Working on the trick up my sleeve to try to get the next IVF covered, we had to consult our attorney. One of our attorneys, actually. I don’t know where other people find professionals, but DH finds real estate agents at the poker table and dentists at the golf course.

This pattern holds true for our attorneys. We have three attorneys that we consult for different purposes (all DH’s business purposes; I have never before needed an attorney for anything).

  1. Former roommate of a buddy that goes to Vegas with DH sometimes (contract stuff)
  2. Guy that went to high school with this other guy we know (corporate stuff)
  3. Dude that used to play basketball with DH (tax stuff)

I asked DH to contact Basketball/Tax Dude to get clarification about some Trick Up My Sleeve issues. DH received some answers via email, then forwarded the email to me. It only contained partial answers, and I knew that DH would have to go back to Basketball/Tax Dude and get further clarification. As I scrolled to the bottom of the email, I saw a query from Basketball/Tax Dude.

So when are all the little DHs and Cassandras going to start popping out?

Generally that kind of question pisses me off, but this time it amused me. The irony — embedded in an email in which we are consulting him about the Trick Up My Sleeve that may pay for the next IVF(s)!

So then, DH calls Basketball/Tax Dude to get the clarification we need. After some back and forth about business details that I won’t bore you with, Basketball/Tax Dude says, “The only reason you’d need to do that would be if you were doing In Vitro Fertilization or something.”

DH: Yeah, well, actually, that’s exactly it.

Basketball/Tax Dude: Oh. Okay. Then that is the right course of action.

DH: Great, thanks. And, um, we’re not telling people about IVF or anything, so I’d appreciate it if you don’t say anything to anyone.

Basketball/Tax Dude: Dude, attorney-client privilege!

Ha!

It’s official. I am not going to make any new friends unless they are attorneys, physicians, therapists, or priests.

Perfect MomentKnow what? Weebles Wobblog also keeps some tricks up her sleeve, along with a bunch of Perfect Moments.

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Show and Tell: Jaded

January 19, 2009

Three orders of business.

#1. The Meds Fairy! I have most of a 900 IU pen of Gonal-F (probably about 700 IU worth) left over from IVF #2 that just ended. I won’t be starting the next IVF for a couple of months, and the pen is supposed to be used within a month of being opened. Since I paid out of pocket for all of my meds they are extra precious, and I don’t want them to go to waste. It would be even better if I could save another self-payer a few hundred dollars. Please, if you can use some Gonal-F in the next couple of weeks (or know someone else who can), leave a comment or email me.

#2. Update on the IVF storyline on ER: the first time I can remember seeing subcutaneous FSH injections incorporated into daily life on television. This episode also illustrated the way that the meds make you a complete maniac, alternately bitchy then fragile — something most of us know all too well. Good stuff.

#3. Show and Tell! During my trip to Asia in the fall, I insisted on a detour to a Jade Market. Not for jewelry (okay, I did also buy some jewelry), but for fertility talismans. Also because I thought it would be cool to go to a Jade Market.

There were several dozen stands. A few were simply a table covered with a sheet (often an amusing sheet like Snoopy rather than a tasteful plain sheet); untold riches lay under the sheet, but you had to get a special sit-down. Most stands had hundreds of items on display. Some had particular specialties, but others had a wide range of jade offerings. Here’s an example of a typical jewelry-oriented stand.

Jade Market

Ahead of time, I’d done my research and determined that traditional fertility symbols included dragons, bunnies, and double fish. Dragons allegedly benefit male fertility, and are recommended regardless of whether problems are male factor or female factor (the ancient Chinese seemed be more cognizant of potential problems in either partner than many other cultures).The rabbit is a fertility symbol for obvious reasons — even though we all know that more sex does not necessarily mean more babies. Fish represent fertility because they have hundreds of babies.

Dragons were plentiful. I chose a red one for maximum power. He now lives on my husband’s nightstand.

Dragon

Rabbits were also plentiful at the Jade Market, since they (along with dragons) are among the twelve Chinese zodiac signs. I chose purple because, uh, I like purple. This little bunny lives on my nightstand, to achieve feng shui balance — since there’s a dragon on his side of the bed, I needed something on my side too.

Bunny

Finally, I had to find the double fish. This was quite a challenge. Most stands didn’t have any; a few had double fish that were quite ugly, with giant open fishy mouths. One was very nice but was a couple hundred dollars — a bargain, actually, considering that it was several hundred years old, but not what I was looking for.

At last, I found this little necklace. I wear it occasionally, always hidden under my shirt, but the day of my egg retrieval for IVF #2, I kept it close at hand. While driving to the retrieval, I had the cord wrapped around my hand while driving. Then, during the retrieval, because I would be wearing only a hospital gown and my striped socks, I made DH keep the fish necklace in his pocket until everything was over.

