I am SO angry at the world. My friend Kristen lost her baby at 11 weeks. It’s not fucking fair. My heart just aches for her. I wish there was more I could do.

Ultrasound this morning went well, and Den even came with me for once, as he had to get a haircut… though I think he spent the entire appointment reading magazines.

We were in and out pretty quickly. Got my blood drawn first… and she got it on the first try this time, and on my left side – yay! Though now I have matching bruises on my left and right arms. We didn’t wait long to be seen for the ultrasound.

Basically, it showed me exactly where I expected to be: close but not quite there yet. Count of my follicles:
Left had 12 total, big ones of note were 18, 16.5, 16, 14.5, 14, 13.5.
Right had 11 total, big ones being 18.5, 18, 18, 15, 15.5, 13.5
And my lining was a nice 13mm triple layer.

I wasn’t able to answer the phone when the nurse called (I was watching the new Harry Potter movie, WOOT), so I didn’t get my E2 for today… but they are dropping me down to 100iu of Follistim today, then having me trigger tomorrow evening. (I’m not going in for another U/S – just triggering tomorrow evening.) Transfer will be Saturday! That makes me very happy.

And now I’m seriously considering bed. I have so much to take care of the next two days…. but I am really, really looking forward to my retrieval on saturday and then sunday-monday-tuesday of a nice anniversary vacation in Boston with my hubby. No work. I may turn off my phone (except I can’t, because I’m going to be waiting for news about transfer). I’m just going to relax. And I hope I feel better this time around after retrieval, because we plan to be walking around Boston…

I’m sitting here at my client’s waiting for the phone call that will tell me when to take my trigger shot tonight (and therefore when my surgery will be on Saturday). It’s making me feel a little queasy… not because the phone call will reveal anything catastrophic (it’s just the trigger shot, after all) but because the last time I was sitting at this desk waiting for a phone call from the nurses it was the fertilization report that smacked me across the back of the head with the force of a steel beam. So yeah, the memories aren’t very fond. I am extremely happy that my retrieval is going to be on a saturday… so we’ll get the report on a sunday and the news of our transfer date both while we’re away. Yeah, bad news could make our vacation less happy, but at least I won’t be at work.

But regardless of any of that, my stomach is upset today. And for the past two days or so I’ve been feeling more than twinges in my ovaries… particularily my left. Strong twinges… painful. It comes and goes. I notice it most when I’m laying down to sleep on my stomach, and when driving in the car. Urk. Bumps are bad.

I’m going to have to read my entries about my previous retrieval to remember exactly how I felt the day of retrieval and the days after. Den is under the erronious assumption that we are both going to be spending Saturday (after my retrieval) cleaning our house. I have a far different view of the day: me, in bed, sleeping. I figure I’m not going to argue with him about it until Saturday when I actually do feel terrible. (I can turn into SuperBitch when I’m feeling bad, and he’ll quickly realize it’s in his best interest to leave me alone.)

I’m kind of sad I didn’t have an ultrasound and blood draw today – no E2 number to put in my handy chart. The appointments give me something to look forward to instead of just waiting. However it’s probably a good thing for my arms… I have matching bruises on both arms from my last two blood draws. So sexy.

I went through the anger phase. I went through a very hopeful, peaceful stage. Now I’m just at the sad stage.

I don’t know what to think about this cycle. I never thought a second cycle would be so hard… no, I never thought there would be a second cycle, and that’s the problem. I’m still so stunned to be here. My spirit is pretty squashed at this point. The first failure is always on my mind, reminding me not to be too positive about this cycle. Reminding me not to get my hopes up. Not to get my heart broken.

I’m scared. The last time the dropping shoe caught me so off-guard. Now this time I know in my head that we’re doing ICSI and that it should be so much better this time… but I’m nervous, waiting for the bad news. I want a 5-day transfer, but I won’t be expecting it this time.

