new beginnings

i got my period today. no surprise there, really. we did an okay job trying on our own this cycle, but life has been quite busy and my body has been readjusting to life off of the hormones -- i wasn't exactly sure when i ovulated so we just kind of guessed. turns out that my cycle was on the longer side so i probably ovulated later than i thought. but -- it's ok. i wasn't feeling like it was going to happen during that cycle. but that wasn't coming from a pessimistic place... i am still feeling really good about things.

i went back to the doctor last week so that they could check on the cyst in my ovary and it was completely gone. the doctor said that everything looked great and that if i wanted we could try another IVF cycle. but i told her that we were happy taking a break until after the holidays. and i wasn't disappointed at all. she totally understood and thought it was a good idea to enjoy the holidays and continue taking a breather from the hormones. she told me to call her when/if i got my period so we could try to estimate when i should come in to see about getting things going in january. and before i left, she said, "i just have to tell you... i know this is going to happen for you. i do some ultrasounds and i can see how difficult it will be for some women... but you have beautiful ovaries. so don't give up hope." i guess, coming from a reproductive endocrinologist, being told you have beautiful ovaries is about the highest compliment one can receive. i was thankful for her optimism, and i know she wouldn't have said that if she didn't really mean it.

and i'm optimistic, too. not just about the possibility of trying IVF again in the new year, but even about this new cycle that will play out over the next few weeks. i'm on my winter break and have tons of leisure time and little fun getaway time over the next two weeks. thus, sex will be easily "scheduled" and hopefully plentiful. and my body still feels really good. i didn't have any pms at all. no cramps, no headache. my acupuncturist was so excited to look at my basal body temp chart it was as if i'd given him a holiday gift (which i probably should next week... i am so thankful for all he's done). he said my temps are indicative of a very healthy cycle. this chart looks completely different than the jagged ups and downs of the years i charted before. we have every reason to be optimistic. and we are.

the winter solstice is days away -- the only winter holiday i really celebrate anymore. it's a time of hope and new beginnings: the longest night before the slow return of spring and life renewed. it's perfect timing for me to ovulate and for my quiet time with the hubby. and while i can't possibly know what the new season or the new year will hold for us, i have a feeling that i'm moving closer to my dream of starting a family. and that is a really good feeling.

better than normal

it has been so lovely to be off of the hormone injections. i didn't even anticipate how great it would be. i mean, of course i knew i'd appreciate not having to give myself the shots or go to the doctor all the time, but i had forgotten (or hadn't realized) what it was like to feel normally hormonal rather than super-stimulated hormonal. i am so much happier, calmer, and balanced than i have been in months. in fact, i've been feeling even more "normal" than what i was calling normal before. i give props to acupuncture and therapy for this. and whatever else has helped me to get to this newly positive and relaxed mindset.

i've been reading a couple of books that take a more holistic approach to fertility treatments, addressing a lot of the same things that my acupuncturist discusses with me. i like them because they value both western techniques and traditional chinese medicine and speak to the strengths of both rather than proposing one in exclusion of the other. i see a lot of sense in that. the western stuff is obviously tried and true and proven in many ways, but it is not individualized in any major way. traditional chinese medicine practitioners treat individuals based on a host of factors, including both physical and emotional/spiritual, and focus on the whole body rather than on one particular problem. not surprisingly, fertility issues (like many other physical ailments) are tied to lots of things aside from one's uterus or ovaries.

for example, my acupuncturist knew from the beginning of my treatment that i am -- in his words -- yin-deficient, which means in a physiological sense that the moisture and fluids in my body aren't flowing properly. for years i have been constantly dehydrated and hot when most people are comfortable or even chilly. i thought this was just how my body worked. but in the couple of months i've been going to acupuncture, that is starting to change. and this doesn't just make me feel a million times better on a day-to-day basis (though it really does!), it also speaks to some possible reasons why the fertility treatments i've received so far haven't been successful. obviously fluids and moisture need to be flowing properly for reproductive organs to work and for menstruation to happen as it's supposed to.

in tandem with this, i have learned from one of the books (Making Babies) that my fertility type -- based on their in-depth quiz -- is "Dry." aside from the obvious symptoms in my regular life (the thirst, dry skin, etc.), women of this fertility type often lack the cervical mucus necessary for adequate sperm travel and also don't have success with the ovarian stimulation drugs. clearly we've seen evidence that my body doesn't like the drugs. and -- believe it or not... and TMI or not -- my mucus situation has changed dramatically the past couple of cycles. i really, truly thought i was drying up like an old lady, but suddenly things are, well, flowing again. (i'm sure that my acupuncturist also knows about the mucus issue but THANK THE STARS he hasn't brought that up.) so in addition to acupuncture, which is already treating this issue for me, the book also gives a lot of advice about nutrition and exercise and other general practices that are best-suited to my particular type. since i know that mucus may be a problem for me, i've thought a lot about staying away from foods and drinks that tend to make one acidic, because that can also kill sperm. i am learning so much! and, of course, knowledge makes one feel more powerful, which is a good way to feel in this situation.

i am on a new regimen of herbs specifically to target fertility issues. my acupuncturist is trying to make my cycle longer, since he thinks my very short follicular phase (the time before i ovulate) could be an issue. so i take one formula of herbs from day 5-11 of my cycle (follicular), another from day 12-20 (ovulation and possible fertilization), and the last from day 21 until the end (possible implantation). the hubby and i are trying au naturel this cycle, which has been a LOT of fun for me. remember i haven't been able to have sex around when i ovulate for the past five cycles because we were doing IUI, plus my hormones have been all out of whack so i wasn't really in the mood much anyway. now it feels fun again, and i really do feel that my body is in a very different state and more ready for pregnancy than it was before, so it could happen. i'm not counting any chickens, of course. but i still feel positive.

we've pretty much decided that we won't do any fertility treatments until after the new year. we're even going to go on a little getaway for a few days after christmas. the hubby had a pretty dark and depressed few days last week but i think he's feeling better now. he is an eternal optimist and the reality of our struggles (that i've been feeling for months) just hit him, it seems. but he's on board with acupuncture and the herbs and has even been reading some of the fertility books with me. he's watching his diet, too, and still taking his sperm vitamins. we're doing all we can, and the next few weeks are filled with fun and excitement with family and friends... can't help but smile about that. and i'm sure smiling helps fertility, too, right?

hiatus

got my period yesterday, as predicted, and went to the doctor this morning to see how my ovaries were looking and if we'd be able to start an IVF cycle. alas, one of my ovaries is still a bit out of whack. i have a cyst, which sounds awful but isn't likely threatening to my health. it is just from one of the follicles not doing what it was supposed to. here are some details about "functional cysts," via www.womenshealth.gov:

Follicle cysts: These cysts form when the sac doesn't break open to release the egg. Then the sac keeps growing. This type of cyst most often goes away in 1 to 3 months.

Corpus luteum cysts: These cysts form if the sac doesn't dissolve. Instead, the sac seals off after the egg is released. Then fluid builds up inside. Most of these cysts go away after a few weeks. They can grow to almost 4 inches. They may bleed or twist the ovary and cause pain. They are rarely cancerous. Some drugs used to cause ovulation, such as Clomid® or Serophene®, can raise the risk of getting these cysts.

regardless of what type i have, they won't do any kind of stimulation hormones or procedures this cycle because of this. not even IUI. they want my body to take a complete break over the next few weeks in hopes that the cyst will go away and things will regulate themselves. i am going back on december 8, which will be near the end of this cycle, to see how things look and make a decision about next cycle.

i was slightly disappointed to find out i wouldn't be able to do IVF again. but once i had a few minutes to think about it, i realized i am actually really relieved. with thanksgiving and choir performances and other fun things coming up these next couple weeks, it will be nice to not have to worry about giving myself injections or having numerous doctor appointments. but we'll have a really big decision to make if the doctor says i'm a go for trying IVF in my next cycle, because it would mean canceling some travel plans at the end of the month. then we have to weigh the costs... if we don't do another assisted cycle this calendar year, we lose our remaining insurance money. if we cancel trips, we lose money on airfare and possibly other reservation fees... and, well, our holidays will just suck a lot. is it worth it? i just don't know.

at this point, there's no guarantee of anything. who knows how long this cyst will stick around, or what else might be going on in my ovaries, or if they'll even respond properly if we try another stimulation cycle. so i'd rather take a step back and try to enjoy these next few weeks. heck, i could even have a glass of wine or seven. that sounds almost as nice as not having to stab myself for the foreseeable future. obviously the hubby and i will need to talk all of this over. he's the money man. but he also can appreciate how stressful this whole process has been for us. in any case, we've got a couple of weeks of peace. and i'm going to try my best to not think any further ahead than that.

negative

i wish there was another word for test results that wasn't so... negative.

i had a pretty bad couple of hours yesterday after i talked to the nurse, especially because they messed with my mind. when i called to get my results they asked if they could call me back. no explanation. i waited an hour and a half. of course by then my brain had led me to all kinds of conclusions, the winning one being that i was convinced the doctor was going to call to tell me it was positive. but no... the delay was just because they had to check with the doctor first in order to tell me next steps since i didn't start that medication last week. why on earth they couldn't just tell me the test results and then talk to the doctor and call me back with those details, i have no idea.

luckily, i had acupuncture after school. i walked in there pretty damn depressed but walked out feeling mostly okay. the whole experience is so relaxing, and plus he's so good at talking through things in a way that makes me remember the big picture of my life and happiness. he told me that if i wasn't able to get back to the positive frame of mind that i'd been in the past week or so (after my understandable immediate reaction to the bad news) that i should think about whether or not i want to push ahead with all of this right now. he really thinks my state of mind is the most important thing and good things can only come from good perceptions. i told him i would keep that in mind.

