Better Luck Next Time

Well I talked/rationalized/googled/chatted myself into utter indecision last night.  As we were pulling into the doctor's office this morning I said to DH - I just want a clear sign of what the right thing to do it.  This, apparently, is the one request God decided to listen to. The ultrasound showed the 25mm follicle I had the other that that they think is a cyst is still there and hadn't grown.  The other two they measured on Sunday have either shrunk or I already ovulated them.  IUI cancelled.  I started crying right on the ultrasound table.  The poor tech kept apoligizing.  She finally got my doctor's nurse to come discuss options.  She called my doctor and they agreed that it would be best to start over next cycle.
This time they want to do a baseline ultrasound on CD3, that's gonna be delightful.  They want to make sure this cyst has resolved itself before starting another round of meds.  I also want them to consider going to straight injectibles since Femara may have caused the estrogen problem.  I'll have to wait until my doctor is in the office and has a chance to review my chart to see if they'll do that.
I am beginning to feel completely defeated.  I guess today is the day I get to feel sorry for myself and then I'm moving on.

Who knows...

Yesterday we went from the high of 3 great looking follies to the disappointment of bad blood work.  This morning we went in to repeat the blood work.  I spent all kinds of time yesterday scouring the internet and all I learned is you can find something on the internet that supports any crazy assed thought/dream/hope you want.  Basically it comes down to this.  Femara, which I took from CD 3-7, is an estrogen suppressant.  There is some stuff on the internet about Femara masking estrogen and the blood work not being an accurate representation of what's going on. The second thing that gives me hope is my lining thickness, it's at 8.7 (that's good).  The lining  develops from estrogen, no estrogen = thin lining. Last night I decided that if my estrogen went up today, we'd go ahead with the IUI.
We went in at 7:30 this morning for blood work and the nurse didn't call until 1:15 - I was FREAKING OUT! She tells me it went up, yesterday it was 126, today it's 162.  She's confident there is one good follicle in there.  I explained to her that the two she thinks are cysts based on their last ultrasound is actually and ultrasound from two cycles ago.  I went on to explain to her that the ones she says are the same size as back then can't be possible (this month the two she's referring to are on the same side, this cycle they are on different sides).  So now she thinks one of the 20+ size ones is the active one, which is good.
So basically we can do the IUI tomorrow or wait till next cycle, it's up to us.  They have one follicle IUI's all the time that result in pregnancies but she gets how much we are spending on this and would understand if we wanted to wait for better results.  Damn I wish they'd just tell us what to do...
After talking to her and questioning her for a while we decided to go in tomorrow morning for another ultrasound and see if any other them have grown since Sunday and decide from there if we are going to go ahead with the IUI.  I went ahead and gave myself the trigger shot in case we decide to do the IUI.  So, if we bail on this cycle we are out $250 for the first ultrasound, $140 for two rounds of blood work, $150 for the second ultrasound and $120 for the trigger shot & femara. That's $660.  But, if we move ahead and it doesn't work we're out $520 for donor sperm, $278 for the cryolab and $200 for the IUI.  That's an additional $998.
So, I guess we'll see how things look tomorrow and decide from there.  We just need to decide ahead of time what will make us want to move ahead and what will make us cancel the cycle so we don't spend 3 hours agonizing over what to do.
I'll let you know tomorrow what we decide to do.

