birthdays

Today is my birthday. I’m 33, now. As I mentioned before, it’s also my wife’s birthday. It’s really, actually pretty fun sharing a birthday, like we have our own special club, that no one except my wife, me, and my wife’s college roommate are in.

And yet, after finally getting our positive pregnancy test this week, it’s hard to focus on anyone’s birthday except our little one’s, which we are hoping to be celebrating some time around the end of January. I never thought celebrating a birthday sans champagne would be so much fun.

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day 1

Yesterday was day 1, marking the end of my month off of trying to conceive.  The month was great.  I abandoned all thoughts of getting pregnant, so much more gloriously than intended.  I did not temp.  I did not pee on any sticks.  I did not even take my prenatal vitamins.  I rode rollercoasters, ran 6 miles at a time, and drank as much wine as I wanted.  I lost 7 pounds, I gained 2 back.

And most importantly, when my period came yesterday, it was a surprise.  Like it used to be!  Not the culmination of 3 days of frantic TP-checking every time I go to the bathroom, but a complete and utter “Oh shit!” in the bathroom of a client’s office in the middle of a meeting.  And it was then that I realized how much good this break had done me, and really, all of us.  To just be able to forget about my womanly rhythms and just live my life normally was such a gift to myself.  Fertility Friend might be my fertility’s friend, but it is certainly not my friend.  And that app stayed firmly closed for all 28 days of my cycle.

Today, when I called my RE’s office to order more sperm, and talk about a trigger shot for this month, I was excited and hopeful again.  Not depressed, not even sad, but excited.  Which means that the month off accomplished exactly what it was supposed to.

optimism

half empty

This is my actual, current, real life water glass (well, technically it’s plastic, not glass, but we are not hear to discuss what a shitty environmentalist I am).*  As the trite expression goes, you will see that it is half-empty.  Perhaps more like two-thirds empty.  But not totally empty, because that would be too simple.

You see, floating around in the back of my head are all the stories.  You know the ones.  We totally gave up trying, because we thought it would never work for us/it was too late/it was too early/she got sick/Mercury was in retrograde/etc. and lo! and behold!  That was the time we got pregnant!

I really, really wish my glass was empty, but I can’t help holding out a liiiiiiiiiiittle hope that it actually maybe did work this month.  Even though I know it didn’t!  Still.  Which means the fog has crept back in just a little, as I try to remind myself not to be optimistic — not at all — because we actually know that this time we inseminated too early, and we therefore know that we aren’t pregnant.

This is why you actually take a month off. Hello, April, I am looking at you. Because even if you tell yourself it didn’t work, and even if you know, deep down, that it didn’t, someone keeps sneaking up and pouring just an inch or two of water in your glass when your head is turned. Which means it really sucks when the end of the month comes, and you knock that glass over, and it drenches a stack of mail that someone left on the counter.

Although we are also not here to discuss how neat and tidy I am, do you see how clean my desk at work is?  That is because I moved all my confidential lawyer-type documents out of the picture for internet posting purposes.  Note the eraser crumbs around the bottom of the glass. That is a bit more accurate when it comes to visualizing my workspace.  Yep, I’m a pencil writer.  At least they are not food crumbs.

decisions

Friday, my temperature was still elevated, and I had been nauseated all day.  Saturday morning I woke up with the temperature a little lower than Friday, but still elevated.  I was still nauseated, and really, really thought I was pregnant.  But by late morning, spotting had started, and I knew I wasn’t pregnant, again.  Yesterday the real bleeding started.  It was heartbreaking.  It’s hard to explain, really, what it’s like to not be pregnant, month after month.  I wish I knew why.  I spent the better part of the weekend sobbing in the corner, yelling at my spouse over nothing, and painting my bedroom.

Maybe it’s the prolactin, I don’t know.  I didn’t get it checked last month, although now I wish I had.  Not that it would matter.  One thing that has been hard to accept is that no amount of information will get me pregnant.  Whether or not 28% of pregnancy charts show nausea at 11 days past ovulation, whether or not my prolactin levels are high or normal or slightly elevated, none of that information, alone, will get me pregnant.  None of it even matters.  Whenever I test, whatever symptoms I have, no matter what the correlation is with other people who are pregnant, none of it matters.  Because I’m not.  So this weekend I thought, I either want to take March off, or I want to do something more aggressive.  What I don’t want to do is the same damn thing I have been doing for the last seven months.

My wife really does not want to take a break, although she is willing to if it’s what I want.  So this morning I bit the bullet and called the doctor’s office for a consultation with my doctor.  I thought that if she could explain to me why she thought Clomid would help, and what the side effects (short and long term) really are, maybe I could get myself comfortable with taking it.  Except for how it turns out that my doctor is on vacation all week.  So I can’t ask her these things.

