Hounds of Love

Yesterday was my first ultrasound. It went well, according to them the embryo is measuring about 5 weeks and 5 days, so I didn’t see a heart beat or fetal pole yet, it’s just too early. Most people see it about 6 weeks 2 days. What I did see was a gestational sac and a yolk sac. According to my Dr everything is “excellent” so far. I will now get a scan every week, until I’m 10 weeks, and then I will have graduated from my clinic and will move onto an ObGyn.
I saw my regular Dr this week and I asked her for a referral to a high risk Ob because of my age. She then said “I have someone really good in mind for you, it will be a good match.” She then proceeded to tell me generally people don’t see a high risk Ob unless they have had a kidney transplant or something equally serious. But that since I was so concerned about the age thing, she would refer me and that it might take some time for my HMO to approve it. They approved it by the time I got to the car so that’s in place should I need it. He wont see me until after I’ve graduated from my clinic.

It’s weird how I expected that my symptoms would be more consistent. But they aren’t. Yesterday For the last few days I’ve been convinced that it died because my boobs were a little less sore, and I haven’t had the nausea that’s been fairly consistent “so far” I didn’t blog about my ultrasound immediately because I’ve been really anxious about it. Last night BLAM! My backs killing me, uterus feels like its stretching Stretch Armstong and saltines and water are all I can choke down. Unless you know, you’re old, chances are you don’t know what a Stretch Armstrong is, but I’m OK with that.

My most obvious pregnancy symptom is I must drink ALL. THE. WATER. I went to a work lunch yesterday and people kept looking at me funny because I didn’t eat much but I drank at least 6 glasses of water just at this one lunch alone. I drink plenty of water normally but now, I’m some sort of nauseated camel. I can smell fruit from 3 rooms away. I can smell BO from about 100 yards and blargle. It makes me gag. Husband says my nose is like a bloodhounds now.  Its been warm and windy the last few days so I opened the door to the backyard last night and I could smell the ammonia from the opossum that peed in my side yard last night.

It’s the closest I’ve ever come to having a superpower. While a lot of smells are super disgusting, it’s really weird to be able to identify random things like fruit, or opossum urine or someone who hasn’t uh bathed recently from a football field away.

Next week I hope to see the fetal pole and the heartbeat. Right now the embryo is about the size of a pea and it has a TAIL! Grow little pea, grow! But lets dial it back on the superpower. It’s really weird and sort of unnerving.

Today

I went to my clinic to get a final blood draw, and ultrasound this morning to see what my levels are and what my Endometrium (lining) is. Dr Yelian did it himself.

Results: Endometrium 12.4, E2 185+, P4 26.87. My PIO dose has been increased to 1.5ccs. Ow! The transfer is tomorrow at 2:15pm. I will need to be there 30 minutes early, and I will be having acupuncture both before and after the transfer.

I stopped by the Temple today to light candles, meditate, pray, I asked a monk for a blessing, I asked for strength and grace, for this blessing to become a reality, and for happiness good health and harmony for my family. I also asked for forgiveness because I’m a tremendously flawed person. But I am becoming someone I like.

Then I went and got my hair done, because you know what? I don’t want to spend the next few weeks looking at my dark roots. I’m such a girl (I don’t know where this vanity comes from, I’m not even a big makeup wearing person). On the way home, I stopped Costco and bought a big fragrant pineapple, some milk, and some nuts.

You know what I didn’t do today? I didn’t hide me knickers at the ultrasound. In fact I took a picture to prove it.

I even wore hot pink ones just to give my otherwise boring underpants choices a pop of color. I’m starting a knicker revolution. Not really but my blue skirt and hot pink underwear made me laugh and Dr. came into the room before I could shove them out-of-the-way. So here you are. My knickers. It’s not the full shot but its them all the same. Also notice I was not tidy and didn’t fold anything. Its been about 100 degrees lately so knit skirt, t-shirt sandals, I’m golden.

Meditations tonight, some happy thoughts, my first butternut squash soup of the season. A nice peaceful, quiet, evening.

Thank you to everyone that responded to my earlier post, What ever happens is out of my hands now. But I will be praying my little Jinyu snuggles in tight.

Lastly, I’m going to post my IVF song. Don’t look at the video just listen to the music and lyrics. It’s by Ian Britt, an incredible artist and a friend. It’s what I’d say to my imaginary baby. (Shameless plug) You can buy Ian Britts amazing work on iTunes.

Wish me luck. Thank you so much!

The Shape of Us

 

Textbook

Here’s a first. I’m having a textbook cycle. I know right? I didn’t think Id ever have one again!

Ideally in a retrieval cycle, you want your lining to be about 14 on the day of your retrieval if you plan on doing a transfer after. I don’t know if I will be doing one, I’m leaving it to the Dr so probably not.

