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


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.