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...

Begin at the Beginning....Again.

Previously on Self-Made Motherhood Blog, our heroine was peeing on all the sticks trying to figure out exactly when she would ovulate so she could figure out exactly when to inseminate.  Long story short: Nothing came of it.  

Moving on.  So, after that (was that January?), I took February off to collect some finances, etc. I went for it again in March, taking Clomid again, with nothing to show for it.  March was my fourth Clomid cycle and, judging by my very sparse cm of any kind the whole cycle, I concluded that, even if the Clomid was giving me decent eggs, it was also thinning my lining to the point where nothing could stick even if it wanted to.  My 41st birthday was coming up soon (tick-tock! get a baby in there already, right???).  I did a ton of research and reading and decided I wanted to switch to Femara/Letrozol.  From everything I'd read (both actual scientific studies and anecdotes), women who don't respond well to Clomid sometimes respond better (and get pregnant) with Femara.  Plus, Femara doesn't have the side effect of thinning the uterine lining.  I was somehow able to snag an appointment with my gyno on March 31st (exactly one week before my birthday).  I was on cd3 and eager to get on the Femara in time to do an insem for that cycle (coincidentally ovulating sometime over my birthday weekend).  PLOT TWIST!  My gyno said she didn't prescribe Femara because, in her opinion, it requires monitoring and she doesn't do that kind of close monitoring.  I cried for just a second, but then mentally resolved to just go for it drug-free for April cycle anyway (I kept that to myself).  She referred me out to a new RE (I'd told her how I'd been treated at my first RE and she said she wasn't really surprised because they're such a big practice, they can pick and choose their patients and focus all their energy on their IVF success rates. Anyone that doesn't fall in line with their program is a necessary casualty).  The one thing I did like about my former, crappy, rude RE was that they had early morning monitoring hours starting at 6:30am, so I could go in for blood work or whatever and still make it to work on time. I was worried that this new place might not be so accommodating to my work scheduling needs.  I made the appointment anyway (figuring if I got pregnant with April cycle, then they could confirm and monitor.  If not, then we could talk next steps). 

Side note: I did snag this extremely dope video of my donor's swimmers swimming like crazy (so I think we can definitively say my un-pregnant-ness from January and going forward is a me-problem and not a him-problem).  I mean, LOOK AT'EM GO!!!

Obviously I'm not pregnant, so we talked about next steps at my May 5th appointment.  The new RE seemed very straightforward, but warm.  Didn't seem to be drawing any hard conclusions about my state of health based on my weight alone (it's always nice to not be stereotyped for being both Black and overweight at the same time).  I told her about my hopes to try out Femara.  She really feels like it's a lateral move from Clomid and doesn't think it will do me any good (she'll go forward with it if that's what I want, but it's not what she is advising).  She suggested injectable FSH with monitoring for egg development/size and a trigger shot, followed with in-clinic IUI.  I let her know that, because of my job, I can't do a lot of monitoring appointments unless I can be in and out in time to get to work (from Newark, as opposed to old, crappy RE that was very conveniently situated in West Orange).  She said she'll work with me in whatever capacity makes me most comfortable, but she has to tell me her best recommendations.  She also suggested doing a laparoscopy to check for endometriosis, or any other adhesions that might possibly be blocking an ovulated egg or a fertilized one from entering the fallopian tubes.  She said we could go forward with the FSH for a cycle and do the lap if I didn't get pregnant, OR do the lap first and then proceed with the FSH if they didn't find anything.  It was a lot to think about to say the least.  Next came "the exam". SUPERFUNTIMEZ!  Who doesn't love a transvaginal ultrasound?  Am I right?  My AFC (antral follicle count) is definitely down from where it was last year this time (I think I had 15 total last year.  This year closer to 10).  There's the same fibroid in the back wall of my uterus, but on the outside and not obstructing anything.  PLOT TWIST!  She found another fibroid in there and couldn't tell if it was inside or outside.  And a third "something" near the bottom of my uterus that could be a fibroid, or could be just a little flap of endometrium waiting to get shed with my period (since I'd just ovulated a couple days before).  In order to tell, she'll need to do a saline sonogram, which is like an HSG.  HSG uses blue dye and takes an x-ray of your uterus and tubes to see if everything flows out how it's supposed to.  Saline sonogram uses saline (hence the name) to fill up the uterus and tubes so that the doc can get a better 3D image of the topography of the uterus (letting her know if that fibroid is inside or outside, for instance).  They both have the advantage of flushing out the tubes (if there's no major blockage and the tubes are, in fact, flushable), possibly clearing the path for fertilization and implantation to happen.  

So....because my cycle is like clockwork, I called ahead of its arrival to schedule the saline sonogram for the 22nd (a Monday, not the most convenient day for me, but it's all they had within my window - it has to be done after menses, but before ovulation) at 11:30am (a decidedly inconvenient time of day for me to need to disappear from work).  I finally had to come (partially) clean at work.  I decided on an email to my lady boss (because talking about my uterus isn't a conversation I really ever want to have with my guy boss).  I told her about the appointment time I needed off on Monday (which was still two weeks away at the time).  And then I explained that once you hit 40 and haven't used your uterus for anything, everyone is pretty sure it's going to turn against you (which is generally true).  Mine isn't (at least we don't think so), but I do have a couple of suspicious fibroids that they'd like to get a better look at to see if there's anything going on (which is true).  And said that the reason I'm doing so many appointments is because I had to be referred out to a specialist (which is true), and that we want to do all of the tests and screenings before the Turnip in Chief and his cronies in DC make having health insurance a non-option for me (which is also true for me - I really don't think the doctors care at all  as long as they're getting paid).  So, I told her everything except for the trying to get knocked up part.  Bless her, she was really great about it and just wants me to make sure I'm "getting the care that [I] need", and even offered to discuss them providing healthcare or getting some kind of healthcare deduction through work, etc (I adore this work fam so much y'all. I really do).

So!  That brings us up to the present.  I have my saline sonogram tomorrow (and probably also bloodwork because I was so dehydrated at the last appointment that they couldn't find a vein - and oh, how they tried! Ouch!).  Hopefully, all fibroids are outside the uterus and not interfering with anything baby-making related (and also that the last suspicious something is gone, flushed out with my period).  Hopefully the tubes are all clear.  Directly after the appointment, I'm going to call The Bank to schedule shipment of one vial to arrive on Wednesday (cd11), so I'll be ready for ovulation with my newly flushed out tubes.  

Fingers crossed!  Stay tuned....

Is This Thing On?

When last we left our heroine, super spermcicles had arrived from MSB and all she had to do was laze about all weekend and obsessively pee on test sticks to know when ovulation was approaching.  And she did.  All weekend.  And the dip strip tests went from light to darker and back to lighter again.  And the digital tests were all definitively negative. Like this.

Light, lighter, light, getting
darker, darker, nearly there...
NOPE! Back to light again!
wtf???

By the time Monday rolled around, she began to despair for two reasons: First, she was on the edge of running through a box of twenty digital test sticks.  Second, the cryotank was supposed to be returned by Wednesday, and ovulation was nowhere in sight....

Of course I freaked out a bit.  Posted this photo to my ttc group to get opinions, or at least have someone to freak out with me.  Bless their hearts, they talked me down.  Don't insem! Don't do it! Wait for that damn smiley face!  *sigh* I really needed that.  I stopped freaking out.  I went online to buy some more digital OPK's, and discovered that the bigger (cheaper per stick) box of refill sticks for the Clearblue monitor fit and work with their digital OPK's as long as you still have the holder/tester.  Thank the heavens for Amazon Prime and one day shipping because I rationed out the few sticks I had left to get through the workday on Tuesday and came home to claim the box of refills in my mailbox Tuesday night.  And not a moment too soon!  I tested at 7pm before leaving work and pulled up another negative, but then I tested again at 10pm at home and got that smiley face!!!  Whew! Yay! My uterus isn't broken. After all this suspense though, Clomid better ovulate me the most perfect egg that the universe has ever seen.  For serious.  So, now it's on for insem #LuckyNumber13.  A friend in my ttc group (the one that just gave birth to her third baby conceived via home insem with frozen sperm) suggested I do 22hrs and 32hrs post first OPK+.  So the plan is to cancel my ASL lesson, rush home from work, start the thawing process and insem by 8pm-ish tonight (Wednesday).

