Saturday, December 30, 2006

The four horsemen

About 12 hours after I posted about my ambivalence about testing early, I was reminded once again that when it comes to this fertility business, I am NOT in control.

I had forgotten that I come complete with a handy-dandy design feature(flaw) that serves as a near-foolproof predictor a negative pregnancy test result. Since I was a small child, I have suffered from horrible migraines a few times/month. They have had a powerful effect on my life choices, as they are shockingly painful, can last several days, and until recently were unresponsive to medication, and the main trigger seems to be sleep deprivation. So, I've had to avoid getting myself into situations where I'm likely to be sleep deprived. The migraines were actually the reason that I never seriously considered becoming a doctor (I'm a total biology geek), because I knew I'd never survive the residency. Anyway, a few years ago, my neurologist asked me to start keeping a migraine diary, plotting my headache status against sleeping patterns, consumption of common food triggers, and my menstrual cycle. I swore to her that the headaches had nothing to do with food or my menstrual cycle. As it turns out, I was right about the food (thank goodness! I could never give up chocolate!), but completely wrong about my cycle. I discovered that I get migraines at midcycle, around the time of ovulation, about half of the time, and always get a migraine a few days before my period. I had just never made the connection because of the time-lag between the migraine and the day that I see red. That doctor was really a lifesaver, because she was the one to discover that there IS a medication that stops my headaches in a few hours. Thanks Dr. Friedman!

Anyway, fast forward to yesterday. I woke up around 9 am with my head on fire. Then I stumbled to the bathroom to find that a big pimple had erupted on my nose overnight. A few minutes later, the cramps set in. Recognizing these as three of the four horsemen of the apocalypse, I half expected the "ride of the Valkyries" to start playing in the background as I stumbled over to the kitchen to prepare the (now obviously futile) progesterone-in-oil injection for that morning.

The migraine was unusually ferocious, even for one of mine, and even though the writing was on the wall, I didn't feel like I could take my migraine meds, as they are contraindicated during pregnancy. I spent the whole day in bed, in the fetal position, with a bag of ice on my head, moaning. (I suppose that in the interest of full disclosure, I should also mention that I tore my poor sweet husband's head off when in response to my imperious demand "make my head feel better!", he quite reasonably said "I can't." Obviously he SHOULD have hugged me and kissed me and told me that he'd do anything to be able to make my head feel better, but still, I suspect that my reaction may have been a bit over the top.)

So, this morning, I decided to put myself out of my misery, and did a home pregnancy test. It was no surprise to me that the result was the starkest, whitest, negative that has ever been. It was so white that to be any whiter, it'd have to be transparent.

If it was just the test, I could console myself by saying that maybe it's too early, but the combination of the negative test with intense PMS symptoms seems to be too clear of a sign for even the eternal optimist to overlook. (Oh, and I'm not in any way the eternal optimist).

So, it seems that 2006 has decided to kick me in the ass on its way out the door. Welcome 2007!

Friday, December 29, 2006

Test anxiety

As a former academic perfectionist and generally fortunate person, I just assumed that the first home pregnancy test that I ever took would be positive. Yes, I knew that the odds of pregnancy were only around 20% per cycle, but I still thought I'd be the lucky one. The though of my arrogance and naiveté back then really cracks me up now. If there's one thing that I've learned on this bumpy journey, it's that I'm not special.

I haven't tested much after that first disappointment. I realized quickly that there's nothing at all fun about a negative home pregnancy test, and that knowing that the cycle failed just made the time between the test and the arrival of my period horribly depressing. So, I'm finding myself in new territory knowing that I actually have a (slim) chance of a positive result this time. Should I test?

Here are the arguments FOR testing

1. Good news would be wonderful, and would make me feel a lot less anxious.
2. This weekend is New Year's Eve. If I'm NOT pregnant, then I might as well have a glass of something bubbly to celebrate.
3. If I don't actually know the result, I'll be a total basket case waiting for the doctor's phone call on Tuesday.
4. I really don't want to cry at work, so if it's bad news, it might be better to know before the phone call.

The arguments AGAINST testing:

1. It might be negative
2. I think it will be negative
3. I don't know how I will handle it if it's negative
4. Repeat #'s 1, 2, and 3 several more times...
5. A negative result probably still wouldn't allow me to drown my sorrows over the weekend, since there will always be a shred of doubt in my mind. Maybe the test is too old? Maybe I was a late implanter?

What to do?

Regarding the previous post, a couple of commenters discussed their experiences with infertility after having a first child, and stated that they don't feel guilty about wanting another child. Well of course you don't! Why on earth should you? I really hope that my post didn't come off as unsympathetic to people who are struggling with infertility after their first (or second, or third, or fifth) child. What I MEANT to say was that I realize now that a positive result, and even the delivery of a healthy "take home" baby, won't take away the pain of infertility. I hope that I didn't hurt anybody's feelings. I wish that we all could have as many (or as few) children as we want without going through so many struggles along the way.

Tuesday, December 26, 2006


Whew! That last post was maudlin, wasn't it? Embarrassing really. I guess the combination of crazy hormones, my first Christmas away from my family, worry about my dad, and endless free time to imagine negative outcomes isn't a good combination. Go figure!

A couple of important lessons that I've learned this week: 1) Don't arrange my IVF schedule so I have large blocks of free time during the two week wait. Keeping busy, it seems, is the key to preserving my sanity. 2) I am never alone. Thanks for the sweet supportive comments. They really meant a lot to me.

