Wednesday, April 25, 2012

Math and sperm don't mix

We had our first taste of for-profit reproductive medicine on Monday with our IUI. The waiting room at the Swanky Place was bigger than the entire clinic at our other place. The chairs in the waiting room were super contemporary and everything looked stark and white and clean and expensive. And I swear to god they only hire beautiful people there. Seriously.

Somehow, my blood test results (and Devon's... which I don't really understand why both clinics need Devon's STD report, but alas, it's nicer than not being treated equally) had gotten lost by our clinic when they were sent, but I got a call first thing in the morning from Swanky Place to let us know that they'll take care of finding them and will approach our provincial labs directly. We had a lot of paperwork to fill out, but all was easy and smooth, considering everything.

The nurse was lovely and apart from the speculum yanking me open, I didn't feel a thing. I didn't even know she had done anything until she stepped back and turned the light off. I don't know what the hell my nurse at our regular clinic does to me and why it hurts so bad, but I hope I don't have to endure it again.

I decided to cancel the ultrasound on Monday morning, simply because it wouldn't have changed anything, and why get two things up your youhoo when you can only get one? I really wanted to see how I responded to letrazole, but I also felt like I just needed to trust the Universe on this one. I had a really horrible morning at work (this whole week has been awful), so I just ducked out at noon and made sure I relaxed before the IUI.

Everything felt good... until we got the sperm preparation report. I still have not figured out what it all means, because they measure things so differently than our other clinic. We usually get the post-thaw results which include p.H balance, volume, sperm motility (rapid progression, slow progression, non-progression, immotile, sperm concentration and number of motile sperm) along with the final volume, final motility and total number of motile sperm. Our donor usually comes in post-wash at about 15 million.

Swanky Place measures both the semen characteristics (volume, concentration, motility - rapid, slow, non-progressive, progression grade and total motile sperm) and sperm preparation characteristics (volume processed, final volume, final concentration, motility, progression grade and total motile sperm). Our sample ended up being 2.7 million (written as 2.7 x 106). Now I am trying to figure out if it's just the way the figures are written that I don't understand (I have a real-life math deficiency) or whether it's a horrible sperm sample.

I'm really confused because the motility was way better than we've ever had, but the final volume was almost 1/3 less than our usual volume. We always have about 0.6 ml and this IUI was done with 0.2 ml. I don't actually get what "final concentration" means... because that was 23.2 million.

The sperm bank guarantees 25 million prior to washing, but I don't know what happens when it's then released to a third party who has the potential to fuck it up. And I don't even know if the sample really was as little as 2.7 million... it just doesn't seem plausible... and the nurse didn't seem that concerned about it and in the moment. I didn't question it because it takes me minutes and minutes to figure out math stuff in my head and I was lying half naked on a table and just wanted everything to be over.

If it was only 2.7 million, I know that's a horrible number. I hope I'm just being dumb and overlooking something super simple. I know "it only takes one," but I also know that sperm quality is one of the most important things in fertility and conception. I'm also trying not to freak out about it and again, just trust the Universe, but I also want to know if it's worth trying to get our money back from the bank (though it's a tedious process that involved your doctor having to do work).

Anyway, all in all, Swanky Place was nice and it was wonderful to have Devon, me and the nurse fit into a room comfortably, but I miss the people at our clinic, and that's what keeps us there. They have become like family and I wouldn't feel right leaving them. Even if one of them does hurt me every time she comes near me (is that weird?). I also adore my RE and wouldn't dare leave him. Even for a beautiful doctor.

Monday, April 23, 2012

Today it is!

Didn't expect to have an LH surge on my own, and earlier than usual, but I'm very happy that our IUI is today and not tomorrow! I actually tested positive last night and again this morning, so I'm hoping I don't miss ovulation. I don't have my appointment time yet, but hopefully it'll be no later than early afternoon.

