The ghost of blood tests past

I just got the bill for my blood test. You know, the blood test to confirm that the FET failed, the test that was pretty much superfluous on account of my, you know, massive period. Yeah, that blood test.

And how often can I combine infertility and expat life in a single blog post? A beta test costs 51.30 Swiss Francs, which at the current conversion is US$41.97. How's that for killing two Vögel with one Stein?

And to throw in some non-Swissness for good measure, I won't be rushing to pay that bill before the holidays.

Wow was that an efficient post! Infertility, snark, random Switzerland fact, a German lesson, and a cultural faux pas in under 100 words (not counting this sentence)! Perhaps I shall retire, for how can I top that?

Thanks

R and I told nobody in our physical day-to-day world about the FET; only Dr L knows we tried and only Dr L knows we failed. It's just the way we are. We didn't tell anybody about the initial IVF, either, and I was 16 weeks along before we told anybody I was pregnant. It was 18 weeks before we told his parents. It's just the way we are. I don't quite know how to handle words of kindness and sympathetic glances; better to keep our trials to ourselves and avoid the whole thing, I say.

But the words of kindness here have been very kind, and they have helped, and I appreciate it, and thank you.

For those of you expecting an expat blog, sorry you got blind-sided by fertility treatment this month. For those of you expecting an infertility blog, sorry about the onions. This blog is a mish-mash, much like life I guess. I would put things in boxes if I could, but I can't. I don't work well that way. I'm not sure I work well this way, either, but it's who I am.

Anyway, thanks.

< 5

It's official. My blood work came back, to nobody's surprise, showing no measurable hCG (a hormone produced in pregnancy) in my blood.

I didn't speak to Dr. L yesterday - I missed his call - so I don't know what the story is from here on out. If there is a story.

It's raining. Small Boy is at The Farm. I'm sad.

Figures

Dr. L's office is closed today - it's a bit of a Festtag in Big City, which I'll blog about with pictures tonight - so I can't even get the satisfaction of an official Not Pregnant until tomorrow.

Figures.

It's all over but the counting

There is no longer any doubt that this FET has failed; I can't pretend that the blood is anything less than my period. The blood test - which I hope to take tomorrow simply to be done with this and to enable myself to have a few stiff drinks with a clean conscience - is simply a formality.

FET update aka straw, meet fist; fist, meet straw

So. I was moving along, doing my thing and passing the two weeks between the transfer of Draft Pick and the beta (blood test - scheduled for Tuesday) quite calmly, if I do say so myself, perhaps in part thanks to the Thanksgiving preparations and celebrations which distracted me and took up large amounts of time. Okay, I confess to wondering about the occasional twinge now and then, but for the most part I think I've stayed on as even a keel as one can stay on while knowing that there is a tiny two-celled embryo floating around in one's comparatively enormous uterus and wondering if it has found safe harbour.

Until this morning. A pink stain on the toilet paper, a bit of blood clinging to the Crinone applicator. Tears in the shower, hope swirling down the drain with the soap suds. It's eleven days past a two-day transfer; this is too late for implantation spotting, if I even believe that implantation spotting is always a good sign, which I'm not sure I do. For I had none with Small Boy; I had nothing with Small Boy and was convinced it had failed and you could have knocked me down with a feather when I got that positive beta back. But it's been hours, and I've been up and walking around, and there is no fresh blood on my pad, and now I don't know what to think. I didn't spot with Small Boy, at implantation or any other time, and it would be so late in the game for implantation anyway. Eleven days. But I do remember one night during the Small Boy cycle eleven or twelve days past transfer when I had such severe cramping that I was lying on the floor moaning and I was sure it meant it was all over. But I went on to have a positive beta just a few days later. Implantation cramping? Who knows. I've always thought it was the second embryo (for the initial IVF we transfered two) giving up the ghost. I have always thought that, that both implanted and that night one of them gave up the ghost. But now, in my attempt to cling to straws - and given my apparant fears about my ability to parent a second child I'm surprised at how hard I am looking for straws to cling to - now in my attempt to cling to straws I'm writing a new story line: if that was implantation cramping, then this pink toilet paper is falling at the same time in the cycle and could be implantation bleeding. Maybe I'm just a late implanter? Maybe?

Although I know how pointless it would be I'm considering throwing away the money on an HPT anyway. But it really would be just a waste of money, because if I'm such a late implanter wouldn't the thing turn up negative anyway? And if it turns up positive, then how do I explain the blood but that Draft Pick implanted and then died? Frankly at this point even a positive beta - and I'm going to call Dr. L's office Monday and see if we can't push that up one day - isn't going to be entirely reassuring. You know, what with the blood and all.

