Monday, 23 September 2013

Surviving the thaw

We froze a sperm sample last week in advance of the super major endocrine crashing surgery (for which we still don't have a date). They take the sample, divide it into 8 "straws" and then this morning they thawed one to test. The good news is they survived the thaw. The bad news is that enough survived for ICSI, but not for natural fertilization. I was hoping to avoid ICSI. A big part is the extra cost. $1500. Not covered by OHIP. Nor is the sperm banking by the way, even though both have become "medically necessary".

FYI - the original page from which I found this image is well worth a read, 
I mean with a headline like "will swallowing semen make my girlfriend gain weight" how could you resist?

Under normal circumstances, the "best" sperm win the race. This is what makes me nervous about ICSI. Despite what the clinic doctors said, I am an avid pubmed user and I know there is data out there to suggest that there may be more risks of fetal abnormalities with ICSI simply because the best, healthiest sperm didn't win the race. Whether the sperm was not strong enough to do the job on his or her own, or whether the egg was developing a harder less penetrable zona (shell if you will, although it's not a shell per se), the need for ICSI arises when one or both parties are not in tip-top shape. It's giving a helping hand sometimes to genetic material that otherwise wouldn't make the cut. It's not the process of ICSI, it's the selection of sperm to use. The success rate for ICSI (and there are twice as many as non-ICSI IVF done in my clinic) is not nearly as good. This, and the studies that show more potential problems with ICSI outcomes all reflect pre-existing problems. If only a small number of sperm survive the thaw, they are clearly the best, so I guess the selection process is pretty simple. It just makes me nervous. I wanted to make this as natural as possible, just by-passing my damaged tubes. I want minimal ovarian stimulation. I want 6 follicles. I want them to fertilize because they want to, because they are healthy, and develop the same way, and I dream of 3-4 good embryos, transfer one and freeze the rest for later. And never have to do another retrieval cycle. Maybe I'm being naive.

I also had a dream the other night that I was asked to care for 3 foster babies, infants, but they were all boys and all I could think was why are they all boys? I hope it's not a sign.

Tuesday, 17 September 2013

Weighty issues

Before I moved last year I was at a svelte 133lbs (give or take a pound), and comfortably sporting size 4. I'd completely revamped my wardrobe in size 4. I'm only 5'2" so don't get too too jealous, I was still at a BMI of 24, but life was good and I was pleased, even if everything was still flabby and no way was I going to wear a bikini. Since I moved,  and we started trying to get pregnant, it creeped up. Just a tad, but I'm sitting at 140 and have been for a few months. I let this happen. First, because every month I assumed I'd be in maternity clothes in no time, and second, because my stupid hormones give me almost constant mild morning sickness (and have for the past 4 years) that is effectively managed with the same trick as real morning sickness - food. Carbs and nuts especially. At some point along the line I discovered that B6 and magnesium supplements keep the queasiness at bay, so now my only excuse was not to introduce a diet or new workout because maybe this month will be my month.

When I got my diagnosis and it started to sink in, and I started to think I'd never be pregnant again, I searched for a 30-day-abs program that a friend had posted on Facebook a while back. I was planning to start, but never got around to it. Where have we heard that before? I did start randomly doing cardio, but life gets in the way sometimes (again, if you let it). Now that I'm hoping to have a successful IVF before the year is out, getting those washboard abs I never had seems silly. I should still do more cardio, and I should still drop 5-10 lbs so my pants fit again, but who cares about abs.

Well, I've found my calling. The totally-won't-be-undone-by-pregnancy 30-day-ARMS! Thank you Jodi Higgs!

Day 1 - success!

Panic attack!

I don't want to trivialize the experience of people with panic attacks. I think I'm just having very mild ones. But they are interfering with my ingenious plan to work from home as much as possible. We are closing in on the likely timeframe for my husband's surgery. His major major surgery. But we still haven't been given a date. Our reproductive endocrinologist (RE - the fertility doc) is aware of how quickly it is likely to happen, and is working with us to freeze some sperm. But no date for that either. I wish I could carry on full steam ahead like he is with an attitude of "get as much done before they call" but I can't seem to do that. Instead I'm having regular panic attacks. Sometimes it's a near paralyzing anxiety that keeps me from doing anything except reading my fertility board. Sometimes it's heart pounding, racing, or whatever that was last night - it seemed to be composing a hip-hop song with a crazy irrational beat. I haven't even gotten dressed yet this morning and I'm already paralysed. I have a meeting at 9:30, it's 9:05 and I'm in my robe. Luckily it's online and no one can see me, but I can't go for a run until it's over.

I only have two tricks up my sleeve to cope with this right now. One is running. I literally feel like I am running away from the anxiety, and while I'm running it feels like it's working, but it doesn't seem to last.

The other is SleepyTime Tea, coupled with something mindless like a talk show to distract and sedate me ever so slightly. It gets my heart rate back down closer to normal, but I don't seem to settle enough to concentrate on any work. And it seems strange to drink it so early in the day.

It's taking everything I have to keep up, to keep going. On the days I go in to my office, I'm pretty effective, and they end up being long days. So far, no one is the wiser. I was waiting until we have a date set to tell my boss what's going on. I was tempted to tell him on Friday. Now I'm tempted to tell him this week. I'm not sure what would happen if I needed to take stress leave for a few weeks, it's not like someone can just come and take over for me. Can they? What would happen if I were hit by a bus and in a coma for 6 weeks? There must be a contingency plan. My contingency plan has never extended beyond a day or two.

9:18 am. Time to shake it off as best I can. Get dressed. Eat something. I can do this.

Saturday, 14 September 2013

Full steam ahead!

