This week

This was a rough weather week and a lot of people didn't feel well, myself included. For some people it was their joints aching, for others it was constant headaches. For me it was sinus pressure and neck pain. On Tuesday I made a same-day appointment at my pcp and went in to get it checked out. I was complaining of dizziness and lightheaded feeling. It alarmed me because at one point I thought I was going to pass out. It had started a few weeks ago, right around the time I cut sugar out. I thought that I was cutting too much sugar out so I had slowly reintroduced some back in, but the lightheaded feeling didn't go away and just got so much worse during the week with bad weather. Maybe it's related to the anesthesia from my hysteroscopy? No idea.

The doctor who saw me -- not my pcp but whoever in the practice had an opening that day -- did an exam, asked questions, took down history, etc. He couldn't find anything specific other than pressing on my sinus causing discomfort so suggested that I treat the sinus pressure symptoms to see if that helps. One thing that did concern him was my blood pressure: 160/90. It concerned me too. I know it usually reads high at the doctor's office, but it's been closer to 130s/80s the past few times I've been to - even as recently as all my pre/post op appointments for the surgery. He said he wouldn't put me on meds just for one reading (even though it was two within the time span of 30 min, same results). His recommendation was to record readings for a week at home and if symptoms persist to come back.

The next day I was scheduled at my clinic to take their two hour IVF class, which is mandatory for all new patients regardless of whether you've done IVF before or not. I didn't necessarily learn anything new but I did get more acquainted with the clinic, nurses, and protocols. It relieved a bit of the anxiety that has been sitting on me about starting another cycle and a new clinic.

I brought in my blood pressure cuff with me. After the class I asked the nurse if she could help me calibrate my cuff: she would take my pressure on their machine, then I'll take it on mine, and I can compare to see if it's at all similar and whether I could rely on it. Came out to 150/85 -- similar on both machines and still high. I thanked her and left for work.

This morning I tried my cuff again at home. I took three readings and they were each different, even though they were two minutes apart: 150/86, 142/89, 120/84. The last one is basically normal! I also noticed that the pulse was going down with each one.

I know some people have this "white-coat" syndrome where their bp spikes when it's about to get tested. I have mixed feelings about this - if something makes you nervous and your bp spikes then you have high bp. If someone cuts you off in traffic and your bp spikes? If you're caught off-guard and your bp spikes? Basically if you're getting these really high spikes then you have a bp issue, no? Maybe I just don't entirely get how bp works. I assume it's like your pulse that rises and falls throughout the day but that the baseline should test normal.

Anyway. Apparently I have this syndrome because I've had issues with my bp for years. At one point they put me on medication to lower it because every time I had it tested at the office it would be high enough to alarm them, even though when I was testing it at home it was fine. Eventually the meds were making my bp so low that I advocated to get off them and I did with doc's blessing. I haven't been on them for years. I even remember that some of the bc pills raise blood pressure and I had to switch from that. I feel like I'm back on that brand now and that might be a factor too.

From what I'm reading, limiting salt is a factor in controlling bp via diet. Oh awesome. So now I can't have sugar or salt. This is fabulous. I also read that getting rid of inches off your waist is a big help in lowering bp: approx 8 lbs off for every inch you want to lose.

So what's the moral of this story? Exercise is important to get blood pressure under control, to lower resting heart rate, and to control insulin. As much as I can't get away from it, I have every reason to up my exercise.

I treated the sinus pressure with some not-yet-expired flonase spray I had from last year's sinus infection, plus the weather finally cleared up, and some of the sinus pressure receded. I was still feeling fatigued and lightheaded. I used to wake up in the morning full of energy - I'd get up before the alarm most days, get up and immediately do things like load the dishwasher, fold laundry, or some other noisy tasks that would annoy my husband. These days I'm so tired. I feel alert and awake for maybe a few hours before I feel like I need a nap, and when I don't get a nap I just function at like 40% capacity until I collapse into bed.

The tightness in my neck led to the base of the skull and felt like heavy cement just hanging out there. I debated whether it was worth going for a massage or going back to the doctor. I decided to visit a physical therapist. I got in on a cancellation appointment on Thursday morning and got a full workup. She found that my right side is more tight and after several prodding questions deduced that it was probably because of the way I sit at my desk at work. She asked about medical history (I skipped the whole fertility part), did a few diagnostic tests, and then put heat on my neck and back for 15 minutes. After cooking my muscles she started to work on them.

It. was. painful. I didn't actively cry, but tears sprang up when she touched the sore muscles. She worked on my head and neck for a while "loosening" up whatever was tight in there, but less like loosening it felt like the worst pain I can remember having. At one point she was working on a neck muscle that triggered a really bad headache/dizziness, literally like an on button. She then worked on my back to loosen the headache she caused. After that she moved to my lower back and the agonizing pain continued. At one point I asked through clenched teeth, "is it supposed to hurt this much?" and her response was that she wasn't going to work on a muscle she didn't feel needs work. In other words, if it feels good then she's wasting both our time. The full appointment took about 2 hours from paperwork to leaving. The torture massaging lasted about half of that. While my muscles did feel looser in the areas she worked, everything else hurt. My skin was bruised and my head was pounding. I didn't even have energy to buy lunch somewhere and just ate the small snacks I brought from home.

Today I'm just sore and tired, with remnants of a dull headache in the back of my skull. We were supposed to have out of town company for the weekend but they rescheduled for another week. I'm thankful to have the weekend to rest and recharge.

For the time being, or at least I can come up with a new passion project, I need to make my health my main focus.
- Balanced eating
- Drinking water
- Exercise

I want to get my blood pressure under control without medication. On the other hand, I'm exhausted. Tracking food is exhausting. Constantly utilizing self-control is exhausting. I'm limiting sugar and carbs, and apparently now salt is limited as well.

Exercise is my biggest challenge. I know it needs to happen. I know all the benefits: healthier weight, lower blood pressure, lower resting heart rate, insulin benefits. Secondary benefits are to look better and feel better. All those things are excellent motivation and yet this is a real struggle for me. I need to find a solution.

Let's say I don't do it? That means adding blood pressure medication and metformin to my cocktail of daily meds. That means side effects. That doesn't solve other problems that come along with unhealthy lifestyle which will eventually catch up with me, regardless of how many meds I take. Not least of which, not addressing these issues could mean complications during a potential pregnancy. I'm not there yet, but this is my chance to address and reverse these unhealthy issues.

Every single day I need to make the choice whether to take care of my body or to put in on a back burner behind... netflix? social media? What am I prioritizing instead of it? Whatever it is, it's not as important. I need to make an effort, make the choice, and just do it.


We're gearing up for IVF 8 as August gets nearer. The cycle starts as soon as I get a period so it's helpful to have somewhat of a say when that is with the bc pills. We're waiting for my husband's recovery window to end. In the meantime we got approved by insurance to move forward; I'm getting my meds ordered; and finalizing any last minute things with the nurses so nothing is held up once we're ready to start. This might change as we get closer, but I'm not worried or excited for it; it just seems like one more thing to check off a list.


