Iron Man 3, or beginning of Phase 2
Let me begin by thanking you, dear readers. I can't believe how many of you are still slogging through this muck with me. And that, despite how cracked out I sound at times, you're still supporting me. It's humbling. It's beautiful to know that, when you're at your lowest, your friends can swarm to support you.
Moving on.
Over the weekend, I had a bunch of questions about what was going to happen next. I have a sharps container that's filling up; where does that go? What do I do with this shit ton of medication I have left over taking up room in my fridge?
More importantly, I'm preemptively worrying about progesterone. I know it's a hormone that everyone who goes through any fertility process has to take in some form. A lot of times, and probably what it will end up being for me, it's painful injections. They're different from the last ones I took; those just went anywhere in your stomach, where as progesterone is intramuscular. It's also not given in a spot you can usually reach yourself, so my hubby's going to have to put his big boy pants on and inject me. Sometimes its given as a suppository, which I hear is less painful but just generally kinda gross.
I've spoken to someone who believes that most people have an excess of estrogen based on foods that they eat. That was her unofficial "diagnosis" for our problem, based on some estrogenic foods that my husband and I love (namely peanut butter and beer). Now I'm into looking up foods that can increase your progesterone levels to try to counteract this issue.
When I had my miscarriage, one of the problems I encountered was my progesterone was low. In a sort of unfounded way, I believe that I may have had a miscarriage earlier this year, as well, in May. In that month, I had similar physical sensations to what I had in this past month. I felt small flutterings in my stomach and had some very mild nausea almost every day. I realize that that sounds crazy. I know you're not able to feel any fluttering from your baby until you're several months along. But I know what I felt, even if I would have only been two weeks pregnant. Should you not know your body enough to know when you feel something different than normal? I was a few days late getting my period in May, and I got my hopes up; it was devastating when I did finally get it. That was why I didn't want to get excited a few weeks ago when I started to feel exactly the same symptoms.
Except now I know that I did have a miscarriage that time.
So can you blame me for fully suspecting that this has happened once before?
Now that I think I may have experienced this twice, I'm even more concerned about my progesterone levels. Am I going to have to take extra injections to make up for this? Am I even going to be able to have a pregnancy work? I did some preliminary research and found that, while there aren't any progesterone supplements that can be taken, there's an herbal supplement that mimics progesterone. There are creams that can be applied. And there are fertility supplements in general that can help increase production. Should I be taking any of these?
I e-mailed this slew of questions to my doctor and my nurse, and I was amazed that my doctor called me back within 10 minutes. I was able to speak to her later in the day and... well.
It didn't go exactly as I had thought it might.
I am a bit of a planner; not every minute of my life, but I like to have an overview of what's happening when. Because of that, because it's the holiday season, because I have a lot of commitments coming up, and because we were supposed to go on vacation just after Christmas, I had tried to lay out what I thought the rest of this process was going to be for myself. No one ever sat down and gave me a timeline or even explained all the steps involved, but I was able to piece together my own timeline based on various conversations I had had with doctors and friends.
The way I envisioned it: After we knew how many fertilized embryos we had, we would have to wait six days to find out how many make it to the blastocyst stage (which means they're maturing well). Then the embryos will be sent out for extra genetic testing, which will give us even more information about them. Once we get the results back, boom, in goes the best little embaby. That'll be about 2-3 weeks from now. Two weeks after that, I take a pregnancy test. And then bam! I'll know that I'm pregnant. (I mean, there's a 65% chance of that, right? And I'm not at all negative and worrying that it won't work and thinking that 35% isn't exactly a small number and that I'm in real danger of having a complete mental breakdown if this doesn't work. Nope. Those are not the thoughts that sometimes invade my brain, no matter how much I try to stop them.) I figured I would know just before New Year. And then I could celebrate and be relieved and be happy. Yay.
Well, not quite. As the doctor was going through her timeline with me, she said something that probably will sound innocuous and common sense to you, but it wasn't anything I was expecting to hear. I tend to react very passionately to things when they're first presented, and I'm a bit sensitive at the moment, anyway. (Here I go justifying my craziness again.)
