Clinic #2

I called clinic #2 yesterday to discuss “what’s next.” Do we need to do a second consult with Dr. Awesome before beginning treatment? Should we go right to IVF? What happens if I have a cyst? Should we try a third and final IUI?

The nurse was lovely and went through my file with me and answered all of my questions. She said Dr. A is satisfied with hubs’s SA results and my hormone levels from the fasting blood tests I did a few weeks ago. He feels an IUI is not a waste of time, but he would support our decision to do IVF, too. It’s 100% up to us what we do next. She went through the IVF start dates for the fall and asked me to call back as soon as we’ve made a decision—either way—so we can get the necessary meds ordered and paperwork signed. I also gave her all of the relevant details from this current cycle and let out a sigh of relief when she didn’t seem fazed by my number of big follies vs. low E2 number. (I’m sorry about this, but you should know that I am QUITE obsessed with my estrogen and will probably be talking about it for a while. 🙂 )

On Friday, when I got my E2 results, the only thing that prevented me from melting down at work was the thought that we could go directly to IVF and be done with this #@$^#* IUI crap. But the more I think I about it, the more I feel like we should probably do an IUI with Dr. A and let him get a firsthand feel for my body’s weirdness and response. Besides, he will have a different protocol (potenitally stepping up my Gonal-F dosing mid-cycle, not using Luveris, adding Ganirelix to absolutely prevent premature leutinization) and that could be helpful as a diagnostic when creating my IVF plan.

Plus, there is a chance this low E2 thing would happen again during an IVF cycle. IVF is not a guarantee that I’ll have good hormone levels, a fluffy lining and some good eggies. Everything is a freaking crapshoot, even IVF.

So I am thinking that we will do an injects/IUI cycle with Dr. A in August. (Hopefully my cysties only keep me on the bench for a week or so this next cycle?) And if that IUI doesn’t work, we’ll either jump into the September 12 or the October 3 IVF cycle. I have a fair amount of unused vacation left and want to take a REAL trip with hubs (not a wedding weekend trip where we eat all of our meals with place cards in front of us). So maybe we’d take September off treatment, take a trip just the two of us, and come back ready to IVF in October. (Side note: It’s painful to think about taking a voluntary month off, given all of my bench time.)

Behind all of this planning, excel sheet calculating, etc—I am almost ashamed to admit it—but, the teenie tiniest bit of hope is maybe-sorta-kinda blossoming. I don’t know why. Maybe it’s treating myself like a pregnant woman…no glasses of red vino after a long day at work, no runs along the lake, no lifting weights in front of the Today Show, no hot yoga classes. Maybe it’s the emails/blog updates I’ve been reading with “It worked!” updates. Maybe it’s the hope that we are about to begin working with a new doctor and a new clinic. But the moment I  start to feel hope, my face blushes red and hot with the ridiculousness of it all. I feel like a complete fool. I have visions of the Baby Gods Up Above shaking their heads and whispering to one another, “Poor thing, she actually thinks there might be a chance.”

I want this to be over. Over. Over. Over. I have never been so ready to have the luxury of thinking about something else, my friends!!!

PS Anyone seen Season 5 of Weeds? We have been watching the DVDs all summer and began the final disc last night. Darnit if the plot development isn’t a complete buzz kill. I mean…a show about drugs and pot where the lead character perpetually carries around either 1) a venti iced Starbucks, or 2) a bottle of white wine? I thought I was safe getting hooked on it!

I wish

I wish I didn’t know my estrogen number.

I wish I didn’t believe this cycle was doomed before I even IUIed.

I wish that on top of IF, my body didn’t respond like a freak of nature to the meds.

I wish I had a few good eggs after my month on the bench, my two weeks of injections and my six monitoring appointments.

I wish I wasn’t scared to death that I don’t even have one in the bunch.

I wish I didn’t feel like I’ve utterly let hubs down. Again.

I wish I were the patient who didn’t have an “unusual” response.

I wish my big follies held healthy eggs like they’re supposed to.

I wish I hadn’t gone from feeling 80% filled with hope to 99% not filled with hope.

I wish this chapter of my life would be over.

I wish I could embrace any of the, “you never know/stranger things have happened/it only takes one/maybe there IS an egg in there” mantras floating all around me.

I wish I could think about something else.

I wish I could forgive my body for fracking up another cycle.

I wish a good night of sleep had made me feel stronger, instead of weaker.

I wish I could stop being so sad, scared, jealous, resentful, selfish, envious, angry, and afraid.

I wish I didn’t know my estrogen number.

