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I kinda left you all hanging about the embryology report didn’t I?

While I was at Ye Olde Fertility Clinic today, I ran into SuperDoc and he told me we are likely a go for tomorrow for transfer, but no promises. It will probably be a last minute call, but for the moment I’ll assume we’re a go for 1:15 tomorrow afternoon.

There’s at least one little embryo who could. Possibly another. Whether they’ll be blasts by tomorrow remains to be seen.

So you all know I’ve been doing these interviews for Ye Olde Fertility Clinic. It’s awfully nervewracking, because it’s SO not me. I put on this big act of being all open and extroverted about this stuff, but truthfully? I never talk about this stuff, ever. Well, that’s not true. I do talk about it – but I don’t talk about it publicly while I’m in the middle of a cycle. I go through a treatment cycle under a shroud of secrecy whenever possible.

And yet, three times now, I have sat in front of a television camera with a reporter in front of me and declared to the greater metropolitan area that I am pursuing fertility treatment right now. And why? Well, because Ye Olde Fertility Clinic asked me to, that’s why. And because putting a face and a voice to infertility is important. It’s all together too easy for society to pretend like infertility is “someone else’s problem” and that it’s one of those things we don’t need to talk about. Or worse, one of those things we should be ashamed to talk about.

In some ways, I’m not the poster child for fertility treatment. I was the aberration – the nightmare outcome – the now-mother to HOMs. But I’m also the survival story, and the mother who came back for more, despite knowing the pain, suffering, and inconvenience of it all. And the mother seeking to do this in a the way most likely to result in the best outcome – a healthy singleton pregnancy – by doing elective Single Embryo Transfers.

Infertility and its treatment is a multi-billion dollar industry, that’s for sure – but when it comes down to it, the industry is in the business of making life. Babies. Building families. Sure, there’s a payout in the end, but they earn it. I’ve been to the other side of infertility and I know it’s worth every bit of the toll the process takes and every penny I (and my insurance company) spent. And I also know that there is no way that I can ever repay the kindness that Ye Olde Fertility Clinic has offered me in helping me to build my family. So when YOFC asked me to do these interviews, of course my answer was yes. (With the condition that the mobile gets hung in Room 1 ASAP – oh you thought I’d forgotten about that, didn’t you? No sirree! I have the memory of… um, whatever it is that has a really good memory – I forget)

I know that I’m a giant pain in the ass. I know that I give my doctors a lot of crap. Do you think I don’t know that they probably could live without hearing about the damn missing mobile in Room 1? Do you think I don’t know that they have far more important things on their plates than dealing with me? Of course I know that. But hey, at least I bring them cookies! (Did I mention I brought cookies today?) The fact that they put up with me despite my… ah… we’ll call them idiosyncracies (what can I say? It’s all part of my charm!)… is what makes me love them so much. There is a reason that I refer people to them time and again (aside from their stellar statistics, their cutting edge medicine, and their convenient locations – that’s all secondary to the fact that they are, simply, good people).

But absolutely none of that is why I’m telling you that I have complete faith that my clinic is way cooler than yours. Do you know why I’m telling you that my clinic is so cool? I’ll tell you why!
Because today I went and interviewed with News Station #3, which meant I had the pleasure of meeting once again with J, Marketing Supervisor Extraordinaire*, which is always great. As I said, I brought cookies. Anywhozit, I got to meet with him and meet a lot more of the behind-the-scenes crew at Ye Olde Fertility Clinic, which is always all kinds of fun. I got to see my nurse (and she got a little more camera time, also, which is always fun for her!). The story isn’t airing until March, but I’ll let you peeps know when it airs. I know, I know, my adoring fans *need* to know, right? Of course right.

Afterward, I came home, a little sad knowing that this was my last interview – not because I’m so keen on putting myself all out there and all (honestly, it really IS tiresome to talk quite so publicly about this rather private subject all the time), but because I realized that I pretty much have no excuse to see J (Marketing Supervisor Extraordinaire) anymore or send him random eccentric emails (well, that’s not quite true… that mobile hasn’t been hung yet. He can’t get rid of me until it’s hung!! bwah hah hah!)

And what should appear at my front door a few hours later?

