The Inseminator

We did an IUI procedure this morning. No one told us that we had to abstain for 24-36 hours before, so D's semen volume was about half of what it should have been ("the other half wasn't wasted," the doctor said.) but the percentage of motile sperm was extraordinary (a fact that D is very proud of), so the doctor said that this made up for the lack of volume. We had to wait 45 minutes while they "washed" the sperm, so because I hadn't done that level of planning, D had to run off to work. I went to get a yogurt from Starbucks as a prophylactic against the impending yeast infection likely to follow the super-dose of doxycycline that I had to take the day before, the day of, and the day after the insemination.

The procedure itself was as uneventful and painless as all of the online information I read described it to be. The doctor used "the inseminator," (package pictured above) which was a syringe with a flexible catheter attached. She used a speculum, and then urged the catheter up through the cervix, which she said was "hiding." (They say that about my left ovary sometimes, too. Weird.) She told me as she was inserted the washed and concentrated sperm, and then she turned out the lights and told me to take a little nap for about 20 minutes. But my mind was racing and I started worrying about whether the seepage was D's sperm saying "oh, no you didn't!" and rushing back out because they didn't like the egg for some reason. I wanted to jump up from the table and ask someone, but I stayed still--if not calm. Then I started worrying about whether they'd forget me in there, and the fact that I had to get to a meeting by noon (it was already at least 1030 am). I spun the computer screen that was in reach towards me and it appeared to be 10:50, so I figured I would give them ten minutes to come and get me before I got up and got dressed. No one came to get me, so I just got myself ready and on my way out, I asked about the seepage and was assured that it was completely normal. (I didn't believe it, though, so googled it as soon as I could. It's fine.)

So, I don't want to jinx anything, but I have to say, if we're not successful this month, I have a list of things to remember from next:

1. Have sex 36 hours before the IUI so that the sperm is fresh, but abundant.

2. Build in enough time for the partner to be there.

3. Take your iPhone to the table so you can time how long you've been laying there, and have something to distract you with (maybe even update Facebook while laying on the table).

4. Take the day of the IUI off so you don't have to rush back to work.

5. If you do rush back to work, make sure you don't jump on the train going the wrong way, start reading, and not realize that you're in Queens until you're like, halfway into Queens half an hour before your meeting starts.

Intrauterine Attempt #1

Tomorrow morning we're off to the doctor to give D's little guys some direction. When I went for my check-up yesterday, the doctor told me that I had one really good follicle that will absolutely produce one good egg. She said we'd be ready on Friday morning. D had to give me the trigger shot (obtaining the medication is a whole nother story that I'll deal with in a separate entry) at 9 pm on Wednesday.

My insurance company covers at least three intrauterine insemination attempts (IUIs). Tomorrow begins another two week wait. I should have sushi tomorrow night.

The latest worry: a friend telling me that the quality of a woman's eggs at this age can mean that if assisted fertilization and implantation actually does happen, a less-than-perfect egg can produce a child with flaws. I harbor no illusions that my possible future child will be perfect; no one is. But to intentionally create a less-than-perfect infant....gives me pause. I gotta find more information about that.

Sushi Panic

On my way to the doctor's office on Wednesday morning, I had a thought that made me gasp: if the test indicated I was pregnant, I hadn't had any sushi lately, and from what I understand, sushi is verboten during pregnancy. Many a friend has counted down the days until she could drink and eat sushi again.

For whatever reason, the universe said no to conception this month, so we went out for sushi.

What's Going On Up in There?

It's so mysterious, this female reproductive system of mine. As prescribed, D and I made love this morning and I stayed still for 30 minutes after as I imagined the journey of the millions of little spermatazoa, excited by their sense of the egg(s)--their destination. All day long, I've been walking around thinking: Did they make it? Did more than one make it to more than one egg? If three made it, will all three attach to the lining of the uterus? What's going on in there? I want to go to a lab, hop on a table, and have them look inside and show me what's happening. It's hard to believe that such life-altering, momentus things might be happening (or not) inside my body while I walk through the mundanities of my life--doing dishes, feeding the cats, sitting in meetings . . .

