herveryown

What Would You Do?

Now with 15% more polyunsaturated updates

We have a big decision to make and as there is no definitive right answer, I figured "What the hell, I'll ask the Internet!"

First, the facts:

I am thirty years old.  I have Endometriosis and PCOS, but no structural uterine problems such as scarring or shape abnormalities.  We have no male factor issues.  I am willing to cycle again, but clearly I have a history of OHSS, so it might not go too well.  We have six 'good' frozen embryos and our clinic has an 80 to 90% survival rate upon thaw.

Update:
Our embryos are Day Three.
We have one 4 cell, a 5 cell, and four 8 cell.
They range in quality from grade 1 (no fragmentation) to grade 3 (25 to 50% fragmentation).  Most of them are grade 2 (0 to 25% fragmentation).
They are frozen in pairs.

Now, during the fresh cycle, Dr. BrightEyes always discussed transferring no more than a single embryo because the risk of multiples would be too high, and neither of us are particularly interested in having twins.

We're not anti-twin or anything, we're just uncomfortable with electively starting a pregnancy that would be guaranteed to be high risk.  I haven't been hiding under a rock on Mars with my fingers in my ears or anything, so I know that a singleton pregnancy can carry a significant amount of risk as well, but given my current ability to rack up the reproductive disasters, a twin pregnancy seems like...well, just inviting asking for getting down on our hands and knees and motherfucking begging for trouble.

I'm fine with taking risks with my own health but am less inclined to do the same with my potential children.  If I spontaneously conceived twins, well, that would be...ha!  Yeah, me, spontaneously conceiving anything?  What the fuck was I thinking?  Anyway, we would be unlikely to ever transfer more than two, because we've already decided that we would selectively reduce high order multiples, and Dr. BrightEyes informed me that transferring more than two doesn't raise the pregnancy rate, but does increase the multiple rate.

Our clinic's fresh transfer success rate for my age group is about 60%.  Frozen transfer success rates are considerably lower, at 15 to 20% for single embryo transfer, 30 to 40% with two embryos.

When performing frozen transfers, our clinic typically transfers two because it raises the pregnancy rate.  Naturally, it also raises the multiple rate, but it's not a one to one correlation.  Transferring two carries a 30% chance of twins in the (somewhat unlikely) event of pregnancy.  Conveniently, there are no absolutes here.

Transferring two doesn't guarantee us twins, but it does get us a better overall chance of pregnancy.

While crunching the numbers, Dr. BrightEyes said "Sometimes it comes down to which bothers you more, the idea of having twins, or the idea of not being pregnant at all?"

I don't know.

Soper asked me what my gut said, and I said "My gut says 'Get these huge ovaries off my head!'  It's way too crowded in here."  "That's not helpful," Soper said.  She's right.

There is also one more factor at play here, and that is the nigh unbreakable Law Of Akeeyu's Fucked Up Snatch which states (among other things) that the chances of crotch related things going wrong, whatever they may be, should probably be multiplied by thirtytwelve, and that whenever there is a slim statistical chance of a medical disaster transpiring, I will end up on the wrong side of the odds.

So, what do you think?

If you have any particular experience with any of these issues, please leave your pertinent in/fertility vitals: Did you use ART?  Did you have a FET?  What were the results?  If you had twins or HOM, how did it go?  If you had twins, did they suffer any long term complications?  How long were they in the NICU?  How long were you on bedrest?  How close did you get to your due date?  Can you think of anything else we should know before we make this decision?

Please note: This is not the time or place for a nasty debate on selective reduction or the ethical issues of ART, so don't go there.  I will delete and ban people who can't play nice.

Thank you.

Needles and Pins

Somehow, my life has become Tom Petty's Greatest Hits.  If not "The Waiting (Is the Hardest Part)," (that perpetual theme song of the Infertile) then "Running Down A Dream," "I Need To Know" and "Breakdown."

So, I Need To Know: Exactly how bad is this hysteroscopy thing, anyway?

Here's the information I have: They're not going to knock me out for it.  I can eat and drink beforehand, so I would say they're not anticipating knocking me out, either.  They recommend I take Ibuprofen before the procedure, and that there may be "mild pelvic cramping" afterwards, and that I might want to have someone else available to drive me home.  Also, I'm supposed to arrive with my bladder "about half-full."  According to Dr. Google, "Nonprescription pain relievers may help ease discomfort. Women may want to take the day off and relax after having hysteroscopy."

