And here we are

We triggered last night (twelfth night of stims, not too bad!) and will IUI tomorrow. We officially have one good follie on the left, with a “maybe” on the right (if it works really hard to catch up). I had a bunch of follies hanging out in the 12-13ish range and there was talk about canceling or converting to IVF. So, we triggered quickly to save the cycle. Phew.

I love Dr. Awesome. I love his knowledgeable, compassionate nurses. I love his online patient portal where hubs and I can access my daily monitoring results. I love his protocol. I love that he is checking my P4 in a week. I love that I have a Beta test scheduled and don’t have to take an HPT. I love his aggression with my treatment. I love his caution. I love everything about clinic #2.

Can we be friends?

That’s what hubs and I say to each other as a way to make up after we’ve argued. Those words are code for, “I don’t want to be in a fight in more, let’s move on!” An olive branch, if you will.

I feel like that’s what I’m doing with blogging. I want to be friends with it again. Lately I’ve been focusing more on commenting and less on writing about myself because it was fueling my tendency to freak out, moan, weep, obsess, complain and feel jealous and angry and sorry for myself. There is a fine line between venting and enabling negativity. I am working hard to find the balance. I want blogging to be a healthy, therapeutic thing for me again.

I’m still trucking along with injections and monitoring for IUI 3.0 at Clinic #2. Dr. Awesome is using a similar protocol to Clinic #1’s, except instead of Luveris to help out my super-duper low LH, he asked me to begin inject low-dose HCG on my fifth night of stims and also to start Ganirelix (to prevent premature ovulation) on my seventh night of stims. I’ve “checked out” (well, more than usual) and I’ve been letting hubs do the Googling and cycle comparing when I get monitoring results. He has also been taking the pressure/stress off of me with injections. He preps them each night (mixing up the low dose HCG, dealing with the Ganirelix, setting up the Gonal-F pen), and then injects me while I look away. It’s amazing what a difference it makes to take all of my injections in the evening and to have someone else worry about them for me!

I’ve also been focusing on being more gentle with my body. I’ve been doing lots of yoga, and no running. I bought a meditation CD aimed at infertility and have actually been leaving my desk for a half hour every day at “lunch time” (we all eat at our desks) and listening to it on a park bench. I’ve been practicing the deep breathing I learned on that spa trip with my Mom in April. I have not managed to chillax into a blissful Yogi state by any means, but I am really trying to be more “okay” with everything. The good and the bad. The happy and the sad. Even Steven.

Honestly, I know that all of the hard work I’m doing on myself hangs in a fine balance….the moment my cycle goes off the rails, or a friend emails with baby news, or whatever, I could potentially melt down. It’s easy to be Zen when everything’s going okay. Still, it’s more pleasant than the alternative—being a crumpled mess of despair no matter HOW things are going.

I’m trying really hard to take this cycle day by day dear bloggies. I’m trying to find my sweet spot.

Let’s make a deal

The stakes are higher this go-round. No, not just because of my inevitable post-2ww cyst and bench time, or the emotional trauma and inconvenience of having to go through another three weeks of injections/monitoring/etc, or the impending holy-sh*tness of IVF.

You see, back in June, hubs and I compromised that we would go through one more cycle with Dr. K at clinic #1. (I really wanted to jump ship and go to Dr. Awesome a clinic #2 right away.) If it didn’t work, we’d head to Dr. A for our third and final injects/IUI cycle. Somewhere in the middle of the June injections, I think it was after my first monitoring appointment, I made a deal with hubs. If we got pregnant this cycle, I would buy him all of his beers* for the next 12 months. As the champion of Dr. K and her Luveris/slow & steady/no stepping-up meds protocol, I decided that he would deserve some HUGE PROPS if this actually worked. So. Yes. A full year of beer, on me. If, and only if, Dr. K’s plan worked.

