9; Follicle-ing the Leader

Sometimes I make up asinine songs about mundane things in life, especially if I’m nervous about said mundane thing and especially if everyone else around me seems to be perfectly sane about it.

Example: I hate flying. Well, not flying itself, but turbulence, even the slightest bit. No matter how many statistics I read about how safe flying is, all the “You’re 239123819x more likely to die in a car accident!” comments do is make more more scared to get in a car. Yes, I know turbulence is like a pothole in the air, but if growing up in Mid-City New Orleans didn’t ensure me mental-anguish immunity based on that analogy, some dude’s blog is not going to.

Anyway, this is that song, because I know you’re dying to hear/read it. I wrote half of it on a plane in May 2017 and half this past November, after dropping an ex-friend off at the airport after a visit that ended up turning into a disaster proving I should’ve followed my gut and we should’ve stayed not friends. (Silver lining: It got me the rest of the way in the lyrics to this masterpiece.)

Sung to the tune of “Under the Sea” from The Little Mermaid:

The stratus is always whiter
When you’re high up in the sky
You dream about going farther
To do that, you got to fly
Just look at this space around you
Right here on this Boeing plane
How you going to store your luggage
A way that will keep you sane?

Under the seat, under the seat
Darling it’s better, when you’re a jetter
Keeps your bags neat
They won’t tumble in overhead bin
When you’re knocking back your third gin*
It’s very small now, don’t try to crawl down
Under the seat

*I was, in fact, on my third gin when I wrote this line (not during the aforementioned drive, wow, I’m not an animal)

“None of this has a damn thing to do with IVF, Jen,” I KNOW, I’m getting there. Look, all this to say I started making up another song about ovarian follicles to the tune of “Particle Man” by They Might Be Giants and I just wanted to tell you it’s a work in progress. But now that I write this, I realize I just wasted so much time and maybe I’m just that damn proud of my booze-infused flying song.

OK. Follicles. So I had my second post-stim scan and blood work today and everything is looking extremely…decent. The nurse told me my blood work looks good, and I have about 10ish measurable follicles — 5 on each side — and maybe a couple more little ones hiding up in there. I’m staying on the 300 IU of Gonal-F (the stim shot) every night, and I have my next scan Monday morning at 8:30. I also need to start taking Cetrotide every morning starting tomorrow, which is the shot that will keep me from prematurely ovulating. And yes, I want to write “ejaculating” every damn time but I haven’t yet, ha HA.

I’d be lying if I said I wasn’t starting to get anxious. I think a part of me hoped there’d be a whole host of follicles that would forget I’m such a wound-up B and once I pumped my body with more drugs than the entirety of Daytona Beach has ever seen they’d be like

No such luck. But my doctor isn’t upping my meds, so I’m taking that as a good sign.

There is still the potential for a miracle to happen, so until Monday, I will hope for a miracle — and in the meantime, work on being thankful that I have what I do have.

8; Taking the (Needle) Plunge

Well, long time no talk. It’s been about three months since I’ve updated this blog after starting it and subsequently going balls to the wall with my brain dump, and I truly wasn’t even finished. I had lofty goals about rehashing the events up to this point — breaking out each failed IUI individually, for example — but I realized I really don’t want to. I don’t have the energy, and looking back to a stage I feel moved on from (mostly) sounds 100% unappealing. That’s probably why I stopped for so long.

What I do want is a place to just write out what I’m feeling along this path, when I’m feeling it — and from late October to now, I was feeling like I just didn’t want to think about it. Which was good. Josh and I were able to, despite a few bumps, enjoy the holidays, which came with five extra pounds for me on top of the 10 I gained post-miscarriage, but I’m working on it, OK?

I was also kinda sorta hoping that the miracle pregnancy people told me happened to their great-aunt’s neighbor’s niece right before she started IVF would happen to us, but here I am, which means it did not.

We *did* get to drink fancy warm winter drinks at Tavern on the Green in N.Y.C. at Christmastime, though. #win
Also grabbed a drink at Eataly’s swanky rooftop bar.
And ice skated at Rockefeller Center because it was a bucket-list item for me and not everything we do is alcohol related (unrelated side note, we gave up alcohol this month).

