Anarchists

CD 18 Monitoring appointment this morning.

E2 186, FSH 25, LH 17, P4 1.43

1 follicle measuring 15.8 left side.

Egg retrieval scheduled for Saturday morning at 9:45am

I don’t know what to think or say really.

This has been a really difficult cycle, for a lot of reasons. Some personal and some because my ovaries are anarchists who are defiant and refuse to coöperate or behave themselves in any kind of “normal” way. They are probably into Steam-punk or something equally hipster-ish that I wouldn’t be caught dead wearing. They just wander around giving me the finger and making obscene gestures at every turn. Just my luck to have hipster ovaries. They probably wear ironic mustaches and really tight skinny jeans.

I asked the Dr if I would ever have another normal cycle. His answer was, probably not. His answer was actually more complicated than that, but I’m tired and don’t have it in me to write about it and be witty today.

It doesn’t help much when it comes to coping with the fear, anxiety and uncertainty of this process. So I have that going for me.

Lupron shot tonight at 10:45, Ibuprofen tomorrow twice, to delay ovulation.

Circus School: Luteal Phase Follicle Edition

I am a Geek, a Nerd, a Dork. I want to know statistics, algorithms, percentages. I want to know whats happening to me, to understand the language.

Dr Yelian has commented on it before, saying that most patients don’t want to know, or don’t care, they just do what the Dr says. I say, this is something I am invested in being successful with so, I want to understand the language. That means breaking it down into terms the normal person can understand.

While I am sure many of you would disagree, I am the normal person in this scenario.

What is happening to me this month is an anomaly, because I get every weird scenario/cycle possible. So much for normal. Welcome to my life.

In the Mini-IVF community, the Luteal Phase Follicle is mythical. Everyone has heard of them, knows someone who had one, but no one really understands them, what they mean, why they happen or what their quality or outcomes are.

They occur, but not often and not usually with very good results. (this information is subject to change because Dr Yelian vehemently disagreed with me when I saw him on Monday but didn’t have time to go into specifics) I have asked him about these before, and he was ambivalent about them. Not sure if there was any real value to them, however he just returned from a conference in China and says he has some data that has changed his mind. I will be asking for that data the next time I sit down with him. Because I need to know things.

To review: I am doing Mini IVF, which is IVF with fewer medications, so you don’t get lots of eggs each cycle you may get 1 to 8 depending on your age, secondary fertility issues, autoimmune issues, and whether you have Diminished Ovarian Reserve (DOR), or Primary Ovarian Failure (POF) PCOS, Cysts or Endometriosis.  I have had as many as 5 and as few as 1. It varies from month to month.

I have diminished ovarian reserve, low AMH and I am of advanced maternal age.

Today, I am CD 17, have one follicle that Monday, before it was assaulted with Menopur and Clomid measured 9.8mm. Anything after CD 14 is considered to be “Luteal Phase” or post ovulation.

During an IVF cycle, the dr retrieves an egg right before the woman ovulates, while the mature follicle is still in the ovary. They want the follicle to be as mature as possible but don’t want it to have ruptured from the ovary. In a normal natural cycle (non medicated), this is the only egg that would be retrieved, and so you begin the 2ww wait for the next menstrual cycle and follicular phase to begin. However, sometimes there will be other follicles in the ovaries that may not have been mature enough to rupture at the time of ovulation, but are still viable. With monitoring and sometimes stimulation, the Dr is able to retrieve another mature follicle that has developed even after the patient has entered the Luteal Phase.

The statistics and data on the success rates of Luteal Phase Follicles is murky at best. Generally the egg quality is thought to be poorer by 10 to 20%. I know that there have been LPF pregnancies however again, the data is not easily found. If I could translate the Kato Ladies Clinic white papers and general information about it into English I could make a fortune. The Japanese don’t believe that American women want to know this information. So they see no need to translate these documents. Which harkens back to what Dr Yelian said about some patients not wanting to know.

I don’t understand that. As in, I can not wrap my head around the idea of not wanting to know. I want to know EVERYTHING. Not to second guess the Dr, but to be informed about whats happening to me, why, and if there is anything I can do to change it, stack the odds in my favor or improve my outcomes. Who the hell puts themselves through this without wanting to know?

Anyway. There is one scenario under which my chances might be improved this time. My cycles started getting bizarre in March. Why? I’m not sure, possibly over suppression, however it created a sync issue between my follicular stage and my menstrual cycle which I’ve been combating ever since.