You want your E2 to be about 200 or higher for single a good quality egg, your LH not to be peaking, anything under about 20 is fine. P4 should be low, because a high P4 means you’ve ovulated. A high P4 is anything over about 1.8. As your E2 rises your FSH should decrease which is also happening to me.

Blood work again today, and ultrasound, Dr came in to check the size of the follicle which has gone from 15mm to 17 mm since yesterday. That’s another thing. Any follicle over about 20mm before retrieval, will likely be “post mature” or you know, unusable.

While doing the ultrasound, he said “that is really a beautiful follicle” patting me as he left the room. A beautiful follicle? Another first. I don’t know what that means, all I saw was a big round blob of dark grey, but it made me happy, and he said please wait for blood results before discussing retrieval.

Results: E2 194.4, LH 15.7, P4 .42.

Lupron trigger tonight, at 10:30pm, retrieval scheduled for Friday morning at 9:30.

Welcome back to the Circus!

101

My last post was post number 100. I didn’t even notice.

I went to the RE today for CD7 monitoring, I have 1 follicle still on the left ovary that is 12.1. FSH is lower, *weird* E2 is about where it’s supposed to be.  It’s grown exactly 6mm in less than 5 days with a natural cycle. Which as of this morning is no longer natural. I’m on a new protocol this month, where instead of Clomid, I’ve been prescribed Tamoxifen. Which I am only familiar with as a cancer drug. Because my mother took it for 10 years, before being diagnosed with breast cancer for the second time. That scared me a little, however it seems my RE has discovered that it acts (stimulates) similarly to Clomid but doesn’t thin your Endometrium or cause your LH to surge unnaturally. I monitor again on day 12 (Tuesday) to see whats happening. I imagine, since I’ve done this 10 or 11 times before, that I will trigger, and get a retrieval at some point next week if all goes well with the new meds. In 10, 11, oh who the hell knows, how many retrievals, I’ve never had a dominate follicle come from my left side. Ever. I’ve gotten a follicle or 2 from it before but they always wind up being the immature ones.

My left ovary is all wallflower-ish and under achieving. Like me in High School. Kinda. It’s the one that’s most easily visible and isn’t in a weird place like my right one, but it’s generally kind of lazy. Who else has 1 lazy ovary? How do you get it to be less lazy? Tell it, “You’re grounded until you produce a follicle?” Seriously, is there anything anyone can do to wake the lazy one up? Throw ice water on it? Poke it? What causes one to be lazy? Is there a difference in the egg quality?

Its been a busy week. Remember how I took Chinese III (Mandarin) a few months ago? We this semester I decided since I’m at home alone a lot at night, to take Honors Economics and Honors Political Science and Chinese IV, for fun. Note to self: Stop making decisions while hopped up on fertility meds or in the middle of a depression after a failed FET. Most people would avoid making decisions during times like that. Not me. Bring on some school, and some homework, and some new pencils, and SHUT THE FRONT DOOR this is expensive! Yes. I am an idiot.

My new “plan” is actually going pretty well so far. I’m avoiding the people and the “friends” and the situations that don’t add something positive to my life or my day-to-day. Instead, I’m trying to focus on friendships and classes and activities like Yoga, that make me feel better about myself. I’m also trying to avoid added stress and while the classes “might* have been counter intuitive, I have to admit it does feel good to have my brain engaged in something intellectual. Add a little more exercise and I should have a good recipe for how to better manage the outside stressors in my life.

Since I had to get a scrip filled from the Dr, I stopped at Costco this morning after my appointment. Where I got the scrip filled and decided to bring home some flowers for no other reason than because I felt like it. Usually there has to be an occasion. But not today. Today I just want to be surrounded by pretty, happy, peace and serenity, and there doesn’t have to be a reason. Right?

Degenerated

I had this post written by 5am this morning about what it would be titled about what would have happened. It was done in my head. And truthfully on my WordPress account.Twice

Then something else happened. I had the retrieval and heard Molly say “it’s degenerated” where Dr looked at my left ovary to see if some miracle had happened and no. Left ovary is quiet, so I was hustled out of the surgery and into recovery, where Dr Yelian said Molly’s first look is that its degenerated, so we will take a second look but be prepared. Nurse Ching came in same thing said egg looks degenerated chances are it’s no good, rest and we will see you in a while.

Meanwhile, I’ve taken pics of me pre-surgery and sent them to 2 friends so they can see, it’s not a joke this is serious the procedures are scary as hell.

I decided not to wait for the 20 minutes to go by I went to the bathroom removed the gauze and went to get dressed.

I’d rather be with my husband to receive bad news than alone.

When we were taken in Dr Yelians office he said the egg was good, and it was a good retrieval. So now we wait. To see what happens.