Me and my big mouth. Hubris, I tell you, hubris. It cometh before a bleed.

Is that good or bad?

The first time around, while waiting to find out if the Small Boy IVF had worked, I made no attempt to read the tea leaves of bodily aches, pains, changes, ups and downs, and I assumed it would be the same this time around as well. Just wait for the definitive blood test, I think; everything else is magical thinking. But I can't help but wonder, that twinging and pulling I've been feeling all day that sometimes makes me take a sharp breath - is Draft Pick implanting, or dying?

FET update - transfer

We transferred a single two-celled embryo, the Draft Pick, this morning. We didn't get a picture like last time; the lab camera was broken. We did, however, get to go into the lab and look through the microscope, which was totallly cool. The Draft Pick looked good - all two round cells of it. (Yes, we're doing an FET with a TWO. CELLED. EMBRYO. Oh the optimism of it all.) A second had been thawed as well - to transfer one you really need to thaw two in order to be sure you have something good to work with - and didn't look very good; three very unequally developed cells so there is little chance at all that they will re-freeze it. Not much point, really, since it's pretty clear that it would never make it in the Big Leagues.

So our hockey team is down to eight. And the Draft Pick, of course.

Blood test in two weeks.

And just to keep up with my reputation of the ART cycle with the fewest possible updates, I should warn you not to expect any HPTs along the way. I just never saw the point.

Boys, men, and people who think one should not discuss one's girly bits with all the internets should stop reading now

I appreciate that Dr. L prescribes Crinone gel (propgesterone, which has been added to my regimine in advance of tomorrow's transfer) rather than progesterone in oil (PIO). I'm not interesting in giving myself - or, more to the point, having R give me intramuscular shots in my rear for up to twelve weeks, so I really appreciate that Dr. L prescribes the gel rather than the shots. Makes my life easier and less painful. I used the Crinone in the Small Boy cycle, so I'm confident with it.

But I'd forgotten how really and truly icky the discharge is. Yeck.

Transfer tomorrow at 09:45. Small Boy will be spending the day at the farm, and I will be spending the day on the couch.

FET update

The short version is everthing looks good and we've got a transfer scheduled for Tuesday morning.

The long-ish version is my lining is measuring at about 9mm and I'm pretty sure I'm triple-striped. "About nine?" you say. "Pretty sure?" What is this about and pretty sure business? (I was 9.8mm and triple-striped at this point in the Small Boy cycle, btw.) Dr. L took three measurements, one was over 10 - I wasn't reading the ultrasound screen yet - one was 8.9 and one was 9.2, so let's just call it a nine. (Consider it my mulligan for this round.) I only know those precise numbers because I was reading the screen, because it's hard to get exact details out of Dr. L even though it's, you know, my uterus. He's just not a fill in the patient with medical details unless the patient makes a point of asking for it kind of guy and I forgot to ask flat out if I was striped, but from the ultrasound I think I am. I think. To some extent I see his point; what good does it do me to know if I'm 9.8 or 9.2 or 7.5? It's not as if I can do anything about it. On the other hand it's, you know, my uterus. Seems like I'm entitled to that sort of information. At any rate, from the minute the ultrasound started he was all "Schon, sehr schon" and even said "Bravo" so who the hell cares what the exact number was. I'm plumped up and ready to go. Still. Would it kill him to give me the number up front?

At some point I'm going to have to write a post about Dr. L. He's an odd duck. Very good at what he does, and I'd never consider looking for somebody else, but short on the interpersonal skills department. Or maybe that's a culture clash happening, I don't know. He's definitely not the most forthcoming of doctors - maybe he's just traditional and I'm all patient-proactive and give me the details - and not a hand-holder (literally or figuratively). It's culture clash, most likely, and in the big picture not that important. But definitely worth a post at some point.

The non-update FET update

Because I have noticed that I keep getting new traffic coming from being listed on Julie's list, I feel like I should be posting more about the FET for people coming here expecting, you know, infertility stuff. But as I mentioned, we are low monitoring over here in Switzerland and there is really nothing to update. I upped my Progynova from 4mg/day to 6mg/day today - how non-interesting is that? - and I seem to have stopped expanding like a water balloon, thankfully. Other than that...I'm sorry. I've got nothing at the moment.

Ultraschall on Thursday to measure my lining and pin down transfer dates (I assume).

And that concludes this non-update update.