HIGHS and l..o..w..s

Monitoring was fantastic. 8.1mm lining. (The tech had to measure it a few different times to give me that great number, but hey, I’ll take it.) Rightie got up to 18! Leftie is going nutso with a 20, 18.5, 18, 17.5. I swear on the walk into work the entire world was so super duper sparkly I needed sunglasses. I kept thinking to myself, THIS IS AS GOOD AS IT GETS! I even thought about how if THIS didn’t work (my thickest lining yet and four follies, amazing for me), we should just go directly to IVF because no IUI cycle would ever work.

I had a cartoon-size smile on my face all day.

Before you tell me I could become octo-mom, let me tell you about my blood work. My E2 is 292. If you’re thinking that number sucks, you’d be correct. The rule of thumb is 200 E2 per mature follie. Which leaves me with….maybe one follie? And my LH is officially so low that it’s not even measurable.

Ugh.

So. I’m triggering tonight. And they want me to come in TOMORROW a.m. for the IUI. It’s odd that they’re not doing the standard 36 hours post-trigger IUI. Especially since I’m most definitely NOT surging on my own (low LH, see above). I can’t help but suspect they’re rushing me so no one has to come in and deal with a patient on July 4th. I’ve got calls into the nurse and Dr. K. I’m sure they won’t change the protocol but maybe they can give me a tiny piece of hope back.

The ups and downs absolutely kill me.

***Update***

What do you know, Dr. K agrees with me and we’re doig the IUI on Sunday instead of tomorrow. The on-call RE’s reasoning for doing the IUI tomorrow morning was that my E2 seems to have plateaued (sad). He wants to catch any viable egg before it goes bad, so to speak. Dr. K sees his point, but would rather IUI 36 hours after trigger. They are hoping that out of all those big guys, one holds a good egg. So after 15 days of stims and 4 follies measuring 18mm or bigger, I have maybe one good egg. Please. Please. Please. Please. Please let it be the one.

Roller coaster. Done.

I imagine a BFN must be the worst feeling in the world when you’re cycling. But since I’ve never gotten that far, I will share my personal hell (November, January, February, half of March, now April): being benched. I’ve experienced that wind-out-of-my-sails–feeling three times in the past two weeks. Weird. (Still, it was nice to have some ups during this roller coaster ride.)

This afternoon Dr. K canceled this pseudo-cycle because my E2 dropped a bit and my lining didn’t improve. I’ve been put on BCPs to try to shrink the—now official—cyst. (Bye Scrappy The Follie, it was nice to know you.) Truthfully, I’m super bummed. 😦

Since Sunday evening my stomach has fluttered with excitement that I might go into April, my lucky month, with the secret hope you only feel during a 2ww….but it was not meant to be. Annoyingly, I also can’t start injects right after I finish a cycle of BCPs—because of our wedding gauntlet I’ll be on them longer than 21 days.

Still, I know that some REALLY good things came out of this roller-coaster. Thanks to this random and sort of emotionally-grueling monitoring, I now have some legit hope that my lining might improve on better meds. Totally worth it. And I’m grateful Dr. K broke protocol to see this through. I’m excited about meeting with her in a few weeks for a second opinion consult. So really, even though this news stings and I can’t shrug the blah feeling that’s descended upon me, know that I am happy about these things.

Thanks to all of you for rooting for Scrappy; I’m sorry I couldn’t turn the weirdest-cycle-ever into a trigger-IUI story!

Scrappy

I went to monitoring this morning. My follie/cyst is hanging in there. And my estrogen is up a little bit. (LH is down, can’t win ’em all.) Best of all….my lining thickened up from 4mm to 5.3mm in 48 hours! I don’t know if it’s the supps, or the acu, or the lack of Evil Clomid, but I am HAPPY!

I am so uplifted by the amazing Dr. K for giving this wacky cycle a chance. I’m like, CD6 or CD33, depending on how you look at it. She says this is really unusual, but she’s pursuing it. For that, I am so grateful. I mean, if she hadn’t let me go in for these random monitoring appointments, I would’ve gone the entire month of April having no idea if my lining could get any better than 4.4mm. I know 5.3 isn’t thick, but it’s progress for me. (It’s def that bone I’ve been hoping for!)

Tomorrow will be the moment of truth: one final day of monitoring. If Scrappy can grow just a smidge more, and if my estrogen rises a bit, they will let me trigger. I so want to believe Scrappy is a follie!

Very very interesting

Remember how I wanted my estrogen to fall? It did not. It rose from 305 to 410. My LH is up a bit, too. And my lining grew from 3mm to 4mm since Friday.