and today? i feel pretty okay. i am disappointed, of course. but i'm still hopeful. i'm not looking forward to attempting another IVF cycle, the medications, all of that discomfort and inconvenience. but i still believe it could work for us and at this point i'm still willing to make those sacrifices.

but -- we'll see what happens. i have to go in when i get my period so that they can take a look at my ovaries and see if things are dormant enough to begin stimulation for IVF. my guess is that i'll go on monday. having stopped the progesterone, i should get my period by sunday... and, if not, i may just go in on monday anyway because i will definitely get it that day. i don't want to delay this. hopefully they'll say we're good to give it another shot this cycle. if that's not the case, i think we'll be looking at post-christmas. i'd rather not wait that long. i'd rather not lose out on the insurance money that expires on dec. 31. but i knew that was a risk. and i'm not freaking out. all good, for now.

herbs

yesterday the china town pharmacy called to confirm my order and told me it would be ready that afternoon, so i took the relatively easy 20-minute trip to pick it up. the pharmacy itself was a pretty impressive place. it looked like an old-school apothecary with floor-to-ceiling drawers, barrels of dried items, and hanging scales for measuring. the clientele was mostly chinese people, but given the prevalence of non-chinese who now receive traditional chinese medicine they had some folks on staff to deal with us english-speakers. my herbs came in granules, all mixed together into one container... that looks like a regular plastic container with a plastic-sealed top. nothing old-school or mystical about that at all. it came with a tiny spoon that is what i'm supposed to use to measure it out: 5 spoonfuls into hot water, two times per day.




this is what's in there:
Shu di huang - Chinese foxglove root
Shan yao - Chinese yam
Mai men dong - ophiopogon tuber
Fu ling - poria (a type of fungus)
Ze xie - type of tuberous stem
Mu dan pi - peony tree bark
Bai zhu - white atractylodes rhizome
Gou qi zi - Chinese wolfberry
Tu si zi - Chinese dodder seeds
Du zhong - eucommia bark (rubber tree)

i did some (minimal) research on each item to see what they're used for in TCM, and overall it seems like all general health stuff. liver and kidney function, yin balance, that sort of thing. definitely can't hurt. when i mix it with the hot water everything dissolves really easily, and it doesn't taste terrible. it doesn't taste good, either. but it's not awful. i can definitely get through it without trouble. so we'll keep this up for the week and by the time i see my acupuncturist again friday afternoon we'll know if i'm pregnant or not. !!!

it's all in my mind... but that's a good thing

i spent this week kind of living in the same state of mind that i was last time i wrote. i've been paying attention to my body and operating on the assumption that i am growing a baby inside of me. it no longer feels scary to give myself that hope. it feels necessary. either for this theoretical pregnancy or another one in the future, it feels like this is the mindset that i need. and i'm listening to that.

in the past i have felt like after the IUI procedure -- or, at least, after the 24 hours or so afterwards -- that it was just a done deal and that all there was to do was wait. it seemed interminable and impossible that there could be such a long period of radio silence from my body when there was no way to know if it had worked or not. but actually, this isn't true at all. of course fertilization should happen within a day or two of the insemination, but it doesn't end there. i knew this, of course, on an intellectual level... but it was never a part of my consciousness during the two-week wait.

this two-week wait doesn't just feel like two weeks of agonizing waiting. i've been thinking all along about what might be happening in my body and believing that it really may be. implantation should be occurring sometime in the past/next couple of days. i've just been imagining it and sort of coaching it along. telling my uterine lining to be ready, telling the baby what a sweet life it'll have if it sticks around, that sort of thing. and visualizing my body being the right environment for all of this to take place. it's a very, very different mindset than i've had at any other time in this process. and i know it may seem silly, or pointless, or like i'm setting myself up for even greater disappointment. but it really doesn't. it just feels right.

it's not that i've noticed anything physical that seems to indicate pregnancy. i have felt about the same as i have any other cycle that we've done IUI, i think. tired from the progesterone. SO tired. some cramps the past few days, mostly pulling/tugging sensations on my lower left side. i've read that some people had those when they were pregnant, but i'm pretty sure i've also had them before. my boobs and especially my nipples are super sore. but that's happened before, too. my stomach feels kind of off after i eat, but that's likely from all the medication. so no -- i don't have any hard and fast reason to believe that this time actually worked. and, to be honest, i don't know if i have much of an intuitive sense that it did, either. i just feel that if it's going to work, i need to believe that it's going to work. and so i am.

yesterday i went to acupuncture, and that was the most encouraging thing that's happened. my acupuncturist was really happy that i decided not to start the Ganirelix, and told me that even though i had told him the doctor's explanation last time that he was dubious about it being the right course of action. he also said that he's had great success with patients who took a break from the medication between cycles and he was in full support of that. i told him that i have been paying attention to my body and taking care of myself, prioritizing well-being over work and stress, etc., but i didn't really explain my whole visualizing and "believing" situation. i guess it felt a little silly. i just said i felt that we had a good chance with this IUI and that i was feeling positive about it.

it all felt like a normal session. but then he listened to my pulses and said that my left one could be indicating pregnancy, but that my right one wasn't clear. and then he sprang into action. my treatment was totally different than it's been before. he told me that he wants to start me on some herbal treatment that will help sustain the pregnancy over the next few weeks if i am pregnant. he called a prescription into a pharmacy in china town for me. the needles that he used yesterday were in some very different places than where he usually targets, and he also did a lot of feeling my kidneys and paying attention to different parts of my body. my hunch is that he thinks i could be pregnant but he didn't want to really come out and say that to me, for obvious and understandable reasons.

and so while i wish i could know sooner if this attempt was successful, i am content with letting things take their course. i may try an early-detection home pregnancy test this week prior to the blood test on friday. but in the meantime... i'm okay. i really am. just help me out and think some encouraging thoughts about my uterus in the next few days, alright?

taking control of my destiny

i believe today marks the day i've moved into a new phase of dealing with this whole process: empowerment. not a bad feeling, i have to say.

i went back to the doctor yesterday so that they could confirm that i ovulated as predicted (i did). when they did the ultrasound it was clear that some of the follicles had collapsed (meaning they hopefully released eggs and then dissipated) but also that i had two follicles that were still big and fat. now, this doesn't mean that they will ovulate. they won't. once the hormone shift happens that's impossible. but it means that this was just a really wacky cycle and that my body is still responding to the medications despite being off of them for days. they told me to come back on friday and that we'd see when it was time to start the ovulation-suppressant, Ganirelix, in prep for my next cycle of IVF. i said, "if i'm not pregnant, we'll do IVF." and she said, "of course. if you're not pregnant." it felt a little bit like that scene in The Princess Bride when Prince Humperdinck is pretending he had sent ships to search for Buttercup's beloved Westley:

Humperdinck: Ahhh, my dulcet darling. Tonight, we marry. Tomorrow morning your men will escort us to Florin channel, where every ship in my armada waits to accompany us on our honeymoon.

Buttercup: Every ship but your four fastest, you mean. [pause] Every ship but the four you sent.

Humperdinck:Yes. Yes, of course. Naturally not those four.

it's like the possibility that i could be pregnant from the IUI is all just pretend except in my pretty little head, and everyone else is already assuming we'll do another IVF cycle.

last time i was pretty skeptical, too, and running on the same assumption. well, i'm not letting that happen this time. because, in my pretty little head, i think we have a damn good chance that it worked.

so i did a lot of research about Ganirelix last night and found out (not surprisingly) that you are not supposed to take it if you are pregnant. AND that at a lot of fertility clinics they don't let patients go right from one assisted attempt to another, especially if IVF is involved -- they require women to take a cycle off to get their bodies off of the drugs and start up on the new ones for the next try. on one hand, i'm pleased that my doctors will rush things along. less waiting, more apparent progress. but on the other hand, i don't like the assumption that the IUI was just a feeble attempt to salvage a cycle and that it didn't really count. i also really don't like the idea of taking a medication for a week when i could be pregnant that could have a negative effect on the pregnancy. i didn't even think about it last cycle... i just started using Ganirelix when they told me to and didn't even research it. i assumed they had my best interests in mind. but now... i think the push ahead to IVF might be premature.

so i said no.

i called Dr. B. this morning and we had a nice chat. he repeated some of the things that we'd talked about on friday -- to reassure me, i assume -- and told me that he had checked my hormone levels again from the bloodwork and that my FSH (follicle stimulating hormone) levels were normal, leading him to believe that this cycle was indeed a fluke and that i'd respond better another time, if needed. he also echoed what i'd read online: that many women respond better after taking a "breather" -- a cycle off to let their bodies balance out before starting the injections again. i told him that i wasn't sure if i needed to take a breather, but that i'm not comfortable taking the Ganirelix until we know for sure if I'm pregnant or not. he agreed that this IUI had a great chance of being successful and that if my intuition is telling me not to rush ahead, then we should listen to that. and he said that we can see how my ovaries are looking if i do get my period and assess if it's possible to start an IVF cycle then or not. we'll play it by ear, as they say.

i'm comfortable with this scenario. i realize it might mean losing the insurance money for this calendar year if we can't fit in an IVF cycle before december 31. i'm okay with that. (the hubby is less okay with that, but understands.) the fact that i still have some weird mutant follicles rolling around in my ovaries is not a good sign to me that my body will be ready to start all of that crap again in a couple of weeks. and, honestly... i am feeling really good about our chances of being pregnant this time. i know it's not super likely given that it's our 5th IUI. but let's look at things under a virtual microscope, shall we?