I'm looking forward to the weekend. I'm excited to relax and catch up with people I'm too busy to talk to during the week. Shabbat shalom.

Pre-transfer jitters

Today I had a full-blown meltdown. Tears, runny nose, puffy eyes, sobs... the works. It started out as a conversation about Pesach plans and what we're going to do this year. For the past few years, ever since we bought our house, we've had my in-laws stay with us for the first days of the holiday. It's a lot of work and expensive to host them, and without a master bathroom there's a lot of space-overlap with me feeling claustrophobic toward the end of the visit. This is part of the reason I'm constantly talking about remodeling and adding another bathroom. Not inviting them would make them sad. More importantly, not having them would make my husband sad. In the past the issues have been discussed in passing but I've always just sucked it up because I'm a people pleaser and I wanted to make my husband happy. This year it's very close to a transfer and I don't want to risk the work and effort that goes into preparing a major holiday and hosting sleepover guests.

During the conversation, we discussed plans for a good-transfer outcome and a failed-transfer outcome. As we discussed different options and solutions for issues that have come up in the past I was getting more and more upset. I realized that just the thought of contingency plans for a failed transfer were incredibly upsetting. I want this transfer to work so badly and I've nearly convinced myself that it might. But speaking about a possibility of "maybe we won't want to host because I'll be depressed" made the whole thing immediately real. There's a chance it won't work and... holy shit... I don't know if I can go through that again.

Adding to it all is that my sister is due the week after Pesach so everyone is doing their best to accommodate her family and anticipate her needs. I don't hold it against her that she's growing her family. I know I'll love her baby regardless of when it's born. Yet here's another factor seemingly pouring salt in an already incredibly sensitive wound. Sure, I'd like to be due any day with a baby and have someone else make Pesach for me. Instead I get to work hard and possibly grieve another miscarriage.

So maybe I'm upset about the Pesach options, but more than that I'm really scared about this transfer and what might happen. What might not happen. I'm so sick of failure. I'm so sick of feeling stuck. I'm so sick of being stuck in the support-system phase. When do I get to build my own family. Why are the two mutually exclusive that I can't do both, helping my sister while also being pregnant? And if my transfer fails will it be complete torture to help her for the first few weeks while they adjust to their family with a newborn? Just thinking about it all makes me sick to my stomach and brings on a fresh wave of tears.

I'm getting ahead of myself because I'm projecting. I'm using bad memories from previously failed cycles and assuming the worst. My mood is in the dumps and the gloomy, rainy weather isn't helping. But that doesn't mean I have to anticipate the worst. I'm crying over nothing. Nothing happened yet. Nothing may still happen. In fact, there's even a chance good things may happen. So I need to get out of my own head, get off the what-ifs hamster wheel, and work on praying that this time we'll have a different memory from a transfer.

Thyroid follow up

My first appointment with the endocrinologist was early December. Last week I went back for a follow up to see how my body is reacting to the dosage. I got bloodwork done and the results just came back that my TSH is higher.  My initial test back in Dec had my TSH at 2.96; last week it tested just above 3.

I don't get it. I've been taking the dose as recommended for 8 weeks. Why would my numbers go up? My doc is recommending doubling the dose from 25 to 50 and retesting in six weeks. I told the tech relaying this message that I want to speak to the doc because I have questions. Am I supposed to delay a transfer for this? It's too precious and expensive to transfer before fixing this, but in the meantime I'm not waiting six weeks to find out if it worked. If she doubles my dose I want to be on it for a week and then retest. If it's still not good then the dose needs to go up again. I'm not being impatient, I just don't think the endo doc realizes my timeline.

My doc answered some of my questions. First she said the number is within normal variation range so she would interpret the results that the TSH didn't change, not necessarily that it "went up," and the dose needs to be increased. Second, she said it takes a minimum of 4 weeks to see the full effect of a dose so she doesn't recommend repeating labwork within a week but would cut it down from six.

She did say that since my "TSH is in the normal range now, it will not cause a miscarriage or fetal demise so it would be safe to continue with the FET." Do I trust that? I don't know if I believe her. Every single article I read says that TSH numbers above 2.5 have a greater chance of a miscarriage.
I don't want to take Google's word over that of the trained professional doctor who is paid to treat my specific case but it's hard to argue with a study like this: First Trimester TSH levels between 2.5 and 5.0 are associated with increased pregnancy loss

Do I loop in my RE? I can already imagine that his answer would be "it's up to you." On one hand I definitely don't want to delay. Four weeks to wait to test seems like a lifetime right now. And then what if it's still high? That's another increase with an additional four weeks of waiting. What if this is just my normal and no dosage will help? On the other hand I don't want to risk it. I don't want to have found an actual issue and then just plow forward and ignore it. I know I would be devastated if the FET doesn't take and I will feel like we could've done something... like wait for TSH levels to get to the ideal range. But at the same time if we're increasing the dose and then checking it again soon (and possibly increasing it again due to a pregnancy?) then isn't that enough? Some women get pregnant not knowing their TSH levels are up and only add on thyroid meds once they're already in their first trimester. Is that a risk I'm willing to take?

What to do??

One year ago

Last year on June 20 marks the first time our fertility treatment took an encouraging turn: it was our third transfer and the first time we got a positive beta. We were ecstatic yet cautious because beta was only in low sixties. We believed it would work because it was the first that stuck. Unfortunately, it was the first of three miscarriages. The second beta a few days later showed that the numbers had gone down and instead of a pregnancy we spent the summer doing injections for two consecutive ERA biopsies.

In November, we were encouraged again with our fourth transfer when our beta came back in the four hundreds. Wow! We continued to hope as the numbers more than doubled at second beta. Then the rug got pulled from under us when I started spotting and the third beta came back in the 20s. It was discouraging and disheartening. I'm not sure how we went on but somehow we got through it as we processed our feelings through a second chemical pregnancy.

Then we started IVF 5, followed by FET 5. This time it really stuck. We had great numbers. Numbers doubled and got so high we were told to schedule an OB ultrasound. We got past the first ultrasound with no issues at all. We were nearly 8 weeks along and thought this was actually the real thing. And then there was the second ultrasound. The day started with excitement and ended in utter devastation. The following week included a D&C to remove the "product of conception" and four weeks after that brings us to present day.

One year.  It's been a rough year. A really, really tough year.

Each try brings us a little bit further along only to end in disappointment. It's really hard to keep going through the bogus successes. Each time we get good news I worry about when the disaster will strike. It's dreadful.

