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...

*sigh...

Previously on Selfmade Motherhood Blog....Our hero freaked out about some weird OPK results, but eventually settled down and did another home IUI.  The two-week wait was so weird this time around!  I decided to apply OTC progesterone cream a few times a day (totaling about 360mg), in an effort to support my LP and give any fertilized thing in there a chance to stick around.  I was legit nauseous from 3dpo onward.  It happened first at work.  I'd eaten breakfast (oatmeal, as usual) with my work baby, but then I got all....weird.  Like my stomach was unsettled.  I wasn't sure what it was, but I figured it would pass.  But it didn't.  It was starting to get a little work, in fact.  I finally identified it as nausea and ate a small piece of candied ginger (because I keep a stash of random teas and candied ginger at work), and felt better almost immediately.  This happened almost every time I ate anything for the next 8 or 9 days.  So, that was new.  On top of that, 8dpo rolled around, and my boobs weren't sore and pms-ish like they usually are.  Then came 9dpo. Still no sore boobs.  I decided to test.  I mean, I was getting nauseous and dizzy AND my boobs didn't hurt in the slightest????  Could this be it?????  Nope.  Not according to my 9dpo pregnancy test anyway.  I tested again at 11dpo, and 13dpo.  Both negative, but I didn't want to give up hope.  After all, my cycle pretty much never gets past 11dpo, not even using the progesterone cream during my "shutdown".  But then on 13dpo, I started cramping in the evening.  Then I spotted something brown around 9:30pm.  I knew this could spell the beginning of the end, but it still wasn't full-on bleeding, and I didn't spot anymore that night.

By the next morning, however, I definitely was doing more than spotting.  The cramps came after that.  Not horrible and debilitating as per my usual though.  I strapped on a heating pad and went about my business.  I didn't medicate until I got home from work later that evening.

So, no pregnancy, but I swear this is the strangest and most pregnant I've ever felt (based on my previous ttc experiences of wondering if all of my pms symptoms might actually be early pregnancy symptoms - SPOILER ALERT: They weren't. Not once. Not ever so far. - and the lack of all of my usual pms symptoms made me really think/feel like this might be it) .  The "symptoms" were just all so completely out of the ordinary for me.  I really didn't know what to make of it all.  Except no impending baby.  So, yeah....pretty bummed out.

My brand new shiny (Bronze level - read: crappy, not that great) health insurance had just kicked in though, and I decided to make an appointment with the closest RE's (reproductive endocrinologist) office that accepted my insurance.  I booked an appointment for Wednesday, February 17th.  At this point, I have no idea what anything was going to cost or what would or would not be covered by my insurance.  And I realize I haven't been going hard on the ttc front every single month for the past five years (six if you count when I started charting to figure all my lady business out).  So, it's been five years since my first sperm bank purchase and home insem ttc experience, but I've also only made actual ttc attempts for eight out of maybe 65 or more cycles.  So, my journey hasn't been as intense emotionally and physically as a lot of other people's, but....You know what?  I'm gonna make this into a new post.  This was my "Hi, Still Not Pregnant!" post and I'm going to give that post the space it needs and deserves.  I will move on to the next conversation on the next post and we can discuss what all is going on with my lady business.

Stay tuned...

Home Insemination: For When Your Life Just Isn't Insane Enough Already...

Last time on Selfmade Motherhood Blog....The Tardis arrived (WHAT THE FUCK???).  That was "fun".  Shortly thereafter, it was time for me to start peeing on things (OPK's).  I did my usual, starting on CD9, expecting to get a + some time on CD12 for a CD13 ovulation.  I usually pee in a cup & dip in a midstream OPK & a Clearblue Digital (aka CBD), or balance peeing on them both at the same time when I'm not at home.  The idea is to give the digital test a baseline reading so that it will be able to more accurately detect my LH surge, and to be able to see right away any changes in test line intensity on the midstream test.  That was going fine until....I was testing during the work day on CD11.  Hadn't gotten a positive digital all day and the midstreams were only showing a faint test line.  My last test of the day was at 2:40pm.  I was going to test again around 5:30pm, but I skipped it and decided I'd test at 11pm, before going to bed.  Then I fell asleep watching tv in the living room and woke up at almost 5:30am.  Freaking out because I always test so much so that I can pinpoint the LH surge and more accurately time my insem (I try to get as close to 30 hours after the first OPK+ digital as possible), I ran and peed in a cup and dipped the digital and midstream tests.  Midstream was an unequivocal positive with two dark lines. Digital pulled up a smiley face.  That's when I went into an even more high frequency freak out mode. If my last OPK at 2:40pm was resounding negatives, and my latest test at 5:30am was hyper positive, how could I gauge when my actual surge happened?  Urrrgggghhhhh!!!!

