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678 …

Well, the uncertainty continues. I’m trying to get used to the anxious/everything-is-up-in-the-air feeling that pretty much permanently resides in my brain.

To recap: I got (very) positive home pregnancy tests on Friday 3/16 and Saturday 3/17. I started spotting on Saturday, and light-medium flow on Sunday. The bleeding was red and by Monday was very heavy. I had 2 days of heavy flow, then another light/medium day, and then 2 more days of spotting. Overall, it felt like a “normal” period to me (my periods have been super heavy since they returned after having Riley), but with a couple of extra days of spotting. I’ve had no cramping or pain, but the bleeding was red, heavy, and clot-y (sorry for the TMI but also this whole blog is TMI so …). I had a bit of spotting on Saturday and nothing on Sunday or today.

Blood HCG levels have been low and rising, though slowly.

  • Monday 3/19 – 127
  • Wednesday 3/21 – 199
  • Friday 3/23 – 271.42
  • Monday 3/26 – 678

This most recent rise was closer to normal – I think that’s a 52 hour doubling time. BUT, the numbers are still too low to be able to see anything on an ultrasound. And obviously the overall picture continues to be abnormal. So, I get to go back in for blood work again on Wednesday. They’ll check my HCG but also look at other things (they did not tell me what the other things were, just that I don’t have to fast). And I am now scheduled for an ultrasound on Friday morning (3/30). That was originally supposed to be on Thursday, but my doctor is apparently on IVF/surgical duty that day so can’t be in for the ultrasound. Even though I want answers sooner, Friday is better for me all around because I work on Thursday but am off on Friday.

I asked the nurse what the possible paths at this juncture are. She said:

  • If they don’t see/can’t find a pregnancy in the uterus, they’ll likely recommend a Methotrexate injection (chemical abortion)
  • If they can confirm an ectopic pregnancy, they’ll recommend Methotrexate as well
  • If they can see a pregnancy in the uterus but can confirm that it is abnormal/not viable, we’ll discuss options including a D&E
  • If they can see a pregnancy in the uterus and it could be normal, we’ll do more waiting and seeing

I also asked whether a normal pregnancy progression is a possibility here. She said “never say never” and that she has seen it happen. She gave it maybe a 10% chance (this is just a nurse totally guessing here, not based on any evidence or data … kind of thought it was weird that she put a number on it but also 10% was higher than I expected so I’ll take it).

Sigh. So that’s the continued state of my uterus. I’d love to hear from anyone who has had slow rising HCG (and/or full-on bleeding in early pregnancy), regardless of what the result was. I don’t really have anyone in my life who has experienced this (to my knowledge), and I try not to google too much …

I’ll catch y’all back here again on Wednesday I suppose!

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Slow climb

HCG came back 271.42 today. To recap:

  • Monday 3/19 – 127
  • Wednesday 3/21 – 199
  • Friday 3/23 – 271.42

Obviously not good doubling times, obviously most likely indicative of a miscarriage/non-viable pregnancy, but annoyingly still trending upwards. My RE ran some additional blood work as well, though I’m not even sure what – I think a complete blood count and liver function maybe? Anyway all of that came back normal. The plan is still to wait it out. More blood work Monday, ultrasound Thursday. Sigh.

53%

I went in for my second beta this morning, and fully expected the numbers to be dropping given how much heavy bleeding I’ve been experiencing. In fact, the number increased, albeit slower than is typical for a normal pregnancy (which makes sense, given how unlikely a normal pregnancy is at this point). They reminded me that my Monday beta was 127. Today’s was 199. That’s a 53% increase in 48 hours. I’m pretty sure the guideline is for doubling every 48-72 hours, with at least a 60% increase over 48 hours. Basically it’s more uncertainty (with a healthy dose of nope). In the meantime, I’ve been bleeding since Saturday, and bleeding heavily since Monday. Today is less heavy, but Monday and Tuesday were VERY heavy, and it’s been dark red bleeding with clots the whole time (sorry for the TMI). All of that said, I am still getting the fun early pregnancy side effects like heightened sense of smell, very minor nausea (the thought of beef made me retch today), and major exhaustion.

So I’m just hanging out, continuing to consider this a miscarriage/chemical pregnancy, and waiting for the numbers to drop so that I can move onto the next. I’m not doing anything to sabotage the outside chance that things may turn around and this may become a viable pregnancy, though the chances are so so low. I’m honestly not feeling as awful about this as I thought I would. Disappointed perhaps, but in the same vein of the disappointment I felt each time an IUI or that first IVF didn’t work. I haven’t cried. I AM frustrated at the not knowing, and anxious to be able to get to the next steps (which I can’t do until my HCG is below 5).

