Sunday, October 31, 2010

A Love Letter

Today is Halloween--a cold, sleety/snowy Halloween. But it is also my one year wedding anniversary. Here's to you, Bryce...

Even though we have been married only a year, it already feels like a lifetime (in a good way). We have endured so much over the past year. We have managed to make it through tests and treatments and hopes and disappointments no worse for the wear--if anything we are stronger for having the difficulties that we face together. You have been an amazing support through all of the painful moments, especially since those moments are just as painful for you, too. You make me laugh and distract me when I'm feeling down. You put me in check when even Clomid or 18 ginormous follicles are not a good excuse for my poor behavior. You are patient, and giving, and so, so loving. I am so grateful that if I have to be going through this sad, maddening, and painful experience, that I am going through it with you--a partner who is supportive, loving, and has a great sense of humor. Someone who can stick a big, scary 1 1/2 inch needle in my ass while telling me he loves me...and I can believe it 100%. Someone who knows me so well that he can deflect conversations or comments made by others that may be too much for me to take before I even realize that my feelings may have been in jeopardy. Someone who doesn't mind that fertility treatments have taken their toll on my body and appreciates my curvier curves.

I really thought that we might celebrate our first anniversary with our baby already here, or at least on his/her way here. It makes me a little sad that at this point it may not even be possible to celebrate our second anniversary with our future child... but I am comforted because you love me so deeply and so completely that even if we celebrate our 5th anniversary with no baby, we will be happy together. I know because you told me so! So thank you--thank you for being my friend, my lover, my nurse, my pillow, my support, my comedian, my litterbox-cleaner. Thank you for loving me so beautifully, for much longer than the one year we have been married. Thank you for being the father of our future children, no matter when or from where they come. How can we not be fabulous parents when we have such a solid foundation of love between us and such a desperate longing?

Happy anniversary, Bryce. I love you so, so, so, so much.

Thursday, October 28, 2010

Testing, Testing...

With infertility comes a lot of tests. What's wrong? Which part is wrong? How many parts are wrong? In the beginning, the tests can help you figure out if you are dealing with male factor or female factor, or both. They can help you figure out which course of treatment is best for you. Or, they can invade your body and NOT tell you anything about why you can't get pregnant. I am lucky to have a definitive diagnosis (PCOS and male factor infertility). Even though it sucks to be in a position to have a diagnosis, there is a clear reason for why I can't get pregnant. I can't imagine how frustrating it must be to be labeled with "unexplained infertility."

Testing is on my mind because I am checking two more tests, hopefully my last, off my list this month. Today I had a Saline Sonohistogram, and I've been in the midst of a Clomid Challenge Test for a week now. But, up until this point I have also had oodles of blood tests to gauge hormone levels, Bryce has had oodles of semen analyses, and I have had two HSGs. Some of these tests occur during your initial workup. Some of these tests will come up after you've started treatment and there's an idea that there may be further sleuthing to do. And some of these tests you may want to ask for.