I’m not just scared that it won’t work this time… I’m scared of what will happen if it doesn’t work. I don’t know how much more I can do right now. This whole cycle has been strange in a way… I feel like I’m struggling to keep up. I both want to be here and don’t want to be here. And if this cycle fails… I just don’t know if I can do another one. I wonder if my mental fortitude for IF treatments has run its course for now and I just need to move on. In a way we just started – since we just found our problem – but emotionally we started a long time ago.

Not to mention we can’t afford another one. Hopefully we’ll have frozen embryo transfers to consider – but again, there’s that voice in my head telling me to just aim for a transfer of two good embryos, any frozen is a bonus. And FETs still cost a chunk of change – a chunk that we simply do not have right now.

I’m certainly not ready to give up for good. But I do think I will need a break – I don’t even know how long of a break. In a way I’m scared of that too… scared of where that would take my life. Pregnancy and babies and parenting… it was a topic that I was and am willing to devote myself to for a very long time. I have a lot of friends on forums and blogs and I worry what would happen if I dropped out of the game. In a way going on an extended break would necessitate me stepping back from all of it – because I can’t be there, immersed in everything, and not be actively working towards it. It would be a constant reminder, and a break would require a break mentally and emotionally.

Then there’s the fear of, what would I do with myself? I have two main “projects” in my life right now – building my business, and infertility. Maybe I should just focus on this fledgling business of mine and stop working it around treatments? That’s not how I pictured my life. I’m not really the career-driven type. I love what I do, and I want to excel at it – but in no way do I want to devote my entire life to it.

And then my mind turns to my husband. I am 24 and have plenty of room for long breaks and soul-searching and healing. But my husband is already 41. Is it weird that I hear his clock ticking instead of my own? My husband is patient and supportive of everything that I do… but I feel his pain. I feel his panic that time is slipping past. Sure, men don’t have their sperm deteriorating like women do with their eggs, but he already feels old to be having a newborn. He doesn’t want to be 50 with a new baby. We were going to have kids – or at least be pregnant – by his 40th birthday. And I know he gets more depressed each year that goes by.

I don’t even know what I’m trying to say in this post. I’m not really in a good place right now. not a bad place – but not a good one either. Today was not a great day, emotionally. I was feeling very run-down, very strung out, and very close to a meltdown standing in the garage at work. Plus, making matters worse, carrying some supplies inside resting against my stomach was unpleasant, and my stomach was already quite upset with lunch, so I spent a good part of 2 hours trying not to barf. Like I said… unpleasant.

The other day I was standing in our yard letting my dog do her business, and I was staring down at my stomach. It’s… large. I was still standing there staring when Den came out with his dog.

“Do I look three months pregnant?” I asked. “Or four?”

“Oh shush you. It’s bad posture.”

“Honey, it doesn’t matter how I stand.”

“Stop it.”

I stood to the side to show him, and patted my large belly.

A pause. “Three months.”

To say I’m bloated right now is only skimming the surface. And unfortunately for me, my injection sites are a little sore as well. I am really loving skirts right now. Jeans with a belt are the absolute worst, and my tight-waist-band work sweats aren’t doing me many favors either.

::

I feel sick this morning. Last night Den and I were in the kitchen getting some food to eat and I kept having these chest pains… it started in my stomach and went right up into my chest. I’d make a face and stop what I was doing, and then just like that it’d be gone… until a couple minutes later when I’d have another one. This morning I just have a very upset stomach. (And a twinged tendon/muscle in my foot, but that is totally unrelated.)

Plus I’m really horny. And we can’t have sex. Thanks, trigger shot.

We’re back from our very-early-morning retrieval. We had to get there at 6:30am, for a 7:30 retrieval. The nurse went through all the paperwork and questions, we joked around for a bit.