Anyway, Doctor was talking about getting the test results back, at which point we find out which embryos are euploid (which means they have a normal number of chromosomes; not something the doctor told me, something I had to google just now, but at least I did understand that that meant they were genetically viable). "That should be about the same time you're getting your period," Doctor said.
Wait, WHAT? I thought I was going to be done with Aunt Flo for awhile! I thought we were going to go right into a transfer, and then I would be pregnant. I did my best to calmly express my confusion without either screaming or crying hysterically.
"We don't do live transfers," Doctor said, laughing lightly. "You know that."
NO! NO I DO NOT! I didn't even know that there were live transfers vs. whatever you call it when you freeze an embryo. I did know my embryos were being frozen, but I did not know that there were different procedures.
"We discussed that," Doctor insisted.
Again, no. The only time we sat down and spoke at length about anything was at our initial meeting in August. At that time, we had so much testing to complete, we had no idea what route we would be taking. I know we saw pictures of embryos and how they develop into blastocysts. But we also mentioned so much medical jargon that my head was spinning by the end of it, and I basically understood that there were two major options (IUI and IVF) and what the basic differences between them are. Did someone say "We don't do live transfers" to me? Probably not. But even if they did, it was August, and now it's November, and I've had a miscarriage, paid $5,000, and injected myself full of hormones, not to mention started a new school year, met all new students, dealt with their issues. Maybe, just maybe, I've forgotten a little something.
Since then, I've only actually seen my doctor two or three times due to the fact that so many of my visits have had to be on weekends or holidays. So there isn't much we discussed at all.
One of my major pet peeves is being treated like I'm stupid. If you're telling me that we discussed something that I know we did not with that patronizing tone of voice that goes along with it, I feel like you think I'm dumber than I am. (A lot of the time these days, I wish I was dumb. Then I wouldn't overthink everything. But I digress.)
This means that I should be getting my period right around my birthday. Happy birthday to me, I'm still not pregnant, and I won't be for another 4 - 5 weeks afterwards. Apparently, the clinic has found that transferring embryos to a fresh uteran lining, rather than the current one I have which is probably all hopped up on more estrogen than it should be, leads to a higher success rate. So my 5 little babies (I hope) will live in a freezer until I'm halfway through my next cycle. Maybe the transfer will be closer to the end of December, so I can celebrate that being over for New Year.
Oh, but there's another little snafu that we never discussed. As previously mentioned , all 5 of my embabies might not make it to blastocyst or euploid. The clinic's rate of success is 65%, so we have to think of things as one baby for every two embryos (and obviously that's not even a guarantee). So if we end up with two, we have a good shot at one child.
Because of this super accurate mathematical equation, Doctor urged Jon and I to definitely decide how many children we want to have now so that, once we know how many embabies make it, we can decide if we want to go straight to implantation or if we want to do another egg retrieval. Since we know my body responds well to the hormones at this point in my life, it would be a better idea to do another retrieval now. Otherwise, if we do implantation, it will be at least another year before we do another retrieval, and my body will have changed a bit after having a baby. My response to that would be more unpredictable.
This is yet another idea that hadn't been presented to me before, and it added to the upset. Having a child is its own unknown, so Jon and I have always known we wanted one child and thought we would decide if we wanted more based on how that went. Maybe it'd be a great experience, but maybe we'd be so overwhelmed and it would be a financial burden and yada yada, etc. Now we were being told that it's best to make that decision absolutely right now. I mean, in about 2 weeks when we get all the test results back.
When I got off the phone, I sobbed. I know it's ridiculous, but I was thrown by all of that new information. Making that kind of decision for sure now? Really? And having to wait 2-3 weeks longer than I initially thought before I get the embryo transfer... It's not a lot of time, I get that. But what others need to understand is that every time (or the vast majority of times) I hear about someone being pregnant or see someone's baby announcement on social media or see a baby or pregnant person out and about, even though I can feel some happiness, it also feels like I'm being punched in the chest. And as I've mentioned before, then I feel worse about myself for getting upset with others... So the sooner that downward spiral is over, the better. I am moving at the speed of can I make it through today? at the moment, and on bad days, it's can I make it through this minute? And I do, but I can't wait for this to be over. Then everyone (mostly me) can stop thinking I'm awful and crazy, and I can be normal again.
