Still Waiting

Still in the 2ww, with no news. My nipples hurt, I'm nauseous on and off through the day, I've had a series of bad headaches, and my temp is still up. Anyone else would say that, at 10dpo, these were all signs of pregnancy, but I had the same exact symptoms last cycle just from the increased hormones, so I'm not counting my chickens. I am glad to be home, where I can feel sick in the comfort of my own house, but mostly I'm just counting time until I know something definite. And reading holiday cards from all of our friends, as they recount the details of their growing children and newly-announced pregnancies.

Blech

Quick update from the in-law's house. I've been feeling tired and, most notably, nauseous, for the past several days. I'm carrying candied ginger around with me everywhere I go, and sucking on piece of it usually calms my stomach enough to keep me from throwing up. It's been particularly bad today, which has made it interesting, since we don't want to say anything to S's family.

I'm also still not positive that I've ovulated yet. The trigger shot was Monday, and I felt like I ovulated late Tuesday, but this morning (Saturday) was the first morning that my BBT was up at all, and that was just barely. Keeping my fingers crossed that everything is going well.

Egg On Its Way

The IUI was yesterday. Dr. M. had to use a tenaculum to "get traction" on my cervix, which, in addition to sounding rather disturbing, hurt like crazy and had me doubled up in pain (and spotting) for the rest of the afternoon. Last night, as I was going to bed, I felt a sudden, sharp pain from my left ovary, and this morning I can feel the "fullness" easing up, so I think that I might have actually felt myself ovulating. I'm still a little nauseous (from the trigger shot?) but feeling loads better than the past few days. Quite a relief, since maybe I'll be feeling close to normal by the time we leave for Christmas. In the mean time, nothing to do but down folic acid and wait.

Go, Little Follicle, Go!

My follicle scan today showed one mature follicle (19mm) so we did the trigger shot at 11am (last cycle, I barely noticed the shot, but this time it strung like crazy) and we have an IUI scheduled for 2:30 tomorrow. My uterine lining was a little on the skimpy side (7mm, putting it just outside the desired 8-13mm range, and I couldn't really see the three-striped pattern that we saw last cycle). Dr. M. said that it would probably be thick enough, but I worry sometimes that he just says that to try to paint a rosy picture. My web research seems to show that it's only a real problem if it's 6mm or lower, and it can still thicken after ovulation, since there are several days between ovulation and when the (hopefully fertilized) egg implants in the lining, so... I guess I have to cross my fingers and say "good enough."

Anyway, I'm a little disappointed that there was only one follicle (on my left side, like I couldn't have seen that coming), and I'm a little worried about the endometrial thickness, but overall not bad. Today is Cycle Day 14, so we're more on track of a "normal" length cycle, since the follicle matured several days earlier than last month. IUI tomorrow. Trigger shot should clear my system by December 25. Pregnancy test around December 30. So, we should know the result of the cycle by New Year's.

In the mean time, the hCG shot knocked me out for the day, took away all appetite, and made me fairly nauseous for the afternoon. By this evening, I was in a lot of pelvic pain, too. Another day of getting nothing done at work (kinda lucky I still have a job, at this point).

Okay, back to my regularly scheduled pelvic fullness....

Abdomen

The last 3 days or so, I've felt like my stomach was pumped full of air. This is different than the "pelvic fullness," which is definitely around my ovaries. This pain is higher up in my abdomen, and is making my entire stomach feel oddly firm to the touch (S. said it feels like I developed amazing body-builder stomach muscles in just one week). The bloating is coupled with overall pain, which feels like some sort of cross between over-eating and gas. Blech.

I've done some web searches, and of the pages I've found, half of them mention abdominal bloating and pain as a "normal" side effect, along with the hot flashes and headaches. The other half of the web pages take a much more alarmist approach, listing abdominal bloating in its own category, and urging patients to call their doctor. Annoyingly, they don't say what horrible condition the bloating is a condition of, to warrant such a reaction.

By last night, I was tempted to call Dr. M's office. But now I'm just trying to talk myself through surviving today on my own. We have an appointment tomorrow for a follicle scan, and if I can just talk to him about it tomorrow, I'll probably be fine. I hope.

Holy Night Sweats, Batman!

I woke up not just once, but twice last night completely drenched in sweat. I feel like I didn't sleep at all. I've had 3 hot flashes this afternoon alone. And, my usual ovarian pain on my left side is back, even this early in the cycle (today is Day 9). I also kept spacing out all day (not sure if it's the lack of sleep, the temperature fluctuations, or the emotional drain from the Clomid). Twice, in meetings, I realized that I had no idea what was going on, and got the distinct impression that I had just repeated something that someone else had already said. Woopee. All of this should keep getting worse, at least through Monday. Fun stuff.

On the topic of "pelvic fullness" (I don't know why I find that term so amusing)... the pain on my left side keeps getting sharper, though pressing on it gently makes it feel slightly better. (Last night, I made S. reassure me that I wasn't irreparably crushing our potential future children.) My left ovary is always the one that hurts, and it is also the one that Dr. M. has trouble "finding" with the ultrasound, so my working theory is that my left ovary is crammed into a bizarre nook where it doesn't belong, and at the least provocation, it starts kicking the shit out of my appendix. But that's just my theory.

Also, one quick rant: if one more person uses the phrase "But you don't even have kids!" to minimize my ability to be busy or stressed, I'll start throwing punches. I'm a full-time PhD student, I work 2 jobs, I do almost all the housework for my household, I'm taking care of a husband who is still recovering from surgery, and I'm dealing with infertility treatments. Yes, I assure you that even though I do not have children, it is possible that I have a lot on my plate! It seems to me that a reasonable, friendly response of, "Wow, sounds like you're busy! Me too!" would make sense. But my friends all respond with, "You can't be as busy as me - you don't have kids!" which has the double whammy of minimizing my stressful life AND reminding me of what I may never be able to have. Thanks a bunch.