Note: Stepped away from updating....for about two months.  Aaaaanyways....as I was saying: I pulled up super positive OPK's at 5:30am on CD12, but couldn't pinpoint exactly when my LH surge occurred because I'd fallen asleep and ought to have tested about twelve hours earlier.  I decided to go back to bed for another hour or so (this time in my bed) before getting ready for work and test again in a few hours with not-first-morning urine (I thought the fact that I'd had what equated to a sleep cycle and then OPK'd may have given me a false positive).  I OPK'd again at 8:30am.  This time with conflicting results: Two dark lines (positive) and NO smiley face on the digital.  WTF???  If my freak-out-fest wasn't already in high gear....Weeeeeeeeee!  I went to work and continued to test throughout the day. Finally, at the end of the day getting positive after positive midstream test paired with negative after negative digital tests, I pulled up a midstream test with a test line that looked like it might be starting to fade.  I decided to go ahead and do the insem right then.

I broke out the Tardis and started the thawing process.  I'd bought a mini microscope that connects to a cell phone camera to give up to 200x magnification.  I thought it would be perfect for getting a closer look at my thawed swimmers and easier capturing a photo or video of it than pressing the lens of the phone up against the little 60x magnification ferning microscope (while also keeping the light button on the scope pressed so everything is visible).  This damn cell phone scope wasn't worth a damn thing!  I could get the damn thing to focus on everything BUT my sperm sample....*grumble-grumble*.  I ended up doing the same old same old with the ferning microscope and my cell phone camera.  I could still see everyone swimming, but I was disappointed that I'd spent the money tryna be fancy.  Moving on!  I went for the proper IUI again.  I was worried that I might get some spillage of the sample out of the cervix, but the new set of syringes with "professional IUI catheters" did the trick!  The uppermost part of the uterus is about 4cm in past the opening of the cervix.  These catheters actually have a little stopper around 4cm down the length which helps accomplish two things: 1. You know that you've inserted the catheter far enough, but not too far. 2.  There's no spillage because the stopper plugs the os (cervical opening).  I was still a little concerned that there might be some spillage after I removed the catheter though, so I very lightly, gently squeezed my cervix shut with a long pair of smooth-tipped sponge forceps as I removed the catheter (it sounds awful, but I swear it didn't hurt at all.  In fact, I could barely feel it & kept checking in the mirror to make sure I was still holding it in the right position).  I stayed in that position for about 5 minutes or so, then inserted an Instead cup lined with a little PreSeed (just in case of spillage...I know. I'm paranoid.), and lay down with my knees to my chest while watching some Netflix for a bit before going to bed.  The insem was complete by 12:29am (just after midnight on CD13).  I got up and went about my day as usual, removing the Instead cup around 9:30am.  Then all I had to do was wait!

More to come in the next installment.  Stay tuned!

The Tardis

You guys...YOU GAIIIS!!!  Okay, so for those that don't know, when you order sperm from a bank and have it sent to your home, they generally send the cryotank with your spermcicles in a reinforced cardboard box. Some banks' labeling is more discreet than others.  For instance, when I used to order from Pacific Reproductive Services in California, the box had a THIS END UP sticker and PRS stamped on the sides. By contrast, my Manhattan CryoBank boxes have always had Manhattan CryoBank in large print on two sides of the box.  Not the best, but not the worst....until.....until I got home from work tonight and went to the front desk to pick up my box-o-sperm. Holy Shit! What?????

Ladies and....well, probably more ladies...I present to you The Tardis!!!



This box is about as discreet as the town crier.  The only way it could be less discreet would be if they slipped a note under every apartment door in my building and posted large-print announcements next to the elevators on every floor.  I was legit a little afraid to even open it to check the donor number on the vial because I was worried that The Doctor might reach out and pull me into a parallel universe.  It's bloody ginormous. And HEAVY.  *sigh* So much for keeping it private.  Now anxiously anticipating the look I'm going to get when I drop it at the front desk for FedEx to pick it back up next week...*fun*

Anyhoo....as can be surmised by the arrival of The Tardis, I am going forward for home insem this cycle.  I'm expecting to ovulate on Wednesday, so the insem could be Tuesday or Wednesday, depending on what day and time I get my first OPK+.  I shall keep you abreast of any further developments.

Stay tuned....

No News Is Good News, Right...?

Or....I just wanted to enjoy Thanksgiving and not think about the fact that I'm not pregnant (again).  Probably the second one.

