Friday, May 30, 2008

Let the obsessing begin!

My baseline ultrasound and blood work this morning went well. At least I think it did. During the ultrasound the tech did a lot of pushing on my stomach in an attempt to view my left ovary. Apparently, it is quite shy and doesn't like to be on camera. Later I overheard the tech and the nurse talking about how it's favored position of sitting atop my uterus may make egg retrieval difficult. When I questioned the nurse she down played the difficulty and said never fear, that a nurse would be able to "really press" on my abdomen during the retrieval thus moving the ovary into a better positions and that I wouldn't feel a thing thanks to some very powerful drugs. I then queried the nurse as to what my antral follicle count was. She said that at this point it didn't really matter. Oh, but it does to me because what good is it to obsess about big things when there are minute details that I could obsess over? I was taken aback when she looked and told me 16 on the right and 4 on the left. What???? 20 antral follicles? That's double what it was last time and puts me well into the normal range. As I was driving home it occurred to me that she probably meant to say 6 and not 16.

A very nice nurse called later and gave me the dosages for the multitude of drugs I will be injecting myself with. Here is the plan:

Sunday - begin 20 units of Lupron every morning and every evening along with one baby aspirin per day
Tuesday - continue Lupron and baby aspirin but add in 25 units of Luveris every morning and every evening and lastly, do a megadose of Gonal-f (600 units) in the morning
Wednesday until told otherwise - continue Lupron, baby aspirin and Luveris but change to doing 300 units Gonal-f every morning and night.
Thursday - ultrasound scheduled in the morning, lots of follies to be seen I'm sure

Count with me here: two injections x three drugs = six injections every day

Turns out that the $5,000 plus of drugs I've already gotten won't last nearly long enough given the mega-doses I'll be taking sooooo more drugs have been ordered and more money has been spent. In a bit of speciality pharmacy/insurance humor when I called to check on the order they informed me that they wouldn't be able to fill the new prescription until after June 19th. Don't they know that my perfect embryos will be nicely implanted in me come June 19th? For a speciality pharmacy they don't seem too quick on the uptake. Once I explained that these weren't re-fills of the drugs but instead a dosage increase they kindly agreed to ship them out to me asap, which really means that I will get them Tuesday.

Friday, May 23, 2008

average number of eggs retrieved in a micro dose lupron flare protocol

Yes, I really did just google that. The closer I get to actually starting this ivf cycle the more I wonder, no, it's more like worry, about whether or not I'm doing the right protocol. I know that it's impossible to know if it's the right protocol until we're in the midst of it but shouldn't there be some hard and fast rules about all this? People with fsh under 10 get this, people with fsh over 10 get this, etc.? I don't think I'd be questioning this nearly as much if the new, new RE had stuck with what he originally suggested to us, which was an antagonist protocol using Ganirelix. I have a friend who just finished an IVF cycle using a Ganirelix protocol and she had 9 eggs retrieved, which was great considering her high fsh. My fsh is technically in the normal range and so I'm wondering why I'm doing what seems to be considered the protocol of last resort. It's like being on the short bus to go to grade school. I feel as though he has no faith in my ovaries to produce good eggs and isn't even willing to give them a chance to show him what they can do. And I know they can do well, I have a child for god's sake. I love the instant access to information that the internet affords and yet let's face it, it is a curse much of time. Sometimes not knowing really is better and back in the day I would have just accepted my doc's recommendation, trusting that his medical wisdom certainly was better than anything I could ever come up with because basically I would have nothing to come up with. But now I can come with a hundred studies saying that such and such may work better and a hundred more that say we're doing the exact right thing. I won't know which is really right for me for another month. That's going to be a long wait!

Monday, May 19, 2008

What would you do for a Klondike bar?

Or, more accurately, what would you do for a Trader Joe's chocolate ice-cream bon bon? I spent entirely too much time shopping on Saturday, buying foods I shouldn't be eating, clothes that I don't need and shoes that I really, really, really don't need.

So, to catch up, here is the rundown of how last week went:

Thursday - good day at work, friend had her egg retrieval and they got more eggs than she had follicles so that was great news, and I was so looking forward to my acupuncture appointment when the guy next to me went straight instead of turning left and ran right into my car. I think I handled it pretty well and was even able to laugh about it. That's easier to do when no-one is hurt and your car is still drivable. I ended up missing my acupuncture session because I was busy reporting the accident to the police, who in turn told ME to fill out the accident report form and then send it off to the Department of Transportation. Since when did I become a police officer? When did the police stop doing accident reports? If the guy who hit me didn't fully admit to being at fault who would then make that determination?

Friday - another good day at work, talked to insurance company about car accident and finalized the prescription order for all the many IVF drugs. Wow, there's a lot of them and it's a lot of money. My payment was $518 but the price without insurance would have been over $5,000. The Gonal-F alone is over $4,000. What is it, liquid gold? The drugs should arrive tomorrow and I'm sure then things will seem more "real." Right now I'm just popping a birth control pill every morning and it doesn't feel like it's enough.

Today my friend told me that her egg transfer went well. They had four grade A eight-cell embryos and they transfered two of them on Sunday. The two other grade A, along with two grade B embryos were frozen. Almost everything I've read talks about waiting it out until day 5 before freezing but they froze hers on day three. That lead me to google like mad about which is better and from what I found it sounds as though it's better to freeze on day 3. But, if there is a higher implantation rate with day 5 embryos then what? Is it better to transfer and freeze on day 3 or wait it out and hope like heck you have something left come day 5? I'm seeing having any frozen embryos as a huge bonus but is it strange that I'm actually hoping we don't get too many? The husband and I both have some reservations regarding creating embryos and agreed that any we have and are frozen we will use in the future. Neither of us can see voluntarily having them destroyed and although at some point we may agree to give them to another woman it would be weird to think of our biological child being raised by someone else and our children not knowing their sibling/s.