Fish

Here are all of them together, accompanied by our old pal Wonder Woman Pez, for scale.

Scale

The funny part is that I don’t actually believe in good luck charms — we’ll talk more about that on Thoughtful Thursday. But I sought these out for two reasons:

  1. I thought it would be a great blog entry.
  2. Although I don’t believe in them, they can’t hurt. Seriously, I can use all the luck I can find.

In honor of Delurking Week, I’m going to donate money to a specific charity (more on that next week) for each comment. Regular comments from beloved existing readers get $1; comments from soon-to-be-beloved delurkers get $2. C’mon, spend my money! To make commenting extra easy, you can answer the following question:

Do you have a good luck charm (either in general, or specific to fertility)?

Go see what the rest of the class brought to Show and Tell.

Hooray! It’s Thursday! Last week’s Thoughtful Thursday was so fabulous. There were more than a score of diverse, carefully considered comments, and that was amazing. But, the stats say that there were many more people who read the post yet didn’t comment. C’mon, delurk! (There will be an official call to observe Delurking Week this weekend, but feel free to delurk more than once.)

Let’s keep the thinky fun going with a topic that was first brought to mind in my IRL support group last month, and then raised by one of the comments in last week’s TT.

One of the IRL support group members (the same person who said both “I would never do IVF. It’s not natural.” and “At least I’m not 40!”) declared her hope that injectables will bring her twins. Girl-girl twins, specifically. Because then she’d “be done” with infertility treatments forever and also because she doesn’t really want to have a son.

The other members and I quickly rushed to explain all of the risks associated with multiples, and that twins aren’t simply a convenient two-for-one. We all left the boy-hating alone. In my mind, my immediate reaction was:

Honey, you obviously haven’t been infertile long enough if you’re trying to dictate what kinds of babies you get. Beggars can’t be choosers, sweetheart.

And yes, I do call people “honey” and “sweetheart” condescendingly in my head. Not out loud, usually.

Krysta mentioned a similar person and her own reaction, almost identical to my line of thinking, in her answer to last week’s Thoughtful Thursday question, “Does it change your impression of someone to find out they’re infertile?”

Great topic! Yes, it does change my impression of people when I learn that they are one of “us”. I feel for them and I have a bond with them, so it draws me to be friends with them more than I would if I didn’t know that about them. Except for this one person I know. They tried for about a year to get pregnant and did some treatments, not sure what, but ended up getting pregnant naturally with a baby girl. So now that child is around 2 years old and they learn that they are pregnant again. When she found out that she was having a boy, she was depressed and didn’t want to leave her house for days. She wanted a girl so bad, that she was actually depressed when hearing it was a boy! She obviously isn’t one of “us” after all……

Krysta and I share the sentiment that a “real” infertile would be happy to have any baby, period. A real infertile wouldn’t dare to try to tell the stork which babies to bring.

But there are “real” infertiles with sex preferences. How else could so many REs offer “sex selection for family balancing?” Sex-based selection on the basis of disease (such as an X-linked disease that only manifests in boys) aside, some people just want a certain combination, and pre-implantation genetic diagnosis makes that possible. If you’re doing IVF, especially if you’re doing PGD anyway, sex selection is barely an extra step. Personally that’s not something that either DH or I would do — the word “cherry-picking” has been used in our house — but ultimately we wouldn’t sex-select because we each would be happy with a boy or a girl.

DH, in fact, so ardently does not have a sex preference that he will not even entertain the question. He will admit to sex preferences for specific breeds of dogs, but not for human children. An equal opportunity daddy.

Personally, I have not had any sex preferences for as long as I’ve been TTC. As a kid, though, I only wanted to have daughters. I remember the moment when that changed: at 16 years old, I was sitting in the car, waiting for my mom to come out of a store, and I saw a mother and her 4-year-old boy in a crosswalk. As they crossed, she joyfully twirled him around in circles. It was an epiphany for me that having a son could be a wonderful experience. I guess I didn’t think much of the little boys I knew up to that point, or at least I didn’t think much of their relationships with their parents.

I have had perfect boy and girl names picked out for a long time (the girl’s name for 14 years, the boy’s for 10 years). Because I love the names, I’ve hoped that I would be able to use them both by having one of each sex. But over the years, as it has taken soooo long to have even one child, ending up with one child of each sex has become less and less important. As long as I get to use either of the names and finally have a child, any child, I am satisfied. Because I am an only child, I would strongly prefer that my child have a brother or sister eventually, but at this point, having taken 7 years to get to zero, let’s work our way up to one and see what happens.

This week’s Thoughtful Thursday query:
Did you start out with a set idea of how many boys and girls you wanted to have? How has infertility changed your sex preference?

Nope

January 14, 2009

It’s confirmed — negative beta.