Anyhoo...Keep moving forward!  I'm taking December off (which is actually two cycles because I'm scheduled to ovulate the first week of December, cycle through and ovulate again the week after Christmas).  There are two (or three) reasons for this.  The first (and absolutely least scientific) is because the Chinese Birth Chart tells me that January is a good month to conceive a girl, but December would be a boy (I'll take whatever I get, but I'd like to start off with a girl).  The second is that I've been rocking this game completely uninsured thus far, and it's open enrollment season for that type of thing and I'd like to have some insurance this year moving forward. Also, if I can get in to see an RE at some point and see if there's any real reason I haven't already thought of or addressed why I'm not knocked up already.  The third reason is that I'm going to try a progesterone shutdown for the two cycles I'm skipping in December.

What is a Progesterone Shutdown (or NPC Shutdown, as it's also known on the interwebs), you may ask?  Well, let me tell you.  Basically, there are several reasons why some women may try this method, but for me it's because I have a short luteal phase.  As you may or may not know, short luteal phase (the period of time between ovulation and the beginning of a new cycle) may occur if you have a progesterone deficiency.  I have long suspected this to be the case for myself because 1) I have a shorter than average luteal phase (mine is typically 10-11 days, usually 11. The average, and shortest necessary to allow pregnancy implantation is 12 days), and 2) the only time my LP was longer was when I did my medicated IUI cycle in Thailand and was on progesterone suppositories afterward, suggesting that the only thing keeping my cycle from lengthening (that hadn't already been addressed by my acupuncturist) is a low progesterone level.  Now that you know that progesterone can lengthen LP at the right dosage, you should also know that it is generally prescribed post-AI to begin the day after confirmed ovulation.  The reason it is not given before that time is because high progesterone levels can impede, delay, or stop ovulation altogether (depending on the dosage).  That's where the "shutdown" comes in.  You can prevent/stop ovulation for 2-4 cycles using Natural Progesterone Cream from days 5-25 of your cycle.  Begin applying the cream twice daily on or around CD5 of your cycle. Stop using the cream on CD25 and allow your period to come to start a new cycle (it may happen within 1-4 days after stopping progesterone).  Cycle as usual until CD5 of the new cycle, and repeat.  The idea is that you halt ovulation for 2-4 cycles (and use the time off from active ttc to detox your body and set up a healthier diet and exercise regimen), and then after the "shutdown", you stop using the progesterone and cycle as usual, checking for normal ovulation, and when you do ovulate, it's a super good quality egg because you've been holding it back and nourishing it for however many cycles.  Many women have gotten pregnant on the cycle directly following a shutdown in this way.

Now, if you read my previous post, you know that I was using progesterone cream after my most recent home insem attempt in the hopes of lengthening my LP and giving anything that may have gotten fertilized enough time to implant.  BUT, I started spotting on the day when my period would have been due anyway, and started bleeding full-on the next morning.  So, I think I wasn't using a high enough dosage (I was using about half of what the dosage was with the prescribed progesterone suppositories I'd used after my medicated cycle). The shutdown begins now...I'm at CD7 and just decided to go ahead with the shutdown today, and I'm using a slightly higher dose.  I'll be checking to see if thee's any sign of ovulation in about five days (I typically ovulate on CD13) and hopefully, there won't be.  If my cycle lasts long enough for me to still be applying the cream on CD25, I will.  Otherwise, I'll start again from next cycle at the end of December and up the dosage a little more (Because of my size, I already need a slightly higher than average dosage).  Continue using it until CD25 and wait to see when the January cycle begins and get ready to order more spermcicles for home insem on that one.

So that's all the news for now...Stay tuned...

Oh No She Didn't!......*Pssst! Actually, Yes I Did.

Previously on Self-Made Motherhood Blog....Our hero discovered that she was not knocked up and the world continued spinning (somewhat out of control, but more on that in a sec).

Right, so after my last attempt at Getting Knocked Up: The Home Game in late May, I had to move out of my apartment by the end of June.  My job had moved to New Jersey and the commute was killing me.  But also, my lease was up and I still hadn't found the mythical NYC apartment somewhere in/near/commutable to Midtown Manhattan that would allow me to work in New Jersey while still remaining a New Yorker.  So I ended up moving in with my work family.  Their new house was big sized and I had the third floor to myself. I had resigned myself to looking for an apartment in Jersey somewhere commutable to work.  This took me for friggin' ever. I came in contact with SO many shady sheisties, y'all! Just when I thought I'd found the perfect place, it turned out that they wouldn't even process my application without putting down a one month deposit....without signing anything. Without even seeing a person.  Just leave your application and your check for this ridiculous amount of money in the building super's mailbox which anyone can access and we'll get back to you.  Um...nahhhh.  I'm good.