Blah! OK to end on a positive note – Riley started a new daycare on Monday and seems to really like it. At her old daycare, she came home every single day with a rash and “allergy shiners.” So far this week she has looked awesome, which just reinforces my perception that she was just a little allergic to her old daycare (detergent, pets, mold … something like that). Our doggo came through surgery well, though we are waiting to hear on the biopsy still. But she’s finally seeming more like her self (barking at the mailman and all those good things). Also, I love my kid so much I can’t even handle it sometimes. The biggest difference between TTC the first time vs. this time around is that I have my beautiful bundle of awesome that I can go home and snuggle. It makes it easier to not fixate on all of this and keeps the bigger picture in perspective. I know that I couldn’t have had that perspective the first time around, and am grateful to have it now.

MOAR BLOGGING

I am a terrible blogger. So there’s that.

Where was I? Oh, so I am definitely not pregnant (which I pretty much already knew, but, ya know … confirmed). It was pretty disappointing to have our first IVF attempt fail, and no one likes waiting, but I feel like I’m in a good place and ready to take on 2016. Let’s do this.

When we finally got confirmation that my blood test was negative, they said that the plan was to wait out this January cycle, and gear up for a frozen transfer with my February cycle. While I am not thrilled with all the waiting, this is what I expected. I made an appointment to see my RE on 1/16 to go over the frozen transfer protocol. My RE’s office apparently knew that we ended up with frozen embryo, though I never actually got the e-mail I was supposed to get updating me to that end. Whatevs.

So we showed up on Thursday at the appointment and my RE went over everything, basically reassuring us that all of my numbers throughout the cycle were perfectly average and we shouldn’t get too down about the BFN, because obviously the 40-50% success rate means that inevitably at least 50% of people don’t get pregnant the first time. I am not sure why she thought math was going to make me feel any better given that I’ve already had 12 failed IUIs but that’s another story. Either way, I was glad to hear that they felt like the number of eggs and embryos and hormone levels and everything were normal. She said that my protocol was conservative because the goal was not to overstimulate and to do a fresh cycle, so I guess that makes me feel a little better about having fewer embryos in the end.

If you recall, we transferred 1 great looking day 3 embryo for the fresh cycle, and I still had 3 that they were watching to see if they could freeze. Of those 3 – 1 looked good (8 cells, can’t remember the grades), and 2 were potentials (both 4 cells). Apparently the 8 cell actually ended up being fragmented, but one of those 4 cell guys caught up and ended up being of great quality to freeze. The grade of the 1 little frosty we got is a 4AA which I am told is good. 4 refers to the stage of blastocyst it is (stage 4 is pretty advanced, right before hatching), and the As are like letter grades so who cares what they refer to – it’s good.

I guess it feels bittersweet to only have 1 on ice, but to have the 1 be seemingly really good looking. My RE said that my chances for the frozen cycle are actually a little bit better because of the embryo quality and the fact that it’s a blastocyst (as opposed to the 8 cell embryo I transferred last time). And it has a 95% chance of surviving the thaw.

So everything seems good, right? Wrong. Because then we met with our nurse who shared with us that Blue Cross Blue Shield has new fertility policies starting 1/1/16 which affect us. The first (and more relevant) issue is that they now require that my uterus be looked at (either via HSG or SHG) every year. My HSG was 1/29/15, so even though it isn’t expired yet it is about to be and they thought that BCBS wouldn’t even look at the prior authorization until I get a new one. Which, you guessed it, means we would have to skip ANOTHER cycle because the SHG can only be done days 6-14 and I was already at day 22 or something. They didn’t care that I haven’t ovulated yet either. Cue me trying not to cry in the doctor’s office because I don’t want to deal with ANOTHER delay and ANOTHER disappointment. My eyes were welling up and all I could say was “that really sucks Tracy.” Why does it suck? Because they should have noticed it. And had they noticed it like 8 days sooner I could have done the damn test this cycle. UGH

BCBS new policy number 2 that kind of set off our emotions: Apparently BCBS of MA is now paying for IUIs for same sex couples. Like, right away. And our nurse chose right after dumping the above on us to tell us this. I seriously love this nurse but really?! I wish I didn’t know that. Apparently they are JUST paying for the IUI part, which is only like $150/cycle but that is quite a lot of money when you’ve just paid for 12 of them …
So I’m almost at the point where I’m happy that BCBS is being more fair to lesbians, but I’m still kind of at the “seriously?!” phase and probably will be for at least a little while.

I basically guilted the clinic into submitting the prior auth for my frozen transfer anyway, just to see if it goes through, and it actually looks like it might be paying off. We didn’t get an immediate denial for the February cycle and the nurses think that since it is in process that it’ll end up going through. I’ll know more in the next couple of days hopefully. Cross your fingers that the universe throws me a bone here.

