Being on birth control was nice and simple. It was a clear and easy break from the pressure and stress of it all. I started taking it in early December, when we got the results of the genetic test on Nugget 2. Took it through the hysteroscopy, and then it was January.
We went in to see the RE on Monday, January 4th. Two days after my birthday and a week after the hysteroscopy. I was nervous...I even told Michael it felt scary. I knew the next step was IVF, and I wanted to take that step, but I had this awful dread in the pit of my stomach. A fear mainly of putting myself in a position to get disappointed and emotionally broken again. The second miscarriage was awful, and as we were just pulling ourselves out of that grief, here we go again.
What if the hormones make me an emotional wreck? ,,,ahem, or more appropriately: "an even bigger emotional wreck than I already am at the moment?"
I have never given myself an injection before. What if I do it wrong?
Or stab myself in the finger by mistake?
What if I drop and break the expensive medicine when I stab myself in the finger?
Ok, assuming I don't stab myself, ruin all the medicine, and actually get the injection pat right, what if we don't get any follicles to grow?
What if we do get follicles, but didn't get any eggs?
Or what if we don't end up with any embryos? Can we handle that disappointment now!
It's a lot of work, hormones, discomfort, hope, and science to end up back at 0 again. That's awfully pessimistic, I know...but that was me at the beginning of January as we walked into the RE's office. All of these ridiculous questions and more were swimming around in my fearful head.
As usual, he made us feel better about the whole thing, especially when he said that for someone my age, it's very rare to have to "cancel" a cycle (stop shots due to poor response / not enough follicles) or even end up with no embryos. He said they would go forward even if I only had 3 follicles when it's time to retrieve.
He performed the ulrasound to check my baseline, and there was a hitch. I had a cyst on my right ovary measuring 13mm. The risk of starting injections (or "stims" as they are often referred to by the initiated), is that the cyst that is there might get all the benefit, when it might not even have an egg in it. If other follicles grow, the cyst, taking up the space that it is now (or more, if it grows) could get in the way of their healthy development. It was clear that a blank slate is more optimal as a starting point, and ironically the first time my ovaries were over-performing vs. expectations, just in the exact wrong way. Figures.
He said cysts like this are common after miscarriage and invasive procedures like the hysteroscopy. The nurse would go ahead and teach us how to mix and give the shots today, but that the blood tests needed to come back with my estrogen at a certain level and I needed to come back for another scan later that week to see if the cyst is shrinking.
Now nervous at the prospect of NOT getting to start the IVF cycle due to my craptastic and belligerent ovaries (overreaction, sure, but exactly what I was thinking), we were led into another room where we were asked to sit down amidst what seemed like a buffet of injection paraphernalia. The nurse went to get some instructions on paper, and I locked in on a GINORMOUS needle staring back at me from the array. I do not like needles...not that anyone really does, I suppose...but I could feel my blood pressure rising. She came back, arranged the notes alongside the supplies, and began to walk through what would become our nightly routine. One of the first steps, thank the Lord!, was to remove that awful 20 gauge needle, and replace it with a much smaller one. Whew! There were way more steps than I expected. I will bore you with them later in another post... We received our very own needle buffet in the mail in a large styrofoam cooler the following day.
I came back that Thursday. For the past 2 days, the injection medicines had been safely stashed in my refrigerator, behind the milk, which was less intimidating not to have to see them the instant you open the damn door. The scan showed that cyst was the same size as before, which after so many of these ultrasounds, I could now tell as he measured it, before he said it. Here were my already uncooperative ovaries just continuing to make things difficult... We had two options: wait another month on the birth control, and see what the cyst does, or take our chances. The RE seemed on the fence. When he recalled how long we had already been on birth control (since Dec 2) and how low my estrogen level already was, his opinion took a turn. He said the cyst wouldn't likely shrink much further with another month of birth control. In fact, being on the birth control for much longer would more likely have the opposite effect, suppressing my ovaries into a state that would be even less responsive to the hormones. He recommended that we go ahead with the "stims". Chances were good that the cyst wouldn't be an issue at all (this was not an uncommon obstacle in IVF), and he would keep an eye on it as we go, just in case.
It was after the Monday appointment, but even more so during this discussion on Thursday, that I realized how much I wanted this to happen. The chance of NOT getting to go ahead and having to wait another month suddenly struck me as far less desirable than jumping in head-first now. I still left feeling uneasy about the shots we would start on Sunday, January 10th, only 3 days away, but now we were both pretty excited to take the plunge. We left the office hand-in-hand, excited and hopeful for the first time since early November.
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