Anyway, about three months later I really did find the perfect place.  And, even though I wanted to hate it for not being Brooklyn, I'm getting more space than I've had in years for less than I've ever paid for a one-bedroom in my adult life.  Plus, it has 24hr front desk staff, so I will never have to worry about being home to sign for packages. Which brings us up to the now....

Just before my all-access info subscription ran out at Manhattan Cryobank, I zeroed in on a new donor.  Irony of ironies, his height is listed as "below 5'7""...so it looks like my mutant tallness (I'm 5'6", but taller than everyone on my mother's side of the family, including my brother and uncles) will likely not be passed down to the next generation.  But on every other front, he's a good match in terms of what I'm looking for in a donor.  When I'd first found him back in July (while I was still living at work), he had a decent supply of available samples. When I checked back in September, his supply was "medium".  When it finally came time to put in the order for my November cycle, he only had IUI samples available.  Someone on one of my TTC forums had gotten pregnant twice doing home vaginal insems with IUI sperm, so I didn't worry about it.  I checked all of my other supplies and got ready to get down. 

For some reason, I got super obsessed with the idea of seeing my cervix (don't ask).  And then I thought that since I was going to be using IUI sperm instead of ICI sperm, maybe I should know exactly how my cervix was sitting so that I could get it as close as humanly possible to where it needed to go.  So I went on a speculum hunt (as one does).  Now, I've actually tried this before with standard disposable speculums.  And it was extremely painful.  The open had exactly one setting and it "clicked" into place. OUCH!  So I wondered if I could find something else on the internets that would be more comfortable.  And I did!  It's called a Collins speculum.

Collins Speculum

Not disposable, so I had to sterilize it before and after use.  It's meant to open side to side instead of up and down (but I found it more comfortable to insert it sideways and open it up & down like any other speculum), and it opens with a screw instead of clicking into place, so I can open it as little or as much is comfortable for me.  It's pretty dope, as speculums go.  I didn't want to freak my body out too much on the day of, so I practiced twice in the week or so before I was expecting to ovulate to make sure I knew what to expect when the time came.  

Somewhere along the way, it crossed my mind that I might be able to do an actual IUI by myself at home.  I mean, I could see my cervix.  I could see the opening.  I've got the stuff.  Everything is sterile.  Maybe...?  Of course, everything I've ever read EVER about doing home insemination says that this should never, ever, ever, ever, EEEEEVER be attempted. Because you will get an infection and die.  I mean not really, but really that's pretty much what everything I've ever read has said.  I googled "IUI at home" anyway, and was surprised to find a couple of very good resources (here and there) from women who had successfully done it themselves ("successfully" meaning that they didn't get an infection and die, AND they got pregnant and had living babies).  I was considering it more seriously...

   

Box-o-Sperm

Anyhoo...I was expecting to ovulate on a Tuesday, so I had to put in the spermcicle order  the week before because they only ship/deliver Monday to Friday.  Put in the order on the previous Wednesday with 2-day shipping to receive it by Friday (and I came home to my swanky new apartment building with 24hr front desk staff to find it had, in fact, been delivered while I was at work.  Cheers!).  I checked inside to make sure they sent the right one (They did), closed it back up and left it alone for the next few days.

I started OPK testing over the weekend, then kicked the testing into high gear on Monday.  I tested at 10am and 4:20pm and pulled up negatives.  I decided to test one more time before leaving work and pulled up a positive at 6:50pm.  Aiming to do the insem as close to 30 hours post-first OPK+, I planned it for between 12:30-1am the next night.  I hadn't made the decision yet on whether or not to go all the way with the IUI.  I wanted to see what I was working with and how I was feeling when I got to that bridge.  

The Work Station
Alcohol. Sterilized syringe & catheter.
Ferning microscope. Long cotton
swabs. PreSeed lube for the
speculum. Sterilized Collins speculum.
Gloves. Mirror.

And here we are at that bridge! I already posted this to my TTC forums, so I'm just gonna cut and paste from there. Here's how it went down:
Uncharacteristically, I think I actually felt ovulation twinges in my left side in the afternoon while I was out & about. The only other time I've ever felt my ovaries doing anything at all was my one & only medicated IUI cycle in Thailand in 2012. I did another set of OPK's around 3pm & came up with another smiley face on the digital & very dark test line on the midstream. 
Got home from work & did some cleaning. Set out all my insem gear & readied my work area to make sure I had everything i needed within arm's reach. Then took a shower. Watched a movie & had something to eat. Did another set of OPK's at 11:55pm. Negative on the digital/still very dark test line on the midstream, so I inferred that my surge had recently ended, but my LH levels were still pretty high. So either just ovulated or right about to. 

