IUI #1 (Second Time Around)

Ovulating 6 eggs is hard work!  I am in so much pain, I can't even stand up straight.  I am just lying in bed groaning and holding my breath.  I thought I should try and update the blog in between groans.

First of all, why in the heck did Winter have to choose today to finally make it's appearance??!!  The drive is normally an hour there, an hour back, but today it was an hour and a half there, 2 hours back.  And the highway was closed on our way back, so we had to take backroads.  Apparently there was a 26 car pileup in the lanes I was driving in on the way there, about 20 minutes behind me.  Man, am I glad I missed that!

Now, onto the IUI - there's not much to speak of, except that we only got 6.7 million sperm.  We are both disappointed with this, but there's not much we can do about it.  Hopefully at least one of them will function properly, find one of the SIX MATURE EGGS I have, and create a baby.

The nurse was so sweet.  She was really young, probably mid twenties, very pretty, and the whole time she was doing the IUI she kept asking if I was okay, if there was any pinching, warning me that there would be pressure, that I might feel cramping, etc etc.  She must have asked me if I was okay 5 or 6 times.  I finally said, "I pushed a baby out of my vagina without an epidural... trust me, this is nothing."  

Okay, I'm in so much pain, I feel like I should have asked for an ultrasound to check my ovaries while I was there.  I'm starting to worry about having OHSS or something.

Sidenote: it's 2:40pm and Noah is in his crib, but NOT sleeping.  He didn't sleep at all in the car either.  That sure made the harrowing 2 hour drive home super fun.  Thank goodness I bought a portable DVD player for him this past weekend.  I don't know how we would have handled it otherwise.

First and Only Monitoring Appointment

Today was my first (and only) monitoring appointment for our first IUI for our second baby.

Or maybe for our second, third, fourth, fifth, sixth, and seventh babies.

There is a very good reason this is my only monitoring appointment.  I went into the ultrasound this morning and Holy Guacamole, that was a lot of follicles!

A follicle of 16mm or greater almost always contains a mature egg.  Some clinics say 15mm, my clinic says 16.

On my right ovary I had 4 follicles at: 22, 18, 12, 12

On my left ovary I had 6 follicles at: 19, 18, 17, 15, 10, 10

Um, yes, you counted correctly, that would be FIVE mature follicles.  And that 15mm follicle?  Well, that was at 11am.  By this evening it is probably 16 or greater.

My uterine lining was 12.8.

So, I guess there goes my "poor responder" status.  In the past I have been on a combination of Femara, Clomid, and Injectables.  In one cycle I got one egg, in two cycles I got 2 eggs, and in one cycle I got 3 eggs (I got pregnant in my fourth cycle when I had two eggs, for the record).

This time, with 5mg of Femara CD 4 - 8 (started a day late), and 150IU of Bravelle CD 6 - 10, I had 5 (possibly 6) mature follicles on Day 11.

I was (and am) pretty excited.  But at the same time I am pretty freaked out that I might end up pregnant with higher order multiples.  There is a very thin line between "Oh frick, only 2 follicles??  Let me go to my car and cry"  and "Oh yay, 5 follicles!  Oh shit, we might have quadruplets."

Then again, we've done an IUI with 3 mature eggs and lots of sperm and didn't get pregnant with even one baby (which is probably why this cycle isn't cancelled or converted to IVF).  I feel like it's going to be all or nothing.  Either the sperm will get 'er done and we'll have several babies, or it'll suck and we'll have no babies, despite having 5 or 6 eggs waiting.  I hope I am wrong and there is a happy medium.

Like I said, I am triggering tonight, and we are doing our IUI on Thursday morning.  Wish us luck!  Pray for us!  I would prefer to have just one baby at a time.  I could deal with twins.  But please, please, no triplets!  And I'm sure it goes without saying, no quads, quints, or sextuplets either, please!!!

Much Better Mood, Much Better Potty

For the record, I got out of the house today.  I drove into town, dropped Noah off with my parents for an hour and a half, and ran some errands.  Then we had dinner at my parents' house, came home, and it was bedtime.

