"There's obviously something broken..."

"There's obviously something broken..." Those were the words of the doctor who did my last scan last week. And yes, they hit like a ton of bricks. I mean, clearly, we knew that something was not right. But hearing it so matter-of-factly was a bit startling. But let’s back up…

When last I wrote, I was pretty much in a panic that the cycle was failing. I found out that the doctor had decided to kick back my meds because my follicles were all growing together (2 many mature follicles = risk of too many babies) and my estrogen was increasing very quickly. My understanding is that he thought scaling back my dosage would stop some of the small ones from progressing. Well, what happened was that the dosage ended up being too low and it basically shut everything down. By Sunday’s scan, I had no growth and my estrogen levels had dropped off. Plus, I lost my uterine lining thanks to the lack of estrogen (can you say spontaneous period!?). Dr. Freedman called and explained all this to me on the phone, which was nice. He felt badly that this had happened. He kept saying “I don’t want to overcook ya.” – Nothing like feeling like a Thanksgiving turkey – ugg. He didn’t cancel the cycle but just decided that I would basically be at baseline and starting over. I was 2 weeks into injections and not pleased…

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Pic of the inside of my sharps container! Lots of needles...

 

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I went back for scans the next week and there was minimal growth and my estrogen was SLOWLY creeping up. On Friday, the doctor came in…

As an aside – let me explain the situation with the doctors. When we switched to RMA, there were 4 doctors from the Philly practice that rotated days in Mechanicsburg. Dr. Freedman was there the day of our consult so he became our doctor. We would see whichever doctor was in the office for scans, but Dr. Freedman was handling our care decisions. However, when we were in our first cycle, the Mechanicsburg office got a full time doctor – Dr. Nguyen – and the Philly doctors would no longer be coming to Mechanicsburg. They offered us the option of switching over to the new doctor but we decided at the time to stick with Dr. Freedman because we had talked to him so much and felt so impressed by him. But since August, Dr. Nguyen is who I have been seeing at my scan appointments.

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 Site of our new fertility dr - RMA of Central PA

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So Dr. Nguyen came in and asked me if I was frustrated. She said she had looked over my cycle and even she felt frustrated for me. I told her that we have been at this for so long that we don’t even notice the frustration anymore. She began to talk about IVF and asked if we had thought about it. (She had dropped an IVF comment on me before so I wasn’t overly shocked this time.)

Another aside – IVF is in-vitro fertilization – basically they used injectable meds to grow a whole bunch of eggs, then the eggs are retrieved in a “minor” surgical procedure, they are fertilized with the sperm in a lab, and then the embryo(s) are transplanted back into the uterus to hopefully implant. It’s invasive, time consuming, and expensive (think out-of-pocket without insurance - $10,000-$15,000ish) but offers success rates that are leaps and bounds higher than any other treatments.

I told her that we were pretty resigned to the fact that that is probably where we are headed. I also told her about our stellar insurance coverage…her response: “Oh you should do IVF!” She seemed pretty certain that was the best option based on what she was seeing. I told her that we were okay with moving on to that and we were both just ready for it to be over – baby or no baby. She told me not to think of IVF as the end of the line – that some patients are just better suited for it and she feels that way about me. She said that it’s not like I failed at everything else so now it’s on to IVF. In my head I am thinking – I am pretty sure that’s exactly what it is like!

After my scan she said that things could go on in the cycle to work out but to think about IVF for next time. The nurse also mentioned to me again about switching doctors and I left considering if that would be best (I hate making decisions!). Luckily, the decision was soon made for me. That afternoon the office called – Dr. Freedman was cancelling my current cycle and recommending that I set up an IVF consult with Dr. Nguyen. It was a tough message – it’s like I knew it was coming but to have it actually be right there in front of me was painful. I also felt a little relieved that the doctor switching decision was made and that we were finally moving on to the final level in this long battle.

Our consult is tomorrow. I am anxious to get the scoop on the whole thing. I have read enough – and talked enough to a fellow IVFer – to feel a bit afraid but I am trying to hold out on any true fear or judgment until I get the whole story. We are armed with a list of questions and will see how it goes.