Semen Analysis: Ok, so I didn't go through this one, but it's one of the first tests a clinic (or your OB/GYN) will do to rule out male factor. This is most commonly the only test that the men going through fertility treatment have to do. Basically, they provide their contribution in a cup--this is called "collecting." They can collect at home or at the clinic, in a lovely room with dorm-style furniture (that is hopefully easily sanitized) and a host of supposedly exciting magazines and/or videotapes. There are also explicit instructions on how to make sure that your sample stays sterile (and by sterile I mean uncontaminated. Bad choice of words). Your partner can go in the room with you and there are specific instructions for what you can and can't do to "help." It is a very bizarre setup. If you collect at home, you have to live 45 minutes or less from the clinic and you have to keep the sample warm en route. Which means it gets tucked into your pants or in your bra if you (the lucky lady) are delivering the goods alone. It seems like boys get off easy (haha) here--their test is somewhat familiar territory to them and supposedly "fun." But, speaking for the boys, there is a tremendous amount of pressure to perform in this situation. It is not fun. There are people walking by the collection room at the clinic and people are waiting (in the case of IVF, really clear that they are WAITING for you so that they can get mixing). Or your wife or partner is sitting in the car, not so patiently waiting for you to come out with your cup so that you won't be late for your appointment at the clinic. There is a lot of stress and uncertainty and feelings of having your manliness judged by the meager contents of a sterile cup. It is definitely not a sexy moment. I think the best thing you can do is have an honest conversation about what works for your guy. Some guys welcome help, and others want to just be left to do their thing. You can talk to your clinic and see if collecting there is less stressful than collecting at home--everyone wants you to have the best possible sample. Once the sample is in the andrologist's lab, it is analyzed. You get a report that explains the quality of the sperm. It will tell you the total number of sperm in the sample. Then it will tell you the total motile sperm per sample. "Motile" is the same as "good swimmer." It will also tell you the morphology, or the shape of the sperm. Odd-shaped sperm don't swim as well and can't fertilize, so those count against you. The average man has 40 million sperm. When you have male factor, it's way less. Or it can be not so much less, but those that are there are not good swimmers, funny-looking, or both. If you have 20 million sperm but only 2 million are motile, that's not so great. In order for IUI to be a truly viable option with a good prognosis you need to have 10 million or more, or so we have been told. BUT, male factor infertility can be pretty treatable, at least in the IVF stage. You only need 100,000 motile sperm to qualify for a financing program for IVF at my clinic--that's pretty amazing. And, as people say over, and over, and OVER, "It only takes one." 

Blood Tests: The lucky lady gets these. All the time. They start in testing and then just keep on coming. You will have blood tests to check your thyroid (sometimes that's the culprit). To check your prolactin levels (too much of the hormone prolactin can cause irregular ovulation). To check your estrogen, progesterone, and FSH (follicle stimulating hormone) levels. Your FSH levels will tell you what your ovarian reserve is--how many quality eggs you have to play with and the likelihood that you will be able to get and stay pregnant. Levels that are too high early in a cycle indicate a low ovarian reserve and possible premature ovarian failure. You actually want low levels of FSH. High estrogen at the start of your cycle can also indicate poor ovarian reserve. Estrogen levels should steadily increase when you are responding to treatment (or normal and producing a healthy mature follicle). Then there's progesterone. That comes from the empty follicle sac (called the corpus luteum) and tells your body to keep that uterine lining nice and plush so that an embryo can implant itself and stay there. If you have low progesterone levels, or they drop too soon, then you might be able to have a fertilized egg become an embryo but your uterus can't sustain it through implantation. If this is the only issue it's great--they can give you progesterone support in the form of suppositories, gel, or shots. Or in my case you can add this to a host of issues, but at least there's a fix for this one. The Clomid Challenge Test is also a blood test, but you have to take Clomid cycle days 5-9. They look at your FSH levels on day 2 or 3 and then they look again around day 10 to make sure you have a good ovarian reserve. I am actually not sure why you take Clomid for this other than maybe it causes your body to start the process if it wouldn't otherwise, but it seems just mean to have such a nasty little drug be a part of a test. 

