Part III

Seriously?!? I thought the posts for today were over... I mean, I've had enough drama.. but no Dr. M wrote me back...

You have had a few cycles where you started with an 11mm follicle, but nothing so big and not with an elevated estrogen.

I would try to use luteal estrace (estrogen priming) before the next cycle

You would start a week before we think you will get your period – so checking blood in10 days..

This is a sign that the brain and ovary are not exactly on the same page..

Try to hang in there

Does he know that he just made me crazy and that's why he put in "try to hang in there"? 

I promised Chris (the DH) that I would shut up and listen to the doctor this cycle. I just need to keep saying that over and over again because I am so freakin confused!! I'm rediagnosing myself as unexplained infertility because if that's what he's saying to do- I know nothing about my diagnosis and it contradicts everything he explained to me. 

I'll probably bring this up in therapy next week- and she will yell at me because I should be self advocating and telling DH to shut up (she says it much nicer).. but here are my issues.

If my brain and uterus aren't talking, shouldn't I stop my cabergoline- brain meds- since my prolactin levels are normal? I mean that makes sense to me. I am so tempted to just write him back and ask that... but 

I can't even touch the estrogen priming- I was told no estrogen- keep it super low.. I mean I avoid soy and caffeine during my cycles so my estrogen doesn't go up.. I almost wanted to tell him about the studies that say people on the DHEA I'm taking show a significantly higher level of estrogen than those not taking it.. and he wants more estrogen.. So- are we taking a chance on the SERs? Will it be stopped beforehand so I don't need to worry about the estrogen affecting egg quality. It was on estrogen priming protocol that gave me ZERO eggs fertilized- a canceled IVF cycle and tons of heartbreak. To say I don't feel comfortably about this is putting it mildly. 

Try to hang in there... ugh.. I feel like I'm hanging by my neck... or my hair... but I feel gravity or some other natural force is trying to pull me apart. 

Maybe he should have signed it "Keep it together"

Part II

He doesn't see a trend. Every response is "if this persistent" and "this is a one time event" and "Given that we've never seen it in any of your prior cycles, I am hopeful it won't happen again."

I saw this less severe in December. I mean 2 cycles in a row (ok yes it was a while, but it was the next time I was allowed) that I have measurable follicles at baseline.. That can't be a coincidence- nor can a one time thing happen more than once.  And my natural IVF in August wasn't any better. I triggered on CD8- which is very early. To me, it keeps getting sooner and sooner.

So naturally, I am less hopeful than he is.

I'm ok. (Part I)

So today I am ok. I wrote my doctor my list of questions and he got back to me right away. Which I found kind if shocking. It was after 8:30pm. But I guess that made up for the fact that he wasn't even at the building yet when I got there this morning.
He started off the conversation with "Before we get crazy.." Ha. I've already been there and done that!  But I could see why he might think that with me being the first patient at 6 am.
So my results were sucky. I have a 24mm, 14mm and an 11mm.  For no drugs 3 follicles is crazy good. Just umm not while you still have your period.
Remember in health class when they said you could get pregnant during ur period. Yup- I just proved it.
So since I'm ovulating in the next few hours- my cycle is cancelled. He originally said to take the ovidrel to restart the clock but didn't think it was worth the extra hour drive to go get it. He agreed I'm out of sync and this cycle is kind of a lost case. He said if we had sperm he would say just go for it. But my sperm in storage isn't worth this. Too low of a chance of success to use it.  I agreed and started going home.

But now I'm sitting at a wawa writing this because A) I can have real coffee with caffeine and
B) I had an urgent question for my doctor. He already thinks I'm crazy- might as well give him some proof and email him 10 minutes after I leave, right? I am thinking about those 2 other follicles. What happens to them? Do I ovulate them? Or do they turn into cysts? Or do they grow slower and then on my next CD3 I am in this same boat?? I feel like I should know this. Basic ovulation question. But who the heck naturally has 3? Ugh! So just in case I have to go to RE pharmacy- I'm going to sit here and drink this coffee and hope he answers my email in the next 40 minutes.

But right now. I have coffee so it's making everything ok.  Later I'll freak out about canceling my appointments in Chicago.