But NOW, this infertility shiz is priority No. 1 yet again because tonight, my friends, is my first dose of stims (stimulation drugs) for our IVF retrieval cycle. Hooray!

So to start — remember when I told you my AMH was .31 and all the details about what that means? Of course you do. Well, I got my blood drawn in December and after three months of taking DHEA, it went up to .79. Which at first consideration is still low, but when I really think about it, it more than doubled. Which is fantastic. I’m hoping by retrieval time at the end of this month/beginning of February, my egg count and quality will have made the four to five months of taking the DHEA 3x a day worth it, even if only in my mind. Good enough for me.

Speaking of shit I have to put into my body, here’s my pharmaceutical setlist for the foreseeable future:

  • Letrozole (more mild – oral stims)
  • Gonal-F (injectable stims – these are the $$$ drugs)
  • Cetrotide (prevents premature ovulation)
  • Novarel (trigger shot to ovulate 40ish hours later)
  • Vivelle dot patch (estradiol/estrogen)
  • Progesterone and oil – More on this fun later once I start it, but if you want a preview, you can read this amazing post by my favorite infertility blogger, Heather (and this one too tbh, she’s fantastic)
The spoils, part I.
Non-refrigerated spoils, a.k.a. part II.

$3,600 worth of drugs, folks, which…I’m relieved about. I never thought I’d say paying $3,600 for one month’s supply of medications would make me say that, yet here we are. I’m relieved because the clinic estimated $5,000 to $7,000, so Josh and I prepared ourselves for $7,000. And I should be getting a rebate from this amazing program my friend Amanda told me about called Compassionate Care, which anyone can register for and then they offer you a percentage off certain medications based on your income. Josh and I “only” qualify for 10%, but 10% off of the two in the above list that it covers — Gonal-F and Cetrotide — is $335! Big chunk of change for us.

To be candid, we applied for two grants and did not get chosen for either one, so we took out a home-equity loan to pay for this which, if we don’t end up needing more meds and do a fresh transfer, is costing us $16,500 out the gate including the meds. If we produce enough good-looking embryos to risk aging to day 5/blastocyst stage and doing the PGS testing with a frozen transfer later, that will add about $4,000 to the total. Each subsequent transfer/”try,” assuming we have embryos frozen, is $5,000 to $7,000, so the idea is that having PGS “normal” embryos to work with will make our chances of a successful pregnancy higher the first time. Our loan was for $25,000, so we have a little wiggle room for now, and time to save up if, God forbid, this journey continues beyond the first try or two.

I’m putting these numbers out there because it’s completely insane that so many insurance plans (including ours) do not offer to help couples struggling with infertility. It’s garbage, and I really hope that changes ASAP. We are in the lucky group who can somewhat reasonably afford it, if not via our ideal scenario. So many people cannot.

Anyway, the plan is to start the stims (Letrozole and Gonal-F) tonight and take them for four nights. Then I have my first follicle-check ultrasound on Wednesday morning to see how those babies are growing. I should mention that on my medicated IUI cycles, I took 75 UI of Gonal-F two or three times, every other day. This time? 300 UI every damn night for what they estimate will be 12 nights. Oh boy.

I’m pretty worried about how they’re going to affect me, physically and emotionally. Josh says he’s ready and not worried because the 75 UI didn’t really have a big effect on my moods, but I don’t think he really knows what he’s getting into. I already asked him in advance to forgive anything that comes out of my mouth this next month and, if I get pregnant, the next 18.75 years after that.

The list of things he does for me is endless. This is us having fun.

There are a few more exciting things going on for me. I got full-time hours at my job, writing for PEOPLE.com, which is faaaaab. I’m very thankful to be working 8 to 4, Monday through Friday at my dream publication and not having to feel the need to seek out side projects. And I’ve rejoined Weight Watchers (sorry — it’s “Wellness That Works” now) and lost almost 5 lbs. these first two weeks back. Overall, I’m feeling good, and like I’m allowed to relax some and move forward.

But this post was mostly to tell you guys that IVF is officially a go, and moving full steam ahead. We’re scared. We’re nervous. But mostly we’re excited — truly. It’s been a lot of waiting up until this point and regardless of how this all turns out, we feel like there’s nowhere to go but up.