HSG: This is the Hysterosalpingogram (go ahead, try to say it!). It looks at your uterine cavity and the tubes to make sure they are clear. It is usually done at the hospital. They do an x-ray of your uterus and fallopian tubes while they are pushing dye through your uterus and out your tubes. Sound uncomfortable? It is. Some people have no problem with the HSG--a little pinching, a little cramping, that's it. That was not my experience. I actually had the HSG twice in a 2-month period because there was an error in the first one. An error where the radiologist did not do the test correctly. There is a balloon on the catheter that is supposed to inflate and then sit like a stopper in your cervix to keep the dye in your uterus and the pressure such that the dye can be easily pushed through the tubes if they're clear. In my case, the balloon was in the middle of my uterus and so there wasn't enough pressure. So the doctor told me that both my tubes were blocked, which would have made all my IUIs up until that point a total and complete waste of time, and would mean IVF was my only chance barring surgical correction, since you don't need tubes to do IVF. Understandably I was very, very upset. Especially since I had already done 5 IUIs and was in the middle of a 6th, and had requested the HSG since it was not a part of my initial workup. Luckily for me, upon reviewing the films and seeing the error, my doctor at the clinic called for a re-do, that he personally would administer, and which turned out normal. My tubes were not blocked at all. Whew! It just stunk that I had to do a painful test twice to figure that out. My thoughts on the HSG: Definitely take ibuprofen before to help take the edge off. I honestly don't know why they don't offer light sedation for this test! Know that your husband or partner can't come into the room with you, since it's an x-ray. He will be able to come in with you to review the results later, after you've really needed a hand to hold and squeeze.  Request that a reproductive endocrinologist (RE) from your clinic perform the test, not a radiologist. I love radiologists and they are very nice and talented people. But radiologists perform a lot of different tests throughout the days and weeks, and they do NOT do a lot of HSGs. REs do these ALL THE TIME and so it will most likely be faster, more comfortable, and more accurate if you have an RE do it. And, lastly, I would ask for this test if it is not part of your early work-up. If your tubes are clear, you are all set and have one less thing to worry about. If not, you will find out before spend time and money and mental energy on IUI cycles that will not work because of tubal blockage. 

Saline Sonohistogram: This test looks solely at your uterus. You can do it in the doctor's office, no need to go to the hospital. It is also not as uncomfortable as the HSG, although I had one today and while it was less uncomfortable during the procedure, I feel much more tender afterwards. I did take Advil before just like the HSG, but it didn't seem to be too effective. The HSG looks at the periphery of the uterus, while the saline sonohistogram looks at your entire uterine cavity. It can unearth fibroids and polyps that may have been missed on an HSG that could compromise your ability to carry. I asked for this test because I wanted to make absolutely sure before we paid a lot of money to put my body through IVF again that NOTHING was physically wrong with my uterus. The actual test is kind of cool--a catheter with a balloon (again with the balloon!) is passed through the cervix and a saline solution is injected into your uterus to highlight what's inside. At the same time, the lovely internal ultrasound is making a nice movie of your innards on the screen. It's a little crowded down there. But, luckily for me, this test was also normal--there is no physical reason why a little nugget couldn't nestle into my womb for nice long while. That peace of mind is definitely worth the discomfort. 

So there you have it--some tests that we have gone through in the course of our infertility journey. There are others, of course, for both men and women, but hopefully I won't have to experience those too! 

Thursday, October 21, 2010

Little White Pills of Evil

I am not a fan of Clomid. It looks harmless enough--tiny white pills, no needle necessary. It's often the first level of treatment when you go in for infertility concerns. Your OB/GYN can prescribe it. You don't even need to see a specialist to get it.

What is it? It's a drug that works on your brain to tell your ovaries to produce more eggs than usual. Basically, your ovaries will typically produce one big follicle that will release one mature egg each month. Usually your ovaries will alternate sides, so your left produces this month and your right produces next month (and so on and so on). But, when either you aren't producing follicles or you need to produce more than one to increase your odds (say if you have male factor to contend with, or you're doing an intrauterine insemination (IUI) and the goal is 1-3 eggs released), Clomid comes in to the rescue. It prompts your ovaries to make a few follicles at once. It's notorious for producing "Clomid Twins." I have stubborn ovaries with poor listening skills, so historically for me Clomid tells my ovaries to produce and my ovaries do... nothing. 

