it has been a trying week.

my friend and coworker, a fellow IVF-er who has supported me so much throughout this process, lost her baby on tuesday. she went into early labor and the baby wasn't viable. she lived for about an hour and then she passed. and now my friend, who thought she'd finally found success after years of fertility challenges, is back to square one. i have shed more tears over this than i thought possible. at this stage of the game for me, i just can't imagine the depths of what she's going through... but i know it is hell.

in the meantime, things are going pretty well for me this cycle. at least so far. when i went back to the doctor yesterday they were pleased with what they saw. the doc said it's hard to tell exactly how many follicles there are just from the ultrasound, but that there are definitely four or five good ones in my right ovary, and three in my left and she thought more would develop in my left. so i have stayed on the same meds these past couple of days (4 doses of Repronex and Ganirelix to keep me from ovulating) and i will go back in the morning to see how things look. i'm thinking they should schedule my retrieval pretty soon, assuming that everything is still progressing as it should be. i'm at day 11 of my cycle today, and i've had eight days of stimulation. i feel almost guilty being excited after everything that my friend has been through, but i think i'm starting to see just how unpredictable this fertility journey really is. it's even more complicated than i've lived so far. so i'm thankful for this optimistic upturn in my luck right now. one day at a time.

IVF, attempt #2

after another trip to the doctor, i started the stimulation drugs last thursday. i went in friday morning to see how things were progressing and all looked good: a total of 8 follicles were developing, four good-sized ones in my right ovary and four smaller ones in my left. i continued the meds (four doses of Gonal) through the weekend and went back this morning, hoping to see a huge change. but nothing really had changed. there are still 8, and four of them are still too small. this was frustrating, though the doctor isn't alarmed yet like they were last time. they are putting me back on the Ganirelix (the ovulation-prohibiting drug) to give us more time for stimulation before i ovulate, and changing my stim drug to the Repronex. which, of course, is the one that f*cking hurts like hell. i'm taking four doses of that tonight and four more tomorrrow, and the Ganirelix every morning, and then going back to the doctor on wednesday. by then they should definitely be able to tell if this is going anywhere this time.

i'm trying to remain optimistic, even though i was hoping to walk in this morning and have 15 follicles sprouting. it really does vary from person to person, i've read, and while doctors would like to see 10-12 eggs prior to retrieval there are often more and often less and people do IVF anyway. so as long as the ones i have continue to grow i'd say we'll be fine. but if i end up with just those four in my right ovary and the left side slows down, i'm not sure what will happen. it seems like a lot of risk and money to try it with only four follicles. but maybe this is just the best my ovaries are going to do with this. anyway, nothing i can do now except continue stabbing myself with needles twice a day and update again on wednesday.

ugh. well, while i don't feel like writing any updates i guess i should.

i went, grudgingly, to the doctor last thursday. the doc told me to come that day because it was about a week before the end of my cycle, so we could get me started on some of the meds in prep for theoretical IVF. she said i definitely ovulated last cycle, my ovaries looked great, and i started the one injection that makes sure the ovaries don't start getting ready for next cycle. they also put me on three antibiotics. the nurse told me they often give them to patients prior to IVF just to make sure there aren't any infections that might complicate things. i asked why i didn't get them last time we tried IVF, and she had no answer. she said maybe they're just pulling out all the stops for me this time since it didn't work last time.

so that was that. until i started bleeding sunday night, at least five days before i should have.

stupid me let myself think for about 12 hours that maybe i was pregnant and it was implantation bleeding. the timing was perfect, but the amount of blood wasn't. i have now sadly realized that it is definitely my period, and that this past cycle was just a royally screwed up one... the shortest one i've had maybe ever. i probably ovulated around day 8, which is early even for me. the hubby and i still did a really good job trying, though... we basically had sex every other day until i went back to work last week. so it still could have worked. but it didn't.

this put me into quite a state. i have been thinking (and feeling!) that my body was regulating and that acupuncture and the herbs were helping and that if we had to do IVF my body was so much more ready for it than it was in the past. but it seems like it's still the same old slightly screwy mess it was before. which i guess bodes better for complete medical intervention like IVF than for us trying on our own, so... so be it.

i went back to the doctor this morning. they said my ovaries look fine and normal for the beginning of my cycle, so there's no reason to think that anything weird or bad happened. i stop the ovary-hostage drug today and am starting the stimulation hormones on thursday. we're starting out again with the less powerful one (Gonal) that i took for all of my IUIs. we started that one for my failed IVF cycle, too, but then they bumped me up to the stronger stuff (Repronex) when it wasn't working. hopefully this time it will work, because Repronex is the one that had me in agony (super painful injection, sore and bruised legs). i do two injections thursday morning, two thursday evening, and then go back on friday to see what's what.

and there we are. i'm feeling a bit less likely to hurl myself from my 4th floor office window today than i was yesterday at this time. which is to say i am still incredibly depressed and frustrated to be back on this rollercoaster. but i know it's the right thing to do, because it's the only way we're going to make any progress in this journey. so i press on.

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.