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Wow, today I don't have to do anything infertility related.  No shots.  No bloodwork.  No ultrasound. Nothing. 

I think I'll take the opportunity to talk about some unrelated or marginally related things that have been on my mind lately.

First, completely unrelated to infertility:  I love Hillary Clinton.  I really wanted her to be our next president.  However I loathe primaries.  Democrats fighting democrats makes me sick!  The minutia of differences between Hillary and Barrak's platforms are infinitesimal yet they get blown out into an "us" or "them" fight.  Us or them?  We are we! Anyways that's not my point.  I can securely get behind Obama if that is what the party decides (although I think I'll write him a letter about his stance on NASA - which is a little weak and nearsighted).  Anywho, my real point about bringing this up is that I am so pleased that discussion of the next president now includes the phrase "he or she".  What a great development in American evolution!  Young girls growing up are hearing subconsciously that they can be president.  Of course we might tell them overtly that they can be anything they want but never underestimate the power of the subtle language patterns in society. 

Ok, my next one is related to infertility and it is pretty controversial/deep.  I am a feminist (of course!  don't get me started on women that don't consider themselves feminists!).  I am also a Christian.  Often it seems that neither the twain shall meet.  This gives me a unique, although not difficult in my opinion, stance on abortion.  As a Christian - heck, as a human - I abhor the death toll that abortion brings and I firmly believe that life begins at conception.  I feel a divine spark in the idea of conception; it is beautiful and miraculous and with purpose - not accidental.  However, I am deeply shamed by Christians who act in a very un-Christ-like manner about abortion.  From outright harassment and hatred (can you picture Christ doing that?) to extreme measures to change the law of the land, Christians give themselves (and me) a bad name.  I espouse an apparently unique view that I can be a good Christian and believe in the separation of church and state.  I don't understand why some Christians feel that their primary goal is to enforce their doctrine on the whole country.  I do not believe that was the great commission.  We are to go out and tell the good news not enforce Christianity as law.  Fine, I hear people saying "but someone has to look out for the unborn!"  Great, I agree it tears my soul out to know that innocent babies are dying.  That doesn't mean I feel I can exact my worldview of when life begins on someone else who feels their view is as valid as mine.  God has a judgment day for this reason.  If you want to combat abortion do it like Jesus would have with love and compassion and education.  Not only will this be living like Christ instead of like tyrants but it is actually more effective.

Which is my long preamble to how infertility effects one's opinion of abortion.  I know that I still firmly believe that laws against abortion are at best discriminatory and at worst dangerous to women.  However, my whole "sanctity of life" views are so much more tangible now.  It isn't just something I "believe" because that is my particular choice in moral compass but I feel it.  I know (more than I ever imagine I would) what an amazing miracle conception is and that there is absolutely positively no such thing as an unwanted baby.  Maybe you don't want her but someone does, trust me.  Seeing my sisters in infertility struggle with miscarriage, failed cycles, and lost hope just drive home the perfect gift that a baby is.  Always.  Not sometimes.  Always a perfect gift.

Does this mean I am suddenly wanting to overturn Roe v. Wade?  Of course not.  I believe that a society is only as free as its most subjugated class.  I feel 100% in my heart that freedom of and from religion is the best possible environment for my religion and yours - whatever that may be.  It does mean that I believe that infertile women and men have a unique perspective from which to educate society about the alternatives to abortion.  It does mean that I shed an extra tear to hear that another pregnancy has been terminated when I would give anything to get pregnant.  It is a deeper, soul-wrenching familiarity with pregnancy and pregnancy loss - both artificial and natural - that makes us kindred spirits with those contemplating abortion.  We have seen inside pregnancy and conception in a way that no one else ever has.  Not mothers, not abortion doctors, not pro-lifers, not pro-choicers.  We have lived in these trenches and I think that gives us a valuable and unique perspective on abortion.  It makes me want to say to the pro-lifer "you don't really know what you are talking about" and to the pro-choicer "you don't really get it either."  I don't disrespect either of these groups (except the crazy militant ones) but I just feel I know in a way that they can't.