A beautiful Edible Arrangement from J and the Marketing Team at YOFC:

Now, be honest, have any of you ever received such a cool present from your clinic? I can’t hear you! That’s right. I didn’t think so. So just think about that the next time you’re thinking about where to go for treatment, why don’t you. 🙂

*Note the name change – I previously referred to him as “marketing guy” but (God help me) for some reason I was crazy enough to let him know my blog URL and apparently he actually read it (ohmygosh) and felt a little slighted. Seriously, I mean, if my nurse gets to be “NurseAwesome” and my doctor gets to be SuperDoc and my sonographer gets to be M, Sonographer Extraordinaire… but he’s “marketing guy”… well, he had a point when he pointed out that it sounded kinda cold and creepy. Which he is not. He’s one of the nicest people I’ve ever met. He suggested TalentAgent, but unless he’s going to get me a suh-weet deal with one of the stations where I get to market myself as a “childcare expert” on account of my large(ish) family, I’m not *quite* convinced that he can market himself as a Talent Agent just yet. Though, he did manage to get me my first three television appearances. Oh wait, that’s not true, in high school, I appeared on tv bunches of times… Hrm. I think I need an agent…

How do you feel NORMAL?

It was an important question. An innocent question, actually. Posed by a friend of mine over Shabbos dinner last week. It was my fault, really. I had told him that in any given IVF cycle, a woman could be on 10-12 (or more) different medications.

Just as an example, here’s what I took/take:
Doxycycline
Baby Aspirin
Birth Control Pills
Lupron
Follistim
Luveris
HCG Injection
Zithromax
Estrace
Prenatal Vitamin
Metformin
Progesterone in Oil Injections

Now, I didn’t list out my medications for him, but just at the sound of 10-12 (or more) medications, he was shocked. Visibly shaken. How do you feel NORMAL?

He immediately tried to retract the question, sensing, perhaps, that he may have stepped over a line into territory that was too sensitive. But, honestly? It was an honest question. It was an important question. And it deserved an honest answer.

The truth is, you don’t feel normal. Nothing about this process is normal. And nothing subsequent to this process is normal. A friend of mine who has four children, including a set of 3 year old IVF twin girls is still so completely traumatized by her IVF experience that she can barely remember any of it – she has so completely blocked it out of her mind. She herself is a physician, and so had a deep understanding of the clinical aspects of the process, and yet she has retained nothing of her one IVF cycle because being forced through this emotionally draining experience was too much for her to process. And, in fact, it was the sheer number of medications that pushed her over the edge of sanity with the whole experience. To her, it was taking someone who was, on the surface, a completely healthy human being (save slightly elevated cholesterol in her case), who took no medications in her life and suddenly handing them this enormous box of medication that would become their life for the next month. That aspect alone was so life-changing for her that it seems that she will never be the same, and possibly will never be over the bitterness of the experience.

I, for one, am fascinated by this, as I’ve always been a person who has to take a handful of pills before I go to bed at night, so the boxes full of medication don’t bother me a bit. That being said, there’s nothing normal about giving yourself injections three times a day. There’s nothing normal about any of this, of course. There’s nothing normal about going in for ultrasounds every three days, or every other day, or in some cases (like mine) every day by the end. There’s nothing normal about all the bruises we end up with all over our bodies. On our arms from the blood draws. In our hands from the IVs from the egg retrieval anesthesia. In our stomachs from the subcutaneous injections. In our buttocks from the PIO injections. There’s nothing normal about any of this, is there? How could we possibly feel normal?

Nevermind any of that, he said, if you’re taking all of those medications, sooner or later the side effects have to add up! That’s for darned sure. The debilitating headaches. The hotflashes. The exhaustion. The snippiness. The crankiness. The nausea. The headaches. The weight gain. The weight loss. The headaches. The weepiness. The mood swings. The headaches (have I mentioned how much I hate lupron?). You’re right, my friend, we don’t feel normal. We feel like shit.

And yet, we are expected to lead our normal lives. We are expected to lead our normal lives without letting on to the world that there is anything at all out of the ordinary going on in this very private aspect of our lives. We are expected to sit quietly hoping and praying for a miracle. We go to work each day. We come home each night. We shower, we get dressed, we socialize (if we can). If we already have children, we still have to tend to them, run their carpools, help them with their homework, take care of their appointments, get them to soccer. We are expected to sit at baby showers and smile as if they don’t bother us. We are expected to ooh and aaah at other people’s pregnancy bumps. We are expected to be normal, functioning members of society with all of these hormones injected into us – side effects and all.

