24 weeks

Twenty-four weeks and holding strong. Dr. Awesome told me at my last appointment that if my cervix hasn't budged by now, it probably isn't going to open prematurely and took me off the weekly monitoring schedule. Or, as he puts it, the "million dollar ultrasound machine" schedule. Now when I go in every two to three weeks, he checks the babies for movement and heartbeats using the "hundred thousand dollar machine." I don't get to have any more million dollar scans until the babies are big enough to weigh and they start doing the biophysical profiles. While I know this is the best possible news, I'm going to miss those high resolution scans and weekly confirmation that the babes are alive and kicking.

Fortunately, they now let me know on a regular basis that they are alive by kicking the heck out of me. Baby number 3 is the most active (or perhaps just has the most room); her territory is the upper right quadrant of my abdomen. In fact, she is pounding out a little rhythm as I am typing this. I also feel babies 1 & 2, but as they are both on the left side and kind of overlapping, it's harder to distinguish who is responsible for the movement unless it occurs at the very top or bottom of my belly. I've been able to see and feel them from the outside but so far my husband has missed the show.

I had the follow-up appointment with my new cardiologist and my heart is fine, so that's a relief. The new cardiologist was quite the character. I told her that they are all girls and she turned to my husband and said "poor you" to which my husband replied "as long as they all love their daddy." Without missing a beat, she turned to me and said, "oh, they always love the daddy; it's the mommy that they hate." She had a couple of other good lines, we quite liked her. In other pregnancy fun, I'm retaining a fair amount of water and having a lot of swelling in my legs and feet. Still dealing with mild nausea and now reflux and figuring at this point that it's not going away until after the babies are born.

We're still working on setting a price with our contractor so we can get a few improvements done on our house, hopefully they'll be starting work in a week or two. I ordered fabrics for the girls' room and have started to look at baby gear but haven't bought anything yet. I figure that as long as I have it all picked out, we'll have plenty of time to buy things as the time they will be needed draws nearer.

22 weeks

Finally, a belly shot to prove that I am indeed pregnant:

Phew, I'm tired. I just returned from a trip to the west coast to see my family. The babies went crazy on the flights there, kicking and squirming like I had never felt before, must have been the changes in pressure. It was a good trip, but a little more difficult to travel at this stage in pregnancy than I had anticipated (see photo). Airplane seats were uncomfortable, walking through airports dragging my bag was tiring and having to fit into all sorts of unfamiliar compact cars was a challenge. Despite the minor inconveniences, it was fun to show off my bump and I was always mindful that this would be my last solo trip for some time to come, so I tried to get as much quality time as I could with family and friends.

My mom and I took a trip to the most wonderful wool shop where she treated me to gorgeous wool to make sweaters, hats and booties for the babes. She did not, however, approve of my choice of deep plum, mauve and sage green as she is still firmly of the opinion that appropriate colors for babies are white, cream, pale pink and pale blue. Ahem.

Although I somehow managed to gain four pounds this week (!) I am still dealing with background nausea and threw up twice. It's more irritating that incapacitating, but it would be nice to just feel "normal" again. My monitoring appointment on Wednesday turned out to be another fetal survey which was very difficult to get through as I can't lay on my back for more than five minutes without feeling like I'm going to pass out. I had to keep rolling from side to side and sitting up during the exam and wasn't really able to concentrate on watching the babies on the screen because I was so uncomfortable. They all look fantastic and are starting to look pretty darn cute, if I say so myself. Cervix is still holding strong and Dr. Awesome told me everything was looking perfect and that I didn't have to come back for another two weeks.

I did get some sad news: my cardiologist died this week very unexpectedly. It was quite upsetting, even though we'd only met him once, both my husband and I had enjoyed talking to him and felt very comfortable having me in his care. And his poor family, losing him right before the holidays, so very difficult. It was a sobering reminder of how short life is and how precious these three new little lives inside of me truly are.

20 weeks

I just returned from my weekly monitoring appointment. My cervix is still holding strong and all three babes are looking good. I was catching up on some other triplet blogs and realize how different the management of triplet pregnancies is depending on the doctor and the hospital. So many women seem to be put on mandatory bed rest, or are told how much weight to gain or otherwise terrorized into very conservative behaviour without any indications that it is necessary. My doctor, who delivers ~30 sets of triplets per year, has fully informed me of the possible complications of this pregnancy, and monitors me accordingly, but has put no restrictions on my activities. I really appreciate this sort of approach; I know I'm in a high risk category of pregnancy and I feel well taken care of, but no on is trying to instill unnecessary fear in me. Good thing, too, because I am a total worrier and prone to assume the worst.

For example, last Friday I came home from a busy day/week of work and noticed that my ankles were so swollen that I couldn't see my ankle bones. I freaked out, assuming that I was developing congestive heart failure (I am being following by a cardiologist, after all) or pre-eclampsia and was going to die, lose the babies or both. Seriously, I was sobbing uncontrollably. My bewildered but ever rational husband consulted Dr. Google and informed me that this sort of swelling was normal for any pregnancy and managed to calm me down. At my appointment today, I asked Dr. Awesome about it and informed me I had possible courses of action: (1) to ignore it, or (2) to put my feet up and that whichever option I chose, the swelling was only going to get worse as the pregnancy progressed. Can you see why I love Dr. Awesome so much?

Everything else pregnancy-related is going well, I still have loads of energy, good appetite despite the mild lingering nausea and am occaisonally feeling the top two babies move, although it's a lot more pinching and sharp poking than the delightful tickles that most people seem to experience at this point. Still no food cravings (I'm being to think that this cravings business is a convenient excuse to eat a lot of junk food :) although I do enjoy my daily ration of the extruded chick pea snacks that we get at the local Indian grocery.

19 weeks

Still feeling great with the exception of the occaisonal mild GI upset and a strange taste in my mouth that will not go away. I'm in full time maternity clothes now and loving every inch of my baby bump: my husband says it grows bigger every day and is just as enamoured with it as I am. He loves to say hello to his girls and we've spent many an early morning talking about potential names and wondering just who these babies are. Friday night I was knitting on the sofa and definitely felt baby #3 (top right) move and called him in, but of course it's still too early to feel anything from the outside. It was pretty amazing; it felt just like I was being lightly tickled from the inside. There have been a few other times I thought I felt some movement, but wasn't sure until this most recent occaison. I was told I would feel movement later than usual becasue the positions of all three placentas are on the anterior of my uterus, providing an extra layer of insulation between me and the babes. Yup, they are already locked in their rooms with the doors closed :)

It was a beautiful weekend here. Sunday we went for breakfast at our favorite diner and then managed to get out later in the day for a walk in the woods. It was much harder than the last hike we did, but I just took it slow and accepted a little help up the steeper parts from my husband. We came across a family with two little girls and my husband commented that he couldn't wait to hear his three calling "Daddy, Daddy." So sweet.

Hopefully I'll be able to make a trip out to see my family in the next couple of weeks, but I would really like to get an H1N1 vaccination before I travel. Unfortunately, due to the limited supply, I haven't yet reached the top of the priority list at my doctor's office. I'm torn, I really don't think I'm in any greater danger getting on an airplane that I am going about my daily life at home, but my husband is feeling very protective and doesn't want me to take any chances. We'll see what they say when I go in for my weekly ultrasound tomorrow.

Care to join the sorority?

There are currently four members, though I'm the only one who seems to have any actual responsibility, you could call me the house mother. For the other three it's just party, party, party and non-stop skinny-dipping. No alcohol allowed and we haven't finalized our name, though ABC is what we're going with for now. My husband is feeling a wee bit left out and really, who can blame him? It's not like he took to his bed in despair (it was just a short nap) or expressed any misgivings about missing out on the full experience of parenthood (?) or suggested there might be a fourth child in our future (when Hell freezes over) or anything like that. He's already rising to the occasion; calling out "where are my girls?" whenever he enters the room and banning cheerleading in favor of soccer and music lessons.

