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.
Thursday, September 27, 2007
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?
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.
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.
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.
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!
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.
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. |
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