Ironically, I realized that my first treatment cycle – a diddly 50 mg of Chlomid – was in September 2012…one year ago. IVF will be my TENTH round of treatment. We started trying to get pregnant in August 2011…TWO YEARS AGO. The time that has passed blows my mind. In that time I have had friends get pregnant, have their babies, and celebrate their babies’ 1^st birthdays. I just pray that in a year from now we are in a different place in our lives and off this path of sadness and waiting.

 

Let's get caught up!

End of July 2013 –

Well a lot has happened since I last wrote…I finished my Prometrium pills and after a few days – still no period. So Jared and I geared up to go to the beach for a week with my family and figured we’d deal with everything when we got back. A week before we would have left for vacation, Aunt Flow showed up! I was shocked. (I also forgot how painful these dang periods are – I am so out of practice!) So it was back to the doctor for a baseline scan and to see what the game plan was. Scan was perfect – thin lining, no cysts. The NP even said I have “perfect anatomy” – I am thinking, “yeah, so perfect I can’t get pregnant!”

After reviewing my blood work, the doc decided to do Menopur.  We were of course excited to be starting another round. But we were also bummed – because I’d have to be in for scans and blood work every couple days, we would likely miss the beach. Sacrifices!

He initially wanted to start me on 75 units (1 vial) per day but later I emailed him and asked him to reconsider. The doc at Danville had seemed to think that my previous cycle didn’t work because they had started my dosage too low. The last thing I wanted to do was repeat the last cycle (especially if I was going to miss vacation!). He was very understanding and opted to start me at 2 vials (150 units) and that he would back it down to 1 if things started to progress too quickly. After a few days, my hormone levels hadn’t budged so he upped me to 3 vials (225 units). – As an aside, I find it interesting that the new doc looks at all my hormones, whereas Danville only looked at one (Estradiol).

After a week of scans and blood work every other day (it was a crazy week! We managed to drive to the beach between my Mon morning and Wed morning scans!), things slowly progressed. We were at Hershey Park (since the cycle busted our plans to spend the whole week at the beach, we opted for mini day trips instead) when I got the call that I had one follicle at 17 and to take my trigger shot that night and come in for IUI on Sunday. The Good – the HCG trigger they use is a pre-filled syringe (no mixing vials!) and they do IUIs on the weekend to get optimal timing…the Bad – they only do weekend IUIs at the King of Prussia office.  As if we hadn’t done enough driving that week, it was off to Philly!

The IUI itself was easy-peasy – I felt that it was way quicker and less painful than at Danville. I love the sense of calm and happy after an IUI – it’s like everything has been done that can be done. It’s the day or 2 after the IUI that the crazy begins to creep in, haha…if I didn’t get my period before, I was to come in in 2 weeks for a blood test.

Jared & I after the IUI

 

Another new aspect with the new doctor – an awful invention called “Crinone”…this is a progesterone vaginal cream that they recommend you use once a day after IUI. It’s intended to, as it was described to me, “make your uterus nice and sticky”! Really it’s to help thicken the lining in hopes that an embryo will implant. Well, as if using a vaginal cream isn’t in and of itself annoying, it also made me feel excessively tired. I felt like a zombie for days!

Two week wait was murderous as always. I chose not to drink at all which is not fun. Plus, I read the Crinone can delay your period so I didn’t know whether to expect period symptoms or not.  Although it was 2 days later than it would normally arrive, Aunt Flow came knocking the night before I was to go in for my blood test. (As an added bonus, once I stopped the Crinone, I had “withdrawal” symptoms – a headache for 2 days and the inability to stop crying. The fun really doesn’t end.)

End of August 2013 –

So it was back to the doctor for baseline. Jared and I had talked about getting a sit-down with the doctor to try to get an idea of what is happening and where we go from here. But we were trying to be patient too – although this was our 8^th failed cycle, it was only our 1^st with the new doctor. At the baseline, I asked the doctor doing the scan about her thoughts.  Her response still rings in my ears – “At your age, with this many cycles, you should be pregnant by now.” It was haunting – I could just hear Zoma back in February – “You have been with us for such a long time.” I felt hopeless. It was looking more and more like we were on a crash course with IVF. And once that starts, the insurance money is going to run out really quickly – and then it’s the end of the road.