So that’s where we are. I’m waiting to get insurance approval and then waiting to get my period so we can get this party started again. Sorry for the novel of a post. It’s my own damn fault that I never remember to update. New Years resolution 2k16: try to actually post things on my blog.

Happy New Year! Cross your fingers for the prior auth to go through so I can get preggo in February (because we all know it would be a travesty to wait until March). Oh, and any of you with BCBS (especially BCBS MA) who are doing IUIs – look into this new coverage update!

IVF: Let’s Get This Party Started

I’m sitting here right at the beginning of my very first (hopefully only!?) IVF cycle. This post may perhaps be slightly boring if you are not super interested in exactly what protocol I am using and what led me to IVF. If that doesn’t sound fun to you, feel free to read something else. I can recommend a couple hundred lesbian romance novels if you’re interested.

SO IUI #12 was a bust (which was actually a relief, because can you imagine if it worked on the last try before insurance kicked in?! And then I got to start all over again with the out of pocket bullshit when we try for number two?!) – got my BFN at the beginning of November and immediately submitted for IVF prior approval. Having done this twice already, I felt like a champ at urging my RE to get the paperwork in, etc … and I also felt very certain they were going to deny it for no good reason again. Miracle of miracles it was approved! As I mentioned in my last post, I was traveling a lot during the month of November so knew it probably wouldn’t work with the constant monitoring that IVF requires. That said, I was hell bent on not waiting until the new year to get this started.

My RE’s initial plan was to wait for my next period and then start IVF. But I can do math, so I knew that that was never going to happen without running straight through Christmas. I spend Christmas several states away in Ohio with my family, so trying to do a retrieval or transfer around the holiday is a no-go. I have a friend who is also starting IVF this week and her RE had put her on birth control as a way to both suppress her ovaries as well as allow them to time her cycle as soon as insurance approval came through. I asked my RE if I could do the same and she agreed (without even any discussion which makes me think … how do you make these decisions? … but whatever), so I started birth control in early November on day 3 of my cycle. So birth control is fun times, huh? Also, it’s free?! Thanks, Obama!

I had a suppression check (baseline ultrasound as well as bloodwork) yesterday and they told me that after that they would know whether we could start my stim meds in the next couple days. So then I get the results voicemail and they’re like “okay so you are going to start your gonal-f tonight, and inject 300 IUs for the next 4 nights until you come back on Friday for another ultrasound and bloodwork.” I totally didn’t expect to start that day! I haven’t even gotten my period yet but apparently that doesn’t matter. I assume I’ll still have a period this cycle? I don’t even know. Ah!

So last night was the night! I took one of my Gonal-F pens out of my refrigerator and dialed the handy-dandy dose dialer thing to 300 and went for it! I have to say that all of the syringes and needles and putting the needle on the pen and everything is fairly overwhelming. How have y’all tracked your IVF meds? Right now I’m using Fertility Friend but I let my subscription expire so it doesn’t give me the whole grid with my custom meds on it. Should I pay for that subscription again or is there another/better way to keep track?

The plan from here … Gonal-F every night through Thursday night, ultrasound and bloodwork again first thing Friday morning and I’ll have further instructions. My protocol from there as I understand it is:

  • Ganirelix in the AM to keep me from ovulating
  • Gonal-F in the PM still
  • Add Menopur in the PM
  • Keep going until I’m ready to pop
  • Novarel to trigger ovulation
  • Retrieval
  • Fresh transfer?
  • Crinone after transfer (ugh I hate this damn goop)
  • Vivelle patches after transfer

IF I don’t hyper stimulate (oh! another poll – how many of y’all hyper stimulated and had to wait and do a frozen transfer?), we’re hoping for a fresh transfer on day 3 or 5 post-retrieval. I opted NOT to do ICSI because it was not covered by insurance and my doctor seemed to think it was better to try without. I’m really hoping we get more than enough embryos so that we can freeze some for baby numero dos. I feel so lucky that insurance is covering this all at 100% other than my 10% co-insurance and my medication co-pays. I think I ended up having to pay around $700 for the co-insurance (I have an out-of-pocket yearly maximum that I was almost at, so I just had to pay that and not the whole 10%) and $130 or so for the medication co-pays. Of course, that’s after we sunk $18,000 into IUIs and sperm over the past almost 2 years, so we could have just paid for IVF out of pocket up front. But now that I qualified for fertility coverage, I am automatically already qualified when we try again.