Simple Answers

I'm feeling really good right now. I went to therapy and my superb therapist and I really worked on this whole IUI issue. And then we realized- if I need 2 perfect IUIs to feel good about moving onto donor eggs, then I can still do that. I'll just need to buy more sperm. Luckily, there is still more available with our donor even though he stopped making deposits and I know the numbers are dwindling. Just buy more sperm... Why couldn't I see that as an option?
I know DH freaked when I suggested that a few weeks ago- but my therapist reminded me that this level of crazy that went on in my brain isn't worth the few hundred dollars... and she was going to talk to him about that. She reminded me how he said he would be supportive and this is what we need right now.
So- for right now I'm going to need to pinch my pennies a little tighter- but I won't ever regret the cup of coffee I didn't buy- or the pair of shoes- or the hair cut I didn't get (Lord knows how many times I've regretted the ones I did get)...
This is more important and needs to be treated as such.... and we wrote down all my questions for the doctor... which I just e-mailed him ahead of time.
I don't even care if he thinks I'm crazy because trust me- having someone think you're crazy feels so much better than actually being crazy... and I feel like I let the crazy go.

This is so my life...

Strength

I don't understand how when HUGE things happen in my cycle- I am ok. But stuff like this kills me. I am still so upset. I don't know if I should ask my questions to the RE or just see how many of them don't really matter/apply to me.

I feel like my situation fertility-wise is too complicated... I never have the feeling of giving up, but I sometimes wonder if I should be and these are all signs to not venture down this road.

So I'm writing this before work- hoping my fears stay here and strength comes with me.

Why Can't Anything Go As Planned

Well today is what is considered the most uneventful day in a cycle.. CD3 or baseline. Its where you find out nothing has happened and you get to go on all your drugs and make eggs grow.

But... nope.. not me. See... my eggs are like me.. impatient- they don't believe in this wait until CD14 bullshit.. they're ready now.. and like that one kid in class who finishes everything too early.. I want to bitchslap my ovaries...

I had some idea that my cycle would be a little early.. I've previously triggered on CD8, and CD10.. so when my RE said he wouldn't check my ovaries again after baseline until day 10, I knew that wouldn't be true.. and I reminded him of my past and I was supposed go back in on Tuesday...  fair enough..

But today at monitoring- I saw it right away... big massive follicles. So glaringly big and more than one.. I was really looking forward to squinting and looking for these little follicles and to find out the my astral follicle count (AFC- the small ones) was in the normal range. Previously I've had 5-7. Well this time I had 8 all on one ovary- the right one.. But the left, had 3 small ones.. and 2 huge ones. The first one was 14.4 mm and the 2nd one was a little over 13. I also found out that I have blood still in my uterus, so my period isn't quite over and that my lining is at 2mm.

Typically, this might be a cyst- something left over from last cycle that didn't ovulate.. but that's never my case. Mine is an estrogen making follicle. And now I am not allowed to take any medicine and have to go back for monitoring on Saturday. And here is where I start going crazy...

We planned a medicated cycle.. which means, I expected maybe 3-4 follicles using medicine. I know using medicine with my condition is a risk and natural is so much better. Countless studies will tell you that SERs are NEVER seen in naturally stimmed eggs. But..
My lining is a 2.. My eggs are growing way faster than my lining... Come on RE- you always talk about syncing up your eggs and your lining and that's why FETs work better... well WTF do we do now??? I can't alter anything in an IUI-- so is it even worth it?? Are there studies that show horrible rates when the syncing is off??
And I'm supposed to be on Lovenox blood thinner for this cycle- I won't even have a chance for it to work because I can't start until my period is over. So maybe I'll get one dose from it?? And what about the test in Chicago to see if the Lovenox is working??? Is it safe to get a long extensive transvaginal ultrasound days after an IUI?
And I had to tell the pharmacy I may need the drugs early because I may need them...
I'm so confused- I don't even know what I want.
Maybe I am normal again... and like my very first cycle I need to be suppressed on Lupron so I don't jump the gun with these ovaries... but do they even do that for IUI???

Thank god tomorrow is therapy day. Maybe I can sort some of this out...

Shitty Day All Around

(This is really just a long vent... not unlike any of my other posts)

So cycle wise, today is CD2. I called yesterday and made sure my nurse remembered to order my drugs. You would think after talking about this cycle since January, and every month since then she asked if I was doing the IUI that cycle, she'd order the friggin meds!!! Nope!
So today I had to run around to the specialty pharmacy to get my drugs for tomorrow morning (and I thought I was last minute), just to find out that I need authorization for most of the drugs. Ugh!! Luckily the one for tomorrow did not need authorization- so I got that.
The RI never sent over the script I need for blood work for CD1-3.. I emailed over the weekend and called 2x. They finally sent it at 5pm today- so tomorrow I will go for blood work before work and during lunch.
I am just really ticked because I tried hard with my nurse- she's messed me up in the past, but I gave her once last shot... and now I've been with her over a year. I just don't think its fair that I have to work so hard to prepare for my cycles.