Three perfect baby girls, can you believe it?

18 weeks

It's hard to believe I have summitted the half-way mark in this pregnancy. I just stopped feeling horrible all the time, my bump has only been getting attention from strangers for a couple of weeks, how can I been on the downward slope already? It reminds me of one of my friends who had her second son at 30 weeks lamenting "I was barely pregnant." At least in my situation, I know the numbers going in and have some time to prepare for our three little premies. And nesting I am. We have a call in to a contractor to have a few long-standing items on our wish list taken care of. Upgrading our basement bathroom to accomodate my MIL when she comes for an extended stay to help with the babies, stuff like that. Nothing that absolutely has to happen, but things that will make life more comfortable with a house full of people.

Overall, I've been feeling great. Lots of energy, good appetite and the desire to plan meals and cook again. Still some lingering nausea (Saturday was bad) but I'm definitely having more good days than bad. There was an incident last night involving too much tofu eggplant stir-fry (the stuff is crack to me) that I am still paying for, but I can't blame pregnancy for that one. I went to yoga last week for the first time in many moons and it was hilarious. So much harder to negotiate poses with an unyielding baby bump, I must have looked ridiculous. Regardless, it felt so good to stretch that I'm heading back this week for more.

I've submitted to maternity pants even though they don't quite stay up yet because my regular pants are just too uncomfortable. Underwear was a challenge until I discovered the GAP hipsters and they are just right. It was horrifying to discover how many truly ugly and ill-fitting maternity undies are out there, and how much they cost. And I'm not even talking about the maternity thongs which, in my opinion, are just plain ridiculous.

Tomorrow is our first fetal survey; the ultrasound where they will take a look at all the organs and see how our little babes are developing. I say first fetal survey because, at my monitoring appointment last week, the ultrasound technician was of the opinion that the babies would still be too small to see everything this week. Fingers crossed that we'll at least learn the sexes; the suspense is killing me. Plus, people are offering us all sorts of baby items and I don't want to accept a bag full of pink frilly clothes if we are having all boys. I don't have any sort of feeling about who is hanging out in there, but I was at a "Ladies Night Out" event last week and had a tarot reading in which the psychic told me I was having two boys and a girl. We shall see (and soon, I hope).

17 weeks

Our first monitoring appointment last Wednesday went perfectly. The babies looked great, they are all measuring the same and keeping pace with their gestational age. The ultrasound technician tried to determine their sexes, but 2/3 were non-compliant and the technician only took a quick peek at the third so I'm waiting for further confirmation before I'll believe it. My cervix hasn't changed and all of my vitals were normal so I was in and out of the office in short order. I also had my cardiologist appointment where baseline data were collected, again all normal. I'll go back for follow-up in a couple of months and have an echo-cardiogram done. The number of ultrasounds that I'll have accumulated of my various body parts by the time the babies get here is quite astounding. Still having more good days with less nausea and I've regained my nearly normal pre-pregnancy appetite. My beacon of hope through these past 11 weeks of feeling craptastic has been the knowledge that I would once again be interested in eating lobster (my absolute favorite treat) and I think I'm nearly lobster ready, so progress is definitely being made.

We celebrated our friends' son's third birthday on Saturday which was lots of fun. They are expecting their second son in three weeks and the mom looks and feels fantastic, which was encouraging. Also at the party were a couple with a 5 1/2 week old baby boy who I was able to snuggle with for a good long time (I may have monopolized him just a little). He was so tiny and still at that floppy newborn stage but starting to make eye contact and smile. He is a very relaxed baby, hopefully some of his easy-going vibes made their way to my little ones when I was holding him. I had a bit of a shock when I realized that at 9.5 pounds, he was twice as big as our babies will be when they are born - yikes.

I'm starting to buy a few maternity items and went out to try on a few things yesterday but I'm still at that intermediate stage with the maternity stuff is way too big but I need the longer shirts and lower waists to accommodate my bump. On the home front, we're discussing which room to turn into the nursery. My husband has already turned into super-protective dad and is adamant that the babies are going to sleep in our room because "anything can happen with babies" and he's convinced he won't be able to sleep if they're not right next to us. He's very sweet, but really, it's not like they're going to spontaneously combust.

16 weeks

After 3 days of feeling pretty darn good in the nausea department, I celebrated the 16 week milestone by losing my breakfast a mere 30 minutes after consuming it. I think I have to resign myself to the reality that, unlike the start when I was fine one day and sick as a dog the next, there is going to be no clearly defined end to my morning sickness. It really is getting better, my food repertoire is steadily increasing, my husband no longer has to make coffee in the garage and I'm down to a few mints or pieces of gum per day. I'm just so sick of being sick and fussy about food, I wish I'd wake up one morning and feel normal again.

On Saturday I braved the rain to go look for a fall/winter coat (since I can't zip or button any of the ones in my closet) and headed to a local Gap maternity. It was pretty disappointing, they had only a fraction of the items on their website and no coats. I did pick up a pair of maternity jeans and a sweater that were on sale, but despite my impressive bump (my husband is in awe) it's really too soon for me to wear them. I'm still good with my one size up from usual jeans and long T-shirts. My husband has repeatedly offered to buy me a poncho for the winter and I may have to take him up on it. Ponchos are in again, right?

In other pregnancy news, it's a lot harder to bend over to tie my shoes than it used to be; my mid-section feels rather firm and unyielding. Maybe it's the skin stretching or just the change of seasons and dry air, but my belly is also really itchy. And why did no one warn me about the congestion and snoring? Twice I've woken up to find my husband has defected to the guest bed, even the cats don't want to sleep in the same room as me.

I start my weekly monitoring appointments on Wednesday and can't wait to get another peek at the babies. The appointment with the cardiologist I'm less excited about, but I'm having my husband come with me for moral support so it shouldn't be too bad.

15 weeks

Not much new on the pregnancy progression front; still growing a belly, still nauseous and pukey but eating better (relatively speaking) and easily winded. As in, I walk up one flight of stairs and am huffing and puffing in the most embarassing way. I'm ready for activation of my second trimester super powers any time but they are still MIA. Was I supposed to fill out a form or something?

People have been saying weird things to me. More than one coworker has heard about my pregnancy and approached with with congratulations, which is very nice until they get to the follow-up questions. Just this morning, in fact, I ran into a colleague in our cafeteria who was giddy with excitement (why are 50+ year-old woman so excited about pregnancy? I find it odd and somewhat disturbing). After the usual "how are you feeling, how far along" questions, her manner became very serious and she said "you're going to need help, you know" followed by "there's no way I could do it." To which I replied "no shit, Sherlock yes, we'll probably need a hand" and "I really don't have a choice WTF? seriously?."

It's like people think I'm sitting around eating sushi and soft cheese with a glass of wine while ordering baby Uggs and silver rattles online. Don't get me wrong, I am in no way offended by such comments, I just can't imagine that anyone who knows of our situation would think we were doing anything other than obsessively running through our options and trying to prepare for the parenting tsunami heading our way. Trust me, people who have never been pregnant with triplets, this scares me way more than it does you.

14 weeks

Let's see, where were we? Oh yes, I was still feeling incredibly icky and waking up nauseous and pukey in the middle of the night. Last week was pretty rough and I ended up staying home from work on Friday because I woke up sick at 2 am and then 4 am and couldn't get back to sleep. It was so worth a sick day; I slept all morning and then had another nap in the afternoon and felt somewhat refreshed by the evening. It takes a lot of energy to put on a happy face and charge through my day pretending I'm not on the verge of vomiting in front of my coworkers, truly it does.

