Posts Tagged 2ww

What to think about when you’re thinking about peeing on a stick

So, you had your IVF cycle, and now you’re in the hell that is the 2ww.  And (a) you are sure you are pregnant and/or (b) you can’t stand the not knowing, so you’re thinking about doing a home pregnancy test.

I have for you a cautionary tale.

Now don’t get me wrong, I am not philosophically opposed to POAS (peeing on a stick).  My personal belief is that one should always POAS before the beta, because do you really want to have a heart attack every time the phone rings on beta day, bust out into tears while talking to the nurse, and then have a hysterical crying jag right before some important meeting because the nurse chose that time to call?  I don’t think so.  No, you want to have privacy and plenty of time after finding out the result to either celebrate with your sweetie or to lean on each other’s shoulders as you plumb the depths of some serious depression.  But in my opinion the POAS should happen as close to the beta as is possible while still leaving the necessary private dealing-with-the-news time.

Let me tell you how I came to this conclusion.

On my very first IVF cycle, I had realized the necessity of the therapeutic pre-beta POAS, and the time I selected for it was the Sunday before my Tuesday beta.  That was late enough that I could be confident of the FRED results, but left plenty of time, if necessary, to mourn with the sweetie before the workday began on Monday.  I POAS’d, and it was negative.  And mourn we did.  For several hours.  Then we somehow scraped ourselves together and made it through the rest of the day.

Tuesday morning for some reason I decided to POAS again – I guess under the theory of you never know.  And for sure you never know, because this time – this time it was positive.  And I had never, ever in my life seen those two pink lines.  Time for a celebration!  Woo-hoo!  All the crying and moping around had been for nothing – what a waste of time and emotional energy!

Then on Tuesday afternoon I got the call from my clinic.  My beta was 48; the clinic’s cut-off for a viable pregnancy was 50.  It was the start of low beta/low doubling hell, which dragged on for weeks – long enough that an RE at the clinic suggested that he give me a shot of methotrexate to “help the process along”.  Fortunately, I had recently discovered A Little Pregnant, so I knew what “help the process along” was a circumlocution for, and how completely not safe it would be to have a methotrexate-induced abortion while my husband was out of town and there was no one to take me to the ER if necessary.  I miscarried naturally the next week.

If there is something I learned from this series of events, it is that peeing early doesn’t give you any certainty. You can have a negative even though you are pregnant.  Worse, you can get a positive and actually be pregnant but it is irrelevant if the pregnancy does not stick around until beta day, or only shortly thereafter.  And at this point in my reproductive history crap pregnancies that yield positive sticks are a dime a dozen.

Note: after this experience Mr. Nishkanu also begs me in heart-rending terms not to POAS early, when I am tempted in a moment of weakness.

Sadly, I have actually come to the point now where, as awful as it is, the 2ww beats what inevitably seems to come after it – the horrible pain of mourning and the slow hormone-addled depression and anxiety which comes after almost every IVF cycle.  At least in the 2ww you have some hope, even if it has been horrifically beaten down by fear.  I have come to the point where I don’t want to POAS, and I don’t want my beta either – I’d rather just wait and see if my belly ever gets bigger and put off the seemingly inevitable pain.  That’s not practical, so I stick with the POAS at the last possible minute.

Now my story doesn’t have to be your story.  Obviously there are a lot of people who have better outcomes.  But also there are a lot of people who use POASing in different ways to manage the stress of cycles, and who find that peeing early is better for them to deal with the anxiety of the 2ww.  So figure out if this assvice fits you before trying it on.

p.s. Just after I finished drafting this, Mr. Nishkanu said to me, “I think we have been using the wrong strategy with the pee tests.  I think we should have started with the pregnancy tests really early and done one each day.  That way it wouldn’t be such a big shock when you actually do it.”  So much for the consistency of our household philosophy.

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What to expect when you’re in the 2ww

There are a lot of 2ww’s when you are suffering from infertility.  Here I am referring specifically to the progesterone-supplemented 2ww – the one that comes after a medicated IUI or an IVF, where you know there really might finally be something happening down there and you are thoroughly brain-addled from the hormones that you are on.