I decided to go the Manhattan office of our doctor’s practice to at least get the prolactin levels checked, and maybe get the prescription for Clomid from a different doctor.  If we have to make this decision on our own, I thought I would rather have the Rx in hand.  Long story short is that I got the run-around about if/how I could even get a prescription for the Clomid from some other doctor, and ended up loudly ugly-crying on a street corner on the upper east side while on the phone with my wife.  It seems that our chances of starting the Clomid this cycle are slim to none, so now we are down to the options of another natural cycle, or a month off.  While sobbing into the phone, my wife offered me the month off.  She held it out there for me, and I grabbed it.  Less than an hour later, I question that decision.  What if she’s right, and the right ovary is better?  Maybe I will do a natural cycle after all.  I have no idea what the right choice is.

What I do know is that I hate this.  I hate this so much.  Getting pregnant is not fun, like I thought it would be.  It is hard, and stressful.  It involves making uninformed decisions, and missing work, and having your blood taken for the fiftieth time, and talking about deeply personal things with loud-mouthed receptionists and crying in your office, in your bedroom, on street corners.  And extremely bitter disappointment.

Last night, our kids came home from their vacation with their father.  BC was telling some long, complicated story about what to do if you are being attacked by a German Shepherd, and I just thought, this could be it.  These three could be the only kids I will have.  And they are already so big.

fallopian tubes and other two week wait thoughts

Because I am a lawyer, today’s blog entry, which is mostly a list of random thoughts, will have headings.  You’re welcome.

Fallopian Tubes and Lazy Eggs

Today is the second day past ovulation and insemination. This is the day where I start to get annoyed at how long it takes the egg to bounce its way down the fallopian tube and implant.  The sperm can make their way up there in a matter of seconds, but the blastocyst that is hopefully making its slow, meandering way down the tube takes days.  Annoying, right?

But, I will say, this annoyance is partially a result of the cartoon images of the female reproductive system that I saw in fifth grade, which depict the fallopian tube as being about a quarter of an inch long and perfectly straight and wide.  Today I remembered that when I had the HSG test, I saw my actual fallopian tubes.  Not straight.  Not short.  Not wide.  Instead, they are skinny, long, meandering tubes.  I actually tried to put a picture of my fallopian tubes on here to enlighten everyone, but due to my limited computer skills, I am unable to pull my protected health information off the CD-rom they gave me at the hospital and post it on the internet.  Probably for the best, I guess!

So, you will have to take my word for it.  Those sperm are so small, and mobile, compared to a drifting little blastocyst that is just sort of floating along, and the fallopian tubes are extremely (relatively, you know, considering how small the blastocyst is) long and winding.

Another interesting thing I learned from the HSG test is how small the uterus is.  It’s like the size of a walnut or something. The metal speculum shows up on the x-rays, and it looks gigantic compared to the uterus.  For some reason I always pictured the uterus taking up the better part of my abdomen, but I guess that would be a little ridiculous, considering how little use it gets.  And also! How amazing that it can grow and stretch enough to accommodate a whole human.  Now, this is getting a little too “miracle of life” for me, so I will move on to another fascinating topic:

Basal Body Temperature and Mean Guy

Yesterday, I had a humungous basal body temperature up-tick.  My temperature has consistently been between 96.9 and 97.1 degrees for the entire first half of my cycle.  Then, yesterday, it shot was up to 97.7, just like that.  In case you are new to temperature charting, the follicle that releases the egg begins producing progesterone after ovulation, which causes your temperature to rise.  So the day that the temperature rises is the first day after you ovulated.  Thus, a temperature rise on day 18 means that I ovulated the day before, on day 17.  Although you technically need three days of sustained increased temperatures to confirm ovulation, this seemed like pretty good evidence to me.  Now, I have no idea why Mean Guy measured that follicle at 17mm. Maybe he wasn’t careful enough, because he was rushing. Maybe he didn’t notice that it was actually already collapsing from having just ovulated.  Maybe he just sucks, whatever.  But the important lesson I took away from this is that actually, I do know my body.  The eight months of charting and watching how my body looks and reacts around the time of ovulation taught me something.  I am the expert on my own fertility, not some guy who barely looked at my chart, even if he does happen to be a doctor.

I took my temperature again this morning, and it was off-the-charts high.  Maybe this is because I am sick (which I am – I have a horrible head cold) or maybe it’s because I was up every hour last night because of a combination of a stuffy head and an annoying cat.  I am sure it wasn’t the half bottle of wine I drank last night at my early Valentine’s Day dinner with my wife.  Anyhow, it was up well over 98 degrees at 6 am, but by 8 am, it was down to 97.8, which is the temp I actually ended up recording for my chart.