The weekend went pretty well, I woke up feeling nearly normal on Saturday so we headed out to the Sear's outlet to buy a new refrigerator. Our current fridge was old when we bought the house, the door handle falls off constantly and it's definitely not big enough for a family of five, especially when we have visitors. We found my dream refrigerator (French door, bottom freezer) for 45% off retail price so we bought it and it was delivered the next day. As with most items at the outlet, it is brand new but with some visible damage: fortunately this one just has a few dents that aren't really visible and some scraping on the freezer door handle that we will doctor with some touch-up paint. It is beautiful (I keep sneaking into the kitchen to gaze upon its loveliness) and so much quieter than our old one, which now lives in the garage as our overflow cold storage.

I don't want to jinx things, but I *may* *possibly* be feeling better. Still fussy about foods, still mildly nauseous most of the time, but I managed to go to the grocery store on Monday and actually buy ingredients for a few dinners; actual meal planning, it's progress. Today I enjoyed a cup of black tea for the first time in 7 weeks and managed to go 4 hours without eating anything with no negative ramifications. I've got my fingers crossed, but I'm not declaring myself out of the woods yet.

There has been progress in the baby belly; there is really no hiding the fact that I am pregnant at this point. It's really sensitive, I don't even like my husband touching it. I think I'm at 4-5 pounds for weight gain at this point, but our scale is kind of fickle so I'm not positive. We have been having fun thinking about names, although my husband is not taking the process as seriously as he should. For three girls, he suggested we use the ABC theme and celebrate our three nationalities with America, Bosnia and Canada and he thinks it would be hilarious to have three boys named Jeremiah, Jedediah and Jebediah. All I have to say about that is that the nurses in the hospital will be under strict instructions not to let him near the birth certificates.

13 weeks

Hi there babies, it's me, Mom.

Remember me, the owner of the uterus where you are currently hosting your wild house party? I'm delighted that you are making yourselves at home, but do you think you could quit with the secreting of whatever toxins or other chemicals that are making me sick? I imagine it's hilarity akin to riding a really awesome roller coaster when I throw up, but it's time to stop, OK? Mommy doesn't like emptying the contents of her stomach and spending every waking minute trying not to throw up is tiring and inconvenient. And what's with the middle of the night vomiting, don't you guys have thumbs to suck or something to keep yourselves entertained while I sleep? Really, it's only polite.

I promise you that once you get to the other side and start breathing air with the rest of us, I'm not going to question your diet or lifestyle choices. But Mommy is not a vegetarian and she'd appreciate being able to have a steak or a pork chop once in a while. She'd also appreciate a little more leniency with the fresh fruit and vegetables and she'd really, really like to be able to have a chai latte sometime in the next 22 weeks. Trust me, it's never too soon to have open minds, which is something you might want to consider if you have any leanings towards tattoos or body piercings in your futures. Pay it forward, you won't regret it.

Love,

Mom

My crunchy granola side

I really, really want to use cloth diapers. I did a rough back-of-the-envelope calculation and estimated we would spend $9000 on disposable diapers over three years. I'm pretty sure I could buy a complete set of the adorable Fuzzibunz diapers for less than $1000, and there's no way we would spend another $8000 on water/electricity/detergent. Frankly, it would be nice to put that money into college funds rather than literally throwing it away. Plus, the idea of disposing human waste into a landfill is abhorrent to me, it really is supposed to go into the sewage system so that it can be properly treated. My husband is revolted by the idea of diapers in general (he has never changed a diaper in his life) so he has no real objections (and is foolishly hoping his no-diaper changing record will remain intact).

Am I crazy to even think of undertaking such an enterprise with triplets?

Just another pregnant woman

I had my first real OB appointment yesterday with Dr. Awesome and Nurse B. It was so nice to walk into a waiting room full of pregnant women and feel like I belonged. Granted, I have a big old red sticker in my file reminding everyone of our high risk triplet status, but for the first time no one treated me like the fertility treatment failure that I have felt like up to now. Very refreshing. I was there for about an hour and half and came away feeling like I have a plan and an idea as to what the next few weeks are going to look like. Starting in October I will have weekly ultrasounds to check the length of my cervix. According to Dr. Awesome, if it doesn't start to shorten by 23 weeks it is unlikely to do so and I will graduate to bi-weekly appointments until my scheduled c-section after 35 weeks or I go into labor, whichever comes first. On average, triplet pregnancies last 32 weeks, but I fully intend to be one of those data points on the high end of the curve. Dr. Awesome told me that if I make it to 35 weeks I'll get to take the babies home with me, so that's my plan and I'm sticking to it. Other important events in October will be the big anatomy (and hopefully gender-revealing) ultrasound and a consulation with a cardiologist. The last one is not so fun, but Dr. Awesome has observed an increased incidence of cardiomyopathy in women of advanced maternal age with high order multiples and monitors all of his triplet moms who are over the age of 35.

Yesterday I told my manager that I was pregnant and he was thrilled for me, even after his eyes widened when I got to the triplet part. He also told me he'd been wondering for the last week or so because I have been "standing like a pregnant woman." My husband's supervisor said his wife asked him if I was pregnant after we saw them socially a couple of weeks ago, so I guess I'm definitely showing. So much for me thinking I was still incognito; the whole office is probably speculating about me and I'm the only one out of the loop. I won't be able to hide it much longer, I'm totally growing a baby belly and can no longer button any of my pants. This morning I had to resort to the elastic band trick to keep my jeans on. Thank heavens leggings, baggy tops and chunky sweaters are in style, hopefully I can get away without having to buy maternity clothes for a while longer.

In other news, I am cautiously optimistic that the nausea may be abating. I'm eating better (less frequently and healthier foods) and the horrible taste in my mouth is noticeably less horrible. Cinnamint Orbit is still my best friend, along with Hot Tamales, cinnamon Altoids and Genmaicha. I still shudder at the thought of a big hunk of meat, but I've been able to enjoy some juicy falling-off-the-bone roast chicken and homemade turkey curry meatball soup. My husband and I joined a gym last night and are planning to go swimming 3-4 times per week for as long as my doctor says it's ok (currently I have no restrictions). Bed rest is a real possibility at some point during the next 23 weeks, and I'd like to maintain as much muscle tone as possible in preparation (also because I'll be having major abdominal surgery).

Consultations & decisions

We had our triplet pregnancy consultation yesterday. It was a full day affair, starting with the nuchal translucency ultrasound and an opportunity to spend 20 minutes watching our little fetuses flip and stretch in their individual condos. They were all sleeping when the technician started, but soon woke up and started wriggling. One was curled up on his/her back with fists next to the face. Freaking adorable, I tell you. The results showed no indication of potential abnormalities which reduces my overall risk by 70% which was the best possible outcome.

After a lunch break we went back and spent an hour with the genetic counsellor. She was wonderful, and gave us lots of good information. I was surprised/disappointed to find out that they won't do either CVS or amniocentesis for all three fetuses as the risk of total pregnancy loss is too high. They will test 2/3 which didn't make much sense to us since we were hoping to get definitive information on whether there were abnormalities present that would warrant doing reduction. Next, we met with the doctor who gave us additional reality checks. I was hoping he would consider my specific circumstances and give me an indication of whether or not I was a good candidate for carrying this pregnancy, but he said in his 16 years of experience with multiples, there is no way to judge whether or not someone will have a good or bad outcome. Lots of statistics about risks due to prematurity, it was quite sobering.

After going home and talking it through, we decided that based on the information we have and our good NT results, we will go forward with the pregnancy. I'm still terrified, but it does feel like the right decision for us. My first prenatal appointment will be next week. Our practice delivers 25-30 sets of triplets per year and their average gestational age is 32 weeks. I'm hoping to get to the magical 35 weeks when the babies come home with you from the hospital, which gives us a due date range from the end of January to the middle of February. Which means they have a chance of being born on my 40th birthday, Groundhog Day or Valentine's Day. Hmm...