Last cycle from start of my menses, through the aspiration of the cysts, the 10 days of Provera to the beginning of my next cycle was only 16 days. I don’t have confirmation on this yet but it would seem logical to me that while this is another abnormal cycle, the condition where a sync issue exists, would also show that while this may be a luteal phase follicle, it may also be a regular follicle that happens to have begun maturation later since the duration of my previous cycle was so short. By “regular follicle” I mean one of good quality.

This logic could also be a mechanism to encourage myself to move forward with it, and keep my head from exploding.

Maybe no one else really wants to know this information. Maybe I really am an anomaly. I find writing it down in words that make sense to me, helps me process through it. If its boring, I’m sorry. Maybe these school posts are really just for me.

Acupuncture today, Clomid with a big shot of Menopur tonight, and doing everything I can to keep my stress level down. Which means vegging out and trying not to think too much. There should be an off button. Seriously.

Phoenix

No. I didn’t run off to Phoenix, nothing personal to anyone who lives there, but I’m not a fan of the desert. If I am not near a body of water I get disoriented and wander around in circles like some kind of dehydrated nomad. Plus as I’ve said before, my natural color is somewhere in the range of “pale blue” so the desert doesn’t generally look good on me.

I went to see Dr Yelian this morning, was happily greeted by my favorite vampire, where my blood was drawn and she informed me that I was indeed scheduled for an ultrasound. To which I responded “Dammit!” because if my cycle is going to be canceled I should be exempt from having to take my pants off. Right? It’s in the rulebook. Oh that’s right, there is no rulebook.

The ultrasound tech did the ultrasound, “cold gel, I’m sorry its cold, please let me know if its gets too uncomfortable” Right ovary, no clear visualization. Because its Memorial day, and it apparently went away for the long weekend.

Left side… 1 follicle that at first appeared around 5.2 mm, then after looking around again and checking from another angle measured 9.8. She didn’t believe it so she called for Dr Y to verify it. I hung out pantsless for about 20 minutes before Dr Y came in, shook my hand, looked for himself, couldn’t find anything and said “Get K in here so she can show me this follicle.” She came in, showed him, he said “Yep that looks like a real follicle”. What? There are fake follicles?

E2 137, LH 15.3, P4 1.47

What does this mean? I’m not sure, to quote the Dr. “I was monitoring your levels from China, and this is a very strange cycle”  My P4 from Friday made it seem I had ovulated. Although, how an egg can be mature at 6mm is beyond me. Whatever. Yes this is still a strange cycle. I now having something called a Luteal Phase Follicle. Which means a new, maturing follicle of good size AFTER I’ve already ovulated. Wait, are you still confused? Me too. I will do another post later about Luteal Phase follicles, just bear with me here.

They left, I put my clothes back on and put the paper sheet in the trash and was told to wait to be called by the nurse. Dr. Y was insanely busy so I didn’t really get a chance to speak to him but he said I would be given meds to take home, and when my blood work came back they would call me with a plan.

296.00 for 2 shots later, I left with 2 big doses of Menopur, in the clinics signature pink bag, and a lot of questions.

We had Dim Sum with my husbands mother, and sister, and her husband. His mother told me I was not eating enough, but that I’m too fat, and that my face is too thin, so keep losing weight, but not in my face. Hard to please much? Shes 89. My understanding is that women over the age of 60 can say and do anything they want, to anyone they want, when ever they want. So we have that to look forward to.

Here’s the treatment plan, 1, 150ml shot of Menopur tonight at 8pm along with Clomid. Continue Clomid daily, another 150ml shot of Menopur on Wednesday night and I see the Dr on Thursday.

Do I know what happens after that? No. What do I think? I have no clue. Am I hopeful? I don’t know. But it feels better to be DOING something than to be contemplating my navel and berating my ovaries.

People ask me all the time, “Why do you call it the Fertility Circus?” This cycle is a perfect example of why. Plus it sounds way better than the Fertility Roller-coaster, or Fertility Merry go Round.

Why did I call this post Phoenix? Because apparently like that mythical bird, this cycle has risen from the ashes.

Loco

Rather than start this post with the qualifier that it’s a downer I’m just going to post a funny picture.

No. Its not my picture, or my dog but the hairy eyeball is something I’ve given out pretty frequently lately. I like that little dogs crazy eyes.

I’ve been wrestling with where I go from here (as though I am in control, see what I did there?) There is nothing to be decided really, but I feel the need to create a plan or a strategy. Because planning things I have no control over is super useful.