* IUI #1: three follicles, two inseminations: both done prior to ovulation (boo)
* IUI #2: only one follicle (a crazy early developer that they thought was leftover from the previous cycle but were wrong), two inseminations: possibly both before ovulation but timing was ok, they think (i also had a total emotional breakdown the day of 2nd IUI... this was kind of the psycho-emotional low-point of the process) = crazytown
* IUI #3: two follicles, two inseminations: one of the day of ovulation and one the day after
* IUI #4: unstimulated, only one follicle, done prior to ovulation and possibly too early (ultrasound post-ovulation was "inconclusive" in terms of determining precisely when i ovulated)
* IUI #5: three follicles that all seemingly ovulated, one insemination done on day of ovulation

in this light, it's pretty clear to me that these five attempts were not equal. #3 was definitely our best attempt until this last one. and i feel like this one was a really, really good attempt all around, in spite of the frozen specimen and only one shot at it. the timing was absolutely perfect -- i could feel that in my body, which hasn't always been the case. also it was the only time i didn't bleed afterwards, which i attribute to two other important pluses: that one of the best doctors did the procedure, and that i spent the whole day afterwards resting and doing yoga and having acupuncture, generally thinking positively and taking care of myself and even being a little bit superstitious by carrying around voodoo pouches and fertility charms in my pockets. can't hurt, right?

listen, i'm a realist. i am completely aware that IUI just might not work for us because there's something else going wrong that only IVF will reveal. but given the fact that we don't have any concrete reason to believe that that's the case, i'm going to stay optimistic. i am feeling good right now and trying to trust my body which -- if nothing else -- seems to be wanting to break free from the trappings of all of these controlling drugs. those follicles this cycle kept developing regardless of our attempts to slow them down and wait for others to catch up... maybe they were just really determined. i've been trying to picture them saying, "wait -- we've got this. give us one more chance to work on things from the inside." so we'll see. you never know. and if it doesn't happen this time, i will be even more ready to move on to a different route, because I will at least feel that we gave IUI our very best try.

and i feel very confident about my decision not to pump any more substances into my body until we know whether or not it worked. i want to give this one every possible chance of making it. i know, too, that a big part of that is my state of mind, which -- i have to say -- is better than it's been since we started this process. that is one thing that i now feel i really have control of, and i'm so glad.

IUI #5

Today was the day for our fifth IUI. When I went in yesterday morning they could tell that I was close to ovulation but decided to rely on the bloodwork to make the final decision about how to time the insemination. I could tell by how my body felt that it was coming soon. In fact (here's some TMI for you) I have had more cervical mucus this cycle than I remember in quite some time. Like, over a year. I had thought that had gone the way of my younger self! But that, in combination with cramps and my lusting afer random men on tv and the subway, let me know the timing was spot on. The bloodwork obviously agreed; I spoke with the nurse yesterday afternoon and she said we were a go and that I should do the ovulation trigger shot (HCG) as soon as possible. Luckily they had mixed the medication for me that morning (it's a controlled substance so I'm not allowed to mix that one myself) so I had it school and I'm an expert at quick bathroom injections now!

It took a bit longer to prepare the specimen this morning, I assume because it was frozen. I wasn't concerned, first because I'm totally sucked into a book right now, and second because I had already decided (with my principal's heavy influence) not to go to work today. When it was finally time, I was quite pleased to see that they seem to be taking this fifth attempt very seriously. One of the two directors of the institute did the procedure, which I don't think is common. I know those two do the surgeries and IVFs, but there's a team of four other doctors who have done all of my exams, sonograms, and inseminations before today. Dr. B told me he knows I'm probably disappointed That we couldn't do IVF this cycle, but that i shouldnt be discouraged. He said I have five (5!) good follicles as of today, which is obviously great news for our IUI attempt and also not a terrible indicator if we do need to do another IVF try. He thinks, like Dr. K. said, that this cycle just probably isn't my best and since i responded the way i did in previous IUI cycles he believes I could do better in the future. He did the insemination and told me he thought it would be best for me to take it easy today, even more than I have in the past. He was delighted to hear that I wasn't going to work today. He said to do as little as possible so that the sperms can do their best swimming, but that I could resume regular life tomorrow.

It's really nice to know that they're not just going through the motions and treating this IUI like any other. They're taking care to address my emotional needs and to give this insemination the best possible chance to work. Frozen sperm don't live as long inside the body, so hopefully all of our ovulation evidence is correct and some magic will happen today. Luckily I already had acupuncture scheduled for this afternoon, so that will certainly increase the likelihood of magic. It sucks that the hubby's not here to supplement the IUI with a natural attempt just in case. But... it's all better than nothing. I go back Monday for a follow-up sonogram and bloodwork, but for the weekend I am drug- and doctor-free... and husband-free, which mostly means the pets pile on top of me on the couch and I get to watch a lot of bad tv. Not too shabby.

from bad to worse

i have to say i was pretty excited to go to the doctor this morning and see how many follicles were developing after all of these monster doses of meds. the injection last night didn't hurt as badly as the first one, though it still wasn't fun and my leg is quite sore today. i took the advice of some folks online who suggested refrigerating the meds and also letting the syringe sit for a few minutes after mixing it to let things settle. today i still feel like someone has punched me -- now in BOTH legs -- but either i'm getting used to it or it's not as painful.

then again, i'm pretty distracted by the bad news i got this morning.

on monday, if you recall, the doc was disappointed that i only had four follicles developing -- hence the start of the stronger medication. today i STILL only have four follicles. and one of them has continued to develop in spite of me taking the medication that was supposed to halt it. which means that, most likely, nothing else is going to happen this cycle. when the doctor who did my ultrasound/sonogram saw this, she immediately asked how old i am, which indicated to me that my body wasn't responding as it should for someone my age. she said they'd have to look over my records and see, but that they might recommend doing another IUI and waiting until next cycle to try IVF again. four follicles just isn't enough.

this was crushing. i started crying as soon as she left the room, and cried on and off for the next hour. miserable.

then i got to talk to the big head honcho doctor (the director of the institute) again; he looked over all of my charts and said that he definitely didn't think we should do IVF this cycle. he said it would be a waste of money with only four follicles. he said that this response was quite poor for someone my age, so his theory is that this is just a bad month. perhaps if we need to do another cycle, my ovary response would be better. i realize that this makes sense, but it isn't really based on anything other than hopefulness and general statistics about my age. he has no way of knowing that my body won't respond exactly the same way if we did all of this again.

he recommended converting this cycle to another IUI and going from there. since i have four follicles, it's a good opportunity for IUI. i never had more than three. the bad news is that the hubby is going out of town tonight and - based on the size of the one large follicle - the IUI needs to happen pretty soon, possibly tomorrow. so after sobbing my way out of the hospital, i had to run back home to deliver a specimen cup and cryo-preservation consent forms to the hubby so that he could drop off a sample today for them to freeze and have for the IUI. i ended up sobbing some more as i explained everything to him. i don't remember the last time i cried so much. i think it's a combination of the disappointment of having been so hopeful about IVF and also fears that my body is just too old or too dysfunctional for all of this. which makes me worried it won't ever work.

the hubby reminded me if it doesn't ever work that we can still adopt the little korean babies that i often talk about. also true. also viable. but not what i wanted to think about this morning. one thing at a time.

so -- tonight i give myself another painful Repronex injection and go back in tomorrow to see if i'm ready for IUI. if not tomorrow, it will be friday. and then another two-week wait to see if somehow, maybe, the 5th time will be the charm. i will try to remain positive about this. but i won't lie. it sucks. it really, really, really sucks.

stop & go

it has been a miserable 24 hours. i went to the doctor yesterday morning to see how the ovary-stimulation was going. things were happening -- two follicles developing in each ovary -- but not to the satisfaction of the doctor. we want way more than four follicles to work with. so we stopped the follicle stimulating hormone i've been taking (Gonal), which is the one i used for all of IUI, and she told me i would start a different one (Repronex) beginning last night in order to entice more follicles to develop. but, in the meantime, i also had to start taking the anti-ovulation one again (Ganirelix), to stop the development of the four follicles that are already on their way until some others catch up. got that? stop one injection, start one new one, and restart something i'd previously stopped.

ok, no biggie. i do one injection in the morning (Ganirelix) and one at night (Repronex). Repronex has follicle stimulating hormone (FSH) in it like Gonal, but it also has lutenizing hormone (LH). that's another reason why i need to take the Ganirelix, because LH helps to encourage ovulation, which we definitely don't want right now. i'm an expert at doing the Ganirelix now, so i knocked that one out at the doctor's office before hopping on the train to work. had a rather exhausting day and came home to a house full of poop. my dog was apparently having some kind of stomach distress and managed to explode all over the house not once but twice in between the hours of 10 and 6 when he was alone. i spent a good hour cleaning up that mess before rushing off to choir rehearsal. home at 9, scarfed down some dinner, and just had to do my final injection of the day before bed.

so i got everything ready for my first Repronex injection (four vials of powder mixed with one vial of sodium chloride) and planned to do it quickly and get some solid sleep.