I have to admit that I am starting to doubt that the second trimester will bring me any relief from the nausea, which seems to be intensifying, especially in the puking department. Seriously, it is really difficult to cope. Twice, I have thrown up so violently that I got nose bleeds - I could actually feel a capillary pop. I wish I was exaggerating, I really do. The only things that get me through the day are eating regularly (although I have zero enjoyment of doing so and never feel hungry) and chewing gum constantly. Sometimes I even go to sleep with a mint in my mouth although I know it's not the greatest idea, it being a choking hazard and all, but you do what you have to do.

I think I'm going to set up a new blog to document our pregnancy. I'd like to be able to print out the blog as a memento for the kids and don't really want all the IF stuff included. Not that I won't tell them, but I don't think it fits into a baby book. I'll keep updating here until I do so.

Holy, holy, we're having babies!

10x10

10 weeks

(of pregnancy under my belt)

10 months

(since our first appointment with the clinic)

10 minutes

(time spent by our RE giving us the news of our triplet pregnancy)

(yes, I am bitter, she didn't even say "congratulations")

10 hours

(tminimum amount of sleep I need per day right now)

10x per day

(number of times I need to eat to keep the nausea at bay)

10 litres

(estimated volume of gas filling my intestines)

(no weight gain, but can barely button my pants)

10 Google searches

(made by my husband on topic of "triplets and older women")

10 pages

(in packet of introductory information sent by my prospective MFM clinic)

10 pages

(of introductory packet dedicated to topic of selective reduction)

(not even a paragraph of it was on prenatal information)

(WTF?)

10 thousand questions

(to which I have no answers)

Thanks for the supportive comments on my last post. We are muddling through and counting the days until our first appointment with our MFM practice next week.

Worries

Internets, I'm worried about being pregnant with triplets. About the genetic screening we plan to have done, what the results will be and the decisions we will make thereafter. About having a difficult pregnancy, about the possibility of bed rest and how my husband will do everything wrong while I'm incapacitated. That I will gain a ton of weight on top of the 20 extra pounds I didn't manage to lose before getting pregnant (truth be told, I didn't try very hard) and develop gestational diabetes which I am already predisposed to on my mother's side. That my job will suffer and I won't be able to recover from being off for so long.

About having babies in the middle of freaking winter in New England and having to figure out how to get them into the car parked on our ski slope driveway. Also, the fact that I don't think we can fit three car seats into either of our cars. Or three cribs into our designated baby room (do they make double deckers?) That we have no family nearby who can help us. That my husband's mother will move in with us and take over my house and I'll hate it.

That we will have premature 3 pound babies with health issues that will follow them their whole lives. That I won't be able to nurse three babies and give them the start I want to. That I will be so overwhelmed with three infants and no sleep and having my mother-in-law living with us that I will resent them all and secretly wish for a different life.

Or that this pregnancy will end and we will have no babies and I know I don't want to go through this again and then we will be childless and get a dog and go on great vacations and continue to be everyone's favorite aunt and uncle and for the rest of our livesalways wonder "what if?"

9 weeks

I'm officially nine weeks along and am crossing my fingers that the morning sickness begins to ease up soon. We had a pretty good weekend (i.e. no puking or near-puking encounters) although we did nothing but sit inside with the air conditioning on. I left the house once to go to Whole Foods where I filled my cart with Vitamin water, vitamin B6, Preggie Pop Drops and some other herbal concoction that is supposed to help with pregnancy-related nausea. Thumbs up for the Vitamin water, I am finally getting enough fluids. For some reason plain water and seltzer taste just aweful to me, and I don't want all the sugar that comes with soda and juice so the Vitamin water is a happy compromise. I'm making a conscious effort to each more which does seem to help.

My husband has been hilarious about the possibility of having triplets, coming up with all sorts of scenarios, some more realistic than others. He's excited that he'll be able to organize 2-on-2 soccer games (I'll be sitting on the sidelines drinking lemonade). However, he thinks we should forgo cribs in favor of just lining up the babies on the bed in our spare room. When I suggested that they might wiggle their way off the bed, he said we'd wrap them up like cocoons so they couldn't move. I mentioned wanting to use cloth diapers (we estimated we'd have 27,000 diaper changes by the time they're potty-trained) and he was adamant that "single use" diapers are the greatest invention since babies themselves. When I expressed my worry about the logistics of taking three kids somewhere, he told me he'd design a carrier for three babies with two on the front and one on the back and that he'd be sure to rotate them so they all got equal time in each spot. It's pretty funny, even if he clearly has no real concept of what small babies are like.

I'm not putting a due date ticker on the blog yet. Our likely gestational time is somewhere around 34 weeks which puts us at the end of January/beginning of February. Once we get a bit further along and accumulate more evidence that things are going well I might put one up.

Deep breath in

More than twenty-four hours have passed since we received the shocking news of our triplet pregnancy. Even with the three ultrasound photos on the fridge it doesn't seem real that there are three little beings inside me. That I might have three little babies by Valentine's Day. Wow.

We took the day off yesterday to process the news and make some plans. My wonderful husband came to me and said that everything was going to be alright, that this is our life now and we will rally the troops and do what needs to be done going forward. I also learned that no maternal fetal medicine practice wants to see us before 11 weeks even for a triplet pregnancy, which kind of surprised me. I guess all the risks associated with high order multiples come later and the first trimester is the same solitary ball of suckiness that any pregnancy is. So, I feel like we have time to breathe now.

Morning sickness (a.k.a. constant-will-it-never-end-I-want-to-crawl-under-a-rock-and-die nausea) continues to up the ante. There has been vomiting both at home and at work. Food in general continues to repulse me. We went to the grocery store last night and the smell from the seafood counter nearly knocked me over. I stocked up on my go-to nausea foods: Welch's grape juice (purple), gingerale, gluten-free pretzels, gluten-free crackers and some healthy foods I thought I could snack on all day (baby carrots, grape tomatos, apples, grapes etc) as well as some junky foods that sounded good like olive and pimento loaf and processed cheese slices. Each day I feel worse with fewer periods of reprieve, it's quite amazing actually, and very scary given that there are weeks left before I might expect some relief.

*Thanks to those of you who are hanging in there. I am delighted about my pregnancy, but the truth is that pregnancy is really scary and I feel the need to talk about those feelings here. I know there are many readers out there who are dying to be in my shoes and I hope to read about your BFPs and your own pregancy experiences soon*

A-B-C...1-2-3

My head is spinning: we currently have a viable triplet pregnancy. Three embryos, three separate sacs, three strong heartbeats, all measuring at exactly 8w2d. My RE looked at my report and said "I wouldn't have expected that 3 follicles was too many for IUI in a 39 year-old, but apparently it was." Holy mother of triplets, I'm terrified. Of the pregnancy, of the many possible poor outcomes, of having three infants to manage. And I know enough about multiple births to realize that you don't enjoy more than one newborn, you cope with them. My youngest two brothers are twins and I think taking care of them nearly robbed my mother of her sanity, quite honestly.

Even though it's early, we decided to tell our families and a couple of close friends who have been through difficult pregnancies. Really, at this point if something catastrophically bad happens, we'd tell them after the fact, so why not let them know now was our logic. Officially, we are pregnant and delighted and looking forward to happy healthy babies this winter. I know we have a long road ahead of us, and for now we're just going to take it one day at a time.

If anyone has thoughts or recommendations on high risk pregnancy specialists in the Boston area, please send me an email.

Crisis averted and weird dreams

I talked to the coordinator at my clinic and I can have my ultrasound tomorrow as scheduled. For some reason they only schedule them at 9 am which is the absolute worst time for me to get away from work. When it became apparent that I wouldn't be able to get in until next week we managed to work it out so that I can keep my original appointment. Phew! Given my current state of mind/body, it would have nearly killed me to have to wait another day, much less another week, especially given the fact that I would have gone in last week had I not been on vacation.

