The Commonwealth Of Limbo

So. Absorbed those statistics yet?

Me neither. We're not quite ready to throw in the towel, though.

We're going to move ahead with another IVF cycle, at a different clinic where I get at least some coverage for one cycle. Of course, getting an appointment and gathering all the paperwork means that we won't be able to start right away, so we're going to try another IUI cycle first, in March. I think.

My new acupuncturist tells me my kidneys are tired and that I should do some wacky liver cleanse blahblahblah before trying again. Atomic also thinks I should let my body rest. While I agree that I have been a tad draggy-assed lately, my spidey sense tells me it may have more to do with the 12 hour days I've been working than with the purported lack of chi flowing to my kidneys.

At any rate, the insane work hours and the wealth of Really! Attractive! Options! and the teensy bit of post-failed cycle blues have left us in a State of Limbo. Or is it a Commonwealth?

You do remember Limbo, don't you? You know, the place where unbaptized babies wear big straw hats and dance to calypso music for all eternity because, as much as God thinks babies are cute, it's strictly no baptisey, no paradisey in Catholic Heaven.

Hmmm. Maybe that's where the unbaptized embryos go, too, I mean, if they can find hats that small.

Lies, Damn Lies, and Statistics

It's a racket, I tell ya. A real racket.

Funny thing about numbers, especially ones with that little % after them. They're malleable and squishy and susceptible to many different interpretations. They can simultaneously stand for so much and for nothing at all.

We went to the fertility clinic for a post mortem (well, yes, literally). Dr. Glass Half Full was soooooo nice. She gave me a hug, and got a little teary, and told us we've got about a 15-20% chance of actually having a baby with my eggs. Conversely, phrased in glass-nearly-devoid-of-any-liquid language, that means that there's an 80-85% chance that my eggs will never, ever produce an actual human being.

Even Dr. GHF felt it necessary to point out that if I were taking on those odds in Vegas, I would officially be a Chump. She also recognized that when you're betting on your fertility, while the table minimums are high, so are the payouts.

So, yes, the odds pretty much suck, but it helped me to put them in perspective. According to Dr. Google, a normal 40-year-old has about a 25% chance of getting pregnant with her own eggs. I know people who are cheerfully and hopefully pursuing infertility treatment despite being told they had a 5% chance, or a 1% chance, or a 10% chance of success.

What then to make of the lovely 70% figure I mentioned last post? Well, I suppose that's an aggregate that includes lots of younger women with unscrambled eggs who happened to have a run of bad luck. And the 70% carry-to-term figure is for women to manage to get pregnant again. So, IF I manage to get pregnant again, what are my odds? No one can say for sure.

The really encouraging news is that if we eventually decide to use donor eggs, we'll have a 65-75% chance of having a baby. It won't be genetically related to me, but I think we can get past that if we have to.

Even better, the statistical likelihood (adjusted for inflation, of course) that Atomic and I will get through this latest loss with our sanity and our love for each other intact approaches 100%*.

P.S. As I wrote this, a huge rainbow appeared out my window. Maybe there's (statistically improbable) hope after all.

*This offer is void where prohibited. Some users experience dizziness, congestion, headache, and nosebleed. Closed course, professional driver. Do not attempt. If you'd like to make a call, please hang up and dial again. Your mileage may vary.

Fall Down Seven Times, Stand Up Eight*

It's official. The short but inspiring reign of Cecil I is now over.

As is my wont, I am dealing with this latest loss by thinking thoughts about words. Medical words in particular. The medical world has such a charming way with words. Such creativity, all apparently designed to make us feel like crap about our bodies.

Women who dilate early have an "incompetent cervix," as if their cervixes didn't pay enough attention in cervix school and will be stuck in dead-end jobs for the rest of their lives. Women over 35 are considered of "advanced maternal age." (Watch it, sonny, or I'll clobber you with my gigantic pocketbook!)

And then there's my new favorite: Habitual Aborter. Yes, friends, with this latest doomed embryo I have joined the exclusive club of Hab-Abs, as we like to call ourselves. We mostly hang out in dark alleys swilling rotgut, with torn stockings and bright orange lipstick smeared all over the filters of our Kools. You know, I thought about not having another miscarriage, but I can't help it! It's such a lousy habit! Hmmm. Maybe I'll just start biting my nails instead.

The good news is that it is better, statistically speaking, to have miscarried repeatedly than never to have conceived at all. In his wonderful book, Coming to Term, John Cohen writes that 70% of women who have miscarried three or more times will eventually go on to carry a normal pregnancy to term, even without any medical intervention at all.