So I was trying to vent to DH about this today and he did 2 3 things that really pissed me off:

1) he started the suck-Olympics with me.. comparing everything I am going through with his job. Geesh man, I didn't even bring up my job cause that sucks, too. I just wanted him to acknowledge my struggles.

2) He said this cycle is already starting off bad and maybe we should cancel it because it's too much. He's gone to one appointment with Dr. KK and signed some papers at the RE saying it was ok for me to use donor sperm, and got an HIV test.  And that's too much for him? I have gone to several appointments alone, spend much more time in therapy dealing with these issues. I have made at least 16 phone calls/emails this week while teaching (it's really hard to use the phone when you're a teacher). I've kept appointments around going to school and tests and finals. I coordinated my next appointments around my sister's schedule so she could go with me... and it's too much for him? I need him. When I cycle- it's like a 2nd job, keeping track of everything and now with trying to make sure I coordinate working with 2 doctors (RE and RI), it's a lot more work for me. And he wants to throw that all away because the nurse didn't order my meds? These IUIs are the final shots of using MY DNA. DH already said he was done and perfectly ok to use donor sperm. But my weekly therapy appointments have proven, this is not an easy next step- and taking these IUIs is huge in order for me to either see that my eggs are good enough- or that it really is time to move on. I've been reading about the burning of the drugs, the hot flashes, everything.. and it's too much for him... I didn't even ask him to go to the IUI or monitoring with me.

3) He forgot what I said last week. Today is the EDD of our only pregnancy (m/c at 5 weeks). I told him I was aware of the date and I wasn't sure how it would affect me and he called me crazy for still thinking about it. I don't think about it all the time. I had a cycle buddy and I check up on her- and know its her EDD, too. I see her ticker and think, I'd be just as far along. It's not crazy- its normal. I brought that up in therapy and she told him that I can be sad on that day. And I thought I would be fine- I mean, I knew it was coming, just another day, right? Period, IF bullshit, and Christina Perri... and BAM! Messy, can't breathe tears as I'm driving in to work. I hate my commute- 90 minutes of my own thoughts- it's like a prison... But DH didn't remember. When I told him today sucked more than usual- I got the suck Olympics. He took an extra volunteer shift tonight- and I didn't want to be alone.. and the dogs got into the locked bedroom and ate/destroyed a few bags of random stuff... so now I have to clean.

Shitty Day all around....

Support

Lately I have been feeling lost. I used to think of a certain board on TB as my home, but I feel unwelcome there. I am just another girl doing IUI when everyone else has already done them and moved on. Well my path is different- I'm working backward and I don't know where that puts me. I wanted to stay where I was- I thought I could at least help others since I've been around the bush. But I feel like I'm at a different place and so many people are new- and my situation is so weird- I'd rather not be a part of the group. But I still lurk, and try to help when I can.

I am thankful that I was invited to join another group, where no one gives two shits where you are on your journey- just that you have the same goal. I think that's where I am- a place that isn't definable.

But no matter where I go- I feel like I have been trying to longest.. Even when I came back from the break when my mom passed- most people have been successful since then and I NEVER see anyone from when I first started the IVF cycle.

This song kind of helps me understand that feeling- trying to be there for others, showing them that even if the journey is forever, I am still here working at it. I don't understand why most Christina Perri songs remind me of my IF journey (I still cry thinking of my FET and 'A Thousand Years') but they do and this one, "I Believe" is where I am right now.

