Archive for January, 2009

Celebrity Status

I went to Ye Olde Fertility Clinic today for my interview with Local News Station #1 this morning. It went really well and J, the Marketing Supervisor Extraordinaire (MSE), for YOFC said I was awesome and hit all the best points possible. I don’t like to brag, but… I rocked.

Seriously, if I get a DVD of it (the MSE at YOFC did promise me he’d do his best to deliver the goods) – I’ll see if I can figure out how to upload it.

After the interview, I went down to meet with my nurse to sign papers in advance of tomorrow’s retrieval. I disclosed to her the fact that I screwed up my trigger shot this morning… I mean, I didn’t screw it up, but I was 15 minutes late (I knew this wasn’t a problem, but I figured full disclosure was a good thing, right?). Anyway, she said it was completely inconsequential.

So I signed everything, educated her on the weird ways of Judaism, and as I was wrapping up, another nurse knocked on the door and told me that MSE wanted to know if I could stick around because Local News Agency #2 was on their way over and wanted to talk to me!

Well, golly! I’m in high demand!

I wasn’t AS in love with this reporter and this one wasn’t quite as, um, smart. But it went well, and I got to have a little more fun on camera. 🙂

And now I’m home and it’s time to get ready for Shabbos.

I feel good about tomorrow. I think it’ll be okay. I think we’re going to get more eggs than expected. I think this cycle isn’t going to be a bust. I hate even saying that. I hate that I’m actually putting optimism into print. I am so pissed off at myself that I’m allowing myself to make it publicly known that I have any hope, but I do.

So there.

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Trigger Shot: 5:15am tomorrow morning (1/30/2009)
Nothing to eat after: 10:15am Saturday (1/31/2009)
Nothing to drink after: 1:15pm Saturday
Arrive at Ye Olde Fertility Clinic: 3:45pm Saturday
Retrieval time: 5:15pm Saturday (1/31/2009)

I was getting nervous – I hadn’t heard from the clinic with a trigger time by 6:25pm. Their offices close at 5pm. I wasn’t sure what to do. Should I wait for their call? Should I page the doctor on call? Should I figure it out by myself? What to do?

I called in reinforcements. I called Mel. I called Leah. I asked advice. Both advised I call the doctor on call, and though I felt ridiculous, I did have him paged. Not one minute after I got off the phone with the answering service, my cell phone rang and it was the OR Scheduler from Ye Olde Fertility Clinic with my trigger information. Crap. Anyway, at least I got all the information, right?

And so 15 minutes later when the doctor called back, he was very nice when I told him I got the information I needed. “Good luck,” he said.

Good luck, indeed.

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Trigger Time

Today’s appointment was quite interesting. First of all, I had my old buddy, Dr. S. in monitoring. Also a medical student (maybe a resident? I’m unclear. Actually, she was introduced as Dr. So and So, so she must be a resident or fellow). I immediately gave him some crap about the lack of a mobile in Room 1 (I was in Room 4 today, but that’s not the point). He assured me he’s on it, and I told him that I swear if he doesn’t take care of it by the end of this cycle, I’m getting one myself, hanging it myself, and sending him the invoice and he said that he had no problem with that. 🙂

“Hey, do you want to be on television?”
“What? huh?”
“Seriously, do you want to be on television?”
“I hardly think I’m interesting enough to be on television.”
“Ohh, I wouldn’t say that! You’re not giving yourself enough credit here!” M (sonographer extraordinaire) chimed in.
“Seriously, I need someone who is doing an elective Single Embryo Transfer, and all the better if it’s someone with HOMs.”

So I made him a deal. I’d do his TV gig if he got a damn mobile in Room 1! I think it’s a pretty sweet dealio, myself! And he agreed, so we’re all set. Tomorrow, I’ll be interviewed by a news station. Neat, huh? So much for keeping a low profile, though! I probably will not be disclosing the location of my blog. 🙂

(Turns out what the deal is … is that they’ve been getting a lot of media requests since the octuplets were born to find out their stance on the whole thing. My clinic does a lot of eSETs… as far as I can figure, they do more than any other clinic in the area… and they’re really trying to push that angle. My nurse thinks it’s great because she’s hopeful it will help get insurance companies to cover IVF when they didn’t used to, etc. She has more faith than I do…)

Anyway, back to the appointment.

We’re focused on:
Right: 25.2 (probably past it’s prime), 19.1
Left: 19.3, 18.6

There are some smaller ones, but those are the ones we’re counting on. I have in my head an idea of how many we might get above and beyond those 3 or 4 (based on the measurements we saw today), but I don’t want to jinx it and I don’t want to go all crazy, so we’ll just go with 4 for now and be happy with anything above and beyond that. Trigger tonight. I don’t yet know what time. Retrieval Saturday. This is a logistical nightmare, but my nurse is trying to find the least painful way around this.

And that’s where things stand right now.

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Not ready to trigger, apparently. WHATEVER.