OUCH.

in the past only my HCG (trigger) injection has actually felt painful going in. and even that went away not too long after administering it. this one is awful. after recovering from the initial stinging and limping off to bed, i tossed and turned for a good portion of the night without ever actually waking up to figure out why i was so uncomfortable. when my alarm went off this morning and i tried to get out of bed, i couldn't even put weight on the leg where i did the injection last night. man alive. i took pain meds and went back to bed for an hour or so -- not that i slept -- before dragging myself to work.

it's now almost 6pm and my leg still feels like someone punched me as hard as they could. i am dreading doing another injection tonight and making my other leg feel the way this one does. how will i walk around tomorrow? i also seem to have lost my appetite and feel a little bit loopy. at least i get to go to the doctor in the morning to complain. though i doubt they'll have much to say about it. i checked online and it seems that a lot of people who take this medication have had the same issue. so i guess i just have to suck it up and think about the big picture.

tomorrow the hubby leaves for a boys' weekend, so i'll have a few days to myself. it'll be nice to catch up on couch time and to watch whatever i want on TV, while probably nursing my poor, sore legs. i'll have to double-check with the doctor again tomorrow that there's no way we'll need to do the retrieval while he's gone. i'm a little anxious about that. he plays such a tiny role in this whole thing, but it is -- obviously -- quite a significant role. i guess depending on how the follicles are doing tomorrow we'll have a better idea of when the retrieval will actually happen. in the meantime, i'll try to stop whining and tell myself all of this will be worth it someday.

sperm balloons & a plan

This morning as I was walking to the fertility institute I saw a woman carrying a gift bag that I immediately thought was decorated with colorful, striped, and polka dotted sperm. They were birthday balloons. It was a birthday gift bag. I think this helps to illustrate how much this process has taken over my life. I no longer feel that I have a full-time job other than trying to keep straight all of my medications, appointments, and continually researching and reading about assisted fertility. The good news is that by virtually ignoring everything else in my life I don't feel terribly overwhelmed. Yet.

I got my period on Wednesday like clockwork (two days after stopping the progesterone) and so I went in today to start the IVF cycle. I've still been taking the ovary-suppressant injection, so as of this morning my ovaries were clear and calm. The doc said everything looks good, so I stopped that drug and started on the follicle stimulating hormone today.

Instead of doing one injection as I did the first two IUI cycles, or two like I did in my third IUI cycle, now I'll be getting a quadruple dose. But the cool part is that they want me to put it all in one injection. So I use one syringe of water but mix in four vials of powder. Sounds like a crazy amount of hormones, but at least it'll be all in one injection. They gave me two this morning and I will do two more tonight, but for the next couple days i will do four vials each night. I go back on Monday to see how things are progressing.

If all goes according to plan, the egg retrieval will take place on Tuesday, November 8. That's assuming that my ovaries respond to the stimulation as they should and I have enough developing follicles by then. If not, we may have to continue stimulation a bit longer. I am guessing I will be going in for frequent ultrasounds to check on progress, even more than with IUI. And of course this is a much longer stimulation period than with IUI. Hopefully the meds don't make me feel awful or go crazy. And hopefully they work! I don't want this to drag out any longer than already expected.

I have all of this paperwork to take home for the hubby and I to read and sign. I had some consent forms with the IUI, too, but nothing like this. Today I had to sign off on all of the medications, saying that I understand their purpose and the side effects, and on the IVF procedure itself. I was interested to see that they asked us to consent not just to IVF but also to ICSI (intra-cytoplasmic sperm injection), which is when they determine that sperm quality is too low to fertilize on its own, so they inject it right into an egg. (This may be an issue for us since we know the hubby's morphology wasn't great in his analysis last fall.) We also have to consent to assisted egg-hatching, which I think is when a fertilized egg can't break out of its shell and continue developing into an embryo. I knew about both of those procedures but thought they might occur in a later IVF attempt, perhaps if there were problems with earlier tries. I asked the doctor about this and she said they leave those decisions up to the embryologist but that very often they will decide to take those additional measures; we need to consent to them just in case. This made me happy - it's nice to know they're going to pull out the whole bag of tricks on the first try if needed.

We also need to give consent for them to freeze any embryos that we don't use this cycle and make all kinds of decisions about what happens to them afterwards - say if one of us dies or if we don't need them for future cycles. Which is kind of a strange situation, to have little frozen possible babies of ours in a lab somewhere. Weird.

Overall, I am still feeling mostly excited and optimistic about all of this, so let's hope that continues. With not too much hormonal craziness. Fingers crossed.

IVF, here we come

and it's official: i am not pregnant after round 4 of IUI, and we're beginning the IVF adventure.

there was a time when i never thought i'd be in this position. but now that i'm here, while it's overwhelming, i'm kind of excited to up our odds once again and see if we can make this work. don't get me wrong, i'm dreading the medication and the time i'm going to miss from work and everything else. but it's the next step, and i'm ready for the next step.

i've been taking the ovary-hostage drug since last week and it's pretty much given me a non-stop headache. i'm not even exaggerating. the number one side effect is headaches, and man... they weren't kidding. pain meds help a little bit, but it never actually goes away. the injection itself is easy and painless. i even gave it to myself while camping with 5th graders. no sweat. and of course i've been using the suppositories (ugh), same as always.

today i went back to the doctor for the pregnancy test and i really never even thought it would be positive. i'm not sure if it was just because it was round 4, or because i have my mind set on doing IVF because things are already rolling, but i was not expecting anything other than another big fat negative, which is exactly what i got. so now i stop the progesterone and continue the ganirelix (the ovary-hostage taker). when i get my period, which should be by wednesday or so, i go back in and they tell me what to do next.

it's just amazing how much time and energy this whole process takes... and i know IVF will be so much more intense than IUI has been. i've had nothing but drama since thursday with the insurance company. i've practically maxed out my "specialty" prescription benefit, which is a LIFETIME benefit (and who knows what qualifies as a "specialty" medication as opposed to regular). so that means i can't really order most of the drugs i'll need from the pharmacy anymore. instead, i will be buying them at discount from the doctor's office or trading in things that i already have for things that i need more. this morning i traded in ten of the follicle stimulating hormone for five more ganirelix, since that's what i need right now and they cost a bajillion dollars from the pharmacy. it has been so confusing -- i finally asked the doctor's office to call the insurance company and work it out so they have a handle on things now. now they'll just strategically place only orders for things that are still covered and not for things that i'll have to pay out of pocket. it's insane how much some of these things cost. for a two-week supply of one of the drugs it was going to cost me over $3000. yeah, you read that right. INSANE.

but hopefully the out of pocket costs for this first round won't far exceed the $5k we'll have to pay for the procedure itself. seems like we should be able to work all of that out this time. and if we have to make the decision to do it again, we'll have to weigh all of the costs as part of our decision-making. but either way that won't happen until next calendar year. honestly, the thought of having a break from all of this is as exciting as moving on to this next step. maybe more so. after this round of IVF, whatever the outcome, we're not doing anything except having plain old-fashioned sex until january. i can't wait.

my ovaries: hostage

I went back to the doctor this morning to get started on one of the new drugs I will need if we do end up doing IVF. They did the sonogram, determined that nothing was going on for next cycle yet (I'm only at Day 18), and showed me how to use the new drug. It's called Ganirelix, and it basically takes my ovaries hostage. It will render them incapable of doing anything on their own, which is exactly the way we want it if we do IVF. Unlike with IUI, when we were just stimulating my natural cycle and ensuring timeliness by using the trigger shot, there is nothing natural about IVF. They will control every step of the process.

If it happens. Because, remember, I could be pregnant from our 4th IUI. Probably unlikely, but possible.

Anyway, the Ganirelix injection comes already mixed together, so it will be slightly easier than the follicle stimulating hormone, Gonal; that's when I get to be a chemist mixing powders with liquids and switching needles and whatnot. This one is all ready to go. But it has to be given subcutaneously (under the top layer of skin, I think is what that means) rather than intramuscularly like Gonal. Basically Gonal I just stab straight into the center of my leg. Ganirelix I inject at a 45 degree angle into a hunk of skin that I pinch together on my leg. Not much of a learning curve, really.

The nurse showed me how to do the first one at my appointment this morning, and then told me that I have to give myself the injection every morning at the same time. Which means I'll be stabbing myself in the school bathroom and - even better - on our 5th grade camping trip this week. That'll be fun to maneuver when I'm sharing a bunk with six 10 year old girls. I was also told to continue the progesterone (bane of my existence) until I either get my period or come back into the office for the blood test a week from today. If I'm not pregnant, I'll continue to Ganirelix until they determine it's time to start inducing ovulation for IVF.

The GREAT news of the day is that my good friend and colleague who has been going through all of this fertility stuff for way longer than I have is finally pregnant! Her second IVF did the trick and she's now almost 12 weeks along. She told me today and of course was nervous that I'd be upset. But I was truly so thrilled for her. I cried, entirely from happiness. She and I have have gone through so much of this together and I could never not be happy for her after everything she's been through. And it bodes well for me... it's so nice to see that it works out. She has also been doing acupuncture and is convinced that did the trick. AND another one of our colleagues also had a successful IVF over the summer- that news was just made public. We always have tons of pregnancies at school... maybe this year is the year of the assisted pregnancies!