That's happening RIGHT NOW! Insem at 8pm, then sleep and get up at 5am to thaw the second vial for insem at 6am.  I'll have about 30 minutes to lay around with my hips up before I have to get ready for work.  THIS IS SO EXCITING!!!

Stay tuned........

The Eagle Has Landed...

Minor Update:  My spermcicles have arrived from Midwest.  The shipper was a cardboard box (which I prefer) with the words "BIOLOGICAL SHIPPER" in large block print on four sides (I was less enthused with that part).  BUT...it didn't say Midwest Sperm Bank or MSB on it anywhere (and I liked that a LOT. Score one over MCB already.).  I had a boatload of paperwork in with the nitro tank.  It seems they actually take all orders over the phone and write everything out by hand.  I'd be mad about them being a bit behind the times on that one, but I'm too busy being grateful that they have more than reasonable prices and very high sperm counts/motility with all their donors.

So...now I'm just waiting to ovulate.  I'm low-key hoping it might happen Monday morning so that I can insem at my leisure late Sunday night.


Stay tuned...

"Friday the 13th" or "Lucky 13"? Hmmm....Hard To Say....

I'll spare you the details and just let you know up front that my September insem did not result in a pregnancy of any kind, but I didn't feel any type of way, so I didn't really think it would by the end of the tww.

Aaaaannnnnyhooooo....Here we are.  This week has been insane, logistics-wise, and today was particularly frustrating and tear-inducing.  It was only just a moment ago when I sat down to write this that I realized it's Friday the 13th.  (The Universe clearly got jokes.)  Okay, so I told you about my awesome new gynecologist.  After I didn't get knocked up in September, it was holiday after holiday, and I didn't want the stress of ttc again.  Also, after having used two vials for that insem, I didn't have the capital to ttc again before Holiday Bonus Season. So, I chilled.  I saw my family for both Thanksgiving AND Christmas (I know, I'm so brave, right?!).  For Christmas, I bought myself another 3-month subscription to The Bank's database so I could have full access to all information on all of their donors.  I was on the hunt for a potential new bachelor.  I found TWO new donors that I liked a lot (and Indian guy and a Black guy).  I decided to go with the Black guy and move forward for a January insem.  Start the new year off with a bang, right?  WRONG!  I had a follow-up appointment with my gynecologist on January 6th (a Friday).  I needed another Metformin Rx, and also wanted to get a higher dose of Clomid (my September cycle I was on 100mg and didn't feel much going on. When I looked over my medical records, I'd been on 200mg when I did the IUI in Thailand in 2012).  Now, I'd just spent the afternoon wistfully looking over my prospective new bachelor's profile and info, waiting for this gynecologist visit to get the go-ahead before putting the order in.  I got home on Friday evening and went online to put in the order....THEY RAISED THE PRICES BY MORE THAN $100 PER VIAL.  WHAT IN THE ENTIRE FUUUUUUUCK???  I'd been on the site quite a bit since I'd gotten the 3-month subscription and didn't see anything about raising prices anywhere.  And I know they were still normal prices on that Thursday, but sometime after the close of business on Friday, the price hike went into effect and I was screwed.

I was in full-on panic mode.  There was just no way for me to afford insem with even just one vial in January and still have anything leftover to try again the next month, or put something in storage for a potential sibling if I did get knocked up.  I Googled prodigiously and asked around on the FertilityFriend home insem message board, and I was pointed toward Midwest Sperm Bank (MSB) as being very affordable.  Looking at their site, I wasn't that jazzed about my prospects.  They had a short list of donors and almost all of them "Caucasian".  On top of that, many of the donors didn't have any photos of any kind available (not childhood, nor adult). They had exactly ONE Black donor, and one mixed race (biracial Black & white) donor.  I spent $5 to get the long profile of the Black donor, then realized that he also had a childhood photo and audio interview available for purchase.  That was unexpectedly good.  I wasn't sure what their whole registration process was like or what medical hoops I might have to jump through yet though, so I decided to wait until I'd made contact and had a few questions answered before spending more money. Things were looking more promising though.  While I was looking for contact info to ask about which forms my doctor would need to sign if I were doing home insem instead of clinical, I noticed something on their front page.  There were four donors on sale during the month of January...and the lone Black donor was one of them!  I could get one vial for $375 or two vials for $600.  Hell of a deal.  Naturally, I was immediately suspicious.  I  mean, what if they were on sale so cheap because he had a low sperm count/motility and you need to buy a bunch just to up the motility percentages for each insem?  Didn't want to take any chances.  I sent a couple of inquiries through their online inquiry request form.

When Monday rolled around (and my cycle started) and I still hadn't heard from them, I emailed them directly (as opposed to using the online form) and went into more detail with my questions.  Instead of just answering my questions via e-mail, they responded on Monday night (via e-mail) that I should call.  Grrrr...If I had time to be on this phone to get an immediate answer don't you think I would???  So frustrating.  I put that on the back burner and called the pharmacy to see if my Clomid Rx was ready.  They didn't have a new Rx in the system.  WHAT???  Greeeeaaaaat!  More bullshit.  Just what I needed.  Called the doc's office to check up on it.  Apparently the fax didn't go through on Friday and no one had bothered to re-send it.  Niiiiice.  She re-faxed it right away and it went through.  Called the pharmacy a few hours later.  They now had the new Rx, but they'd call me when it was ready for pick-up.  They were waiting on insurance approval.  Swell.

Tuesday came around and I had to make it my mission to somehow get someone from MSB on the phone to answer my questions so that I could get this show on the road.  Thankfully, I got both work babies down for naptime in a timely manner (and neither of their parents were working from home that day), so I called as soon as I came down from their bedrooms.  The person I spoke with was lovely, but it was as if my e-mail hadn't been read at all.  Fine.  I laid out my questions about the documents needed and got satisfactory answers to my questions about the donor himself.  Though they have several forms under the "Printed Forms For Physician" menu, my doctor only needed to fill out one short form in order for me to purchase spermcicles to inseminate myself with at home.  I hung up with MSB & called my gyno office right away.  I explained my situation and that my cycle had already started and that I needed the doc's signature on this form in order to get my samples on time to inseminate this cycle.  She gave me a fax number.  I asked if I could e-mail it instead.  She gave me an e-mail (why isn't e-mail the default in 2017? c'mon, people!).  I downloaded the form to my phone and saved my printed name at the top.  Then I emailed it to the doc's office at 3pm on the dot.  Pleased that I'd gotten all that taken care of, I logged on to The Bank's site and purchased the rest of the available info on my donor (childhood photo & audio interview).  He had five or six childhood photos (cute kid) and his audio interview was nice.  Later that night, I got a call from the pharmacy that my Clomid Rx was ready to pick up.  End of CD2, and I was getting excited for the start of the new year.