Pregnancy loss is truly horrible. Part of it is wanting something so badly, and admitting that you want it by pursuing it with all your heart, body, soul, and bank account, and then failing. Part of it is not only the failure of what is (treatment) but also the failure of what could have been (child). Part of it is feeling older every time there's a failure and feeling the biological clock ticking, no matter what age you're at. Part of it is the mental anguish of putting faith and hope in a system that has really sucky odds, with more losses than wins.

I'm learning that it takes more than just moving on logically and physically to be able to try again. I learned that I need to be able to visualize us being successful in order to be able to start up everything again. Each step individually is no big deal: coordinating the meds; figuring out insurance and payments; starting injections; going in daily for monitoring; the daily wait for results; egg retrieval anxiety and recovery; embryo progress reports; genetic test results. The big deal is all of it together all at once in the time span of only a few weeks while being hormonal and emotionally invested. It's more than wanting to build a family; it's also wanting to not feel stuck in an awful chapter of your life playing in repeat.

I  was always led to believe that I am capable of achieving anything I put my mind to, but that doesn't account for being unable to solve problems beyond our control. I'm not ready to stop trying but I'm also not ready to start again. Beside for worrying about when my period comes so we can try again, I worry that my body will be ready before my mind. I'm not going to rush it though. I know going in that there's a very real chance the next try may also not succeed and I need to be ok enough to handle that.

I used to completely believe that if we try enough times we will be successful. But with every loss I grow more cynical. I fear that one day I won't be able to believe that anymore. I stress about being able to continue affording treatment. I dread what this is doing to my body long term. I panic when I think about everything we've gone through and second guess every decision that led to this point. I'm scared that we may one day have to face a reality that it's just not working. It's what keeps me up at night. It's what makes me panic. It's what keeps me from believing that there's a path to building our family because today I just can't see it.

First of the season

It's been a long week. I wake up in the mornings feeling hung over and groggy and puffy. Morning nausea lasts until lunch time and if I eat a solid lunch then it simmers down to manageable levels. I've been uncomfortably gassy and running to the bathroom constantly with a lot of TMI. There's a special gross-factor about taking pills with water on an empty stomach, while nauseous, and knowing the pills will make them worse. But sometimes happens when I'm running late in the mornings.

All that pales to the anxiety. Today that boiled over. I was running errands, getting stuff ready for Shabbat and for my mom for Mother's day. I thought I should drink more water but figured I'd get to it as soon as I got home. I later had some cramps that were.... different. Then I went to the bathroom and found discharge that was... different. I freaked out. I started contemplating whether this is the beginning of the end. At some point the tears started and I just couldn't stop. I decided to take a shower to try to calm down.  Things took a turn when I decided to brush my teeth to get rid of the gross taste in my mouth. Between the tears, runny nose, and sobs I gagged on the toothpaste and then threw up. Luckily it was mainly water but the whole thing just upset me more. First barf of the season.

My husband heard and came over. He helped me clean up and did what he could to try to settle me down. It wasn't until I thoughtfully and purposefully made up my mind that everything is from Him and that there's nothing I can do either way, that I started to calm down. 

I had more thoughts but it's almost Shabbat. It's just insane to realize that infertility trauma is for life. It never goes away and there's no time you feel you can breathe easy. Every day is a miracle; every day we get closer is just one rung higher to fall if it all goes sideways.  Praying and hoping that doesn't happen. 

Shabbat shalom.

Choices

I've been stressing about the possible options moving forward.

The fact that we don't know what can help means that we're just going with trial and error until something sticks. Nothing we tried worked until now, which means everything else is an option.

I found it helpful to write out all the pros and cons of each option, however minuscule.

The first thing I did was go to pdfcalendar.com and print out a 12 week calendar starting at 1/15. I laid out the potential timelines. Being generous for a cushion in case insurance verification takes a while, I estimated a potential baseline at 1/23. From there, it branches out to several options:

• For a new IVF, we're looking at a potential egg retrieval date at about 2/9 
• If we transfer right after, potential FET 2/15 
• If we wait a cycle, potential FET 4/5 
• For only FET, possible transfer on 2/10 

I kind of hate the idea of a possible timeline that doesn't have a transfer until April. Why April? History has shown that it takes my body about 2.5 weeks after an egg retrieval to get my period. They can't start the FET protocol until after a bleed. Once the period comes, it's back on birth control for three weeks before they start the FET meds. That's approx 7-8 weeks total. So, April. I don't want to wait until April to try again. That's four months away! Pesach starts on 4/10 so I'd have a transfer like a week before? I really don't like that.

We talked about all the options and discussed each one. My husband is more gung ho about doing another IVF now than I am. I'm ok either way but I might also be ok just doing the FET. The arguments for it are that it's better to bank embryos while I'm younger; getting it out of the way, since we'll probably have to do it again if we want more children; sooner we get it done, sooner we can keep trying if FET 5 fails. The argument against it? We've been so focused on thinking several steps ahead, but it hasn't really gotten us anywhere. Maybe I should stop being so greedy about trying to get "more children" and just focus on having one first, one at a time. In thinking back about our past trials to try to bank embryos, after the first IVF cycle where we got two healthy embryos, it took three more cycles until IVF 4 to get any additional healthy embryos. Yes, two back-to-back cycles (#2 and #3) resulted in zero transferable embryos. So even if we do IVF now, there's no guarantee it will results in any additional embryos. There are no guarantees at all in this, part of which is what makes it so frustrating.

In the grand scheme of things, waiting an additional 7 weeks for a transfer is not a big deal. I know that. I can be patient if need be. But if we're waiting that much time before we can transfer and then that transfer fails, it's devastating that we've lost all that time.

And that apprehension about waiting is the truth hitting where it hurts. It's not the time I'm really worried about; it's the fear of another failure. I'm continuing to go through the motions and doing what needs to get done, but I have no faith in the protocols anymore. I don't know if it will work. Maybe ever? I don't know. I'm worried and scared. All we can do is continue to do our part, brace for the worst, and hope for the best.

Follow up and then some

Our follow up appointment this morning went as well as it could. Our doctor is a nice person and says the right things to make us feel comfortable. He tries, but he doesn't have answers. If it were up to him he'd say to just keep everything the same and try over and over doing the same thing until it works. If treatment was painless and free of charge, yeah maybe we'd go that route. But since it's not, I feel the need to research the hell out of our options and try something different if the first things didn't work.

We went over several options. He doesn't seem confident that any of them are our silver bullet, so to speak, but is willing to give anything a try. He was patient and answered all our questions. I never felt rushed or dismissed, but I also didn't feel satisfied that we have exhausted all of our options. Here's a summary of what we talked about:

• Blood thinners, baby aspirin, steroids, and anti-inflammatory medication
• Intralipid therapy
• Weight loss
• Fresh IVF or another transfer
• Hormone levels
• Age
• Next steps

Blood thinners, etc.