I ended up emailing Dr. Freedman and he called that evening and we got to talk about the cycle. Basically, it was not an ideal cycle. They decided to trigger me because I did have a technically “mature” follicle but it was only 17. He likes to have 19 or 20. But they were concerned that if they let me go any longer, some of the other follicles would catch up and I’d end up with too many mature (ie. too big a risk for multiples).  He didn’t make me feel much better about the likelihood that IVF isn’t the answer, but I felt okay about trying another round of Menopur and IUI.

So that brings us to the present – September 2013. I am on injection day #9. I started out alternating 3 vials, then 2 vials, then back to 3, etc. Two days ago my scan showed 1 follicle with a small lead – a 12 – and then 3 others that were closely behind. He kicked me back to 2 vials. This morning there was minimal growth – if anything the smaller ones are starting to catch up – not good. He is kicking me back to 1 vial. I don’t feel good about this at all. It is my understanding that I should have 1 or 2 follicles that take the lead but all of mine seem to want to grow together. I go back in 2 days and am praying for a miracle.

A new beginning…

After my Menopur cycle was cancelled, the doc said to wait 2 weeks and to call when my period comes (which it should, so he says…). Well, after 1 week I started spotting but he said it was too early for it to be my period.  But even after the 2 weeks, it never came. I was not the least surprised but I wasn’t really worked up about it because I knew I could start a Menopur cycle without a period just as I did before. But you know how I have said before that the second we think we know what’s coming everything gets turned on its head…

When I called the clinic I was informed that my doctor was out of the office for 3 weeks! And the nurse casually tells me that the doctor covering his patients is in Wilkes-Barre (another 45 minutes up the road)!! I knew that driving to Danville every other day was one thing, but going to Wilkes-Barre was just not an option. Plus, the nurse wasn’t even sure this other doctor would start me on a new cycle of Menopur without a period so it was looking more and more like I was in for the 31-day cycle of pills. She was going to talk to the doctor and get back to me on Monday. I was beyond frustrated and I told Jared I really want to quit if it doesn’t happen by the end of the year. I felt very reminded of a quote I had seen on Pinterest: “If God shuts a door, stop banging on it! Trust that whatever is behind it is not meant for you.”

As an aside – starting a few months ago, ads for a new fertility center in Mechanicsburg had run in our local paper and billboards went up on the highway en route to Harrisburg. I honestly hadn’t given much thought to switching doctors because I felt so invested in our path in Danville. Plus, we didn’t want to go backwards – we were afraid a new doctor would want us to start all over from the beginning of the process (diagnostics, clomid, the horrifically painful HSG, etc).

The weekend after I talked to the clinic I googled the office I had seen advertised – Reproductive Medicine Associates of Central PA. There are 4 doctors in the practice and they are out of Philadelphia and have a satellite office in Mechanicsburg. Something just came over me and I decided it was time to talk to someone new. I called Monday to set up a consult. I have to say – just the friendly demeanor of the person who took my call was refreshing. Plus, I was expecting a wait for an appointment (it took us over a month to get in to Danville) – nope! They could get us in that week!

Jared and I went into that appointment still on the fence about whether we wanted to switch. Needless to say, they had us sold before we even left the office. It’s crazy that we did not know how badly we were being treated until we got to experience being treated well!  We had a long discussion with the doctor about each of our and our families’ medical histories as well as everything we had been through so far (so thankful for being a type A nut and having kept an excel spreadsheet of all my treatments and dosages!). He asked so many questions and really seemed stumped as to what is going on. He really didn’t seem to understand the 31-day cycle of pills business. However, I was really won over during my ultrasound. I have had what seems like a million of these done…and I can’t believe I didn’t realize how the doctor and nurses at Danville were never talking TO us but rather just AROUND us. It was amazing to have someone explain what we were looking at. My uterine lining was very thick (which is odd for me) – even Jared commented on it right away, haha. He’s now an expert on what my uterus and ovaries look like on a computer screen!  I was very relieved to hear the doctor say that everything looked totally fine – uterus and ovaries.

Next we sat down with 1 of the 2 front desk nurses to go over our insurance. (I love that there are only 2 nurses…each time at Danville I had 1 of 5 or 6 who rarely remembered me).  We were blown away to learn that we have used only $250 of our $20,000 fertility maximum. Of course, the insurance lady at Danville had never pulled this information for us. Another awesome feature is that you can elect to communicate via email! No more phone tag!

