Fertility Evaluation

My toes in the Usambara Mountains of Tanzania

For anyone that missed it, for my first ICLW week I decided to recap the course of my journey before I started this blog.  A couple of days ago I posted about deciding to become a Choice Mom.  Today, I'm blogging about my first visits with my RE; I think my next blog will be about choosing my donor, and then in the next day or so I'll write about my first 3 IUIs, and how crazy they made me.  It's been fun writing these; time really does have a way of putting things in a different perspective!

* * * * * * * * * 

By the time I had an appointment with my RE, the summer after I turned 37, I knew all about IUIs, OPKs and BFPs, thanks to my hours spent on SMC discussion boards. My choice of an RE was easy; one of my best friends is an OB, and she said her patients always had the best results with this particular doctor, and so that’s who I went with. At the start of our evaluation, he was optimistic that, based on my history of normal periods, all would be great. He even recommended we start with non-medicated cycles

He did want me to have a full fertility evaluation done first, though, and so I had my Day 3 labs done with an ultrasound, an AMH level and an HSG. My HSG looked great (aside from a wonky cervix that required a balloon catheter to get through – ouch!), but the rest of my labs were not so great. My AMH level was low at 0.49, with an FSH running just a tad high at 9 with a good estradiol level, and my antral follicle count was on the low side.

I got all these results over the phone from the nurse; because of a scheduling conflict I couldn’t get in to see the RE until a month after we’d finished all the tests. It embarrasses me a little now to admit how I felt then, but I had a major freak out. I guess because I look younger than I am, I expected my ovaries to act younger than they are, too. I was so sure my fertility evaluation was going to be perfect, and when I found out it wasn’t, I was terrified. I went from imagining a couple of IUIs, to anticipating multiple BFNs, IVF, huge bills and the potential for no baby at all. In retrospect, I overreacted, imagining problems and obstacles that might never materialize. As my RE had pointed out in our first visit, nothing shows what your fertility status is like actually TTC.

Which is what he reminded me of when we had our first post-evaluation visit. He told me that if I’d come to him after a year of TTC on my own, we would be talking about going straight to IVF. But since I’d never tried to conceive on my own, he thought that 3 IUI cycles with Clomid would be reasonable, and then reassessing after that, based on my response. “Your labs are only indicators of a potential problem. They don’t tell us the whole story.”

I was a little comforted by our appointment, but I still worried. One wonderful result of that worry was an appointment with an acupuncturist who specializes in fertility. I honestly think that my weekly appointments with her helped to restore my sanity. And they probably helped with my fertility as well. But even if it turns out that traditional Chinese medicine does nothing at all for fertility, I feel so much better, so much more like myself as a result of working with her, that I don’t really care.

I happily took all my herbs, did my fertility yoga, ate organic and lost 15 pounds over the course of the next six months, looking forward to my last vacation before starting the IUI process in January 2010. I was ready for the thought that it was going to take me a few tries to be successful. I was optimistic, with a healthy dose of pessimism mixed in, so I was sure I was going to sail through TTC with no major problems, no weight gain and just joyful anticipation.

I was wrong about that! I think that’s what I’ll cover in my one of my next posts.  :)

ETA:  I just realized that I have 99 days left until my due date....and this was my 99th blog entry.  This makes the third crazy number thing this pregnancy (after a conception date of 8/9/10 and 111 days left on 1/11/11) - I wonder if he's going to be a math genius?

In the Beginning

Me standing in Ngorongoro Crater

Welcome IComLeavWe'rs!  As you can see by my profile, I’m a 39 year old single mom by choice, currently 25 weeks pregnant after 4 IUIs and1 miscarriage.  Most of my bloggy friends are other SMCs, or women on the road to becoming SMCs, but I’ve randomly found other non-SMC blogs that I enjoy following, which led me to decide to sign up for ICLW this month so I could find some more.

I started this blog less than a week after my miscarriage in May. It initially started as a blog about loss and grief, then turned into a TTC blog, and now it’s become a pregnancy blog.  The one unifying theme throughout all these entries is the fact that I’m doing this as a single woman, and I try to remember to talk about that aspect of things as I write, though it can be surprisingly hard to remember to cover those feelings while writing about ultrasounds and IUIs! 

Because of when I started this blog, I never really covered much of anything that came before my miscarriage.  So I’ve decided to take this week to write about things like how I decided to pursue this path, choosing a donor, and talking a little about my first few IUIs when facing the diagnosis of diminished ovarian reserve. 