Doesn't sound too terribly bad, right? Except that Clomid works with your brain. And it alters your brain chemistry. And turns some people (including me) totally batshit crazy while they are on it. Emotionally, I am all over the place on this drug. I cry. I curl up in a little depressed ball like a pillbug. I snipe and snap. I turn into a total raving bitch from hell over nothing. I also feel completely and totally overwhelmed by absolutely everything and nothing, all at the same time. And, it sneaks up on you--for me, I don't feel the affects until I've been taking the drug for a couple of days. But once those couple of days have passed, watch out! I had to spill the beans that I was going through some medical stuff with my administrator last year because I got all hot and bothered and teary eyed in a parent meeting while on Clomid. I pulled over to cry because a cat came within 100 feet of my car and I was convinced I was going to hit it, or I had almost hit it, or something equally ridiculous. Road rage is at an all-time high while taking this medication. My husband is a very, very good man for putting up with me while on Clomid. I really, really, really hate this drug.

So why am I writing about Clomid now, when I have moved on to IVF, which in no way, shape, or form uses it as a stimulating drug? Because apparently before I can do IVF again under the refund program my clinic offers, I need to undergo a Clomid Challenge Test. This test looks at my FSH levels to see if I have lots of eggs in my ovarian reserve or if it is low and therefore an indicator that I won't respond well to IVF. Even though I have already done one IVF cycle and shown myself to be a good responder to the drugs (even if my embryos weren't so great), the test is a requirement for the refund program application. I'm just irritated because I did 4 cycles of Clomid last year, and they were not fun. I thought Clomid was behind me. I thought I would never have to take Clomid again. And yet, here I am again, getting ready to take the drug of insanity for no actual productive reason. It's a requirement for the refund program, so if I want to potentially save a ton of money and have an "insurance policy" for the next cycle or 3-6, Clomid it is. 

I will do my best to manage Clomid-induced weepiness and rages with grace, but consider yourselves warned. Hopefully November will return me to my normal, non-psychotic self. 

Saturday, October 16, 2010

Stop Sneaking Up On Me!

I was really proud of myself yesterday. Home sick, I watched Julie & Julia in bed and I didn't cry. Why would I cry during a feel-good movie about a beloved famous chef and a slightly whiny blogger in Queens? Because it is also a movie about infertility. It only shows up twice in the movie and it's subtle--the first hint is Julia's longing look at a baby buggy while walking in Paris with her husband. The second is the scene that had me sobbing in the movie theater last summer--Julia receives a letter announcing her newly married sister's pregnancy and dissolves into tears, snuffling into her husband's chest while trying to be positive, "Isn't it wonderful? I'm just so, so happy." That scene so accurately captures the conflicted feelings of getting someone else's pregnancy news--she really is happy for her sister but just gut-wrenchingly sad for herself. When I saw the movie the first time, we hadn't officially started on the journey but knew it was ahead of us. The uncertainty of what we were facing was what really made me so upset at that scene. I had no idea just how easy or difficult it was going to be for us, and putting myself in the shoes of someone who had no choices to go to a clinic and get pregnant scientifically was incredibly sad.

The book Julie & Julia actually has more infertility pieces to it, because Julie Powell has PCOS and is constantly talking about how she's going to die fat, hairy, and childless because of it (oddly, they left that out of the movie...). Which brings me to the amazing amount of books, TV shows, movies, etc. that have incorporated infertility into their plotlines. I should be really happy about this--more exposure means more conversations about it and more openness that will hopefully lead to better care and treatment. However, it would be really, really nice to be able to crack open a book or go to the movies or turn on the TV and NOT have infertility smack me in the face when I turn to those media for escape. I can't tell you how many books I have read that were not actually about infertility but were just infested with it. A few examples: The Know It All by A.J. Jacobs--a book about a man who decides to read the entire Encyclopedia Brittanica -- also includes his struggle with infertility throughout the book. While I appreciated a book with the male perspective, I was not looking for a book on infertility when I picked that one up! Three Junes by Julia Glass--a book following a Scottish family through three summers where the main protaganist is gay--also includes the infertility struggles of a couple as a prominent subplot. The Ten-Year Nap by Meg Wolitzer--a novel (admittedly ill-advised but a really good read) about different women's decisions to stay home with their children or work and the impact that has on their families and professional lives--one of the main characters suffers through infertility and adopts a child from Russia. Not one of these books mentions the subplots in their flap copy or reviews. I feel like I've been suckerpunched when this happens--here I am reading a book for entertainment and BAM! Infertility in my FACE!