First and most important: when you are on progesterone you cannot know based on your symptoms whether or not you are pregnant.   OK, this seems kinda obvious when you have been around the block, but the first time I was on progesterone I was sure I was pregnant: my boobs hurt like heck, I felt kinda nauseous sometimes, I had all kinds of funny feelings “down there”, this is just like what people described when they were pregnant!  Success at last!!  Well, the joke was on me.  Because the sad, evil fact is: progesterone replicates all the symptoms of pregnancy.  And many of the symptoms of getting your period.  It is the sucker double-punch of infertility.  So repeat after me, every time you feel a funny poke, twinge, cramp, or bout of nausea:  “It is just the hormones.”  You just can’t know if it means anything.

Here is how I wish I could report that I spent the 2ww’s: two weeks of basking meditatively in the knowledge that a potential new life had moved into my belly – a new life that might or might not take, but in any case was there now.

Here is how I actually spent the 2ww’s: “I don’t feel so good… it’s just the progesterone… but wait, something smells, do I have the super human pregnant smell power?  Shoot, my husband smells it too… in any case it’s just the progesterone… it’s going to bite when I get that negative pregnancy test… don’t be so negative, I making myself miserable for no reason, there’ll be plenty of time to be depressed if the test is negative… hey, does that mean maybe the pregnancy test will be positive? [stamp stamp stamp (hope being stamped on to avoid crushing defeat later)]… it’s just the progesterone… dang, cramps!  I hope my uterus is not killing the babies!… get a grip, girl… I wonder if there is something good on TV… hey, look at the cute bunnies in that commercial!   [round of total hormonal crying begins]… *#^$#^%@&# progesterone!!”

Man, I can’t even stand to be around myself.  My poor husband.  But if there is something even worse than being around me, it is being me!  Poor me!

There were a couple of strategies I used to attempt to maintain some tiny shreds of dignity and sanity during the 2ww.  Maybe some of this might be useful for you.

1. Have your Plan B in place.  Getting a BFN is bad enough.  Getting a BFN without knowing what you will do next – for me, that would be total hell.  I never wanted to be in a place where you were mourning a failed cycle with no idea of what you wanted to do next.  That is not a good headspace for planning your next move.  Having Plan B ready means a BFN does not mean total, complete, unmitigated disaster – you have something that you are ready to move on to.  I am now in the 2ww of my last DE cycle, if this doesn’t work we are moving on to adoption.  Not only that, we know exactly the kind of adoption we want to do and we have our agency picked already.  The day we get the BFN is the day I call the agency to place our deposit.  And it has made handling the uncertainty of this cycle so much easier – because it’s not an uncertainty about whether we will have a baby, just about the route that baby will take to us.

2. Do not calculate the due date that you would have if you were to become pregnant.  If you actually do get pregnant, there will be plenty of time to find out.  But if you don’t get pregnant, what you are doing is calculating at which day in the future you plan to get really depressed about the fact that you could have had a baby by then.  I really prefer just not to know.

3. Do not believe you are pregnant. Just don’t.  Don’t don’t don’t.  Assume the worst, if you turn out to be pregnant then it will be a pleasant surprise.  Or, if you can manage it, just don’t assume anything at all.  The times when I really believed I was pregnant for whatever reason – because of symptoms, or because I was using fresh young hip donor eggs – I was completely crushed when things turned out otherwise.  Not that I was ever so peppy when I got a BFN or yet another unviable pregnancy, but it really made things worse if I had truly believed.  For me, I just couldn’t afford to have that kind of hope anymore because I knew the kind of depression it would turn into.

4. Remember that you are pepped up on hormones and stress, and don’t expect yourself to be able to live up to your usual standards.  So you cry at the drop of a hat?  So you lie on the sofa all day because you felt a cramp and are scared you are going to lose the baby?  So the house hasn’t been cleaned and dinner hasn’t been cooked in days? So you are watching trash TV and eating junk food?  So what?  It is totally normal to be slightly insane.  And it’s only two weeks of your life. Let your sweetie or other loved ones wait on you hand and foot, if they are willing.

Do you disagree?  Did you find other things helpful?  If so, please add your suggestions in the comments.

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