Ever since then it’s kind of been a joke that it would be really really really really really awesome for him if we were to get pregnant this cycle. Not only would it be, you know, the happiest and most relieving thing EVER, it would also mean he’d be drinking on the house for the next year. (Picture a pregnant lady buying her husband’s beer at a bar, the liquor store, at dinner….whew, we’d get some raised eyebrows! I would revel in them!)

So you can see this is a very important 2ww for us, my friends! The only problems: I don’t know if 1) I had a good eggie because of my fracked up E2 level on trigger day, 2) if I even ovulated, and 3) I haven’t had single DANG SYMPTOM suggesting Dr. K’s protocol worked. (I feel just like I did in my May 2ww….and we know how that ended.) But if I were suddenly to develop tingly nipples/aching breasts/metallic taste/twitching uterus/bloating/cramps/nausea/sensitivity to smell/WHATEVER in the next five days….I would be the happiest person on Earth. And I would love nothing more than to start saving my pennies for hubs’s beers.

*In case you were curious, hubs isn’t a big drinker. He just enjoys the occasional unwind-after-a-long-day beer or football game beer or dinner beer.

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.

Starring….LEFTIE!

Hello bloggies. I had an excellent monitoring appointment this morning. My lining is up to 7.0 and….wait for it….triple stripe. HUZZAH! I am slightly concerned that the u/s tech realizes I’m a crazy, emotional fool who will turn into a weeping puddle if my lining report is not good, and that she’s inflating my numbers or taking four or five measurements just to appease me. But, whatevs. It’s totally working, I’m appeased. 🙂

It turns out my left ovary is working some serious OT this cycle. That’s great and all, but….crapola….the same thing happened last time I cycled (a super active left ovary with one to two viable contenders and a ton of little guys bringing up the rear). I’d really love the 14.5er on rightie to catch up. I’m happy with my lining, I’m happy about my follies waking up, but I’m still finding it within me to worry my left side is my….bad side.

Rightie: 14.5, 10.5

Leftie: 16, 15.5, 14, 12, 12, 10.5, 10

E2: 236

LH: 0.5 (it’s kind of ironic how the more consectutive days I take my PURE LH INJECTABLE, the lower my LH number)

I am to stay the course. 75iu of Gonal-F every night and 37.5iu of Luveris every morning. Back on Friday for CD17 monitoring. That’ll be 15 days of stims, folks. I’m going for a record in blog-land!

I swear there is other interesting stuff going on in my life right now, but, let’s be honest, this is all I think/obsess/daydream/worry about. One story for you, before I pretend to care about work for the next five hours. Last night as I was swigging my water while taking my cocktail of nightly supps—three L-Arginines, a Vitamin E, a Pre-Natie, a baby aspirin, a fish oil—dressed in a cropped-ish tank top that exposed my bruised tummy and a baggy pair of drawstring khakis that hubs not-so-affectionately calls my “prison pants,” he came around the corner, paused to examine the visage of beauty in front of him, and finally remarked that I looked “bloated.” What I heard was, “fat.” [Blame it on the Luveris, the inject that not only gives me bruises and stings like a $&*#@ going in, but also lowers my LH and makes me crazy.] Well, he was right. It turns out I am bloated, and I’m glad I finally have some follies that prove it. I hit the gym extra hard this morning but I realize my bod is a bit of a lost cause at this point in the cycle. Just saying….it is a lesson in self-acceptance to look pregnant when the one thing you most definitely are NOT is pregnant.

A fly on the wall

There is a staging room at clinic #1 where women wait for their ultrasounds during early morning monitoring. While one woman is getting her u/s done, you are shown into the room, given a sheet, and then you undress and wait in a curtained off stall. The ultrasound room is riiiight next door so you can hear exactly how the woman in front of you is doing, where she is in her cycle, etc. Then she comes out, you get called back, and after she changes someone else is shown into the room to wait for her turn while your ultrasound is completed.