In other news, I've been having really weird dreams, some more obviously pregnancy-related than others. In one dream, my husband and I were handed quadruplet boys and were trying to sit them down side-by-side in the front seat of a convertible so that we could drive them to daycare. They were super slippery and kept falling into the space between the car seat and the door and I was trying to grab them by their arms and legs to pull them back up. One looked like an exact miniature of my husband and sat very calmly on the seat without moving. I picked up one of the wiggly ones and asked him his name, which was something odd like "Mandingo" and also why they were all boys when we had requested some girls. His response (of course he talked like an adult) was "you don't get to make those requests, that's not how it works." My other dream had me babysitting two sets of twin girls who were about 3 years old. For some reason their parents, who I didn't know, had let me take them to Costa Rica for a week. Two dreams with four kids in each, I hope it's just my paranoia about high order multiples and IUI and not foreshadowing of the future.

Home and sick

We had a good vacation. Great to get away and visit family that we only see once or twice a year. But, wow, was it hard to deal with the morning sickness and remain incognito regarding our pregnant status. Consider, for example, a brief list of things that made me nauseus while on said vacation. Items on the list include, but are not limited to the following:

*meat; appearance, smell and thought of

*fish; appearance, smell (especially if grilled or fried) and thought of

*coffee; appearance, smell and thought of

*cigarette smoke (not that I liked it before, but now even the faintest whiff makes my head spin)

*heat greater than 25 degrees celsius

*riding in a car on windy mountain roads

*the thought of eating

*not eating

We spent a week on the Croatian coast where it was stinking hot, didn't cool down at night and even with the A/C was well above 30 degrees celsius the whole time. We drove there and back from Sarajevo, through the mountains and around 76,000 stomach-churning turns. My husband's family, like all Balkans, eat a hot mid-day meal every day starring some form of meat or fish. I've never been a fan of a heavy lunch, especially in hot weather, but I've always liked my mother-in-law's cooking. People were perplexed at my small appetite, "you eat like a bird, are you on a diet?" but seemed to accept my explanation that it was hot and the food was heavy. They have always treated me like a bit of a delicate flower, with my fair skin and Northern European heritage, so I wasn't that conspicuous in the end (or so I think).

Three out of the six people in the house were practically chain smokers and Croatia recently repealed their smoking ban in public places; apparently it was interfering with people's civil rights to lung cancer or some such thing. Holy, holy, this was the absolute hardest thing about being pregnant on this vacation. I had three migraines, each triggered by cigarette smoke.

Somehow I managed to deal with the morning sickness by avoiding all of the activities on the above list and making sure my stomach was never empty. Which was difficult, given my almost complete aversion to food. It's weird, I sit down to eat, convinced I can't put anything in my mouth without hurling but after the first few bites I'm ok and can finish about a third of what I would usually eat. After eating, I feel better for an hour or two and then the bile starts to rise and I have to eat some carbs of some sort or drink juice. I also napped a lot, like an hour after every meal, and slept 10-12 hours per night but was never refreshed.

I am grateful for the constant reminder that I am, indeed, pregnant but am struggling to figure out how I'm going to manage at work. My job requires a lot of energy; I manage multiple projects and a lot of people depend on me being on top of things on a daily basis. There is no room for taking it easy over the next few weeks, or taking a lot of sick time, especially after having been away for two weeks on vacation. I guess I'll figure it out starting tomorrow, but I'm pretty stressed about the situation.

I also came home to a message from my clinic rescheduling my ultrasound and I may not get to have it this week which is a huge disappointment. I'll know more when I call in the morning.

Vacating

I'll be back in time for my ultrasound on August 12.
In the mean time, I'll leave you with this clue as to where we went...

One part queasy, nine parts paranoid

I woke up this morning feeling a little off. You know that fuzzy feeling of impending illness that precedes a virus where you don't feel sick yet, but you know something bad is around the corner? That's how I felt: I even told my husband I thought I was coming down with something. I skipped breakfast because I just wasn't hungry and headed to work. As I was walking through the parking garage, I started to feel really unwell and actually dry heaved a little but managed not to throw up - phew. I was convinced I was going to have to go home sick, but I had a meeting I had to attend first and was just hoping I could make it through without having to run for the bathroom. By the time the meeting was done (an hour later) I felt fine. No more sense of impending doom, no more queasy feeling and I was hungry enough to eat a Snickers bar. So weird. Does morning sickness feel like a virus, with chills and the works? I always assumed it was just nausea, like you had eaten something that disagreed with you as opposed to full-on stomach virus symptoms.

Now my dentist knows too

My husband asked me the other day if I was having a hard time refraining from telling people we're expecting. Truthfully, it doesn't feel real yet (still no symptoms) and it hasn't been difficult to remain mum on the subject. Until this morning, when I went in for a routine dental appointment and told the hygienist that I am pregnant in response to her inquiry about whether there has been any change in my health since my last visit. She congratulated me, as did the dentist and even the receptionist who had heard about it by the time I was checking out. It was really fun to tell someone, even though I felt like a bit of a fraud, since all the proof I have are the two betas and being one week late. I did learn that pregnant and nursing women should go in for cleanings every three months because the hormones can cause problems with your gums, so that's good information to have and probably worth the early disclosure.

We are leaving Saturday for a two week stay with my husband's family. Let's just say that we will be living in very close quarters and they are very observant and not afraid to ask questions. So, even though I feel fine today, I'm hoping* that I will start to have some pregancy-related symptoms while we are away. We're trying to figure out how to keep our news from his nosey family who will wonder why I'm nauseous or not drinking and whose first question when someone is ill is if she is pregnant. Honestly, they are lovely people and a very close-knit family but they are used to full disclosure (I can't tell you how many diarrhea stories I've endured over the years) and we want to keep this on the QT until we are out of the first trimester.

*Not that I'm some kind of masochist who is looking forward to nausea and fatigue, but a few symptoms would help reassure me that this pregnancy is still progressing.

Scheduled

The OB ultrasound with my clinic is scheduled for August 12, the day after we return from vacation, and also my mom's birthday. I'm hoping this is another good omen, just like the Cheerio was.

It's official!

Ok, even I am convinced that I'm pregnant now. My beta this morning was 848 and according to this handy calculator, my doubling time is 2.21 which is textbook perfect. I can hardly stand the excitement! The next hurdle is the OB ultrasound which they want me to go in the week of Aug 3, but we're going to be on vacation so I imagine I'll go in the week after. I know there's a long road ahead before I can cross "healthy pregnancy" off my parent-to-be check list, but today I'm just happy to be right where I am.

My heart is so full, I wish I could buy a round of BFPs for everybody who's been hanging out at the IF bar with with me.

Processing

Thank you all for the kind words yesterday, I really appreciate it. I spoke with the nurse and she said that the plan is to look for doubled beta by Thursday and then she will schedule my OB ultrasound at ~6.5 weeks, and assuming all looks good, they will discharge me to my regular doctor. Who I actually have an appointment scheduled with next week for a pap in anticipation of starting IVF in August. I might as well keep the appointment, who knows what could happen, plus it took me forever to get the appointment. Since I only started seeing her a year and half ago, I don't know her really well, so I'd like to chat her up a bit and make sure she's someone I want to continue with should this turn into a full-fledged pregnancy. I'd always assumed I would go with a midwife practice, but I'm not even sure if they take women at my age.

As for pregnancy symptoms, I really have none. Still a little crampy in a PMS kind of way and I feel slightly dehydrated but I've never seen that listed as a symptom. I feel totally normal, it's surreal to think that there might be a collection of cells burrowing into my uterus as I type this. (You can thank my husband for the imagery, he's full of medically correct but unromantic terms for this process).

