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Wednesday, April 23, 2014

Negative #2

At least I took a home pregnancy test two days ago so that I had a couple days to adjust to the disappointment before getting the confirmation via blood test today. I cried my heart out in the shower Monday morning, just feeling empty and so disappointed. (It's important to note that I'm taking progesterone supplements, which keep you at a PMS level of progesterone for an extended period of time - probably not helpful to my emotional stability.) I carried that feeling throughout most of the day, then felt a little better Tuesday, so by today I felt relieved to have gotten it out of my system so that I could get through the day and not break down when I got the call.

Not so much.

The PA was the one to take my blood today, seemingly because they didn't have any sonogram patients but the phlebotomist was with another patient. (They know you have to go to work after these appointments.) She told me she was crossing her fingers and hoping for the best, and when I saw her sweet and excited smile, I started to tear up. I told her that I wasn't very optimistic because I'd taken a test that was negative. She said, "When did you take it?" and I said, "this morning," and she said, "...oh." Clearly she was not optimistic anymore either. So then I said I felt silly for having come in so confident that it wouldn't take me very long because they told me I seem healthy and fertile. She said, "I know it's hard to be patient," and I said, "and expensive, too." She said, "Yes, and expensive." Sometimes I feel the need to remind them that I'm paying out of pocket for this. My "healthy, fertile" state means I have no insurance coverage, and they're not used to that. Not for insemination, anyway. (IVF is a different story.) About 90% of me is disappointed about still not being pregnant when I'd become so convinced and felt sooooo excited and ready, and the other 10% of me feels the pressure of an additional $3000 for each attempt. It feels like $6000 has already been flushed down the toilet, since nothing came of those attempts.

I told the PA that the last two vials had only had 8 million motile sperm so now we have the additional stress of wondering whether we need to switch banks and donors. She said, "For you, 8 million is plenty. You're fine with that." What does she mean, "for me"? If I had different fertility struggles, would it be more important to have more? Is 8 million motile sperm a good amount for the average person? I don't know, but it was reassuring. She said to reach out to the bank to try to get some sort of compensation if it's less than their guarantee, but that she sees no issue with continuing with this donor.

All of a sudden I realized she was bandaging up my arm and I'd had no awareness of her taking blood. Having blood drawn is always a horrendous process for me. It hurts so much in a way that makes me squeamish, but I hadn't even noticed. Either she's just that good because she's a PA, or sobbing and having therapy during it kept me distracted!

I fought tears off and on all morning until I gave in around 10:30 and went to talk to a coworker who had revealed to me that she'd needed IUI to get pregnant. I felt comfortable bawling my eyes out to her because I knew she knew what it's like. She told me that it took her five cycles to get pregnant and not to get discouraged yet, though my emotions are completely normal. She said that she isn't sure whether this was too awkwardly spiritual for her to say, but that she tells herself her daughter wouldn't be her daughter if the pregnancy had taken at any previous cycle, and that she knows this child is who was meant to join her family. Our friends A&A said the same thing today when we sent a group text among the four of us. One of them got pregnant the first time, but it took the other five cycles, and she said her son wouldn't be her son if it hadn't happened that way. It makes total sense, but without the kid here, it's difficult to find much comfort in that. But it IS a reminder that our baby will join our family when it's ready. And it's okay to cry here and there until that happens.

Friday, April 18, 2014

Symptoms?

I've resisted writing about this for almost a week because it makes me quite vulnerable. I have no idea if I'm pregnant, if I'm imagining things or reading into them, if fertilization took place but implantation won't...I could feel like a total fool if I excitedly write a post about why I'm nearly convinced I'm pregnant and then have to write about how I was wrong. My initial plan was to write about this only if and when pregnancy was confirmed.

But then I realized that the purpose of this blog is to (1) describe my own experience so that I can look back at it later, (2) process my emotions and experiences as they happen since it is all a swirl, and (3) be a possible source of support and validation to others going through a similar process. By trying to protect my vulnerability, I'm not doing any of those things. And what's the worst that could happen? I certainly wouldn't be the first person to suspect pregnancy and be wrong. That's a real experience and it's okay for me to share that if that's what happens. This is supposed to be an honest chronicle of my journey, not a skimmed-over, carefully crafted narrative of the highlights. This is real and it's raw.