SuperDoc is this cute little South African Jewish man. My primary nurse is as Irish Catholic as you get. Me? I’m an Orthodox Jew. So SuperDoc loves to torture my nurse by peppering his notes to me with little Hebrew & Yiddish phrases. She can never pronounce them and certainly has no idea what “meshuga” or “shiksa” means.

So today he tells her that I should stay on the same dose tonight and come back for monitoring tomorrow.

“Are you frickin’ kidding me?” I said.
“You’re not ready to trigger, darlin'” my nurse replied.
“Oh for crying out loud. This is going to mean a Saturday retrieval.”
“Or not. If I had to guess I’d say you’re goint to trigger Friday, not Thursday. But that’s just a guess.”
“Friday? So a Sunday retrieval then. Hrm. I could work with that. But you know it’s going to be a Saturday retrieval. He’s doing this to me on purpose.”
“He said to say something else to you, but you know he’s just trying to make me look stupid, because you know I can’t pronounce any of this…”
“It says, ‘peekoowa’ I dunno… there’s that ‘ch’ thing on the end. Then ‘ne-‘ um. Peekooo. I don’t know.”
We went on like that for a while before I realized what she was saying.
“Are KIDDING ME? Pikuach Nefesh? Is that what he wrote? REALLY?”
“Yeah! Exactly! I knew you’d know what I was trying to say!”
“You know, that quiet, serene, calm little man is evil. EVIL. Do you know what he just told me?”
“Um, no? I have no idea!”
“He just told me I’m having retrieval on Saturday.”
“Oh, he acts all quiet and and soft-spoken and sweet, but underneath it all? He’s a little smartass, that one! And don’t you forget it!”

(for the record, pikuach nefesh does not apply here, though that doesn’t mean that there aren’t halachically appropriate ways to be able to go to a retrieval on Shabbos – it’s just a logistical nightmare)

Needless to say, this is not going to be fun at all if that’s the way it plays out. But hey, maybe another day or two will get us to 8? Meh. We’ll just have to see what happens, right? There’s really not much we can do about it regardless. It’s going to be the way it’s going to be and it will either work or it won’t.

Update: same dose = same dose as prescribed originally. I did tell my nurse about the accidental double dose. But no harm, no foul, and we’ll just see what happens.

and yes, my doctor does have a sense of humor. And he certainly does think I still have a sense of humor. Little does he know.

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Probably Six

Here’s what I’ve got:

Right: 20.9, 15.6
Left: 16.9, 15.7, 16.3, 14.6
(Endo, 11.5)

Probably will get 6. Me? My gut says cancel. My husband says go forward. I’m sure, when I hear from him, that’s what my doctor will say as well. Whatever. I know many people would be thrilled to pieces with 6. Over the moon. And I know that quality over quanity is what we’re looking for, but I have no guarantees of quality right now. And I have no guarantees that if I had quantity right now that the quality would suck. It’s not always one or the other.

Yes, I only need one. And yes, I’m only planning on transferring one. But I was NOT hoping to only have one available for transfer. Bah.

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So, um, I’m kind of an idiot.

So last night I was seriously considering taking no meds for two days until tomorrow’s appointment and just throwing in the towel on this cycle. I meant it, too. But, as I said last night, I’m not a rebel. I’m a good girl who does what she’s told.

Unfortunately, I’m also a tired girl, who’s getting terrible headaches and therefore apparently can’t keep everything straight.

I just took my Follistim and my Luveris. But. Um. I forgot that I’d taken it at 6pm between getting home from one appointment and rushing off to my evening class. Originally I’d been planning to just wait until after the class because I didn’t think I’d have time (I didn’t really have time, but I’d managed to squeeze it in, since 6pm is my normal time to take it and I do hate to be off schedule).

I completely forgot I took it at 6pm and stuck to my original plan to take it after class. Um. Whoops?

So my husband’s a pharmacist, so I’m sitting there thinking that maybe he can impart some words of wisdom, or at least comfort. Maybe he can tell me that I’m not going to grow an eleventh toe or a third head (wait, um, how many heads do I have?), or turn purple with green spots because of this.

“So I did something really bad.”
“You saw me take my meds just now?”
“I also took them at six.”
*stifling a laugh, badly, I might add*
“Wow, your head must hurt like a motherf*cker.”
“Yeah, um, thanks hon.”

Given that overly empathetic response, and the obvious professional concern he had for my physical well-being, I can only assume that I will not die a gruesome death from this error on my part.


Now all I have to figure out is whether to own up to my error to the doc tomorrow…

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Ovaries in pain.
I hate fertility drugs.
Head pounding also.

How’s that for an early morning haiku? Technically Haiku starts in the very specific and moves to the very general. Or maybe the opposite. And it usually has to do with nature (hey, this is biology, right? That’s nature, sort of) So my form sucks, but at least I’ve got the whole 5-7-5 thing going (which, by the way, is not a requirement for haiku – haiku simply has 17 or fewer syllables). So, to recap: lousy form, bad writing, but not bad for someone who can’t stand even attempting haiku.

It’s snowing. I love snow. It was snowing the day I had the IUI that worked. I mean the one that worked that did not result in a miscarriage. There was a big snow/ice storm that morning/previous night. It was Valentine’s Day – a huge cliche except I don’t celebrate Valentine’s Day.

