IVF

I've decided that this whole IVF process is kind of a big mind-fuck. The last time I thought something was a mind-fuck was the California Bar Exam. That one was truly a mind-fuck. Maybe IVF is a mini-mind-fuck. I dunno.

The process can be brutal. Luckily (or not, depending on your perspective), medically I have been through a lot worse. 11 years ago I was diagnosed with a blood disease callped TTP, which is a rare side effect of e-coli poisening. I lived on the brink in the ICU at a San Francisco hospital for 39 days, with daily bouts of plasmapheresis, dialysis, blood transfusions, chemo and all sorts of other crazy and invasive things. I'm not going to dwell on that whole experience now (save that uplifting story for another day!), but I will say that it made the IVF process, which many consider absolutely horrifyingly invasive, to be, well, not quite as horrifying.

That's not to say it didn't stress me out majorly though. The multiple early morning doctor's appointments, ultrasounds and bloodwork didn't really bother me. There were only two really terrible parts, the shots and the financial worries. But let me walk a beginner through the process:

THE SHOTS: After I had the aforementioned (in previous blog) cysts removed, they started me on teh shots. Oh the shots. I didn't sleep for 2 weeks because of the stress of giving myself the shots. At night I knew that I had to wake up in the morning at a specific time to give myself a specific shot, and there was nobody around to make sure that I didn't (a) screw it up or (b) chicken out. Well, my dog was there, and he watched with a timid curiosity, but he certainly didn't tell me if I was using the wrong needle gage or mixing my meds improperly. His role was purely cuteness support (which, by the way, cannot be underestimated).

Anyhoo, the shots really sucked. By the end I had bruises on my belly and both thighs. I was obsessed with the chart that my doctor provided to me (updated at each visit) with instructions on which meds to give myself each day. At one point I was injecting myself with four separate shots per day, plus giving myself estrogen patches, multivitamins and various other assorted hormonal thingies. Some of the meds had to be refrigerated, and others didn't. Some meds came prepackaged with needles and syringes, and others had to be put together by hand. For an English major with a fear of needles, this was not fun. My hands shook every time. I fucked up a couple of times but mostly I was able to do it. I was even a little proud of myself for the accomplishment of getting through each round.

THE APPOINTMENTS: So I went in for early morning (pre-work) ultrasounds and bloodwork every two days until I had enough mature follicles to remove. To no surprise to anyone, my follicles did not grow as quickly as the doctor would have liked, so I ended up having to take several extra days of the damn shots, and still only had 3-4 potentially decent follicles. When they finally said I was ready to go, I gave myself one last shot (HCG, to trigger ovulation), then the shots were thankfully done for the cycle. 35 hours later, I went in for the egg retrieval.

ACUPUNCTURE: In addition, I was seeing my acupuncturist once a week. I know so many people who swear by it, but I have to say I did not enjoy it. Who the hell likes to know they have needles sticking out of them all over their body? What if there was an earthquake, or I had an anxiety attack and had to puke? I definitely didn't like the feeling of being trapped on that table by myself. I did it weekly for about 2 months but then I ran out of money so it has to be the first thing to go.

FINANCES: The other stressor, which I have discussed on this blog at length, was the financial commitment. That stressor will be here long after the 2WW is over and will haunt me for years no matter what the outcome. I try not to think about it too much because at this point the credit cards have been charged and there is nothing I can do about it. I do work freelance so my temp job could end any day, and my minimum payment on my Amex is way more than I'll be able to pay this month....but honestly at this point there is simply nothing I can do other than not spend money on anything but pure necessities (though I do have plans to go to the movies tonight and tomorrow night, for the first time in MANY months - I already feel guilty but the plans are made and I can't flake on my friends). The truth is, I did the best I could by shopping around extensively for meds online - I have a 3 page spreadsheet with all the different IVF med pharmacies and the breakdown costs of each med. I even was able to get some of the meds donated. Believe me, I spent over a month researching and scraping to get the best deals and a few breaks. So I know I tried my hardest to save. Unfortuantely the tab was still well over $16k just for the IVF (well over $30k spent total in the past year).