I think my body is trying to tell me something: Keep trying!! These fertility treatments have not been failures, strictly speaking. There's some sort of spirit in there, I think, trying desperately to be born. I count these near misses as signals that if we keep at it, something, maybe, will eventually make it to term.



*This is the Japanese version of the proverb. The American version is, "Fall down once, sue the guy who owns the sidewalk."

Golden Piggies

Happy New Year! Gung Hay Fat Choy!

I love holidays. Everyone's holidays. Especially those that mark a new beginning of one sort or another. In the last few years I have really come to love the Lunar New Year.

According to the Chinese, this is the Year of the Pig. And not just any old pig. This is the Year of the Golden Pig. Chinese hospitals are bracing for a baby boom, because this is a most auspicious year to have a child.

It is also the beginning of a 20-year cycle. Supposedly, what we do today will set a pattern for the next 20 years. Be careful not to sweep your house or wash your hair today, lest you sweep or wash away good fortune. Tomorrow, the second day of the new year, is considered the birthday of all dogs, so be sure to give the pups some special love (and maybe a treat as well).

We'll be putting in a special word to our ancestors in the hopes that the year 4704 brings us a golden piglet or two. Those (like me) born in the year of the sheep "have a special place at the pig's table," so perhaps now our luck will take a turn for the better.

Blessings and prosperity to you all!

Oh, for Pete's Sake

I started bleeding this morning. Not spotting. Full-on bleeding.

Aaaaaaand my beta went up to 34.

Someone up there has a hell of a sense of humor. Fortunately, so do I. This is so preposterous, so drama queeny, so over the top, so bathetically cliffhangerish, all I can do is laugh.

Is there any chance that this will turn out well? Hell, no. So, there's nothing to lose really. It's just a rollicking good story.

I get to decide whether to have another beta in two days or wait four. I haven't decided yet.

Stay tuned for the dramatic conclusion of "As The Cecil Turns."

Cecil Rides Again

Ah, yup. The news is not good, but this race is apparently not quite over.

My beta doubled. It is now a whopping 16. Now, that's half as crappy as Monday's news, but half of "really crappy" is, by my calculations, still pretty crappy.

The nurse at Kaiser tried to find a glimmer of hope in this latest development. On the other hand, the nurse at the fertility clinic said, categorically, "This is an abnormal pregnancy. That is not a normal embryo. I'm very sorry."

So, we're not holding out any real hope, but I have to admire our Cecil, slow and tenacious little bugger that he is, for hanging in there.

Oh, Cecil, if there is any hope at all that you might be viable, we're rooting for you to go the distance. If not, that's ok. Your mere presence gives us the hope to try again.

The Gods Hate Us

My beta was 8. That's pretty much a negative. It's worse than a negative, because it means I have to keep taking the prometrium and go for another blood test in two days.

I don't know what the hell I did to so offend the universe, but whatever it was, haven't I paid for it already? Enough. One of these days I would just love to catch a damn break.

Agony

Nausea. Profuse sweating. The shakes. Dizziness. The attention span of a flea. Diminished appetite. Nervous pacing.

Pregnancy symptoms? No, just the anguish of waiting for beta results.

I'm convinced it's negative, trying to steel myself for the worst, trying to anticipate how sad and disappointed I will be. I'm hoping it's positive, barely daring to let myself hope. Every little twinge reminds me that I don't know yet.

Do Hormones Make You Stupid?

Obviously, the hormones have taken over my body quite completely. Certain parts have declared independence and formed their own autonomous (not to be confused with erogenous) zones. And then there are all those pings, aches, and twinges I've been obsessing about.

The completely whacked out, technicolor dreams (with guest appearances by Nicole Ritchie and Gavin Newsom) were the first sign of serious hormonal brain involvement. But now I think my basic common sense and judgment have been affected as well.

On the day of the embryo transfer, the nurse told me, in no uncertain terms, not to pee on a stick before my beta on Monday because it would be, and I quote, too early for the pee sticks to detect anything. (Emphasis in the original). Right. I know that. And, everyone knows you should test in the morning, when the hormones are most concentrated.

So what did I do? (No yelling out the answer).

I let my friend talk me into peeing on a stick yesterday. In the afternoon. After about a minute, I didn't see a second line, so I figured, negative. I got really upset. I stuck the stick in the garbage and put the kettle on for some tea.