But I digress. I love snow. It’s calming – soothing. Which brings me to tomorrow. If they see more than 4 or 5 favorable follicles, I won’t cancel. If it’s four I’ll cancel. If it’s 5 – I swear on all that is holy (I know I’m not supposed to do that), I’m flipping a coin.

I’m not feeling all zen about it, but I’m calm. I hate this. I hate every stinking second of this. This wasn’t how this was supposed to go. This was supposed to be easy; straightforward. This was supposed to be simple. (not that this is ever easy – but at least this was supposed to be straightforward)

I remember sitting in SuperDoc’s office after my 6th IUI. The one that was supposed to fail. I was sitting there for my 2nd IVF consult (I’d had an IVF consult right before my 4th IUI which was also not supposed to work, but did, though it ended in miscarriage). Anyway, I was talking to him and I said that I do realize that compared to many women who have been through this fertility gig I have had it pretty easy and haven’t been through all that much. He looked at me earnestly, paused, and said, “Let’s just say you’ve handled your burden with extraordinary grace.”

You know what?

I’m tired of handling this with grace.

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There was a piece of me that really didn’t want to bother taking any of my drugs tonight. Or tomorrow. I seriously considered just coasting until Wednesday. Blowing it all off. Probably guaranteeing a cancelation, but at least eliminating the uncertainty.

But I’m not good at being a rebel, so, good girl that I am, I dutifully took my drugs, as planned. We’ll see how things go on Wed.

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Update from SuperDoc – raise Follistim dose to 150IU. Back on Wednesday for monitoring. Wednesday is the worst possible day for me to deal with monitoring. My husband is going to work at 6:30am and I’m on duty at home until 7:30 and then have a myriad of other things to do. Dammit.

My nurse thinks we’ll get 7, not 4. I guess we’ll just see. I’m inclined to scrap the whole thing, frankly. This just hasn’t been going as expected, but I guess – when has it ever?


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Right: 19.6, 12.1
Left: 14.8, 13.1, 13.9, 13.4, 9.9, 9.8

Basically, my doctor is hoping that 19.6 just floats away and that MAYBE we’ll get the others to grow enough by tomorrow to trigger. That would mean retrieval on Thursday, my 33rd birthday. And maybe get four eggs.


Originally, we were really worried about hyperstimming me. Don’t get me wrong – I’m extremely happy that didn’t happen. But… Four? Now, if I were forty, I’d take four joyfully. If I had premature ovarian failure, or even unexplained infertility, I’d take four. But I have frickin’ PCOS, for crying out loud. Four?

What if we go through all this, retrieve four, at best, and then only 3 actually fertilize, and only one makes it to blast? Or what if none make it? Gah. There are too many “what ifs” involved here. I don’t know what to do.

My doctor is inclined to go ahead with just four. But his original prediction of a 40-45% chance of pregnancy with an elective single embryo transfer (their normal rate of pregnancy with elective single embryo transfers is 67%) is now down to 30%. Me? I’m inclined to cancel. It just seems like an awful lot of work, time, money wasted for … four.

I have three IVF cycles covered per live birth. If we cancel before retrieval, this doesn’t count against my three. I get that I’m “only” on my first, but if that fails, I’m down to two. That’s 30% down.

Oh, there was another option. We could have triggered today and converted to an IUI. Over my dead body. I would have been risking quadruplets if I’d agreed to that.

SuperDoc had students with him today, and while they were poking around at my ovaries I was being as lighthearted and joking away as I could. As he reviewed my previous cycle with them to see what they would think retrospectively, I mocked him a little “Oh no, this cycle will never work. We’ll trigger you early, blow this cycle off – we know you’re moving on next cycle anyway. No possibility you’ll even get pregnant let alone with HOMs!” He said if I weren’t back for more he might pay attention to me. A fair point. I apologized later to one of the students for being such a pain in the ass, but she said it was great comic relief.

SuperDoc was jovial and calming as always, but once I sat up, I got more serious and so did he. I wasn’t happy. He was calm and seems comfortable with proceeding, but I feel like I’m being followed by a shadow. He did note that if we cancel and start over, we’ll start my Follistim at 220 IUs and we’ll be much more likely to see the 15 follicles we expected. Still, like I said, he’s comfortable proceeding as is. Me? I’m not so sure.

I waffle. The Lupron sucks so badly I’d hate to think I took it for two weeks just to cancel.


Update: Thanks, Bean, for noting that I should double check my insurance – I did just that on my way out of the clinic this morning… I checked in with the financial counselor to find out what the financial implications of canceling would be and whether it would count against the three, and the long and the short of it is that each of the monitoring appointments would get billed separately to my insurance and I’d have my copayment for those and coinsurance for all the labwork. I had her double check to make sure that the cancelation would not count against the three cycles and it will not.

Another Update: the 19.6 is not the one. By Thursday, it’ll be gone. Definitely good points for moving forward, but it’s a lot of money I stand to lose.

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