Peeing without the Stick

So, today is the 21st -- PT Day (Pregnancy Test Day). Of course, both D and I couldn't stand the wait and decided to jump the gun and test early yesterday, mid-afternoon. Sadly, the test came up negative, but we're hopeful that we just tested a little too early and/or D's pee wasn't as concentrated as it needed to be to get an accurate reading (the instructions recommended either using first morning urine or holding pee for a certain number of hours prior to testing). Since we did neither of these, we had planned to re-test this morning with the recommended first morning urine, but in her normal sleepy, zombie-like state, D peed without testing while I was in the shower. Hence, we've decided to wait until tomorrow morning. D's last period began on the night of June 22nd, which makes today the 30th day. By tomorrow, she'll officially be three days late. While we both are thinking optimistically because of her lateness, we're still skeptical given the negative reading yesterday. We're also unsure of whether inducing ovulation with the HCG shot can delay her period. So, we'll wait some more... And I'll make sure to put the toilet seat up before I go to bed tonight just in case a comatose D decides to direct her sights on the toilet without being armed with the stick.

Musak and Stirrups

I hope everyone's thinking positive thoughts for us. We had our first IUI procedure yesterday. Before the procedure, the nurse asked us to verify that the donor's number was the same as that marked on the vial. Then the doctor told us about the donor sperm's concentration (40 million per ml) and motility (65%), both of which were apparently excellent for a frozen specimen. You go Eagle Scout Drummer! During the IUI, a catheter is used to inject washed sperm directly into the uterus. D said that it hurt a little. The whole procedure took a momentous five seconds -- we exhausted ourselves worrying about this for the last three months and it's over with one five second plunger push. How anticlimactic!? Afterward, D was told to remain lying down for fifteen minutes before dressing, so we were left in the room listening to bad Musak with D's feet in stirrups. Despite the unromantic, sterile atmosphere and the Air Supply, I still managed to get weepy thinking of the possibilities while D and I held hands and waited for the nurse to return. Our next appointment, which is to test D's progesterone level, is scheduled for one week after the procedure. Pregnancy, though, can't be confirmed until one week after that -- the 21st. Since it is a thirteen day wait, maybe it's not appropriate for me to ask that you keep your fingers crossed, but do think positive thoughts.

Page One of Our Family Fairy Tale

The follicle had grown to 15mm by the time of our Saturday appointment, so we were told to give D the trigger shot on Monday evening and schedule the IUI for Wednesday. At 12:45 tomorrow, D will be inseminated.

We're a little worried that the timing isn't right, but then again worrying seems to be old hat for us these days. We bought an ovulation predictor kit Sunday evening and have tested D practically every hour since. The box is supposed to be a one-month supply but I'm certain that it won't last us longer than Wednesday morning.

Monday (pre-shot) went something like this:

1. First, we panicked when we couldn't find the medicine, which over a month ago we had carefully placed behind the eggs in the refrigerator. I frantically threw yogurt containers around in what seemed to be a frenzied dance as D said over my shoulder "Where the hell is it?! What did you do with it?! I put it right there!" (We finally realized that it had somehow fallen to the first shelf).

2. We were all set to go -- washed hands, clean work surface, sterile gauze pad, rubbing alcohol, cotton balls, pre-filled Ovidrel syringe -- check. We then read the instructions and realized we had to wait for the medicine to return to room temperature prior to administering it. Of course we then panicked about not knowing how long it takes for medicine that has been in the refrigerator to return to room temperature. And we had no idea how we would know when it was room temperature.

3. After waiting about twenty minutes, we then freaked out again over the brevity of the directions that came with the medicine and frantically searched for videos on YouTube to make sure we were properly clearing the air from the syringe and injecting it correctly. When in doubt, check YouTube. Who would think that we'd find one? http://www.youtube.com/watch?v=A55hXymEXnQ

4. I watched D stand with the needle positioned at a 90 degree angle ready to stab it into her pinched abdominal flesh for what seemed like twenty minutes while she laughed and said things like "This just isn't natural [...]. I don't think I can do this [...]. I can't do this!" I offered to do it for her, but D was apparently more scared by that idea than stabbing herself.

She finally did do it (which is good because although I offered I didn't know if I could really do it), and after reporting our injection success to the soon-to-be grandmothers, we settled in for a night of catching up on recorded TV shows.

So, Wednesday is the day that we hope our son or daughter's life begins.

Once upon a time, on a Wednesday afternoon in July...

Hoping for stained blouses...

