My appointment with the fertility doctor started at two in the afternoon on one of the most major streets in Philadelphia. It took me fifteen minutes to park and I didn't see the entrance to the garage right next to the doctor's office and had to park two blocks away.
Now most people will look at that and say "so what?" That's what I was thinking as I pulled into the garage. Unfortunately, those two blocks were up a very gentle slope and I had to stop half way because things started having that wavy, dizzy look about them and I didn't want to fall over in the middle of the sidewalk. By the time I got to the door of the medical office building I was totally out of breath and already dreading the walk back to the car and the drive home.
It's weird to think that two years ago, I was taking the train downtown and walking the five blocks from the train station to the education building four days a week. Or that a year before that I was working full-time in addition to going to school four nights a week. It's more than weird, it sucks.
Anyway, I had a good meeting with the doctor. She's not promising anything, but she's not ruling anything out yet either. The first problem is that I've been on Depo-Provera for three years now and my ovaries are practically in hibernation. They've been showing signs that they're beginning to wake up for the last couple months though, so that may not be a huge problem. The next problem is that estrogen can cause blood clots and while the protocol doesn't call for estrogen, the whole process causes natural estrogen levels to get pretty high, so I might be at a higher risk of developing a clot. They might be able to go with a slightly higher dose of blood thinners to counteract that one. The biggest risk is called ovarian hyperstimulation syndrome. Now this is a risk for any woman going through IVF. The follicle stimulation can get out of control and can release fluid into the abdominal cavity causing pain and congesting breathing. This is obviously a concern for anyone, but a risk that could be deadly for me. So the plan is to start off with a relatively low dose of FSH to see how my body responds before we go full-throttle.
It wasn't all about risks though. There is a definite possibility that this will happen. She also said that we could freeze a mix of embryos and eggs so that if BF and I were to split up before we use the embryos, I could still use the eggs with a future partner of a donor's semen. Not that we're thinking of splitting up, but Pennsylvania law stipulates that in the case of separation, one of the genetic contributors to the embryo cannot use them without the consent of the other party. So while I'm covering all of my bases here, I might as well cover all of my bases, even the possibilities that I think are remote now.
So in the next couple of weeks BF and I will have to undergo some testing. We both have to have a battery of blood tests to ensure that if we use a gestational surrogate in the future, our embryos won't be carrying any potentially communicable diseases and to check for blood typing, etc. I already had an ultrasound to take measurements of my ovaries and uterus (the uterus I could totally see, but jesus christ, ovaries are just dark splotches and that doctor was measuring them and counting and measuring follicles that I couldn't differentiate at all). Oh and I got to have a pelvic exam with four people in the room in addition to the doctor. Gotta love an audience right? It's a good thing I've never been especially modest or I might have been massively horrified.
After all of the checking of things, I got to sit down with the research study coordinator to go over a whole bunch of paperwork. I'm taking part in two research studies in addition to the IVF and there was a shit load of paperwork to sign and questionnaires to fill out.
Once we were finished with all of it, it was five thirty in the evening. Rush hour in Center City. I wanted to cry. I hadn't taken any Percocet or Ativan all day because I was going to be driving and I was in lots of pain and in a pretty shitty mood. Getting back to the garage wasn't nearly as bad as I was afraid it would be; it's finally spring in Philadelphia and though it isn't warm per say, I love light-sweater weather.
Turns out that the weather wasn't the only beautiful thing that day, the traffic that I assumed was going to trap me on I-76 for an hour was perfectly smooth all the way back to my mom's house, where the little guy was busy being spoiled.
So on the whole, I'm encouraged. Things aren't going to move as fast as I want them to, but there's still nothing barring the way entirely. I also get to participate in some important science that will hopefully help women maintain their ability to have children after chemotherapy. One study will help them figure out how to mature eggs outside of a woman's body, from frozen ovarian tissue. The other study will monitor my hormone levels before, during, and after the chemo to help them learn about how chemo affects the hormones that are produced in young women. Cytoxan causes early menopause in nearly all of the women who use it as a medical treatment, but they don't have any real information on the markers for menopause in young women, only on women who go through menopause at the normal age. So this will allow them to see if it's the same or different and what determines whether or not the drop in hormone levels will reverse itself.
Oh and on a final note, does anyone else find the beer commercials that advertise the brewing method, such as "triple hops brewing" without actually explaining what that does to make the beer any better totally obnoxious? I don't know a damn thing about brewing beer, they could add the hops to the beer in sixteen separate batches and I would be no more or less impressed. How is this an effective advertising campaign?
And on that note, I'm going to attempt to go sleep.