So - optimistic vibes all around here. I go to acupuncture tomorrow and, of course, back to the doctor in a week. We're pushing ahead, one way or another. Oh, and one more weird thing that I don't think counts, but still: the hubby has a client who's a shrink, and she asked him out of the blue last week if we were expecting a baby. She said she just had a feeling that he was going to be a father. Maybe it's just my acupuncturist's theory about the parenting journey beginning once you're trying that came across. But my husband is the most skeptical person on the planet about anything other than science determining anything, so the fact he even mentioned this to me in a semi-serious, hopeful way is saying something.

less uncertainty and more acupuncture

got the results of the bloodwork, and they indicate that i did ovulate. so it's the monitor that's a little bit off. i guess out of the three (my own body sense, the numerous medical assessments, and the monitor) it makes sense that it's the thing that isn't totally on top of things. i'm assuming i ovulated yesterday, which is why my temp hasn't gone up yet. so fine. timing of this round was ok. not perfect like last time, but ok. they want me to start the dreaded progesterone suppositories tonight (whimper) and then i go back next monday to start getting prepped for possible IVF.

i had a lovely acupuncture session this afternoon, too. i like that we do something different each time. it reinforces my belief that he really knows what he's doing and that he tailors my treatments to the time in my cycle and what else is going on with me. he could tell (of course) by "scanning" my body as he calls it (basically just holding his hands over different parts of me) that i had some blockages that caused me to have a wicked headache and some digestive issues over the weekend. which i totally had, and blamed on my body adjusting to various hormonal changes. he spent a long time figuring out where the most severe blockages were the treated only those today (three spots: two on my feet and one on my head) and then also did some work on my back for the first time. he says the back is the way to target the causes of the physical symptoms: the fears, anxieties, feelings that create problems in the first place. it felt much more targeted and technical-seeming than any other treatment i've had with him: there was a lot of consulting manuals and charts and measuring where certain spots were on my body in relation to other spots. i'm fascinated with the whole process.

he said that i'm responding really well to treatments and that he can already sense the changes in my body. i can too -- last week when the temperature dropped down into the 60s i think i reacted to those temps like normal people do instead of remaining my usual sweaty self! it was amazing. that balancing out of my yin and yang (cool and heat) is one of our biggest goals... i'm too hot and dry. he told me that water -- both literal and metaphorical -- is what i need more of in my body to calm and balance me, and that one way i can increase that in the metaphorical realm is to have more time to myself. meditative and calm = water. we talked about my age-old habits of overscheduling and overtaxing myself, and how i load myself down with "fun" social things in an attempt to try to balance out the amount of time i spend working, but that it's counterproductive. he wants me to do less and "be" more. i know it sounds like hippie nonsense but i get it. i really do. and i know he's right.

so what am i doing this afternoon? well, i'm working my ass off on school stuff that just can't be avoided. but tonight i get to sing my heart out at choir and then the rest of the week is relatively peaceful. we'll see how i do with this meditative calm stuff. not exactly my thing... but hey -- not much i've done these past few months has come easily or naturally.

uncertainty

i do think it's ridiculous that IVF costs as much as it does. but the further i get in this process, the more i understand why. the female reproductive system -- even when closely monitored -- is incredibly unpredictable and complicated. the ability to eliminate a good portion of that uncertainty is probably worth $10,000.

this morning my ovulation monitor told me i would ovulate in the next 48 hours. wtf. i kinda thought it was just confused and that it wouldn't tell me i was ovulating at all. i mean, it's one thing to miss it. but to mis-detect it??? i took my temperature, and it hasn't spiked above the typical baseline, which would mean that i haven't ovulated yet (or that it just happened yesterday). yesterday -- according to my body -- makes sense... i had just started to notice the tell-tale mucus and some other symptoms that are probably just TMI. so why would the monitor (based on me peeing on a stick) indicate today or tomorrow? especially when the size of my follicle and the fact that i took a freakin' ovulation trigger shot seem to indicate saturday? you would think that a day on either side wouldn't matter that much, considering the inability to narrow it down more precisely, but it totally does matter. if i did ovulate yesterday, the IUI on saturday still has a decent chance of being effective. decent, not great. if i was to ovulate today (or tomorrow!), it was pretty much pointless.

insane.

so i went to the doctor as planned, told the doc all of those details, and she -- of course -- said we'd check things out. the sonogram wasn't totally conclusive. it showed a collapsed follicle, which means i most likely ovulated. generally when i've gone in for the post-ovulation sonogram the follicle has been completely dissipated -- not visible at all. the internet tells me it's usually only there for a day or maybe two after ovulation, but i've gone in two days post-IUI before and have never seen it. the doctor admitted that this wasn't a definitive sign, but that the bloodwork that they'll do today will tell us for sure if i've ovulated or not. i have to call them this afternoon to get those results and to find out when i have to start taking the progesterone (ugh). either way i have to go back in a week to start taking a new drug, ganirelix, to get me ready for theoretical IVF. it's an ovulation suppression medication, to make sure that things don't start too early. yes, it's another injectable. so i'm glad i enjoyed this little respite from stabbing myself, because it's about to get amped way up.

unless i get pregnant now. which is, theoretically, possible regardless of my doubt. i am going to acupuncture today so hopefully i did ovulate and he can do his magic to make things come together as they should. i'll write later about bloodwork results and next steps... there's never a dull moment around here, that's for sure.

#4

we did the IUI yesterday and all went well, as usual. the specimen was especially great for some reason: 96 million and 61% motility! the doctor was super impressed. and it's really funny what those stats do for the hubby's machismo. the doc said that i would probably ovulate yesterday afternoon or last night, based on the size of the follicle and the fact that i got the trigger shot on friday morning... but my monitor still hasn't given me the sign. as of this morning it still said high fertility but no ovulation. of course, there was another cycle during the IUI process when it thought that i never ovulated. and i do feel like i'm ovulating. so i'm not super concerned. we also gave it another try on our own this morning, so that can only help matters. at this point, i'm not stressing over it. it will work, or we'll move onto phase 3. i go back to the doctor tomorrow so that they can check my ovulation and hormone levels, and then they'll tell me what our next steps are. as long as there are next steps, i can't complain.

IUI #4, east vs. west, and other rambling thoughts

it's amazing how quickly the first part of my cycle goes when i'm not giving myself injections every day. i barely even noticed, and suddenly i'm pre-ovulatory. i went to the doctor this morning and i have one nice, big, fat follicle about ready to go, so we're doing IUI tomorrow. they gave me the trigger shot before i left, which is also great because that's the worst injection of all (it hurts and makes me sore afterwards) so i didn't have to worry about doing it myself OR having a sore leg because they give me the shots in my arm. the doc said because of the timing we will only do one insemination this cycle, which is fine by me. and i love that it's happening on a saturday... much less stress and i can go home and back to bed afterwards!

in related news, i've really been enjoying acupuncture. and no, not just because the guy is a hottie. it is such a completely different experience than the fertility stuff that is happening at the doctor... it seems incredible that they both can be intended to serve the same purpose. the divide between eastern and western medicine has never been so clear to me. frank, my acupuncturist, was upset by the fact that the head honcho doctor said, "time is of the essence" at my last appointment. well, he was as upset as a buddhist can get. which isn't really upset. but he had a lot of things to say about it. he said anyone who would say that to a patient doesn't understand the mind-body connection: what he thinks is the most important aspect of it all. not that he doesn't see truth in the fact that older women tend to struggle with fertility more often. but he won't generalize just on the basis of statistics when there are so many unknown factors about each individual situation. he told me he hadn't even met his wife yet when she was 35 -- and they have one child and another on the way -- so basing something on age isn't an effective measure of success.

so he talked to me a lot about different perspectives and ways to think about this from a more spiritual way, very much from buddhist ideals which are familiar and comfortable to me. we talked about attachment and impermanence, and how my mindset can and does affect this whole situation. he said i should think of myself already on a parenting journey, and that that journey began the moment i decided that i wanted to try to become a parent and turned my body over to the possibility. he said everyone's experience is different, and this is mine. it may include me getting pregnant and giving birth, or it may take another path. but i should stop thinking that i'm waiting for the experience to begin, because i'm already in it.

accepting that there are endless possible outcomes to this adventure is actually very comforting to me. i thought that idea might make me anxious, but it had the opposite effect. there are many ways to build a family and to give back to the world, and i will find a way to do it one way or another. i'm not going to let this crush me. we're doing what we can with a lot of medical assistance -- miraculous stuff that i'm so happy they can do. but it's not the be-all and end-all. these next few months will determine a lot, and then this phase of our journey will be over... no one can know what will come next.

next steps: IVF

got my period on friday (in the midst of an amazing new orleans trip... i barely even noticed/cared) so i went to the doctor this morning. i told the nurse that i wanted to talk with one of the doctors about next steps instead of just plunging ahead with another IUI cycle. she brought in the big guy -- the director of the whole fertility institute, the guy who's written up every year as one of the best doctors in the city. i haven't interacted with him until today. of course i was already spread-eagle on the exam table when he walked in and introduced himself, but i guess he used to seeing women like that.

he looked over my file and did the sonogram and told me that he thinks it's time for us to move on to IVF. three unsuccessful IUIs now that i'm 35 and it's been almost six months since my surgery (which means the endometriosis could come back) indicated to him that "time is of the essence." the sonogram showed that i already have two follicles developing, one in each ovary (again on day 4... this is another early, early cycle); that in combination with the fact that they need to order some more medications for me in order to do IVF means we can't do it this cycle. but the doctor said that's actually better. he wants to start "fresh" next cycle.

BUT -- this was the best news i've heard in awhile -- we are going to do one more insemination this cycle with NO DRUGS. since there's already two follicles and he wants to get as much of the hormones out of my system as possible before IVF, he said we'll just monitor my cycle this time and give me a little "boost" just before ovulation and then do IUI again. then, if it doesn't work this time, we'll be all set to go with IVF.

i talked to the lady in billing and she said they'll double check with my insurance company but it looks like we'll have to pay $5,000 out of pocket. not exactly pennies. hopefully my in-laws will put their money where their mouths were a few months ago when they said they'd help us out. i don't want to ask them directly, because it's not that we can't afford it on our own, but they certainly have way more money than we do and if they're willing to invest in the future of their family tree who am i to say no?

so what happens with IVF that makes it so different from IUI, you ask? a quick overview of the procedure, as I understand it:

1) follicle stimulation and ovulation induction: this is pretty much what i've already been doing, except i will probably take a lot more hormones because they generally want a lot more eggs to develop for IVF than when you're just doing IUI.

2) retrieval: when the eggs are ready, they take them out of the ovaries before they ovulate themselves. this is a minor surgical procedure that involves a hollow needle inserted through the pelvic cavity to draw the eggs out. most people have local anesthesia and sedation for this procedure, though i've heard of some people having general anesthesia... not sure why.