Remember how I wanted my cyst to get smaller? It did not. It grew by 1mm.

Remember how I said this is the weirdest, lightest period of my entire life? Dr. K has a theory about that.

She’s the attending doc, who’s on call for two weeks while Dr. C is on vaca. She thinks my body may not be ready to call this cycle off. I had a mini-consult with her during this morning’s ultrasound and spoke to her on the phone this afternoon after my blood work came back. She thinks this might be a viable follicle—a slow-grower leftover from the Clomid. She’s having me come back on Tuesday for more monitoring to see if my estrogen and LH continue to rise. If they do, she wants me to take the HCG trigger. And then IUI. And then take progesterone. She said this is extremely unusual. And that implantation would be a long shot with my thin lining (which the Provera didn’t help, but didn’t hurt much either). She wants to check it out.

She also has a theory on my thin lining….that I’m estrogen deficient and that it’s possibly due to endurance-level exercise in my past. (I have majorly chilled out on exercise after a decade of marathons and triathlons.) For that reason she might recommend a different injectable (Menopur instead of Gonal-F, since my LH is chronically low and Gonal-F is an FSH-only drug while Menopur has both FSH and LH). I asked her if it would make her or Dr. C uncomfortable if she looked at my medical and TTC history and met with me and hubs for a consult in April. She said it would be perfectly fine and she thinks it’s a great idea.

No matter what Tuesday brings, I think this is what we’d call, a bone. 🙂 Right my friends? A doctor who is looking at my case with fresh eyes. One who has a plan. And who thinks outside the box (potentially trigger on CD30 to salvage the wonkiest cycle ever?! Awesome!).

So, for 36 hours, I have hope again. (Is that okay? Am I setting myself up for another crash on Tuesday afternoon?) How amazing would it be if I could trigger and IUI for the first time? C’mon estrogen & LH….RISE!

Throw me a bone! *updated*

Okay, so after Googling IF counselors and reading your extremely supportive and awesome comments yesterday afternoon (thank you!), I got a nice surprise. MY PERIOD! I almost posted right then but something told me not to count my chickens before they’d hatched. So to speak.

And that something turned out to be a big 22mm leftover follie/cyst at this morning’s baseline monitoring this morning. ARE YOU FREAKING KIDDING ME? Can someone throw me a bone here, please? Please? PLEASE?!?!?!

My heart sank as the u/s tech measured it. I felt like shouting, Where the F- was that guy when I needed it, during my cycle? Geez. Also, if my ovaries were stagnant (remember, ZERO follies over 10mm) and the cycle was canceled on CD16 how the heck did I develop this big follicle? Is it possible I had a semi-mature one last week that was missed in the monitoring? I’m so confused. And frustrated. This is a final F-YOU to Clomid. I really tried to be your friend. We are finished, this is the last time you’ll hurt me!

I know what happens now. The nurse calls or leaves a message on the lab line at 2pm trying to gently explain that I have  a cyst and Dr. C (or whoever is on call) wants me to wait a month and she’ll call in my Provera Rx because she knows I don’t ovulate or get my period. And then I’ll call back and ask WTF is going on, how the heck do I have this cyst and she’ll say, “It happens. Cysts are a side effect of Clomid. I don’t know what else to tell you.”And then I’ll tell her I’m not taking my chances that it’s going to grow (like it did in January, sigh) and that I’m starting BCPs. And she’ll say, “Okaaaaaay. Bye hon.” BYE!

I should’ve been on the 100mg dose this past cycle. If I’m going to get a cyst anyways, why not actually give me a shot at ovulating? Every cycle I find things we should’ve done differently. I know, I know, hindsight is 20/20 or whatever, but seriously. I kept saying I thought we needed the 100mg dose. Whatever, it doesn’t matter: My lining sucked so regardless of ovulating the cycle was destined to be a bust. It just really blows that it also busted April.

So after the appointment I headed to the gym (monitoring was so early I had time to kill before work) and sweated on the StairClimber, lifted weights. Then I showered up and stopped into Starbucks, where I ordered a grande coffee and a calorie-bomb of a glazed donut. Because why the hell not? Now I’m hopped up on caffeine and sugar (groooooss, I’m regretting that horribly unhealthy breakfast) trying to think of all silver lining, because I can’t bear to leave you all with yet another DOWNER EGG post. There have been so many lately!

1. The cyst/follie is on my right ovary. First time I have EVER seen action from rightie. It’s nice to know she’s alive and well. I do wish she had not picked this moment to wake up, but this is my silver lining part of the post so I’m just going to be grateful she has the power to produce follies.