I unloaded all of this on my MIL when I got home, and we had a long, logical conversation. Logic doesn't make me feel much better, though. I know I've mentioned that. Logic says: I don't need a baby, my life is full of wonderful things, two weeks is not a long time. My heart and hormones say: I want a baby, and I want this to be over. Argh.
Jon and I did our best to discuss our options based on the number of euploid embryos we end up with. There is so much more that Ms. Doctor Lady didn't mention in that conversation, probably because I am both a paycheck and a bit of a science experiment. Namely...
While I'm not young, I'm not old, either. I won't be considered a geriatric pregnancy even a year from now. We know that natural conception is a legitimate option for us, so maybe it isn't quite as pertinent to decide how many kids we want. There's also IUI, or introuteran insemination, which has a lower success rate than IVF, but is a lot less of a process. So there are options other than IVF.
Also, about an hour after the conversation with the doctor, I realized that I paid $5,000 for the retrieval and freezing of eggs and embryos. As I'm writing this, I realize that I might have to pay more for the implantation, although since the "entire" process is "covered" by insurance, maybe not. But if I did another retrieval? Yeah. Another $5,000. Did the doctor even mention to me on the phone, "Remember, you might have to incur a fee if you decide to do this again"? No. She did not.
Because, as pleasant as doctors can be, they are pretty much totally removed from this process. I get that they have to be, but could they at least pretend that they're concerned about money and emotions, not just their success rates? (Really, my doctor is very nice, but again, I'm smart, and I analyze this shit way too much.)
So the decision we've made at the moment is if we have at least 3 embryos, we are not doing this again right now. That should be a safe bet for one kid, possibly 2. But if there's only one or two? I don't know. Trying not to get too ahead of myself. It is terrifying to think that we went through all of this and will go through quite a bit more and possibly end up with nothing. I don't really think that will happen at this point, but it's a minor concern.
The next day, there was also a whole big to do with my prescription insurance. It's a long and convoluted story that doesn't actually matter in the end, other than it made me angry at how incompetent they are, even though everything worked out for me. Basically, they needed prior authorization for one of the medications I was prescribed, but they were contacting me about it two weeks after the fact. They must have also contacted the clinic, because two weeks ago, I got a different brand of the same thing. But it was annoying that it took so long for them to call me about it. According to the woman I spoke to, they had attempted to call me five previous times, though why their automated system wouldn't have left me messages each time is beyond me. I couldn't believe the whole thing, though. Suppose the medication I needed was some kind of life sustaining? (I guess at that point, I'd have been making more phone calls, but you get the point.)
The other thing I learned from that particular venture? The medications, which are really just hormones that the female body produces naturally, that I paid $200 for would have cost $11,630.01 (gotta love the one cent) without insurance. Just... HOW? HOW IS THAT EVEN A THING? Mind boggling, and while it makes me grateful for my insurance, it infuriated me for the people who don't have it. Why should I end up entitled and lucky while they have to suffer through this depression inducing nightmare without it? What is wrong with our country?
Well, that's for a different blog entirely.
I also got a call from my nurse that morning to plan our next steps. I'm sorry, you actually want to plan something in advance now? What a novel idea! Even though she knows we can't make a definite decision until we have a euploid count, she hypothesized that we'd have at least three. If that's the case, I told her we wouldn't do another retrieval, so my birth control is ordered. Not sure when I'll need it, but I probably will at some point to freeze my cycle until they're ready to do the implant. Such a relief to be on the planning end of things rather than the catching up at the last minute end!
TBH, this week has been a lot better for me in general. I have been in a pretty decent amount of internal pain, as my ovaries are still swollen, but my brain is in better shape. Last night while sitting on the couch, I actually started stressing out about food I was going to eat. That's a normal concern of mine that I haven't thought about in weeks. I must be reverting back to my normal crazy for the moment.
The conclusion that I've come to is that estrogen depresses me. I'm always depressed when I get my period (so my birthday will be a blast), though this is partially because it means I'm not pregnant. But I was also really having a rough time on the injections. Now that I'm on a break from all that, I even started laughing at myself yesterday and wondering why I'm this desperate fool. My life is just fine the way it is, thank you very much. Why am I this stressed about something that will happen? Stop worrying about it, self!
