Saturday, December 29, 2007

Firsts

"Is this your first?"

That's the question people ask -- in the deli, in yoga classes -- when they find out you're pregnant. It's a question I can't quite bring myself to answer.

My first would be about a year old now. Maybe he'd be walking. (For some reason I feel it was a boy.)

My second and third -- identical twin boys -- would have been born this month.

My fourth stopped developing about five weeks ago, and its sibling -- my fifth -- still seems to be around, kenina hora.

Yesterday after my prenatal yoga class, I went to a crowded taqueria for lunch. A woman from my class sat down to share my table. In talking about our pregnancies, we discussed our past ones. I realized that for the third time in a month, I shared very personal information about my miscarriages with someone I barely know.

I have fought so hard to become a mom. In my life, I've dealt with major work difficulties, breakups, and family health crises. I fought to lose and keep off 75 pounds, and I trained myself to run half marathons. But nothing has been harder than trying to conceive. And nothing has been harder than staying on track after disappointment upon disappointment. So when a woman sits down at a restaurant to share chips and salsa with me, I can't just blithely pretend that this pregnancy came easily. Infertility and miscarriage are part of this narrative, and I don't feel the need to whitewash it. Moreover, I feel that to get me, and to get what this pregnancy means to me, you need the back story.

No, this isn't my first baby. It'll hopefully be my first child, but it isn't the first time a living being has taken up residence in my womb and in my heart.

Wednesday, December 19, 2007

It's alive!

It should come as no surprise to regular readers of this blog that I'm a little anxious about this pregnancy. Since passing all of the initial tests, I've graduated to a state of regular pregnant-ladyness. Which is great, except for the part about not seeing the doctor that often. How the hell am I supposed to go a whole month without knowing for sure if it's still kicking?

Well, I don't have to, thanks to the combined wonders of modern technology and the Internet. Yesterday the fetal doppler monitor I ordered came in the mail. For $46 a month, I can use this thing to find the baby's heartbeat and even see what it is on a digital readout.

I didn't really think it was dead; even though my nausea has mostly subsided and my fatigue has improved, I'm definitely getting bigger and hungrier. But with my second miscarriage, I had no miscarriage symptoms and the embryos were gone. So there's no guarantee that the absence of symptoms is good news.

But a display of munchkin's heartbeat -- it was in the 150s -- is a pretty good guarantee for now. Worth every penny.

Wednesday, December 12, 2007

Milestones

I definitely feel like I'm in a foreign country without a map. This whole 12-weeks-pregnant-and-everything-looks-good thing is completely foreign territory.

Today I am 12 weeks. 12 weeks! Never would have thunk it. Can't decide if this is the start of the second trimester -- even the medical books don't seem to agree. I'm going to be literal (for a change -- NOT) and decide that I'll be in my second trimester at 13 weeks 3 days (divide 40 weeks by 3, etc.).

Last night I received my last intramuscular progesterone shot -- something I'd been getting daily for more than two months. Thank God. My ass is going to be confused when it doesn't get stabbed every night.

At this point, I'm like a regular pregnant lady, going to see the doctor every four weeks. Which means I don't go back to the doctor until 2008. After being wanded every two weeks at a minimum, it's bizarre to go four without seeing an ultrasound machine.

My newest worry: figuring out when to tell people, mostly at work. I would like to wait until the amnio results come back, but that won't be until around January 23, when I'll be 18 weeks (kenina hora). I can't imagine I won't be showing by then, and while I am generous of belly even when not knocked up, I think by then it will be obvious that I've gone beyond eating too many Christmas cookies.

So the question becomes, to tell before the amnio results? That terrifies me. I believe that everything will be fine, but at the same time, I am having a hard time balancing my desire to tell people before it's completely obvious and my desire to keep it quiet until I know the test results are okay.

Feedback welcome!

Thursday, December 6, 2007

CVS converted to amnio

We went to our appointment today. All looks good, but the doctor was concerned it might be difficult to get a sample of the cord for the surviving twin. He was having trouble telling what went where and felt it would be better if we wait to do an amnio, since at that point there will be no question of whether he's getting into the right sac.

So, no CVS today. However, we did get to see a bunch of really cool ultrasound pictures. We saw the head, the arms, and the legs! (It seems to have two of everything it should have, and just one head.) It seems to have my big nose, and it was really active -- moving around a lot, and it grew 4 mm just in the last two days! It had a heart rate of 170 bpm. We're 11 weeks 1 day today (cannot believe that!) but it measured 11 weeks 5 days. Maybe it'll take after its big momma.

The doctor was able to see that the nuchal translucency -- the fold at the back of the neck -- was nice and thin. That's good, because a thickened NT can indicate Down syndrome. He thought everything looked great, so we have to wait 5 more weeks for the amnio and 2 weeks after that for the results.

I was really nervous this morning about this test, and while I wish I didn't have to wait so long, I'd rather wait and know that the answers are pretty definitive instead of get ambiguous results and then end up having a CVS AND an amnio. So, provided nothing goes awry, we have no doctor's appointments until 2008.

Tuesday, December 4, 2007

My one and only

What was two is now one. And really, that's okay.

The ultrasound we had two weeks ago showed two embryos. One looked fine, and one looked a little small and had a rapid heartbeat. Today's scan showed one great-looking embryo (measuring 3 days ahead of schedule) with a good heartbeat, and one embryo that was half the size and didn't have a heartbeat at all. This is now a singleton pregnancy.

We are both sad and relieved. The idea of twins terrified me, and the idea of a selective reduction pained me. At least if I'm not going to have twins, I can be glad the decision was made for me.

The next step is a CVS, which happens (egads) Thursday. I had been advised that a CVS wasn't recommended with twins, though our perinatal clinic apparently does them on twins all the time. Their miscarriage rate is the same (1 in 1,000) with both CVS and amnio, and a CVS happens several weeks earlier. I realized that if this pregnancy isn't going to happen, I'd rather know sooner than later. So Thursday it is.

I seem to have produced a lot of chromosomally problematic embryos. Here's hoping the one that's left is perfectly fine.

Sunday, December 2, 2007

Public service announcements

1. Pedestrians have the right of way in California.
2. On the BART escalator, you stand to the right and descend or ascend on the left.
3. Things not to put on a resume: "Typing speed: 48 wpm" or "GPA: 2.5." If it's not helping you sell yourself, skip it.
4. During IVF, embryos are transferred to the uterus. They are not implanted. If they could be implanted, a lot more IVF babies would be running around the planet right now.
5. I am sorry to say this, but implantation spotting is rare.
6. There's a Internet newsgroup called "alt.possessive.its.has.no.apostrophe." Consider this sentence: "It's cute that the dog is carrying its leash like that." "It's" is a contraction for "it is." It takes the place of a subject and a verb. "Its" is possessive. You use "its" just as you would use "his" or "her."
7. If you sell fish oil and dog food that contains meat, you are not a vegetarian co-op.
8. Everyone's height is proportionate to his or her weight, regardless of how tall they are or how much they weigh. If you are placing a personal ad and don't want to date fat people, just say "no fatties." It helps tell people more about you, and it does all of the rest of us the favor of not answering your ad.
9. Cappuccino doesn't have an H. Espresso doesn't have an X.
10. Panino means sandwich in Italian. Panini is plural. Therefore, a "panini sandwich" is both redundant and incorrectly plural.
11. Yes, your carry-on is probably too big for the overhead bin.
12. Al Gore won the popular vote in 2000.
13. Your golden doodle is cute, but it's still a mutt that cost $3,000.
14. No, I do not want a Jews for Jesus pamphlet, ever.

Monday, November 26, 2007

Follow your nose

I seem to be developing a supersonic sense of smell. I've always had a strong aversion to most dairy products, but lately cheese is showing up in unusual places. First, the squash soup at Thanksgiving tasted cheesy. It wasn't, because the chef had described to me, in detail, the vegan recipe. Then, at dessert, I took a slice of pecan pie, and as I raised it to my mouth, I thought, this smells like cheese. Now, I've never made pecan pie before, but I read enough cooking magazines to know that cheese isn't typically found in pecan pie. (Apple pie, maybe.)

I asked the baker if there was cheese in the pie. She thought I was insane, of course, and said no. But I was later vindicated when my partner smelled the pie and agreed about the cheese scent. The baker later recalled that she had used some kind of raw butter that's particularly cow-y. Hence the cheese smell. Later on, I found myself holding my breath every time someone opened the leftover-laden refrigerator. Bleah.

This is either going to launch my career as a private investigator, or become unpleasant really fast.

Monday, November 19, 2007

Pretty, pretty, pretty good

I am still pregnant, and I am still pregnant with twins.

One embryo measures 20mm or 8 weeks 3 days, with a heartbeat of 183. That was deemed completely fine.

The second embryo either measures 18mm (8 weeks 2 days), as determined by the first doctor, or 15mm, as determined by the second, with a heartbeat of 197. The combination of the smaller size and rapid heartbeat suggests that this embryo may not make it. But it's hard to know.

If the second twin doesn't make it, I think I'll feel a combination of sadness and relief. If I'm not going to have twins, I vastly prefer that the decision be made for me.

I go back either next week or the following week for another ultrasound, and I'm going to schedule my genetic testing. Apparently CVS isn't recommended for twins (hive mind: input is welcome), so we'll probably do an amnio. I am concerned that I'll start to show before the amnio, and that I'll have to tell people before I'm ready, but perhaps I can cross that bridge, etc.

Thank you, as always, for your well wishes. And happy Thanksgiving -- I hope all of you have as much to be thankful for as I do.