JJ's comment made me think about the age-old primary vs. secondary infertility debate that routinely appears on infertility boards and websites. Should people who already have one just count their blessings? If not, what about people who already have two? Three? At what point does a couple's (or a person's) desire for an additional child stop being worthy of sympathy? As a long-time primary infertile, it would be easy to say "I'll thank my lucky stars to have just one child, and NEVER complain about secondary infertility" (and I have certainly said this myself on many occasions). However, the reality is that most of us didn't start out dreaming of having just one child, so while the achievement of a successful pregnancy is huge, it doesn't mean that we haven't suffered serious losses along the way, and it doesn't mean that our struggle is over.

On my third date with the mysterious man that I eventually married, we had a long chat about how many kids we would have. I said that I'd like two, and he said that he'd like to have two, and then wait several years, and then have one more. I said "at my age, if we want three, I don't think we'll be able to space them out like that". (Are you admiring what a sexy third date I am--working in the biological clock already! No wonder he couldn't resist my charms.) And he said "well, two would be good also." (Always the diplomat, no wonder I married him.) So, I thought that we had it all figured out. Now we never think or talk past #1.

I realize that in part this is realism, but it's also partly cowardice. The very thought of actually having a child, and then having to start this whole process AGAIN, from square one, but without the starry eyes that shielded me from the ugly realities of infertility for a while, is more than I can bear. I guess that's one of the reasons that so many women going through IVF actually wish for twins. It would mean a harder, scarier pregnancy, and a more difficult early infancy, but the thought of never having to walk into a fertility clinic again is absolutely intoxicating.

Of course, one would be good also.

Sunday, December 24, 2006

The last woman standing

When I started trying to conceive, I didn't make any public service announcements, but over a glass of wine with friends one day not long into this fun adventure (yes, I drink wine while "trying"--clearly I deserve everything that I get), the topic came up, and I admitted that we were indeed "trying". Another friend then immediately fessed up that she was "trying" too, and the other two sat there looking stunned at the mere concept of feeling ready to become parents. I suppose that I don't need to tell you that all of those friends now have beautiful babies, and are trying for their second. That's just a given.

In fact, since I have been trying, most of my friends have had at least one child, and several have had two. For a while, there were some exceptions. One dear friend had a bit of a hard time. It took her about a year to get pregnant, and then she had a miscarriage at 10 weeks. It was awful. Several months later, she still hadn't become pregnant again, so we ended up doing our first clomid cycle together. We discussed ovulation pains, cervical mucus, the joys of transvaginal ultrasound, and annoyance of scheduling sex according to our ovaries' whims on a daily basis. It wasn't FUN exactly, but it was kind of nice having that special bond, and having someone who knew how I was feeling. Luckily, that first clomid cycle worked for her, and she now has a gorgeous daughter.

Then there was my friend H. H is a year older than I am, and has been talking about having children for years, but various things just kept getting in the way. Then right around the time they were really ready to start, she had a cancer scare. It ended up being a false alarm, but it took about six months to be sure of this, so by the time she was able to actually start trying again, she was already rather frantic. Well, when things didn't work out quickly, they went in for testing and got devastating news--her husband produces no normal sperm. 100% of his sperm have abnormal morphology, and they were to a man incapable of fertilizing an egg. So, IVF/ICSI was their only hope. There were a lot of tears, and a lot of soul-searching, but they decided to give it a try. Last week, I was thrilled to get the great news that their first cycle was successful, and that H is now pregnant.

Today it struck me that I am now completely alone. While I have received overwhelming support from my friends in the computer (bless you all!), nobody among the people that I knew BI (Before Infertility) is still trying to conceive their first. Of course I wouldn't wish this hell on my worst enemy, so I'm happy that my friends have been spared. However, I can't even kid myself this time about what will happen if this cycle doesn't work out. H, like all of my other friends, will not be emailing me every day to ask how my cycle is going any more. She'll try, for a while, but then she'll get caught up in her own pregnancy (and perhaps the survivor's guilt), and the messages will slow to a trickle. I do understand that after a while there's just not much left for the fertile to say to the infertile on the subject of "so how's that no baby thing going for you?". I'm glad that my friends don't have to wallow in my grief. However, the fact that they're not here with me makes the whole thing a bit lonelier too.

I told one of my best friends three weeks ago that I was starting IVF. I haven't heard from her since. If she was like most people, there would be a lot of logical explanations for this seemingly unsupportive behavior. Her line of work is very seasonal, and she gets totally slammed around the holidays, so it could be that she simply doesn't have a moment to breathe. However, this is the same friend who phoned me after my lap to see how I was doing even though she was IN LABOR, having contractions 3 minutes apart. She's never let being busy get in the way of being a good friend before, and I really don't see her doing so now in my hour of greatest need. You know what I think? I think that she's pregnant with #2, and just doesn't know how to tell me.

God infertility can be lonely.

Friday, December 22, 2006


Something amazing happened today. I'm just not sure that it happened to me.

My transfer time was 11 am, so I had plenty of time in the morning to relax, get a nice shot of progesterone, and generally go about my favorite activities before heading in to the clinic. We decided that there was not much point in having my Mystery man go with me to the clinic, since I was going to be on bed rest for three hours after, and they don't let the spouses come in with you. He has been a total trouper about coming with me to everything, but I just really didn't see how having him sit in a waiting room for 3.5 hours would really do me any good, so I just asked him to be there when I came out to ride home with me.