Yet, we cannot lead our normal lives. This week alone, I’ve had to cancel three meetings and two lunch dates. Last week I had to keep three people on call for Shabbos to have things arranged so that I had adequate child care and halachically appropriate arrangements for me to go to the clinic should I have to go for retrieval on Shabbos (I did have to go on Shabbos). Things change at the drop of a hat. I had only 48 hours notice to make my arrangements for retrieval on shabbos – a complex set of arrangements to make – and that included moving my entire work schedule around on Friday so that I could go into the office in order to sign all my consent forms ahead of time, since I wouldn’t be able to sign anything on Saturday. This week, I was supposed to have Transfer on Thursday. Then Tuesday. Then Thursday. But maybe Friday. Who knows!

We can’t schedule vacations. Heck, I can’t even schedule lunch with my friend L who wants to take me out for my birthday which was last week.

So, no, my friend, we don’t, and can’t, feel normal. But I thank you for your very honest, and very important, question.

PIO: It Does So Sucketh

PIO injections? Not nearly as horrible as I expected them to be. They don’t hurt as much as I thought they would. They go in relatively easily. We haven’t hit an artery yet (er, does that happen often?). Basically, we’re all good.

Or, um, I thought so.

I mean, there’s the mood changes. PIO, is systemic, you see, unlike Prometrium or Crinone, etc. So the mood changes. And the exhaustion. And all that good stuff. I can live with that. I’m moody and exhausted anyway (Shut UP!).

(and the estrace? Did I mention estrogen makes me cry at the drop of a hat? yeah…)

Anyway, back to the PIO. It’s going well. It’s all good. Not hurting. Life is good. I even gave myself my own PIO injection last night without any difficulty. Not bad. No real pain. Life is good.

Except now, every single injection site (not that there’s so many now) is all lumpy and owie. And, in the face of this morning’s news, I have decided to be annoyed about this development. Bah. How am I going to deal with 18 days of this (more if I’m pregnant, but who’s counting on that?)

Edit: Yes, I know all about crinone, etc. I was even in a study for crinone once. But, my clinic uses PIO exclusively for IVF patients for at least the first 18 days after retrieval, except when there is an allergy to sesame. And, frankly, it’s not that bothersome to me to do the PIO shots – it’s just that this morning I had a lump in my patootie and I needed something to focus on and whine about other than that damn embryology report. I’m so sick of embryology reports. (though, I am, of course, on pins and needles awaiting tomorrow’s report…I never claimed to be consistent)

Yes, people, I know it only takes one. I get that. But the cliche isn’t helping me right now. I have a right to wallow for a few hours in my less-than-stellar news, and that’s precisely what I’m going to do now, because today’s news was even less promising than yesterday’s news.

Let’s Review:

Going into Retrieval: We were expecting 4-6 eggs (not stellar news, but at least we were expecting not stellar news)

Retrieval Day: 10 eggs retrieved! (Double what we expected! A great number, all things considered)

Day 1 Fert. Report: Of the 10 eggs retrieved, 9 were mature (1 post mature) and all 9 fertilized and were 2 celled embryos (unbelievably good news! I was stunned and overjoyed by this news!)

Day 2 Embryology Report: 1 didn’t make it at all, 6 2-celled embryos still (1 with no change; not a good sign), 2 6-celled embryos (with 10-15% fragmentation, not good). Not a good enough report to warrant a 5 day transfer. Transfer scheduled for day 3 at 2pm. Disappointing news at best as with Single Embryo Transfers, they always try to go to blast in order to find the cream of the crop when possible.

Day 3 … (Today):

I’m on my way in to work and the weather is crappy, my head is pounding, my tushie is sore from the PIO shots, I’m cranky. You get it, right?

I’m walking out of my parking garage on my way into my office juggling my keys, my briefcase, a couple shopping bags (I bought candy to re-fill the candy jar I keep for people to snack on in my office), and my phone rings. I’m fumbling for it, but I have to pull off my glove (did I mention it’s snowing?) to get it open and turn it on; I almost miss the call. It’s my nurse at Ye Olde Fertility Clinic.

“Hi Perky One*, it’s NurseAwesome*. SuperDoc wants to talk to you.”
“Yeah? All right,” I sighed.
“You okay??”
“Yeah. Yeah, I’m fine.” I said, knowing that this just wasn’t going to bode well.
“Okay, hang on, here he is.”

Why the man couldn’t have just dialed the phone himself is beyond me. Because that introduction is exactly what gave me the anxiety I had, you know. But whatever. I do love him, and I know he has my best interests at heart. And for all I know it was NurseAwesome that wanted to make the call to me so that she could guage how I was doing, since she knows how pissy I’ve been all cycle. (Update: It turns out that SuperDoc did call me directly himself – but he called me at home and left a message at 8:45. Of course, I wasn’t home – I was on my way to work. NurseAmazing knows better, and she knows me well enough to know that I probably wouldn’t have been okay with just hearing a voicemail on my home number … which I may or may not have checked before I went in for my appointment this afternoon, by the way … so she probably said, “Yeah, no, we’re going to call her cell phone now.” That’s why I love her.)