Wednesday (CD3). Didn't get an e-mail response or phone call from the doc's off nor The Bank, so I called the doc's office in the afternoon (after I'd gotten the work babies to sleep).  It was normal business hours, but I got the answering service (it's a small practice and they all take lunch for an hour each afternoon).  It wasn't a medical emergency, so I left a message detailing that I had e-mailed the form with my name in the e-mail subject line and that I needed the form faxed over to The Bank by the end of the week.  I filled out all of the forms that I needed for myself for The Bank and e-mailed those over. I had my ASL lesson that evening, so I didn't pick up the Clomid Rx after work.  No worries though because I don't start taking it until CD6 (Saturday).  Side note: A friend on my cycle charting site said she used MSB, and she just gave birth to her THIRD child conceived with home insem.  AND she said she'd been with Fairfax for a couple of years before that with no luck, and then got pregnant with her MSB donor right on the first try.  AND that for her second and third babies, she did it with just one insem with just one vial.  She says that MSB has atypically high sperm counts per vial (she's had one over 100mil).  This gives me great hope! She's a Black single mother by choice who conceived all three of her beautiful children via home insem, and she's also a newborn photographer.  Obviously, she is my hero.

Thursday (CD4).  Called The Bank to see if they got all my paperwork and whether or not they got the form from my gyno.  Yes to my paperwork.  No on the fax from the gyno.  DAMMIT.  Called the gyno office and got someone on the phone (obviously, they can't be trusted with leaving a message).  Despite my telling her I was e-mailing the form, no one over there had actually checked for it.  Sweeeet! She literally opened the e-mail and printed it while I was on the phone.  I stressed to her that I was starting Clomid in two days and that the doctor MUST get this faxed over to The Bank by Friday (the next day) in order for me to be able to buy the sperm to insem for this cycle.  She said she understood and would make sure to put it in front of the doc.  Stressed, but at least I got through to everyone that I needed to speak to and all would be well.  Then I got to the pharmacy to pick up the Clomid Rx after work.  He ran my insurance card again and kept saying that it should be cheaper and he doesn't understand why it's not showing the discount.  He goes back and forth with his supervisor and his computer screen, then finally turns to me and says the insurance declined and I'd have to pay the full charge of $47 and some change.  Obviously, it's too late for me to do anything about it when I'm supposed to start taking it in two days, so I pay it.  I'm pretty pissed though because my premium is going up in 2017, but I'm getting less coverage.  What the hell is up with that?  Grrrr....

Until Friday (CD5).  Called The Bank and they still hadn't gotten the form from my doc.  Called the gyno office at 10am sharp and was assured that the doc would get to it today.  Called The Bank around 3:30pm (after both work babies were sleeping - their mum was working from home, so I literally took the baby monitor with me to the basement to make the call so I wouldn't be overheard).  They STILL hadn't gotten the form from my gyno.  What. The. Fuuuuuuuuhhhhhhhhhhhck?????  And they could not ship without the doc's signature on that form.  Called the gyno office.  Guess what?  The form is still sitting unsigned on the doc's desk and she's left early for the day.  Oh, and she won't be back until Tuesday because their office is closed Monday for MLK Day.  Now I'm freaking out on the phone because I'm about to start taking these Clomid pills that are gonna mess with my hormones and give me who knows what kind of side effects (as per the gyno's own orders) and it could all be for nothing because I may not even be able to get the fricking sperm! The receptionist asks me to ask The Bank if they'll take the form with just the doctor's info and her license stamp on it.  Umm....prolly not.  But what do I have to lose at this point.  I call back The Bank.  They'll accept the form to let me place the order, but I will need the completed form signed by the doctor before they will ship.  By now, I'm looking at the baby monitor.  I've already had to go back in and put the baby back down to sleep once and now the toddler is looking wide the fuck awake in her bed after barely sleeping. I'm still trying to deal with this mess that my gyno's office has left me with, and now I'm literally in tears.  I just gave myself two minutes to pull myself together.  I tell the toddler it's still naptime and she needs to lay back down (through the monitor).  I call back the gyno's office.  The receptionist says they've faxed the stamped-but-unsigned form over to The Bank.  I tell her that that's a temporary measure and that the doc HAS to sign it and fax it over first thing when she arrives on Tuesday.  I ask what time they open on Tuesday. 10am.  I let her know that I will be calling at 10:01am and every half hour thereafter until I get confirmation that the deed is done.  I thank her for "trying her best" and wish her a good weekend.  Go back up from the basement to finish making dinner for the kids, and then bring the toddler down from her not-a-nap.  A while later, the toddler and I go upstairs to wake the baby from her nap-in-three parts (her big sister's naptime shenanigans woke her up twice, but she settled herself back down (bless)).  We run into the mum coming downstairs from her office.  She gonna make cookies with the toddler before dinner.  So I keep the toddler with me for baby wake up time while Mum gets all the cookie making stuff together downstairs (p.s. Despite my own personal naptime hell and the fact that she hadn't slept for more than 15 minutes, the toddler was super adorable: "Good job waking up, Baby!"  I mean....seriously.  Best job ever.).  While we're all in the kitchen, I get a call from The Bank.  My baby making plans are total secret at work because there are no guarantees in life and I'm not ready to put everyone on stand-by for something that may or may not happen in any specific time frame (I mean, if I'd been an open book about it when I first started, I'd have disclosed myself right out of a job and never moved to HK with my other work babies).  So, obviously I couldn't take the call.  I sent it to message.  I checked the voicemail a minute later and MSB said that they got the stamped-but-unsigned form from the gyno and they could accept it to put the order through, but that I'd still need the signed, completed form before they could ship the spermcicles, and if I called her back in the next 30 minutes, she'd start processing the order (It was already nearly 6pm at this point, so thank God for the time difference between my location and The Bank).  After prepping the cookie dough, Mum took the toddler down to the basement to play for a little bit (it's finished and has a play area with all her "other" toys...and a giant tv for watching Paw Patrol - a thing she only does with her parents because I don't hate myself).  It was just me and the baby upstairs and the basement tv was loud enough that I took the chance and called MSB to set up the order.  Because it was just the order process, I was able to be vague enough for discretion on my end of the line.  (MSB: What donor? Me: #xyx. MSB: To ship Wednesday and arrive Thursday? Me: Mmmhmm. Yes.)  Still figuring out some finances, but I ordered two vials to ship overnight on Wednesday for a grand total of $780.  My mind still boggles at this bargain of bargains.  And after I get a couple of transfers in from other accounts, I'm going to order another 2 vials while my donor's still on sale to keep in storage (they have the first three months of storage free, and then only $250 for a year after that).  And I'm hoping to shift some things around so that I can order two more before January ends.

Got home Friday night and started typing up this blog....and that's when I realized that it was Friday the 13th!  This explains so much about my day. Like, sooooooooooo much. LOL.

Wait, it gets better (like, really better, not sarcastically better).  Remember how mad I was that my insurance had declined to cover my Clomid Rx?  Yeah, I don't even know where the pharmacist got his info or what he was reading.  Yes, it cost me almost $48 for my new Rx...BUT I compared the package for the 200mg Rx with the one I had at home already for 100mg.  It's not higher dosage pills (like 100mg tabs instead of 50mg tabs), it's just MORE PILLS.  So I have a pack of 10 50mg pills for 100mg daily dosage from my last go round.  And I have this new Rx in a pack of 20 50mg pills for a 200mg daily dosage.  It cost me twice as much because I was literally getting twice as many pills.  AND right on the packaging label with the printed prescription instructions, it tells me the manufacturers cost, the cost I'm paying out of my pocket, and how much my insurance saved me.  It's the same manufacturer's cost and insurance savings on both.  I'm not paying more for meds. I'm just getting more meds.  The US healthcare system is still a giant clusterfuck, but so far it's the same clusterfuck and not a worse one than it was a few months ago (Congress is working on screwing that up some more real soon though).

So....anyway.  Here I am on CD6, starting my Clomid (the doc didn't say whether or not to take it all in one dose, so I've decided to take it twice a day in hopes of spreading out any possible side effects).  Feeling good about my donor and my chances of getting knocked up this round (and good about actually getting the spermcicles shipped on time because I fully plan to call the gyno's office every half hour until it's done on Tuesday).