Total Ditz

I can definitely feel the difference between the lower doses of Clomid and the highest one that I'm on this cycle. The hot flashes have been about the same so far (only a few mild ones, but history tells me that they should start with a vengeance tomorrow or Tuesday). The headaches have been worse. The crying jags have been much worse. In fact, the overall emotional effects have been off the charts; several times in the past few days, I've simply broken down, feeling totally crippled by hopelessness and despair. I usually snap out of it within the hour, but wow it sucks.

The new and exciting side effect, though, is the total lack of mental abilities. In the past few days alone, I have:

• broken down crying at my inability to open our front door, only to discover that I had never unlocked it.
• while conducting an interview, lost the ability to string words into sentences, stumbling and slurring repeatedly over the complicated question, "What is your favorite class?"
  
• tried to put a hot pan back into the oven without oven mitts, because in the 30 seconds it took me to check if it was done cooking, I apparently forgot that it was also scalding hot.
• while trying to measure olive oil, poured large amount of oil all over my hands not once, not twice, but three times in a row, before giving up in frustration and letting S. do it for me.

I've also completely lost the ability to do simple math. Or remember where I've left my keys. I'm not sure that it's safe for me to be operating a motor vehicle. If I thought that I could get away with it, I would call in sick to work for the entire week.

More Finances

For some reason, Dr. M's office has stopped charging us for appointments. Not that I'm complaining. It always made me vaguely uncomfortable to pay them for the privilege of being romanced by an ultrasound wand. So, for now, we're only paying for drugs.

Clomid prescription #3: $5

Total spent so far: $60
(plus the cost of many, many pints of ice cream)

When I picked up the prescription at the drug store, I found out that when Dr. M called it in, he authorized 3 refills, in case this cycle, and the next one, and the next one, all don't work. Very practical of him, I'm sure, but wow it made me want to cry.

Definitely Not

It is now official - my period started this morning, the cycle failed, I'm (still) not pregnant. I start the next round of Clomid on Thursday, this time at the maximum dosage. We're going to be cutting it very close as to whether we will be able to do an IUI this cycle before we leave for Christmas. If the timing is the same as last cycle, we'll be doing the procedure on our way to the airport; if I ovulate any later than that, we'll be trying the old-fashioned way (though still with pharmaceutical assistance), very quietly, in the guest room at S's parents' house. Woopee.

The stats thus far:
IUI#1 - Oct'07 - 50mg Clomid - canceled
IUI#2 - Nov'07 - 100mg Clomid - failed
IUI#3 - Dec'07 - 150mg Clomid - underway....

Probably Not...

I took a HPT this morning (approximately 11-12 dpo) and it was negative. My BBT also dropped a bit this morning, compared to the last week, so I'm not feeling all that confident about this cycle. I've been feeling increasingly crampy all day as well, and I've had a persistent headache since yesterday afternoon, all of which seems to point to my period starting soon. (But, as S. and I keep pointing out to each other, since I've never been pregnant, I don't actually know what early pregnancy feels like, so what do I know?)

For now, there's nothing I can do other than wait. Dr. M. had suggested waiting until Tuesday or Wednesday to take a HPT, so I'll plan on taking another one then (anything's possible, right?). But, if this cycle really has already failed, I'd rather just get it over with and move on to the next one. If my period starts in the next day or two, we might still have time to do another IUI before we leave for Christmas.

hCG Clear

I took a HPT this morning, which was negative, so I can be reasonably sure that the hCG trigger shot from last week has cleared my system. This means that when I'm ready to really test myself early next week, I can be reasonably sure that a positive result actually means something. So, one more week of waiting.

Today I also had blood drawn for a mid-luteal-phase progesterone level test. I was anxious about the results, since I've had short luteal phases before, but B. at Dr. M.'s office called late this afternoon to say that everything was fine. (She actually just said that my progesterone was elevated, so I definitely ovulated, but I already knew that much... I wanted to know whether it was elevated enough, which I guess is an assumed "yes".)

In other news, on and off I've been feeling vaguely nauseous all day. It's too early in the 2ww for it to be morning sickness, so it's probably all in my head, but still... what's up with that?

Turkey Weekend

We are back from spending Thanksgiving with S's family. Some highlights of the holiday:

• Watching the entire family fawn ceaselessly over the two-month-old that S's friend brought along. The baby was the main entertainment for the entire 4 day holiday....
  
• Bursting into tears the one time that I held the baby, practically throwing the infant at S. so that I could get out of the room before anyone saw me. (I don't think I succeeded. I think the family now just thinks that I hate children.)
• Listening to S's mother argue that she should get to hold the baby more than the other women there, because she doesn't have any grandchildren of her own.
• Being the only one to turn down the wine for a family toast, which seemed to then make everyone think that I'm already pregnant.
• Listening to the baby's mother commiserate with the other women over first trimester symptoms, then listening to the other women commiserate with each other over hot flashes, knowing that I have experienced the symptoms in both discussions, at the same time, in the last several months, but not being able to say anything out loud.
• Quietly suffering through cramps, headaches, and uncomfortably rising internal temperatures without saying anything, trying to act cheerful.
  

When we got home, I also found out that another one of our friends is pregnant. This will be their second, and they had to have the doctor estimate the due date because they weren't really trying, so hadn't been paying attention to timing. She's due in July, just after A. So, add yet another baby shower to the calendar.

As for me... my BBT is still up, but other than that, we won't know anything for at least a week. On Tuesday, I have a blood test to check progesterone levels, and I can start checking to see of the hCG shot cleared my system, but it will be another week after that before I know anything definite.

IUI!

We made it to an IUI! Woo hoo!