I told her about my previous IV horrors. She said she’d check out my veins and if she thought they were going to be hard she’d leave it for the anesthesiologist. So she checked my left hand and I showed her where they did it last time. She decided to use the smallest needle and no lidocaine… it hurt going in, but hot damn she got it on the first try. Thank you! I still hate IVs, and they make me feel like I can’t move my hand at all (when I move my hand I can feel it a little and it creeps me out), but this one was the best I’ve had.

Then it was only quarter to 7 and we ended up just sitting there for over half an hour. Den was barely awake and kept asking me why we came in so early?

The anesthesiologist didn’t show up until 7:25. He introduced himself, took the paperwork from my file that he needed, asked me if I had any problems with anesthesia, checked to make sure I had an IV, then left to get ready.

As the clock ticked past 7:30 with no Dr I started getting panicked and running all these scenarios in my head. What if she didn’t show up? What if she was really late? My retrieval would be totally screwed. Den saw the panic in my eyes and told me to try to relax. (I tried.)

Finally the Doctor showed up at about 7:32. The anesthesiologist came over and put something in my IV. Nothing happened at first. They wheeled me down the hall to the OR and I started feeling a little light-headed… that fun drunk “everything is so cool” feeling. They got me onto the bed/table in the OR, had me lay down just so, put an oxygen mask on my face. I remember all that happening, but it was pretty dream-like. Then I happily succumbed to the anesthesia. (I was looking forward to that all day. For someone who deals with anxiety like I do, being loopy and knocked out is just fabulous.)

I woke up slowly. I didn’t want to wake up. I remember opening my eyes and looking around, then closing them and trying to go back to sleep. I was so comfortable there, so tired, so happy to still be woozy. I heard my husband comment that I was coming out of it a lot slower than last time. (I bet that was mostly because I didn’t want to wake up.) Then Den started whining at me. He was tired and he wanted to go home. Hurry up Nat, wake up. I tried going back to sleep anyways, even though I was feeling more “with it”.

My doctor came in, I think, reassured me that ICSI this time will make a big difference and that the embryologist would be in to let us know how many eggs they got.

The embryologist told us we got 13 eggs. I know both Den and I felt this wave of disappointment. Last time they got 24 eggs. They dropped my dose down slightly to prevent the OHSS I had last time, but I had the same number of follicles this time as last time. I guess they weren’t all useful.

I’m pretty disappointed… and worried. I keep telling myself that ICSI will make a huge difference. But really, how many embryos can we expect from 13 eggs? How many will survive? We might be looking at yet another 3 day transfer and that just makes me so upset. I want a 5-day goddamnit. And we needed a ton of embryos to freeze for backups.

I guess we just hold our breath until tomorrow’s fertilization report. That will really tell us where we stand.

Anyways, after that news the nurse got me crackers and tea, both of which were very good. Den was getting progressively more whiny and impatient and it was starting to irritate me. The nurse helped me into the bathroom so I could pee. I had some red spotting, which she said was completely normal. She then removed the IV and said I could get dressed and go.

The way home I was talking about this and that, mentioned breakfast (I was hungry). Den, already whiny and tired, was getting annoyed with what seemed like every other driver on the road (which isn’t entirely unusual with him). When I asked what he wanted for breakfast he snapped, “I want to SLEEP, Natalie. I just want to go to bed!” So we didn’t stop for breakfast. Now I was irritated. I mean, seriously, I’m the one who just had surgery, and he’s all freaking cranky? I wanted to smack him. and I guess he realized it because when we got home he cooked me breakfast (eggs). Now he’s asleep and I’m heading there myself.

I’m really glad we’re going away for a few days. I just need a break, I need to get away. I want to enjoy myself and not sit around and wonder and worry how everything’s going to turn out. I’m also really glad my parents are arriving on wednesday. That will be a great distraction for the 2ww.

I’m not going to be bringing my laptop with us to Boston. I really do honestly need a break from work and everything. I’m taking my camera, so expect a ton of photos, but unfortunately I’ll have no way of updating everyone on our fertilization and transfer date until we return tuesday evening. I’m going to try to set up a post-by-text message function so I can send a quick text, but I don’t know if it’ll work.

