IVF Round 1, Baseline

Somewhere after the consult with our RE and before my last CD1, DH told me he was solidly ready for a third child. There would be many logistics to work out to make sure things that matter to him are still possible, but having a third was worth the challenge to him. So with CD1, I called my RE's office. I got scheduled for their IVF class just over two weeks out. Took the class, then had the nurse consult where she asked if I was tracking my surge. Sure was, I said. It was yesterday, I said. Great, she said! I'll send your calendar and you'll start priming this weekend.

So there we are. I'm doing ~10 days of estrogen priming, 3 days of antagonist priming, baseline, then stims. It'll be a Gonal F, Menopur, Saizen, Dexamethasone protocol with cetrotide as the antagonist.

Baseline/suppression check was today and my AFC was 8. That's seven on the right, one on the left. Overall, I'm really happy with that, and am just pleading with them all to respond. I'm now awaiting the call to confirm the start of stims this weekend. I was relieved to hear that DH will be allowed in recovery with me after ER.

I am so grateful that I'm not going into this with the same sense of desperation I felt in all my past cycles. I am hopeful, but at peace with any outcome. Given the insurance I now have, it's in my best interest to do 3 back to back cycles. My total cost will wind up around $12k for that, which is unbelieveably amazing. If I can't get a third living child from 3 rounds, I'm ready to be done. If we get ~3 PGS normals, I'll have a pre-pregnancy lap TAC done. If not, we'll see.

Wish me and my old ovaries luck and responsiveness?

Baby Book: 15 Months

The last month has flown by, although I feel as if we had fewer new developments between 14 and 15 than between other months. Perhaps that's me taking things for granted. The kids continue to be amazing, and I love every second. I'm getting increasingly worried that neither has any obvious spoken words, but both have solid receptive language and decent sign language. We'll ask at their ped appointment in another week and see what she says. So much love and joy in the house with these two!

• A is now walking, running, and can actually walk up the first step of the staircase on his own. 
• A continues to have the most fabulous grin in the world, and remains a happy little dude.
• A also continues to have trouble falling asleep. He gets a full hour sleep per day less than his sister does because he takes so much longer to fall asleep. He's nice and calm, and just plays with his lovey in his crib the whole time.
• We got them a craft table with stools, and A immediately and expertly sat on his stool to play on the table.
• The craft table came with storage bins that are nearly as long as A and T. Both kids immediately started playing with the bins, running around with them, sitting in them, and generally  having fun. 
• A is mellow. He lets his sister steal toys, mostly without complaint, and he'll give her things she wants without getting upset. He's a sweetheart, and I feel the need to protect him so his sister doesn't overrun him!

• T also sits up on her new craft stool by herself. 
• T has developed the ability to stand up from a squat, and also to stand up with her legs far apart and then draw them in to walk. 
• T will find her jacket on the sofa, bring it over to you, and put one arm in so you can help her put the other arm in.
• My mom brought T and A a wooden puzzle. One piece is a circle with a picture of an apple. T has not let go of that wooden circle in the ~10 days she's had it. It goes on every stroller ride, it goes on every nap. We pry it out of her hands for bath time, but it's the second or third thing we hand her when she wakes up, and her face lights up like you wouldn't believe! 
• T loves to wave at things. When the chipmunk appears in the window behind her in that picture, she waves. When we see deer outside, she waves. When people arrive, she waves. 
• T takes what she wants. Whatever A has, T wants. She doesn't respond well to redirection in those cases. She tantrums. The next few years will be fun, I think! 

Body of Work

My body and I have never been overly fond of each other. I was largely raised by an amazing grandmother who practiced food as love. I had juvenile rheumatoid arthritis. I had a thyroid tumor irradiated during college. As a result, my pre-pregnancy weight has bounced from a high school low of 115 to a grad school high somewhere around 160 (I stopped getting on the scale after 155).

When I got engaged, I decided to clean up my act and vowed never to go above 125 again. I kept that vow until pregnancy. Still, even at my lowest weight, even at my fittest, I have always been ashamed of how I look. I finished my first bike century in 2015, and felt so good about myself until the moment I sat down in the car and looked at my thighs. My immediate thought was “those look like walruses. Sure you can ride 100 miles, but maybe if you rode without eating so much, something good would come from it.” Even as I thought it, I knew just how fucked up it was, but I couldn’t stop the thought.

At the start of each pregnancy, I was 118. With A and T, my weight gain topped at 23 pounds. I stress ate my way through their NICU stay and came home at 127. I reached 124 by the time I returned to work. I was 120 by their first birthday. I’m 116 now.

Writing that down, it looks awesome. I, on the other hand, do not look awesome.

This 116 is not a good 116. Yes, my arms rock, from carrying around 20+ pound babies. My back is stronger. I can do lunges (to stand while holding a baby) like nobody’s business. I’m fit enough to walk the 5 mile around-the-lake-loop in 16 minute miles and then do another 3 miles with the babies in the stroller later in the day. But that’s where the good ends. My middle? My middle is just thick. I don’t look 116 in my middle. I look pregnant in my middle.