Anybody out there familiar with Progynova side-effects?

Does anybody out there know if I can blame the fact that I have gained a kilo since Sunday - and it's Thursday, people, nine a.m. on Thursday - on my Progynova? And if so, will my weight gain taper off or only increase as I move from 2mg to 4mg to 6mg daily?

Gah!

FET update - no numbers, lots of emotion

There's nothing particular to report; I've got an ultrasound to measure my lining scheduled for Nov 9th and until then I just roll merrily along taking my 2mg of Progynova. Saturday I'll bump up to 4 mg and stick at that for the rest of the week and then bump up to 6mg.

I'm much more low-key about this FET than the original IVF; something about not having to jab a needle in my thigh every night makes this a much less stressful process. (Progynova is an oral estrogine supplement.) That and the presence of Small Boy. I'm very conscious of the fact that if this fails, then the worst that happens is Small Boy is our only child whereas the ramifactions of failure prior to Small Boy were enormous, too enormous for me to contemplate. I can grasp having a single child; I know what that looks like and feels like and I know how to do it. I know everything that's been great about it; it's easy for me to see the genuine positive in it. It takes a tremendous burden off this FET; failure will not feel like the end of the world.

A small part of me wonders if that's unfair. Going into the IVF I was so greedy for Small Boy and to contemplate his eternal absence was heart-rending. To contemplate the eternal absence of Player to be Named Later* is sad; it is not heart-rending. That feels disloyal, as though I committed more to Small Boy, gave more, when he was but a Blob than I am committing, giving, to PtbNL.

I am going into this knowing that succeed or fail, on the far side there is certain happiness. I feel guilty saying that, that if PtbNLnever makes it past 4 cells I'll still be happy. It's the truth, but it feels wrong - it feels disloyal - to think it, much less say it. I'm not saying that it wouldn't matter, that the scales are equal and it's all the same to me if it works out. No. I'm not saying that. But it is true that I'm not as desperate for this to work as I was the first time around. I'm hoping; prior to Small Boy I was wildly longing.

I don't know what to do with this knowledge. It troubles me. It comforts me, because I'm on a much more even keel than I was then, but it troubles me. Am I playing favorites already?

I am troubled.

* R and I call our frozen embryos The Hockey Team, so our still frozen embryo that will be transfered in a few weeks is the Player to be Named Later. You know, as is So-and-So was traded for the number 1 draft pick and a player to be named later. Okay, it's cheesy but once I went with The Hockey Team I got stuck in this sports metaphore, didn't I?

Achtung, fertig, los! *

So today is cycle day 3 (CD3) and I started the Progynova. Tomorrow or Tuesday I'll call Dr. L's office to make an appointment for an ultrasound to measure my lining; that appointment will fall on the 8th, 9th, or 10th - the middle to end of next week - and at that point we'll have a better idea of a transfer date. (I really need to find a better pseudonym for Dr. L than Dr. L, but Dr. SocialSkillsAreNotHisStrongSuiteButIReallyLikeHimAnyway is just too long.) And that's it. No blood work, just the one ultrasound (assuming all looks more or less well) before the transfer. We didn't do blood work on the initial IVF, either. We're low-monitoring over here in Switzerland, so between now and the ultrasound there really won't be anything to report in the FET department.

But technically, this attempt has officially begun.

* Ready, set, go!

CD1

Yep, that's all. Just CD1.

On again

My on again off again FET is on again. We'll be cycling in November, which is pretty much when we were going to cycle before I freaked out and decided that November was too late and tried to squeeze in an August cycle which I then cancelled after freaking out that it was too soon. I find the timing oddly perfect - odd because just a few months ago I thought this same schedule had us waiting far too long before all the right people were in town at all the right times. But now it all just seems to fit: we can go on vacation worry free and I can drink wonderful red wine with my elk medallions and prime rib and buffalo steaks. Dr. L will be away when we return - attending the ASRM conference, actually - but his office will re-open just about the time I should start a cycle. I have the Progynova in hand, so I can start taking that CD3 without having to see Dr L again. We'll both be in town the entire month of November so he can do all the monitoring, and of course he'll perform the transfer. It means not returning to the States for Thanksgiving this year, but that's okay: we've developed a wonderful expats' Thanksgiving tradition here and last year I was sorry to have missed it even though it was wonderful to see my family.

I feel good about this schedule, and it's been really good for my body to be neither injecting, pregnant, nor nursing for six whole weeks in a row (we weaned August 1). After a roundabout trip, I ended up with the schedule we had in the first place. But I think the trip was necessary.

