Monthly Archives: January 2010

I choose to call it Focus rather than Obsession

Today on my OPK I saw that second faint line and was greatly relieved. Thank you for your comments which reassured me that it isn’t all that unusual to only get one line.

Now that this small issue has been resolved, I have started focussing on another, also small, issue (and yes, I think of it as dedicated focus rather than obsessing!). I have to do something to keep myself occupied, after all.

Now that I am a “charter” I was reading some of the information on Fertility Friend about temperature changes at ovulation. My temps seem to be pretty erratic, and I was wondering how FF would be able to identify a true temperature shift in the midst of such a mess. FF kindly informed me that after ovulation my temps should rise by about 0.2 degress celsius. And herein lies the rub. My temp has been varying by more than 0.5 degrees since I started temping, so any temp rise will be obscured by the background changes.

 

So…. am I doing it wrong? No, I don’t think so. I’m waking at at the same time every day, I take my temp before even turning on the light, and all other conditions are consistent. And that leaves me wondering… do I need to buy a new thermometer?

I haven’t been looking at other charts to see what the usual spread of temps is, because, well that seems to cross the line between focus and obsession.

After thinking about it a little today, I have decided that I will continue doing what I’m doing for the remainder of this cycle. If my CD23 bloods confirm that I ovulated but my temps were too erratic to pinpoint ovulation on my chart (and assuming I get a BFN) I will buy a new thermometer for next time. Any excuse for a shopping trip, right?

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Filed under Charting, Infertility

A Shout-Out to All My Peeps

Dear Bloggy friends,

Thank you for your support after my little tantrum earlier this week, I felt much better once I got that out of my system. It was nice to know that I’m not the only one who gets a bit carried away at times.

I don’t want to be needy, but could you help me with something else?

I’ve been using OPKs for the last two days and something strange is going on: I’m only getting one line. I don’t claim to be an expert, but I thought two lines were the norm. Last cycle I got two lines every time, it was just the darkness of the test line that changed.

And this odd little development has me second-guessing everything. I was feeling confident about this cycle but now I’m feeling suspicious that I might not even ovulate.

So my question is: does the mysterious absence of that little purple line mean this cycle is a bust?

♥ Tio

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What’s in a Name?

I’m patient about a lot of things. I’m patient with children; I used to work as an Intervention Therapist with Autistic pre-schoolers – that took a lot of patience. I’m patient with animals; our family dog had a rough start in life and needed a lot of patient training. I’m occasionally even patient with my husband.

But I called myself The Impatient Optimist because I am, most definitely, NOT patient about trying to conceive.

 Today I am particularly impatient.

Last night I had a dream – the second this week – in which I was pregnant. I peed on a stick and right before my eyes two lines appeared, two of the darkest pink lines to ever appear on a HPT. And I felt so happy. And even more overwhelming than the happiness was the relief.  During my dreams I am almost invariably aware that I am dreaming. But these two dreams (although unrealistic in ways only dreams can be) felt very real. That relief was real. There was no running commentary in my head saying “WARNING: this is a dream”. And as a result I’ve had a strange day. At times I have been calm – that nagging sense that something is missing from my life has been gone. At other times I feel sad because I remember that those wonderful feelings were just an illusion. I almost feel like I’ve lost something.

I logged in to Google Reader this afternoon for my daily blog-a-thon. There were 28 updates. Twenty-eight! So I settled down with the Australian Open playing in the background and I started reading. And as I was reading I felt myself becoming more and more impatient. Sure there are stories of success (Kate and Stef for example) but there are also stories of loss, of cycle after cycle with nothing to show for it but heartache, of people coming to terms with giving up their dream because – damn it! – they just can’t bear to do it any longer. And it struck me….

(Just a warning, dear readers. I’m about to throw a tantrum – a genuine, squealing, foot-stamping, fist-pounding tantrum. I dare any two-year old to do better. So, if you’re not in the mood for a bit of self-indulgent whining, just skip this part).

… IT’S BLOODY NOT FAIR!! Why the hell do any of us have to go through this? As much as I love the ALI community, as much as I’ve enjoyed getting to know people I would never have otherwise made contact with, I just don’t want to be here! I don’t want any of us to be here!