Today there was a couple in front of me, getting their “10 day” ultrasound. (Not to be confused with the VERY different CD10 ultrasound.) I sat on my little stool and tried everything under the sun to distract myself from hearing what was going on in that room….I played Wurdle, checked email, etc etc. But darnit if those walls aren’t as thin as paper…I could hear every single word. The congratulations and hugging between the u/s tech and the newly pregnant woman. The congratulations as Dr. C came in to do the u/s. The talk about symptoms (No spotting, great! Feeling nausea already, great sign! A little crampiness, perfectly normal!). The measurements (on sked). The lining (thick and healthy). The heartbeat (110bpm). The calculation of due date (February 22). More hugs and congratulations as she left the room. My eyes uncontrollably welled up with tears.

Bloggies, why in the world do I respond that way? I should feel hope that success was literally sitting a few feet from me. I should feel relief that clinic #1 is getting patients pregnant. This woman is a fellow infertile and lord only knows what horrible-ness she and her husband have suffered to get to this point. It’s not jealously. I think it’s mostly fear. Fear that I will never, ever know that joy and happiness. Fear that I’m too busted to ever conceive. Fear that I will never be pregnant. Fear about my lining. Fear about my egg quality. Fear about conception. Fear about implantation.

Fear that the closest I’ll ever be to a “10 day” ultrasound is the stool in the staging room.

*****

In, ahem, better news. My lining woke up over the weekend! He’s back up to 6mm. (Yeah, my lining is a “he,” go figure.) I even have some measureable follies! I’ve got one 12mm-er and a 10er on rightie. Leftie has four little guys clocking in at 10mm. My guess is we will continue my slooooow and steaaaaaady stimming protocol (37.5iu Luveris in the a.m., 75iu Gonal-F in the p.m.) and I’ll be injecting for a while longer. I am getting a little tired of the injections (I’m on my 11th day of stimming) and monitoring, but my lining could definitely use extra time to improve so I’m assuming it’s a blessing that I’m a slow responder.

Friday did open up Pandora’s Box with my lining weirdness. I had pretty decent control over my intense lining anxiety after I got up to 7.6mm last cycle, but Friday brought the dangers of thin lining back into the spotlight. I’m afraid I’ll lose a couple of millimeters again by the next monitoring appointment. Or that he’s maxed out at 6mm. I don’t feel confident or home free with my lining. Hubs suggested instead of going into “worry” mode, I try to embrace the good news when I get it. And it IS good news. Going from 3.6mm to 6.0mm in three days is awesome for me. Truly! I am very, very grateful today. Hopefully as the follies continue to grow I can fluff up even more.

*****

Dear woman in front of me in the u/s line this morning,

I am incredibly happy for you! The joy you and your husband expressed took my breath away. I have read about early pregnancy ultrasounds in blog-land, but the reality was even more special and miraculous than I had imagined. It was incredible to hear the intimate details of the miracle of life you are carrying. I wish you all the very best for a wonderful pregnancy.

Oh, one more thing. I hope and pray that you left me some baby dust in the staging room. 🙂

xoxo,

Egg

It was nice knowing ya, Yoda Egg

CD10 monitoring this a.m. My lining went from 5mm to 3.6mm. My jaw sorta dropped in disbelief at this news, which inspired the tech to re-measure it. “4.1!” she exclaimed happily. Riiiiight.

How the frack does my lining go down by 1.4mm when I have the bruises and holes in my stomach from 15 injections to prove that I should be producing copious amounts of estrogen?

I’m worried that my 7.3mm lining was a complete fluke last cycle. I’m afraid that the tech mis-measured it and it was really much thinner. I’m scared that my lining problems are back. I don’t know you guys, this lining thing has me reeling a bit.

It’s like, just when I think I’ve got my body figured out (cysts, okay I can endure them; slow-growing follies, fine, I take a long time to stim), it throws something else at me. Seriously, what the heck body? Geeeeeez.