I haven't taken Ibuprofen (for anything) since 2002.  No, seriously.  It never actually, um, works, and yet it tends to make me incredibly dizzy.  Does anyone else have this problem? 

Is the "mild pelvic cramping" bit accurate, or is that just their polite little way of saying "This might sting a little bit" prior to peeling me off the ceiling because they just did something insanely painful to my delicate feminine areas?

I'm not going to have anyone available to drive me home afterwards, so my usual pain management plan (sweet, sweet Percocet) isn't going to be feasible.  Sam has to work, and somehow, I can't quite picture myself calling up my inlaws and trying to bum a ride to a fertility clinic.

I'm alternately amused and bemused by the "bladder half-full" instructions.  If I'm a pessimist, does that mean I should arrive with my bladder half-empty?  Also, what the hell does that mean?  No, seriously.  There are times when I've needed to pee, and times when I haven't needed to pee, but I'm not sure it's ever occurred to me that I half-needed to pee.

Dr. Google just pissed me off.  "Take the day off and relaaaaaaaax" indeed, as if a hysteroscopy is a trip to the beach or a day at the spa.  If I'm going to take a day off work, really, I'd like it to be a day of fun, not a day of uncomfortable medical procedures.  Hey, Dr. Google, some of us work for a living and can't take time off every time somebody shoves a camera up our vagina, okay?  The best I can do is switch shifts and arrange to come in later.

So, am I kidding myself, or what?  Am I going to be clinging to a toilet bowl fighting waves of nausea and crippling agony afterwards, praying for merciful death, or do you think I can just dose up with Percocet when I get to work and be pretty much okay?  I mean, that's how I get through Endometriosis pain and my periods, and my periods?  They're bad.

Exactly how bad is this hysteroscopy business?

Irony Sale

Every spring and fall, it happens at least once: I walk into a department store and see winter coats and bikinis being sold side by side.

Apparently my body is having an ironic Clearance Sale of its own, or maybe (more accurately) a Scratch and Dent Sale.  We're overstocked!  New IVF inventory is arriving soon!  Everything must go!

Including, you know, this egg.

Yes, that's right, after the 123 day cycle, I have reason to believe that I ovulated a few days ago, following a frantic round of Forced Deathmarch Style Sex.

While I'm studying up on ART, getting my medical records and charts together and trying to figure out what the hell to say during the appointment, I'm smack in the middle of the dreaded/yearned for two week wait.  Furthermore, this means that the two week wait will end, if my calculations are correct, two to three days before my IVF intake appointment. 

Apparently, my body only coughs up an egg when there's a punchline involved somewhere.

Day 123

The seige is over! Akeeyu's Red Riverbank National Campgrounds is officially open.

This Is A What?

Hmm?  What's that you say? 

Oh, riiiiiight.  This is an Infertility Blog...in which I haven't been talking about my fruitless snatch.  What the hell?

Well, don't worry.  I'm not pregnant and being coy about it. 

I'm still as barren as the fucking sahara.

For those of you playing along on the home game, today is Day 121.  My chart thinks I ovulated last week.  You know, for the third fucking time.  Interestingly, my chart seems to think I've ovulated about every 30 to 40 days, but my vagina strongly disagrees.

Yes, I know.  See my doctor.  Get progesterone.  But see, I did that, and the progesterone didn't work.  I've gotten two appointments since then and have had to cancel them.  When I emailed to request a third appointment, I discovered that they have apparently stopped trying to get me in right away, and have scheduled me for mid September. 

I'd call and yell "Come on, September?  Is that the best you can do?  Have you noticed that it is currently July?" but...look, Day 121.  Clearly, my ovaries are pissed off about something, and I don't think getting a pelvic and another round of progesterone sooner rather than later is going to make a damned bit of difference.

What's the worst that could happen?  I could not get a period by the time my appointment rolls around and what, NOT bleed to death?  Ha.

I wish I'd known I was never going to ovulate again in my fucking life.  I would have quit using the Ortho Evra birth control patch a long time ago and saved a shitload of money treating those goddamned migraines it gave me.  Also, I'm currently having less bleeding now, completely off the hormones, than I ever did while on the goddamned patch constantly, back when the whole point was to suppress bleeding.  What the fuck?