I’m really happy in a lot of ways, that the egg made it out of the lutenization furnace alive, but I’m concerned again as to if it is realistically viable and if it will make it down the blastocyst cycle.

They couldn’t have done any better. Even Dr said he was worried about my LH level.

From here all I can do is wait.

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.

Laying an egg

Ive talked in rather..explicit detail about my experience so far, and I have to admit a lot of it is pretty funny. This, in my opinion is less so but it still has its moments.

I have had oocyte 4 retrievals. One each month since December.

My first was 12/19/2011, where 2 oocytes were retrieved, 1 wasn’t mature enough and was discarded, the other was fertilized on day 2, and according to the embryologist wasn’t of “high” quality. It wasn’t awful but it wasn’t ideal either.

The second was 1/16/2012 there were 5 oocytes, 4 of good size, I ovulated the 2 lead ones early from my prodigal right ovary, 2 more were taken from the left side. 1 wasn’t mature and was discarded, the second was frozen on day 2 because the Dr felt like I was so upset by the early ovulation and the loss of the other egg, that he decided to freeze it rather than grow it to blast. The difference in quality of these 2 eggs was quite obvious when the pictures were given to me. The first picture looks like a textbook example of what they dont want, and the second is a textbook image of what they do want. 4 clear cells with no fracturing.

The third was 2/13/2012, a completely non medicated cycle because I was also going to do a transfer a few days later, there was  1 oocyte, I was prepped for the procedure, told that I ovulated the egg early and told to come back on 2/15 for the FET, also known as a Frozen Embryo Transfer

Ive pretty much covered my march retrieval so I wont go down that path again but will instead tell you about my one experience of having an Embryo Transfer.

It was amazing really, you are all naked from the waist down, (not new) they put your embryos up on a big monitor so you can see them kind of wiggling around, they ID you, ID your embryos, you sign your paperwork stating that you know whats being transferred to you and then the Dr inserts a catheter into your cervix. You can see the catheter from the sonogram pictures on a screen right next to your face. He tells you he’s transferring one embryo, then that the second is being transferred, and then you can see them swimming around in the fluid they are inserted with. The Dr. checks the catheter to make sure no embryos are stuck in it, they remove it, and you are given images of your embryos, and led out of the surgery, and onto a recovery kind of bed/chair.

Anyone else in the recovery at that time, is also doing transfers so you might be there with one or two other women. In my case the woman next to me whispered nonstop. She was Japanese so I think she was whispering prayers. She could have been whispering the periodic tables but I assume it was prayers. Who could blame her? I did the same thing.

No matter how religious you are or are not, never in your whole life have you wanted more for those little cells to be happy and flourish in your body. To implant and grow and become your child. I didn’t expect to have such strong feelings about the transfer, but I did, I admit it, I prayed and wished and hoped and the entire experience was somewhere between being super surreal and somewhere on the verge of tears.

Then the dreaded two-week wait.

You are given progesterone tablets, suppositories or shots that must be taken twice a day. Assuming you become pregnant you will take them for the entire 10 weeks, possibly longer before your RE releases you to your ObGyn.

After my transfer I was told to go home, stay pretty much still for a day or three, and then just be careful, no lifting more than 5 pounds, no baths etc. My husband bless his heart, practically had a fit when I tried to push the cart in Target. It was a really funny feeling, who the hell am I kidding, it was a fantastic feeling to be doted on.

For me, somewhere around day 3 after the transfer the progesterone was building in my system, and I started getting nauseated. First I threw up once a day then 3 and 4 times a day, until about day 9 when it finally subsided. I paid attention to every little twinge, every little movement, every little flutter or backache. For whatever reason my back ached a lot.

I was so relieved about finally having completed the first round of IVF that for at least a week I didn’t think about taking a HPT. Then my friend kept asking me every day, “when are you taking one?” , “how come you haven’t taken one yet”. What I didn’t know yet was that it was too early to show up on a HPT. But I finally gave in the night before my Beta because if it was negative I didn’t want to cry in front of the Dr. Id cried enough in front of him and I wanted to be in control of my emotions.

It was negative.

That was on Monday 2/27/2012. By Friday 3/2/2012 shark week had started and so I started the monitoring carousel again. And this blog.

As I said this isn’t for the weak or faint of heart. Its hard, it hurts, and a lot of emotions are involved. Some are constructive and some are not. You get to choose how you want to deal with it, if you want to get discouraged, or beat down.  You get to decide how you want to cope.

I am coping by writing it down. It’s not lost on me that this could turn out badly, or that I am really putting myself out there for criticism by documenting my experiences. I choose to face it, to own it.  If the day comes when I have to explain to my child, that he/she was made in a petri dish, well, I will jump off that bridge when I get to it.

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.