Pirate Maps and Easter Eggs

Yesterday was my cycle day 11 monitoring. The good news is that the ultrasound tech drew a map to my wayward right ovary and has now found it twice in a row with no trouble.

A map. Seriously? As if losing your dignity, your pants and displaying your business weren’t bad enough, there is now a drawing of my uterus and ovaries out there somewhere and someone is using it to find them. Ponder the absurdity for a second, let it sink in. All you need is an “X Marks the Spot” or a red arrow with a “Treasure is Here” and you’ve just moved into pirate territory. With all the advances we have made in modern medicine why don’t ultrasound machines come with gps technology? I’m just asking.

My results were E2 was 66.3 (which is still really low) no FSH reading today, LH was high, 15.4, probably because my FSH is so elevated, and my little follicle is very slow-growing but is now 9.6.

When I asked my RE what all this means he said “I don’t know” which may be the truthful answer but it doesn’t alleviate any of my fears. So, I will be monitored again on Monday.

No one knows what the outcome of this cycle will be, if  I will do a retrieval or just let it go. Because no one even knows if what I am growing is a follicle or a cyst, and as queen of the worst case scenario, I am not sure I want to try to retrieve something that is responding so poorly.

Lastly, after 10 days on clomid I am not having nausea or hot flashes, but I have the backache from hell, I feel like my ovaries are going to burst, which I would be happier about if there were actually follicles in there and generally feel like a beast.

So its back to one little hurdle at a time, and a remedial class in patience and positive thinking.

Happy Easter or Passover everyone!

Kryptonite

Today was Monitoring Day 3 appt. I was nervous, I admit it.

Blood work and ultrasound, and the results of my AMH test. Blood work was ok. E2 59.9, FSH 11.2. The ultrasound, not so much.  After not being able to find my stupid right ovary again, there were no follicles visible in either ovary. I was nervous about this happening again, after last months cycle. Dr said not to be too worried about it since my periods are every 28 days, my E2 and my FSH are in the normal ranges for my age.

You can learn what AMH is here http://en.wikipedia.org/wiki/Anti-M%C3%BCllerian_hormone

Last month on day 2, E2 was 61, FSH was 13.9. Theoretically these starting numbers are a little better than last months.

The AMH test was .16   Which I believe puts me in the bottom 1 percent of women in my age bracket.

When I asked him what it meant, he refused to answer and said “I want you to go home and do your homework” So I have researched it. Part of me thinks he wants to test me to see what attitude I take, to see if I choose defeatism or to see the more complete larger view. I am a methodical person, it’s very easy for me to get bogged down in the details, the negatives, and focus on a single issue.

Under normal circumstances he doesn’t even bother testing for AMH because unlike a lot of clinics he deals with older women, and some really tough cases. A lot of clinics see AMH as the “gold standard” for fertility. I don’t think he does. He only asked for me to be tested because I had the zero follicles on day 2 last month. That being said, last month I had my best numbers ever and the single egg I did produce, on an un-medicated cycle, became a very high quality blastocyst.

He’s spent 27 years in this field so I’m going to take a page from his book and believe he’s correct. It is a factor. It is not definitive in terms of whether or not I can become pregnant, or what my egg quality is. It does however mean, I need to probably bank while I can. It’s a big deal for me to trust someone like this. I’ve said it before. I question everything.

I joke a lot in this blog, because my life has become something almost unrecognizable to me. I am not normally overly emotional. I am not normally illogical. I am not normally unreasonable.

“Infertility is like kryptonite to reason and logic. When reason and logic are obliterated by that kryptonite, what takes their place is the mental equivalent of a Swiss army knife; a single tool that can make you question your faith, challenge a marriage, wreck a friendship, destroy a savings account…all at once” – http://infertilit-he.com/

I am a control freak. I am type A. I am also a perfectionist, I am methodical, detail oriented, and I am the most pragmatic person I have ever known. I am the Queen of the worst case scenario, and predicting them. It’s been how I’ve coped with my work, my crazy family, (not my husband and stepdaughter) Nothing in my life has ever come easy. Nothing has ever been handed to me. Nothing has come without work, why should this be any different? Even coming out the other side at hope for me has been a journey and hard work. I’ve said it before and I will say it again. I refuse to live my life in despair. I refuse to allow this to define me.

Am I scared? Yes. But tonight at 8pm I will take the clomid he gave me, and I will hope for the best. Next week, I will face whatever comes.

Viva La Vida

Today was my day 8 monitoring appointment after hearing that on day 2 there were no follicles. The plus side of this is that I wasn’t bleeding, but no I still can’t look the ultrasound tech in the eye. I’ve given up on that. Shes a really pretty, nice, woman. I just want to apologize to her that she’s seen my vagina more in the last 4 months than I have in my whole life.

It was stressful. I was given the blood-work, then the ultrasound, for some reason they can never find my right ovary, I’ve mentioned that before but I’m not kidding, at least once a month they can’t find it. It wanders off like my husband in the grocery store when he sees that there are 1 bazillion choices of soup. I keep shopping and he stays there staring. 10 minutes later I notice he’s not with me, and then I can never find him either.

During the ultrasound, the tech couldn’t find my right ovary. She called for the dr to come in, who also couldn’t find it. He told me to get dressed and from the lack of success I assumed this would be a throwaway cycle at best, and the beginning of the end at worst. I was at the desk waiting to check out my bloodwork came back, the Dr stopped me asked to do another ultrasound. Apparently my E2 was so high that there was no way there were not follicles in there. Without ever getting a clear look at my right ovary, the Dr  found 2 follicles, one that was 5mm and the other was 14.1mm so he wants me to monitor again on day 10. There was good news today but after the fear of this past week, I am back to squishy and a little raw. I’m sitting here relieved, a little hopeful, and a little vulnerable. I don’t know yet what comes after this, if I will be doing a retrieval or not, but after the anxiety of this week I’m trying to slow down, to one day at a time, one hurdle at a time. LH was 4.3, so I’m not close to my “surge”.

To clarify a few things, I’m not doing traditional IVF, I’m doing something called Minimal Stimulation IVF or Natural Cycle IVF, it’s a protocol used a lot in Japan, and China, its supposed to be a good for older women, and women with certain issues, like cancer, or PCOS. It also costs a lot less than traditional IVF, the idea is to get fewer, but higher quality eggs. There are only a couple of clinics in the US that do it, and they are crazy busy. Upon entering the office for the first time, my husband said, “He’s either incredibly talented at what he does, or its free”. I’ve never been to any doctors office that’s so busy. It still surprises me every time I go.

I should also mention that the Dr is compassionate, kind and patient. I am not the easiest person to treat, I question everything, I am impatient and vague reassurances don’t cut it for me. I am demanding, without being a dragon lady, but he has always taken the time to answer my questions. I believe he cares about his patients and isn’t a used car salesman like so many of the IVF clinics you hear about are, making promises they know they can’t keep.

Women in this for the long haul, I think the most important thing you can do for yourselves is take care of you. Eat well, sleep enough, avoid additional stress, exercise enough. This process is not for the weak or faint of heart, have a good support system. If its family or your significant other awesome. But a solid group of girlfriends wouldn’t hurt either *something really I need to work on*, and if there is a peer-to-peer support group offered at your clinic, give it a shot.

Today was good news. I think I need to take some time to breathe, and then actually put in practice the awesome advice I just gave you.