Same thing with TV shows. I don't watch TV very often but love my Grey's Anatomy. Hot surgeons behaving like horny adolescents is just so much fun! And yet, in that world of hot sex in the on-call room and bizarre health conditions needing rare surgeries, infertility has weaseled its way in too. In the very intense, very scary shooter-in-the-hospital season finale, Meredith discovers that she is pregnant only to miscarry during the trauma of the day. Now this season has a steady subplot of infertility--apparently she has a "hostile uterus" and fibroids. No doubt she will go through various procedures and medications on the show, taking my completely unrealistic, sexy hour of escape and morphing it into more reality than I am really looking for right now.

Movies, too--there's been a slew of movies about choosing single motherhood, none of which I have seen and all of which piss me off. In these movies, the women figure out their sperm donor, go in for one IUI (intrauterine insemination), and POOF! Pregnant. Pretty irritating for someone who has sperm (albeit "special" sperm) at the ready and has done 6 IUIs and 1 IVF and still has yet to get pregnant. AND, through support groups, I know of a few ladies who have chosen this path of single motherhood by choice, and none of them have gotten knocked up after one IUI. Totally unrealistic. But I guess having J.Lo enduring tons of bloodwork and tests and attempt after attempt would make for an unentertaining date movie premise. Juno is a movie that I think handles the family-building topic well but makes me cry--I can't chuckle with Ellen Page's sarcastic pregnant teen because I am too busy connecting with Jennifer Garner's infertility and her hope that this adoption won't fall through like her previous attempts. I cry through the whole movie now. But at least with Juno and the other movies like it, the infertility aspect is up front and center--there is no sneak attack.

I think this is why Julie & Julia didn't make me cry this time around--I knew what was coming. The first time it was totally unexpected--I was going to a movie about food and Paris and accomplishing something before turning 30, not the brief but memorable tribute to Julia Child's pain over not having children. This time I could steel myself up for it. So while I am happy that infertility seems to be a "hot" topic right now, and it's getting attention and exposure, I'm also kind of not. I feel a little like there should be warnings (instead of S for sexuality or L for language, IF for infertility reference) so that people like me going through infertility aren't thrown off guard by the sneaky inclusion of a very painful topic in entertainment that's sought out for the purpose of escaping the emotionally-charged reality of treatment.

Monday, October 11, 2010

What's Your Number?

If you are on message boards, or you are at a support group, or just in casual conversation with someone who is in the know about your infertility, you will inevitably be asked this question: "How long have you been trying?" It can feel like a competition (I've been trying for xx long years so I have a right to complain), or a validation of success (They got pregnant with twins after 5 years of trying, they really deserved it).

I have my own feelings about this question, because the number of years I have been trying does not actually accurately present my circumstance. You sit in a support group circle and say you've been trying for 1 year and suddenly you feel like maybe you are a whiner next to all these women who have been trying for 2, 3, 4 and more years. But, everyone's circumstance is different. You can be trying for 6 months and have it be a horrible, urgent experience because your husband was diagnosed with cancer and you have to beat the clock before radiation. You can be trying for 4 years, but be counting a year of "not-not trying" and then a couple years of stretching out treatments because you're still in your mid-twenties and feel like you have the time to take it slowly. You could be trying for 3 years and have started treatment at 6 months but then could only afford a treatment opportunity once every year. There are lots of different scenarios for lots of different experiences. I don't think the number of years you have been trying really matters.