3) sperm & egg party: then they get the sperm -- same procedure as before, obviously -- and they prep it for insemination. but now they try to make the fertilization happen in incubators instead of in my uterus. they put the eggs and sperms together and monitor them for a couple of days and hopefully (usually) some or all of the eggs will get fertilized. they like to have between 2 and 4 fertilized eggs for optimal results.

4) transfer: then they put the fertilized embryos (suspended in fluid) back into my uterus, and hope for the best. this is usually a couple of days after the retrieval. it seems like this procedure is much like the IUI procedure: a catheter through the cervix, shouldn't really feel like much of anything. and then... the wait.

clearly it is more invasive and intense than IUI, but that's why it's more effective. not that it's a given that it will work. they say there's a 20-25% success rate for women aged 35-37. i am hoping i'm still close enough to fall into the "under 35" statistics, which are 30-35% percent. either way, i think the doctor is right that we don't want to waste any more time. i like this plan, and i think i'm ready for all of this. and i am SO PSYCHED to not have to give myself shots this cycle but to still be able to try the insemination one more time. who knows... maybe we'll be surprised and won't even have to worry about IVF after all.

nope.

blood test results were negative. again. i asked the nurse if they recommend another cycle, and she said it's up to me. when i get my period and go back in i will talk with one of the doctors. i just don't know what to do at this point.

tomorrow i'm off to new orleans, to drown my sorrows in copious amounts of coffee and alcohol for four days. cause that's healthy. but at least i should get my period by the time i get back and then we can figure out what comes next.

No extra happy birthday to me

Well, the pee test was negative. My hopes are a bit dashed, though I know it's still early. I shall enjoy my birthday as best I can and hold out hope for good news on Wednesday. Sigh.

IUI: round 3, day 22

well, here's something different. i've had cramps since yesterday, cramps like before my period. which wouldn't be terribly strange if this were a normal, natural cycle. but since i'm on the progesterone, my body doesn't get the message that it's supposed to have a period and i haven't had cramps like this in the other two IUI cycles. generally i have cramps (and really sore boobs) for a few days after the insemination, which seems to be par for the course. but then they've gone away and i've just felt... normal. i'm wondering if these might be implantation cramps. it's ten days post-IUI. i also have a headache, but that could be because i am not feeling 100% (sore throat, etc.). my boobs aren't really sore, but they're a tiny bit tender. like i still can't sleep on my belly normally. not sure that any of that matters. but the cramps... that seems significant. that's physiological, not hormonal... and i know i can't depend on my hormones right now. in any case, i like to see something a little different. gives me hope the outcome of this one might be something a little different.

i may take a home pregnancy test on monday. i haven't taken one yet since we started IUI, but from what i've been reading online on fertility message boards (which, really, no one should read unless they want to make themselves crazy) by 12 days after giving yourself the trigger shot they say your hormones could be adjusted enough to give you a normal result on a pee test. and since monday's my birthday i figure... why not? you never know. even if it's negative it's still not hopeless at that point. but if it is negative... maybe it'll help me brace myself for possible bad news on wednesday.

wishin' and hopin'

it's day 15 and i know there's a long wait ahead, but i'm definitely very focused on it this time. the good news is that i'm still feeling hopeful! though i don't know if feeling hopeful for two weeks will be a good thing if i end up disappointed again.

i went to acupuncture yesterday for the first time, and i'll be going back about every ten days or so. it was a really great session. he has a very holistic approach, so we talked a lot about me and my life and situation before we started, which i know helps the process for me. he is so nice (and... uh, smokin' hot) and given his track record with fertility clients i am excited to start this process. he was really pleased with the timing... for some reason i'd thought it would be better to see him before IUI (what do i know?), but he said this was great to help with implantation. he started out by looking at my tongue and feeling my pulse, and was able to say just from that assessment that he could tell i have an issue with thirst (so true -- i am thirsty ALL the time) and that he thinks my yin and ying are out of balance: i'm deficient in yin. which is what makes me thirsty and hot all the time. he gave me some suggestions of foods and drinks to try to balance things out (and things to avoid: caffeine, alcohol, sugar... sigh), and obviously targeted the acupuncture treatment toward that and some "stagnant blood" he could feel. i know some people are skeptical about eastern medicine but it makes so much sense to me and i really believe it, and i think that will make all the difference. he had me do a lot of visualizing and breathing and the actual acupuncture was quite lovely and relaxing. definitely a nice way to end the week.

my boobs have been sore and i have had cramps since just after the insemination this week. i'm pretty sure that also happened the first time (i don't remember it last time) but i don't remember how long it lasted. the internets say it's normal to feel that way post-ovulation and post-IUI, but i'm kind of hoping it doesn't stop because that might be a good sign.

i'm back on the progesterone suppositories (ugh) and my belly's a bit whacked out already, but otherwise all else is fine. school is super busy, as is life in general, so i'm guessing the next week and a half will go by pretty quickly. my birthday is fast-approaching, which isn't too much of a downer at the moment. probably because i'm so hopeful right now. my birthday falls on a monday, i'll find out if the IUI worked on wednesday, and then i leave for new orleans on thursday. the timing is nice. i can celebrate my birthday happily and optimistically, and if i get bad news on wednesday at least i will be in my second favorite city for the weekend and i can get drunk, drunk, drunk. and i go back to acupuncture the day before i go in for the blood test. i wonder if he'll have any inklings if i'm pregnant by that point! you'd think he might. but really... who knows. who knows???

another round done

had the second IUI this morning and it went really smoothly. fast and easy, and the count was good (better than yesterday, though i can't remember the exact number). AND the doctor said it looks like i ovulated yesterday, as we expected. which is great! even though they've told me in the past that it was "fine" that we did the IUI just before i ovulated, i could tell by her voice that this is preferable, which -- of course -- makes sense.

i start the progesterone suppositories on friday (sigh) and then it's just wait, wait, wait until two weeks from today. i'm going to acupuncture for the first time on friday, too, which is a little later than i wanted to start (he's a busy guy) but could help with implantation and whatever else, maybe. can't be a bad thing, anyway. i have a really good feeling about this time. :)

IUI: round 3

my arms look like i'm a heroin addict and i'm embarrassed when my colleagues catch a glimpse of them, so it must be... IUI day! seriously, a week of blood taken almost every day is just abyssmal for the appearance of one's skin. but i guess there are more important things to think about.

we went this morning for the 1st insemination of this cycle. yes, i said the 1st, because we're doing another tomorrow. yippee! when the doc did the ultrasound she said our timing this round was "spot on." i still had the two big follicles, one in each ovary, and she said one of them looked like it might have been ovulating at that moment. they can't see that very precisely, so it's impossible to know if it's in-progress or not... it's all based on the size of the follicle. but i sure as heck feel like i'm ovulating. i had cramps all day and night yesterday and a host of other symptoms that i aptly recognize now but don't feel the need to list in detail on this blog. not that you must care about TMI if you're following along here. but as of this morning, things were still ripe enough to take another go at it tomorrow -- figuring i'll ovulate sometime today and still have time for things to do their magic for another 24 hours or so (give or take).

the specimen wasn't quite as spectacular today, no doubt because there was a significant depletion of the sperm stores over the weekend. hee hee. but -- it was still 29 million, which the doctor said is still a good specimen. between 20-40 million is a normal count... so 29's fine, just not "good" for the likes of my husband, Sir Super Sperm Count. the doc said the motility was a bit lower, in the 40%s, but with IUI that's much less important. we're putting them right where they need to go!

and, honestly, i think timing is much more important than anything else in this process, and i feel a billion times more confident about the timing this round than the last two times. i understand the logic of doing it early to make sure we didn't miss ovulation, and because the sperms can live for a couple of days anyway, but clearly it's better to do it right when i ovulate. (and even better, in my opinion, to have some backup sperm from the weekend that might still be swimming around in there.) it woo hoo! so we're back tomorrow morning for another insemination, and then my poor veins can heal and i don't have to stab myself with anything undesired for the immediate future. rock.

IUI: round 3, day 10

today's day 10 and my ovulation monitor says it could be an ovulation day. this didn't please me especially, since it's not an IUI day. but i knew it was coming -- i had "high fertility" indicators both saturday and sunday on the monitor. and ya know what? even though they don't recommend having sex right before IUI, we made good use of those high fertility days this weekend. my hunch is that was not a bad decision, for a variety of reasons. :) and since we're not doing the insemination until tomorrow, it'll still be almost 48 hours for the hubby's sperm stores to regroup and for my innards to clean themselves out. in my medical opinion, that is a-ok.

and when i went to the doctor this morning, they could see that i was close to ovulation but that the process hadn't started yet. she said depending on how the follicles look tomorrow, we might only do one insemination this cycle... but who knows. the body is very unpredictable. the past two cycles i've worried that we've done the IUI too early; all signs were pointing to ovulation so they pushed ahead, but it took longer to happen than they expected. so maybe this is a better deal. AND the double dose of injections has definitely made an impact. i have follicles in both ovaries: one super large one in each, and two or three medium sized ones that might also develop in time. bonus!

so tonight i give myself the ovulation trigger shot, which i don't think is necessary but i understand them needing to cover all the proverbial bases, and we go in tomorrow morning for another exciting adventure in insemination!

