Thursday, March 31, 2011

Baseline update

I just got the call with results from this morning's monitoring appointment.  They are:

E2 -- 31
P4 -- 1.19
lining -- 4 mm ("nice and thin")

Having never done IVF with my own eggs, I'm not entirely sure what these numbers mean.  I mean, I was a nurse (and for a while, a biology major), so I know that your lining should be thinnest and your estrogen levels low at the beginning of a cycle, and I know progesterone drops just before you get your period. . . but as for the specific numbers, I couldn't tell you.  My St. Mungo's nurse told me they are exactly what they want to see, though, and I guess she would know.  ;-)

I am starting my estrogen pills tonight and will have another monitoring appointment in a week.  Stay tuned.

Baseline appointment

All righty then. . . . well, I guess I have overshared on here even more than I realize, since my last post asking for unanswered questions about me did not garner a single comment or email.  LOL.  You must all know everything you want to know about me (and more?).

I visited Local Fertility Clinic this morning for my baseline monitoring appointment for my mock cycle.  I had blood drawn for E2 and P4 levels and a (lovely) vaginal u/s.  Not surprisingly, the doctor who did my u/s asked why I chose to go to St. Mungo's for treatment when they have a DE program at their clinic.  I was diplomatic and stressed my (not made-up) concern about using a donor who lived locally and didn't even mention the difference in the two clinics' success rates (which is considerable: Local Fertility Clinic reported around a 65% rate for fresh cycles compared to a 85% rate at St. Mungo's).  No apparent hard feelings.

Dr. didn't tell me specifics about my lining, just said it looked "fine" for this point in my cycle.  I had 18 antral follicles (not that this matters much, since we won't be using my eggs) and no cysts.  So far, so good.  I will get a call from my St. Mungo's nurse this afternoon with further instructions, and I anticipate starting my estrogen tonight.

I also went yesterday and had 4 tubes of blood drawn (at an outside lab, not at Local Fertility Clinic) for all my infectious disease testing and for prolactin and TSH levels, all required by St. Mungo's before cycling.  MM had his blood drawn for infectious disease testing, too, and will be going in for a semen analysis tomorrow (he's really looking forward to it--NOT).

Assuming all that testing comes back OK--and I have no reason to think it won't--the only other test I have to have done besides completing my mock cycle is a sonohysterogram, which I will do while I'm on BCPs after the mock cycle.  Oh, and we have a joint counseling session in a couple of weeks to discuss the psychological issues involved with the use of donor gametes for conception.

So many hoops to jump through, but in a way, it's good.  Every item I tick off the list brings us that much closer to our real cycle.  It feels like we are making progress.

Wednesday, March 30, 2011

Your FAQs

I think I offer up a lot of information about myself and our IF on this blog. . . but is there anything you've been wondering about me that you'd like to ask?

If so, email me or leave your question in the comments.  I will follow up with a post answering them later in the week.

Tuesday, March 29, 2011

She's here

AF has arrived.  I just emailed my clinic nurse for instructions for my uterine evaluation ("mock") cycle.  I know I have to go in for a baseline u/s and blood work in the next few days, but beyond that, I don't yet know all the specifics.

I'm excited about finally taking a concrete, affirmative step toward starting our cycle.  Hooray!

On a related note, I've been kicking a$$ and taking names with my diet and exercise ever since we returned from vacation.  (Funny how having Dr. Dumbledore tell me that losing weight will decrease our risk of miscarriage has motivated me.) 

MM and I were talking about eating habits last night, and he told me that he expects me to "treat [my] body like a temple" while I am "carrying [his] child."  And he wasn't kidding.  When I pointed that he is a little bit of a hypocrite on this point, with his 3/day Mou.ntain Dews, nightly "treats" (donuts, cupcakes, cookies or ice cream), and candy every afternoon, he said "The way I eat during your pregnancy won't affect our child, and that's just the way it is."  LOL

OMG, we are talking like this will actually work and I will actually be pregnant.  Yikes.

Anyway, sounds like I won't be having any junk food myself for a while. . . . oh well.  A small price to pay if this works!

Monday, March 28, 2011

Waiting for AF

According to my nifty "iPeriod" iPhone app, AF is due tomorrow.  Typically I have mild cramps and some spotting anywhere from 12 to 24 hours before she makes her appearance (assuming I haven't recently popped aspirin or ibuprofen for a headache and masked the cramps).  So far, nothing.