This roller coaster ain't for sissies

DH and I were excited to go in for an ultrasound today.  We got up and joined a small army of women who were also spending their Sunday morning at the RE's office instead of church.  We found out there are 3 measurable follicles.  Two on the left at 22 & 25 and one on the left at 17.   The nurse told me she'd call in a few hours with instructions after the blood work came in and she talked with the doctor.
When she called back she told me my estrogen was only 126 (it should be approximately 200 per follicle, mine should have been around 600).  She spoke with a doctor (not mine - she kept saying 'he said' and my doc is a woman) and that he thought two of them were cysts leftover from last time since they were the same size.  He wanted me to do another 75IU of Follistim tonight and come back in tomorrow morning for another blood draw and we'll go from there.  I'm scheduled for an IUI Tuesday morning at 10:30.  I asked if I should bring in the trigger and she said no.  I have concerns that if they don't call by 10:30 Monday with my lab results and instructions the trigger won't have enough time to work and the IUI will be too early but she said it would be fine.
I've been all over the internet today and it seems Femara lowers your estrogen.  This makes sense because it's used as an estrogen suppressant for breast cancer.  I can't expect my estrogen to be at the same level as someone on other meds.  I also remembered that the follies I had at the last ultrasound were on different sides and they are saying they think cyst because two are the same size as last time.  Plus I don't think they realized that I sat out a cycle since my last ultrasound.
So it's critical tomorrow that my estrogen is higher.  The number is 'masked' by Femara but seeing a rise is critical.  In the mean time I'm telling myself that we have a couple healthy follies in there and that this is our month for success.

Things I wish I knew two years ago

Things I wish someone had told me when we started this journey:

Doctors - Reproductive Endocrynologist (RE's)

• You aren't going to end up saving any money going it on your own, if you're using donor sperm save yourself the stress and go right to the doctor.  A good RE will take a lot of the stress of the situation off your shoulders.
• Write down your questions as you think of them, don't depend on remembering them when you get to the doctor's office
• Be nice to the nurses, they are the ones who can fit you in when you need to see someone or get you donated meds which can save you hundreds
• Do your research and trust your gut.  Your RE is a specialist but your opinion has value too.  

Husbands/Partners

• This process is hard on a marriage/partnership  remember your spouse/partner is going thru it too and try to avoid taking your stress out on them
• Don't forget about sex, even if it won't make a baby it can still be fun!

Friends/Family/Co-Workers

• It's never going to be easy to hear about a pregnant friend/family/coworker.  Steel yourself and tell them how happy you are then call someone else who's ttc to vent.  Don't feel guilty about it either, you can still be a friend and have these feelings.
• People say some dumb shit trying to be helpful, just let it go, they really are trying to be nice and don't mean to come off like a fool.  You losing your shit isn't going to help anything.
• The only people who truly understand this process are people who are going thru the same thing.  If you don't have anyone in real life that's going thru it get on the internet, there are all kinds of online communities with women going thru the same thing - you are not the only one going thru this!

Meds

• Call around for pricing on meds.  I recently priced Ovidrel (the trigger shot)  Costco has is for $82 CVS wanted $192.
• Talk to your doctor's office about getting meds women have donated back after successful cycles.  They may be able to hook you up.
• Check out the internet, there's a program that will let you get Femara for $10 a month (it can be a couple hundred if you are paying out of pocket) and another one that will give you 3,000IU (approx. value $3,000) of Gonal F for free

One Poke Down

Today was our first Follistim injection.  DH was so proud of himself.  He went in the bathroom to wash his hands and comes out with his hands up like doctors on tv do when they're getting ready for surgery.  We double and triple checked the dose and he was so careful to go in at a 90 degree angle.  I didn't even feel the needle going in.  He was so gentle and the needle was so small I couldn't feel a thing!  It did burn a little after but I'll gladly take a little discomfort to get our baby.
I think we have our new bank all squared away but it makes me really nervous that I had to send three emails and call in order to get the order set up.  We had this problem at our old bank but you think I'd get better customer service at twice the cost.  I'll be nervous to the guy at my RE's cryolab calls and says our vial is there.  It really needs to ship out tomorrow and get there on Friday because there's a chance they will tell us to trigger on Sunday after our appointment and come in for an IUI Monday morning.  Hopefully they'll send me an email tomorrow with tracking information and I can relax a little.  We'll see....I guess I have to have something to obsessively worry about every cycle.

Round Three

Well here we go, since my body decided to shake things up a bit we're back and are getting ready to try again.  I'm officially on cycle day three today.  I had intended on calling my doctor's office today to tell them about AF's early appearance but they called me before I even had a chance.  It turns out I have to lower the meds I'm on for my hypothyroidism (I originally started on something like 45mcg, I've slowly worked my way up to 150mcg, they are now lowering it to 125 mcg now).  I explained to my RE's nurse that my cycle started unexpectedly and super early and she didn't seem too concerned about it.  She asked some questions about if it's behaving like it normally does but in the end just chalked it up to oddness.