Oh, me. I'm so ridiculous.
And all that said, tomorrow, we get a call about how many embabies are still hanging around. We'll see what kind of tail spin we're in for then.
Moving on.
Over the weekend, I had a bunch of questions about what was going to happen next. I have a sharps container that's filling up; where does that go? What do I do with this shit ton of medication I have left over taking up room in my fridge?
More importantly, I'm preemptively worrying about progesterone. I know it's a hormone that everyone who goes through any fertility process has to take in some form. A lot of times, and probably what it will end up being for me, it's painful injections. They're different from the last ones I took; those just went anywhere in your stomach, where as progesterone is intramuscular. It's also not given in a spot you can usually reach yourself, so my hubby's going to have to put his big boy pants on and inject me. Sometimes its given as a suppository, which I hear is less painful but just generally kinda gross.
I've spoken to someone who believes that most people have an excess of estrogen based on foods that they eat. That was her unofficial "diagnosis" for our problem, based on some estrogenic foods that my husband and I love (namely peanut butter and beer). Now I'm into looking up foods that can increase your progesterone levels to try to counteract this issue.
When I had my miscarriage, one of the problems I encountered was my progesterone was low. In a sort of unfounded way, I believe that I may have had a miscarriage earlier this year, as well, in May. In that month, I had similar physical sensations to what I had in this past month. I felt small flutterings in my stomach and had some very mild nausea almost every day. I realize that that sounds crazy. I know you're not able to feel any fluttering from your baby until you're several months along. But I know what I felt, even if I would have only been two weeks pregnant. Should you not know your body enough to know when you feel something different than normal? I was a few days late getting my period in May, and I got my hopes up; it was devastating when I did finally get it. That was why I didn't want to get excited a few weeks ago when I started to feel exactly the same symptoms.
Except now I know that I did have a miscarriage that time.
So can you blame me for fully suspecting that this has happened once before?
Now that I think I may have experienced this twice, I'm even more concerned about my progesterone levels. Am I going to have to take extra injections to make up for this? Am I even going to be able to have a pregnancy work? I did some preliminary research and found that, while there aren't any progesterone supplements that can be taken, there's an herbal supplement that mimics progesterone. There are creams that can be applied. And there are fertility supplements in general that can help increase production. Should I be taking any of these?
I e-mailed this slew of questions to my doctor and my nurse, and I was amazed that my doctor called me back within 10 minutes. I was able to speak to her later in the day and... well.
It didn't go exactly as I had thought it might.
I am a bit of a planner; not every minute of my life, but I like to have an overview of what's happening when. Because of that, because it's the holiday season, because I have a lot of commitments coming up, and because we were supposed to go on vacation just after Christmas, I had tried to lay out what I thought the rest of this process was going to be for myself. No one ever sat down and gave me a timeline or even explained all the steps involved, but I was able to piece together my own timeline based on various conversations I had had with doctors and friends.
The way I envisioned it: After we knew how many fertilized embryos we had, we would have to wait six days to find out how many make it to the blastocyst stage (which means they're maturing well). Then the embryos will be sent out for extra genetic testing, which will give us even more information about them. Once we get the results back, boom, in goes the best little embaby. That'll be about 2-3 weeks from now. Two weeks after that, I take a pregnancy test. And then bam! I'll know that I'm pregnant. (I mean, there's a 65% chance of that, right? And I'm not at all negative and worrying that it won't work and thinking that 35% isn't exactly a small number and that I'm in real danger of having a complete mental breakdown if this doesn't work. Nope. Those are not the thoughts that sometimes invade my brain, no matter how much I try to stop them.) I figured I would know just before New Year. And then I could celebrate and be relieved and be happy. Yay.
Well, not quite. As the doctor was going through her timeline with me, she said something that probably will sound innocuous and common sense to you, but it wasn't anything I was expecting to hear. I tend to react very passionately to things when they're first presented, and I'm a bit sensitive at the moment, anyway. (Here I go justifying my craziness again.)
Anyway, Doctor was talking about getting the test results back, at which point we find out which embryos are euploid (which means they have a normal number of chromosomes; not something the doctor told me, something I had to google just now, but at least I did understand that that meant they were genetically viable). "That should be about the same time you're getting your period," Doctor said.
