‘E’ is for Exhausted

‘E’ is also for Estrogen, which I have little to none of right now and is cause of the aforementioned exhaustion. Who knew just how important estrogen was on your energy levels until you take a drug that tells your body to stop making it. Do I remember being this tired on the long lupron protocol? The other problem is that lack of estrogen also affects your memory so…I can’t remember! It’s just too funny. Thank God for acupuncture appointments because A) I get a 30 min nap twice a week and B) the treatments help me sleep a bit better for about a day or two. 

The other thing 'E' is for is *Eurp* which is the sound the body makes when it’s about to *ahem* …lose its lunch. Now on IVF#3 I do remember feeling that way very, very clearly but it was due to the dexamethazone with both Hammer and I were on. We could not wait until we were finished. Between the two of us, I think we ate 1 ½ boxes of saltine crackers in a week to try and keep the nausea at bay. So all I have to do is remember how bad I felt last cycle and this nausea is totally manageable. 

So I have my suppression check next Tuesday and from all the symptoms above I think I’m going to be suppressed. Plus let’s recall that with my last three IVF’s I had E2’s all under 15 (yes I said 15 not 51, I get REALLY suppressed) I think they want you anywhere between 25-75 but I lost the argument with the RE about pulling back on the lupron a bit. Whatever; just give me my stims on the 25th so I can get this E2 back up and start getting some decent sleep. I know that the only timing difference between the microdose lupron protocol of IVF#3 and long lupron is the extra week between stopping the BCP and starting the stims but when you are this tired it feels like an eternity. It’s like the key to feeling rested lies in a vial in my fridge but I can’t use it for a whole 2 weeks. Basically my fridge is taunting me every time I open it, “Ha Ha I have your Gonal and you can’t have it.”

It might also be because we are just both ready for this cycle to be over with and the outcome known. So I guess ‘E’ is also for Expectations. It’s hard to be really excited about this cycle. Can God still let us get pregnant this time? Absolutely! If we didn’t believe it we wouldn’t be doing another cycle. But it’s so different going into a fourth cycle versus a first cycle. And I also think its different going into this cycle after a miscarriage. I don’t have the first time giddiness, I don’t have the desire to buy baby items ‘just in case,’ there is a cautiousness that I haven’t had before. I was talking with an IRL friend who is also going on five years of TTC with a history of miscarriage and we were literally planning what was going to happen after our cycles AND THEY HADN’T EVEN HAPPENED YET! How horribly wrong of us. It’s like saying to God, “Yes God I know you gave us the green light on this cycle but instead of spending my time praying and believing that you could make this cycle work I’m going to plan for what comes next.” I totally know it’s a survival method to protect myself from disappointment and to give myself hope for a future if it ends badly, or worse, in another miscarriage. I’m so glad I caught myself doing it and was able to stop and remind myself that by planning ahead I’m not praying for the eggs that I will be growing that COULD be our baby. I think I needed that wake up call. I know I’m not going to be giddy with excitement like the first time, I know I’m looking at this from a more realistic perspective, but I also know that God is bigger than my fears and doubts. He’s asked us to take this step with Him one more time so in faith we are doing it. I think I just need to 'mentally' move forward one step at a time, focus on what is going on right now and be in prayer about it. And then when we accomplish that step, we’ll move on to the next. So suppression accomplished? Check. Next step, follicles (which start with ‘F.’)*

*Hey my last two blog titles are in alphabetical order (D= Vitamin D, E= Exhaustion) so why not, ‘F’ is for Follicle? Too bad I skipped over A, B, & C. Oh well.

Getting my ‘D’ on

I don’t know how many of you have heard of the recent study strongly correlating Vitamin D levels with increase success rates in IVF. This article was published in Fertility and Sterility just this month. To summarize, they had 84 women undergoing IVF participate. Of those women they saw a 6% increase in clinical pregnancy for every ng/mL increase in serum Vitamin D levels regardless of age, race, weight or number of embryos transferred.

Experts are saying that serum levels between 50-70 ng/mL are more optimal and this is higher than standard "normal" levels. So now I’m self medicating. I’m taking 4,000 IU of vitamin D for 1 week and then dropping it down to 2,000 through beta #1 pending a successful cycle where it will continue.

*I've fixed the link
**I found 2,000 IU pills at my local grocery store
***I haven't had the chance to talk to my RE yet about it since I just found out on Friday but I figure it won't hurt and with my background as an RD I feel comfortable self prescribing. Seeing that they've given 4,000 IU to pregnant women I'm not too concerned.

Timeline for IVF #4

Well I officially got my calendar from the clinic and have updated my status bar.  We will really be cutting it close to our vacation day.  But I did a little searching and there is a Que.st Diag.nostics lab in Ma.rco Isla.nd, FL so we won't have to worry if blood work is needed while we're out of town.  Now if I can just convince Hammer to get on a plane...we'll have to see about that.  So far the BCP have been easy with just a little nausea but not too bad.  I have my meds all set up to arrive on Wed so I'll be good to start the lupron on 9/6.  IVF #4 here we come!

Say “hello” to my little friend…

Saturday night I went to bed feeling completely normal with no signs of AF to be found. Sunday morning I woke up, went to the bathroom and discovered she had crept in while I was sleeping. I have never been so happy to see her in my entire life. I called my IVF RN right away to alert them to my cycle start but since it’s the weekend I know I won’t hear from them until Monday afternoon. The best part is that my day 3 FSH will be on Tuesday, which is the BEST possible day to have to get that lab drawn!! I can already see God taking care of us. And of course now I feel very small that I was so worried on Saturday. Yep still human. I still don’t know for sure if we will be on track to take our vacation to FL but if my rinky-dink calculations are somewhat accurate we just might make it. Hopefully I’ll get our schedule this week!