Both Noah and I really enjoyed the change of pace.  When he woke up from his nap he was cranky, but as soon as I asked him if he wanted to go to Granny and Gramper's, he said "Yah!!  Car!  Go!!" and started making his way to the front door.

I am feeling much better.  I am out of my funk, and no longer want to punch anyone (haha).  I also finally bought Noah the Baby Bjorn potty I've been coveting since I was pregnant.  I just couldn't bring myself to spend $40 on a potty (although now I'm realizing that the potty I did buy was 34.99... hmmm self... hmmm), but it finally went on sale half off, so I got it.

Up until now Noah has been peeing on this Elmo potty:

As soon as I got this potty home and assembled, I realized I had made a mistake.  In order to empty the potty basin you have to remove the seat, and then lift out the basin.  And there are actually three separate pieces that pee can get on, and various cracks for it to get in.  Plus, because of the way the base is shaped, Noah has a hard time backing up to sit down independently on this potty without crushing his special parts on the splash guard.

I love Elmo, but this potty is stupid.

Now we have this beauty:

Much more comfortable, easier for Noah to get on and off independently, and much much much easier to dump out and clean.

I bought three of them.  One for home, one for the van, and one for Granny and Gramper's.

Sigh.  I'm in potty love.

~~~~

As a funny aside, when I brought one of the potties into my parents' house, Noah immediately wanted his diaper off so he could sit on it.  But apparently he had just peed - which my Dad confirmed by telling me he was recently saying "Pee!" to him - because nothing would come out.  Something always comes out when he sits on the potty, because he knows exactly how to relax that muscle.  But nothing came.  After about 20 seconds of sitting there, Noah threw both his hands in the air and said "Working!?" in his freaking adorable voice (seriously my kid has the most adorable voice).  As in "It's not working!!  The pee won't come!!"

He cracks me up.

It's Been a Long Week

I want to say Thank Goodness it's Friday... but my husband has a basketball tournament this weekend, so really it makes no difference to me.

I think I'm having a hard time adjusting to him being back to work.  He's a teacher, so he was on vacation for 2 weeks at Christmas.  He did run a training camp, and he did run a few basketball practices, but he was mostly home for two whole weeks.

This week of him teaching full-time, and then spending an extra 3 hours away from home while coaching has been hard for me to adjust to.  The full-time job I can handle.  The extra coaching is what leaves me bitter.  And if I'm being honest, it's not just this week that I've felt that way.  I feel that way every single week of the school year.  His coaching drives me insane.  Seriously, sitting at home alone with Noah, after a long day with a cranky kid (although he is usually very good natured), knowing that if Justin didn't choose to spend all this extra time away from us coaching, he would be home... it kind of makes me want to scream.

This week has felt particularly hard, though.  There was the adjustment of Justin being gone after 2 weeks of being home.  There is the fact that it is the start of a new year, when Justin's take-home salary drops by about $500 per month (because various taxes and deductions that were paid off by September of the previous year start up again in January).  Then there was the stress of the fertility appointment.  There was starting the fertility drugs.  There is a lot of thinking and worrying going on in that area, and although I am trying to not let it bleed into the other areas of my life, it's kind of impossible for that to not happen at least a little bit.

I feel like it's been a long week, but now that I'm really thinking about it, it may just have been a really long Thursday and Friday.  Those two days have felt like a week by themselves.

I think I need a babysitter for a couple of hours.  I need some time to myself.  Time when I don't have the 'threat' of being interrupted hanging over my head.  Justin is playing with Noah downstairs right now, so I am alone, but it doesn't feel like it because any minute now Noah could decide that he's done being downstairs and come interrupt my quiet time.

Part of me is kind of looking forward to cycle monitoring next week, just because it'll be a change of pace.  I think I need to borrow or buy a portable DVD player though.  Noah is going to tire of the daily 2 hour round trip very quickly.

Here We Go Around Again

My appointment today went really well.  Everything went exactly how I was hoping it would go.  I'll break it down.

Medications

Dr. Martin said what they normally do right away with repeat patients is "what works." When I got pregnant with Noah I was on 7.5 mg of Femara on Day 3, 100mg of Clomid on Day 3-7, and 75IU of Bravelle (the FSH injections) from Day 6 on (it was supposed to be day 6-10, but I always had to continue the injections past day 10).  

I wasn't very happy with my reaction to my protocol the first time around. You're supposed to mature 3-5 eggs with that protocol, but I would only get 1-3 (I only got 3 once).  So for that reason I was up for a change.  But beyond that, I didn't want to take Clomid this time because of some of the negative effects it has. It dries up your cervical mucus; it can affect your uterine lining negatively (mine was always nice and thick, but there was no way to know how great the quality was); and it causes hot flashes and night sweats.  Not fun.  Plus they give it to some mothers right after they have babies in order to stop their milk from coming in, so I didn't want to risk losing my milk supply.  

Femara works to induce ovulation in a similar way to Clomid (it blocks the production of estrogen, while Clomid just blocks the estrogen receptors), but for some reason Femara doesn't have any of those negative side effects, so my hope was that I could go off the Clomid and just take Femara.