Wednesday, November 14, 2007

8 weeks, 3 days

That's how pregnant I am. I've never been this far along before, so this is uncharted territory. I have had some cramps in the last few days, which I do not appreciate, but the nurse said not to worry (yeah, right) unless I see blood -- not spotting, but actual red blood. (No spotting whatsoever, and you can bet your grandmother's Venetian glass collection that I check every single time I'm on the toilet.)

Our next appointment is at the clinic on Monday. If all goes well, I graduate to an actual OB -- just like a regular pregnant lady! -- and have an appointment with one later that afternoon.

Meanwhile, the Twin Freakout Level has been reduced to Schoolbus Orange from Blood Transfusion Red. I find denial is a wonderful thing. But it's hard to deny completely -- last week my pants began to be tight, and this week I had to raid the supply of clothes I saved when I lost a lot of weight four years ago, in the event someday I'd need them again. (I'm attributing my larger size to a twins thing because probably most women who are eight weeks pregnant with singletons aren't out shopping at Pea in a Pod.)

Even some of the clothes I saved are too small in the waist. I thought I'd just buy a few things in larger sizes at the Gap, but when I couldn't find what I wanted in the store, I ordered a few things from Gap Maternity. Of course I am conflicted about this: I fear I'm jinxing myself, but at the same time, since I work in an office rather than a gym, I need to attend my job wearing something other than sweatpants.

Viability is still a huge concern. I've had a few dreams where I started spotting, and at least one with a too-small embryo on an ultrasound. (I think there was just one in that dream. See? Denial.) Sometimes my breasts aren't as tender, or I feel more energetic, and I think, shit, this is already going downhill. But then a wave of nausea hits, or I feel assaulted by fatigue, and I think, this still seems to be happening.

Hopefully the doctors on Monday will agree.

Wednesday, November 7, 2007

In which I reveal myself to be a horrible person

I'll just say it: I don't want twins. My partner, a reluctant participant in the Bun Project to begin with, definitely doesn't want twins.

Now, I recognize there are all kinds of horrible things about saying this. I have friends who have twins. I actually was a little obsessed with twins in high school (blame the Sweet Valley High books). I would like to have two children, if the first one doesn't kill me. I smile at women with twins in strollers just like you. I think there is something wonderful and special and unique about having two children at the same time.

But I don't want to do that myself. First, I worry about the complications of a twin pregnancy -- I've heard too many horror stories, even though I've personally observed some big successes. (Luckily for me, I have no medical problems other than the whole infertility thing.) I like to think I'm quite competent -- okay, I am quite competent -- but I'm not sure I can handle two babies. I have no close family in the Bay Area, and though my close family isn't that far away, they're not here. I have wonderful friends, but most of them have their own families to take care of. I have some financial resources, but I'm not sure that would be enough. I have a demanding job that I have every intention of keeping. (Hell, we can't afford for me not to work.) I have a partner whom I love dearly, but who generally would prefer not to have children and has described her ideal involvement with a child as being like a "50's dad." How, precisely, is this supposed to work?

This may be an awful thing to write, karmically, given the two embryos that seem to have taken up residence in my uterus. I know. And I know some people will say, "God/the universe doesn't give you anything you can't handle." At the risk of sounding ridiculously callous and practical (bingo!), I don't think so. People don't choose to get cancer, but I think my brilliant friend who recently died of cancer in her early 50s didn't get sick because she could handle it. She got sick because sometimes life sucks. People aren't given sextuplets because they can handle them; they, and their doctor, make a choice to risk and then have sextuplets. It's a choice.

And this twin pregnancy was, I regret to say, something of a choice. We had two embryos, and we could have chosen to transfer one. Given the embryo quality, we could have put in one, but given my history of miscarriage, the doctor (who described her approach as conservative after we said, adamantly, "We don't want twins!) recommended two. One would be a fail-safe measure.

We have discussed selective reduction, but I don't know that we could do it. We'll have to see how the next ultrasound looks, and later, what the genetic testing shows. (If you're really offended by talk of selective reduction, I'm sorry, but please don't flame me in the comments. The management has a strict no-abuse policy. Especially because the management, at the moment, is an emotionally fragile, bloated, and nauseous pregnant lady.)

In the meantime, I'm trying to balance my joy at getting asked back for a second interview here, and my absolute, utter terror at what it might show.

Monday, November 5, 2007

Three words

Viable twin pregnancy.

Or, to use a few more: there are two embryos in there, two heartbeats, both good. Two sacs, one smaller than the other but still probably fine. The doctor gave it a 20 percent chance of becoming a "vanishing twin." In other words, he gave it an 80 percent chance of sticking around.

Excuse me while my partner and I completely freak out.

Sunday, November 4, 2007

Tonight's fortune cookie

It read:
"You will pass a difficult test that will make you happier."

Sure hope so. My first ultrasound/viability check is tomorrow morning.

Wednesday, October 31, 2007

Taking care of the girls

I don't remember my breasts ever getting so big in a pregnancy. I'm six weeks today, and they feel like they're taking over the planet.

After losing a lot of weight years ago, I went to the Town Shop while in New York and had the bra queen measure me. After telling me that my current brassiere was a disaster, she got quite friendly and then declared me a 34D. For perspective: A few years earlier I'd worn a 42C -- perhaps misguidedly -- and arrived in the store wearing a 36C. And while I may normally be a 34D, I don't look particularly stacked.

With my bras feeling a little tight -- last week, a sports bra that closes with a zipper literally burst open while I was taking a walk, which was delightful -- last night I hauled out the measuring tape and pulled up a few Web sites to find out what I should be wearing. At Victoria's Secret, I'm a 38A; at Barenecessities.com, I'm a 34DDD.

WTF? Do I have to go back to the Upper West Side to get the real story?

PS If you've carried a pregnancy to term -- or even if you've had a pregnancy last longer than 8 weeks -- did your breasts ever stop being so sore?

Monday, October 29, 2007

Disclosures

Last night I dreamt a (nonexistent) co-worker found out I had done IVF and was gossiping about it with other colleagues. In the dream I ripped into her, asking her why it was her business to disclose my medical condition to others. I was really pissed off.

I have a complicated relationship with information. As I've mentioned in the past, I'm an information junkie. At the same time, I'm quite private about this whole TTC thing -- there are two people in my large, close-knit office who know about the bun project and IVF, and one knows I'm pregnant. I like to assume that the many, many others have no idea.

As IVF began to take over my life (and, more importantly, my brain) recently, I told a few friends about it. At a bris for a friend's newborns the night of my egg retrieval, I told a few friends not normally in the loop what I'd been doing earlier that day. (I partly felt I needed to explain why I didn't want to spend a lot of time standing up.)

Two weeks later, to the day, one of them emailed to "see how I was doing." Of course she wanted to know if IVF had worked. Since this friend and her partner tried for years to get pregnant, eventually succeeding with IVF, I was surprised she even went there, but she did. I ignored the email.

Another close male friend has called several times lately to check in, and asked how IVF was going. Since we've exchanged voicemail and email for the past week or two, it's been easy to ignore this as well. But finally, this morning, freshly awake from my screaming-at-the-co-worker dream, I wrote him an email and said, among other things, "Thanks for asking about IVF. I don't have any news to report, but if I do, I'll let you know."

I know: I can't have it both ways. If I opt to open up to people, I'm allowing for the possibility that two weeks later, they'll ask a question and expect an honest answer. But for me, two miscarriages and three embryos down and no children in tow, "no news to report" is an honest answer. It may be months before I have any news. I'm the publicity director of this project, and I'll schedule my press conference when I'm good and ready.

Thursday, October 25, 2007

Small steps

It's a cliche that you can't be a little pregnant. But, as Julie has written eloquently, actually being "a little pregnant" is totally realistic. I'm in my third pregnancy and have no children. At least five embryos have seen the inside of my uterus; at least four have implanted. If I'd stayed pregnant the first time, my kid would be 10 months old; if I'd stayed pregnant the second time, I'd be something like 34 weeks along with identical twin boys.

Some women, upon seeing two pink lines on a stick, immediately head to the babies emporium and stock up on maternity wear. They send out mass emails announcing that their baby is due eight months later. They tell their bosses. At the risk of sounding like a complete asshole, when I hear about those people, I sigh and think, good God, they have no idea. I've never bought myself anything baby-related. I refused to go to a prenatal yoga class last time, wanting to wait until I saw a good heartbeat. (I never did.) I go to the dentist while pregnant and hope it doesn't come up.

I am treating this pregnancy as if I were unemployed and saw an ad for my dream job. I've submitted my resume, and secured a first interview, but I'm miles away from getting an offer and signing up for benefits and putting my feet up on my new desk.

The big interview is Monday, November 5. My third seven-week viability check. Sure would be nice if they invite me back this time around.

Monday, October 22, 2007

Second beta is back

The first was 828, at 16 days past retrieval.

Today, at 19 days past retrieval, it was 3,079.

The nurse said that's in the range for twins.

Say it with me: "holy crap!"

Friday, October 19, 2007

First beta is back

It's 828.

That seems high and great and everything, but last time I was pregnant, it was 520 at 16 days past ovulation, and it tripled in two days, and I still miscarried.

Next test is on Monday.

On the plus side, I definitely feel pregnant.

Tuesday, October 16, 2007

Evidence

So I succumbed to temptation

and took the test. (It's 2:30 am. I said the Serenity Prayer first.)

Two pink lines.

Please, please, PLEASE let whatever's in there last for the next 9 months.