S. did his part this morning, we waited in the coffeeshop while they spun and washed his "deliverable," then did the procedure. Dr. M. had to use the large speculum in order to see my cervix, and then kept pushing it as far as he could, which was uncomfortable, but just like a bad pap smear. Inserting the catheter though my cervix, which is the part I was nervous about, didn't actually hurt at all (couldn't even feel it). We hung out with my hips elevated for 15 minutes, then came home to pass out on the couch and take it easy.

Next steps: in one week, I do a blood test to check my luteal phase progesterone levels. Around that same time, I can do a HPT to see whether the hCG trigger shot has cleared out of my system. One week after that (December 4) I should be able to take another HPT to actually see whether I'm pregnant. Until then, lots of deep breaths....

Trigger!

At my follicle scan today, I definitely had one mature follicle (19mm) on the right ovary. We're not really sure what happened to the other two slightly smaller ones that we saw on Thursday. They could have just been hiding -- the ultrasound today was really painful again, particularly on the left side, like in the first cycle, so once Dr. M. confirmed the presence of the one mature follicle, he took an approach of "good enough to work with!" and stopped looking as hard for more. So, definitely one follicle, possibly two more. Got an hCG trigger shot at 3:45 this afternoon, and we're doing an IUI tomorrow morning at 10am. I'm thrilled to have made it to the point where we can even do this. Now, keeping fingers crossed that it actually works.

Also in the equation: my OPK this morning was positive, so I might be ovulating on my own anyway. I'm a little worried that I'll have already ovulated before the IUI (or even, that I already ovulated those other two missing follicles before the scan today) but hopefully the timing is still correct.

After dodging increasingly persistent calls from my brother, M., I finally talked to him again. (Started to feel guilty ignoring him....) They couldn't wait anymore, and told the immediate family about A.'s pregnancy. I listened to him explain everyone's excitement, and complain about A.'s morning sickness, before making up excuses to get off the phone again. Hopefully I've put in enough time to avoid him for a few more weeks, by which time, with any luck, I'll have news of my own....

Follicle Watch

I'm going to go out on a limb and say ... my follicles are still growing. I have been growing increasingly uncomfortable since Thursday evening or so. Yesterday, it was painful to button my jeans over my swollen pelvis (wow, that sounds kinda dramatic, doesn't it...). OPK says that I'm not ovulating yet, which for once is a good thing. The hope is that I hold out long enough to let the eggs mature in the follicles, then use an hCG trigger on Monday afternoon to "encourage" all 3 follicles to erupt at the same time, increasing our odds. Waiting until the trigger to ovulate also will mean that we can try an IUI Tuesday morning, which should increase our odds even more.

In the mean time, I'm massaging my bloated pelvis, willing myself not to complain about the discomfort and mentally encouraging my ovaries to keep up the good work.

Follicle Scan

Today was my Day 13 ultrasound. When I arrived for the appointment, I found out that Dr. M. was delayed in surgery, and they had moved my appointment to later in the day, but I wasn't home when they called to tell me. So, S. and I went out for a leisurely brunch (leisurely, but tense, because I was so nervous, and increasingly uncomfortable), hung out at home, then returned to the office.

As for the scan: my uterine lining is 10mm (ideal is between 8-12mm, so this is perfect) and shows the desired "striped" pattern. My right ovary has 2 growing follicles, one measuring 11mm and the other slightly smaller (maybe 10mm?). My left ovary has 1 follicle, which wasn't measured but it looked about the same size as the smaller one on the right, so probably 10mm also. The follicles are supposed to be closer to 16-18mm or more before they do a trigger shot, and they grow 1-2mm per day, so we scheduled another follicle scan for Monday. That's 4 days from now, so they should each grow 4-8mm more. The hope is that on Monday, I'll have 3 follicles measuring in the 14-19mm range (the bigger, the better). If they indeed grew by then, we'll do the trigger shot at that appointment, and then the IUI on Tuesday.

I asked about doing OPK testing at home, and Dr. M. said that he doesn't care. If I want to know, I can monitor myself, but it won't affect his treatment. That's a little odd to me, because if I were to ovulate on my own before Monday's appointment, I would need to know that so that S. and I can take advantage of it on our own. So, I'm going to keep up the testing.

That's the plan for the next several days. I'm definitely feeling that "pelvic fullness" now, and apparently I want it to intensify over the next few days, so I'm seeing some sweat pants in my future....

Cycle Day 12

So far, so good. The hot flashes and random crying both continue, but they are more nuisance than serious side effects. I've noticed other small things (dryness everywhere, constant need to pee, inability to sleep soundly) but I don't honestly know what I should attribute to the Clomid, what is just ... me, and what is all in my head.

I'm growing increasingly nervous about tomorrow's ultrasound. Although every once in a while my pelvis feels a little tight, it's nothing like last cycle, so I'm nervous that things are too quiet down there.

I found out yesterday that I'm supposed to take a business trip to Spain in January. I can wait to book the trip until I know a little more about this cycle, but not much longer than that. If I get pregnant this cycle, I should be fine, because I'd be 10 weeks during the trip, which is probably okay. If this cycle doesn't work, though... there's one more cycle before then to try, but if that also fails, then I would likely be ovulating while in Spain, which kind of rules out an IUI attempt. Given all the uncertainty, though, what do I do? Plan the trip, and hope for the ability to adjust my cycle if necessary? Just go on the trip and hope for the best? The uncertainty sucks, because it's been so long that it feels like our lives are "on hold."

At the same time, getting pregnant as soon as possible has to be a priority right now. If the question were whether to skip a career event because I'm pregnant, there'd be no question. But skipping things to try to get pregnant, when at the end of the day I've missed career opportunities and I'm still not pregnant, and have nothing to show for it ... that just sucks for so many reasons. I don't know what the right approach is.