SURGERIES: Moving along from the money woes. There were 3 major procedures involved in the process. The first was the cyst aspiration surgery which I mentioned in the last post. Other than the nerves the night before, it went very smooth and I am thankful for that! The second was the egg retrieval, which is a very similar procedure as the cyst aspiration. That one went OK as well, though I only had 3 mature eggs, which is an extremely low number. Most people have 10 or more. I think another clinic would have canceled the IVF and turned it into an IUI. The procedure itself took about 20 minutes, and I was totally out (thank you anasthesia!). I am actually kind of glad I had to have the first surgery, so I knew exactly what to expect for the egg retrival. Thankfully I recovered from both surgeries very quickly and was back to work the next day.

FERTILIZATION and EMBRYO TRANSFER: The day of the egg retrieval is also the same day as the fertilization attempt. So my baby daddy flew down to LA and gave a fresh sample that day. he also drove me to and from the clinic that day. The nurse in the recovery room said to me "he is so good looking!" which I thought was very cute.

The day after the egg retrieval my doctor called to tell me that 2 of the 3 eggs fertilized. The day after that, he called to tell me that both were dividing. We (he) decided to do a 3-day transfer (as opposed to a 5-day transfer which they would have done had there been more embryos). So on Day 3 after the egg retrieval I went in for the embryo transfer. I found out that day that one of the two was dividing more slowly than they would like to see, so it was up to me if I wanted it transfered. There is a risk that it could implant and form an abnormal embryo. In my mind I figured that if it wasn't dividing properly, it just wouldn't implant and would go away. So I took the risk and implanted both embryos. I have a picture of both sitting on my bedside table at home - what gorgeous looking cells they are!

EMBRYO TRANSFER: They give you 2 valium so that your uterus is relaxed for the transfer. At first I thought it wasn't working then next thing you know I was konked out. I was awake for the procedure (which was remarkably like an IUI except that they use ultrasound to guide where exactly to place the embryos). Easy and quick.

BED REST: After I got home I was ordered 3 days of bed rest. I was nervous about the bed rest but it honestly was a lovely break for me from all the stress of everything over the past months. I had essentially a craft service table set up next to my bed so that everything (snacks, meds, books, dvds, computers, tv, remote) were within arms reach. I had visitors. I slept a lot. My dog stayed with a friend so I literally had no responsibilities except to rest. I have to say, I really loved it. I don't think I realized quite how exhausted I was both mentally and physically from all the hormones, shots, appointments, procedures and money woes, until I forced myself to just sleep it all off.

2WW: So now I'm in the midst of the two week wait. I think this is where the mind-fuck comes in. I've been told not to exercise, so I am trying to limit my dog-walking and commute-walking to very short and slow periods. I can feel the weight piling on. My clothes don't fit. And then I get angry that this could all be for nothing. If after the 2 weeks I am not pregnant, then not only will I be saddled with 5-10 extra pounds, but I will still be broke and majorly in debt. But I try not to dwell on it because stress is not supposed to be good. My acupuncturist told me to eat the core of a pineapple to help implantation, which I did - but she also told me that those chinese herbs were "magic" and that was totally bogus, so I take it with a grain of salt.

My birthday is coming up in a few days (41, don't get me started) but I will still be in my 2ww then. I don't know if that is good or bad. Part of me just wants to KNOW one way or the other, but part of me is dreading a negative outcome. I think I have handled the other negative outcomes OK, but there is so much more at stake with this one, and I don't know how I will react. Either way I will be reminded for many years with each credit card statement.

It has been a trip to say the least. I can't wrap my mind around what will happen next. If it doesn't work, I HAVE to find a way to try again. But I just don't see how I can do it. If it does work, well, let's just wait to even think about the consequences of that.

Mean time, I am thankful every day for my adorable dog who brings a smile to my face every time I look at him. There would be a lot less smiles without his gorgeous little presence in my life.