I actually have a monitoring ultrasound scheduled in a half hour, but I think I might cancel it. I feel like I just need to trust that this month is going to work and that the timing is good. I'm not sure I need the extra information just for the sake of having it... though at the same time, when you're spending $1000 a shot, perhaps a little reassurance is worth the discomfort. Ugh, I'm undecided. I kind of want to know how I responded to Femara, but I also know that the gel they use on the dildo cam isn't the best for having an IUI the same day. Maybe I need to let go and let the Universe take care of this one. Plus, why shove two things up my yoohoo today when I can only go with one?

I am hoping that the people at the new clinic are a little gentler than our one nurse at our old clinic who always hurts me.

Yikes, why am I so nervous about this one??

Saturday, April 21, 2012

IUI on the first date?

We are gearing up for an IUI this week and hopefully this girl will live up to the lesbian mom title in her blog name soon. It's getting a little tiring logging in to Blogger and seeing that I still only fit one of the three words that I've chosen to describe this space. Ah well. Let's hope this is it.

I've been able to do some de-stressing, though work isn't getting any easier though I am trying to focus on the good. Devon and I had some issues to deal with these past few weeks, which rarely happens, and I think didn't help the situation, but we've done some talking and worked through the issues and are on the right track.

How's that for vague. Oy. Really, it's nothing. Moving on...

I'm going to call our clinic to book an ultrasound for Monday morning (CD14) if I don't get a positive OPK tomorrow. I'm a bit torn: There is one day a month that Devon cannot get out of work (full board meeting) and that one day this month is Tuesday, which is probably when we will be doing the insem. It's tough - I always want us to be together for it, but it's just something she cannot get out of. I don't think I'd care as much as if it was our old clinic, but it's the first time going to a new one and within 5 minutes of meeting some stranger, I'm going to be naked from the waist down on a table with him/her in my cooch. I'm kind of nervous about it, but trying not to put much energy into it.

If we still don't test positive on Monday, I'll speak with my doctor about whether it looks as though we might make it 'til Wednesday afternoon (triggering Tues night if I haven't had a surge) but I'm guessing I'll be good to go before that and obviously don't want to risk missing ovulation.

If there is anything that has been the most challenging about this process is the lack of control. I am a planner and have a clear vision/idea of what the week/month is going to look like... so when I am a slave to my reproductive system and have no choice over the matter, it's really hard. I actually have an event at work on Tuesday afternoon and had to do something I absolutely hate doing: Ask for help. I told my boss I had an appointment but won't know which day until the morning of and there is no way I can get out of it. She's not happy, but she's agreed to cover, if needed. I just have to be okay with that kind of thing now, which is so not my personality.

I don't like the thought of doing the IUI alone this month, but I am happy that I'm back on the TTC wagon. Please send me some non-Tuesday vibes :)

Tuesday, April 17, 2012

Stress in early pregnancy

Thank you so much, as always, for your comments about the IUI timing. I'm feeling a lot better about it and am going to try to be more aware of my own personal timing for ovulation. We've been using the digital OPKs because we had trouble reading the strips (I tested positive 6 days in a row the first month), but perhaps it's time to try to find another brand.

We're probably less than a week away from the next IUI, and I finally feel like I'm back on the TTC wagon. I never thought one month off would feel like eternity, but it has. Possibly even more so because it was not our choice to take a break.

Work is kicking my ass right now. My colleague's mat leave replacement doesn't start for another month and essentially I've been working two jobs since she left in February. My director is under a lot of pressure (and just had a really bad review, which unfortunately didn't wake her up to anything) and she's taking it out on me. I am so not happy with her, or my job, right now. I'm extremely overwhelmed at work and working in PR/Communications, everything is now, now, now. Except when they can't be... like the press release I just couldn't get out the door today, so have to tackle first thing tomorrow, which was supposed to be a day dedicated to other time-sensitive tasks. I've had some things going on at home too, and haven't had a stellar week in my personal life.