Dr. Martin went right along with taking me off of Clomid and adding more Femara.  He also thought we should increase the injections this time around, as well.  I agreed.  I was supposed to take 5 injections of 75IU each last cycle, but I could never just take 5.  Some cycles I ended up continuing the injections for up to 10 days because of a poor response.  I was actually hoping that I could go on a higher dose right up front, but I hadn't even mentioned it yet when Dr. Martin brought it up (seriously, we were so on the same wavelength during the whole appointment).  So instead of being prescribed five 75IU vials, I was prescribed fifteen 75IU vials - 2 per day for 7 days, plus an extra one.  

This raises my medication costs considerably.  My medication cost per cycle right now is $1200. I only have $15000 lifetime coverage for fertility drugs, so hopefully we can get pregnant with this baby quickly and have enough insurance money left to have another baby (or two) without having to pay out of pocket.

My new protocol is: 

5mg of Femara on Day 3-7, and 150IU of Bravelle from Day 6 on. Then I'll do a trigger shot when my follicles are mature, and an IUI after that.

Infertility Investigation

I am very thankful that I don't have to do an HSG test (checking to see if your tubes are open) this time around, because I was allergic to the dye last time.  Apparently it's not even in their normal protocol to do an HSG right away the second time around.  They just go right to doing what worked the last time, and if you're not pregnant within two cycles, they test the tubes in the third cycle.  We are going to do two IUI cycles, and if I'm not pregnant by then we will do the basic infertility investigation again.  I got my Day 3 bloodwork done today, and we will have SA's done with our two IUIs, so all that investigation will entail is doing a saline sonohystogram to check my tubes, instead of the HSG.  They can do that right in the clinic instead of going to the hospital, so that is much more convenient for me (even if it is an hour away).


Nursing

I was adamant (to anyone who asked) that I would not be weaning Noah in order to do fertility treatments.  I have looked into it extensively, and I am sure these medications are safe for me to be on while breastfeeding a toddler.  Clomid is sketchy while nursing, so I won't be taking it this time (unless the Femara alone doesn't work).  My RE, and my clinic in general, are incredibly supportive and accommodating, so I didn't anticipate that this would be a problem.

It wasn't.  Noah was pretty unsure of things when we went into Dr. Martin's office (he hates doctors, especially since he broke his leg), so he asked to nurse.  When he couldn't be distracted with toys or food, I went ahead and nursed him.  Dr. Martin didn't bat an eye.  It wasn't even mentioned.


Success?

Dr. Martin said half of their repeat patients are pregnant within the first two cycles. BUT they're doing what got them pregnant in the first place. We are trying something different, but he thinks the changes we made are for the better.  Hopefully they are.  

However, half of their patients probably don't have to deal with male factor infertility, so I don't really consider their chances to be the same as ours.  I'm hoping we will be pregnant within 4 completed IUI cycles, like last time.

Extra Thoughts

Everything went really well, exactly the way I hoped it would. Noah was really well behaved, and everyone was excited to see another "SOFT baby," especially Dr. Martin (SOFT is the acronym for my clinic's name). We were supposed to send them a birth announcement and take him in for a visit, but we never did.  I always felt bad about. So this was the first time they've seen him.

Dr. Martin said they would be quite happy to have us do an IUI with them this cycle. They are so nice at my clinic. They really feel like it's their PRIVILEGE to help you get pregnant, instead of like they're doing you a favour. I love them.

I was saying to a friend the other day that even though I wish we didn't have to do treatments to get pregnant, I really do love my clinic.  You know how you kind of fall in love with your OB by the end of your pregnancy?  Imagine how you'd feel about the people who finally got you pregnant in the first place!  I just want to gather up everyone in that office and give them a huge hug.

Overall we feel much more excited and optimistic this time around.  We are very hopeful we will get pregnant again, and that it won't take years.  We aren't depressed and scared like we were last time. We have Noah, and know exactly what we're looking forward to.  Justin was in a funk this weekend, but I think he's over it and just looking forward to getting pregnant, even if the journey is incredibly inconvenient.

Amazing Memory

For a 21 month old, I think Noah has an amazing memory.  Couple of stories:

-We hadn't seen my brother's family for 2 months before we saw them on Boxing Day, so it's not like Noah really knows them.  But almost 2 weeks after the Boxing Day gathering I was showing Noah a picture of their family on Facebook.  I hadn't reminded him of any of their names before showing him the picture, but when I pointed to each person he said each of their names.  Correctly.  Nick, Hilary, Elijah, and Josiah.  I was seriously impressed.

-Lately Noah is randomly thinking about his grandparents a lot.  He'll just start saying "Nana!  Papa!  Granny!  Gramper!" (or, rather, Nana, Papa, Ganny, Bamper).  Tonight at dinner he was doing that, so I started asking about other people in our family, like Uncle Matt, Aunt Lynsey, etc.  I asked about Josiah (my 14 month old nephew), and Noah looked at me very seriously and said the following:

"Siah.  Soodah.  Yittle.  Cying."

Translation:  "Josiah.  Soother.  Little.  Crying."

Yes, Josiah always has a soother in his mouth, he is little, and he cries.  A lot.  No, I have not been saying any of these things to Noah.  It's been 2 full weeks since we saw them, but he remembers exactly what Josiah was like.

He never ceases to amaze me.