Monday, October 15, 2007

Oy, the temptation, part 2

Six and a half months ago, another two week wait was ending. On the Monday morning my period was due to arrive, I woke up at 2 am needing to pee. I had been on edge all weekend, cranky as hell. In the middle of the night, as I looked at the clock, I thought: am I ready to take a test? Because, I said to myself, if it is negative, that means you are going to do IVF. Are you ready for that information?

I was ready to end the suspense, so did my duty. And saw two pink lines.

Today I'm in the same situation. My blood test isn't until Friday, which, I learned today, is quite a bit later than it would be at some other clinics (one popular one in town has patients get their blood tests two weeks after the retrieval; mine does it two weeks after the transfer, which adds three entire days).

At this point, a test should be pretty accurate. Last week I took one to ensure the trigger shot was out of my system. A positive last week wouldn't have meant a positive; it might have meant the trigger was still hanging around. A negative meant that a future positive would be meaningful. It was negative, so a test now would be the real deal.

Not knowing is driving me nuts. Last night I woke up, needing to pee, and considered taking a test. But I didn't have the nerve. And now I'm pondering taking one tomorrow. The question is, what's weighing on me more? My desire to know, regardless of the answer, or my desire to not have my hopes for my first IVF cycle be quashed?

I am an information junkie. I am overly cerebral and logical and analytical. I am so Type A. So it's pretty uncharacteristic that I would fear information, but that's kind of what it is: I'm nervous about it, but I want to do it. If someone could do the test for me, without me knowing, and only tell me if it was positive, I'd be in heaven.

Wednesday is my birthday, and I don't want to get a negative test then. So either I take a test tomorrow morning, or I wait until Thursday. What would you do?

Sunday, October 14, 2007

Oy, the temptation: a dialogue

Aspiring Baker: "I can't figure out when to test, but I don't think I'm going to last that long."
AB's smart partner: "What about Wednesday?"
AB: "I don't want to get a negative on my birthday."
ABSP: "What about Thursday?"
AB: "I'm not sure I can wait that long."
ABSP: "Well, if you test sooner, isn't it possible you'll get a false negative?"
AB: "Yes, but then I'll know."
ABSP: "Well, if you get a negative, you'll just be on an emotional rollercoaster that you don't need."
AB, contritely: "True."
ABSP: "What about testing Thursday?"
AB: "Yeah, that might be a good idea."

[Background: Blood test is Friday, which will be 13 days past transfer and 16 days past retrieval. Tomorrow I'll be 9 days past the 3 day transfer. Symptoms: impossible to distinguish among the effects of the progesterone, estrogen, and usual two-week wait paranoia.]

Thursday, October 11, 2007

Open letter to Pope Benedict

Dear Pope Benedict,

Thanks for your recent comments that embryos should not be used for stem cell research, because doing so "violates the sanctity of human life."

Now, I realize you don't speak for me -- I'm a Jew, and we believe human life begins at birth. Still: On Saturday I made the decision of what to do with 11 embryos created in a lab with my eggs and a stranger's sperm. Those embryos were of varying qualities. Two went into my uterus, and remaining nine stayed in the petri dish. Why? Because despite your beliefs to the contrary, these embryos were not, really, human life. They wouldn't have survived in my uterus, and they never would have become children.

But they're not without potential. You see, Pope Benedict, I am participating in a stem cell research study, and my remaining embryos have been donated to science. I could not be more convinced that this is the right thing to do -- particularly because someone I love dearly has Parkinson's Disease, an illness that could someday be cured with therapies developed from embryonic stem cells.

If I'd transferred those embryos to my uterus, they would have died. I could have had the lab toss them in the trash. But instead I think they're doing more for human life in their current capacity than they could have in any other circumstance.

The embryos that had the potential for human life (note: potential) are dear to me; I am crossing my fingers that I get to meet one or both of them some day. I wish more of the others had more baby-making potential. But they didn't, and I am thrilled to be participating in the stem cell study.

The practice of doing research on stem cells was severely curtailed in the US by President Bush in 2001, when he banned the use of Federal funds for embryonic stem cell research. This, despite widespread public support for the practice. Pope, I can only hope that my incompetent, lame-duck government doesn't try to implement your religious viewpoints any more than it already has.

I pray for the embryos in my uterus and for the ones in petri dishes everywhere, in the hopes that all of them can make dreams of all varieties come true.

Yours,
Aspiring Baker

Saturday, October 6, 2007

Now with 200 percent more embryos!

Had the transfer today. Of the 23 eggs that retrieved, 11 fertilized, and only 2 produced embryos worth transferring. That's quite disappointing, given that everyone seemed certain we'd have something to freeze. The remaining 9 embryos were pretty poor quality, and the clinic didn't think it was worth it to try to grow them some more and freeze them. (She seemed to think that while my ovaries are producing large quantities of eggs, apparently the quality is not so good.)

That left us with two embryos. The clinic grades them on a scale from 1 to 6, 1 being the best and 6 being the worst. It's rare to have a grade-1 embryo, but we had one, and the other one was rated a 2. The doctor felt these were very good and recommended transferring both. She thought the pregnancy rate might be 50 percent with two, and that we'd have a 25 percent chance of getting pregnant with twins (or: 50 percent chance if I got pregnant). The rate for transferring one, of course, was lower. We agonized, given our fear of twins, but in the end decided that two was the best choice. It wouldn't have been worth it to freeze the grade-2 embryo, and I couldn't see going through that whole process to end up with just one embryo.

So, cross your fingers that this whole adventure ends in a healthy pregnancy -- preferably a singleton pregnancy. We'll know if it worked in about two weeks.

Thursday, October 4, 2007

48 percent

That's the portion of my 23 eggs that fertilized. That's 11 embryos, for the kids in the back of the class. Of the 23 eggs retrieved, 10 were not mature, and 2 fertilized abnormally, leaving just less than half of those puppies left to divide in the comfort of a warm petri dish across town.

The transfer is scheduled for Saturday. If you're reading this, please cross your fingers that some of those 11 embryos are still in good shape then.

Wednesday, October 3, 2007

The eggs have left the building

Had my egg retrieval today. All seemed fine -- they got 23 eggs. I'll find out tomorrow how many fertilized and what they're looking like. The transfer should be this weekend.

Thursday, September 27, 2007

Side effects

Steve Martin once published a piece in the New Yorker called Side Effects. It began,

"DOSAGE: take two tablets every six hours for joint pain.
SIDE EFFECTS: This drug may cause joint pain, nausea, head-ache, or shortness of breath. You may also experience muscle aches, rapid heartbeat, and ringing in the ears. If you feel faint, call your doctor. Do not consume alcohol while taking this pill; likewise, avoid red meat, shellfish, and vegetables. O.K. foods: flounder..."


Reading the folded-into-tiny-pieces papers in my fertility medicine, one wonders why side effects can't be a little more desirable. Why does everything cause weight gain (check), headaches (yes, thank you), nausea (thankfully, no), fatigue (not too much) and bloating (why, I'd be delighted)? Where's my weight loss, high energy, unusual wit, surprise talent for the clarinet, and super intelligence? With Lupron, my main side effects were weight gain, crankiness, and, according to one friend, shinier hair. I will admit that my skin hasn't been this clear since the fourth grade, thanks, no doubt, to the ridiculously high levels of estradiol present in my bloodstream (1,200 today).

Seven days into Gonal-f and Repronex, my latest side effect (in addition to the above) is ovaries that are starting to feel rather large. That's because they are: today's ultrasound showed 19 follicles of various apparently appropriate sizes. I go for another check tomorrow, and if all goes well, I expect the embryo retrieval to happen early next week.

The nice thing about all of this bodily funkiness is that I won't be able to attribute every physical symptom in the two week wait to early pregnancy symptoms. Instead, they'll likely just be side effects.

Monday, September 24, 2007

Playing the numbers

OK, readers -- all four of you -- here's the math question of the day. The subject: whether to transfer one or two embryos. Here's what you need to know:

1. I have a 25 to 30 percent chance of getting pregnant if I transfer one.
2. I have a 40 percent chance of getting pregnant if I transfer two.
3. If I transfer two and get pregnant, I have a 20 percent chance of having twins.
4. If I get pregnant, I have a 15 to 20 percent chance of miscarriage PER EMBRYO that takes.

Twins scare the hell of out of me. But I could do without another miscarriage and another failed cycle. Seems to me that if I transfer two, I'm just as likely to miscarry as I am to get pregnant with twins. Yet my overall success rate is higher.

Anyone got an opinion here?

Friday, September 21, 2007

Chances

I am obsessed with the numbers. My doctor gave me a 25 to 30 percent chance of getting pregnant if I transfer one embryo, and a 40 percent chance of getting pregnant if I transfer two. In my dream last night, I asked her what she thought my chance of another miscarriage was. She said, since you've had two, I'd give it a 40 percent chance. 40 percent. In the dream, I sat down in the middle of the street and curled up into a ball.

After 10 days on Lupron, I start the "stims" -- the FSH drugs that should make my ovaries feel like baseballs -- tonight.

Monday, September 10, 2007

Book club, part 4: Everything Conceivable

Here is a tip: If you are electing a risky, complex, and invasive medical procedure, do not read a lengthy nonfiction book about said procedure. Whatever does not scare the shit out of you will invariably make you bitter, sad, or frustrated.

If you are worrying yourself silly about how many embryos to transfer in aforementioned risky, complex, and invasive medical procedure, perhaps you should skip the section about the couples who transferred several embryos and ended up with dead 20-week-old triplets, or ridiculously preemie quads, or whatever. If you're scared of twins, you should skip the section where the author mentions that IVF embryos are more likely to split into identical twins, particularly if you have already lost an identical twin pregnancy. If you're feeling sensitive about your move to IVF, you'll want to avoid the temptation to find places where the author seems judgmental or unkind about the subject. (But: said places are rare.)