I thawed the sample & kept it in my bra under my boob (I'm top heavy, so it's a good place to keep something at body temperature). Opened the catheter package just a little bit didn't remove it (to keep it sterile) & attached the syringe to the catheter while keeping the catheter in its package. Double checked I had everything I needed, then did a couple of pumps of the syringe. Drew up 1cc of air into the syringe then removed the catheter from the package & slowly drew up the swimmers from the vial. I placed a couple of drops onto my ferning/saliva microscope lens, then put the catheter length back into its package & held it under my boob (bra off). Looked at the sample on the microscope &, after a little focusing, saw my swimmers swimming (!!!!!!).  Magnification is not the greatest & it's a cell phone pic, but it's still pretty cool. SEE????>>>>>>

My thawed swimmers on the ferning
microscope....Need a better view?

My thawed swimmers: The Close-Up!
See all the little black dots? Those are
swimming sperm! I could actually see
all their little tails & see them swimming!

I laid back, careful not to disturb the syringe under my boob, and inserted the Collins speculum which I'd lubed with Pre-Seed. I actually use it sideways so that the bills open up & down like any other speculum. Turned the screw to start opening it. Used a hand mirror & my cell phone flashlight to see what was what. Took a little repositioning to get a good view of my cervix. There was a LOT of mucous. I used a few long handled cotton swabs to clear some mucous out so I could see the os clearly. It was wide open & looked like a smiley face (I took a photo of that too, but I think we've reached our mutual threshold of overshare for one post). Looking in the mirror, I guided the catheter toward my cervix. This was the do I or don't I point (Oh no she didn't!). I decided to go for it (OH YES SHE DID!). I inserted the tip of the catheter into the os & waited a few seconds to see if I felt any pain or discomfort. Nothing. I inserted it a little farther, then a little farther (probably about 4cm in). Then I very slowly pushed down on the plunger over the course of about a minute, stopping when the plunger got to the 1cc mark (so i knew all the sample was out, but i wasn't pushing any air into my uterus). I waited another minute or so before slowly removing the catheter. Saw a tiny bit of fluid escape the os (not sure if it was sperm or cervical mucous). Tilted my hips up & turned the screw to close the speculum, then slowly removed that. Stayed with my knees up for about 20-30 minutes, then went to the bedroom to lie down & orgasm (because what could it hurt?). Then I actually fell asleep for a few hours. Woke up & orgasmed again figuring I was still in my window of opportunity & the uterine contractions might help any lazy swimmers get to where they needed to be. Then went back out to the living room to clear everything up, & went back to bed for a little bit before my proper wake up time for work. 

Weird Super Positive OPK 24hrs
Post-IUI/Ovulation

That all happened on Tuesday (as predicted).  Here's where it gets weird(er).  The next day, I came home late after karaoke league and OPK'd again.  I was expecting resounding negatives all around. Instead, I got a negative on the digital, indicating that my LH surge was definitely, definitely over. BUT, I got this on the midstream>>>>>>>  That's not even ambiguous. The test line is definitely not even slightly lighter.  But the digital pulled up a negative, so I marked it down as a negative.  It made me think that maybe something did get fertilized & was maybe already throwing out HCG hormones which would give a false positive on a midstream OPK, but not fool a digital OPK.  If that's the case, then the mission now is to coax my uterus into delaying the start of my period long enough for a fertilized something to stick and stay stuck for nine months or so.  To that end, 24 hours after insem, I started applying progesterone cream. This one>>>

I still have a bottle of the Progestelle oil that I used the last time around, but the more I read reviews on that, the more I am convinced that I was completely swindled on that stuff.  If it actually contained any progesterone at all, my next cycle would have at least been a day or two late...Anyway, people TTC and trying to do as much on their own as possible recommend this cream, and it's from a brand I trust already, so I'm not worried about it being shady or misrepresented.  I'm applying about 80mg per day (40mg, twice a day). Hoping it helps bulk up my lining and delay my period long enough for implantation to happen.



Fingers crossed, right? Anyway, I'm now at 5DPO (five days into my two-week wait). I'm good for now, but I know I'll be fighting the urge to test in the few days before my period would normally be expected about 6 days from now. I will fight the urge really hard. But I make no promises. Stay tuned...