According to the doctor, the data isn't conclusive one way or the other. If it does work, there's no way to say this is why. He said side effects are minimal, if any. He said he would do both a bloodthinner and an anti-inflammtory combo. I asked about only using one because of the slight chance of side effects on the baby like cleft palate while on steroids. He'd be ok with doing only one, but his suggestion is if you're already gonna do it, go all in with both.

Intralipid therapy

He says that he wouldn't even know where to recommend going for this. The data is inconclusive and there is no current practice for any of the physicians in the clinic to recommend this. He knows about it but does not believe there is any value to this expensive therapy.

Weight loss

It's not the first time I'm hearing this. There's no way to know if this is a factor or not, but it's within my control (somewhat) and so I'm not dismissing it. I know it's the only thing he can come up with because everything else is testing normal. If I can lose weight I will, but I'm not pushing off treatment for this. 

Fresh or frozen

We have a unique challenge in that we need to have our embryos PGD tested. In a regular IVF cycle where you don't need genetic testing, you get to transfer on the 5th day after the egg reterival because your lining is primed due to the medication. Since we have one remaining embryo already tested, it presents with a few options: 

• Option 1: just do a FET
• Option 2: do a fresh IVF and transfer 6 days after the egg retrieval 
• Option 3: do a fresh IVF and wait a cycle before the FET

I originally went in thinking we'd do option 2, with a fresh IVF and then a transfer as soon as possible. The doctor said that there is a slight chance that the extra estrogen from the stim cycle might cause a decreased chance of success, so I think we might do option 3. I know it's only a slight chance, but regardless of how small, I don't want to risk it. We have some time to decide. 

Hormone levels

I asked the doctor to review all my hormone levels and double check if everything looks good. No anomalies spotted. Thyroid, prolactin, etc. all ok. If there is a problem it's not showing up here. 

Age

I'll be 33 in March. I'm feeling an immense amount of pressure to not only have a child, but also give it a sibling. Nothing we've done to this point got us any closer to that goal. Some people think that they want a baby. I don't just want a baby - I want a big family. Dreaming big, even if it seems greedy.

We talked with the doctor about doing another IVF before another transfer in order to bank some embryos. He seemed confused at first, so I explained that if we want to have more kids then the next transfer we do, if it works (big if) I'd have to take off about two years from treatment, one for the pregnancy and one for breastfeeding/recovery/having an infant to care for at home. If I'm ever lucky enough to take home a baby, I want to enjoy it as much as possible before having to worry about the next one. I said I was worried about my age and that isn't it better to bank some embryos at my current age rather than waiting?  I'm getting ahead of myself, I know. I should probably try to focus on just #1 before anything else. 

He responded that I don't need to worry about that until age 37 or 38, especially since I've been a good responder until now. I'm not sure how much I believe him about that. I get that he's the professional and he's used to seeing women in their 40s trying to get pregnant, but the only thing I have going for me right now is that I'm still relatively young. Why not use it to my advantage if I can bank some now? 

My other thought process is that iyh when we are trying for #2, we'll have a #1 running around. If I don't have to wait, I'd rather get an IVF/egg retrieval out of the way now instead of having to deal with it later with a toddler. Again, I know I'm getting way ahead of myself, but this is part of my thought process. 

Next steps

So now we have to decide what we want to do next. We have so many unanswered questions and too many unknowns. Here's what we do know: 

• We want to continue trying. 
• We have one healthy embryo in the freezer. 
• We know I can get pregnant. Embryo implanted and continued to grow. Therefore we will focus our efforts on keeping a pregnancy rather than implantation issues.
• We know our insurance coverage won't kick in until mid-Jan at the earliest. 
• We know that since insurance won't kick in before my next period is due, we're looking at a late Jan or early Feb cycle.
• We know that we are nearing our lifetime maximum benefits for fertility treatment coverage so a lot of our treatment moving forward may have to be out of pocket at the reduced insurance rate. 
• We know we want to bank more embryos before doing a transfer. 
• We know we want to wait after the IVF to do a transfer.
• We know we have two options for the next transfer: 
• Change nothing
• Add bloodthinner/steroid protocol
• We know that losing weight is an option. 

Based on that information, we will discuss in the coming days what we want to do and take it from there. 

To his credit the doctor is willing to discuss any option. He's seems mildly interested in helping us succeed, but he's a skilled clinician who is professional and efficient at his job. He told us to take our time to think about things and let him know if we have any questions, asking us to include a phone number in our email if we want him to call to discus anything. 

I think the temporary plan now is to wait for my next period, start an IVF cycle late Jan, wait a cycle and transfer in Feb with the bloodthinner etc protocol. In the meantime to try to lose weight. I'll let that pickle for a few days and if it still seems like a good idea and we both still agree then we'll go forward with that.

I'm a little bit over all this. I'm feeling deflated and drained. This last loss really took a lot out of me. I don't have the same hopeful optimism. The fear of failure is so great that instead of calculating due dates after a transfer, I calculate how soon we can try again in case of a loss. I don't think I'll ever have a sense of relief where it relates to pregnancy.

We spent a large portion of our 20s in debt and unemployment due to the 2008 recession and it took us a while to climb out of it. We're now spending the best time of our 30s suffering with infertility. I feel like we were late to bloom and we're wasting the best of our youth just trying to stay afloat. Where did we go wrong? What did we do to deserve this? More importantly, how do we overcome? If not overcome, how do we shift our goals and priorities to still lead happy lives?

I don't have answers. I just have an emptiness. When I start feeling happy a guilt creeps in. I don't know why or what for, but I feel guilty for trying to be happy. Maybe in a way it feels as though being happy invalidates all the sad things we're going through. I think I just need to not rush the time it takes to let things heal.

We talked about going on a trip to try to get a little space and fresh surroundings, but it's the same issue again that comes up. The more money we spend, the less we have for treatment. Our 10 year anniversary is coming up this summer and I've been saving for a major trip for almost 4 years. It now seems like we may need to use those funds for more treatment. It's unfair and it sucks, but I feel like I have to try everything before giving up. I don't want to live with regrets. We will iyh celebrate our anniversary wherever we are together, but there's only a finite window to build a family. I wanted to compromise and have a quickie getaway nearby, but anywhere nearby that's worth traveling to during this season still has zika issues. It feels like we can't win.

I feel like if we just can keep going we can thrive, not just survive.  We just need a little bit of luck to get through this latest rough patch. I also need to remember to learn to enjoy the journey. I feel blessed that we have the opportunity to try again. Our life is currently being made up of these memories and it is what we make it. We are so fortunate to have the things we do - I'm too superstitious to list them here - and I am thankful every day. 

One step at a time

Part of me wants the extended weekend to last as long as possible. The weeks ahead are going to be busy at work and it's going to be non-stop until mid-December, so the break has been nice. Another part of me is anxious to get to the clinic for Monday's bloodwork and hear the next update.

