Empty Circle means empty uterus

When i was responding to comments on my blog yesterday I was struck by two comments...  one person suggested that the circle was a fill in the blank... leaving us to put our own emotions on the lack of ovulation.  Another suggested that it was because it best expresses how you feel with negative test after negative test... that empty feeling inside.  As a result all I can think now is that the emptiness of that circle will lead to another emptiness in two weeks time.

Despite the continuing negative tests and the absolute lack of a faint line at all on any ovulation test at all I am playing the second guessing game:

1) did i miss it?
2) is it going to happen late?
3) did it happen early?
4) maybe I didn't do it right?
5) my boobs are sore, so I must have ovulated right?
6) my BBT is a little higher than normal but not as high as post ovulation - what could THAT mean?
7) maybe I am already pregnant, and what I thought was my period was actually just break through bleeding and i watched this show where this woman didn't know she was pregnant until she actually gave birth so it could totally happen even though there was a wand looking at my uterus on day 3 of this cycle and they took blood and they saw follicles growing for my next cycle... it could still happen right?

I sometimes wonder if delusions is a symptom of infertility.  I so desperately want to be pregnant that I am willing to play mind games and engage in a complete suspension of disbelief.  But, I should probably accept the reality... this is not going to be my month.  But, to be honest, I'm still going to play the maybe it happened game.

Our visit to the clinic. Part the First.

First, I want to say that I think I love, love, love our RE.  She is funny and nice and when she took my medical history and heard I'd had a miscarriage she said "that sucks" which to me is exactly the right thing to say, because it does and it did.  And there are no right words to make it better.

I am a little annoyed that she seems to be pregnant herself, but about 4 or 5 months along... I will try not to hold this against her as she pushes her 8 month belly into my face at our next appointment.

She wants us to try, with miliatary precision for the next 3 months again.  I don't know what it is about the 3 month waiting period but all the doctors seem to want to prescribe that first.  It is mostly because we did get pregnant within 6 months even if it didn't stay.  She was less enthusiastic about my AMH numbers than my doctor was, she thinks my doctor might have checked the wrong units, so she's ordering that again.  My husband is quite relieved that his sperm is very normal and he can go back to his Y fronts.... I think the ones I bought him are much sexier... maybe i can make an argument for boxer briefs.

Right now we have blood work ordered and I have to do a follicle test on day three.  So, i'm sitting here hoping my period makes an appearance early enough today that I can have the test done on Sunday morning rather than Monday.  I don't want to fight through traffic to get to the clinic on a weekday if i can help it and my husband would come with me on Sunday which would be nice.  I like when he's there.  He makes me smile. 

I don't think i've ever wanted my period to come so badly.  I mean I shouldn't be hoping right, until it does there is still a chance that I could be pregnant.  But I've pretty much given up that hope this month because my temperature has been a little bit lower the last couple of days.  I"m pretty sure it was 36.26 this morning... but i took it in the middle of the night and i sometimes dream that I do that.  And when I took it when i woke up this morning it was 36.5 but I had been awake for about 5 minutes and snuggling with my hot blooded husband.   He's nice to snuggle.

We decided to go out for dinner last night to celebrate the fact that we won't have to pay for any fertility treaments for at least 3 months and we went to the Keg.  The Keg is a Canadian chain that is sort of an upscale steak house.  My husband ordered prime rib but instead got brought a sirloin.  We only just politely asked what we had and they tried to replace his meal.  I pointed out that my husband didn't really care what kind of meat he had as long as it wasn't made of soy.  They sent over the manager to make sure we were ok and she comped us his meal and a dessert each for the mix up.  I want to say that The Keg has the BEST customer service of any restaurant that I have ever been to.  They bend over backwards to make sure you enjoy your dinner and that is one of the reasons my husband and I go so often.

Plus if you say "How are you?" they respond "I am well, Thank you for asking", which is so cute it makes me giggle. 

What goes well with stirrups?

Yep... .i'm nervous as hell right now.
Our appointment is today, at 1:30pm.
Gulp

Getting dressed this morning was weird. I decided on a tank top to make taking blood easy, under a jacket to keep warm and decided to go with blue jeans.  I don't really work in a blue jeans kind of place.  But I can go days without seeing any of my colleagues just because of what I do, and since i intentionally didn't schedule any meetings today I am sort of hanging out in my office.