So for now our schedule is this:
5mg Femara starting today (CD3) thru Friday (CD7)
75IU Follistim Wednesday & Friday
Ultrasound and blood work Sunday morning.
They will call Sunday afternoon and tell us what to do from there.

I also emailed our new sperm bank yesterday to confirm all our paperwork was in order and ask them to give me a total, with shipping for one vial of our new donor.  What worries me is I haven't heard back yet, we had this problem with our last bank, taking forever to get back to us, sometimes not responding at all.  I really hope this was just a fluke.

Our RE seems really hopeful about this cycle.  Apparently statistically our odds are greatest at the third IUI and the addition of injectables only made her more confident.  Here's hoping (and praying) she's right!

In the mean time, I'm gonna curl up with the new Marie Claire and try to think about things like fabulous shoes and must have purses instead of med doses and sperm orders.

What the hell?

DH and I have been trying to get pregnant for over two years now.  I've tracked my cycles, recorded my temps, checked my cervical fluid (don't ask), eaten my weight in pineapple, pumped myself full of hormones and done countless other things to help this process along.  I'm even considering buying a CD full of meditation/ visualization techniques for fertility (if you knew me, you'd know that's not my style).  I thought I had this process down, I thought I knew my body.  In response to all this confidence my body has decided to reward me with a curve ball.  This month my body decided to treat me with an 18 day cycle.  Seriously, I've had short cycles before but this borders on ridiculous.  I thought we had another week or two before we got back on the roller coaster.  I was enjoying the break from the madness that comes with ttc.

I'm beginning to think my body did this so I could do more than cheer my virtual ttc family along.  There's a group of us that met online because we were all using the same sperm bank (the one that is currently 'reorganizing').  We've become our own little support system.  We've cheered each other on thru a lot of crap, especially all the drama at the sperm bank.  I would have been certifiable without them during that.  So, most months there were maybe 20 women trying and only 2 or 3 would get the cherished bfp.  Last month almost half my girls got their bfp's.  Because of that we decided to keep the thread going. Since I had to skip a cycle while we waited to meet with our doctor I was excited to cheer my girls along and watch the bfp's roll in.  Since AF has decided to show up super early it looks like I won't be sitting out after all.  If things progress like they usually do I'll probably be having my IUI sometime around the 29th or 30th.

DH, on the other hand, is ecstatic that we're at it again.  We went grocery shopping this morning and strolled past a man pushing twins in a stroller.  I've known this man for a decade and seeing him react to those twins shocked me.  I realized he's actually hoping we'll get pregnant with twins.  I think he's more excited about that than he is about giving me shots (which is saying something because he's pretty excited about the shots).

"Sure I'll Poke You" he says

Hubby and I went to the RE today to meet with the nurse for training on the shots.  They aren't nearly as intimidating as I thought they would be.  She started to give us a rundown of how they work and had to leave the room for something.  While she's gone we're talking about how this may not be as hard as I thought and just as she starts walking in again my dear husband says "I'll poke you as many times as you need, do you want me to poke you in the butt?"  I was MORTIFIED!  Needless to say, the price of my dignity is apparently the $40 it costs to get shot training at my RE's office.
And for my girl Doozie let me share this story for you:  Backstory - I live about 9 hours from my family.  My parents, up until about 3 years ago my parents lived overseas, they retired and moved back to the states.  Supposedly to be closer to my sister and I.  My sister only lives about 2 hours from them.  Since they've been back in the states my parents have come here twice.  I've asked them to visit more and hinted that it's really not fair to always expect us to come to them (they don't know we are ttc but I'm trying to lay the groundwork for when we have a little one)  My mom called yesterday and left me a voicemail saying she's thought about it and really doesn't think it's fair to her horse for her to board her and come down here for a week so they probably won't be coming down here anytime soon.  Seriously?  HER HORSE?