That said, Liza Mundy's Everything Conceivable: How Assisted Reproduction Is Changing Men, Women, and the World is interesting and informative. I read it somewhat obsessively, though skipping over the parts that did not feel immediately relevant, and I learned a lot. It has chapters about egg donors and sperm donors, on surrogacy, on selective reduction. I think the author is sympathetic to her subject and well-informed. But I still kind of wish I hadn't read it. Sometimes knowing more isn't a good thing.

Friday, August 31, 2007

The perfect man

At first, you think: there is no other man for me. He's perfect! Tall/short, brown-eyed/blue-eyed, musical/athletic, smart (they all have to be smart, don't they?), the ethnic background I want, etc. He kind of reminds me of my high-school boyfriend. He is the one!

And then time passes. You get pregnant, and you imagine what your children will look like, and then you miscarry, and you think, was he the one, or was it me? And so you try another guy, and the more you pore over his profile, you think: this one's even better! He's shorter/taller, has better hair, better family health history, whatever. He's gotten other women pregnant, too. Yes!

But then he seems not to be the one, or more specifically: the two of you fail to produce anything of note, other than several costly cycles of disappointment. And so you move on. And you find another guy, and you think: he sounds like such a nice guy! But he doesn't have any pregnancies. That's okay -- I'll try him! Maybe I'll get lucky! And you're excited about
him, until the doctor doing the IUI gives you the sperm count from the lab, and it sucks, and two weeks later think, this guy is not the one!

So you go back to the first guy, miscarriage man. Maybe that was a one-time thing! You never combined that guy with fertility drugs! And the cycle when you have lost all patience and hope, and you decide, this is it, after this I'm taking a few months off from this crap and then I'm going to IVF, you wake up one morning, wonder where your period is, pee on a stick and get two pink lines.

And you think: I am so lucky, this guy is the one for me! It works! And you imagine what your children will look like, and your beta numbers are great, and all is well until you have an ultrasound and your partner looks at the screen and says, it looks like there are two in there, and the doctor says, yes, well, it was identical twins, and now it looks like what was two will soon be zero.

And you miscarry, and you somehow, incredibly, do not fall apart, and you take time off, and eventually you get ready to try again. And you find out that miscarriage man does have a higher spontaneous abortion rate than other donors you've tried, even though it's still within normal range. Forget him, you say, trying to pin the trisomy 12 diagnosis on him. And you try a new guy--seems funny! smart! whatever!--for an IUI that you fear will be unsuccessful as soon as the nurse practitioner holding a syringe full of sperm gives you the disappointing sperm count.

Weeks later, your not-pregnant self prepares to deliver an unknown man's seed to the IVF clinic. Which guy to use? Crappy sperm count? Miscarriage man? Guy who might have some kind of birth defect in his genes somewhere? Another guy altogether? And you panic, thinking, what if I can't find all of my vital qualities in one of these donors? What if the person I pick lacks these things I've held so dear? You worry: what if, after spending so long not getting what I want, I still can't get what I want?

And you pore over profiles, and look at other sperm banks at this late date, thinking, maybe if I shop around I'll find the right guy, and you think, maybe X quality or Y quality isn't that important, or maybe I should reconsider. And you think of your friends, whose beautiful 3-year-old was the result of changing donors at the last minute, and of the woman at the sperm bank who said, "no matter who you pick, you're going to get the right kid." And you close your eyes, and pick someone, and drive a nitrogen tank full of frozen sperm through San Francisco, and you hope and pray mightily that she'll be right.

Saturday, August 25, 2007

What the UPS fairy brought

I got a present in the mail today: 5 pounds worth of drugs. Check it out.

Wednesday, August 22, 2007

The drug dealer calleth

The scene: A San Francisco apartment, August 2007, 8:30 am. A woman (mid-30s) is trying to leave for work when the phone rings.

Woman: Hello?
Caller: Hello, may I please speak with Aspiring Baker?
Woman: This is she.
Caller: This is Your Insurance Company's Pharmacy Department. May I verify your date of birth?
Woman: Well, no, actually, because you have called me.
Caller: Yes, and we need to verify your date of birth.
Woman: Uh huh. But how do I know you're who you say you are?
Caller [testily]: Because I am.
Woman: In this age of identify theft, I'm sure you can appreciate my hesitation to reveal my date of birth to a random caller. I wouldn't give you my social security number, either.
Caller: [more testily] I didn't ask for that.
Woman: [conciliatorily] Right. But surely you can understand why I wouldn't want to give out personal information over the phone when you have called me.
Caller: [resigned] May I verify your zip code, then?
Woman: Yes.

Now, I recognize that I'm a little cranky these days, but really -- what corporation in this day and age -- particularly one that's subject to HIPAA -- thinks that someone who answers the phone is just going to verify their date of birth?

Said phone call subsequently revealed that the insurance company will send via UPS seven -- count 'em, seven -- drugs to my home. They are:

- Lupron
- Gonal-f
- Repronex
- Novarel (HCG shot)
- Estradiol
- Medrol
- Progesterone

They even include all of the syringes and alcohol pads. This is going to be fun!

Monday, August 20, 2007

Now we're both on the Pill!

Well, okay, only one of us is on the pill. But who can resist a Sixteen Candles reference? (Bonus points to anyone who can name the line following this one...*)

Got my period yesterday, started birth control pills today. I expect to start shots in about three weeks and do a retrieval/transfer in about six.

The next big question: provided eggs are stimulated, retrieved, fertilized, etc. -- how many embryos to transfer? The minimum is one, and the maximum is two. The issue: if I hope to avoid twins, and if each embryo has a 20 percent chance of implanting and at least a 20 percent chance of miscarrying, and if IVF has a 30 percent chance of twins, how much do I need to pay a statistician to figure this out for me?




* It's: "You gave me birth control pills? Do you know what that can do to a guy my age?" Such a good movie.

Friday, August 17, 2007

Signs point to no

Looks like I'll be starting the birth-control pill this weekend (just what I always dreamed of!).

Wednesday, August 15, 2007

7 Reasons Why/Not

(Scroll down because Blogger is being silly)


































Reasons why /Not
Breasts are tender but not necessarily any more tender than any other day 25 of my cycle.
Temperature was really high today as it has been many other times when I was not pregnant.
I was pretty tired over the weekend. So?

I've felt sick to my stomach the past couple of days

and also have a little sore throat, which isn't typically a pregnancy symptom. Plus, if morning sickness is kicking in already, I'm going to be the first woman on record to naturally conceive septuplets.
Lots of weird dreams which means I've been getting lots of good REM sleep.
Cranky! Again, so?

Cramps

In a theoretical universe where you're trying to keep things in your uterus, motions to expel are not so good.

Sunday, August 5, 2007

Back in the saddle again

If you knew me, you'd probably be surprised to learn that I am superstitious. I am extraordinarily logical and practical; I've been accused more than once of being unemotional at times when emotions should have been front and center. What can I say? I'm a Myers-Briggs ESTJ, all the way.

But it was superstition that guided me to the sperm bank yesterday morning, to commence my 18th two-week wait. After all, yesterday was my father's birthday, which was a good sign, and if I got pregnant, my due date would be the second anniversary of my first miscarriage. That has to be two good omens -- a coming full circle, if you will. Plus, even though I'm not religious and only learned about this tradition a few years ago, the number 18 is lucky in Judaism.

And so yesterday, after journeying to my favorite farmers' market and watching sea lions frolic under the San Francisco Bay Bridge, I wandered into some stirrups and got shot up with some guy's spooge.

To be frank, I am ambivalent now about this decision. On the one hand, my timing was good (felt ovulation sensation all day), and I am anxious to get on with this baby-making process. On the other hand, I'm a little on the fence: I traditionally abstain from a lot of TWW exercise (at the advice of multiple acupuncturists), and I'd sure love to go running right now. I'm not at the weight I thought I'd be when I tried again, and part of me wanted more time for a break.

What's more, I had planned to do a little ceremony for embryos 2 and 3. I planned to bring the ultrasound photos to the beach, write a letter, and say Kaddish for them before I tried again. I feel like I'm supposed to do that. But instead the photos are sitting in an envelope on my desk along with some positive HPKs (gross, I know, but don't pretend you wouldn't do the same thing! Please?).

Part of me feels it's bad luck to say I'm not 100 percent excited about this cycle, that I'd still like to hop on the treadmill and find a way to fit into my skinny jeans. But the logical part of me believes there's nothing I can think that will change the outcome of this cycle. After all, being totally gung-ho hasn't had an effect in the past, so why should the reverse be true? At the moment, I think I need to stop my quest for self-improvement and tendency toward self-doubt and just try to be.

Monday, July 30, 2007

From PostSecret



This image from PostSecret resonated with me even before I saw this comment that went with it:


" Sent: Sunday, July 29, 2007 9:09 PM
Subject: "You aren't being punished..."

Not sure if this is the correct email to comment on a post card or not but....

All I can say is thank you. I just recently suffered a miscarriage and have felt for weeks like God was punishing me for something I had done. You have been the only person who knew just what to say."

Still trying to decide about an IUI later this week.

Sunday, July 29, 2007

Decisions, decisions

The problem with lists of pros and cons is that such lists don't usually assign weights to the options. Everything is equal. Which makes this list of pros and cons a bit flawed.

On doing an IUI this cycle (it's day 8):
Pros:
1. I'd like to have a baby.
2. I might avoid IVF.
3. I could get this show on the road earlier.
4. Physically, there is no reason not to try -- I'm in good health, don't have any contraindications that I can think of.