In retrospect, I have been unusually tired the past few days, but we've also been really busy. We spent the weekend with friends who have an almost 3 year old which was really fun but exhausting. Last night friends from out of town stopped by for a BBQ with their two girls who are 6 and 4. Holy, holy, they had energy with a capital 'E'. They immediately started stalking the cats, going so far as to crawl under my bed to find the big one who is terrified of children. He quickly exited to the basement, but the little one had no such luck and was purred at and petted to within an inch of his sanity. Fortunately he's really good with kids (even at his advanced age and with his medical issues) and he did score a piece of chicken that one of the girls dropped on the floor. When they left at 10 pm I headed straight to bed, I was completely worn out and didn't even clean up the kitchen until this morning.

The glass was half full

Unbelievable.

After all the negativity and planning for the worst, my beta came back at 332. They will repeat on Thursday and then will determine whether or not I am truly pregnant. I almost skipped the beta today because I was feeling so crampy and expecting my period any minute. Huh. Dumbfounded would be the correct term to describe my current state.

I'm holding out for the repeat on Thursday before getting too excited but, wow, just wow.

If I wasn't feeling bad enough already...

Christ on a cracker, my clinic will simply not give me a break! Mere moments ago I received a phone call from the pharmacy about the prescription that was just faxed over for my next round of IUI meds. The IUI cycle that will never happen because if we do end up with a BFN on Monday we are switching to IVF and our RE knows this. We have, in fact, scheduled a consulation on the 24th to discuss this very thing. I told the pharmacy to put the order on hold while I called the clinic.

Fortunately, considering it is the first sunny Friday afternoon since May, a nurse was actually still at the clinic and picked up my call. She looked into my file and was appropriately surprised when she saw that I hadn't even had my beta yet. After a little more investigation, she explained that someone had verified that I had insurance coverage for another IUI cycle which automatically triggers a medication order. Once I explained that we were switching to IVF, she quickly said she would cancel the prescription order and put a note in my file. She even apologized, which was nice since she isn't the IUI nurse that I usually deal with and so was in no way culpable for the error.

I am a little irritated, not that I was inconvenienced in any real way, but that I am so clearly a number and not a face at my clinic. There is no personalized attention being paid to our particular situation, no one is trying to address our particular flavor of infertility, we are just chugging along the ART assembly line with everyone else.

And the doubt creeps in

Yeah, so I know I'm supposed to be gently incubating during this time between IUI and beta, but the reality is that the closer I get to Monday the more I Google to try to figure out the odds of getting a positive based on our particular circumstances. Not that it's even possible to figure out my exact chances, but I've been looking at studies of sperm quality and IUI pregnancy rate, stimulated ovulation IUI at my age and pregnancy rates etc. And the numbers, they are not good whichever way I look at them. First there's our male factor issue which was deemed "minor" by my husband's urologist, "suitable for IUI" by my RE and "pretty frickin hopeless" (my definition) by the literature. Most studies talk about requiring at least 10 million motile sperm after processing for pregnancy to occur, our sample was only 2.5 million. Other studies mention needing pre-processing motility to be >50%, ours was 26%. Rate of progression needs to be at least 3, our sample was rated a 2. Pregnancy rates overall for IUI were only about 7% per cycle for couples in circumstances similar to ours. No need to start thinking about painting the baby's room, that part seems clear.

I know they are just numbers, and a 7% chance is not insignificant enough for me to indulge in a pitcher of margaritas with a clear conscience, but chances, they are slim. I guess all I can do is wait for Monday and try to prevent myself from wasting $10 on an HPT.

1ww down, 1 to go

Seven days until my beta and, frankly, I don't feel a thing. No inklings, no hunches, no dreams about babies. Not even any anxiety about whether or not I am pregnant, not tempted to POS. Nada. We managed to have a relaxing weekend away in Vermont. A little hiking, a visit to the Trapp Family Lodge for dinner (their restaurant is excellent), a little sunshine and a whole lot o' rain. So, here we are back to normal life, back to waiting. I did go ahead and schedule that follow-up appointment with my RE in a "hope for the best, plan for the worst moment." Fun times.

And I thought things were going well

Not 30 minutes after I arrived at work (post-IUI) I got a call from my nurse scheduling my beta and asking me to make a follow-up appointment with the RE to discuss the next step. Reminding me that this was our third IUI (really, second) and we needed to think about what to do next. WTF??? Evidently, this IUI was already considered to be a failure less than an hour after it was over. I'll admit we didn't get the best sample, the numbers were considerably lower than for the first IUI, but they were still in the range that was acceptable for IUI. Couldn't they have let me enjoy the post-coital glow (so to speak) for a little while before getting all doom and gloom on me?

And on a tangental note, what do I have to do to get them pronounce my name correctly when they call me? Seriously, if one more allegedly literate person calls me "Elsie" after reading my name from my chart, I'm going to explode. Honestly, does anyone actually name their children Elsie anymore? I just don't get how so many people can mess this up. Internets, don't name your daughters Elsie, it sounds like a cow. And if you name them Elise, put a "y" in it like the mom on Family Ties because there are a lot of morons out there who will transpose the "i" and "s" which will result in a lot of cringing for your undoubtedly lovely daughter.

And that's all I have to say right now.

Your eggs are cooked

So said the ultrasound technician this morning after measuring my follicles. The left one is now 22 mm and the 3 on the right are 16, 16 & 17 mm. Ovadril tonight and the IUI is scheduled for Monday morning. Of course I have two meetings first thing Monday, fortunately I called both of them so I can easily move them to later in the day. Maybe I'm just more comfortable with the process, but I feel really good about this cycle. Fingers crossed.

Cautiously optimistic

Things appear to be progressing nicely, the follicle on the left is now 19 mm and there are now 3-13 mm follicles on the right, with my estradiol level up to 753. I am to take another 150 units of Gonal-F tonight and then go back in tomorrow morning for monitoring. When I pressed the nurse for more details (I'm getting much better at this) she said we are aiming for 3-4 follicles that are at least 16 mm in size and that she "wouldn't be surprised" if I used the trigger shot tomorrow night. I asked if the larger follicle on the left was problem and she said that it is likely to be re-absorbed and that we are really only working on the 3 on the right. I can't remember the exact details of our first IUI cycle, but I think we were in a similar boat with 4 follicles but one much larger than the others, except that time around using twice as much FSH. So far, so good.

In other news, I found the results of this study to be sobering. They were looking at the rate of live births in a cohort of women undergoing up to 6 cycles of IVF at a clinic in Massachusetts. In the paper they claim that they picked 6 cycles because Massachusetts has a mandate that fertility treatments must be covered by insurance, and that typical coverage in this state allows for 6 cycles. I live in this state and I definitely don't have enough coverage for six cycles of IVF: my insurance caps my coverage for fertility related treatment at a dollar amount that might pay for 2-3 IVF cycles, which is one of the reasons I insisted that we start with IUI (the main reason being that our doctor said we were good candidates). Anyway, the main findings were that the chance of having a pregnancy resulting in a live birth after six full cycles of IVF were between 65 and 86% for women under 35, but only 23-42% for women over 40. That's less than a 50% chance that I will take home a bio baby after a lot of treatment, much of it that will not be covered by insurance. I never really believed the statistics about the rapid decrease in fertility after the age of 35 because it just wasn't part of my life experience. My mom had a surprise pregnancy at age 37, one of my best friends just had her first baby at 40 after barely trying. I know their experiences don't mean anything for my odds, but hey, when you're not trying to get pregnant you really don't pay attention to these things.

I don't know how far I want to take this. Personally, when it comes down to whether or not I would pay out of pocket to continue trying to get pregnant after my insurance runs out, right now I don't feel inclined. Given my odds (I'll definitely be on the other side of 40 by then), I think I would rather spend the cash on adoption fees, assuming my husband is on board. Hopefully I won't have to make that choice, but hey, I like to be prepared.