~~~~

Tomorrow is our RE appointment... I'm equal parts nervous and excited.  We're bringing Noah.  I'm hoping everything will go according to the little plan in my head, but I have to remember to prepare myself for things not going that way.

Wool Works!

Last night's diapering adventures were successful!  The fitted he was wearing was wet through all the layers in the front (countless layers of bamboo and hemp - his bum area was dry, though... he's a boy AND a tummy sleeper), but the inside of the wool cover was barely damp.

His diaper wasn't totally saturated, so I think I might take out the hemp doubler I had folded in front for tonight.  His diaper was very thick in the front, and I don't think it was necessary.

I only slept 4 or 5 hours last night, probably because I kept wondering what was going on with his diaper.  Hopefully I rest more peacefully tonight, knowing he will wake up dry:)

Unfortunately, Noah is still sick.  I think it might actually be the 18th time.  He got sick on Christmas Day, but it is January 6 now and I don't think this is the same illness.  I think two separate illnesses - both from his loving father - ran into each other and overlapped.  Right now he seems to have bronchitis.  He is up coughing a lot. Hopefully he gets better soon.

Tonight is the Night

Tonight is the night we can finally cloth diaper overnight.  Canada Post has been extremely slow for the holidays, and apparently our regular mail carrier isn't working right now for whatever reason, so our mail has been even more delayed than it would have been.  I have ordered 3 big shipments of cloth diapers, and am still waiting on one of them - one which should have been delivered today, but wasn't.

Last night I finally got my bamboo fitted diapers and my wool covers.  The bamboo had to be properly prepped (10 washes to reach full absorbency, but I did 6), and the wool had to be lanolized, so I couldn't use them last night.