So he said he took a look at the embryos with the embryologist this morning and what I’ve got is a 7-cell, a 6-cell, a 5-cell, and 2 four cells. If I were any other patient, with their normal criteria, he’d be recommending a two-embryo transfer today (day 3), but he does NOT recommend that with my history. With HOMs at home, and with my pregnancy history (e.g. not good) and with my need to ensure I do not get pregnant with twins (unless, you know, they’re monozygotic, in which case, we just had no way of controlling that risk), he is wholly opposed to a 2-embryo transfer. Which is good, because I am also opposed to it. My exact words were “absolutely not.” And he responded, “We are on the exact same page, don’t worry, I’m not recommending it – I would caution against it.”

My embryos look pretty crappy. They do not meet the criteria to go to a 5 day blast, but given the choice between picking a crappy single embryo for transfer today as planned or trying to grow one to blast by Thursday or Friday, he thinks our chances are better if we wait. He believes we are likely to have one at the blast stage if we wait.

So what happens if we don’t have any blasts by Thurs/Fri? We transfer whatever the best we’ve got is. And what if there’s nothing? We scrap the whole thing and start over. After all, we were all set to cancel this cycle last week before we got to retrieval, remember? It’s really no different, except that now we’ve been through a lot more hell than if we’d canceled ahead of time. But at least now we’ve got more information, right? What I don’t know is whether this would count as a full IVF cycle for insurance purposes if we don’t make it to transfer. My guess? Once you get to retrieval, it counts. That being said, my doctor is confident that we’ll have something to transfer either Thursday afternoon or Friday morning, it’s just a question of quality.

And so it goes.

*Note, she did actually use our real names… she doesn’t refer to herself as “NurseAwesome” though she’d be perfectly justified in doing so.

Oh so we've reached THAT stage have we?

Every morning when I go into the nursery, Abby has managed to unzipper her PJs *just* a little more…  Today they were a completely off.  I live in fear of the day she figures out she can also take off her diaper and smear poo all over the wall.  I believe there is a roll of duct tape in my future.

Respecting John M-Who?

J-man in the car this morning:  "Abba, if Bionicles were alive, they wouldn't respect John McCain."
S is pretty sure J was having auditory hallucinations.

Not funny, but heart-melting:

Ellie says "Mama" now, and means it.  I touch her nose and say "Ellie" and she touches my nose and says "Mama!"  It's so cute.  :)  If I'm in the kitchen and she's in the highchair, she turns to look at me and calls "Mama!"  Hooray!  (this reminds me I still haven't written a post about the speech therapy consult or subsequen therapy plan)

Attachment

Every day when I walk in the house, Sam looks up, drops what he's doing and runs over "aaahh!!!" he screams and immediately begs to be picked up.  Then he snuggles in tight for a hug.  But don't try to snuggle too long – he's got important things to play with!

Day 2 Embryology Report

Today’s news isn’t as great as yesterday’s news.

To review, yesterday we had 9 two-celled embryos from our nine mature eggs retrieved, which was fantastic news. I was overjoyed, shocked, and amazed.

Today:

1 didn’t make it at all.
6 are still 2 celled embryos (1 has had no change and therefore will not make it to tomorrow)
2 are 6 celled embryos, but they are breaking down (fragmented) and are unlikely to make it.

Transfer tomorrow at 2pm, unless I hear otherwise. Not looking great for having anything to freeze by Thursday (they bring everything to blast for freezing at my clinic, as they find they have a much higher FET success rate that way).

Interviews

I do have links to the interviews that aired on the news the other day – I don’t want to post them publicly here, but if you email me and you don’t strike me as a completely scary stalker-type, I’ll email you the links.

chezperky [at] gmail [dot] com

Fertilization Report

Good news today as well.

Expectations for a fertilization rate are that 50-75% of the mature eggs retrieved will fertilize. So if all 10 of the eggs retrieved yesterday had been mature (unlikely), we’d expect 5-7 of them to fertilize by today.

Of the 10 that were retrieved, 9 were mature (we expect that one of them was post-mature… remember that 25.9 follicle?)

Of the 9 mature eggs yesterday –

I have 9 two-celled embryos today.

Honestly, a girl can’t ask for better news than that, can she? I think I actually shed some tears.

I’m still in a fair bit of pain – but it’s worth it.

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.