Am I pro-life?  Am I pro-choice?  Am I a good feminist?  Am I a good Christian?

I am all and more of these.  I am infertile.

The moon is full tonight and tonight I do my trigger HCG shot at 9PM.  Perfect time for an early spring harvest don't you think?

My ovaries look spectacular like bubbling balls of follicles.  I'm so proud of them!  Here is an example of an ultrasound of a superovulated ovary.  The black areas are follicles.  Mine are all around 18mm which means they are mature.


My estrogen level was 4.259.  Yikes!  Most doctors consider you at high risk for Ovarian Hyperstimulation Syndrome (OHSS) if it is above 3,000.  The Nurse said I would get albumin with my sedative at my Egg Retrieval (ER).

So, ER. Basically with the aid of transvaginal ultrasound (our friend the dildocam) they use a long needle to suck all the fluid out of the follicles (all the black area in the above ultrasound).  This contains the egg although they aren't actually finding the egg when they retrieve.  They just try to get all the fluid and the egg will be in there.  Here is the best image I could find about how this works.


Fun, huh?  Yes, you are seeing correctly - that is a long needle being poked through the vaginal wall.  If ever two words should never be together - needle and vaginal wall are it.

While I'm in surgery for ER, DH will be "producing" a sample.  Since we have MF they will use intercytoplasmic spern injection (ICSI pronounced ick see) to fertilize the eggs.  Here is an image of ICSI.


The thing on the left is a pipett used to keep the egg in place and the thing coming in from the right is the needle with a single sperm cell in it. 

I'm so excited to have made it to this point!  I actually have eggs!  I pray they are mature and healthy and that they fertilize.  Just thinking about fertilization gives me goosebumps - for the first time ever a part of me and a part of DH will combine to make a new life.  That will be so affirming.

Sooo, today I started thinking about home pregnancy tests (HPT).  I'm on a great message board for IF called Hannah's Prayer.  Lots of the ladies there are POAS addicts (POAS = Pee On A Stick, aka take a HPT).  They start POAS as soon as their Embryo Transfer so they can see the HCG shot get out of their system.

//pause for family and friends:
You take HCG (human chorionic gonadotropin) to make you ovulate right before Egg Retrieval.  So, a HPT would be false positive since this is what HPT test for. 
//pause

So once they start getting negatives then they continue to test so that when they get light positives they know it isn't the shot but their embies producing HCG. 

The alternative, of course, is to wait patiently for the beta blood test that the doctor does that is much more accurate.

So which am I?  A wait for the beta person? or a POASer?

It is a cruel fact of reality that 6AM comes at the same time every day even on the weekends.  :(  I let DH sleep since he has a harder time getting back to sleep if he wakes up (I could sleep anytime anywhere) and stabbed myself with 20 Lupron and 100 Follistim.

There are definitely things happening in my body and I'm trying to focus on that.  I'm actually taking heart that my ovaries are sore and that my left one is even having sharp pains.  Maybe that's the egg that will be my son or daughter - already giving me a hard time!  I am definitely irritable - like repetitive noises make me want to stab someone (what is it with men and mouth noises?).  Poor DH is being so great. 

I am SO attractive right now!  I have a pimple on my chin, my stomach is a rainbow of different ages of bruises as is my right arm, and I've gained 4 lbs. in one week.  And of course this is all compounded by my rosy demeanor.  Grrrrr.

Through it all I remember:  This opportunity is a miracle.  I wasn't supposed to get to do IVF with all its ups and downs.  I am thankful for the pimple, and the bruises, and the weight (?, ok, not so much), and the bitchiness because it is all thanks to a wonderful foundation that believes people deserve to have their best shot at a biological family.  God bless this foundation and its people, you know who you are. 

C'mon follicles, grow!  11mm by Monday!  You can do it!

/Sigh

I know you aren't supposed to compare your progress on stims to the progress of others and that I should trust my doctors on my protocol but it is so hard sometimes.  I had monitoring this morning and all my follicles are under 10mm still which didn't really bother me because I want them to grow healthy not fast.  But here's the problem - my e2 was over 1,000. 