Cycle Day 8

So far, so good. Mild hot flashes on Thursday, much more intense ones on Friday, a few bouts of no-reason crying on each of those days, but that's about it. (And one bad headache, but that could easily have been the weather.) The Clomid is finished for this cycle, so now we wait for the follicle ultrasound on Thursday.

I've started drinking as much water as I can manage, which is keeping a bit of the bloating in check, but this afternoon I started to feel my jeans tightening up around my pelvis. On the left side. Again. This is earlier than last time, so I'm thinking that there are 2 possible explanations:

1. I'm totally imagining it.
2. My left ovary is stepping up, and giving itself more time to do its job.

I'm hoping with all my heart that it's a sign that the Clomid is working. And I'll weather any necessary hot flashes to make it so.

Cycle Day 4 (Take 2)

Today was the second day of this round of Clomid and it was ... not bad at all. Yesterday was one giant fuzzy sweaty fog. I took the Clomid in the morning, and by mid-day I was not quite awake, not quite asleep, not able to concentrate on anything, not even able to tell the difference between a '-' and a '=' on my monitor (if my fuzzy-brained thinking hadn't stopped me from getting any work done, certainly not seeing characters correctly did the trick!). So, I spent the day napping on the couch, with bad television in the background, fanning my hot sweaty body with a magazine and drinking gallons of water in an attempt to bring down my bloating.

After an uneven night of sleep (kept waking up feeling hot and sticky) today was actually okay. My body temp felt normalized (though S says I am still emanating an amazing amount of heat, so maybe I've just gotten used to it). My thinking wasn't 100%, but closer. Enough to get through a series of meetings and get some real work done, anyway. No headaches. No sweating. No crying. A little remaining bloating, but overall, I am pleasantly surprised! Of course, last cycle, it was Cycle Days 5 and 6 when I broke down in endless crying, so we'll see. But, so far so good!

Three days to go.

Finally

My period finally started today, with a vengeance, after a very respectable (and long!) 16-day luteal phase. I'm telling myself to be happy that it took so long, because it's a sign that my body is still capable of doing some of what it's supposed to do, correctly, on its own. Well, not completely on its own, since the Clomid is almost certainly what brought about the on-time ovulation and lengthened luteal phase, but I'm happy that it didn't need additional "prompting."

So, the doubled dose of Clomid starts on Monday, and I have an ultrasound scheduled for November 15. My outlook for the near future: cramps for the next two days, followed by complete emotional and physical upheaval for a week, followed by increasingly uncomfortable "pelvic fullness" for the week after that. And if I'm lucky, the pelvic fullness will be evenly distributed this time. Fun stuff.

To Tell, or Not to Tell

S. and I have been talking a lot lately about whether to tell anyone about the infertility mess that we're going through. So far, we haven't told anyone, but as treatments disrupt our daily lives more and more, it becomes harder to keep it to ourselves.

When we first started trying, we didn't tell anyone, because that always seemed odd to me. ("Mom, guess what! We're gonna start having unprotected sex! Thought you'd want to know.") When that wasn't working, we still didn't tell anyone, because, well, there was nothing to tell. ("Guess what! We're still not pregnant. But you already knew that.") When we went to the doctor, we decided to wait to tell anyone until we actually had a diagnosis to share, and a plan for getting around it. And now, at any given time, in any given cycle, we're hoping that in a few short weeks, we WILL be pregnant, and in the mean time, I don't want to be constantly answering questions ("No, we're not pregnant yet. Thanks so much for asking. Again.") So, nobody knows.

Some of my friends have noticed the side effects of the drugs, or at least my avoidance of alcohol, caffeine, and pain-killers, so many of them seem to think that I am already pregnant but haven't announced it yet. (You'd think that, after observing what they think are first-trimester symptoms for 4 or 5 months in a row, with me not saying anything and certainly not showing, that they'd realize they were wrong....) Some of them have even asked S. if I'm pregnant -- he has mastered getting a shocked look on his face and saying "What?!? Who's the father???"

In the mean time, almost every single one of our friends has had a baby (3 newborns in the last 3 months alone). And they have all taken it upon themselves to try to convince us to have children, so it's all we hear about whenever we get together. S.'s parents are even worse -- the constant guilt trip to provide them with grandkids is particular tough to take when I just want to scream, "We're trying! We're trying! Leave us alone already!" (If we told them the truth, though, I think that the pity and constant questions would be even harder to take....) So, our silence continues.

Thanksgiving this year will probably be the toughest. When we saw my in-laws this summer, they were ruthless in dropping hints, bringing up children, making passive-aggressive comments, .... They push harder each time we see them, and the presense of a newborn being brought by their "adopted son" (D., one of S.'s best friends from grade school) will make the issue that much more at the forefront. When hearing that D. was coming to Thanksgiving with his 3-month-old, my mother-in-law's reaction was that she was thrilled that somebody was bringing an infant, so that the family would finally have someone to coo over and entertain them during the holiday. Point taken.

Timing, continued

Three weeks ago, my brother M. called to tell me that he and A. had just gone off birth control and were going to try to have child #3. Today, I received the obvious follow-up to that call: A. is pregnant. They conceived each of their other two children easily, too, but even so, M. explained to me that he was "blown away by how easy it was" to conceive again, especially since they "weren't really even trying yet." He complained some about how, because they conceived so quickly, it was throwing a lot of their planning into disarray, then explained how he wanted me and S. to arrange all our future vacation plans to better accommodate their happy news, since we have no such constraints.

I was so desperately trying to avoid crying into the phone, I told him that I was late getting somewhere and practically hung up on him. I don't think that I even said congratulations. Then I drove for several miles while sobbing hysterically into the steering wheel (real safe, I know, but at least I stayed off the freeway).