Wait, WHAT? I thought I was going to be done with Aunt Flo for awhile! I thought we were going to go right into a transfer, and then I would be pregnant. I did my best to calmly express my confusion without either screaming or crying hysterically.
"We don't do live transfers," Doctor said, laughing lightly. "You know that."
NO! NO I DO NOT! I didn't even know that there were live transfers vs. whatever you call it when you freeze an embryo. I did know my embryos were being frozen, but I did not know that there were different procedures.
"We discussed that," Doctor insisted.
Again, no. The only time we sat down and spoke at length about anything was at our initial meeting in August. At that time, we had so much testing to complete, we had no idea what route we would be taking. I know we saw pictures of embryos and how they develop into blastocysts. But we also mentioned so much medical jargon that my head was spinning by the end of it, and I basically understood that there were two major options (IUI and IVF) and what the basic differences between them are. Did someone say "We don't do live transfers" to me? Probably not. But even if they did, it was August, and now it's November, and I've had a miscarriage, paid $5,000, and injected myself full of hormones, not to mention started a new school year, met all new students, dealt with their issues. Maybe, just maybe, I've forgotten a little something.
Since then, I've only actually seen my doctor two or three times due to the fact that so many of my visits have had to be on weekends or holidays. So there isn't much we discussed at all.
One of my major pet peeves is being treated like I'm stupid. If you're telling me that we discussed something that I know we did not with that patronizing tone of voice that goes along with it, I feel like you think I'm dumber than I am. (A lot of the time these days, I wish I was dumb. Then I wouldn't overthink everything. But I digress.)
This means that I should be getting my period right around my birthday. Happy birthday to me, I'm still not pregnant, and I won't be for another 4 - 5 weeks afterwards. Apparently, the clinic has found that transferring embryos to a fresh uteran lining, rather than the current one I have which is probably all hopped up on more estrogen than it should be, leads to a higher success rate. So my 5 little babies (I hope) will live in a freezer until I'm halfway through my next cycle. Maybe the transfer will be closer to the end of December, so I can celebrate that being over for New Year.
Oh, but there's another little snafu that we never discussed. As previously mentioned , all 5 of my embabies might not make it to blastocyst or euploid. The clinic's rate of success is 65%, so we have to think of things as one baby for every two embryos (and obviously that's not even a guarantee). So if we end up with two, we have a good shot at one child.
Because of this super accurate mathematical equation, Doctor urged Jon and I to definitely decide how many children we want to have now so that, once we know how many embabies make it, we can decide if we want to go straight to implantation or if we want to do another egg retrieval. Since we know my body responds well to the hormones at this point in my life, it would be a better idea to do another retrieval now. Otherwise, if we do implantation, it will be at least another year before we do another retrieval, and my body will have changed a bit after having a baby. My response to that would be more unpredictable.
This is yet another idea that hadn't been presented to me before, and it added to the upset. Having a child is its own unknown, so Jon and I have always known we wanted one child and thought we would decide if we wanted more based on how that went. Maybe it'd be a great experience, but maybe we'd be so overwhelmed and it would be a financial burden and yada yada, etc. Now we were being told that it's best to make that decision absolutely right now. I mean, in about 2 weeks when we get all the test results back.
When I got off the phone, I sobbed. I know it's ridiculous, but I was thrown by all of that new information. Making that kind of decision for sure now? Really? And having to wait 2-3 weeks longer than I initially thought before I get the embryo transfer... It's not a lot of time, I get that. But what others need to understand is that every time (or the vast majority of times) I hear about someone being pregnant or see someone's baby announcement on social media or see a baby or pregnant person out and about, even though I can feel some happiness, it also feels like I'm being punched in the chest. And as I've mentioned before, then I feel worse about myself for getting upset with others... So the sooner that downward spiral is over, the better. I am moving at the speed of can I make it through today? at the moment, and on bad days, it's can I make it through this minute? And I do, but I can't wait for this to be over. Then everyone (mostly me) can stop thinking I'm awful and crazy, and I can be normal again.
I unloaded all of this on my MIL when I got home, and we had a long, logical conversation. Logic doesn't make me feel much better, though. I know I've mentioned that. Logic says: I don't need a baby, my life is full of wonderful things, two weeks is not a long time. My heart and hormones say: I want a baby, and I want this to be over. Argh.