Welcome, and I’m looking forward to reading your stories, as well!

* * * * * * * * * *

The first time I can remember consciously deciding I was considering the SMC route was about 9 years ago, when I was a medicine resident, sitting in the ICU with a sick patient, chatting with Dr. C, one of the nephrology attendings.  She was also single, and I’m guessing she was not much older than I am now.  I’m not sure exactly how the subject came up, but I remember saying to her, “I thinking of adopting if I’m still single by the time I’m in my late 30s.”  Dr. C said, “I always thought the same thing, but I just never did it, and I guess it’s too late now.”  That was one of the saddest things I’ve ever heard, and then and there I vowed I would never let myself get to the point where I felt like it was too late to pursue my dreams.

But then suddenly I was 36, with no husband, no boyfriend and no baby.  I had dated – I tried a couple of online dating sites (and went on a lot of dates), joined clubs, took photography classes, traveled the world and accepted every blind date that was offered to me, with no success.  I know that many of my friends think I should have done more with the online dating, but I really hated it, and while I tried several times to make myself sign up for one of the sites one more time, I just couldn’t do it.  But I also couldn’t commit myself to going further with adoption, even though I still really wanted to be a mom. And it was then that I realized that I really wanted the chance to be pregnant, and my plans changed. 

I talked to my Gyn at my next appointment with her, and she was full of advice and information, since she herself had twins through IUI with an anonymous donor.  Armed with the names a couple of sperm banks, I started googling, and discovered the online world of SMCs.  I also told my parents, who were surprisingly supportive and excited, and my sister, who promptly asked if she could be my birthing coach when the time came.  I also told my closest friends, who encouraged me to go forward with my plans, and to hurry up already!

I had to put things off a bit, though.  I was still hopeful I would meet Mr. Right, and thought I probably had more time to wait before my eggs really started to age.  I also had some traveling to do.  I love to travel, and I just wasn’t ready to give that up in favor of being a mom.  My plan was to make it to all seven continents before trying to conceive, which would have led to me having my first IUI this past fall, after I turned 39. 

My visit to the RE accelerated those plans a little, and led to me knocking Australia off the list of travel destinations so I could start TTC in January of 2010 instead.  I think that part of the story deserves another entry, though, so I’ll stop writing for now, and start reading some new-to-me blogs!

Estate Planning

I’d never given much thought to wills and estate planning until my friend Heidi’s husband died unexpectedly and without a will almost 8 years ago. Even though they were married, the fact that he didn’t have a will meant that a horrible and stressful time was made even worse as Heidi had to deal with all the financial craziness that ensued. Her experiences made me realize that I needed a will, because I definitely didn’t want my parents to have to deal with all that if something happened to me. For a few years I used one that I created online, but about 5 years ago I met with an estate attorney and created a will that was designed just for me. She also brought up that fact that as a single woman, I have no one to take care of finances if I’m temporarily incapacitated, and that it would be up to my parents to make medical decisions for me, if I wasn’t able to do so myself. At her suggestion, I had her draw up a durable power of attorney, so my sister could pay my bills and act on my behalf if I couldn’t. I also now have a health care power of attorney, since I don’t want my parents to be the ones to ever have to make hard medical decisions for me, and a living will that puts all my wishes in writing, so that my sister will have further proof that I meant what I said when we had The Talk a few years ago.

Now that I’m pregnant, I have a whole other issue to think about – what would happen to Chiquitito if something happened to me? Last month I called up my wonderful estate attorney and made an appointment to meet with her this afternoon. In less than an hour we discussed guardians and executors (and discussed the qualities that each would need to possess), and wills and trusts, and how they work together. While it’s possible (and easy) to make a will that creates the trust when the will goes into effect, that does result in more paperwork and hassle for those left behind. The other option is creating a trust now, that’s separate from the will, which makes finances incredibly easy when the trust is needed. So we’re going to create a trust, and put my non-retirement assets in there (if you can call my condo an asset) and then make the trust the benefactor of my retirement accounts and the life insurance policy that my financial guy is working on for me. Of course, creating a trust up front is more work for me, but I think it’s worth it, if it might save my family extra work someday.

I really hope that none of this is ever needed. I fully intend to watch Chiquitito grow up, graduate from college and maybe even have some Chiquititos of his own some day. But life never goes exactly as expected, and I feel better knowing I’ll have a contingency plan in place, just in case.