Then I made the VERY big mistake of texting my Mom an update. She texted back, “You should’ve cycled with clinic #2.” Thanks, Mom! That makes me feel awesome. (Also, I think she’s wrong. Dr. Awesome wanted to use the same dose of Gonal-F and no Luveris. I’m happy we’re giving the Luveris a chance. I don’t think the Luveris thins my lining. This is my body’s fault.)

I feel like going home and just crying under the covers for a couple hours and then taking a long walk to get myself together. But that’s not happening. Work is incredibly busy and stressful on Fridays and I’ll be here late. I’m hoping the nurse has some words of wisdom when I get my dosing update, but I can already see how that convo will go.

Me: “So, what’s up with my lining, why did it thin out?”

Nurse: “I know, we’re surprised, too! Sometimes that happens and no one knows why.”

Me: “I haven’t been bleeding, where does the lining go?”

Nurse: “Hmmm, good question. You’ll have to ask the doctor.”

Me: “Why am I not making enough estrogen to thicken my lining? Should I be on a higher dose of meds?”

Nurse: “I really have absolutely no idea how any of this works and I’m not allowed to comment or speculate or soothe you. My job is to draw blood. You’ll have to ask the doctor.”

Me: “Okay, can you have Dr. K call me back?”

Nurse: “Ohhh, sorry. She’s not on call today.”

The upside of all of this is that my follies are still too small to measure, except for one on rightie, who’s at 10.5mm. So here’s what I’m repeating to myself: Once they start growing and I’m making more estrogen, my lining will fluff up again. It’s much, much too early to freak out or be down. Things can only improve from here….

Giorno otto del ciclo

That post title? Cycle day 8, in Italian. Gotta keep everyone on their toes. Also, I already named a post CD8 and can’t bear to repeat last cycle’s meltdowns, especially the one on CD8. New cycle, new attitude.

Soooo, monitoring. Nothing to see here, folks! I have zero follies over 10mm, none big enough to measure. But it’s okay. I think some little guys will probably wake up and begin growing in a few days. My lining was 1.8mm at baseline and it’s up to 5mm. Which is, you know, AWESOME for a lining-challenged–girl like me. I think my lining is digging the Luveris.

We also got some great news yesterday. Hubs’s SA #2 with Dr. A’s preferred Kruger Test for morphology came back all good. He has some great looking swimmers. So if we can get to IUI land again this cycle, we know we have a shot.

My blood work with clinic #2/Dr. A is also rolling in and everything looks okay so far. TSH (the reason I was referred to an RE last August), is normal. AMH is normal. Dr. A noted some perhaps alarmingly high kidney- and liver-related hormone levels in previous rounds of blood work. So, even though he said it wouldn’t be related to my ferility troubles, he was a bit concerned and ran extra tests on secondary hormones that give a better picture of the health of those organs. Everything is normal. PHEW! Seriously, part of me was awaiting a call from Dr. A to the effect of, “You’re going into premature kidney failure, get to the ER immediately.” (I know, I’m nuts.)

Which begs the question, what the frack is wrong with me and why don’t I ovulate? I know the answer doesn’t matter….it simply is what it is. (Yeah, Yoda Egg is currently in the house.)

Ciao!

The compromise

This post is too long and all over the place (aren’t you dying to read it now? haha), but so are my thoughts so here goes….

We had a great consult with Dr. Awesome at the new clinic yesterday morning. The only downer: I went into the appointment with the mentality that Dr. A was/is our new RE. Apparently hubs missed the memo….for him, it was an exploratory meeting.  Dr. A is smart and mellow and aggressive and honest and chillaxed and positive. I’m hyper and type-A and a little gloom & doom and prone to freakouts and Dr. A’s qualities are an antidote to my crazy. I am ready for a fresh start and some more urgency with my treatment.