I wanted to feel comfortable as I walked into the office today, or at least look like I felt comfortable, and blue jeans will do that for me i hope.  My husband is leaving work today at noon and we are meeting at home to travel there together.  It's a bit of a backtrack for him....  He works North of the city and we live East, but i didn't want to try to deal with two cars there, and i need him to hold my hand through today.

And I want to be able to analyze and discuss everything that is said to us in the appointment on the drive back home, not being trying to fight through both traffic and tears at the same time.  Anyone been through this already?  Help!!

Baby on Credit

If there is one thing that I knew about IVF before we started on this journey it was that this wasn't going to come cheap.  We still don't know exactly what this will cost us of course, we don't know what treatments we will need.  We don't know how many it will take before they are successful.  So, even though we can look up and see that our fertility clinic will cost us about $1,500 for an IUI that basically tells us nothing.

My husband and I decided to go to the bank yesterday to see how much money we could arrange before our appointment at the fertility clinic tomorrow (Gulp!).  I know the clinic offers financing, and no doubt they will pretty give you anything since they are filling a space in your soul and you know you will pay anything to have that baby you want so badly, but we also wanted to know, financially what our other options were.  Who knows if the clinic will give you the lowest rate?  Maybe it's like a credit card at 20% where you will be required to send all of your frozen embryos out to work just to pay it off.

The woman at the bank was ridiculously happy for us.  "Fertility treatments!  How exciting!"  My guess is she is baby crazy, but still confident that her nubile body will produce the children she is going to have one day... she doesn't understand that fertility treatments are filling me with dread and fear not excitement.  

She notices the title "Dr." attached to my file.  I hold a PhD and it has been put on my file as such.  But she mistakes it for an MD.  "I think we can get you a business loan.  It has a much lower interest rate."

There is nothing more ridiculous to me than the idea that our baby making be financed by a business loan.  This is not an investment that is going to be paid off any time soon. This is a long term investment that is going to require repeated infusions of cash as our child struggles to define themselves throughout childhood and adolescence.  Unless our child is the next Justin Bieber (and i really hope not after watching his latest string of petulant tweets) there is little hope that this baby is going to post a profit margin in the first quarter of his or her life.

How solving a mystery can result in pregnancy symptoms

I have no doubt that the phenomenon is well studied by any woman who is currently trying to conceive.  It is almost mystical the rate at which she can develop every symptom known to affect those in early pregnancy simply by reading a list.  Like the "communicated" wind turbine syndrome  early pregnancy symptoms are, no doubt in my mind, completely and totally caused by the nocebo effect.

In one of my many dozens of searches I have done over the years into "early pregnancy symptoms" I once came across this sage advice:

Remember, many pregnant women who were not trying to conceive do not even realize they are pregnant until well into the first trimester, meaning that symptoms are often subtle or nonexistent during the two week wait.

Oh, yeah... that is definitely advice i need to take.  It should help me to stop googling symptoms to see if that twinge in my back, that dryness in my mouth, that queasiness in my belly could herald the arrival of a baby.  Of course it never does.  Every month I announce to my husband "I'm pretty sure I'm pregnant.  Don't you think?  Do you think I could be pregnant?"  He wisely nods yes and we play this game for two weeks until my period arrives and brings with it a flood of tears.

So, this month when i was convinced that I had not ovulated  my boobs felt no bigger than usual for a period.  The nipples did not seem to mysteriously darken in certain light (duh... that's called shadows) and my cramps seemed to be nice normal run of the mill pre-menstral cramps... gearing up for the visit by the painters on Thursday or Friday.

That is until I ran a single Google search yesterday at lunch: "Can ovulation be delayed after a positive OPK?"  Well, as usual The Google Oracle spit out an answer and in summation the truth is that sometimes it can take as much as 3 days for your body to experience a thermal shift after ovulation has occurred.  And now my pattern is definitely biphasic... which means suddenly these damn breasts seem so sore... and I can't seem to stop feeling them (making them more sore no doubt).  And I'm definitely tired this morning.  Really tired.  And... damn... i'm playing that stupid two week wait game again. 

Coming out of the IVF closet

I suspect it all starts with the taboo of sex.  It is something that we aren't supposed to talk about.  We sort of vaguely know that other people do "it" but we don't want to know the details.  Especially when it comes to our parents. 

This is of course different with girlfriends.  They know I have a very raunchy sense of humour and love to joke about sex.  A friend has never started the sentence "I just have to download some..." without me finishing for him "porn" even if that's not what he has in mind.