A Trip to the NICU

Early this morning, around 2am, I got a call from LB’s husband; LB’s water had broken just a little while earlier, and they were at the hospital, prepping for an emergency c-section. LB was 34 weeks pregnant, just started her high-risk monitoring two weeks ago, and had already had an overnight stay at the hospital this week for low amniotic fluid and non-reassuring heart sounds. LB was really hoping that she’d be able to hold out at least another week or so, but her little girl had other plans, and decided, quite forcibly, that it was time for her to be born!

Despite the drama surrounding her delivery, this was the best c-section LB has had yet (last time the spinal didn’t work, and she pretty much felt the entire thing – thank goodness a different anesthesiologist was on call last night!) and she’s doing well. Little Lillian is just 4 pounds, 2 ounces, and looks like a little elf. While she’s having trouble regulating her temperature, she’s already breastfeeding like a champ. She’ll probably have to stay in the NICU for two weeks, but we’re really hopeful this will be an uneventful stay and she’ll be home very soon.

I got to hold her for a few minutes, and as soon as I had her in my arms, partially resting on my bump, Chiquitito started kicking me. Hard. Right where Lillian was resting. I wonder, is it too early for him to be feeling jealousy?

As I held Lillian, I couldn’t help but remember how upset I was when I first learned that LB was pregnant. I’ve felt guilty for that a lot the past few months, especially since this has been such a hard pregnancy for LB. But holding that sweet little girl, I could barely even remember how horrible I felt when I first had learned of her existence. It seems like a lifetime ago. I hope that I would be able to still feel that same joy, love and wonder when holding her if I weren’t pregnant right now; but I am so very thankful that I did not find myself in that situation today. I’m not sure that joy even begins to describe how I felt when holding Lillian while feeling Chiquitito kick inside me. It was definitely one of those moments I’ll treasure for the rest of my life.

A New Edict or Two

After I finished my blog post yesterday, I found more books.  And by more books, I mean a lot more books that I haven't read yet.  So I'm making a new rule for myself that I am NOT to buy another book until I've read at least 5 of my as-yet-unread physical books, and 2 of my Kindle books.  Not one single book.

Good thing I pre-ordered Shadowfever last week, so it doesn't count.

I'm also going to take more pictures.  I love photography (just about every picture I post on my blog is something I've taken, some better than others), but I tend to do it only when I'm on vacation, or with family.  So I'm going to try to take pictures more often.  I'm not committing to a picture a day just yet, but maybe a picture a week.  The picture on the right is from this morning, when the sun came up over the ice.  It's hard not to take pictures on a morning like this morning, though.  I found myself wanting to pull over on the side of the interstate to take pictures on my drive to work this morning; the ice covered snow and trees in the sparkling sun was just breathtaking.  The challenge will be when there's not much interesting to take pictures of readily available.  On the bright side, the subject for my weekly photography edict should longer be an issue, in say, about 110 days or so!

1/11/11

Today is 1/11/11- and the day that marks 111 days left until my due date. (Thanks to Erika for pointing that out when commenting on her own pregnancy.) What are the odds? Probably about the same as the odds that my IUI on 8/9/10 would result in this pregnancy!

Today is also the second day in a row I’ve had off, thanks to the snow and ice that hit our area on Sunday and Monday. I think our office could have been open yesterday (even though everyone was closed) but today the roads are just solid sheets of ice after the freezing rain we had overnight. It’s been grey and dreary, but the trees are so pretty all coated in ice. I hope it’s sunny tomorrow and I can get a few pictures in before it all melts, but I couldn’t resist taking a few from my back porch today. Ok, my back porch is also a sheet of ice, so I really took them from my back door. But close enough.

I have managed to get a lot accomplished the past two days, even though I’m not really sure it actually looks like I have done as much as I have. Yesterday I got the dining room completely finished, with everything put away, and managed to clean up the kitchen and living room as well. And so I do have a few home pictures to share of my dining room, with the new wall upstairs where the railing once was.

the box is my crib, waiting to be taken upstairs

(I swear, I don't tell the cats to get in the picture!)

dining room from the other side 

view from above

not a great shot of the room, but love Vagus in this picture

I’ve gone from project to project all day, as it hasn’t taken much to get me bored with anything. I’m in a relatively small space, but have managed to create a lot of storage with shelving and built-ins – storage that has been used to keep all sorts of things I don’t really need. I can’t count the number of books I’ve given away to Goodwill in the past few months (well over 150!), and yet my house is still overflowing with books I can’t bear to part with, so I’ve had to find some creative ways to store them all. I did manage to get rid of a few more paperbacks, cleaned out my bathroom cabinets of all toiletries and candles not used in the past 6 months, cleaned out the closet in the nursery and found another entire bag of perfectly good clothes I know I’ll never wear again that are going to Goodwill.