When I got there, I checked in as usual, and was quickly called back, along with five other women, to the same area in which we were prepared for our retrievals. I'm embarrassed to say that I'm not sure if any of the other women there were waiting with me for retrievals on Tuesday or not. I guess I've been in my own little mental world throughout this all. Anyway, we changed in the locker room again, and then waited to be called. I should mention that while the gowns fit the other women here perfectly, and look quite fetching, the tie that is supposed to be around the waist falls just below my boobs, and on me, the skirt is decidedly mini. I think I was taller than everyone else there by at least five inches.

Anyway, I was called first, and they had me go into the same room as the retrieval, and get up onto a gurney with my feet up on the end. There weren't any stirrups, it was just like a normal hospital bed on wheels. Then the doctor came in. It wasn't my normal doc (she had warned me that she wouldn't be there), but to my great surprise and delight, he spoke passable English. He immediately told me to look at the monitor (the same one from retrieval), and there on the screen were four gorgeous embryos. Now I realize that I may be biased, but they really looked beautiful to me. Each was 7-8 cells, nice and round, and just generally pleasant-looking. Then I saw a big pipe come in and suck them up. The doctor said "you have four very nice embryos--very good", and then without further ado, very gently put in the speculum. He told me to relax, and then within a few seconds they were in! Just like that. It was actually easier than any of the IUI's that I have had. He also said that my lining looked really good.

I don't know what to do with all of this good news. I want to be happy. I AM happy, but I also realize that it doesn't mean anything if at least one of those little guys doesn't decide to stick. I've seen so many people have great cycles up to this point, and then end up with a negative. So, I'm trying to just remember that this is all a good sign that it might work some day, without getting up too much hope for this particular cycle. (I admit that I did hold the phone to my belly a few minutes ago, so my sister in the USA could say some encouraging words to the little guys, but I don't think that counts as a sign that I've lost my mind. Do you?)

As for the part about there being four, well, I'm just trying not to think about that. I had been planning to ask to transfer only three, but clearly the doctor had other ideas, and honestly, I'm kind of glad that I didn't have to make the choice. There are a couple more that are still being incubated, and will be frozen if they still look decent on Sunday.

After the transfer, they wheeled me into the resting area. A few minutes later, they wheeled in one of the other women. Then another, then another. In the end, there were six of us, all lying there together. It was a bit dull, resting for three hours, but they gave us a nice lunch, and a lovely foot massage (free!), so it wasn't so bad. As I was lying there, I realized that given this clinic's success rates, at least two or three of the women there had probably just had their actual take-home babies put inside of them. This could have made me feel competitive, but actually, I found it really inspiring to think about the fact that someone who had been through all of this actually was realizing their dream, right there. Today. With me in the room. How utterly amazing.

Now I'm just hoping that today, my clinic was six for six.

Thursday, December 21, 2006

My cool: lost.

Today started like any normal day. Well, any normal day in the twilight zone which is fertility treatment, anyway. I got up, had breakfast, pulled out a big fat hypodermic, pulled a dose of protesterone into it, asked my dh sweetly to stick it into my butt, kissed him goodbye, and then went to work. You know, the usual.

The clinic was supposed to phone at about 10 am to let me know the time of the transfer tomorrow (assuming that it will be a 3dt). So, I sneakily arranged to be out of the office running an errand at 10, so I could speak freely without worrying that the thin walls would allow someone to hear me discussing e.g. sperm, fertilization, or embryos. (I am "out of the closet" as infertile everywhere but at work. I actually think that they'd be sympathetic, but I'm a little leery about letting my boss of only a few months know that I'm actively trying to get knocked up.) I managed to dawdle outside until 10:30, but still no call, so I reluctantly went back to work to stew in my office. By 11:30, there was still no word, so I phoned the doctor. She wasn't in the office, but her nurse took a message, and said that she'd phone back around 12:30.

By 1:30, I was on the verge of stone cold panic. Somehow I convinced myself that she was putting off phoning me because she didn't want to break the bad news that the embryos had all died (or none had fertilized in the first place). I tried to remind myself that the nurse that told me that someone would phone at 10 am had probably not thought about the fact that most of the clinic staff can't communicate with me. So, while patients might normally be phoned at 10 am, I get special treatment from my lovely English-speaking doc, so the normal rules don't necessarily apply to me. However, my own pessimistic retort was that if that was the case, they'd probably forgotten about me entirely, and would never phone. I promised myself that I wouldn't phone the doctor until 3, but by about 1:50, I started hyperventilating.

So, at 2, I cracked, and phoned. The doctor answered, but then immediately put me on hold. I was seeing stars, and my whole life was rushing before my eyes. I was sure that she was tryinig to find the right words to tell me that my embryos had died, and that there was no hope that I'd ever be successful. Ever. I was outside (on the second conveniently manufactured errand of the day), and had to quickly find a bench to sit down before I fell over. Then the doc came on and said "here, I have your report", and went on to tell me that of the 9 eggs, seven had fertilized ("half" on their own, and "half" with ICSI), that the fertilization had looked normal, and that we have two very good embryos, and several "so-so" embryos. She said "they're not great, but they're not bad. Maybe a little better than average".