Since the Wegmans incident there have been less and less symptoms. Cramping is nearly gone. My husband and I kind of stopped talking about it all together. The Wegmans incident really scared us. Every so often I'll get a twinge or feel something in my lower belly and remember, but for the most part we're trying to keep it in the back of our minds until we know more.

I haven't worked out since last Tuesday. We've taken walks around the neighborhood but nothing to work up a sweat. I've kept my feet up and drank a lot of water and tea. Spotting stopped but I dread going to the bathroom, worrying I might see something new. The bloating has gotten better, no headaches, no fatigue. My appetite is gone which is unusual for me but I'm probably just full from all the liquid trying to stay hydrated. The only symptom to report is a phantom tight-undies feeling. It feels like my pants or my skirt is just a hair too snug, but I know it's not the clothing because the feeling happens in the shower sometimes too.

Thinking about the what-ifs is exhausting. I find it emotionally draining to think about all the things that could go wrong, but I want to enjoy what could possibly be the beginning of our child's journey into the world. I'm trying my best to put the worrying on the back burner and try to take things as they come.

Happy Thanksgiving

I love Thanksgiving. It's one of my favorite days of the year. I love that it's a no-stress holiday. I love that it combines things I love: family and food. I love that the one legal holiday turns into a nearly 5-day weekend!

Spotting slowed significantly overnight and changed to brown, so I take that as a good sign that its stopped and this is just whatever's left over. I've googled as much as I can and everyone on the internet says cramping is normal. They also say that bleeding isn't automatically a miscarriage, but to monitor closely. So my doc knows about it and I've done everything I could. Possible harmless causes are either implantation or the meds, none of the other explanations the internet offered were relevant. At this point whatever is supposed to happen will happen.

I tried to think back about my day yesterday wondering about what could have contributed. I realized that with all that was going on -- getting bloodwork, running errands, cramming everything I could into the half-day before we were dismissed for the holiday weekend -- I'd been basically fasting the majority of the day. I drank a bottle of water on my way to the clinic for bloodwork, but other than that I wasn't hungry and didn't think of eating until after 3:00 pm. The Wegman's incident (as we are now referring to it) happened about 12:40 pm and after that I really had no appetite. Is that the cause? I worked out on Tuesday, for the first time since transfer, and felt extra cramping but nothing too intense. Was that it? We'll never know. But I'm going to be more mindful about making sure to stay hydrated and take it easy.

I did my best to relax yesterday evening and fell asleep around 9. I was up early this morning but it was still dark and decided not to start my day just yet. I feel like the only thing I can do to help things is to just take it easy and keep my feet up, so I'm enjoying my pajama day on the couch and in bed, getting up occasionally to baste the turkey or get a snack. Thanksgiving and the long weekend couldn't have come at a better time.

The cramping has subsided a lot and I barely feel it when I'm sitting or lying down, unlike yesterday when it was active all day. I didn't think anything of it because I'd been having cramping since transfer day. I plan to park it until bloodwork on Monday and hope for the best.

While it may sound cliche, I feel truly blessed this Thanksgiving. Wishing you and yours a very happy turkey day!

FET 4: 11dp6dt

Well, here we are.

It's the night before beta. Still officially pupo. Last night of the unknown for FET 4. I'm proud to say that I've stuck to the no-testing pledge. Not a single HPT peed on in the past two weeks.

I've had cramps on and off the past few days. They've gotten less frequent and more intense. I feel it more when I stand up from after sitting a while. I think the cramps are from the PIO, regardless of whether something stuck or not. Otherwise no symptoms that I can tell.

My cold is almost all gone, thankfully.

I'm nervous for tomorrow. I spent some time today doing research for my interview, but I'm not nervous for it. If they like me for me then I'm the right fit for the job. If not, then it just wasn't meant to be. I want to do well, but I'm not freaking out about it.

I'm nervous about it being a top-heavy day, with everything crammed in the morning. I need to wake up earlier than usual so that I have a chance to beat traffic on the way to the clinic and get there in time. If at all possible I want to avoid getting stuck in the queue waiting for bloodwork. It's the shortest and most significant part of my day. There's nothing I can do about the results and it's the thing I'm most nervous about. From there I have to get through traffic to my interview. At some point I have to remember to call in sick from work.

I was randomly googling thoughts and came across this poem which captures a lot of the same things I'm feeling.

I'm ready for some good news!

Pre-transfer jitters

I finally broke out the aerobic step I bought a few months ago. It's embarrassing how long it took me to get motivated enough to actually use it. But I did and, along with a great YouTube video, I worked up an awesome sweat before work. They say one good deed leads to another and it's true for this too, because I even took the time to prep breakfast and pack a healthy lunch. 

My new diet philosophy is 5/2: eat well 5 days during the work week and then enjoy the weekend with less restrictions. I see the most results when I low-carb but it's hard to keep that up for too long at a time, so this might be a good compromise. I've definitely enjoyed the weekend so now it's time to do the 5 'good' days. I feel like it's easier to be more structured at work so we'll see how it goes. I'm also using the free app from myfitnesspal.com and it's really helping to keep me accountable.

Today the clinic called to give us the exact time for the transfer. They always have egg retrieval surgeries in the morning and then after lunch they do transfers. The schedule depends on how many egg retrievals they will do that day, and that depends on today's bloodwork from monitoring. From past experience I knew that the surgery schedule comes out around 4 PM.

Shots are going fine. I think my butt is getting numb quicker this time because of past damage to the area from previous PIOs. It used to alarm me when the area went numb after several shots, but now I'm just embracing it and trusting that it will eventually wake up again. I was hoping it would make shots less painful but it doesn't. #itiswhatitis

Last transfer I did a recap so I can remember what I did. I'm already doing most of it - trying to eat healthy and keeping active at least 3x/week. I'm eating pineapple because I like it, so it's part of my regular snack rotation. I'm debating whether to buy pom juice and nuts again... I doubt they did anything the first time and I didn't really enjoy them. I guess it will be a game time decision when I go grocery shopping tomorrow. I booked my massage for the day before transfer. I feel like it helped me relax so for that reason it was worth it. Whether or not it helped otherwise I'll never know, but I feel like I'm doing something proactive to try to help implantation. And then there's the added day of PIO before transfer, thanks to two ERA cycles, two biopsies, and nearly $2k later. I hope that this is the ultimate trick that helps this work.

I'm anxious and excited. It's hard to put into words how much I want this to work. It's hard to admit how much I want it to work because for some reason it feels like that much more of a failure if it doesn't.

Nervous

Tomorrow is my second baseline appointment and I've been worried and anxious all day. I've kept a really trim diet over the past week which was difficult over the holiday but I stuck with it.

This morning I weighed myself and there was no change from Sunday's weight, which was lower than the clinic's recorded weight by 4.2 lbs. I'm worried that it's not enough. I'm worried that there is too much of a difference in the two scales, both digital, but still. I'm worried that we'll have to wait an entire month for my next cycle to get started.