Well I’m not feeling as good as I had hoped. I had a bit of cramping this morning though nothing much to complain about. When we got home I felt good. Then I had a nap. I woke up with a sore stomach… I feel very bloated. I had to pee really bad, that didn’t help – it was almost painful.

So for the rest of the day I’ve discovered that standing/walking isn’t too comfortable, but laying/sitting down is fine. I feel very tender inside. Very tender. I also have felt a little aching down lower, from what I can only imagine is where they went in? I just had to go to the bathroom (not to pee…) and oh BOY did that hurt. I don’t know what happened, but for a few seconds there was lots of pain down below and I was sucking in my breath. Then I was fine. Weird, weird.

Den’s been pretty good today. Very good, actually. When I woke up from my nap I found that our breezeway – a previous disaster zone – had been in large part cleared out. I was happy, since I’d been asking him to move the big cupboards for quite some time. Then he turned me and pointed and I saw… a clean litter box!! I was downright SHOCKED. Den has never, ever cleaned the litter box before, not once! He says he’ll do it when I’m pregnant, but not before… and here he goes and does it today! It was very sweet of him. :)

We’ve been sort of cleaning/packing today. Since I’m not up to much moving around I stationed myself on the bed and went through all the dirty laundry. We picked out the clothes we want to pack, then Den wrapped the bottom of our (still leaking) washer with dirty towels and did one load of laundry. It went fine, I suppose. The towels soaked up most of the leakage. And we have clean clothes now, which is really exciting for us at this stage.

After they were all dry I made up several outfits (you know… skirts, shirt that match, socks that sort-of match) and packed them all into my backpack. It’s going to be interesting, since we’re leaving tomorrow morning, we’re driving most of the way in and then taking public transit. And I don’t think check-in is until 4:00pm with our hotel. So we plan to be tourists and just walk around and see stuff for a while… which means any luggage has to be pretty light and fit in my backpack. Except my camera, I’m going to be carrying my big camera around the entire time.

Den’s actually going out tonight, to see his brother’s band play. I declined to go with him. ;) I think I’d be in pain if I stood for more than 15 minutes…. and I am certainly not up to dancing. I’m capable of fending for myself here with the dogs. I’m just really hoping I’ll be in better shape tomorrow, or it’s going to be a really rough vacation for me!

Anyways I had better take care of a few more business things tonight while I have time. I did manage to get this blog set up to post from my cell phone so I’ll post a short message when I get my fertilization results tomorrow.

Kel here… Got this text message from Nat this morning, she asked me to post it for her.

This is completely unbelievable. Out of 13 eggs, only one was mature. It was ICSI’d. We have one embryo. Transfer will be Tuesday.

Thanks to Kel for posting my quick text message… of course after going to all that work to set up posting from my cell phone it was returned as undeliverable. (Talk about adding insult to injury, I’m sitting in the car, thoroughly upset, tapping away at the phone for a good 15 minutes and it won’t send it.)

So yes, the initial phone call was from the doctor herself giving us the news that of my 13 eggs retrieved, only 1 of them was mature. She asked me questions about the HCG injection I took to confirm that I did it correctly (I did). She said it was “very unusual” for this to happen and it sounded to me as if she just didn’t understand it and thought that something went wrong. Den immediately blamed the change in dosage – this cycle they dropped from a starting dose of 150iu of Follistim (in cycle 1) to 125iu this cycle. He was uncomfortable with the change from the start, though I was not. I understood that last time I stimmed quickly and coasted at the end, and this time they wanted to avoid that and the (mild) OHSS I had last time.