Usually when I'm waiting for AF, I am secretly hoping that she isn't going to show (because I'm pregnant, natch).  Even as we are on the precipice of embarking on our DE IVF cycle, there is still a faint, faint glimmer of this hope; MM even mentioned it as we were walking the dogs last night.  (Ah, wouldn't it be glorious to be able to use the money we've set aside for DE for something else?  We could have enough to replace my income during a 6-week FMLA leave and also take a little pre-baby trip.  Sigh.)

But my predemoninant feeling is wanting AF to arrive so that I can get on with my mock cycle.  Now that we have a concrete plan, I want to put it into action.

[Although actually, if she could manage to delay her appearance by a few days, I could go in for my baseline u/s and bloodwork on Saturday and not miss work.  Just sayin'.]

This waiting is a lot easier, though, than the waiting I was doing before MM agreed to go ahead with our DE cycle this summer as planned.  Probably because it is a shorter wait which is certain to be finite in duration.

BTW, in case you don't read her blog, my blogger buddy Roccie got a second awesome beta result this morning.  Looks like she is definitely knocked up from her DE FET.  Congratulations!

Thursday, March 24, 2011

Another step along the path

We have "reserved" our chosen donor for our cycle!  St. Mungo's allows you to "match" with a donor when you start your uterine evaluation cycle, and since that will likely be next week for me (today is CD 21, and my iPeriod app tells me AF is due on Tues. March 29), I was allowed to "reserve" her a little early today.

We are using one of our clinic's in-house donors.  They are carefully screened, and as I mentioned in my last post, the clinic declines about 80% of women who apply to be donors for various reasons including BMI, age and personal/family health history.

How did we choose her?  After much contemplation, soul searching and browsing of donor profiles, ultimately I decided that the most important criteria for me were someone who looks like she could be a member of my family (slightly broader than "looks like me"); someone "proven," with at least one successful donor egg cycle already under belt; someone no older than 27; and someone whose writings did not make me cringe when I read them.

MM's criteria: someone who looks like she could be a member of my family; someone who was not only healthy but had no family history of allergies or anxiety (both of which have plagued him and his father throughout their lives); and someone who was attractive and not trashy-looking.  (When I would show him profiles, he vetoed some donors on looks alone or on just a gut feeling of "I don't like her" or "I wouldn't want my kid to look like her.")

Our donor is anonymous, but I have been amazed at the amount of information which the clinic makes available about the donor.  Although I do not know her name, I have seen photos of her as an adult and as a child.  I know her height, weight, hair/eye color, blood type, date of birth, ethnicity, etc. I have read what she has written about herself and her reasons for donating, as well as many details of her health and reproductive history. Complete genetic and psych evals for her are also available on the database.

I wouldn't say that she looks like me, but she certainly looks like she could be related to me. . . . and we both have high foreheads and curly medium brown hair.  Her skin tone is similar to mine, and she is a couple of inches taller.  She even has dimples which look very similar to the dimples both my dad and sister have.

The database also provides a thumbnail sketch of how the donor has performed in previous cycles, and the third party program manager provided me with even more detailed information about this on the telephone.  In short, she is a proven donor who has done five cycles, four of which resulted in ongoing pregnancies.  (The one "failed" cycle was a chemical pregnancy in a couple in which the husband had severe sperm issues.  Reportedly she was very sad that that cycle did not work.)  All her prior cycles resulted in frozen embryos in addition to the fresh ones transferred, too.

In addition to her proven track record, at 27, she is a little older/more mature than some of the donors in the database.  She had high GPAs in school--4.0 in high school, 3.94 in undergrad--and is currently earning an advanced degree in naturopathic medicine.  (Her intelligence is a bonus about which I am very pleased.)  She is athletic and does yoga daily.

Finally, when I talked to the third party program manager about our chosen donor, she described the donor as "a stellar donor and a fabulous person," someone who is always cheerful and happy.  Just what we need to offset MM's inherited moodiness, LOL.  (Kidding.  OK, kind-of kidding, kind-of not.)

When I first started looking at the St. Mungo's database several months ago, it felt really weird to be "shopping" for my child's genetic mother.  If I stop and think about it, it still seems kind-of surreal.  At the moment, though, I am feeling more grateful for the opportunity to (I hope) bear a healthy child through this young woman's generous assistance.

(I need to come up with a clever name for our donor.  After learning so much about her and being close to receiving a priceless gift from her, calling her "the donor" just seems so impersonal.  Suggestions?)

With each step I take, the idea that we are actually doing this takes hold more and more.  And I continue to be excited at the prospect.

