Issa No From Me, Dawg...

So....previously on Self-Made Motherhood Blog....we were testing positive on EPT's and also bleeding like nobody's business and also waiting on bloodwork results to tell us what any of this might mean.  No. It means 'No'.  The bloodwork results are in and I am unequivocably not pregnant.  "What were your HcG serum numbers though?" you might be asking.  The answer to that question is "0".  This can mean one of two things (probably of more than two things, but these are the two most likely scenarios I can come up with).  1) My light positives on 12 & 13dpo were a fertilized little ball of something that failed to implant or got impeached when I started bleeding because my uterus is stubborn and the only thing about me that ever runs according to schedule; or 2) positive tests on 12 & 13dpo and fading positive tests on 14dpo were my HcG trigger shot still filtering out of my system and the Osom brand tests really are just that damned sensitive.  Either way, I need to plan my next move.  My bank account is telling me I'm not ready to do another cycle right away.  Most likely I'll wait for my holiday bonus to come in from work and plan a January cycle with that.  

Last year, I was planning to buy/finance a new laptop, but my crap cell phone died semi-unexpectedly and because cell phone companies no longer give you the latest phones for $200 when you sign a new contract, I ended up spending a hefty chunk of my bonus on a new phone and accessories (gotta have the screen protector and indestructible case or else you may as well just give them all of your money now for when it breaks) & the rest on TTC.  This year, I'd really, really like to actually get a new laptop (and also throw some funds at TTC).  So I'm currently planning for a January cycle (same protocol: Letrozole, follie ultrasound, trigger, IUI at home, progesterone for the tww).  But...I'm gonna try to save some extra leading up to the holidays so that I can, hopefully, afford to do two or three consecutive cycles and up my chances with the cumulative effect.

For a hot second, I considered saving up for a cycle with the injectable FSH (Follistim) like I'd been planning for this last cycle before I got smacked in the face with how much the Follistim alone cost (and how shit my insurance is that the Follistim is "covered", but I'd still have to come up with $3k out of pocket).  But then at that price, if I could get that kind of money together in that time frame, I might as well wait and save some more and just do IVF.  And since I brought it up...I really don't want to do IVF, but I'm getting older and it's starting to look like a semi-attractive option (I mean, they fertilize the eggs and pick the best looking ones and put them directly into your uterus...It takes a lot of the guess work out, ya know?).  I'm not saying I'm looking into IVF for real-for real, but I think I'm going to start investigating it as a viable option (or, rather, investigating it to see if it is a viable option for me).  New Jersey actually has some kind of state mandated financial assistance for IVF, but I don't know what the income or maternal age restrictions might be.  I know my insurance is too crappy to cover the actual IVF procedures, but I don't know if it covers any of the meds or monitoring.  And then, what's the state financial assistance look like once the insurance coverage (or lack thereof) is factored in.  And would all of this still be more expensive than if I just went to Barbados or somewhere and did the IVF there?  And does my sperm bank even ship internationally???  It's a lot of questions and I probably don't even know the right questions to ask t this point.  So, there's definitely research to be done there.  I like to have my bases covered so that if it does come up at an RE visit, I'll already know what else I want to know.

So, umm....yeah.  Guess that's that for now.  Stay tuned...

Yes? No? Maybe So?

Last time on Self-made Motherhood Blog.....saw RE2 for the CD11 ultrasound to check on pre-O follies and got the go-ahead to trigger.  I'd brought it with me (because intramuscular needles are scary and I'm a wimp), so the nurse at the office administered the shot for me, and I was all set to do the IUI at home the following morning (which happened to be a Saturday, so no work worries or anything else scheduled).  I woke up at 6am on Saturday and started the thawing process around 6:30am or so (took me a while to locate my deep freeze handling gloves before I could open the spermcicle canister).  Set the timer on that (40 minutes at room temperature).  My procedural area was mostly set up already from the night before, so I just double checked that I had everything I'd need and got the mirror, light, and support pillows in place.  Then I ate a little something so that I wouldn't get hungry while I was reclining afterwards.  Timer went off and I held the sample in my hand for a minute to bring it to body temperature (as per the thawing instructions). I got the syringe and catheter ready, tested a drop on the microscope (his swimmers really are amazing), and assumed the position.  Insem was complete a little before 8am.  As I'd been up so early, I actually dozed for a bit on the sofa (where I do the insem - it's firmer than my bed, so makes for a better surface to keep things in place).  When I looked at the microscope again after a couple hours, there was still a lot of action happening.  So we know that my bachelor of choice has some very vigorous and hardy swimmers.  Since I'd anticipated ovulating on the left, I spent some time on my left side, then a little bit on my right, just in case.  And that was it!