Den and I talked it over – well, talked and then sat in silence for a good 10 or 15 minutes, just feeling the weight of failure and disappointment… dealing with the fact that there would be no 5-day transfer, there would be no FETs, there would be no second chances. On the phone the doctor mentioned “next time”. I was too stunned into silence about the whole thing to yell “there won’t BE a next time, you IDIOT!” They really did NOT seem to grip the full reality of our insurance situation – two IVF cycles. That’s it. We will now be facing some very serious financial considerations if we want to do it again.

Then I started wondering about last cycle. I put in a call to the nurses and asked them what my egg maturity rate was last cycle – that at least would tell us if it was something specific to this cycle, something we changed or did wrong this cycle that caused this. I got a call back the next morning with my answer, and the answer made me very, very angry. Last cycle I had 24 eggs retrieved. Of those 24 only 4 were mature, and two of those were “dead”. We had 2 alive, mature eggs, and BOTH of them fertilized without ICSI, and made it to transfer.

Why were we not informed of this last time? Why was this NOT taken into consideration when deciding our protocol for the second cycle? Someone fucked up, that’s the only conclusion I can reach here. They erroniously assumed that a fertilization rate of 2/24 was due to the sperm not penetrating the egg, when in actuality it was because the overwhelming majority of my eggs were immature to start with and never even had a chance. Furthermore, 100% of the available eggs successfully fertilized! If we had done ICSI last cycle it would not have changed the outcome!

So WHY in god’s name did they think ICSI would change our situation this time? In fact, by knowingly reducing the number of eggs available in total they reduced the number of mature eggs as well. Basically, they did exactly the wrong thing. They made our situation WORSE, instead of better. We know nothing more than we did last time, and we really didn’t stand a chance. And this entire cycle failure could have been prevented had they simply looked at the egg maturity rate of last cycle – data which they obviously have on-hand, since the nurse was able to retrieve it for me without a problem.

We feel like we just got cheated out of an entire fucking cycle. Our LAST fucking cycle. It was nearly a complete bust, and it was a preventable situation. Now maybe it could not have been “fixed” – I don’t think they really know what to do. But they could have done SOMETHING. They could have increased my menopur, or stimmed slower, or done more ultrasounds, or triggered differently. Who knows what they could have done, but they could have done something, ANYTHING, aimed to mature my eggs. They did no such thing.

So Den and I are far past feeling upset and disappointed… we are angry – very, very angry. I took two valium when I got to the transfer, which I think helped me just push it all out of my head and chat with the nurses (I don’t blame the nurses, or the U/S tech – well, not really) and try to just meditate and remain calm through the transfer. Den on the other hand sat on his stool with his arms crossed, glowering and not talking to anyone. He told me later that he’s feeling so angry he found it extremely difficult to be civil to anyone. He made a few snappish comments in response to comments made by the nurse – such as, when one of the nurses said something about, “Next time….” Den retorted with, “We won’t have to worry about that for a long, long time.” I don’t blame him. I did wish he could have mellowed out in order to help me mellow out, but instead I just held his hand and focussed on myself. He’s perfectly valid in feeling the way he does.

We did really push for a 5-day transfer. Den and I talked about it and our feeling is that we’d rather have the embryo arrest in a petri dish and end our misery early, rather than transferring it earlier and then living in this horrible state of limbo for nearly 2 weeks, only to have it fail anyways just like last time. I know that this is in large part influenced by last cycle, how we had 2 good embryos and far too much hope, and we were completely crushed when it didn’t work. We don’t want to go through that again. There were parts during Sunday when I didn’t even want to have a transfer. I just wanted to walk away.

And to be fair the nurse and the doctor did discuss it and even talked to the embryologists, but everyone agreed that a 3-day would give us the best chance of pregnancy… that some embryos don’t do well in a petri dish, but would do better in the uterus. I know other IVF labs around the country are doing 5-day transfers no matter how many embryos there are, but our lab uses 5-day to weed some out to hopefully pick out the “best candidate”. Since we only had one candidate, to them there was no benefit to going to 5-day.