I can't help feel a little uneasy right about now.  Sure, my doctors said that the Ortho Evra patch was the same as the pill.  They said it shouldn't cause longterm fertility harm.  They said that I should resume ovulation when I stopped using the birth control patch.  The question is, did they know what the fuck they were talking about?

Look at the articles!  Now they're saying that the Ortho Evra patch is worse than the pill, more likely to kill you (and interestingly, one article said that women with migraines shouldn't even use the birth control patch, something I'd never heard before).  The doctors are still saying it's safe.  They're also simultaneously saying that they're actually not seeing as many deaths as they would expect, but that we shouldn't worry, because we'll all know more when more women use the patch.

Keep using it, little guinea pigs!  We'll know more when more of you die!

Does this creep anybody else out?

Not creeped out yet?  Well, try this one.

So...we currently have a drug being given to women that might have significantly more and far deadlier side effects than originally thought, and the drug company's new head of research is a guy who has admitted to making shit up?

What the fuck is this, Freaky Bizarro World?

No News

Well, I got nothin'.

A big steaming pile of nothin'.

No period, no positive, no clue.

I also have Promethazine coursing through my body, due to the amazing technicolor nightmare migraine I had yesterday.  I also had it the day before yesterday, too, just for good measure.  You see, the Promethazine keeps me from vomiting when the pain gets so bad that it feels like my eyeballs are going to ooze right out of my motherfucking skull.

Now.  Why is the Promethazine significant?  Because I peed on a negative stick yesterday.  If you ask this website, it will tell you that Promethazine can lead to false negatives on home pregnancy tests.  On the other hand, if you ask this website, it will tell you that Promethazine can lead to false positives on home pregnancy tests.

If you ask this website, it will tell you that Promethazine plus home pregnancy tests equals one batshit crazy Akeeyu.

I'm not pregnant, so please, no optimistic commenting about how I might be, and that I should get a beta.  I mean it.  I have a delete button, and I know how to use it.  No, wait, actually I don't know how to use it, but I would learn.

The funny thing is, I'm not disappointed that I'm not pregnant.  Not really. I'm disappointed that I'm not having my period right now, because that means that I didn't really ovulate when my chart said I did.  There is absolutely nothing going on in my pelvis except a rather ominous increase in pain.

I've spent years arguing with doctors that merely suppressing ovulation was not the end-all be-all cure for eliminating Endometriosis pain.  They kept telling me that I should have been better because I was on continuous birth control hormones and that endometrial implants shouldn't act up in the absence of ovulation.

Once again, I am proving them wrong.  It's starting to look like the Endo is creeping back in the absence of both birth control AND ovulation. 

How do you think they're going to explain that one?

Second Verse, Same As The First

The arguments between myself, my chart, and my peesticks have continued to escalate.  It's getting ugly over here, people.

Any minute now, one of the neighbors will call the police and we'll all end up on Cops.  I can see it now: Mr. Stick will be dragged out of the house in a wifebeater shirt and a mullet, and Ms. Chart will be tagging along behind the arresting officer in her housecoat, yammering on about not wanting to press charges.

For those of you playing along on the home game, my temperature is still up, my Endometriosis pain is still absent, and yet the damned pregnancy test is still negative.  Yeah.  What the fuck?

In light of that, I have decided to jinx myself.

Tomorrow, I'm posting the 'bitter little bitch grousing about pregnant women' post.  Fuck it.  If anything's going to bring on my period, it's going to be that.

Disclaimer/Warning: Tomorrow, there will be grousing about pregnant women.  If you're pregnant (congratulations!), you may want to skip it.  Also, for the record, I am not talking about you (or you).  I am talking about women I run into in real life, not any of you fine ladies.  If that's not specific enough, fine, I'm talking about Expat, who said I could blame her.

Failing Chemistry

I am not pregnant, but I play a pregnant woman on my chart.

Ms. Chart says: "Well, Akeeyu, you're17 days past ovulation, your temperature is still above coverline, you haven't had any significant Endo pain for seven days, and your period is late.  You appear to have swallowed a watermelon seed."

Mr. Stick: "That's all very interesting, but you're not pregnant."

Ms. Chart: "Oooh, oooh, is it too late to change my answer?  I vote Chemical."

Akeeyu: "I vote you both eat shit.  Now, if you don't mind, I'm going to go to work, print  babyshower pictures and glare at pregnant women with my red, swollen, sleepless eyes."