Ultimately, I'm ridiculously stressed. Which isn't great, but it's fine if it's just me. It's hard, but I can handle it. But I'm worried that work won't let up and may be like this for a couple of months. And in that couple of months, I really want to get pregnant. I imagine once I tell my director that I'm pregnant (hopefully in July, if this month is our month), she'll go a little easier on me, but what until then? I wouldn't feel comfortable telling her before the three month mark... actually I don't feel comfortable telling her at all, considering our department's situation, but I'm sure I'll work up to it when I have to. But quite honestly, I can't imagine this level of stress willlead a burrowing embryo to want to stay anywhere near me.

I could leave my job, but I really don't feel good about starting a brand new job and leaving seven months later. Plus, PR/Communications jobs are really hard to come by in this city. I actually love my job when it's manageable. I do not have a good relationship with my director simply because I don't actually think she's human. Everyone (including her peers) have the same problem with her. But other than her, my colleagues rock.

I know there is no point getting stressed at the possibility of being stressed, but considering my mental health history, it's worth thinking about what steps I can take to lower my anxiety levels so that my uterus is nice and welcoming for baby. Just not sure what those steps are yet.

Saturday, April 14, 2012

IUI timing with frozen sperm

The new clinic has a completely different protocol for scheduling IUIs than our other one and it's throwing me off a bit.

At the new clinic, I am to call before 8:00 am on the morning that I test positive on an OPK and they will schedule me for the IUI that same afternoon. But doesn't it take anywhere from 24-36 hours to ovulate after testing positive? And doesn't previously frozen sperm die within 6-12 hours? Doesn't that timing sound a bit off? Maybe I'm just used to doing things a certain way. I don't know. I'd be interested to hear from some of you.

The other issue I'm having is that for the last three cycles, I haven't tested positive with OPKs, but instead have gone in for an ultrasound at about day 14, injected a hCG trigger shot at about 10:30 am that day and had the IUI 24 hours after that. 

There is the added trouble that although the new clinic will do the actual inseminations, our old clinic will do all the monitoring of the cycle, so there is a disconnect there too.

So what if I go in for an ultrasound at the old clinic, they tell me I'm ready, give me a prescription for the hCG shot, and I'm not scheduled for my IUI until 4 pm the next day at the new clinic (they only do IUIs in the afternoon, except on weekends)? I'll have missed the boat. But if I go in the same afternoon when the trigger shot is hardly registered within me, the boys will fizzle out and die before the egg is ready.

It's kind of hilarious - in a dark comedy sort of way - how ridiculously small the time window is for getting pregnant. Especially with donor/frozen sperm. We have a peak of 6 hours out of a window of about 72 hours where it could possibly be an optimal time. And to boot, it's $1000 each time to "try". Frustrating as hell, but we have no choice.

And I know the worrying is not making my stress levels, and in turn my chance of pregnancy, any better, but I just want to have a plan. I'm a planner. That's what I do. No-one at either of the clinics can really give me an answer, or at least any reassurance, for how the timing is going to work. My clinic just said to call them, tell them I'm going for a confirmation ultrasound, and do it that day.

All of this will be moot if I actually do test positive on the OPK, so let's just hope for that.

It's day one of Femara and so far no nasty side-effects, though it's only been a few hours. I also want to have an ultrasound to see how I am responding to the meds, and to compare with my response to Clomid (which is generally good follicle count wise, but my lining is shit). I trust everything will work out; I'm just anxious... and anxious to get going.

I got my prolactin levels tested again and it's only 1/3 of what it was when it was high. I went from a level 31 to a level 10. Not sure why they were so vastly different, but I'm not worried about it. Huh, not worried about something. Surprising.

Tuesday, April 10, 2012

Crying in a parking lot

Today is better than yesterday and even better than the day before that. I feel like I've been pretty negative on the blog lately, but I always wanted to be true to what was going on and have always used this blog as a sort of self-processing tool.