One benefit of POAS knowledge: the nurse seemed surprised that I took her bad news so well.

One ray of hope: I may have a trick up my sleeve that will allow future IVFs to get covered by insurance — don’t ask yet, since I’m not sure if it’ll work. Sure, it would have been nice if I’d discovered this trick earlier before paying for 2 IVF cycles out of pocket (plus assessment and 2 IUIs earlier in 2008, all of which actually would have been covered by my current health insurance except that I didn’t have this job at the time) but that’s water under the bridge.

Thanks for all of your hope and well wishes.

Now, I’m going to go wash the magic marker PIO targets off my butt.

Edited to add: I’m pasting the timeline here, just so that I have it recorded.
11/20-12/15: BCP
12/19: start stims (Gonal-F)
12/23: blood & U/S
12/23-12/24: Gonal-F plus Repronex — itchy!
12/25-12/28: Gonal-F, Repronex, and Centrotide
12/26: blood & U/S
12/28: blood & U/S
12/29: blood & U/S: follicles are ready; time to trigger!
12/31: egg retrieval, ICSI, start estrogen
1/1: start progesterone in oil
1/2 embryo transfer
1/14: beta: BFN

Warning: This post is not about IVF, betas, or peeing on sticks. Read at your own risk.

I just heard something I have never heard before, in 33 years of being my mother’s daughter.

My mother giggled.

My mother complains to me about the neighbor’s cat almost daily. In the midst of today’s complaints, she was telling me about how the cat set off the motion detector lights in the driveway. And then she giggled. “Hee hee.”

Honestly, I can never recall my mother giggling before. My mother’s laughter repertoire otherwise consists of:

  • uncontrollable hysterical laughing for 5 or 10 minutes, usually at totally inappropriate times like funerals (and once in college, famously, in the middle of a play — while she was on stage)
  • silence when she doesn’t get the joke while everyone else laughs
  • sarcastic deadpan “ha ha”
  • “Are you trying to be funny?”

IVF #2 2WW Blow by Blow

January 13, 2009

By nature, I am a pretty calm person. DH’s über-calm style has influenced me to be even more calm. But some powerful chaos lies dormant inside me — I inherited some pretty nutty genes from multiple family members.

Those chaotic genes have been activated during the second half of this 2WW.

With IVF #1, my patience (and avoidance) was so great that I didn’t POAS until 3 days after the beta would have been scheduled, extending the 2WW into a 2-and-a-half-WW. IVF #2 has been the complete opposite.

During the chicken-with-its-head-cut-off phases of this 2WW, I have scoured the IF blogosphere for posts of people who were at the same point in their 2WW, and I have found their subjective accounts immensely helpful. So, I’m going to give you a blow-by-blow in the hopes that it is helpful to someone else, now or in the future, during the throes of 2WWorry.

The following information comes from my IVF #2 spreadsheet — after abandoning them for a few treatment cycles, I am back to spreadsheets. It’s either indicative of optimism or an inability to distinguish one day on the couch wearing pajamas from the next. Probably both.

transfer day, 1dp2dt: Houseguests still here; some residual cramping from retrieval, but otherwise fine.

2dp2dt, 3dp2dt, 4dp2dt, 5dp2dt: Feeling lazy and sometimes sleepy, but otherwise fine. I stare repeatedly at the photos of my beautiful embryos.

(Here is where the “fun” begins.)

6dp2dt: After many lazy days, I am suddenly full of energy. I get as far as cuing up the video for a Qi Gong workout (which I have never done before, but it is gentler than the power yoga that I usually do) but don’t actually manage to do any exercise. I also have a tiny bit of nausea during the day, but in the evening I am moderately nauseous. That night, I am completely unable to sleep until after 4 a.m., totally anxious and 2WWhacked out. When I finally fall asleep, I have drawn-out dreams about BFNs and BFPs. Full scenarios, such as BFN followed by changing health insurance followed by FET or another IVF.

(My husband likes to make fun of me for my lame dreams, because he dreams about sports and sex but I tend to dream about topics like work and math. I may have topped my own nerdiness by dreaming about insurance.)

7dp2dt: Although I was planning to wait until the weekend, obviously my brain cannot take it anymore and I decide to POAS. My strong nausea must mean I’ll get a BFP, right? Nope. BFN. Granted, it is extremely early to be testing. Later in the day, I am again nauseous at night. I am also constipated, which often makes me cranky but in this case my mood is okay. I also spend most of the day being active or sociable, which probably helps.

8dp2dt: Bleeeeeeh. Constipation has given way to loose stools. I have a tummyache with some nausea most of the day. I am decidedly cranky. Oh, and also still lazy.