As a young woman, having her first sexual encounters my parents were the last people I wanted to find out about it.  They never knew anything about my first.  Even with my husband I have trouble admitting that there were men before him. 

I suspect that is why it all seems so strange to have a conversation about IVF with those very people.  See, sex is what is supposed to lead to babies right, and the fact that we haven't yet, even though we are "TRYING"... that's something that is hard to say to my parents.  "Yes mum, even though we have sex throughout my fertile period we haven't had success".  "Yes dad, we tried all of the positions designed to put your son-in-law's penis close to my cervix during ejaculation".  Ug.  Not a conversation I can have.

Still... through a bunch of tears I managed to choke it out over the weekend to my mother.  Not the imagined conversation above... Not with that detail.  But yes, that we were going to go to an IVF clinic.  That it was going to cost us thousands of dollars to give them a grandchild. 

I wonder if we could post it on kick-start.  Anyone wanting to give a full round of IVF would have naming rights.  Anyone contributing a half round of IVF would have the baby's room named after them.  Anyone paying an IUI would be able to have his or her name embroidered on a bib.

Dear BBT, WTF?

BBT:36.79 yesterdays BBT: 36.54 Thursdays BBT 36.71
So, I had a low BBT for two days following my expected ovulation, and so i mourned slightly the lost chance for getting pregnant, my bank account mourned a LOT and my bank rejoiced knowing they were going to be able to post record breaking profits as we pay a team of doctors to stare at my cervix.

Now, it seems my BBT likes to play mind games with me.  For the last 3 days my temperature has been up.  Why??  What does my body gain from torturing me.

Now of course things like alcohol can raise my BBT.... and I may have had a glass of wine last night... but just one!  But that doesn't account for the torture of the last three days.

Has anyone else ever experienced this?  Can it be a delay in ovulation?  If so I'm not sure we timed the baby dance right.  So did we waste our last precious month??!!

Why some two week waits are shorter than others

Years ago I was moving back to Canada from the United States and I contracted a storage facility over the phone to rent a 5 x 10 storage locker.  On moving day I pulled my U-haul truck up to the front door with all of my possessions inside and i started unloading.  I took one look at the storage room and I knew there was a problem.  There was no way this space was a 5 x 10.  My stuff wasn't going to fit.  We paced it out and the room ended up being a 4 x 8.  "Listen lady", the manager told me "Some 5 x 10's are bigger than others".  I refrained from asking him if he was using his penis as the measuring device.... but just barely.

This is when I first learned that standard measurements are not always that standard.  My period has also learned this lesson.

When I first went to see my doctor about going to a fertility clinic she asked me if we were "trying" for a baby.  I told her yes, we weren't using birth control.  That is the day that I learned that trying was something completely different.  And we introduced things like the basal body temperature (BBT) and the ovulation prediction kits (OPK) into our marriage and instructions from my doctor that it should be "military style"... which isn't a new position, it was her code for timed, on demand sex.  She suggested this for 3 months.... if nothing stuck she would refer me to the fertility clinic.

I've since told my doctor that I've had worse prescriptions.  And we try to make sure it is fun and flirty and not any of the "just shut up, i don't even want to talk to you right now, but we need to have sex because it's ovulation time" sort of sex that I've heard of from other people I know.

Military style though has made one thing very clear to me.  My two week wait is shorter than others.  It seems to go from 9 - 10 days.  Which is on the very cusp of having a luteal phase defect according the The Google.  See the Luteal Phase is the time in your cycle where you have progesterone coursing through your body and it allows the fertilized egg to implant in your lining.  It is normally 10 - 14 days, though most common is 14 days.  Anything shorter than 10 days is considered to be a defect which can prevent the implantation of the egg.  This was a bit of a revelation for me, and something I never would have found out without all of the joys of sticking a thermometer in my mouth before kissing my husband in the mornings.

The Google of course had suggestions.  Apparently "some people" report a lengthening of the luteal phase with vitamin B6.  I'm always somewhat suspicious of anything that says "some people", but since there doesn't seem to be any toxicity i can find associated with vitamin B6 I am trying it for the first time on this cycle.  We will see if it makes a difference. 

I am of course hoping that this apparent Luteal phase defect is the cause of our infertility.  The cure seems to be straight forward... throw a little progesterone on and you can fix anything.  Of course the testing required to make that diagnosis official is probably awful.  It seems to involve biopsies and needles stuck through places I don't want needles to go. 