All of that pep rally spirit you've been exuding seems to be working, but don't put those pompoms down yet! On cycle day 9, today, D had a follicle sized 13.4 mm. Follicles apparently grow about 2 mm per day. With 18 mm being the optimal size for the release of a mature egg, D's follicle should be done "cooking" on cycle day 11 or 12. At that time we will be instructed to give her the HCG trigger shot. So, if all goes well, the insemination would be scheduled for days 13 or 14 (Monday or Tuesday). We should hear more when D's bloodwork is analyzed later this afternoon. Apparently, they can tell more specifically where she is in her cycle by her estradiol (E2) levels. So, please keep cheering and twirling those batons for a few more days. Hopefully, if all goes as planned, sometime in late March of next year, I'll be going to work with spit-up on my blouse -- and I really do mean that I'm wishing for that.

UPDATE:
The bloodwork came back with 102 E2 level, which is good but indicates that the follicles are still maturing (200 E2 per mature follicle.) So, we have another appointment on Saturday (day 11) for a second ultrasound and blood test. If the follicles have grown up enough by then, the doctor will recommend that the HCG shot be administered that day. Monday then would be THE DAY!

Pep Rally for Follicles

D took the prescribed medication as instructed, but her ovary check on cycle day 10 did not show enough "action" for the nurses to get excited about. Are her ovaries supposed to be discoing, I wondered. "Action," we've since learned, refers to follicle growth. D had some follicles but they were all really small. We were asked to return for another check in a few days to see if the follicles had grown.

I chanted "GROW, GROW, GROW!" to D's ovaries over the next couple days, thinking that maybe those little follicles were just confused or unmotivated and needed a pep rally. Well, no such luck. The second check revealed six follicles on one ovary, but none of the six were more than 9 mm. Apparently 18 mm. is the optimal size for insemination.

The good news is that Dr. Jaffe was utterly unfazed by this information and told D that there is absolutely nothing to worry about. D craftily asked the same question several times just to make sure:

"So there's nothing to be concerned about?"

"No, there's nothing to worry about."

"So, we shouldn't be worrying about anything then?"

"No, we'll just monitor things this month."

"So, we're just monitoring this month?"

I wonder if all patients do this weird parroting thing.

Since I didn't attend the second appointment, I came home from work armed with a gazillion questions even though D had given me a play by play on the phone while she was at the doctor's.

"So, she said that we shouldn't worry? Did you ask her specifically if there was anything wrong?"

Can you believe that this is what we've been reduced to? We used to have intelligent conversations in which we rarely repeated ourselves and now look at us!

Anyway, it seems that D's body just didn't have the response to the medication that they would have liked, but there are other medications to try. So, no insemination this week, but we'll start the whole cycle again soon. Grow, follicles! Grow!

Doc Martin

Tuesday of this week, we had a consultation with Dr. Jaffe. Both D and I agree that Dr. Jaffe has a similar bedside manner to Doc Martin, which if you're unfamiliar with the show, means that she essentially doesn't have one. I find the fact that she doesn't sugarcoat anything oddly comforting though. I feel confident that since she hasn't driven us to tears(yet), that our prospects for pregnancy are good. Anyway, she did say that because D has a low ovarian reserve (this is based on AMA level; she has a .6 and .7 is preferred), she'd like to take an aggressive approach with us -- meaning that D will take ovulation inducing drugs and the doctor will monitor follicular growth through ultrasounds to determine the optimal time to inseminate. This was the first we heard of this low reserve, so we were pretty concerned, but Dr. Jaffe seemed unfazed. In fact, when D asked if that meant that this would be our only chance to have a child, she answered with an emphatic "No" but added that if we want a second, we shouldn't wait too long after the first. Our plan for the end of May / beginning of June will look like this:
1. D will call to schedule an ovary check on day one of her cycle.
2. The ultrasound ovary check will occur on days two or three.
3. If everything looks good, then D will be started on a five day regimen of
Letrozole (we chose this drug because it has less side effects and is less likely to produce multiples than the more popular and less expensive alternative Clomid).
4. On day eleven of her cycle, D will have another appointment for a follicle scan to see how her follicles have responded to the drug.
5. D will then be sent home with an injectable drug called Ovidrel to induce ovulation and be instructed to administer it on a particular day (based on the size of her follicles in the scan.)
6. Two days after the Ovidrel shot is administered, D will then be inseminated through an IUI procedure (this is where the concentrated or "washed" sperm is injected directly into the uterus.)
7. A week after the IUI, D will go in for a Progesterone check.
8. One week later, we'll either be excitedly buying pregnancy tests or waiting around for the next time we can try again.

It actually felt really good to finally order some of our donor specimens to be shipped from California Cryo to CRM -- it felt like the beginning of something. What's weird is I have almost begun to feel like my contact over there at California Cryo, Shawn, is an old friend since I've spoken with him so often about paperwork, medical authorization, etc. So when Shawn wished us "Good luck being Mommies!" before he hung up with me this last time, I couldn't help but smile.

D and I have been tossing around baby names for weeks now -- actually we've made about a zillion solid name decisions that we thought (at the time) were definites and (as would be expected) consequently reversed those decisions -- we already went through Sophie, Sophia, Isabel, Isabella, Jaden, Sebastien, and Skylar. Right now, we like Gracie and Hannah for a girl and Dylan and Jaxson for a boy. I'm partial to Gracie because my grandmother's first name began with a G, but I have a feeling we'll go through a few million more than this before delivery day.