CD8 by the numbers

3 measurable follicles: 2 on the right (11, 12 mm) and 1 on the left (15 mm)
2 more days of 150 units Gonal-F, then back on Friday for monitoring

1 last day of rain and cold before we see some sun

One

I understand that many women in the throes of infertility are deeply irritated by the phrase "it only takes one." For me, "it only takes one" is a mantra that allows me to consider the possibility that I will win the baby lottery. The reality is that while one egg and one sperm do a baby make, it may never do so for me, and I have no control over whether it does. At 39 1/2 I am fully aware that my window for conception narrows every day. Honestly, I never thought I'd be in this position (who does, right?) but I happen to have good insurance and a top-notch clinic right down the street and when I realized how important it was to my husband to do everything possible to try to have a child that shared our genes, I shrugged and said I would try. Somehow in just six months we seem to have become deeply entrenched in a process that I know is more likely to fail than to succeed. And while I won't say that I'm ok with it, I do understand that the outcome is as out of my control as it is for any woman. Money and medical treatment can only increase my odds of getting pregnant by a small percentage, and in the end it will come down to a random collision of two cells that triggers a cascade of biological events that has the potential of resulting in a baby. Right now, it's enough hope to get me by.

And so, it begins

It's CD3 and I've taken my first hit of Gon.al-F, courtesy of my awesome husband who is always willing to help me out with the shots. Even though they're subcutaneous and via a superfine needle, I much prefer having him do the injections. Funny how we both find it so much easier to be the caregiver than the patient. Four more days of 150 units and then I go in for monitoring on Wednesday morning. I can't quite believe that this seems normal to me now, the hormones and the blood draws and ultrasounds.

As ready as I'll ever be

The consult with the anesthesiologist went well. I told him about my previous experience with conscious sedation and he said that there is a small percentage of people who become more anxious with these types of medications as opposed to relaxing. He told me what he plans to give me during my retrieval procedure, should it come to that, and assured me that he thought I would do well with the medications. I feel heard, if not yet totally comfortable with the idea of surgery. It was interesting to go visit the surgical area of the clinic. There were 6-8 women sitting in recovery bays and not one of them was crying hysterically, so that was good. I did get a little jittery, but at least I know what it looks like now.

After my consult I grabbed some lunch at a local fast food place and overheard a funny conversation. Two older women were finishing their meal and bemoaning the lack of full service gas stations. One said "I drove all the way from Massachusetts to Florida and didn't find one full service station; I had to get out of the car and do it myself every time. Next time, I'm taking the bus." Apparently sitting on a cramped bus for 20 hours is preferable to having to get out of your car a half dozen times to get gas? People are funny.

Game on

As anticipated, CD1 has arrived and we begin our last IUI attempt. Third time's the charm, right? At least I have the pleasure of driving to and from appointments in my shiny new (to-me) car. We ended up with a 2008 Hond@ CR-V and I think she and I are going to be great friends. It was a close contest between the CR-V and the T0y0t@ RAV4, but in the end I decided that the hatch-style rear door of the CR-V was going to work better for me. When we test-drove it I found a single Cheerio under the rear seat and took that as a good omen for this cycle. I've got my appointment with the anesthesiologist this morning, hopefully I come away from it reassured about my options if we get the point of IVF.

Hey, does anyone else use Tylenol for cramps? I am dutifully staying away from Advil, but don't think I can get through the next few days without some form of pain relief.

Waiting, waiting

CD1 should be right around the corner and I'm ready to get the IUI#3 party started. Meds are in the fridge (does anyone else store their trigger shot in the egg compartment? Ovadril, anyone?) and I have a consult with the anesthesiologist set up for Wednesday just in case we end up in a position where we need to convert the cycle. Now that I have a plan, and my preparations in place, I feel so much more confident. I hate the uncertainty of it all, you know? Having a road map forward is so helpful, even if all the streets aren't marked.

I just found out that one of my friends is pregnant and if ever I needed a reminder that I want a baby, this was it. I am so, so happy for her, she has had two miscarriages (one at 14 weeks) since her first baby and waited until well into her second trimester to announce this one. Baby boy #2 is due shortly after her son's third birthday so it's going to be a fun autumn around here. I need to get started knitting a baby blanket for the little guy. Sometimes I can get so bogged down in the process of ART that I forget that it's all about the wee babe to be, hopefully with my husband's dark eyes and my sweet disposition.

Baby-friendly cars and other leaps of faith

We spent the weekend test-driving cars because I either need to spend a small fortune repairing my current one so that I don't die from carbon monoxide poisoning, or I need to replace it. Given that my car is 9 years old and has been having more and more frequent and expensive issues, I have opted to ditch it and buy a new (to me) one. I have a thing for station wagons, what can I say, I like to haul stuff. I'd like to upgrade to all wheel drive and the options for wagons in my price range are limited (I know there are a bazillion of them on the road, but I didn't love the Out6@ck I tried). Oh, Toyota, why can't you bring back the Corolla wagon, circa 1982?

Anyhow, we decided to expand our options and looked at small crossover SUVs since they are really just station wagons with a few more inches of head room. As the sales people went through the features, they inevitably asked if we were planning to expand our family, and then went on to talk about car seat tethers etc. Now, while we want to expand our family, given our ages and medical issues, the odds are pretty even that we won't. So, do I buy a car with good child seating options or not? If I choose the car with the most child-friendly features and we don't end up with a baby in a year will the damn car be a constant reminder of our fertility journey?

It's a decision that is requiring a certain leap of faith, at least on my part. Since we're unlikely to have our parental status decided by a spontaneous pregnancy, we've already had to put our desire to be parents out there by pursuing ART and, in doing so, putting metamorphic neon signs above our heads that scream "We're Trying to Have a Baby" to innumerable doctors, nurses, receptionists and insurance companies. It's just a little bit scary, declaring my intentions and being unsure of my body's ability to deliver on them. So, while I'm much more comfortable standing securely on the edge, peering over to observe danger from afar, leap I will.

Besides, I have to think of the resale value.

We're all falling apart around here

I took the small cat to the vet last night for his thyroid re-check (he's been on medication for 4 years for hyperthyroidism) and casually mentioned that I didn't think he was seeing very well these days, and also that he seemed really needy and whiney. So, I really shouldn't have been surprised when Dr. Sarah checked him out and agreed that, yes, he's pretty much blind and that it is probably very confusing and upsetting to him, hence the constant demands for attention. She says he can see shadows, but not much else, and that it's likely the consequence of senile changes in his brain due to advanced age (he's 17). Poor little guy, he's always been such an outgoing and friendly cat, it's hard to see him decline like this. He's always been really great with kids, it's sad to think that he might not be around to play with our hypothetical future children.

CD1(-5ish) and counting down to the next IUI cycle. I'm going to meet with the anesthesiologist at my clinic next week to talk about some of my concerns regarding sedation so that I am prepared in case we need to convert this cycle. I've had conscious sedation in the past for medical procedures and h-a-t-e-d it; I woke up crying hysterically and it was very upsetting. Hopefully he/she can address my fears and I can figure out how to deal with the sedation/retrieval process if we have to go there.

IUI, IVF, I just don't know

I called my clinic yesterday to let them know I wanted to switch to IVF for my next cycle and was immediately overwhelmed. Apparently I'm supposed to have had a recent physical and current PAP??? You'd think someone would have mentioned that earlier, like when there was still time for me to make an appointment with my doctor. I tried my gyn, but she is booking physicals out to Sept/Oct and my internist out to Jan/Feb. I managed to get an appointment with the nurse practitioner who works with my internist for Friday, but I've never met her and it doesn't make me very happy - so much for continuity of care. I can't figure out if I have unrealistic expectations from my clinic/RE with regard to information and preparation, but I'm not happy. If I wasn't so daunted by the prospect of trying to find another clinic and waiting weeks for an initial consultation I would seriously consider switching doctors.