We obviously did end up leaving Boston at 8:30am this morning and driving all the way back here to the IVF lab and having our transfer. The good news – the one little bit of good news through all of this clusterfuck – is that our one little embryo developed into a very high-grade 8-cell and they said it is “compacting”, which is the precursor to becoming a blast.

Not that we are holding out a whole lot of good feelings and hope about it. Last time we had one 8-cell high-grade embryo and it flunked the implantation test.

We still need to decide on a name for the embryo. Den suggested “Han [Solo]” but I want something a little more…. meaningful and reflective of the anger and disaster.

It is time for bed here, but I wanted to post and let everyone know how very much I appreciate your comments and support. You are all just so wonderful. It’s good to know I have so many people backing us, and feeling outraged on our behalf.

I’m feeling very emotionally unstable lately. Our trip to Boston really was wonderful for the most part, but there were some hours where we’d just walk randomly around, not even knowing where we were going, as I ranted outloud about the whole damn situation. Den’s a good listener. And he did a little bit of ranting too.

I am just feeling so… well, disappointed doesn’t even come close to the emotional black hole I’m feeling… about how poorly this cycle went. Last cycle was a total shock but we thought we finally had the diagnosis and the answer. What do you do when the answer is wrong? How do you handle that? Last time we consoled ourself with, “Well next time we’ll do ICSI and it will all be okay.” That was my mantra. At least we have ICSI. So what now? What happens when your miracle cure turns out to not fix anything at all? I am panicked. I am lost. I don’t have the answer to this one, and neither do they. If we do manage to somehow get supplimental insurance to cover more IVF tries, or we take out a second mortage or whatever, all we’re looking at is trying random things to see if they can increase our odds. There is no “this will fix it”.

And not only that, but quite frankly my trust in the clinic is shot. They let us down in a very major way, and no matter what “fix” they propose, what change in our protocol, I’m going to be constantly second-guessing. I was doing so well with just relaxing about it all and trusting in the doctor to do her job. I am always a self-advocate and always questioning, but I never imagined this.

So now I’m looking up other clinics. The next closest one, according to SART, is 29 miles away – that’s over an hour drive. And that’s the only one. Beyond that there are 3 at an hour and a half. I don’t know how we could pull any of them off, to be honest. I guess one hour isn’t too too bad, but driving in for monitoring would pretty much shoot my entire day to hell. And with only one vehicle… I have no idea how we could manage it. No idea. It really sucks that we have so few choices here.

Another option is switching doctors at the clinic we go to – there are 4 RE’s, one of whom runs the place (and I’m not sure he actually takes in patients). But then you’re still dealing with the same clinic, and the added guilt of switching doctors.

But before we can do any of that we need to have a discussion with our current RE and somehow find a way to afford another cycle. It was mentioned to me that I could get my own insurance through massachusetts – which is a mandated state. (Connecticut, where our current insurance is located, is also a mandated state but they allow limits placed on it, which is what we’ve run into.) Now this supplimental insurance could run us as high as $600 a month, but that’s still cheaper than $12,000 for a fresh cycle. And with my business bringing in a little bit of cash right now I could possibly afford to pay it.

Anyways, I guess that’s all something to worry about another day. I will be making the appointment with the RE (hopefully they can code it as a “follow-up”) so we can sit down and get some freaking answers. An apology. Hell, maybe they’ll actually surprize us and give us a discounted or free cycle. (Somehow we doubt that.)

I will be writing up a post about our Boston trip for my other blog, plus uploading and sorting through the hundreds of photos I took while there (I am not exaggerating – I took well over 300 photos), but that will have to wait until who-knows-when. I have to work tomorrow to get caught up, then do some grocery shopping and pick up a few necessities like extra pillows for my parents, who are arriving tomorrow evening at the nearby airport. I’m really excited to see them, and am hoping that spending time with them will help me put all of this out of my mind.