Expectations: Counting Down

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When we scheduled Charlie’s egg-retrieval appointment for the middle of January, it felt like an interminable length of time away. Now, out of nowhere, it’s the end of December and our trip to Tucson is looming. Charlie and I talk nonstop about what will happen, what we hope will go right, what we’re terrified will go wrong. I’m so excited and so anxious that every day seems to fly by and crawl at the same time.

Charlie has finished his two cycles on birth control, and in the first week of January will start taking ovulation-stimulating drugs – “stimming,” in the parlance of trying-to-conceive blogs. He quits taking the Metformin, which was making him too nauseous, but is still dieting and biking to work, even in the cold of December mornings–we drop some serious cash at REI for winter riding gear, and he heads out in the morning before the sun is up.

The doctor has also banned alcohol–not a drop, he says, until after the procedure, although of course if the procedure goes well it will be a lot longer than that before Charlie has another drink. We had some tequila at Charlie’s coworker’s Halloween party, but since then Charlie is abstaining–and, in solidarity, so am I. This will be my first sober New Year’s Eve in at least eight years, but it seems like a good time to try holidays without drinking, as getting fucked up and puking in someone else’s bathroom becomes less and less appealing the closer I get to 30.

My friend Mickey comes to town from Arizona to stay with us for New Year’s, which happens to coincide with her birthday. She’s one of the few people who knows about our attempts to conceive, so when we tell her we’re not planning to drink when we ring in 2015 she’s understanding and even excited. Nineteen-year-old Lindsay would have been deeply disappointed in our New Year’s plans, but we end up staying at our house, playing pinochle, experimenting with mocktail recipes, and watching Marvel movies. It’s not the most thrilling New Year’s Eve I’ve ever spent, but it’s easily one of the most satisfying. These are two of my favorite people in the world, and spending time with them is so easy and joyful and relaxing. I want all of 2015 to be like this.

On January 1st, well-rested and not at all hungover, we drink tea and make our new year’s resolutions. Charlie’s goal for the year, of course, is to get pregnant. Mine is to support him as much as possible, to be the best possible partner I can while we go through all this frustration and difficulty. I also plan to finish my book-in-progress before its February due date, go back to therapy to deal with my anxiety, and generally take better care of myself this year.

A few days after Mickey leaves for Tucson, it’s time for Charlie to start giving himself nightly injections of follicle-stimulating hormone. The medication arrives, its delivery carefully scheduled for a time when I’ll be home, since it has to be refrigerated immediately.

On the first say of stimming, Charlie has to go to a local reproductive endocrinology clinic to get another snatch-wand ultrasound. This isn’t the same RE clinic where we had Charlie’s IUI procedures, since that doctor doesn’t work with IVF in any capacity. Instead, we had to find another practitioner in town and pay for the ultrasounds out of pocket, not to mention a frustrating amount of back-and-forth to get this clinic and the IVF doctor in Tucson on the same page about who’s allowed to see Charlie’s medical records.

The purpose of this ultrasound is twofold: to make sure that the birth control effectively thinned Charlie’s uterine lining, and to count the number of antral (AKA resting) follicles in his ovaries. Antral follicles are developed enough to be visible on ultrasound, as opposed to primordial follicles, which are microscopic. Fertility specialists consider antral follicle count a fairly reliable predictor of how someone’s ovaries will respond to stimulation; a high count usually means a high number of eggs retrieved, while a low count means a low number of eggs–or even a canceled cycle, if so few follicles respond that it’s not worth doing the retrieval surgery.

People with PCOS, like Charlie, often have high antral follicle counts and lots of eggs retrieved, but fewer eggs than average fertilize. Charlie also gets a blood test to determine his hormone levels; if they’re normal, we’ll have a better chance of a successful cycle.

Charlie has 52 antral follicles, which is way high. Even better, his blood test is normal. We are psyched. Charlie seems to be in exactly the category that has the best odds of success with IVF: under 30, lots of resting follicles, no hormonal abnormalities. We might get as many as 20 eggs–20 chances of pregnancy. This is going to work.

I watch YouTube videos about the medication Charlie is taking and memorize the procedure: attach the needle cap to the pre-filled medication “pen,” tap out any air bubbles, clean a patch of skin with an alcohol wipe, inject the needle at a 90-degree angle. Feeling like an expert, I offer to help Charlie with the injection, but he prefers to do it himself while I take pictures, immortalizing the process for our future baby scrapbook. Since he’s already done this twice while we were doing IUI, he’s a lot less squeamish out about it than I am.

I’ve watched several YouTube videos of other people undergoing IVF doing their self-injections, and they all totally freaked out beforehand–there are tears, panic, and a lot of swearing. This is definitely how I would behave if I had to give myself a shot, but Charlie is collected and cool. After the injection is done, he covers the tiny drop of blood with an Angry Birds Band-aid, throws the needle into the sharps receptacle we got from the RE clinic here in Denver, and poses for a picture holding up one finger. One day of injections down; 10 to go.

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