9dp2dt: Time to POAS again. BFN. I check Betabase and determine that there is more than a 50-50 chance that even if I were truly pregnant, I would still get a BFN at 9dp2dt. This does little to affect my mood, which becomes miserable. DH offers the wisdom that if I were supposed to test on 7dp2dt or 9dp2dt, they would have scheduled the beta then instead of 12dp2dt. The constipation returns, and I also have a bit of spotting/light pink bleeding. This is the first bleeding since the post-retrieval bleeding stopped. I don’t know what to make of this. DH goes out of town, and when I drop him off at the airport it feels as if I’m saying goodbye for months instead of a week. On the way home I go to the store and come close to bursting into tears more than once. Not much of an emotional eater, the only thing at the market that I can find to bring me any comfort is high-end hot chocolate mix.

10dp2dt: A little more spotting, but not much. Energy is higher, and I actually make it to the office. Still a bit nauseous and a bit constipated — I don’t know what to make of these symptoms. When I get home and check the mail, it contains a letter from the embryologist saying that none of my three extra embryos made it to freeze. I start to freak out, because the two embryos that were transferred were graded the same two of the ones they did not transfer. This means that if this cycle fails, instead of FET it’s right back to IVF. But more importantly, I also feel like it bodes poorly for the embryos that were transferred. Not entirely logical, I know, but my hope was already fragile and now it’s almost non-existent.

11dp2dt: POAS, BFN. Back to the drawing board. I guess there’s a tiny chance that the beta will be positive, especially given that I accidentally used First Response Rapid instead of First Response Early for today’s BFN, but I’ve wasted too much of my energy in the past seven years on glimmers of hope.

(Oh, and since my out-of-town husband is going to get the BFN news by reading this post, sorry. I love you.)

The beta is tomorrow. Tonight’s PIO injection is going to suck.

Conclusion #1:
Early POAS is great if it’s positive, but torture if it’s negative. (Obviously, you don’t know which it will be until you test.) But without POAS, I don’t know if I would have slept in the past five days.

Conclusion #2:
No matter how optimistic an RE is about a cycle, he is not in control of the babymaking gods. I wish I knew who the god-wrangler was — I’d bake him all the uterus cookies in the world.

I haven’t heard anything in the IF blogosphere about the most recent episode of ER. I think I may be the only person who’s still watching after all these years.

Ladies, time to set your TiVo’s — and not just because John Stamos is hunky.

Outspoken stirrup queen Angela Bassett is a regular cast member this year as the new Chief of Emergency Medicine. Her character is fair but tough; the prickly exterior turns out to result from her grief after the death of her young son several years earlier (one flashback episode heartbreakingly portrays his death). It has offered an unusually nuanced portrayal of the loss of a child.

But this past week, the loss storyline became an IF storyline! (Perfect Moment #1)

She and her husband decide that it’s time to rebuild their family. Following one failed cycle with charting (!!) and timed intercourse, Basset’s character considers her advanced maternal age and immediately consults the Chief of Obstetrics (who, frankly, is not the person I would approach for fertility issues — I would go straight to an RE, but the OB is a recurring character). The OB tells her that her estradiol and prolactin are fine, but that her FSH is elevated. I’ve never heard all of the IF lingo in such detail on television before, with acronyms and terms tossed around casually just like on our blogs.

The obstetrician tells her that the odds for IVF with her own eggs approach zero, and that many fertility clinics won’t even attempt IVF on someone with those FSH levels. She lays out alternative options: “adoption, surrogacy, egg donation.”

A realistic portrayal of odds and options! I was shocked. My husband kept exclaiming, “Blog! Blog!”

Bassett’s character decides to take one shot at IVF with her own eggs and then pursue the other options.

As with the second season of Mad Men, I am so excited to see what happens next. This is the last season of the show, so there isn’t a huge amount of time to go through an extended portrayal of multiple routes to family-building, but there is time for her to do an IVF cycle or two.

Perfect Moment #2: What’s particularly exciting about this for me is that Angela Bassett and her husband Courtney B. Vance (who also plays her character’s husband on the show) have talked openly about their 7-year battle with infertility and successful use of a gestational surrogate, resulting in boy-girl twins. It is so gratifying that not only has she been forthcoming about the difficulties she encountered bringing her children into being, but she is drawing on her experiences to bring an intelligent, informed infertility storyline to a network television show.

About 6 or 7 years ago, I saw Angela Bassett in person. I’d always found her to be somewhat pretty on the movie screen, but in person she was absolutely stunning. And, if I do the math, she must have been dealing with infertility at the time I saw her — despite that, she had an aura that drew the eyes of everyone in the room. Many people didn’t even recognize her at first, but just had to keep staring at this unknown woman with magnetic beauty.

She seems to have dealt with her infertility better than I have been dealing lately. Hundreds of turned heads is not what I get when I walk into a room. Most days, I can’t even manage to put on actual pants.

Perfect MomentHead to Weebles Wobblog to see more Perfect Moments.