Saturday evening, which was three days post-ovulation, I noticed my nipples were very sore and sensitive. This is not something that just happens to me randomly, only the day or so before my period which would still have been a week and a half away at that point. This was suspicious. And now, seven days later, they are still sore, and my breasts have become tender too, all the way up to the sides. Saturday I told Nicole that they were sore but said, "There's no way that's related. It's way too soon!! ...Right??" We looked it up and found several valid websites that confirmed that nipple sensitivity and tenderness is the earliest sign of pregnancy and can be felt as soon as a day or two after fertilization. All I could think was how relieved I was that I felt something before beginning the next round of progesterone, because I feel like I can't trust my body's signals once I add that into the mix.

Since then, I have experienced: continued nipple soreness, increased breast tenderness, and increased cervical mucus similar to that at ovulation. (I freaked out thinking something was wrong, because why would it be like it is at ovulation?? and then later read that this is a symptom). Then yesterday I felt a tiny but distinct twinge in my lower abdomen. Anyone less in tune with their bodies than I am would not have even noticed it, but it was distinct enough that it wasn't imagined. I wondered briefly if implantation was happening, but then told myself I was crazy. How could I possibly feel that? Then I woke up at 4:00 this morning with severe diarrhea and had two terrible bouts of it before going back to bed. I think it's important to note that I have a stomach of steel and that nausea, vomiting, and diarrhea are extremely rare for me. I can't even remember the last time I experienced any of those. Years ago for sure. Today my lower back began to ache - again, something that only happens right before my period which would still be a week away. This evening I started having burps that just kept coming; this is usually only something I experience with soda, which I haven't had in months, and my dinner was a bland beef stew with white rice, not something that would or ever has caused any sort of reflux or reaction.

I started using a cycle tracker program today where you can check off different symptoms, fertility signs, the day you ovulated, the day you inseminated, and ultimately the result of your pregnancy test. The purpose is to help you track "symptoms" and whether they are really related to pregnancy. So if I'm not pregnant, then next month when I'm checking off "nipple soreness" on the third day post-ovulation, I'll be able to see that I did so the month previously as well and it clearly didn't mean anything. I'll be able to see if similar symptoms come at different times, or if there are new symptoms I didn't experience the previous cycle. It's just a good tracking tool to keep me in touch with the signals my body might be giving me. It also let me see a whole slew of symptoms that I've been experiencing (those noted above) that I wouldn't have connected to that, and it has various tools that are pretty cool, like the "implantation predictor."

Your Results

Ovulation Date: Apr. 9, 2014
Day Past OvulationDateProbability of Implantation
6 DPOApr. 15, 2014Less Common
7 DPOApr. 16, 2014Common
8 DPOApr. 17, 2014Common
9 DPOApr. 18, 2014Most Common
10 DPOApr. 19, 2014Common
11 DPOApr. 20, 2014Common
12 DPOApr. 21, 2014Less Common
13 DPOApr. 22, 2014Less Common
April 18 is today, the day I experienced the diarrhea, lower backache, and strange burping.


Am I reading into things? Looking for things that aren't there? I really don't think so, because last month I was ridiculously excited (seeing a negative pregnancy test and having to start all over with a now-familiar routine quelled that, and I'm much more emotionally level this month) and constantly looking for symptoms and didn't find them. I kept saying to Nicole, "Shouldn't I be feeling something? I know it's so early...but shouldn't SOMETHING feel different?" and we'd reassure each other that it was indeed too soon. Our efforts to convince ourselves that I may be pregnant were all based in rationalization, that we had optimal conditions, etc., but not based on any physical changes, because they just weren't there. So knowing that while SO STOKED and convinced I would get pregnant I didn't notice any symptoms (remember my post about how I was poking at my breasts all day, wanting desperately for them to feel tender but they just weren't?) makes me more apt to trust the changes I'm noticing now. And if any of this is caused by the progesterone (excluding the nipple soreness which started before I took it)...well, it didn't cause these things last month, so what's THAT about?