2. My lining was 3mm. This is still thin for most women, but considering my lining is usually in the 1-2mm range at baseline, I am impressed. However, today is only CD2 so perhaps I’m just catching it before it gets super thing from bleeding. Oh wait, this is silver lining time. Yay, that is a good number for me! If I can start there next time I have a better shot at a decently thick lining when I ovulate. (Yeah, I’m going to freaking ovulate next time I get to cycle. You have no choice in the matter, body. We are MOVING FORWARD.)

3. We have an out of town wedding the weekend of April 10. I was getting nervous about squeezing in an IUI before hubs leaves town. I guess we will not have to worry about that now. Unfortunately, there is another wedding the weekend of April 30. I have already calculated what three weeks of BCPs does to my timeline and it isn’t pretty. I’ll probably have to stay on them longer to ensure we’re not in the middle of injects when we go to NYC at the end of April. But, silver lining, I can control my period better with BCPs than I can with Provera.

4. Back to the lining. I guess this gives my body more time to clear Evil Clomid out of its system. That can only be good.

I think that’s about it. Whew. I will take my bone any time now….is someone up there listening?

**********Update************

A different nurse called me this afternoon. A really nice one. The news was not nice: Estrogen-producing cyst. Typical! I hate to say it, but I was pretty sure that’s how the convo would go. She has no explanation for why I grew a big follie in a canceled cycle. BUT, because I only started bleeding late yesterday, they are going to re-test my Estrogen level on Sunday morning. My level is currently a sky-high 305. They want it to be 75-ish or lower. And if it goes down, they’ll let me cycle through this. I guess there’s a chance it could be artificially high because it was too early to test me. I don’t know. This period is pretty weird. I’s EVEN lighter than it has been since I went off the Pill. Like, I’m bleeding, but so little that I don’t even need a pad. Or a panty-liner. And as I’ve remarked a few times to hubs since last night at 7pm, I have no cramping. None. It’s unusual. (He chalks it up to my daily dose of Vitamin E supps, which would be a nifty side-effect of that supplement!) But still, I’m bleeding…so it’s my period, right? Right, said the nurse.

I really can’t decide how I feel about this. I guess perked up just a bit to have some hope for the next 36 hours. But really you guys, you have seen my body’s history (look to the Long & Short Of It sidebar to the right), it has an amazing ability to develop all of the worst side effects of fertility meds. Right now, so frustrated, I feel like I watch people get good news or at least green-light news month after month, while I sit here spinning my wheels and switching between cheering everyone else on and shouting for help. (I do love cheering you guys on, I hope you know that!)

Sunday would be a GREAT time for that bone…

Welcome to my world

Hi ICLWers! Thank you so much for stopping by; I’m happy you’re here!

To get you up to speed, here’s a quickie version of my TTC history….

After 10 years of BCPs I went off them and never got my period. I was prescribed Provera a few times to kickstart it: I’d get it but then weeks and weeks would pass sans period. Finally in October I began seeing an RE. Diagnoses: anovulatory.

We have tried three cycles of Clomid since October, taking breaks in between the first two due to cysts. In December I ovulated for the first time since TTC. (Yip!) But my lining was so thin (3.2mm) that even if I had conceived, there was no chance of it sticking. My most recent cycle was canceled on CD16: no follies over 10mm. But worse, my lining only got to 4.4mm. Yes, I do know that happens to a lot of women on Clomid—however, I was also taking Estrogen suppositories, so I really ought to have had great lining.

That seemed slightly worrisome, but became slightly crushing. Last week we met with our RE for a third consult and he informed us that my lack of response to Estrogen is a serious concern. He’s hoping I magically fluff up on injectables, but he warned us we’re nearing the end of the road if my lining doesn’t improve. (You can always try new and different meds to improve follicles and trigger ovulation; but without decent lining, you can’t get pregnant.) It was a pretty devastating conversation.

We are hoping with all of our hearts that injects do indeed improve my lining, even though I don’t respond to Estrogen. But if they don’t, we will seek a second opinion from an RE who’s willing to try alternative therapies on my lining. Or we’ll take a break. Or possibly both. That makes this upcoming injects cycle pretty important. Of course my heart physically yearns for a BFP. But above all else, I need my lining to get better. Otherwise, we will be heading down a new rabbit hole…

Now onto the more fun parts of my world: hubs, running, writing and cooking. I’ve gotten to enjoy them all today.

7am Suit up for a 5-mile race.

9:30am Finally cross the start line and run through downtown Chicago on a blustery, gray, frigid but awesome morning. Hubs runs it, too—the longest distance he’s completed. He ROCKED it! 🙂

11am Hubs and I relax with big cups of java in a coffee shop to warm up and then take a cab home.