He wasn't supposed to tell anyone yet (the rest of the family is being told over Thanksgiving, though she'll only be ~8 weeks along then) and I'm under orders to "act surprised." That's not the only reaction I'll be faking. And now I'm left to wonder... would I have rather that he waited to tell me, so that I could at least have these next 3 weeks in peace, without the incredible suffocating feeling in my chest that I've had since he told me? Or is it better that I find out now, before I again have Clomid coursing through my veins?

And waiting still ...

I stopped the progesterone on Thursday, and it's now Monday, and still no period. I've been feeling vaguely crampy for several days, but nothing to indicate anything is really happening. If I believe my BBT chart for this cycle, today is Day 12 of high temperatures. My luteal phase is usually 10 or 11 days, very rarely going to 12, and my temps usually drop a day before my period starts, which means that my period is unlikely to start tomorrow, either (bringing my luteal phase to 13 days at least). Part if me is pleased, because it means that I probably did ovulate, and it's good to have my luteal phase be a respectable length. But at the same time... I want to get going with the next cycle already!

I'm definitely feeling the pre-menstrual headache today, though. With no advil. Damn.

And more waiting ...

Progesterone is done (again). Period should start in the next few days (hopefully tomorrow) so that I can start the next round of Clomid. I'm glad to be moving on from the progesterone; the fuzzy-headedness is really affecting my work.

My BBT is still up, and if it's acting normal (and overrides the progesterone tablets) then I won't actually get my period until Monday or so. We'll have to see if my ovulation theory is correct, and my cycle gets reset on its own, regardless of the hormone pills....

Progesterone Fuzziness

Today is day 7 of progesterone. I'm definitely feeling better than I was last week (no nausea, and only mild headaches) but I am feeling more fuzzy-headed than ever. Everything seems to be taking forever. I have energy, but I can't concentrate on anything, and I'm so absent-minded that I can't actually trust anything I'm accomplishing, anyway.

I keep thinking through scenarios in my mind. When is my period likely to start? If the Clomid works, when will the IUI be? What phase will I be in when we're with family over Thanksgiving? How do I explain Clomid side effects to family without telling them everything? Should I bring a pregnancy test to Thanksgiving, or is it better not to find out until I'm home? If the Clomid doesn't work this cycle, when can we try again? Blah blah blah.

I'm also obsessively looking things up on the internet. There's only so many articles I can read about side effects, odds of conception, ovulation problems, and unresponsive ovaries, and honestly I'm not learning anything new at this point, but I can't ... stop ... searching. The combination of my "focus" on fertility stuff and my lack of true focus on everything else means that I'm getting squat done at work.

Ovulation Mystery

So... my ovulation test on Tuesday, just before my ultrasound, was an ambiguous positive. Starting a day or two before that, the left side of my pelvis was extremely swollen and painful. At the ultrasound, Dr. M. had a hard time finding my ovary on my left side (no problem with the right), then said that he saw it, but it had no follicles, and canceled the cycle. (I also told him about the bloating and uncomfortableness on my left side, and he brushed it aside.) Wednesday and Thursday, my left side continued to feel swollen and uncomfortable. Today: my BBT spiked, I've been feeling feverishly warm all day (like I usually do just after ovulation), and my pelvis suddenly feels 100% better.

I'm willing to bet good money that I just ovulated. I bet my left ovary was performing exactly as it was supposed to, but Dr. M. misread it somehow. I'm no doctor, but I think we just needlessly wasted this last cycle. I'm thrilled to be feeling better at last, but really annoyed that I don't fully know what happened, and that it may have been a mistake. I'm also kicking myself for not speaking up more at the appointment on Tuesday, to insist on an explanation for what was going on with my left ovary. Pathetic.

Nothing I can do about it now, though. If I did ovulate, it was probably yesterday, so we've already missed our window of opportunity. Once again, sucks sucks sucks sucks sucks.

More Finances

Ultrasound appointment: $15
Progesterone prescription #2: $5
Clomid prescription #2: $5

New total: $55

Canceled

My Day 13 ultrasound was today. My blood tests all came back normal, S.'s semen analysis is great, my HSG was normal, and according to the ultrasound, even my uterine lining looked great. But my ovaries apparently decided to take the month off. The right ovary had a few tiny follicles, but not as far along as they were supposed to be. The left ovary, the side that has been causing me pain for the last several days, was MIA. Dr. M. had to poke around ... a lot ... in order to even find the left ovary, by which time I was in enough pain that I wasn't even watching the screen anymore because I was too busy trying to breathe and not scream. But, I'm told that once it decided to show itself, it also showed that it had no follicles.

So, the cycle is canceled. Apparently, 50mg of Clomid is not the right dosage to get my body to respond -- I need a much stronger kick. Thus, this evening I started another 10 day regimen of progesterone to reset my cycle again, to be followed on Cycle Days 3-7 of 100mg of Clomid. On Day 13, we'll try again, and see if I can summon the follicles to even attempt an IUI.

Sucks sucks sucks sucks sucks. The weird thing is that my ovulation test this afternoon appeared positive, which means ... I don't know what. That I'm ovulating immature eggs? That the test was wrong? That I read the test wrong? At least, barring a bizarre reaction to the progesterone this time around, I'll have either ovulated or canceled again by the time we leave for Thanksgiving. We won't know anything else by then, which will suck (and make the family event, complete with newborn baby, that much harder), but we won't be missing out on a cycle, either. In the mean time, progesterone nausea, dizziness, and addled brain for 10 days. Again. Sucks sucks sucks sucks sucks.

Feeling Eggy

For the first time in several weeks, I'm not taking any medications. Woo hoo! The antibiotics are done, the hormones are done, and I have an ultrasound appointment for tomorrow to find out how I'm responding to the therapy. The hope, I think, is that my ovaries are developing a few, but not too many, follicles that are at just the right maturity to release eggs in the next few days, and that my uterine lining is ... welcoming.