More on Charting

Also: My friend Emily told me to use Fertility Friend to record my BBT and other chart items, rather than the app that I had been using and only sort of liked.  Fertility Friend is like crack.  Do not click on that Fertility Friend link unless you are prepared to devote about 10 hours a day to poring over all the information they have and obsessively staring at your own chart. They also suck you in with this one month VIP membership trial thingy.  The VIP membership, which normally costs about $10 a month, is about the best thing I have ever seen.  They take your chart and statistically compare it to other people who got pregnant to tell you whether it’s likely that you are pregnant before your period is due.  They give you little information tidbits.  They draw lines and stuff all over your chart to show you it’s bi-phasic nature and other technical sounding things.  I LOVE IT.  I also love that they use a grainier version of Courier font on your chart to make it look like it was created circa 1996.

Time Travel

Which brings me to my final thought for the day.  The other night at dinner, I was upstairs working while my family at chicken and couscous.  My wife asked the kids if they could go back in time to any time period at all, what they would choose.  And BT said that she wanted to go back to 1985-1996.  Because “I could be an 80s chick, and then I could be like YO.”  Now, 1985-1996 were good years, in terms of fashion and otherwise, but I can’t believe that is her choice, because those are the years that I was my kids’ ages, and I am so glad to not be in middle school anymore that I can barely stand it.  BC wanted to go back to the big bang.  MO never really answered, because she got distracted by thinking about how if there was a shrink-ray, and she was shrunk to the size of a hamster, she wouldn’t want to go on top of someone’s head, because scalps are disgusting.  See what I miss by working? Kids are weird. I want another one.

Only 10 days to go…

seventeen

Today is cycle day seventeen.  I spent the weekend agonizing over my pee sticks, as I always do when ovulation is imminent, and finally decided after lining up four nearly-identical pee sticks in front of my wife and sister on Sunday night, that it was too early.  Yesterday, I got a true “light line” in the morning, scheduled my IUI for today, and then confirmed with a “dark line” last night.  I was still fretting that I had missed my ovulation, since I usually don’t get the dark line until I am practically ovulating, but my temp this morning was nearly identical to what it was yesterday, so I took that as a good sign.

[An aside about temping.  As annoying as it has been, I find it really useful. My temperature barely fluctuates from 97 degrees, and it was a relief this morning to find it at 96.99, so that I was pretty confident I had not missed the boat. I am hoping to see a good solid shift after ovulation.  All-in-all, useful, and not nearly as annoying as I thought I would find it. Also I get up to go to the bathroom, and I drink, and whatever, and it hasn’t fluctuated too much, so if you are on the fence, give it a try.]

Allllllright. So I go in this morning for my IUI at 8am. The first bad news is that the one doctor in the practice that I really don’t like will be doing my IUI.  He ignores my wife, he doesn’t tell me when he’s about to stick shit in my vagina, etc.  We refer to him informally as “the mean guy.”  He’s also the doctor who habitually keeps us waiting — once it was over an hour, with our little squiggles just sitting there in a test tube, losing vitality.

We pick up our sperm at apparently a really high-traffic time, because there is a guy leaving the masterbatorium (what is that jack-off room called? I don’t know) awkwardly standing there with a paper bag and two other guys waiting for use of the masterbatorium while we wait to pick up our sperm.  Classy.  Our numbers are good – upwards of 60% motility. I am feeling happy as we head into the room.

HOWEVER.  The Mean Guy enters, and as per usual, talks to the countertop while ignoring my wife.  He does not adjust the stirrups, so my heels are somewhere up my ass and it’s really uncomfortable — even after I joke that the bed is set up for a person much shorter than me.  Without a word, he sticks the biggest metal speculum I have ever seen up my dainty lesbian vagina, and does the insemination.  I jump when he touches me, because every other doctor that has shoved things in my vagina ever has said something along the lines of “I am about to shove something in your vagina” before they go ahead and do it.  In fact, every person who has shoved something in my vagina has given me some kind of a heads-up, doctor or otherwise.

After the insemination, he does the sonogram with the screen tilted away from both me and my wife.  When my wife stands up and asks to see, he says impatiently “I’m going to show you.”  Okay fine.  Only he doesn’t, not really. The other doctors all show us the whole thing: Here’s your uterus — this is your lining, looking good.  This white stuff is the sperm we just put in there.  This is your right ovary, no follicle.  This is your left, let’s measure that follicle, do you see it, etc.   Not so for Mean Guy. He is keeping all the info for himself, and only after he finds the follicle does he turn the screen.  He says “This is your follicle.  You haven’t ovulated, so you need to come back tomorrow,” and then turns the screen back to himself.  I ask how big it is, and Mean Guy says he’s about to measure. “Seventeen millimeters,” he says.  Then snap-snap off come the gloves, and he’s gone.