Hubs really likes Dr. A, too, but he (hubs) is being all academic and reasonable about the decision to switch doctors. He feels like my reasons for wanting to switch are “emotional and reactionary.” Is that possible? Ummm, yes. But geeeeez. I have been with clinic #1 for 9 months and spent 6 of them sidelined. I took Clomid three times even though it wreaked such havoc on my lining that I couldn’t have supported a pregnancy even if we’d gotten an eggie to meet up with a swimmer. The word surrogacy was uttered at a very premature stage! So. Yeah. I’m over them. And I have been for a long time.

Here’s what I like about Dr. A, aside from his demeanor that exudes confidence/mellowness.

• He does not automatically bench patients with cysts. He considers each one (size, number, whether or not they’re secreting E2) and then either 1) lets you cycle through it, 2) watches it with monitoring every 7 days so you can jump back in if it goes down, or 3) tries to get it to burst (and maybe even release an eggie if it’s a viable follie) with an HCG shot. For someone like me who is SO PRONE to cysts, this is a pretty huge deal. It would theoretically eliminate a lot of my bench time. (And my friendly cyst would NOT have benched me this month. Sigh. Another lost month.)

• He does not cancel injection cycles for too many follies. He lets the patient decide when the multiples risk is too high. He might strongly recommend canceling, but ultimately it’s up to the patient.

• He gives patients the option of converting to IVF if they produce too many follies during injects.

• While he does not employ it often, he thinks I’m a good candidate for a “step up” protocol…which basically means he’s open to tweaking the injects dose to a higher level if the response isn’t great at a lower level. (Clinic #1, as a rule, only lowers the dose. To me that suggests cycles could be a bust, like when I was on too low a dose of Clomid?)

• He is the only doctor at the clinic, which means that he is ALWAYS the one making the decisions about treatment. (It bothers me that Dr. K is “my” RE at clinic #1, but two other docs are often making the decisions when she’s teaching or not on call.)

• He has the best IVF success rates in town.

Aside from those differences, his thoughts about my protocol are pretty similar to clinic #1. He’d stick with the Gonal-F, starting with a lower dose and potentially building over the course of stims. He’s not a big fan of the Luveris, and doesn’t think it’s a big deal that I have trace amounts of LH. So he’d probably nix that part of the stimming. He also wants to repeat hubs’s sperm analysis, because he didn’t love the morphology number from the one back in October. He has a test methodology he likes better than the one clinic #1 used, which will shed more light on that subject. (I really believe it will be fine.) If it turns out morphology is an issue, he’d recommend we move onto IVF sooner rather than later.

Whew! Right?

So, over dinner last night, we hashed out our course of action. We will move forward with all of the testing Dr. A has suggested. (A new SA for hubs, bloodwork for me, including a metabolic panel, androgens, AMH and re-testing my TSH.) While all of those tests are being run and the results come back and Dr. A tweaks our protocol, we will do one more IUI with Dr. K. Hubs feels like she has learned a lot about my body and we should give it one more shot. He reminds me that both of us were sick on IUI-day last time, and maybe this one will go better. Even Dr. A concedes that my last injects cycle “looked great,” so it’s not like we’re wasting a chance by sticking with clinic #1. Plus, hubs feels like it’ll be easier on me to go to them this month…because I know the monitoring drill, I know the nurses, etc etc. And if it doesn’t work, I can jump over to Dr. A on CD3 and potentially not have to be benched as long next cycle since he will manage my cyst differently.

As you all know, I’m ready to pull the plug with clinic #1 rightthisverysecond, but I have been convinced that hubs does have valid points. Plus, it could take a little while for hubs’s SA results to come back and I’d like to move into the next cycle ASAP. It might take a couple more weeks to get the ball rolling at clinic #2. When you’ve been on the bench as much as I have, waiting a couple more weeks is just….ouch.

What do you think? Would you be frustrated that we’re not doing IUI #2 with Dr. A? Or do you see the benefits of sticking with Dr. K for one more go-round? And, isn’t it fun how my TTC life is finally heating up a little? 🙂