I'm feeling mostly better, though still a little queasy and lightheaded (and distracted). And my abdomen still feels a bit swollen to me, particularly on my left side. It's strange that I feel lopsided, but it might be entirely my imagination. I'm a little worried that I have OHSS, but since the symptoms are awfully close to the side effects of the erythromycin, I won't know for sure until the appointment tomorrow. I so desperately want my body to have reacted right to the Clomid....

In the mean time, I'm happy to not be nauseous, and I'm hoping to actually get some work done today. And I'm trying not to drive myself too nutty anticipating tomorrow.

Finances

After much discussion of the cost of fertility treatments, I decided to keep track of how much we're actually spending. Our insurance is actually not too bad -- it covers all the normal procedures, including IVF, should that end up becoming necessary, and medications. But, only up to a point. There's a lifetime cap which, by my estimates, should be enough to see us through many, many IUIs and associated meds, but probably with only enough left for a single IVF cycle (possibly two, if it's on the cheap side). I'm still hopeful that we won't get to that point, so all the major costs might still fall under the spending cap, in which case we're only responsible for the copays for appointments and prescriptions. So, the total should stay relatively low (in the hundreds, rather than the thousands that other people seem to spend) until we hit the insurance cap.

So far:

initial consulation: $15
progesterone: $5
Clomid: $5
Erythromycin: $5

Total so far: $30

The cost to my mental health, of course, is much higher....

Timing

I talked on the phone with my brother, M., today. He started telling me about a home remodel that he and A. are thinking of doing, and before I knew it, he was explaining in detail their plans to have a third child. Highlights of the delightful conversation, during which I mainly concentrated on not bursting into tears:

• When they were trying to have Child #1, they got pregnant on the first try, miscarried, then got pregnant the very next time they were allowed to try.


• For Child #2, it took them two whole months to conceive, which really sucked.


• For both pregnancies, when they were trying to conceive, they "did the whole charting temperatures, testing for ovulation, timing sex thing" and the process was sooo technical and "nauseating" (M.'s word) that it drove M. mad. I mean, between the two kids, they had to do all of that crap FOUR TIMES. That's really rough.


• For a while, they weren't sure whether they wanted a third kid, but A. is adament that their family doesn't feel complete yet. M. was very descriptive of how horrible the heartbreak would be for the two of them if they only ended up with two happy children instead of three.


• This time around, M. refuses to do all of that detailed stuff, even if it means that they might not get pregnant during the first month. Even if it takes two or (gasp!) even three.


• A. wanted to start trying in January, because if they start trying now, she'll be in her third trimester over the summer, which will interfere with their camping plans, but M. convinced her to take the "see how it goes" approach and just start now. His view is that, since Child #1 was born 3 weeks early, and Child #2 took an "extra" month to be conceived, they obviously haven't been able to "time" births at all anyway, so why bother trying?
  

The whole thing was sickening. Listening to him complain about not being able to plan the exact month the kid would be born, and how inconvenient that was. The hassle of having to chart temperatures. The unimaginable sadness that would come with only having two children. The casual way he talked about everything, and the things he chose to complain vociferously about. I wanted to scream.

But, the bottom line is, A. went off the pill this month. They're assuming she'll probably be due with Child #3 in July. And it's likely to all happen before it happens for us. Sometimes, the world is incredibly unfair.

Moral Support

Clomid is done, but I still can't stop crying. Two days of antibiotics are behind me, which means that I've had stomach pains and debilitating nausea for 48 hours and counting. The nausea woke me up at 6am this morning. I had to force down some food at 8:00 so that I could take the next pill, and both the unwanted food and the additional medicine made the nausea that much worse.

S. had an appointment to have his sutures removed this morning. Last night, he said that he could go by himself, since he's off the Vicodin and driving himself around again, but this morning he threw a temper tantrum when I pleaded with him to let me stay in the fetal position on the couch because of the nausea. He even made me drive, though I insisted on taking his car so that, when I threw up, it wouldn't ruin mine. He claims he needed me for "moral support," for a 10 minute exam (and an hour in the car) that involved nothing. I was choking back vomit the entire time and doubled up in pain, but at least he got the support he needed. It's now more than 12 hours later, and I still can't believe how resentful I am about it. I mean, I've been 100% there for him since he injured his leg more than 2 months ago, doing everything he asks. I've been dealing with side effects of fertility drugs and treatments for 3 weeks without any support from him, because he's been laid up. But I thought that now that he was doing better and I was doing worse, I would finally be the one who got to put my needs first, and he could start doing some things for himself, if not for me. But he wouldn't even do that much.

All evening, he keeps saying "Thanks, I love you," and waiting for me to say, "No problem, happy to help," but I can't bring myself to do it. I'm just feeling so miserable, and I don't have support from any friends or family, and it sucks that I can't even get that support from him.

HSG

Well, today sucked.

Today is Cycle Day 6, which makes it the fourth day of taking Clomid. The Clomid actually hasn't been as bad as I was expecting. I had night sweats the first night, and I've had some relatively mild hot flashes (they're mildly annoying to me, but seem to be freaking out S.). A few headaches, but not as bad as my usual migraines, so definitely manageable (even without any Advil, which I'm trying to avoid). Mainly, it's the uncontrollable crying that's been the most noteworthy. Constantly. For no reason at all, much of the time. But, as far as the Clomid so far, nothing I can't handle.

The HSG, on the other hand... wow. It started off bad because they wouldn't let S. come in with me. He's on crutches because of his surgery, and he couldn't really stand next to me for 45 minutes during the procedure, and the nurse refused to let him bring a chair into the room, even though there was lots of empty space, so he had to wait outside. Inserting the speculum was more uncomfortable than a normal pap exam, but not by much. Prying open the cervix, however, .... holy crap that hurt. Even worse was inserting the catheter. I felt hot pain, and then it would go deeper, and then deeper, and every time I thought he must be done inserting it, the pain would intensify and spread even further. The x-ray itself was fast, and thankfully, it seemed to show that my uterus is fine and both my tubes are open, though we'll get the final results next week.