They sent me for the litany of blood work-11 vials! (I just found out today that all came back normal.) We did one final sit-down with our NEW doctor – Dr. Freedman – and were very happy to hear him say that he didn’t want to make us go backwards. He said we will probably be doing Menopur but first he wants to try something new to bring on my period (new to us, not new in existence) – Prometrium, which I will take for 7 days. Of course, I am VERY skeptical that this will make me get a period. If it works, I will be very conflicted …happy – yay! A period in 7 days of meds! …and MAD – at all those wasted 31-day rounds they made me do before.

Right now, Jared and I are feeling so excited and rejuvenated by this fresh start. There are all of these positives that I have mentioned and, of course, a big big one is the location as well. My drive will now be less than 1 hour, it’s close to Jared’s work so he can come to appointments without having to take off the whole day, and there is so much more to do in the Harrisburg area (shopping, lunch with friends, yoga classes) versus Danville.

As we were leaving the office, I found myself looking around, taking everything in, and wondering – “will this be a place for happy?” Even when I was getting my ultrasound, I found myself imagining what it would be like to get happy news in that room. Danville had become a sad place for us and I feel so glad that we decided to make the leap and let it go.

An unexpected surprise…and an unexpected disappointment

After the upsetting news about my ovarian cysts, Jared and I settled into the idea that we were done with treatments until July. So when I called the clinic to get my “period pills” when my period didn’t come at the end of May, I was surprised that they wanted to me to come in for a scan. The nurse said the doc wanted to check the cysts and “maybe try something new.” I was intrigued but didn’t give it much thought. In all honestly, I was actually expecting the cysts to still be there.

 

After another hiatus, it was back to Danville:

The entrance to the clinic @ Geisinger:

 
Well, the scan revealed NO CYSTS! I was happy about that alone. Then the doctor said he wanted to start me on a new drug – Menopur – and that I didn’t need to wait for my period so we could start right away! We were elated. It was so unexpected…I had packed June full of fun activities to make the time go faster and now we didn’t have to wait. I should have known – if we have learned anything in this fertility game it’s that the second you think you know what’s going to happen, things get turned on their head.

 

So the new drug is much like the Follistim – one injection per day. However, unlike the handy Follistim injection pen, Menopur has to be reconstituted which means mixing vials and dealing with syringes. I had had some practice at this for my HCG shot so I wasn’t too concerned. After a messy ordeal with getting the meds ordered (the clinic faxed the order to the wrong company…at 5:00 on a Friday!), we got everything straightened out  - thankfully we weren’t on a clock to start because I had not had a cycle (normally you would have to start on a certain day after day 1 of your period). The reconstitution process was more complicated than I expected but after a few days I got the hang of it. The shot hurt more than the Follistim – it burned when going in but it really wasn’t terrible. And my stomach didn’t bruise like it did before.

The new drug - Menopur:

 

All the supplies to do my injection every evening:

After a few days on the meds, it was marathon running to Danville for blood work and scans...Thursday, Friday, Monday, Wednesday, Friday…it got old pretty quick. Work is already crazy busy so losing big chunks of my days was really stressing me out.  My first scan showed that my uterine lining was thickening (good news!) and that I already had a follicle developing (more good news!). The doctor seemed happy that the meds were working. Subsequent scans showed more follicles and a little growth. By Wednesday, I had 4 follicles but they were all still pretty small. I was starting to worry a little bit because by this time on the Follistim my follicles were almost mature (big enough for me to trigger ovulation and get my IUI). After my Wednesday appointment, the doctor ordered me to increase my dosage so I was hopeful that by Friday the follicles would be close to mature and maybe I would be ready for IUI on Monday.