I started to bleed today, picked up my prescription for Letrozole, got a follow-up blood tests (results pending), picked up some chasteberry extract, and called the new clinic to let them know to expect me in a few weeks (protocol is to call on CD1). I'm interested to know if I can handle the Letrozole a bit better than the Clomid. Although my side-effects were bearable, my uterine lining really did suffer. I'm hoping this change is a good one. I just read over the government warnings and feel as though I'm about to ingest poisonous snakes with a lead paint kick, but you gotta do what you gotta do, right?

I'm not a crier. Even at my worst, when I was in psych wards on suicide watch, I couldn't cry. It's just something that our family never did and I've always been angry or self-destructive before I've shed a tear. But on Sunday, I finally lost it... and it took a really shitty circumstance to get me there.

Scenario: One of my very best friend's daughter's first birthday party. I am one of two people out of 35 at the party who does not have kids. Which sucks, but whatever... I was expecting it and felt prepared. My Absolute Best Friend in the whole entire world is there with her 16-day old son. I am sitting next to her while she is breastfeeding and my other Very Best Friend (whose daughter's birthday party this is), comes to sit next to me, literally leans over me and says to Absolute Best Friend, "I can't believe we're moms... isn't it AMAZING?!" To which Absolute Best Friend leans back over me and says to Very Best Friend, "Yup, and we have the milk to prove it!" And then they giggle and smile and share a very obviously motherly moment.

I had to get up and excuse myself to the bathroom. If it had been anyone else, I would probably not have reacted the way I did, but these are extremely close friends who I have talked to ad nauseum about the pain and frustration of this TTC process. I had JUST spoken to Very Best Friend on Friday about the overwhelming feeling of emptiness around not being a mother.

I tried to regroup, but I think the damage was done. It was near the end of the party, but left quite abruptly (careful to be smooth about it) and sat in the car in the parking lot and cried for half and hour. Everything from the last year and even before that just came out. The pain of not having what was being rubbed in my face was just too much. I finally exploded.

And then I came home and cried in front of Devon, who was really supportive and surprised me by saying that I wasn't overreacting (not that she doesn't support me always, but sometimes what I think of as a big deal is not even a small deal to her, so I wasn't sure what to expect).

I don't know. It just pushed me over the edge. And it also made me never want to talk with either of them about this TTC process, which I don't know whether is fair or not or whether I will follow through with that, but I think I just need to reel back a bit and choose who I open up to.

So, I will be more careful. Which sucks, but I can't risk this type of hurt. I've already stepped back from a social night with the both of them this week, and will put up some walls for the next time I see them.

But, as I said, today is better and I am really excited about this month's cycle. I'll just focus on that.

Monday, April 9, 2012

A few days of calming down and a follow up

I wanted to write a quick post as a follow up of my last one, which very understandably riled up a few people. I've had a few days to ponder over the appointments I had, and I do feel that I need to (or at least want to) reiterate and/or clarify that I passionately disagree with the views of my non-Western doctors. I by no means want it to come across that I believe that IVF kids aren't healthy and perfect. They are no different from the general population. In fact, as S from An Offering of Love pointed out, they could potentially be healthier because of the pre-conception and prenatal care and because they have parents who want them so much.

I didn't take offense to the comments at all. In fact, if anything, they've made me feel as though I'm not overreacting to the nonsense that I got fed earlier this week. And it is nonsense. And it's been making me mad and madder and madder than that. If I do continue to see these docs, I think I may have to do so for non-pregnancy related issues (which is why I started seeing them) and if they decide to feed me their opinions on IVF, I'm just going to have to be strong enough to say that I do not want to hear them.

Devon and I had a good talk about it tonight and I just let all of my frustrations and fears out and she was really good about reminding me of the fact that it is our choice and WE know the truth and the science behind the outcomes of IVF kids. [I work in a child health research institute for God's sake, so I really did spend the entire week reading clinical studies, and the only thing I found that has been proven is that singleton IVF babies can have a lower birth rate that singleton naturally conceived babies... and not even to the point where it's a health concern].