Then, in an act of true desperation, I pulled the damn thing out of the garbage to look at it again and torture myself with it. At that point, I think just about 10 minutes had gone by, but I'm not sure because, well, apparently the hormones have shut down the part of my brain that can look at a clock and retain the information it sees there.

I saw a faintfaintfaint little teeny eensy beensy second line, in a somewhat rose-ish color. It was most likely an evaporation line, not an actual positive. Past the 10 minute mark, all bets are off.

So now I'm $8.99 poorer, put myself through a lot of grief, and am no better informed than I was before.

Perhaps there are some pearls of wisdom that I can glean from this experience:

1. Although this particular friend is one of my dearest and most reliable confidants, she is not infallible;
2. Never pee on a stick early;
3. Don't expect to find answers when there are none;
4. Don't make important decisions when I'm hormonal and Atomic's not around;
5. Reading premature pee sticks, like reading tea leaves or entrails, is ultimately a frustrating business and probably not worth the time.

Hormotionally yours,
Binky

OCD Jeopardy

"I'll take Googlemania for $400, Alex."

"The answer is, 14 . . . so far"

*ding!*


"What is, how many different ways can you phrase a Google search for 'early pregnancy symptoms'?"

"Correct! Make a selection."

"Procrastination for $800, please."

"The answer is, Your appellate brief is due on February 20th."

*ding!*

"What is, why I ought to stop obsessing about the results of this IVF cycle and get back to work?"

"Right again! Select a category."

"These two symptoms are literally keeping you up at night."

*ding!*

"What are crazy dreams and insomnia?"

"Ooooh, I'm sorry. The correct answer is 'What are frequent urination and insomnia.'"

The really weird thing is that as I lay wide awake in bed at 4 this morning, I was thinking about this post and envisioned myself, hugely pregnant, eating a giant bowl of Rice-a-Roni and rubbing Turtle Wax on my hunormous belly. It cracked me up at the time, but then again, things are much funnier at 4 am.

Three more days of weirdness until Beta.

*sigh*

Why?

My mom suggested a few weeks ago that I write a post about why Atomic and I want children. Great idea, I said. And since then, it has been rolling around in my brain, banging against my other thoughts.

The banging got louder the other day when I looked at my friend's "Dear Birthmom" website. She and her husband are seeking to adopt, and the website included a lovely, heartfelt list of reasons why they want a child. It made me cry, and not just because it was such a perfect vision of parenthood. It struck me as so unfair that people all over the world pop out babies without even thinking, yet we infertiles have to justify our desire for children. That sucks.

The other reason for the banging in my brain is that, while I can think of many, many things I would love to do with my children, I have a hard time articulating why I want them. It's like trying to explain why I love eating. Or why I'm fond of breathing. The best I can do is to say that I want children because, in my heart, I am already a mother. I have a mother's love to give, and no one to give it to. It's the most primal desire I have ever had, and I would gladly give up eating and breathing to achieve it.

Planning Around The Possible

Since we've started the journey toward parenthood, making plans has become a real pain in the ass.

When we had the first miscarriage, we learned the hard way that making plans too early can end up feeling like a sucker punch to the gut. Since then, we've learned that fertility treatments look at your plans and collapse giggling on the floor. You want to go on vacation when? Hahahahahahah. Oh, sorry. Too bad those tickets were non-refundable. Guess United Airlines made a few bucks off you, huh?

I've already missed a reunion of some dear college friends because we were maybe possibly going to start an IUI cycle right around then. In January, my brother and his family went to Arizona to surprise my Dad for his birthday. We wanted to go, but I ended up having a date with the dildocam that weekend.

There are lots of exciting things on the calendar this spring and summer, all with multiple question marks around them. Some are small trips to see friends and family. Other plans are considerably more involved. One requires international travel. Two others are extended camping trips in inhospitable settings.

If I am pregnant, I might feel like crap. Or I might be advised to avoid the long travel and camping trips, given my history of miscarriage. If I'm not, our plans may be in the middle of another IVF cycle. And we may be stretched a little thin, resources-wise. It's a little daunting, to say the least.

On the other hand, maybe this is just the experience I need to one day become a maestro of soccer practices, violin lessons, slumber parties, band camp, PTA meetings, and the occasional grownup dinner party.

Working Without A Net

I suppose it's for the best, since leftovers tend to sit in our fridge until they're unrecognizable. But still.