Here’s the thing: as upset as I am at my body, I am even more upset at my mind for being upset with my body. I *hate* that this takes up headspace. Further, I look at T and I would do just about anything to keep her from experiencing the self-hatred that I feel. I practice positive mental self talk. I practice observing without judging: “Hey, look, it’s a body” vs “Hey, look, I’m tubby.” The farthest I’ve been able to come after years of this is to instantly recognize that my negative self talk isn’t helpful and to occasionally observe without judging. Having this new post-partum body, though, that’s reduced the observe without judging ability. Turns out I was only observing without judging when I was thinner.

Because of my daughter, I will keep trying. Because I want her to have a healthy relationship with her own body. And with food. Because of my daughter I will tell my mom, bluntly, to STFU when she ‘jokingly’ comments that T needs to stop drinking so many bottles because she’s got a big belly. (Yes, she said this before T was 1. Yes, I told her to STFU. Yes, I see where my issues might have come from.) Maybe I’ll be able to make progress again. Maybe not. I heard that wisdom comes with age, so maybe greater acceptance will too. That said, I’m still waiting on my wisdom!

Carrying On

Our house has an amazing 'three season room'. Note: 'three season room' seems to be a Minnesota term for an enclosed, windowed, unheated/cooled space. Not sure what part of the country it could be used for all 3 seasons in, with our freezing fall/spring temperatures, I'd go with more of a 'two season room'. Still, from the time the temperatures hit the 70s until they drop again, it's my favorite place in the house. It's on the second story and is surrounded by trees, so it feels like being in a tree house. It contains the patio table that I bought as a kitchen table in grad school (end of season closeout, cheapest option I could find), and the matching uber-comfy swivel rockers. I love to sit out there with my feet up, enjoying the view and relaxing.

Because it's my favorite room, I have some fairly indelible memories associated with it.

• I remember sitting in a chair, reading everything I could find about low AMH and successful pregnancies with low AMH after getting my results back in 2016.
• I remember sitting in a chair, feet up, arugula and chickpea salad in my lap, utterly amazed after the call saying my second beta had risen with Alexis and Zoe's pregnancy.
• I remember chatting with the nurse about the fact that I was bleeding at the start of Alexis and Zoe's pregnancy, and being told to keep my feet up and minimize my activity levels. I remember being sure that the pregnancy was ending due to the bleeding, after having lost my last three pregnancies back to back in the first tri.
• I remember sitting out there with my dad, stepmom, and DH trying to act like life was normal the first weeks home after losing Quinn. 
• I remember reading every infertility & loss/TAC blog I could find, searching for some hope that maybe someday I'd take a baby home. Searching for a glimpse into what my future might hold.

After all those memories, we had our first dinner of 2020 out there the first weekend in May. We brought out the twins' high chairs and fed them with us. My MIL was feeding T and DH was feeding A, and because of the layout of the room, all I could see was T's little hand, waving at me over MIL's shoulder. That wave brought all the other memories back. All of those memories of wanting children and being so afraid that I'd never have living ones. Seeing that little waving hand created one more indelible memory. All the emotions of the last four years washed over me, leaving me grateful beyond words for where I am today, but with a greater appreciation that I have every right to be emotionally exhausted.

As I prep to embark on an IVF cycle with my next CD1, I know I'll be running another emotional ultra-marathon. As much as I want to start reading again in the futile hope that some corner of the internet will be able to tell me my outcomes before they happen, I know that corner doesn't exist. I will have to keep journeying, keep making new memories. I'll have to live with those memories, no matter what the outcome. I think that's the scary part of heading into IVF - not the IVF itself, or even that it won't work. I think the scary part is knowing that it too will create indelible memories that I'll have to carry for the rest of my life and that will change me. I hope that the possibility for a happy ending is worth the cost of that burden. We'll see.

The End of an Era

Today marks the end of an era. Today the babies, who are no longer babies but now full fledged toddlers, got their last bottle of breast milk.

I ran the numbers, because I was curious. We've tracked every single bottle of breast milk and formula since they came home from the hospital. The spreadsheet tells me that's been 2,829 bottles of breastmilk, for a total of 358,443 ml. If you haven't lived the NICU life and gotten used to measuring everything in ml, that's 12,120 oz.

They've also had 1,774 bottles of formula, for a total of 275,159 ml or 9,304 oz of formula. In case anyone is wondering, I did the math on that. With Neosure until they hit 9 months, and then Similac Advanced after, we've spent a total of $1,981 on formula. Yikes!

Overall, I'm really proud of myself. My goal was to give at least some breast milk until they hit one. If I could stockpile enough in the freezer to make it to one adjusted, even better. I met those goal. Pumping was awful, it was miserable, it slowed my physical recovery by months. Heck, it took more than six weeks after my last pumping session for the skin to stop peeling off my nipples daily. That was the first time since the babies' birth that I could dry myself off after a shower without wincing in pain when the towel touched my chest. Despite all that, and despite the fact that applying any logic at all makes it seem like it was a terrible idea to pump for so long, I'm glad I did. Providing breast milk was one thing I felt I could do for my children after being in so many situations where no amount of physical sacrifice would help them. It may not make any difference at all to them physically, but it gave me a measure of mental relief. So I'll take it and be proud of what I accomplished.

Tomorrow morning will be hard for all of us, I suspect. We'll get up and get straw cups of milk. I suspect the babies will miss lounging in their twin-z pillow with their warm bottles. I'll miss knowing I was the one providing for them. As much as I love watching growth and change, sometimes even the best of progress is hard, and this is one of those times.