A Convert

Today's u/s left us confused and with a big decision. We now have a lead follicle and 4-5 smaller ones just shy of 18mm (between 14-17). A bunch of little ones popped up but there is no way they will be ready in time ~7-8mm. With the lead follicle we can't keep stimming to get the smaller ones because it will launch on it's own ruining a retrieval. My RE said we'd be lucky to get 5 mature eggs. We're all scratching our heads at what could have happened to cause this. The good news is that my lining is now up to 11.5mm and my E2 is at 1592 which is the highest it's ever been.

Hammer was not willing to consider a 4th full IVF and so now that it's 4-5 vs 7-8 possible mature follicles I'm ok with IUI. With our past history of 5 failed IUI's with 3 mature follicle's our RE is not concerned about us ending up with a litter babies and our own reality TV show. Neither are we. So instead of getting all drugged up on Thursday for a retrieval we'll be doing the quick wham-bam,-thank-you-ma'm IUI. And to be honest with you I'm at peace with this decision.

What you see is what you get

At this point I need to come to terms with the fact that I will never be the type of woman who will grow more follicles as I continue on stims.  Honestly I'm really disappointed and frustrated with my RE.  I feel like for the last three cycles all we've done is beat the dead Lupron+Bravelle+Luvaris horse and had minimal results.  Before we started this cycle I had been trying to get Hammer to consider going to a different RE but he was unwilling.  So here I sit for our final IVF cycle with the same minimal results on practically the same protocol.  This is not the end to our final cycle that I was hoping for and now I'm feeling like if this is it and it doesn't work I'm going to feel completely unresolved with moving on.

We actually had a long talk last night about what we should do.  Hammer only wants to go through one more full IVF cycle.  So that means if I want to try a totally different protocol we'd have to cancel this cycle pre-retrieval.  But yet it feels like such a waste to do so.  At this point we may get between 7-8 mature follicles and hopefully as many mature eggs.  I know that our clinic wouldn't even consider an IUI with that many follicles.  So I've asked Hammer to consider if this cycle doesn't work for us to try one more, and ONLY one more.  When you consider that our first cycle was a total bust, we've really only done two cycles (including this one).  I'd really like have walked away having done three cycles knowing that we did everything we could and right now I don't have that peace.  It was definitely an interesting conversation because Hammer came from the "I don't want to do anymore, I'm ready for adoption" direction and that since he was ready, we needed to move on.  So for me to explain how you can't go into adoption if one of us is unresolved so where did this, "I'm ready so therefore my opinion rules" mentality come from and I think it challenged him a bit.  And don't get me wrong this wasn't a fight just a discussion between us.

I apologize to all the women reading that would die for 7-8 follicles.  Being 31 with normal FSH, AMH etc. and on crazy amounts of stims it's been difficult to accept that this is the best I can do.  And with Hammer's issue we need as many follicles to find the one healthy combination of us both.

Here is where we stand as of Saturday (6/26):

R: 12.7mm x2, 12.9mm (3 total)

L: 11.5mm, 11.3mm, 11.1mm, 10.3mm, 8.2mm (5 total)

Lining = 8.8mm

I'm not sure that our 8.2 will catch up in time to be mature so we're maybe really looking at 6-7 mature eggs at retrieval.  Compare that to our last cycle where we had 9 follicles and 8 mature eggs and hopefully you can see why we are upset that this cycle is worse than the last one.

I have one more appointment on Monday for another check.  Right now they are talking about doing the trigger on Tuesday for a Thursday retrieval which is extending me out one day more than anticipated.  And at this point I'm still not bloated nor feel anything, weird.

Quiet

Last cycle at this time I was so bloated I was miserable. Last cycle at this time I could feel the follicles growing. Last cycle at this time it was irritating if my cloths rubbed against my skin. Last cycle at this time it was nowhere near quiet in there.

But today it’s quiet and that makes me worried.

Tomorrow is follicle check #2, first thing in the morning.  And after that I'm indulging myself in a full body massage* for a whole 60 minutes.  And a manicure.  Because why not.

*My acupuncturist told me that massage has been shown to keep stress hormones down for 3 days.  And we all know that stress is bad for an IVF cycle.

Déjà vu – of the crappy kind

*Before I start, I am well aware this is early but my past IVF cycles have shown that what I see on scan #1 is what I see at retrieval.*

After my first follie check this cycle is looking just like cycle #1.  Hammer and I are literally preparing ourselves and praying over if we have to make the decision to cancel and convert to an IUI. It would be cheaper since at this point we are only out ~$50 bucks in meds, ~60 bucks in u/s, and ~$400 in acupuncture treatments.

I have no idea what could be going wrong! With the first cycle I thought maybe it was a combination of my messing up the stim medication + being overly suppressed. But now I just realized that for all of my normal FSH & AMH, I’m just a poor responder. And that is wholly dishartening.  I’m trying not to get discouraged yet at this point but our past IVFs just hang over my head.

I’m on an insane amount of Bravelle (450IU/d) + microdose lupron (40u/d) and here are my results:

R – 9mm, 8.5mm, 7mm

L – 8mm, 8mm, 7mm, 6mm

Lining = 5mm

7 total follicles, just like cycle #1 which ended up with a lead follicle and we only retrieved 3 mature ones. And this is less than the second cycle which went better but ended in a m/c.