Better than average! I can live with "a little better than average". Heck, given my mental state five minutes before, "so-so" sounded positively beautiful.

Then she told me that transfer is tomorrow, and that I'll have to stay for at least three hours after the transfer to relax. During this time, they'll feed me lunch, and massage my feet! Yes, at my no-frills clinic, I have suddenly found a huge frill. And this foot massage is FREE! (with purchase of one complete IVF cycle). As it turns out, membership has its privelages.

P.S. Thanks for your kind words about my dad.

Tuesday, December 19, 2006

The mental and the physical

Thanks so much for your good wishes. It's quite an astonishing and wonderful feeling to have people that I've never met popping in to wish me good luck. My heart is thoroughly warmed, and to be honest, I needed it.

It's been a roller coaster the last couple of days. I found out yesterday that my father, with whom I am very close, has cancer. There are a million things to be grateful for. They caught it very early. He is healthy enough to have the surgery that should (fingers crossed) cure him. He lives close to one of the best doctors for this type of cancer around. All in all, if you have to have cancer, this seems to be a decent situation in which to find oneself. But, of course, it's terrifying. I cannot even seriously contemplate the prospect of losing my dad. There is a little emotional switch in my brain that flips when I even begin to go there, and does the cerebral equivalent of sticking its fingers in its ears and shouting "LA LA LA I'm not listening LA LA LA..."

We won't know the extent of the cancer for sure until after the surgery, and of course there are always risks of any surgery. I am feeling horribly guilty and sad about not being there right now, and the fact that I probably won't be able to be there for the surgery either, as it's likely to be scheduled for this week. Not that I could really do anything much if I was there, but being there IS something, and I feel dreadful that I can't even do that, being half-way around the world.

In other news, the retrieval was today. It was a truly interesting experience. The clinic that I go to in Korea is worlds apart from my old clinic in California. Wheras my old clinic was small, cozy, and personal, my new clinic is more like a baby factory. It's not really a clinic at all, but rather a whole fertility hospital (actually, in Korea, it's called an "infertility hospital", which strikes me as a refreshingly honest, if jarring, way of looking at things). The place is vast. On a Saturday morning, there will be many tens of couples waiting downstairs to see their doctors, and undoubtedly many more on the upper floors, which have areas for retrievals and transfers, hospitalized OHSS and surgical patients, and the embryology labs. While I do know a couple of the nurses by now, and of course my doctor, I see tons of new faces every time. So, it could be described as a little impersonal, but I don't really see it that way. My doctor and the nurses are very kind, and take a lot of extra time to explain things to me in English or using body language, so I feel very comfortable with that aspect of my care. My doctor actually phones me directly with news, rather than delegating it to a nurse, which I very much appreciate. Also, patients can just walk in any time during business hours to see a doctor. You may have to wait for a couple of hours (if it's your first appointment, after that they rush you right in), but you don't have to wait for six weeks or more, as sometimes happens in the USA. They seem to save time and the patients' money by dispensing with some of the frills that American patients are led to believe are essential. You don't do an "injectibles class" before starting: the nurses just show you how to do the injection the first day that you're actually doing it. You don't spend hours going over paperwork, or having test after test to make sure that your husband isn't somehow going to infect you with an STD in the lab after managing not to do so in years of ttc. They also haven't monitored me as intensely as I've been led to expect. I had a total of three ultrasounds, and only one round of blood work. However, the success rates at my clinic here rival that of the top US clinics, and they take all kinds of patients, so clearly they're doing something right.

Anyway, 9:30 a.m. today found me on the subway with a jar of sperm wedged between my boobs, trying desperately to keep it warm on the way to the clinic in freezing weather. We got there, and I was called almost immediately to the "retrieval area", along with two other women. We were all told to go into a locker room (with actual lockers!) to put on hospital robes, and strip from the waist down. It was a little wierd doing this all together, but was also absolutely fine. Then we were called one by one to have an injection of painkiller. The nurse slapped my butt several times before doing the injection, which was a little wierd, but actually made the injection not hurt at all. Maybe I'll have to have my hubby do that at home with the PIO shots. Fun for the whole family! Then they called me back to the retrieval room. I had heard that in the USA they sometimes tie your legs to the stirrups, but here they just had me put my feet up, and then started putting the speculum in. I was a bit alarmed, and thought they were going to go right in then, but at the last minute, they gave me a lovely shot of demerol in the arm, so I was conscious, but veeeeeerrrryyyy relaxed. Then she went in, and gave me a local anaesthetic before starting the retrieval. The collection from the first ovary didn't hurt. I felt pressure, but nothing that could accurately be described as pain. After a few minutes, she told me to look at the screen. They had a video screen on the wall, and I could see the embryologists working with my first egg! It was absolutely amazing. Unfortunately, I was too groggy to really watch, but I could at least glance at it from time to time and see that there were real live actual eggs coming out of me! Then she switched sides. The second side definitely hurt. It wasn't excruciating, but I could feel the needle moving around, and when she stuck it into a new spot, I felt a painful jab. During all of this, the nurse was an absolute champ. She held my hand, and rubbed my arm, and did everything that she could to make me feel safe. The doctor also asked me every few seconds if I was OK. The funny thing was that I WAS OK. It hurt, but because of the demerol, I couldn't get very emotionally involved with the pain. My ovaries hurt, but my elbows felt fine, and my legs felt quite comfortable, and my face felt quite lovely, so all in all it was very tolerable. Then they were done before I knew it. They mad me lie back for a minute, then transferred me to a rolling cot, and rolled me into a quiet room to recover from the anaesthetic. It took me about 15 minutes to realize that there was another woman recovering to my right (behind a curtain). Then they brought in another to my left, then another, then another. So, I was in good company at ye olde egg factory. After a while, the nurse came in, got me up, and told me that they got 9 eggs! I had been so worried that my follicles would be empty, or something like that, so this was VERY good news. Yeah, I would have also liked a number with two digits (preferably two high digits), but I can certainly live with 9, if the quality is OK (fingers crossed!) I almost didn't mind when she stuck two more needles in my butt (one progesterone, one antibiotic), and gave me the HUGE package of needles and progesterone in oil (PIO) that my hubby will be sticking into me over the upcoming weeks.