Lanolizing wool is pretty straightforward, even though there are a ton of different interpretations of the instructions.  Basically you just need to make sure your lanolin is properly dissolved and suspended in tepid water with the appropriate wool wash or baby shampoo, and then you soak your cover.  I used more lanolin than I'd read was necessary, because I knew my covers needed to be lanolized before first use, and I don't want to end up with a cover leaking straight through in the middle of the night (fingers crossed that doesn't happen to me anyway).  I also soaked the covers for over 3 hours instead of the 15-60 minutes I'd read in most instructions.  Like I said, I don't want to end up with a leaking cover.

After the lanolizing was done I gently squeezed out my covers (never wring out your wool), and then I put them in the washing machine for a spin cycle.  This was a trick I was very glad to have come across in my reading.  You're not supposed to machine wash your wool because the agitation can ruin it, but when it's spinning it's just staying flat against the side of the tub.  It worked like a charm, and those babies came out with no excess water in them.  To air dry the rest of the way I laid them flat on top of an overturned laundry basket and positioned them so that the fan in my room (that I have running every night) was blowing on them for 8 hours.  They were totally dry in about 12-13 hours.  Much better than the 2-3 days some other people experience!

So tonight I am taking the plunge.  I have to admit, as much as I've read that a good fitted diaper with a wool cover is pretty much a bullet-proof night-time solution, I am still nervous.  When I've described the system to people they've said "A wool cover?  Won't that leak?"  I have rattled off everything I've read.  "No!  It doesn't leak because wool is highly absorbent, but also water resistant.  The lanolin repels the liquid, and it's also breathable, so the liquid has a chance to evaporate a bit, blah blah blah."  So yes, I know all of this.  But having never experienced it myself, I am still nervous.  I want to be a wool lover.  It's surprisingly easy to care for, and with all the good things I've read about it I feel like I already am a wool lover.  I just hope it doesn't fail me tonight.

I am going to add both bamboo and hemp doublers to whichever style of fitted I choose to put on Noah tonight (I haven't decided between the Bamboozle Stretch or the Bumboo).  I think it'll be good for my peace of mind to overstuff, and then in the future I can adjust the absorbency lower if I need to.  These particular diapers are pretty trim, so extra stuffing will be tolerable for Noah.  I double stuffed a pocket diaper with microfiber for naptime once, and Noah cried until I came and changed his diaper into a thinner one... he hated being overstuffed.  But I can add some super absorbent hemp to these diapers without him feeling overstuffed like that.  Actually, the trimmness of the diapers is actually part of the reason why I'm a little nervous.

Alright, wish me luck!  It's almost bedtime!

T Minus 6 Days

Well, things are clipping along at a much faster rate than I thought they would when I first decided to call my RE.    I decided on December 13 to stop making excuses and denying my baby fever and just call.  About a week later I wrote about finally making the call to my own doctor to get a new referral (since it had been over 2 years since our last visit) but by then my clinic was closed for Christmas - the only days of the whole year they are closed.

They opened back up on the 3rd of January - yesterday.  All day I was thinking I should call them to make sure they got my referral and to schedule an appointment (referrals happen faster when you make follow up calls), but just hadn't brought myself to do it.  I was just too nervous.  But then my phone rang, and it was my family doctor's office.  The nurse was calling to find out if I knew about my appointment NEXT TUESDAY.  As in one week from the day she called.

I was very surprised.  I mean, once she called I remembered that's how it works at my clinic - they call your referring doctor to give THEM your appointment time, and the message gets passed along to you.  So that's not what I was surprised about.  What I'm surprised about is how freaking quickly we're getting in.  When I was trying to get pregnant with Noah, it was a 3-4 month wait to see Dr. Martin (the head of my clinic).  I got in a couple of months sooner by asking to see an associate instead.  I regretted seeing her, but at least I started doing treatments earlier than I would have if I waited, and I DID end up getting to see Dr. Martin a couple of months sooner than I would have, because we discovered my messed up hormones and annovulatory status (at the time, anyway).