All day I tried to think of ways to get an 'edge' in case it comes down to a minuscule amount. Like, I was trying to contemplate what to wear that won't add extra weight. Since I couldn't stop thinking about it, I actually weighed the clothes I wore last week (weighed myself, then weighed myself again holding the clothing) to see that they actually weigh 1.4 lbs. Getting weighed unclothed is not an option.

I drank so much water today that I'm hungry and stuffed at the same time. I trimmed my nails because it was time, but when I thought of it I was like, "Oh, there go another few ounces!" I'll find some normal, light clothing and I'll shower tonight instead of the morning so my hair isn't wet. Once I started thinking that maybe I should trim my hair I realized I've taken it too far. It is what it is. If we need to wait another cycle, so be it. I hope it's not the case.

Weekend

This weekend had a lot of what I needed: sleep, unhooking from all screens, spending time with people I love, walking, and lots of delicious food.

We had a potluck lunch at my sister's for a family birthday and among other things, I was in charge of dessert. I brought fresh fruit, two mousse pies (one chocolate and one vanilla) which were divine, and the winner was the mini cinnamon buns with cream cheese frosting. I am a huge fan of baked goods already but these came out really out of this world.

Mini cinnamon buns.... with cream cheese frosting

They were perfect. Even though everyone was full from lunch and the relatively heavy mousse pies, we still finished nearly 2/3 of that 9x13" pan of cinnamon buns. If you like baking, or eating delicious baked goods, I highly recommend this dessert.

I also did a lot of thinking over the weekend. As much as I feel aggravated by the doctor and his lack of phone skills, I notice I still defend him when someone trash-talks his indifferent behavior. I know I technically CAN move to a different doctor if need be but I'm not ready. The trapped feeling I have is due to needing fertility treatment in general, not necessarily this particular doctor.

I worry that changing doctors may delay the next steps somehow, as though they'll insist on repeating all the prelim testing for which we already have answers, instead of moving forward and picking up where we left off with this doc. If I was unhappy with the medical care I was receiving, that would be an acceptable delay. But the part I'm unhappy with is the manner in which he communicates. He relies too heavily on the nurse to do the majority of the communication and when he's needed to step in, he doesn't do it on my timetable. I could change to a different doctor with a more hand-holding bedside manner, but will that get me to my goal any faster?

In full disclosure, I realize that this is a common theme with this clinic. Before January I was assigned to a different nurse. I felt like she was distant and had a robotic, detached demeanor. There were several mistakes that she made that I felt warranted a complaint letter. This happened before I started the blog so I have nothing to link to, but suffice it to say that I was ready to request a new nurse then. It happened to be that I held off with the complaints wanting to think it over and in January she was assigned to a new office and I got the nurse I have now, which I love. Fast forward to a few weeks ago, I was ready to request a new financial counselor because of all the things she did. The issues are real issues and my complaints are valid, but I'm noticing a pattern here. Either everyone is incompetent or I just have extraordinary expectations.

So I need to be prepared to keep going to this place and know that I have to keep a vigilant eye on things because they tend to screw up, or I need to cut my losses and start looking for another place.

I'm inclined to give this doc one more chance simply because I don't want to lose sight of the big picture, which is trying to get pregnant with a healthy baby. We finally have a thread to pull: we were told my uterine lining is pre-receptive. We just found out we have a variable we know was wrong in the protocol. Changing it may be the key to finally getting somewhere on the road to having a baby. Do I want to put the brakes on that while I yell at him for not calling soon enough? No, that's not helpful and will not get me what I want.

Is his manner frustrating? Yes. Could he be a better doctor? Probably. But I am willing to look past this so we can move on to the next steps. I don't want to hold a grudge, I'm not interested in being mad at him, and I don't need the added stress of thinking about switching right now. I know this is probably not the last time he'll disappoint me, but my wanting a successful pregnancy supersedes all the disappointed feelings.

Putting things in perspective has really helped calm me down. It's hard not to lose the forest for the trees, especially when everything is so emotionally charged.

I am a big believer in stepping in and advocating for yourself, which has proven helpful time and again along this journey. But I also believe in balance and picking your battles. There is a time to fight and there's a time to be patient, and right now is the time to put away the boxing gloves and sit tight.

Still no call

I haven't heard from the doctor yet. I read all these fertility blogs and they all talk about how their doctors go out of their way to make them feel comfortable and supported. I get none of that from my doctor. He's a world-renowned clinician but when it comes time for anything related to the phone, he's the worst. The most recent time I felt like he didn't give me the time of day was after the chem pregnancy beta results came back and I was a complete mess. I attributed that situation to my hormones, misplaced sadness, and extraordinary circumstances that were beyond his control.  After the wtf appointment I felt better.

Until now.

Now I'm angry.

Our results from the ERA were delayed to begin with. There was anxiety already. Finally on Thursday morning (five days after we were expecting the results to begin with), my nurse emails with the results and that "I put those results on Dr. X's desk for review and he will contact you to discuss." That was at 7:44 AM on Thursday. That evening, I emailed her back and said that I didn't get a call. Maybe I misunderstood?  Was I supposed to call him? Should I have scheduled a phone appointment? Her response came back at 7:53 AM this morning, "No need to make a phone appointment. He will call you." Yet, it's now Friday evening and still no call.

It bothers me that I've been on pins and needles for nearly 48 hours waiting for these results. It bothers me that I haven't allowed my phone to leave my sight for more than a few seconds for fear that I might miss the call when it finally comes. It bothers me that the earliest I'll hear from him is probably Monday, and even then there's no guarantee.

What kind of service is this? You'd think they were doing me a favor, as though I wasn't paying thousands and thousands of dollars for their services.

It bothers me that I feel trapped because it's the best clinic, and he's considered the best RE. It bothers me that I'm stuck with them because they have my embryos. It bothers me that I'm stuck with them because I still need them.

I'm so annoyed and frustrated. It's so unfair to keep people waiting like this. No matter what benefit of the doubt I try to give him, it still doesn't excuse this kind of treatment. If he's on vacation, or has a family emergency, or is swamped with patients... whatever the excuse is.... he could've told the nurse to pass on the message that he is unable to talk immediately and he may not call for a few days. What is this madness keeping someone waiting for results???

This whole ERA process was a cluster from start to finish. Everything along the way was awful - from the financial, to the scheduling, to the appointment itself, to the checking out of the appointment, to payment, to results.

It pains me to think that we have to go through this again. Or do we? I assume I know what are options are but I don't really know because the trained medical professional has yet to call me.

I know I need to calm down. I'm so frustrated and infuriated at this trapped/dependent feeling that we're stuck with him that I have hot angry tears simmering just below the surface. Should I switch doctors? Should I complain to the office manager? Should I just suck it up and wait to get pregnant? Are my expectations just unrealistic?