I don't know how I feel about herbal medicines.  I am trained as a scientist.  I want to see results and studies done with proper controls... but I also can't help but think... "well, what if it is that
easy, just take a few vitamins..."

Especially since I don't think there is any chance of being pregnant this month. 

Procreation versus Recreation

I told my husband over breakfast today that we never need to have sex again.  He made me explain myself.  I pointed out that any further actions my husband and I take in procreating will be facilitated by doctors and speculums and needles... oh my!  Therefore we didn't NEED to have sex ever again.

My husband looked at me with an arched brow "Really?" 

Well, of course not.  My husband knows me well enough to know better than that.  But as I point out, after nearly a year of focusing on the procreation from here on out we can just consider everything to be recreation.  

"It's good right?  You'll know that I'm not using you for sperm anymore... I'm just using you for sex." 

The idea of having a baby has definitely had an impact on how we view sex.  For a few days every month there isn't the option of if.  Or which position.  Or what time of day.  Everything has to be planned.  And there needs to be enough time afterwards for me to practice my hanging upside down yoga.  (I actually have no idea if there actually is any improvement in pregnancy rates for women who contort their bodies after sex.  But it sure decreases cuddling.)

Now, we can go back to the way things were before right?  I mean just because we don't have to be in the same place when we conceive our child... but we can sure make sure that we are together when we practice. 

We celebrated by being a bit late for work this morning.

I guess the chicken comes first...

Basal Body Temperature:  36.27

In the old riddle "which comes first the chicken or the egg" you know if your BBT doesn't rise there is no egg.  Therefore, the chicken comes first.

I had harboured these secret unrealistic hopes and wishes that somehow we would squeak one in.  That I would go meet our reproductive endocrinologist and she would order blood work that would reveal their services were not necessary because we were already pregnant.  That will not happen.

So, in a bid for silver linings I am happy that we will not have a baby born too close to Christmas, because that always sucks.. plus we were sort of thinking of doing Christmas in Florida this year and waking up to sunshine instead of snow.
 

Did I or didn't I...

Temperature:  36.22 or 36.77

Last night was a late night.  Very late. 

I woke up this morning in time for work... took my temperature and fell asleep while doing it.  The beeping of the thermometer woke up me... it said 36.22.  But... was it actually in the right place, under my tongue, or was it off to the side as my tongue lolled out of my mouth.

Then... when I woke up again and the reading on the temperature was 36.77.  This is higher than normal for my BBT post ovulation.  But I don't know if i was asleep long enough after getting out of bed for it to be my BBT.  Actually it is higher than normal for my non-basal body temperature.  So, i am left in doubt.. .did i?  or didn't i?

I know that you can have an LH surge from the ovulation kits and not actually produce an egg.  So, I don't know yet if have a chance to get pregnant this month or not.  I will have to wait until tomorrow.  I don't want to wait until tomorrow.

UPDATE:  when I got home from work I noticed that you can get almost a 1 C temperature drop if you take your temperature with your mouth open. So I am keeping my fingers crossed for tomorrow.

The Big O...

Do you remember the time when if you got a text message asking if you'd O'd this morning it was from an insecure lover wondering if it was good for you?  Not anymore.  Now all of the O's have to do with Ovulation.  The biggest most important O in my life right now. 

I have learned a lot about ovulation through charting my temperature.  But although this seems like a really easy task it can become ridiculously complicated.  Your basal body temperature (BBT) is supposed to be taken as soon as you wake up.... errr... following at least 3 hours of uninterrupted sleep that is... which is where it becomes complicated for me.  I will often wake up during the night, and now as soon as I do I become obsessed with the fact that I have to take my temperature.  Since my thermometer is not lit (which is a really stupid for a digital thermometer that you are supposed to check before you are allowed to even get up and pee) this is something i have to manage in the semi-darkness and something i try to do without waking my husband.  So, if I wake up in the middle of the night then I will take the temperature, and try to read it in the bathroom.  If i just wake up because I am tossing and turning then i will try to take the temperature and try to see the numbers by the glow of my cell phone.