5; Being My Own Advocate, or It’s My Ovaries and I’ll Plan If I Want To

If there has been one constant in this ever-changing puzzle called Baby Haupt or Bust, it has been the fact that the only person who is going to advocate for what is best for me is myself. Josh too, of course, but to a point — over the past two years, our idea of what’s best has differed from each other’s. More on those super-fun fights in a later post or seven, but rest assured these experiences have actually made us so much stronger in the long run. Even now, before we have a baby in our arms, we can feel it. Wine helps.

Yesterday, we had a big disagreement — over Google Hangouts of all places, even though once we started this journey, we swore we wouldn’t talk about anything important over email or chat or anything like that. But when you’re married to a writer who can go on forever about things, you learn that sometimes that person has to get it all out through writing — and when that writer is a neurotic psychopath, they have to get it all out through words right. The. FUCK. NOW. (Being married to me is paradise, really. Can’t wait for all the hormone shots! Lucky Josh!)

Our disagreement was over how to proceed with our IVF treatment. We met with our doctor Wednesday to go over some of the basics and here’s basically what transpired:

Me: So doc, blah blah, egg retrieval in January plus PGS (pre-implantation genetic screening) and a frozen transfer in May, right? YAY!

Doc: Actually I think we should do a fresh transfer in January and skip the testing, a.k.a. the exact opposite of what you’re telling me lolz!

Me: …?

Doc: Your diminished ovarian reserve means you probably won’t produce a lot of eggs so we don’t want to put them at risk by testing them, freezing them, defrosting, etc.

Me: OK cool that makes sense.

A little background, which I touched on previously but didn’t go super into: I have something called diminished ovarian reserve (DOR), which means the little ovarian follicles that produce eggs? I have fewer of those than most women my age, and therefore fewer eggs and years of fertility remaining than most women my age. Dr. Google gave me this handy article predicting IVF success rates at this one clinic based on AFC (antral follicle count).

I had 12 at my last scan, which is pretty close to the low end of normal but my doctor says the Anti-Müllerian hormone (AMH) is a better indicator of how my body will respond. Anything over 1.0 is considered OK, with somewhere around 2-3.5 being average for my age. Last blood draw, in April, mine was a freaking .31. Nine months before that it was 1.3, so it dropped like whoa. My doc said that can happen as a result of fertility medications, which…great. Nice catch-22. My ovaries are literally a perfect reflection of my personality, which is the type to throw out shit I might need later based on the self-assurance that I probably won’t need it, and half the time I’m kicking myself because I trashed an important document or something. See also: My nails, which I have bitten since before I can remember, and my eyebrows, which I over waxed/plucked in high school and are now mere shadows of their formerly bushy selves. Josh is even worse — he thinks I’m a pack rat, and I probably am compared to him. But the point is, if he had ovaries, he’d have NOR, which is Nonexistent Ovarian Reserve, which is something I made up. But alas, he’s a man, and his man reserve is fine because OF COURSE IT IS.

I’ve been taking this supplement called DHEA, which is a controversial thing in the medical field. My doctor gave me the OK to safely take it but warned me there haven’t been enough studies to back up its supposed benefits, which are that it could help elevate AMH and AFC. This, in theory, seems absolutely ridiculous because AMH and AFC are indicators of how many eggs you have left and women are born with all the eggs they will ever have, meaning you can’t magically start producing more like Yoshi. But I’ve heard stories from other women who beg to differ and whose egg quality and AFC/AMH numbers have been improved as a result of DHEA supplementation. There have been been some studies that report this, too — specifically for younger women with DOR, like me — such as this one, but I’ve also read it can be detrimental to women whose DHEA is not low to begin with. From everything I’ve read, I think we can assume mine isn’t great. ALSO…my AFC was always around 8-10 before this last ultrasound I had (my first since starting the DHEA, about three weeks prior), which tells me the DHEA might be up to something. Regardless, I’m taking it until my retrieval cycle and going to get my blood drawn again in December. So we’ll see.

Oddly, DOR doesn’t really affect pregnancy rates because you’re usually still ovulating fine. So even though I have this, I’m still a case of unexplained infertility.

Anyway, back to the soul-crushing IVF consultation, with a little aside. This was also a fun convo:

Me: I’m thinking May if we do a frozen transfer.