Things I am anxious about now that I don’t have to be anxious about ovulation and timing:

  • That my body won’t respond well to the stimulation
  • That my body will respond slowly and it will fuck up my Christmas travel plans
  • That I won’t have any viable eggs
  • That none of the eggs will fertilize
  • That we won’t have any good embryos
  • That we won’t have any embryos left to freeze

Well, I have to be anxious about something right? Here’s to new adventures and to being back in the blog-o-sphere!

Anyone Still Out There?

Oh my goodness where have I been? Well … at any rate, I’m back. Anyone still out there reading?

I took some time off from blogging for a few reasons. The first being my first ever experience with depression. I don’t think it was entirely TTC-related (though I’m sure it contributed), but it was not a fun time for me. Or for the wife of course, though she was wonderfully supportive. I believe I’ve talked about my OCD on here before, but if not I will now. After the depression lifted (it took maybe a month or two?) my OCD kicked in full force. Lots of anxiety and compulsions … all fun stuff.

Reason number 2? Things weren’t going well in TTC land and I didn’t want to think about it any more than I had to. So I stopped writing (and reading) and tried to focus on other things in my life. I also chose that time to become completely obsessed with reading lesbian fiction, which I’m not at all ashamed of (okay, maybe a little). But seriously lesbifriends, there’s some great romance out there for us. Also, reading quick, guaranteed-happy-ending, romance novels is a great way to escape and get the happy feels going.

The last reason I haven’t been back for a while is that I opened up to a few friends about TTC and suddenly had some more people to talk to about it. It’s been nice to have that outlet, but (as you all know I’m sure), people who aren’t going through all this fertility razzamatazz don’t really get it.

SO that’s what brings me back, and I’m so ready to be back here now. I hope I can reconnect with you guys as I try to catch up on everyone else’s journeys – and of course get you caught up on mine.

I last checked in back in February when I had just had BFN #7. If you really want the facts of what’s happened since, I updated my timeline page. The short version? Insurance denied me coverage twice so I paid out of pocket for 5 more IUIs, all (obviously) BFNs. Now, with 12 failed IUIs under my belt, I’m headed into IVF land. I’m actually going to write another post about my IVF plans and protocol specifics so I’ll leave you with that. I’ve missed you, cyberfriends, and I am happy to be back 🙂

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You know what sucks?

Not being pregnant. Again.

To start, I had an “IUI #7” post that got lost somewhere in the WordPress Bermuda triangle. So, ya know, I had another IUI 2 weeks ago, and it didn’t work. Now we’re all up to speed.

I feel like I have been a super positive Polly about TTC in general since we got started. I mean, I’ve had the expected ups and downs with each cycle, but have generally maintained a certain level of hope and excitement about being pregnant in the near future, at the right time, blah blah blah.

Today? Not so much. I’m feeling, for the first time, really let down, sad, and hopeless. I know that this feeling will probably only last for a day or two because the progesterone will slip away and my estrogen will increase and my brain will feel happier. But right now – right now I feel super super bummed out.

I remember perusing lesbian TTC blogs forever ago (in grad school maybe?) … back when it was very not real … and reading through some people’s timelines and totally freaking out. I remember thinking, “wow, they tried like 5 times before it worked?!” And here I am, almost a year later, with nothing to show for it. I feel like my worst fears are coming true. And on top of that, at least 3 different doctors/nurses/medical-types have mentioned IVF in the past few weeks. Actually, my nurse (my favorite nurse) mentioned that we might want to consider it literally right after the IUI. I would’ve loved at least a day or two of pretending that this one was going to work.

Honestly, I am totally comfortable with the idea of IVF. I’m not scared of it, and I have accepted that it is a thing that I might have to do. And I know how lucky I am that it will be covered by insurance, and that cost doesn’t factor in too much anymore. But right now, it just makes me so sad that I am inching ever closer to IVF. That I am inching closer to the Hail Mary option. The option that doesn’t have any more options after it. The option that takes longer than just a couple of weeks.

I know that the best thing for me to do is to focus on the next steps and the plan moving forward. So after I am done wallowing today, I’ll try to do that. What are the next steps? I scheduled an appointment to check in with my RE regarding the plan. Her next available was March 11th, and her next available Thursday appointment (my day off) was March 26th. For now, I’m scheduled on the 26th. I’m certain we’ll talk about IVF. I told the nurse on the phone that I wanted to go ahead with at least one more IUI cycle. Of course, I consulted Dr. Google today (will I never learn?) and found out that the success rates for IUI drop after 4 or 5 unsuccessful cycles. Great. Onto IUI cycle number 8 then …

I’ll happily accept any words of encouragement/hope/etc from y’all. I sincerely dislike feeling like such a downer. Hey – at least it’s the weekend, right?

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