Now I'm just taking deep breaths and working on cleaning and decluttering my living/working space in an effort to help me clean and declutter my mind/spirit space.  WoooSaaaaaahhhhh....

*Stay tuned...

Diiiiiiiid I Tell You About My Awesome New Gynecologist???

Previously on Self-made Motherhood Blog:  Surprise! (or not) I'm not pregnant.  Anyway, remember when my greedy RE wouldn't give me the Rx for progesterone suppositories and told me to get it from my regular gynecologist (which she knew I didn't even have because I'd just moved to Jersey and gone directly to her)?  Right, well she recommended someone, but this doctor had a two-month wait for an appointment.  So I soldiered on and get trying on my own.  Before the last ttc cycle, I did actually call to make an appointment though.  It was still more than a month to wait, but I figured either I'd be pregnant and need a blood test, or I wouldn't be and could talk to her about ttc stuff.  The latter prevailed (obviously), and I went in to see her at the end of September. First off, she's Black.  This is awesome because, often times, PoC receive biased care from medical professionals, and though it's not impossible to get the same results with a Black or PoC caregiver, it certainly makes for better odds (read this article if you want more info on that).  She was immediately very congenial and very open & responsive to my questions.  We talked and she decided that I may have some sort of androgen imbalance and/or insulin sensitivity or resistance issue (since all my bloodwork from the RE came back normal), something that may not show up in hormone levels, but could be throwing things off (possibly borderline diabetes or other sensitivity/resistance disorder).  She prescribed Metformin for me to start immediately (I was a few days from ovulation in a non-ttc cycle) and Clomid for me to use CD 6-10 of my next ttc cycle.  The Metformin is often used for PCOS patients to help regulate the hormones and also (I've since learned) in some women through the first trimester as a way to stave off gestational diabetes in women who are borderline).  The Clomid is to help my follicles ripen more fully and give me a chance at bigger, better eggs when I do ovulate.  Her plan was "The Fives".  Five days on your cycle. Then five days on Clomid. Then five days after finishing the Clomid, do the insem. Then insem again two days later.  And again two days after that.  Three vials are too expensive for me in a single cycle.  I told her this and she said to insem on CD15 and again two days later.  I started talking about the cycle after and when I might be able to afford to ttc again after using two vials and she stopped me.  "Let's not get ahead of ourselves.  One thing at a time.  Finish the cycle you're on.  Start the Metformin today. Keep taking your vitamins and supplements. Do the Clomid protocol.  Do your inseminations at home.  And we'll see what happens.  This might be the one that works.  We may not need to even think about the next cycle and so on.  One thing at a time."  After the gloom and doom proclamations of the RE, it's really refreshing to meet an optimistic medical professional.  She so the complete opposite of the RE, I'm a bit surprised that the RE recommended her.

So, that was a few weeks ago.  Now I'm on CD4, and on the verge of starting the Clomid protocol and getting this whole show on the road.  I'm nervous, but hopeful.  Guess we'll see what happens...

Stay tuned...

Pssssssst!!!

I'm not pregnant.  I don't really have any other news for you right now.  I may try again in October or November.  Not sure.  Currently just thinking some thoughts and feeling some feelings.

Stay tuned....

Aaaaannnnd....We're Back!

Welcome! Last time on Self-made Motherhood Blog....our heroine was (surprise) not pregnant and contemplating switching donors (among other things). Still contemplating some things, but very much decided on others.  Let's dig in!

Donor:  As much as I like my last donor, he has no reported pregnancies, has some random genetic anomaly on his y chromosome (karyotype variant something or other) that apparently affects 2-3% of the male population but can also kinda suck if you're ttc, and also has a dwindling supply.  Moving on!  I narrowed it down to two back-up donors.  One is Black (child of Caribbean immigrants).  The other is Asian.  If you've been following for a while, you know that I've always been interested in having a donor of color, specifically Black or bi/mulit-racial with a Black parent.  Mostly because I'm doing this on my own and I don't want every rando on the street who stops to tell me how cute my child is to constantly ask "what" he/she is or remark on how he/she must have gotten (insert random non-stereotypical African feature) from her "father".  I just don't want my child constantly being reminded of a person that, apart from donating the sperm that made him/her possible) will not be a person he/she can refer back to for anything.  I'm Black.  I want my child to be Black and for randos on the street not to ask overly personal questions and/or make inappropriate/rude remarks (like people who straight-up asked one of my cousins if she was her son's babysitter, then if he was adopted - because healthy white, blue-eyed newborns are all the rage in Black family adoption circles...?).  So that's my reasoning behind that.  Making the addition of the Asian donor give me pause.  I really want brown babies. Just about anyone in my family who's had children with a white person has had very fair skinned children, so now I worry that choosing a Asian donor (though his baby photo is on the browner side of Asian) will make my child some sort of fetishized topic of conversation for randos on the street.  *sigh*

Then there's the other back-up donor.  This is gonna sound a little weird....I like a lot of things about him, but his audio interview comes off as very gay, but very religious and very closeted. If not for this, he might have had the top  back-up spot, but I'm not sure he's the person I want to potentially have meeting my free-spirited future child in 18 years.

At any rate, both back-up donors have reported pregnancies.  So, I'm going forward (for the time being) with the Asian donor.

Other contemplations:  I did decide to go ahead with the DHEA.  I started in June at a dose of 25 mg/day.  This continued through my June and July cycles.  I just started my new cycle and upped it to 50 mg/day, taken in two doses of 25 mg.  I had no side effects from the 25 mg dosage, and so far not feeling anything off with the 50 mg.  I'm also taking Ubiquinol instead of CoQ10.  Was taking 200-300mg/day until the start of this cycle, when I upped that to 400mg, split in two doses.  I also ordered a box of Pregnitude and started that just a couple of days before my current cycle began.

I ovulated a day early (cd 12) in my last cycle, but I'd expected to because of the proximity to the full moon.  But then, my LP turned out to be uncharacteristically short (only 9 days instead of 11 or even 10).  So, now I'm trying to figure out the timing to have the spermcicle shipped.  I could ovulate as early as cd 10 (which turns out to be a Monday), so I'm not sure if I should try to schedule it for Monday delivery or be extra safe and schedule delivery for the preceding Friday.  I e-mailed the Bank to see what they think and what my shipping options are.  Have to remember to request the plain brown box and not the Tardis.

That's about it for now.  Stay tuned...

The Results Are In!

You're not gonna believe this: Someone actually read my blog AND commented on it.  (I know! Like, whaaaat???)  Anyhow, after reading the last entry, she said she was praying for me to get a BFP (how sweet is that? I mean, really??), and I didn't want to keep her in suspense with my natural inclination towards procrastination, so I decided to hurry up and finish this entry to alleviate any tension she may be feeling.

No, I'm not pregnant (but thanks for the prayers and well wishes).  I'm hoping when that happens I'll be able to come up with a more clever title for the blog post.

Now that that's out of the way, let's sort through what's what.  I didn't mention this in the last post because I'd looked (briefly) into the possibility of switching donors, but didn't find anyone I liked as much as this one; so I was already set on forging ahead with the insem.  But since I'm not currently pregnant, I'll give you the skinny.  When my spermcicles arrived for my last insem, as usual, I opened the box to confirm the correct vial/donor number.  I had also requested (again) the vial with the highest recorded post-thaw motility, so I looked over the vial stats insert to see what I was working with.  That's when I noticed something I hadn't noticed before.  Actually, I had noticed it before.  When I saw the short profile.  But it was downplayed in the profile as "Analysis shows an apparently balanced pericentric inversion of one chromosome 9. This inversion 9 is considered a normal chromosome variant, and has not been associated with any phenotypic abnormality."   So I didn't think anything more of it because it was (according to the very report I was reading) "normal".  Anyway, I re-noticed it when I opened the packet this last time.  The entire thing I noticed was: "46,XY, inv(9)(p12q13) – Variant male karyotype."