One of my little follicles being measured on the screen:

Friday’s scan showed almost no growth. The doctor seemed stumped. They keep a “log” of my scans and he just stared at that paper for what seemed like forever. And then, and I could tell with reluctance, he said he thought we should cancel the cycle. He said the follicles just weren’t growing and that we shouldn’t just keep pumping me full of meds. As you can imagine, I was heartbroken.  I was sad that we weren’t going to get to try at all this cycle and that I had done 11 injection days for nothing. But I also felt afraid that the meds hadn’t worked – that whatever is wrong with my body might not be able to be fixed…

So the doc says I SHOULD get my period in 2 weeks because my uterine lining did get thick on the Menopur (which it does not do on its own). But I am not getting my hopes up. Even if I do get my period, I am thinking I will probably have a bunch of cysts again like I did after the Follistim. But when I do come back in, he wants me to do the Menopur again but starting at the higher dosage. I asked if we should go back to the Follistim (duh, since that like, you know, worked!) but he said Menopur is actually a better drug, whatever that means.

In this moment, which may or may not last, I feel completely discouraged. I feel like we are putting our life on hold waiting for something that may never happen.  And as is always the case when we get bad news, I get weak in my thoughts and feel angry and sad that we have to go through all of this, especially when so many can have children so easily. But this thinking is like tears -- it really serves no purpose and doesn’t change a darn thing…

In the end, as close as I am to my breaking point, I’m not there yet. So, as always, we shall press on…

"Wow..."

"Wow." Those were the first words out of the doctor’s mouth when he came into the room where I was waiting for my baseline scan. But let’s back up a little bit…

The 2 week wait was horrendous – the worst one yet, I think because everything had gone SO well. It was like the perfect cycle. That’s a lot of pressure. I had moments where I felt like maybe it had actually worked and then others I felt like I just couldn’t believe it. I had some symptoms that I hadn’t had before (SUPER sore and puffy boobs!) and I noticed a lot of twinges in my abdominal area. But I told myself that it could just be side effects of the Follistim (or gas!).  Also, both weekends of the wait put me in situations where I was the only one in the group not drinking which was really not fun. It’s one thing to be the pregnant one of the group but being in that in-between “might be pregnant” place was not easy.

Friday – 11 days after my trigger shot and 9 days after I was supposed to have ovulated – I broke down and bought 3 pregnancy tests and went home and took one. I knew it was too early and that it wasn’t going to tell me anything but I was just tired of giving my period all the power (as strange as that sounds!) I wanted bad (or good) news from another source.  There was a super, super faint “am I really seeing this?” line – but I knew it could be the HCG trigger still in my system so it really didn’t help at all. (As an aside, the injection I take to make me ovulate is the same hormone that makes a home pregnancy test show positive. That’s why they tell you to wait 2 weeks after the trigger to test – it can be a false positive.) But I knew if I took another test and the line was darker, it could mean it was the HCG of a pregnancy. I broke down and took another test on Saturday (so impatient!) and it looked pretty much the same or maybe fainter.

Sunday was the 13^th day past my trigger – the day my period had come every other treatment cycle. I remember lying in bed that morning in pain from having to pee but being scared to get up and find that my period was starting. To my relief, it hadn’t. I decided no tests that day – if I made it through I was going to test again Monday. Then when I got up and around, I started to feel queasy – not like I was going to vomit but just upset in the stomach. Of course, I immediately Googled “how soon can morning sickness start?” and began to feel hopeful. The queasiness gradually developed into a feeling I can only describe as “weird” – I just felt weird. But then the lower abdominal cramping began to get worse.  We were standing in line at the grocery store and I knew it – it took everything I had not to break down crying.

As an aside, one of the worst parts of when my period starts is telling Jared. It’s always the same – me in the upstairs bathroom getting the bad news and then the slow walk downstairs.  He starts talking about something or asks me a question and I have to stop him in his happy tracks…

We were, of course, terribly upset – even though you try to remain as neutral as possible during the 2 weeks, it’s still a crushing blow. I think we were both terrified about having had a “perfect cycle” and it still didn’t work. But I also read that success rates of Follistim increase each time up to 3 times – I told Jared “we just need to play out our odds!” That night I had 2 glasses of wine and a big bowl of ice cream and tried not to cry.

 It was back to the clinic for a baseline scan to start another round of Follistim…or so we thought. (You know how something bad happens and you are upset, and then something worse happens and you look back and wonder why you were so upset about the first bad thing.)