I believe if I knew where I was going I’d lose my way

I believe that the words that he told you are not your grave

I know that we are not the weight of all our memories

I believe in the things that I am afraid to say

Hold on, hold on

I believe in the lost possibilities you can't see

And I believe that the darkness reminds us where light can be

I know that your heart is still beating, beating, darling

I believe that you fell so you would land next to me

‘Cause I have been where you are before

And I have felt the pain of losing who you are

And I have died so many times, but I am still alive

I believe that tomorrow is stronger than yesterday

And I believe that your head is the only thing in your way

I wish that you could see your scars turn into beauty

I believe that today it’s okay to be not okay

Hold on, hold on

This is not the end of me, this is the beginning

This is not the end of me, this is the beginning

Hold on

This is not the end of me, this is the beginning

I am still alive

We have a plan

With countless unknowns within the world of Infertility, a plan is like gold. It is treasured and for a brief moment you know what to expect. Whether the plan works or not- another of the unknowns, but how to prep and what protocols you're doing.. it helps the mind get prepared so you can focus all your energy on hoping and praying and wishing.

My plan (Combined from RI & RE)
Start steriods (prednisone) tomorrow; CD3 scans/bw and start Femera; CD6 Start Lovenox & Menopur injections; CD7 Drive out to Chicago for scans; CD8 Drive back to NJ for scans; CD10 another scan.. by then my eggs are usually as good as they will ever get.

We discussed back to back IUI vs. just one day. He admitted the last cycle did not have optimal timing- which I kinda knew. He is all in favor of back to back and said thawed sperm should live for 36 hours so that would not be an issue. I told him he was in charge of how the sperm was used- I'm just going to follow along. He seemed that we would be using more vials on the 2nd IUI than the first, which is what I would have said if I made the decision. (I kind of promised Chris I would shut up and listen to the doctor this cycle- so I'm trying real hard to do that)

I felt pretty good- he made changes based on my concerns, which sometimes makes me question it since I'm not the expert... but I always have strong evidence with a concern (i.e. start scans on CD8 instead of his idea of CD10 since last 2 times I triggered before CD10). He also asked me how I wanted to trigger.. I told him I wasn't that informed on triggers (after I told him I was concerned with the lower dose given my BMI- so I was somewhat informed) so he decided to change it.

I am also feeling better about the RI. I feel like when I get information from one that I didn't get from the other, it makes me confused and wonder which one I should trust. Given my relationship with the RE, I trusted him more from the beginning, but the RI scored some points today.

RE checked my notes and apparently I do have a tiny uterus (unlike the generic everything is perfect paragraph copy and pasted in all new patient files)- score 1 for the RI
But the RE called it crazy to swallow prometrium since it is metabolized in the liver and can cause anti-progesterone antibodies and it would make me super sleepy all day long - score 1 for the RE

As much as I like my RE, he sometimes does something dick-ish to stop me from going over the top liking him. He is a really caring person and goes out of his way to accommodate Chris and me, but every once in a while he just hurts my feelings. Today he laughed at the idea of me having twins from an IUI- like the odds were so out of our favor. Seriously- no odds are in our favor. We know it would be a miracle for anything to work- but geesh!

Last time he told me if an IUI worked on the first try we could consider ourselves geniuses. Ugh! Part of how I see myself is my advanced cognitive ability.. I felt like he was trying to call me dumber for not having children and I could only be a genius if I was pregnant.

The other thing was when he did the endometrial scrape and didn't warn me. I don't believe in the whole, it hurts less if you don't know its going to happen. Very dick-ish of him.

I still trust him very much and I do like him. But it reminds me that he is human and like everything else not perfect. Oh well, enough of him.

I have a plan that I am happy with- and two doctors who I am trying to have faith in. Like I mentioned before, I promised Chris I would just trust them so I'm keeping my FX'd that they knock me up this cycle.

Edited because I get Lovenox and Letrozole mixed up. Doh!

Quick Update- nothing new

So I am new to blogging and already took a much longer break than intended. Graduate school is finally wrapping up and I should be working on some stuff right now. Unfortunately I've been in this 'get nothing done' funk for quite a while. It's just become too easy to get wrapped up in everything and then become really behind.
Cycle-wise things are just becoming annoying. Bills, insurance, trying to figure things out... I've been on break since Christmas- and now I am rushing to get everything ready for the next cycle. (This one isn't my fault for being behind- honest)
I am having some anxiety with the whole Reproductive Immunologist (RI). It still feels like too many diagnoses. I have an appointment with my RE for the first time since seeing the RI and I'm a little nervous. I'm actually multi-tasking and trying to get my questions lined up for him now.
Things overall are looking up. Chris and I decided that since we are poor anyway, might as well go on vacation. This has made me very happy. We need a break from daily life. I need something to look forward to if all of this fails.

So I guess this is just a quick update as I probably should be getting back to work.