I do feel more emotionally calm this month, more prepared for the reality of disappointment, so I don't think that I'm so convinced of pregnancy that I'll fall apart at the seams if it's negative. But I do think I will be very surprised, confused, and disappointed that I apparently can't trust my body. I also think I will be convinced that fertilization occurred and it just didn't implant, which would explain at least the nipple soreness (the one symptom pre-progesterone and the one symptom so strong and consistent that I can't be imagining it).

And so the roller coaster continues.

Thursday, April 10, 2014

A Different Direction

We chose our sperm donor based on many traits, both ones that were desirable to us (good health, smart, productive adult) as well ones that we wanted to match Nicole (ethnic background, hair color, eye color). When naming these ideals to our friends A&A one night, they told us that everything we were saying matched the donor they used for their second child, and they offered to give us the donor number so we could use him as well. We immediately agreed, knowing that our preferences and requirements would only bring up a few options. It's difficult just to find a Jewish donor who is Open ID (willing to be contacted by the child when they turn 18), let alone the other, smaller details. We all checked in about whether it felt weird to any of us, and the immediate and unanimous reaction was that we felt it was a beautiful way to build families and connection.

We looked up his profile, listened to his audio interview, and looked at his baby picture. Then Nicole did some sleuthing with her genius detective brain and found his current Facebook and Linked In profiles so that we could see that he is a normal, successful adult. (Don't judge - this is a HUGE decision to make, choosing someone to provide half our child's DNA, and we also know our kid can meet this person someday without us there to protect them. This was the first tough decision that wasn't entirely clear or comfortable that we had to make in our child's best interest.) He is 5'11", brown hair and brown eyes, Jewish (Reform), of Ukrainian descent on one side and a Western European mix on the other, speaks three languages, went to a prestigious engineering school on scholarship, is athletic, loves to travel, is family-oriented, is easygoing, and most importantly, is in good health. He is also CMV negative, which is important since I am as well (which is pretty uncommon, apparently) and being exposed to the virus while pregnant could harm the baby. It also doesn't hurt that he helped make a super cute toddler whom we adore!

Our vial in the warmer, waiting patiently to fulfill its destiny.

Suffice it to say, we are completely sold on our donor and didn't anticipate any issues since our friend had gotten pregnant the first time using his sperm. During our first cycle, we were told the second day that the vial had 7 million, "which is a good number." It sounded a little low to us and we remembered the sperm bank telling us they guarantee 10 million motile sperm per vial. So when we went in for my progesterone check the next week, I saw the PA and asked her to look up how many were in the first day's vial because we hadn't been told. She said the first day was 10 million at 54% motility and the second was 7 million at 52% motility. She said the motility was on the low end of normal, but that anything over 50% is normal and good. I said, "So if we don't achieve pregnancy on the vials we have, should we be looking at another donor?" She said, "No, I don't think so. Those are still decent numbers, and you never know what will be compromised in freezing. It's not the donor's fault and it could happen to any specimen. These numbers are okay, I wouldn't switch."

We took that as some comfort, until we reached out to our friend who said she'd had 12 million!! What the heck?? Then yesterday, after getting the great news that my follicle was at 22mm (it went from 18mm the day before to 22mm the day of IUI, whereas last time it only went from 18mm to 19.5mm - optimal size at ovulation is 20-22) we were told there were only 8 million at 49% motility. Then today's vial had 8.3 million at 46% motility. What is going on here?? Why were three of our four vials below the guarantee of 10 million, and why did the last two have motility below 50%, putting them in the below normal range? The nurse practitioner doing my IUI today said that, while they like numbers to be a bit higher, these numbers are pretty typical for what they see with frozen specimens. I'm not sure if that's a comfort or not.

We're trying not to get too distressed, because if I'm pregnant it won't really matter. But if I'm not... I guess we'll cross that bridge if we come to it. We already knew we'd have to take a month off after two cycles to save up money for another two (we refuse to go into debt over this), so we could use that month to start over with a new donor and a new bank if we decide that's what's best. But before I jump that far, we're first sending in the specimen analyses to the bank we used so that they can look at it (they wouldn't tell me what they do if the specimen doesn't meet the guarantee, they just said to let them review it first) and we'll see what they offer. If they offered two vials for the price of one so that we can ensure we have enough sperm, then we'd keep using them. If they just refund us some of this, well that's nice, but we are also spending $2000 on each IUI itself, so we still wouldn't be using them again. I also want to talk to the PA and get her thoughts again now that she can see what's in the last two vials; maybe she won't be concerned. I'll wait til I hear back from the bank before I reach out to her so I'm armed with as much information as possible.