Wednesday, March 23, 2011

Consult with Dr. Dumbledore

I have decided that Dr. Dumbledore will be my new nickname for our RE.  For one thing, in a roundabout way, it is a play on his actual name.  For another, anyone who has read the Harry Poster series knows that Dumbledore was considered one of the greatest wizards of his time.  We are hoping that this RE can work some magic and get me pregnant, so it seems apt.

We had our initial consultation with Dr. Dumbledore via telephone a week ago, so I am late in writing about it.  It took place the same day we left on a week's vacation, though, so I really haven't had an opportunity to post about it until now.

The bottom line is that Dr. Dumbledore is confident that we can achieve pregnancy through DE.  He talked with us in general terms about what a DE cycle entails, how his clinic screens its donors, and our medical histories as they pertain to reproductive health.

Interestingly, he told us that they decline about 80% of potential donors and noted that, with my family history of heart disease and diabetes, I would be ineligible for donating through his clinic (obviously even assuming that I were young enough and met the BMI requirements).  For this reason, in addition to my advanced age, he noted that the child we have through DE will be much healthier than a child we might have conceived naturally.  I had thought about the reduced miscarriage rate and reduced risk of various hereditary disorders which would come with using eggs donated by a much younger woman but hadn't really thought about this aspect. 

It's odd to think that, by giving up my genetic link to a child, I am (likely) sparing our future child some bad genetic inheritance.  In mourning never having a genetic child, I'd focused more on our DE child not having my musical talent, intelligence or curly hair and really hadn't thought much about him/her also not having all the health risks that a family history of heart disease, diabetes and obesity brings.

In addition to completing a "mock" cycle prior to our real cycle, MM and I also have to get a whole slew of infectious disease testing done.  I have to have a sonohysterogram and get my thyroid levels checked.

When I asked Dr. Dumbledore if there was anything which would lead him to believe that a DE cycle might not work for us (based on what he knows about me currently from my records), he pointed out that my weight puts me at an increased risk for miscarriage.  For "reasons that aren't clear to us," women with a BMI above 28 or above 32 (depending on which study you read) tend to have higher miscarriage rates.  He told us he would estimate that the miscarriage rate for DE cycles generally is about 5% but that my current BMI would make our risk around 10%.  He told me "If you were looking for some motivation to lose weight, I hope this information has provided it."

Um, yeah.  My current BMI is around 36.  I'd need to lose about 30 lbs just to get my BMI under 32 and over 50 lbs to get my BMI under 28.  I think a 30-lb loss (or something close to it) is possible; I doubt that I can lose 50 lbs. . . . certainly not before June and maybe not at all.  I am working on this.

Dr. Dumbledore also told us that his clinic has about a 40% rate of twins.  I had previously read around 30% for DE cycles.  MM thinks twins would be great and was delighted to hear this.  I am mildly concerned about the risks associated with twins, but we are both at a point where the chance of no baby is worse to us than the chance of two babies.

In terms of concrete dates and scheduling, I will have a separate phone conference with Dr. Dumbledore's nurse this coming Monday.  She will be my point of contact for all things cycle-related.

I continue to feel optimistic and am looking forward to getting started!

Monday, March 14, 2011


I have never regarded my father as a particularly subtle person.  In fact, he and I are a lot alike in personality--every trait I dislike in myself is one I inherited from him--and I have certainly never regarded subtlety as one of my strong suits.  I'm usually too plain-spoken to be subtle, often to my detriment.

I must say, though, that I was impressed by my father's approach to the topic of whether we want children during his visit this weekend.  I believe I have mentioned before that my father is on limited information status about our TTC efforts and IF.  (I wrote in detail here about the reasons for this.)  Although we have always had a close relationship, all I have ever told him is that we want children and that I have been off birth control since before our wedding in November 2008.

I suppose any father with a daughter who finally married at 37, is rapidly approaching her 40th birthday, and is still childless would be wondering whether his daughter ever intends to have a child of her own.  The subject must have been on his mind on Saturday afternoon during his recent visit.  MM was out ,and I was relaxing at home with Dad and his wife, when we began talking about the interesting dynamic in MM's nuclear family of all three members being only children.  (Yes, MM is an only child, and his parents are both only children as well.) 

During this discussion, Dad asked me whether MM's parents are anxious to have MM "carry on their line."  I told him that, while I think they would enjoy being grandparents, especially my MIL, I know that passing on their genes is not particularly important to them because the topic has been discussed.  (They were/are both on board with adoption as an alternative to ART, and my FIL clearly told MM "Don't feel like you have to have a child for our benefit; just do what you want to do.")

This exchange followed:

Dad:  So what about MM?  How does he feel about that?

Me:  What?  You mean passing on his genes?