And for whatever reason (possibly because I've been at this for a hot minute with the same donor and am still (as you'll remember from the first sentence of this post) not pregnant), it struck me as odd this time around.  So I googled it.  Do you know what you get when you google "ttc 46, XY, inv(9)(p12q13)"?  Nothing good.  Apparently....this particular "normal chromosome variant" can be responsible for spontaneous early abortion/failed implantation due to chromosomal abnormality of the embryo.  Quick question: WHY IN ALL OF THE UNHOLY FUCK WOULD A GODDAM SPERM BANK EVEN OFFER A SPERM SELECTION THAT COULD CAUSE SPONTANEOUS FUCKING EARLY ABORTION?????  You know what else there is?  In one study, increased instance of children with dysmorphic features.  Sounds great! What else?  Probably a bunch, but suffice it to say I was upset enough from there.  So, naturally, I was freaking out a bit.  I mean, I had this box-o-sperm sitting in my closet waiting for me to ovulate and had already lost $1000+ in my previous "dead sperm" insem cycle.  I didn't want to call off this cycle.  But at the same time, I worried that using this donor at all would be throwing away money if anything that happens is just gonna jettison itself before anything can stick anyway.  On the other hand, it's considered a " normal" variant and occurs in 2-3% of the population.  Men with this variant can and do father perfectly healthy children.  It doesn't necessarily spell doom from beginning to end.  Plus, the sperm is already at my house.  Even if I sent it back, the bank can't trade it out for another donor because it's already left their facility.  It's officially-officially mine, whether I want it now or not.  So, I decided to go for it.

I knew early on in my tww that I wasn't pregnant, so the EPT-'s were not a shock.  I mean, it's always a disappointment, but it wasn't a surprise.  Now that I'm looking ahead to future cycles, I'm debating with myself on whether or not to change donors.  I still have to get my medical release form signed for The Bank (PP New Jersey doesn't do anything but give pregnancy tests and pap smears, so I'm making an appointment with PP NYC to get it signed at the same facility where I had my previous one done last year).  And I'm kinda broke and waiting until my raise comes through at work in July to get back on the horse again.  Looking like hopefully August, maybe as late as September.  It's Memorial Day weekend now, so I have a couple of months hiatus until I go for it again.

In the meantime, I'm gonna look into other possibilities.  I really, REALLY like my current donor (despite his shorter stature), but given the facts at hand, I think I'd be remiss (and blame myself later) if I didn't look into other donor options.  To that end, I'm going to get a 3-month subscription at the Bank and look over all of the Black/Bi-/Multi-racial/More-or-less Brown donors that they have (and keep checking back every month until it's close to go time).  I'm still focused on Open ID donors, but may look into an anonymous donor if I see one that's somehow leaps and bounds better than the one I already have.  I also have a ttc friend on the west coast who recently met a donor from the Known Donor Registry, which is essentially a meeting hub for women/families that want to conceive with a donor that they've actually met and potential donors who are interested in helping create families while being open to meeting the families/potential future children in person.  His sperm report is off-the-charts good and she felt a really good connection with him when they met in person, so they've decided to draw up a loose agreement and go forward with her next cycle.  The plan, as far as I understand, is for her to do intravaginal home insems with his sperm a few times during her fertile phase, and also have a midwife come over once to do an insem.  With the midwife involved, he will be considered a donor only and not the father under the law.  I think it's amazing and I'm super excited for her (fresh is best after all!), but it's kind of like online dating to me.  I just don't think I have the disposition to make something like that work.  I'm naturally suspicious of other people already.  Trying to find a known donor from that registry would probably set off all of my social anxiety bells and whistles.  If I were wired to to connect that easily with other people, I probably wouldn't be so focused on making science babies instead of doing this all with a partner.  *sigh....

I also finally got my hands on my actual medical records from the RE's office, so I can see exactly what my numbers are as opposed to going off the vague non-explanation of the RE nurse.  I'm a little concerned about my cd3 FSH (10), but then all my other stats are normal and healthy for someone in the 27-33 and 33-37 year old ranges.  So not hopeless.  And no tubal impediments.  I'm convinced that I'd have been knocked up ages ago if I'd been doing it with fresh sperm.  It's just stronger and lives for freaking ever!  BUT, one of my other ttc friends (and my personal hero) is another single Black woman that I met online while she was ttc for her second child (she'd already had a little girl using spermcicles a couple years before).  She is currently pregnant with her third child.  All three conceived at home with IVI using frozen donor sperm.  I've gotten the details of her particular method from her, and I think I may try it her way on my next go round.  I won't go into specifics here and now, but if/when I try it, I'll give you the lowdown at that time.

Back to the medical records/test results though...On that note, I'm considering other supplements and whatnot that I may try out for the next round.  I'm currently taking 800mg of CoQ10, but I may switch to a 200mg dose of Ubiquinol instead.  It's more concentrated and more easily absorbed than CoQ10 in women over 35.  Another online ttc friend (also another single Black woman) is drinking wheatgrass juice every other day to help lower her FSH and boost egg health.  I might try that, too.  One way or the other, it's healthy for you and can't do any harm, so why not?  On the other hand, high FSH is just an indicator of how well you might respond to stimulation meds; and since I'm not planning to take any Follistim or Clomid-like anything, I'm not sure if it matters for me.  High FSH numbers on cd3 indicate that your body is working a little harder to make you ovulate, so I'm not sure what lowering FSH would actually do for me doing non-stimulated cycles.  Of course, FSH also fluctuates from cycle to cycle, so maybe if I tested this cycle it may have been lower.  Who knows?  BUT, because of my high FSH, I'm concerned about egg quality and production (even though there's no test for egg quality besides taking a dna sample from an extracted egg), I'm contemplating trying to supplement with DHEA for a few months (3-4 max).  In IVF patients on a DHEA regimen, the egg quality is better and also the number of follicles/eggs is higher. The side effects can be extreme though (heart palpitations in rare cases and hair loss), but you never know how you react to something yourself until you try it, as every woman is different.  That's also why I'd only try it out for a few months though.  I figure to start it during my two cycles off to get it built up in my system and make a real difference for new eggs coming down the line, then up to ovulation or bfp/bfn for the next two ttc cycles in August/September.  The recommended dose is 75mg daily divided into three doses, but I'm not sure if I'd start out that high and decrease based on side effects, or start off at a lower dose and increase if there are no side effects.  That one, for me, is still very much in the research phase though, so it will be a little time before I've made a decision on that.

I think that's about it for now.  Re-cap:  Still not pregnant.  Still not completely hopeless.  Still single and focused on making some science babies.  Still contemplating changing donors.  Still contemplating various vitamins/supplements to go with for the next round...but still not independently wealthy, so sitting out ttc until August or September.

Stay tuned...

Something Witty About The Number Eleven Being Lucky (or whatevs...)

Previously on Self-Made Motherhood Blog:  Our heroine received a dud vial full of dead swimmers and then flew across the country to celebrate her birthday before she'd had any time to process.  The birthday celebrationings were stellar, yay for amazing friends on that one.  The next decision upon my return was whether or not to go forward with an insem for the next cycle.  Should I take a break and give myself time to process? Should I switch donors after the dud vial?  Should I switch sperm banks altogether??