Maybe it won't come to IVF and this next IUI will work (I'm still waiting to bleed), but if we do go to IVF, we're not going to think twice about it. My body, our choice.

Thank you also for your comments about the elevated prolactin. I spoke with my nurse and picked up a req today for more blood work, which I'll do tomorrow morning, so we'll get a better sense. I'm looking for some Chasteberry stuff and will get going on that too.

Anyway, please know that I appreciated all of your comments and thanks for reading this follow up.

Sometimes, people (in this case, my doctors) suck and should keep their opinions to themselves...

Saturday, April 7, 2012

In Disagreement with the Docs

Long story short: I've been seeing a Naturopath who is not just a Naturopath, but a healer, with a gift of seeing and hearing and experiencing things that the rest of us can't see or hear or experience. You can't deny it once you've seen and experienced her. She knows things about me, my past, my future. Devon saw her for the first time this week and the next day, the Naturopath gave Devon a message from her (dead) mom, that could only have come from Dev's mom.

So when she is assessing me this week and stops, takes a step back, has her fortune-telling look on and asks me "What happens if you never get pregnant? What would you do?" my heart and everything in my body sank.

What would I do? I would break in half. I would not know how to move on from this place. I would lose all of the hope that I'm rummaging up inside of me to drive me forward every month.

I know she's just one person, but she's been right about so much. She then asked me to put as much energy into not being a mom than I am becoming a mom, so that I can have an "equal" head about it. I am not willing to go there. I am not ready to go there. I will become a mom. And I really, really hope I will become a biological mom.

To add insult to injury, both the Naturopath and my Chinese Medicine doctor (who I respectably call my witch doctor, and who is also quite tapped into things that aren't necessarily "there") are vehemently against IVF. In their experience in treating IVF kids, they've found that the kids aren't as healthy as the general population, that there are cognitive "wires crossed" and it's not fair on anyone to go that route. I know enough IVF kids - and I know enough about all of your lovely, healthy IVF kids - to know that this is not necessarily the case, but it is really hard to feel as though I would be going against everything these two women stand for.

I know it's my body, my choice, but I've built an amazing rapport with both of them. In tandem, they have essentially rid me of the chronic pain that no Western doctor could get rid of over a span of 5 years. They have both been working on me throughout this TTC process and I go to my witch doctor every day that I inseminate for acupuncture.

My Naturopath also wants me to take three months off. My body is tired. My hormones are out of whack. I am apparently in dire need of a break. But my fear is that I'll lose that hope I hold on so tight to, and that every month we don't try will be a month of wishing that we were. I'm also not ready to go there.

Additionally, the Naturopath wants us to find a known donor going forward. We have someone in mind, but have not been serious about the option (I'll save it for another blog post). I would much rather use an anonymous donor. It's easier. But apparently it's not working. And with a success rate of 7-20% per month, it's frustrating. With "live" sperm, our chances increase significantly over frozen sperm, but so do the risks, in my mind. And, I can't help but notice on so many blogger's TTC Timelines, that many start with a known donor and then move onto IUI after months and months of BFNs.

I am not closing the door on IVF, but I do hope it becomes a moot point. We will be trying an IUI this month, against my naturopath's orders. We will be doing it at a new clinic, as our clinic has been shut down until the end of April, at the earliest. We had to go through all of the consent forms AND the blood tests (which I JUST checked now... and huh - my prolactin levels are above normal. I don't know what that means... Dr. Google will hopefully tell me shortly), which was a pain... but apparently now a good thing, considering something may need to be addressed.

I'm just waiting to bleed and then we'll be on our way (unless there is a problem with elevated prolactin?). I just want to fucking try again and get all this shit from my Naturopath out of my head. Maybe just to prove her wrong.