I've had horrible cramps ever since, and a TON of bleeding (worse than a normal period day for me). If I sit very still on the couch, the cramps subside some, but standing, moving, or lifting heavy objects (like S.'s freaking therapy machines) sends horrible pain through my lower abdomen. To top it off, Dr. M. prescribed 5 days of Erythromycin to ward off infections after the HSG, which always makes me nauseous. So even though I was looking forward to ending the Clomid tomorrow and having a few symptom-free days before ovulation, it's not to be. I spent the entire afternoon at home crying.

Cycle Day 2

Today is Cycle Day 2. Tomorrow I go in for the first of my blood tests, and I start the Clomid. My HSG is scheduled for this Tuesday; my ultrasound and cultures are scheduled for the following Tuesday. Depending on the number and size of the follicles, we'll figure out where to go from there.

S. had a post-op check today, and he will continue be stuck on the couch or bed 24 hours a day, at least until Monday, when he starts physical therapy. In the mean time, I'm doing the cooking, cleaning, bringing him food and water, helping him to the bathroom, bathing him, refilling his ice therapy chest every 5 hours (also requires daily trips to the grocery store for more bags of ice), moving his passive motion machine around 4 times a day (darn thing weighs 60 lbs, and has to be lifted up and down each time he gets in/out of it), and getting him pain meds every 4 hours (including the middle of the night, so neither of us has slept in 2 nights, either). He's getting understandably restless, and my cramps, headaches, and nervousness about the Clomid and HSG are starting to take their toll on my ability to lovingly cater to his every whim. It's obviously not his fault, and he's actually being a great patient, but I can't help feeling guilty that I'm not helping him more, because I'm too wrapped up in hormonal nuttiness.

So, yeah, Clomid starting tomorrow. The next few days should be real fun in our house.

Start Counting....

S. had his surgery this afternoon. He was still loopy from the anesthesia when I drove him home, with a long list of post-op care instructions for me to follow. After helping him into the house, getting him comfortably settled on the couch with his leg elevated and the auto-cooler humming merrily along, I headed out to buy the things he needed (big bags of ice, juice, soup, toast). I was in a hurry to get back, because he can't move around at all and was still having waves of nausea from the pain killers. As I'm running around the grocery store ... sudden cramps. Then dizziness. And more cramps.

So... right now, it's just spotting (bright red, but not exactly flowing). My normal pattern would be for full-on period to start tomorrow, then. For the purposes of counting my cycle days for the Clomid, I'm not sure if today or tomorrow is supposed to count as Day One. But, I have to call Dr. M. tomorrow either way, to schedule the various upcoming appointments, so I guess I'll just ask him. The timing isn't *that* great, because either way I'll be on the Clomid while also taking care of my immobile and needy husband. But, I am excited that we're moving forward!

In the mean time ... damn, cramps just keep getting worse.

The First of Many Waits

I took the last of the progesterone today. Now, we wait for my period to begin. I'm glad the progesterone is over, since I've been feeling rather sick and dizzy while on it, and haven't been able to concentrate on anything. I'm also anxious to move on to the next step (the part that can actually have a chance of getting me pregnant -- this is just the preliminary stuff to start my cycle going). At the same time, I'm nervous about the clomid. If I was feeling sick just from the progesterone, I can just imagine what the clomid is going to be like.

Dr. M. said that I could expect my period to start either during the progesterone, or 2-3 days after I finish it. Search online today, it looks like it might be up to a week after finishing it. I hate all the waiting! I had been thinking that I'd be starting my cycle Thursday or Friday, but I guess it might end up being later than that... so for now, we wait.

S. surgery is tomorrow. On the one hand, it's good that I won't be on the clomid and being a bitch to him while he's recovering. It will also be good that taking care of him will hopefully distract me from the anticipation. At the same time, I've been counting down the days to both the surgery and the clomid, and epxected them to be happening around the same time, so this is kind of disappointing. Oh well.

Bring on the Progesterone

Period Watch continues. Today was Day 4 of my 10-day progesterone protocol, to try to force my period. We postponed the start of the medication by about a week so that we could be sure that I wouldn't be ovulating while S. was laid up after his knee surgery next week. S. did his tests on Monday (his first time making love to a plastic cup.) He clearly did not enjoy the experience. I "helped" as much as I could, though I failed in my mission to buy him some porn, since I think he was a little disappointed that he didn't get to go into a masturbation room with lots of "reading" materials, like they always allude to in the movies. But honestly, I think that the blood test freaked him out even more (he hates needles, and has been known to faint at the site of his own blood -- yes, he's my macho man!).

From what I've read, progesterone has the mildest side effects of all the fertility-related drugs that may be in my future, but I'm already complaining (I've also already apologized to S. for any monsterously bitchy behavior that he'll have to deal with). I've been nauseous every afternoon since starting the drugs, and lightheaded throughout the day. Trouble concentrating. Forgetfull. Or maybe I'm just distracted.... When I picked up the clomid at the drug store, so I'd have it for when I needed it, I asked the pharmacist about side effects. She looked at my sympathetically and said, "women do not have fun on this drug." She listed off headaches, nausea, vision problems, dizziness, ... but then said "but it is very effective!" and warned me about multiple pregnancies. But for now, the progresterone. One step at a time.

The Beginning

Well, today we started the "process." By that, I don't mean that today was the day that we started trying to conceive (far from it). Instead, today was the day that we finally saw a doctor to find out why it's not happening, and what we can do about it.