IUI: round 3, day 7

went back to the doctor this morning and things are progressing, but rather slowly. i am surprised especially since i've been giving myself two shots a night. i thought by the time i got in there today things would really be hopping! but i guess they had the right idea when they checked things out on tuesday. as of today, i have one follicle developing in my right ovary and two in my left. they are still fairly small, but i think this is actually much more normal than my last cycle. they want me to continue the two shots a day and to come back on monday. that will be day 10 of my cycle, so i'm guessing the IUI will definitely happen tuesday and wednesday. and, lucky us, it's the weekend and i'm not on the rag, in the midst of IUI, or using the gross progesterone suppositories... so maybe that means we can actually have sex! fancy that.

IUI, Round 3

got my period on saturday. this has been a rough one. not my period, i mean, but my emotional state. i'm doing okay, but it's definitely getting more difficult to go through this process. doesn't help that school's starting, so i just have much more on my plate. luckily i had therapy last week on the day i got the bad news, so i worked through some of my initial frustration. my therapist reminded me that i'm not obligated to continue on this path, that i do have some choice, and that i could just decide to skip a cycle or take a little break from all of this. in the end, i decided NOT to take a break... but something about the simple realization that i had the option made me feel so much better. sometimes i just feel like i'm spiraling through this mechanized process completely without agency, so it was nice to remember that i am still in charge of my body.

the good news is that i called the insurance company to find out how much of my 2011 $5k worth of benefits has already been used for the treatments thus far, and they've only billed $400 towards my fertility assistance benefits! i guess that's just been the IUI procedure itself, and all of the doctor visits and bloodwork have just fallen under my regular medical care. that was amazing news. i've also finally decided to get in touch with the supposed "miracle worker" acupuncturist in my neighborhood to give me an added boost, and something a little different to focus on as we move forward.

thus, i went to the doctor this morning to get things rolling. again. sigh. it's day 4, and this time there are no crazy early-developing follicles. (last cycle there was a fairly large follicle already formed on day 3.) the doctor said everything looked good, and she wanted to increase my medication this time around. so instead of one shot, i'll be giving myself two shots each night. and the doctor doesn't want to see me again until friday -- which makes sense in a normal cycle (day 7), but i was surprised given my early-ovulating history that they didn't want me to come in sooner. but. they're the experts. and, honestly, it's great that i won't be late to school on the first or second day with the students.

trying to stay positive, and even though i'm sleep-deprived and stressed out by back-to-school insanity, it's not bad to be distracted.

negative... again.

i don't really have anything else to say.

two-week wait

it's been a bit of a rollercoaster the past 24 hours but i am feeling fine now. perhaps because i was finally allowed to have actual, real sex and boy, did i need it!

this morning my ovulation monitor still didn't think i was ovulating. it has given me a "high fertility" but not "peak" sign for the past several days. though i knew this was slightly illogical, i was completely freaked out that the doctor had gotten it wrong and that we did the inseminations way too early. when i took my temperature it seemed to indicate that i did ovulate. and i suppose it makes sense that blood tests and sonograms/ultrasounds (wtf is the difference? the docs use them interchangeably) are better predictors than peeing on a stick at the demand of a $200 over-the-counter product. and, indeed, i went to the doctor and she said that i did ovulate, and that everything looked great. huh. i guess i don't need to use the monitor anymore... i had a hunch that the hormones i'm pumping myself full of might screw it up, and i assume that's what's happened. again i wonder if it might have screwed us up in months past... but i'm not dwelling on that, either.

so now we embark on another two-week wait. i go back two weeks from yesterday (wednesday the 31) for the blood test unless i get my period first, which i doubt will happen. i start the progesterone on saturday, so i can look forward to more stomach aches. and that's that! i am going to do my darnedest to think about it only productively and not to get too wrapped up in the wait. at least i've got back-to-school to keep me busy!

end of round 2

i went this morning for the 2nd IUI of this cycle. i told the hubby he didn't have to come with me, since he had a busy work day ahead and a home appraiser coming to look at our house this morning (we're refinancing... crazytown). i really felt like it wasn't that big of a deal... i like having him there, but i know it's stressful for him when he's working, and i'm fine on my own. right? well... most of the time.

on monday in therapy my therapist was pushing me to dig deep into my feelings about all of this and i/we realized that i've really been making myself numb to the whole process. i know that it was in an attempt to not feel discouraged. i told myself that the ups and downs were just too much, and once i knew something definitively -- one way or another -- i would let myself react properly. but my therapist worries (rightfully so) about my history of depression and about how easily i could stay in this state of numbness for... who knows how long. she said what if i did get pregnant, and couldn't be happy about it because i was worried about miscarrying or something, and then the cycle could go on and on. the truth is that i know it's better to let myself feel things. i lived a good portion of my life not allowing myself to emotionally connect to much of anything. and it made me a very angry person. this is what i've been in therapy for for the past five years. so i know she's right. but i really wasn't into the idea of letting myself feel the frustration and the anger that i am actually feeling about this whole TTC situation.

so she made me say it ("i'm angry! i just want to get pregnant like a normal person!") and then shout it, and bring myself almost to the point of tears in our session on monday, and then told me i needed to try to allow myself to really feel what's going on inside of me as i lived through the IUI this week. i thought i was giving it the college try, but it wasn't until this morning when i really, finally, connected. and then i lost it and was sobbing in the exam room.

nice.

it started because there were only two doctors there today, so the wait time was a bit longer than usual. just a touch. but it was enough. normally once they get me in the room and prep me and take the blood and i have the washed specimen in hand the doctor comes in within five minutes and we get started with the insemination. today it took about 15 minutes. and since i was sitting in there alone... my brain got the best of me. it started with general anxiety about the wait (would i make it home in time to meet my friend who's coming to visit? is the sperm dying in the test tube in my hot little hand?), moved to anger (what the f*ck, people. what's going on out there?) and finally morphed into all-out anguish that i'm even living through this in the first place. i stuck my head out of the room (knowing the nurses' station was right across from the door) and asked if someone was coming soon and they told me it would just be a little longer for the doctor. they probably thought i was nuts, standing there in the doorway holding a spermy test tube and the paper exam sheet around me like some kind of awful wrap-around skirt.

i went back in and was frantically wiping my tears away when the doctor came in and said, "don't worry, we didn't forget about you!" and then i just started sobbing. she was kind, of course, and said she knows the process is frustrating and that my hormones are probably wreaking havoc with my head, and i did my best to calm down as quickly as i could. but it was hard! i wished today's doc had been the middle-aged and very maternal greek lady instead of this girl who's even younger than me, but she did her best to comfort me. she asked if i need a couple of minutes or if i wanted a drink of water, and offered me gauze to wipe up my face! that gave me the little giggle i needed to get things under control.

but i am angry. and frustrated. and i've played this game throughout this process where i've continually reminded myself that this isn't the end of the world and i don't have the right to feel worry for myself. i'm not dying of a terminal illness. i have the money/insurance and the ability to pursue these non-traditional ways of getting pregnant. if i don't get pregnant, we can adopt. i know all of these things to be true, and i know that there are a lot of other people in the world who are suffering much worse than i am. but the truth is... i'm really pissed. i'm angry and i'm frustrated and i'm sad. it doesn't seem fair.

i don't like being a victim. there is very little else i like less in the world than receiving people's sympathy. i HATE when other people feel badly for me. it makes me incredibly uncomfortable. that's also something i've been dealing with for a long time in therapy: when bad things happen to me, i often don't let myself dwell on them because i want to show people that i'm strong and that they don't need to worry about me. so this is another battle i have to fight in my head... because i am hurting over this, and i suppose i could use whatever support people have to give.

in the end, the insemination went smoothly as usual. the specimen was another above average one (51 million) and the doc said it looks like i'm in the process of ovulating. i will go back in the morning to confirm ovulation and then they'll give me further instructions, which i assume will be to start using those godawful nausea-inducing suppositories again and come back in two weeks for a pregnancy test. and for today, i'm going to try to relax, enjoy myself with my friend, and also let myself feel. this f*cking sucks, i'm not gonna lie. all i can hope is that it will all be worth it.

IUI again

this morning i went in for the first of our 2nd round of IUIs. since we know the procedure now, it went pretty smoothly. the doctor who did my surgery did the insemination; i haven't had a procedure with her since, and i was happy to see her again. she's very laid-back and funny. she told us that it was a great specimen: 81 million sperm, which is kind of ridiculous. the hubby is VERY proud of this. the minimum required for IUI is 20 million, last time he had 41 million, which was impressive enough... this is just kind of silly. i almost feel like if it doesn't work now, how could it ever? she also said it was 53% motility, which they didn't tell us last time, but that's higher than his sample was when he was tested in the fall, so that's also good.

anyway, the rest went just like last time. they did the ultrasound to see how my follicles were, and while there are a few more developing it's just going to be that one monstrous early developer that we have to work with this cycle. once that bursts -- as it should today or tomorrow -- my hormones will shift and any remaining developing follicles (there were a couple today) won't have a chance to catch up. this one just got a running start out of the gate for some reason. hopefully that means it's a good, strong one! or something. they did the insemination, took my blood, and that was that.

they also gave me the hcg (ovulation trigger) shot before i left the office to make sure that things happen in the next 24-36 hours, and we'll go back in the morning for another insemination. and then it's back to the two-week wait. seems like that's how i've been spending the bulk of my time lately. but i guess it's good to not have too much wasted time in between attempts. ok, time for a nap. the damn hormone injections make me so sleepy. but at least i'm done with them already! fancy that.

sooner rather than later...

i went back to the doctor this morning and it seems that things are progressing even faster than last month. i was doubtful and worried that we were rushing it, and i voiced those concerns to the doc. but she insisted that follicle size and uterine lining quality were telling her i was almost ready to ovulate, and that the bloodwork would be the final word. i just called to get the results of the bloodwork, and it seems that my estrogen levels are high enough that they want to do the first insemination tomorrow.

the sad news is that there's only one follicle ready, as of this morning, at least. remember the one that she told me on friday was a "leftover" from last cycle? well, she was wrong... it was one developing WAY early, and that one is about ready to go. i totally understand what the doctor told me -- that we can't wait around if that one's about to go, because if we miss it that'll be it for this cycle. i just hoped to have more follicles to up our odds. that one's in my left ovary, where there are just a couple of other little ones, and nothing doing at all in the right ovary. today's only day 6, and i normally never ovulate this early... but i know that the hormones i'm taking can alter things. maybe by tomorrow a miracle in follicle stimulation will have happened! in any case, i trust that they're on top of things at the fertility institute. so i go back in the morning with our "specimen" and also with my ovulation trigger shot, which they may have me do in the morning or tomorrow night. this process is already different than last time, but again... i have to trust them.

i can't say i won't be glad to not have to do any more injections for awhile, after the trigger one at least... i've had a really hard time with them this cycle. i thought i was all bad-ass last time, stabbing myself without thinking twice, but for some reason it's been a lot tougher the past few days. so at least that part will be done (for now)! silver linings, right?