Of course, this could be because I am a 1-year tryer, and sometimes feel sensitive that my "number" doesn't give the full story on my experience. Usually people count the requisite year of trying on their own. I didn't have to do that, because we already knew from Bryce trying on his own pre-me that we were facing significant male factor. There was no need to waste time trying on our own because we already knew that wasn't likely to work out well for us. So, we started with a consultation last September and our first Clomid IUI cycle in November (because call me crazy, I wanted to wait to do a cycle until we were actually married. We had our wedding October 31st and I started meds November 2.). We ran through cycles pretty quickly, not taking any time off until after my second injectible IUI cycle in April. After we got the no-go on that cycle in early May, I scheduled some tests and then we took a few months off before starting IVF in August. Our situation is unique but probably not too terribly rare--jumping right into treatment because of a known issue only to have more issues crop up. I am SO glad that we did not have to spend time trying on our own, because between the male factor and the PCOS our chances of conceiving on our own are low, low, LOW. So, we've condensed a whole lot of trying time into one jam-packed year (so far).

It's depressing when we really sit down to really think about it--although we started out right away with wasting no time and getting right into treatment cycles, it means that we've robbed ourselves of a few things. We didn't get the exciting time period of charting and having mystical, meaningful "babymaking" sex. (For those of you who have done this and had it not work out, I'm sure it stops being mystical and starts being a chore and takes the wonder out of the process after a while, but it would have been nice to have the option.) I pretty much never get to pee on a stick--people in labs and clinics know I'm not pregnant before I do. Because of the medications I am strongly urged to NOT pee on a stick because the HCG trigger shot I have to take before procedures can mimic a positive pregnancy test, and because the blood test is so much more reliable. And, most importantly, we have spent our entire first year of marriage, our newlywed year, the year of romance and new bliss, all on this process. Our money goes into this process. Our emotions go into this process. Our time certainly goes into this process. It is draining. It is depressing. But, it will all be worth it if we can just get all the stars to converge and align and go from tired, strung-out-on-medications, cranky, weepy, discouraged, financially imprisoned, overscheduled newlyweds to tired, strung-out-on-no-sleep, weepy, financially imprisoned, overscheduled, but completely blissed-out new parents.

Friday, October 8, 2010

It's My Pity Party and I'll Cry If I Want To

The oddest things can make me cry. I'm not even under the influence of hormone medications right now, which can make me weepy and/or rabid for no apparent reason. Tonight, after going to Maria's for a lovely dinner (including lovely margaritas which I am fully enjoying while not in treatment), we made two pit stops--Barnes & Noble and Target. At Barnes & Noble, I made it through the whole store without feeling sorry for myself. Even when I checked the infertility section to see if there were any new books I hadn't read yet that were interesting enough to buy (there weren't), and then when I pretended to look at the bargain book display but was really peripherally perusing the pregnancy and baby books to see if there was anything I'd want to buy sometime in the near future if things go well next time. No tears! No woe-is-me-here-I-am-looking-at-books-I-don't-need-while-I'm-tipsy-off-margaritas-because-I'm-decidedly-NOT-pregnant sadness. Next, off to Target to get cat food and hand soap among other things. I could look at adorable baby costumes and "Grandma's Little Boo" Halloween bibs no problem. (Especially since "Grandma's Little Boo" was a more than a little ridiculous.) I was even fine passing by all the impossibly tiny onesies, socks, and hats. I felt great, even boastful--look how well-adjusted I've become! Or...not.

Rocky nesting in a basket.
Do you know what sent me over the edge? What caused me to stand in a Target aisle, quietly sobbing and angrily hissing at my bewildered husband, "Would you just LET me be SAD already?!?" The cat aisle. The stupid, ridiculous cat toy aisle. There was a Kitty City bed thing that had two levels and a dangling moon. I thought about buying it for my cat, Rocky, who is effectively destroying the dining room chairs by nesting on them all day and night--this doodad would give him a soft place to curl up and a covered space to hide away in, like being under the table. Except the freakin' thing looked like a miniature pack-n-play. And the thought that I could buy a frigging pack-n-play type contraption for my cat but not for an actual baby depressed me to the point of tears. I had brief nightmarish flashes of a childless 45-year old me dressing up my cat in a bib reading "Grandma's Little Boo." The classic "it's just not fair" wail echoed in the back (and ricocheted off the front) of my mind. And I cried, tipsy and slightly empty-feeling, in the aisle full of catnip and laser pointers shaped like mice. Poor Bryce. He stood there helpless and bewildered--failing at attempts to cheer me up with silliness and inappropriate jokes because he can't stand to see me sad. But that's just inevitable during this stressful, emotionally draining time. Sometimes these things just sneak up on me and I just need a moment to be the crazy crying cat lady under the influence of Don Julio anejo tequila.