This time we're getting in basically within less than 2 weeks.  We called for our referral on the 13th of December.  Their last day of work was on the 16th.  When they opened back up on the 3rd, we had an appointment for the 10th.  I wonder why it's moving so much quicker this time.

I am kind of freaking out, both with excitement and with nervousness.  I'm sure that most parents with an infertility past can relate to those feelings regarding adding to your family.  Deciding to have a second child is probably a little nerve wracking even in simple situations, but add in the 2 hour round trip 7+ times a month, the drugs, the invasion of your lady parts, and trying to juggle all that with a toddler.  And remembering my crappy pregnancy with Noah certainly makes me feel nervous about being pregnant again, because I have to deal with the crappy pregnancy while I already HAVE a 2 year old.

I know it will all work itself out.  But it still makes me nervous.

However, I am CRAZY excited as well.  My consultation appointment is going to land on Day 3 or 4 of my cycle.  And my clinic likes to start treatment ASAP, so most likely we will be doing an IUI within this month.  Or, at least attempting an IUI this month.  I may even make it to the consultation in time to start actual meds this cycle.

It's just crazy.  It's happening so fast.  I'm going to try and keep my expectations low, though.  I wouldn't be surprised if we attempted to do an IUI this month and ended up not being able to for whatever reason, because that's what happened to us 3 years ago.  I don't want that to crush my spirit.  So I'll just try to stay realistic, but optimistic at the same time.

And of course, there's still the hope that this cycle I'm currently in will knock me up and the appointment will be unnecessary:)

My Wish for 2012

2011 was an amazing year.  In fact, yesterday I said the same thing I said a year earlier: Today is the last day of the best year of my life.

Noah's growth and development was as drastic in 2011 as it was in 2012.  He went from being a baby to being a little boy.  I still catch glimpses of my baby, but they are few and far between.  It is my absolute joy to watch him grow up each and everyday, but it also makes my heart ache.  My heart aches because I can never go back.  I can never again experience him as he was as a newborn and infant.  That time is gone.

I am so thankful that I have been a stay at home mom all this time, so I didn't miss anything.  I spent as much time as possible with him through every stage.  But the days do blur together.  And more often than not I am too absorbed in everyday life to remember to take pictures to aid in my recall all of these days.

From the day Noah was born I have been saying that I wish I could PVR my life.  But more than that, I truly wish it was possible to actually go back and experience those little moments again, in person, however brief.  I wish it was possible to go back to the moment I gave birth and Noah was placed on my chest.  I wish it was possible to go back and nurse my tiny newborn Noah.  I wish I could go back and hold my little baby, scrunched up on my chest.  I wish I could snuggle and kiss Noah when he was 3 months old, rejoice over him learning to sit up at 5 months, and cheer when he fell over backwards.  I wish I could go back to when he first started crawling at 6 months, the first time he pulled up to stand at 7 months, his first steps at 10 months.  I wish I could go back and experience it all again.

There are things I sometimes say I will do differently with the next baby.  Like trying to get him to sleep through the night at a much earlier age.  Or putting him down for naps and nighttime when he's awake, so he's not so dependent on me and I have more time available for other things.  Actually, pretty much the only things I would change are sleep-related.

But now I don't know.  I don't regret a single thing I did with Noah.  Yes, I got up in the night to nurse him for 18 months.  And sometimes it was frustrating, because I often couldn't fall back asleep afterward.  But that was the fastest 18 months of my life, and now it's over.  And I don't regret it.  I loved holding my sweet, sleeping son, carrying him to his crib, and kissing his cheek before lying him down.  If it is possible to be able to do all that and still have a baby to who will go to sleep on his own, that would be my perfect situation.  I guess we will see.

I really want another baby.  I want to give Noah a sibling.  I want to add to our family.  I want to experience that newborn love again, and watch another child - my child - grow up to become a real little person.  I am very ready.  And I hope that 2012 is the year that fulfills that dream.  Chances are that the actual baby won't come in 2012, but I sure would love to be growing one:)