Jon and I did our best to discuss our options based on the number of euploid embryos we end up with. There is so much more that Ms. Doctor Lady didn't mention in that conversation, probably because I am both a paycheck and a bit of a science experiment. Namely...
While I'm not young, I'm not old, either. I won't be considered a geriatric pregnancy even a year from now. We know that natural conception is a legitimate option for us, so maybe it isn't quite as pertinent to decide how many kids we want. There's also IUI, or introuteran insemination, which has a lower success rate than IVF, but is a lot less of a process. So there are options other than IVF.
Also, about an hour after the conversation with the doctor, I realized that I paid $5,000 for the retrieval and freezing of eggs and embryos. As I'm writing this, I realize that I might have to pay more for the implantation, although since the "entire" process is "covered" by insurance, maybe not. But if I did another retrieval? Yeah. Another $5,000. Did the doctor even mention to me on the phone, "Remember, you might have to incur a fee if you decide to do this again"? No. She did not.
Because, as pleasant as doctors can be, they are pretty much totally removed from this process. I get that they have to be, but could they at least pretend that they're concerned about money and emotions, not just their success rates? (Really, my doctor is very nice, but again, I'm smart, and I analyze this shit way too much.)
So the decision we've made at the moment is if we have at least 3 embryos, we are not doing this again right now. That should be a safe bet for one kid, possibly 2. But if there's only one or two? I don't know. Trying not to get too ahead of myself. It is terrifying to think that we went through all of this and will go through quite a bit more and possibly end up with nothing. I don't really think that will happen at this point, but it's a minor concern.
The next day, there was also a whole big to do with my prescription insurance. It's a long and convoluted story that doesn't actually matter in the end, other than it made me angry at how incompetent they are, even though everything worked out for me. Basically, they needed prior authorization for one of the medications I was prescribed, but they were contacting me about it two weeks after the fact. They must have also contacted the clinic, because two weeks ago, I got a different brand of the same thing. But it was annoying that it took so long for them to call me about it. According to the woman I spoke to, they had attempted to call me five previous times, though why their automated system wouldn't have left me messages each time is beyond me. I couldn't believe the whole thing, though. Suppose the medication I needed was some kind of life sustaining? (I guess at that point, I'd have been making more phone calls, but you get the point.)
The other thing I learned from that particular venture? The medications, which are really just hormones that the female body produces naturally, that I paid $200 for would have cost $11,630.01 (gotta love the one cent) without insurance. Just... HOW? HOW IS THAT EVEN A THING? Mind boggling, and while it makes me grateful for my insurance, it infuriated me for the people who don't have it. Why should I end up entitled and lucky while they have to suffer through this depression inducing nightmare without it? What is wrong with our country?
Well, that's for a different blog entirely.
I also got a call from my nurse that morning to plan our next steps. I'm sorry, you actually want to plan something in advance now? What a novel idea! Even though she knows we can't make a definite decision until we have a euploid count, she hypothesized that we'd have at least three. If that's the case, I told her we wouldn't do another retrieval, so my birth control is ordered. Not sure when I'll need it, but I probably will at some point to freeze my cycle until they're ready to do the implant. Such a relief to be on the planning end of things rather than the catching up at the last minute end!
TBH, this week has been a lot better for me in general. I have been in a pretty decent amount of internal pain, as my ovaries are still swollen, but my brain is in better shape. Last night while sitting on the couch, I actually started stressing out about food I was going to eat. That's a normal concern of mine that I haven't thought about in weeks. I must be reverting back to my normal crazy for the moment.
The conclusion that I've come to is that estrogen depresses me. I'm always depressed when I get my period (so my birthday will be a blast), though this is partially because it means I'm not pregnant. But I was also really having a rough time on the injections. Now that I'm on a break from all that, I even started laughing at myself yesterday and wondering why I'm this desperate fool. My life is just fine the way it is, thank you very much. Why am I this stressed about something that will happen? Stop worrying about it, self!
Oh, me. I'm so ridiculous.
And all that said, tomorrow, we get a call about how many embabies are still hanging around. We'll see what kind of tail spin we're in for then.
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