Dad:  Well, yes, having children.  Do you want them or plan to have them?

Me:  We have been trying to have a child unsuccessfully the entire time we have been married.

Dad:  Oh.

Dad:  I suppose you've both been tested and everything.

Me:  Yes, we have.

Dad:  And did they find anything wrong?

Me:  No, they did not.

Dad:  Oh.

I was proud of myself for staying calm and matter-of-fact throughout this exchange, while also not giving up any details about our IF or our treatment plans.  (Several times over the weekend, I was tempted to fill Dad and Stepmom in on our plans, because they are much on mind. . . . but I reminded myself that my reasons for keeping them out of the loop were/are sound and have not changed.)

Not much more was said on the subject, aside from Stepmom's comment that we would be "great parents" and Dad's comments that "you never know what will happen" and that "you hear all the time about people having a baby after they adopt" (I did gently set him straight on that one).  After a few minutes, conversation moved on to other topics.

It's really not like me to hold back on talking about something which is such a HUGE thing in my life.  Maybe my reserved approach to this topic is what led to my father's uncharacteristic subtlety in approaching it.

Monday, March 7, 2011

Hope reborn

The road that is built in hope is more pleasant to the traveler than the road built in despair, even though they both lead to the same destination. ~Marian Zimmer Bradley

Ever since we made our (rescheduled) appointment for our consultation at our new clinic (hereafter "St. Mungo's," for reasons to be explained soon), I have been feeling very hopeful, sometimes to the point of giddiness.  Maybe it's because for so long I had no hope and had almost despaired of ever being a mother.  Maybe it's because I have spent a lot of time waiting around over the past several months without any action, and it feels good to finally be doing something to move in a positive direction.
I saw something today which gave me even more hope.  The SART Report for 2009 is out, and the results (for us) are great!  St. Mungo's has an even higher success rate for 2009 for DE than previously reported: 85% for fresh cycles and 69% for FETs.  Praise technology!
When I first started feeling hopeful and excited, my initial thought was to hold myself back.  I mean, the more I get my hopes up, the more I will be disappointed if DE IVF doesn't work, right?
But the more I thought about it, the more I realized that I will be really disappointed no matter what if it doesn't work.  Not only will we have kissed around $30K goodbye (and will be still paying a significant chunk of that total off each month), we will have essentially exhausted all our options. . . . or at least all the options we feel comfortable with and can afford.  Sure, we might get lucky and have some frozen embryos for another try with a FET, or MM may come around to the idea of donated embryos. . . . but as it stands currently, we are pinning all our hopes on this DE IVF cycle. 
(We even talked yesterday about the fact that, if a fresh cycle and any subsequent FETs don't work, this is "it" for us.  We will cross that bridge if/when we have to, and I hope we don't come to it.)
So I decided I might as well enjoy these positive feelings while they last, since the fall is going to be just as miserable regardless if it fails.  It's been such a long time since I did something to try to get pregnant that I actually thought might work!  Probably since we first started treatment with our first or second IUI, I'd think.

Friday, March 4, 2011

CD 1 again

Yep, the feelings I wrote about in yesterday's post were, in fact, denial.  AF made her unwelcome appearance just before I went to bed last night.  Another short cycle: only 25 days.  Oh well.  Now that we are planning to do DE, the approach of menopause really doesn't matter. . . not that I have any control over it either way.

I had an hour-long phone conversation with the third-party coordinator at our new clinic yesterday.  She was great and answered all of my questions.  I was heartened to learn that she concurred with the reasoning behind my choice of donors, and she had very positive things to say about our first choice donor who, as of yesterday, was available, yea!  (We are using an in-house donor because they have a good in-house program, and it is slightly less expensive--and less cumbersome--than going through an agency.)

I hung up the phone feeling so positive and even a little excited about taking this step.  Yes, I know intellectually that DE may not be a magic bullet for us.  Logically, I realize that a clinic with an 80% success rate still has 1 couple in 5 go home without a take-home baby.  But I feel much better about those odds than I do about anything I've done (or could be doing) with my own eggs.

I can't believe I am looking forward to gambling $30K+ on a treatment cycle.  Infertility has, indeed, warped my brain.

So actually, this month I don't care that it's CD 1 again.  My next CD 1 will be the start of my uterine evaluation cycle, and assuming that goes as planned, the next cycle after that will be coordinating with our donor's to move forward with our treatment cycle.  Even if we hit a snag or two along the way, we are only a few months from FINALLY doing something (again) to actively work toward having a baby of our own. . . . and this time, it'll be something that has a much greater chance of success than failure.