As I said, the first thing the doc said was "wow." He and the nurse couldn’t believe we were back and that the cycle hadn't worked. As soon as he started the scan, I looked up at the screen and saw the big blobs and knew something was not normal. Yep – a bunch of pretty sizeable cysts on each ovary. The doc and the nurse said they were worried this would happen (a side effect of injectables that no one told us about!).  As I understand it, because I had so many follicles in the last cycle, the ones that do not ovulate an egg sometimes fill up with fluid causing the cysts. They would naturally go away but it meant we couldn’t start a new round of treatment this month and, to add insult to injury, without treatment this month, of course I will not get a period and I’ll have to take my 31-day round of pills to get it again. So that means we are out of the game until JULY. I started to bawl right there…

I wish I could accurately explain the pain I feel right now (and I will admit it is very raw at this particular moment in time). It’s a constant state of heartache. I feel like we are living a tragedy.

But even in my sadness, I feel like I have no right to feel sorry for myself - there is so much in all this that I have to be thankful for…

-- Unlike so many other couples facing a similar battle, we do not have to worry about the costs associated with these treatments. (I read online that one vial of Follistim, which I would go through in a few days, would retail for $900!!) Our insurance is such a blessing.

-- In the world of women with fertility problems, I am considered young (versus women trying to get pregnant in their 40s) – and my age increases our odds of success with treatment.

-- I follow some online infertility message boards because I like to read about other women’s experiences. I cannot believe how prevalent miscarriages are – there are women who are going through the same struggle I am but that have gotten pregnant and miscarried (sometimes more than once). I can’t even imagine going through that and I am thankful that I haven’t.

-- Most importantly, I am most thankful for Jared. He is the most supportive and caring partner that any person could ask for and he is fighting this battle right alongside me. My life is blessed in unimaginable ways and I know I have to focus on that at all times.

So what now? It’s back to life as usual I guess…and waiting for summer.

The Dreaded 2 Week Wait...

When we last left off, I was just starting my Follistim injections.  I was at the clinic for bloodwork and scans every other day (which was painful not only for my time but also for my gas tank and my veins –my arms are still sore). I started at 50 units, then it was 100, and then 150…by my 9^th injection day (a Friday), we finally had measurable follicles on the screen!  I was so relieved in that moment! After 2 previous visits of seeing nothing, I had begun to panic that the meds wouldn’t work. So they kept me at 150 through the weekend and at my Monday scan I had 5 measurable follicles! 2 of them were mature – a 17 and a 19 (I believe 16 to 21 is the goal). Plus, as soon as the doc started the scan, he said that my uterine lining looked the best it ever has (previously it was thin, making implantation more difficult)…I was totally overwhelmed with good news J


**Here is a pic of all my injection equipment:

 

They informed that I would do my HCG trigger shot right away and come in for an IUI the next morning. This kind of surprised me because the shot is supposed to make me ovulate 24-48 hours later, making a next day IUI a bit early. But I think they wanted me to do the shot ASAP so that none of the other 3 follicles got closer to maturity (risk of too many babies!).  Then there was another problem...

The nurse came in and said the lab was slammed for the morning of my IUI because the doc was in surgery in the afternoon and had to take all his patients in the morning…could we collect the sperm sample at home??!! I started to freak out and explained to her that it takes us AT LEAST an hour and 15 minutes to get to Danville. She said it would be okay as long as it was no longer than an hour and a half…I was like, geez – I have to risk my whole cycle and 11 days of injections on a 15 minute window! I could just see the spontaneous traffic on the bridge in Northumberland ruining everything.  Needless to say, I was not a happy camper. In the end, Jared and I decided that the risk was too much so we opted to drive back out to Danville that night and stay in a hotel. It made for a very strange, outside our routine 24 hours but I still think it was the best option.

When the doc and nurse came in for my IUI, they said that the lab paperwork had noted the sperm sample as “Excellent!”  This combined with my super uterine lining had us high with hope! The IUI was more painful that my previous 2 (which stinks because I will now have anxiety if I ever have to do it again)…the doc had a resident with him and he let her do it and I think she bumped my uterus making it contract. I am pretty sure he said “sorry” 100 times as I was moaning in pain, haha.