Here's hoping that I'm knocked up and won't have to worry about all this!

Update: Apparently the motility percentage is how much of the unwashed specimen is motile. So if the percentage was higher, then the number of sperm in the vial after washing would be higher since the washing separates out the motile sperm. Someone from the clinic told me that the bank might say they guarantee 10 million before washing. But I had specifically asked them what their guarantee was back when I first ordered, and I thought that was clear. Maybe I'm misremembering. But one vial had 29 million before washing, and another had 10.1 million. That's still a very alarming difference. And one vial only had .9mL when they're supposed to be 1.0mL, and the other three had 1.0mL. All questions for me to ask them...but it may not lead to us switching banks and donors if we can't guarantee getting anything better at another bank.

Tuesday, April 8, 2014

Thawing Out

I've been oddly numb to the idea of starting this process again. I haven't felt the crazy excitement nor the nervous anxiety that I felt the first time around. I was able to go on about my life and wait pretty patiently from the first day of my cycle to Day 11 when I was told to come back in for monitoring. It has felt more routine and less surreal. I figured this was normal, and it certainly felt self-protective and probably more realistic than my previous emotional approach, so I've let it rock. Though I missed the excitement I felt the first time around, I carefully let this be the way it was, figuring my mind knows what to do to keep me safe and not wanting to ruffle any psychological feathers.

Then today I went in for my first day of monitoring and learned it's already time to go! We were expecting to go Friday and Saturday based on my last cycle, but we're going in Wednesday and Thursday. My excitement is slowly starting to climb again, but in a containable way. I think it helps to know what to expect and to be better prepared for the real possibility of disappointment. But I'm still starting to get pretty excited.

But let me back up a minute.

I got into my old familiar position in the stirrups and was grateful to see that it was the physician's assistant who would be doing the sonogram. I've gotten very comfortable with her since she has done all but the first sonogram of the first cycle (which was done by Dr. K). It's nice to feel like people have an investment in you, that they are getting to know you and are excited for you and rooting for you.

So the PA did the sonogram and, after raving about how wonderful my lining looks, said, "It looks like you have a small cyst on your right ovary. It's small and shouldn't be a problem...unless it affects your hormone levels, in which case you wouldn't be able to start this cycle. Wait, what cycle day is this?" I tried to speak over my heart that was in my throat and said, "Day 11." She said, "Ohhhh, okay, I don't know why I was thinking it was only Day 6. That's not a cyst, it's a mature follicle. It's already 18mm." GEEZ, woman, can you think a little longer before you speak?? This happened the time she thought the follicle had shrunk a millimeter last cycle, and I had the same momentary freak-out where in ten seconds my mind went through a hundred questions and possible scenarios and implications. Why would I even be in there for a sonogram if it was only Day 6? And she had confirmed what day I was on when I first came in. But no harm done, and the surprising news was that I was already at 18mm on Day 11. Last time I was at 17mm on Day 12. So for some reason my body was moving much more quickly this time! She gave me a prescription for Ovidrel (the ovulation trigger injection) which I dropped off at a Bronx pharmacy so I could pick it up from work the next day and have it on me for whenever I received the call.

When I hadn't gotten a call by 2:10, knowing the office closes around 2:30, I gave them a call. The receptionist had to pull the PA out of a meeting about me. The PA got on the phone and said, "We are consulting with Dr. B about your case right now. You may need to come in tomorrow. I'll call you back in two minutes." As a clinical social worker, it was a really strange feeling to know I was the subject of someone else's case conference! The PA called back in less than a minute and said I was surging and needed to come in at 9:30 the next day for insemination. In an excited panic, I said, "But the injection won't arrive until tomorrow!" She said she had a connection somewhere that keeps it on hand, could deliver it today, and would only cost $60 instead of the $80 I paid last time. I assume there is a good reason that they didn't use this place last time??