Drugs

A few weeks ago, I started getting a series of calls from Cigna saying that I had ordered some drugs and where did I want them delivered. I'm like: "what drugs? I didn't order drugs! Put me on your 'do not call' list." Then I find out that the drugs my doctor prescribed were supposed to be delivered to me, and Cigna was calling me to confirm delivery address and get my credit card number for the copay. Fed Ex next day delivery to my office the next day allowed me to start this course of treatment this month. Thank you Fed Ex. Except one more problem: they didn't send the pre-filled syringe of hCG that they were going to--the shot that releases the eggs. Apparently it's a controlled substance and they only fill it upon a written scrip. So I call the doctor back, and they say that Cigna is notorious for this kind of screw-up; of course they mailed the scrip. Cigna just always loses them. So I ask to speak to the doctor to see if I can figure out whether the rest of the drugs (the clomid, the ones pictured here) will boost my chances enough so that I can risk maybe not doing the shot this month, or whether the hCG shot works in tandem with the rest of the drugs such that I should fork over the $90 out-of-pocket expense. The doctor's assistant got back on the phone after about 15 minutes and said that the doctor just happened to have an extra shot in the office and they'd administer it for free. Bingo. So, off to the doctor I go again, shot in the butt, and I'm off. Doctor advised us to make love that night, and then again Friday morning. (The math is just crazy: shot releases the eggs in 40 hours; sperm lives for 72 hours; egg lives for 12-24 hours unfertilized; sperm takes 30 minutes to reach an existing egg...) Unfortunately, I was so exhausted from work and running around all week that I just could not muster the energy for seduction. Thankfully, D knew what he had to do, and while it didn't work out that night, he dutifully performed the next morning. We were prescribed one more try on Friday morning (several hours after the eggs are supposed to have been released), and I've already arranged to go into work a little late, so we're cool. Pregnancy test on December 1, and if we're not successful, we try again in December. It's super exhausting to deal with all of this, but I feel like we're taking the right steps.

Offbeat Mama

I just read an amazing blogpost on Offbeat Mama. The founder of Offbeat Bride, the book and accompanying social networking site that helped me keep my sanity during our year-long wedding planning process, started Offbeat Mama, right around the time of our wedding last May. I check back every now and then to see if she creates a feature, like the Waiting Room on the Offbeat Bride Tribe website, for women who are trying to get pregnant. I don't think she did (yet), but I did find this post, by Ariel, the founder herself. She introduces her own story of problems conceiving with a video by a woman who poses a series of "what if" questions...questions that have been swirling around in my mind about infertility for the past year. I have been searching for something to read, something that I could identify with, around all of this for the longest time. My husband is so certain that it will all work out in the end, he insists on speaking in terms of "whens" as opposed to "ifs." Ariel's story was poignant, and scary . . . I hope I only have to go partway through the course of action she had to take in order to become pregnant. But I've already gone farther than I thought I would in order to conceive.

Two parts of Ariel's post particularly resonated with me:

the weight of the trying and failing got heavier and heavier. After a year of trying to conceive, it's not so much fun. It's depressing. It starts to mess with your head. I started feeling like a core part of my body had become an untrustworthy stranger. A breech of trust with your own body is emotionally brutal.

And this one, which describes so many things in my life about which I've harbored fear and loathing:

IVF was this terrible awful procedure that I'd invested a lot of fear in. It just didn't fit with my identity — who's heard of offbeat infertility? Offbeat IVF? Pshaw. It was the expensive invasive terror that desperate people indulged themselves in. It was like gambling: this thing that you keep tossing money at hoping that this time you'll win but ultimately the house always wins and you always lose. Of course you lose. It makes you crazy, and worst part? It doesn't even work most of the time.

. . .

What I want to say is this: I was wrong. I invested years of my life living in fear, seeing something (in this case Western fertility treatments and especially IVF) as the awful boogey man in my hippie closet, the terrible admission of defeat that would forever turn me into a person I hated myself for being. Ultimately, I was wrong. This makes me wonder ... what other massive fears of mine are completely unfounded? What other things that I see as the worst WORST case scenario could actually lead me to a place of profound happiness? What other paralyzing grief and fear could I release?

Indeed, the ovulation test showed a surge just an hour before I was to leave the house and go away for the weekend with my girlfriends while D packed up to head off in the opposite direction to a frisbee tournament. Thankfully, we had given it one try in the morning before we knew the surge was positive. What happened that day, however, I think will bear more fruit, so to speak, in the coming months. We had a really difficult discussion about priorities and our approach to this whole babymaking project that will be helpful next month. And then we gave it another try before I ran off to catch the train. : )

To my delight, D actually drove up the Catskills from his tournament in Philadelphia so that we could log one more attempt during the second fertile day. I love him for that (and so many other things).