SEVENTEEN?  It just can’t be right.  I have never, ever in the 8 months I’ve been monitoring, ovulated after day 18, and almost always on day 16 or 17 — only once on day 18, ever.  The follicles grow about 2 mm a day, which I know from a different doctor who actually stuck around for questions. And I usually ovulate with that sucker around 25mm.  That would have me four days away from ovulation, which can’t be right given all the other signs.  I have never ovulated as late as day 21, and I would be shocked if I was about to start doing that now.

We then find out that there are no doctors available to do another insemination in the morning tomorrow, only in the afternoon.  So we make an appointment at 2:15, which I will have to cancel if my temp is up in the morning, as it will be far too late in the day to catch an egg that is released sometime today or overnight.

So I am sitting here worrying.  More, again.  There is so much of that in this process. Did Mean Guy mess up the measurements?  Is my follicle really only 17mm?  Is it possible I have already ovulated and that the follicle he was measuring was already collapsing? Shouldn’t he have been able to tell that, if he’s any good?  I wish he hadn’t even done the sonogram.  I wish I didn’t have to have Mean Guy anymore. He always seems to be the Tuesday morning doctor, though, and I’d rather have the timing right with an asshole doctor than miss the timing and have a nice doctor.

Also. What if sonograms kill sperm?

one pink line, and the problem with maybe

This weekend, I got my period.  Again.

Friday, I was sure I was pregnant.  I planned to test on Saturday morning, because then we would have some time to revel in it before getting back into real life. How could I not be pregnant?  We used a different donor, the donor that we thought we were meant to have been using all along, but originally had not chosen because he was an open donor.  His numbers were much better!  I had the HSG test, and my tubes were clear.  My prolactin levels were down (still not in the normal range, but very close).  We timed it right, finally, for our two back-to-back inseminations.  I would surely be pregnant this time, lucky try number six.

There are lots of women who feel nothing, less than nothing, no pregnancy symptoms at all, before they are late.  So I could be one of them.

When I woke up Saturday, I knew I was not pregnant.  “Are you going to test?” my wife whispered.

“It’s going to say no. Give me just one more minute to hope.”  But I had to go to the bathroom, and eventually I couldn’t put it off any longer.  I set the test on the nightstand and put my head on my wife’s shoulder for three more minutes.  I was right.  It was negative.  I stared for a while at that blank, white space next to the one pink line before I got up and threw the test in the garbage. I crawled back into bed and cried, for kind of a long time.

This was the worst loss.  The other times, I knew it might not work.  I really, really thought this time would work.  I let myself read week 3 on Amalah’s zero-to-forty pregnancy calendar (and week 4, and 5).  I had a dream that I had a baby, and it was a boy, and BT was happy about it.  I avoided brie, and smoked salmon, and drank sparkling water, just in case.  I hoped.

On Sunday, I had the worst fucking cramps I have had in a decade, and got my period. I spent a good portion of the afternoon sitting on the couch with a heating pad, feeling sorry for myself.  I discussed Clomid with my wife and my sister, who is a consultant that works with pharm companies and knows things about drugs.  I talked with my wife about how long we would do this, and how hard it is on me emotionally.  We talked about Clomid, we talked about IVF.

The thing about not being pregnant, month after month, is that you start to think that it’s you.  I am starting to lose faith in my body’s ability to become pregnant without some further assistance.  I look at my lifestyle, and I think, maybe it’s because I refused to give up drinking.  Or even drinking coffee.  Maybe I should do more yoga.  Maybe I should not have skipped acupuncture. Maybe it’s all the late nights of work.  Maybe it was staying home to care for my son, and catching his cold.  And you know what? Maybe it is.  Or maybe it’s not.  I don’t really know.  I don’t know why I’m not pregnant yet.