I rushed in a vacation slip to my supervisor (who I've kept in the loop so she has been very supportive and flexible about all my appointments) and then left work so I could get home and take the injection as soon as possible. I was home by 4:30 but the pharmacist called and said there was traffic and she couldn't get it to me before 6:30. She asked when I needed to take it, and I said, "several hours ago!" so she said she would deliver it herself on the way home from work to get it to me more quickly than it would with the courier who had a list of deliveries to make. She pulled up outside my house and sent her pre-teen son up to the door to give it to me. Now THAT'S service!

And for $20 cheaper than the last prescription, it came with much more than just an injection in a cold package. This is what I got:



That is a tote bag which had in it the freezy envelope with the syringe on the left, a sharps container for the used needle, alcohol swabs, gauze, bandages, and Yogi tangerine tea for relaxation and mood. A BOX OF TEA. I didn't even get alcohol swabs last time and had to ask for some at the clinic! This setup made the money feel worth it.

So I'm all injected and ready to go. Excited but not out-of-my-mind Christmas-Eve-as-a-kid excited. I'm taking the day off, but Nicole is going to work afterward. I may go to a movie to relax, since that's something I love that Nicole doesn't enjoy doing. And it will be what it will be.

Here we go!

Thursday, March 27, 2014

Spoiler Alert: Negative

Receiving the call was not a total surprise, but was still disappointing. How can you miss something that was never there? Nicole and I sulked a little but then were just eager for me to get my period so we can start again. We went out to dinner as planned, and it was really nice. Nicole’s sister had given her a gift certificate for her birthday last month for the local Italian restaurant that we LOVE right across the street from us. I suggested using it to go out and celebrate if we learned we were pregnant, and Nicole said she thought we should go no matter what. That way we wouldn’t feel extra punished after already receiving difficult news, and it would be something we could look forward to no matter what. I’m so glad she said that, and it actually ended up feeling like the start of a new beginning, looking forward to the next cycle and the next attempt.
And in the meantime, I’m going to enjoy a few things that I couldn’t while possibly being pregnant:

--a frozen Coke (check! Nicole brought me one when she picked me up from the train yesterday)

--a Frappucino on Friday morning

--a pedicure (Nicole didn’t want me going into a nail salon where there are strong vapors)


Those will be my three indulgences, and then we will get back on the horse.

Monday, March 24, 2014

Emotional Roller Coaster

Oh what a ride it has been...and I'm acutely aware that we're just at the beginning, and that couples can spend years trying to conceive. It's only been one cycle and we feel like we're going out of our minds!

A coworker I'm close with is also going through IUI (but with Clomid) because a recent accident left her husband with a low sperm count so they're having difficulty conceiving their third. We both started the same month, with her having experienced her first negative test result within days of when I was getting inseminated. I was telling her about the agonizing two-week wait because I knew she'd understand, and she said, "You know you can take a home pregnancy test days before that, though, right?" Ummm no, no I didn't!

Cue the crazy. (And yes, she said today she regrets having told me that.) I calculated within two days when I would likely be due for my period, which would be this Tuesday or Wednesday. I bought a Clear Blue Easy digital pregnancy test that is extra sensitive to hcg so it can detect pregnancy up to four days before your missed period. Saturday was four days before (if I was due Tuesday) and I couldn't wait any longer than that to take it. Nicole and I were huddled in the bathroom waiting so patiently for the little hourglass to stop flashing and to show a result. And it was negative. We were disappointed but then tried to remind each other that only 65% of positive pregnancies show four days prior (it goes up to 90% three days prior, I think) so it could be a false negative, and also what if my period was due Wednesday? But my mood was muted and Nicole was cranky the rest of the day.

That evening we started trying to find silver linings because we couldn't stand staying in that space. These included: avoiding a Thanksgiving/Hanukkah birthday; pushing my five months maternity leave closer to my mother-in-law's summer break when she could watch the baby for another few months; not being quite so uncomfortable at my brother-in-law's much-anticipated wedding way out on the tip of the island September 27; not putting my mother-in-law in the position of having to help plan a baby shower immediately after her son's massive wedding that is already stressing her out.

The silly thing is that none of that would actually bother us if we learned I was pregnant, but we did a good job in the moment of telling ourselves that we'd be better off with a January 2015 baby. Willing suspension of disbelief, as they say.