Doc: Why wait that long?

Me: I’m not trying to have a baby over the holidays, we already have way too many of those plus our anniversary.

Doc: Wow, I’ve never heard of a woman caring about timing before when it’s taken them this long to have a baby.

Me: First time for everything huh? HAHAHAHA. (< I did not say this but I should have, like GTFO I do what I want.)

I shit you not, he used the word “inappropriate” twice. TWICE. Not about this, but in general — and he meant it like “not the right course” more so than “Bitch, what are you on?” (I think). I’m probably the most annoying patient he has ever had but when I pay you $20,000-$25,000 after I’ve already paid you at least $10,000, you will take it. I have learned in the past two years not to apologize for asking questions or for pushing for a certain test or procedure, and I’m so thankful for that. I truly believe it has made all the difference in getting us closer to becoming parents.

So many tangents. I’m going to wrap this up and finish over the weekend with the thrilling conclusion about how I Josh and I decided to move forward and why. Surprisingly, it involves me letting go of some of the control, but it’s not blindly following exactly what the doctor says either — which is something my husband wishes we could do, but we cannot. Not for this much money and not when so many variables are at play.

2; “Just Relax – It’ll Happen When You Relax!,” or: GTFO

Let me preface this by saying that I am NOT a patient individual. Anyone who knows me knows that, and so the very first thing I did when we decided to try getting pregnant (besides get down to 15 lbs. less than where I am now, but that’s another story) was buy a shit ton of ovulation tests. Now if you don’t know what these are or have never used them and you have children, congratulations. Also, as an aside, please know there is going to be a lot of “GOOD FOR YOUUU”s in my posts and it is not directed at ANY one person who didn’t have trouble conceiving. I hate you all equally. :o) Not really, of course. I love you, especially if you’re reading this and especially if you have Reese’s you are willing to part with in exchange for literally nothing. But those complex emotions are, again, another story for another time.

Sorry to use a Dane Cook joke because it’s not 2005 nor am I an asshole, most of the time, but let’s Tarantino this and go back in time. I used ovulation tests – which, like a pregnancy test without the pregnancy part, is a stick you pee on to tell you when you’re going to ovulate, therefore your most fertile time – on our EUROPE TRIP, in September/October 2016, the first month we started trying. The night I got a positive result, I will not go into massive detail about, but let’s just say we’d spent the evening at Oktoberfest in Munich after spending the day in Salzburg in ANOTHER COUNTRY and had to get up at like 3 a.m. for a flight to London. It was…not the most laid-back experience, let me just put it that way. I don’t have many regrets but if I could go back I’d probably just chill the fuck way out on that trip because the timing was not ideal. At the airport, I literally fell backwards down an escalator. Luckily no one was watching except my equally terrified and amused husband, who still calls me Doodlebug to this day because of how I just. Kept. Fucking. Rolling. (And in New Orleans, where I’m from, that’s what we call roly polys, pill bugs, whatever the rest of you weirdos say.) Also, to be fair, the suitcase Josh was “holding” fell into me. I was the overpacker though so Josh 2, Doodlebug 1 I guess. I’m not mathing right now. I’m in the bathtub and I’m tired.

Speaking of chilling out, ever have anyone tell you “Just relaaaxxx, it’ll happen!” LOL BECAUSE I HAVE HAHAHAHA yeah. No. There is no scientific proof that NOT trying to time sex properly and enduring a little bit of stress to make that happen won’t lead to a baby but gosh golly, we tried it anyway. Josh and I went away for weekends a couple of times, I tried not tracking my basal body temperature (oh we’re about to get real educational and maybe even a little TMI up in here because I have learned A LOT) and symptoms. I tried drinking more water to help with my fertile cervical fluid (I warned you), eating and drinking out of glass instead of plastic, every vitamin you can think of, reading books about how to get pregnant faster, and nonnnne of that worked, guys. None of it. We are a case of unexplained infertility, which – you guessed it – is a case that the doctors can’t figure out. My Fallopian tubes are open. I don’t have endometriosis or PCOS. I seem to be ovulating on my own and have regular periods. I’m a human. I’m not THAT old. Josh had three – THREE – analyses done on his situation and those came (no pun intended ugh SORRY) out fine. A little tip (lolz) if you’re a type-A individual and have unexplained anything: don’t.