12pm We prepare The World’s Best Pancakes with maple syrup–butter to celebrate his longest-ever race. And drink mugs of spicy hot coca.

1pm I work on some freelance assignments in front of the TV while hubs watches basketball. (I’m KU fan; my ‘hawks lost last night—so sad! Fortunately, hubs’s team, University of Kentucky, is still in the tourney and looking great.)

Up next Bottling hubs’s latest batch of beer (a Saison), cooking din, more freelancing…and injects training in the a.m.!

The past few days

I have not been feeling super blogariffic this week, so I really apologize for my lack of commenting and reading and posting. That said, I am feeling better, so I’ll be back in action soooon.

Monday was kind of a sad, doomsday-ish blur. You guys were there. I was upset and scared. The ubiquitous darkness of IF felt twisted and nightmarish in new and horrible ways. Suddenly I was thinking things like, Would I even consider a surrogate? And, Would hubs and I be okay as just the two of us forever and ever? There was a lot more brewing in the witches pot of Bad IF News, but I think you get the picture. YUCK.

Then Tuesday I felt pretty ticked off at Dr. C. I mean, what RE tells a sensitive, hormonal, baby-desperate woman that he doesn’t know whether she can get pregnant? We appreciate honesty, but I am apparently a fragile little thing who really benefits from a more positive bedside manner. We still trust in Dr. C, but I think his consult performance was begging us to go out and find a second opinion. Some internet research suggests there are some experimental ways to get around lining that won’t respond to Estrogen. That said, we think any RE would be taking this course of action (injects) so I feel good about proceeding with this cycle as planned. And if ditching the Clomid and trying new drugs doesn’t thicken up my lining as we are so desperately hoping it will, and Dr. C won’t think outside the box with us, then we will move on. We are very fortunate to live in Chicago, where there are a number of fantastic RE clinics. Hubs and I are not accepting this good-lining-or-bust thing. I hope we can prove ourselves right.

By Wednesday, it was time to get busy. Action is the antidote for despair, right? Even though he has an actual dissertation to work on in real life, hubs is currently working toward his PhD from Google in the esteemed field of Uterine Lining-ology. (And he’s on track to graduate with Honors, as you will see in a future post wherein I bestow all of the findings upon you.) For the past few days he’s been sending me links to studies and RE-penned blogs, all of them related to thickening the endometrium. At night, he comes home bearing Walgreens gifts. 🙂 I’m now taking Vitamin E, L-arginine (an, um, male performance supplement that works similarly to Viagra), baby aspirin, Fish Oil and Pre-Natals. And going to acupuncture. Oh, yeah, and I’m also taking Provera and have some Gonal-F arriving this weekend. It’s a freaking Fertility Pharmacy next to our coffee maker!

Now on to the really important stuff: the world’s biggest THANK YOU! Thank you all so much for your kindness via comments and emails on Monday. To those of you who know me and have been reading along, your heartfelt comments warmed me on a chilling day. To all of the folks who aren’t regular visitors and dropped by to offer support, I am so grateful and uplifted by your words. And to those of you who had successful stories to share, thank you so very much. You gave me hope. Thank you all from the bottom of my heart.

My heart is breaking

Injects consult 10am this morning: Dr. C said it’s a huge problem that I don’t respond to the Estrogen. 😦 Like, super HUGE. I said, “Do you still think I can get pregnant?” And he said, “I really don’t know.” And then he said that if my lining doesn’t thicken on the injects, then we have to think about a surrogate. He wasn’t being fatalistic, he was telling us the truth. Lining is pretty much a deal-breaker. They can always give you more meds for bigger, better follies. But if your lining is thin, game over.

I am dying inside. This nightmare just gets worse and worse. I may not be able to get pregnant.

This cycle is officially canceled. I can start Provera next week. We’re going to injects class at 8am on Monday. I have no idea if lining will thicken with injects. Dr C doesn’t know either. Hubs just seems numb. (Please, someone, anyone, tell me a story about how your lining was in the 3mm range on Clomid and thickened up past 7mm with injects.) I teared up in the meeting, and now I’m barely holding it together. I  asked about Viagra and acupuncture to thicken lining. He said there’s no evidence that either one works, but I can do acu to de-stress.

How can I be so healthy and yet so totally f-ed?  My hormones are all normal. I’ve never had a problem with light periods until I went off BC and began TTC. I don’t have fibroids. I don’t have scar tissue. I don’t understand why my body is like this.

My heart is breaking.