The whole experience of feeling the pain, but not minding the pain made me think about the emotional aspects of pain. I think that one of the worst things about pain is the fear associated with it. Pain is, after all, your body's way of telling you that something's wrong, and that you need to deal with it. So, pain that you can't fix is inherently frightening, and the fear, in turn, seems to exacerbate the pain, which of course can make you even more stressed and frightened. During the retrieval, I wasn't frightened at all, thanks to the lovely drugs. So, the pain was just what it was, and didn't take on monstrous proportions in my mind.

I wonder if the pain of infertity is the same way. The pain is real, and can be dreadful, but it's also usually intensified by so much fear. Fear of failure. Fear that infertility will result in childlessness. Fear of receiving an awful diagnosis. Fear of receiving no diagnosis at all. Fear of making the wrong treatment decision. Fear of the treatments themselves. Fear that the treatments will fail. Fear of adoption. Fear of not being able to adopt. Fear that the sadness will damage your marriage, your friendships, your soul. In the end, I think that the pain is usually manageable. It's the fear that can destroy you.

Saturday, December 16, 2006

The other side effects

Since starting the meds for this IVF cycle, I've experienced several side effects that I expected (headaches, mood swings, bloating, a bruised belly, etc.), but also two that are completely unexpected. The first of these can be described as "nipples of fire". My breasts are not just tender, they are sore sore sore. I feel as if I had been riding on a bus with no shock absorbers for 12 hours on a poorly-maintained road in rural Guatemala without a bra (I did that once, not recommended.) And the nipples, oh lord the nipples. They are angry, no, FURIOUS about something. It's hard to know what is going on in their little heads, but they are bright red and send stabs of sharp pain coupled with a more general sense of irritation at me if anything brushes against them, even lightly, or whenever I move. Poor Mystery Man has been forbidden to so much as look at me between the neck and waist, lest they blind us both with their fearsome jets of fire. People talk about tenderness in their breasts while on progesterone, but I really wasn't expecting them to start up before retrieval! It figures that my body would find some new and bizarre way of inconveniencing me.

The other side effect is perhaps more worrisome. Hope has entered the building.

I went into this cycle assuming that it would fail. I don't mean that I don't want it to succeed, but I'm a logical person, and realize that a ~35% chance of success (my RE's estimate, although then she frowned and said "maybe a little less") means a 65% chance of failure. The whole time, I've been telling myself that we'd do at least 3 cycles, unless there was some cataclysmic sign of certain doom before then (no response to the meds, eggs coming out already scrambled, embryos immolating themselves in the dish as a form of protest, an eerie voice whispering "get OUT of the fertility clinic"). With a 35% chance of success in any one cycle, the chance of success across 3 cycles is a respectable 82%. I can live with those odds. However, as things have gone along, and the cycle hasn't been cancelled (yet), I've started to actually have a smidgen of hope that it might work. I don't mean that I've calculated a due date, or thought about names, or fantasized about an actual baby making an appearance on the other end, but I have at least considered the possiblility that I may actually see two lines on a stick at the end of it all.

Hope scares me. After 32 cycles all ending in failure, including three medicated IUI cycles, six post-lap cycles (my RE said I had an about 50% chance of getting pregnant once the mild endo was removed), and a lot of cycles in which I had hope for no apparent reason, I am thoroughly jaded. So, contemplating a different outcome after so much disappointment puts me into a very strange place. I honestly have no idea what I should do with this feeling. It's tempting to squash it like a bug, but I just don't know if I have the heart. Maybe I'll let it stay for a little while while I think about it.

Yesterday's scan showed at least 8 and probably 9 big follicles of approximately equal size, and a couple of smaller ones. I trigger this evening, and retrieval will be Tuesday morning.

Friday, December 15, 2006

Violet Beauregarde

I have only one recurring nightmare, and it's about chewing gum. In the dream, there's gum in my mouth, and it keeps expanding. I'm pulling handfuls of it out, but it sticks on my teeth, and just keeps expanding. The more I pull, the more there is. It's horrible.

I'm not the only one who has this dream. I've met a couple of other people now who also have the gum dream. Needless to say, most of us have had a lifelong aversion to gum.

When I was about six, I saw the film Willy Wonka and the Chocolate Factory for the first time. I was entranced, but also a bit unsettled by the misadventures of Augustus Gloop, and by the time Violet Beauregarde turned blue ("you're turning violet, Violet!") I was outta there. I've often wondered if seeing her blow up like a balloon from Willy's gum a formative age had a role creating my nightmare.