Is that really a problem?  Maybe not.  I just hang on every word the nurse says when she calls.  And not just the words the tone, inflection, even the volume of her voice.  I feel it all holds some mysterious truth to my cycle.  She said, "you are sensitive to the meds."  What does that mean?  She said, "we don't want your e2 to get higher without those follicles growing." Could that happen?  ...increased panic...is that happening?  Maybe I can't grow eggs!  My IUI's were always with one despite stims.  She said to only take 100IU of follistim for the next two days and come back on Monday.  Why so low?  What's wrong with me?

Basically all of this spirals in my mind until I'm wound up like a Jack-in-the-Box with a huge rock on the lid.  The thing is that she wouldn't even have told me about my e2 level if I didn't ask and then I caused her to explain.  She didn't sound worried or like this was greatly unusual.  I got home and read in one of my (many) IF books that the reduction is stims signals your body to stop producing follicles and to start growing the ones you have.  That sounds perfect.  I don't want 20 eggs, 10-12 sound perfect to me (less snowflakes, no OHSS).  The fact that my body is sensitive to the meds is better than not responding, right?

This should all be making me feel better.  But, somehow I can't help but be in this state of worry tonight.  I've been so good about relaxing and enjoying the ride of this cycle.  Tonight though I feel like I can't breathe with worry and my lips are tingling like mad (s/e of zoloft when you get stressed).  I just want to cry and sleep for 4 days.  There is this huge lump in my throat.  I can almost feel my baby in my arms and it is like she is being pulled out of my embrace by some unseen and malevolent force. 

In the back of my mind I have the realization that I might be feeling this way because of the meds.  Worry won't help my eggs grow.  Obsessing about my e2 isn't going to make it drop.  Maybe this happens all the time.  I need to go along for the ride.  It is all decided by God already anyways.  I'm just here to experience what is already planned. 

I have to trust and let go and breathe.

Oh yeah, and good news: my lining is 15mm!

You have to read Jen's hilarious post about how she is official 1 day pregnant!

Since a pregnancy is calculated from the date of your last period, you are technically 2 weeks pregnant before sperm ever meets egg.  So, if this cycle works - I am already 8 days pregnant.

I think I need to go lie down and put my feet up!

Ok, I'm feeling it now.  My ovaries are so sore.  I always thought I was lucky that I have mittelschmerz and know when I ovulate but it also means I can feel my ovaries all the time.  Now they are kind of pulsating with a throbbing ache.  It isn't unbearable but it is unpleasant.  I am also exhausted - more exhausted than I've ever been.  Yesterday we were cleaning out the stock room in my Library for an upcoming move (we are getting awesome new digs!) and I just felt so tired and a little light headed and I had to sit down. 

My e2 was 398 yesterday (up from 29 last Friday at baseline) so that was good.  I'm continuing on with 225 Follistim, 20 Lupron except I'm supposed to skip Follistim tonight, resume Follistim tomorrow morning and then go back for monitoring.  They also started my surgical paperwork for Egg Retrieval because I'm "looking good."  I can tell it is working because of the pain and also the TONS of EWCM (if you don't already know what that means then trust me you don't want to know).

I have an appointment with my counselor today and I'm thinking of canceling and getting a pedicure instead.  Hey, spa treatments are therapy too!

I am mentally compiling a list of "Laws of Infertility" that I will one day write down here.  But, today I learned an important one:

"Thou shalt trust thy Follistim pen!"

I went in for ultrasound and bloodwork this morning and everything looks fine.  My follies are still small but I have 6 measurable ones on the L and 4 on the right.  No lead follicle developing.  They said I looked "normal" for being on the 3rd day of stims.

Whew!

Oh NO!!!!  I got panicky about that extra 75 dose this morning and I called my clinic.  They want me to come in tomorrow to make sure everything is ok.  OMG, I'm so worried that I messed everything up!  They did tell me to just do my regular dose tonight and tomorrow.  What is the likelihood that one 75 extra on stim day 2 could mess the whole thing up?  This is going to be a sleepless night!