Cons:
1. The chances of success are low.
2. Particularly since I haven't taken any fertility drugs this month, and it's too late to do so now.
3. Absurdly, doing an IUI this month will probably cost me more than doing IVF in two months.
4. Supplies of my new donor are very low, so it would make sense to try to maximize his seed.
5. I haven't done very much acupuncture lately.

Of course, if I try this month and don't succeed, it has no effect on my IVF plans. But I'm getting impatient.

Any thoughts?

Wednesday, July 25, 2007

Small blows

It is not getting easier.

At times I think I'm fine, I'm handling this so well, I am a trooper. I rock. Then new information knocks on my door and punches me in the face.

Sunday my period arrived in full force just before I attended a friend's baby shower. In addition to the in-utero fetuses in attendance, a new mom brought her newborn to the shower. I remember when the mom, the pregnant friend, and I were all knocked up at the same time. We were going to go out for pregnant ladies tea, only I nixed it, wanting to wait to see a good heartbeat. I made it through the shower pretty well, but I look miserable in the photos.

Yesterday it was the news that another co-worker is pregnant. I suspected this woman might want to have another baby, and just yesterday I saw her walk by and thought she looked pregnant, so I'm not entirely surprised. Then today the news that another co-worker's wife is expecting -- more news I anticipated. This is now past the time that I would have shared my news. I would have been part of the pregnant people club. Instead I'm part of the one-person club that has to leave the office to walk around the block and keep myself together after someone whispers to me that his wife is pregnant.

When I was a kid, the street next to ours always had block parties for the Fourth of July. I knew kids on that block but always felt left out, wishing we had parties on our street. Thirty years later I feel the same way. As my co-worker mentioned something about how much your hormones rage during pregnancy, I wanted to say, I know -- I've been there. Of course I haven't been there, really; I've spent about 12 weeks being pregnant in my life, less than a trimester. But when someone tells me their news, I feel this urge to share mine, to be recognized. After reacting probably not as enthusiastically as I should have with co-worker number 2 today, I pondered opening up to him. Instead I'm writing a blog post from my desk, wishing my block would just throw its own party already.

Sunday, July 15, 2007

Numbers

Women don't often discuss their weight. I was once at lunch with a group of male co-workers when, to my amazement, one of them began asking the others what they weighed. Nearly all of them chimed in, and none seemed to really think anything of it. I sat silently, in awe. Can you imagine being a table of women tossing out their weights like it was their batting averages? Not so much.

For most of my twenties I weighed more than 200 pounds. I am five-foot four and a half, and I wasn't that big because I was big-boned; I was that big because I was fat. I weighed around 225 in the mid-90s, and by my early 30s I had dropped to about 210. When I was 32, I began losing weight. I didn't diet, count calories, or have surgery. I started watching my carbs a little bit, ate more protein, stopped snacking so much, and started a running program. When I turned 33 I weighed 161. I dropped to about 150 six months later, and I've hovered around that weight ever since. I ran a half-marathon on my 34th birthday; I ran a second one a week later.

When I was heavy, I thought there were ways I could hide it. In college I always left for classes early, so I could hike to the third floor and pant without being noticed. At my first job after college I developed a habit of not turning my head to the side to talk to people; I thought they'd notice my double chin if I did so. (Um, they probably noticed it anyway.) I avoided an office river rafting trip because of the whole bathing-suit issue. I hated summer business trips because I'd get sweaty. I hated having to scoot by someone on public transit because of how big I was.

When I was heavy I always felt there was a smaller person inside. My self-esteem was horrible, and though I always felt awful about my body, the idea of losing weight -- I probably thought I should weigh around 130 -- was insurmountable. That's why I am probably more amazed than anyone that I've managed to keep the weight off. I still don't know exactly how I did it and what prompted me, but it's among my proudest accomplishments. Not just the weight loss but the keeping it off, because it's said that 95 percent of people who lose that much weight gain it back in two years. (The National Weight Control Registry tracks people who've kept off weight for longer periods of time; I reached a milestone when I'd kept my weight off long enough to become eligible to join it.)

It was absolutely incredible to me the first time I tried on something in the Banana Republic women's department and it fit. I'd bought men's XL sweaters for years, but I wasn't able to dress as I wanted because the apparel industry is so incredibly backward when it comes to meeting the needs of its potential customers. (Do you know how much more money I would have spent on clothing in those years if I'd found something that fit me, was age-appropriate, and that I actually liked?) When I first started shopping at regular-size stores, I felt a bit disloyal to my former self, who had written angry letters to the CEO of J. Crew, asking why they didn't carry anything beyond a size 14. (Now they've expanded to size 16 -- whoopee. I meant two-digit sizes starting with the number 2, people.)

I've kept my weight off over the years not by dieting like a mad woman -- I've previously mentioned my penchant for baking -- but by exercising and weighing myself religiously. I believe the body has certain weights it can naturally maintain, and 150 seemed to be that for me. (220 was, too.) Even though at 150 pounds I still have a belly and would never be described as skinny, I decided that I could handle 150, plus or minus 3 lbs. So when I got up to 156 recently, after the second miscarriage, I decided I had to deal with it. I spent two weeks doing the first phase of the South Beach diet, eating only vegetables, protein, and nuts. My energy sucked, but I got enough to eat, and I lost 6 lbs. I originally thought I'd stay on the diet for a while and try to keep dropping weight; I have this fantasy of getting down to 145 and fitting into a pair of jeans I could wear back when I was running half marathons.

Instead I spent yesterday eating candy and pizza. I'm going to start eating better soon, like maybe tomorrow. But things are hard enough right now without feeling perpetually in denial. I am working on convincing myself that weighing 150 pounds is good enough. Sure, it would be great to weigh 145 before getting pregnant again. It would be great to weigh 130. But 150 has been good enough for more than three years. What's different now?

Blessed events

There are three invitations on our fridge right now. One for the wedding of my 26-year-old cousin, who's having a very large, presumably extravagant (and heterosexual, if that's not obvious) wedding; ten bucks says she's pregnant before she's 30. The second is to the lesbian wedding of a friend with a toddler; she conceived on the first try, and for their wedding gift, they're asking friends to contribute to an IVF fund. Not because they need to do IVF for kid #2, but so they can use one partner's egg and the other's uterus. The last invitation is to a baby shower of a close friend who's expecting twins after struggling with infertility for a while. When I was pregnant, I imagined attending these events with a nice little second-trimester belly. Instead I have my usual grandmotherly figure.

Is it any wonder I'm a little cranky these days? This summer was supposed to be a break, and in some ways it has been: I haven't touched my basal body thermometer, haven't gone to acupuncture, and even spent two less-miserable-than-expected weeks on the South Beach diet (more on that later, maybe). In other ways this hasn't been a break at all, because the very nature of a break makes me anxious. The longer I wait, the longer I wait. I probably won't be pregnant again until I'm at least 37. Given that I got pregnant at 35 and 36, and given that I've always wanted two kids, this freaks me out. I worry that if I do get pregnant, it may be my only pregnancy -- if I'm able to maintain it.

It's also not entirely a break because of the hoops I need to jump through to prepare for IVF -- blood tests, copious forms, choosing the next sperm donor, etc. My doctor's office wanted me to see a psychologist to discuss my feelings about "third-party reproduction." This nearly made my head explode: for some reason no one has required me to see a therapist for the 17 cycles of third-party reproduction and two miscarriages I've already experienced. Why is it different now? (Since I already have my own therapist, I'm finding a way around this, but the very idea of this enrages me.)

To get started with IVF, I need to call my doctor's office when my period arrives. From there, I take birth control pills for a month (that'll be fun!), then start the other no-doubt-delightful drugs in anticipation of an egg retrieval about 6 weeks after my period arrives. At the earliest, an egg retrieval could happen in late August. Until recently I thought I'd wait until the end of the summer to get things going. But this week I realized that this break isn't a break; it's a stagnant pause I never wanted. Maybe the best way to stop feeling pissed off and sorry for myself is to accept that I'll never be ready for another miscarriage. I'll never want to do IVF. Maybe going to Paris before I get pregnant again isn't as important as just getting this goddamn show on the road.

Thursday, June 28, 2007

Why?

Listening to Jeff Gammage discuss his book China Ghosts: My Daughter's Journey to America, My Passage to Fatherhood on Fresh Air yesterday nearly made me cry. Gammage wasn't particularly excited about becoming a parent when he and his wife traveled to China to adopt their daughter. (This after being unable to have biological children.)

I adopted a dog from the SPCA and would never buy a purebred. How could I, when so many great dogs need homes? Yet I view adoption as a last resort, even though
when I think of the efforts I have gone and will go to in order to become a parent of my biological child, I'm frankly a little embarrassed. It brings tears to my eyes to think of all of the children in orphanages around the world, yet I'm still hoping to have my own child.

Part of the reason is I want the experience of pregnancy. And I undeniably want a child that's genetically related to me. But why? Are my short, chubby, musical, cheese-hating, Type A Jewish genes so precious that they must be preserved for posterity in creation of another human being? Of course wanting biological children is rooted to some degree in narcissism. I think it also reflects a passion for one's family and roots -- particularly important to Jews who saw our ranks decimated last century.

My child will be only 50 percent related to my partner and I. Most of the time I cling to that 50 percent, minimizing the donor's biological importance. But occasionally I wonder, if I'm only getting that 50 percent to start with, why not just dump it and go for adoption? If I have my own biological child, does that leave one more child in an orphanage somewhere who will never have the kind of loving home I could provide?

