fertility work-up: the second time is twice as nice!

Nearly three years have passed since I last went through a fertility workup, and I am due for a repeat. The standard workup consists of a battery of tests. All things being equal, in terms of number of tests, simple blood analysis make up the majority. I couldn't give you an exact number, but I have learned that it's best not to count the number of vial labels that the lab tech exchanges for the lab requisition slip (one label per tube, at least three tubes per work up). Also-note that the pre test instructions are not theoretical. During my first work up, in my mid twenties, I made the mistake of having an FSH analysis (I think it was an FSH analysis, anyway) shortly after taking a dose of Clomid. I wouldn't recommend that particular course of action unless you are the bizarre sort of comedian who wants your ob/gyn to think you are a candidate for premature ovarian failure.

Certain other tests, including follicle counts with the craftily designed transvaginal ultrasound, (in the interest of not getting booted off Blogger, I’m not going to include a link) do not exactly rank high on the fun list, but can be gotten through. Others, such as the HSG, are rather unforgettable and I will in no uncertain terms drink bleach if I am made to repeat that particular test again. I will say, with regard to the HSG, that I object to the idea far more than the actual procedure, which was uncomfortable but not painful. Luckily, the only tests I need to repeat are the labs and the follicle count.

Because no test has ever indicated a definitive cause of infertility, there's not a good reason for me to worry about the results, which doesn’t mean that there aren't plenty of other shoddily constructed and weakly articulated reasons. I'm one of those people who subscribes to the idea that if you don't believe in the principle of induction, (not to be confused with a similarly named step in the IVF procedure) the principle of induction doesn't apply to you, much like ghosts for children or hell for athiests. I am absolutely aware that people who go around verbally articulating these things are irritating to be around, but by God, I've earned it, what with the rare cancer lottery and all. So just because a test has come back normal five out of five times, doesn't mean that, say, the sixth time, it's not going to indicate that I am not only in full-blown premature menaupause, but have contracted liver flukes and will any day now express a latent gene for supernumary teeth, because I've always had sort of questionable orthodontia.

All this is to say that I’m not having the tests re run until my next appointment with the endocrinologist, which will be in approximately 33 days +/-.

Comrades in ART(s)

Two years ago, I started trying to get pregnant. And then, because I was 35, about six months later, I started fertility treatments. In January, I amped up the intensity of that project by starting an IVF cycle. This is an intense thing, with lots of shots and appointments and nausea, and maybe that’s why I was able to ignore the frequency with which my mother was taking my father to doctors to address his fatigue. Maybe.

In March, the doctor retrieved a bunch of eggs, and my husband made his contribution, and then, like magic, there were these embryos sitting in a cryopreservation facility in San Jose California. My parents were thrilled. They talked about their hypothetical grandchildren as long as I can remember. Three days after the creation of these embryos, I went back down to San Jose and the doctor transferred two of them back into my uterus. A week later, while waiting to find out whether I was pregnant, my parents told me that my father had stage-four pancreatic cancer. He had between six and nine months to live. I was devastated. I was also, unbelievably, pregnant. Nine months, I thought. Nine months for my father to live. Nine months of gestation for his grandchild. Could I beat that deadline?

I spent the next few months in Florida with my parents. I went with them to the doctor appointments. I went with them to chemo. And one day, I drove myself to the emergency room and found out I was probably having a miscarriage. I went into the hospital for three days, because it was not a normal, routine miscarriage. And then the normal terrible series of events of cancer unfolded. My father died on May 31. I did not beat the deadline. I did not give my father the grandchild he had talked about all of my life.

And now I have started round two of IVF. Is it a sad, tragic time? Is it a hopeful adventure? I have no idea. What I do know is that in the books and blogs on fertility, they like to talk about a Fertility Journey, which makes it sound a lot more like a Carnival Cruise than the malarial jungle trek that it has been for me. Which bring me to the top three reasons for writing this blog, right here, right now, with Erin:

1. I am a Compulsive Information Gatherer: When I started IVF the first time, I went on Amazon and purchased a whole bunch of books. I did random internet searches, and scared the estrogen out of myself with those. I kept hoping to find the source that would tell me exactly how to give myself the shots, exactly what they would feel like, exactly when it was okay to feel hopeful, and exactly when it was okay to be annoyed that I have to go through all of this crap. I read all the books, and they gave some modicum of information about the process, but Erin was really my go-to person. As a bonus to her natural intelligence and writing skills and her personal experience with fertility treatments, she also has a medical background, so she actually knows how things work.
2. Erin is Entertaining: I find conversations with Erin to be endlessly witty, informative, and fascinating. Other people should have the opportunity to be entertained by her posts. Especially women going through IVF, who need all the entertainment and understanding they can get. And especially, especially women who are going through IVF after the recent loss of a parents, because, well, life just kind of sucks for them in a very particular way.
3. Comrades in ART(s): When my father was dying of cancer, I started to get the feeling that I didn’t want to be around people who hadn’t gone through a tragedy. Not that that there weren’t lovely, empathetic people who supported me through my first round of IVF and then through my miscarriage, and then again through my father’s hospitalizations and death. I was blessed with an amazing set of friends all through all of that. It’s just that the people who had lost a loved one, they really knew. It made me understand why people who go through war together have such a bond, because no matter how empathetic or well-read or a good listener, no one else really understands. And to add to that the Big Crazy that can be a result of Assisted Reproductive Technologies like IVF, well, it makes Erin my comrade in Assisted Reproductive Technology and Grief, it puts me in her elite Special Forces Unit of Fertility and Mortality.