I know I have a lot to be grateful for. I seem to be responding well to the Clomid. As far as we know, now that I’m ovulating there shouldn’t really be any reason we can’t conceive. Yes, we’ve really only had one unsuccessful cycle, because I only started the Clomid in December. There’s a pretty good shot that we won’t need to advance as far as IVF – so really, I shouldn’t be complaining.

But today, I just don’t care.

I’m impatient. We waited more than two months to see our FS and get our treatment started. We spent 7 months before that hoping my cycles would regulate and we would conceive on our own. We spent 2 months investigating my prolactin and dealing with the adenoma before we could even start trying to conceive. And before the diagnosis we spent 6 months wondering why the hell I wasn’t having periods.

I’m sick of the “what if’s?”. I’m sick of wondering where this stupid IF journey will take us. I’m sick of worrying that it might never happen. I’m even sick of the optimism. In a month’s time I’m going home to visit my family for a 4-day weekend. And I keep thinking…. wouldn’t it just be great to be able to tell my mum, in person, that I’m pregnant? STOP IT! I’m tired of the day dreams and I’m tired of the waiting.

I. Just. Want. To. Be. Pregnant. RIGHT. NOW!

NOW, DAMN IT!!!!!!!

 

Whew…. I feel better already.

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Filed under Infertility, Photos

Big News and a Tale of Two Countries

I have an announcement. It’s a big one. In fact, it’s HUGE. So prepare yourselves, sit securely in your seat, this is going to Blow. You. Away.

I have started charting.

Um, so maybe it’s not that big an announcement. And my chart doesn’t look like much yet. But I’ve never done it before, and to be honest I didn’t think I ever would. It’s just not that big a deal in the Land Down Under and in my experience it’s not common for TTCers to take temperatures, chart cervical mucus and analyse graphs. In the end I made the decision to chart because the inactivity of my last 2WW almost drove me crazy, and I hope that the small daily act of charting might give me a sanity-saving – although totally false – sense of control. 

This difference between Australia and the US made me think. One of the things that I have noticed from all my blog reading is the difference in fertility treatments between Australia and the US.  The drugs are much the same, and some of the protocols are similar, but the process itself is totally different.

To start with, unless they have specific gynaecological issues, most childless young women here do not have an Obs/Gynae. They see their GP for pap smears and the like. So right from the start of the IF process we are referred to a Fertility Specialist.

And that’s another thing. In the Land Down Under our IF docs are trained O&Gs who have sub-specialised in fertility. In theory it is possible to be a fertility specialist by training as a physician, specialising in Endocrinology, and then sub-specialising in reproductive endocrinology, but I don’t personally know any doctors who have done that.

Then there is the amount of monitoring throughout a cycle. I’m doing 4 cycles of Clomid, with no monitoring except for one blood test on CD23 (LH, β-hCG, Progesterone). This suits me, although sometimes I do wish there was more monitoring just to give me a sense of purpose! I’m sure I would get more monitoring if I was doing injectables, but even so… you gals in the US sure do have to undergo a lot of blood tests and ultrasounds!

In terms of IVF, the level of monitoring seems more similar. But the big difference is that in Australia and New Zealand it is uncommon for a FS to transfer more than one embryo. They will only do it if, after lots of discussion, the couple absolutely insists. While it is common for REs in the US to routinely transfer two or even three or four embryos, any FS who routinely transferred two embryos would be considered a renegade, and to be honest would probably find it difficult to get a job in any major clinic. They are absolutely prohibited from transferring more than two embryos. Fertility clinics consider multiple births a blight on their reputation, and the aim is always one healthy baby and one healthy mother. Which system is best is a matter of opinion. Based on some (admittedly haphazard) research our rates of pregnancy per IVF cycle are lower (around 30% per egg retrieval), but so are the rates of complications. There are two main IVF clinics in Melbourne, and they differ slightly. The pregnancy rates and hyperstimulation stats are roughly equivalent, but the clinic my FS is linked to base their model of care on day 2 transfers and do less monitoring than the other clinic.

To be honest, despite the fact that I like to feel proactive, the relatively non-invasive treatment plan suits me. I work at a job that is almost totally inflexible and getting time off for appointments can be tricky. Doctor’s appointments play havoc with my psyche because although I usually feel reassured after one, I feel uniformly anxious beforehand. If we need to move on to injectables or IVF I’ll do what it takes to make it work, but in the meantime I’m enjoying the sense of normality that the system here provides. That’s one of the reasons that I chose to see a FS linked to my particular clinic – the less disruption to my life the better!