About a week later at 7dpo, I tested with an Osom just to see if the trigger was still in my system.  Positive test said yes to that.  I also did another OPK (dip strip and digital) just to see if they would pick up on the HCG in my system (as some OPK's can confuse it for LH as they're molecularly similar) and both showed up negative with very faint lines, which is my standard for that time of my cycle after ovulation.  I'd read that some women tested out their triggers as early as 10dpo, so I started EPT'ing every couple of days after that to see the HCG trigger fade down & that way, I figured, I'd know for sure I was pregnant if it started to get darker again.  HA!  What's the saying about how we make plans and God laughs?  That.  I experienced that.  I tested with Osom (the most sensitive EPT I've found, recommended by a friend in the struggle) on 9dpo at 7am and it was still a faint line. 10dpo at 4:30am: barely visible line.  I figured the trigger must me almost out of my system because I could just barely make out there was a test line. 11dpo at 7am (more than 24hrs after the last one) and the line was faint, but darker than the day before!  Maybe we're on to something.  Also did a dip strip OPK that wasn't positive, but darker than usual for the part of my cycle.  12dpo at 3:15am (I often fall asleep watching tv, reading, or doing something on my laptop and wake up around this time, just in time to pack up my laptop, set out the next day's vitamins, and go to the bathroom before getting a couple more hours of sleep in before work).  Anyway, 12dpo at 3:15am there was barely a line there. OPK dip strip was showing up near positive though.  Weird, but whatever.  I went to bed.  Tested again upon "really" waking up for 12dpo a few hours later at 7am.  Faint line darker than the 3:15am try! WHAT???  And a dark positive OPK dip strip.  Intrigued.  I went through the day tentatively.  My LP is never more than 11 days unless I'm on Clomid, so this was uncharted territory and I could've gotten my period at any moment.  But I didn't.  Not all day. But I was steeling myself against the inevitable disappointment of my period coming along to ruin everything.  I tested again when I got home from work: 12dpo at 7:40pm: the line was much lighter than 12hrs earlier.  My heart sank. Maybe I had a fertilized egg that tried, but just didn't implant. Happens all the time.  Right?  13dpo at 3:30am (fell asleep watching tv and woke up & tested):  Even fainter line than before.  Ugggghhhhh!  Went to bed and tested again at 6:50am:  A very recognizable faint line! Darker than the last TWO tests.  Maybe something had latched on after all? Also a super dark positive OPK dip strip AND a technically negative digital (no smiley face), BUT the test line on that stick was nearing dark, too (as opposed to when you're really just not producing anything of note and there's no test line at all).  It was Friday.  Exactly two weeks from my follie ultrasound and trigger.  I had a busy day planned at work and didn't have time to call RE2's office until after 3pm, but thanked God for no spotting or bleeding every time I used the toilet the whole day.  I sneaked off to the bathroom and left a message for the RE2 nurses telling them I had a positive pregnancy test (it felt so odd to say that out loud - most especially because both my bosses were working from home that day and I was extra self-conscious about being accidentally overheard).  Then I went to the bathroom (which I hadn't done since about 10:30am - told you it was a super busy day).  Blood.  Not just a pink tinge when I wiped.  Blood drops in the toilet when I peed and clots (CLOTS) on the paper when I wiped.  I was gutted.

The nurse service rang me back.  I told them about the positive tests for the past couple days and that I was currently bleeding.  She asked if it was spotting or real bleeding.  I said it seemed like a heavy bleed, like the start of a period, but that I'd gotten a positive test in the morning, so what now?  She wanted me to come in for bloodwork (HCG beta) on Monday (because you may be pregnant and miscarrying, but we're not coming in to deal with you on a weekend, dearie).  Then I'd need to come in and do the repeat beta on Wednesday to see if the numbers were going up or not.  I asked if there was anything else done at this type of appointment or if it was just the blood draw.  Just the blood draw.  I suggested she get the Rx for the beta sent to Labcorp, so I wouldn't have to miss work to do it (there's one close-by where I work).  Plus, the one close by my job is open on Saturday, so I could do a walk-in and get the beta done even sooner.  She agreed to that and sent the request over to Labcorp.  I'd have to go back Monday to do the repeat beta.  I was worried about the wait being too long for me to get it done without an appointment on Monday (they only had late afternoon appointments left for Monday and I can't take a chatty 3yr old and a squirmy 15mos old from work with me for this. I mean, the baby's pre-verbal.  The 3yr old would blow my cover as soon as we got home though. Plus, I never mess with naptime. No way).  BUT when I'd done my walk-in on Saturday, I got there 30 minutes after they'd opened and the waiting room was already near full; but they had me in and out in about 30 minutes regardless (even had the same phlebotomist who'd done my pre-cycle labs).  So I figure if I get there at 6:45am on Monday (before they open at 7am) and can be the first walk-in in line, I should have no problem getting to work on time. Just in case it doesn't happen that way though, I booked an 11am appointment for Tuesday (after I drop the big girl off to school).  I figure a day late is better than nothing and math is math.  If the numbers are going up or down, it'll still show up in the bloodwork a day later than planned for. Forgot to mention, tested 4:30am & 3:30pm on Saturday (14dpo) and both super faint lines, lighter than 13dpo morning.  OPK's were super dark test lines on both, but digital is calling it a negative (possible the digi knows the difference between LH and HCG, even when it's lines are dark).  Tested again at 9:35am (my weekend version of 7am) and have a very faint, barely there line.  OPK's still coming out super dark.

