follow up

I had my post-surgical follow up appointment this week. It was fairly anticlimactic. Reviewing the findings of the lap, Dr. RE informed me I had the pelv!s of a 16 year old. Hmm...that's a good thing, I guess. But why couldn't I have the unplanned pregnancy rate of a 16 year old?

The new game plan is another round of fsh injections, but with an iui this time. I asked about the relative advantages of an iui over the at-home version, and his equivocal response was that for anovulatory infertility it is not of tremendous gain over ovulation induction alone, but for unexplained infertility it doubles pregnancy rates over oi alone. And the way he let his explanation trail off certainly implied that we are heading into unexplained territory.

After that heartening discussion I was ushered in to my favorite nurse's office to try to deal with a headachey insurance issue. I am lucky that so far much of my treatment has been covered. But the insurance company likes to make me jump through hoops, which stresses me out a whole lot more than sticking myself with hormone laden needles.

Oh, and highlight of the appointment: As I sat with my nurse (who was on the phone with the insurance company) I heard Dr. RE remark to another nurse in the hallway "She's got a great chance of getting pregnant. Of everyone I have seen today, she has the best chance of getting pregnant." Need I tell you? He was not talking about me. But that is exactly what he said to me at my first visit, over a year ago. I guess the outlook is no longer quite so rosy.

how did this happen?

So, I decided to take the month of June off. Off! No fertility for me in June.

I had an interesting visit with the RE and we decided that after one cycle off (my decision because, you know, I recently had a stress breakdown) we would try one more round of clomid (my decision, because when it came down to it I freaked out in the face of injectable FSH) combined with an HSG (mutually agreed upon most genially) and then on to injectables (dependent, of course, upon the results of the HSG). I was to keep temping, and to come in for a shot of progesterone on cycle day 21 if I hadn't had a temperature spike (or, I decided, whenever I was finished with my time off, because let's face it, there would be NO temperature spike).

Flash forward to day 21. I was at the beach. Happily not caring about my lack of a temperature spike. After all, I was taking the month of June off. And I was at the beach! With my husband. And we were having lots of sex without special sperm-friendly lubricants or even a thought of cervical mucous. And I was only taking my temperature every 3 mornings or so, and it was always low, and who cares? I'm taking the month OFF!

And lo did I drink much diet coke and a little champagne and eat much fish with no thought for mercury contamination, and oh, I forgot all about taking my metformin and vitamins most days. And on the last morning of our vacation my temperature was so low I took it twice, because after all I'm not a corpse so how could such a low reading be accurate?

And along came day 28, the first day home, the day I was planning on going in for a progesterone shot because I was rested and happy and ready to try again. Only, it turns out the shot was unnecessary because that morning I got my temperature spike. "I'll just wait and see," I thought. And my temperature kept going up. And staying up.

And somehow, I am now in the middle of a 2 week wait for the cycle that I was taking OFF. The one where I didn't take any clomid. And went on a freaking vacation.

I was in a bit of denial at first, based solely on temperatures, but a few days ago my breasts became sore, sore, sore, and I gave up on denial and let hope creep in. So today (8 dpo) I took myself to the RE for a progesterone draw, just to prove quantitatively that I actually managed to ovulate on my own. Still a delayed ovulation, but earlier than last cycle on 150 mg of clomid.

Can I please be one of those annoying people who get pregnant right after they stop taking fertility drugs and while they are on vacation? Please, oh please, oh please?

I know it's a long shot. But, like I said, I just had a lovely vacation, and right now I am feeling strong enough to hope even when I know it's stupid.

I'm still here

Thank you, Thalia and DoctorMama for your thoughtful encouragement. It truly cheered me to read your comments. Although, I have to say, my favorite thing anyone said to me regarding the lost job was when my Dad called to say, "Who is this person who didn't hire you? Do you want me to call her and tell her what an idiot she is?". Gotta love that love.

So at this point I have mostly crawled out of the little black hole of depression that I was wallowing in for about a week. I actually love many things about my new position. But it is EXHAUSTING trying to figure out the ins and outs of it! More than I could have imagined. I am now working well over 50 hours a week (if only I were getting paid for all that time, sigh). I am sure there are good reasons for all of this, and I'm really not complaining. I'm just explaining that while I've been trying to get my feet solidly underneath me in this new environment I have been too tired to write about it at the end of the day. Or even on the weekends which I have devoted to sleeping, mostly. I have been keeping up with the blogs that I read. Can't sacrifice that to sleep or sanity.

Anyway, I hope I will be back to blogging more regularly soon, because I miss it. Miss the release and bit of clarity I get from channeling these thoughts out of my head and into the vastness of the internet.

Oh, and just to prove that this is still an infertility blog . . . here is what I am completely preoccupied with at the moment: On Friday morning I, um, produced? discovered? encountered? fertile quality cervical mucus. That's right, my very own eggwhite. Not something I have encountered before in such an unambiguous way. I almost thought I was hallucinating. I dug out my battered copy of Taking Charge of Your Fertility and compared to the pics. Yup, that's what I thought. Now, I know this doesn't mean that I will ovulate, but it's a good sign, right? So, the requisite sex followed. And then again for good measure. With plans for more, more, more. (Isn't it amazing what a shot of optimism does for the sex drive?) It has been a good weekend! Now I just have to remind myself (constantly) that this does not, in fact, mean that in a few weeks I will be staring at my own positive pregnancy test.

Goals

A. and I have come up with a somewhat arbitrary plan that is geared toward having a baby by our tenth anniversary. I don’t know why I even think plans are worth making in this area of my life, but here it goes:

We will continue trying to get pregnant without artificial assistance until February 2006. Just a few more months of relaxation, exercise, improved nutrition, and spontaneous sex – sex that occurs at least every other day, how spontaneous . I guess it's a good thing we still like sex!

In February we move on to fertility drugs. Clomid, of course, and maybe whatever comes after or in conjunction with that. I don’t know how I feel about IUI, should it come to that, but we have already decided against IVF. With my already ambivalent attitude toward pregnancy, we feel that if we get to that point our emotional, physical, and monetary currency is better spent in pursuit of adoption.

Moving along. We try fertility drugs and if I am still not pregnant by November 2006 then we start the adoption process. After all, it’s a baby we really want, not a pregnancy, and we have been waiting a long time.
There it is. Let us all laugh long and hard at the foolishness of making such a timeline.