I don't want to say "fingers crossed," because I don't want to set myself up for a big disappointment in two weeks, but I can honestly say that we gave it the best try yet.

Now, I just have to make sure that I scale down the stress level next month.

Hundreds of Women Crying

I cry alot. I cry at dog food commercials, I really do. I wear my heart on my sleeve. What I don't understand is why you don't see more people crying on the subway. I come into contact with thousands of people a day in my travels through this big city, and I wonder about the folks around me: didn't anyone get dumped today? didn't anyone lose a friend? didn't any of these women just find out that they weren't pregnant? I mean, there must be thousands of women in NYC trying to get pregnant. Odds are I'm riding the train with some that aren't finding success; I mean, jeez, it seems like I run into a pregnant woman every 30 seconds these days. So why aren't more women crying? Or are people generally better able to keep it together in public places than I am?

Hysterosalping-o-what??

Hysteria After a tumultuous weekend, I feel like a stereotypical woman who, at the turn of the century, was diagnosed with hysteria. I got my period early Sunday morning and completely freaked out. My reaction to finding out our July attempt was not successful was very different from last month--I was totally sad, blamed my partner for not trying hard enough and being not as concerned as me, and I was angry about everything: I was angry that he was on the conputer playing video games, angry that he wasn't helping me around the house, and angry at everything he did. I should have been put down with a horse anesthetic.

Dictionary.com defines hysterical this way:

hys·ter·i·cal

   /hɪˈstɛrɪkəl/ Show Spelled[hi-ster-i-kuhl] Show IPA

–adjective

1. of, pertaining to, or characterized by hysteria.

2. uncontrollably emotional.

3. irrational from fear, emotion, or an emotional shock.

4. causing hysteria.

5. suffering from or subject to hysteria.

6. causing unrestrained laughter; very funny: Oh, that joke is hysterical!

---

Origin:
1605–15; < L hysteric ( us ) hysteric + -al¹

1610s, from L. hystericus "of the womb," from Gk. hysterikos "of the womb, suffering in the womb," from hystera "womb" (see uterus). Originally defined as a neurotic condition peculiar to women and thought to be caused by a dysfunction of the uterus.

He didn't deserve my ire; and I shouldn't have let myself go off the deep end either.

Take steps; take charge. That's what I did on Monday morning.

I made my annual OB/GYN appointment and asked about a procedure called a hysterosalpingogram that a friend recently told me about. Dye is inserted into the uterus and fallopian tubes to determine if the passages are clear; and apparently, there is a slight increase in fertility after the procedure. I want it. My doctor called me back and told me that since we'd only been trying really on the right schedule for two months that he wouldn't immediately advise me to do it. He suggested waiting for two more months, sending D off for sperm analysis, and being persistent. And patience. He didn't recommend patience, but I think patience is in order. Even though I feel the clock is ticking.....

On the kitten front: D's friend brought over our one-eyed kitten to see if she got along with our existing cat. Things seemed to go well. Kitty Coco (the one-eyed one) will have her sutures taken out next week, and then, if I can get D to agree, we will bring her home.

Happy Implantation Day!

Today would be the day that the egg would dig a comfy little nitch in my uterus if all else went as planned. If the egg is fertilized, I hope it finds the space acceptable. : )

Finally, a surge!

Well, already our zero dollar baby is not a zero dollar baby. I've spent well over $50 on ovulation tests so far! ($15.99, $23.99, and $22.99 respectively)

Yesterday, I almost became hysterical when the test, again, failed to show an LH surge--the sign that you are about to ovulate. I let out one of my banshee yells (which David hates), spent about an hour googling things like "Does no LH surge mean that I'm entering early menopause?", and then finally made up my mind to be calmer and go through with the plan--have sex anyway and just cross my fingers. I didn't get to the stage where I attempted to make peace with the fact that we might not be able to have children--I'll save that effort for a more desperate time.

This morning we tried again, and after breakfast I walked up to the drugstore to purchase yet another kit. This time, I bought the one with 20 test strips (I've been testing 2-3 times a day).

I waited a few hours, tried not to drink too much water, and when I finally tested at around 2 pm, voila! The test line was darker than the control line, which means that there is now an LH surge. I think this morning's attempt was perfect timing. Now we just have to keep at it for another day or so and hope for the best.