Oh, other fun facts (in case this isn't confusing enough for you yet):  My BBT temps started dropping at 12dpo and tanked HARD (below the coverline) on 14dpo.  But SURPRISE! BBT is back WAY up this morning (15dpo).  I'm still taking the progesterone until I get a definitive answer from RE2 about my bloodwork.  That didn't stop my temps from plummeting over the last few days, so I can't be sure it's in any way responsible for the temp spike this morning.

Remember that thing I was saying about us making plans and God laughing?  Yeah, well I just got a text from work and they want me to come in about 15 minutes early Monday....so I'm still gonna try to be there before Labcorp opens and do a walk-in to get the repeat beta, but if they can't get to me by 7:15am, I'll have to leave and try to walk-in again Tuesday morning (and if that doesn't work, bring the baby & come at the appointment time I have saved for Tuesday which is at the exact same time as the Halloween party at the library that the baby and I are supposed to be at).  #SuperFunTimes  I also went ahead and scheduled appointments for Wednesday and Thursday in case they need to repeat it again to see what's going on.

So that's where I'm at for the moment.  Stay tuned....

Hurry Up and Wait...

Previously on Self-made Motherhood blog, our heroine was advocating for herself like a motha to get RE2 on board with the original recipe plan - monitored Femara/Letrozole cycle with a trigger shot and progesterone support for the tww (especially since finding out that a single round of injectables featuring FSH would cost a little over $3200. Hard pass.).  Eventually, and not without considerable effort and strife on our heroine's part, grace was given and Letrozole was prescribed.  And here we are...

My cycle started like clockwork on October 3 (a Tuesday).  I called in to RE2 to report the start of my cycle and get the Rx for the Femara (turns out my insurance covered Letrozole, same-same), and asked for the higher dose (5mg daily instead of 2.5mg - two pills a day instead of one).  I was also told to call the nurse's line to schedule my monitoring ultrasound (scheduled it for cd11, the following Friday (not Comic Con Friday), at 7am in the Jersey City office - p.s. I didn't even know they had a Jersey City office).  Picked up the Letrozole at my local pharmacy (10 pills for less than $1.29 with my insurance!!!  Clomid had cost me $26 for 10 pills & $47 for 20 pills.  I hate the healthcare industry in the US. Total clusterfuck of uselessness and bureaucracy designed to make rich people richer instead of actually helping regular people get the care that they need).  I also had to call the specialty pharmacy to have them send just the HCG trigger shot.  They said they were sending me generic, but when it arrived it was Pregnyl, the name brand.  It also came with super long (well, 1.5") needles for intramuscular injection which had me freaked all the way out because I'd been trained for the half inch subcutaneous injections into the belly fat. This was not that.  More on that later. On my alibi day off on Friday, I got an email from the First Steps program.  Guess what? I qualified for 5% off! You read that right: A WHOLE 5% DISCOUNT OFF OF $3200!!!!  WHAT A BARGAIN!!!  So that was a good laugh.  Glad I'd advocated so hard for myself and was already underway with Plan B. I started the Letrozole on Saturday the 7th.  (Side note: If single little me doing this all on my own with no partner to fill out their half of the proof of income paperwork is only eligible for 5% off the cost of meds, how do married/partnered people afford any of this?? They'd have to be damn near homeless to qualify for any financial assistance. How, Sway???)  Work messaged me to see how I was feeling about my alibi (*cough-cough*comiccon*cough-cough*).  I said I was feeling okay, but not great.....and that I had my follow up scheduled for the following Friday (again, not completely untrue. I had my "follow-up" cd11 ultrasound to see how I responded to the Letrozole).  See how I made that Comic Con alibi work for me in my actual real life?