I can’t seem to stop myself from trying to create a strategy, and running through all the possible scenarios. If x happens then the result will be y, if y happens then z will be the outcome. I have control issues. Sue me. Maybe I am a drama queen but every bad cycle discourages me a little, and chips away at whatever faith/hope/trust I have in my own bodies ability to make good eggs and my belief in my ability to get pregnant. I keep reminding myself to “Have faith in your journey” When all I really want to do is yell WTF? Not just the letters either.

“Maybe I should take a break?” because of my AMH, I am afraid to.

I’ve been “unpleasant” to be around since Friday, and by unpleasant, I mean scary. I cry easily. I’m overly emotional, I’m short-tempered and I’m tired. I haven’t been sleeping past 4 or 5 am no matter what time I went to bed. I don’t have a lot of patience with myself, I am sick of pouting, sick of myself. Sick of not feeling like myself. I’ve spent most of the weekend in my head. Talking to myself, and trying not to talk to my husband because I don’t trust myself not to say something critical or unkind.

My one real-life friend who knows about my IVF went to Costco the other day and called me asking me if I needed anything. My answer was “Yes please. Id like the ovaries of a 25 year old, a new life and an Asian baby. And some sour patch kids if they have any.” She lives in Canada so, you know, she didn’t buy me anything on my list.

I’ve worked in the yard a lot. Moving things around, replanting some trees and flowers, moving lawn furniture, washing it down, cleaning the low wall around my patio with a scrub brush, soap and hot water. Raking, lacing out trees, trimming hedges. Moving the statuary to better locations and fixing the fountain.

I do that when I am unhappy, I clean until everything is spotless, laundry, iron, put things away, purge closets, clean some more, wash everything down, polish furniture, sweep and mop floors, organize until there is nothing left to be organized. Except whatever is in my head. Which if I could fold like a load of laundry and put it away, I would. Consequently as I type this, you can eat off any surface in my house. Not that you’d want to. I’m just saying.

I will see the Dr this morning and have my hormone levels checked. I can’t say I’m nervous. I’m not, I’m numb. I don’t expect anything good to come out of this meeting. Chances are he will say “No more Clomid for you, only natural cycles”, which are a whole other can of worms. You can’t control ovulation with natural cycles, and I’ve had 3 of them where I ovulated the best, lead follicles early so, no bueno. Or… “were going to give you Birth Control Pills, or Estrogen”… or something else that is new, and scary and may over suppress my already defective ovaries.

After,  I have to go have Dim Sum with my In-Laws who love tolerate me. Why you might ask? Because my husband decided last night that today was a great day to drive up and see them. The insensitivity is strong in this one Luke. I know he means well, but he doesn’t get that I am about as stressed out as it is possible for one person to be, and frankly. I don’t want to see anyone. Crap, if I am truthful I don’t want to see myself right now.

The plus side of my cleaning frenzy is my little fountain is fixed, I have created a new seating area in the rear of my yard, and all my little Asian statuary looks fantastic.

The outcomes of the meeting wont be posted for a while after, but I will post it later tonight.

Here are some pictures of the work I’ve been doing in the backyard so it will hopefully counterbalance the negativity of this post. You can see each picture in more detail if you click on them.

Japanese Maple tree, with a tiny pagoda.

My fountain whose filter is no longer clogged with roots, or biodegradable ew.

Yes, that is a Buddhas head.

Foo Dog, it’s an antique and I’m not sure if I love it or hate it. Husband loves it, but the painted eyes creep me out.

If you look into the tree and see all those Moroccan stars, they each hold a candle and we light them when we have parties.

My avocado tree is shedding a lot of leaves now so even after all that work yesterday there are leaves in the yard making my perfection imperfect.

Story of my life.

Validation

Monitoring CD12.

Ive been up since 6am. Feeling the best I have since Wednesday. I was pinned by my acupuncture Dr., who also listened to me cry and when I told him “I wish someone would just come out and say that my family is crazy” His answer, completely straight-faced was “You realize its a given, don’t you?” Which made me laugh through my tears.

He can’t relate but I think he can empathize. He has a normal loving family but he sees what my intentions are, knows I’m not any of the things my sisters and mom accuse me of being. And for once, it was really nice to be validated. Thank you Dr P. You really are a great friend to me.

All of this drama with my family, which I don’t handle very well..has just made me more determined to find a way to complete my own family. Whatever that looks like. If I am ever lucky enough to parent a child that’s mine, I want them to grow up kind, and sweet. I don’t want him or her to grow up like me, tough, always fighting, always afraid to be vulnerable.