What a good feeling.

Thursday, March 3, 2011

In denial

Next month will mark three years since I threw my birth control pills away (and quickly discovered how little I actually needed them).  I started BBT charting that same month, and MM and I have been TTC ever since.

In all that time, we have only ever seen one BFP, and it only lasted a few days.  That pregnancy did not even progress far enough for me to have an ultrasound.

Nearly a year ago, when MM pressed our local RE to give him a "hard number" in regard to our chances of conceiving naturally, he told us about 5% per cycle.  As another year of unsuccessful TTC has since passed, and I am now nearly 40, I can only imagine that our odds of conception have decreased since then.

And yet. . . . we hear of women all the time who conceive naturally against the odds, even in this community.  Circus Princess found herself unexpectedly pregnant naturally against the odds last summer and gave birth to a baby boy a few days ago.  After multiple failed IVFs, R was told she would never conceive using her own eggs and moved on to donor egg. . . . only to get pregnant naturally at Christmas time.  A woman on an egg donation forum I visit recently found out she was pregnant as she was planning her second DE IVF cycle (the first one didn't work).

Couple these against-the-odds natural conceptions with our "unexplained" diagnosis, and I find that, even as I prepare to pursue a DE IVF cycle, I am unable to completely let go of the hope that we will somehow, miraculously, conceive on our own.  As I was looking at the calendar yesterday to try to map out the earliest possible date when I might be able to start a mock cycle to prepare for DE IVF, I realized it was CD 24 for me.  (My cycles are usually 26-28 days long.)  I also realized that the cycle days when I likely would've been most fertile--based on past experience, as I haven't charted for over a year--fell on the weekend and that we did the deed then.

And even as I make logical, well-thought-out plans on how to move forward, a little voice in my mind whispered "Hey, maybe you are pregnant right now, and you & MM will be able to spend that money you have been saving for your cycle for something else!"

Yeah.  Even after three years, even for logical me, on some level, hope springs eternal.

I must be in denial.

Wednesday, March 2, 2011

Life from Scratch Book Tour

Today I am participating in a book tour for the book Life from Scratch.  Although it is not strictly infertility-related, the book was written by the absolutely fabulous Melissa Ford, AKA Lollipop Goldstein of Stirrup Queens.

If you don't know Melissa, at least online, you should.  She maintains a blog roll of thousands of IF blogs and is very kind and approachable, a real community builder.

You can buy her book in paperback here, or in Kindle edition here.

I am going to post, and answer three discussion questions about the book.  Feel free to share your own answers in the comments section.

To continue to the next leg of this book tour, please visit the main list at Write Mind Open Heart.


(Main character) Rachel's blog gets very popular when she wins a blogging award, and she starts averaging about one hundred thousand hits per day.  Would you want your blog to become that popular, or would you prefer to stay small?

Hmm, this is a tough question.  On the one hand, the topics about which I write are rather intimate, and I would hate to think that there are enough women actively struggling with IF to get 100,000 hits a day.  (Can't imagine the subject matter of my blog would interest too many others who don't know me.)

On the other hand, it would be a really cool feeling to know that that many people liked your writing enough to visit your blog.  And you could make money from your blog with that much traffic.  Hey, money I could put into our treatment fund!  :-)

While she is trying to move on from her divorce, Rachel cleans out The Box--a box of sentimental mementos from her marriage.  Do you have a Box of your own?  What do you (or would you) keep in it?

I do have such a box.  Nowadays it is quite small.  It contains small mementos from various relationships I had prior to meeting my husband MM, mostly cards and photos.

Why would I save these things, you might ask?  I am saving the items this box on the off chance that I someday have a daughter who might be curious about her mom's pre-marriage life.  Yes, weird and sad, I know.

At one time in my life, I saved these things for a different reason.  I used to periodically take out some of the items to look at and reminisce.  But since I have been married, the box is sealed with my BFF's name on it.  This is so that, in the event of my untimely death, MM knows to deliver it to my BFF; I wouldn't want him to open it and think that it meant that I still loved any of my exes after I'm gone.  That's not why I'm saving the stuff, but I'm not sure he'd understand that, especially if I were no longer around to explain.

Rachel talks about the kinship of marriage and how being on the "crazy ride" together is better than waiting outside in line.  Do we rush to/stay in marriage because we think the alternative is too isolating to think about?

I think that this is true of some people.  I happen to have about an equal number of friends who long for couplehood and who embrace the freedoms of being single.  I certainly have had friends who have stayed in not-so-happy marriages for fear of being alone, but they are the minority in my circle.