FET update, now regret-free

For those of you keeping track, I had originally planned on undergoing an embryo transfer right about now. And then, just days before I was supposed to start taking my Progynova, I changed my mind. It suddenly occured to me that in four weeks I would be pregnant, and my first reaction to that thought was mild panic and the realization that I'll be exhausted forever. And I realized I wasn't ready to do it. Not just yet.

And did I just say confidently "I would be pregnant?" How odd. You see, in matters reproductive I generally downplay the optimism and throw in a dash of doomsday in an attempt to throw the universe off my trail. I can't help but think that it does not do to be filled with hubris in matters reproductive. We all know what happens to people with a good case of hubris, right? But I'll be honest just this once. Because of my alarmingly lucky IVF track record - we're batting 1.000, after all - I can't help but think in my secret heart that in spite of success rates hovering around 20% (ever notice how they put the FET success rates, which are not exactly encouraging, way down the page?) our single embryo FET will, of course, be successful.

That would be hubris. Which I try to avoid. At least in public. But there it is. What I secretly really think. Keep on moving, universe, nothing to see here. Keep moving.

Sunday I hosted a baby shower for a friend. A baby shower attended by the baby, by the way, who decided last week to make an early and unexpected - and healthy - arrival. And I expected to have some sort of infant envy, especially since there was tiny baby N in my house just a day before I should have been transfering an embryo which we had suddenly decided to keep on ice. And I didn't. I didn't have infant envy, I didn't think "I want one of those," and I didn't even once think "maybe I'll never have one of those again." And maybe I'll never have one of those again, though - look away, universe! - honestly I think when we choose to go forward with an FET we'll be lucky. Why I think that I have no idea, and it's just a giant invitation to be put in my place, isn't it, saying something like that? But baby N spent hours in my house, mostly asleep, and I didn't feel any of those doubtful second-thoughty things I thought maybe I would feel. I take these as signs that I made the right choice, or at least not the wrong one.

And knowing that feels really good.

Murphy's law or something like that

Awhile ago I wrote that we had a schedule for the FET and that we would try something at my next regularly scheduled period, and I made that crack about being more regular than the moon, remember? So doesn't it just figure that I'm late? I mean really. Doesn't that just figure.

Which is actually fine, because, well, because. Because I'm exhausted, my body is exhausted - I got my first shot for the IVF on April 1, 2004, and since that time have been either shooting myself up with hormones, pregnant, or nursing. We weaned one week ago. And honestly? Suddenly I'm really not sure I want to turn up pregnant four weeks from now. I'm really not sure. I'm exhausted. Bone tired. I think my body needs a bit of a break, and I think I'm going to delay my own FET cycle. Who delays their own cycle? Who does that?

I think me. I think I do that.

I think this is okay. I think this is the right thing to do.

I think I think too much.

The pre-season

I saw Dr. L yesterday to get a schedule for the FET.

(And yes, following my track record there in fact was a baby in the waiting room, but in all fairness Dr. L is not exclusively a fertility specialist. He also has a regular OB/GYN practice, and one sees all sorts of people and pre-people in his waiting room. I found that it didn't bother me too much, other than a knee-jerk "yeah, that figures" response - probably because the FET feels less fraught than the initial IVF did. And also because after the Absolutely Unbelievable You Can't Make This Stuff Up Infant in the Office For My Beta Incident a baby in the waiting room is, like, so whatever. The whole Absolutely Unbelievable You Can't Make This Stuff Up Infant in the Office for My Beta Incident pretty much immunized me against all future baby and/or pregnant person in the office during my fertility treatment interactions.)

Anyway. We've got a schedule. I'm doing a controlled cycle, meaning on day 3 of my next naturally occuring period (that's CD3 for short) I start taking Progynova (estrogen supplements) starting out at 2mg/day and gradually increasing. We'll do an ultrasound to check my lining around CD14 and, assuming all looks well, transfer a single embryo a few days after that. Then we wait, wait, lather rinse repeat, and wait some more. Fourteen days of waiting and then we do the blood test.

And this time there'd better not be a baby there. And she'd better not hand it to me.

Moving forward with the FET

I need to see Dr. L again sometime in the next two weeks/ten days. It looks like although this cycle was a bust, everybody who needs to be around actually will be around at the right times for the next two cycles. Unless my period, which is so regular that the moon checks in with me to see if she's on schedule, decides to go hinkey on me. Which, in spite of my tendency for negative thinking in all things fertility related, even I don't think is going to happen. Wow. This might actually happen this summer after all.