Well, I decided to go forward using the same donor from the same bank and hope that lightning doesn't ever strike twice (especially since the home insem discrimination means that I can't even file an official complaint because they only accept those from lab technicians).  It was definitely a risk.  But I decided to do it anyway.  I was pretty committed to staying with MCB (who has time/resources to get all new paperwork done for a new bank, go through that whole process again, and wait until everything clears?).  I contemplated changing donors, but I didn't see any new (or old) donors of African descent that were Open ID.  I discussed it on one of my ttc message boards and one woman reminded me that the Open ID isn't an iron clad guarantee, and that even a previously anonymous donor may decide to disclose his identity to a birth family if asked at a later date.  I looked through a bunch of anonymous donors, but no one that I liked as much as my current donor.  I didn't have time to lose.  I forged ahead.

In light of my early ovulation on my last cycle, I made sure to get my box-o-sperm delivered two days earlier than my usual prediction. This worked out well because I got a smiley face on the digital OPK at 10am on CD11.  That was a Thursday and I was working all day Friday, so the options were to insem CD12 early morning before work (less than 24 hours after my first OPK+) or wait until after work (34-36 hours after the +).  I decided to do it after work.  I kept testing all day CD12 and kept pulling up positives and smiley faces the whole day.  I was able to leave work about an hour early and got home around 6:30pm instead of 7/7:30pm.  Got another smiley face when I got home.  I decided to check my cervix and see what was up.  Overshare:  I tend to get a metric ton of ewcm, so I try to swab some of it away before doing an insem to make a clearer path.  I started having what I think were ovulation pains on my left side, so I did another OPK at 7:30pm and got a negative on the digital and a waning test line on the dip strip.  I started the thawing process and did the insem right away (lots of swimmy swimmers when I checked on the microscope this time).  Afterwards, I put in an Instead cup with a little body temperature Pre-seed in it just in case anything didn't make it in.  I had some more pains on my left side and just lay with my hips/bum elevated for a while.

I had called my RE's office and asked if I might be able to get progesterone support for my at-home insem and was basically told that they won't prescribe me anything because I'm not doing the insem with them and they can't monitor me.  Fine. Whatever. I'll use the cream as usual.  No big deal.  I swear these people are out for money and money alone, and they will invent new ways to part you from it at every turn.  Case in point, just before this cycle, I e-mailed the RE and asked her to sign my medical release form for the sperm bank (it has to be renewed annually, and mine had expired at the end of April).  I'm not doing any cycles with them, but they did all of my fertility testing and latest bloodwork (and reviewed my medical records from elsewhere), so it seemed logical that they could sign off on my being fit for a pregnancy should one occur.  She rang me to tell me that the only way they would sign it is if I paid to meet with their genetic counselor and get genetic screening done for myself AND for my donor, even though I'm using frozen sperm from an accredited bank.  What the fuck kind of bullshit is that???  It's from a sperm bank.  Where they test for all the same genetic markers that the RE wants to test for.  Why do I have to pay extra to have them test a sample that's already been tested and verified?  And would I have to buy a vial just for them to play with??? And naturally, all of this testing would be out-of-pocket because their genetic testing firm is private and not covered by insurance. Fuck. That.  She recommended I get the Rx from my regular ob/gyn.  Luckily, the bank sent this shipment along and then just sent me a reminder to get the release done before ordering again.  But the RE rang me at the last minute to tell me that she couldn't sign the release form because I hadn't agreed to doing the genetic testing.  Yet another reason for me to hate the US healthcare system in general, and the infertility medical establishment in particular.

Anyhoo...I thought for a minute I might skip doing the progesterone cream this time around because it's inconvenient to have to apply it so often throughout the day when I'm working.  But then I didn't want to wonder "what if?" at the end of my cycle, so I've decided to do it.  This time I'm applying 80mg four times per day (6:30am/pm & 12:30pm/am).  I also decided to take 80mg of bromelain from 1-5dpo.  It's derived from pineapple core.  I was reading up about it and discovered it's not just for helping to build your uterine lining for implantation.  It actually contains an enzyme that helps to break down the wall of the corpus luteum once it enters the uterus (assuming that an egg was fertilized and made its way out of the fallopian tube) so that it can more easily attach itself to the uterus and implant.  Sounded like a good idea to me.  I also started taking 400IU of vitamin E during LP (not sure if I should have started it earlier in my cycle or not).  It's also supposed to help prepare the uterus for implantation.  In addition, I'm doing the moxabustion recommended by my acupuncturist when I was living in HK in 2012.  As with most things related to acupuncture and fertility, it's meant to increase blood flow to the uterus.  Other than that, just waiting around trying not to obsess over my body's every little twinge and eating healthy, nourishing foods.

I'm now at 6dpo.  I had a little bit of spotting on 3 & 4dpo (not uncommon after an IUI).  Very light and only when I wiped after going to the bathroom.  I felt a little nauseous from 2-4dpo, but only really felt it on 4dpo because I had to work and function on a busy Monday that day, whereas the first two days was on the weekend and I could just lie down and take a nap if I felt like it (so I did). And it wasn't anything debilitating.  Just uncomfortable.  Woke up to slightly sore breasts this morning (which is one of my chiefest pms sypmtoms), and have been having odd little twinges/discomfort in the general uterus area today, but that's not really conclusive of anything.  We wait.  We wait.  We wait.

Stay tuned...

Well, That Was Anticlimactic....

...or Things To Do in Jersey When Your Sperm Is Dead.

Yup, you read that right.  I wasn't even going to go forward with insem this cycle.  I'm traveling tomorrow (cd12, the day before my projected usual ovulation day), so I had originally decided to have my box-o-sperm shipped to my destination, figuring with the time difference, I'd still be on my usual schedule to insem before ovulating overnight/early morning on cd13.  BUT THEN, I started OPK'ing in the morning on cd10.  It was fmu, so I just used a dip strip, figuring either a) it was too early to get any real reading, or b) if I was starting to produce LH, fmu would be a concentrated sample and better not to throw the digital off.  Yeah, well that dip strip came up with two dark lines. WHAT????  I did my best not to panic.  I packed a few OPK's to take to work with me (digital, midstream, and dip strip).  I POS around 9am and came up with two more dark lines on dip strip and midstream, and a big fat smiley face on the digital.  This was a Wednesday.  There was absolutely no way that ovulation was gonna wait until late Friday night.  I frantically dialed The Bank.  The Tardis was supposed to ship Wednesday to arrive at my destination on Friday.  They were able catch it before it left and re-rout it to my home & send it overnight so I'd receive it Thursday (cd11) and be able to insem when I got home from work.  I kept getting positive tests all day until about 9pm Wednesday.  Negative digital and the test lines on the midstream and dip strips were starting to fade.  I was also (very uncharacteristically) experiencing what I think were sharp ovulation pains on my right side.  I was positive I had ovulated and was out for the count.  Adding insult to injury, all the trouble I'd gone through to get the Tardis delivered overnight (more money out the window).

A friend on one of my message boards looked at my chart and said that my cd11 temp rise wasn't a high spike like it would have been if I'd ovulated and that I should just go for it.  I decided to check my cervix when I got home from work, just to soothe my conscience  that I'd given it every logical effort before shipping the sample back to The Bank and asking them to hold it until the next cycle.  Disappointing, but at least I wouldn't be throwing away money trying an insem when I was already sure it was too late.  You know, save that money for the next one.  But my cervix was open and ooooozing ewcm.  I decided to go for it.  I did my usual and set up my area (magnifying mirror, light source, speculum, Pre-Seed, Instead cups for just in case, cotton swabs, syringe and catheter, ferning microscope) and began the thawing process.

I took the vial out of the Tardis and placed it in the finger of a sterile exam glove (to protect it from any water getting in), then placed that into a luke warm water bath (97.6 F) for a little under ten minutes.