Yesterday we had our first IVF consult meeting. I was so anxious a few hours beforehand that my hands were shaking and my heart was racing. I didn't think it was appropriate to have a glass of wine to calm my nerves, but I found some SleepyTime tea in the cupboard, watched a mindless talk show, and managed to take the edge off enough to not be a complete basket case.

Our doctor was great. She explained everything really well, including what we need to do because of our "special situation" and had everything ready for us to begin the pre-tests (my OB had sent everything, but there were a few special tests the clinic needs). They require basic infection screens, and we did it right away. I need a sonohysterogram (where saline is injected into the uterus to inflate it and then ultrasound is used to look around) to make sure there aren't any polyps that could cause a miscarriage. I need to repeat my cd3 bloodwork because even though my FSH was low, estrogen wasn't measured and abnormally high estrogen can also suppress FSH making it misleading. Follicle Stimulating Hormone (FSH) levels begin to rise late in the luteal phase as progesterone and estrogen drop, causing FSH to peak around 3 days after the first day of menstrual bleeding. When ovarian reserve gets low, FSH levels tend to rise overall making the peak even higher, but it's just a symptom, you won't improve your ovarian reserve by trying to lower FSH and occasionally it can be misleading. So both of those tests can be done for me in my next cycle and fingers crossed I could have my first IVF in November. We also have a mandatory 3 hour information session with a nurse and social worker. We are waiting for that to be set up too.

The big deal is the recommendation that we freeze semen samples and soon. This is critical. The surgery will have a direct effect on his endocrine system, and the long-term consequences are uncertain, from a fertility point of view. He could get a hormone replacement regime that only results in a brief period of poor sperm quality, an indeterminate period of poor sperm quality, or permanent sterility. So this is a one-shot deal. Pun intended. But we are going full steam ahead!

We left the clinic but hadn't really discussed anything together, privately. After we had our private discussion, and had decided that yes, we're doing this, we were excited. We wanted to celebrate. We didn't celebrate when we first decided, yes let's try and make a baby (although I know some do) so it was strange that we were feeling this way. So now the surgery preparations are in full swing, and the IVF preparations are in full swing. It's a crazy but exciting time.

Thursday, 5 September 2013

Do you put your trust in fate?

It feels like Kismet. Fate. Today the Universe delivered. I got a call this afternoon that there is a cancellation next week and the clinic can fit me in for my initial consult. This is it. Here we are, September, when my life gets really chaotic. I have worked it so I only have to work out of town 2 days a week, and I have two semi-open and one completely open day. Thursdays are my day. Thursday is the opening. Score one for good luck.

As soon as I got off the phone I called my other half to make sure he'll be there. He needs to be there, and I accepted without even checking, but he didn't have any conflicts and I told him to mark it in his calendar. Score two for good luck.

My anxiety was subsiding already, and now I'm psyched! There is a lot to be anxious about. We are still waiting to hear about his surgery date. Will we get the chance to do anything before his surgery? Will they freeze and store his sperm? How does he feel about it? Should I buy a lotto ticket and make it a trifecta? The future is always uncertain, but everything always works out in the end.

Ironically, while my womb might get a dust-off, my aching old joints just ix-nayed my afternoon run plans.

Wednesday, 4 September 2013

Why does calling my doctor fill me with such anxiety?

Here is the way health care works in Canada (at least my experience of it). If you think something is wrong, but not so much so that you're dying, you call your doctor and make an appointment. That appointment could be within a week, or it could be a month from now, depending on whether your schedule is flexible enough to take the random slot that's open (aka probably your doctor's 10 minute lunch break). You go to said appointment and the doctor orders up some tests (or you get a diagnosis and prescription on the spot with instructions to "come back if it doesn't improve in two weeks"). If the doctor isn't really concerned, you get the standard "you'll hear from us if anything is abnormal" and chances are you won't - but trust me, if for example your cholesterol is through the roof, you'll get that phone call inviting you back! If the doctor thinks something is wrong, you're booked in for a follow-up as soon as they expect the results, like the time my doctor was convinced I might have an ectopic pregnancy, and didn't believe me that I wasn't pregnant but sent me for blood tests and had me come back the next day! I haven't seen my OBGYN in about 6 weeks now. The last time I saw her she said I'll get a call about an ultrasound appointment and from the fertility clinic. I got the ultrasound call quickly, which made me concerned / pleased that I really am in need of fast-tracking. But then the day of the ultrasound I got a call rescheduling. So I waited, the ultrasound rolled around, and I knew my OBGYN was away that week so I went about my business figuring I'd get a call. I haven't had a call, and it's been 3 weeks since the ultrasound. Not a call from my OBGYN to say there was a problem with the scan, and not a call from the fertility clinic to schedule my consult. Most of the day, I've sat with both numbers in front of me, to call, but I get filled with such anxiety at the thought of it all. Finally, 20 minutes before they close for the day, I got up the nerve. Please leave a message. I hung up. I guess I need even more courage to leave a message than I can muster in the span of one business day.

Ups and downs

I was doing well, acceptance-wise. For about two weeks I was at peace and accepting of the infertility and ready to move on. I could look at babies, even hold babies, and not feel that tremendous pain. I was feeling good about how nice it is to have a mature self-sufficient child rather than a baby or toddler who needs constant attending. But then something happened. I crashed. I've been a barrel of near explosive anxiety for two days. It's not just the infertility, the bulk of the anxiety has to do with the fact that my other half is waiting for a date for surgery. Major surgery. And I'm trying to plan the next 12 weeks knowing that any minute now he's going to get a surgery date and I need to plan around it but I can't wait, I need to finalize commitments in the next two days. The last thing I should be worrying about is an IVF consult appointment. But I am and I don't know why. I can't seem to motivate myself to get other things done. I'm at the brink of tears day and night. I started running again, which only helps temporarily, and really does feel like a brief chance to "run away" from the anxiety that is eating me alive.