 

**I had Jared snap this pic of me after the IUI (they let you lay there for 10-15 mins with your hips elevated - it's actually very relaxing...a chance to take a breath and feel relieved.) -- I figured if we did make a baby this cycle, it would be a picture we'd be happy to have:

 

But all is a done deal now and we are officially in what I believe to be one of the WORST parts of these treatments – THE DREADED 2 WEEK WAIT. That’s how long it will take for me to (a) get pregnant; and (b) have it show up as a positive on a pregnancy test.  It’s 2 weeks of: Googling about success rates, questioning every abdominal twinge, worrying about how much I should exercise or if it can hurt my chances, wondering what could be going on in my body (or not going on). Also, I am choosing to have no alcohol this round. I have not drank before and then allowed myself to have a few in previous cycles. But I've decided to err on the side of caution this time because everything has gone so well.

I find myself walking that fine line between not sabotaging myself with negative thoughts and not getting my hopes up. I think that might be the worst part of the 2ww – the hope. I want to feel hopeful – it’s unlike other moments in time because I could actually be pregnant (or be getting pregnant ) – but I am also terrified of allowing that hope to creep in…because once it creeps in, it makes a sad outcome so much worse.

How to have a full scale melt down in the hospital pharmacy…

So after 2 weeks of waiting for my period to come after the Femara failure (which I knew it wouldn’t) and then my 31-day cycle of pills to induce a period, we were back at the clinic this week! It was actually kind of nice to have had the 6 week break. It gave me the opportunity to relax and focus my energy on things other than fertility meds…driving to Danville for scans…am I eating enough?...am I running too much?...am I ever going to be able to get pregnant?...It was like my brain got to be just a little bit quieter for a brief moment in time.

We knew we were starting injectable meds this cycle so Jared came along to my baseline scan appointment, which he doesn’t normally do. I knew I’d be getting injection instructions and I have a tendency to not listen when it’s important that I really pay attention. J (I am SO thankful he was there!) All went fine with the scan, everything looked good and we even got the happy news that our insurance would cover everything and we didn’t need to pay anything out of pocket up front. After my scan, they sent me next door for a blood draw (injectable meds involve scans as well as the monitoring of blood work – oh joy) and then I was to go the pharmacy in the hospital to pick up my meds (Follistim is the name of the new drug) and come back to the clinic for my injection lesson. I would be starting my first injection that night (cycle day 3). When we went to the pharmacy, I verified that they had gotten the script from the doctor and she began to get it ready. Then she called me up to the window – as it turns out, because it is such expensive medication, our insurance requires that we obtain it from a “Walgreens Preferred Pharmacy” – a mail order company – and that it had to be shipped to us!

I have to explain that upon entering the clinic and Geisinger Hospital in general again, I found myself to be on edge…I have so many sad and frustrating memories of this place – it’s like I was just waiting for the floor to drop out from under me. So when I heard this, I lost it. I pretty much had a panic attack and began to sob uncontrollably in the pharmacy.  I just remember thinking that if we couldn’t get the meds I wouldn’t be able to start the new cycle that night and I would have to take Clomid again, which doesn’t work, or go through another 2 month break. I just felt that cloud forming over me again – “it just shouldn’t be this hard”. I was overwhelmed in one moment with all the awful things that I try not to let come to the surface…it’s not fair that other people can just get pregnant…why is this happening to us?...Did we do something to deserve this?...I am never going to be able to get pregnant.

Long story short – despite the efforts of the wonderful pharmacy tech, who was on the phone for 40 minutes trying to get Highmark to grant us a one-time emergency exception, it was a no-go. Thankfully, we found out that the company could overnight the meds to us and, although not ideal, I could start the injections the next day (CD4). Did I freak out for nothing? Pretty much, haha. It made for a very long and exhausting morning…

So here’s where we are – 1 injection a day (they are easy peasy – in the belly, tiny needle, no pain – even a reusable injection pen which is way easy to use)…I go back to Danville in a few days for a scan and new blood work. Based on how things look, he could increase my dosage. (This is the nice aspect of injectables – with oral meds, I wouldn’t be able to increase dosage until the next cycle.) The nurse told me to expect probably 8-10 injection days until I am ready for my HCG trigger shot (to ovulate) and an IUI.  I am trying to not to get my hopes up because, as I learned with Femara, there is just no way to know how my body will react to any medication (stupid lazy ovaries!!). But, right now, I am thankful to be starting a new chance at getting pregnant.