Tuesday, June 26, 2007

Yes, I still exist

It's been a while. One of the things about not trying to conceive for the first time in a year and a half is that you suddenly have all of these other things to think about. It's remarkable to start my day with a Web site other than Fertilityfriend.com. It's amazing to spend the month not constantly monitoring my cervical mucus and breasts for possible signs of ovulation or pregnancy.

I am spending my break trying to drop some weight -- currently on day six of the South Beach diet. It's been nearly 20 years since I actively went on a capital-D diet. This one has its benefits, like the fact that it's not low-fat, but it also has many drawbacks. (Cannot believe I haven't eaten a piece of fruit in six days.) I'm planning to cheat on the Fourth of July, but beyond that I don't know exactly how much weight I'm trying to lose or how long I'll tolerate this. Probably not much and not very.

It feels both good and bizarre to be doing something with my body other than trying to get pregnant. Last week I ate a nicoise salad for the first time in eons. Yes, I know the mercury takes a long time to leave your system, but it sure was a nice change.

At the moment I'm waiting for my RE's IVF coordinator to call me so we can think about getting things moving. I had some blood tests earlier this month, both for my primary care physician (cholesterol and fasting glucose) and fertility doctor (HCG, TSH, and some antiphospholipid thing that could have contributed to miscarriage). Everything was normal. At this point, the only explanation for miscarriage #2 is trisomy 12. Number 1 will always remain a mystery, I guess.

Which leads me to this existential issue. I've always been fascinated by twins. I loved the Sweet Valley High books as a teenager. At the same time, knowing people with twins has only increased my fear of having them myself. (As a result, I'm pretty sure that conceiving identical twins last time around was nature's way of giving me the finger.) One of my main reservations about IVF has been the risk of twins, though of course that can be minimized with a single embryo transfer.

And hence the dilemma. Back in the single-miscarriage days, it seemed perfectly reasonable to transfer a single embryo. Hey, no reason to think that this one embryo will be flawed even if the first one was, right? But miscarriage #2 has changed the game. I've had two conceptions that I know of and two that failed. If I'm going to go to the bother of IVF, and I have a history of making problematic embryos, does it make sense to transfer two in IVF to maximize my chances? (Personal policy is not to transfer more than I am prepared to raise or carry, at the moment.) Or, again, would doing so only ensure that Mother Nature would again give me the double-fingered salute?

Tuesday, June 5, 2007

Results are in

It is odd, to say this, but the miscarriage pathology results are good. The embryos were male and had trisomy 12, a genetic abnormality that causes miscarriage; embryos with this genetic profile aren't viable. This is good, because a) the fact that they were male ensures they were able to isolate the embryo's genetic material from my own, and b) this kind of trisomy is a one-time occurrence, more common among women of my advanced maternal age (36), but not a sign of any long-term problem.

My doctor is a dream -- smart, competent, warm, and nice -- and she remains quite optimistic about my chances. She still considers me a "great" candidate for IVF, and she also suspects that if I tried several more times with Femara and IUIs, I'd probably get pregnant again. I'm not exactly sure what I'll do next -- probably IVF. But I'm going to take at least the summer off. Still, I'll have a saline sonogram (to investigate the topography of my uterus) and a blood test in a few days. I'm hoping to get as much of the IVF prep out of the way now, so I can relax and not worry about it.

It's incredible to have a doctor who actually inquires after my well-being. And a relief to hear she's very supportive of me taking a break. Walking into that office today, I really didn't know what to expect; I felt there was a possibility I'd learn I would never have a baby. So to leave the office hearing the echoes of optimism in my head was quite a treat.

Monday, June 4, 2007

Book club, part 3: Baby Love

What I disliked about Rebecca Walker's Baby Love: Choosing Motherhood After a Lifetime of Ambivalence

Where to start?

1. Her meandering. I don't need to know about the trials of her hot water heater and the moths that ate half her wardrobe. That's great if she enjoyed steak and spinach and salad and mint chocolate ice cream. But why am I reading about it?

2. Her astonishing self-involvement. Walker treats her pregnancy as if it were an international event. (Predictably, this bit raised my blood pressure: upon being told a friend had a miscarriage, she declares, "Well, I'm not going to be having one of those, thank you very much!" Lucky you.) Lucky for her, she's able to take time off from her work when she needs to. She has the money to buy anti-stretch mark potion number 59. She has the luxury to interview multiple doulas.

3. Her assumptions. Yes, I know her mother is Alice Walker. But does every reader? It's not mentioned anywhere in the book. Might have been nice to go beyond describing her mother as simply a writer and mention, say, that she won a Pulitzer Prize, or something.

4. Her subtitle, "choosing motherhood after a lifetime of ambivalence." This so-called ambivalence is a central tenet of Baby Love, but I have some news for Walker: I don't think she was nearly as ambivalent about having a child as she thinks she was. She tried getting pregnant in a previous relationship, she considered having a child with a male lover. That doesn't sound like ambivalence: it sounds like a combination of luck and good, old-fashioned family planning.

5. Her obfuscation. One section talks about her several-year romance with the mother of Solomon, a boy she helped raise. Another section talks about her several-year romance with an unfaithful rock star -- a woman who's a mother, but doesn't necessarily seem to be the mother of Solomon. Only she must be, given that Walker and I are the same age, and there's no way she had two eight-year relationships since graduating college by the time she wrote this book. What's more, many of us know this mysterious mother-of-Solomon/rock star to be Me'shell Ndegeocello. Why does she bandy about her hematocrit numbers and mother drama but refuse to name her ex?

6. If the answer to the last question is because of Solomon, I have to ask, if Walker is so concerned about Solomon knowing his mother was unfaithful, how will he feel when he reads this much-discussed section?

"It's not the same. I don't care how close you are to your adopted son or beloved stepdaughter, the love you have for your nonbiological child isn't the same as the love you have for your own flesh and blood. It's different."


This feels like a giant fuck-you not only to Solomon but to millions of parents -- including many lesbian and gay parents -- around the world. Walker may feel this way, but who the hell is she to make that pronouncement for all adoptive and non-biological parents everywhere?

I read this statement to a friend who has two children; she gave birth to one, and her partner birthed the other. She responded, "I don't know what you're talking about. Both my children are my biological children." I imagine many other parents would agree.

Saturday, June 2, 2007

Two small blows

So May pretty much sucked completely. Miscarriage, family stuff, everything. I was so happy when June arrived, a clean slate.

But it didn't start off so easily. Yesterday two small pieces of news felt like punches in the stomach: first, a former co-worker -- someone who could easily be described as the least maternal person on the planet -- had a baby. Second, I overheard another co-worker telling people his wife is pregnant. Her due date? Same as mine would have been. I had to go into the bathroom and breathe deeply to ensure I would remain composed.

Frankly, things have gone so awfully lately that it wouldn't surprise me in the least if the news Tuesday at my pathology appointment was the worst kind.

I sure am making a lot of solo dinner reservations lately under the name "bitter."

Tuesday, May 29, 2007

28 days later

It's been four weeks. Incredibly, my period showed up today, almost right on time (usually I have 26-day cycles). I'm surprised only because I thought my body would take longer to kick back into gear. But no, we're back in business, earlier than I'd expected.

Here are a few random thoughts:

1. Overall, I recovered from the D&C very easily. However, my breasts were still really tender for five days afterward, and I didn't feel like myself (read: not pregnant) for about a week.
2. I read and intend to post a review of Rebecca Walker's new book Baby Love: Choosing Motherhood After a Lifetime of Ambivalence. The summary: this book annoyed me. More, hopefully, on that later.
3. I have a few new phrases in my vocabulary. They include, "my first miscarriage," "the second time I was pregnant," "my second D&C," and, my favorite, "I am down two pregnancies and three embryos."
4. Today in Whole Foods I really enjoyed pushing past an extremely fertile woman (two babies under the age of 2) in order to grab three boxes of tampons. Fun!
5. On the bright side, I have lately enjoyed tuna, tequila, and running. I have stopped taking all vitamins. I have painted my toenails with abandon, done a shoulder stand in yoga without caring, and bought clothes without worrying that soon, they may not fit.
6. On the less bright side, I have still not returned to my pre-pregnancy (#2) weight. As I was miscarrying I gained a few pounds, and I have not dropped them. (Lest you think I sound like Bridget Jones: years ago I lost nearly a third of my body weight, and it's important to me to maintain that loss. I do that by trying to vigorously police my weight and dieting when I exceed the maximum weight I can tolerate. I am still not skinny in the least, and as I've said in the past, I'm a girl who enjoys my chocolate cake.)

This has been a difficult and hectic month for me -- aside from the obvious, I've also been dealing with a now-somewhat-abated family health crisis. As a result, I haven't yet adequately mourned my embryos -- I'm sorry, I can't call them babies. Next week I should get the pathology results back from my doctor's office, and that should provide some closure. It seems the results could show a few things:

a) Down Syndrome. This is actually the best scenario, as it explains the cause of the miscarriage and doesn't indicate anything about the prognosis of future pregnancies, theoretically.
b) Genetic translocation. This would indicate something about either my or the donor's genes, in a more permanent way. Since the donor has a number of births, it would probably be me. So not good.
c) Nothing. If the pathology can't explain the miscarriage, that's bad. Either it could mean I have some kind of clotting disorder that prevents blood from getting to the embryo (diagnosed by blood tests, treated by injections that may not be proven to work). Or it could suggest I have a uterine malformation that could explain both the miscarriages and the infertility. (Treatment: surgery.)

Never have I hoped for Down Syndrome more.