I'm about halfway through She Looks Just Like You: A Memoir of (Nonbiological Lesbian) Motherhood by Amie Klempnauer Miller. It's not the greatest writing I've every seen, but it's certainly heartfelt (I teared up a few times and was thankful that I had my sunglasses on.) There are so few books about our experience! Perhaps if this all goes as planned, I'll write one. : )

All Clear for Take-Off

Last Monday we had our psychological evaluation with Dr. Ott at the Center for Reproductive Medicine (CRM). Each of us filled out about ten pages of paperwork prior to our consultation, answering questions about everything from our perceived self confidence levels to sleep habits. And when I say "everything," I actually do mean "everything." We had to rank our satisfaction levels with our sex lives and our relationship, so of course I demanded D tell me exactly what she wrote for everything (I doubt that was part of Dr. Ott's plan).

Dr. Ott was a warm and very friendly thirty something woman who had actually given birth to her daughter after going through IVF at CRM. Following her treatment, she decided to dedicate her practice to couples facing infertility issues so she opened the Mind and Body Program at CRM. I'm privy to this information because I of course researched her history before our appointment.

We waited only about ten minutes before Dr. Ott's blond head appeared through the opened door in the waiting room. "Which of you want to go first?" I immediately jumped up and D grumbled. I knew though that I'd likely have a coronary if I had to wait in the waiting room wondering what D was saying in there during her interview. I had tried to anticipate questions like I do for job interviews -- "Why do you want to have baby?" "Have you prepared a financial plan for a baby?" etc. But she didn't really ask anything like that. Instead, she read through my paperwork and asked some very specific questions about what I had written. For example, one of the questions in the paperwork was "What three things would you like to change about yourself?" And part of my answer involved developing better public speaking skills since my lymph nodes swell at even the thought of presenting in front of colleagues. She found this amusing with me being a teacher and we discussed that for a while. After about ten minutes, I felt myself relaxing. Then it was D's turn and I uncomfortably waited in the waiting room and entertained myself as best I could with my iphone -- feeding virtual fish in a virtual fish tank. About twenty minutes later, I was called back in so the two of us could speak with Dr. Ott together. She smiled warmly and announced, "I think you two make a great couple!" And with that my shell of nervousness finally melted into a puddle at my feet. She excitedly went on about how we'll make great mothers and how we balance each other's personalities really well. While D is calm and peaceful (and apparently has "a great aura" -- which of course made me wonder if my aura was the color of poo or something), I worry enough for the two of us (or three of us when the baby comes). We then went on to discuss places in the area that offer prenatal partner yoga and types of foods that cut down on morning sickness. For that, she recommended mint ice cream. So D and I walked out of there feeling great about ourselves, our relationship, and our motherhood prospects. In fact, in the car D mentioned that it felt like our relationship had finally been validated -- it was sort of like the first time that we'd been approved of by a third party (probably because we're gay and thus never get the public support that straight couples get.) Regardless, we both felt great and went to our favorite Thai restaurant afterward to celebrate.

We scheduled the HSG test (a test during which a dye is injected into the fallopian tubes to determine if they're open)for last week as well. For that, I have very little to say since I spent the majority of the time in the waiting room watching the television screen read "no satellite signal" and listening to the FL rainstorm raging outside. I also brought with me a Chilean coin a colleague and friend had brought back for me after one of his many adventures -- he had said that it'll bring me good luck. I've had it with me for every important appointment we've had so far and will likely be clutching it in my palm when D's inseminated and when she gives birth.

After D emerged from the closed door, she said "Everything is fine" and then ushered me toward the exit. I assumed (as is my nature) that something was wrong; otherwise she wouldn't want to wait to talk until we were in the car, but of course I worried for nothing. When we were finally in the car, she said both fallopian tubes were open and Dr. Jaffe had even remarked that her reproductive system made a "beautiful picture" -- not one we'd likely frame and put up in the living room, but that still sounded really great. D prodded Dr. Jaffe with as many questions as she could get in during the short minutes it took for the doctor to reach the door (it was really crowded at CRM that day and Dr. Jaffe had appointments back to back) -- Can we buy the sperm? Can we get pregnant? To which, Dr. Jaffe gave her the all clear. "Order the sperm. You can get pregnant!"

So, we've ordered the sperm from California Cryobank -- six vials of a "very handsome" musically-talented tall blond and blue eyed high-STA-scorer who sounds in his audio interview to be extremely intelligent and kind. And we have a consultation with Dr. Jaffe on Tuesday, D's Birthday, to discuss drugs to promote ovulation and to schedule our first insemination in June!

Everyone think happy pregnancy thoughts for us in June.