Let's say I write him an angry email. Then what? What am I expecting in return? He'll say sorry? He'll write back, "Oh I don't have your file, talk to you Monday." Anything he writes will make it worse.  But a thought came across my mind that what if he doesn't even know he needs to call me? Then I thought that of course he needs to call. We have a baseline appointment next week and we don't even know if it's for another ERA or an FET. Plus the nurse would have made sure that he knew. He knows. Maybe he's ashamed for being so wrong about nothing being amiss that that we should "just keep transferring." Yeah right.

It seems like he doesn't care at all. He's won awards for his work, he has 20+ years of success. He has a pristine reputation and has nothing to prove. What's in it for him to be a good doctor? He's got no incentive to see us succeed. He gets paid regardless. In fact, the more we fail the more he gets paid. He's basically got no motivation to keep me happy or help us get pregnant.

He'll apologize, come up with some dumb reason why he didn't call sooner, and then we all have to move on because we still want to have babies.

I'm so sick of this. I'm sick of this clinic and all their bs. I'm ready to move on from them but there's nowhere to go. I'm done dealing with the uncertainty of the unknown and the dread of the news of the next phone call. I'm done with fertility treatment and I just want to move on.

Shabbat shalom.

Total eclipse of my life

Simmering just below the surface is an underlying annoyance. Easily provoked by the slightest inconvenience, I'm on edge and everything is ticking me off.

Annoying things:

- I got into a tiff with my husband about something stupid. I find something to pick at and lash out. Getting caught off guard, he lashes back and it's on. Not being hormonal and moody, he gets over it long before I do and I'm left stewing.

- I applied for two jobs on Thursday and haven't heard back. I felt like the shizzle applying and not hearing back makes me question whether I should have bothered.

- We haven't gotten our mail since Friday. UGGGHH. If it doesn't come today I'll have to call the post office and the thought of dealing with USPS employees is too much.

- Not sure why I'm so anxious for my mail, since last time it came they brought me a bill for $3600 in a "medication billing error" that I'm trying to sort out. I spoke to the contact person, I followed up on Friday, I emailed, I followed up again on Monday, and now I'm waiting for a director to get back to me. I don't have an extra $3600 lying around, and we're so careful about spending, so this feels like a noose around my neck.

- My coworker is grating on my nerves. She likes to think out loud and make sound effects and ask me for feedback on her thoughts.

- The High Holidays are coming up and I don't have a plan for shul yet. Our shul situation is complicated and stressing me out. If going to my in-laws was an option, I'd choose that just to avoid having to deal with this.

- My butt hurts from the latest round of PIO shots. I'm also back on the BC and it's making me nauseous and is partially responsible for my mood swings.

- We need to buy another car and we're procrastinating because it's a big deal and we're overwhelmed with the options. We're also terrible at haggling and don't want to overpay.

- Waiting for results sucks. It's been 6 business days. They said 10-14 business days for ERA results.

- The facebook highlight reels are getting to me. People on adventures, taking advantage of the last summer weeks. Families enjoying each other's company. Beach, fruity drinks, sunglasses, beautiful sunsets, happy tanned faces. I want a family vacation. I want to have my own family to take on vacation. I want to have money to spend on vacation instead of "wasting" it on fertility treatment. It wouldn't feel like a waste if we had anything to show for it, but we don't. Not yet, and holding on to hope feels like a heavier burden every day.

- My new diet is making me hangry.


As I was thinking about all the things that were pissing me off last night, I was in my bathroom when I heard the rain pounding on the pavement outside. I took a moment to step out of my bubble of misery to recognize that I'm being partially ridiculous. I have a house and a roof over my head. We didn't lose electricity in the storm and I have air conditioning. I have food in the fridge and clean clothes. There are people for me to love and people who love me.

I complain that we don't have money to renovate the bathroom, but we can renovate tomorrow if I felt like going into debt for it. I grumble about not being able to afford vacation but we choose to spend that money in ways that are more important to us, like finding out if our FET transfer window is right. I'm intentionally making choices from the options we have available based on the priorities I've set. I can't be upset that it's taking time to reap the rewards.

Sure, things aren't where I want them to be, but that's why you set goals and work toward them. Just because I don't have everything I want doesn't negate all the gifts I've received until now. I'm working on accepting things beyond my control and working through the challenges as they come. I feel justified in my sadness about not being successful in having babies, but I can't let that be the only thing that defines me. While it's overwhelming and always on my mind, it shouldn't eclipse everything else in my life.

Meltdown

I kind of had a meltdown this morning before work. I had the tiniest bit of tan color on the TP this morning and it made me so sad and so sure that it's all over. I couldn't stop crying and was worried I'd have to take the day off work since I can't go as a blubbering mess.

As of noon today the cramps are back but they feel like period cramps and I'm scared to look every time I go to the bathroom. I'm having weird discomfort around my cervix. Can I even feel that? I don't know - that's what I'm assuming it is.

My nurse said that if things progress I'll have to be on the shots until about 10 weeks. Even though I'm running low I decided I'll only place the order if the numbers from tomorrow's bloodwork indicate that's necessary.

I told my mother the news. I went over to the house this morning on my way to work. It was scary! We chatted about random stuff for about 10 minutes while my heart was pounding trying to figure out how to best tell. Now I get why people get funky with the reveal. It was hard to actually say the words, especially when the situation is still so precarious and I'm so superstitious. I basically just said it and the reaction was immediate. She was so excited and so happy. I got a big hug and we cried together. Once I caught my breath I explained that the numbers are low and that there's still a long road ahead. I explained that the numbers need to double now every time I go back for bloodwork until such time that they can do an ultrasound and so on. Here I thought the 2WW was the worst.

I kind of felt bad landing that on her at the beginning of the day but at the same time it felt like the burden was suddenly not as heavy to carry. She has plenty of experience with kid-related anxiety raising us so I'm not so worried about that. I'm not sorry we shared the news. I was happy to have the news to share and until I hear otherwise, I'm calling it what it is!

4w2d

I'm so bummed. I know it's not over til it's over, but things feel different.

For one, the cramping stopped. It's been a constant buddy since transfer day and this morning I just didn't feel it anymore.  For another, I took a HPT with fmu and the line barely showed up. I cried most of yesterday evening after reading what it takes for such a low beta to result in a healthy progressing pregnancy. It wasn't hysterical sobbing, just a quiet mourning and sadness of what's possibly to come.

I told my husband that we should have shared the news with parents while it was still relevant and we were excited, instead of just sharing a chem preg / miscarriage. He said that we can tell them tonight, before Thursday's bloodwork, and that it may still be ok. I feel like at this point we shouldn't get their hopes up only to possibly crush them tomorrow. Then again, the support and prayers would be appreciated so I might take him up on the offer.

Whenever I starting thinking about cutsie ways to announce the pregnancy I stopped short, not letting my train of thought run wild. I didn't calculate a due date. I didn't figure out with a calendar when each trimester would be done. I didn't come up with a list of friends I want to personally notify. I didn't think about a way to let my supervisor and her boss know. I didn't devise a cute plan of how to tell my coworkers. I put everything on the back burner - first I wanted to see a heartbeat.