Sunday, October 3, 2010

Weighty Issues

My weight is not a steady thing. I have been as skinny as a size 6 and as voluptuous as a size 12 over the course of the past 6 years alone. No matter how thin I get, I always have a round belly. I recently found out that this tendency to carry extra weight and carry it in my midsection the way I do can be attributed to PCOS. Other things contribute to my ups and downs too, though--during my first marriage I was very unhappy and ballooned to my all-time high weight.  Within months of initiating my divorce I started to drop pounds--in part because I wasn't under constant stress, in part because I was feeling better and working out more often and eating better on my own. During this time I eventually dropped to a size 6. But, I don't think my body is meant to be a size 6. I went back up to a 10 when I started teaching full-time, but then dropped back to an 8 after going gluten-free.  8-10 seems to be where my body is happiest, but that is impossible to maintain right now.

Here's the crappy thing--carrying extra weight can hamper your fertility. PCOS (polycystic ovarian syndrome) makes you prone to carrying extra weight, especially in the unhealthy midsection of your body that, in turn, makes you more prone to diabetes and heart disease. Then you add in that all the medications you take for infertility, especially at the high doses needed for IVF,  also contribute to weight gain. On top of that, by the time you are getting ready for egg retrieval and your ovaries (once the size of almonds, now the size of large navel oranges) are sore and painful, you can't even imagine going to the gym. Then you go through the extraction process and are unable to exercise because you are recovering and your ovaries are even more sore, and you are bloated beyond what seems reasonable. Elastic pants (or no pants) are necessary and work is not possible. But then it's time for your embryo transfer, and you are put on strict orders to move as little as possible the day of and restrict activity for the next 3 days. Honestly, if you just spent thousands and thousands of dollars on this chance, to not restrict your activity would be just plain stupid. It's smart to protect that investment and fleeting chance at biological parenthood! So, that's at least a couple of weeks that the gym is either not appealing because it will be painful or not possible because you have been ordered to stay sedentary to protect the possibility of implantation. Which is highly irritating because tons of people who work out regularly get pregnant and don't realize it until later--so why do I have to languish on the couch and watch my ass spread out?

This is on my mind because I had frozen my gym membership for September since I wouldn't be going frequently due to the IVF attempt, and I un-froze it today. Going back to the gym felt good, because I have been feeling very pudgy lately. I gained about 10 pounds this summer between the fertility drugs, the procedures and recovery, and the no-exercise period to protect the embryo(s) that decided not to implant anyway. Because I am planning on doing this whole thing again relatively soon, I would really like to try to lose some of that 10 pounds before I feasibly put more weight on with my second cycle. I am perfectly ok with the idea of putting on weight because I am actually pregnant and sustaining a fetus, but putting on weight pre-pregnancy with no payout is frustrating. A little extra cushioning is ok with me since after egg retrieval I have to start progesterone in oil shots, which are very scary 1.5 inch intramuscular needles that go into the muscle of your behind--I feel like it's good to have a little buffer there for that process. But since I gain weight in my midsection and not my hips/butt area, it's hard to gather that cushioning without getting a bit excessively curvy everywhere else.

So, today I went back to the gym and am going to attempt to at least feel better about myself and maybe lose a few pounds before I get ready to gain some more in a little while. Hopefully this time I'll follow that up with some nice, healthy, pregnancy weight gain!