The story so far:
I went off the pill in September of 2005, after being on it for the better part of 10 years. I don't really remember when I started taking the pill, but it was somewhere around 1995, when I was about 18, not because I needed birth control, but because my cycles had always been so irregular. My gynecologist told me that it was unhealthy to have as few periods as I was having (he said something about uterine cancer, which may have reflected medical opinion at the time, but is not generally thought to be a big risk anymore). The pills were just supposed to regulate my cycles. Ever-worsening migraines eventually made me bounce from one pill to another, hoping to find one that wouldn't leave me in agony for two weeks every month, before eventually stopping them all together sometime in 1998. Off the pills, my cycles resumed their original weirdness, being extremely unpredictable but typically lasting 60+ days. My doctor at the time told me that it was okay to have fewer periods, but that I may have trouble conceiving a child some day. I took this news with a shrug -- I was barely 21 and still in college, certainly not worried about having kids. I stayed off the pill until 1999, when I decided that I *did* want them for birth control (you know, just in case - ha!) and finally had a gynecologist who knew what he was doing and could prescribe one that was better for migraine sufferers.

I stayed on those same pills until 2005, when my husband and I decided that we were ready to start a family. We both knew that it might take a while, but didn't expect any *real* problems. Months earlier, my friend K had recommended the book "Taking Charge of Your Fertility", which had helped her to understand her similarly irregular cycles, and I had dutifully bought a thermometer and tracked my temperatures for a few months while still on the pill, just to get in the routine.

Off the pill, my cycles once again reverted to their natural state. My first cycle off the pill was a respectable 35 days. The next one was over 70. My temperatures were spiking the way they were supposed to, but they were highly variable and abnormally long. After a year of blissfully having lots of sex and taking daily temperature readings, with no pregnancy, we decided to be more proactive. I started charting my cervical mucuous, which I had resisted doing when I thought I wouldn't need to know the *exact* day, but which now I hoped would help me to make the most of the measly 6 cycles I have each year. My charts now showed my mucuous "peaking" every 4-5 days, then disappearing again only to peak again... every week, convinced I was about to ovulate, we would have night after night of sex (normally enjoyable, but with the added pressure of *having* to do it, constantly, it was a bit of a drain)... and every week, the mucuous would dry up, my temperature would stay low, and we would start again a few days later. Since the mucous peaks when I ovulated and the ones when I didn't looked the same until several days later, we had to assume that each peak was going to be the real one. And for each one, I got my hopes up, calculating eventual due dates should that time be "it." Each night after sex, S. would kiss me and say, "Just think -- we may have just conceived our child!" I admire how he kept up enough hope to say this month after month.My charting got more obsessive, and we started to look for other things we could do to increase our odds. I cut out alcohol and caffeine, with the unfortunate side effect that many of our friends assumed that I was already pregnant, a painful thing to have to disavow your friends of when you really are desperately trying. I made S. switch to boxers. I started using ovulation predictor kits, an expensive habit for someone with highly variable cycles, since they come in packs of 7, but I often needed 3 or more packs for a single cycle. I elevated my hips for 15, then 20, then 30 minutes after sex. After reading an article that Advil and other painkillers can prevent conception, I stopped using painkillers, suffering through my usual migraines without any relief.

By the summer of 2007, I was done being blissfully hopeful. Almost every single one of our friends was pregnant or had small children, and after each happy announcement and baby shower, I came home and cried. We had told only one friend, back in November 2006, that we were trying to conceive. The rest of our friends, and all of our family, assumed that we weren't. Over this summer, they all decided that they needed to convince us of why we should have children. I dreaded being constantly asked how it was going if they knew that we were trying, thinking that this would just add to the pressure (and I really didn't think I could handle the suggestions, comments, and pity that would inevitably come once they all found out we were having trouble) so instead, we had to just grin and bear all of the comments about what great parents we would be -- don't you want to have a kid yet??? Particularly hard to deal with were my in-laws, who desperately wanted to be grandparents, and didn't hide their belief that the only reason we didn't already have children was that I was selfishly focusing on my career.So, we decided that 2 years would be it. If we weren't pregnant on our own by September, we would make an appointment to see a doctor. I ovulated in August, our "last chance" to do it on our own. For the two weeks between when I ovulated and when my period confirmed that I still wasn't pregnant, I did obsessive research on the web. I read about different kinds of fertility treatments. Advantages and disadvantages of each. What kind of doctors I could/should be seeing. What types of therapy are typically tried first, and how often they succeed. What drugs are used, and for what. I read blogs about women dealing with infertility. I made lists of questions to ask the doctor. I researched our health insurance to see what would be covered, and how much we could expect to spend on our own under different scenarios. All of this I did while whispering, "just in case," and wondering how far we would really be willing to go in order to get pregnant.

So, today we started the process. We haven't made any decisions about we will eventually be willing to do, should each progressively complicated technique fail for us. Instead, we've agreed to take it one step at a time, seeing how each thing goes, and seeing whether I want to put my body through whatever the next thing is. For now, we just keep telling ourselves that we just want to know "what we're facing." We're hoping that it has a name, so that the doctor can say, "Oh! You have X! Here's the way to get pregnant that works for people with X!"We met with Dr. M. this morning, and he described the first several steps of the process. The tests on me need to be done at particular times in the cycle, so I'm starting on progesterone in order to force my period to come soon, rather than waiting 2 months for it to happen on its own. S. will do the usual blood test and sperm analysis in the mean time, so that we can hopefully rule out any problems from him (my weird cycles should be enough for us to deal with, I think). Since my cycles are so long, one of my problems (hopefully the only one, but we don't know yet) is clearly ovulatory, so I will take Clomid during this next cycle, to try to encourage my body to have a more predictable cycle. I'll be monitored throughout that cycle, so that they can see whether I'm really producing any eggs. Then, we'll discuss a game plan for actually fertilizing 'em.