I know there's technically still hope but none of the signs point to a good outcome from this and I'm so guarded about holding on to false hope. Even if tomorrow's bloodwork comes out shitty they still want to see me again on Monday to follow the progression, if any.  So we might not get a definitive answer tomorrow, but hopefully we'll know more. 

:'(

4w1d

I finally connected with my nurse late this afternoon. We played phone tag and then emailed a few times before she caught me on my way out of work.

She gave me an overview of the next couple of weeks and what we can expect, assuming things continue to progress. They want to see me for bloodwork every 3-4 days now. They want the numbers to at least double every time. Once the number reaches at least 2000, they do an ultrasound to determine the placement of the sac. After that I do an ultrasound every ten days for a total of 3. At that point, usually around 8 to 10 weeks, they release to the OB. Shots continue until that time.

I asked about the cramping and she said it's normal, even if it's intense at times. She said I should be concerned if it's localized to one side, if there's bleeding, if I feel clammy, or don't feel well otherwise because those are indications of an ectopic pregnancy.

I also asked about what happens if the number doesn't double on Thursday or beyond. She says that if it's close to double they'll consider it progressing, but if it only rises a little bit then they consider it stalled and that they would expect it to expel naturally. If not, they give a shot to help the body expel it. It sounded like she mentioned a drug given to cancer patients to make fast-growing cells stop growing, which make sense and sounds like a nightmare. It would be a shot given in the office, so it's serious business. They trust us with the PIOs so how horrible can this one be that they need the professionals to administer it. She wanted to answer my questions but at the same time felt the need to calm me down by saying let's take it one step at a time.

I told her I was concerned about the low number because I know that they usually like to see numbers slightly higher. She said that it's true, they do like to see numbers closer to 100 on the first beta but that she has seen cases where it's lower and the pregnancy still progresses normally. As long as it doubles at the next bloodwork and so on then the first number shouldn't affect anything. Still, I don't like hearing that the number is low.

At the end of the conversation when I was really rattled at all the things that could go wrong, I jokingly said, "So at no time do I get to sigh in relief?" and her response was, "Welcome to motherhood - this is forever!" So true.

At this point I'm just overall worried. I also stupidly took a HPT to try to reassure myself everything was still fine and got a super faint line, probably because my pee was so diluted from a day's worth of drinking. But seeing that faint line after hearing all the things that can go wrong just made me so sad and scared and worried.

There are no guarantees and I know this can be over in an instant. I hope it continues to grow and result in a happy healthy baby.

Grow, baby. Grow!

2WW thoughts....

I woke up this morning at 4:30 AM to use the bathroom and wasn't able to fall asleep afterward. It's unusual for me to wake up in the middle of the night, but once I'm up I'm up for good. I started thinking about all the steps that we need to get through in order for this to be real.

The beta needs to come out positive (high number? I don't know much about this stage and beyond). Then there's a second blood test to confirm numbers are rising. Then there's an ultrasound to check for heartbeat. At some point after that I assume I get released to my OB/GYN for the rest of the pregnancy, which comes with its own slew of appointments and tests: anatomy scan, diabetes check, etc. etc. There are probably a bunch of things that happen that I have no idea about since we were never there before.

There's no guarantee that pregnancy will last full term without complications (protein in urine? high blood pressure? preterm labor?) and then labor and delivery need to go well and the baby needs to survive infanthood with the dreaded SIDS lurking around every corner. Once it starts eating solids you have to make sure it doesn't choke on a grape or a button lying around or randomly sticks a fork in an electrical socket.

Even once you're past all that and your kid becomes a walking toddler, happily playing on vacation, some monster can come out of the water and snatch him away. If puberty and bullying don't get to him first, he might become a young adult hanging out with his friends who ends up in a club with a terrorist and a semi-automatic weapon.

No matter what we do, we cannot predict the future or protect them forever. It scares me all the steps that need to go right in order for this to happen for us to have a health child. It scares me more to think about the responsibility entrusted to us if having a child does become a reality.

I'm no expert, but I'm going to guess that these thoughts are part of the reason I couldn't fall asleep again at 4:30 in the morning.

T minus 1

What a weekend! I had lots of wine, sushi, and deli - yum! Stocking up for what will hopefully be a long hiatus from those. I did the grocery shopping for the week and for Shavuot. I also started cooking and stocking the freezer. Over the weekend our AC conked out so now the house is incredibly hot and they can't get anyone here sooner than Wednesday to fix it.

I started today full of hope and excitement. I organized the house yesterday and sorted through all the mail in prep for the cleaning company today. I had the good kind of nervous butterflies all morning and texted my husband about it. Then my RE called around lunchtime with a random clinical question and after taking care of that, I was like, "Hey doc, while I got you on the phone..." and I asked whether there was a plan in case this transfer doesn't work. The conversation left me worried and anxious.

In general my doctor has an ok bedside manner but sometimes I feel like he's annoyed at me for asking questions. I don't care. We pay a lot of money for treatment and it's his job to answer whatever questions I have. This is the third FET of a strong, healthy, PGS-tested, 6 day blast. We're literally giving these embryos the best chance possible and success rates range around 60% so if there's something else that can be done to help it succeed, I want to know about it. According to my chart, everything is ok with lining and bloodwork, and there's no visible reason for it not to work. I asked what the plan is if it doesn't work and at first he kind of avoided the question, instead suggesting that we should be positive and hope for the best. After I pressed, he said can recommend an invasive test for $850 where they biopsy my uterus lining for two cycles in a row to try and get some answers as to why the embryos don't stick. Besides sounding painful and invasive, it doesn't sound like he thinks it will give any conclusive answers. I hope it doesn't get to that.

I had the house cleaned today and I love that it's all clean, even though it's hot. I also had my massage this evening and I feel ready. Hopefully the AC repair guys will find a quick fix for the AC in time to get it working for the long weekend. I have guests coming and I don't want to cancel but will if it's too hot - I wouldn't subject anyone to that.

I talked to a friend about my anxieties and it helped calm me down. It also happens to be Erev Rosh Chodesh Sivan and someone on FB posted that it's a special time to daven for children. I found the prayer online in Hebrew and English which is called A Parent's Prayer . It applies to parents-to-be as well, and I got choked up at, "Hear my plea and grant me sons and daughters" in the second paragraph. I know it's all up to Him and regardless of what I do it's He who decides whether we will merit having kids of our own.

Tomorrow is Rosh Chodesh Sivan and I plan to get up early in time to daven and say hallel. I'm grateful we got to this point and I appreciate all the good we've been given every step of the way. We're lucky we have three embryos to transfer and I feel blessed that we got this far. I hope that it is in His plan to help this FET be successful.