Wednesday, May 2, 2007

No longer pregnant

It's over. The D&C yesterday was a bit painful, but the pain was brief, and overall it was a piece of cake. (I was in and out of there in less than 45 minutes.) Unlike last time, every person in the office I saw offered their condolences. It's funny how much of a difference that makes.

I spent the remainder of the day on the couch, sleeping, watching quality TV like "Celebrity Fit Club," and eating won ton soup. I was pretty knocked out by the drug cocktail they gave me, but haven't had any pain. Today I'm back to normal.

This time was much less physically draining, but I don't know where I am emotionally. I'm still stunned that this happened again. When this first started happening last week, I thought, I have never been inclined to read a book like When Bad Things Happen to Good People until now. When I mentioned this to someone else, she said, "I just keep thinking of Job." The night before the D&C, I was up for a couple hours in the middle of the night, thinking, reading, and crying. I tried to re-read Job, though my attention span was a little lacking. He has everything -- kids, servants, land, etc. Then he loses it all, and asks God why. Eventually he gets everything back -- twice as much as he had before.

That first pregnancy felt like everything to me. I was so excited; I distinctly remember driving on the freeway being so thrilled with my secret. I was devastated when it ended. And the second pregnancy was really a savior: it came at a very dark moment as my hope was eroding. I was so confident it was going to work this time, especially given my HCG levels. I was superstitious about numbers, about the fact that it was my last IUI attempt before moving to IVF. It felt like everything had finally fallen into position.

So you'll forgive me for not sequestering myself in a corner this time, sobbing constantly. I've done that before. And I really don't know what to do with this experience. I don't think it was my fault; I don't feel there are any lessons to learn; I wouldn't have done anything differently. I am still in shock.

The doctor will analyze the pathology of the tissue she removed yesterday, and we'll get the results in about five weeks. If it's a common chromosomal abnormality, they don't worry too much, but if the tissue has a more unusual genetic variance or is genetically normal, then they'll want to test me for a bunch of other things.

In the meantime, I am taking a big fat break. Last time I miscarried I tried again as soon as I could, and I didn't stop for 12 consecutive cycles. I was a woman on a mission. Now I am really excited about having some serious time off -- time to sit in a hot tub and not worry that it's frying my eggs, time to drink whenever I want and not worry what half of my cycle I'm in, time to eat raw fish, go running, get back into shape, and travel. But most importantly, I am excited about getting back to my pre-TTC self. This process has been so hard on me. It's warped my priorities and made me a crazy person, and it's hurt my relationship. I'm ready to put the bun project aside for a while so I can get my life back.

Monday, April 30, 2007

Coming soon: miscarriage number 2

No heartbeat on today's ultrasound, so I'm having a D&C tomorrow morning.

The universe is awfully rude. Not only do I have two embryos with no heartbeat, but I also have a bad cold coupled with zero miscarriage symptoms and still-present pregnancy symptoms. Good times.

Thursday, April 26, 2007

Anniversaries, part 2

Today is the anniversary of what may now have the distinction of being my first miscarriage. And since I seem to be the subject of the world's biggest practical joke, it is also Take Your Children to Work Day at my office. Whoo hoo! Plus, there's this whole, 'is my pregnancy going to fail and when' question. Good times, really.

It's hard to know what's going on with my body: my breasts are still quite tender (I keep feeling myself up in the night to double-check), my mild nausea is still around (though is it ebbing? Is my stomach unhappy because I'm upset? Hard to tell), and my temperature is still really high (98.8 this morning, about as high as it ever gets.). I've had no spotting since Sunday, when I had a minuscule amount, and pretty much no cramping. WTF?

Emotionally I don't even know where to begin. Last time I was a mess from the moment I had the bad ultrasound. This time I'm numb and in shock. I feel like, I'm not sure I can afford to go there again. It just seems so obvious. This last two week wait made me crazy. I was tired of being depressed and despairing even when I was depressed and despairing. I identified with what Max's Mommy wrote about being sick of her infertility:

I'm tired of me. I'm tired of thinking about This all the time, writing about This all the time, talking about This all the time. I'm tired of hanging out at my very own personal Pity Party. The chips are stale and the music never changes. (For some reason it's Come On Eileen by Dexy's Midnight Runners. Makes me want to jam an ice pick into my eye socket. Repeatedly.) And don't get me started on the guest list, a boring navel-gazing crew which consists solely of Feeling, Sorry, For, Myself.

I'm kind of there, too. (But I love "Come On Eileen," and the cookies at my party are always fantastic.) Maybe -- probably -- my somewhat stoic black humor will evolve to massive fits of sobbing. But when you pile upon the logistical challenge of getting pregnant as a lesbian, a miscarriage, a year of unexplained infertility, the reluctant decision to have one more IUI and then move to IVF, and then a second probable failed pregnancy that -- just to pour some kosher salt into the wound and stir it around real good -- would have yielded not one but two children: I mean, if that isn't the universe flipping you the bird, what is?

I'm Jewish but not very good at it. In Jewish tradition, you light a Yarzheit candle in memory of someone's death. Judaism doesn't have a ritual for miscarriage, nor does it even recognize a person's existence until something like 40 days after birth. But I always thought I'd light a candle today for last year's miscarried embryo. But given where I am now, I'm not sure I can do it. Last year, after I miscarried, I went to the beach, wrote a letter to what would have been my first baby, said the Mourner's Kaddish, and cried. The letter, the ultrasound picture, and the positive pregnancy tests are in an envelope labeled #1.

I cannot believe I may have to label a second envelope #2 and #3.

Monday, April 23, 2007

Unkind universe

I wish I had good news to post, but I do not. Today's ultrasound showed almost exactly the same thing that my 7-week ultrasound did last time.

The main difference: this pregnancy started off as identical twins (thus explaining the high HCG numbers), but one twin is very small and has no heartbeat. Unfortunately, the surviving twin is one week too small (measuring 6w1d, as opposed to 7w1d) and has a slow heartbeat (115 -- they'd like to see it at 140). My doctor gave me a 95 percent chance of miscarrying. I am scheduled to go back in a week to see if anything's improved, but this embryo basically grew 2 days worth in 8 days based on the last ultrasound.

If I end up having a D&C, they'll run some tests on the tissue to see if they can figure out what went wrong. (I wasn't able to do that last time, since I passed the bulk of the pregnancy before the D&C.)

I am in complete shock. I was so sure this one was going to work -- I feel more pregnant than last time, and I just felt the universe couldn't do this to me twice. Apparently, I was wrong. I simply cannot believe this is happening again.

Tuesday, April 17, 2007

Countdown

Last week I came home from a super-relaxing yoga class and noticed some spotting. Of course I totally freaked out, even though the amount was small. I've been having menstrual-like cramps throughout this pregnancy, which didn't worry me until I saw the spotting.

I called the doctor's office and was told to monitor the spotting and call if my cramps or spotting worsened. The spotting went away for a bit, but when it came back I called my doctor's office and was able to go in for an ultrasound. (On a Sunday morning -- I am very lucky.)

I was six weeks exactly, and there was some good news: first, I am indeed pregnant; second, the pregnancy is in the uterus, and third, the embryo measured 5 weeks 6 days (the machine has an error rate of plus/minus 4 days), which is perfect. We didn't see a heartbeat, which the doctor said was okay because it was a little early (he said seeing a heartbeat would have been "a bonus"). But seeing that ultrasound was a huge relief. At least now I know what not to expect next Monday, when I have my next appointment.

I have faith this is going to work. I definitely have pregnancy symptoms -- crazy tender breasts, a bit of nausea, fatigue, low energy, crankiness. The spotting is gone, and here's hoping I can remain calm for the next six days and two hours.

Tuesday, April 10, 2007

What happened last time

I was cautious. I barely told anyone, even my family, and when I rubbed my belly, I said, "I hope I get to meet you."

Thus it was not entirely a surprise when, seven weeks pregnant and on a one-day trip to Los Angeles, I looked at the toilet paper after peeing and saw a tiny, miniscule amount of spotting.

The following day was my "viability check." This is the ultrasound they do at around 7 weeks to check the pregnancy -- is there a heartbeat, is it ectopic, etc. Even before the spotting, I was counting the hours before the appointment, as I knew that if you see a good heartbeat at that first visit, your risk of miscarriage drops from 25 percent to 5 percent. And when that day finally came, the office people gave me a big book about giving birth at the local hospital -- stopping once to swap out the first book they provided after realizing I was an elderly gravid -- before the ultrasound. Or in other words: before they knew if I was going to need it. Which, it seemed, I would not.

I will never forget how Dr. Unsympathetic squinched her face looking at the screen. The ultrasound revealed a week-smaller-than-expected embryo and a slow heartbeat. This, coupled with the spotting, was not good, but she was optimistic and sent me off for urine and blood tests and instructed me to return in a week. Only later would I learn, from reading my own medical records, that on this day she had recorded the phrase "possible embryo demise." Information that might have been useful if she had actually uttered it to me. (The good news, I suppose, was that I was pregnant and it was not ectopic.)

The following day, as I continued to spot, I called her and asked, how likely am I to miscarry? Her answer: 70 percent chance of a miscarriage. Hey, now that's information. Over the agonizing following week I barely held it together, shying away from children, painfully aware of my fading pregnancy symptoms, and petrified the increasing blood would begin flowing uncontrollably while at work. One week later, the follow-up ultrasound revealed what I already knew: the embryo was dead. We scheduled a D&C for the following day.