Turns out the Jersey City office is super easy to get to from my house (2 stops from my home station to Hoboken and then a 10 minute walk), and since the appointment was at 7am, the morning rush hour trains were running very frequently.  I could do my appointment and likely still get to work by 8:30 (only 30 minutes late).  Remember when I said I didn't even know they had a Jersey City office? Yeah, apparently neither does their website nor their answering service.  I woke up at 3am on Friday panicked because I couldn't remember the address for the office.  I looked all over their website and found not a single mention.  I started to think maybe I'd imagined it, but then I saw an ad advertising that they were looking for a Spanish speaking intake nurse or their Newark and Jersey City offices.  So it definitely wasn't a figment of my imagination.  By this time, it was after nearing 5am and I needed to de-fuzz my body (hate the idea of going to a gyno visit without being properly groomed) and shower.  I was in the shower when I realized that I had looked up the office address while I was on the phone with the nurse scheduling the appointment.  I ran from the bathroom to dive through a week's worth of internet browsing history.  Found it!  Crisis averted!  I had to run to get ready to catch the 6:12am train.  Made it and got to the office (which has a different clinic name than the one I usually go to in Newark, so I wasn't sure I was in the right place at first).  RE2 arrived shortly after I'd had my blood pressure taken, so I stepped out of my under things and hopped up on the table.  I told her if anything was going on, it was on the left side and I was right.

Details: I had two follies on the right (18x12 & 8x8).  Three on the left (18x23, 18x14, & 12x8).  My lining was at 7 (millimeters, I guess...?), which she said was normal, but the lower end of normal ("we see pregnancies with linings anywhere between 7 and 9.").  She asked if I'd received the trigger shot.  I told her I had brought it with me because I was a little freaked out by the long needles (understatement) and   I had questions about how to do it because it's not what the nurse at the other clinic had trained me for.  She said it was great that I'd brought it with me because my follicles were a good size and she could have the nurse do the shot for me right there in the office and then I could do the insem tomorrow morning (she was still very obviously not too jazzed about me doing my own IUI at home, but she also realized that she was only at the Shrewsbury office the next day and that is FAAAR.  Plus, she seemed surprised yet satisfied with all of my answers to her questions about my process).  I asked her about progesterone support for the luteal phase and she kind of balked a bit, saying that they really don't prescribe progesterone anymore.  I explained that I was really worried about my cycle length and I wanted to give everything the best chance possible, and she agreed to give me an Rx for the pill form. So that was all done.  RE2 left and the nurse came back to do the trigger shot for me.  Seriously, how do people inject themselves into their own butt muscle?  I'm glad I'd brought it with me.  It did hurt, but not as much as I'd thought it would, and there was no soreness at all afterward. I managed to get back to the train station so quickly that my same e-ticket was still valid and I made it to work by 8:30am as promised!  I went about my day at work as usual.  Tired as hell from being awake since 3am, but more or less normal.

I did a pregnancy test at home because I'm weird and wanted to see what a proper positive looks like while I still have the HCG in my system (as opposed to the few barely there, nearly invisible, very, very faint positives that I've gotten in the past).  Also because I usually make myself crazy agonizing over if/when/how early to test and I figured I'd get it out of my system since you have to wait a full two weeks before the HCG from the trigger shot clears your system to see if you're really knocked up or not. So, that was fun.

Welp! Now we wait...Stay tuned...

A Funny Thing Happened On My Way To Femara...

I didn't get pregnant on my own naturally, so calm right on down if that's what you were thinking.

Previously on Self-made Motherhood Blog....our hero was trying to get the medical professionals around her to just give her some damned Femara and let her do her little home insemination.  But forces against this were too great.  Like I said in the last post, my regular gynecologist wouldn't prescribe Femara because it requires monitoring and she doesn't do all that.  She referred me out to RE#2.  RE2 was personable, knowledgeable, straight forward, and a woman of color (which makes me feel better because studies show that white medical professionals tend to give a lower standard of care to Black & PoC patients).  I told her that I'd done four non-consecutive rounds of Clomid with my regular gyno, but I felt it didn't help (or, if it did, the Clomid was drying up all my CM and thinning my lining so that nothing fertilized could stick); so I wanted to switch to Femara/Letrozole (same drug, different brand names depending on what your insurance covers) because women who don't respond well to Clomid often respond much better on Femara (and vice versa). Plus, Femara doesn't have the side effect of thinning the uterine lining.  RE2 got where I was coming from, but thought that Femara was a lateral move from Clomid and I should step up my game because I'm all old now and whatnot.  Read the last post to see where I ended up with all that.  Anyhoo...did the saline sonogram and she was able to see that my one big fibroid in the back wall of my uterus is definitely on the outside-ish and not interfering with anything.  My tubes are clear and everything is the size and shape it ought to be.  She literally told me I have beautiful uterus.  This was all preliminary because, as I told RE2, I wasn't planning to try again until October (because that's what my bank account was telling me).