In the end, we decided that we are going to try one more “natural cycle,” and I am going to really give it a go doing all the shit they tell you to do in books about fertility.  I am not going to eat crap that’s bad for me.  I am going to cut down to the four drinks a week they recommend when you are trying to conceive.  I am going to re-give up the second cup of coffee and the diet coke that has been sneaking back into my hands on the weekends.  I am going to do better with remembering both the prenatal vitamins and the B-6.  I am going to diligently try to get to bed earlier, even if that means no Downton Abbey for me.  If it works, so much the better.  If it doesn’t, then there are worse things than being super healthy for a month, and it will give baby a little head start on having a healthy mama, when I start the Clomid in March.

if we wanted Chlamydia, we’d ask for it

I have spent a lot of time over the past few days fretting about how my doctor proposed maybe considering Clomid for the next cycle if this one doesn’t work.  I think this one will work, right? There are a lot of variables that have changed:  new donor, HSG test, two inseminations this month (one today, one tomorrow, yay!), and ever-lowering prolactin levels.  Good for pregnancy odds, not so good for a controlled study, I guess.  Nonetheless, I feel like “considering Clomid” is hanging over my head like a dark cloud.

Yesterday, I confessed to my wife that I was worried about this.  I don’t want to try medication, yet, I told her.  It made the already-awful HSG test worse to have it popped on me while I was still bleeding on the x-ray table that we had to start thinking about fertility meds.

“Well, honestly.  I don’t think she needs to keep bringing it up.  If we wanted Chlamydia, we’d ask for it, right?” my wife said.

“Clomid.”

“What? What’s that?  What’s Clomid?”

“That’s the medication.  The medication is Clomid.  Chlamydia is an STD.”

“Oh, right.  Clomid, then.  Whatever, the logic still stands.”  The woman has a good point.

peesticks and dignity

Here is a picture of my peestick (not surging).  It is resting on top of the toilet seat protector thingy dispenser in a stall in my office restroom.

20140110-164710.jpg

My dignity was apparently flushed down the toilet.  It’s hard for me to think of something as degrading as testing your ovulation in a public restroom at work, while other women come and go.  I have learned that there are a few times one should never, ever test one’s ovulation in the work ladies’ room.

1) 4:49 pm – 5:15 pm.  This is the time that hoards of secretaries come to brush their teeth and reapply makeup before leaving for the day.  Let me tell you, if they did a study of dental hygiene habits, I am willing to be that legal secretaries would be in the 99th percentile.

2) Immediately after lunch.  For the same reason.

3) 10:00 am.  This is when the attorneys roll in, and they are likely to go to the bathroom on their way to their desks.  Also, someone will be pooping, and if you stay in the stall for 3 minutes so as not to jiggle your precious peestick, people will almost certainly assume it’s you.  And, I, for one, have memorized most of the shoes on my floor, so you can bet I know who’s in what stall.

The emotional turmoil of trying to get pregnant should be enough.  It should not also be required that I remember not to pee for some four-hour stretch in the middle of my workday, the end of which will not coincide with one of the time periods described above.

the hsg test – ow, and nooooooo

Today, I had the HSG test.  I had to take a pregnancy test before I could have the HSG test, so I went to my ordinary doctor’s office about an hour and a half before my appointment to find out if I was knocked up already.  I failed one test, and passed the other — I’ll give you one guess which is which.

I had been advised by the nurse to take ibuprofen an hour or so before the test, but of course, because I was so insanely early for the HSG test, I instead sat in the sandwich shop, eating broccoli soup and reading my book until my frantic and late-as-usual wife showed up to hustle me down to radiology.

The test itself was painful.  More painful, actually, than I thought it would be.  I think this is because my doctor had some difficulty getting the catheter in deep enough, so she used some horrible sword-like device that “would cause considerable cramping.”  That’s an understatement, when someone is shoving a sword into your cervix.  The one upside is that it was fast — about 2 minutes, once they wrangled that catheter through my apparently maze-like cervix.

And, I guess the other up-side is that my tubes are clear.  Totally clear. So now there’s just some dye swimming around in my abdominal cavity and some residual bleeding from the sword fight to deal with.  And a free and clear path for this month’s lucky gentlemen (the sperm, I mean).

After the procedure, when the doctor told me my tubes are clear, she dropped the bomb — she thinks that if this cycle doesn’t work, I should consider Clomid for next time.  My desire to go on Clomid ranks somewhere between “root canal” and “brain removed through nasal passages using a hook.”  Not to mention the risk! of! multiples!  Maybe she wasn’t paying attention when we told her we already have a shit-ton of kids, and we would like to up the ante one at a time.  When she said this, I wanted to say to my wife “See!  It’s really abnormal that it’s taking this long!  And therefore breaking down the bedroom door was a totally normal reaction to the frustration and disappointment!”  Unfortunately, she wasn’t allowed in the x-ray room with me, and I was still lying prostrate on an x-ray table with god only knows what on display for the rest of the room to see, so I just nodded and told her we would think about it.

I’m done thinking about it.  No.  No Clomid.  Maybe I’ll just go ahead and get pregnant this month, instead.