Then Sunday morning I felt a horrid compulsion to take the second test in the box. I knew Nicole regretted having taken the first one, but I had to know. And maybe today, farther in, there would be a more accurate result. And maybe even a positive to ease our minds! I figured if it was negative, I wouldn't tell her I'd taken it because I knew it would increase her anxiety and distress (and probably mine too, but I couldn't stop myself). If it was positive, I could jump into bed next to her with it and squeal excitedly, and what a nice surprise that would be for her.

I was so careful to be quiet. I got a new disposable cup from downstairs instead of using the one in our bedroom so I wouldn't alert her. Then I turned the shower on first to drown out the noise, and peed and tested while it was on. Then I suffered the disappointment, showered, and went back to the bedroom where Nicole immediately said, "Were you taking a pregnancy test in there?"

Then I asked her if I could drive myself to Hebrew class because it was silly for her to waste gas going back and forth both times, plus it was early and she shouldn't have to get up yet. She insisted on taking me but I pushed the issue. All so I could sneak by Rite Aid and buy another pregnancy test. I swear, I felt like an addict. I'm never deceitful with my wife, but I HAD TO KNOW. And if it was positive, she'd be happy, and if it was negative, I wouldn't tell her until after it was confirmed by a blood test, at which point I'd be able to admit to my crazy.

This time I bought First Response, which can detect hcg as early as six days before your missed period. I was only at two or three days before, so this would REALLY be accurate! I came home and Nicole was talking to one of our international students, so I slipped upstairs and took the test. Another negative.

Again Nicole said, "What were you doing up there? You didn't even say hello." And I had to admit that I'd bought another test. There is one left in the box and I agreed to wait until Wednesday morning to take it so that I don't keep going crazy and I can just know for sure before getting the call at work with the results of my bloodwork. But it is NOT easy. I'm thinking about it constantly, up there under my bathroom sink. What's the harm in taking it and then just buying another box, which I could then use for Tuesday AND Wednesday? But I promised. I'm taking the advice of not giving in to my anxiety and making it worse. And it is so, so hard. It's like I just want to keep peeing on sticks until one shows up positive - the very definition of insanity, no?

I keep thinking I feel something and wondering if it's my period coming or implantation. Then I remember that since I'm taking vaginal suppositories of progesterone three times a day (oh I didn't mention that my levels were a little low so I got to add in this messy, chalky game?), my period will probably be delayed AND its common side effects are the same as symptoms of pregnancy and menstruation (mood changes, tender breasts, etc.). So I can't even trust the signs my body is giving me. I feel so out of sorts. Emotional and disconnected from my own processes.

And stupidly, some part of me is still holding out hope that all these negatives are false and I'll be blown away by happiness Wednesday. Even as I cry and stress about why our vial only had 7 million when our friend who used the same donor had 12 million and what if we had done this or that differently, I cannot change that my personality and my soul, to its very core, is hopeful and optimistic.

Tuesday, March 18, 2014

The Waiting Game

We are soooo impatient!!!

The first couple of days after IUI, I was flipping-out excited pretty much nonstop, thinking of what was potentially happening in my body. I was so in awe of even the possibility of it. Then for a good portion of one day, I wasn't even thinking about it, and when I did, I flipped out even more at the idea that I had been just going about my daily life as if everything was normal when in reality EVERYTHING MIGHT BE DIFFERENT.

We research incessantly for any possible indicators. I push on my breasts several times a day to see if they're sore, but they're only sore because I keep pushing on them. I want to notice something, anything, to give me hope, even though I know realistically that it's way too early for any symptoms.

It's all we can talk about. We have other conversation for a bit, but it inevitably ends or is interrupted by "what ifs" and hopes and doubts.

Eight more days til my blood pregnancy test. Six more days until we can take an early-indicator home pregnancy test with any accuracy. I'm trying to make myself enjoy the process, even the antsy-ness, because if it takes us months to conceive, the excited nerves could turn to anxious, frustrated, fearful nerves after a couple of failed cycles. I'm trying to appreciate the anticipation and the closeness it has brought us as we dream together. But, please, please, please, can it be next Wednesday already???