Ms. Chart: "Wow, you look like crap."

Akeeyu: "So do you."

Mr. Stick: "You realize, of course, that carrying on a conversation with a piece of paper puts you in the running for Miss Padded Room of 2005."

Akeeyu: "Excuse me, I hardly think I need the advice of a talking pregnancy test."

Mr. Stick: "Good point.  Enjoy the bullet train to Crazy Town."

Is This Thing On?

So.  This two week wait thing.  This sucks. 

It would probably suck less if I had any reasonable expectation of, well, expectancy, or if I weren't such a lousy charter.  Meticulous, yes, but undeniably lousy, because although I carefully note and graph each significant symptom, I just have no damned idea what to do with such a conflicted chart.  My temps are up, they're down, they're sideways...my cervix is high, low, soft, overeasy, sunny side up?

In an attempt to take my mind off of this, I'd like to try a little Infertility Standup:

"Good evening, ladies and gentlemen.  I just came back from a pelvic exam, and boy, is my snatch tired!" (rimshot)  "Thank you, thank you.  Boy, I gotta tell you, I am so not pregnant..."

"How not pregnant are you, Akeeyu?"

"I am so not pregnant, I actually lost weight during the two week wait." (rimshot)  "I am so obsessed with my chart..."

"How obsessed are you, Akeeyu?"

"I am so obsessed, the other day one of my co-workers asked me what day it was, and I almost said 'Cycle Day 23'." (rimshot)  "But enough about me.  How about those SILs, eh?  Any of you ladies have pregnant SILs?  You, ma'am, in the front?  Your SIL is having twins?  No shit?  Waiter, get this woman a double martini.  She's drinking for not-having-two right now.  You'd love my SIL.  My SIL is so fertile..."

"How fertile is she, Akeeyu?"

"My SIL is so fertile, she called the whole family to tell everyone she was pregnant before the pee was dry on the stick."  (rimshot)  "I gotta tell you, though, ladies, I am just tired of this cycle.  I am so tired of waiting..."

"How tired are you, Akeeyu?"

"I'm so tired of waiting that I'm starting to look forward to getting my period.  Thank you, you've been a great audience.  Don't forget to tip your waiters."

Well, what say?  I believe it's Open Mic Night at the Buttmansion Abode.  Any of you fine ladies want to get up on stage?

Uncharted Territory

I am not sure what to say about this.

I've been off the patch for eight whole days and already, my chart, usually so perfect in its steadfast pointlessness, has gone insane.  Clearly, my body is returning to its regularly scheduled hormonal anarchy. 

I spend a considerable amount of time each day trying to learn how to be positive, trying to figure out what the right attitude is so that I can cram my head full of it, studying the books and websites for clues, signs, hints, that magical chapter that must exist somewhere, the one that says "This Will Get You Pregnant, Akeeyu, Guaranteed."  Instead I find pictures of the stages of Endometriosis, pictures of reproductive organs so distorted by adhesions and cysts that the ovary can only be identified by the nearby label, blurbs about couples who charted for seven days and miraculously became pregnant, accompanied by a helpful photograph of a baby.

Attention Writers of Infertility Books: Enough with the pictures of babies.  We all know what babies look like.  Also, enough with the helpful anecdotes about everyone else who is pregnant after charting, IUI, IVF, adopting, or (my personal favorite) relaxing.  We have a lifetime supply of these stories, courtesy of the entire fucking world.  We don't need to pay $14.95 for a whole new batch.

I am exhausted and depressed, which seems like a bad way to start trying to conceive.  It's as if I've arrived on the day of the big track meet and collapsed on those little toe-kick wedges five minutes before the gun is scheduled to go off.

I can feel the hormones bouncing around my body like a thousand superballs in an empty room.

I feel empty. 

Sam and I have not yet started the Forced Death March-style sex, but will soon, not because my chart indicates that we should, but because we might as well.  It seems like the right thing to do, just in case.  I mean, what the fuck, miracles could happen.  I could become pregnant the first month off the pill, despite the Endometriosis, and become an anecdote to annoy the crap out of others for years to come, right? 

In the meantime, I am not quite trying or failing to get pregnant.  I am not in any meaningful kind of wait.  I am not yet excited or devastated.   I am neither winning nor losing this battle.

I have not yet begun to fight.