Wednesday is my third wedding anniversary. I got the husband a new pair of sandals. How romantic is that?

Monday, May 12, 2008

Let them eat cake!

I have a piece of sugar free cheesecake in the frig right along side a huge piece of yummy looking cake. Which to choose?

Our break cycle ended today and so our IVF cycle starts today! I picked up the birth control pills on my way home from work and will start taking them tomorrow. My baseline ultrasound is scheduled for the 30th. I'm so excited and I'm vowing to stay positive despite there already being a snag with my insurance coverage for the meds. I am sure that all that will be resolved tomorrow and then it's pregnancy here I come! I can't wait for the vomiting, heartburn, sciatica, and wonderful kicking to start.

Wednesday, May 7, 2008

Spoke too soon

Losing weight? Ha! Apparently all it took was me writing about how I'm finally losing weight for me to stop eating better and stop losing weight. It just seems that every time I turn around someone is inviting me out to dinner or brining junk food into my house. I know those aren't really good excuses because I am the one who chooses to eat the wrong foods or to eat too much but it is easier to stay on track when there is little to no temptations. I only have two to three more weeks before I'll start the stimulation drugs so I need to get back on track asap..........or, right after dinner out tonight..........

I talked to my RE yesterday and he has decided on a micro-dose Lupron flare protocol. Assuming I'm not pregnant, and we are all assuming that aren't we, I should be starting the birth control pills next week. I'm excited and nervous. Most times I just have this feeling that ivf will work for me, and on the first try, but then I remind myself that the odds aren't really that great and I should assume the first one won't work and set my sights on having a second. But, I can't get rid of that feeling that it will work. I think I'm over confident because we had a natural pregnancy.

Sunday, May 4, 2008

Still Infertile but Finally Losing Weight

Wow, how time flies. QT finally started walking on his own at 18 months and now he's all over the place all the time. He's turned into such a little boy and although I am overjoyed watching him evolve into a real little person I ache for a little baby again.

Let's catch up and I'll start with the part of my life that is actually somewhat successful right now. I've been eating better and have FINALLY gotten back to my pre-pregnancy weight. I'm still battling my mindless eating. My first week went pretty well but each week since has had more and more slip-ups. It's hard to go out to eat and not over do it or it's hard to not eat the chips once they make their way into they house. Just tonight I gave in to a craving for chips and salsa. Despite these falls, I'm still proud of the weight I have lost and I resolve to do better starting now.

I got serious about losing weight because we will be starting our first ivf cycle this month. Ugh, did I really just say that? Yes, we are going to ivf. The new RE did a whole bunch of tests. I passed the Clomid challenge test with flying colors. The hsg showed totally open tubes. The husband's sperm analysis came back with multiple problems. Low count, low motility and zero normally shaped sperm. We were both pretty shocked given how easily I got pregnant with QT. The husband saw a urologist who couldn't give us any explanation for why his numbers were so bad and how I got pregnant the first time around.

Here's where things started going wrong with the new RE that I had such high hopes for. First, he questioned whether I was being honest about having been trying for a year. Second, he suggested that we just keep trying on our own for another year. Third, when I pointed out that I wouldn't be there talking with him if I just wanted to try for another year with no help, he suggested we do three iui's. Okay, I thought now we're getting somewhere. So, I took clomid for the 7th time and had an iui. I had two decent sized follicles, good uterine lining, and my husband's count wasn't great but wasn't horrible. No success. I assumed we'd move on to injectables but the RE wanted to do another cycle with clomid and an iui. So, I took clomid for the 8th time and had an iui. I had two decent sized follicles, good uterine lining and my husband's count was quite a bit higher. No success. While the RE was doing the iui I asked him what the next step would be and he said that we should try the clomid a third time. Third time? It would actually be my 9th round. When I said that to him he said that I'd only done two. Yea, two with him but six previous with my ob/gyn. He actually seemed shocked and had to go look at my records to confirm that I was telling the truth. We had discussed my history at my consultation and he had all of my medical records so I was really taken aback that he making recommendations without having any clue what we had already tried. He then said that I didn't need anymore clomid. What I need, according to him, was ivf and then he added "which I've been recommending all along." I almost lifted my leg out of the stir-ups to kick him upside the head. Since when had he even brought up ivf to me? It certainly wasn't during the just keep trying for another year speech. And so that is why I decided to get a new, new RE.

The new, new RE is wonderful and is with a clinic with a very high success rate. He did an antral follicle count which came back a tad low at 10. That made him question my clomid challenge test results and so he re-tested my fsh and it came back at 9.5. Anything under 10 is considered normal but the higher number makes my follicle count make more sense. He also performed a hysteroscopy because they suspected a polyp and/or fibroid. Turns out I have both but neither are big enough or in a place that would prevent me from getting pregnant. Now we're just waiting for my next cycle to start and we're on our way to ivf. My advanced maternal age coupled with my husband's sperm issues give us about a 35% of getting pregnant. I'm nervous and excited all at the same time.

I think we're caught up and so I'm off to catch up on some reading.