So today I start my acupuncture appointments. And just in time too, I was really missing my afternoon naps!!

The Waiting Game

Well I know almost for sure that this cycle is a bust, I think. Actually I'm not really sure what to think. I THINK today is 14 days past ovulation so I THINK I should be getting my period either today or tomorrow. I really need this cycle to start on time for a couple of reasons.

1) I have to get a day 3 FSH prior to starting my BCP. Doesn't seem like a big deal except that I have two acupuncture appointments this week and we're leaving for Canada on Thursday. If AF doesn't come on time I'll either have to cancel one of my appointments or figure out if there is a lab near the boarder that will take my insurance. I might just call my RN once AF arrives and ask exactly how necessary the FSH is at this point.

2) Hammer and I were invited to stay in Marco Island with his aunt in October. Our concern is that if we don't start this cycle on time we'll end up missing out on the trip because our transfer will be that same week. Obviously the transfer is the priority but who wouldn't want to spend their 1 -1 1/2 week wait by lying on a beach.

Right now I don't feel at all like I'm going to start soon and that is making me quite nervous. I even had a script for prom.etri.um but my RE did say that if I O'd on the script my body would still be controlling when my period started. Basically, I'd be in this situation with or without having taken the prom.etri.um. *sigh*


Dear Ute,


Please, for once, cooperate with me. I'd like to think that you would want to get this show on the road as much as the rest of me. I know these past few months haven't been easy and what I'm about to do to you might end up in 9 months of housing a small human but if you read your job description you'd notice that was part of the deal any way. I can't promise that you won't go through another miscarriage (which was not fun for either of us) but if it works it will be worth it. What I can promise is that I'll never turn you into the octo-ute.


Sincerely,


Mrs. Hammer

Well that was unexpected

With my first natural cycle after IVF #1 I knew I didn't ovulate.  My RE seemed skeptical but I assured him that I knew my body and there was no way I ovulated.  This was later confirmed with a blood test. 

With this cycle I was prepared and walked out of our WTF appointment with a lab order in hand.  He also told me that he could go ahead and write a prescription for prometrium and forgo the blood test but I wanted to see what my body could do on it's own.

By the morning of cycle day 16 and 6 negative OPKs I gave in and called the RN to ask for a prescription to be called in, seriously why delay IVF #4 if I know it's not going to happen.  If I haven't ovulated by this point it just wasn't going to happen.  But wait...what was this?  Fertile quality CM?  Are you kidding me?  Literally 6 hours after I called the RN.  The next day I was staring at a little smiley face on my CBE digital OPK.  I was shocked.  Fortunately I had held off on taking the progesterone to see what would happen after my discovery in the bathroom.

I really can't believe I ovulated.  And it makes me wonder if I was under suppressed on the microdose which could have caused all the erratic follicle sizes.  There is no way to know but at least we get one more shot at a natural cycle.  Otherwise we are scheduled to start BCP the last week of August.  Just a bit delayed since I ovulated 3 days late. 

Acupunture and Infertility

For Q&A #3
Amber asked: how has your experience with acupuncture gone? I have my first appt. Friday. Could you give me a little insight into what they actually do and where? Also if you don't mind how much do you pay per session?

I absolutely love doing acupuncture. One of my friends who is a 2xmother after successful clomid + IUI turned me on to it. For her it was the only thing that made her ovulate as clomid alone was ineffective. I started doing acupuncture with our second IUI. If it wasn’t for the sessions I would have never pushed for the lap to remove my endometriosis. It gave me amazing pain relief for my cycles and I realized that I had been miserable for years. After my lap I felt like I had a new body. She also pushed me to get my thyroid checked out because research has shown that TSH over 2.5 reduces fertility. Now my RE’s office has an official TSH policy for all of their patients because of her.

Typically for IUI you lie on your back and they put needles into points in your calves, stomach and wrist. My Acupuncturist will also ask about stress, headache or sleeplessness and do extra points in my forehead and ears if needed. Inserting the needles hurts less than getting a finger prick for a blood test. If you have a good person you should hardly feel it at all. The ears do hurt a bit more but it's really not bad at all. There are usually 1-2 sessions pre-ovulation and one post ovulation. I pay $75 for a 45 minute session but I think the first session I ever did was $90 minutes because she did a whole health assessment before doing points.

Because acupuncture for IVF is twice a week for a month she lowers her rate to $60. My first IVF cycle I didn’t include acupuncture and I will never make that mistake again. It was a mandatory naptime twice a week during IVF and kept me so calm and rested compared to the first time. The points are totally different. You lie on your stomach and get needles in the back of your calves, hips and wrists. The calves and hips then have a low current run through them which is supposed to increase blood flow to the pelvic area. The sessions stop right before retrieval. And then the day of transfer she does a session pre and post transfer on the same day. These treatments are done in your stomach to prepare the lining for the impending embryo. They say it is like planting a seed; the first session is to create the hole for the embryo and the second is to cover up the embryo. There are very well documented studies that show 10 treatments of low current acupuncture and pre/post transfer acupuncture have a significant positive affect on IVF pregnancy rates. We’ll definitely be doing acupuncture again for IVF #4.

I love my acupuncturist because all she does is fertility related and she mixes Eastern treatments with Western medical. She’s always up to date on the latest fertility studies AND I think she has excellent needle technique as it’s not uncomfortable in the least.

*As before if you have any other questions for me just leave them in the comments and I will do a post about them.