These days, Violet and I have a few things in common beyond our winning personalities. I'm still my normal color (think Elmer's glue, and you'll get the idea), but my abdomen has started expanding at an alarming rate. I'm starting to look around nervously whenever I hear music, thinking that it's the Oompa-Loompas coming to roll me off to the juicing room.

I look about 3 months pregnant right now. The look is quite fetching, I think, (pregnant is in this year--it's the new black) but it's also remarkably uncomfortable. Last night, I had trouble sleeping because I couldn't figure out where to put my newly enormous belly.

So what's going on? A little math, if you don't mind...

A mature follicle should be about 20 mm in diameter, or 1 cm in radius. A mature follicle should also be approximately spherical (although I suspect that mine look more like this).

The volume of a sphere is 4/3π times the radius cubed, or in this case around 4.2 cubic centimeters, or 4.2 milliliters. So, if I have 5-10 follicles that are close to mature, their total volume should be between 21 and 42 ml. That's less than half of a juice box, whereas I look and feel like I swallowed a chihuahua.

I can't wait for my next ultrasound tomorrow morning to see what on earth is in there.

Thursday, December 14, 2006

Elvis lives

Since I moved to Korea, going to the bank has become one of my favorite routine chores. The first time I went in, I was rather intimidated about the prospect of having to try to conduct financial business in Korean, given that I don't actually speak Korean. So, I was pleasantly surprised when by chance (they use a take-a-number system here, so you can't choose your teller), I got a teller who actually spoke quite good English. The fact that he had a delightful pompadour hairstyle was just an added bonus. Since then, every time I've been there, he has just happened to be the one that calls my number. Actually, I think that he does it on purpose. He now knows my name, where I work, and of course everything about my finances. I think that we may be Best Friends Forever.

Anyway, today was my big day to go to the bank, but the trip wasn't nearly as much fun as usual. It was delightful to see my own personal Elvis, of course, but not so nice to see my current bank balance. The fact is, IVF and financial happiness don't seem to mix very well.

Don't get me wrong, I am a very lucky girl. Six months ago, I was living in southern California, where the cost of a single round of IVF runs from ~$12,000-$15,000, and my health insurance had no interest in paying a cent. While of course a baby is priceless, baby roulette is somewhat less appealing. People often make the argument that few people would balk at paying $15,000 for a new car, and isn't a baby much more important than a new car? Well, that would be a good point, except that when you buy a new car, you actually get a new car. Then if you decide that you don't like it, you can even sell it and buy a different one. When you buy IVF, you MAY get a baby, you may get three babies, or you may just pay all of that money to get bloated and moody, have a sharp metal object shoved into your ovaries, spend two weeks trying not to lose your mind as you wait for the results (IF you're lucky and you make it to transfer), and then end up with nothing to show for it but needle tracks, a fine collection of used hypodermics, and a bitter taste in your mouth.

The good news is that here in Korea, reproductive assistance is much much cheaper than it is in the USA or Canada. I am expecting to pay not much over $3000 for the whole cycle, including drugs. Yes, that's several fun-filled rides on what is euphemistically called the cooter-cam, enough hormones to make a bus grow boobs, egg retrieval, loving care for the developing embryos in a top-notch embryology lab, and then the return of said embryos to their carefully prepared uterine home, all for the low low price of only $3000. What a bargain!

As it turns out, though, $3000 is still kind of a lot of money. It's not $15,000, but since most people manage to get pregnant without spending more than a few bucks for a couple of margaritas and maybe a Barry White CD, paying $3000 to a doctor for a CHANCE at a baby does tend to make me feel a bit sorry for myself. I do know that I'm very lucky to have this opportunity. I really do. Tens of thousands of infertile women worldwide have no access to this kind of care at all. The fact that I can afford to try IVF makes me one of a lucky minority. The fact that I just happened to move to Korea right when I realized that I needed IVF is unbelievably fortunate. Still, when I start to feel anxious about whether this cycle will work, the financial ramifications of failure do feature prominently in my waking nightmares. I am determined to be a mother one day, whether through IVF, embryo donation, adoption, or whatever other options come along. The question is just whether the money will run out before my will to keep trying does. We can afford this round of IVF, and if it doesn't work, it won't be too much of a strain to do another. However, what if that one fails? And the next one? At what point do we have to cut our losses and start saving for adoption? These are some of the the questions that keep me up at night.

Then I think--maybe I should just give it up and spend the $3000 on that nice pair of Korean cowboy boots that I saw the other day. Hey, I could be a Korean cowboy, couldn't I?

Wednesday, December 13, 2006

First scan

When they come in clusters, follicles look like grapes on an ultrasound scan. Positively delicious.

The doc estimates based on what she saw today that we'll retrieve 5-10 if everything goes well. I was hoping for more (of course), but can live with those numbers. I go back again on Saturday. I sure hope those little grapes grow!

Tuesday, December 12, 2006

The return of the conquering hero

My husband came home yesterday after being in his home country for almost three weeks visiting his family. I would call him a selfish bastard for leaving me in my hour of need, but a) he hadn’t seen them for over a year, so I suppose a visit was in order, and b) it might ruin the loving tone that I’m trying to set here.