After removing it from the water (and the glove), I gently turn the vial over a few times to mix the contents.  Then I place it under my right boob (a thing I can do at my cup size) to keep it at body temperature until I'm ready to insem.  I attach the catheter to the syringe, keeping the length of the catheter in its packaging to keep it sterile until use.  When I'm sure I've got everything in place, I set the vial on the table and slowly draw the sperm up through the catheter into the syringe.  Then I place a single drop from the tip of the catheter onto the lens of my ferning microscope so I can have a look at my swimmers swimming.  Except they weren't swimming.  Instead of a million tiny dots dancing, I saw a million tiny dots completely still.  I thought I must be focusing the lens wrong.  I looked away and looked again with fresh eyes, adjusting the focus.  Still all dead.  This had never, ever happened to me before.  I tried to keep a level head.  I cleaned the lens and tried another drop from the tip of the syringe.  Same thing.  I cleaned the lens again and tapped out as much as I could manage from the lid of the vial.  I looked again.  Nothing.  The only time there was any movement was when I rebalanced the microscope in my hands and the liquid of the sample would move with gravity. A Dead Sea of sperm.  I was livid.  In shock.

I did the insem anyway since I was already in position, hoping against all hope that there might be one living, fighting swimmer in the sample that might hit its target; but I'm absolutely not optimistic.  I e-mailed the Bank that same night.  The next morning, I received this response:

"Good morning,

In situations such as these, normally a specimen report form is completed and sent back to us for review.  Unfortunately these are normally completed by lab technicians at their respective fertility clinics and as this was done at your home, you will not be able to complete it as required.

There would be no compensation or anything in this case, I am sorry.

Regards,"

So, basically, because I chose to home insem, I have no recourse for recompense of any kind.  $1000+ wasted on a cycle that never even had a chance. I felt so frustrated, defeated, sorrowful, and angry.

I'm on vacation for my birthday, and after paying the rest of this month's bills this morning, I'm pretty broke. A bit worried that I may have to dip into my savings (aka Spermcicle Fund) to cover rent when I get back home at the end of the week.  On top of that, I still have to find a new gynecologist so that I can have a new medical release form signed for the Bank so that I can go forward with another insemination.  Between booking that appointment and this month's bills, I may need to skip May and wait until June to try again.  I'm so angry right now, but trying to get myself into a better frame of mind so that I can enjoy my time on vacation with my friends, and celebrate my birthday.  

Stay tuned...

In Which Our Heroine Gives Doctors Pushing IVF All Of Her Very Best Side-eye...

Previously on Selfmade Motherhood Blog...I was extolling the virtues of the US healthcare system and how it is changing lives for the better.  I'm just playin'!  American healthcare may be better for some people under the ACA, but it's still a total clusterfuck controlled by the insurance companies and Big Pharma.  ANYWAYZ....For the first time since moving to New York 12 years ago (okay, okay...technically I'm a Jersey girl now...but for the first time since 2004) I have health insurance in the US.  I make that distinction because previous to 2004, I lived in Japan for two years and was covered under the NHS there (before that, I lived in LA and worked at a company that provided my health insurance), and from 2011-2013, I lived in HK and was covered under the NHS there.  Don't get too excited though.  I have the cheapest plan I could find (not that I could afford, because I can barely afford this one, but the cheapest one I could find) and it's a Bronze level plan with a $3000 deductible and something like $6300 out of pocket yearly cap.  So on top of the almost $300 per month premium, every single doctor's visit or procedure or test or whatever is going towards my $3000 deductible, but coming directly out of my pocket (which might not even be so bad if that wasn't taking away from my buy-some-more-frozen-sperm money).  Having insurance does have a few advantages (and several very big disadvantages), but we'll get into that as we move on.

So...I went onto my insurance company website to find an RE in my area.  There are exactly two RE practices (lots of doctors, but only two practices).  So I called and made a new patient appointment with RMANJ (Reproductive Medicine Associates of New Jersey) as they have an office in West Orange and I live in East Orange.  Beforehand, through the patient portal online, I had sent them all of my pertinent medical records and my fertility charting highlights in pdf form from my FertilityFriend.com account.  I went in on February 17th, their last available appointment, 2pm (because when you charge this much for your services, you can afford to go home at 4pm every day and not work on weekends).  It was inconvenient having to miss work, but I managed to get the work baby out and activitied in the morning & the parent who'd worked from home that day took over to feed her lunch and put her down for nap so that I could go.

Moving on....I arrived at almost exactly 2pm and filled out all the new patient paperwork before heading back to talk to Dr. M. in her office.  The low-down:  The RE & and nurse team seem nice (they pair each RE with a nurse so that you'll always know who to ask for when you call...since the nurse's pretty much do all of patient relations).  Dr. M. knows I'm not interested in IVF, but gave me their stats etc. anyway.  She went over my medical history and explained all of the preliminary diagnostic tests (which I already knew about).  She seemed concerned about my age and that I might have a low follicle count (because that's the thing that they are all programmed to be concerned about, I suppose).  She explained all the options as far as natural cycle vs. medicated Clomid cycle vs. medicated injectables cycle (p.s. they use an hcg trigger shot even on natural cycle IUI....I'm not ruling that completely out).  Then we went into the exam room where an intake nurse took my vitals....Let me digress for just a second.  I'm not a small person.  I'm actually at my all-time heaviest weight right now (Hush! I'm working on it. Baby steps...baby steps...), but I take pretty good care of myself.  I don't eat meat (haven't since I was about 15), have never been a smoker, rarely if ever consume alcohol, and my work is relatively low stress and makes me happy.  So, it's always interesting watching the intake nurse's face while she's trying to reconcile my size, my melanin, and my low-to-normal blood pressure.  Coming back to the actual story:  Transvaginal ultrasound: FUN!  Okay, not really. But it wasn't too uncomfortable once the probe (read: specially outfitted dildo-like device) was in place.  Apparently my uterus is lovely and my ovaries are equally lovely.  Dr. M. seemed surprised by the antral follicle count (7-8 follicles on each side), but was careful to stress that "they might not all be of good quality because of [my] age." (These IVF people...they really just can't help themselves, can they?)  She did notice a fibroid off in a corner somewhere (not on an ovary or obstructing anything) , but said it didn't appear to be bothering anything.  That was it!

Then I got dressed and peed in a cup, and talked to a nurse about when to call in to schedule my Day 3 labs (where they check all your ovulation & pregnancy hormones and do and AMH test to check your ovarian reserve - how many eggs you actually have left to work with) and when to schedule the HSG (where they inject dye into your uterus to see if your fallopian tubes are open).  At that time, the way my nurse, R., explained how & when all this testing got done, I was under the impression that I'd be able to schedule the HSG on a weekend (it has to be done between cycle days 6-10) since they only do that test at another facility that's about 30 miles away and I didn't want to miss work if it could be avoided.  That turned out not to be the case.  The bloodwork can be done at my local office, and the lab is open from 6am 7 days a week, so I could do bloodwork any day and never even be late for work.  The HSG, done 30 miles away, can only be done Monday to Friday, and only between 8am - 12pm.  I didn't find that out until about a week later when I went in for my Day 3 labs though. (more on that later)  The RE's office is actually located just across the street from the fancy dine-in movie theatre that has become one of my local favorites for mainstream blockbusters, so instead of going straight home, I decided to walk over and watch Deadpool again.  So the day wasn't a total loss.

They gave me a bunch of info in two folders:  One about required tests and cycles and options. The other about the financial side of it all.  I looked through the financial packet when I got home and nearly lost all hope while looking up the cost of pre-cycle services.  The HSG alone was listed at $1075.  FSH/LH/Progesterone were $75 each.  Plus anothe set of annual screenings that wasn't even listed (thyroid, AMH, STI's, CBC, blood type, etc.).  I was nearly paralyzed with fear that anything could possible be wrong with me because, as per my crap insurance and its super high deductible, I was already looking to be out of pocket for all of this up to $3000, and then the insurance would still only pay 50% of the cost after that.   I just felt like my insurance was completely useless and the premium was  just more money out the window every month that could have been going towards the purchase of spermcicles and shipping.  Grrrrr....I hate American healthcare so much.

