Tag Archives: Estrogen

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!

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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.

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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.

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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!

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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!

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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!

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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…

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