hopefully the good doctor will share (though rumor has it that he’s quite the cookie monster, so who knows!?).

Two hours later, I got a call from SuperDoc himself.

“I’m sorry to say, I don’t deserve the cookies. It wasn’t the result I was hoping for; unfortunately, your beta was negative.”
“Oh, I know that!”
“Really? How’d you know?”
“Please! You can’t trust your patients not to pee on sticks! Plus I’m mighty certain my period is going to start any second now.”
“Unfortunately, both of those were correct. I already had a cookie and then saw your results and felt guilty about it.”
“Are you kidding me? All the more reason you deserve the cookies!”
“Why’s that?”
“Because now you’re stuck with me! Seriously, you can’t get rid of me now!”
“Wow, when you put it that way, I think I’ll have to have another cookie…”

It shouldn’t bother me, you know? None of this. I’ve been there, done that. Why, it feels practically anticlimactic. After all, I would have probably passed out from shock if he’d given me any news other than a negative today. But there’s something very, very final about the quantitative blood test. There’s no going back from there. It isn’t so much a fall from hope as it is the end of this chapter – knowing that there really are only two more chapters left before the conclusion to this part of the story.

And so… what now? What’s the plan?

In a word, or three? I don’t know.

Originally SuperDoc told me that what he’d do is check my progesterone in three weeks, if I hadn’t ovulated (which he doesn’t anticipate that I would have, he’d put me on provera for 5-7 days to induce a period, start BCPs, and on day 19 start Lupron, etc. etc.

Gah, I said. That gets us into Pesach. No problem, he said, we’ll check your progesterone in 4 weeks, provera, etc, etc, we’ll be a week after Pesach.

I hate the timing. Hate it. I told him so. I hate waiting that extra week I hate waiting that long. I am not a patient person. I don’t want to wait any longer I don’t want to do it. A break isn’t a bad thing, he said. Yes it is! I countered. I was petty, I’m sure. Irrational, no doubt. I gave him no logical reason why waiting was not an option. He said he’d give my nurse a few options on timing and I could work out the dates with her and see what worked best with me on timing, but if I really wanted what I can do is start BCPs as soon as I get my period. Take BCPs for four weeks (rather than the usual 3), then start Lupron, etc. He said from an ovarian perspective, he had no issue with that and I hadn’t hyperstimmed this cycle so he didn’t think it would be problematic in any way. SuperNurse and I can review the calendar together and see what works best for my schedule. [Update: Talked to SuperNurse – I can, in fact, start BCPs on CD2. However, the trick to that is that sometimes it takes a while to get a period, so if it takes a few weeks, we’ll just have to push it off until after Passover anyway. Bah. Hopefully all these cramps are a good sign that this won’t be an issue regardless.]

Which brings me to the protocol issues.

Lupron. Yeah.

He is going to increase my Follistim (not as much as he’d originally planned – my estrogen rise was appropriate for once, once I got to 150IUs… and the accidental 300IUs that one day…). He’s also going to increase my Luveris to 50units (up from 37.5). And… the Lupron. He’s going to keep the Lupron at the same horribly high dose. I told him the headaches were absolutely unbearable and he said that they should have gotten better once my estrogen rose (they got somewhat better around day 9 or 10 of stims, that’s true), and that on higher doses of follistim/luveris, my estrogen rise should happen earlier in the cycle which should mean that the headaches are alleviated sooner in the cycle. I hope he’s right.

His logic is this (or something like this… I was juggling a lot when he was talking, so I wasn’t really taking notes): he feels that the best option is to get more follicles growing early on, while avoiding a dominant follicle. He wants to use the high dose of Lupron to heavily suppress in order to avoid the dominant follicle (and also avoid hyperstimming), but more Follistim to greater stimulate the ovaries into producing a greater number of follicles. I did ask about not using Lupron and using an antagonist protocol instead, but he was against it for a number of logical reasons. While he has had success with that protocol with other patients, with patients with MY profile, he has better success with a Lupron protocol.

There’s a piece of me that wonders if I’m just tying SuperDoc’s hands by forcing the eSET issue. But then I think back to my appointment on Dec. 15th with my perinatologist and his dire warnings about me and a twin pregnancy and I realize that it just isn’t a possibility. I simply cannot take that risk, even if it means I don’t get pregnant again. And it is that reality – the knowledge that it is my own determination to push forward with eSETs that may be my downfall – that humbles me, reminds me that hope is something I may just have to let go of some day.

And at the same time, I know that I am unendingly lucky, for I have smiles and hugs and snuggles every day from the miracles I already have in my life.

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Seriously, people!

Will 9:30 tomorrow never come? And why, oh why, did I not make the 6:45 appointment instead? What was I thinking?? (Oh, wait, that’s right, my husband has to be at work at 0630, so I couldn’t go in at 6:45 regardless… it’s HIS fault!) Yes, I totally get that tomorrow’s vampire draw isn’t going to change anything. But at least it’s something to do.

Bah.

In other news, I need a new blog layout. Seriously. And I’m not creative enough to make one. And I’ve searched for free blogger skins that I could modify and I can’t find any that I love. So I need help.

Help?

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Do you know the definition of insanity? Doing the same action over and over again, expecting a different result.

Why, then, do I continue to POAS? Is it insanity? Or, as Jody suggests, simply ritual?

Truthfully, though I don’t deny that I’m crazy, I don’t expect a different result, so I imagine there’s simply some comfort in the morning ritual, just as there is in the evening ritual of drawing up the PIO injection. At least I’m doing something.

It certainly won’t change tomorrow’s beta, that’s for sure. But after tomorrow, there won’t be anything to do for at least a few weeks. That time is interminable to me. I remember after my miscarriage in 2006 I had to wait a couple of months for my hCG to zero out, and then they still made me wait another month before starting a cycle.* That was absolutely the worst three months of TTC for me, ever.

I suppose I’ll use my break this time to make random drop ins at YOFC to check and see if that mobile has been hung yet. AHEM. What do you think, J – has it been hung yet?? Don’t think I’ve forgotten about it! I’ll cut off the cookie supply if it doesn’t get hung!

Just kidding. I’d never cut off the cookie supply. I’m too nice. Snickerdoodles tomorrow. They’re already made.

*Note, there are no scientific studies (that I can find) that support a need for a month off after the beta bottoms out (my OB/GYN supported my theory on this) – most doctors admit that this is purely because they believe it will help a patient emotionally. However, I believe that the 2 months it took my beta to bottom out was a sufficient break. Furthermore, my completely unscientific survey with a sample size of, oh, 6 or so, showed that being forced to take an additional month break without being consulted as to whether this month was emotionally necessary was, in fact, perceived as patronizing and was more emotionally harmful than helpful.

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