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Filed under Charting, Doctors, Infertility

Occupational Hazard

I started my Clomid last night, and today I was a bit of a wreck. I don’t have any physical side effects but after H’s less-than-subtle comments last cycle I’m was alert for mood changes. I had a rough day at work today, and to be fair I can’t really blame that on the Clomid, but it does seem to impede my ability to cope. Sometimes today, in an endeavour to distract myself from tears, I imagined Clomid as a balaclava-clad criminal who had hand-cuffed and hog-tied my usually resilient coping skills before locking them in the trunk of an abandoned car. I wanted to cry. I wanted to yell. I wanted a nap. And, dammit, I wanted the keys to that trunk!!

It’s not really the Clomid at fault though. To be truthful, it’s been a rough week at work. It’s busy, and we just don’t seem to be able to get on top of our workload. But that is only part of the problem.

At the moment I work on a psychiatric ward. Challenging work at best, and occasionally distressing. But this week I have found it difficult for a new reason. We have a patient on the ward who has been very unwell but who is thankfully getting better. I have been involved in several in-depth discussions with her this week. Just like all of us, she has many problems. One of her major issues is that she has been through 10 years of IVF treatment. She does have one child, but she has also suffered numerous failed attempts, side effects, and miscarriages. She’s undergone two laparoscopies. And recently, when it became clear that at 48 years old there would be no more pregnancies, she had to make the decision to destroy the last of her frozen embryos. She sobbed as she told me this. To her, these embryos were her child’s brothers and sisters.

I don’t want to suggest that infertility or IVF are the reason this woman is unwell. She had mental health problems for some years before she began fertility treatments. But it was clear listening to her that the whole experience has been hugely traumatic. She refused any blood tests when she was admitted to hospital because after so many blood tests and injections during IVF she now has a needle phobia. She has so much scar tissue in her abdomen from laparoscopies and a caesarean section that she developed a sub-acute bowel obstruction this week. Her marriage has slowly disintegrated while she focussed all her energy on IVF and her husband withdrew emotionally to avoid the pain and disappointment. They gave up on sex years before they finally gave up on IVF.

As if this story was not already too close to home, I soon discovered another commonality. She too had been diagnosed with a pituitary adenoma. She was treated with the exact same medication I was due to start before my Prolactin levels mysteriously normalised, much to my Endocrinologist’s amazement. This medication, Bromocriptine, seriously messes with the Dopamine levels in your brain and one of it’s more serious side-effects is psychosis. When my doctor discussed this drug he told H that he would need to be vigilant about monitoring my mental state. H, ever the jester, postulated aloud that Psychotic Tio probably wouldn’t be all that different from Everyday Tio. It might seem like a cheeky comment to make in a doctor’s office, but it made me smile. This comment reminded me that my darling H wouldn’t let me take things too seriously, and it told me that he wasn’t scared to face whatever might lie ahead.

But this woman, who already suffers from psychosis, needed to take a medication that causes psychosis in order to have a chance at conceiving. How much scarier can it get?

I tried to remind myself that to some degree, her story is one of success. She has a child that she adores. But I just couldn’t shake the horrible feeling that to some degree, this woman will never recover from the trauma of IVF.

It was confronting to sit and listen to this story. I wanted to reach out and hug this woman, but I could not. I wanted to cry, but I could not. I wanted to excuse myself from the room, run from the building, drive desperately home and give H a great big hug. But I could not.

I have had a sobering reminder this week of just how destructive infertility can be.  I am going to have to carefully assess my emotional state tomorrow before I decide if I can walk back into that interview room.

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Filed under Clomid, Infertility, Photos, Pituitary Adenoma

Day One, the Second Time Around

It’s CD1! I’m tired, and sore, and grumpy. Cramps woke me up out of a sound sleep at 3am this morning. But I don’t care, because tomorrow I get to start Clomid again, and that makes me happy and hopeful.

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Breaking News!

Progesterone: 22.5

Finally, my ovaries have done something I can feel proud of.

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Filed under Charting, Infertility, Ovulation