I am beyond thrilled that he’s finally back. Under normal circumstances, perhaps I would have enjoyed the solo time a bit more, but my life rarely approximates anything like “normal”. First, there’s the geography. I am a citizen of one country (the USA), while my husband is a citizen of another, and we live in a third (Korea). Each of us is a legal resident of two countries simultaneously, but oddly enough, the country in which each of us is NOT a legal resident is that of our own citizenship. Did you get that? Good, then you can explain it to me. He speaks three languages, I speak two, but we don’t (yet) speak Korean, the language of the country in which we actually (physically) reside. Yes, my friends, we are geographically complicated. Second, we have a fairly unusual living arrangement. We moved to Korea a couple of months ago in response to my receiving a really great job opportunity. Sadly, it doesn’t pay as much as I might like, but trust me, it’s still a winner. The problem—I’m the one with the cool job, and it is a condition of my husband’s visa that he cannot work here. So, by coming here with me, he stopped being a breadwinner and became a Kept Man. When asked to fill out a form, he always looks a bit glum when he gets to the “occupation” line, so I cheerily suggest that he list his occupation as “International Man of Mystery”. He has yet to do this, but I’m optimistic that he’ll come around. My Mystery Man’s main job, therefore, is to keep me happy, which he ordinarily does quite well. I’m kind of like a classic 50’s American husband, now that I think of it, albeit with a much more interesting wardrobe and a spicier vocabulary. So, having him away for so long was a stark reminder of the fact that while he doesn’t contribute to the family income any more, he really does look after me in a million different ways. Without him here, the house was falling apart, I was malnourished, and my mood had gone decidedly south. As it turns out, I’m no good without him. You can call it love, or you can call it pathetic. Both are undoubtedly true.

While he was gone, I realized that I have no idea where the garbage goes, don’t know where the grocery store is, and make really shitty coffee. I would use everything happening in Korean as an excuse, but I only speak English with the coffee maker, so I really don’t know what’s going on there. Anyway, while I have placed “get a grip on yourself and learn how to function” high on my priority list, I nonetheless have heaved a huge sigh of relief now that he’s back home, and barefoot and ..., OK, just barefoot.

An example of why IVF and absent husbands don’t mix. Yesterday I was so proud of myself because I actually made myself a lunch before heading off to work. (Hey, it’s progress). However, I forgot the critical step #2 which is “take lunch to work”. I am not normally this forgetful. I blame the hormones. Had Mystery Man still been away, I would have been stuck eating out, while my food rotted at home. As it was, he delivered. Love that man.

Anyway, back to our regularly scheduled programming. There seems to be some progress down south. I’m decidedly sore around the ovaries and experiencing some mild, um, digestive issues. I am embracing these as signs that ye olde ovaries haven’t yet given up the ghost entirely. We’ll see. Tomorrow is my first scan since starting the injections. I’m all aquiver.

Sunday, December 10, 2006

Famous last words

I hate to admit this, but yesterday I found myself thinking “this is it?” After all of the hoopla, IVF so far seemed pretty, well, ordinary. Each morning I stick a few needles into my belly. Other than that life goes on as usual. Honestly, I felt a little cheated. When would the clouds part? The angels sing? The Valkyries ride in? Something!


This morning, I got up, stuck a needle into my belly, and watched as a red rash started immediately spreading across my skin. Wondered idly if I am allergic to the suppression meds. Also wondered if being allergic would make me stop taking them. Still wondering about that. Should have known that this was a sign that I should just go back to bed.

Today a co-worker got married. Given that my husband is still out of town, and that I wouldn't actually know many people at this wedding, I wasn’t exactly looking forward to it, but I was experiencing some kind of pleasant anticipation, based mainly on sheer curiosity. I hadn’t yet been to a wedding in Korea, and had no idea what to expect. Having been assured by my assistant (Korean, and a close friend of the groom) that Korean weddings are generally very institutional and devoid of a spirit of festivity, I wasn’t really expecting it to be FUN exactly, but was hoping for an interesting show anyway. So, I got ready and headed out, expecting an adventure. Once I had gone down the elevator (I live in a high rise), and out almost to the subway station, I realized that I had forgotten my wallet. So, I went back up and got my wallet. Then at the bottom of the elevator again, I realized that I had forgotten my mobile phone. Since I needed to co-ordinate with friends to actually find the right place for the wedding (the directions on the invitation were in Korean, and while they had been briefly summarized to me verbally in English, they involved complicated steps like “go 100 meters, take the shuttle bus to (incomprehensible name), go left...”), I really did need my mobile phone. Back up I went, and back down again only to realize (while still moving downward this time, apparently I am capable of learning, although it occurs slowly) that my phone battery was dead, and that the spare freshly-charged battery was, you guessed it, still in my apartment. By the time I made it to the station, I was already 30 minutes behind schedule. It was clear that I had zero chance of making it to the wedding on time, so I screwed up my courage, phoned my friends, and told them to go ahead without me, since there was no sense in all of us missing the ceremony. [Geographical aside: mobile phones work on the subway in Seoul. How brilliant is that? Where could you possibly need to use the phone more than when you are stuck on the subway and running late. A+ to Seoul for good urban planning.] To their credit, they resisted, but I was insistent. I assured them that if I had any difficulties, I could just take a taxi from the station. They reluctantly agreed to go on without me.