For a comparison here is where I was at for the last two cycles on the same day:

Cycle #1            versus             Cycle #2

R – 1-13mm, 3 -<10mm         R – 12mm, 10x2mm, 9mm, 8mm

L- 2 -<10mm                               L – 12mm, 11.5mm, 9mm, 8mm

Lining = 6.5mm                         Lining – 7mm

This is why we are preparing ourselves for a possible IUI conversion. Since all the money is in the retrieval it would be better to call it off before that happens. We will just have to wait until Saturday to see what u/s #2 shows us from there we will be closer to a decision. In the best case scenario we have lots of extra little ones pop up that will possibly be in the running and so we would continue on based upon their best guess at a mature egg count. But worst case would be lead follicles and we would most likely convert to IUI. Now that our pharmaceutical plan has IVF med coverage it puts us in a place where we could talk about doing a 4th cycle if we have to cancel this one but we’ll cross that bridge if we have too. Right now we just need prayer for us to make good decisions based upon the results of our u/s over the next few days.

The only redeeming result of today is that my E2 was 282 which is the best it's ever been.  Although on average most women are around 500 by day five of stims.  In previous cycles I was 107 (#1) and 195 (#2).  So either that means I have a few more lurking around or that I'm just having a higher E2 because of all the meds. Your guess is as good as mine.

Stimming, technically

So yesterday I started my microdose lupron which is 40 mcg/mL vs 5mg/mL in standard Lupron. I have to take 20 U twice a day so it’s a very tiny dose of meds. Apparently when given in small amounts it causes the body to produce natural FSH for 2-3 days and then supresses the body just enough to keep the follicles in place until the trigger is given. So technically I started mini-stimming yesterday. And ladies, I can feel my ovaries waking up. I can tell you from doing two long Lupron protocols prior, I never felt this when I took Lupron before. I hope this is a good sign. I also hope I don’t end up with a lead follicle that screws everything up like cycle #1 either but I don’t want to get myself all worked up over the what-if’s. (But it’s so easy!)

Yesterday I did have a horrible migraine which I do remember was an issue before but I had an acupuncture appointment that day and she did some extra points – sweet relief! Today I am migraine free and feeling the tingling in my tummy. Bravelle starts tomorrow at 3 vials twice a day so I’m really going to start feeling it then.

On another subject, one of our IRL couples just had their second child. We are really excited for them and they have been very supportive and sensitive towards us. They had a little girl and held off on sharing her name until she was born. Unfortunately they used the girl name that Hammer and I had picked out. We didn’t share our choice with them so it wasn’t a case of name swiping but it did make us feel a bit sad. Mostly because if we could have had a child when we wanted to, and it was a girl, we could have used that name – infertility is so unfair! But then it feels just silly to be sad because we’d have to A) get pregnant first B) have a successful pregnancy and C) have the baby be a girl. Basically we would be jumping several steps ahead of ourselves. But there was a twinge and I just wanted to acknowledge it. Thanks for listening!

Cleared for Take Off

I had my E2 blood draw and ultrasound today and was given the all clear to start my meds. It was good news too. Normally I have very few antral follicles on my left side but this time I not only had a good count but it was even better than my right side. I'm actually starting to feel 'normal.' Maybe our time of rest, smoothies and synthroid have done my body some good! My E2 came back showing I was quite suppressed. They want you at least below 50 but I was at 13 on birth control alone. When I was on BCP + Lupron my E2 would come back as indiscernible i.e. barely any at all. That is why I wondered if I was over suppressed on my last two cycles.

In other good news I had received a letter back in January regarding my fertility med coverage, which I didn't have so I was confused by the letter. What we found out is that I now HAVE fertility medication coverage. The last two cycles we paid close to 2 grand for all of our meds. So imagine our shock when we got our total bill for this cycle (with more meds than ever before) at less than $55. We thought it was a mistake, it was too good to be true. But it was. Plus we got a few vials of donated Luvaris.

So Thursday I start my microdose Lupron and then stims start on Saturday. I feel like this cycle is just flying by so quickly!

Headless Chickens and Such

I know I totally feel off of the blogosphere but that is because I have literally been going non-stop (hence the headless chicken reference.) In some ways it’s great because I’ve hardly noticed the three weeks of BCP and now I’m just three days away from finishing them. But the flip side is that I didn’t want this time to be stressful and it HAS. In between acupuncture appointments twice a week, impromptu travel for work, coworkers dropping the ball so I have to pick up their slack, weekends filled with events, and even a live TV interview! I seriously haven’t had a second to blog, read blogs, think blogs, you get the point. But come next week I’ll be staring my microdose lupron on Thursday and stims on Saturday.

I finally got around to telling my new boss about my cycle and I think she’ll be supportive. I did preface it by 'this is our last cycle' to hopefully make it more apparent how desperately I need her to be supportive. So far so good. On Tuesday of next week I’m hoping that my baseline E2 and ovary check show I’m nice and suppressed so we can get this show on the road without delays.

Hammer and I will be celebrating our 6th anniversary on Saturday, I sure hope that we can finally make our family complete!

Scheduled

Hello internets! Just a quick pass through to say that my side bar schedule has been updated. So far we are on task. There is nothing much to report other than feeling really nauseated by the antibiotic this go around. I'm REALLY glad that is only for 7 days!