I’ve got my storage closet downstairs and the cabinets in my living room to tackle next, and then the next task is to get some storage organizers and sliding shelves/baskets for cabinets to make all the storage space more functional. I will find a way to make this condo accommodate me and baby without becoming a mess!

Best of all, I feel so much more relaxed about all I have to do between now and May. I haven’t actually been able to scratch much off my list, because no task is fully completed, but I’ve made a good dent in everything, which goes a long way towards making me feel like I’ve got things under control.

Slowing Down

For the past few years, I’ve had a busy schedule, and I’ve liked it. It’s not uncommon for me to be out of town, either for work or visiting friends, for 3-4 weekends in a row, and I’ll have weeks where I don’t get home before 10pm every night. All I’d need was a quiet weekend day at home every now and then, and I’d be happy.

That doesn’t work so well these days – since the week of Thanksgiving, I’ve been going nonstop, and I am exhausted. On top of that, my blood pressure has been a little high – not terribly, but unusual for me in the 130s/80s. And then I got a nasty cold. Which led to me getting a lecture from LB on how I’m not taking care of myself, and the high blood pressure is my body telling me I need to slow down. The worst part is, I know she’s right.

So this weekend was my last weekend of travel (I hope) until after Chiquitito comes. And it was a great weekend – I went to Dallas for a conference on Thursday and got home late last night. I saw lots of old friends, most of whom had no idea I was even considering trying to conceive, and so weren’t expecting to see me almost 24 weeks pregnant. That was a lot of fun! The hotel was crappy (I found a couple of dead roaches in my hotel room, and yet the front desk staff acted like I was inconveniencing them when I asked if someone would go to my room and get rid of them for me), but the conference was good. If only I hadn’t been coughing and sniffling my way through the entire thing, it would have been perfect.

The flight home was crowded, and everyone was grumpy and anxious to get in the air before the bad weather started to delay flights. I was in an aisle seat, but squished next to a huge guy in the middle seat, starting to get overheated and nauseated, and was really dreading the two and a half hour flight home. And then I heard my name called overhead with the instructions to bring my bags to the front with me – I got a first class upgrade! It’ll be my last, since I didn’t fly enough last year to get preferred status on USAir (for the first time in 4 years), but for a final upgrade, the timing couldn’t have been more perfect. I was able to stretch out and relax for the flight home.

I’ve spent today lazing around, watching bad TV and doing a little furniture rearranging in the nursery. I still have no idea how it’s all going to come together, but I’m sure I’ll figure it out. My place overall is really looking great. I should be at the point where I can post a few pictures, at least of downstairs, by next weekend. Maybe earlier, if the promised snow and ice really hits and I get tomorrow off work!

Did I Say That?

Today I was talking to a patient of mine who was singing the praises of her orthopedic surgeon, a wonderful man who has gone out of his way to help her. Half joking I said, “Is he single?” Her eyes lit up and she said, “Yes! And I think you two would hit it off! Do you want to come with me to my next appointment so I can introduce you?”

I laughed, rubbed my stomach and said, “Only if he has a thing for pregnant women!”

She was all excited to hear I’m pregnant, offered me happy congratulations and then said, “Do you still have a relationship with the father?”

Remember that post last week about sharing the news at work? Well, I forgot everything I wrote, and instead the words that came out of my mouth were, “Oh, I have no idea who the father is.”

Really.

I said that.

So then I had to explain, laughing at my own stupidity, while feeling my face turn bright red, “I mean, I used an anonymous donor; I went to a doctor to get pregnant.”

Luckily, my patient has a sense of humor!  And she likes Jennifer Anniston, because she referred to her statements when telling me how great she thought my decision to become a choice mom was.

**********

I have an OB appointment tomorrow morning, and in preparation I weighed myself today, so I could be shocked by the weight on the scale in private. According to my scales, and my somewhat faulty memory of what my last weight was, I think I’ve gained 4 pounds this month. Which is less than I expected, considering my recent milkshake cravings and the overeating that comes along with the holidays.

Now that I think about it – I’m more than a little constipated now, too. What are the chances that I’ll get relief from my constipation before my weigh in tomorrow? Because I’m sure I’d lose at least 2 pounds if I could just poop.