That brings us to the present-ish.  I had to travel for work in the second week of September, so I scheduled my injectable FSH info session & consult for September 20th the week of my return so we could get meds and everything (FSH and all of its accoutrements have to be ordered through a specialty pharmacy).  Great. My October cycle was set to begin on the 3rd or 4th of October, so just about two weeks exactly.  About a week after the last visit with RE2, I get a call from the specialty pharmacy saying that my prescriptions are all ready and they just need my credit card so they can send it out to me via overnight post.  Sure.  How much? Oh, about $3200.  Excuse me....WHAAAAAAT????  RE2 had said that the FSH, HCG trigger shot, and Ganirelix (another shot to stop your body from ovulating before your eggs are ready) should cost a couple hundred dollars with insurance.  Apparently thirty-two hundred dollars.  Needless to say, I did not give them my credit card number and called RE2 to initiate Plan B (which was my original Plan A - monitored Femara cycle with optional trigger shot and home IUI).  She told me to call the clinic's IUI coordinator to ask about their financial assistance plan, which could give up to 75% discount on the meds if I qualified.  At this point, my cycle is going to start in less than a week, and she wants me to jump through some more bureaucratic red tape in less than a week???  Fine, I call the IUI coordinator and leave a message.  She rings me back the next day (because we have all the time in the world, right?) and tells me to go to some random third party website (First Steps) to apply.  So...we're not even going to get into it that RE2 doesn't even seem to know that the clinic she works in doesn't even have a financial assistance program of its own, but if she had known that, it would have saved me two days of worry because she could have just directed me to the website herself.  Funny story:  When the IUI coordinator told me to go to the First Steps website, I asked for the web address and she seemed genuinely confused.  Me: "What's the web address....?  Like, FirstSteps.com or something else?" Her: "Huh? Oh, yeah. Yeah, that's it.  Call me back when they tell you what discount you qualify for."  THEN, on top of that, there is no FirstSteps.com.  It doesn't exist.  I had to Google "First Steps" and "infertility" to find it.  Submitted the application, but had to wait until I got home to send it because they required last year's 1040 as proof of income, but you have to black out your social security number).  Called RE2 back again because the IUI coordinator told me that turnaround on the application is usually about a week and it was already Thursday by this point.  Whether I got a discount or not, it may not come in time for my October cycle (and I'll be damned if I'm spending fall and winter holidays tryna plan around all this instead of hanging out with my nieces and the rest of my fam, so probably not trying again until January or even March).  Besides which, 75% off of $3200 is still several hundred dollars more than I was planning to spend on a single cycle.  RE2 rang me back at 7:30 Friday night (I was finished with work, but prepping stuff for the next week, so I had to step outside to take the call).  I told her about the timing for the discount application and that I wanted to prep for a Femara cycle like I'd originally asked her for.  She acquiesced.  Turns out the monitoring for Femara/Letrozole is way less rigorous than for the injectables.  I'd start the Femara on cd5-9, then go in for an ultrasound to check how the follicles are growing on cd10 or 11, and the doc would tell me if/when to trigger.  Plans made.  Stress lessened by about 1000%.  I could semi-enjoy my weekend.  Now, due to converging life events, New York Comic Con was coming up the next weekend, and it just so happened that I had bought tickets for Friday, Saturday, and Sunday months in advance.  I'd low-key forgotten about it because I was dealing with RE2 and her people since before I even left on my work trip at the beginning of September, so I hadn't requested the Friday off.  I needed to construct an alibi. This required some thought.  My guy boss saw my face when I came in from the phone call and asked if I was okay, but I kinda just shrugged it off.  But then that seemed useful to my narrative.  So on Saturday morning, I emailed work and constructed a careful tower of half truths to get the whole day off on Friday ("I'll need 24-48 hours to recover, so I scheduled the appointment for Friday, so I'd only have to miss one day of work.").  Grace given.  Friday off granted. I know this seems irrelevant, but it ties in to the story.  Trust me.  It'll all make sense when you read the next post.

Anyway, that's how I finally got the Rx for Femara/Letrozole.  Funny, right?  Stay tuned...