A Step in the Right Direction

We met with our RE again last week and she agreed, injectables is the appropriate next step.  We actually decided to do a combined protocal, Femara & Follistim.  I questioned her quite a bit about how many follicles would cause her to cancel the cycle and she thinks I probably won't produce more than 3 follicles since Femara only gave me 2.  She thinks, since 2 wasn't getting it done that I wouldn't be at any risk for high order multiples unless I had 6 or more follicles.  DH and I have been talking about this a lot and decided that, of course, for health and safety one baby is ideal but if we had to, we'd love twins.  It's the idea of more than that that really freaks us both out.  So, we go back Tuesday morning and DH gets to learn how to give me shots.  He better not enjoy it....

It looks like we'll start next cycle sometime around the 27th.  We'll have to do a couple more ultrasounds to make sure everything is progressing like it should and we still need to pick a new donor (I'm still holding out hope that our bank will reopen and I can talk DH into going back) but things are moving along well for our New Years baby :-)

Karma Swinging My Direction... Finally!

Midway thru last cycle I decided that if it didn't work we were moving on to injectables.  It seemed like an obvious choice for me.  I love my husband and I love our life but I want a family.  If it were up to me we'd be like the Walkers from Brothers and Sisters.  I love big families, I love that they are their own little tribe and that they may fight but don't ever let an outsider say something negative about another member of the tribe.

All of this is a build up to the research I've been doing on the internet.  It seems injectables have a higher rate of multiples than IVF.  The RE can control how many eggs they put back with IVF, they can't control how many I make with injectables.  Every office is different, most factor in your age and that determines how many they will let you develop before they cancel the cycle.  I have no idea how many that is at my doctor's office but all my reading shows me 4 follicles would be ideal.  4 follicles has the best odds of a singleton and minimizes the odds of higher order multiples.  I think twins would be a fun adventure but I also know how risky it can be.  I've had twins born in my family that unfortunately premature only because they were twins and ultimately didn't survive.  I also know how expensive twins can be.  This economy has hit my industry hard.  I'm an interior designer in a commercial architecture firm.  Companies aren't doing a lot of new construction or renovations in this economy and in response to that everyone in my office is working a 4 day week (and took the corresponding 20% paycut).  Having said all that I'd be both delighted and terrified to have twins (the whole head/heart thing).  Anything more than that would be terrifying.  I also don't want to face the 'selective reduction' choice.  That seems like such and awful choice to make.  The whole thing is really up to God and nature but I'd like to give up the best odds of having one, maybe two babies and try to reduce the risk of anything more than that.  Everything I've read says 4 follicles would be the ideal setup for that.

So - why am I doing all this research and obsessing if I have a whole month to figure this out?  Because they found me an earlier appointment - NEXT TUESDAY!!! Woo Hoo! I haven't told DH any of this yet, he's not home yet.  I'm making his favorite meal (goat cheese stuffed chicken with cornmeal casserole and fresh bread).  I figure I'll make him all happy with food, scare him with my multiples research, then get him excited with the new appointment.

Third times the charm???

Well, another failed cycle... I feel like crap, I hate this whole process.  I'm mad at myself for my body not cooperating, I'm mad at my husband for choices he made before he ever met me, I'm just mad.  I know it's not tied to any kind of logic but dammit I'm mad.
I've got a call out to my doctor's office to start another round of meds and schedule our third IUI cycle.  I've asked them to get a little more aggressive with the meds this time since two follicles isn't getting the job done.  I don't want to be octomom but I do want to give us the best chance possible for the this next IUI to be the one that gives us our baby.  I've been reading a lot of about this process and everything I find says 3-4 follicles is ideal for IUI, maybe increase my meds or adding a new one will help make that happen.  I'm also concerned because the counts with our old donor were so high, the new one will be lower so we have that working against us so if I can balance more eggs against less sperm you figure it has to help (fertility logic = not always reality bound)
I guess I'm going to appreciate the one good thing about not being pregnant and go make myself a martini.

edit:  got a call back from my doctor's office - they want me to come in for another consult before moving on to injectibles to make sure I know how to do it and inform me of the risks.  Right now I have an appointment for April 6th but they are going to try to get me in early, we'll see... I'm really bummed about this, I don't want to wait that long!