*sigh....So, after my weird, not-pregnant-but-feeling-pregnant cycle, I had a super weird cycle (flow was different, ovulated earlier than usual, and had only 9 day LP).  I called the RE's office on cd1 of my next cycle to schedule the Day 3 labs and the rest of the annual bloodwork screening.  I wanted to schedule the HSG, but that's when I found out that the hours were ridiculous and I couldn't take another day off work in such a short span of time.  I resigned myself to do the HSG in the following cycle and maybe just go ahead with another home insem if all the bloodwork came back normal.  The next day, I talked on the phone with their financial consultant to go over what is and isn't covered by my crap insurance.  I told her how concerned I was about the cost of all the prelim testing and she said (you're gonna love this!), the prices they list in the financial packet are out-of-pocket prices WITHOUT AN INSURANCE COMPANY DISCOUNT.  What?????  Yeah, so apparently if you have insurance, even if your insurance doesn't cover something, the price you get is a discounted price vs. if you're paying out of pocket with no insurance.  So the HSG that was listed at $1075 was actually going to be more like $258.  This was such a weight off my shoulders! (UPDATE:  It took nearly a month to see the actual financials on that, but the insurance discounted price on the HSG did, in fact, turn out to be $268 or something, AND the insurance covered the whole thing and I don't have to pay a dime out of pocket.  I think it's because it's all diagnostic and not actual treatment at this point.) But then I was immediately pissed off that insurance companies are completely dominating what the standard of care is for people, since the financial aspect is what keeps a lot of people from seeking treatment in the first place (i.e. why I never saw an RE until five years into my ttc journey because I was uninsured all that time).  Anyways....I went in the day after that for the bloodwork.  It took two nurses and three tries to find a vein (and the bruise on one of the failed attempts lingered for over a week!).  But it was over pretty quickly, and I called an Uber to take me to work and went on with my day.  I thought I'd have to wait at least 24 hours to hear anything back, but Nurse R. rang me that afternoon (just as I was trying to hustle my work baby down the block to catch the bus with her by one hand an umbrella in the other, and a sack full of toddler detritus and library books over one shoulder), so admittedly, my attention was a bit divided.  She said that my Day 3 labs were all good and within normal range.  My FSH was a little high, but just on the higher side of normal...so still within the normal range.  The rest of the bloodwork was sent out to another lab, so I should hear back about that in about a week, she said.  (I literally never heard a single word or received any phone calls or correspondence about the rest of the bloodwork until I called three or more weeks later to schedule my HSG for the following cycle, btw.  Guess I'm fairly healthy and not interested in IVF, so I'm not really at the top of their priority list.)

That was basically all the news there was until my current cycle.  Without the financial millstone around my neck (the insurance is stealing all of my spermcicle money, but at least it gives me a discount on diagnostic labs and stuff...), I scheduled the HSG.  Unfortunately, I had to take the whole first half of the day off from work to go out there, but it was on a Friday & my work baby mama was planning to work from home anyway; so she ended up taking the whole day off work and the two of them had a fun morning out.  My Uber driver was a bit of an idiot...and drove completely in the wrong direction.  Twice.  My appointment was at 10am and they ask that you arrive 30 minutes early.  I got there at 9:55am and had to wait in line to sign in, so I didn't even check in until after 10am.  Grrrrr....They were really tight on the schedule though, and as soon as I was signed in, they brought me back to the ultrasound waiting room, and as soon as I arrived there, a nurse gave me a cup to pee in.  Right after I handed that off, I was taken to the HSG room.

I undressed from the waist down, and lay down on the exam table with a drape over my lower half.  The team came in (different facility, different doctor team), and the doc explained the procedure.  They put my legs up on these weird knee stirrups, but they were a bit limited on horizontal movement, and I felt like my legs/hips weren't open enough to get the speculum in comfortably (UNDERSTATEMENT).  It didn't help that he used some kind of elephant-sized speculum and it was mad painful just getting it in, let alone adjusted.  I was in a lot of pain, so he got a narrower one that felt more like normal going in.  Still uncomfortable while he was adjusting it for a better view of my cervix though (the man did not have a gentle touch or comforting bedside manner in the least).  More discomfort while he cleared away mucous.

Next was a "pinch" (again, understatement) as he injected two shots of lidocaine into my cervix (not through the os, but into the actual muscle of the cervix) to numb it because they have to "pinch the cervix open in order to insert the metal catheter that they use to inject the dye.  Then came the actual dye injection: OH MY GOD IT HURT SO MUCH!!!!! One of the nurses was talking me through it, coaching me on how to breathe through the pressure and pain. It couldn't have lasted for more than a minute, but WHOA!  There was "spill out" from my right tube right away (meaning the dye went through the fallopian tube and spilled out into the pocket near the ovary.  Then, eventually, spill-out on the left side, too.  The doc proclaimed me ALL CLEAR!  While he was cleaning me up and waiting for the bleeding to stop (from the lidocaine injection sites on my cervix), I asked if I could take a photo of the image(s) on the screens.  He said that once he was done "down there", he'd scroll through the images, explain each one to me, and find the best image for me to photograph with my phone.  See?

(click to enlarge)
You can see my pelvis, the speculum
in place, & the catheter that injected
the dye. The middle is my uterus, the
roundish sacks on either side are the
spaces around my ovaries to where
the dye spilled out.

Then, they all left the room and I got dressed (they gave me two cheapie sanitary pads, but I'd brought my own good ones from home - Yay internet research!).  I sat in the waiting area for five minutes and then I was free to go!  Done and DONE!

Here's my amateur theory:  The two times that I've had a transvaginal ultrasound and seen my ovaries, I've had more follicles on the left than on the right (or the left ones seems to mature faster).  The very few times I've ever had any kind of ovulation pain, it's been on the left side as well.  I think there may have been some kind of slight blockage on the lefthand tube and the HSG helped to clear it out (which is why it was so painful for me).  Hopefully, this helped set the stage for this cycle's successful home IUI attempt and cleared the way for a pregnancy to happen. (fingers crossed!)

Here's the overview:  RE's (I'm assuming in general, but at the very least at the one practice that I've visited so far) are really all about IVF and they use all the scare tactics they can to encourage women to take on more aggressive treatments and push for IVF because that's what they do best and how they get paid best.  And when they can literally find nothing wrong with you (as in my case, all bloodwork normal and no fallopian blockages), they use the one thing they can't test for to scare you with: Your "advanced age" and your "possibly poor egg quality".  There are tests to see how many eggs you have, but there is absolutely now way to know the quality of your eggs, so they go by the woman's age as the only determining factor.  And since I'm not keen on IVF and would prefer to do my insems on my own at home if there is no reason to believe that I can't get pregnant, I'm of no interest to them.  This was confirmed by RE Nurse R. when we spoke about my HSG results.  She wanted to talk about next steps and I said (as I have from the beginning) that if there were no problems found besides my "advanced age", I'd prefer to continue trying home insems.  When I asked about the possibility of progesterone support for after my IUI, she said that Dr. M. told her to tell me to get it from my regular OB/GYN....of course, they know that I just moved to Jersey and I don't have one, so if I don't agree to moniter my cycle with the RE's office and submit to any and all of their testing prerequisites, then I'm on my own.  As of yet, I've not formulated any plan that will get me progesterone suppositories in time for this cycle's insem, so I'll likely just use the progesterone cream that I still have in the cabinet until I test and go from there...

Stay tuned...