Turns out I DO have a weirdly positioned and difficult to penetrate cervix (imagine that!) and something called diminished ovarian reserve (DOR), which is a likely lower egg count than most women my age (33). So maybe these could be issues? I don’t know. But I had an ovarian antral follicle count (AFC) of 12 the last time I went to the doctor, about three weeks ago, and I believe most women my age have 15-25? Definitely more than I have. And the higher your AFC, the better because it means you have more fertile years left and if you undergo fertility treatment (more on our history of that later), you’re likely to get more eggs on one round of stimulation. My AMH hormone is also very low, which signals DOR as well. However, AMH and AFC tell you absolutely nothing about egg quality. Know what does? IVF! What a coincidence. The possibility of paying thousands upon thousands of dollars to potentially be told your eggs are a complete Dumpster fire. What a steal. Luckily my doctor believes I’m a very good candidate for IVF and that my eggs aren’t all hot garbage, which is probably just something he says to all the girls but alas. Josh and I are meeting with him next Wednesday to go over our schedule and get a few questions answered and cry over the price they give us so that should be a really fun time.

I joke but we actually are excited about it at this point because it’s something new to explore that we haven’t failed at before, which I know is a very glass-half-empty way to look at it but it’s almost impossible not to feel that way at times. Over the past two years, we have been through five intrauterine inseminations (IUIs – lots of fun acronyms when you’re dealing with infertility), one miscarriage and dilation and curettage (D&C), at least 10 friend/family pregnancies (three during months we had failed IUI cycles), approximately 73 bottles of wine – shout-out to that for playing its part in these 15 lbs.! – and roughly $15,000 spent (between medications, IUI treatments, a surgery, pregnancy and ovulation tests, vitamins, acupuncture, a crib that is sitting forlornly in the room we don’t feel right calling a “nursery” anymore, etc.) that has gotten us nothing tangible, so it’s safe to say we’re ready for this next step. And despite my sarcasm through 85% of this post…I am thankful for it. It has made me so much better of a person, and I’m excited to explain why to you guys.

But for now…bed. The water is cold and I regret everything.

1; The Beginning, or How I Learned to Stop Worrying and Panic Instead

So this blog has been a long time coming, I guess. It started as a few very informal, very wet-haired selfie-recorded videos on my iPhone (like, some in my bathtub, guys), and then morphed into a Facebook post draft that I continually updated every time something new happened in this now-two-year journey of Josh’s and mine. Once that Facebook-post draft got over 2,500 words long and the big question mark in my head took the form of “if” instead of “when,” I knew it was time to go back to writing my thoughts down in a blog.

Josh and I have been trying to have a baby since our trip to Europe. For those of you not keeping track of my personal life, that was two years ago. In fact, Oct. 4, 2016 was when we returned and we were both so excited knowing the new chapter of our life could be right around the corner. I had a feeling I’d get pregnant the first time we tried because, up until that point, I had succeeded at everything I had tried my very best at without having to do it more than one time. Some things took longer than others, but there was always a known end/goal date and a defined way to achieve that goal. Not this time, Jen.

I’ll get into some of the more specific aspects of what has gone down in the past two years in subsequent posts, but I just wanted to start out with something to say thank you to everyone whom we’ve reached out to in this time period, even if you don’t read this. The group of people we shared our struggle with started out very small, but has grown large enough to the point where, when we miscarried in March, I was having trouble remembering whom all we had told about finally achieving a pregnancy so that I could go back and tell them it didn’t work out. At first, this upset me — I felt like maybe we had jinxed ourselves by telling so many people.

But looking back, I’m so glad we did, and we’d probably do the same thing if given the chance to do it again. Josh and I are both very stubborn, proud, textbook oldest children, which can be a good thing but can also be very difficult because when both people in a relationship have trouble asking for help, they are both prone to emotional drowning a lot more easily. So to those of us who have asked how we’re doing, sent us messages of encouragement, “sat in the shit” with us (as my therapist likes to say), thank you. We know it’s not easy when you don’t know what to say, and we’re very thankful for each and every one of you who have tried anyway.