No leftover frozen embryos on a stick for us. It's the three they transferred or nothin'. According to the clinic, one of the three stragglers actually made it to blastocyst stage, but it was a sort of crumbly Grade 3 and, well, not worth freezing.

That news scared me. If none of these embryos I'm carrying sticks, it's back to square one. And of course I had to wonder if the three beautiful blastocysts we put in there yesterday have already met their demise. The thought of it made me nearly choke with fear.

And then I remembered that, as a good friend of mine constantly reminds me, I have this horrible tendency to go automatically to the Bad Scary Place Where Nothing Good Ever Happens, and that's just not rational. The fact that three of our embryos didn't make it to the freezer pales in comparison to all of the unexpected good news we've had this cycle. Plus, from what I've read, most people who do Day 5 transfers lose at least half of their embryos before Day 5. We lost none before Day 5. And the ones that made it in were all top grade.

As the same dear friend put it the other day, my job for the next two weeks is to be hopeful. I've got to keep focused on that. It helps that I've got a whole host of symptoms: I'm cranky, fatigued, sore-boobed, and alternately a little queasy and STARVING (after all, I'm eating for four!). Those symptoms could all be attributable to the progesterone and the HcG trigger shot, or they could mean something else. I don't know. But for now, I'm just going to hunker down and hope my little ass off.

Picking Up The Kids

We went to the clinic to pick up the kids today, hoping there'd be one or two left.

There were. We transferred 2 rather gorgeous Grade 1 blastocysts* and one spunky Grade 1 early blast.** One Grade 2 early blast and two Grade 2 morulas*** (they're a little slow -- about a day behind, but could still turn into blastocysts) are still in the dish. If they make some progress by tomorrow morning, they'll stick 'em in the freezer just in case.


Dr. Glass Half Full was absolutely incredulous. She said that the number of healthy blasts was way better than she would have expected from someone with an FSH of 13.7.

So now we wait. And wait. And hope, and pray that these little blasts (a) have healthy chromosomes and (b) find a nice soft nest in there, and stick, and grow.

Photos of our lovely blasts to follow, as soon as I'm allowed off the couch. I'd love to hear some ideas for how to distract myself until the pregnancy test.



Some definitions, for those of you who aren't embryologists or intimately familiar with IVF:

*Blastocysts usually develop five days after fertilization. They consist of 60-100 cells, and the cells have differentiated into two types: an inner cell mass, which will (we hope) become the fetus, and a trophectoderm, which develops into the placenta.

**An early blastocyst is an embryo that has reached the blastocyst stage, but is a little bit behind in terms of size and/or cell differentiation.

**A morula, so named because of its resemblance to a mulberry, is an embryo that hasn't reached the blastocyst stage. It consists of 12-32 cells packed tightly together. Embryos usually reach this stage four days after fertilization.

The Little Embies That Could

The clinic called this morning. Apparently things look healthy enough to wait until Day 5 for the transfer. We go in on Saturday morning.

Of the six that fertilized, we have,as of today:

4 8-celled, Grade 1 embies
1 7-celled, Grade 1 embie
1 8-celled, Grade 2 embie

We're cautiously optimistic.

Go little embies, go!

In Memoriam -- Molly Ivins

I was going to title this post "Rest in peace, Molly Ivins," but then it occurred to me that peaceful rest has never been something that the fabulous Ms. Ivins sought. She was a rabble rouser, a poker of wasps' nests, a speaker of often unpleasant truths to power, Diogenes with a ten thousand watt flashlight.

She was hilarious. With her brilliant command of the English language, she skewered politicians who hopped around with one hand in the till and one foot in their mouths. With glee, but also with affection, she shared with the world some of the more delightful verbal gaffes of Texas legislators, such as "This bill is the Sword of Damocles dangling over Pandora's box," and "This legislation would surely derail the Ship of State."

She was relentless. She went after the Shrub and called him on his bullshit. "The president of the United States does not have the sense God gave a duck," she wrote in her very last column, "so it's up to us. You and me."

And now it's up to us. Molly Ivins died of breast cancer yesterday at age 62.

For more of her wit and wisdom, look here.

I would love for progressive people all across America to honor her memory by taking these words to heart and living them:

"So keep fightin' for freedom and justice, beloveds, but don't you forget to have fun doin' it. Lord, let your laughter ring forth. Be outrageous, ridicule the fraidy-cats, rejoice in all the oddities that freedom can produce. And when you get through kickin' ass and celebratin' the sheer joy of a good fight, be sure to tell those who come after how much fun it was."