The problem is that this often leads to 2 or 3 different temperatures being taken in the course of the night.  So which one is right.  Normally I take the lowest temperature.  This is an especially important rule during the two week wait because that plummet of temperature the last 2 days before my period are the early wake up to the fact that I am not pregnant.  But today is (possibly) ovulation day.  My first temp was 36.12C, then I woke up sometime in the middle of the night with a temp of 36.25C and finally when I woke up this morning it was 36.42 C.  So... the question is... is my temperature up because I ovulated?  Or is it up because i wasn't asleep again between the second and the third time.  My "coverline"  the imaginary boundary that my temperature crosses when I ovulate is around 36.55.  Are we almost there?  is there an egg lose in my fallopian tube looking for a partner?

Cross your fingers, hold your breath... the two week wait has begun. 

A two week wait I never expected!

OMG!  I have a sneaking suspicion that we are the luckiest couple ever to have to go to a fertility clinic.  I had expected that it was going to take us months to get in.  I had even anticipated that it would be at least June because I try not to set myself up for disappointment. I have already calculated exactly when we would have a monitoring cycle, and when we would have our first treatment and when we could either get our first BFN or the BFP that we want to bad.  It was like August.

 But no we have an appointment in only two weeks!  Crazy. 

I am overwhelmed and shocked.  That's so soon!

You would think that any woman who has tried to get pregnant would find the two week wait to be a breeze.  I find after a year of trying I have a routine for the tww.  I know which days to start feeling my boobs to see if they are swelling, i know which days to expect the cramps... i know exactly which days I can stop feeling hopeful...

This is a two week wait i have no idea how to handle. 

Missed periods and opportunities

I never know what to say.

We've only been married for 9 months, but we're old... I am 39, my husband 44 and this fact is not lost on any of our friends.  And so the comments come up, a lot.

And the funniest part is no one ever questions the if... they question the when.

Let me start with Saturday... we were at a party with some old and cherished friends of my husband's.  They all have kids... some one, some three, some through adoption or ivf or some through what comes naturally.  But they all have them.  And they all can apparently hear my biological clock.

I am drawn to kids.  I love the things they say, or how the brother and sister gang up to keep me trapped in our modified version of Mouse Trap.  I love how they will hop into my husbands lap and confess that her parents met each other before they met her, and when would we meet our kids?  And i actually love the one little boy who argues with me and tells me that I am a mom. Because i completely feel like I am.

The kids are too precious to me, each one of them funny and charming, and sometimes spoiled and difficult, but they are perfect.  You can see why their parents love them so much.  And this natural inclination in me, to listen to children as they talk, and play with them sitting on the floor in the midst of a pot luck where i was required to read name tags before addressing the veritable strangers who greet me as a best friend merely as an extension of the man I married, this is what leads them all to say "when we have kids".

"You are so natural, so maternal" says our host as she admonishes us to hurry up and get on with it.  See, the thing is... i'm a bit shy.  I can be dirty and raunchy and funny.  But this journey is so incredibly personal and so incredibly painful that I can't talk about it yet with my family, or friends, so far it is my husband and any hapless wanderers to this blog page.

I am fairly certain that this is why i have the blog.  Because i feel like i am able to confess my secrets, the way you might confess to a stranger on a plane who you will never see again that you cheated on your high school boyfriend.  It is cathartic and it prepares me for the question of "when" from the people in my life.

The problem is that for us it isn't a when.

On my 39th birthday i had my period start about a week early.  And then after 24 hours of a very minor period it stopped.  And I knew that we had finally got the best birthday present ever.  Our baby.  A pregnancy test on cycle day 27 revealed i was pregnant.

Two weeks later I wasn't.

It was devastating.  There's no other words.  The pain was unbearable, not just physically but my heart was wrenched from my body with the loss of that pregnancy.  And i knew then why you wait until you are 13 weeks to share the news.  Because the pain is so great that you carry that secret with you deeply inside what is left of your heart.

Our baby should have been born in May.  Which always leads me to think about where i should be right now in our pregnancy.  We should be fighting over names and picking out furniture for the nursery.  Instead I am peeing on ovulation prediction sticks again.

And the hardest thing is I never know how to answer the questions.  Do people want to know about my phantom baby that still lives in my memories?  Do they want to know the pain of each month realizing that the two week wait was for nothing.  Do I smile and laugh and pretend it doesn't matter and then collapse in tears in my husbands arms as soon as we get to our car?  Do people want to really know that we are "trying" and all the inherent unromantic it-doesn't-matter-if-you-are-tired-tonight-you-have-to precision of it all?

Or do people still think that the stork brings babies... and we just haven't bothered to call and order ours yet?