This morning at 11am I will find out if the meds worked, and if 2 the follicles grew. I hope they both did. I hope they sucked up the Clomid, and got fat and healthy and that I will get scheduled for a retrieval for Monday. That’s a first, actually WANTING to get an egg retrieval. Not that I didn’t want the others, I kind of dreaded them and they scare me so looking forward to one is… new.

I’m not going to complain about feeling like my ovaries are heavy or full, or that I feel bloated. Because I would take that over a conversation with my sister any day of the week and twice on Sunday. I can handle my mothers diagnosis, I can handle making peace with her, and possibly her even coming to live with me, I can handle nursing her, I’ve done it before. What I can’t handle is getting ambushed by someone whose sole intention was to be hurtful and nasty.

Enough about that, it’s a new monitoring day, it’s a chance, it’s the start of a long weekend, and while we don’t have big plans, we have good things to look forward to. If it doesn’t turn out well today, I will try again next time.

Sister

*This post is a major downer, and isnt about my IVF process so please feel free to skip it. It just makes me feel better to write it down*

This morning at 8:03am my sister, the one who hasn’t spoken to me in 4 years called. Because I happen to know she’s visiting our mother, and was afraid something happened I answered the phone.

“Hello?”

“Hi, I want to know what you know about moms condition”

“This feels loaded B, what do you want?”

“Fine, I will make this clear and frank. Are you aware that mom has pancreatic cancer?”

Yes

“Well what are you going to do about it?”

“I’m going to visit her soon, I’m going to try to get along with you and I’m going to try to be a good daughter to her. Shes a grown woman, and I have to respect her choice not to get treatment for it”

“You realize that its fatal”

“Yes, so is congestive heart failure. Endgame for pancreatic cancer is roughly 5 years. Without treatment I figure if we are lucky we will have 2″

“We can expect 2 to 2.5 years, so you’re not going to try to talk her into treatment?”

“No”

“It’s obvious I care more for her since I’m here and you aren’t, and I want her to get treatment and you don’t”

“It’s not a competition, and I live 8 hours away, you live less than an hour, where do you get the balls to call me at 8am after 4 years with this snotty, condescending attitude?”

Click

This particular sister is 50 years old. She seems to forget that in 95′ I was the one that came home from the East Coast and took care of our father when he was first diagnosed with congestive heart failure, drove him to a million appointments, fought with his doctors about his medications and why they kept causing him to faint. It’s a long way to the ground when you’re 6’4″. At the same time our mother was diagnosed with breast cancer for the first time. Again with the Dr appointments, and the meds and the chemo and radiation. I nursed them both. Alone.

Our mother has survived breast cancer twice, she’s been to the cancer rodeo before. She doesn’t want to do it again. I understand that. I respect her decision. I choose to stay neutral. Shes never been someone that anyone could make do anything so I’m not going to try. It has nothing to do with how much I love her, it’s that I respect her decision to live her life on her own terms.

My sister also seems to forget that in 2001, I was the one that ID’ed our fathers body, closed his eyes, signed all the paperwork, chose his urn, got in touch with the priest, set up the memorial, and paid for the funeral. About that. No one ever told me that a man 6’4″ would need two urns. I also picked up his ashes and dealt with every single ugly task around his passing. Alone. Not a single one of my 4 siblings ever offered to help with even the most basic tasks.

Shes accuses me of “living my life in secret” because I don’t share anything but the very basic facts of my life with anyone in my family. I don’t share them because I don’t trust them. Because they gossip, and tend to be judgy and unkind. While I wish with every single fiber of my being that it was different, it isn’t. I can’t make it so. So I keep my stepdaughter achievements to myself, I don’t tell them when we have gone through a rough patch, I don’t tell them about my successes or failures. And none of them know about my IVF or anything else in my life that matters. My mother and sisters have these hen parties where I get regularly trashed and gossiped about. They say I am “stuck up”, and have my “nose in the air” and that I think “I am too good for them”.

None of those things are true. I don’t think I am better than anyone. In fact, if I am perfectly honest, I have spent my whole life feeling not good enough, not accomplished enough, just not, enough. I guess to them, my reserve comes across as aloof. It’s not my intention. I swear that it’s self-preservation. it’s the only way I can subdivide my life into chunks that I can handle.

My husband wants to bring my mother here and have her live with us until the end. I will talk to her about it. If, on Friday, I wind up scheduled for an egg retrieval, I will go through with it, and then I will drive the 8 hours to see my mother. I will talk to her about coming to live with us and I will do my best to put the past in the past.

I haven’t posted a song in a while, but this one seems fitting to me. It’s a cover of a Bonnie Raitt song.  I know it’s about lovers, but for me it represents all the feelings I have about my family.