IUI, Round 2

i got my period on wednesday -- luckily not too long after stopping the hormones. i have enjoyed feeling slightly less nauseated and awful the past couple of days, though drinking coffee (again) was a huge mistake. so sad. anyway, i went to the doctor this morning to get started on the next round of IUI. it was actually the most depressed i've been since getting the negative test result. most of this week i've been able to get myself out of my funk and feel optimistic about the next attempt, but being there this morning in that damn waiting room again with so many of the same people who have been doing all the same stuff as me all along was really a downer. i am really ready for this to be done.

but anyway. they drew blood and did a sonogram and said that my ovaries look fine, other than one of them having a "leftover" follicle that's developed for some reason. the doc said that shouldn't interfere with anything. she told me to start with one injection a day like last cycle and to come back on monday to see how things are progressing. here we go again!

negative

this morning i went in for the blood test to tell if i was pregnant, a little over two weeks after our IUI attempt. they told me they could tell definitively at this point, one way or another. i went in early this morning, somehow managed to waste five and a half hours until i could call for the results, and then was told that it came back negative.

i wasn't surprised, i guess... i didn't really have a hunch one way or another. the hormones have totally whacked out my body, so i don't even feel premenstrual. but i was definitely disappointed, and a little anxious as i realize that this is one step closer to us running out of options. but mostly i didn't have as much of a reaction as i thought i might. maybe i've just psyched myself out so badly over this that i can't react properly. hours later i'm still a little numb about it, and just trying to look ahead to the next step: another IUI cycle.

i'd been using the progesterone suppositories all along as i'd been instructed, which would have prevented me from getting my period regardless. so the nurse told me to stop them today, wait for my period, and then call them to set up my appointments to get things rolling again. apparently it takes a week for some women to get their period after stopping the progesterone... i really hope that isn't the case with me. i want to keep things moving. as it is we will barely squeeze in a second cycle of IUI before school starts. although it does sound lovely to not be taking any hormones for a few days. i've been sick to my stomach from the progesterone almost every day, not to mention being grossed out and annoyed by the discharge and vaginal swelling they cause. i could use a reprieve from all of that.

so... that's all there is to report. still can't drink alcohol or coffee on account of the other meds i'm still taking; i made the mistake of getting a latte to cheer myself up this afternoon and paid for it with crazy nausea and diarrhea tonight. sigh. but i suppose i will find other ways to distract myself until we begin again. ever onward!

IUI follow-up

went back to the doc's this morning for more bloodwork (the nurse took a look at my poor abused arms and said, "wow, you're... colorful!") and a quick sonogram. the doctor said, based on the sonogram, that i definitely ovulated as predicted. i didn't have any doubt about that. she said i should start using the progesterone suppositories today, twice a day until i either get my period or don't. the progesterone is supposed to help with implantation and also keep my hormone levels regulated... low progesterone levels sometimes lead to early pregnancy loss. online talk says there can sometimes be some icky side effects to taking these, but we'll see. i'll do my first one tonight.

and then it's just waiting. the doc said if i don't have my period by two weeks from today that i should come in for a pregnancy test and they should be able to tell for sure by then. if i get it sooner than that, i need to go back in to start the next cycle of IUI. I am going out of town next week, which shouldn't interfere with anything unless my period comes super early. if it does, i might need to head home early, because if we don't get things going for IUI by day 4 i will have to skip a cycle, and i definitely don't want to do that. but i think the earliest it should come is next friday, so I should be fine. i feel pretty calm about the whole thing right now. somewhat optimistic, but definitely not over-the-top. i'm prepared for disappointment after this first attempt. not expecting it, but prepared for it. the past year and a half has done wonders for my level of acceptance of bad news. so until the time we get some kind of news, i will try to distract myself as much as possible. summer vacation should help with that! woo hoo!

part 2

yesterday we did the second (and last) IUI attempt for this cycle. it went totally fine, after a tiny bit of difficulty, uh... collecting the specimen. the hubby's brain is SO WEIRD under pressure. but anyway, we got through that just fine and got the stuff to the doctor's office, where we had a wait a bit longer than the first day because we weren't the first in line. no biggie, though.

first, like the previous day, the doc did a sonogram to see how my follicles were doing. she sounded a bit disappointed to see that i hadn't ovulated yet. she didn't say that out loud, but we could hear it in her voice. she said the trigger shot that i gave myself on wednesday night typically insures ovulation within 24-36 hours. obviously i was running much closer to the 36-hour mark. which doesn't mean that thursday's IUI wasn't useful, because the sperms can live in there for a couple of days (especially the girl sperms, which are hardier and live longer!). but it would have been more bang for our buck had i ovulated in between the two inseminations. but anyway, the sonogram still showed the three follicles in my right ovary, ready to go. (the ones that were developing in my left ovary had already dissipated, but we already knew those ones wouldn't be viable.) she said ovulation should happen sometime in the few hours after the insemination.

then we just went through the same process as the first day. the only slight difference was that the "cleaning" out of my innards prior to the insemination took a bit longer because i had some spotting on the afternoon of first procedure and she had to get rid of all of that. of course i was a bit alarmed by the bleeding when i saw it on thursday, but i called the office and was told it's completely normal. so anyway, they took care of that, did the IUI the same as the first day, and that was that.

they told me that i need to come back on monday for a blood test to confirm that i ovulated and then they'll give me instructions for next steps. but she said i won't have to do any injections for the rest of this cycle. i'm done with the follicle stimulating hormone, obviously, and the other two injection meds that i have she said not even to worry about yet. she said if we have to do another cycle of IUI i may use them then, but for now it will just be the progesterone suppositories. and, of course, the vitamins and other awful metformin pill, which i had been doing much better on by taking it at night until i forgot to take it thursday evening and had a miserable nauseated day yesterday. i won't make that mistake again.

my ovulation monitor said i would ovulate yesterday or today, so it seems like all signs point to the same conclusion. the hubby and i gave it another try this morning, the natural and much more fun way, so we've definitely covered all of our bases. now it's just the usual wait-and-see. and so we shall!

IUI Day!

i have to admit i was a little more excited than i wanted to be.

woke the hubby up early, helped him out with his business (it's the least i can do...), and then tucked the "specimen" in its plastic container under my arm and headed to the fertility institute while the hubby showered and got ready. the nurse had told me it was super important to keep the specimen at body temperature during transport, which wasn't difficult considering it was already pretty humid and sticky outside and i didn't catch a bus. i gave it to the receptionist, who gave it to one of the nurses, who took it upstairs to the lab.

then i settled into the waiting room, read some Game of Thrones on my kindle, and waited for the hubby to arrive. he just made it; punctuality -- exact punctuality -- is his thing... he came through the door about 15 seconds after the nurse called my name. then we went into one of the exam rooms. the nurse brought in the "washed" specimen in a little test tube and gave it to me to hold. she told us that it had been a "really good specimen," 41 million sperm. the hubby was very proud of this, even though (as we both know) quantity has never been an issue for him. but when i repeated a couple minutes later, "wow, 40 million..." he was quick to correct me: "forty-ONE. that's a whole million there." ahhh, men and their manhoods. the nurse took some blood (of course... i look like a junkie these days) and the doctor explained how everything would work.

she did another sonogram and we could see that -- WHOA! -- there had been some serious follicle growth since yesterday. the one that was big yesterday was huge. and there were two more, right next to it, that were also really big. we had to explain all of this to the hubby, since he had no idea what he was looking at on the screen or what any of it meant. boys have no idea how girl bodies work, by the way. NO idea. the doc said the two biggest ones were pretty much ready to go (i.e. the egg is ready to burst out) and the third one could be ready by tomorrow, and that would likely be it for this cycle. but three! three is good odds.

then she did some "cleaning" of my insides, which just felt like a cool rinse. then the catheter was inserted through my cervix -- felt like a little pinch just like everything else they do to your cervix. then i passed the doctor the specimen and she inserted it in the catheter and started the insemination.

it took a minute or two or maybe three to actually insert it all into my innards. i didn't feel much during that time but definitely could tell something was going on down there. the hubby was sitting next to me and we made small talk. with the nurse and the doctor in the room, totally silent, possibly getting me pregnant. it was kind of awkward, but kind of sweet. then i had to lay down and rest for five minutes during which they left us alone. i think we were both more excited than we wanted to admit. it was nice to have that time together. knowing now how it all happens, i would have been pissed at him if he wasn't there.

and that was it! they gave us another specimen cup for tomororw, and we go in the morning to do it all again. in the meantime, i don't have to give myself any injections, which is a bonus. so now i'm just trying not to get my hopes up TOO high... though a little optimism surely never hurt anyone. :)