40 minutes later (and five minutes into the ceremony), I was still standing on a street corner trying to hail a cab. Someone had thought that it was a good idea to build a wall between the sidewalk and the street [D- to Seoul for bad urban planning], and it took me a good 10 minutes to figure out a way around it. Finally I got a cab, and made it to the right building, only 20 minutes late.

I had been imagining a hotel with a single wedding space and banquet hall. That’s pretty much what I found, except for the 400 billion weddings going on at once, on three separate floors of an enormous city building apparently entirely dedicated to marrying people as efficiently as possible. I saw a sign and thought “A HA, no problem, I will just use my newfound hard-earned command of the Korean alphabet to look through the list of wedding names to find the one that I am looking for.” Have I mentioned that about 40% of the people in Korea are named Kim? That left about 10 weddings, on three different floors of the building. At this point, I started feeling a little anxious. Nonetheless, I forged on into the building, where I was met by huge swarms of well-dressed middle-aged men and women, all of whom seemed to be determined to shove me out of the way to get somewhere VERY IMPORTANT. Then someone rushed by pushing a huge cart of some food item that looked suspiciously like a brick covered in that gravy normally reserved for elementary schools and prisons. Then I realized that each wedding had approximately 300 guests, all of whom were SHOUTING at each other in Korean.

People, at this point, I cracked. I realized that if I didn’t get out of that building that second, I was going to burst into tears. I debated the merits of each course of action:

Option 1. Go to colleague’s wedding 40 minutes late with tears streaming down face.
Option 2. Bolt.

I went for option 2. By the time my friends called to see where I was (again with the handy subway phone action), I was already most of the way home. I really didn’t know how to explain that the lupron (and some large and determined mothers-of-the-bride) had suddenly hit me like a ton of bricks, and that if I wasn't home in 10 minutes I would DIE, so I just mumbled something about not feeling well. It was thoroughly unimpressive.

I may never leave the house again.

Saturday, December 9, 2006

IVF Day 2

If my head explodes in my apartment, and noone is here to hear it, will it make a sound? This question is starting to seem more than merely rhetorical, as the suppression meds march through my brain, kicking things with their steel-toed boots as they move along. I woke up wanting to scream, and couldn't convince myself to get out of bed until 11 am, when I had to get up to give myself another shot of the drug that put myself in this condition in the first place. I really hope that this doesn't go on for weeks. I have always been a headachy person, but normally I manage it with some much nicer meds. I don't know if I should be taking lovely migraine meds with IVF meds, though. Hmmmm.

To make things worse, my husband will be out of town until tomorrow, so there's nobody here to feed me chicken soup. Actually, now that I mention it, maybe this is a good thing, because a) my husband does not specialize in being sympathetic to sick people, especially those with recurrent migraines, and b) I am a vegetarian, and therefore wouldn't touch chicken soup with a 10 foot pole.

I'm off to bang my head against the wall to see if I can distract myself from the rumblings on the inside.

Friday, December 8, 2006

By any other name

When considering names for my brand new bouncing baby blog, I realized that I've always sucked at choosing titles, restaurants, music, or pretty much anything else. Decisions are not my thing. I am GREAT at brainstorming, rationalizing every angle, carefully listing the pros and cons, but when it comes to actually selecting among the actual options, well, let's just say I'm not exactly setting the world on fire. A Decider, I am not.

I started to think about what sorts of treats I should offer any reader so foolhardy (or insomnia-stricken) as to set foot into my little lair. One of the ideas that for some inexplicable reason makes me giggle uncontrollably every time I think about it (I have the same problem with the phrase "explosive diarrhea") is featuring a body part of the week. I could post a fetching close-up photo of the lucky part, discuss its history, merits, views on current events, favorite recipes, etc. The possibilities are endless. And of course the very first body part to be featured would have to be my navel. Not because my navel is particularly interesting, or attractive, or special in any way. It's a perfectly ordinary little navel. Round, an inny. Quite unremarkable. Its only distinguishing feature would be the tiny (OK, invisible) scar from a laparoscopic surgery, which serves to give it a little street cred. No, I would invite you to gaze at my navel as an ironic acknowledgment of the narcissism inherent in posting my routine little life details on the internet for everyone in the world to see.

However, featuring the navel in my inaugural post would also be misleading, since the REAL subject of this blog, and my life these days, is located somewhat lower on my anatomy. No, not that low, you pervert.

This blog isn't intended as a love song to my girly bits, but rather a place to vent my frustration at the failures of some of their internal accessories. I would identify the offending anatomy more precisely if I knew where to point the finger, but the best efforts of three medical professionals (so far) have left the exact location of aforementioned part "unexplained".

As it turns out, I am infertile. Or rather, my darling husband and I are infertile. Being "unexplained", I can't be certain that the problem is located in (or confined to) my own reproductive organs, but after two and a half years of what is euphemistically called "trying" (translation--fucking like bunnies without so much as a gentle wink in the direction of contraception), my urine remains free of the slightest whiff of contamination from those chemicals which create second lines on home pregnancy tests, make grown men cry, and make one start referring to one's own father as "grandpa". I had a little bit of endometriosis (stage II, located on my uterosacral ligament, if anyone cares) removed nine months ago, but it's been gone for a while now, and yet that second line remains elusive. Other than that, my tests are all "normal", my hubby's sperm checks out, and yet here we are. So, I've decided to pull out the "big guns", as it were. Today is the first day of my first ever IVF cycle. One needle down. Zillions to go. Let the fun begin.