After talking to the admin at the clinic (lovely, warm woman) I started to freak out about my decision. IVF scares me and the fact that my clinic treats it as if it were no big deal scares me even more. I don't really want to undergo surgery and anesthesia, it's a big freaking deal to me. And, given our one shot at IUI, I don't feel like we've explored that option fully. I called my husband in a panic and he agreed to go back to our original plan of another IUI cycle. So, I called the admin back and told her I'd changed my mind and she was completely understanding about it.

The wait for CD1 continues, and I'll also get my physical out of the way and do the pre-op counseling just in case we are in a position where we need to switch to IVF and to be on-track to proceed with a full IVF cycle in August if need be.

Backstory: IUI#1 & #2

We finished our initial testing in November 2008 and tried to start an IUI cycle right around Thanksgiving but getting insurance approval, medications and pre-paid travel plans got in the way. Honestly, I wasn't mentally ready to start fertility treatments and needed some time to sit with the information. Then we had family visiting for four weeks in December/January and needed to recover. In February I started 350 units of Follistim on CD3 (through 9) and got to know the clinic's ultrasound technicians on a regular and intimate basis. Also, I made a mental note to start getting regular pedicures and bikini waxes even though it was the middle of one of the snowiest New England winters in recent memory. That flimsy paper sheet was doing nothing to maintain my aura of confidence, I tell you. But I digress. My ovaries responded perfectly and by trigger day I had three nice looking follicles ready for action. The day of the insemination was stressful. My husband did not appreciate having his "gentleman's time" with a plastic cup at 7 am but he soldiered on and we ended up with a normal specimen. I was too overwhelmed with everything going on to note the numbers, but apparently they were perfect for IUI.

Unfortunately, fourteen days later I was back to CD1. I never felt like it had worked so I wasn't at all surprised or disappointed (truthfully). We were geared up to try again right away, but when I had the pre-cycle testing done there was still a follicle hanging around and my doctor said we had to skip the month. I was crushed. Up to this point, I had been very cerebral about the process, but when I took the call from the nurse I was angry and frustrated for the first time. Twisted-gut-ball-of-fury-how-the-hell-did-this-happen-to-me angry and frustrated, to be precise. Yeah, reality check #1 was realizing that trying to get pregnant was going to be out of my control.

Reality check #2 was realizing that I was likely never going to actually see or talk to my doctor. We initially chose our clinic on recommendation and because it is very convenient to get to from both home and work. After my initial consultation it was as if my doctor no longer existed; I communicated only with the nurses. So, so frustrating as I am the type of person who really needs to develop trust with my health care providers in order to feel comfortable. It became apparent very quickly that I was just one of the thousands of people who file through this particular clinic every year and that cozy relationship I had envisioned with my caregivers involving me bringing in cookies and sending them photos of my (hypothetical future) babies was total fantasy.

So, we waited out the month and started another IUI cycle in April. Same dosage of Follistim and things were looking good, three follicles on CD5, right on schedule. Until my monitoring appointment on CD8 when the ultrasound technician (the young, slightly rough one) spent a lot of time clicking and asked "you're doing IVF, right?" Warning bells were tinkling faintly in the distance, but I told her no, I was on an IUI cycle. When she was done I sat up and she turned the computer screen around and showed me the nine perfect follicles she had counted. Yikes.

When the nurse left a message a couple of hours later confirming that I had too many follicles for IUI, she also told me that the doctor wanted me to switch to IVF. I called back and another nurse was covering for her and told me I had to decide Right Now! because she needed to call in more medications Today! and I'd have to mix something with the Follistim and take something else and one of them was going to be an IM injection* and never actually asked me if I was ok with it. Which I totally wasn't because we had never discussed switching mid-cycle. In fact, I had told my doctor during my one talk with her that I wasn't sure I wanted to have that level of intervention but clearly that wasn't written in my file anywhere. It didn't help my stress level that I had been slipping into empty conference rooms at work from to make all these phone calls and I was having an incredibly busy week at work and had a final exam in a few days. My husband managed to talk me down and agreed that there was no need to rush so I called the clinic back and cancelled the cycle. They were, shall I say, a little surprised. I had responded so well, it was a perfect situation for IVF, why wouldn't I disrupt my entire life for unplanned surgery in 3-5 days? I mean, really, my reproductive organs do not exist purely for them to do procedures on, and I didn' t like having to explain that.

Then in May, the timing was all wrong as my husband had to have surgery and my cycle was completely thrown off from the nine party-crashing follicles from the previous cycle, so we skipped another month. We spent the last month talking about our options, and even had a follow-up appointment with Dr. Frosty (even my husband thinks she is cold) who reminded us that our chances of getting pregnant via IUI were only ~12% and she would only recommend doing one more cycle before switching to IVF. So, here we sit won the brink of starting an invasive procedure that I never in my life thought I would elect to participate in. The most surprising thing? I think we're going to do it.

*All my medications had been subcutaneous and I my husband had been giving them to me. I freaked at the thought of having to have him or me figure out how to give me an intramuscular injection after work that day. Turns out the nurse covering the phone (not regular IUI nurse for my doctor) was wrong, and in fact the clinic hadn't used any IM injections in years. When I learned this I was pissed and even more frustrated with the communication channels.

How I got here, in 39 lines

1. I am the reason my parents got married.
   
2. My mom smoked cigars while she was pregnant with me.
   
3. Eh, I turned out fine.
   
4. My two youngest brothers (twins) were conceived while my mother was on the pill.
   
5. I had a lot of responsibility as a child, especially after my parents separated.
   
6. Like babysitting my brothers after school, making dinner and being my mom's best friend and confidante.
   
7. On Saturdays my mom would drop me off at the grocery store with a list, the folder of coupons and blank check.
   
8. This is not a life I recommend for an 11 year-old and I swore I would never, ever have children. 
   
9. Although I still love grocery shopping.
   
10. I have two aunts who failed to conceive for years, adopted, and then got pregnant.
    
11. There are a lot of surprise pregnancies in my family.
    
12. I had one of my own when I was 26.
    
13. My boyfriend and I had just moved to the US and were living in two distant cities and commuting on weekends.
    
14. The lack of maternity leave and high cost of daycare freaked me out.
    
15. Honestly, my boyfriend was kind of an asshole, I just didn't realize it at the time.
    
16. It really wasn't the right time to have a child.
    
17. So I had an abortion.
    
18. It's something I think about a lot, but I've never wanted to take it back.
    
19. I met my husband at work and knew the moment I saw him that I wanted to marry him.
    
20. Early in our relationship he offered to have fertility testing done because he saw the mother in me and didn't want me to marry someone who couldn't give me children.
    
21. It was incredibly sweet and touching but I declined because he was way too sexy to be infertile.
    
22. I really didn't want to get pregnant before we were married so we didn't start trying until after the wedding.
    
23. A year later he went in for testing.
    
24. Motility and morphology were abnormal.
    
25. His doctor suggested IUI so I found a clinic near work and made an appointment.
    
26. I was floored when my ovaries failed the Clomid challenge.
    
27. I suggested adoption but my husband isn't ready.
    
28. After a lot of research on adoption I'm not sure I'm ready either.
    
29. So we decided to try medicated IUI.
    
30. Round one was textbook perfect but didn't get us pregnant.
    
31. We had to sit out a month because of a follicle that refused to leave the party on time.
    
32. Round two started out fine but resulted in 9 follicles by day 8.
    
33. My doctor suggested switching to IVF but I've only met her once in 6 months and don't really feel like I want to embark on an incredibly invasive procedure at the drop of a hat.
    
34. One of my best friends from high school got pregnant on her first try last year.
    
35. She brought the baby to her 40th birthday party: he's gorgeous.
    
36. I haven't told her we're using fertility treatments, she wouldn't understand.
    
37. Until very recently, I know I wouldn't have.
    
38. But I don't begrudge her, or anyone else, their babies.
    
39. I just want one of my own.