That night, I woke up with very strong cramps and knew the miscarriage was beginning. Over the next two hours I sat on the toilet, watching the products of my conception fall into the bowl. The bleeding was so heavy that I could barely leave the bathroom without making a complete mess. And though this experience was unpleasant, the fact that I was emotionally prepared for it made a tremendous difference. And since I knew I was going to the doctor the following morning, and since a close friend who had two miscarriages had told me what to watch for, I didn't worry too much as I sat there, cramping and reading magazines. All I can say is: thank god this did not happen at work, as it would have been absolutely horrifying.

The following day I brought my iPod to my appointment. When the D&C started, I pressed play on Coldplay's "Speed of Sound." Forty-five seconds later, it was over.

Note to medical staff everywhere: when a lesbian couple comes into the office with one partner pregnant, you can pretty much guess it's a wanted pregnancy. Therefore, when said pregnancy is miscarrying, it would be polite and decent to offer your condolences and express sympathy. A, "I'm sorry this is happening to you," would suffice. Instead, not a single person in that office ever offered emotional support to me; the closest was the one man in the office, a nurse midwife, who guided my partner over to me during the D&C and held my shoulder. He won the decency award that day, but unfortunately the competition was pretty pathetic.

After returning home, I spent the rest of the day lying on the couch. Friends brought me food. I was back at work the following day, ("what was wrong with you?" one boss asked. "A stomach bug," I lied -- I had decided a email reading, "I'll be out of the office Thursday having the remnants of my brief pregnancy sucked out of my uterus" might be uncalled for) and I was able to resume my normal activities immediately.

When I got pregnant last time, I asked Dr. Unsympathetic if I needed a blood test. She said it wasn't necessary, given that I was having pregnancy symptoms, had a positive pregnancy test, and missed my period. Yet those blood tests might have yielded information about how successful the pregnancy was destined to be. Certainly they would have been useful this time around, when I could have used them as a basis for comparison. (Pregnancies destined to miscarry seem to have lower HCG levels at first, and the rise seems to be slower. The general consensus is that last week's numbers are both high and rising nicely, so that's a comfort.)

This time, I've bid farewell to Dr. Unsympathetic (so long! don't let the door hit you on the way out!) and am hoping both for more empathy and, more importantly, better results when I go for my viability check (at my fertility doctor's office) on April 23. You can bet I'll be counting the hours again.

Friday, April 6, 2007

Second blood test is back

They want your numbers to double in 48 hours. Mine TRIPLED!

My HCG level was 520 on Tuesday and was 1,564 yesterday.

I'll have an ultrasound (the viability check -- the appointment that showed the problem last time) on April 23.

Thank you for your kind wishes. They mean a lot to me.

Tuesday, April 3, 2007

First blood test

It's back, and my HCG level at 16 days past conception/ovulation is 520. I'm going back on Thursday for a second round. Cross your fingers that it rises nicely!

Tuesday, March 27, 2007

Bitter, party of one? Bitter?

This is my 17th cycle trying to get pregnant. This time, I took Femara (a breast cancer drug also thought to help with infertility) and had an IUI. Everything on the pre-IUI ultrasound looked fine, and my timing was good. If this try doesn't work, I'm going to IVF.

I always thought I'd do everything "perfectly" on my last try; I'd avoid sugar, I'd get lots of acupuncture, I'd stay relaxed, I'd eat my sweet potatoes and papaya and seaweed. Instead I'm baking like a maniac and my anxiety level is high. On Friday, in a tense meeting, I wrote the date in my notebook and thought, 'a year ago today I found out I was pregnant.' Later that day I attended yet another baby shower for someone who both conceived and will give birth after my pregnancy failed. My office just announced that Take Your Children to Work Day will take place in late April -- on the anniversary of my miscarriage. A close friend who also had trouble conceiving is now in her second trimester. I'm thrilled for her, and we've talked about it a lot, but it isn't easy (see Akeeyu's smart post about this).

There is so much riding on this try. If I don't conceive this time, I won't have a baby in 2007. I always thought that by starting at age 35, I wouldn't be an older mom. So much for that. And of course I'll be moving to a procedure that's incredibly invasive, time-consuming, and costly (even if I'm not paying for it -- thank you, magical insurance). Now, as I wait to find out if this the 17th try is the charm, it's hard to not scrutinize how I'm feeling each day -- what is my temperature doing, are my breasts more or less sore than last time, is my fragile emotional state meaningful or just the universe's way of offering me a gentle fuck-you?

Sunday, March 11, 2007

Kinds of gratitude

I appreciated this post from Barren Mare, who's pregnant after years of struggling with infertility. (Her post about finding out she was pregnant during an IVF consultation is pretty priceless.)

Anyway, here's a bit of what Barren Mare had to say about being pregnant after all of her efforts:

Somebody said to me several weeks ago that one of the nicest things about being pregnant must be the great relief to know I'm not infertile after all. I've been thinking about this a lot since then. I suppose that, strictly speaking, it appears to be true, at least for the moment. But it's odd. It's odd to think that somehow getting pregnant can cancel out all the aggro and grief I felt during the years when we tried and tried and tried without success. During which we endured invasive testing and fertility treatment, without success or even answers as to what the problem might be. And even now, I have no idea why it suddenly happened. [...]

When something finally, miraculously occurs, it's undeniably lovely- but it's also kind of scary. Because if you don't know why or how it happened- luck? timing? an unusual planetary alignment?- then it's hard not to believe that this is your one and only chance. That lightning can't strike twice, so if something goes awry, you're cast out of the kingdom forever, with no way back. And having finally seen your way clear to safety on the horizon, it's impossible to fathom how you might ever recover from that.

So no, "relieved" is not really the word I would choose. I feel greatly, vastly fortunate, but also hugely wary. Much of the time I feel like this happiness is on loan to me, rather than a permanent keepsake. But that's one of the life-changing aspects of infertility- there is less inclination to take anything for granted.


I appreciate Barren Mare's realism and ability to recognize the universe's randomness. I wish her all the best. The same goes for Infertile Pediatrician, whose smart blog chronicles her experience trying to conceive "all the while working with those who are quite fertile and their offspring." IP is newly pregnant, and I'm crossing my fingers for her that this one sticks.

Friday, March 9, 2007

Anniversaries

Today is the one-year anniversary of when I got pregnant. I am "celebrating" by getting my first mammogram. Ironic, as I could not get a mammogram if I was pregnant or breastfeeding (as I would be now if I'd stayed pregnant), and as I am considered high-risk for breast cancer because a) my grandmother had it late in life, and b) I am 36 and have not given birth.

I got pregnant on the fifth try, and as I miscarried, I comforted myself with the thought, hey, I got pregnant pretty quickly, so I shouldn't have trouble getting pregnant again. Eleven tries later, I'm getting a mammogram. This cycle is my last IUI before moving to IVF. (I have incredible insurance coverage for IVF, so the decision to take that path is much easier.)

I have a lot of hope for my 17th try -- despite being a very rational person I have a strange superstitious streak when it comes to this stuff. Seventeen is a lucky number for me, and I really don't want to do IVF. First, I know I can get pregnant without it, and second, I'm worried about scheduling all of the shots, appointments, egg retrieval around my very busy job, as my bosses and most colleages doesn't know about the bun project. Furthermore, many of my friends who've done IVF have ended up with twins; that's not my first choice. So here goes number 17: this time with Femara, acupuncture, and now, yoga.

As the months have passed my brief pregnancy has felt like a dream, a fluke. I'd give so much to know and harness whatever magic was in the air on March 9, 2006, when two different ovulation predictor kits couldn't agree on whether I was ovulating, when an ultrasound showed imminent ovulation, and when a single IUI, performed apparently at the exact right time, knocked me up.

Sunday, March 4, 2007

What I've tried

Here's a partial list of the things I've done to get pregnant:

- 12 non-medicated cycles of IUIs
- 1 cycle taking 100 mg of Clomid
- 1 cycle taking 100 mg of Clomid with an estrogen patch
- 1 cycle taking 50 mg of Clomid
- 1 cycle taking Femara
- 1 hysterosalpingogram. That's the delightful x-ray where you lie half-naked on a table in the hospital's radiology department, with your legs spread so far apart you have a whole new understanding of your hip flexors. Then it gets better: a radiologist squirts dye into your uterus, and everyone in the room watches the monitors to see if the dye behaves as it should and moves through the uterus and into the fallopian tubes. (It does.) The idea is that it both identifies any blockages in your tubes and also clears them out. I have (what turns out to be futile) faith in this procedure, as I was conceived after my mother had one.
- Several cycles with Acupuncturist #1 and three with Acupuncturist #2
- Used a mail-ordered speculum to monitor my cervical opening
- Tried three different sperm donors
- Rolled my body onto one side after an IUI when I knew which ovary had the golden egg
- Taken my temperature nearly every day for almost two years
- Tried to radically reduce the amount of sugar I eat, with limited success
- Taken Chinese herbs
- Taken up yoga
- Had tests to measure my FSH, LH, progesterone, and antral follicle levels (all fine).
- Avoided: hot tubs, wine, massage, running, abdominal work-outs, lifting heavy things.

It's funny how much more relaxed -- in a limited way -- I've gotten over time. It's 12 days after ovulation, and in the past I would have chastely turned down a margarita in the two-week wait. Lately, though, my attitude has been, I'll have the pinot noir. My alcohol tolerance is pathetic, so it's not as if I'm pounding shots. But I like wine, and I'm no longer interested in denying myself something that I don't believe will really make a difference. If I find out I'm pregnant, I'll stop drinking, and only then.

This cycle I didn't take any drugs and have been seeing Acupuncturist #1. I've decided I've got one more IUI cycle in me (next time with Femara again) before moving to IVF. Here's hoping I don't have to.